Sex Estimation of Han Adults in Western China Based on Three-Dimensional Cranial CT Reconstruction / 法医学杂志

OBJECTIVES@#To examine the reliability and accuracy of Walker's model for estimating the sex of Han adults in western China by using cranium three-dimensional (3D) CT reconstruction, and to study the suitable cranial sex estimation model for Han people in western China.@*METHODS@#A total of 576 cranial CT 3D reconstructed images from Hanzhong Hospital in Shaanxi Province from 2017 to 2021 were collected. These images were divided into the experimental group with 486 samples and the validation group with 90 samples. Walker's model was used by observer 1 to estimate the sex of experimental group samples. The logistic function applicable to Han people in western China was corrected by observer 1. The 90 samples in the validation group were scored and substituted into the modified logistic function to complete the back substitution test by observer 1, 2 and 3.@*RESULTS@#The accuracy of sex estimation of Han adults in western China was 63.2%-77.2% by applying Walker's model. The accuracy of modified logistic function was 82.9%. The accuracy of sex estimation through back substitution test by 3 observers was 75.6%-91.1%, with a Kappa value of 0.689 (P<0.05) for inter-observer consistency and 0.874 (P<0.05) for intra-observer consistency.@*CONCLUSIONS@#There are great differences in bone characteristics among people from different regions. The modified logistic function can achieve higher accuracy in Han adults in western China.

Anatomical features of sella turcica with comprehensive literature review

SUMMARY OBJECTIVE: This study aimed to explore the relationship between skeletal patterns and the frequency of sella turcica bridging in a sample of young Turkish adults in order to provide a better understanding of the relationship between craniofacial morphology and sella turcica abnormalities. METHODS: A total of 90 individuals aged between 18 and 25 years were examined in this study. The individuals were classified according to their skeletal pattern, specifically Class I, Class II, and Class III. Each group consisted of 15 males and 15 females. The length, depth, and anteroposterior diameter of sella turcica were calculated. The shape and bridging of sella turcica were estimated using lateral cephalometric images. All data were correlated and statistically analyzed according to skeletal patterns, genders, and age. RESULTS: The mean length, depth, and anteroposterior diameter of sella turcica were 7.02±2.13, 7.56±1.38, and 10.54±1.3 mm in Classes I-III, respectively. There was no significant difference between the dimensions of sella turcica according to gender and age (p˃0.05). The length of sella turcica was larger in Class III, and the depth of sella turcica was larger in Class II individuals (p<0.05). A total of 44.4% of the individuals had normal sella turcica, while the remaining 56.6% had other types of sella turcica. It was determined that 31.1% of the individuals have no calcification, 62.2% had partial calcification, and 6.7% had total calcification. CONCLUSION: The normal dimensions, shape, and bridging of the sella turcica can be used by the orthodontist for diagnosis, treatment planning, and evaluation of various pathological conditions associated with the sella turcica.

Internal acoustic opening: different osseous landmarks and their clinical implications / Poro acústico interno: diferentes hitos óseos y sus implicaciones clínicas

SUMMARY: Internal acoustic opening is a space that opens to facies posterior of the petrous piece of temporal bone that goes inside facial nerve, vestibulocochlear nerve, intermedial nevre and labyrinthine artery. The purpose of this study is the assessment of internal acoustic opening from a morphometric perspective, determination of the shape of the hole and determination of the distance to some important anatomic formations. This study is conducted on 166 temporal bones with unknown sex formation which are part of the skull collection in NEU and KTO Karatay University, Anatomy Department. In this study, the vertical and diameter of internal acoustic meatus, its distance to the bottom and top sides of posterior surface of the petrous part, its distance to groove for superior sagittal sinus and its distance to apex were measured. Moreover, in this study internal acoustic opening spaces are categorized into six groups as round, oval, U-shaped, fissure, irregular and V shape. Digital caliper was used for internal acoustic meatus measurements. While the vertical horizontal diameters and distance to groove for superior sagittal sinus of internal acoustic opening on the right side are 4.12 mm, 6.83 mm and 19.64mm respectively, they are 4.56 mm, 7.10 mm and 21.06 mm on the left side respectively. We have observed in this study, 37.3 % of the internal acoustic opening as round, 34.3 % as oval, 6.6 % as U-shaped, 6.6 % as fissure, 12.7 % as irregular and 2.4 % as V-shaped. We believe that these measurements can provide guidance and help in surgical procedures.

