Stafne bone defects radiographic features in panoramic radiographs : assessment of 91 cases

To evaluate 91 cases of Stafne bone defect (SBD) in panoramic radiographs (PR) to determine the prevalence of different SBD variants, considering age, gender, and side. Additionally, to assess the most frequent imaging features of SBD. Participant data were collected from 91 SBD cases with PR imaging. First, SBDs were classified according to their location, as anterior, posterior, or ramus variant. SBD imaging features were classified according to radiographic imaging findings, assessing margins, degree of internal radiolucency, shape, topographic relationship between the defect and mandibular border, location of the defect according to mandibular teeth, and locularity. The topographic relationship between the SBD and the mandibular canal was described for the inferior variant only. Mean sizes were also described. A total of 92 SBD cases were evaluated from 91 radiographs. One case presented multiple defects. Mean patient age was 60.80 years. Men were more affected than women. The most frequent SBD variant was the posterior variant, and the least frequent was the ramus variant. The most observed radiographic features were thick sclerotic bone margin in the entire contour of the defect, partially radiolucent internal content, oval shape, continuity with mandible base without discontinuity of mandible border, third molar region location, and unilocular shape. With the posterior variant only, the most common topographic relationship between the defect and the upper wall of the mandibular canal was the defect located below the upper wall and continuous with the inferior wall of the mandibular canal. The knowledge of common SBD radiographic imaging features in PR can help dental practitioners with the differential diagnosis of SBD

Palatal bone defect mimicking a chronic periapical lesion: a case report emphasizing the importance of the use of a three-dimensional radiographic examination

Lesão periapical crônica é uma das patologias ósseas mais comuns em dentes humanos, e é detectada primariamente por radiografia simples, como a panorâmica ou periapical. Radiografias simples são amplamente utilizadas em odontologia; no entanto, elas são limitadas por questões inerentes à técnica em si, tais como a sobreposição de estruturas anatômicas e a falta de informação sobre a extensão da lesão. Portanto, métodos radiográficos tridimensionais, como a tomografia computadorizada de feixe cônico, são valiosos para avaliar com precisão as lesões periapicais. Dessa forma, este relato clínico descreve um caso em que as características radiográficas de osso levaram a um diagnóstico primário de lesão periapical crônica nos incisivos superiores, no entanto, era um defeito palatino. A radiolucência resultante foi causada pelo defeito palatino sobreposto ao osso maxilar, imitando, assim, uma lesão periapical. Além disso, no mesmo caso, demonstramos uma lesão periapical crônica verdadeira em outra área. Essa lesão apareceu como uma radiolucência sutil na radiografia periapical, mas foi maior que o esperado quando avaliada por tomografia computadorizada de feixe cônico.Chronic periapical lesion is among the most usual bone pathology observed in human teeth, and it is often first detected by plain radiographs, such as panoramic or periapical radiography. Plain radiographs are widely used in dentistry; however, they have limitations inherent to the technique itself, such as anatomic structures overlapping and lack of information on the extension of the lesion. Therefore, three-dimensional radiographic methods, such as cone beam computed tomography are valuable to accurately assess periapical lesions. Thus, this clinical report describes a case in which the bone radiographic features led to a primary diagnosis of chronic periapical lesion in superior incisors, however, it was a defect in the palatal bone. The resulting radiolucency created by the palatal bone defect overlapped the maxillary bone, mimicking a periapical lesion. Additionally, in the same case, we demonstrate a true chronic periapical lesion in another area that presented as a subtle radiolucency in periapical radiography, however, it was larger than expected when evaluated in Cone Beam Computed Tomography

Relationship between stylohyoid ligament calcification and systemic osteoporosis by CBCT and panoramic radiography

