A comparative study between xerographic, computer-assisted overlay generation and animated-superimposition methods in bite mark analyses.

This study was to compare the suitability and precision of xerographic and computer-assisted methods for bite mark investigations. Eleven subjects were asked to bite on their forearm and the bite marks were photographically recorded. Alginate impressions of the subjects' dentition were taken and their casts were made using dental stone. The overlays generated by xerographic method were obtained by photocopying the subjects' casts and the incisal edge outlines were then transferred on a transparent sheet. The bite mark images were imported into Adobe Photoshop® software and printed to life-size. The bite mark analyses using xerographically generated overlays were done by comparing an overlay to the corresponding printed bite mark images manually. In computer-assisted method, the subjects' casts were scanned into Adobe Photoshop®. The bite mark analyses using computer-assisted overlay generation were done by matching an overlay and the corresponding bite mark images digitally using Adobe Photoshop®. Another comparison method was superimposing the cast images with corresponding bite mark images employing the Adobe Photoshop® CS6 and GIF-Animator©. A score with a range of 0-3 was given during analysis to each precision-determining criterion and the score was increased with better matching. The Kruskal Wallis H test showed significant difference between the three sets of data (H=18.761, p<0.05). In conclusion, bite mark analysis using the computer-assisted animated-superimposition method was the most accurate, followed by the computer-assisted overlay generation and lastly the xerographic method. The superior precision contributed by digital method is discernible despite the human skin being a poor recording medium of bite marks.

Current approach in the management of patients with foreign bodies in the maxillofacial region.

The aim of the present study was to describe and discuss the gamut of current diagnostic and therapeutic modalities regarding impacted foreign bodies in the head and neck region, addressing xeroradiography, magnetic resonance imaging, computed tomography, and ultrasonography as diagnostic aids and stressing the importance of a multidisciplinary team in the treatment of such injuries. Considerations are also offered on the different types and forms of presentation of foreign bodies that may be impacted in the maxillofacial region and specific treatment methods.

Calciphylaxis in a patient with normal renal function: response to treatment with sodium thiosulfate.

Calciphylaxis is a rare, life-threatening cause of skin necrosis. The condition is primarily reported in patients with end-stage renal disease, and is associated with significant morbidity and mortality. Treatment has mainly been empirical. We report a case of calciphylaxis in a patient with normal renal function and hypoparathyroidism, who responded to treatment with sodium thiosulfate. To our knowledge, this is the first reported case of the use of sodium thiosulfate to treat calciphylaxis in a patient with normal renal function.

Age-related morphological changes in the human hyoid bone.

OBJECT: Age-related morphological changes in the human hyoid bone were investigated radiographically and histologically. MATERIALS AND METHODS: Thirty-two measurements were performed on radiographs of 238 hyoid bones from autopsy cases of known age and sex. Thirty-one hyoid bones that were studied by radiography were also examined histologically in horizontal sections. RESULTS: Analysis of the length and width of the hyoid bone revealed significant increases in the body and the anterior part of the greater cornu and a significant decrease in the posterior part of the greater cornu with aging. Most measurements of the body and the greater cornu revealed differences between male and female hyoid bones. The outer margins of the body and the greater cornu were situated further outside in older males compared with females. The breadth of the joint space showed a significant age-related decrease, and the degree of fusion showed a significant age-related increase. Histological findings showed ossified or calcified fusion, with osteoclasts in the marginal area of the joint space. CONCLUSIONS: Increasing age induces fusion of the body and the greater cornu. The morphometric changes in the shape of the hyoid bone may represent functional adaptation to articulation fixation.

[Imaging of the painful cervical spine]. / Imagerie du rachis cervical douloureux.

Neck pain can occur in several circumstances: traumatic, spontaneous, associated or not with motion, with or without head or upper limb irradiations. Each case requires appropriate clinical examination and radiographs. CT and MRI can be used to obtain additional information. Myelography and arteriography are exceptionally used. Cervical discography and facet joint arthrography are used therapeutically. After a brief anatomical review, normal and pathological patterns will be reviewed using radiographs. Each circumstance is studied: traumatic, degenerative, inflammatory and tumoral. It is emphasized that discogenic cervico-brachial neuralgia usually has a favorable spontaneous outcome. A special chapter is dedicated to calcifying and ossifying diseases of the cervical spine. Cervico-occipital neuralgia is also discussed.

