An evaluation of dental methods by Lamendin and Prince and Ubelaker for estimation of adult age in a sample of modern Greeks.

Teeth can be used as accurate tools in age-at-death estimation in forensic cases. No previous data exist on estimating age from teeth in a modern Greek population. The aim of this study was to evaluate Lamendin's and Prince and Ubelaker's ageing methods on a modern Greek skeletal sample. In total, 1436 single-rooted teeth from 306 adult individuals (161 males and 145 females) were examined. Only measurements of periodontosis and translucency showed positive correlation with age. Results showed a bias - an overestimation for ages under 40 years and an underestimation over this age. However, the use of wider age groups proved to be more appropriate. Low values of error were observed for the group of middle-aged individuals. In conclusion, both methods can be considered accurate in estimating age-at-death of middle-aged individuals. This study provides more information about the accuracy and applicability of these dental methods on modern European populations.

Assessing the effect of manual physical activity on proximal hand phalanges using Hellenistic and modern skeletal samples from Greece.

In humans, physical activity is an important regulator of bone size. Furthermore, hand bones have been proposed as a potential avenue for assessing patterns of manual activity. However, there are very few studies presenting a metric comparison of proximal hand phalanges among different populations. Moreover, an osteoarchaeological approach to the manual activities performed by an ancient population is yet to be made. In this framework, this study aims at assessing and interpreting the metric variation in these bones between a documented modern Greek sample (20th century) and a Hellenistic sample from Demetrias (3rd-1st century BCE), in terms of size and sexual dimorphism. Ancient males were significantly larger than females for ten phalangeal measurements out of 35. Even though the degree of sexual dimorphism was lower in the Hellenistic material (the maximum sexual dimorphism observed - 12.46%) than in modern sample (the maximum observed - 21.19%), the ranking of rays and bone parts by sexual dimorphism was similar in both populations. No metric difference was observed between modern and ancient males, whereas ancient females were larger than modern females in seven dimensions (the maximum variation observed was 11.58%), which involved the bases and midshafts of phalanges. Given that these dimensions are affected by the degree of muscular recruitment for the formation of various hand grips, it is suggested that ancient females were involved in manual activities of greater grasping variance than modern females. Indeed, the historical and archaeological sources suggest that sexual distribution of labour in the Hellenistic society seems to explain the differences estimated between the sexes and the two populations under study.

Sex determination by tooth size in a sample of Greek population.

Sex assessment from tooth measurements can be of major importance for forensic and bioarchaeological investigations, especially when only teeth or jaws are available. The purpose of this study is to assess the reliability and applicability of establishing sex identity in a sample of Greek population using the discriminant function proposed by Rösing et al. (1995). The study comprised of 172 dental casts derived from two private orthodontic clinics in Athens. The individuals were randomly selected and all had clear medical history. The mesiodistal crown diameters of all the teeth were measured apart from those of the 3rd molars. The values quoted for the sample to which the discriminant function was first applied were similar to those obtained for the Greek sample. The results of the preliminary statistical analysis did not support the use of the specific discriminant function for a reliable determination of sex by means of the mesiodistal diameter of the teeth. However, there was considerable variation between different populations and this might explain the reason for lack of discriminating power of the specific function in the Greek population. In order to investigate whether a better discriminant function could be obtained using the Greek data, separate discriminant function analysis was performed on the same teeth and a different equation emerged without, however, any real improvement in the classification process, with an overall correct classification of 72%. The results showed that there were a considerably higher percentage of females correctly classified than males. The results lead to the conclusion that the use of the mesiodistal diameter of teeth is not as a reliable method as one would have expected for determining sex of human remains from a forensic context. Therefore, this method could be used only in combination with other identification approaches.

Osteometric sex determination using proximal foot phalanges from a documented human skeletal collection.

Diagnosing sex is vital for developing biological profiles from human skeletal remains. For that purpose, osteometric evaluation of bone size has proven to be usually effective. The present study investigates the degree of sexual dimorphism in proximal foot phalanges from a documented human skeletal collection, known as the Athens collection. Furthermore, it utilizes the data for the development of sex-discriminant formulas in Greek population. The material used consists of 749 proximal foot phalanges (left and right), which belong to 174 adult individuals (91 males and 83 females) that lived during the 20(th) century. The degree of sexual dimorphism reached as high as 16.76 %, with the left side demonstrating higher sexual dimorphism. The 1(st) proximal foot phalanges are proven to be the most sexually dimorphic among the bones of the sample. The minimum sexual dimorphism observed was in the maximum lengths of phalanges, whereas the most sexually dimorphic measurement was the medio-lateral width at midshaft. The discriminant functions developed provide classification accuracies that ranged between 77.1 % and 90.9 % for left and between 72.2 % and 86.6 % for right proximal foot phalanges. The results of this study suggest that proximal foot phalanges are useful for sex determination in Greek population.

Sexual dimorphism of root length on a Greek population sample.

