Application of knee MRI in forensic age estimation: A retrospective cohort.

INTRODUCTION: Forensic age estimation is performed via clinical examination and utilizing various imaging modalities. Currently, radiography and CT are used. In this study we aim to evaluate if magnetic resonance imaging (MRI) can be used to determine stages of fusion in the epiphysis of the tibia and femur, and if these stages are significantly different regarding the mean age of subjects classified in each one. METHODS: A total of 193 subjects were included in the study. Knee MR imaging was performed on all of the patients, and the patients were categorized based on imaging findings of the tibial and femoral epiphysis. Tukey multiple comparison test and analysis of variance were used to assess if the difference in the mean age of the groups were significantly different. RESULTS: Analysis of variance revealed that the mean of the five groups, both in tibia and femur imaging were significantly different. Analysis of variance showed that in most of the cases, the groups mean age significantly differed from the other groups. Tukey multiple comparison tests showed that although the differences between stages I-III could not be regarded as significant, MR imaging was suitable in distinguishing stages IV-V from stages I-III. CONCLUSION: MR imaging of the knee may be a suitable imaging modality to assess an individual's age, does not involve ionizing radiation, and that with imaging a single anatomical location, at least two epiphyses could be used to determine the age. IMPLICATIONS FOR PRACTICE: Utilization of knee MRI by clinicians as a safe and practical age estimation method.

Simultaneous comparison of 1 gel with 4 dry electrode types for electrocardiography.

We designed a spandex tank top with dry electrodes for continuous electrocardiogram (ECG) recording. This pilot study determined the best fabric, the best electrode types, sizes, and locations. Optimal electrodes provide high signal to artifact ratio (SAR) and reliability by meeting the following criteria: 1) low baseline shift, 2) high adhesion, 3) good physical stability, 4) large effective area, 5) thin with high flexibility (Luo et al 1992). We compared electrodes from three main groups: Ag/AgCl gel electrode, commercial conductive rubber and foam-metal based electrodes. Ag/AgCl gel electrodes are easy to apply, make good body contact and do not slip during the course of an experiment. We found that higher SARs are obtained when electrode area is increased (40 mm diameter) and the two dry measurement electrodes are located on convex areas (over chest muscle) rather than concave areas (over sternum), so the spandex will apply light pressure to the dry electrode to yield good electrode to skin contact. We experimentally validated findings with 24 subjects: 12 men and 12 women wearing the tank top with gel and dry electrodes, by monitoring movements imitating daily life while continuously recording their ECGs.

Dry electrodes for electrocardiography.

Patient biopotentials are usually measured with conventional disposable Ag/AgCl electrodes. These electrodes provide excellent signal quality but are irritating for long-term use. Skin preparation is usually required prior to the application of electrodes such as shaving and cleansing with alcohol. To overcome these difficulties, researchers and caregivers seek alternative electrodes that would be acceptable in clinical and research environments. Dry electrodes that operate without gel, adhesive or even skin preparation have been studied for many decades. They are used in research applications, but they have yet to achieve acceptance for medical use. So far, a complete comparison and evaluation of dry electrodes is not well described in the literature. This work compares dry electrodes for biomedical use and physiological research, and reviews some novel systems developed for cardiac monitoring. Lastly, the paper provides suggestions to develop a dry-electrode-based system for mobile and long-term cardiac monitoring applications.

[Valvular surgery for an exercise-induced functional mitral regurgitation in heart failure and preserved ejection fraction: a case study]. / Traitement chirurgical d'une insuffisance mitrale fonctionnelle aggravée par l'effort avec insuffisance cardiaque à fraction d'éjection préservée : une étude de cas.

We here report the case of a 67-year-old woman with moderate mitral regurgitation without significant structural abnormalities that get worse during severe recurrent heart failures and preserved ejection fraction with concomitant paroxysmal atrial fibrillation. Atrial fibrillation became permanent and despite a well-controlled cardiac frequency, new heart failure episodes occurred. Exercise doppler echocardiography showed that the mechanism of this mitral regurgitation was a two leaflet mitral tenting. We discuss here the different mechanisms that could induce these kinds of mitral regurgitation with excessive tenting. We emphasize the interest of early detection by exercise doppler echocardiography even when a triggering factor like atrial fibrillation seems to be involved. We also discuss the interest of mitral valve replacement for these patients.

[Colonic actinomycosis: report of a case and review of the literature]. / Actinomycose colique: à propos d'un cas et revue de la littérature.

Actinomycosis is a chronic granulomatosis infection caused by a Gram positive anaerobic bacteria, Actinomyces. Abdominal localizations are rare and simulated a malignant process. The difficulties of diagnosis are usually leading to surgical resection. We report a colonic actinomycosis case of a 62-year-old woman with a abdominal tumor and diagnosed after surgical resection.

Giant R-waves in a patient with an acute inferior myocardial infarction.

We describe a case of a male patient with "giant" R-waves (GRWs) in association with an acute inferior myocardial infarction (MI). Such electrocardiogram (ECG) pattern has been associated heretofore with the hyperacute phase of an anterior MI, and unstable, and variant angina, although it is found in illustrations of many previous publications in conjunction with inferior MI. The GRWs, along with ST-segment elevations, were noted transiently in the inferior ECG leads, early in the clinical course of our patient. Subsequent evolution of the ECG revealed classic appearances for an inferior MI. Cardiac enzymes, and thallium-201 myocardial perfusion scintigraphy revealed evidence for inferiorly-located myocardial necrosis. Coronary arteriography showed stenosis of the right coronary artery, for which the patient underwent an uneventful angioplasty and "stenting" of the culprit vessel. The pathophysiology of the syndrome of GRWs is briefly discussed.