Diagnosis and management of benign fibro‐osseous lesions of the jaws: a current review for the dental clinician

Benign fibro‐osseous lesions of the maxillofacial skeleton constitute a heterogeneous group of disorders that includes developmental, reactive (dysplastic) and neoplastic lesions. Although their classification has been reviewed multiple times in the past, the most common benign fibro‐osseous lesions are fibrous dysplasia, osseous dysplasia and ossifying fibroma. For the dental clinician, the challenges involve diagnosis and treatment (or lack thereof). A careful correlation of all clinical, radiologic and microscopic features is essential to establish a proper diagnosis and a clear treatment plan. This article aimed to review the clinical, radiologic and histopathologic characteristics of benign fibro‐osseous lesions of the jaws, with emphasis on their differential diagnoses. With a deeper understanding of benign fibro‐osseous lesions, clinicians will be better prepared to manage these lesions in their practice.     

基于血氧水平依赖性的功能磁共振成像联合弥散张量成像技术纵向观察视觉通路病变中皮质功能和白质纤维结构的动态变化

目的：联合应用血氧依赖功能磁共振成像和弥散张量成像技术纵向观察视觉通路病变的皮质功能和白质纤维结构的动态变化,探讨病变后恢复期脑功能和结构重组的特点. 方法：病变组患者为2006-01/09解放军南京军区福州总医院收治,因视觉通路病变致单侧或双侧视觉障碍患者8例,采用美国GE公司Signa Excite HD 1.5T双梯度16通道磁共振成像系统,在病变早期和恢复期分别进行血氧依赖功能磁共振成像和弥散张量成像检查,对比治疗前后双眼刺激下脑激活区的体积以及视放射解剖结构、局部各向异性值,并与对照组12名正常被试比较. 结果：20例受试者均完成测试进入结果分析.①血氧依赖功能磁共振成像结果：正常被试采用黑白棋盘格刺激明显激活双侧枕叶距状回,平均激活皮质体素数为（9.12±2.47）万;病变组患者双眼刺激视皮质激活体积较对照组比较明显减少（P＜0.05）,治疗后复查,刺激的皮质激活像素数增多,激活区扩大.②弥散张量成像三维纤维束重建：对照组双侧视放射均能追踪至皮质下,12例被试视放射平均部分各项异性值为0.39±0.13.病变组中4例视觉通路病变患者视放射显示完整,与对照组间比较无明显差异,治疗前后纵向观察亦无显著变化;4例枕叶视中枢病变患者患侧视放射纤维部分中断、纤细,并可见移位,部分各项异性值均明显下降,治疗后视放射纤维束有一定程度恢复,部分各项异性值增加. 结论：血氧水平依赖功能磁共振成像联合弥散张量成像从皮质功能和纤维解剖方面诠释了病变的发展及康复过程,可帮助了解视觉通路病变后皮质功能区的重组.     

Influence of facial skin attributes on the perceived age of Caucasian women

Background and objective The facial appearance of a person does not always reflect the chronological age; some people look younger or older than they really are. Many studies have described the changes in skin properties (colour, wrinkles, sagging, micro relief, etc.) with age, but few of them have analysed their influence on the perceived age. The primary objective of this study was to assess the contribution of individual skin attributes of the face on the perceived age of Caucasian women. Secondary objectives were to assess the influence of age and gender of graders with regard to the age perception. Subjects and method A random sample of 173 subjects of 20 to 74 years of age was taken from a database of more than 5000 healthy Caucasian women. A trained grader performed visual assessment of facial skin attributes (using a visual analogue scale), and a front face photograph was taken from each subject. Photographs were shown to 48 graders (20 men and 28 women, aged 22–64 years) who were asked to estimate the age of the subjects. Graders were classified as young (less than 35 years), middle age (35–50 years) and seniors (older than 50 years). Partial Least Square regression models were built to predict the chronological and the perceived age from the measured facial individual attributes. The contribution of each attribute within the regression model enabled to measure the relevance of this attribute with regards to age prediction. Results The eye area and the skin colour uniformity were the main attributes related to perceived age. For age prediction, older graders’ estimations were more driven by lips border definition shape and eyes opening, whereas younger graders’ (older than 50 years) estimations were more driven by dark circles, nasolabial fold and brown spots. There were statistically significant differences in graders’ age perception between gender and among age ranges. Our findings suggest that female graders are more accurate than male, and younger graders (under 35 years) are more accurate than older (over 50 years) to predict Caucasian women age from facial photographs. Conclusions Different skin attributes influence the estimation of age. These attributes have a different weight in the evaluation of the perceived age, depending on the age and of the observer. The most important attributes to estimate age are eyes, lips and skin colour uniformity.     

