Undoubtedly, the use of radiographic imaging has entirely revolutionized diagnosis and treatment planning in medical sciences. The role of imaging in oral malignancies can be broadly grouped into those used to evaluate primary disease and those to evaluate metastatic disease.
It is a useful tool for staging and management planning in oral cancers. Awareness of the presence of cervical node metastasis is important in treatment planning and in prognostic prediction for patients with head and neck cancer (HNC).
. Panoramic radiography (also called pan tomography or rotational radiography) is a radiographic technique for producing a single image of the facial structures that include both maxillary and mandibular arches and their supporting structures.
Multiparametric Quantitative MRI as a Metric for Radiation Treatment PlanningCrimsonpublishersCancer
Magnetic resonance imaging (MRI) provides excellent soft tissue contrast, and in combination with its quantitative functional imaging capability, this modality is ideal for use in radiotherapy. MRI images, either used directly or fused with CT, play an increasingly important role in contouring gross tumor volume (GTV) and organs at risk (OAR) in radiation treatment planning (RTP) systems. The soft tissue contrast of MRI images provides more accurate tumor delineation than CT, although CT images have sufficient geometrical stability and electron density information for accurate radiation treatment planning. Many vendors now offer 70 cm wide-bore MRI systems with dedicated radiofrequency (RF) coils and immobilization devices for RTP simulation comparable to CT simulators.
Multiparametric Quantitative MRI as a Metric for Radiation Treatment PlanningCrimsonpublishersCancer
Magnetic resonance imaging (MRI) provides excellent soft tissue contrast, and in combination with its quantitative functional imaging capability, this modality is ideal for use in radiotherapy. MRI images, either used directly or fused with CT, play an increasingly important role in contouring gross tumor volume (GTV) and organs at risk (OAR) in radiation treatment planning (RTP) systems. The soft tissue contrast of MRI images provides more accurate tumor delineation than CT, although CT images have sufficient geometrical stability and electron density information for accurate radiation treatment planning. Many vendors now offer 70 cm wide-bore MRI systems with dedicated radiofrequency (RF) coils and immobilization devices for RTP simulation comparable to CT simulators.
Magnetic Resonance Imaging is a technique that uses the magnetic field and radio waves to create detail images of the organs and tissues of the human body
Application Brief: Tumor Microenvironment Imaging with Photoacoustic TechnologyFUJIFILM VisualSonics Inc.
Photoacoustics (PA) combines optical contrast with the high spatial resolution and deep tissue penetration offered by ultrasound. Such applications are especially beneficial for monitoring tumor development, measuring blood concentration changes within it, and quantifying networks of vasculature formation and carcinoma growth over time.
Application Brief: Tumor Microenvironment Imaging with Photoacoustic TechnologyFUJIFILM VisualSonics Inc.
Combining photoacoustic technology with high-resolution ultrasound projections offered by the Vevo 2100 system provides tremendous benefits for cancer screening. Researchers can now benefit from the combined high-resolution ultrasound and optical contrast ability of the Vevo® LAZR photoacoustic imaging system to achieve clear, deep, images in 2D and 3D for optimal in vivo visualization and quantification of internal anatomy, tumor tissue, and hemodynamics.
Many evidences that CSCs also play a central role in the pathogenesis and progression of carcinomas of the head and neck (HNSCC), including OSCC,have been found.
Early tissue culture studies showed that only a subpopulation of OSCC cells can form expanding tumor colonies, suggesting that human OSCC may contain some form of stem cells and it was subsequently shown that only a small subpopulation of the cells in OSCC corresponds to tumor-initiating cells.
These finding are in accordance with CSCs concept (17,34) that the tumor mass is a mixture of (a) CSCs dividing themselves to feed the tumor's growth, b) transient amplifying cells that divide themselves a few times before maturing into (c) differentiated tumor cells that do not contribute to tumor growth (4).
The isolation of CSCs from oral cancers has mainly been performed with the CD44 marker that was initially used to isolate breast cancer CSCs.
Many evidences that CSCs also play a central role in the pathogenesis and progression of carcinomas of the head and neck (HNSCC), including OSCC,have been found.
Early tissue culture studies showed that only a subpopulation of OSCC cells can form expanding tumor colonies, suggesting that human OSCC may contain some form of stem cells and it was subsequently shown that only a small subpopulation of the cells in OSCC corresponds to tumor-initiating cells.
These finding are in accordance with CSCs concept (17,34) that the tumor mass is a mixture of (a) CSCs dividing themselves to feed the tumor's growth, b) transient amplifying cells that divide themselves a few times before maturing into (c) differentiated tumor cells that do not contribute to tumor growth (4).
