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Periyasamy V, Sumana R, Doddappaiah A, Mythilikrishnan R. Anatomical variation in the sphenoidal sinuses in patients with chronic rhinosinusitis: A CT scan study. J Taibah Univ Med Sci 2024; 19:114-121. [PMID: 37876595 PMCID: PMC10591004 DOI: 10.1016/j.jtumed.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/26/2023] Open
Abstract
Computerized tomography (CT) of the skull base region has become an indispensable tool for endoscopic sinonasal surgery. Objectives Fundamental knowledge of the sinus anatomy is crucial for preoperative surgical planning. The aim of this research was to evaluate associations between the anatomical variations sphenoidal sinuses and chronic rhinosinusitis (CRS) by using CT. Methods A descriptive study was performed on patients with CRS, who were referred to the department of radiodiagnosis and imaging for CT scanning. Parameters were compared between the study and control groups. Results Among the anatomical variations, the presence of bilateral accessory septa within the sphenoidal sinus, and dehiscence and protrusion of the internal carotid artery and optic nerve (ON), were high in men and women in the case group compared with the control group. Among the anatomical variations in the sinonasal region of the male participants, a significant association (p < 0.05) was observed with ON protrusion and ON dehiscence. ON protrusion (OR = 2.168) in men was associated with elevated risk of CRS in the study population. Conclusion Knowledge of the anatomical variations in the sphenoid sinuses enables better understanding of the limits of surgical dissection during the treatment of sphenoid sinus surgeries.
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Affiliation(s)
| | - Radhakrishnan Sumana
- Department of Anatomy, Velammal Medical College Hospital & Research Institute, Madurai, Tamil Nadu, India
| | - Anupama Doddappaiah
- Department of Anatomy, Shridevi Institute of Medical Sciences and Research Hospital, Tumkur, Karnataka, India
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Sağır A, Köse H, Ertem K. Consecutive posterior shoulder fracture dislocation after a cerebral saccular aneurysm episode: a rare case. JSES Rev Rep Tech 2022; 2:391-394. [PMID: 37588861 PMCID: PMC10426595 DOI: 10.1016/j.xrrt.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- Ahmet Sağır
- Kadirli State Hospital Orthopedics and Traumatology, Osmaniye, Turkey
| | - Harun Köse
- Inonu University Faculty of Medicine, Orthopedics and Traumatology, Malatya, Turkey
| | - Kadir Ertem
- Inonu University Faculty of Medicine Orthopedics and Traumatology, Malatya, Turkey
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Caputo D, Coppola A, La Vaccara V, Passa R, Carbone L, Ciccozzi M, Angeletti S, Coppola R. Validations of new cut-offs for surgical drains management and use of computerized tomography scan after pancreatoduodenectomy: The DALCUT trial. World J Clin Cases 2022; 10:4836-4842. [PMID: 35801047 PMCID: PMC9198862 DOI: 10.12998/wjcc.v10.i15.4836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/03/2021] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Postoperative pancreatic fistula (POPF) is the most fearful complication after pancreatic surgery and can lead to severe postoperative complications such as surgical site infections, sepsis and bleeding. A previous study which identified cut-offs of drains amylase levels (DALs) determined on postoperative day (POD) 1 and POD3, was able to significantly predict POPF, abdominal collections and biliary fistulas, when related to specific findings detected at the abdominal computerized tomography (CT) scan routinely performed on POD3.
AIM To validate the cut-offs of DALs in POD1 and POD3, established during the previous study, to assess the risk of clinically relevant POPF and confirm the usefulness of abdominal CT scan on POD3 in patients at increased risk of abdominal collection.
METHODS The DALCUT trial is an interventional prospective study. All patients who will undergo pancreatoduodenectomy (PD) for periampullary neoplasms will be considered eligible. All patients will receive clinical staging and, if eligible for surgery, will undergo routine preoperative evaluation. After the PD, daily DALs will be evaluated from POD1. Drains removal and possible requirement of abdominal CT scans in POD3 will be managed on the basis of the outcome of DALs in the first three postoperative days.
