ABSTRACT
This article describes an alternative method for mandibular reconstruction following tumour ablation. We report a case with a wide anterior oromandibular defect, involving soft and bony tissues, which was reconstructed using horizontal sliding osteotomies and an osteocutaneous forearm free flap.
Subject(s)
Carcinoma, Squamous Cell/surgery , Mandible/surgery , Mandibular Neoplasms/surgery , Mouth Neoplasms/surgery , Osteotomy/methods , Plastic Surgery Procedures/methods , Surgical Flaps/blood supply , Aged , Bone Transplantation/methods , Forearm/surgery , Humans , Male , Mandible/blood supply , Treatment OutcomeABSTRACT
PURPOSE: The aim of the study was to investigate the prevalence of the noncardiac collateral findings during multislice computed tomography coronary angiography (MSCT-CA). MATERIALS AND METHODS: Six hundred and seventy patients undergoing MSCT-CA with 16-slice and 64-slice CT scanners for suspected atherosclerotic disease of the coronary arteries were retrospectively reviewed. All data sets obtained with a large field of view (FOV) were analysed by two radiologists using standard mediastinal and lung window settings. Collateral findings were divided according to clinical importance into nonsignificant, remarkable and compulsory to be investigated. RESULTS: Eighty-five percent of patients revealed coronary artery disease (CAD). Only 138/670 (20.6%) were without any additional finding. An additional 1,234 findings were recorded: nonsignificant 332 (26.9%), mild 821 (66.53%), compulsory for study 81 (6.56%). A total of 81 patients (12.08%) had significant noncardiac pathology requiring clinical or radiological follow-up. Among these, newly discovered pathologies were revealed in two patients (2.46%). CONCLUSIONS: A significant number of noncardiac findings might have been missed in MSCT-CA scans; the appropriate approach should be as a team trained in cardiology and radiology.
Subject(s)
Coronary Angiography/methods , Coronary Disease/diagnostic imaging , Radiography, Abdominal , Radiography, Thoracic , Tomography, Spiral Computed/methods , Aged , Data Interpretation, Statistical , Electrocardiography , Female , Follow-Up Studies , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , Retrospective Studies , Risk Factors , Sensitivity and Specificity , Time FactorsABSTRACT
PURPOSE: The aim of this study was to assess the feasibility of three-dimensional (3D) reconstructions and quantitative analysis of the volume of each component of the lung with cystic fibrosis (CF). MATERIALS AND METHODS: Twenty-two patients with CF (mean age 17+/-8 years) were included in the study. The patients underwent an unenhanced single-slice spiral computed tomography (CT) chest scan with the following parameters: collimation 3 mm, table feed 6 mm x rot(-1), reconstruction interval 1 mm, soft tissue reconstruction kernel. Four image data sets were obtained: native axial slices, cine-mode display, virtual bronchographic volume-rendered images with algorithm for tissue transition display and virtual endoluminal views. The lungs were segmented manually from the hilum to the visceral pleura on the axial images, and the entire lung volume was calculated. A histogram was generated representing the fractional volume of tissues, the density of which was within a preset range. A curve was then obtained from the histogram. RESULTS: Native axial images and cine-mode display allowed complete evaluation of lung volumes. Virtual bronchography allowed a better assessment of the distribution of bronchiectasis. Virtual bronchoscopy was limited by the fact that it visualised only the surface, without differentiating mucus from the bronchial wall. Manual segmentation and generation of density-volume curves required 41+/-7 min for each lung. Three curve patterns were identified depending on disease severity. CONCLUSIONS: Volume-density analysis of lungs with CF is feasible. Its main advantage is that image analysis is not analogical, as the assessment is not performed using scoring systems or similar ordinal scales. This technique cannot differentiate acute from chronic findings, and the predictive value of the curve should be assessed.
Subject(s)
Cystic Fibrosis/diagnostic imaging , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Lung/diagnostic imaging , Adolescent , Algorithms , Bronchi/pathology , Bronchiectasis/diagnostic imaging , Bronchiectasis/pathology , Bronchography , Cineradiography/methods , Cystic Fibrosis/pathology , Data Display , Feasibility Studies , Humans , Lung/pathology , Lung Volume Measurements , Mucus , Tomography, Spiral Computed/methods , User-Computer InterfaceABSTRACT
Nineteen of 50 sera from children with type 1 (insulin-dependent) diabetes mellitus showed anti-platelet reactivity. This reactivity was significantly associated with the presence of proteoglycan cross-reactive anti-ssDNA antibodies. As well as DNA-anti-DNA interaction, increasing salt concentration of the dilution buffer caused a decrease in the binding of positive sera to platelets. Purified ssDNA inhibited also the anti-platelet reactivity of anti-ssDNA positive sera. The addition of purified IgG from anti-ssDNA positive but not from anti-ssDNA negative sera to washed platelets caused an increased collagen-induced platelet aggregation similar to that obtained with the addition of polycationic agents. It may be suggested that ionic interaction between anti-negative charged molecule antibodies (such as anti-ssDNA antibodies) and platelet surface negative charges may be a pathophysiological mechanism contributing to the altered platelet function observed in diabetes.