The isolation of CSCs from oral cancers has mainly been performed with the CD44 marker that was initially used to isolate breast cancer CSCs.
More Related Content
Similar to radiographic technique of oral tumors.pptx
Magnetic Resonance Imaging is a technique that uses the magnetic field and radio waves to create detail images of the organs and tissues of the human body
Application Brief: Tumor Microenvironment Imaging with Photoacoustic TechnologyFUJIFILM VisualSonics Inc.
Photoacoustics (PA) combines optical contrast with the high spatial resolution and deep tissue penetration offered by ultrasound. Such applications are especially beneficial for monitoring tumor development, measuring blood concentration changes within it, and quantifying networks of vasculature formation and carcinoma growth over time.
Application Brief: Tumor Microenvironment Imaging with Photoacoustic TechnologyFUJIFILM VisualSonics Inc.
Combining photoacoustic technology with high-resolution ultrasound projections offered by the Vevo 2100 system provides tremendous benefits for cancer screening. Researchers can now benefit from the combined high-resolution ultrasound and optical contrast ability of the Vevo® LAZR photoacoustic imaging system to achieve clear, deep, images in 2D and 3D for optimal in vivo visualization and quantification of internal anatomy, tumor tissue, and hemodynamics.
Many evidences that CSCs also play a central role in the pathogenesis and progression of carcinomas of the head and neck (HNSCC), including OSCC,have been found.
Early tissue culture studies showed that only a subpopulation of OSCC cells can form expanding tumor colonies, suggesting that human OSCC may contain some form of stem cells and it was subsequently shown that only a small subpopulation of the cells in OSCC corresponds to tumor-initiating cells.
These finding are in accordance with CSCs concept (17,34) that the tumor mass is a mixture of (a) CSCs dividing themselves to feed the tumor's growth, b) transient amplifying cells that divide themselves a few times before maturing into (c) differentiated tumor cells that do not contribute to tumor growth (4).
The isolation of CSCs from oral cancers has mainly been performed with the CD44 marker that was initially used to isolate breast cancer CSCs.
Many evidences that CSCs also play a central role in the pathogenesis and progression of carcinomas of the head and neck (HNSCC), including OSCC,have been found.
Early tissue culture studies showed that only a subpopulation of OSCC cells can form expanding tumor colonies, suggesting that human OSCC may contain some form of stem cells and it was subsequently shown that only a small subpopulation of the cells in OSCC corresponds to tumor-initiating cells.
These finding are in accordance with CSCs concept (17,34) that the tumor mass is a mixture of (a) CSCs dividing themselves to feed the tumor's growth, b) transient amplifying cells that divide themselves a few times before maturing into (c) differentiated tumor cells that do not contribute to tumor growth (4).
The isolation of CSCs from oral cancers has mainly been performed with the CD44 marker that was initially used to isolate breast cancer CSCs.
Clinical Description
Cleidocranial dysplasia (CCD) spectrum disorder is a skeletal dysplasia representing a clinical continuum ranging from classic CCD (triad of delayed closure of the cranial sutures, hypoplastic or aplastic clavicles, and dental abnormalities), to mild CCD, to isolated dental anomalies without other skeletal features [Golan et al 2000]. Most individuals are diagnosed because they have classic features. CCD spectrum disorder affects most prominently those bones derived from intramembranous ossification, such as the cranium and the clavicles, although bones formed through endochondral ossification can also be affected. Cooper et al [2001] recorded the natural history of 90 probands and 56 first- and second-degree relatives; findings highlight the clinical variability of this condition within affected members of the same family who harbor the same pathogenic variant. Roberts et al [2013] reviewed their experience with more than 100 affected individuals in South Africa.
Classic CCD. The most prominent clinical findings in individuals with classic CCD are listed in Suggestive Findings and include: abnormally large, wide-open fontanelles at birth that may remain open throughout life; clavicular hypoplasia resulting in narrow, sloping shoulders that can be opposed at the midline; and abnormal dentition
Further medical problems identified in individuals with CCD spectrum disorder include short stature, skeletal/orthopedic findings, dental complications, ENT complications, endocrine findings, and mild developmental delay.
Molecular Pathogenesis
RUNX2 encodes runt-related transcription factor 2 (RUNX2), a transcription factor involved in osteoblast differentiation and skeletal morphogenesis. RUNX2 is essential for osteoblast differentiation during intramembranous ossification as well as chondrocyte maturation during endochondral ossification [Zheng et al 2005]. RUNX2 contains an N-terminal stretch of consecutive polyglutamine and polyalanine repeats known as the Q/A domain, a runt domain, and a C-terminal proline/serine/threonine-rich (PST) activation domain. The runt domain is a 128-amino-acid polypeptide motif originally described in the Drosophila runt gene that has the unique ability to independently mediate DNA binding and protein heterodimerization [Zhou et al 1999].
