Contralateral MRI scan can be used reliably for three-dimensional meniscus sizing — Retrospective analysis of 160 healthy menisci

BackgroundMeniscus allograft transplantation is a valuable surgical option for post-meniscectomy syndrome. For best results, the selected allograft should be as similar as possible to the original meniscus. Three-dimensional meniscus sizing could be a new approach to improve the accuracy of meniscus matching. The contralateral anatomy might therefore be a suitable reconstruction template. The purpose of this study was to compare the three-dimensional shape of the right and left menisci by bi-planar segmentation of magnetic resonance imaging (MRI) scans.MethodsThree-dimensional surface models of healthy menisci were created based on 40 bilateral MRI scans. Manual segmentation was performed on the MRI data in sagittal and coronal planes. For side-to-side comparison, each left meniscus model was mirrored and then superimposed to its corresponding right meniscus model. Differences between the meniscus pairs were assessed by width, length, height and surface distances. Inter-reader reliability, as well as accuracy of bi-planar segmentation was assessed by two different readers.ResultsThe meniscus pairs were not significantly different in terms of width, length and height (P = at least 0.138). Side difference of mean surface distances was 0.76 mm (± 0.13 standard deviation (SD)) for medial and 0.78 mm (± 0.15 SD) for lateral menisci. Inter-reader reliability was good to excellent (0.828–0.987).ConclusionThe three-dimensional shapes of the left and right menisci are very similar. Therefore, the contralateral meniscus can be used as a template for three-dimensional meniscus allograft sizing. Three-dimensional meniscus segmentation and sizing can be performed accurately by combination of sagittal and coronal planes.     

Medizinischer Kinderschutz während des Corona-Lockdowns

Monatsschrift Kinderheilkunde - Es gibt Anhaltspunkte dafür, dass die Gefahr von Kindesmisshandlung, sexuellem Kindesmissbrauch und Vernachlässigung während der strengen...     

Diagnostic profiles in outpatient child psychiatry

Outpatient child psychiatrists appear to be treating a broadening array of complex, highly comorbid, and difficult-to-treat youths. In this study, designed to evaluate the current demographic and diagnostic profile of outpatient child psychiatric patients 1,292 outpatient records from 8 treatment settings were reviewed. Patient age, race, gender, and diagnoses were recorded and analyzed. Externalizing disorders (ADHD and/or behavior disorders) were diagnosed most frequently, followed by internalizing (depressive and anxiety) disorders. Comorbidity was evident in nearly half of all patients, regardless of age. Substance abuse was infrequently reported as a comorbid condition. Externalizing and internalizing pathology frequently co-occurred. Findings reinforce the need for clinician vigilance and thorough assessment of outpatient children and adolescents.     

Evening exposure to blue light stimulates the expression of the clock gene PER2 in humans

We developed a non-invasive method to measure and quantify human circadian PER2 gene expression in oral mucosa samples and show that this gene oscillates in a circadian (= about a day) fashion. We also have the first evidence that induction of human PER2 expression is stimulated by exposing subjects to 2 h of light in the evening. This increase in PER2 expression was statistically significant in comparison to a non-light control condition only after light at 460 nm (blue) but not after light exposure at 550 nm (green). Our results indicate that the non-image-forming visual system is involved in human circadian gene expression. The demonstration of a functional circadian machinery in human buccal samples and its response to light opens the door for investigation of human circadian rhythms at the gene level and their associated disorders.     

Visual pain mapping in endometriosis

Purpose

To construct pain maps in order to describe the distribution of pelvic pain in a group of endometriosis patients and endometriosis-free patients, to assess the feasibility of this method.

Methods

A total of 159 patients with pelvic pain who were scheduled for diagnostic laparoscopy.

Results

A total of 117 patients with and 42 patients without endometriosis were included. The pain distribution between these two patient groups appeared to differ in some peripheral anatomical structures. In the endometriosis patients, the pain was most frequently located in the rectouterine pouch.

Conclusions

In endometriosis patients, pain mapping to assess preoperative pain sensations relative to the anatomic location of endometriotic lesions is feasible. The pain provoked by vaginal examination is frequently perceived as median relative to the actual anatomic location of the endometriotic lesions. Several anatomic and neurophysiological factors may explain this phenomenon.     

Successful Retrieval of an Embolized Vascular Closure Device (Angio-Seal®) After Peripheral Angioplasty

CardioVascular and Interventional Radiology - A 55-year-old male with peripheral arterial disease underwent angioplasty of the right lower limb arteries via antegrade femoral access....     

Low-dose methotrexate treatment in ectopic pregnancy: a retrospective analysis of 164 ectopic pregnancies treated between 2000 and 2008

Purpose

Ectopic pregnancy is an acute, potentially life-threatening condition. The aim of this study was to compare the results of surgery and methotrexate treatment in women with ectopic pregnancy, along with a review of the literature.

Methods

164 women with ectopic pregnancy, treated from 2000 to 2008 at the university gynecology department, were examined in a retrospective analysis. Patients with diagnosed ectopic pregnancy underwent one of the following treatments: Salpingotomy, salpingectomy or administration of a single dose of 30 mg methotrexate. The main outcome measures were treatment success rate, rate of patients wishing to have children after the ectopic pregnancy, and rates of pregnancy, live births, recurrent ectopic pregnancy, miscarriage, use of assisted reproduction and side effects.

Results

There were no significant differences in success rates between the groups (methotrexate 83.9 %, salpingotomy 88.2 %, salpingectomy 96.8 %). Significantly more patients in the salpingotomy group wished to become pregnant afterward than in the salpingectomy group. No significant differences were observed between the groups in the rates of intrauterine pregnancy, live births, recurrences, miscarriages, or side effects.

Conclusions

With defined inclusion criteria, similar results can be achieved with low-dose single administration of 30 mg methotrexate in comparison with surgical treatment for ectopic pregnancy. On the basis of the data presented here, further research to establish optimal dosages for methotrexate is needed.