The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatme... more The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatment and rehabilitation of those injured on the roads. The administration of the scheme by the Transport Accident Commission includes an in-house clinical panel of clinicians in many disciplines including dentistry who liaise with treating practitioners with the aim of optimizing the outcome for the injured claimants.
Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT sca... more Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT scans and 3D visualizations generated with Vitrea 2 and MIMICS graphic workstations with the aim of comparing the results with previous X-ray examinations performed by Dawson and Gray in 1968. Although the previous analyses reported that the children had been excerebrated and eviscerated, no evidence of incisions or breaches of the cranial cavity were found; 3D visualizations were generated showing the brain and the internal organs to be in situ. A larger number of skeletal post-mortem damages were identified, such as dislocation of mandible, ribs, and vertebrae, probably suffered at the time of embalming procedure. Different radio-opaque granular particles were observed throughout bodies (internally and externally) and could be explained as presence of natron, used as external desiccating agent by the embalmers, or as adipocerous alteration, a natural alteration of body fat. Age-at-death was estimated using the 3D visualization of the teeth, the state of fusion of the vertebrae and the presence of the secondary centers of the long bones: two mummies died at the age of 4 years ± 12 months, the third one at the age of 6 years ± 24 months. Hyperdontia or polydontia, a dental anomaly, could also be identified in one child using 3D visualizations of the teeth: two supernumerary teeth were found behind the maxillary permanent central incisors which had not been noticed in the Dawson and Gray's X-ray analysis. In conclusion, CT-scan investigations and especially 3D visualizations are important tools in the non-invasive analysis of the mummies and, in this case, provided revised and additional information compared to the only X-ray examination.
The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatme... more The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatment and rehabilitation of those injured on the roads. The administration of the scheme by the Transport Accident Commission includes an in-house clinical panel of clinicians in many disciplines including dentistry who liaise with treating practitioners with the aim of optimizing the outcome for the injured claimants.
uctal carcinoma in situ (DCIS) is a heterogeneous Address correspondence to: Melvin J. Silverstei... more uctal carcinoma in situ (DCIS) is a heterogeneous Address correspondence to: Melvin J. Silverstein, M.D., The Breast Center, 14624 Sherman Way, 6th Fir., Van Nuys, CA 91405, U.S.A.
In the Disaster Victim Identification (DVI) response to the recent bushfire disasters in rural Vi... more In the Disaster Victim Identification (DVI) response to the recent bushfire disasters in rural Victoria, Australia, forensic odontology played a significant role in the identification process. Particular features of this disaster were challenging to the odontologists. A characteristic of house fires is the extended time period during which the remains may be subject to heat, and their subsequent disruption as buildings collapse. This can result in dislodgement of teeth from sockets, loss of tooth crowns from roots, disruption of anatomical location of teeth and damage to bony features. Commingling of human remains also is often a feature, as is commingling of animal remains with human. Two cases which illustrate these features are described. A strategy for improving familiarity with comparative dental anatomy and improving skills in dental anatomy is suggested.
BACKGROUND. There is controversy and confusion regarding therapy for patients with ductal carcino... more BACKGROUND. There is controversy and confusion regarding therapy for patients with ductal carcinoma in situ (DCIS) of the breast. The Van Nuys Prognostic Index (VNPI) was developed to aid in the complex treatment selection process.
Blarney RW, et al. Ductal carcinoma in situ of the breast: a proposal for a new simplified histol... more Blarney RW, et al. Ductal carcinoma in situ of the breast: a proposal for a new simplified histological classification association between cellular proliferation and c-erbB-2 protein expression.
Axillary lymph node metastases (ALNM) are the most important predictor of survival in patients wi... more Axillary lymph node metastases (ALNM) are the most important predictor of survival in patients with T1 breast carcinoma. Due to a relatively low incidence of axillary metastasis in tumors < or = 2 cm, the role of axillary lymph node dissection for these patients has been questioned. The purpose of this study was to determine the association between the incidence of ALNM and 11 clinical/pathologic factors by univariate and multivariate analysis. The authors reviewed data from 918 patients with T1 breast carcinoma who underwent level I/II axillary dissection between 1979 and July 1995. The association between the incidence of ALNM and 11 clinical/pathologic factors (size, lymph/vascular invasion, nuclear grade, S-phase, ploidy, palpability, age, estrogen receptor status, progesterone receptor status, HER-2/neu, and histology) was analyzed by univariate and, when significant, by multivariate analysis. Approximately 23% of the 918 patients with T1 breast carcinoma had ALNM. Multivariate analysis identified four factors as independent predictors of ALNM: lymph/vascular invasion (P < 0.0001), tumor palpability (P < 0.0001), nuclear grade (P = 0.0004), and tumor size (P = 0.01). Among the 117 patients with nonpalpable, nonhigh grade tumors < or = 1 cm without lymph/vascular invasion, the incidence of ALNM was only 3%. However, the 43 patients with T1c tumors with all 3 additional risk factors had a 49% incidence of ALNM. Clinical and pathologic features of the primary tumor can be used to estimate the risk of ALNM in patients with T1 breast carcinoma. Such a risk assessment might facilitate appropriate management. Routine axillary dissection can be omitted in patients at minimal risk of ALNM, if the treatment decision is not influenced by lymph node status. Axillary lymph node dissection should be performed routinely for all patients with lesions > 1 cm. [See editorial counterpoint on pages 1856-61 and reply to counterpoint on pages 1862-4, this issue.]
Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT sca... more Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT scans and 3D visualizations generated with Vitrea 2 and MIMICS graphic workstations with the aim of comparing the results with previous X-ray examinations performed by Dawson and Gray in 1968. Although the previous analyses reported that the children had been excerebrated and eviscerated, no evidence of incisions or breaches of the cranial cavity were found; 3D visualizations were generated showing the brain and the internal organs to be in situ. A larger number of skeletal post-mortem damages were identified, such as dislocation of mandible, ribs, and vertebrae, probably suffered at the time of embalming procedure. Different radio-opaque granular particles were observed throughout bodies (internally and externally) and could be explained as presence of natron, used as external desiccating agent by the embalmers, or as adipocerous alteration, a natural alteration of body fat. Age-at-death was estimated using the 3D visualization of the teeth, the state of fusion of the vertebrae and the presence of the secondary centers of the long bones: two mummies died at the age of 4 years ± 12 months, the third one at the age of 6 years ± 24 months. Hyperdontia or polydontia, a dental anomaly, could also be identified in one child using 3D visualizations of the teeth: two supernumerary teeth were found behind the maxillary permanent central incisors which had not been noticed in the Dawson and Gray's X-ray analysis. In conclusion, CT-scan investigations and especially 3D visualizations are important tools in the non-invasive analysis of the mummies and, in this case, provided revised and additional information compared to the only X-ray examination.
The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatme... more The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatment and rehabilitation of those injured on the roads. The administration of the scheme by the Transport Accident Commission includes an in-house clinical panel of clinicians in many disciplines including dentistry who liaise with treating practitioners with the aim of optimizing the outcome for the injured claimants.
Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT sca... more Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT scans and 3D visualizations generated with Vitrea 2 and MIMICS graphic workstations with the aim of comparing the results with previous X-ray examinations performed by Dawson and Gray in 1968. Although the previous analyses reported that the children had been excerebrated and eviscerated, no evidence of incisions or breaches of the cranial cavity were found; 3D visualizations were generated showing the brain and the internal organs to be in situ. A larger number of skeletal post-mortem damages were identified, such as dislocation of mandible, ribs, and vertebrae, probably suffered at the time of embalming procedure. Different radio-opaque granular particles were observed throughout bodies (internally and externally) and could be explained as presence of natron, used as external desiccating agent by the embalmers, or as adipocerous alteration, a natural alteration of body fat. Age-at-death was estimated using the 3D visualization of the teeth, the state of fusion of the vertebrae and the presence of the secondary centers of the long bones: two mummies died at the age of 4 years ± 12 months, the third one at the age of 6 years ± 24 months. Hyperdontia or polydontia, a dental anomaly, could also be identified in one child using 3D visualizations of the teeth: two supernumerary teeth were found behind the maxillary permanent central incisors which had not been noticed in the Dawson and Gray's X-ray analysis. In conclusion, CT-scan investigations and especially 3D visualizations are important tools in the non-invasive analysis of the mummies and, in this case, provided revised and additional information compared to the only X-ray examination.
The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatme... more The State of Victoria, Australia operates a no-fault accident compensation scheme for the treatment and rehabilitation of those injured on the roads. The administration of the scheme by the Transport Accident Commission includes an in-house clinical panel of clinicians in many disciplines including dentistry who liaise with treating practitioners with the aim of optimizing the outcome for the injured claimants.
uctal carcinoma in situ (DCIS) is a heterogeneous Address correspondence to: Melvin J. Silverstei... more uctal carcinoma in situ (DCIS) is a heterogeneous Address correspondence to: Melvin J. Silverstein, M.D., The Breast Center, 14624 Sherman Way, 6th Fir., Van Nuys, CA 91405, U.S.A.
