Purpose: This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods: Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results: The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2±11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion: The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.
Objective: Multilocular cystic renal cell carcinoma (MCRCC) is a recently described variety of renal cell carcinoma with characteristic pathologic and clinical features. The purpose of this study was to analyze the imaging findings of MCRCCs. Materials and Methods: Ten adult patients with pathologically proven unilateral MCRCC who underwent renal US and CT were included in this study. The radiologic findings were retrospectively evaluated for cystic content, wall, septum, nodularity, calcification and solid portion by three radiologists who established a consensus. Imaging and postnephrectomy pathologic findings were compared. Results: All patients were adults (six males and four females) and their ages ranged from 33 to 68 years (mean, 46). On US and CT images, all tumors appeared as well-defined multilocular cystic masses composed of serous or complicated fluid. In all patients, unenhanced CT scans revealed hypodense cystic portions, and in four tumors, due to the presence of hemorrhage or gelatinous fluid, some hyperdense areas were also noted. In no tumor was an expansile solid nodule seen in the thin septa, and in only one was there dystrophic calcification in a septum. Small areas of solid portion constituting less than 10% of the entire lesion were found in six of the ten tumors, and these areas were slightly enhanced on enhanced CT scans. In all patients, imaging and pathologic findings correlated closely. Conclusion: On US and CT images, MCRCC appeared as a well-defined multilocular cystic mass with serous, proteinaceous or hemorrhagic fluid, with no expansile solid nodules in the thin septa, and sometimes with small slightly enhanced solid areas. Where radiologic examinations demonstrate a cystic renal mass of this kind in adult males, MCRCC should be included in the differential diagnosis.
Jeong Jin Park;Seung Jae Cho;Seong Hyeon Jo;Chul Hyun Park
Journal of Korean Foot and Ankle Society
/
v.28
no.2
/
pp.60-67
/
2024
Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.
Objectives This study was carried out to investigate the experimental effects of Lonicerae Caulis and Bee-venom Acupuncture in Yanglingquan (陽陵泉, GB34) that have clinical efficacy in the Rheumatoid Arthritis. Methods Materials of present study are Lonicerae Caulis Extracts (LCE), Bee-Venom Acupuncture (BVP), Sprague-dawley rats (250 g or so, ♂), and various kinds of needing experimental studies. We measured several experimental items of the rats with the arthritis induced by Freund's complete adjuvant (0.2 ml/kg), such as body weight, rate of paw edema, analgesic effect by hot plate method, WBC, TNF-${\alpha}$ cytokine and IL-10 cytokine. Rats were divided into four groups; Normal group that was treated with normal saline 1.0 ml (o.p) and $15{\mu}l/kg$ (GB34) to normal rats, Control group that was treated with normal saline 1.0 ml (o.p) and $15{\mu}l/kg$ (GB34) to pathologic model rats induced by Freund's complete adjuvant 0.2 ml/kg, Experimental group A that was treated with LCE 1.0 ml (o.p) and normal saline $15{\mu}l/kg$ (GB34) to pathologic model rats induced by Freund's complete adjuvant 0.2 ml/kg and Experimental group B that was treated with LCE 1.0 ml (o.p) and BVP $15{\mu}l/kg$ (GB34) to pathologic model rats induced by Freund's complete adjuvant 0.2 ml/kg, and the experiment took over after 28 days. The results were analysed using SPSS for windows 12.0. Results Experimental group A showed the increase in body weight, paw licking times and IL-10 cytokine compared to Control group. Also it was decreased in rate of paw edema, WBC, and TNF-${\alpha}$ cytokine compared with Control group. Experimental group B showed the increase in body weight, paw licking times, and IL-10 cytokine compared to Control group, and showed the decrease in rate of paw edema, WBC and TNF-${\alpha}$ cytokine compared to Control group. Especially TNF-${\alpha}$ cytokine and rate of paw edema were accepted statistical significance compared with Control group. Conclusions It is suggested that Lonicerae Caulis (o.p) and Bee-venom Acupuncture (GB34) can be used in the treatment of rheumatoid arthritis.
Information on productivity of hospital personnel is required for optimum staffing and hospital management. This study deals with the quantitative aspects of workload of medical personnel in training hospitals by their specific characteristics. Specifically this study attempted to find relevant determinants of the productivity of medical personnel using multiple stepwise regression analysis based on data obtained from 135 training hospitals. The findings of this study were as follows: 1) Daily average number of outpatients and inpatients treated by a physician were 20.4 and 10.2, respectively. 2) Daily average number of patients cared by a nurse was 8.2. Daily average number of tests performed by pathologic technician and radiologic technician were 83.2 and 21.5, respectively. 3) Productivity of medical personnel were significantly different for the three groups of factors: hospital sire (number of beds, number of medical personnel per 100 beds): institutional characteristics (medical school affiliation, training type, profit status); and environmental factors (location, number of physician and beds per 1,000 population in the region). 4) The factors a(footing the productivity varied according to the types of medical profession: the number if beds, the number of physicians per 100 beds, training type, and profit status for physicians; the number of nurses per 100 beds, the number of beds, medical school affiliation for nurses; the number of physicians per 100 beds, the number of technicians per 100 beds, and ownership for pathologic technicians; the number o( technicians, training type, and the number of physicians per 100 beds for radiologic technician.