Sexual dimorphism in teeth has been an area of research for osteoarchaeologists and forensic anthropologists studying human skeletal remains. As most studies have been based on the mesiodistal and buccolingual crown measurements, sexual dimorphism from root length dimensions remains "neglected" by comparison to crown dimensions. The aim of the present study was to test the existence of sexual dimorphism in the root length of single-rooted teeth with the purpose of investigating whether maximum root length can be reliably used to determine sex. A total of 774 permanent teeth in 102 individuals (58 males and 44 females) from the Athens Collection were examined. The maximum root length of each tooth was measured on the mesial, distal, buccal, and lingual side. Almost all teeth presented a high degree of sexual dimorphism with males showing numerically higher values in root length than females. The most dimorphic teeth were the maxillary second incisors followed by maxillary canines. The percentage of sexual dimorphism reached 16.56%, with maxillary teeth showing the highest degree of dimorphism. The classification results show that the overall correctly specified group percentage ranged from 58.6% to 90.0%. The data generated from this study suggest that root length measurements offer a reliable method for determining sex and are therefore useful in osteoarchaeological studies, particularly in cases of fragmented or cremated material, but also in forensic contexts. Moreover, root length can be used to separate the remains of female and male subadult individuals with a high level of accuracy thus addressing one of the most problematic issues in human osteoarchaeology and anthropology as immature skeletons are the most difficult to sex.

Use of a segmental thermoexpandable metal alloy stent in the management of malignant ureteric obstruction: a single centre experience in the UK.

INTRODUCTION: The Memokath 051™ is a semipermanent inert metal alloy ureteric stent which can bridge strictures and, compared to double J stents, causes less bladder irritation and pain, is more resistant to external compression forces and may be more effective in patients with malignant ureteric obstruction. We present our experience with this novel stent in such cases. METHODS: All suitable patients referred to us with malignancy-associated ureteric strictures over a 4-year period had ureteric Memokath 051™ stents inserted. Data on aetiology and position of the strictures as well as length of the Memokath stents used and their efficacy and complications were recorded prospectively. RESULTS: 42 ureteric Memokath 051™ stents were inserted in 37 patients (mean age 64 years). 40.5% of strictures were related to gynaecological cancer, 21% to bowel cancer, 14% were post radiation, 14% occurred in prostate cancer patients and 9.5% were found in other cancers. The mean follow-up was 22 months (range 5-60 months). The main complications were stent migrations in 5, urinary tract infections in 3 and blockage of stent due to progressive transitional cell carcinoma of the ureter in 2 cases. CONCLUSION: Memokath 051™ ureteric stents are safe, effective and durable in the long-term treatment of malignant strictures.

Treating bladder-outflow obstruction with thermo-expandable prostate metal stents.

Bladder-outflow obstruction is a common age-related clinical entity due to a variety of benign and malignant diseases of the prostate. Surgical treatment is not suitable for high-risk elderly patients who seek minimally invasive management. We present a prostatic thermo-expandable metal stent for treating bladder-outflow obstruction. In this review, we include the design characteristics of this novel device, the performance assessment in comparison with alternative devices, the limitations, our personal clinical experience, as well as a long-term perspective. According to our experience among 127 patients (who underwent insertion of 192 stents) after 1, 2 and 3 years, 82, 61 and 47% of the original stents were functional without apparent complications, respectively. The mean single stent indwelling time was 1 year, with a maximum of 4 years. In 41% of patients, the stent needed to be removed and/or exchanged owing to stent encrustation (15%), migration (10%), penile pain (6%), bladder-outflow obstruction symptoms (5%), urinary incontinence (<3%), tissue granulation (<3%), recurrent urinary tract infections (<3%) or urethral stricture (<3%). The thermo-expandable prostatic stent seems to be an effective minimally invasive treatment of bladder-outflow obstruction, especially in high-risk patients.

Genetic profile of ischemic cerebrovascular disease and carotid stenosis.

OBJECTIVES: Carotid artery stenosis (CS) is a major risk factor for ischemic cerebrovascular disease (ICVD) and is therefore of interest in genetic investigating. Here we report the distribution of 100 polymorphisms in 47 suspected susceptibility genes for ICVD and its risk factors. MATERIALS AND METHODS: Previously published markers in suspected susceptibility genes were genotyped in ICVD patients and controls (928/602). Genotyping was performed using multiplex polymerase chain reaction (PCR) and linear immobilized probe array assays. ICVD cases were subtyped according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) or subdivided into CS and non-CS patients by ultrasonography in a separate analysis. RESULTS: Three polymorphisms located in the lipoprotein lipase (LPL), angiotensinogen (AGT) and guanine nucleotide-binding protein beta-3 (GNB3) genes were significantly associated with ICVD after correction for age and gender. The strongest association was found for the protective LPL Ser447Term polymorphism. All the significant markers showed varying frequencies in different subphenotypes of ICVD. Factor VII, apolipoprotein E and two renin polymorphisms were differentially frequent in patients with evidence of CS compared with non-CS patients. CONCLUSIONS: We have found that some previously described susceptibility polymorphisms are weakly associated with ICVD and that subdivision of patients into CS and non-CS groups may help to identify new candidate polymorphisms.

Prolonged action of bupivacaine hydrochloride.

This paper describes a case of prolonged action of bupivacaine hydrochloride following supraclavicular brachial plexus block with complete recovery.