The purpose of this study was to use panoramic radiography and cone beam computed tomography images to investigate (1) the accuracy of these methods concerning osteopenia and osteoporosis diagnosis, and (2) the correlation between presence of stylohyoid ligament calcification and osteopenia and osteoporosis. A hundred seventy-one images from digital archive were enrolled in this study. All panoramic radiography and cone beam computed tomography images were obtained using the Veraviewepocs 3D system and observed at i-VIEW-3DX software. For osteopenia and osteoporosis diagnosis, the mandibular cortex was assessed.  Presence of stylohyoid ligament calcification was also assessed and mineralization in all parts of the stylohyoid complex was considered. All recorded data were referred to statistical analysis and the significance level was set at 5%. There is an agreement between the imaging modalities for osteopenia and osteoporosis diagnosis, since the rate of disagreement is 21.6%. The results confirmed the osteoporosis diagnosis in elderly women and the correlation between osteopenia and osteoporosis diagnosis and the presence of stylohyoid ligament calcification (p 0.06). The present study suggests that (1) panoramic radiography and computed tomography images are accurate enough for osteopenia and osteoporosis diagnosis with low disagreement rate between methods and (2) there is a significant correlation between presence of stylohyoid ligament calcification and osteopenia and osteoporosis diagnosis in elderly women

Evaluation of basilar expansion and internal septa of human sphenoidal sinus using cone beam computed tomography

The objective of this study was to assess the types and frequencies of basilar expansion of the sphenoidal sinus and internal septa by using cone beam computed tomography. Archived images from 300 adult subjects of both genders were retrieved. A descriptive analysis relating age and gender to basilar expansion of the sphenoidal sinus and internal septa types and frequencies was performed. The associations between basilar expansion of the sphenoidal sinus, internal septa and gender for each age group were assessed using the chi-square test or Fisher’s exact test. Among all the images evaluated, 69% showed basilar expansion of the sphenoidal sinus, of which 81% were considered critical. Internal septa were observed in 60% of the images. There was no relationship between the presence of basilar expansion of the sphenoidal sinus and gender and age. Internal septa were independent of gender; however, of the subjects older than age 40, 36% had only a main septum, 6% had accessory septa, and 18% had both types of septa. Cone beam computed tomography is an accurate method that should be considered for the evaluation of this anatomic segment in order to avoid unnecessary exposure to radiation.O objetivo deste estudo foi avaliar os tipos e as frequências de expansão basilar do seio esfenoidal e septos internos utilizando tomografia computadorizada de feixe cônico. Imagens arquivadas de 300 indivíduos adultos de ambos os gêneros foram recuperadas. Foi realizada uma análise descritiva relacionando idade e gênero à expansão basilar do seio esfenoidal e a tipos de septos internos e frequências. As associações entre expansão basilar do seio esfenoidal, septos internos e gênero para cada grupo de idade foram avaliadas por meio do teste do qui-quadrado ou teste exato de Fisher. Entre todas as imagens avaliadas, 69% apresentaram expansão basilar do seio esfenoidal, das quais 81% foram consideradas críticas. Septos internos foram observados em 60% das imagens. Não houve relação entre presença de expansão basilar do seio esfenoidal, gênero e idade. Septos internos apresentaram-se independentes do gênero; no entanto, dentre os indivíduos com mais de 40 anos de idade, 36% tinham apenas um septo principal, 6% tinham septos acessórios, e 18% tinham ambos os tipos de septos. A tomografia computadorizada é um método preciso que deve ser considerado para a avaliação desse segmento anatômico a fi m de evitar a exposição desnecessária à radiação

A validation of abstracted dive profiles relayed via the Argos satellite system: a case study of a loggerhead turtle

Satellite telemetry devices can record movement data of animals along with the environmental data. Such data are relayed remotely via satellite systems, but are constrained by the limited bandwidth availability. A satellite relay data logger (SRDL) that can abstract dive profiles and compress the data for transmission using a broken stick model (BSM) has been widely used in studies on dive behavior and physiology of marine animals. However, there is still uncertainty in the abstracted dive profiles. Here, we aimed to evaluate the certainty of abstracted dive profiles (via satellite communication) in terms of dive performance (dive depth, duration, and dive type) by comparing it with the actual dive data (from the retrieved tag) in a loggerhead turtle deployed with the SRDL throughout a 1.4-year foraging period. There was no significant difference in the maximum dive depth between the retrieved and satellite transmission data; however, there was a slight but significant difference in the dive duration. The dives from both datasets were classified into five types. Inconsistent dive classifications occurred in 1.7% of the data. There was no significant difference in the proportion of time spent diving between the retrieved and satellite transmission data for each type during the common recording period. In monthly scale comparisons, however, a significant difference was detected when the amount of data via satellite transmission was the smallest. Our results demonstrated that the dive data abstracted using BSM almost reconstructed the actual dive profiles with certainty in a loggerhead turtle, although slight inconsistencies were observed

Comparative genomics of Fructobacillus spp. and Leuconostoc spp. reveals niche-specific evolution of Fructobacillus spp.

