[Anatomic and radiological observations of th bifid mandibular condyle]. / Osservazioni anatomiche e radiologiche sul condilo mandibolare bifido.

PURPOSE: To determine the morphology and the frequency of bifid mandibular condyle (BMC) in anatomic material and to study its diagnosis in living persons. MATERIAL AND METHODS: The morphology and the frequency of BMC were studied on a sample of 210 intact mandibular condyles belonging to a collection of 200 dry male adult skulls held by the Institute of Anatomy of University of Bologna. Diagnostic imaging was verified retrospectively on 6 cases of BMC observed in living subject. RESULTS: In the anatomic material, we found 29/210 mandibular condyles with the articular surface simply parted in two (13.80%) and 1 condyle consisting of two separate articular heads (0.47%) at different levels and without the neck. Therefore BMC with separate neck is very rare. In living persons diagnosis was established by radiology using orthopantomography and demonstrated 2 cases of bilateral BMC (one dysplasic and the other traumatic) and 4 of unilateral BMC. DISCUSSION AND CONCLUSIONS: We believe that primitive BMC is a consequence of a dysplasic process of the condyle cartilage at the early stages of its development, while secondary traumatic BMC is caused by bone remodelling after articular trauma or repeated microtraumas from malocclusion. In dysplasic BMC, as evidenced by the observation made on a living subject, a distinction should be made between the complete type in which the accessory articular head is separate from the principal head, at a different level and with its own separate neck, and the other, incomplete types. Orthopantomography, which proved to be a valid diagnostic tool, must be integrated with CT and MR if surgery is planned.

[Clinical anatomy of the human mental foramen]. / Contributo sull'anatomia clinica del forame mentoniero dell'uomo.

BACKGROUND: The great diffusion of the surgical technics in oral implantology and the progress of the radiological imaging produces some interest for the clinical anatomy of the mental foramen (MF). The study, in addition to the measurements that define it, considers others anatomical features of practical utility and the variableness of them. METHODS: In the Anatomic Institute of the Bologna University, it has been made a morphometric revision of the MF on 100 dried mandibles of normal young adults (78 males, 32 females) random chosen with the complete integrity of the dental apparatus and of the mandibular bone criteria. The measurements have been made by anthropometric methods on the two sides of the same mandible (n = 200) and for everyone has been reported in the tables the medium, the maximum and the minimum values with their specific variation interval. The results are applicable to the common work conditions because they take in consideration among the specific characteristics of the MF in addition to the seat, the course of the mandibular canal, the thickness and the height of the mandibular bone. RESULTS: To the clinical and diagnostic imaging object the medium values of the anatomical measurements can be considered sufficent. To anthropometric, anesthesiologic and surgical aims it is also necessary the knowledge of the maximum and the minimum values and the variation interval. In the living man the anatomicomedical study of the MF is made by the diagnostic imaging, especially by computed tomography with specific algorithm, because it makes possible absolutely exact measurements. CONCLUSIONS: Finally, the specifications on the MF provided by the present study are important not only for an anatomical but also for a practical point of view because they are a datum point value in the patient clinical management.

[Changes in the main tensile trabecular group (Gallois' and Bosquette's arch bundle) as a predictor of osteoporotic femur head fracture]. / Sulle alterazioni del fascio arciforme di Gallois e Bosquette predittive per frattura osteoporotica del collo del femore.

Reduced bone strength in osteoporotic femoral neck fractures can be ascribed to the loss of the mechanical properties of the trajectorial trabeculae of the cancellous bone in the proximal femur. Of them, the Gallois' and Bosquette's arch bundle, or the main tensile trabecular group, has particular diagnostic importance. We studied 25 femoral neck fractures in people aged 62 to 95 years, mostly women (22 patients) and classified the osteoporotic status of the proximal femur according to Singh index (grades IV, III, II, I). The regressive changes exhibited by the main tensile trabecular group were an early depauperation of the trajectorial trabeculae (7 cases), evolving into bundle disruption (13 cases) and then into its complete disappearance (5 cases). No correlation was found between age and anatomical changes in the patients experiencing physical activity, not even in our oldest patients. These radiologic studies provide detailed information on the main tensile trabecular group changes which can thus be identified as a good predictor of osteoporotic fractures of the femoral neck.

[Gingival metastasis, the first clinical sign of a silent kidney carcinoma. A case report]. / Metastasi gengivali, primo segno clinico di un carcinoma silente del rene. Descrizione di un caso.

It is not uncommon for renal carcinomas to present with a solitary metastasis. A case of metastasis in the maxillary and mandibular gingiva as primary clinical sign of an asymptomatic, unknown renal carcinoma is reported. The diagnosis was not difficult. The biopsy of gingival swelling showed a clear cell carcinoma metastasis and the CT showed the tumor in the right kidney.