RESUMEN: El poro acústico interno es un espacio que se abre en la cara posterior de la parte petrosa del hueso temporal, donde entran los nervios facial, intermedio y vestibulococlear, además de la arteria laberíntica. El propósito de este estudio fue la evaluación del poro acústico interno desde una perspectiva morfométrica, determinación de la forma del foramen y de la distancia a algunas formaciones anatómicas importantes. Este estudio se realizó en 166 huesos temporales de individuos de sexo desconocido que forman parte de la colección de cráneos del Departamento de Anatomía en NEU y KTO, Universidad de Karatay, Se midió la altura vertical y el diámetro del poro acústico interno, su distancia a los lados inferior y superior de la superficie posterior de la parte petrosa, su distancia al surco del seno sagital superior y su distancia al vértice. Además, el poro acústico interno se clasificó en seis grupos: redondos, ovalados, en forma de U, de fisura, irregulares y en forma de V. Se utilizó un calibrador digital para las mediciones del meato acústico interno. Mientras que los diámetros horizontales, verticales y la distancia al surco para el seno sagital superior del poro acústico interno en el lado derecho fue de 4,12 mm, 6,83 mm y 19,64 mm respectivamente, en el lado izquiedo fue de 4,56 mm, 7,10 mm y 21,06 mm, respectivamente. Hemos observado que en el 37,3 % de los casos el poro acústico interno era redondo, el 34,3 % ovalado, el 6,6 % en forma de U, el 6,6 % de fisura, el 12,7 % irregular y el 2,4 % en forma de V. Estas medidas pueden servir de guía y ayuda en los procedimientos quirúrgicos.

Organ histopathological associations with hyperostosis frontalis interna in humans / Asociaciones histopatológicas de órganos con hiperostosis frontal interna en humanos

SUMMARY: An increased thickening of the frontal bone by irregular laminar additions on the inner surface just deep to the dura mater have been known in the archaeological and medical record as hyperostosis frontalis interna (HFI). The distribution of this is idiosyncratically restricted to the frontal and has no known etiology. The prevalence among post-menopausal females and rarity in males suggests that it is hormonally driven. Here we report histopathological findings of particularly hormonally active organs (pituitaries, gonads and liver) from a geriatric cadaveric sample in which HFI is assessed. HFI was present in 50 % of males (7/14) and 95 % (21/22) of females. All males with HFI had testicular atrophy or had testes absent. Males with HFI category C or D had moderate to severe testicular atrophy. Decreased numbers of interstitial cells (Leydig cells) were present in 83.3 % of males with HFI. All but one female (21/22) from this study exhibited evidence of HFI, and ovarian pathologies were unevenly distributed (fibromas in two) and most exhibited signs of being healthy and post-menopausal. Liver pathologies had opposite patterns between the sexes, with more liver pathologies occurring among males without HFI (particularly passive congestion and bile stasis). The only exceptions were that the one case of liver neoplasia was found in a male with HFI and steotosis was found in two cases with HFI and one case without HFI. In females all cases of liver pathologies (steotosis, hepatitis, passive congestion, fibrosis, and bile stasis) were associated with HFI. It appears that gonadal pathology is most closely associated with HFI in males but not females, suggesting that the role of estradiol in this unusual growth of bone in geriatric humans may be worth investigating further.

RESUMEN: Un aumento del engrosamiento del hueso frontal, por adiciones laminares irregulares en la superficie interna, justo en la profundidad de la duramadre, se conoce en los registros arqueológicos y médicos como hiperostosis frontal interna (HFI). La distribución de ésta, se restringe idiosincráticamente al hueso frontal y no tiene etiología conocida. La prevalencia entre las mujeres posmenopáusicas y la rareza en los hombres sugiere que se debe a las hormonas. Aquí informamos los hallazgos histopatológicos de órganos hormonalmente activos (hipófisis, gónadas e hí- gado) de una muestra de cadáveres geriátricos en la que se evaluó HFI. La HFI estuvo presente en el 50 % de los hombres (7/14) y el 95 % (21/22) de las mujeres. Todos los hombres con HFI tenían atrofia testicular o no tenían testículos. En los hombres con HFI categoría C o D se observó atrofia testicular de moderada a grave. Hubo una disminución en el número de células intersticiales (células de Leydig) en el 83,3 % de los hombres con HFI. En 21de 22 mujeres se observó evidencia de HFI, y las patologías ováricas se distribuyeron de manera desigual (fibromas en dos) y la mayoría exhibió signos de estar sana y posmenopáusica. Las patologías hepáticas tenían patrones opuestos entre los sexos, con más patologías hepáticas entre los hombres sin HFI (particularmente congestión pasiva y estasis biliar). Las excepciones fueron que el único caso de neoplasia hepática se encontró en un varón con HFI y se presentó esteatosis en dos casos con HFI y un caso sin HFI. En las mujeres, todos los casos de patologías hepáticas (esteatosis, hepatitis, congestión pasiva, fibrosis y estasis biliar) se asociaron con HFI. Al parecer la patología gonadal está más estrechamente asociada con la HFI en los hombres que en las mujeres, lo que sugiere un rol del estradiol en este crecimiento inusual de hueso en hombres de avanzada edad. Sería importante realizar investigaciones más detalladas precisas respecto a la hiperostosis frontal interna.

