The final, definitive version of this paper has been published in Acta radiologica by SAGE Publications Ltd, All rights reserved.Final publication is available at http://acr.sagepub.com/ / 京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19582号 / 医博第4089号 / 新制||医||1014(附属図書館) / 32618 / 京都大学大学院医学研究科医学専攻 / (主査)教授 山田 泰広, 教授 戸井 雅和, 教授 羽賀 博典 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20559号 / 医博第4244号 / 新制||医||1022(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 高田 穣, 教授 萩原 正敏, 教授 松本 智裕 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

AIM/PURPOSE: To investigate the correlation between the histopathology of periapical lesion of endodontic origin and the radiographic findings of the maxillary sinus observed by cone-beam computed tomography (CBCT). MATERIAL AND METHODS: Retrospective record review study, data collected of patients received surgical root canal treatment at Boston University school of dental medicine. Total of 39 periapical lesions all had CBCT scans and pathology reports. Each periapical lesion was biopsied and examined by oral & maxillofacial pathologist. CBCT scans for each lesion were examined by two examiners: endodontic resident and board-certified endodontic faculty. RESULTS: 65% of the lesions associated with changes in the maxillary sinus and 35% had no changes as seen on the CBCT scans. 82% of the lesions were granulomas 15.5% were cysts and 2.5% OKC. Out of the 65% (26 lesions) maxillary sinus changes were 50% (13) were periapical mucositis (PAM) & 50% (13) were periapical osteoperiostitis (PAO). CONCLUSION: Histopathology of the periapical lesion didn’t have an effect on the type of changes observed in the sinus. And the closer the lesion was to the sinus the more chances of developing changes in the sinus.

This study was conducted to compare the gizzard integrity between two broilers flocks, one under a no antibiotics ever (NAE) program and the other from a conventionally raised flock (CONV). One-hundred Ross 708 x Ross YPM broiler chickens from two flocks of the same company but raised under two distinct management systems were allocated for this study. At 1, 14, 28 and 42 days of age, birds from both flocks were received at the Poultry Research and Diagnostic Laboratory. Gross and histopathologic evaluations of gizzard lesions and microbiological determinations of the gizzard mucosa were conducted and body and gizzard weights were recorded. Birds under both programs showed very similar growth rates, however gizzards were heavier in the birds under the CONV program. The birds under the NAE program had higher gross gizzard lesion scores at days 1, 14, 28 and 42, with statistical significance at day 42 (P<0.05). Histopathologically, the birds under the NAE program had greater gizzard lesion scores compared to the CONV flock at days 14 and 28, however no statistical significance was established. Escherichia coli was more frequently isolated from the birds under the CONV program. According to these observations, gross and microscopic gizzard lesions appeared to be more associated with the NAE program.

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Orthodontic treatment may cause an increase in the rate of enamel decalcification on tooth surfaces, producing White Spot Lesions (WSL). Orthodontic patients are at a higher risk for decalcification because orthodontic appliances retain food debris which leads to increased plaque formation. Dental plaque, an oral biofilm formed by factors including genetics, diet, hygiene, and environment, contains acid producing bacterial strains with a predominance of Mutans Streptococcus (MS). MS and others metabolize oral carbohydrates during ingestion, the byproducts of which acidify the biofilm to begin a process of enamel decalcification and formation of WSL. This study tests if patients in orthodontic treatment at Temple University can be used as subjects for further longitudinal study of WSL risk factors. Twenty patients between the ages of ten to eighteen after three months or greater of treatment were enrolled to determine if duration of treatment, hygiene, sense of coherence, obesity, diet frequencies, age and gender correlated with development of WSL. Of these, age is positively correlated with the number of untreated decayed surfaces. WSL and plaque levels may negatively correlate with increased brushing frequency and duration, while flossing frequency demonstrated a statistically significant negative correlation. This population may be suitable for further study because of its high incidence of WSL (75%), however difficulty in enrollment and patient attrition necessitates that future studies be modified. / Oral Biology

The use of brightness mode (B-mode) ultrasound (US), color Doppler (CD), and power Doppler (PD) can all help evaluate and characterize splenic lesions. A relatively new non-Doppler technology used to evaluate vasculature called B-Flow helps overcome certain limitations of CD and PD that affect visualization of blood flow. There are no studies describing the use of B-Flow characterizing splenic lesions in dogs. A total of 97 splenic lesions were evaluated. Splenic lesions that were larger than 2 cm, distorted the splenic capsule, or accompanied free fluid were significantly associated with malignancy. Lesions with tortuous internal vessels on CD or B-Flow were significantly associated with malignancy. Lesions with large internal vessels compared to external vessels on PD and B-Flow were significantly associated with malignancy. In conclusion, these B-mode and vascular characteristics on CD, PD and B-flow may help clinicians prioritize malignant etiologies over benign ones and prompt more aggressive diagnostic recommendations.