Objectives: In these days, patients with stage I breast cancer have increased by regular health examination and diagnostic tool development. The aim of this retrospective study is to identify systemic recurrence related factors after breast conserving surgery (BCS) for stage I breast cancer. Methods: In this study, we analyzed the correlation between systemic recurrence and pathologic factors. We reviewed 223 patients who underwent BCS for stage I breast cancer. Postoperative pathologic factors, recurrent rates and sites were studied. In addition, preoperative patients'data were also collected. Statistical analysis was done by using PASW 16.0 (SPSS Inc., Chicago, IL, USA). Results: Systemic recurrence was found in 16 patients (7.17%) within 5 years after primary surgery. 5 patients had lymphatic invasion and 6 patients had vascular invasion. Lymphatic and vascular invasion had statistical correlation with systemic recurrence (P = 0.004, P = 0.001). Conclusions: In this retrospective study, we can conclude that vascular invasion and lymphatic invasion are related systemic recurrence after BCS for stage I patients. Further studies with large cohort will be required to fully understand the risk factors of systemic recurrence for stage I breast cancer patients.
Purpose: The aim of this study was to evaluate the clinical significance of 24 hour pH monitoring in the pediatric patients with recurrent vomiting or regurgitation. Methods: We performed 24 hour pH monitoring on 87 pediatric patients with recurrent vomiting or regurgitation using GastrograpH with glass electrode. The pathologic GER was determined by the reflux index (RI). RIs>10% were considered positive in patients <1 year of age, whereas RIs of >5% were positive in other age groups. We evaluated the mean and standard deviation of the reflux parameters between physiologic and pathologic GER groups, and also compared the reflux indices of each group with respect to time zones of the day. Results: Pathologic GER was found in 32 of 87 patients (36.8%), and the age incidence included 32.5% in infants <6 months old, 13.3% in infants aged 6 months-1 year old, 61.5% in children aged 1~2 years old, 14.3% in children aged 2~3 years old and 66.7% in children >3 years old. In physiologic GER patients, the RI was $3.7{\pm}2.9%$ for the patients <1 year old (group A), and $1.8{\pm}1.5%$ for those ${\geq}1$ year old (group B) which was statistically significant between the 2 age groups (p=0.02). The number of long refluxes more than 5 minutes was significantly increased (p=0.03) in group A ($1.7{\pm}1.9$) than in group B ($0.8{\pm}1.0$). The duration of the longest reflux was significantly longer (p=0.007) in group A ($604{\pm}551$ sec) than in group B ($275{\pm}296$ sec). In pathologic GER patients, the RI was $17.7{\pm}11.6%$ for the patients <1 year old and $7.8{\pm}2.9$ for those ${\geq}1$ year old. The number of long refluxes of more than 5 minutes were $8.9{\pm}4.6$ and $3.2{\pm}1.8$, and the duration of the longest reflux were $1955{\pm}2190$ sec and $1093{\pm}706$ sec for each age group. In both physiologic and pathologic GER patients, there was no significant difference of RI among the time zones of the day. Conclusion: Pathologic GER was found in 36.8% of patients. There was significant difference of RI between those <1 year old and those ${\geq}1$ year old in physiologic GER patients. There was no significant difference of RI among the time zones of the day in both pathologic and physiologic groups. In our study, the frequency of pathplogic GER was too much higher in age group of 1~2 years old (61.5%) than in group of 6 months-1 year old (13.3%), which means that further study is needed to determine the pathologic criteria of RI (Vandenplas criteria is >5%) in the age group of 1~2 years old.
The Journal of the Korean bone and joint tumor society
/
v.11
no.2
/
pp.155-159
/
2005
Purpose: To find out the pathologic symptoms, and the incidence and clinical significance of the coexistence of internal derangement of knee(IDOK) in osteochondroma around the knee. Materials and Methods: We retrospectively reviewed forty-five patients under 20 years of age treated with the excision of the osteochondroma around the knee between 1995 and 2004. We analyzed age, gender, past history, family history, solitary or multiple osteochondroma, presenting pathologic symptoms, and causes of IDOK. Results: IDOK was confirmed in nine(20%) among the 45 cases. There were four cases of multiple osteochondromatosis, and IDOK was coexisted in one case among them. The most common presenting pathologic symptoms were painless mass of 38 cases, however 9 cases among them had joint pain for IDOK. There were 7 cases of meniscal tears and 2 of pathologic plica. Discoid meniscus was found in 4 cases among the 7 cases of meniscal tears. Conclusion: Coexistence of osteochondroma around knee and IDOK in this study probably represents a coincidence rather than a real association. However the incidence might be not low, special study and close observation should be done.