Los tipos craneométricos caninos aparecen bien expresados a nivel de conformación del arco cigomático / Craneometric canine types are well expressed at the level of the zygomatic arch conformation

Dentro del espectro de conformación del cráneo, se reconocen generalmente tres amplias categorías que se corresponden con el concepto de biotipo cefálico, determinado por el Índice Cefálico. El Estos tres biotipos cefálicos son: el braquiocefálico, mesaticefálico y dolicocefálico, pero están basados en medidas lineales. A fin de revisar esta clasificación en base a su geometría, se estudiaron 53 cráneos de perros adultos, correspondientes a los tres grupos craneométricos descritos: 16 braquicéfalos, 20 mesaticéfalos y 17 dolicocéfalos. Para ello se obtuvieron fotografías en el plano ventral, en las que posteriormente se ubicaron 17 hitos anatómicos que se analizaron mediante técnicas de morfometría geométrica. De estos hitos, 5 correspondían a la zona neurocraneal y el resto al esplacnocráneo. Los tres grupos craneométricos mostraron diferencias estadísticamente significativas entre ellos tanto por el tamaño como por la forma. Las variables que contribuyeron más a explicar la diferenciación fueron las ubicadas en el margen más lateral de los arcos cigomáticos y en la base de este mismo arco. Las variables esplacnocraneales presentaban una alometría mucho más marcada que las neurocráneos. Puesto que el arco cigomático debe ser considerado como parte del esplacnocráneo, sugerimos que es tan importante el índice cefálico (que tiene en cuenta la máxima anchura de la cabeza) como el facial (que tiene en cuenta la máxima anchura de la cara). La conformación neurocraneal sería mucho más conservativa y por ende el índice craneal, de mucho menor poder discriminatorio entre grupos. El cambio entre tipos se debería a los músculos masetero y temporal, que tienen su inserción en el arco.

Within the wide conformation of skull spectrum, there are generally three recognized broad categories that correspond to the concept of cephalic biotype, determined by the cephalic index. The three cephalic biotypes are: brachiocephalic, mesaticephalic and dolichocephalic, which are based on linear measures. In order to revise this classification based on its geometry, we studied 53 skulls of adult dogs, corresponding to the three craneometric groups previously described: 16 brachycephalic, 20 mesaticephalic and 17 dolichocephalic. Images on ventral plane were obtained and 17 anatomical landmarks were subsequently located and analyzed by means of geometric morphometric techniques. Five of those landmarks corresponded to the neurocraneal area and the rest of the splanchnocranium. The three craneometric groups showed statistically significant differences between them for both size and shape. The variables that contributed to the differentiation between them were located along the edge of the zygomatic arches and on the basis of this arch. Splanchnocranial variables also presented a much more marked allometry than the neurocraneal variables. Since the zygomatic arch should be considered as part of the splanchnocranium, we suggest that the cephalic index (which takes into account the maximum width of the head) is as important as the facial index (which takes into account the maximum width of the face). The neurocraneal index would be much more conservative, and therefore less discriminatory between the groups.

Analysis on the changes of Beagle dog’s intracranial pressure and influencing factors caused by free field live bomb explosion / 解放军医学杂志

Objective To investigate the effect of Beagle's cranium on shockwave blocking after free field explosion, and whether a quantitative relationship exists between intra- and extracranial pressure. Methods Eighteen Beagle dogs were used in the free field explosion experiment. The explosion source was 1 kg and 3.5 kg column-shaped trinitrotoluene (TNT), which was located 1.5 m above the land to rule out the possibility of reflex. Measurment instruments were located 1-6 m from the explosion source. Head of Beagle dog was located at the same location as that of measurment instruments. After Beagle dog was anaesthetised, pressure sensor was planted under parietal bone. One side of the sensor borehole faced to the brain tissue, and the other side of the sensor borehole faced to the cranium to measure the pressure from the skull direction. All Beagle dogs were recumbent fixed, the head was positively faced to the source of explosion. Pressures from the bone and from the brain tissue were measured respectively. Results One dog died after the explosion and the remaining 17 dogs were alive. Twenty-four hours later, Tarlov scores of the alive dogs were graded 4-5, and neurofunctional score in large animals was more than 13. The peak explosive wave pressure was 207(47.6-207) kPa with a mean of 122 kPa. The maximal impact pressure impulse reached to 88 Pa·s. The pressure curve from the cranium direction of Beagle dog was similar to that from the brain tissue, but the pressure curve from the brain tissue direction changed more gently. A logarithmic trend existed of the peak pressure of the shockwave from the cranium direction and the external shockwave at the same position (correlation coefficient = 0.804). Conclusions In free field explosion, shockwave can enter the brain through cranium, chest and abdomen. The cranium has some blocking effect on the shockwave, and partial shockwave pressure can be uploaded to the brain tissue through the chest and abdomen, but because of the blocking of the body tissue, the change curve is relatively smooth.

