MyMedR

Proximal caries lesion detection using the Canary Caries Detection System: an in vitro study

Jan J, Wan Bakar WZ, Mathews SM, Okoye LO, Ehler BR, Louden C, et al.

J Investig Clin Dent, 2016 Nov;7(4):383-390.

OBJECTIVE: This study investigated the accuracy of the Canary System (CS) to detect proximal caries lesions in vitro, and compared it with conventional methods: International Caries Detection and Assessment System (ICDAS) II and bitewing radiography (BW).

METHODS: Visible proximal surfaces of extracted human teeth were assessed by ICDAS-II before setting them in five manikin mouth models. Then contacting proximal surfaces in mouth models were assessed by BW and CS. Histological validation with polarized-light microscopy served as a gold standard. Pairwise comparisons were performed on area under the curve (AUC), sensitivity, and specificity of the three methods, and corrected using Bonferroni's method. Sensitivities and specificities were compared using a test of proportions and AUC values were compared using DeLong's method.

RESULTS: The CS presented significantly higher sensitivity (0.933) than ICDAS-II (0.733, P = 0.01) and BW (0.267, P

Matched MeSH terms: Radiography, Bitewing/methods

The accuracy and safety of fluoroscopically guided percutaneous pedicle screws in the lumbosacral junction and the lumbar spine: a review of 880 screws

Chiu CK, Kwan MK, Chan CY, Schaefer C, Hansen-Algenstaedt N

Bone Joint J, 2015 Aug;97-B(8):1111-7.

PMID: 26224830 DOI: 10.1302/0301-620X.97B8.35330

We undertook a retrospective study investigating the accuracy and safety of percutaneous pedicle screws placed under fluoroscopic guidance in the lumbosacral junction and lumbar spine. The CT scans of patients were chosen from two centres: European patients from University Medical Center Hamburg-Eppendorf, Germany, and Asian patients from the University of Malaya, Malaysia. Screw perforations were classified into grades 0, 1, 2 and 3. A total of 880 percutaneous pedicle screws from 203 patients were analysed: 614 screws from 144 European patients and 266 screws from 59 Asian patients. The mean age of the patients was 58.8 years (16 to 91) and there were 103 men and 100 women. The total rate of perforation was 9.9% (87 screws) with 7.4% grade 1, 2.0% grade 2 and 0.5% grade 3 perforations. The rate of perforation in Europeans was 10.4% and in Asians was 8.6%, with no significant difference between the two (p = 0.42). The rate of perforation was the highest in S1 (19.4%) followed by L5 (14.9%). The accuracy and safety of percutaneous pedicle screw placement are comparable to those cited in the literature for the open method of pedicle screw placement. Greater caution must be taken during the insertion of L5 and S1 percutaneous pedicle screws owing to their more angulated pedicles, the anatomical variations in their vertebral bodies and the morphology of the spinal canal at this location.

Matched MeSH terms: Radiography, Interventional/methods*

Clinical and Imaging Features of Lacrimal Gland Involvement in Granulomatosis with Polyangiitis

Tan LT, Davagnanam I, Isa H, Rose GE, Verity DH, Pusey CD, et al.

Ophthalmology, 2015 Oct;122(10):2125-9.

PMID: 26233627 DOI: 10.1016/j.ophtha.2015.06.026

Lacrimal gland involvement in granulomatosis with polyangiitis (GPA) commonly accompanies orbital disease, but occasionally may be the sole presentation preceding any other organ manifestation or systemic disease. Diagnosis of orbital GPA, especially in patients with lacrimal involvement as the initial presentation, can be difficult because of nonspecific clinical features and lack of diagnostic specificity on histologic and antineutrophilic cytoplasmic antibody (ANCA) testing. Orbital GPA can be associated with a high morbidity from potential visual loss or rapid progression of latent systemic disease, making early diagnosis important. The purpose of this study was to describe the clinical and imaging features of patients with lacrimal gland involvement secondary to GPA and to compare them with those of other orbital inflammatory conditions in the lacrimal gland fossa.

Matched MeSH terms: Orbital Diseases/radiography

Fulltext Metastatic disease of the proximal femur

Faisham WI, Zulmi W, Biswal BM

Med J Malaysia, 2003 Mar;58(1):120-4.

PMID: 14556337

Since January 1999, ten patients had undergone surgical treatment for metastatic bony lesions of proximal femur at this centre. Seven of these patients were treated for complete pathological fractures, one for impending fracture and one for revision of internal fixation and loosening of hemiarthroplasty. Primary malignancies were located in breast in four cases, prostate in three and one in lung, thyroid and neurofibrosarcoma. Two patients had died within six months after surgery, four after 1 year while the remaining four were still alive. The mean duration of survival was eleven months. Nine patients had been ambulating pain free and there were no failure of reconstruction.