The majority of RUNX2 pathogenic variants in individuals with classic CCD affect the runt domain and most are predicted to abolish DNA binding [Lee et al 1997, Mundlos et al 1997, Otto et al 2002]. Pathogenic missense variants cluster at arginine 225 (p.Arg225) of RUNX2, a critical residue for RUNX2 function. In vitro studies have shown that pathogenic missense variants at p.Arg225 interfere with nuclear accumulation of RUNX2.
Hypomorphic RUNX2 alleles with partial loss of protein function, c.90dupC and c.598A>G, are associated with mild CCD, isolated dental anomalies, and significant intrafamilial variability.
Mechanism of disease causation. Loss of function
RUNX2-sp
Cleidocranial dysplasia (CCD) spectrum disorder is a skeletal dysplasia representing a clinical continuum ranging from classic CCD (triad of delayed closure of the cranial sutures, hypoplastic or aplastic clavicles, and dental abnormalities), to mild CCD, to isolated dental anomalies without other skeletal features [Golan et al 2000]. Most individuals are diagnosed because they have classic features. CCD spectrum disorder affects most prominently those bones derived from intramembranous ossification, such as the cranium and the clavicles, although bones formed through endochondral ossification can also be affected. Cooper et al [2001] recorded the natural history of 90 probands and 56 first- and second-degree relatives; findings highlight the clinical variability of this condition within affected members of the same family who harbor the same pathogenic variant. Roberts et al [2013] reviewed their experience with more than 100 affected individuals in South Africa.
Wound healing is a highly dynamic process and involves complex interactions of extracellular matrix molecules, soluble mediators, various resident cells, and infiltrating leukocyte subtypes.
The immediate goal in repair is to achieve tissue integrity and homeostasis
PV is caused by autoantibodies that target cadherins, specifically desmogleins, though there may be some role for desmocollin; thus, this is a type 2 hypersensitivity reaction.[24][25] Acantholysis, or the loss of keratinocyte–keratinocyte adhesion, is interrupted by circulating IgG autoantibodies to intercellular adhesion molecules.[26][27] Acantholysis is seen as a result of the autoantibodies destroying the intracellular connections, leading to bullae that can easily rupture (known clinically as the Nikolsky sign).
A “super-compensation hypothesis” recently submitted by Sinha et al. proposes that additional factors may also play a role in PV.[28] Multiple mechanisms for antibody-induced acantholysis have been suggested, including the induction of signal transduction and the inhibition of adhesive molecule function through steric hindrance, which can trigger cell separation.[29] The pathogenesis of PV has been described in more detail by Hammers et al.[30]
In patients with PV, autoantibodies against desmoglein 1 (Dsg 1) and desmoglein 3 (Dsg 3) is the purported cause.[31] Desmogleins are transmembrane glycoproteins that are an integral part of desmosomes which, in part, are required for cell–cell adhesion via interaction with intermediate filaments. The most common targets of desmoglein for IgG antibodies are the extracellular cadherin domains, which can result in the loss of desmosome-adhesive properties. These signaling pathways trigger endocytosis, depletion, and direct inhibition of Dsg 3 interactions.[32] It is generally believed that the amino portion of the cadherin proteins is most implicated in the pathogenesis of acantholysis leading to PV.[33]
Many animal models have shown that enzymatic inactivation of Dsg 1 and gene deletion of Dsg 3 results in pathology similar to PV.[34][35] This phenomenon was observed to be dose-dependent and suggests that reducing the circulating levels of IgG against Dsg 1 and Dsg 3 can improve patient outcomes.[36] In patients with primarily cutaneous disease, Dsg 1 likely plays a role more superficially, whereas Dsg 3 is more likely to be found in deeper cutaneous structures and mucous membranes.[37][38] The implication is that Dsg 3 can compensate for the absence of Dsg 1 in mucosal structures (thus demonstrating PV in cutaneous lesions only). In contrast, Dsg 1 without Dsg 3 is insufficient to manage mucous membranes or cutaneous lesions alone, implying that Dsg 1 is in lower proportion in mucous membranes.