Anthropometric Evaluation of Cranial Indexes.

Introduction: Craniometric measurements are used inanatomy, anthropometry and surgical fields, especially inmaxillofacial and plastic surgery. The aim of this study was toinvestigate the cranial index values anthropometrically and tocontribute to the literature data.Material and methods: For this purpose, 30 craniumbones with unknown age and gender belonging to AnatomyDepartment, Faculty of Medicine and University of Cukurovawere used.Results: In this study, maximum cranial width, maximumcranial length, bizygomatic width, cranial height, upper faceheight and minimum frontal width were measured. The meanand standard deviation values of the measured values are;139.15 ± 9.89, 172.20 ± 7.90, 125.24 ± 9.47, 126.07 ± 6.23,65.07 ± 5.40, 95.33 ± 5.09 mm, respectively. By using thesevalues, cranial index, transverse cranio - facial index, cranialheight - width index, cranial height - length index, upper facialindex and fronto - parietal index values were calculated. Themean and standard deviation of index values are 81.59 ± 5.60,90.21 ± 6.69, 92.30 ± 6.16, 73.73 ± 3.79, 52.61 ± 5.52, 68.76± 4.86 mm, respectively.Conclusions: The results of our study were classified andcompared with the studies performed in different populations.We believe that the obtained data will contribute to theresearch and literature data in clinical areas.

Effect of 3D-slicer assisted soft channel drainage on surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage / 中国医师进修杂志

Objective@#To explore the effect of 3D-slicer assisted soft channel drainage on the surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage (HICH).@*Methods@#Seventy-six HICH patients treated in Zhejiang Xin'an International Hospital from January 2016 to December 2018 were randomly divided into the control group and the observation group, with 38 cases in each group. Both groups of patients underwent percutaneous cone cranial soft channel drainage.The control group patients used CT hematoma localization, and the observation group patients used 3D-slicer software hematoma localization. The perioperative related data, surgical results, complications and prognosis of patients in the two groups were observed and compared.@*Results@#The operation time and hospitalization time of patients in observation group were (76.24 ± 11.24) min and (15.21 ± 4.01) d, significantly shorter than those in control group [(103.17 ± 17.43) min and (18.63 ± 4.75) d], and there were significant differences (P < 0.05). The blood loss during operation and hematoma residual amount 7 d after operation in observation group were (77.21 ± 11.35) ml and (4.24 ± 0.87) ml, significantly lower than those in control group [(115.35 ± 21.22) ml and (18.63 ± 4.75) ml], and there were significant differences (P < 0.05). The hematoma clearance of patients 1 d and 3 d after operation in observation group were (83.24 ± 11.21) ml and (92.24 ± 15.63) ml, significantly higher than those in control group [(69.67 ± 10.73) ml and (85.57 ± 13.11) ml], and there were significant differences (P < 0.05). The incidence rates of intracranial rebleeding, intracranial infection and pulmonary infection in observation group were significantly lower than those in control group [2.63%(1/38) vs. 21.05%(8/38), 0 vs. 15.79% (6/38), 2.63%(1/38) vs. 21.05%(8/38)](P < 0.05). After treatment for 3 months, the good prognosis rate in observation group was significantly higher than that in control group [86.84%(33/38) vs. 65.79% (25/38)] (P < 0.05).@*Conclusions@#3D-slicer software based on percutaneous soft-channel puncture and drainage for HICH patients can achieve better surgical results, reduce the incidence of complications and improve the prognosis of patients.

