A detailed radiomorphometric analysis of the mandibular foramen, lingula and anti-lingula with a special emphasis on mandibular prognathism.

INTRODUCTION: The aim of this study was to evaluate radiomorphometric differences of mandibular foramen (MF), lingula (Li), and anti-lingula (AL) between prognathic and non-prognathic patients, using cone-beam computed tomography (CBCT). METHODS: A total of 228 3D CBCT images of 57 prognathic and 57 non-prognathic patients were retrospectively evaluated. The distances between MF or Li to occlusal plane (OP), anterior border of ramus (AR), posterior border of ramus (PR), sigmoid notch (SN), gonion (Go) and distances Li to MF were measured. The presence of AL, and the distances to Li were also assessed in both groups. RESULTS: In prognathic patients the mean distances of MF-AR and Li-PR were lesser, and Li-OP was greater (p < 0.05). However, distances from MF or Li to the other ramal landmarks were similar in both groups (p > 0.05). Presence of AL was found at 53 sides in prognathic and 20 sides in non-prognathic groups (p < 0.05). The horizontal distance of Li-MF was greater in prognathic patients (p < 0.05). On the other hand, there was no difference between groups regarding the horizontal distance of Li-Al, and the vertical distances of Li-MF and Li-AL (p > 0.05). CONCLUSION: The present study provided valuable data regarding morphological differences of MF-AR, Li-MF and Li-OP, which should be considered in the preoperative assessment of patients with mandibular prognathism. Presence of AL was more common in prognathic patients and mainly located above Li. 3D CBCT applications facilitated assessment of AL and its relationship with Li.

PAGET'S DISEASE OF THE BONE FOUND INCIDENTALLY ON F-18 FDG PET/CT: CLINICAL SIGNIFICANCE AND DIFFERENTIAL DIAGNOSTIC CRITERIA.

Background: Paget Disease (PD) is usually asymptomatic and discovered incidentally, it is known that it is exhibited low to high grade increased F-18 FDG uptake. Aim: In this study, we investigated the distinguishability of FDG PET/CT in incidental PD cases from other bone diseases and at different stages of the disease. Patients and Methods: In this cross-sectional, descriptive study, "Paget" identification associated with PET/CT reports was found in 69 of 18,119 studies (~3.8%). Of the 45 patients (33 males and 12 females) eligible for inclusion in the study, 35.6% had monostotic and 64.4% had polyostotic disease (p>0.5). There was no statistically significant difference in biochemical parameters between groups. Results: According to the radiological appearance of the patients, 36 were in the mixed stage and 9 were in the blastic stage. Only the difference in ALP and creatinine values between the groups was statistically significant. SUVmax, SUVmean and HU values were found to be statistically significantly higher in pagetoid bones compared to control bone lesions. For SUVmax for PD bone lesion we found the 2.55 cutoff point with a sensitivity of 91% and a specificity of 84%. Conclusion: The specific radiological appearance of bone lesions and the evaluation of metabolic activity compared to normal bone seem to help differentiate PD from other lesions. Prospective studies are needed in the differentiation of FDG's disease stage and treatment response evaluation. The ability to differentiate between benign and malignant FDG avid bone lesions in oncological patients' enables appropriate patient management, including avoiding unnecessary additional invasive procedures such as bone biopsy.

Características tumorales del cáncer de pulmón para predecir metástasis en los ganglios axilares / Tumor characteristics of lung cancer in predicting axillary lymph node metastases

Objetivo: En el cáncer de pulmón las metástasis en los ganglios axilares (MGA) son infrecuentes y, según la 8.ª edición del Sistema de estadificación, se clasifican como enfermedad metastásica M1b. El objetivo de este estudio es evaluar: 1) la presencia de MGA; y 2) el efecto de las características de los tumores primarios en el desarrollo de MGA. Métodos: Realizamos un estudio transversal descriptivo, con revisión retrospectiva, para identificar las MGA. Resultados: Incluimos en este análisis a 157 pacientes: MGA (63 pacientes) y grupo control (94 pacientes). La presencia de ganglios extratorácicos, metástasis contralaterales pulmonares parenquimatosas y distantes y todos los valores SUVmáx fueron significativamente más elevados en el grupo de estudio, en comparación con el grupo control (p<0,05). El valor SUVmáx del tumor primario no fue un factor predictivo de MGA. Con arreglo al diagnóstico histopatológico primario detectamos que el cáncer de pulmón de células pequeñas causaba el desarrollo de MGA en una proporción 3,4 veces mayor que el cáncer de células escamosas (OR: 3,4 [IC 95%: 1,3-10,2], p=0,029) y que el grupo de adenocarcinoma causaba el desarrollo de MGA en proporción 4 veces superior que el cáncer de células escamosas (OR: 4,02 [IC 95%: 1,73-9,34], p=0,001). La probabilidad de desarrollar MGA fue considerablemente superior en los tumores localizados en el lóbulo superior que en el lóbulo inferior. Conclusión: Tras el hallazgo de MGA en las imágenes PET/TC, la necesidad de confirmación histopatológica viene determinada con arreglo a los resultados de la localización del tumor primario, la histopatología de este, el estadio M en PET/TC, la localización de MGA con arreglo al tumor primario y el estadio N en PET/TC

