METHODS: Fifteen intact, non-carious single-rooted teeth were decoronated at the cementoenamel junction. Visually, working length was determined by using a #15 K-file under stereomicroscope (×20). The effect of cellular phones on electronic working length (EWL) was determined under 2 experimental settings: (1) in a closed room with poor signal strength and (2) in a polyclinic set up with good signal strength and 5 conditions: (1) electronically, without cellular phone in room; (2) electronically, with cellular phone in physical contact with EAL; (3) electronically, with mobile phone in physical contact with EAL and in calling mode for a period of 25 seconds; (4) electronically, mobile phone placed at a distance of 40 cm from the EAL; and (5) electronically, mobile phone placed at a distance of 40 cm and in calling mode for a period of 25 seconds. The EWL was measured 3 times per tooth under each condition. Stability of the readings was scored from 1 to 3: (1) good stability, (2) stable reading after 1 attempt, and (3) stable reading after 2 attempts. The data were compared by using analysis of variance.
RESULTS: The EWL measurements were not influenced by the presence of cellular phone and could be determined under all experimental conditions.
CONCLUSIONS: Within the limitations of this study, it can be concluded that mobile phones do not interfere with the EWL determination.
Case Report: Madam Tan, a 71-year-old Malaysian Chinese lady, otherwise healthy, presented to her local GP with a complaint of a nodule over the left cheek that had been there for more than a decade. Her concern was that the lesion was growing and had become conspicuous. She had spent most of her life as a farmer working in her orchard.Upon examination, she had an obvious dome-shaped nodule over the left cheek measuring approximately 1.8 cm in diameter. The lesion was firm, pigmented, well-demarcated, and slightly ulcerated at the top. Clinically, she was diagnosed with a pigmented nodular basal cell carcinoma of the left cheek. Examination of the systems was unremarkable.She requested that the consulting GP remove the growth. The cost for specialist treatment and waiting time at the local hospital were her concerns.
Clinical Questions: Can the basal cell skin cancer be excised safely and effectively in the local primary care setting? What are the crucial preoperative concerns?
MATERIALS & METHODS: Standardised surgical technique with Parametrium & Paracolpium resection approach was adopted by qualified and experienced Gynecologic/Gyne-Oncologic Endoscopic & Minimally Invasive Surgeons in performing Laparoscopic Radical Hysterectomy for Cervical Cancer stage 1A1-1B1 from January 2009-May 2014, involving 53 patients. Electronic Medical Record system (EMR) Of Chang Gung Memorial Hospital(Tertiary Referral Centre), Department of Obstetrics & Gynecology was accessed for surgical and oncologic outcomes.
RESULTS: Fifty-Three patients operated from January 2009 to May 2014 were followed up for an average of 96.7 months with longest follow-up at 127 months. There were no cases of recurrence or death reported. 5 Year - Survival Rate and 5 Year Disease-Free Survival Rate were 100%. Two patients received post-operative pelvic radiation concurrent with chemotherapy using Cisplatin due to greater than 1/3 cervical stromal invasion.
CONCLUSION: It is vital to standardize minimally invasive surgical techniques for early stage cervical cancer, with focus on adequate radicality and resection which may contribute to excellent survival outcomes. Further international multi-center randomized trial (Minimally Invasive Therapy Versus Open Radical Hysterectomy In Cervical Cancer) will provide justification for continued practice of MIS in early stage cervical cancer.
METHOD: The model was formulated by integrating the Caputo fractional derivative with the previous cancer treatment model. Thereafter, the linear-quadratic with the repopulation model was coupled into the model to account for the cells' population decay due to radiation. The treatment process was then simulated with numerical variables, numerical parameters, and radiation parameters. The numerical parameters which included the proliferation coefficients of the cells, competition coefficients of the cells, and the perturbation constant of the normal cells were obtained from previous literature. The radiation and numerical parameters were obtained from reported clinical data of six patients treated with radiotherapy. The patients had tumor volumes of 24.1cm3, 17.4cm3, 28.4cm3, 18.8cm3, 30.6cm3, and 12.6cm3 with fractionated doses of 2 Gy for the first two patients and 1.8 Gy for the other four. The initial tumor volumes were used to obtain initial populations of cells after which the treatment process was simulated in MATLAB. Subsequently, a global sensitivity analysis was done to corroborate the model with clinical data. Finally, 96 radiation protocols were simulated by using the biologically effective dose formula. These protocols were used to obtain a regression equation connecting the value of the Caputo fractional derivative with the fractionated dose.
RESULTS: The final tumor volumes, from the results of the simulations, were 3.58cm3, 8.61cm3, 5.68cm3, 4.36cm3, 5.75cm3, and 6.12cm3, while those of the normal cells were 23.87cm3, 17.29cm3, 28.17cm3, 18.68cm3, 30.33cm3, and 12.55cm3. The sensitivity analysis showed that the most sensitive model factors were the value of the Caputo fractional derivative and the proliferation coefficient of the cancer cells. Lastly, the obtained regression equation accounted for 99.14% of the prediction.
CONCLUSION: The model can simulate a cancer treatment process and predict the results of other radiation protocols.
METHODS: A 3D-printed cardiac insert and Catphan 500 phantoms were scanned using CCTA protocols at 120 and 100 kVp tube voltages. All CT acquisitions were reconstructed using filtered back projection (FBP) and Adaptive Statistical Iterative Reconstruction (ASIR) algorithm at 40% and 60% strengths. Image quality characteristics such as image noise, signal-noise ratio (SNR), contrast-noise ratio (CNR), high spatial resolution, and low contrast resolution were analyzed.
RESULTS: There was no significant difference (P > 0.05) between 120 and 100 kVp measures for image noise for FBP vs ASIR 60% (16.6 ± 3.8 vs 16.7 ± 4.8), SNR of ASIR 40% vs ASIR 60% (27.3 ± 5.4 vs 26.4 ± 4.8), and CNR of FBP vs ASIR 40% (31.3 ± 3.9 vs 30.1 ± 4.3), respectively. Based on the Modulation Transfer Function (MTF) analysis, there was a minimal change of image quality for each tube voltage but increases when higher strengths of ASIR were used. The best measure of low contrast detectability was observed at ASIR 60% at 120 kVp.
CONCLUSIONS: Changing the IR strength has yielded different image quality noise characteristics. In this study, the use of 100 kVp and ASIR 60% yielded comparable image quality noise characteristics to the standard CCTA protocols using 120 kVp of ASIR 40%. A combination of 3D-printed and Catphan® 500 phantoms could be used to perform CT dose optimization protocols.