A comparative study of two different regression methods for radiographs in Polish youngsters estimating chronological age on third molars.

AIM: The aim of this study was to establish a third molar developmental database to model dental age of Polish youngsters, to investigate the rating level of the scores when dividing a year interval into a quarter of a year and to examine sex differences, left-right and upper-lower jaw asymmetry. MATERIAL AND METHODS: A cross-sectional sample of 1048 orthopantomograms of 644 females and 404 males aged between 12 and 26 years was investigated using the scoring system of Gleiser and Hunt modified by Köhler. Reference tables according to age were split in a whole year and in quarters of a year using descriptive statistics. The various developmental stages between males and females were analyzed with a paired t-test and the cusum method. Differences in mineralization between the quadrants were analyzed with a two-factor ANOVA and the Duncan post hoc test. The single quadratic and support vector regression were performed to describe the relationship between score and age. RESULTS: Dividing age classes in quarters of a year discriminated better between individuals provided that there is a sufficient sampling size for all age classes. The mineralization tempo occurred significantly at a faster rate in males. The maturational events in the upper arch developed significantly at earlier ages for both genders. Obtained chronological age had nearly the same standard error of estimate when calculated with both regression methods. DISCUSSION AND CONCLUSION: Comparing the results of the present study with those of other population groups suggests that there are differences in the ageing process of the wisdom tooth. This is the first database of Polish youngsters (15-24 years) with their respective regression equations to yield age estimations.

A scanning electron microscopic study of debris and smear layer remaining following use of GT rotary instruments.

AIM: The aim of the present study was to assess debris and smear layer remaining following canal preparation with GT rotary instruments. METHODOLOGY: Sixteen freshly extracted single-rooted premolar teeth were instrumented with GT rotary instruments using a crown-down preparation technique. All specimens were flushed with 2 mL of 5% NaOCl between each rotary instrument. At the end of instrumentation the following final irrigation sequence was repeated two times: 2 mL of EDTA + Cetrimide for 1 min (Largal Ultra, Septodont, France) and 2 mL of 5% NaOCl for 5 min. A final flush with saline solution was made to halt any chemical activity. Two other uninstrumented teeth that were not irrigated served as controls. All teeth were split longitudinally and prepared for SEM evaluation. The presence of debris and smear layer was evaluated from photomicrographs at x200 and x1000 magnification taken in the apical, middle and coronal thirds of the canals. Blind evaluation was performed by two trained observers and scores were compiled separately. A five category scoring system for debris and smear layer was used. Values obtained were tabulated and statistical analysis was carried out using a parametric chi-squared test. RESULTS: Statistical analysis showed that there was no significant difference between the three regions of the root canals (P > 0.05) for debris. Comparison of the removal of the smear layer between the three regions showed that there was a statistically significant difference between all parts, especially between the coronal and apical thirds (P < 0.001). Overall, the coronal sections were cleaner than the middle and apical sections. The uninstrumented canals showed walls completely covered with tissue, confirming that specimen preparation alone did not remove tissue. CONCLUSIONS: Under the conditions of the present study GT rotary instruments removed debris effectively, but left root canal walls covered with smear layer, particularly in the apical third.

[Malignant or benign thyroid nodules: a diagnostic dilemma]. / Guzki lagodne czy zlosliwe w tarczycy--dylemat diagnostyczny.

The aim of this study was to determine the incidence of cysts and cystoid-solid lesions in thyroid carcinomas basing on preoperative ultrasonographic examinations (USG), fine needle aspiration biopsy (FNAB) and postoperative histopathological examinations. 661 patients with different thyroid disorders were treated surgically. Carcinoma was found in 46 patients (3.9%). Papillary carcinoma was predominant (n = 34). Of the 46 patients with carcinoma, preoperative USG examination revealed cystic or cystoid-solid lesions in 18 patients (39%). FNAB of this 18 patients was positive in 5 cases, negative in 4 and suspect in 9. In 6 cases the neoplastic lesion was strictly connected with cysts (foci in the wall or in solid masses within the cyst) and in the remaining 12 patients lesions were found in the vicinity of the neoplastic focus. We conclude that malignant neoplasms of the thyroid gland are frequently (in approximately 40%) accompanied by cystic and cystoid-solid lesions, FNAB diagnostic material should be obtained even through several USG-controlled punctures and negative FNAB does not exclude thyroid carcinoma, particularly in nodular-cystoid goitre.

