An understanding of the age-related changes in the volume of the normal maxillary sinus will help to identify sinus abnormalities. Normal maxillary sinus volume was measured on axial CT scans in 115 cases, and analysed in relation to age, the presence of premolar and molar teeth, size of the midfacial skeleton and body height and weight. The volume ranged from 4.56-35.21 cm3 (mean: 14.71 +/- s.d. 6.33 cm3) in patients aged over 20 years. There was no significant sex difference and a close correlation between the two sides was found. The volume increased up to the age of 20 years, but then decreased. There was no significant difference in patients with and without maxillary premolars and molars between the ages of 50 and 79 years. The difference in right and left dentitions had no influence on the maxillary sinus volume over the age of 20 years. Adult maxillary sinus volume correlated with the interzygomatic buttress distance. In adult females, there was a significant correlation between the volume and the zygomatic-occipital distance. In adult males, the volume correlated with body height and weight. It appears that volume changes with age might be related to skeletal size and physique.

Abstract. The aim of this study was to confirm the effectiveness of early physiotherapeutic stimulation for lymphatic flow progression in patients with breast cancer undergoing axillary dissection. This was a randomized experimental study on 22 patients who underwent lymphoscintigraphy in their arms on two different occasions, firstly without stimulation and secondly after randomization into two groups: without physiotherapeutic stimulation (WOPS; n=10) and with physiotherapeutic stimulation (WPS; n=12). The lymphoscintigraphy scan was performed with 99m Tc-phytate administered into the second interdigital space of the hand, ipsilaterally to the dissected axilla, in three phases: dynamic, static, and delayed whole body imaging. Physiotherapeutic stimulation was carried out using Földi's technique. In both groups, images from the two examinations of each patient were compared. Flow progression was considered positive when, on the second examination, the radiopharmaceutical reached areas more distant from the injection site. Statistical analysis was used to evaluate frequencies, percentages and central trend measurements, and non-parametric tests were conducted. Descriptive analysis showed that the WPS and WOPS groups were similar in terms of mean age, weight, height, body mass index and number of lymph nodes removed. There were statistically significant associations between physiotherapeutic stimulation and radiopharmaceutical progression at all three phases of the study (p<0.0001). Early physiotherapeutic stimulation in breast cancer patients undergoing radical axillary dissection is effective, and can therefore be indicated as a preventive measure against lymphedema.

Hepatic encephalopathy (HE) is a late complication of liver cirrhosis and is clearly associated with poor outcomes. Chronic liver insufficiency leads to progressive muscle wasting, impairing ammonia metabolism and thus increasing the risk for HE. Given the association between lean mass and adductor pollicis muscle thickness (APMT), it has been used to predict outcome and complications in many conditions, but not yet in cirrhotic patients. Therefore, this article aimed to study the association between HE manifestations and measures related to muscle mass and strength. This cross-sectional study included 54 cirrhotic outpatients with HE varying from subclinical to grade II according to the West-Haven criteria, who were submitted to neuropsychometric tests, electroencephalogram, brain Single Photon Emission Computed Tomography (SPECT), anthropometric measurements, handgrip strength (HGS) and dual energy X-ray absorptiometry exam (DXA). Multiple logistic regression analysis was performed to investigate the association between body composition measures and HE grade. Analysis of the area under the receiver operator characteristic (AUROC) curve revealed the values related to neurological manifestations (HE grades I and II). Reductions in APMT and HGS were associated with higher HE grades, suggesting a big impact caused by the loss of muscle mass and function on HE severity. The link between HE manifestations and anthropometric measures, namely APMT and HGS, point to a significant relation concerning skeletal muscles and the neurological impairment in this population.

Abstract. Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare malignant tumor that accounts for 3% of all tumors of the nasal cavity. The incidence of ENB is 0.4 cases per million in the general population, and the most common symptoms are nasal obstruction and epistaxis. Previous studies have indicated the presence of somatostatin receptors in this tumor type. Common treatment strategies for ENB include resection and adjuvant radiotherapy and/or chemotherapy (combined treatment); however, the rate of recurrence is high. Treatment of neuroendocrine tumors using radionuclides bound to somatostatin analogues is well established in clinical practice. However, a standard and effective therapeutic approach has not been reported for ENB. The current study described the case of a 74-year-old female with numerous recurrences of ENB following multiple treatments and without possibility of resection. The patient was treated with the radiolabeled-somatostatin analogue, 177 Lutetium-DOTA-octreotate ( 177 Lu-DOTA-TATE), which successfully controlled the disease. This suggests that 177 Lu-DOTA-TATE is a potential treatment for ENB and may represent an effective alternative and novel therapeutic strategy for this disease.

