Precision of three-dimensional CT-assisted model production in the maxillofacial area

Individual skull model fabrication was introduced into preoperative diagnostics in maxillofacial surgery in the mid-1980s. The aim of the present study was to collect information on the reproducibility of a skull model milled from hardened polyurethane foam. This model was based on the CT data of a real skull. Twenty comparative studies were carried out on both the model and the original skull, the model showing an average inaccuracy of 1.6 mm. The deviations ranged between 0.0 and 3.6 mm; the general trend favouring enlargements. The total deviation of the model as compared to the original skull was 1.8%. A convincing aspect of the model, which cannot be obtained by any other method, is its plasticity and the possibility of 3 D orientation on a lifesize model. This new method is already used in preoperative planning of corrections of post-traumatic defects and craniofacial deformities as well as in tumour surgery. Correspondence to: P. Solar     

Reduced genital sensitivity in female patients with multiple system atrophy of parkinsonian type.

According to the consensus statement on the diagnosis of multiple system atrophy (MSA), erectile dysfunction is required for male patients to fulfil the urinary incontinence criterion. However, there is no equivalent item for female patients. We questioned 19 female patients with MSA of the parkinsonian type (MSA-P), 28 female patients with Parkinson's disease (PD), and 27 healthy controls on their genital sensitivity. A total of 47% of the MSA patients but only 4% of the PD patients and 4% of the control group admitted to reduced genital sensitivity, a highly significant difference (P < 0.001). Moreover, the appearance of reduced genital sensitivity in female MSA patients showed a close temporal relation to the onset of the disease. If these preliminary results can be confirmed and further specified in a larger sample, a historical item of reduced genital sensitivity in female patients might become a diagnostic feature for MSA, comparable to erectile dysfunction in male patients.     

Prenatal diagnosis of sickle cell anemia. Hemoglobin electrophoresis versus DNA analysis

The prenatal diagnosis of sickle cell anemia (hemoglobin SS) can be established by DNA analysis using two highly sensitive techniques (Southern blot and polymerase chain reaction [PCR]). Hemoglobin electrophoresis provides a third, simpler and more rapid, technique to analyze blood from a fetus at risk for sickle cell anemia. The authors present examples of prenatal diagnostic studies using both DNA analysis techniques and hemoglobin electrophoresis. Hemoglobin electrophoresis of fetal hemolysate can provide a simple and rapid alternative method to PCR analysis for the prenatal exclusion of sickle cell anemia, and it is especially useful in cases in which rapid results are needed because of advanced gestational age.     

Silica dust and lung cancer in the German stone, quarrying, and ceramics industries: results of a case-control study

BACKGROUND: A work force based case-control study of lung cancer was performed in non-silicotic subjects exposed to crystalline silica to investigate the association between silica dust and lung cancer excluding the influence of silicosis. METHODS: Two hundred and forty seven patients with lung cancer and 795 control subjects were enrolled, all of whom had been employed in the German stone, quarrying, or ceramics industries. Smoking was used as a matching criterion. Exposure to silica was quantified by measurements, if available, or otherwise by industrial hygienists. Several indices (peak, average and cumulative exposure) were used to analyse the relationship between the level of exposure and risk of lung cancer as odds ratios (OR). RESULTS: The risk of lung cancer is associated with the year of and age at first exposure to silica, duration of exposure, and latency. All odds ratios were adjusted for these factors. Considering the peak exposure, the OR for workers exposed to high levels (>/=0.15 mg/m3 respirable silica dust which is the current occupational threshold value for Germany) compared with those exposed to low levels (<0.15 mg/m3) was 0.85 (95% CI 0.58 to 1. 25). For the time weighted average exposure the OR was 0.91 (95% CI 0.57 to 1.46). The OR for the cumulative exposure was 1.02 (95% CI 0. 67 to 1.55). No increase in risk was evident with increasing exposure. CONCLUSIONS: This study shows no association between exposure to crystalline silica and lung cancer. The exclusion of subjects with silicosis may have led to dilution with respect to the level of exposure and therefore reduced the power to detect a small risk. Alternatively, the risk of getting lung cancer may be restricted to subjects with silicosis and is not directly linked to silica dust.     

Krankheitsverarbeitung bei Morbus Parkinson

In 45 patients with Parkinson's disease, we investigated coping behavior and its correlations to demographic and disease-related data, locus of control, depression, and psychosocial adaptation. Active, problem oriented, and self-reorganizing strategies were predominantly used and regarded as especially helpful by the 27 men and 18 women (age: 56 years; duration of illness: 9 years). While age and sex were not associated with coping, external locus of control correlated positively to "depressive coping" and duration of illness correlated negatively to "distraction and self-affirmation." Coping strategies regarded as maladaptive and a small degree of internal locus of control correlated to unfavourable results for depression and satisfaction.     

Mitral valve closure and left ventricular filling time in patients with VDD pacemakers. Assessment of the onset of left ventricular systole and the end of diastole

The effect of mitral valve closure on left ventricular filling time and its relation to the onset of systole were assessed from mitral valve echocardiograms and simultaneous apex cardiograms in 21 normal subjects, 11 patients with left bundle branch block, and 19 patients with VDD pacemakers programmed for atrioventricular intervals of 50, 150, and 250 ms. The interval between the electrocardiograph Q wave and the apex cardiogram upstroke was similar in normal subjects and patients with left bundle branch block, but was significantly longer in patients with VDD pacemakers at all atrioventricular intervals. Similarly there was little difference in the time interval between the Q wave and mitral valve closure in normal individuals and patients with left bundle branch block but this was considerably delayed in VDD pacemaker patients with the atrioventricular interval set at 50 ms. With increasing atrioventricular intervals the mitral valve closed significantly earlier, whereas the onset of left ventricular systole and the timing of mitral valve opening remained unchanged. Thus as a result of earlier mitral valve closure left ventricular filling time decreased progressively as the atrioventricular interval was increased. Since the onset of left ventricular systole, with respect to left ventricular stimulation, is considerably delayed in VDD pacemaker patients a short atrioventricular interval is required in these patients to maintain the normal time relations between atrial and ventricular contraction and hence maximise left ventricular filling.     

A volumetric prediction model for postoperative cyst shrinkage

Clinical Oral Investigations - With only limited information available on dimensional changes after jaw cyst surgery, postoperative cyst shrinkage remains largely unpredictable. We aimed to propose...