Effect of 3D-slicer assisted soft channel drainage on surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage / 中国医师进修杂志

Objective To explore the effect of 3D-slicer assisted soft channel drainage on the surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage (HICH). Methods Seventy-six HICH patients treated in Zhejiang Xin 'an International Hospital from January 2016 to December 2018 were randomly divided into the control group and the observation group, with 38 cases in each group. Both groups of patients underwent percutaneous cone cranial soft channel drainage.The control group patients used CT hematoma localization, and the observation group patients used 3D-slicer software hematoma localization. The perioperative related data, surgical results, complications and prognosis of patients in the two groups were observed and compared. Results The operation time and hospitalization time of patients in observation group were (76.24 ± 11.24) min and (15.21 ± 4.01) d, significantly shorter than those in control group [(103.17 ± 17.43) min and (18.63 ± 4.75) d], and there were significant differences (P < 0.05). The blood loss during operation and hematoma residual amount 7 d after operation in observation group were (77.21 ± 11.35) ml and (4.24 ± 0.87) ml, significantly lower than those in control group [(115.35 ± 21.22) ml and (18.63 ± 4.75) ml], and there were significant differences (P < 0.05). The hematoma clearance of patients 1 d and 3 d after operation in observation group were (83.24 ± 11.21) ml and (92.24 ± 15.63) ml, significantly higher than those in control group [(69.67 ± 10.73) ml and (85.57 ± 13.11) ml], and there were significant differences (P < 0.05). The incidence rates of intracranial rebleeding, intracranial infection and pulmonary infection in observation group were significantly lower than those in control group [2.63%(1/38) vs. 21.05%(8/38), 0 vs. 15.79% (6/38), 2.63%(1/38) vs. 21.05%(8/38)](P<0.05). After treatment for 3 months, the good prognosis rate in observation group was significantly higher than that in control group [86.84% (33/38) vs. 65.79% (25/38)] (P<0.05). Conclusions 3D-slicer software based on percutaneous soft-channel puncture and drainage for HICH patients can achieve better surgical results, reduce the incidence of complications and improve the prognosis of patients.

Sexing the cranium from the foramen magnum using discriminant analysis in a brazilian sample

Abstract In the identification process, the foramen magnum has shown controversial results in sex estimation. The present study aimed to analyze the morphometric variables of the foramen magnum in Brazilian adult cranium for sex estimation. The sample was composed of 100 craniums (53 males and 47 females) from the documented collection of the Institute of Teaching and Research in Forensic Sciences. The protocol measurement was constituted of two linear measurements: maximum length of the foramen magnum and maximum breadth of the foramen magnum and two formulas to calculate the area, method one (M1) and method two (M2). Descriptive statistics showed statistically significant differences between sex (p<0.05) for all variables. The univariate discriminant functions showed an accuracy between 56.0-62.0%, and the multivariate analysis showed a percentage of accuracy between 60.0-65.0%, the greatest accuracy was found combining the two linear measurements with M1(71.7%), even after cross-validation (66%). Receiver Operating Characteristic (ROC) curve analysis showed that M2 is the best parameter for estimating sex (AUC=0.693). A reference table for Brazilians using the foramen magnum parameters was developed based on the results of the ROC curve analysis. In conclusion, the foramen magnum should be used with caution to estimate sex in forensic cases of fragmentary craniums, due to the limited accuracy.

Resumo No processo de identificação humana, a análise do forame magno apresenta resultados controversos para estimativa do sexo. O presente estudo teve como objetivo analisar as variáveis morfométricas do forame magno em crânios adultos brasileiros para estimação sexual. A amostra foi composta por 100 crânios (53 sexos masculino e 47 sexo feminino) pertencentes a coleção osteológica documentada do Instituto de Ensino e Pesquisa em Ciências Forenses. A medida do protocolo foi constituída por duas medidas lineares: comprimento máximo do forame magno e largura máxima do forame magno e duas fórmulas para calcular a área, método um (M1) e método dois (M2). As estatísticas descritivas evidenciaram diferenças estatisticamente significativas (p<0,05) para todas as variáveis. As funções discriminantes univariadas apresentaram uma porcentagem de acerto entre 56,0-62,0% e a análise multivariada mostrou uma porcentagem de acerto entre 60,0-65,0%. A análise da curva ROC apontou que M2 é o melhor parâmetro para estimar o sexo (AUC=0,693). Uma tabela de referência para brasileiros que utilizam os parâmetros do forame magnum foi desenvolvida com base nos resultados da análise da curva ROC. Em conclusão, o foram e magnum deve ser usado com precaução para estimar o sexo em casos forenses de cranio fragmentado, devido à precisão limitada.

Diagnóstico y tratamiento en un caso de neurocisticercosis / Diagnosis and treatment of a neurocysticercosis case

La neurocisticercosis es una enfermedad del sistema nervioso central de origen parasitario que genera una alta morbilidad. Presentamos el caso de un paciente de 30 años de edad, negro, del sexo masculino, con historia de dolor de cabeza y disminución progresiva de la visión desde hace tres meses. Fue examinado en la Consulta de Oftalmología, donde se constató la pérdida visual y alteraciones campimétricas. En el fondo de ojo se observó papiledema bilateral. Le fue indicada tomografía computarizada de cráneo que mostró una gran lesión en la región frontal derecha y por lo cual fue transferido para el Servicio de Neurocirugía. Se decidió el tratamiento quirúrgico y se le realizó una craneotomía frontal derecha y resección de la lesión. El diagnóstico histológico confirmó una neurocisticercosis, por lo que se decidió comenzar el tratamiento con albendazol y praziquantel. El paciente evolucionó satisfactoriamente. Después de completar el tratamiento y pasados unos meses se le realizó la tomografía axial computarizada de control, donde se mostró una remisión total de la lesión(AU)

