Analysis of the upper massif of the craniofacial with the radial method – practical use

Introduction

The analysis of the upper massif of the craniofacial (UMC) is widely used in many fields of science. The aim of the study was to create a high resolution computer system based on a digital information record and on vector graphics, that could enable dimension measuring and evaluation of craniofacial shape using the radial method.

Material and methods

The study was carried out on 184 skulls, in a good state of preservation, from the early middle ages. The examined skulls were fixed into Molisson''s craniostat in the author''s own modification. They were directed in space towards the Frankfurt plane and photographed in frontal norm with a digital camera. The parameters describing the plane and dimensional structure of the UMC and orbits were obtained thanks to the computer analysis of the function recordings picturing the craniofacial structures and using software combining raster graphics with vector graphics.

Results

It was compared mean values of both orbits separately for male and female groups. In female skulls the comparison of the left and right side did not show statistically significant differences. In male group, higher values were observed for the right side. Only the circularity index presented higher values for the left side.

Conclusions

Computer graphics with the software used for analysing digital pictures of UMC and orbits increase the precision of measurements as well as the calculation possibilities. Recognition of the face in the post mortem examination is crucial for those working on identification in anthropology and criminology laboratories.     

A system for detecting and describing pathological changes using dynamic perfusion computer tomography brain maps

This paper presents a novel method of detecting and describing pathological changes that can be visualized on dynamic computer tomography brain maps (perfusion CT). The system was tested on a set of dynamic perfusion computer tomography maps. Each set consisted of two perfusion maps (CBF, CBV and TTP for testing the irregularity detection algorithm) and one CT brain scan (for the registration algorithm) from 8 different patients with suspected strokes. In 36 of the 84 brain maps, abnormal perfusion was diagnosed. The results of the algorithm were compared with the findings of a team of two radiologists. All of the CBF and CBV maps that did not show a diagnosed asymmetry were classified correctly (i.e. no asymmetry was detected). In four of the TTP maps the algorithm found asymmetries, which were not classified as irregularities in the medical diagnosis; 84.5% of the maps were diagnosed correctly (85.7% for the CBF, 85.7% for the CBV and 82.1% for the TTP); 75% of the errors in the CBF maps and 100% of the errors in the CBV and the TTP maps were caused by the excessive detection of asymmetry regions. Errors in the CBFs and the CBVs were eliminated in cases in which the symmetry axis was selected manually. Subsequently, 96.4% of the CBF maps and 100% of the CBV maps were diagnosed correctly.     

Thromboprophylaxis in patients with multiple organ injuries--is there an alternative to low-molecular-weight heparins (LMWH)?

The number of body injuries keeps growing and that is mostly due to increasing number of car accidents. How to prevent thrombosis in such cases is still under discussion with the biggest issue being the proper timing. Most of the input to such discussion usually comes from extrapolating data from other studies, which is hardly of help for treatment of such group of patients. The authors focus on collection and analysis of most recent data and recommendations that are available in literature. They show that low-molecular-weight heparins are by far the most common, if not sole pharmacologic means of thromboembolism prevention in patients with numerous body injuries.     

Comparative analysis of the new chronic kidney disease epidemiology collaboration and the modification of diet in renal disease equations for estimation of glomerular filtration rate in HIV type 1-infected subjects

Recently, a new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula was presented as a better alternative to the modification of diet in renal disease (MDRD) formula for GFR estimation (eGFR) in patients with relatively well-preserved kidney function. The main objective of our study was to compare the eGFR results arrived by the new CKD-EPI to the older MDRD equation in antiretroviral (ARV)-naive and ARV-treated HIV-1-infected patients. The study was performed in 287 adult HIV-1-infected patients and was an evaluation comparing eGFR results based on age, gender, race, and serum creatinine. The biggest difference in estimated glomerular filtration rate (eGFR) measured by the two formulas was seen in ARV-naive men with well-preserved kidney function (p = 0.001). Moreover, we found a significant negative correlation between mean difference in eGFR measured by the two equations and the age of the studied subjects (r = -0.37, p < 0.001). No correlation was observed between mean difference in eGFR and HIV viral load (r = -0.15, p = 0.2). Independent of the equation used, a significant decrease of eGFR in ARV-treated in comparison to ARV-untreated HIV-1-infected patients was seen (p < 0.001). In conclusion, in HIV-1-infected subjects, especially in ARV-naive men with well-preserved kidney function, eGFR measured by MDRD and CKD-EPI formulas varies strongly following the method used. Such discrepancies may be important in everyday clinical practice and must be confirmed by additional studies using GFR measured with a reference method.     

Genetic determinants of platelet response to clopidogrel

Antiplatelet agents are the mainstay treatment in the prevention and management of atherothrombotic complications. However, a substantial interpatient variability in response to clopidogrel has been reported. Furthermore, patients with coronary artery disease and lesser platelet inhibition in response to clopidogrel are at increased risk for cardiovascular events. Clopidogrel after absorption requires two-step oxidation by the hepatic cytochrome P450 to generate its active metabolite. Polymorphisms of genes encoding the cytochrome enzymes and P-glycoprotein involved in clopidogrel absorption are regarded as major determinants of the interindividual variability in the clopidogrel-induced platelet inhibition. In our review we discuss the prevalence and clinical significance of various alleles of the genes: CYP2C19 and ABCB1 in the setting of coronary artery disease. Allele CYP2C19*2 is associated with excess of ischaemic events including myocardial infarction and stent thrombosis. On the other hand, CYP2C19*17 allele poses a serious threat of bleeding. Data concerning the prognostic value of genetic variant 3435C→T of ABCB1 remain inconclusive.     

Myocardial infarction without coronary arteries stenoses in a patient with Jervell and Lange-Nielsen syndrome--diagnostic dilemmas

According to the rules of differential diagnostics an acute coronary syndrome (ACS) often constitutes an initial diagnosis while a subsequent patient's follow-up with troponin determination results in further verification of the diagnosis. A 55 year-old female with congenital hearing loss, poorly controlled hypertension, type 2 diabetes treated with oral medications, and hypothyreosis was admitted to the Department of Cardiology with 6 h long severe chest pain radiating over her back with concomitant dyspnea. She underwent urgent coronary angiography which showed no epicardial coronary narrowing. Acute heart failure symptoms occurred immediately after coronary angiography in the form of cardiogenic shock. Even though an ACS was diagnosed on the basis of typical biochemical, electrocardiographic and clinical criteria, a further follow-up suggested a possibility of a co-existance of other diseases which occurred to be a Jervell and Lange-Nielsen syndrome.     

Infective endocarditis caused by Erysipelothrix rhusiopathiae involving three native valves

Human infection with Erysipelothrix rhusiopathiae is extremely rare and occupationally related. This paper presents for the first time a case of a 47 year-old male with endocarditis involving three valves simultaneously.