Matched MeSH terms: Femur/radiography*

Surgical Reconstruction of an Open Medial Malleolus Fracture Using a Novel Technique: A Case Report

Kow RY, Yuen JC, Ahmad Alwi AA, Abas MF, Low CL

JBJS Case Connect, 2019 6 25;9(2):e0163.

PMID: 31233428 DOI: 10.2106/JBJS.CC.18.00163

CASE: A 17-year-old male sustained an open fracture of the right medial malleolus (MM) with significant bone and soft tissue loss following a motor-vehicle accident. Following serial wound debridement, his ankle was effectively reconstructed with MM antiglide plate stabilization, iliac autogenous bone graft, and a free radial forearm soft tissue flap.

CONCLUSIONS: Open MM fracture with bone and soft tissue loss is rare. It is feasible to treat this injury with a novel surgical reconstruction technique involving autogenous bicortical iliac bone graft and radial forearm free flap.

Matched MeSH terms: Radiography/methods

Fulltext Some experiences with non-traumatic paraplegia in Malaysia

Silva JF

Paraplegia, 1973 Aug;11(2):146-58.

PMID: 4584434 DOI: 10.1038/sc.1973.19

One hundred and forty-one patients with non-traumatic paraplegia were reviewed. The common causative factors and the problems arising were evaluated. Management of the clinical problems were described. The need for prevention and early treatment has been stressed.

Matched MeSH terms: Paraplegia/radiography

The Use of Engineered Bilayered Skin (MyDermTM) in the Management of Massive Skin Defect in Grade III Gustilo-Anderson Open Fracture

Mohamed Haflah NH, Ng MH, Mohd Yunus MH, Naicker AS, Htwe O, Fahmi M, et al.

Int J Low Extrem Wounds, 2017 Sep;16(3):212-216.

PMID: 28862056 DOI: 10.1177/1534734617724974

Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect. A tissue engineered skin construct, MyDermTM was employed to cover this large defect. Complete wound closure was achieved 35 days postimplantation. The patient then underwent plating of the tibia for nonunion with no adverse effect to the grafted site. The tibia eventually healed 5 months postplating, and the cosmetic appearance of the newly formed skin was satisfactory.

Matched MeSH terms: Radiography/methods

Fulltext Low-dose intrapleural alteplase (without deoxyribonuclease) in complicated parapneumonic effusion: case series and literature reviews

Lai C, Mohammad N, Hassan TM, Abdul Hamid MF

BMJ Case Rep, 2017 Sep 11;2017.

PMID: 28893806 DOI: 10.1136/bcr-2017-221239

This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions. We made the decisions for intrapleural fibrinolytic therapy using low-dose alteplase 2.5 mg each time, in view of the elderly patient as sacrosanct for risk of bleeding. Furthermore, DNase was not used, as it is not yet available in our setting. Both of our patients had good clinical and radiological outcomes, without the need for surgical interventions.

Matched MeSH terms: Radiography/methods

Fulltext Paediatric one lung anaesthesia by selective bronchial intubation

Lew YS

Singapore Med J, 2000 Aug;41(8):398-400.

PMID: 11256348

One lung anaesthesia in paediatric patients may not always be achievable by bronchial blockade or double lumen tube intubation due to inadequate experiences or facilities. We attempted to isolate right lung by selectively intubating the left bronchus with single lumen tube on a 10 kg child. Optimal surgical condition and satisfactory oxygenation achieved but complicated with severe respiratory acidosis. The possible causes for hypercapnea in this child were discussed.

Matched MeSH terms: Empyema/radiography

Fulltext Nasopharyngeal diffuse large B-cells lymphoma causing acute airway obstruction amid COVID-19 crisis: an anaesthetist's nightmare

Yeap TB, Teah MK, Quay YJJ, Wong MTF

BMJ Case Rep, 2021 Jan 28;14(1).

PMID: 33509897 DOI: 10.1136/bcr-2020-241008

Acute stridor is often an airway emergency. We present a valuable experience handling an elderly woman who was initially treated as COVID-19 positive during the pandemic in November 2020. She needed an urgent tracheostomy due to nasopharyngeal (NP) diffuse large B-cell lymphoma causing acute airway obstruction. Fortunately, 1 hour later, her NP swab real-time PCR test result returned as SARS-CoV-2 negative. This interesting article depicts the importance of adequate preparations when handling potentially infectious patients with anticipated difficult airway and the perioperative issues associated with it.

Matched MeSH terms: Radiography/methods

Fulltext A Missed Late Presentation of a Congenital Pulmonary Airway Malformation as a Large Infected Bulla

Lee CY, Osman SS, Noor HM, Isa NSA

Sultan Qaboos Univ Med J, 2018 Nov;18(4):e541-e544.