Neurocysticercosis is a disease of the central nervous system of parasitic origin and high morbidity. This is the case of a 30 years-old Black male patient with a history of headache and progressive reduction of vision for three months. He was examined at the Ophthalmological Service where visual loss and campometric alterations were confirmed. The fundus oculi revealed the presence of bilateral papilledema. He was performed cranial CT that showed a large lesion in the right front region, so he was transferred to the neurosurgery service. It was decided to apply surgical treatment. He was then performed a right front craniotomy and then resection of the lesion. The histological diagnosis confirmed neurocysticercosis and he was then treated with albendazol and praziquantel. His recovery was satisfactory. Upon completing the treatment and after a few months, the axial computerized tomography for control showed total remission of lesion(AU)

Cesárea electiva en gestante con fractura-hundimiento antigua en región frontal del cráneo / Pregnant With an Old Fracture-Sink in Skull Frontal Region Determines Elective Caesarean Section

Los traumatismos craneoencefálicos constituyen una epidemia silenciosa para la Organización Mundial de la Salud; y en específico, las fracturas de cráneo tienen una incidencia elevada en la sociedad moderna. El objetivo es presentar el caso de una embarazada con una fractura craneal antigua (fractura-hundimiento frontal) que condiciona la indicación de una cesárea electiva. Además, resulta una afectación anatómica poco habitual en la práctica de la Obstetricia. Se presenta una gestante de 22 años que a la edad de 4 años sufrió trauma craneoencefálico al caer accidentalmente desde un cuarto piso. Se impactó en la región frontal del cráneo con un recipiente de cerámica pesado. Quedó inconsciente y con sangrado profuso, se operó de urgencia y la paciente quedó sin secuela clínica de daño cerebral, pero con deformidad craneal por hundimiento de forma ovalada bien delimitada. Se determinó cesárea electiva por orientación del Programa Materno Infantil Nacional a las 40,5 semanas, peso del recién nacido 3 802 g y Apgar 9-9. Tuvo una evolución satisfactoria durante su atención prenatal y puerperio. La valoración y el manejo de una gestante con antecedentes de un traumatismo craneoencefálico antiguo requieren de un seguimiento multidisciplinario que involucre a obstetras, neurocirujanos, neurólogos y otros especialistas, con vistas a evitar las complicaciones que una afección como esta, pueden resultar letales para la madre o el feto(AU)

Cranium cerebral trauma constitutes a silent epidemic for the World Organization of the Health; and specifically skull fractures have risen incidence in the modern society. To present the case of a pregnant woman with an old cranial fracture (front fracture-sinking) that conditions the indication of elective caesarean operation. In addition, it is an unusual anatomical involvement in Obstetrics practice. We present the case of a 22 year-old pregnant that suffered encephalic skull trauma at the age of 4. This trauma is the result of her falling accidentally from a fourth floor to a heavy ceramic recipient and she impacted the front region of her skull. She was unconscious and bled profusely. She underwent urgent surgery. She survived without clinical sequel of cerebral damage but she has cranial sinking deformity in a well-defined oval way. Elective caesarean operation is determined by orientation from the national infantile maternal program to the 40,5 weeks, weight of the newly born 3 802 grams, Apgar 9-9. Satisfactory evolution during their prenatal attention and puerperium. Elective cesarean section is determined at 40.5 weeks, the newborn weight 3 802 g, Apgar 9-9, in alignment with the Cuban national program for the mother and the child. She had a satisfactory evolution during her prenatal and puerperal care. The assessment and management of a pregnant woman with a history of an old cranioencephalic trauma requires multidisciplinary monitoring involving obstetricians, neurosurgeons, neurologists and other specialists, for avoiding complications which can be lethal to the mother or the fetus(AU)

Skull shape and size variation within and between mendocinus and torquatus groups in the genus Ctenomys (Rodentia: Ctenomyidae) in chromosomal polymorphism context

