Morphometric measurements and sexual dimorphism of the piriform aperture in adults

Purpose

The aim of this study was to evaluate the dimensions (maximal width and length), the size and the shape of the PA and their sexual dimorphism.

Methods

Using 3D-CT scan reconstructions and landmarks positioning around the piriform aperture and on the face, a collective of 170 non-pathologic subjects (79 female, 91 male) from Marseille (France) was examined in classical and geometric morphometrics methods.

Results

The mean width of the piriform aperture was 24.00 mm in females and 25.32 mm in males, the mean length was 32.54 mm in females and 36.35 mm in males. The difference between males and females was significant, and our data correlates well with the previously data acquired from humans skulls. Facial measurements also showed a statistically significant dimorphism. In morphometric geometrics, the correlation between the centroïd size and PC1 in the shape space was weak, while this correlation was strong in the size and shape space. Visualization of shape differences was achieved on 2D wireframes.

Conclusion

Shape and size analysis of the piriform aperture showed the existence of a significant sexual dimorphism. These results encourage us to go further with functional and imaging correlations.     

Validation of Mini Nutritional Assessment Scale in peritoneal dialysis patients

Introduction

Malnutrition is a negative predictive factor for survival in end stage renal disease (ESRD) patients. Coincidence of malnutrition, inflammation and atherosclerosis (MIA syndrome) in the dialysis population is an exceptionally poor outcome event. Due to flexibility, ease of performance and reproducibility, clinical scales are of particular value in assessment of nutritional status in ESRD patients. The aim of the present study was to evaluate the clinical value of Mini Nutritional Assessment (MNA) in peritoneal dialysis (PD) patients.

Material and methods

Nutritional status was assessed in 41 peritoneal dialysis patients by means of the MNA scale and malnutrition inflammation score (MIS). Some other clinical and laboratory parameters associated with nutritional status were analyzed. Patients were followed up for 30 months.

Results

In the analyzed group of patients a good nutritional state was diagnosed in 22 patients (54%), risk of malnutrition in 17 (41%) and malnutrition in 2 patients (5%) based on the MNA scale. A strong correlation between MNA based nutritional status and MIS was found (r = –0.85, p < 0.01, ANOVA, p < 0.01). Differences in time on dialysis, body mass index, concentration of albumin, cholesterol and triglycerides were noted between at risk/malnourished and well-nourished (according to MNA) patients. Statistically significant factors determining survival of patients by Cox proportional hazard analysis were age (HR 1.07), being at risk/malnourished according to MNA (HR 5.7), MIS (HR 1.2), and albumin (HR 0.13).

Conclusions

The MNA scale is a valuable, clinically suitable tool for assessment of nutritional status in peritoneal dialysis patients. Risk of malnutrition and malnutrition diagnosed by MNA identifies patients at high mortality risk.     

Use of macular thickness parameters for the diagnosis of primary open-angle glaucoma

Introduction

Retinal thickness in primary open-angle glaucoma patients was determined to establish its correlation with advancement of glaucoma neuropathy.

Material and methods

One hundred ninety-four patients (371 eyes, age 30–65 years) were divided in 3 groups including 50 patients with confirmed primary open-angle glaucoma, 67 primary open-angle glaucoma-suspected patients and 77 healthy persons (control group). The retinal foveola, foveal, peri-foveal and posterior pole average thickness values were determined with an RTA analyzer. For comparison, linear cup-to-disc diameter ratio (C/D), nerve fiber index (NFI) and mean defect of the retina sensitivity (MD) were also determined.

Results

Statistically highly significant differences in the retinal thickness and glaucoma parameters between the individual groups were observed. In the peri-foveal region, the retinal thickness in glaucoma patients was only 173.0 ±11.4 µm while in the healthy patients 201.1 ±13.1 µm. In the posterior pole region, the thickness values were only 168.1 ±11.3 µm and 195.7 ±12.3 µm, respectively. A moderate correlation between retinal thickness in peri-foveal and posterior pole regions and the C/D, NFI and MD parameters was also established (Pearson coefficients below –0.351 or above 0.284).

Conclusions

The retinal thickness in the peri-foveal and posterior pole regions depends on the degree of glaucoma advancement. This original observation may be a basis for acceptance of this method as a quite new tool in glaucoma diagnosis.     

ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study

Introduction

The aim of the study was to assess myocardial ischemia by analysis of ST-segment changes in high-resolution body surface potential maps (HR-BSPM) measured at rest and during an exercise stress test.

Material and methods

The study was carried out on a group of 28 patients with stable coronary artery disease and 15 healthy volunteers. The HR-BSPM were measured at rest and during the exercise stress test on a supine ergometer. The workload was increased in stages by 25 W every 2 min, beginning at 50 W. The maps of ST-segment depression (ST₆₀) were calculated from time averaged recordings at rest and at maximal workload.

Results

The efficiency in detection of myocardial ischemia was higher for HR-BSPM than for standard 12-lead electrocardiography (ECG) when both methods were evaluated by outcomes of coronarography. The sensitivity of HR-BSPM was 82.4% while for the standard 12-lead ECG exercise stress test it was 58.8%. For some patients significant changes in the ST segment were observed at stress HR-BSPM but were not visible in standard 12-lead ECG recorded under the same conditions.

Conclusions

Obtained high values of sensitivity and specificity in myocardial ischemia detection suggest that maps of ST₆₀ calculated from HR-BSPM can improve detection of patients with ischemic heart disease in comparison to the standard electrocardiographic exercise stress test examinations.     

