Computed tomographic analysis of internal structures within the nasal cavities of green,loggerhead and leatherback sea turtles

The morphology of the tetrapod nasal cavity has adapted to the environment in terms of olfaction and respiration. Reports indicate that the internal structure of the nasal cavity of green sea turtles is more complex than that of turtles in general, but whether or not it is similar among sea turtle species remains unknown. The present study aimed to define the internal structures of the nasal cavity of green (Chelonian mydas), loggerhead (Caretta caretta) and leatherback (Dermochelys coriacea) sea turtles using computed tomography. The nasal cavity of green and loggerhead sea turtles contained anterodorsal, anteroventral, posterodorsal diverticula and a posteroventral excavation in the middle. In contrast, the nasal cavity of leatherback sea turtles had more complicated dorsal region comprising anterodorsal and posterodorsal diverticula, and two excavations between the nostril and anterodorsal diverticulum, but no distinct structures at the ventral region. The airway in the nasal cavity was shorter and thicker in the leatherback, than in the green and loggerhead turtles. These species differences might reflect ecological variety and different evolutionary strategies.     

鼻中隔偏曲与鼻窦炎关系的CT影像学研究

目的本文应用鼻窦冠状位CT对鼻中隔偏曲进行观察,并探讨其与鼻窦炎的关系。方法分析754例患者的CT片,从中分出正常组与鼻窦炎组。统计这两组中鼻中隔偏曲的发生率,并分析其与鼻窦炎的关系。再进一步统计分析高位偏曲和低位偏曲的发生率及其与鼻窦炎的关系。结果鼻中隔偏曲的发生率在两组间分布差异无显著性(x2=1.86,P0.05),但鼻窦炎组中鼻中隔高位偏曲的发生率明显高于正常组(x2=5.06,P0.05)。对于鼻中隔高位偏曲,无论是同侧还是对侧窦口鼻道复合体区域的解剖变异的发生率在两组间的分布均有显著性差异(P0.05)。结论鼻中隔高位偏曲可引起窦口鼻道复合体区的解剖异常,与鼻窦炎的发生相关。     

Combined immunohistochemistry for the differential diagnosis of cystic jaw lesions: its practical use in surgical pathology

Tsuneki M, Yamazaki M, Cheng J, Maruyama S, Kobayashi T & Saku T
(2010) Histopathology 57, 806–813 Combined immunohistochemistry for the differential diagnosis of cystic jaw lesions: its practical use in surgical pathology Aims: Histopathological distinction of cystic jaw lesions, including odontogenic tumours, is challenging because their lining epithelia, which are basically stratified squamous epithelia, resemble each other, especially when they become hyperplastic from inflammatory reaction. The aim of this study was to seek practical measures to differentiate such lesions. Methods and results: Nineteen surgical specimens from unicystic ameloblastomas (UAs), 17 from keratocystic odontogenic tumours (KCOTs), 13 from dentigerous cysts (DCs), 10 from lateral periodontal cysts (LPCs) and 20 from radicular cysts (RCs), all of which contained both typical flat and rete‐peg‐shaped lining epithelia, were examined for their immunohistochemical profiles. Among them, keratin (K) 10, K17, perlecan, proliferating cell nuclear antigen (PCNA) and UEA‐I lectin binding (UEA) were selected as useful immunohistochemical markers for their differential diagnosis. K10 was positive (+) in KCOT and DC. K17 was not present in RC. Perlecan was found in UA, KCOT and LPC. PCNA+ cells were found frequently in UA and KCOT. These localization patterns were constant even when linings were not flat. Conclusions: Using a combination of six kinds of immunohistochemical pattern, it is now possible to discriminate reliably and objectively these five cystic jaw lesions in routine practice.     

Iatrogenic pathology, its role in the structure of patient morbidity and thanatogenesis

Iatrogenic diseases which were an immediate cause of death or played an important role in thanatogenesis were found in 319 (14.2%) of 2250 autopsy cases of patients with surgical, therapeutical and neurosurgical pathology. Surgical iatrogenesis was established in 226 (70.8%), and therapeutical one in 59 (18.5%) cases. Revealing a neurosurgical iatrogenesis (10.7%) represented considerable difficulties. The pathologists, in the authors opinion, do not pay a sufficient attention to establishing iatrogenic pathology in spite of its constant increase during last years and the fact it occupies a considerable percentage in the morbidity structure and thanatogenesis. The necessity to respect the instructions of the ICD-9th concerning "second diseases" is outlined. The pathologists together with clinicians should try to clarify the causes of iatrogenic diseases and their true incidence.     

