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Current Medical Imaging 2022In this article, we aimed to present a congenital sialocutaneous fistula originating from the parotid gland in a 4-year-old child with MR findings.
INTRODUCTION AND BACKGROUND
In this article, we aimed to present a congenital sialocutaneous fistula originating from the parotid gland in a 4-year-old child with MR findings.
CASE PRESENTATION
A 4-year-old male patient was admitted to our clinic with a small hole in the inferior right half of the neck and a sticky fluid coming out of this area. Neck ultrasonography (US) and contrast neck Magnetic Resonance Imaging (MRI) were performed on the patient. In the US, a millimeter linear, vaguely hypoechoic appearance was observed in the subcutaneous tissue at this level on the neck. In contrast-enhanced neck MRI imaging, at the level of the right parotid tail, a millimetric linear fistula tract was observed, which was thought to originate from the superficial parotid lobe and extended to the skin at the proximal level of the right sternocleidomastoid (SCM) muscle. After suppressing surrounding fatty tissues in fat-suppressed contrast-enhanced series, this tract area became slightly pronounced.
CONCLUSION
In conclusion, sialocutaneous fistula should be considered among the differential diagnoses in cases of skin fistulization in children. In terms of differential diagnosis, MRI is a very effective imaging method due to its high soft-tissue resolution.
Topics: Child, Preschool; Diagnosis, Differential; Fistula; Humans; Magnetic Resonance Imaging; Male
PubMed: 35578856
DOI: 10.2174/1573405618666220516125309 -
Annals of Medicine and Surgery (2012) Oct 2023Surgical resection is the most efficient treatment for isolated colorectal cancer hepatic metastases. Among the known prognostic factors of this procedure, the impact of...
BACKGROUND
Surgical resection is the most efficient treatment for isolated colorectal cancer hepatic metastases. Among the known prognostic factors of this procedure, the impact of the resection margin width is still a controversial matter in the literature.
METHODS
A retrospective cohort study was performed including 170 patients who underwent surgical resection of colorectal cancer liver metastases (CRLMs) between 2006 and 2016 in our hepatobiliary unit. Resection margin width was determined histologically by measuring the distance from the tumour in millimetres or centimetres. Patients' clinical characteristics were also collected. Patients were then stratified in two tumour margin groups: below 5 mm (group A) and equal to or above 5 mm (group B). Overall survival (OS) and disease-free survival (DFS) were the primary outcomes.
RESULTS
Kaplan-Meier curves showed significantly better outcomes for cases having resection margins above 5 mm for both DFS with 1508.7 days (range 1151.2-1866.2) in group A, compared to 2463.9 days (range 2021.3-2906.5) in group B (=0.049), and OS with 1557.8 days (range 1276.3-1839.3) for group A and 2303.8 days (range 1921.2--2686.4) for group B (=0.020). This survival benefit was not significant for patients presenting with stage IV CRC at diagnosis or cases where extended (7+ segments) resections were performed.
CONCLUSION
Five-millimetre margins provide a significant survival advantage and should be aimed for in the treatment of CRLMs. Further research on the cause for this finding, including tumour biology's impact on survival, is required.
PubMed: 37811094
DOI: 10.1097/MS9.0000000000001113 -
The Journal of Bone and Joint Surgery.... Oct 1993Healing of 0.5 or 1.0-millimeter step-off defects associated with displaced intra-articular fractures of the medial femoral condyle was examined in fifty-four adult New...
