CT of appendicitis in children

PURPOSE: Our goal was to review the CT findings and to help define the role of CT in the evaluation of appendicitis in children. METHOD: Of 730 children with surgically proven appendicitis, 22 underwent preoperative CT evaluation. Their CT scans and operative and pathology records were retrospectively reviewed. The CT scans were evaluated for appendiceal wall thickness, diameter, and location, appendicoliths, pericecal inflammation, phlegmon, abscess, free fluid, small bowel dilatation, and bowel wall thickening. Criteria for diagnosing appendicitis were (a) appendiceal wall thickening (> 1 mm) or (b) presence of abscess, phlegmon, or pericecal inflammation associated with appendicolith(s). Prospective reports of ultrasound examinations performed within 2 days of the CT scans were available in 14 children and were correlated with the CT findings. RESULTS: An abnormally thickened appendix, with a diameter ranging from 9 to 18 mm, was seen in four children. Three appendices were retrocecal and one was near the cecal tip, anterior to the iliac vessels. Appendicoliths were present in 10 children, multiple in 1. Abscesses were seen in 13 of 22 children, multiple in 5. Phlegmon was seen in five children and pericecal inflammation in two. Bowel wall thickening was present in seven children and small bowel dilatation was noted in six. Other findings included free fluid, hydronephrosis, thickening of urinary bladder wall, air in the uterus and vagina, adenopathy, and thickening of the abdominal wall musculature. CT was diagnostic of appendicitis in 11 of 22 children (50%). In 14 children with both ultrasound and CT studies, CT was slightly better in diagnosing appendicitis and visualizing the abnormal appendix and was superior in defining the presence and extent of abscess and inflammation in 9 of 14 children. CONCLUSION: CT is a useful adjunct in diagnosing appendicitis in children, with a major role in cases of complicated appendicitis.     

Generation of interfacial instabilities in charged electrified viscous liquid films

This study is concerned with the stability of a two-dimensional incompressible conducting liquid film surrounded by a passive conducting medium, when an electric field is applied in a direction parallel to the initially flat bounding fluid interfaces. Currents generate charges at the bounding interfaces which in turn affect the stress balances there. In the absence of an electric field, the viscous liquid film is stable (instability can be induced by the inclusion of van der Waals forces for ultra thin films). A complete model is presented, at arbitrary Reynolds number, which accounts for conductivity and permittivity contrasts between the fluid and surrounding medium, as well as surface tension. The linear stability of the system is considered for arbitrary Reynolds numbers and it is shown that the stable film can become unstable if, (i) σ _R ɛ _p >1, or (ii) σ _R ɛ _p <1 and (σ _R −1)(1−ɛ _p )<0, where σ _R is the ratio of outer to inner conductivity and ε _p is the ratio of inner to outer permittivity. Instability is possible only if the electric field is non-zero and the scalings near bifurcation points that can be used to construct nonlinear theories are calculated. Several asymptotic limits are also considered including zero Reynolds numbers and short or long waves. The instability criteria given above are constructed explicitly in the case of Stokes flow.     

Antibacterial activity of calcium hydroxide-containing endodontic sealers on Enterococcus faecalis in vitro

Nickel-titanium instruments purportedly resist deformation and loss of sharpness better than do stainless steel instruments but may be more susceptible to breakage. The processes of wear and breakage of nickel-titanium and stainless steel instruments were examined. Sixty files of five types (12 each) and three manufacturers were used. All were used repeatedly in curved canals until failure or for a maximum of 22 minutes. Each instrument was examined with scanning electron microscopy both new (control) and at spaced intervals for evidence of wear and fatigue. All new instruments were of good quality. Stainless steel instrument tended to wear the most rapidly, and next were nickel-titanium rotary instruments; the most resistant to wear were nickel-titanium hand instruments. There were few instrument separations. In general, nickel-titanium (particularly hand) instruments resisted deterioration better than did stainless steel. Nickel-titanium rotary instruments (2 of 12) had the most breakage.