RESULTS This prospective study could validate the role of DALs in the management of surgical drains and in assessing the risk or relevant complications after PD. Drains could be removed in POD3 in case of POD1 DALs < 666 U/L and POD3 DALs < 207 U/L. In case of POD3 DALs ≥ 252, abdominal CT scan will be performed in POD3 to identify abdominal collections ≥ 5 cm. In this latter category of patients, drains could be maintained beyond POD3.
CONCLUSION The results of this trial will contribute to a better knowledge of POPF and management of surgical drains.
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Affiliation(s)
- Damiano Caputo
- Department of Surgery, University Campus Bio-Medico of Rome, Rome 00128, Italy
| | - Alessandro Coppola
- Department of Surgery, University Campus Bio-Medico of Rome, Rome 00128, Italy
| | - Vincenzo La Vaccara
- Department of Surgery, University Campus Bio-Medico of Rome, Rome 00128, Italy
| | - Roberto Passa
- Department of Surgery, University Campus Bio-Medico of Rome, Rome 00128, Italy
| | - Ludovico Carbone
- Department of Surgery, University Campus Bio-Medico of Rome, Rome 00128, Italy
| | - Massimo Ciccozzi
- Unit of Medical Statistic and Molecular Epidemiology, University Campus Bio-Medico of Rome, Rome 00128, Italy
| | - Silvia Angeletti
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, Rome 00128, Italy
| | - Roberto Coppola
- Department of Surgery, University Campus Bio-Medico of Rome, Rome 00128, Italy
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Inkeaw P, Angkurawaranon S, Khumrin P, Inmutto N, Traisathit P, Chaijaruwanich J, Angkurawaranon C, Chitapanarux I. Automatic hemorrhage segmentation on head CT scan for traumatic brain injury using 3D deep learning model. Comput Biol Med 2022; 146:105530. [PMID: 35460962 DOI: 10.1016/j.compbiomed.2022.105530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 12/23/2022]
Abstract
The most common cause of long-term disability and death in young adults is a traumatic brain injury. The decision for surgical intervention for craniotomy is dependent on the injury type and the patient's neurologic exam. The potential subtypes of intracranial hemorrhage that may necessitate surgical intervention include subdural hemorrhage, epidural hemorrhage, and intraparenchymal hemorrhage. We proposed a novel automatic method for segmenting the hemorrhage subtypes on a CT scan by integrated CT scan with bone window as input of a deep learning model. Brain CT scans were collected from adult patients and annotated regions of subdural hemorrhage, epidural hemorrhage, and intraparenchymal hemorrhage by neuroradiologists. Their raw DICOM images were preprocessed by two different window settings i.e., subdural and bone windows. The collected CT scans were divided into two datasets namely training and test datasets. A deep-learning model was modified to segment regions of each hemorrhage subtype. The model is a three-dimensional convolutional neural network including four parallel pathways that process the input at different resolutions. It was trained by a training dataset. After the segmentation result was produced by the deep-learning model, it was then improved in the post-processing step. The size of the segmented lesion was considered, and a region-growing algorithm was applied. We evaluated the performance of the proposed method on the test dataset. The method reached the median Dice similarity coefficients higher than 0.37 for each hemorrhage subtype. The proposed method demonstrates higher Dice similarity coefficients and improved segmentation performance compared to previously published literature.
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Affiliation(s)
- Papangkorn Inkeaw
- Data Science Research Center, Department of Computer Science, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Salita Angkurawaranon
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Piyapong Khumrin
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Nakarin Inmutto
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Patrinee Traisathit
- Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Jeerayut Chaijaruwanich
- Data Science Research Center, Department of Computer Science, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Imjai Chitapanarux
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Hermelijn SM, Elders BBLJ, Ciet P, Wijnen RMH, Tiddens HAWM, Schnater JM. A clinical guideline for structured assessment of CT-imaging in congenital lung abnormalities. Paediatr Respir Rev 2021; 37:80-88. [PMID: 32178987 DOI: 10.1016/j.prrv.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To develop a clinical guideline for structured assessment and uniform reporting of congenital lung abnormalities (CLA) on Computed Tomography (CT)-scans. MATERIALS AND METHODS A systematic literature search was conducted for articles describing CT-scan abnormalities of congenital pulmonary airway malformation (CPAM), bronchopulmonary sequestration (BPS), congenital lobar emphysema (CLE) and bronchogenic cyst (BC). A structured report using objective features of CLA was developed after consensus between a pediatric pulmonologist, radiologist and surgeon. RESULTS Of 1581 articles identified, 158 remained after title-abstract screening by two independent reviewers. After assessing full-texts, we included 28 retrospective cohort-studies. Air-containing cysts and soft tissue masses are described in both CPAM and BPS while anomalous arterial blood supply is only found in BPS. Perilesional low-attenuation areas, atelectasis and mediastinal shift may be found in all aforementioned abnormalities and can also be seen in CLE as a cause of a hyperinflated lobe. We have developed a structured report, subdivided into five sections: Location & Extent, Airway, Lesion, Vascularization and Surrounding tissue. CONCLUSIONS CT-imaging findings in CLA are broad and nomenclature is variable. Overlap is seen between and within abnormalities, possibly due to definitions often being based on pathological findings, which is an unsuitable approach for CT imaging. We propose a structured assessment of CLA using objective radiological features and uniform nomenclature to improve reporting.