[Power Doppler as a method that is better than color Doppler for evaluation of thyroid nodular lesions]. / Power Doppler jako metoda lepsza niz kolor Doppler w ocenie nieczynnych guzków tarczycy.

AIM: The evaluation of usefulness of color Doppler sonography and power Doppler sonography in the diagnostics of thyroid nodules with the low or absent uptake of (99m)Tc-pertechnate. Although scintigraphy is highly sensitive method in the diagnosis of cold nodules it is non-specific in the diagnostics of malignant changes of thyroid. We tried to investigate the possibility to improve the diagnostic accuracy of sonography. MATERIAL AND METHODS: 122 cold thyroid nodules were investigated with linear 7.5 Mhz Doppler probe. The flow pattern in power Doppler and color Doppler were correlated with cytologic and histopathologic examination. RESULTS: According to cytology, PD has better sensitivity and specificity than CD; consecutively-100% vs. 86.6% and 93.4% vs. 84.1%. CONCLUSIONS: 1. Power Doppler can detect low blood flow in small blood vessels, observed in thyroid cancer. 2. Power Doppler allows the best nodules selection for fine-needle biopsy than color Doppler.

[Surgical treatment of thyroid disease in adolescents]. / Leczenie chirurgiczne chorób tarczycy u mlodocianych.

Surgical treatment of goitre in children and teenagers under 18 is relatively rare and undertaken for strict therapeutic indications. It still arouses much controversy among surgeons, being loaded with a high percentage of complications, usually distant ones. The aim of the study was to analyse the surgical treatment of various goitre types under the age of 18 basing on 65 operations performed in the years 1994-1998. Operations for non-toxic and hyperactive nodular goitre, including Graves-Basedow disease, were predominant. Five cases of thyroid carcinoma were found. No serious complications were observed during and after the surgery. Our own material and the 5-year observation reveal that surgical treatment of thyroid diseases in children and adolescents carried out for definite indications by an experienced operating team is successful and causes only few complications.

[Diagnosis and surgical treatment of pancreatic carcinoma]. / Rak trzustki--diagnostyka i leczenie.

The aim of the study was presentation of our experiences in the diagnostics and treatment of pancreatic carcinoma in confrontation with current opinions. Between 1983 and April 1998 308 patients (198 males and 110 females with mean age 61 years) were treated at our department. In 211 cases tumor was primarily localized in the head and in 97 cases (31.5%) in the body or tail of pancreas. The diagnosis was determined on the basis of clinical symptoms and laboratory investigations. Diagnostic accuracy of performed investigations was as following. Ultrasonography-86%, CT-scan-95%, and ERCP-94%. Ultrasonography or CT guided biopsy and serodiagnostics improved detectability of resectionable carcinoma in the last past years. Among 308 patients, 292 underwent surgery. Since 1997 an intraoperative ultrasonography and cholangioscopy of common bile duct and Virsung were performed as a routine. The procedures depended on the localization and the grade of advance of the tumors. UICC classification of pancreatic tumors, pTNM (4th edition 1987) it was used. Only in 25 patients (8%) (tumors pT1a-bN0M0) it was possible to perform radical operation (resection of the pancreas). However in 172 patients (56%) only palliative procedures were done (pT2N1M0). In 95 patients (31%) only laparotomy and biopsy were performed (tumors pT2N1M1). The study shows that although diagnostic methods are improved, the tumors of the pancreas are diagnosed in stages making unable the radical procedures. Only about 10% of carcinomas are resectable. It is caused by with non-characteristic picture of the disease in its early stage.

[Results of surgical treatment for adrenal gland diseases]. / Wyniki chirurgicznego leczenia chorób nadnerczy.

The authors present their own experience in diagnosing and surgical treatment of adrenal tumors. The group consisted of 52 patients with adrenal tumors treated surgically in our Department in 1980-1996. There were 37 women (71%) and 15 men (29%); 22 with Cushing syndrome, 14 with pheochromocytoma, 4 with Conn's syndrome, 1 with virilizing tumor, 1 with adenocarcinoma, 1 with adrenocortical carcinoma, 1 with ganglioneuroblastoma 2 with adenomas, 6 with adrenal cyst. Diagnosis pre- and intraoperative was verified with histological examination. We suggest that the ultrasonography and computed tomography are the most useful methods in determining of tumor localisation. The authors prefer intraperitoneal approach, enabling evaluation of the contralateral adrenal gland and possible localisation of extraadrenal foci. Good results were obtained in 51 patients (98%).