Kim, Eun-Young;Jung, Kyu-Whan;Park, Tae-Jin;Park, Kwi-Won;Jung, Sung-Eun;Kim, Hyun-Young
Advances in pediatric surgery
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v.16
no.2
/
pp.117-125
/
2010
Unreduced small bowel intussusception requires operative treatment although the rate of spontaneous reduction is 60 to 70 %. The aim of this study is to compare clinical characteristics and outcome between spontaneous reduction and operation group and to analyze factors related to decisions to treat small bowel intussusceptions. The records of 25 patients with small bowel intussusceptions treated in Seoul National University Children's Hospital from January 1999 to August 2009 were reviewed respectively. Spontaneous reduction group (n=12, 48 %) had signs and symptoms of vomiting, abdominal pain, currant jelly stool, abdominal distension, fever, increased CRP but no rebound tenderness. One of them had been diagnosed with Henoch-Schonlein purpura and no one displayed pathologic leading point by image study. Operation group (n=13, 52 %) consisted of patients who had primary surgery. Their signs and symptoms were similar to spontaneous reduction group. Seven of them had underlying diseases such as Crohn' disease, ALL, Lymphoma, Peutz-Jeghers syndrome (n=3), post-transplanted state of liver and 2 of them displayed Peutz-Jeghers polyp and Meckel's diverticulum as pathologic leading point by preoperative ultrasonography. Mean relieve interval (interval between onset of symptoms and reduction/operation) was 1.78 days in spontaneous reduction group and 2.25 days in operation group (p=0.341). Seven of operation group had manual reduction and 6 out of 7 received segmental resection of the small bowel. No one of them underwent manual reduction and all of them underwent segmental resection were found to have pathologic leading points [Peutz-Jeghers polyp (n=3), Meckel's diverticulum (n=2), lymphoma (n=1)] during operation. In conclusion, 48% of small bowel intussusceptions resolved spontaneously. Patients' symptoms and relieve intervals were not related to the operative decisions. We therefore recommend significant factors for determining treatment plan such as change of clinical symptoms, underlying disease or pathologic leading point by imaging.
Sun-Young Park;Min Hee Lee;Ji Young Jeon;Hye Won Chung;Sang Hoon Lee;Myung Jin Shin
Korean Journal of Radiology
/
v.20
no.5
/
pp.812-822
/
2019
Objective: To assess the diagnostic value of combining diffusion-weighted imaging (DWI) with conventional magnetic resonance imaging (MRI) for differentiating between pathologic and traumatic fractures at extremities from metastasis. Materials and Methods: Institutional Review Board approved this retrospective study and informed consent was waived. This study included 49 patients each with pathologic and traumatic fractures at extremities. The patients underwent conventional MRI combined with DWI. For qualitative analysis, two radiologists (R1 and R2) independently reviewed three imaging sets with a crossover design using a 5-point scale and a 3-scale confidence level: DWI plus non-enhanced MRI (NEMR; DW set), NEMR plus contrast-enhanced fat-saturated T1-weighted imaging (CEFST1; CE set), and DWI plus NEMR plus CEFST1 (combined set). McNemar's test was used to compare the diagnostic performances among three sets and perform subgroup analyses (single vs. multiple bone abnormality, absence/presence of extra-osseous mass, and bone enhancement at fracture margin). Results: Compared to the CE set, the combined set showed improved diagnostic accuracy (R1, 84.7 vs. 95.9%; R2, 91.8 vs. 95.9%, p < 0.05) and specificity (R1, 71.4% vs. 93.9%, p < 0.005; R2, 85.7% vs. 98%, p = 0.07), with no difference in sensitivities (p > 0.05). In cases of absent extra-osseous soft tissue mass and present fracture site enhancement, the combined set showed improved accuracy (R1, 82.9-84.4% vs. 95.6-96.3%, p < 0.05; R2, 90.2-91.1% vs. 95.1-95.6%, p < 0.05) and specificity (R1, 68.3-72.9% vs. 92.7-95.8%, p < 0.005; R2, 83.0-85.4% vs. 97.6-98.0%, p = 0.07). Conclusion: Combining DWI with conventional MRI improved the diagnostic accuracy and specificity while retaining sensitivity for differentiating between pathologic and traumatic fractures from metastasis at extremities.
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