Abstract We tested the association between chromosomal polymorphism and skull shape and size variation in two groups of the subterranean rodent Ctenomys. The hypothesis is based on the premise that chromosomal rearrangements in small populations, as it occurs in Ctenomys, produce reproductive isolation and allow the independent diversification of populations. The mendocinus group has species with low chromosomal diploid number variation (2n=46-48), while species from the torquatus group have a higher karyotype variation (2n=42-70). We analyzed the shape and size variation of skull and mandible by a geometric morphometric approach, with univariate and multivariate statistical analysis in 12 species from mendocinus and torquatus groups of the genus Ctenomys. We used 763 adult skulls in dorsal, ventral, and lateral views, and 515 mandibles in lateral view and 93 landmarks in four views. Although we expected more phenotypic variation in the torquatus than the mendocinus group, our results rejected the hypothesis of an association between chromosomal polymorphism and skull shape and size variation. Moreover, the torquatus group did not show more variation than mendocinus. Habitat heterogeneity associated to biomechanical constraints and other factors like geography, phylogeny, and demography, may affect skull morphological evolution in Ctenomys.

Anatomía comparada del neurocráneo y el encéfalo de la raya mariposa Gymnura micrura (Batoidea: Gymnuridae) / Comparative anatomy of the neurocranium and encephalon of the butterfly ray, Gymnura micrura (Batoidea: Gymnuridae)

Mediante la comparación del neurocráneo de la "raya mariposa" Gymnura micrura con especies representantes de cinco familias de Batoidea, se reconoce que corresponde al patrón anatómico del orden Myliobatiformes, por la ausencia del rostro, la presencia de una sola fontanela y el mayor desarrollo de los procesos postorbitarios. La especie en estudio difiere de los Urotrygonidae y Dasyatidae por tener los procesos postorbitarios subdivididos. La organización del encéfalo de G. micrura corresponde al patrón anatómico de los Batoidea, sin embargo, a diferencia de los Rhinobatidae, Urotrygonidae y Dasyatidae, el cerebelo es simétrico; en contraste con los Myliobatidae los hemisferios cerebrales son reducidos; y la principal diferencia con relación a los Narcinidae es la ausencia de los lóbulos eléctricos.

By comparing the neurocranium of the "butterfly ray" Gymnura micrura with representative species of five families of Batoidea, it is recognized that it corresponds to the anatomical pattern of the order Myliobatiformes, because of the absence of the rostrum, the presence of a single fontanelle and the development of the postorbital processes. The species under study differs from the Urotrygonidae and Dasyatidae by having subdivided postorbital processes. The organization of the encephalon of G. micrura corresponds to the anatomical pattern of the Batoidea. However, unlike the Rhinobatidae, Urotrygonidae, and Dasyatidae, the cerebellum is symmetrical; in contrast with the Myliobatidae, the cerebral hemispheres are reduced; and, the main difference in relation to the Narcinidae, is the absence of electrical lobes.

There are No Differences between Factors Determining Graft Infection in Autologous Bone Flap Replacement and Acrylic Cranioplasty: A Prospective Observational Study at Hospital Kuala Lumpur

Objectives: This study, conducted in 2012, was performed to determine the incidence of graft infection after cranioplasty procedures and factors affecting the graft infection rate at Hospital Kuala Lumpur (HKL). Methodology: This was an observational cross-sectional case study of patients who have undergone cranioplasty at HKL over a period of one year (2012). One hundred seventytwo patients were included in the study. A total of 105 (61.8%) cases were autologous bone flap replacements, and 67 (38.2%) were acrylic cranioplasty. Result: A total of five infected grafts were identified among the 172 cases included in the study, resulting in an overall infection rate of 2.9%. Of this infected group, three (4.5%) were cases of cranioplasty and two (1.9%) were cases of autologous bone flap replacement. There was high proportion of male patients undergoing cranioplasty (118 [or 68.6%]) and only 54 (or 31.4%) female patients. The primary pathology in the majority of patients (126 [or 73.2%]) was due to trauma; only 46 cases (or 26.8%) did not result from trauma. Of the patients, 123 (or 71.5%) had undergone a single cranial procedure prior to their cranioplasty, and 43 (or 28.5%) had undergone multiple cranial procedures. Most of the patients (114 [or 66.3%]) underwent cranioplasty 90 days after undergoing decompressive craniectomy while 58 (or 33.7%) underwent cranioplasty less than 90 days after decompressive craniectomy.

