Radical Nephroureterectomy: A Clinical Image

Upper Urinary Tract Urothelial Carcinoma (UTUC) remain rare. Radical Nephroureterectomy (RNU) is the Gold standard for management of these tumours. We are reporting a clinical image of a 45-year-old patient admitted in emergency for left lumbar pain (nephritic colic). The checkups requested computed tomography scanner showed a nephromegaly and left hydronephrosis upstream of a suspicious parietal thickening of the lumbar ureter with cortical and functional repercussion, neighborhood infiltration, and atypical lateral-aortic ganglia. Left lower calicial lithiasis of stasis, pancreatic nodular lesion and the left adrenal gland. The patient was a candidate for an open Radical Left Nephroureterectomy (RNU) (Figure 1). Figure 1: Radical Nephroureterectomy (RNU) picture U (Ureter) R (Renal). There are prognostic factors of tumors of the upper urinary excretory tract, which are the patient’s status, the preoperative, the operation and the anatomopathology [1]. According to current literature data, the oncology outcomes of radical nephrouretrectomy by laparoscopic are lower than those of open RNU surgery [2].

Porosity Distribution in Single Cone Root Canal Fillings Performed by Operators with Different Clinical Experience: A microCT Assessment

The objective of this study was to assess the porosity distribution of BioRoot RCS/single gutta-percha point root-canal fillings performed by a general dental practitioner and endodontist. Fourteen plastic models of maxillary premolars with two roots were selected and shaped with HyFlex EDM instruments to a size 40/0.04 taper and randomly divided into two experimental groups. A total of 14 canals in each group were obturated by two different operators with one HyFlex EDM size 40 gutta-percha point and BioRoot RCS sealer. The specimens were scanned with a high-resolution micro-computed tomography scanner, and the porosity of the fillings at the coronal, middle, and apical thirds of the root canals was qualified and quantified. The differences between groups and root-canal thirds were compared using Mann–Whitney, Friedman, and Wilcoxon tests with the significance level set at p < 0.05. The highest number of pores was observed in the apical third of root-canal fillings in both groups; however, the porosity distribution between the two groups was not significantly different in the apical and middle thirds (p > 0.05). Statistically significant differences were determined only in the coronal third (p < 0.05). The predominance of open pores was detected in all root-canal thirds and groups, with no significant differences in the number of open pores between the coronal and middle thirds (p > 0.05).

Intraoperative Computed Tomography Scanner-Guided Craniovertebral Junction Surgery in a Patient with an Occipitalized C1

Craniovertebral junction surgery is associated with unique difficulties. Type 2 odontoid fractures (Anderson and D Alonzo) have a great potential for nonunion and malunion. These fracture patients may require a circumferential decompression and fixation. The addition of intraoperative CT with neuronavigation greatly aids in craniovertebral junction surgery. We operated on a 59-year-old-male with a type 2 fracture with posterior subluxation of C1 anterior arch and a cranially displaced odontoid peg. First, a transoral odontoidectomy was performed followed by a craniocervical fixation. Occipital plates and C3–C4 lateral mass screws were used as C1 was discovered to be occipitalized intraoperatively and atlantoaxial facet joints could not be reduced as discovered by intraoperative CT resconstruction. Intraoperative CT scan was crucial to this circumferential decompression and fixation, allowed us to resect the odontoid peg safely and completely and to confirm adequate screw trajectory making this complex surgery easier for us and safer for the patient. The patient was discharged 4 months after admission with stable neurology. Intraoperative CT was fundamental to correct decision making.

Automatic validation of the gantry tilt in a computed tomography scanner using a head polymethyl methacrylate phantom

The purpose of this study was to develop an automatic method for validating the computed tomography gantry tilt. A head polymethyl methacrylate phantom with a diameter of 16 cm was used. Gantry tilt angles were measured both manually and automatically. Manual measurements were performed by measuring the length of the anteroposterior and lateral diameters from acquired images using electronic calipers. Automatic measurements consisted of a number of steps: phantom segmentation, determination of the center of the phantom, measurement of the anteroposterior and lateral diameters, and computation of the gantry tilt angle. The method was implemented on the gantry angles from 0° to 15°. The proposed method of measuring gantry angles produced accurate gantry tilt angles. The differences with the angles displayed on the gantry were less than 1°. The results of the automatic method were the same as those of the manual method (R2 > 0.98).

Exceptional thyrolipoma and thymolipoma association: is there a syndrome?

Thyrolipoma and thymolipoma are rare neoplasms of the thyroid gland and thymus, respectively. Their simultaneous occurrence is exceptional. Up to now, only 2 cases have been reported in literature in 1966 and in 1997. For the first time, we report the occurrence of both neoplasms associated with myasthenia gravis in a 64-year-old woman. The value of this case report lies not only in the fact that it allows us to speculate on the presence of a syndrome but also because a complete radiological work-up (computed tomography scanner, magnetic resonance imaging, Positron emission tomography (PET) with fluorodeoxyglucose (FDG)) is reported.