Femoral neck fracture--the cause of death of Emperor Charles IV.

We present the oldest documented case of femoral neck fracture of a particular person in the history of orthopaedic surgery. Examination of the skeleton of Charles IV, the King of Bohemia and Roman Emperor living in XIVth century has revealed a fracture of the left femoral neck. This fracture was most probably an indirect cause of his death as it resulted in pneumonia, the immediate cause of death. This fact has been confirmed by contemporary chronicles.

[Medical X-ray dryview photography and digitized diagnostic technique].

This paper introduces briefly xeroradiography, computed radiography system, x-ray dryview laser imaging series system and its products, digitized diagnostic technique, as well as the electronic radiography etc.

Scintigraphic and clinical findings in the Standardbred metatarsophalangeal joint: 114 cases (1993-1995).

To correlate scintigraphic and clinical findings of the metatarsophalangeal joint (MTPJ) in Standardbreds, radiographic findings in horses with confirmed MTPJ lameness, and determine if stress reaction and more advanced bone remodelling occurred in the MTPJ, medical records of 114 Standardbreds admitted between September 1993 and April 1995 in which bone scintigraphy included standing lateral and plantar views of the metatarsophalangeal joint (MTPJ) were reviewed. Images obtained using a large field of view gamma camera were evaluated visually for location, definition and intensity of increased radioisotope uptake (IRU), which was graded as mild, moderate, or intense. Clinical history and lameness examination findings were recorded and, in horses with documented MTPJ lameness, radiographic examination included the 30 degree (down-angled) dorsolateral 45 degree plantaromedial view thought to be useful in evaluation of the plantarolateral condyle of the third metatarsal bone (MtIII). The most common abnormality, IRU of the plantarolateral aspect of MtIII, was seen in 67 horses, and horses were further classified according to scintigraphic and clinical findings. In 43 horses in which lameness was not localised to the MTPJ, mild (32 horses), moderate (10 horses), and intense (one horse) IRU of MtHII was found. In 24 horses with lameness localised to the MTPJ, moderate (18 horses) and intense (6 horses) IRU was found. Of 18 horses with moderate IRU of MtIII, 9 had radiographic evidence of abnormal bony remodelling of MtIII, whereas 5 of 6 horses with intense IRU had radiographic changes. In 12 horses with MTPJ lameness and radiographic evidence of bony remodelling without fracture, radiographic changes consisted of plantarolateral subchondral radiolucency and sclerosis (7 horses), radiolucency and osteochondrosis (one horse), and plantar MtIII sclerosis without radiolucency (4 horses). In 2 horses with moderate IRU and MTPJ lameness, radiographic evidence of radiolucency and MtIII fracture was found. Of 19 starters with MTPJ lameness and IRU of MtIII, 18 horses raced after diagnosis, but only 13 remained at the same racing class or improved. The results of this study suggest the most common scintigraphic abnormality of the MTPJ, IRU of the plantarolateral aspect of MtIII, may precede other stress-related changes, and in some horses is associated with a continuum of stress-related subchondral bone remodelling which results in lameness and later radiographic changes. Since 24 of 35 horses with moderate or intense IRU of MtIII had MTPJ lameness, and 5 of 7 horses with intense IRU of MtIII had lameness and radiographic evidence of abnormal remodelling, it was concluded that horses with advanced, scintigraphic findings are more likely to have lameness and radiographic evidence of subchondral bone damage.

Periosteal new bone formation in a canine neuropathic model of osteoarthritis.

OBJECTIVE: To characterize, for the first time, periosteal new bone formation in a well-established canine model of accelerated osteoarthritis (OA) with features of neuropathic arthropathy. METHODS: Seven dogs underwent left L4-S1 dorsal root ganglionectomy (DRG), followed 3 weeks later by transection of the anterior cruciate ligament of the ipsilateral knee (ACLT). Eight weeks thereafter, a postmortem examination was performed to assess the severity of cartilage changes of OA and the formation of new bone on the distal femur and proximal tibia in the cruciate-deficient limb. RESULTS: As described previously, extensive full-thickness ulceration of the articular cartilage was present in the unstable knee of every dog. The femoral shaft immediately proximal to the condyles in the unstable limb was consistently wider (mean +/- SD diameter 22.4 +/- 2.2 mm) than that in the contralateral limb (19.9 +/- 1.3 mm; P = 0.01). Xeroradiography and histologic examination of the distal femur revealed extensive formation of woven bone on the periosteal surfaces of the medial, lateral, and anterior aspects of the femoral shaft in the OA limb of every dog. These bony changes were not seen in radiographs of dogs that underwent DRG with the cruciate ligament left intact (n = 8) or of neurologically intact dogs that underwent ACLT (n = 7) and were examined 24 weeks after surgery. CONCLUSION: Formation of new periosteal bone on the distal femur and tibia is a feature of this model of accelerated OA that is not seen in the conventional ACLT model of OA in the neurologically intact dog. This observation suggests that interruption of sensory input from the limb may affect the regulation of osteogenesis in the mechanically unstable joint.