Eighteen patients with maxillofacial infections, who had trismus and swelling of the masseteric region, were investigated by CT. Spread of infection was evaluated with particular reference to the fascial spaces. The masticator space was divided into four parts and the changes in each were assessed together with the surrounding fascial spaces. There were changes in the masseter muscle and infection had spread into the upper parts of the masticator space in more than half of the patients. There was a fall in the CT value in the affected muscles, whereas it was raised in the parotid gland and adipose tissue. The clinical importance of CT is shown to have a significant role in the diagnosis and follow-up of maxillofacial infections.

Abstract. to evaluate the tumor response to neoadjuvant chemotherapy, 99m tc-sestamibi breast scintigraphy was proposed as a quantitative method. Fifty-five patients with ductal carcinoma were studied. they underwent breast scintigraphy before and after neoadjuvant chemotherapy, along with clinical assessment and surgical specimen analysis. the regions of interest on the lesion and contralateral breast were identified, and the pixel counts were used to evaluate lesion uptake in relation to background radiation. the ratio of these counts before to after neoadjuvant chemotherapy was assessed. the decrease in uptake rate due to chemotherapy characterized the scintigraphy tumor response. the Kruskal-Wallis test was used to compare the mean scintigraphic tumor response and histological type. Dunn's multiple comparison test was used to detect differences between histological types. the MannWhitney test was used to compare means between quantitative and qualitative variables: scintigraphic tumor response vs. clinical response and uptake before chemotherapy vs. scintigraphic tumor response. the spearman's test was used to correlate the quantitative variables of clinical reduction in tumor size and scintigraphic tumor response. All of the variables compared presented significant differences. The change in 99m tc-sestamibi uptake noted on breast scintigraphy, before to after neoadjuvant chemotherapy, may be used as an effective method for evaluating the response to neoadjuvant chemotherapy, since this quantification reflects the biological behavior of the tumor towards the chemotherapy regimen.Furthermore, additional analysis on the uptake rate before chemotherapy may accurately predict treatment response. IntroductionBreast cancer is the second most common type of cancer worldwide and the most common among women. It accounts for approximately 22% of new cancer cases among women each year (1), and the 5-year survival rate among the worldwide population is 61%. this high mortality rate is related to late diagnosis, with the presence of tumors of large dimensions and lymph node metastases.locally advanced breast cancer comprises tumors greater than 5 cm in diameter, with wall or skin invasion, metastases to fixed lymph nodes (2,3) and inflammatory carcinoma. treatment for this is multidisciplinary, consisting of preoperative chemotherapy, surgery, radiotherapy and postoperative chemotherapy (4-6).Preoperative or neoadjuvant chemotherapy is standard treatment for individuals with locally advanced breast cancer (7-10). It has been found to substantially improve the survival of these patients (6,11,12). It provides better local control over the disease, with increased likelihood that the breast surgery will be conservative (4,5,13). Moreover, this type of chemotherapy treats preexisting microscopic systemic disease and enables the evaluation of tumor resistance in vivo (14). reduction in tumor volume has been used as the standard criterion for response evaluation among solid tumors such as breast carcinoma (15). techniques tha...

Goal: To evaluate the impact of iodine-131 therapy received during childhood and adolescence and correlate it with the quality of life in these patients. Methods: We studied 19 patients diagnosed with cancer in childhood or adolescence who underwent thyroidectomy and supplemental therapy with I-131. We also recruited a control group of healthy subjects with the same demographic parameters. All patients were subjected to a scintigraphy examination of the salivary glands, and were also asked to complete a questionnaire in order to assess their overall quality of life. In addition, a more specific questionnaire for patients with head and neck cancer was also given to all study participants. Results: The quantitative and qualitative analyses of the salivary glands showed functional deficits with greater involvement of the parotid gland for volume, concentration and excretion. The right submandibular gland showed significant changes for volume in the patient group. The questionnaires made it possible to observe significant differences between the patient and control groups for symptoms such as thick saliva, dry mouth and speech problems. Conclusion: In spite of being very effective and widely used, iodine radionuclide therapy * Corresponding author. L. G. Corrêa et al. 410is correlated with a lower quality of life in young people.

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