Time trade-off utility analysis for surgical intervention in comitant strabismus, glaucoma, and cataract

The utility value was compared among 3 surgical interventions, and the validity of the time trade-off (TTO) method was evaluated by analyzing the correlations of the utility value with the results of the Visual Function Questionnaire-14 (VF-14) and other variables. The subjects were 127 patients aged 40-85 years who were surgically treated between January 2008 and March 2010, including 26 patients with glaucoma, 50 with cataracts, and 51 with comitant strabismus. The scores on VF-14 and utility values determined using TTO were calculated retrospectively. The mean value (SD) of the utility gain was 0.096 (0.105) for glaucoma, 0.101 (0.105) for comitant strabismus, and 0.167 (0.237) for unilateral and 0.245 (0.167) for bilateral cataracts, indicating significant postoperative improvements in the utility value. A significant correlation was observed between the utility value and the postoperative VF-14 scores of the bilateral cataracts, and the postoperative visual acuity of the better eye of the unilateral cataract. The mean value of the quality-adjusted life years was 2.181 for bilateral and 1.424 for unilateral cataracts, 1.132 for strabismus, and 0.870 for glaucoma with an annual discount rate of 3%. The gain of utility value was highest in bilateral cataracts, and lowest in glaucoma, and thus the TTO analysis was considered to be highly valid for cataract surgery.     

Statistical analysis of surgical pathology data using the R program

An understanding of statistics is essential for analysis of many types of data including data sets typically reported in surgical pathology research papers. Fortunately, a relatively small number of statistical tests apply to data relevant to surgical pathologists. An understanding of when to apply these tests would greatly benefit surgical pathologists who read and/or write papers. In this review, we show how the publicly available statistical program R can be used to analyze recently published surgical pathology papers to replicate the p-values and survival curves presented in these papers. Areas covered include: T-test, chi-square and Fisher exact tests of proportionality, Kaplan-Meier survival curves, the log rank test, and Cox proportional hazards.     

Computed tomographic angiography of the superior sagittal sinus and bridging veins

Purpose  

The primary aim of our paper was to describe typical anatomical patterns of the superior sagittal sinus (SSS) and bridging veins (BV) using cerebral venous computed tomographic angiography (CTA) with a focus on the direction of the BV entering the SSS.     

Computed tomographic study of the posterior condylar angle in arthritic knees: its use in the rotational positioning of the femoral implant of total knee prostheses

The epicondylar axis is a reliable reference to check the rotation of the femoral implant in total knee prostheses (TKPs). However, during the operation it seems easier to use the posterior condylar axis as a landmark. The angle between these two axes is called the posterior condylar angle (PCA). The aim of this study was to measure the PCA in arthritic knees to assess the reliability of the posterior condylar axis as a reference for the control of the rotation of the femoral implant and to look for correlation with other radiological measurements. This prospective study consisted of 103 arthritic knees (81 varus, 22 valgus) before a TKP had been done in 103 patients (75 women, 28 men). The assessment of the PCA was made by computed tomographic scanning (CT). The HKA, HKS and HKT angles were measured on the pangonogram. The posterior condylar axis was internally rotated with respect to the epicondylar axis. The average value for all the patients was 2.65° degrees with a range from 0° to 7°. The PCA was significantly increased in the valgus knees. There was no correlation between the angles on the pangonogram and the posterior condylar axis. While the preoperative assessment of the PCA by CT scanning is reliable, the results obtained indicate the marked variability in its value. If one wishes to use the posterior condylar axis as a guide for rotation, it is therefore necessary to assess the PCA for each patient using adjustable jigs according to the value obtained. No measurement on standard radiographs allowed an extrapolation of the value of the PCA, and CT scanning seems to be the preferable radiological examination.

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Electronic Supplementary Material The french version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at

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Etude tomodensitométrique de l'angle condylien postérieur dans les genoux arthrosiques. Intérêt dans le positionnement en rotation de l'implant fémoral dans les prothèses totales de genou