The binding of antibodies to desmogleins has been confirmed by epitope mapping and is presumed to disrupt desmoglein binding by affecting steric hindrance.[39] Another theory for the pathophysiology of PV is the desmoglein nonassembly depletion hypothesis. This theory suggests that autoantibodies not only bind desmoglein but that they also bind each other, leading to crosslinking and the inability of desmosomes to maintain cell–cell adhesion.[40][41]
PV is caused by autoantibodies that target cadherins, specifically desmogleins, though there may be some role for desmocollin; thus, this is a type 2 hypersensitivity reaction.[24][25] Acantholysis, or the loss of keratinocyte–keratinocyte adhesion, is interrupted by circulating IgG autoantibodies to intercellular adhesion molecules.[26][27] Acantholysis is seen as a result of the autoantibodies destroying the intracellular connections, leading to bullae that can easily rupture (known clinically as the Nikolsky sign).
A “super-compensation hypothesis” recently submitted by Sinha et al. proposes that additional factors may also play a role in PV.[28] Multiple mechanisms for antibody-induced acantholysis have been suggested, including the induction of signal transduction and the inhibition of adhesive molecule function through steric hindrance, which can trigger cell separation.[29] The pathogenesis of PV has been described in more detail by Hammers et al.[30]
In patients with PV, autoantibodies against desmoglein 1 (Dsg 1) and desmoglein 3 (Dsg 3) is the purported cause.[31] Desmogleins are transmembrane glycoproteins that are an integral part of desmosomes which, in part, are required for cell–cell adhesion via interaction with intermediate filaments. The most common targets of desmoglein for IgG antibodies are the extracellular cadherin domains, which can result in the loss of desmosome-adhesive properties. These signaling pathways trigger endocytosis, depletion, and direct inhibition of Dsg 3 interactions.[32] It is generally believed that the amino portion of the cadherin proteins is most implicated in the pathogenesis of acantholysis leading to PV.[33]
Many animal models have shown that enzymatic inactivation of Dsg 1 and gene deletion of Dsg 3 results in pathology similar to PV.[34][35] This phenomenon was observed to be dose-dependent and suggests that reducing the circulating levels of IgG against Dsg 1 and Dsg 3 can improve patient outcomes.[36] In patients with primarily cutaneous disease, Dsg 1 likely plays a role more superficially, whereas Dsg 3 is more likely to be found in deeper cutaneous structures and mucous membranes.[37][38] The implication is that Dsg 3 can compensate for the absence of Dsg 1 in mucosal structures (thus demonstrating PV in cutaneous lesions only). In contrast, Dsg 1 without Dsg 3 is insufficient to manage mucous membranes or cutaneous lesions alone, implying that Dsg 1 is in lower proportion in mucous membranes.
The binding of antibodies to desmogleins has been confirmed by epitope mapping and is presumed to disrupt desmoglein binding by affecting steric hindrance.[39] Another theory for the pathophysiology of PV is the desmoglein nonassembly depletion hypothesis. This theory suggests that autoantibodies not only bind desmoglein but that they also bind each other, leading to crosslinking and the inability of desmosomes to maintain cell–cell adhesion.[40][41]
The primary function of platelets is their role in hemostasis. Briefly, under normal physiological conditions, platelets will adhere to and begin to spread over the surface of subendothelial cells exposed by damage to the vascular endothelium.(1) Adhesion is dependent on the platelet membrane glycoprotein lb complex. The von Willebrand factor (vWF) is required for both adhesion and spreading.
The primary function of platelets is their role in hemostasis. Briefly, under normal physiological conditions, platelets will adhere to and begin to spread over the surface of subendothelial cells exposed by damage to the vascular endothelium.(1) Adhesion is dependent on the platelet membrane glycoprotein lb complex. The von Willebrand factor (vWF) is required for both adhesion and spreading.
Phagocytosis begins with adhesion of the phagocyte surface receptors to the pathogen, which then is internalized into vesicles called phagosomes.
Inside the phagocyte, the phagosome fuses to lysosomes, whose contents are released with consequent digestion and pathogen elimination.
Changes in the oxidase’s gene system components present in phagolysosome membrane lead to disability in respiratory burst and generation of reactive oxygen species (ROS).
Phagocytosis begins with adhesion of the phagocyte surface receptors to the pathogen, which then is internalized into vesicles called phagosomes.
Inside the phagocyte, the phagosome fuses to lysosomes, whose contents are released with consequent digestion and pathogen elimination.
Changes in the oxidase’s gene system components present in phagolysosome membrane lead to disability in respiratory burst and generation of reactive oxygen species (ROS).
Platelets have many functions, including phagocytosis of viruses, latex, immune complexes and iron; maintenance of vascular integrity
by filling gaps that form in the endothelium and by directly supporting endothelial cells; synthesis and release of vWF in humans and some animal species, and fibronectin;
participating in surface adhesion andactivation processess (Caen and Rosa, 1995; Clemetson, 1995; Nurden, 1995);
production and release of potent smooth muscle and endothelial cell proliferating factor( s); and retraction of clots, a process that stabilizes the initial hemostatic plug and activates clot lysis.