Binary logistic regression analysis of hard palate dimensions for sexing human crania / 대한해부학회지

Sex determination is the preliminary step in every forensic investigation and the hard palate assumes significance in cranial sexing in cases involving burns and explosions due to its resistant nature and secluded location. This study analyzes the sexing potential of incisive foramen to posterior nasal spine length, palatine process of maxilla length, horizontal plate of palatine bone length and transverse length between the greater palatine foramina. The study deviates from the conventional method of measuring the maxillo-alveolar length and breadth as the dimensions considered in this study are more heat resistant and useful in situations with damaged alveolar margins. The study involves 50 male and 50 female adult dry skulls of Indian ethnic group. The dimensions measured were statistically analyzed using Student's t test, binary logistic regression and receiver operating characteristic curve. It was observed that the incisive foramen to posterior nasal spine length is a definite sex marker with sex predictability of 87.2%. The palatine process of maxilla length with 66.8% sex predictability and the horizontal plate of palatine bone length with 71.9% sex predictability cannot be relied upon as definite sex markers. The transverse length between the greater palatine foramina is statistically insignificant in sexing crania (P=0.318). Considering a significant overlap of values in both the sexes the palatal dimensions singularly cannot be relied upon for sexing. Nevertheless, considering the high sex predictability of incisive foramen to posterior nasal spine length this dimension can definitely be used to supplement other sexing evidence available to precisely conclude the cranial sex.

Morphological and Radiological Studies on the Skull of the Nile Crocodile (Crocodylus Niloticus).

Background and Aim: Present study provides with more anatomical information on the structure and form of the bones forming the cranium of the Nile crocodile helps in understanding the interpretation of X ray images and surgical affection of the crocodile heads. Materials and Methods: The present study was conducted on six heads of the Nile crocodile (Crocodylus niloticus). The heads were removed from their bodies and prepared by hot water maceration technique. The bones of the skull were studied separately and identified by using a specific acrylic color for each bone. Results: The cranium of the crocodile composed of the cranial bones and the facial bones. The crocodile had four paired paranasal sinuses; the antorbital, the vomerine bullar, the pterygopalatine bullar and the pterygoid sinuses. The mandible of crocodile formed from six fused bones (articular, angular, suprangular, coronoid, splenial and dentary). The X ray images were applied for identifying the paranasal sinuses which their contribution to the morphological organization of the head. Conclusion: this results show a bony variation between the crocodile, mammals and also the birds that paves the way to the comparative anatomical and radiological studies.

Surgical Management of Large Occipital Encephalocoele: A Case Report

Cranium dysraphism occur less commonly than spinal dysraphism. Overall, occipital encephalocoeles are more frequent than anterior encephalocoes. A large occipital encephalocoele possess difficulty in surgical intervention, not only the sac contains large amount of herniated brain tissue, but the appropriate positioning for successful intubation as well as the higher rate of surgical complications such as cerebrospinal fluid leakage and skin necrosis. In this case report, surgical management of large occipital encephalocoele is discussed. The use of antibiotics in ruptured encephalocoele is recommended.

Supernumerary Bones in the Walls of the Bony Orbit.

Occurrence of supernumerary bones in the walls of the orbit especially in the medial wall and the roof has been described in the literature. Studies of the prevalence of supernumerary bones in the bony wall of the orbit are scarce in the literature. Present study was undertaken to find the prevalence of supernumerary bones in the walls of the orbit in a collection of adult Indian skulls. In the present study three hundred and twenty six orbital walls from one hundred and sixty three skulls were examined for the presence of the sutural bones. Their location with reference to the sutures in the walls of the orbit and their size was noted. The supernumerary bones were found in 25 skulls (15.34 %) mainly in the lateral wall (11.04 %) and the roof of the orbit (4.29 %). Prevalence of such supernumerary bones in the walls of the bony orbit is of anthropological interest. Many of the bony ossicles were of sufficiently large size, enough to be visualized on lateral skull X-ray and could easily be mistaken for fracture of the bony wall of the orbit.

Sobre la osificación intramembranosa: un modelo de aproximación para la calvaria / On intramembranous ossification: an approach model for the calvaria

En este artículo se ha desarrollado un modelo de la aparición y ubicación de los centros primarios de osificación en la calvaria. Este es el primer modelo computacional que determina la ubicación de estas estructuras óseas del cráneo. Se describe un modelo de reacción-difusión de dos moléculas (BMP y Noggins) cuyo comportamiento es del tipo activador-sustrato y su solución produce patrones de Turing, que representan los centros primarios de osificación. Una vez más, el uso de ecuaciones de este tipo posibilita la explicación de fenómenos de morfogénesis antes no dilucidados por otro tipo de teorías, en este caso, teorías de osificación del cráneo. Este tema es de constante investigación, especialmente en la medicina ortopédica y pediátrica...

The paper deals with the development of a model for the appearance and location of primary ossification centers in the calvaria. This is the first computational model intended to determine the location of these cranial bone structures. A reaction-diffusion model is described of two molecules (BMP y Noggin) which behave as substrate activators. The solution produces Turing patterns representing primary ossification centers. Once again the use of these equations makes it possible to explain morphogenesis phenomena not elucidated by other theories, in this case cranial ossification theories. The topic is under permanent research, especially in the fields of orthopedic and pediatric medicine...