Objective: In lung cancer, axillary lymph node metastases (ALM) are rare, and according to the 8th grading system, it is classified as M1b disease. The aim of this study is to evaluate1) the presence of ALM and2) the effect of the primary tumors characteristics on the development of ALM. Methods: We performed a descriptive cross-sectional study, with retrospective revision, to identify ALM. Results: There were 157 patients included in this analysis: ALM (63 patients) and control group (94 patients). The presence of extrathoracic lymph node, contralateral pulmonary parenchymal and distant metastasis and all SUVmax values were significantly higher in the study group versus the control group (P<0.05). The SUVmax value of the primary tumor was not a predictor of ALM. According to the primary histopathologic diagnosis, small cell lung cancer was found to cause ALM development 3.4 times as much as squamous cancer (SQC) (OR: 3.40 [95% CI 1.3-10.20], P=0.029) and adenocarcinoma group was found to cause ALM development 4 times as much as SQC (OR: 4.02 [95% CI 1.73-9.34], P=0.001). The likelihood of developing ALM was significantly higher in tumors located in the central and upper lobe versus the lower lobe. Conclusion: The finding of ALM on PET/CT images, the necessity of histopathologic confirmation is determined according to the results of primary tumor localization, primary tumor histopathology, M stage on PET/CT imaging, localization of ALM according to primary tumor, and N stage on PET/CT imaging

Tumor characteristics of lung cancer in predicting axillary lymph node metastases. / Características tumorales del cáncer de pulmón para predecir metástasis en los ganglios axilares.

OBJECTIVE: In lung cancer, axillary lymph node metastases (ALM) are rare, and according to the 8th grading system, it is classified as M1b disease. The aim of this study is to evaluate1) the presence of ALM and2) the effect of the primary tumors characteristics on the development of ALM. METHODS: We performed a descriptive cross-sectional study, with retrospective revision, to identify ALM. RESULTS: There were 157 patients included in this analysis: ALM (63 patients) and control group (94 patients). The presence of extrathoracic lymph node, contralateral pulmonary parenchymal and distant metastasis and all SUVmax values were significantly higher in the study group versus the control group (P<0.05). The SUVmax value of the primary tumor was not a predictor of ALM. According to the primary histopathologic diagnosis, small cell lung cancer was found to cause ALM development 3.4 times as much as squamous cancer (SQC) (OR: 3.40 [95% CI 1.3-10.20], P=0.029) and adenocarcinoma group was found to cause ALM development 4 times as much as SQC (OR: 4.02 [95% CI 1.73-9.34], P=0.001). The likelihood of developing ALM was significantly higher in tumors located in the central and upper lobe versus the lower lobe. CONCLUSION: The finding of ALM on PET/CT images, the necessity of histopathologic confirmation is determined according to the results of primary tumor localization, primary tumor histopathology, M stage on PET/CT imaging, localization of ALM according to primary tumor, and N stage on PET/CT imaging.

Evaluation of patient rights practices in a developing country: the Edirne model for the implementation of patient rights in Turkey.

OBJECTIVE: The aim of this study was to examine the development of the implementation of patient rights and the practical course of patient rights legislation in Edirne, as well as the verbal and written applications to relevant departments between 2004 and 2008. METHODS: The present study was a descriptive, retrospective and cross-sectional study. The data of the study were obtained by retrospectively reviewing records of written complaints to patient rights units and on-site solutions between 2004, the year of establishment of these units, and 2008. RESULTS: The incidence of written and verbal complaints were calculated to be 23.1 in 100,000 and 137.9 in 100,000, respectively. The increase was 102.2% for on-site solutions, whereas it was calculated as 97.8% for written applications. It was noticed that the rate of violation judgements was high (42.5% (17/40)) in the first year the Edirne State Hospital patient rights committee was established. CONCLUSIONS: Possible problems encountered during the presentation of health services can be solved by the implementation of patient rights under the legislative guarantee. The implementation of patient rights should be considered as reflections of a socialised government on health services.