Platelets have many functions, including phagocytosis of viruses, latex, immune complexes and iron; maintenance of vascular integrity
by filling gaps that form in the endothelium and by directly supporting endothelial cells; synthesis and release of vWF in humans and some animal species, and fibronectin;
participating in surface adhesion andactivation processess (Caen and Rosa, 1995; Clemetson, 1995; Nurden, 1995);
production and release of potent smooth muscle and endothelial cell proliferating factor( s); and retraction of clots, a process that stabilizes the initial hemostatic plug and activates clot lysis.
Tooth development proceeds with reciprocal inductive interactions between stomadeum ectoderm and underlying ectomesenchymal cells in a strictly controlled temporal and spatial order.
Well studied at the molecular biologic level, over 300 genes and 100 growth and differentiation factors are implicated in the control of cellular differentiation and crosstalk in dental development that result in structures containing combination of mineralized tissues (enamel, dentine, cementum), soft connective tissues (dental pulp, periodontal ligament), blood vessels, nerves and lymphatics.
Tooth development proceeds with reciprocal inductive interactions between stomadeum ectoderm and underlying ectomesenchymal cells in a strictly controlled temporal and spatial order.
Well studied at the molecular biologic level, over 300 genes and 100 growth and differentiation factors are implicated in the control of cellular differentiation and crosstalk in dental development that result in structures containing combination of mineralized tissues (enamel, dentine, cementum), soft connective tissues (dental pulp, periodontal ligament), blood vessels, nerves and lymphatics
Diagnostic polymerase chain reaction (PCR) is an extremely powerful, rapid method for diagnosis of microbial infections and genetic diseases, as well as for detecting microorganisms in environmental and food samples.
However, the usefulness of diagnostic PCR is limited, in part, by the presence of inhibitory substances in complex biological samples, which reduce or even block the amplification capacity of PCR in comparison with pure solutions of nucleic acids .
In general, diagnostic PCR may be divided into four steps: (1) sampling, (2) sample preparation, (3) nucleic acid amplification, and (4) detection of PCR products
Diagnostic polymerase chain reaction (PCR) is an extremely powerful, rapid method for diagnosis of microbial infections and genetic diseases, as well as for detecting microorganisms in environmental and food samples.
However, the usefulness of diagnostic PCR is limited, in part, by the presence of inhibitory substances in complex biological samples, which reduce or even block the amplification capacity of PCR in comparison with pure solutions of nucleic acids .
In general, diagnostic PCR may be divided into four steps: (1) sampling, (2) sample preparation, (3) nucleic acid amplification, and (4) detection of PCR products
The etiology of a disease refers to the causative trigger(s), whereas pathogenesis refers to the mechanism(s) by which the disease progresses.
In other words, while the microbial biofilm developing on the tooth surface constitutes a necessary etiological factor, its mere presence is insufficient for the initiation of the disease.
Further risk factors, such as host genetics, lifestyle, stress, and systemic conditions, that dictate the immunopathogenesis are crucial for the transition from a healthy to a diseased state.
The etiology of a disease refers to the causative trigger(s), whereas pathogenesis refers to the mechanism(s) by which the disease progresses.
In other words, while the microbial biofilm developing on the tooth surface constitutes a necessary etiological factor, its mere presence is insufficient for the initiation of the disease.
Further risk factors, such as host genetics, lifestyle, stress, and systemic conditions, that dictate the immunopathogenesis are crucial for the transition from a healthy to a diseased state.
Nano-composite scaffolds based on electrospun nanofibers have gained great attention due to their ability to emulate natural extracellular matrix (ECM) that affects cell survival, attachment and reorganization.
Promoted protein absorption, cellular reactions, activation of specific gene expression and intracellular signaling, and high surface area to volume ratio are also important properties of nanofibrous scaffolds.
Moreover, several bioactive components, such as bioceramics and functional polymers can be easily blended into nanofibrous matrixes to regulate the physical-chemical-biological properties and regeneration abilities.
Simultaneously, functional growth factors, proteins and drugs are also incorporated to regulate cellular reactions and even modify the local inflammatory microenvironment, which benefit periodontal regeneration and functional restoration
More from Romissaa ali Esmail/ faculty of dentistry/Al-Azhar university (20)
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. radiographic techniques of oral tumors
By
Romissaa Aly
Assistant lecturer of Oral Medicine,
Periodontology, Diagnosis and Dental
Radiology (Al-Azhar Univerisity)
2. Undoubtedly, the use of radiographic imaging has entirely
revolutionized the diagnosis and treatment planning in medical
sciences. The role of imaging in oral malignancies can be broadly
grouped in those used to evaluate primary disease and those to
evaluate metastatic disease.