Healing of 0.5 or 1.0-millimeter step-off defects associated with displaced intra-articular fractures of the medial femoral condyle was examined in fifty-four adult New Zealand White rabbits. The rabbits were treated with either immobilization for three weeks, intermittent active motion, or continuous passive motion for seven days. At twelve weeks, the healing and remodeling of the step-off defects were examined with use of contact-pressure maps on pressure-sensitive film, light microscopy (with hematoxylin and eosin or safranin-O staining), and scanning electron microscopy. Macroscopically, the sharp profile that had been present initially with both sizes of step-off defect had rounded off; however, there was less residual incongruity with the 0.5-millimeter step-offs than with the 1.0-millimeter step-offs. Among step-off defects of the same size, the method of treatment had no discernible effect on the macroscopic appearance of the surface of the joint. With fresh step-offs (the control group), the contact pressure of the cartilage on the elevated side was approximately three times greater than that at a distance from the step-off. On the depressed side, an unloaded zone extended approximately three times the height of the step-off, with an average width of 3.4 millimeters for the 1.0-millimeter step-offs and 1.6 millimeters for the 0.5-millimeter step-offs. After healing and remodeling, the unloaded zone still averaged 2.5 millimeters in width for the 1.0-millimeter step-offs but had decreased to only 0.35 millimeter in width for the 0.5-millimeter step-offs. For seven of the nine 0.5-millimeter step-offs, the contact pressure in the previously unloaded zone ranged from 0.5 to 1.5 megapascals, with a mean of 0.8 megapascal (40 per cent of the normal mean contact pressure at this location). Under light microscopy, the cartilage on the elevated side of the healed step-offs had decreased in thickness, was displaced toward the defect and tapered toward the depressed side, and ended in a hypocellular tissue flap. In contrast, the cartilage on the depressed side had thickened as a result of hyperplasia of the chondrocytes and hypertrophy of the cartilage and had failed to establish continuity between the sides of the defect. There was a marked increase in the subchondral vascular bed and re-establishment of the subchondral plate. With the exception of the aforementioned hypocellular tissue flap, safranin O stained the cartilage on both levels of the step-off uniformly, which indicated the absence of glycosaminoglycan depletion.(ABSTRACT TRUNCATED AT 400 WORDS)
Topics: Animals; Bone Remodeling; Cartilage, Articular; Disease Models, Animal; Female; Femoral Fractures; Fracture Healing; Immobilization; Motion Therapy, Continuous Passive; Rabbits
PubMed: 8408140
DOI: 10.2106/00004623-199310000-00012 -
Voprosy Kurortologii, Fizioterapii, I... 2001Patients with extensive bite wounds given conventional treatment and exposed to millimetric electromagnetic waves (MEW) were compared by therapeutic benefit. MEW...
Patients with extensive bite wounds given conventional treatment and exposed to millimetric electromagnetic waves (MEW) were compared by therapeutic benefit. MEW treatment early after the trauma enhances regeneration in the lesion thus raising therapeutic efficiency of the treatment because the exposure to MEW in hydration phase provides a fast relief of soft tissue edema, lessens intoxication, stimulates adaptation.
Topics: Bites and Stings; Electromagnetic Fields; Humans; Treatment Outcome
PubMed: 11785340
DOI: No ID Found -
Journal of the American Chemical Society Jan 2002This communication describes the fabrication of three-dimensional structures of organic polymers using principles of design inspired by protein folding. The structures...
This communication describes the fabrication of three-dimensional structures of organic polymers using principles of design inspired by protein folding. The structures consist of rigid polyhedral components with dimensions of a few millimeters ("microdomains"), representing alpha-helical and beta-sheet secondary structures, connected with flexible linkers representing loops or turns. These structures were fabricated from polyurethane using photolithographic and soft lithographic techniques. The surfaces of the microdomains were patterned into hydrophobic and hydrophilic regions, and a hydrophobic photocurable liquid (serving both as lubricant and adhesive) was selectively precipitated onto the hydrophobic areas. The unfolded structures were suspended in water and agitated by tumbling. Self-assembly occurred through coalescence of the thin films of hydrophobic liquid, and was caused by minimization of the free energy of the interface between the liquid adhesive and the water. The self-assembled structures were locked in place by curing the adhesive with UV light. These results demonstrate the use of concepts abstracted from the study of proteins-including attractive hydrophobic interactions, shape complementarity, and conformational constraint-in the self-assembly of complex, three-dimensional structures on the millimeter scale.
Topics: Models, Molecular; Protein Folding; Protein Structure, Secondary
PubMed: 11772052
DOI: 10.1021/ja0120633 -
Indian Journal of Critical Care... Sep 2022Diaphragmatic dysfunction has been increasingly documented to play a critical role to determine ventilator dependency and failure of weaning.
BACKGROUND
Diaphragmatic dysfunction has been increasingly documented to play a critical role to determine ventilator dependency and failure of weaning.