[The exposure dose of the sella turcica in panoramic dental radiography with an intraoral radiogenic source]. / La dose di esposizione alla sella turcica in radiografia panoramica dentaria con sorgente radiogena intraorale.

Panoramic dental radiography using an intraoral X-ray source exposes critical organs, such as the crystalline and the thyroid, as well as organs of fundamental importance such as the pituitary gland, to X-rays. An experimental study was carried out to assess the exposure dose to the sella turcica during the radiological examination of the upper and lower dental arches using an X-ray source within the oral cavity. The comprehensive exposure dose for the upper and lower dental arches exceeded that found in orthopantomography (110 micro Gy/examination vs 47 micro Gy/examination) with errors which are respectively inferior to 15% and 30%. The authors conclude that the risk of provoking anatomical or functional changes of the pituitary gland is extremely remote using this type of examination.

[Echographic evaluation of lymphadenopathies of the abdomen]. / Contributo alla valutazione ecografica delle tumefazioni linfonodali dell'addome.

The US findings are reported of 91 cases of abdominal lymphadenopathy examined by either histological or instrumental check-up, or follow-up. Adenopathies were classified according to etiology, which was lymphomatous or leukemic in 19 cases, metastatic in 56, and reactive or inflammatory in 16. Lymph node involvement was most frequent in porta hepatis, periportal and peri-aortocaval locations. US findings allowed a diagnostic approach to be planned based on number, size and morphology of adenomegalies, as well as on the involved lymph nodes. In the porta hepatis and periportal areas, adenomegalies were most often due to neoplastic metastases of the alimentary canal, and to inflammatory-reactive disorders. Adenopathies in the peri-aortocaval area were most often due to systemic and to severe neoplastic metastases having their primary location even out of the alimentary canal.

[The importance of circulation time in intravenous angiography: Schad's method and its practical execution]. / Importanza del tempo di circolo in arteriografia per via venosa: il metodo di Schad e sua realizzazione pratica.

The intravenous arteriography, both in traditional radiology or tomography and in computed tomography (angio-TC) requires the administration of large quantities of contrast medium and the application of intense doses of radiation to a patient. The method of Schad is based on a suitable technique of injection and on the timing of the time-lag between the intravenous injection and the radiological exposure on the basis of circulation time. Therefore the radiological exposure may be effected in the moment of the maximum concentration of the contrast medium in the arterial district which is taken into consideration, with the advantage of a large reduction of the quantity of iodate substance which is administered and of the radiological exposures. A new automatic injector which permits the execution of the method is briefly described.

[Contribution to the study of angio-TC: timing of exposure and subsequent venous lavage]. / Contributo allo studio dell'angio-TC: il "timing" dell'esposizione ed il lavaggio venoso consecutivo.

The text reports the results of angio-CT examinations performed with single intravenous injections of small amounts of contrast medium and with the technique of timing of exposure and immediate venous flush with the use of a suitable injector (168 patients have been examined, in 157 of them the timing was correct while in 11 the timing was not adequate). The exposure is made after a certain period of time from the moment of the injection, corresponding to the number of heart cycles the contrast medium needs to reach the considered arterial district, during its first passage. The immediate venous flush allows one to use almost all the contrast medium to obtain the information and to take advantage of an almost compact bolus. The principal advantages of this technique are that a smaller amount of contrast medium and of radiation dose to the patient can be used.

[Coronary artery calcification fluoroscopy. A report on procedure of detection and clinical significance (author's transl)]. / La fluoroscopia delle calcificazioni delle arterie coronarie. Contributo sul metodo d'indagine e sul significato clinico.

The methodology of cardiac fluoroscopy and the clinical significance of the coronary artery calcification are judged on the basis of a study on the group of 396 normal persons, 22.72% of whom resulted to suffer from it, while the report says that 46.80% of a group of 94 patients with coronary artery disease suffer from the same. In normal people the coronary artery calcification has practically the same frequency in both sexes and increases with the age, while in patients with coronary artery diseases there is a higher frequency in the fifth decade and in male sex. The discovery of calcification in all cases always shows an advanced coronary atherosclerosis. In the patients with clinical coronary artery diseases, there are also evidence of significative obstructive lesion. The fluoroscopy of the heart is the most powerful tool for the diagnosis of coronary artery calcification in vivo, it is easy to be used and gives diagnostic information of great value in the study of a coronary artery disease.

[Recurrences of the gastric carcinoma after surgery (author's transl)]. / La recidiva del cancro gastrico operato.

A series of 71 patients with recurrences of gastric carcinoma after operation is reviewed. The most frequent localization is the gastric bed (48 cases , 67.6%) while the local recurrences is less frequent (22 cases, 30.9%) and usually the esophago-cardial junction is affected. In one patient both the local recurrence and that of the gastric bed were present. The radiologic investigation was negative in about 60% of the patients because it is not useful for a correct examination of the gastric bed. In any case it must be considered essential for the study of the local recurrences and for the evaluation of the post operative anatomic patterns.