Thesis (MSc (Medical Imaging and Clinical Oncology. Nuclear Medicine))--University of Stellenbosch, 2010. / ENGLISH SUMMARY: Introduction: Bone scintigraphy is used extensively in evaluating metastatic disease. There are currently no clear recommendations for the use of SPECT/CT in metastatic bone disease. Existing procedural guidelines from the Society of Nuclear Medicine (SNM) for SPECT/CT do not provide specific indications for use of SPECT/CT in bone scintigraphy, and there are currently no other guidelines for the use of SPECT/CT in bone scintigraphy that the author is aware of. The aim of this study was to investigate the additional value of SPECT/CT, and to identify the clinical indications for which SPECT/CT is most useful in patients with suspected bone metastases. Subjects and Methods: Forty-two patients with equivocal lesions on planar scintigraphy were prospectively recruited and planar imaging, SPECT, and SPECT/CT done on all patients. On reading of SPECT and then SPECT/CT, patients and individual lesions were classified as malignant, benign or equivocal. Radiological studies and available clinical information were also used during reading of scans. Review of clinical information, radiological studies and/or follow-up bone scans were used as gold standard. The results of the SPECT and SPECT/CT were compared in terms of proportion of equivocal findings and accuracy. Results: Forty-two patients with 189 skeletal lesions were examined. There was a diverse variety of primary tumours, although the majority had breast (n=22) or prostate cancer (n=8). Overall, SPECT/CT resulted in a significant reduction in the proportion of equivocal findings on both a patient-wise (p=0.0015) and lesion-wise basis (p<0.0001). The overall accuracy of SPECT/CT was significantly higher than that of SPECT on both a patient-wise (p=0.0026) and lesion-wise basis (p<0.0001). Generally SPECT/CT decreased the proportion of equivocal findings and increased the accuracy independent of the presence of bone pain, type of primary tumour, or skeletal region involved. SPECT/CT did not significantly improve the diagnostic confidence of readers in equivocal lumbar lesions although accuracy was significantly improved in this region. Conclusion: SPECT/CT performs significantly better than SPECT alone for the interpretation of equivocal planar lesions. There is no evidence that the benefit of SPECT/CT is dependent on the type of primary tumour or the presence of bone pain. Where resources are limited, SPECT/CT is indicated only in those patients in whom correct classification of the lesions in question is expected to alter the patient’s management. SPECT/CT images should be interpreted with the aid of a diagnostic radiologist or nuclear medicine physicians should acquire sufficient experience in Computed Tomographic image interpretation in order to optimise diagnostic benefit from SPECT/CT. / AFRIKAANSE OPSOMMING: Inleiding: Beenflikkergrafie word wyd vir die evaluering van metastatiese siekte gebruik. Daar bestaan tans geen duidelike aanbevelings vir die gebruik van Enkelfotonemissie rekenaartomografie gekombineer met rekenaartomografie (EFERT/RT, Engels SPECT/CT) in metastatiese beensiekte nie. Bestaande riglyne van die Amerikaanse Society of Nuclear Medicine (SNM) vir EFERT/RT gee nie spesifieke indikasies vir die gebruik van EFERT/RT in beenflikkergrafie nie, en daar is tans geen ander riglyne waarvan die outeur bewus is nie. Die doel van hierdie studie was om die bykomende waarde van EFERT/RT te ondersoek, en om dié kliniese indikasies waar EFERT/RT in pasiënte met vermoedelike beenmetastases mees nuttig sal wees, te identifiseer. Pasiënte en Metodes: Twee en veertig pasiënte met twyfelagtige letsels op planare skeletflikkergrafie is prospektief geselekteer en planare beelding, EFERT en EFERT/RT is op alle pasiënte gedoen. Tydens beoordeling van EFERT en daarna EFERT/RT beelde is pasiënte en individuele letsels as maligne, benigne of twyfelagtig geklassifiseer. Radiologiese studies en beskikbare kliniese inligting is ook tydens interpretasie van flikkergramme gebruik. Kliniese inligting, radiologiese studies en/of opvolg beenflikkergramme is as goue standaard gebruik. Die resultate van EFERT en EFERT/RT is ten opsigte van die aantal twyfelagtige bevindings en akkuraatheid vergelyk. Resultate: Twee en veertig pasiënte met 189 skeletale letsels is ondersoek. Daar was ‘n verskeidenheid van primêre tumore, maar die meerderheid van pasiënte het borsvi (n=22) of prostaatkanker (n=8) gehad. Die gebruik van EFERT/RT het gelei tot ‘n betekenisvolle afname in die aantal twyfelagtige bevindings, beide op ‘n pasiënt- en ‘n letselbasis (p=0.0015 en p<0.0001 onderskeidelik). Die algehele akkuraatheid van EFERT/RT was betekenisvol hoër as die van EFERT alleen, beide op pasiënt- en op letselbasis (p=0.0026 en p<0.0001 onderskeidelik). Oor die algemeen het EFERT/RT die aantal twyfelagtige letsels verminder en die akkuraatheid verhoog, ongeag die teenwoordigheid van beenpyn, die tipe primêre tumor of die area van die skelet wat betrokke was. In twyfelagtige lumbale letsels het EFERT/RT nie die diagnostiese vertroue van beoordelaars van flikkergramme verhoog nie, alhoewel die akkuraatheid vir hierdie gebied wel betekenisvol toegeneem het. Gevolgtrekking: EFERT/RT vaar betekenisvol beter as EFERT in die beoordeling van twyfelagtige letsels op planare beenflikkergramme. Daar is geen bewys dat die voordeel van EFERT/RT afhanklik is van die tipe primêre tumor of die teenwoordigheid van beenpyn nie. Waar hulpbronne beperk is, is EFERT/RT slegs aangedui in dié pasiënte waar verwag word dat korrekte klassifikasie van die betrokke letsel behandeling sal beïnvloed. EFERT/RT beelde behoort met die hulp van ‘n diagnostiese radioloog beoordeel te word, of kerngeneeskundiges moet genoegsame ondervinding in die interpretasie van rekenaartomografiebeelde hê om die diagnostiese voordeel van EFERT/RT optimaal te kan benut.