Characterization of breast calcification types using dual energy X-ray method

Calcifications are products of mineralization whose presence is usually associated with pathological conditions. The minerals mostly seen in several diseases are calcium oxalate (CaC2O4), calcium carbonate (CaCO3) and hydroxyapatite (HAp). Up to date, there is no in-vivo method that could discriminate between minerals. To this aim, a dual energy X-ray method was developed in the present study. An analytical model was implemented for the determination of the Calcium/Phosphorus mass ratio (mca/mp ). The simulation was carried out using monoenergetic and polyenergetic X-rays and various calcification thicknesses (100 to 1000 um) and types (CaC2O4, CaCO3, HAp). The experimental evaluation of the method was performed using the optimized irradiation conditions obtained from the simulation study. X-ray tubes, combined with energy dispersive and energy integrating (imaging) detectors, were used for the determination of the mca/mp in phantoms of different mineral types and thicknesses. Based on the results of the experimental procedure, statistical significant difference was observed between the different types of minerals when calcification thicknesses were 300 um or higher

Avulsion fractures of the tibial tuberosity in adolescent athletes treated by internal fixation and tension band wiring

Avulsion of the tibial tuberosity is a rarely reported fracture. It is mainly considered as an athletic injury accounting for less than 3% of all epiphyseal lesions. In this study, we hypothesized that the use of tension band wiring as a supplement of the internal fixation for the avulsion fractures of the tibial tuberosity would lead the adolescent athletes to a more effective rehabilitation program and an earlier resumption of their previous activity level. Ten patients were treated in our department over a period of I I years (1985-1995). Operative treatment was thought necessary for all our cases due to tibial tuberosity displacement. Open reduction and internal fixation in combination with tension band wiring was used. The result in all cases was that the reduction was maintained intact and the fracture united. The functional results were excellent, and all patients returned to their previous athletic activities. Our conclusion is that the combination of internal fixation and tension band wiring for avulsion fractures of the tibial tuberosity seems to be more effective and advantageous than conservative or other surgical methods. Avoiding the need of external support and allowing early joint motion, the method described prevents serious quadriceps atrophy, allowing the young athletes to return earlier to their previous sport activities

The significance of rotation in fracture-separation of the articular pillar of a lower cervical vertebra - A clinical and cadaveric study

We report 13 fracture-separations of an articular pillar at the lower cervical spine in 12 patients. There were 9 men and 3 women with a mean age at injury of 32 years, with involvement of C4, C5 and C6 vertebrae. Neurological symptoms were present in 9 patients, 2 were classified as ASIA A and 7 as ASIA D. The average magnitude of rotation of the articular pillar was 24 degrees (10 degrees-36 degrees). 4 patients with neurologic deficit and a rotated articular pillar of more than 25 degrees were operated on, while 8 patients, 3 of which had a rotation of more than 25 degrees, had closed treatment. Patients were followed from 8 months to 15 years (mean 9 years). Patients who had closed treatment and/or with a rotated fractured articular pillar of more than 25 degrees had less satisfactory results. This observation was affirmed by cadaveric studies which showed that rotation of more than 25 degrees is an additional factor of instability in a fractured articular pillar

Electrically Evoked Auditory Steady State Responses in Cochlear Implant Users

Auditory steady state responses are neural potentials in response to repeated auditory stimuli. This study shows that electrically evoked auditory steady state responses (EASSRs) to low-rate pulse trains can be reliably recorded by electrodes placed on the scalp of a cochlear implant (CI) user and separated from the artifacts generated by the electrical stimulation. Response properties are described, and the predictive value of EASSRs for behaviorally hearing thresholds is analyzed. For six users of a Cochlear Nucleus CI, EASSRs to symmetric biphasic pulse trains with rates between 35 and 47 Hz were recorded with seven scalp electrodes. The influence of various stimulus parameters was assessed: pulse rate, stimulus intensity, monopolar or bipolar stimulation mode, and presentation of either one pulse train on one electrode or interleaved pulse trains with different pulse rates on multiple electrodes. To compensate for the electrical artifacts caused by the stimulus pulses and radio frequency transmission, different methods of artifact reduction were employed. The validity of the recorded responses was confirmed by recording on–off responses, determination of response latency across the measured pulse rates, and comparison of amplitude growth of stimulus artifact and response amplitude. For stimulation in the 40 Hz range, response latencies of 35.6 ms (SD = 5.3 ms) were obtained. Responses to multiple simultaneous stimuli on different electrodes can be evoked, and the electrophysiological thresholds determined from EASSR amplitude growth in the 40 Hz range correlate well with behaviorally determined threshold levels for pulse rates of 41 Hz