Fibrin-rich blocks with CGFs act as an alternative to bone grafting and can be a predictable procedure for sinus augmentation.

Computed tomography (CT) plays an important supplementary role in the evaluation of patients with congenital heart disease (CHD). Fast multisection spiral CT can be used to obtain isotropic volume data, and high-quality two- and three-dimensional multiplanar reformatted images can be created to accurately and systematically delineate the normal and pathologic morphologic features of the cardiovascular system. CT may be technically challenging and demanding in uncooperative young children. However, it can be used to systematically evaluate the aorta, pulmonary artery, pulmonary vein, cardiac chambers and ventriculoarterial connection, relationship between the upper lobe bronchi and pulmonary arteries, coronary artery, valves, systemic veins (superior vena cava, inferior vena cava, hepatic veins), and visceral situs with a step-by-step approach. This approach may be helpful in understanding the anatomy of the cardiovascular system in CHD patients. CT has both advantages and disadvantages in evaluating patients with CHD. Nevertheless, it is useful in this setting, and radiologists who perform CT in young children with CHD should be familiar with the advantages and disadvantages of CT and with the normal anatomy and typical pathologic conditions in affected patients.

Background: Endocrine abnormalities, including hypocalcemia, thyroid dysfunction, and short stature, are associated with chromosome 22q11.2 microdeletion syndrome. This study was undertaken to examine the frequencies and clinical features of endocrine abnormalities in patients with 22q11.2 microdeletion syndrome. Methods: We analyzed 61 patients with 22q11.2 microdeletion syndrome diagnosed based on the verification of microdeletion by fluorescent in situ hybridization (FISH) using a probe of the DiGeorge syndrome critical region (TUPLE1) at 22q11.2 and a control probe, ARSA at 22q13. Serum total calcium, phosphorus, and intact parathyroid hormone (PTH) levels were measured, thyroid function test was performed, and serum IGF-1 and IGFBP-3 levels were also estimated. Height and weight of patients were compared with individual chronological ages. Results: Hypocalcemia was found in 20 patients (32.8%), and overt hypoparathyroidism in 8 (13.1%). Two patients (3.3%) showed autoimmune thyroid diseases, 1 each with Graves’ disease and Hashimoto thyroiditis. Ten patients (16.4%) were below the third percentile in height, but the serum IGF-1 level was normal in 9 out of these 10 patients. Conclusion: Our findings show that patients with chromosome 22q11.2 microdeletion syndrome present with variable endocrine manifestations and variable clinical phenotypes. In addition to FISH analysis, careful endocrine evaluations are required in patients with this microdeletion syndrome, particularly for those with hypoparathyroidism or thyroid dysfunction.

The development of multi-slice spiral computed tomography (CT) has increased the clinical use of cardiac CT imaging in patients with congenital heart disease. Multi-slice CT has the advantages of fast scan speed; high spatial resolution, enabling the acquisition of isotropic volume data; and simultaneous evaluation of airways and lung parenchyma, thus increasing the ability to answer most clinical questions about structural abnormalities in patients with congenital heart disease. When coupled with electrocardiography-gating, multi-slice spiral CT can be used in functional evaluations, including ventricular wall motion, ventricular ejection fraction, and motion of cardiac valves, as well as enabling the performance of high-quality coronary CT angiography. In this article, we review imaging techniques of multi-slice spiral CT and imaging findings in pediatric and adult patients with various congenital heart diseases.

This study aimed to investigate left ventricular myocardial deformation in children with Kawasaki disease during the acute phase of their illness. A total of 50 patients and 35 normal control subjects were assessed. Data were obtained from the patients during the acute and convalescent phases of Kawasaki disease. Analyses of myocardial deformation [strain (epsilon), strain rate (SR)] was performed using two-dimensional speckle-tracking imaging in three directions (longitudinal, circumferential, and radial) at the basal and mid levels of the left ventricular myocardium. Basal longitudinal epsilon (P < 0.001) and midlongitudinal epsilon (P < 0.0001) were lower during the acute phase of the disease than in the control subjects and associated with serum albumin level and left ventricular mass index (LVMI). Midlongitudinal SR (P < 0.0001) was lower during the acute phase of Kawasaki disease than in the control subjects and associated with LVMI. Decreased systolic SR was not detected in any direction. In conclusion, left ventricular longitudinal systolic epsilon was significantly decreased during the acute phase of Kawasaki disease. This may be a result of myocardial swelling from myocarditis during the acute phase of the disease.

The flapless transcrestal approach to the sinus augmentation using the HPISE technique with autologous CGF alone could be an alternative to the lateral approach, even at severely resorbed edentulous posterior maxilla with insufficient bone height.

Objectives. The role of prostaglandins (PGs) in the onset of human parturition has been controversial. Specifically, some investigators have proposed that PGs are the consequence rather than the cause of labor. An important question is whether or not amniotic fluid (AF) PG concentrations increase before the onset of labor in humans. Methods. The concentrations of PGs were determined in AF obtained from 167 singleton pregnant women with intact membranes. Patients were divided into four groups: (1) preterm not in labor (gestational age 15-36 weeks, n ¼ 65); (2) term not in labor (n ¼ 68); (3) spontaneous labor at term with cervical dilatation 54 cm (n ¼ 25); (4) spontaneous labor at term with cervical dilatation 4 cm (n ¼ 9). AF was obtained by transabdominal amniocentesis or collected at the time of cesarean delivery. All patients met the following criteria: (1) normal pregnancy outcome; (2) clear AF; (3) no significant medical or obstetric complications such as diabetes mellitus, preeclampsia, preterm birth, fetal growth restriction, or major congenital malformations; and (4) no significant neonatal complications. The concentrations of PGE2 and PGF2a in AF were determined by enzyme-linked immunosorbent assay (ELISA). Non-parametric analysis was performed. Results. (1) AF PG concentrations remained unchanged with advancing gestation until 36 weeks of gestation; (2) however, an abrupt increase in AF PG concentrations was observed before the onset of labor at term; (3) among cases without labor at term, the median AF PGF2a concentration increased with advancing gestation; (4) the presence of labor and the degree of cervical dilatation were significantly associated with a higher concentration of PGF2a.Conclusions. An abrupt increase in AF PG concentrations (25-fold for PGF2a) occurs before the onset of spontaneous labor at term in humans; these observations suggest that PGs increase prior to the onset of labor and contradict the claim that an increase in PG concentrations is the consequence of labor.

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