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Affiliation(s)
- Sergei M Hermelijn
- Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Bernadette B L J Elders
- Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Radiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Pierluigi Ciet
- Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Radiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - René M H Wijnen
- Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Harm A W M Tiddens
- Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Radiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J Marco Schnater
- Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands.
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Sharma P, Rattan V, Rai S, Chhabbra R. Does Intraoperative Computed Tomography Improve the Outcome in Zygomatico-Orbital Complex Fracture Reduction? J Maxillofac Oral Surg 2020; 20:189-200. [PMID: 33927486 DOI: 10.1007/s12663-020-01420-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/10/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose Zygomatico-orbital (ZMO) fractures pose considerable difficulty in intraoperative assessment during open reduction and internal fixation (ORIF), and this can be attributed to its three-dimensional complex anatomy and articulations. Recent advancements in the form of intraoperative imaging and navigation have led to an adequate assessment and correct reduction of these fractures minimizing chances of any revision surgery. The purpose of this study was to evaluate the advantage of intraoperative computerized tomography (CT) scan in the management of ZMO/isolated orbital complex fracture and further to develop a protocol for managing such fractures. Methods Twenty-three cases of ZMO/isolated orbital fractures were managed with ORIF, followed by an intraoperative CT scan. The evaluation was focused on the articulations of the zygoma and orbital wall reconstruction. The score of 0 and 1 was given for inadequate and adequate reduction, respectively. Necessary corrections were performed in case of improper reduction followed by a repeat CT scan if required. The reduction score was statistically correlated with number of incisions. Results In 8 (35%) out of 23 patients, clinical judgment was inaccurate when radiologically assessed with an intraoperative CT scan. In 6 out of 8 cases, a repeat CT scan was done after revision of reduction. The reduction score improved with additional incision and revision in the second CT scan. Conclusion Intraoperative CT has an important role in assessing the accuracy of reduction and confirming implant position in ZMO/isolated orbital fractures. This can avoid the need for secondary corrective surgery and postoperative imaging. Intraoperative CT is an important tool to improve surgical outcomes in the management of ZMO orbital fractures.
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Affiliation(s)
- Preeti Sharma
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Rajesh Chhabbra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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Sabatino A, Regolisti G, di Mario F, Ciuni A, Palumbo A, Peyronel F, Maggiore U, Fiaccadori E. Validation by CT scan of quadriceps muscle thickness measurement by ultrasound in acute kidney injury. J Nephrol 2019; 33:109-117. [PMID: 31729699 DOI: 10.1007/s40620-019-00659-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Accelerated muscle wasting still represents a major issue in critically ill patients. However, a key problem in the intensive care unit is the lack of adequate tools for bedside evaluation of muscle mass. Moreover, when acute kidney injury (AKI) coexists, fluid overload and/or rapid fluid shifts due to renal replacement therapies that frequently occur and may interfere with muscle mass assessment. The purpose of this study is to validate muscle ultrasound (US) by a gold standard (muscle CT scan) for the assessment of quadriceps muscle thickness in critically ill patients with AKI. METHODS Quadriceps rectus femoris thickness and quadriceps vastus intermedius thickness of critically ill patients with AKI were blindly assessed at the same leg sites by both US and computed tomography (CT) scan. Using bivariate mixed-model linear regression analysis, we estimated, average difference in thickness between measurement sites, agreement (differential and proportional bias) of US compared to CT, and precision of the two methods, and eventually performed Bland-Altman analysis for repeated measurements on pooled results. RESULTS We analyzed 233 couples of measurements (30 patients). Average muscle thickness ranged between 1.0 and 1.6, depending on the measurement site. When comparing US to CT, both the observed differential bias (between + 0.04 and + 0.26 cm depending on the muscle site) and the proportional bias (between 82 and 98% of the reference values, depending on the muscle site) were not statistically significant. However, precision analysis showed that US scan tended to be slightly less precise in comparison to CT. Bland-Altman analysis on pooled results showed that the 95% limits of agreement between the US and CT were narrow, ranging from - 0.34 to + 0.36 cm. CONCLUSION In critically ill patients with AKI, quadriceps muscle thickness assessment based on US is unbiased, although it occurs with a minor loss of precision compared to CT.