It is a useful tool for staging and management planning in oral
cancers. Awareness of the presence of cervical node metastasis is
important in treatment planning and in prognostic prediction for
patients with head and neck cancer (HNC).
4. 1.Intraoral radiographic examination is of very limited use
though occlusal radiographs (maxillary and mandibular
projections) have been occasionally used to determine the
medial or lateral extent of the disease and to detect their
presence in palate or floor of the mouth. It may aid in
evaluating patients with trismus
5. 2. Extraoral radiographic examination includes lateral skull
projections and Water projections (occipitomental
projections). The former is more useful for pre- and post-
treatment records for prosthesis and oral surgery, while the
later is useful for evaluating maxillary sinus.
Mandibular lateral oblique body/ramus projections are
largely replaced by panoramic radiography
6. 3. Panoromic radiography (also called pantomography or
rotational radiography) is a radiographic technique for producing
a single image of the facial structures that includes both
maxillary and mandibular arches and their supporting structures.
Its principal advantages include broad anatomic coverage, low
radiation dosage for patient, convenience of examination, and
the fact that it can be used in patients unable to open their
mouth. The usual procedure lasts 3-4 minutes.
7. The main disadvantage is that the resultant image does not
resolve the fine anatomic detail that may be seen on intraoral
and periapical radiograph.
Commonly used panoromic machines include the
orthopantomograph and the panorex. Recent panoramic
radiographic machines are capable of producing digital
images.
8. CT scan is useful for evaluating bony invasion. A sophisticated
software program called Dentascan provides more accurate
details of the mandible.[16,17]
CT can identify tumors based upon either anatomic distortion
or specific tumor enhancement.
Imaging of lymph nodes by CT or MRI is complementary to
the clinical examination for the staging of the neck. CT is also
highly sensitive for detection of extracapsular spread of
tumor.[18
9. Compared with MRI, CT provides equal or greater
spatial resolution, it can be performed with fast
acquisition times thereby virtually eliminating the
problem of motion artifact and it is better for the
evaluation of bone destruction.
CT also has the subjective advantage of being relatively
straightforward to interpret.[19,20
10. Size criteria for pathologic nodes - using clinical criteria of a
palpable node greater than 1.5 cm or fixed or matted nodes, error
rates have been shown to range from 20% to 28%.
Size criteria for pathologic lymph nodes vary although most
agree that homogeneous cervical lymph nodes up to 10 mm in
maximum diameter may be considered normal, and in some areas
(e.g., jugulodigastric and anterior submandibular nodes), lymph
nodes up to 15 mm may be considered normal.[19
11. Magnetic resonance imaging (MRI) and computed tomography (CT)
are commonly used to assess the primary tumor and the neck
status.[1-5] Doppler ultrasound with fine-needle aspiration is also
used these days.[6]
Positron emission tomography (PET) is a functional imaging that can
detect cancer lesions by pinpointing regions of high metabolism. It is
also used in cases demanding assessment of metastases to lymph
nodes that appear morphologically normal.[7,8]
12. PHYSICS OF MRI
MRI is based on the magnetization properties of atomic nuclei. A
powerful, uniform, external magnetic field is employed to align the
protons that are normally randomly oriented within the water nuclei
of the tissue being examined.
This alignment (or magnetization) is next perturbed or disrupted
by introduction of an external Radio Frequency (RF) energy. The
nuclei return to their resting alignment through various relaxation
processes and in so doing emit RF energy..
13. Repetition Time (TR) is the amount of time between successive
pulse sequences applied to the same slice. Time to Echo (TE) is
the time between the delivery of the RF pulse and the receipt
of the echo signal.
Tissue can be characterized by two different relaxation times –
T1 and T2..
14. T1 (longitudinal relaxation time) is the time constant which
determines the rate at which excited protons return to equilibrium.
It is a measure of the time taken for spinning protons to realign
with the external magnetic field.
T2 (transverse relaxation time) is the time constant which
determines the rate at which excited protons reach equilibrium or
go out of phase with each other. It is a measure of the time taken
for spinning protons to lose phase coherence among the nuclei
spinning perpendicular to the main field
15. Magnetic resonance imaging (MRI) is an excellent clinical imaging technique for the
noninvasive detection of tumor. To improve the imaging contrast between normal and
diseased tissues, contrast agents are employed to change proton relaxation rates 17, 18.
