[Radiologic study on postnatal ossification of the first metatarsal bone]. / Estudio radiológico sobre la osificación postnatal del primer metatarsiano.

BACKGROUND: Classical descriptions of the ossification of the first metatarsal bone show the existence of a single proximal secondary ossification nucleus, mimicking the typical ossification of a phalanx. However, there are studies that show the presence of a second distal ossification nucleus and discuss its nature: epiphysis or pseudoepiphysis. The objective of the study is to establish the prevalence of such distal nucleus, determine its role in the growth of the radius and its relation with different qualitative variables. MATERIAL AND METHODS: We conducted a retrospective study that included 971 dorsoplantar images from 225 patients. We analyzed the presence of such nucleus, the age of appearance and closure, the relation with different qualitative variables and their contribution to the longitudinal growth of the first metatarsal bone. RESULTS: The distal ossification nucleus appears in 40% of all images and in 81.1% of cases ages 4-7 years. Mean age of appearance is 3.07 years, while physeal closure occurs at a mean of 7.67 years. We found a significantly higher frequency of physeal closure in children, patients with Egyptian type foot, flat foot, and index-plus and Egyptian type foot combinations. The definitive length of the first metatarsal bone is greater in patients with a distal ossification nucleus. CONCLUSIONS: We may state the presence of the distal ossification nucleus of the first metatarsal bone that behaves as a fertile growth cartilage.

Evaluation of voice pathology based on the estimation of vocal fold biomechanical parameters.

Voice disorders are a source of increasing concern as normal voice quality is a social demand for at least one third of the population in developed countries in cases where voice is an essential resource in professional exercise. In addition, the growing exposure to certain pathogenic factors such as smoking, alcohol abuse, air pollution, and acoustic contamination, and other problems such as gastro-esopharyngeal reflux or allergy as well as aging, aggravate voice disorders. Voice pathologies justify the assignment of larger resources to prevention policies, early detection, and less aggressive treatments. Traditional pathology detection relies on perceptive evaluation methods (GRABS), acoustic analysis, and visual inspection (indirect laryngoscopy, and modern fibro-endo-stroboscopy). This article describes a method for voice pathology detection based on the noninvasive estimation of vocal cord biomechanical parameters derived from voice using specific signal processing methods. Preliminary results using records from patients showing four frequent causes of voice pathology (nodules, polyps, chronic laryngitis, and Reinke's edema) are given. The results show that the alteration (distortion, unbalance, or deviation) of cord biomechanical parameters may serve as an indicator of pathology. Statistical methods based on hierarchical clustering and principal component analysis reveal that combining biomechanical estimates with classic perturbation parameters increases the accuracy of acoustic analysis, improving the detection of voice pathology. This research could open new possibilities for noninvasive screening of vocal fold pathologies and could be used in the implantation of e-health voice care services.

The alternative supply of the pectoralis major flap based medially in cases with previous surgical use of the internal thoracic artery: an anatomical study.

In the present study we analyzed the anatomical basis for the use of the pectoralis major muscle based on alternative pedicles in order to evaluate its clinical applications in cases of potential lesion of the internal thoracic artery. The patterns of blood supply depending on the internal thoracic artery, previously dissected for coronary by-pass surgery, were studied in both sides of five embalmed cadavers and five anterior thoracic walls taken from autopsies. The secondary vascular pedicles depending on the internal thoracic artery for the pectoralis major muscle were dissected and injected with physiological saline stained solution in the embalmed cadavers. Moreover, studies of intravascular injection by means of radio-opaque contrast and physiological saline stained solution were carried out in the anterior thoracic walls obtained from clinical autopsies. The results showed that complete injection of the pectoralis major muscle was achieved depending exclusively on the two proximal perforating branches of the two first intercostal spaces, which represented the vascular pedicle for medial transposition of the pectoralis major flap, in cases with previous dissection of the internal thoracic artery for coronary by-pass.

Diaphyseal nutrient foramina in the first metatarsals in normal and hallux valgus feet: location and surgical implications.

