Focal liver lesions: whether a standard dose (0.05 mmol/kg) gadobenate dimeglumine can provide the same diagnostic data as the 0.1 mmol/kg dose

Objective

Gadobenate dimeglumine (Gd-BOPTA) is a liver-specific contrast agent also showing a distribution in the extracellular compartment which is recommended to be used at standard dose (0.05 mmol/kg) in magnetic resonance imaging (MRI) of liver lesions. However, its use at 0.1 mmol/kg is gradually increasing in recent clinical practice. Which dose should we use in routine MRI of liver lesions from now on? This study investigated the efficacy of Gd-BOPTA at a standard dose versus 0.1 mmol/kg dose in demonstrating diagnostic data in MRI of focal liver lesions.

Materials and methods

The study included 47 patients with focal liver lesions. Twenty-two patients received standard dose and 25 patients received 0.1 mmol/kg dose Gd-BOPTA intravenously. MRI of both groups was carried out with T1-A FLASH-2D and T2-A TURBO spin echo before contrast injection and T1-A FLASH-2D sequences in dynamic and late phase (90th minute) after the contrast injection. The lesion conspicuity for each image was evaluated qualitatively. Liver signal to noise ratio (SNR), absolute lesion-liver contrast to noise ratio (CNR), mean lesion-liver CNR and contrast enhancement rate of the liver obtained from both groups were compared quantitatively.

Results

While liver contrast enhancement rate in the group receiving standard dose Gd-BOPTA were 41% ± 42 in the arterial phase, 66% ± 58 in the portal phase, 45% ± 45 in the venous phase and 42% ± 88 in the late phase, these values were 43% ± 59, 86% ± 73, 63% ± 75 and 61% ± 105, respectively, in the group receiving the dose of 0.1 mmol/kg. There were no statistically significant differences between the means of both groups. While the absolute lesion-liver CNR values were 18 ± 15 precontrast, 22 ± 18 in the arterial phase, 19 ± 17 in the portal phase, 15 ± 10 in the venous phase and 24 ± 26 in the late phase in the group receiving the standard dose Gd-BOPTA, these values were 13 ± 11, 18 ± 15, 15 ± 15, 13 ± 13 and 19 ± 21, respectively, in the group receiving the 0.1 mmol/kg dose. There were no statistically significant differences between the means of both groups (p > 0.05). However, when the mean lesion-liver CNR values were compared, there was statistically significant difference between each arterial and portal phases of metastases in both groups (p < 0.05). There was no statistical difference found in other lesions. When lesion conspicuity scores were compared, there were no significant differences between the two groups.

Conclusion

In liver lesions, similar diagnostic data are obtained in dynamic and late phase MRI with either standard dose Gd-BOPTA or with a dose of 0.1 mmol/kg. Because there was a difference in only metastases in both groups, in oncological patients who are being investigated for liver metastasis, it is expedient to use a dose of 0.1 mmol/kg.     

Efficacy of Oral Fluconazole in the Treatment of Seborrheic Dermatitis

Background: Seborrheic dermatitis (SD) is a common, chronic dermatosis. Although the pathogenetic mechanisms of SD are not clear, Malassezia spp. yeasts are known to cause the disease. Previous studies have shown that topical and systemic antifungals provide clinical benefit. Objective: To evaluate the safety and efficacy of short-term oral fluconazole in patients with SD. Methods: Sixty-three patients with mild-to-moderate SD were randomly allocated to receive either oral fluconazole 300mg in a single dose per week or placebo, for 2 weeks. Twenty-seven patients taking fluconazole and 23 patients taking placebo completed the study and were analyzed. The SD area severity index (SDASI) score and the patient’s subjective assessment of pruritus and burning sensation were evaluated before and after treatment. Both the investigator and the patients were blinded to treatment. Results: A statistically significant improvement in SDASI score after treatment compared with baseline was obtained with fluconazole (p = 0.01) but not with placebo. However, the difference between the treatment groups was not statistically significant (p > 0.05). Subjective improvements in symptoms, such as pruritus and burning sensation, were observed in both groups but no statistically significant differences versus baseline were seen. Conclusion: The results of this study indicate that fluconazole provides marginal and statistically insignificant benefit for the therapy of SD. However, larger studies using different dosages and/or durations of fluconazole therapy may provide a rationale for systemic use of fluconazole in SD.     

Systemic and local antibiotic prophylaxis in the prevention of <Emphasis Type="Italic">Staphylococcus epidermidis</Emphasis>graft infection

Background  

The aim of the study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of Staphylococcus (S.) epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials.     

Assessment of the Effects of Curacel and Bone Wax on the Acute Oroantral Opening Site by means of Computer Tomography and Histopathology

Purpose

In this study, the effects of Curacel TM oxidized regenerated cellulose and bone wax on the healing bone were compared to each other by means of CT based bone density measurement and histopathological evaluation.

Methods

The bone density measurements of the control group were significantly higher than those of both Curacel and bone wax groups.

Results

There was no significant difference between Curacel and bone wax. Histopathologically, the bone wax group showed more osteoblastic activation than Curacel group. For all measurement parameters (osteoblastic activation, osteoclastic activation, fibrous connective tissue, osseous trabeculae), Curacel and bone wax groups had worse results than control group. It is concluded that Curacel has no superiority over bone wax in terms of osseous healing in the oroantral region. There is no need to use oxidized regenerated cellulose or bone wax for small oroantral openings since the healing is better without any intervention. In addition, bone density measurement and histopathological evaluation were consistent in terms of osseous healing of the oroantral opening.     

Caries experience and oral hygiene status of a group of visually impaired children in istanbul, Turkey

Purpose: To evaluate the caries experience, oral hygiene status and oral health knowledge of a group of visually impaired students. Materials and Methods: The study was conducted at one of the largest visually impaired children's schools among students aged between 7 and 16 years (n = 178) in Istanbul, Turkey. A 16-item questionnaire was asked in addition to a clinical tooth examination. The 16-item verbal questionnaire was developed to record the students' general health, impairment, the socioeconomic profile and education level of their parents, oral health knowledge, sources of information about oral health and oral hygiene habits. Oral hygiene was assessed according to Greene and Vermillion's Simplified Oral Hygiene Index (OHI-S). To measure the oral hygiene status, OHI-S index scores were recorded. Additionally, DMFT and dft indices were documented. Results: Only 26.40% of children were caries free, and only 2.2% of students had good oral hygiene. A total of 3.3% of these students were mildly retarded and 2.8% of them had a developmental disability. Visually impaired children exhibited a fair-to-poor level of oral hygiene. Conclusion: Maintenance of oral hygiene remains the greatest challenge in the care of visually impaired children.