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Affiliation(s)
- Alice Sabatino
- UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Giuseppe Regolisti
- UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Via Gramsci 14, 43126, Parma, Italy.,Scuola di Specializzazione in Nefrologia, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Francesca di Mario
- UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Via Gramsci 14, 43126, Parma, Italy.,Scuola di Specializzazione in Nefrologia, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Andrea Ciuni
- Radiologia, Azienda Ospedaliera-Universitaria Parma, Parma, Italy
| | - Anselmo Palumbo
- Radiologia, Azienda Ospedaliera-Universitaria Parma, Parma, Italy
| | - Francesco Peyronel
- UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Via Gramsci 14, 43126, Parma, Italy.,Scuola di Specializzazione in Nefrologia, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Umberto Maggiore
- UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Via Gramsci 14, 43126, Parma, Italy.,Scuola di Specializzazione in Nefrologia, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Enrico Fiaccadori
- UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Via Gramsci 14, 43126, Parma, Italy. .,Scuola di Specializzazione in Nefrologia, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy.
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Periyasamy V, Bhat S, Sree Ram MN. Classification of Naso Septal Deviation Angle and its Clinical Implications: A CT Scan Imaging Study of Palakkad Population, India. Indian J Otolaryngol Head Neck Surg 2019; 71:2004-10. [PMID: 31763284 DOI: 10.1007/s12070-018-1425-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/04/2018] [Indexed: 10/14/2022] Open
Abstract
Computerized tomographic imaging of the nasal and paranasal regions has become an indispensable tool for the endoscopic sinonasal surgery. The case control study was carried out on 120 patients for pilot study and 800 patients for the main study. The cases were selected with a clinical diagnosis of chronic rhino sinusitis. They were referred for a sinus CT scan by otolaryngologists and controls from the normal population. The patients were separated into males and females and anatomical variations were assessed. Increased prevalence of left sided nasal septal deviation and type II nasal septal deviation was seen in males belonging to cases group in our study. Knowledge about the nasal septum anatomical variations provides understanding about the upper limit of surgical dissection and aids in road mapping the confident direction for the functional endoscopic surgeons.
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Stephens L, Mantovani A, Keene DJB, Dickson AP, Khan T, Shabani A, Cervellione RM. Shortened pubic bones in bladder exstrophy: a congenital or acquired phenomenon? J Pediatr Urol 2014; 10:325-8. [PMID: 24139745 DOI: 10.1016/j.jpurol.2013.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/12/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE It is accepted that the length of the anterior segment of the pelvis in classic bladder exstrophy is shorter than that of controls. However, studies performed involve children with a wide range of ages. By studying children with classic bladder exstrophy under the age of 1 year, the authors aim to ascertain if there is a congenital pubic bone length discrepancy associated with bladder exstrophy. MATERIAL AND METHODS Fourteen classic bladder exstrophy patients under 1 year of age and 14 age-matched controls were identified. Three-dimensional (3D) computerized tomography was used to measure the length of the superior pubic ramus bilaterally. In the exstrophy group, scans were performed before bladder closure. The Mann-Whitney U test was used and p < 0.05 was considered significant. RESULTS There was no significant difference (p = 0.76) in the median age in cases (72 days) and controls (64 days). The median superior pubic ramus length was 19.1 mm in the exstrophy group and 20 mm in the control group (p = 0.99). CONCLUSIONS Superior pubic ramus length in children under 1 year of age with classic bladder exstrophy is not statistically different from that in control subjects. Therefore, the authors hypothesize that the previously described shortening of the pubic bones is an acquired phenomenon, which may develop after the first year of life.