Background: Fructobacillus spp. in fructose-rich niches belong to the family Leuconostocaceae. They were originally classified as Leuconostoc spp., but were later grouped into a novel genus, Fructobacillus, based on their phylogenetic position, morphology and specific biochemical characteristics. The unique characters, so called fructophilic characteristics, had not been reported in the group of lactic acid bacteria, suggesting unique evolution at the genome level. Here we studied four draft genome sequences of Fructobacillus spp. and compared their metabolic properties against those of Leuconostoc spp.Results: Fructobacillus species possess significantly less protein coding sequences in their small genomes. The number of genes was significantly smaller in carbohydrate transport and metabolism. Several other metabolic pathways, including TCA cycle, ubiquinone and other terpenoid-quinone biosynthesis and phosphotransferase systems, were characterized as discriminative pathways between the two genera. The adhE gene for bifunctional acetaldehyde/alcohol dehydrogenase, and genes for subunits of the pyruvate dehydrogenase complex were absent in Fructobacillus spp. The two genera also show different levels of GC contents, which are mainly due to the different GC contents at the third codon position.Conclusion: The present genome characteristics in Fructobacillus spp. suggest reductive evolution that took place to adapt to specific niches

A Multicenter Phase 2 Trial Evaluating the Efficacy and Safety of Preoperative Lenvatinib Therapy for Patients with Advanced Hepatocellular Carcinoma (LENS-HCC Trial)

Introduction: The phase III REFLECT trial demonstrated that lenvatinib was superior to sorafenib in terms of progression-free survival (PFS), time to progression, and objective response rate (ORR) for patients with unresectable hepatocellular carcinoma (HCC). This study assessed the efficacy and safety of preoperative lenvatinib therapy for patients with oncologically or technically unresectable HCC. Methods: In this multicenter single-arm phase II trial, patients with advanced HCC and factors suggestive of a poor prognosis (macroscopic vascular invasion, extrahepatic metastasis, or multinodular tumors) were enrolled. Patients with these factors, even with technically resectable HCC, were defined as oncologically unresectable because of the expected poor prognosis after surgery. After 8 weeks of lenvatinib therapy, the patients were assessed for resectability, and tumor resection was performed if the tumor was considered technically resectable. The primary endpoint was the surgical resection rate. The secondary endpoints were the macroscopic curative resection rate, overall survival (OS), ORR, PFS, and the change in the indocyanine green retention rate at 15 min as measured before and after lenvatinib therapy. The trial was registered with the Japan Registry of Clinical Trials (s031190057). Results: Between July 2019 and January 2021, 49 patients (42 oncologically unresectable patients and 7 technically unresectable patients) from 11 centers were enrolled. The ORR was 37.5% based on mRECIST and 12.5% based on RECIST version 1.1. Thirty-three patients underwent surgery (surgical resection rate: 67.3%) without perioperative mortality. The surgical resection rate was 76.2% for oncologically unresectable patients and 14.3% for technically unresectable patients. The 1-year OS rate and median PFS were 75.9% and 7.2 months, respectively, with a median follow-up period of 9.3 months. Conclusions: The relatively high surgical resection rate seen in this study suggests the safety and feasibility of lenvatinib therapy followed by surgical resection for patients with oncologically or technically unresectable HCC

Latitudinal cline in the foraging dichotomy of loggerhead sea turtles reveals the importance of East China Sea for priority conservation

