Long-term neurosensory disturbances after modified sagittal split osteotomy.

We have investigated the long-term incidence of neurosensory disturbances after modified bilateral sagittal split osteotomy, and identified associated risk factors. We prospectively studied 376 patients, and their self-reported neurosensory disturbances were evaluated six months, and one, two, and three years postoperatively. The correlations between the following risk factors and neurosensory disturbances were investigated using univariate analysis and stepwise multivariate analysis: age at operation, sex, type of movement (advancement, setback, or rotation), concurrent genioplasty, type of detachment, iliac crest bone graft, and use of dicalcium phosphate synthetic bone graft. Probabilities of less than 0.05 were accepted as significant. Three years postoperatively, 57 patients (15%) reported altered sensation of the lower lip or chin. Older age correlated significantly with neurosensory disturbances (p<0.0001). Greater mandibular advancement correlated with postoperative "positive" neurosensory phenomena (right side p=0.08; left side p=0.03). Intraoperative surgical manipulation of the left inferior alveolar nerve was significantly associated with postoperative hypoaesthesia (p=0.014). Older age at surgery, extensive mandibular advancement, and surgical manipulation of the left inferior alveolar nerve, were associated with long-term neurosensory disturbances after modified bilateral sagittal split osteotomy. The modified operation seems to safeguard the inferior alveolar nerve from transection, without causing damage to other nerves.

Left vein of Labbé thrombosis associated with ipsilateral dural sinus thrombosis: non-enhanced CT and contrast-enhanced CT (CTV) findings.

A rare case of aseptic thrombosis of the left vein of Labbé in a young woman is reported. Cerebral venous thrombosis was suggested by computed tomography and confirmed after intravenous administration of contrast by computed tomography venography. The combination of the clinical setting with the findings on the non-enhanced CT may favour the diagnosis of vein of Labbé thrombosis. The diagnosis can be confirmed on computed tomography venography.

Density measurements using coherence imaging spectroscopy based on Stark broadening.

A coherence imaging camera has been set up at Pilot-PSI. The system is to be used for imaging the plasma density through the Stark effect broadening of the H(γ) line. Local density values are then obtained by the Abel inversion of the measured interferometric fringe contrast. This report will present the instrument setup and proof-of-principle demonstration. The inverted spatial electron density profiles obtained near the cascaded arc source of Pilot-PSI in discharges with axial magnetic field of B=0.4 T are compared with an independent measurement of electron density by Thomson scattering and good agreement is found.

Modeling the effect of reflection from metallic walls on spectroscopic measurements.

A modification of JET is presently being prepared to bring operational experience with ITER-like first wall (Be) and divertor (W) materials, geometry and plasma parameters. Reflectivity measurements of JET sample tiles have been performed and the data are used within a simplified model of the JET and ITER vessels to predict additional contributions to quantitative spectroscopic measurements. The most general method to characterize reflectivity is the bidirectional reflection distribution function (BRDF). For extended sources however, such as bremsstrahlung and edge emission of fuel and intrinsic impurities, the results obtained in the modeling are almost as accurate if the total reflectivity with ideal Lambertian angular dependence is used. This is in contrast to the experience in other communities, such as optical design, lighting design, or rendering who deal mostly with pointlike light sources. This result is so far based on a very limited set of measurements and will be reassessed when more detailed BRDF measurements of JET tiles have been made. If it is true it offers the possibility of in situ monitoring of the reflectivity of selected parts of the wall during exposure to plasma operation, while remeasurement of the BRDF is performed during interventions. For a closed vessel structure such as ITER, it is important to consider multiple reflections. This makes it more important to represent the whole of the vessel reasonably accurately in the model, which on the other hand is easier to achieve than for the more complex internal structure of JET. In both cases the dominant contribution is from the first reflection, and a detailed model of the areas intersected by lines of sight of diagnostic interest is required.

Rhodium coated mirrors deposited by magnetron sputtering for fusion applications.