Résumé L'axe épicondylien est une référence fiable pour le contrôle de la rotation de l'implant fémoral dans les prothèses totales de genou (PTG). Mais, lors de l'intervention, il semble plus facile d'utiliser l'axe condylien postérieur comme repère. L'angle entre ses deux axes est appelé angle condylien postérieur (ACP). Le but de cette étude était de mesurer l'ACP dans les genoux arthrosiques, d'évaluer la fiabilité de l'axe condylien postérieur comme référence pour le réglage de la rotation de l'implant fémoral, de rechercher une corrélation avec d'autres mesures radiologiques. Une étude prospective comportant 103 genoux arthrosiques (81 varus et 22 valgus), avant PTG a été effectuée, chez 103 patients (75 femmes et 28 hommes). L'évaluation de l'ACP a été faite par examen tomodensitométrique (TDM). Les angles HKA, HKS et HKT ont été mesurés sur le pangonogramme. L'axe condylien postérieur était en rotation interne par rapport à l'axe épicondylien. La valeur moyenne pour tous les patients était de 2.65°, avec des valeurs de 0 à 7°. La valeur de l'angle CP augmentait avec une différence significative dans le groupe des genu valgum. Il n'y avait pas de corrélation entre les angles du pangonogramme et l'ACP. Si l'évaluation pré-opératoire de l'ACP par TDM est fiable, les résultats obtenus mettent en évidence une variabilité importante de sa valeur. Il faut donc, si l'on veut utiliser l'axe condylien postérieur comme repère de rotation, évaluer pour chaque patient l'ACP, et utiliser un ancillaire réglable reportant la valeur obtenue. Aucune mesure sur des radiographies standard ne permettant d'extrapoler la valeur de l'ACP, la TDM semble l'examen radiologique de choix.

     

Internalizing disorders and substance use disorders in youth: Comorbidity, risk, temporal order, and implications for intervention

This review examines the empirical literature on the relationship between internalizing disorders and substance use disorders (SUDs) in youth in terms of (a) comorbidity rates, (b) risk relationships, (c) temporal sequencing, and (d) implications for intervention. Findings from community and clinical samples suggest that comorbidity rates range from 9.0 to 47.9%. The majority of the evidence supports the temporal precedence of internalizing disorders before substance use disorders and a unidirectional risk model in which internalizing disorders increase risk for later substance use disorders. Implications of this relationship for interventions are considered, both in terms of treatment outcome for principal disorders and in terms of the potential “secondary benefit” of treating one disorder for preventing or reducing risk of the other. Finally, recommendations for future research on the relationship between internalizing disorders and SUDs in youth are discussed.     

A rapid method of staining ultrathin sections for surgical pathology TEM with the use of the microwave oven

A rapid microwave method is described for staining ultrathin sections for surgical pathology transmission electron microscopy (TEM). Three sets of Epon sections of human heart biopsy were mounted on unsupported 200-mesh Rhodium-coated copper grids and were stained with uranyl acetate (UA) and lead citrate. The first set of grids was stained for 15 seconds in each solution with the aid of a microwave oven, and the second set was stained routinely for 30 minutes in UA and 10 minutes in lead citrate at room temperature. The third control set was stained for 15 seconds in each solution without microwave bombardment. The overall image quality of the TEM micrographs generated by the "quick-stained" microwave enhanced sections was better than routine stained and control sections. The microwave-treated sections have more contrast, less artifacts in the form of precipitate, and a more uniform overall staining.     

喉上神经襻的新亚型及其临床应用

目的:研究喉上神经襻的分型,为预防颈部手术中喉上神经外支的损伤提供解剖学基础.方法:随机集用成年尸体50具(计100侧),解剖出喉上神经及其分支喉外支和喉内支,显露迷走神经干和颈交感神经链,观察喉上神经襻的组合形式.结果:除2侧外,98侧颈交感神经链与喉上神经及其分支相吻合,形成襻.根据襻的不同形态,将其分为en、tn、in、tnen、inen 5种类型,其出现率分别为82％、9％、3％、2％和2％.本实验显示了18种喉上神经襻的新亚型.结论:颈交感神经链与喉上神经及其分支之间普遍存在交通,86％颈交感神经链与喉上神经外支之间存在交通者;喉上神经外支呈襻状,而非干式;甲状腺手术尽可能接近甲状腺囊单根结扎甲状腺血管,以避免喉上神经襻和/或外支的损伤.     

原发性食管腺癌外科治疗与病理分析

目的了解原发性食管癌的生物学特性，探讨合理的综合治疗措施。方法对15例原发性食管腺癌者行手术切除并作病理分析。结果其中食管单纯腺癌12例，腺鳞癌3例，1、3、5年生存率分别为73．3％、63．5％、57．1％。结论因食管腺癌粘膜下浸润能力强，恶性程度高，有早期扩散和转移倾向，预后差，手术是其首选的主要治疗手段，以胸段食管全切、食管胃端侧颈部吻合术为宜，同时应最大限度地清除区域淋巴结。