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Affiliation(s)
- Linda Stephens
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK
| | - Alberto Mantovani
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK
| | - David J B Keene
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK
| | - Alan P Dickson
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK
| | - Tahir Khan
- Department of Paediatric Orthopaedic Surgery, Royal Manchester Children's Hospital, Manchester, UK
| | - Abdusamea Shabani
- Department of Paediatric Radiology, Royal Manchester Children's Hospital, Manchester, UK
| | - Raimondo M Cervellione
- Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
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Abstract
Purpose: To detect the possible structural brain lesions in the patients suffering from various kinds of epilepsy during the routine neuroimaging. Materials and Methods: Prospective study of 366 epileptic patients conducted at epilepsy clinic, Rawalpindi-Islamabad Pakistan in an outpatient setting. MRI or CT scan of the brain without contrast was advised in all patients to detect any underlying pathology. Results: A total 21.31% scans were found to be abnormal. Many cases of familial, idiopathic epilepsy and patients without any neurological deficit were found to have structural brain lesions, which might be responsible for their seizures. Conclusion: CT/MRI scan of the brain should be advised in all patients of epilepsy regardless of cause and type of epilepsy. The presence of neurological deficit should not be the sole indication for neuroimaging.
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Affiliation(s)
- Ahmed Bakhsh
- Department of Neuroscience, Saad Specialist hospital, Al-khober, Saudi Arabia
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11
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Giri DK, Sharma I. Intracranial (structural) changes in obsessive- compulsive disorder: A computerized tomography scan study. Ind Psychiatry J 2009; 18:88-91. [PMID: 21180483 PMCID: PMC2996199 DOI: 10.4103/0972-6748.62266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To assess intracranial structural changes in obsessive-compulsive disorder (OCD) with CT scan. MATERIALS AND METHODS Thirty patients of OCD between 21 and 40 years of age and fulfilling various inclusion and exclusion criteria were compared with control group. CT scans of all the patients and controls were taken and compared with regard to ventricular size, Evan's ratio and ventricular brain ratio (VBR). RESULTS Patients of OCD were found to have greater cortical atrophy and scored significantly higher in frontal and parietal area. Only 4 patients had enlarged ventricles, and there were none with a smaller ventricle. Mean Evan's ratio of patients was lower than that of the control group but the difference was statistically nonsignificant. The mean VBR of patients was lower than that of the control group and the difference was highly significant. CONCLUSIONS The evidence of neuro-radiological abnormalities in patients with OCD suggests that these disorders should not be considered merely functional in the traditional sense.
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Abstract
BACKGROUND Curettage and wide resection are accepted methods of treatment of giant cell tumor (GCT) of bone. The success rate with curettage in different reports varies widely. There is a paucity in the literature regarding selection of cases for curettage. Present study is an analysis of outcome of 34 cases treated by curettage and bone grafting. MATERIALS AND METHODS Thirty-four cases of GCT of bone, 28 fresh and six with recurrence were treated by curettage and bone grafting. All cases of Campanancci grade 1, 2 and grade 3 which on computerized tomography scan showed break in the cortex confined to one surface and cortical break less than one third of circumference were treated by curettage and bone grafting. RESULTS 4 (14%) of these lesions treated primarily by us showed recurrence after one and half year. CONCLUSION Curettage and bone grafting is a reliable method in the treatment of GCT, provided guidelines regarding selection of cases and principles of tumor surgery are strictly adhered to.
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Affiliation(s)
- Dominic Puthoor
- Dept. of Orthopedics, Amala Institute of Medical Sciences, Amalanagar, Thrissur, Kerala - 680 555, India,Correspondence: Dr. Dominic Puthur, Dept. of Orthopedics, Amala Institute of Medical Sciences, Amalanagar, Thrissur, Kerala - 680 555, India. E-mail:
| | - Wilson Iype
- Dept. of Orthopedics, Amala Institute of Medical Sciences, Amalanagar, Thrissur, Kerala - 680 555, India
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