Feasibility of a large area x-ray sensitive vidicon for medical fluoroscopy: signal and noise factors.

A large area x-ray sensitive vidicon is being investigated as an alternative to the x-ray image intensifier and television camera combination for medical fluoroscopy. Signal generation in an x-ray vidicon involves an x-ray photoconductive layer whose surface is scanned by an electron beam. The single x-ray to electron conversion stage of the x-ray vidicon offers a greatly improved modulation transfer function (MTF) over the x-ray image intensifier. This superior MTF allows signal and x-ray quantum noise at high spatial frequencies to be passed to the preamplifier with less attenuation. In cardiac cine applications this would allow quantum noise limited operation at higher spatial frequencies than is possible with the x-ray image intensifier system.

Uma avaliação dos métodos usados no diagnóstico da cárie dentária / An evaluation of methods used in dental caries diagnosis

Devido às mudanças ocorridas no processo da doença, prevalência e comportamento, o diagnóstico de cárie tornou-se mais difícil e complexo. Novos métodos para identificar corretamente e quantificar a lesão de cárie são descritos. Entre eles estão relacionados, a transiluminação por fibra óptica, detecção óptica por dispersão de luz, fluorescência, corantes, detectores elétricos, ultra-som e imagem digitalizada. Apesar do avanço tecnológico na detecção precoce da lesão de cárie, métodos para quantificar e monitorar estas lesões ainda são necessários

[Chiari "malformation" in Crouzon syndrome]. / La "malformation" de Chiari dans le syndrome de Crouzon.

BACKGROUND: Use of MRI makes the association Chiari malformation-cranio-facial synostosis more frequent than expected. The aim of this work was to ascertain the true incidence of Chiari malformation and to understand the reasons of the association between a bone pathology and a CNS malformation. PATIENTS AND METHODS: The anatomy of the posterior cranial fossa in Crouzon syndrome was retrospectively studied on MRI scan in 49 patients. RESULTS: A chronic tonsillar herniation, similar to a Chiari malformation, was observed in 71.4% of the cases. All the patients with Crouzon syndrome and progressive hydrocephalus had a Chiari malformation, but only 19 out of the 33 patients without associated hydrocephalus had a Chiari malformation (57.6%). Significant differences between the pattern of lambdoid suture closure were founded between both groups, with and without Chiari malformation, the lambdoid closure appearing earlier in patients with Chiari malformation. CONCLUSION: The high incidence of chronic tonsillar herniation in Crouzon syndrome seems related to the premature synostosis of the lambdoid suture.

Estenosis subglótica adquirida: experiencia en 80 casos: Hospital Niños "J. M. de los Ríos" / Adquire subglotic stenosis: experience in cases: Hospital of Niños \"J. M.\" of the Rios

La Estenosis Subglótica Adquirida es una entidad que afecta a tejidos blandos y estructuras cartilaginosas del espacio subglótico. Desde enero de 1987 hasta agosto de 1995, ingresaron al servicio de ORL del Hospital de Niños "J.M de Los Ríos" 80 pacientes con esta patología. El 87 por ciento (70) ameritaron traqueotomía y el 13 por ciento (10) no necesito tratamiento alguno. De los 70 pacientes traqueotomisados el 77 por ciento (60), se les realizó dilatación más infiltración de esteroides. al 10 por ciento (8), se les practicó laringotraqueoplastia, 2 pacientes fallecieron. El 75 por ciento (45) de los traqueotomisados fueron decanulados y dados de alta. El 25 por ciento (15) de los pacientes se mantienen en tratamiento. Fueron decanulados el 75 por ciento (6) de los 8 pacientes a los cuales se les realizó laringotraqueoplastia; y el 25 por ciento (2) no han podido ser decanulados por regresión de la estenosis.