Nowadays, the MRI contrast agents are generally in the form of T1-
positive and T2-negative contrast agents. T1 contrast agents, such as
gadolinium (Gd)-based chelates (e.g., Gd-DTPA) 19, 20, can facilitate the spin-lattice
relaxation of protons and provide a brighter MR image.
T2 contrast agents, such as superparamagnetic iron oxide (SPIO) NPs
(e.g., Feridex) 21, can cause protons in the vicinity to undergo spin-spin
relaxation and produce a darker MR image.
16. However, such single mode contrast agents still have
disadvantages. The Gd-based T1-positive contrast agents
have suffered from their short body circulation time due
to their low molecular weights, making it hard to acquire
high-resolution images, which requires a long scan
time 22. Besides, the clinical use of T2 contrast agents is
quite limited due to their inherent darkening contrast
effect and magnetic susceptibility artifacts 23.
T1-weighted MRI enhances the signal of the fatty tissue and suppresses the
signal of the water. T2-weighted MRI enhances the signal of the water.
27. CT imaging protocols —
CT imaging depends upon the site and stage of the tumor and
also depends on the type of scanner used.
We typically obtain thin (2.5 to 3 mm in thickness, depending
on scanner technology) axial contiguous sections.
Intravenous contrast is administered by a pressure injector in
all cases. After a 40 to 60 sec delay, contrast is injected at 2
mL/sec for a total of 100 to120 mL
28. With ultrafast multidetector scanner technology, scanning
after a shorter delay can result in essentially a CT
arteriogram, with failure to opacify veins, and inadequate
tissue contrast opacifi cation. Soft tissue windows are
routinely evaluated.[17,21]
Both soft tissue and bone should be evaluated, but it may
not be necessary to routinely reconstruct bone “algorithm”
images.
29. CT bone “windows”, even if reviewed on a picture archiving
and communication system (PACS) with a soft tissue algorithm,
are particularly useful to evaluate for erosion of thyroid, cricoid
or tracheal cartilage, or erosion of the mandible, vertebra or
skull base.
When in fact there is none. In these cases, MRI may be
helpful, as it may identify tumor invasion of bone marrow[22]
32. A radionuclide scan (also known as a radioisotope scan)
is an imaging technique used to visualise parts of the
body by injecting a small dose of a radioactive chemical
into the body.
These chemicals localise to specific organs and tissues
depending on the type of substance used and then emit
small beams of radiation (called gamma rays) that can be
detected by the gamma camera.
33. Radionuclide scans are used in various fields of medicine such as
identifying areas of infection or excess bone turnover.
Bone scans and thyroid scans are common examples of
radionuclide scans. In the gastrointestinal tract they can be used
to identify sites of bleeding, measure the extent of inflammation
and assess the movement of food substances through the
stomach.
34. Radionucleide bone scans are often positive prior to
radiographic appearance of bone destruction but they may
seldom provide accurate information regarding the extent of
bone invasion.[8]
Bone scans may also be positive in non-neoplastic
conditions like inflammations.
35.
36.
37.
38.
39.
40.
41. Single-photon emission tomography/computed tomography
(SPECT/CT) is another radionuclide imaging study and is used to
visualize three-dimensional multiplanar tracer distribution in the
region of interest with CT using an integrated CT scanner [33].
With the aid of SPECT/CT, the exact anatomical location and
pathological metabolism can be assessed.
47. F-Fluorodeoxyglucose positron emission tomography (F-FDG PET) is
a functional imaging technique that provides information about
tissue metabolism and has been successfully applied to the
evaluation of HNCs.[18,9,27]
PET is based on identifying increased glycolytic activity in malignant
cells, in which radiolabeled FDG is preferentially concentrated due to
increases in membrane glucose transporters as well as in
hexokinase, an enzyme which phosphorylates glucose
48. After phosphorylation, radiolabeled FDG continues to
accumulate in cancer cells instead of glycolysis, allowing imaging
by PET.[18,27] F-FDG PET is more sensitive than CT or MRI in
detecting cervical node metastases.
It can help identify metastatic nodes which are morphologically
normal.
Currently available data from various studies[28-33]
demonstrate large variations in the sensitivity and specifi city of F-
FDG PET in the detection of cervical lymph node metastases in
HNCs
49. False positives of F-FDG PET are mainly due to its
inherent inability to discriminate inflammatory processes
and reactive hyperplasia from tumor infiltration, because
high metabolic changes occur in both instances.[34]
The main drawback of PET remains its relatively poor
anatomic resolution.