In the Disaster Victim Identification (DVI) response to the recent bushfire disasters in rural Vi... more In the Disaster Victim Identification (DVI) response to the recent bushfire disasters in rural Victoria, Australia, forensic odontology played a significant role in the identification process. Particular features of this disaster were challenging to the odontologists. A characteristic of house fires is the extended time period during which the remains may be subject to heat, and their subsequent disruption as buildings collapse. This can result in dislodgement of teeth from sockets, loss of tooth crowns from roots, disruption of anatomical location of teeth and damage to bony features. Commingling of human remains also is often a feature, as is commingling of animal remains with human. Two cases which illustrate these features are described. A strategy for improving familiarity with comparative dental anatomy and improving skills in dental anatomy is suggested.
BACKGROUND. There is controversy and confusion regarding therapy for patients with ductal carcino... more BACKGROUND. There is controversy and confusion regarding therapy for patients with ductal carcinoma in situ (DCIS) of the breast. The Van Nuys Prognostic Index (VNPI) was developed to aid in the complex treatment selection process.
Blarney RW, et al. Ductal carcinoma in situ of the breast: a proposal for a new simplified histol... more Blarney RW, et al. Ductal carcinoma in situ of the breast: a proposal for a new simplified histological classification association between cellular proliferation and c-erbB-2 protein expression.
Axillary lymph node metastases (ALNM) are the most important predictor of survival in patients wi... more Axillary lymph node metastases (ALNM) are the most important predictor of survival in patients with T1 breast carcinoma. Due to a relatively low incidence of axillary metastasis in tumors < or = 2 cm, the role of axillary lymph node dissection for these patients has been questioned. The purpose of this study was to determine the association between the incidence of ALNM and 11 clinical/pathologic factors by univariate and multivariate analysis. The authors reviewed data from 918 patients with T1 breast carcinoma who underwent level I/II axillary dissection between 1979 and July 1995. The association between the incidence of ALNM and 11 clinical/pathologic factors (size, lymph/vascular invasion, nuclear grade, S-phase, ploidy, palpability, age, estrogen receptor status, progesterone receptor status, HER-2/neu, and histology) was analyzed by univariate and, when significant, by multivariate analysis. Approximately 23% of the 918 patients with T1 breast carcinoma had ALNM. Multivariate analysis identified four factors as independent predictors of ALNM: lymph/vascular invasion (P < 0.0001), tumor palpability (P < 0.0001), nuclear grade (P = 0.0004), and tumor size (P = 0.01). Among the 117 patients with nonpalpable, nonhigh grade tumors < or = 1 cm without lymph/vascular invasion, the incidence of ALNM was only 3%. However, the 43 patients with T1c tumors with all 3 additional risk factors had a 49% incidence of ALNM. Clinical and pathologic features of the primary tumor can be used to estimate the risk of ALNM in patients with T1 breast carcinoma. Such a risk assessment might facilitate appropriate management. Routine axillary dissection can be omitted in patients at minimal risk of ALNM, if the treatment decision is not influenced by lymph node status. Axillary lymph node dissection should be performed routinely for all patients with lesions > 1 cm. [See editorial counterpoint on pages 1856-61 and reply to counterpoint on pages 1862-4, this issue.]
Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT sca... more Three child mummies from the Graeco-Roman Period (332 BCE - c. 395 CE) were examined using CT scans and 3D visualizations generated with Vitrea 2 and MIMICS graphic workstations with the aim of comparing the results with previous X-ray examinations performed by Dawson and Gray in 1968. Although the previous analyses reported that the children had been excerebrated and eviscerated, no evidence of incisions or breaches of the cranial cavity were found; 3D visualizations were generated showing the brain and the internal organs to be in situ. A larger number of skeletal post-mortem damages were identified, such as dislocation of mandible, ribs, and vertebrae, probably suffered at the time of embalming procedure. Different radio-opaque granular particles were observed throughout bodies (internally and externally) and could be explained as presence of natron, used as external desiccating agent by the embalmers, or as adipocerous alteration, a natural alteration of body fat. Age-at-death was estimated using the 3D visualization of the teeth, the state of fusion of the vertebrae and the presence of the secondary centers of the long bones: two mummies died at the age of 4 years ± 12 months, the third one at the age of 6 years ± 24 months. Hyperdontia or polydontia, a dental anomaly, could also be identified in one child using 3D visualizations of the teeth: two supernumerary teeth were found behind the maxillary permanent central incisors which had not been noticed in the Dawson and Gray's X-ray analysis. In conclusion, CT-scan investigations and especially 3D visualizations are important tools in the non-invasive analysis of the mummies and, in this case, provided revised and additional information compared to the only X-ray examination.
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