OBJECTIVE
The goal was to study the diagnostic accuracy of diaphragmatic rapid shallow breathing index (D-RSBI) as a predictor of weaning outcomes in comparison to RSBI.
MATERIALS AND METHODS
A prospective observational study on consecutively admitted patients who were intubated and mechanically ventilated for a duration of at least 48 hours was carried out. The right hemidiaphragm displacement [diaphragm displacement (DD)] was calculated by M-mode ultrasonography, and respiratory rate (RR) and tidal volume (TV) were documented from the ventilator readings. Rapid shallow breathing index (RSBI) was measured as RR/TV (in liters); D-RSBI was calculated as RR/DD (in millimeters) and expressed as breath/minute/millimeter. Extubation failure was defined as the reinstitution of mechanical ventilation at the end of, or during the spontaneous breathing trial (SBT), re-intubation or the need of noninvasive ventilation (NIV) for the patient within 48 hours of extubation.
RESULTS
Of 101 screened patients, 50 patients met the inclusion criteria, of whom 45 patients had successful SBT, and finally, 41 patients could be successfully extubated. Hence, the overall rate of weaning failure in the study population was 18%. The areas under the receiver operator characteristic (ROC) curves for D-RSBI and RSBI were 0.97 and 0.70, respectively ( <0.0001). The Pearson's correlation among RSBI and D-RSBI was 0.81 (-value <0.001).
CONCLUSION
Diaphragmatic rapid shallow breathing index has a positive correlation and greater diagnostic accuracy than RSBI, the conventional weaning index.
HOW TO CITE THIS ARTICLE
Shamil PK, Gupta NK, Ish P, Sen MK, Kumar R, Chakrabarti S, . Prediction of Weaning Outcome from Mechanical Ventilation Using Diaphragmatic Rapid Shallow Breathing Index. Indian J Crit Care Med 2022;26(9):1000-1005.
PubMed: 36213711
DOI: 10.5005/jp-journals-10071-24316 -
ASAIO Transactions 1988Continuing efforts in vascular prosthetic design are focused on understanding the characteristics required for function of small internal diameter and low-flow... (Review)
Review
Continuing efforts in vascular prosthetic design are focused on understanding the characteristics required for function of small internal diameter and low-flow prostheses. The pioneers of vascular surgery developed large diameter textile prostheses for successful reconstruction of the aortoiliac vessels, but fabric grafts function poorly in diameters less than six millimeters. Major advances in small vessel reconstruction include the use of autogenous vessels for coronary artery lesions and microvascular surgery of digital and cerebral vessels. The author believes that future advances in graft design will enable prosthetic repair of two to four millimeter arteries and reconstruction of veins. This manuscript discusses the development of improved synthetic blood compatible surfaces with detailed consideration of prosthetic design factors such as pore size, biomaterial mechanical properties and thrombogenicity of the blood flow surface.
Topics: Biocompatible Materials; Biomechanical Phenomena; Blood Vessel Prosthesis; Humans; Materials Testing; Prosthesis Design; Wound Healing
PubMed: 3285872
DOI: 10.1097/00002480-198804000-00004 -
Orthopaedics & Traumatology, Surgery &... Apr 2022The fixation of posterior wall acetabular fractures often utilizes interfragmentary screws with varying length. Intricate pelvic anatomy and overhanging greater...
BACKGROUND
The fixation of posterior wall acetabular fractures often utilizes interfragmentary screws with varying length. Intricate pelvic anatomy and overhanging greater trochanter make obtaining proper screw trajectory difficult. A large measurement may represent aberrant trajectory and breach of the articular surface. This study aims to identify a preferred maximum screw length that avoids intra-articular penetration.
HYPOTHESIS
We hypothesized that a screw measured 40 millimeters or longer has a high likelihood of being intra-articular.
PATIENTS AND METHODS
A retrospective review included CT scans of 151 consecutive patients collected at a level-1 trauma center was analyzed by two observers. On axial imaging, a straight line was measured at the largest extraarticular portion of the posterior wall simulating ideal screw placement. Another line was measured tangent to the articular surface simulating longest possible extraarticular screw. Measurements were taken at 2-millimeter increments.
