Management Algorithm for Osseous Metastatic Disease: What the Treatment Teams Want to Know

Radiologists play a primary role in identifying, characterizing, and classifying spinal metastases and can play a lifesaving role in the care of these patients by triaging those with instability to urgent spine surgery consultation. For this reason, an understanding of current treatment algorithms and principles of spinal stability in patients with cancer is vital for all who interpret spine studies. In addition, advances in imaging allow radiologists to provide more accurate diagnoses and characterize pathology, thereby improving patient safety

Alkenone unsaturation in surface sediments from the eastern equatorial Pacific: Implications for SST reconstructions

Significant uncertainties persist in the reconstruction of past sea surface temperatures in the eastern equatorial Pacific, especially regarding the amplitude of the glacial cooling and the details of the post-glacial warming. Here we present the first regional calibration of alkenone unsaturation in surface sediments versus mean annual sea surface temperatures (maSST). Based on 81 new and 48 previously published data points, it is shown that open ocean samples conform to established global regressions of U-K' 37 versus maSST and that there is no systematic bias from seasonality in the production or export of alkenones, or from surface ocean nutrient concentrations or salinity. The flattening of the regression at the highest maSSTs is found to be statistically insignificant. For the near-coastal Peru upwelling zone between 11-15 degrees S and 76-79 degrees W, however, we corroborate earlier observations that U-K'(37) SST estimates significantly over-estimate maSSTs at many sites. We posit that this is caused either by uncertainties in the determination of maSSTs in this highly dynamic environment, or by biasing of the alkenone paleothermometer toward El Nino events as postulated by Rein et al. (2005)

Protrusion of the Infraorbital Nerve into the Maxillary Sinus on CT: Prevalence, Proposed Grading Method, and Suggested Clinical Implications

BACKGROUND AND PURPOSE: The infraorbital nerve arises from the maxillary branch of the trigeminal nerve and normally traverses the orbital floor in the infraorbital canal. Sometimes, however, the infraorbital canal protrudes into the maxillary sinus separate from the orbital floor. We systematically studied the prevalence of this variant. MATERIALS AND METHODS: We performed a retrospective review of 500 consecutive sinus CTs performed at our outpatient centers. The infraorbital nerve protruded into the maxillary sinus if the entire wall of the infraorbital canal was separate from the walls of the sinus. We recorded the length of the bony septum that attached the infraorbital canal to the wall of the maxillary sinus and noted whether the protrusion was bilateral. We also measured the distance from the inferior orbital rim where the infraorbital canal begins to protrude into the sinus. RESULTS: There was a prevalence of 10.8% for infraorbital canal protrusion into the maxillary sinus and 5.6% for bilateral protrusion. The median length of the bony septum attaching the infraorbital canal to a maxillary sinus wall, which was invariably present, was 4 mm. The median distance at which the infraorbital nerve began to protrude into the sinus was 11 mm posterior to the inferior orbital rim. CONCLUSIONS: Although this condition has been reported in only 3 patients previously, infraorbital canal protrusion into the maxillary sinus was present in \u3e10% of our cohort. Identification of this variant on CT could help a surgeon avoid patient injury