مجله دانشکده پزشکی اصفهان
پیاپی 554 (هفته دوم بهمن 1398)

Port catheter is a new generation of central venous catheter used in patients with cancer to prescribe chemotherapy drugs. There are various methods for inserting this catheter, and the aim of present study was to evaluate the complications of catheter insertion via subclavian or external jugular vein cut-down.

The study was performed on 80 patients with malignancy requiring port catheter insertion. External jugular vein cut-down and Seldinger method via subclavian vein was used for vein access in groups A and B, respectively. To implant the port chamber, a cavity was created in the subcutaneous tissue below the clavicle. Then, a tunnel was made between the cavities and puncture site for the bypass catheter, and the catheter tip was attached to the port compartment. All patients were evaluated for intraoperative complications such as pneumothorax, hemorrhage, artery rupture, inappropriate port catheter place, and embolism, as well as late complications such as infection, thrombosis, extravasation, catheter rupture, and pulmonary embolism.

Early complications such as pneumothorax (12.5% vs. 0.0%) and hematoma (15.0% vs. 2.5%) were more common in group B (P < 0.050). Moreover, delayed complications such as infection (9 vs. 2 cases), venous thrombosis (7 vs. 1 patients), catheter obstruction (8 vs. 2 cases), and cellulitis (8 vs. 2 patients) were more common in group B, too (P < 0.050).</div>

 Despite higher insertion time, port catheter insertion via subclavian vein was a better method than external jugular vein due to lower incidence of early and late complications.

Lichenoid reactions are defined as a group of lesions that have different etiologies, but present with similar clinical and histopathological manifestations. The aim of this study was to determine the prevalence of types of oral lichenoid lesions recorded in the archives of Pathology Department of the School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran, during a thirty-year period to evaluate the clinicopathological characteristics of these lesions.

This study was performed on 1060 records of patients with lichenoid lesions referred to the pathology department of Isfahan School of Dentistry from 1989 to 2018. The gathered data were analyzed using descriptive statistics, chi-square test, and one-way analysis of variance (ANOVA). P values of less than 0.05 were considered significant.

From all 11964 samples recorded in the archives, 1060 cases were related to the lichenoid reactions. Among these lesions, the prevalence of oral lichen planus was 39%, lichenoid lesions 40%, lichen planus or undiagnosed lichenoid lesions 15.5%, and with no definitive diagnosis 2.8%. The most common site of involvement was the area of the cheek. The mean age of the patients was 47.65 ± 13.59 years. There was a significant relationship between the incidence of lesions and gender; the incidence among the women was higher than that of men (P = 0.041).

 Considering the general prevalence of these lesions compared to all oral biopsies (8.85%) and malignant changes that in our study is reported as 2.7%, understanding the epidemiological features of these lesions that leads to a better differential diagnosis and treatment is necessary.

The aim of this study was to evaluate the influences of iterative model reconstruction (IMR) and hybrid-iterative reconstruction (HIR) techniques on quantitative and qualitative image analysis of 256-slice coronary computed tomography angiography (CCTA).

Sixty-one patients (30 men and 31 women with mean age of 60.68 ± 9.13 years) who had undergone CCTA by the 256-slice CT scanner were evaluated. The raw data were reconstructed using HIR and IMR algorithms. For objective assessment of image quality, parameters of noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were obtained for both reconstruction algorithms. For subjective assessment, two physician specialists evaluated image quality using a 5-point scale.

The mean image noise on HIR and IMR images was 32.74 ± 6.04 and 25.15 ± 3.59, respectively. In IMR, the CNR method (28.81 ± 5.13) was significantly better than HIR method (23.06 ± 5.03) (P < 0.001). However, the HIR method (4.62 ± 0.39) was higher than the IMR method (4.48 ± 0.45) in terms of qualitative or subjective criteria (P < 0.001).

 The IMR method can improve quantitative criteria of image, reduce noise, and increase SNR and CNR of images better than HIR method. However, the images which reconstructed by HIR were superior to IMR in terms of qualitative criteria.