50. CT/MRI merely depicts anatomic details but PET provides
information about tissue perfusion and metabolism.[29]
• FDG is taken up by tissue cells similarly as natural
glucose.[29,30]
• Neoplastic cells have been shown to incorporate more radio
intense images than surrounding tissues: Thus, PET scan is
usually indicated for the identification of metastatic nodal
disease post-radiation or recurrent/ residual tumor.
51. However, it lacks in anatomic detail reproduction
and the thickness of resolution size may prevent
micro deposits from being visualized.[31,32] That is
why PET scan is considered as research tool rather
than frequently used clinical diagnostic entity
52.
53.
54. The fundamental characteristic of human malignancies is the
overexpression of the glucose transporter, especially in HNSCC
55. Figure 4.
Schematic of the metabolic trapping of F18-FDG in a tumor cell showing the
trapping mechanism in FDG imaging.
The glucose transporter 1 (GLUT1) serves as a channel for its uptake. It
accumulates in tumor cells, where the metabolism by hexokinase and
glucose-6-phosphatase takes place.
FDG will be phosphorylated by hexokinase.
Glucose-6-phosphotase (G6Pase) counteracts hexokinase phosphorylation
by converting glucose-6-phosphate (G6P) to glucose.
Therefore, high G6Pase activity leads the accelerated conversion of FDG-6-
phosphate (FDG6P) to its FDG form, as a result, the uptake reduces, and it
will be released from the cell.
65. They described the sentinel lymph node as the first node, which
is the first portal in the diseased cell migration from the lesion.
They proposed the importance of the first node on the localization
of the lesion.
In their paper they emphasized that a “sentinel node” is the
initial lymph node upon which the primary tumor drains. Today we
know that the sentinel lymph node is the first node on the
lymphatic pathway that drains directly from the tumor [41].
66. In the field of nuclear medicine, the sentinel lymph node is
the first node that is visible after the administration of the
tracer. Flow imaging or “dynamic phase” is the first phase,
immediately after injection, which shows the lymphatic
pathway and clearance.
In the late stage also known as the “static phase”, can the
very first node or sometimes more than one node be
visualized and anatomically pinpointed.
67. Recently, to overcome the limitations of the conventional colloid
tracers, a new tracer has been developed to fulfill the aforementioned
shortcomings.
Technetium 99m-diethylenetriaminepentaacetic acid (DTPA)-
mannosyl-dextran (also known as 99mTc-tilmanocept) is a novel
radiopharmaceutical agent that selectively binds to CD206 receptors,
which presents in high concentration in lymph nodes on the
membrane of macrophages and dendritic cells
68. Tilmanocept structure consists of a dextran main domain and
the DTPA as well as mannose units which are attached to the
central part.
The average diameter of this macromolecule is 7nm.
The mannose binds to the CD206 receptor, whereas the DTPA
serves as the binding part for technetium 99m.
Due to its small size, it has a rapid uptake in lymph nodes, and its
targeted binding prevents its migration to distal nodes [43, 44].
69. CONCLUSION
In clinical practice, CT and MRI are commonly because they can
delineate the extent of the primary head and neck tumors in the
same session.
PET is a functional imaging technique that is more sensitive than
CT and MRI. However, it lacks anatomical detail and is seldom used
alone.
Side-by-side visual correlation of PET and CT/MRI is a simple
technique that can increase the diagnostic accuracy of PET. The
combined PET/CT device is an advance in PET technology that can
simultaneously provide precise integrated functional and
anatomical information.
70. Conclusion
Nuclear medicine by using radionuclide substances can detect
the dynamic aspect of a disease process, and when this
dynamic study is mingled by a morphological study, CT or MRI,
the management team can see a clearer picture of the disease
process and plan treatment protocols accordingly.
Sentinel lymph node biopsy is gaining momentum in cancer
treatment protocols as a MUST-DO procedure before the
definitive treatment plan is implemented.
71. The main drawback of PET is its poor anatomical resolution.
Side-by-side visual correlation of PET and CT/MRI can help
determine the anatomical location of abnormal PET uptake and
eliminate some false-positive PET findings caused by spatial errors.[9-
11]
Fused PET/CT is considered to be the most accurate imaging
modality, because it simultaneously provides prompt and accurate
coregistration of functional and anatomical images. However, it is
expensive, less-often available, and still constrained by technical
resolution limits.[12-15]
72.
73.
74.
75.
76.
77. D mandibular reconstruction. (a) In case 4, an extensive defect across the
mandibular midline is completed and demonstrated in different views. (b) The
function of CTGAN in reconstructing different defects with diverse positions
and features [157]
CTGAN is a collection of Deep Learning based synthetic data generators for single table
data, which are able to learn from real data and generate synthetic data with high
fidelity.