A simplified quantitative cervical mucus penetration test

A simplified quantitative cervical mucus penetration test was developed and applied to the semen of 21 prospective donors in order to evaluate its performance. Analysis of the data using stepwise multiple regression revealed that the concentration of spermatozoa in mucus was related primarily to the concentration of progressive spermatozoa in the semen (63% of variance explained), and secondarily to the average path velocity of spermatozoa in semen (70% of variance explained by a model incorporating both variables). However, consistent with previous studies, the derived indices of penetration efficiency including the percentage successful collisions (PSC), percentage successful entries (PSE) and the motile density ratio (MDR) were not significantly correlated with any of the semen variables examined, although multiple regression did derive models which explained 27-31% of the variance in these three dependent variables. The strong correlation and correspondence between the PSC and the MDR suggests that the latter may provide a simplified index of penetration efficiency for routine clinical use and further research in this area.      

Patient burden and patient preference: Comparing magnetic resonance enteroclysis,capsule endoscopy and balloon‐assisted enteroscopy

Background and Aim: We aimed to prospectively determine patient burden and patient preference for magnetic resonance enteroclysis, capsule endoscopy and balloon‐assisted enteroscopy in patients with suspected or known Crohn's disease (CD) or occult gastrointestinal bleeding (OGIB). Methods: Consecutive consenting patients with CD or OGIB underwent magnetic resonance enteroclysis, capsule endoscopy and balloon‐assisted enteroscopy. Capsule endoscopy was only performed if magnetic resonance enteroclysis showed no high‐grade small bowel stenosis. Patient preference and burden was evaluated by means of standardized questionnaires at five moments in time. Results: From January 2007 until March 2009, 76 patients were included (M/F 31/45; mean age 46.9 years; range 20.0–78.4 years): 38 patients with OGIB and 38 with suspected or known CD. Seventeen patients did not undergo capsule endoscopy because of high‐grade stenosis. Ninety‐five percent (344/363) of the questionnaires were suitable for evaluation. Capsule endoscopy was significantly favored over magnetic resonance enteroclysis and balloon‐assisted enteroscopy with respect to bowel preparation, swallowing of the capsule (compared to insertion of the tube/scope), burden of the entire examination, duration and accordance with the pre‐study information. Capsule endoscopy and magnetic resonance enteroclysis were significantly preferred over balloon‐assisted enteroscopy for clarity of explanation of the examination, and magnetic resonance enteroclysis was significantly preferred over balloon‐assisted enteroscopy for bowel preparation, painfulness and burden of the entire examination. Balloon‐assisted enteroscopy was significantly favored over magnetic resonance enteroclysis for insertion of the scope and procedure duration. Pre‐ and post‐study the order of preference was capsule endoscopy, magnetic resonance enteroclysis and balloon‐assisted enteroscopy. Conclusion: Capsule endoscopy was preferred to magnetic resonance enteroclysis and balloon‐assisted enteroscopy; it also had the lowest burden. Magnetic resonance enteroclysis was preferred over balloon‐assisted enteroscopy for clarity of explanation of the examination, bowel preparation, painfulness and burden of the entire examination, and balloon‐assisted enteroscopy over magnetic resonance enteroclysis for scope insertion and study duration.