PMID: 30988978 DOI: 10.18295/squmj.2018.18.04.020

A congenital pulmonary airway malformation (CPAM) is a rare cystic anomaly that may occur during development of the fetal airways. The vast majority of CPAMs are detected in neonates; as such, it is unusual for diagnosis to occur in adulthood. We report a 21-year-old male patient who presented to the emergency department of the Hospital Ampang, Kuala Lumpur, Malaysia, in 2015 with chest pain, breathlessness and tachypnoea. Based on an initial chest X-ray, the patient was misdiagnosed with pneumothorax and underwent urgent chest tube insertion; however, his condition deteriorated over the course of the next three days. Further imaging was suggestive of infected bullae or an undiagnosed CPAM. The patient therefore underwent video-assisted thoracoscopic surgery, during which a large infected bulla was resected. A diagnosis of an infected CPAM was confirmed by histopathological examination. Following the surgery, the patient recovered quickly and no bullae remnants were found at a one-month follow-up.

Matched MeSH terms: Radiography/methods

Vacuum epidural cyst with acute neurological presentation. A case report

El Beltagi AH, Swamy N, Dashti F

Neuroradiol J, 2013 Apr;26(2):213-7.

PMID: 23859245

The widespread use of MRI in the assessment of low back pain has led to increased detection of degenerative cysts of the spine, which was essentially a surgical diagnosis earlier. The awareness of degenerative cysts, the significance of their role in the etiology of radicular and back pain and their effective management is evolving. We describe a case of bilateral, gas-filled lumbar facet synovial/ ganglion cysts causing focal arachnoid inflammation and lateral lumbar canal stenosis.

Matched MeSH terms: Radiography

Fulltext Single stage minimally invasive bilateral video assisted thoracoscopic surgery for simultaneous bilateral primary spontaneous pneumothorax

Sachithanandan A, Nur Ezrin I, Badmanaban B

Med J Malaysia, 2012 Apr;67(2):226-7.

PMID: 22822653 MyJurnal

Simultaneous bilateral spontaneous pneumothorax (SBSP) is a very rare life-threatening condition that requires rapid diagnosis and treatment. Most cases are secondary to various underlying lung pathology but a primary SBSP may occur due to rupture of subpleural blebs or bullae. Surgery via an open or minimally invasive approach provides definitive treatment and can be undertaken as a staged or simultaneous procedure. We report our experience with two such rare cases utilizing a single stage minimally invasive bilateral video assisted thoracoscopic (VATS) approach. The pathogenesis of this rare condition and intra-operative technical considerations for a successful outcome are discussed.

Matched MeSH terms: Radiography, Thoracic

The safety zone for mini-implant maxillary anchorage in Mongoloids

Wey MC, Shim CN, Lee MY, Jamaluddin M, Ngeow WC

Aust Orthod J, 2012 May;28(1):17-21.

PMID: 22866589

This study aimed to establish a safety zone for the placement of mini-implants in the buccal surface between the second maxillary premolar (PM2) and first maxillary molar (M1) of Mongoloids.

Matched MeSH terms: Radiography, Panoramic

Fulltext F-FDG PET/CT as a potential valuable adjunct to MRI in characterising the Brodie's abscess

Fathinul F, Nordin A

Biomed Imaging Interv J, 2010 07 01;6(3):e26.

PMID: 21611044 DOI: 10.2349/biij.6.3.e26

Chronic osteomyelitis (Brodie's abscess) is essentially a problem of diagnosis, and there may be considerable difficulty in distinguishing it from other benign and malignant bone lesions. Early diagnosis of Brodie's abscess is deemed important as the disease has a good curative potential following an appropriate antibiotic treatment. Of late, PET/CT using (18)F-FDG is taking a centre stage in the imaging of bone infection though documentation on its role in characterising the feature of Brodie's abscess is exceedingly scarce. On the other hand, it is well known that MRI imaging plays a very important role in distinguishing abscess loculation from malignancy. The authors present the case of a 13-year-old boy with pain in the right heel for few months. Radiograph of the right foot revealed a lucent focus with sclerotic margin in the right calcaneum. MRI T1-weighted images were inconclusive of penumbra sign to characterise abscess cavity due to the small volume lesion. Whole-body (18)F-FDG PET/CT scan showed multiple small avid lesions at the margin of the sclerotic rim in the right calcaneum. Final diagnosis of Brodie's abscess with Klebsiella culture was confirmed via bone debridement.

Matched MeSH terms: Radiography

Cardiac metastasis: a rare involvement of primitive neuroectodermal tumour of the lung

Ngow HA, Wan Khairina WM

Pathol Oncol Res, 2011 Sep;17(3):771-4.

