AIM: To present a case of extradural temporal bone chondroblastoma and discuss the clinical presentation, radiographic findings, histology and particularly the surgical management of the case.
CASE REPORT: We report a case of a 31-year-old man who presented with a painless left temporal swelling and left sided hearing loss for four months. Computed tomography (CT) scan revealed an aggressive mass involving the left preauricular region with temporal mastoid bone erosion. Magnetic resonance imaging (MRI) showed an extra-axial left temporal mastoid mass pushing the left temporal lobe superiorly. The patient underwent complete excision of the temporal bone tumor. The final histopathological diagnosis was in keeping with chondroblastoma.
CONCLUSION: Temporal bone chondroblastoma is rare but an aggressive condition. Complete tumor resection via an appropriate approach that enables adequate exposure will lead to a favorable outcome.
DISCUSSION: This paper presents comprehensive report on breast carcinoma disease and its modalities available for detection and diagnosis, as it delves into the screening and detection modalities with special focus placed on the non-invasive techniques and its recent advancement work done, as well as a proposal on a novel method for the application of early breast carcinoma detection.
CONCLUSION: This paper aims to serve as a foundation guidance for the reader to attain bird's eye understanding on breast carcinoma disease and its current non-invasive modalities.
METHODS: We sourced articles from Scopus, Ovid and PubMed databases for journal publications related to post-mortem diagnostic imaging. We highlight the most relevant full articles in English that explain the type of modality that was utilised and the added value it provided for diagnosing the cause of death.
RESULTS: Minimally invasive autopsies assisted by imaging modalities added a great benefit to forensic medicine, and supported conventional autopsy. In particular the role of post mortem computed tomography (PMCT), post mortem computed tomography angiography (PMMR) and positron emission tomography computed tomography (PMCTA) that have incremental benefits in diagnosing traumatic death, fractures, tissue injuries, as well as the assessment of body height or weight for corpse identification.
CONCLUSION: PMCT and PMMR, with particular emphasis on PMCTA, can provide higher accuracy than the other modalities. They can be regarded as indispensable methods that should be applied to the routine autopsy protocol, thus improving the findings and accuracy of diagnosing the cause of death.
PURPOSE: To examine the influence of physical activity (PA) and sedentary time on bone strength, structure, and density in older adolescents.
METHODS: We used peripheral quantitative computed tomography to estimate bone strength at the distal tibia (8% site; bone strength index, BSI) and tibial midshaft (50% site; polar strength strain index, SSIp) in adolescent boys (n = 86; 15.3 ± 0.4 years) and girls (n = 106; 15.3 ± 0.4 years). Using accelerometers (GT1M, Actigraph), we measured moderate-to-vigorous PA (MVPAAccel), vigorous PA (VPAAccel), and sedentary time in addition to self-reported MVPA (MVPAPAQ-A) and impact PA (ImpactPAPAQ-A). We examined relations between PA and sedentary time and bone outcomes, adjusting for ethnicity, maturity, tibial length, and total body lean mass.
RESULTS: At the distal tibia, MVPAAccel and VPAAccel positively predicted BSI (explained 6-7% of the variance, p
MATERIALS AND METHODS: This cross-sectional study with retrospective record review was conducted in Hospital Tengku Ampuan Rahimah, Selangor, Malaysia. We included all hospitalised patients with confirmed COVID-19 infection who had undergone CT pulmonary angiogram (CTPA) examinations for suspected PTE disease between April 2021 and May 2021. Clinical data and laboratory data were extracted by trained data collectors, whilst CT images retrieved were analysed by a senior radiologist. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20.
RESULTS: We studied 184 COVID-19 patients who were suspected to have PTE disease. CTPA examinations revealed a total of 150 patients (81.5%) suffered from concomitant PTE disease. Among the PTE cohort, the commonest comorbidities were diabetes mellitus (n=78, 52.0%), hypertension (n=66, 44.0%) and dyslipidaemia (n=25, 16.7%). They were generally more ill than the non-PTE cohort as they reported a significantly higher COVID-19 disease category during CTPA examination with p=0.042. Expectedly, their length of both intensive care unit stays (median number of days 8 vs. 3; p=0.021) and hospital stays (median number of days 14.5 vs. 12; p=0.006) were significantly longer. Intriguingly, almost all the subjects had received either therapeutic anticoagulation or thromboprophylactic therapy prior to CTPA examination (n=173, 94.0%). Besides, laboratory data analysis identified a significantly higher peak C-reactive protein (median 124.1 vs. 82.1; p=0.027) and ferritin levels (median 1469 vs. 1229; p=0.024) among them. Evaluation of CT features showed that COVID-19 pneumonia pattern (p<0.001) and pulmonary angiopathy (p<0.001) were significantly more profound among the PTE cohort. To note, the most proximal pulmonary thrombosis was located in the segmental (n=3, 2.0%) and subsegmental pulmonary arteries (n=147, 98.0%). Also, the thrombosis predominantly occurred in bilateral lungs with multilobar involvement (n=95, 63.3%).
CONCLUSION: Overall, PTE disease remains prevalent among COVID-19 patients despite timely administration of thromboprophylactic therapy. The presence of hyperinflammatory activities, unique thrombotic locations as well as concurrent pulmonary parenchyma and vasculature aberrations in our PTE cohort implicate immunothrombosis as the principal mechanism of this novel phenomenon. We strongly recommend future researchers to elucidate this important clinical disease among our post- COVID vaccination populations.
OBJECTIVE: The aim of this study is to evaluate the ICV in primary craniosynostosis patients after the cranial vault reshaping with or without FOA and to compare between syndromic and nonsyndromic synostosis group, to determine factors that associated with significant changes in the ICV postoperative, and to evaluate the resolution of copper beaten sign and improvement in neurodevelopmental delay after the surgery.
METHODS: This is a prospective observational study of all primary craniosynostosis patients who underwent operation cranial vault reshaping with or without FOA in Hospital Kuala Lumpur from January 2017 until Jun 2018. The ICV preoperative and postoperative was measured using the 3D computed tomography (CT) imaging and analyzed. The demographic data, clinical and radiological findings were identified and analyzed.
RESULTS: A total of 14 cases (6 males and 8 females) with 28 3D CT scans were identified. The mean age of patients was 23 months. Seven patients were having syndromic synostosis (4 Crouzon syndromes and 3 Apert syndromes) and 7 nonsyndromic synostosis. The mean preoperative ICV was 880 mL (range, 641-1234 mL), whereas the mean postoperative ICV was 1081 mL (range, 811-1385 mL). The difference was 201 mL which was statistically significant (P 1.0). However, there was 100% (n = 13) improvement of this copper beaten sign. However, the neurodevelopmental delay showed no improvement which was statistically not significant (P > 1.0).
CONCLUSION: Surgery in craniosynostosis patient increases the ICV besides it improves the shape of the head. From this study, the syndromic synostosis had better increment of ICV compared to nonsyndromic synostosis.