We examined 47 first metatarsals from amputated lower limbs to determine the situation of the main diaphyseal nutrient foramina (NFs) in normal and hallux valgus feet. All the NFs, excepting one, were in a plantar-fibular location. The NF situation was analyzed by means of the foraminal index and three minimum distances: from NF to proximal extremity, from NF to the shaft dorsal face (NFDS) and from NF to the border of the cartilaginous coating of the metatarsal head. We found a constant location of the NF in the middle of the total metatarsal length and sexual dimorphism in NFDS (lower in females); there were no differences by side, neither by digital or metatarsal types, nor between normal and hallux valgus types. Vascular complications in some osteotomies are discussed. In the surgical design, the NF situation can be estimated from either the total or physiological metatarsal length by means of the corresponding equations as reported here.

Análisis isocinético de la flexo-extensión de la rodilla y su relación con la antropometría del miembro inferior / Isokinetic analysis of flexion-extension of the knee and its relationship with the anthropometry of the lower limb

En este trabajo estudiamos la fuerza muscular isocinética de la articulación de la rodilla y las variables antropométricas más significativas de los individuos analizados. La muestra fue de 60 sujetos jóvenes voluntarios y sanos (30 hombres,30 mujeres). Se determinaron: 1º) Momento máximo de fuerza (Nm) y momento máximo/peso corporal ( por ciento), en la extensión y en la flexión a 60º/s en ambos miembros inferiores mediante test isocinéticos (dinamómetro Biodex). 2º) Perímetro de muslo, perímetro de pierna y longitud de miembro inferior. Se realizó un estudio comparativo entre extremidad derecha e izquierda (t de Student) y entre sexos (ANOVA), además se analizaron las correlaciones entre variables isocinéticas y antropométricas. Aparecieron diferencias estadísticamente significativas en todas las variables a favor del lado derecho menos en la variable longitud del miembro inferior. Igualmente el factor sexo determinó diferencias en todas las variables a excepción del perímetro del muslo, siendo estas mayores en los varones. Por último, el análisis de correlación entre las distintas variables, permitió constatar algunas interdependencias entre las variables morfológicas y de actividad muscular que pueden ser aplicadas en el campo clínico. (AU)

Densitometric analysis of the human calcaneus.

A densitometric study was performed on 50 dry calcanei to assess bone mineral density (BMD) in the constituent regions of the bone. In the lateral projection, the area with the highest BMD was the anterosuperior region, where the greatest concentration of trabeculae occurs. The areas with the least BMD were the intermediate or retrothalamic and the anteroinferior regions, where the neutral triangle is situated. In the dorsoplantar projection, a greater BMD was observed in the intermediate and middle regions, whereas the anterior region showed the lowest BMD. These results conform to the arrangement previously described for the trabecular system. It is concluded that bone densitometry, measured by dual x-ray absorptiometry, is useful for assessing trabecular architecture of the calcaneus.

Venous segmentation of the spleen.

The authors conducted a study of the human splenic venous system by corrosion cast. The existence of two main venous territories or lobes separated by an avascular plane is confirmed. Smaller territories or segments, drained systematically by segmentary veins, and also separated by avascular planes, are defined in them. Their number ranged from four to eight, the mean being five segments. Four different ways of confluence of intrasplenic vessels forming the splenic vein are described.

Osteometry of the human iliac crest: patterns of normality and its utility in sexing human remains.

We recorded nine measurements and one index of the iliac crest in 42 human hip bones from a Spanish skeletal collection. Common values of seven of these parameters and index are reported. We could detect statistically significant differences of means depending on side for two of these parameters (iliac crest rise, distance from the upper point of the iliac crest to the anterior superior spine) and for the iliac crest index, and relating to sex for three parameters (iliac crest arch, iliac crest rise, distance from the upper point of the iliac crest to the anterior superior spine) and for the index. These measurements and index are useful for sexing human remains.

Biometry of the anterior border of the human hip bone: normal values and their use in sex determination.

Sixteen different variables and 3 indices for the anterior border of 42 human hip bones from a Spanish skeletal collection were studied. Values for 15 of these variables and for the 3 indices are reported. We were unable to detect statistically significant differences between means relating to side in any of the variables and indices studied. Statistically significant differences were detected between means in relation to sex for 4 variables (distance from the anterior superior iliac spine to the pubic tubercle, distance from the anterior inferior iliac spine to the iliopubic eminence, distance from the anterior inferior iliac spine to the pubic tubercle, length of the notch between the anterior inferior iliac spine and the iliopubic eminence). These variables could be used for sex determination from the human hip bone or its fragments.