Special Issue: Biological traits, geographic distributions and species conservation in aquatic ecosystems[Aim]Quantifying the importance of habitat areas for conservation of highly migratory marine species with complex life histories can be challenging. For example loggerhead turtles (Caretta caretta) nesting in Japan forage both oceanically and neritically after their reproductive period. Here, we aimed to quantify the proportions of turtles using these two contrasting habitats (foraging dichotomy) to suggest priority conservation areas. [Location]North Pacific Ocean. [Methods]We examined the occurrence of foraging dichotomy at three nesting sites (Ishigaki, Okinoerabu Islands and Ichinomiya) based on stable isotope analysis of the egg yolks for 82 turtles and satellite tracking of post-nesting migration for 12 turtles. Moreover, we used the data of three other sites from previous studies (Yakushima Island, Minabe and Omaezaki). [Results]Two neritic foraging grounds (East China Sea and the coastal area of the Japanese archipelago), and an oceanic ground (North Pacific Ocean) were identified. We found a latitudinal cline with respect to the occurrence of foraging dichotomy; >84% of the females nesting at southern sites (Ishigaki and Okinoerabu Islands), 73% at middle sites (Yakushima Island and Minabe) and <46% at northern sites (Omaezaki and Ichinomiya) were neritic foragers; the proportion of oceanic foragers increased at northern sites. Based on the annual number of nests in the entire nesting region of Japan, satellite tracking and the latitudinal cline of foraging dichotomy, we estimated that 70% and 9% of annual nesting females in Japan utilize the neritic foraging habitat in the East China Sea and the coastal area of the Japanese archipelago, respectively, and that and 22% utilize the oceanic habitat of the North Pacific Ocean. [Main conclusions]The East China Sea represents a critical foraging habitat for the North Pacific populations of endangered loggerhead sea turtles. Our findings emphasize the need for international management to ensure their protection

Clinical utility of circulating cell-free Epstein–Barr virus DNA in patients with gastric cancer

Recent comprehensive molecular subtyping of gastric cancer (GC) identified Epstein–Barr virus (EBV)-positive tumors as a subtype with distinct salient molecular and clinical features. In this study, we aimed to determine the potential utility of circulating cell-free EBV DNA as a biomarker for the detection and/or monitoring of therapeutic response in patients with EBV-associated gastric carcinoma (EBVaGC). The EBV genes-to-ribonuclease P RNA component H1 ratios (EBV ratios) in the GC tumors and plasma samples were determined by quantitative real-time polymerase chain reaction in 153 patients with GC, including 14 patients with EBVaGC diagnosed by the conventional method. Circulating cell-free EBV DNA was detected in 14 patients with GC: the sensitivity and specificity of detection were 71.4% (10/14) and 97.1% (135/139), respectively. Plasma EBV ratios were significantly correlated with the size of EBVaGC tumors, and the plasma EBV DNA detected before surgery in EBVaGC cases disappeared after surgery. Patients with EBVaGC may have a better prognosis, but circulating cell-free EBV DNA had no or little impact on prognosis. In addition, repeated assessment of the plasma EBV ratio in EBVaGC showed a decrease and increase in plasma EBV DNA after treatment and during tumor progression/ recurrence, respectively. These results suggest the potential utility of circulating cell-free DNA to reveal EBV DNA for the identification of the EBVaGC subtype and/ or for real-time monitoring of tumor progression as well as treatment response in patients with EBVaGC

Transient loss of consciousness immediately after total pancreatectomy for pancreatic metastases from renal cell carcinoma: a case report

Abstract Background Total pancreatectomy (TP) is often selected for treatment of various pancreatic diseases. However, the resultant lack of autoregulation of glycometabolism necessitates careful postoperative management. Case presentation A 77-year-old man who had undergone right nephrectomy for renal cell carcinoma 11 years previously presented with multiple histologically diagnosed pancreatic metastases. The patient had no notable comorbidities, including diabetes. Because no extrapancreatic organ metastasis was identified, he underwent TP as a curative treatment. He awoke from anesthesia and was extubated without any problems in the operating room. However, 15 min after entering the intensive care unit, he suddenly lost consciousness and became apneic, resulting in reintubation. Blood gas analysis revealed an increased glucose concentration (302 mg/dL) and mixed acid–base disorder (pH of 7.21) due to insulin insufficiency and fentanyl administration. After induction of continuous intravenous insulin infusion and termination of fentanyl, the glucose concentration and pH gradually improved. He regained clear consciousness and spontaneous ventilation and was extubated the next day with no difficulties or complications. Conclusion This case highlights the importance of active monitoring of the glycemic state and pH after TP because of the possibility of deterioration due to TP itself as well as the lingering effects of anesthesia