Avian influenza H9N2 subtype in Poland – characterization of the isolates and evidence of concomitant infections

In April/May 2013, four outbreaks of avian influenza virus (AIV) infections caused by H9N2 subtype were diagnosed in Poland in fattening turkey flocks exhibiting a drop in feed and water intake, depression, respiratory signs and mortality. The subsequent serological survey carried out on samples collected between June 2012 and September 2013 from 92 poultry flocks detected positive sera in two additional meat turkey flocks located in the same province. The analysis of amino acids in the haemagglutinin and neuraminidase glycoproteins revealed that the detected H9N2 viruses possessed molecular profiles suggestive of low pathogenicity, avian-like SAα2,3 receptor specificity and adaptation to domestic poultry. Phylogenetic studies showed that these H9N2 AIVs grouped within the Eurasian clade of wild bird-origin AIVs and had no relationship with H9N2 AIV circulating in poultry in the Middle East and Far East Asia over the past decade. Experimentally infected SPF chickens with the index-case H9N2 virus remained healthy throughout the experiment. On the other hand, ten 3-week-old commercial turkeys infected via the oculonasal route showed respiratory signs and mortality (2/10 birds). Additional diagnostic tests demonstrated the consistent presence of DNA/RNA of Ornithobacterium rhinotracheale, Bordetella avium and, less frequently, of astro-, rota-, reo-, parvo- and adenoviruses in turkeys both from field outbreaks and laboratory experiment. Although no microbiological culture was performed, we speculate that these secondary pathogens could play a role in the pathogenicity of the current H9N2 infections.     

Brucella melitensis Invades Murine Erythrocytes during Infection

Brucella spp. are facultative intracellular Gram-negative coccobacilli responsible for brucellosis, a worldwide zoonosis. We observed that Brucella melitensis is able to persist for several weeks in the blood of intraperitoneally infected mice and that transferred blood at any time point tested is able to induce infection in naive recipient mice. Bacterial persistence in the blood is dramatically impaired by specific antibodies induced following Brucella vaccination. In contrast to Bartonella, the type IV secretion system and flagellar expression are not critically required for the persistence of Brucella in blood. ImageStream analysis of blood cells showed that following a brief extracellular phase, Brucella is associated mainly with the erythrocytes. Examination by confocal microscopy and transmission electron microscopy formally demonstrated that B. melitensis is able to invade erythrocytes in vivo. The bacteria do not seem to multiply in erythrocytes and are found free in the cytoplasm. Our results open up new areas for investigation and should serve in the development of novel strategies for the treatment or prophylaxis of brucellosis. Invasion of erythrocytes could potentially protect the bacterial cells from the host''s immune response and hamper antibiotic treatment and suggests possible Brucella transmission by bloodsucking insects in nature.     

Prospective comparison of scar-related satisfaction and quality of life after laparoscopic versus open radical prostatectomy: no differences from patients’ point of view

Objectives

To evaluate and compare scar-related satisfaction in patients treated with open (ORP) versus laparoscopic radical prostatectomy (LRP).

Patients and method

We prospectively included all patients treated with ORP and LRP in our department between March and June 2010. Scar-related outcomes were collected at 1 and 3 months postoperatively. Three months after surgery, all patients filled up a questionnaire concerning their scar-related symptoms, scar self-consciousness and satisfaction. These variables were statistically compared between the two groups.

Results

A total of 101 patients were included for analysis. Of them, 48, 49 and 4 were treated with LRP, ORP and LRP converted to ORP, respectively. Age distribution was not statistically different between groups. Postoperatively, 5 patients experienced skin infection on their scar site, 2 in the ORP and 3 in the LRP group. The most frequently reported symptom was scar itching, that was more frequent after LRP, although difference was not significant (33 vs. 19 %, p = 0.2). According to patient scar-related consciousness, satisfaction and impact on quality of life, no differences were reported between groups. Impact on quality of life was insignificant in 27 (55 %) versus 21 (44 %) patients after ORP and LRP, respectively (p = 0.3).

Conclusion

With an overall low impact on satisfaction and quality of life, scars gendered by LRP and ORP were not different from patients’ point of view. In patients undergoing radical prostatectomy, the cosmetic aspect of scars does not seem to be a concern.     

Influence of zirconia framework thickness on residual stress profile in veneering ceramic: measurement by hole-drilling

ObjectivesFramework design is reported to influence chipping in zirconia-based restorations, which is an important cause of failure of such restorations. Residual stress profile in the veneering ceramic after the manufacturing process is an important predictive factor of the mechanical behavior of the material. The objective of this study is to investigate the influence of framework thickness on the stress profile measured in zirconia-based structures.MethodsThe stress profile was measured with the hole-drilling method in bilayered disc samples of 20 mm diameter with a 1.5 mm thick veneering ceramic layer. Six different framework thicknesses from 0.5 mm to 3 mm were studied. Two different cooling procedures were also investigated.ResultsCompressive stresses were observed in the surface, and tensile stresses in the depth of most of the samples. The slow cooling procedure was found to promote the development of interior tensile stresses, except for the sample with a 3 mm thick framework. With the tempering procedure, samples with a 1.5 mm thick framework exhibited the most favorable stress profile, while thicker and thinner frameworks exhibited respectively in surface or interior tensile stresses. Significance: The measurements performed highlight the importance of framework thickness, which determine the nature of stresses and can explain clinical failures encountered, especially with thin frameworks. The adequate ratio between veneering ceramic and zirconia is hard to define, restricting the range of indications of zirconia-based restorations until a better understanding of such a delicate veneering process is achieved.