Metallic mirrors will be essential components of all optical spectroscopy and imaging systems for ITER plasma diagnostics. Any change in the mirror performance, in particular, its reflectivity, due to erosion of the surface by charge exchange neutrals or deposition of impurities will influence the quality and reliability of the detected signals. Due to its high reflectivity in the visible wavelength range and its low sputtering yield, rhodium appears as an attractive material for first mirrors in ITER. However, the very high price of the raw material calls for using it in the form of a film deposited onto metallic substrates. The development of a reliable technique for the preparation of high reflectivity rhodium films is therefore of the highest importance. Rhodium layers with thicknesses of up to 2 microm were produced on different substrates of interest (Mo, stainless steel, Cu) by magnetron sputtering. Produced films exhibit a low roughness and crystallite size of about 10 nm with a dense columnar structure. No impurities were detected on the surface after deposition. Scratch tests demonstrate that adhesion properties increase with substrate hardness. Detailed optical characterizations of Rh-coated mirrors as well as results of erosion tests performed both under laboratory conditions and in the TEXTOR tokamak are presented in this paper.

The value of magnetic resonance imaging in the differentiation between malignant peripheral nerve-sheath tumors and non-neurogenic malignant soft-tissue tumors.

OBJECTIVE: To assess the sensitivity and specificity of MRI criteria in the differentiation between malignant peripheral nerve sheath tumors (MPNST) and non-neurogenic malignant soft-tissue tumors (MSTT). DESIGN AND PATIENTS: MRI examinations of 105 patients with pathologically proven malignant soft-tissue lesions (35 MPNST and 70 MSTT) were retrospectively reviewed, the reviewers being unaware of the pathological diagnosis. Using a standardized protocol, the tumors were evaluated for multiple parameters regarding morphology and appearance on different sequences before and after gadolinium contrast administration (location, distribution, delineation, homogeneity, size, shape, relationship to bone and neurovascular bundle, intralesional hemorrhage, necrosis, perilesional edema, lymphangitis and signal intensities). Results were compared using a chi-square or Fisher's exact test. RESULTS: MRI findings suggestive of MPNST (p<0,05) were intermuscular distribution, location on the course of a large nerve, nodular morphology, and overall non-homogeneity on T1-weighted images, T2-weighted images and T1-weighted images after gadolinium contrast injection. MRI findings in favor of MSTT were intramuscular distribution, ill-delineated appearance of more than 20% of the lesion's circumference, and presence of intralesional blood vessels, perilesional edema and lymphangitis. There is no significant difference for degree and pattern of enhancement after gadolinium contrast injection, nor for presence of bone involvement or cystic or necrotic areas. CONCLUSION: MRI provides several features that contribute to the differentiation between MPNST and non-neurogenic malignant soft-tissue tumors. MRI findings suggestive of MPNST should be helpful to pathologists in the strategy for further examination.

Ruptured tuboovarian abscess causing peritonitis in a postmenopausal woman. A difficult diagnosis on imaging.

Pelvic inflammatory disease with tuboovarian abscess is rare in postmenopausal women. Clinical and sonographic findings are usually sufficient to recognize pelvic inflammatory disease in premenopausal women, but in the elderly the disease may easily be overlooked, largely by unexpectedness. Computed tomography can be helpful when the clinical and sonographic findings are complex or equivocal. However, when the level of suspicion is low, it can be very difficult to interpret, especially when complicated with peritonitis, as illustrated in the present case report.

Rotary fixation of the atlantoaxial joint.

Rotary fixation of the atlanto-axial joint is a rare disorder in which the atlas gets fixed in a position normally achieved during rotation. A persistent asymmetrical position of the dens in relation to the atlas during head rotation is the clue to the diagnosis. Rotary fixation can be demonstrated by radiography/fluoroscopy and computed tomography (CT). However it is easily overlooked, largely by inattention. We present a typical case in an adult in whom the rotary fixation was demonstrated by radiography/fluoroscopy and CT.