RESULTS
The intra-class correlation coefficient between both observers was excellent (0.75-1.00) for most recorded values. The maximum mean length for straight line measured (m=32.18mm, SD=3.74) which was smaller than the mean length for tangent line (m=38.44, SD=4.29). Exploratory multivariate logistic regression analyses demonstrated increased height, age, and acetabular version were associated with larger measurements greater than 40mm (p<0.05).
DISCUSSION
This study demonstrates that most acetabular posterior walls cannot accommodate a 40 millimeter lag screw. If the measured drill hole is greater than this length, then careful reconsideration of the screw trajectory is warranted to ensure the screw is not intra-articular. Older and taller patients may be able to accommodate longer screws.
LEVEL OF EVIDENCE
III.
Topics: Acetabulum; Bone Screws; Fracture Fixation, Internal; Fractures, Bone; Hip Fractures; Humans; Spinal Fractures
PubMed: 35041993
DOI: 10.1016/j.otsr.2022.103202 -
Archives of Pathology & Laboratory... Jan 2022Multiparametric magnetic resonance imaging (mpMRI) of prostate with targeted biopsy has enhanced detection of high-grade prostatic adenocarcinoma (HG PCa). However,...
CONTEXT.—
Multiparametric magnetic resonance imaging (mpMRI) of prostate with targeted biopsy has enhanced detection of high-grade prostatic adenocarcinoma (HG PCa). However, utility of amount of HG PCa (Gleason pattern 4/5) in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse outcomes on radical prostatectomy (RP) is unknown.
OBJECTIVE.—
To examine the utility of amount of HG PCa in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse RP outcomes.
DESIGN.—
We performed a retrospective review of prostate biopsies that had corresponding RP, 1 or more mpMRI-targeted biopsy, and Grade Group 2 disease or higher. For the 169 cases identified, total millimeters of carcinoma and HG PCa and longest length HG PCa in a single core were recorded for 12-core biopsies and each set of mpMRI-targeted biopsies. For RP specimens, Gleason grade, extraprostatic extension, seminal vesicle involvement, and lymph node metastasis were recorded. The main outcome studied was prostate-confined disease at RP. A logistic regression model was used to test which pre-RP variables related to this outcome.
RESULTS.—
Univariate analysis showed significant associations with adverse RP outcomes in 5 of 8 quantifiable variables; longest millimeter HG PCa in a single 12-core biopsy, highest Grade Group in any core, and total millimeter HG in mpMRI-targeted biopsies showed no statistical association (P = .54, P = .13, and P = .55, respectively). In multivariate analysis, total millimeter carcinoma in all cores, highest Grade Group in any core, and longest millimeter HG PCa in a single mpMRI-targeted core provided additional predictive value (P < .001, P = .004, and P = .03, respectively).
CONCLUSIONS.—
Quantitation of HG PCa in mpMRI-targeted biopsies provides additional value over 12-core biopsies alone in predicting nonorgan confined prostate cancer at RP. Linear millimeters of HG PCa in mpMRI-targeted biopsies is a significant parameter associated with higher pathologic stage and could be of value in risk models.
Topics: Adenocarcinoma; Biopsy; Humans; Image-Guided Biopsy; Magnetic Resonance Imaging; Male; Multiparametric Magnetic Resonance Imaging; Neoplasm Grading; Prostatic Neoplasms
PubMed: 34015819
DOI: 10.5858/arpa.2020-0568-OA -
Physical Review. E Mar 2019This Rapid Communication reports on an experimental study of granular craters formed by a mechanism, namely, optical energy, via a pulsed laser focused onto the surface...
This Rapid Communication reports on an experimental study of granular craters formed by a mechanism, namely, optical energy, via a pulsed laser focused onto the surface of a granular bed. This represents an insight into granular cratering for two reasons; first, there is no physical contact between the initiation mechanism and the granular media (as typical for impact or explosion craters). Second, the resulting craters are millimetric in scale, which facilitates a test of energy scalings down to a previously unobserved lengthscale. Indeed, we observe a range of energy scalings conforming to D_{c}∼E^{β} with β≈0.31-0.43 depending on the characteristics of the granular media.
PubMed: 30999424
DOI: 10.1103/PhysRevE.99.030901