PMID: 21213128 DOI: 10.1007/s12253-010-9328-9

A 15 year-old adolescent was referred with 2 month history of worsening of breathlessness and haemoptysis. He also reported constitutional symptoms of fever, poor appetite and weight loss. The chest roentgenogram showed a massive right pleural effusion with apparent cardiomegaly. The cardiac silhouette over the right heart border was obliterated and the mediastinum was widened. Computed tomogram of the thorax showed a bulky heterogeneous mass in the right lung with extension to the heart. Subsequent CT guided lung biopsy revealed Primitive Neuroectodermal tumour (PNET). Here, we illustrate the clinical course of an aggressive pulmonary PNET with lethal cardiac metastasis.

Matched MeSH terms: Radiography, Thoracic

Progressive gas formation in a deceased person during mortuary storage demonstrated on computed tomography

Singh MK, O'Donnell C, Woodford NW

Forensic Sci Med Pathol, 2009;5(3):236-42.

PMID: 19669956 DOI: 10.1007/s12024-009-9103-y

We report the case of an 82-year-old woman with a past history of diabetes mellitus who died following blunt head injury sustained in a fall resulting in an acute subdural hematoma. Serial postmortem CT scans of the chest and abdomen performed over a 3-day period demonstrated progressive intra-hepatic and intra-cardiac gas formation whilst the deceased was stored in a standard mortuary refrigerator at a nominated temperature of 4 degrees C. Measured mortuary refrigerator temperatures over a 7 day period showed statistically significant day to day variability in temperatures above 4 degrees C as well as variations in temperature depending on location within the refrigerator space. In the absence of other known factors associated with such gas formation, putrefaction seems the likely cause despite a lack of obvious external features. This phenomenon must therefore be taken into account when interpreting the presence of visceral gas on postmortem CT and relating such gas to the cause of death.

Matched MeSH terms: Radiography, Abdominal

Fulltext Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation

Chan CY, Kwan MK, Saw LB

Eur Spine J, 2010 Jan;19(1):78-84.

PMID: 19763636 DOI: 10.1007/s00586-009-1157-8

The objective of this cadaveric study is to determine the safety and outcome of thoracic pedicle screw placement in Asians using the funnel technique. Pedicle screws have superior biomechanical as well as clinical data when compared to other methods of instrumentation. However, misplacement in the thoracic spine can result in major neurological implications. There is great variability of the thoracic pedicle morphometry between the Western and the Asian population. The feasibility of thoracic pedicle screw insertion in Asians has not been fully elucidated yet. A pre-insertion radiograph was performed and surgeons were blinded to the morphometry of the thoracic pedicles. 240 pedicle screws were inserted in ten Asian cadavers from T1 to T12 using the funnel technique. 5.0 mm screws were used from T1 to T6 while 6.0 mm screws were used from T7 to T12. Perforations were detected by direct visualization via a wide laminectomy. The narrowest pedicles are found between T3 and T6. T5 pedicle width is smallest measuring 4.1 +/- 1.3 mm. There were 24 (10.0%) Grade 1 perforations and only 1 (0.4%) Grade 2 perforation. Grade 2 or worse perforation is considered significant perforation which would threaten the neural structures. There were twice as many lateral and inferior perforations compared to medial perforations. 48.0% of the perforations occurred at T1, T2 and T3 pedicles. Pedicle fracture occurred in 10.4% of pedicles. Intra-operatively, the absence of funnel was found in 24.5% of pedicles. In conclusion, thoracic pedicle screws using 5.0 mm at T1-T6 and 6.0 mm at T7-T12 can be inserted safely in Asian cadavers using the funnel technique despite having smaller thoracic pedicle morphometry.

Matched MeSH terms: Radiography; Spinal Canal/radiography; Thoracic Vertebrae/radiography

Tumour volume and lung metastasis in patients with osteosarcoma

Munajat I, Zulmi W, Norazman MZ, Wan Faisham WI

J Orthop Surg (Hong Kong), 2008 Aug;16(2):182-5.

PMID: 18725669

To assess the association between tumour volume and occurrence of lung metastasis in patients with osteosarcoma and to determine the cut-off value.

Matched MeSH terms: Radiography, Thoracic

Residual nonunion following vascularised fibular graft treatment for congenital pseudarthrosis of the tibia: a report of two cases

Sulaiman AR, Nordin S, Faisham WI, Zulmi W, Halim AS

J Orthop Surg (Hong Kong), 2006 Apr;14(1):64-6.

PMID: 16598090

Resection and reconstruction using a vascularised fibular graft is a viable alternative treatment for congenital pseudarthrosis of the tibia, although distal junctional nonunion and residual deformity are known complications that are difficult to treat. We illustrate 2 cases in which bony union was achieved following a technique using fibular grafting and intramedullary nailing, without additional bone grafting. This technique was feasible because of hypertrophy of the fibular graft.

Matched MeSH terms: Radiography

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