Debris production in bovine bone during implant site preparation. A comparative in vitro study: ultrasonic and drilling procedures.

The aim of this study was to compare the size and shape of bone fragments produced by the ultrasonic and drilling procedures in implant site preparation. Six pieces of rib selected as experimental animal model of 15 cm in length and at least 13 mm of thickness were used. The samples were treated and divided into 2 groups as follows: group A (GA) ultrasonic implant site preparation technique; group B (GB) traditional surgical drill technique. Ultrasonic implant site preparation (GA) was carried out using a sequence of progressive diameter (1.00 mm, 2.00 mm and 3.00 mm) conical inserts at a depth of 10 mm. Standard drill implant site procedure (GB) was carried out with a sequence of 1.00 mm, 2.00 mm, and 3.00 mm cylindrical twist drills, for preparing an implant site at a depth of 10 mm. From each group bone fragments (0.1 gr) were collected from both cortical and cancellous bone preparation and their dimensions were evaluated by optic microscope analysis. The bone debris dimensions procured by cortical bone of Group A and Group B were, respectively, 0.14×0.16 mm (±0.13) and 1.15 ×0.92 mm (±0.68). The bone debris dimensions procured by cancellous bone of Group A and Group B were, respectively, 0.15×0.10 mm (±0.10) and 1.98×1.27 mm (±0.94). Ultrasonic implant site preparation technique was able to micronize bone and to remove all debris with cooling system. Surgical drills tend to fracture bone, creating a weaker structure and fragments of larger size, which remain in considerable quantity over bone walls during site preparation. Within the limits of the present study, the ultrasonic implant preparation was able to produce reduced bone sediments and a clear bed implant favoring osseointegration.

[Spiral computerized tomography without perfusion of contrast media as first line investigation in patients with renal colic]. / La Tomografia Computerizzata spirale senza perfusione di mezzo di contrasto per venam come indagine di prima istanza nei pazienti con colica renale.

INTRODUCTION: We investigated the diagnostic accuracy of unenhanced helical CT in the detection of stones in patients with suspected renal colic from ureteral stones and compared CT findings with the results of plain abdominal film and US. MATERIAL AND METHODS: We reviewed the findings relative to 80 patients (age range 24-75) who came to our observation to the Emergency Department with acute flank pain. All patients had been examined with plain abdominal radiography, US and unenhanced helical CT. RESULTS: While abdominal radiography showed the presence of radiopaque stones in 38 patients only (47.5%), US demonstrated ureter dilatation in 72 patients and detected stones in 36 of them (45%). Helical CT performed best, depicting a stone in 72 patients (90%), with high sensitivity and specificity. Mean stone size was 3 mm, with 7 mm-1 mm range. The biggest stones were seen in 3 cases and the smallest ones in 34. In 8 patients with no signs of stones we found other extraurinary conditions, namely pancreatitis, diverticula, renal cancer. We also found a case of urinary tract infection. CONCLUSIONS: Thanks to its short execution time and accuracy, helical CT makes the examination of choice in patients with acute flank pain due to renal colic. It is also a most valuable tool in the differential diagnosis of other pathological causes of pain such as abdominal or pelvic masses and inflammatory conditions.

Appendices epiploicae of the large bowel. Sonographic appearance and differentiation from peritoneal seeding.

Solid hyperechogenic nodules of different sizes and shapes surrounded by ascitic fluid were seen growing from the peritoneal surface of the large bowel in three patients with biopsy-proven alcoholic liver cirrhosis; they were spaced at regular intervals along the course of the colon. The same images were visible during in vitro examination of two surgical specimens of the large bowel and corresponded to appendices epiploicae of different sizes. The appendices epiploicae can be identified by sonography only when surrounded by fluid; their shape may be similar to that of peritoneal tumors. Careful analysis of both the relationships of the appendices epiploicae with the outer surface of the large bowel and of their regular spacing along the course of the colon itself may help to avoid possible misinterpretations.