240 resultados para Deformities
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Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured using sequential MRI scans to investigate coronal plane deformity progression with growth. Sequential MRI data showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in overall Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.
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Introduction Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured to investigate coronal plane deformity progression with growth. Methods A 0.49mm isotropic 3D MRI technique was developed to investigate the level-by-level changes that occur in the growing spine of a group of Adolescent Idiopathic Scoliosis (AIS) patients, who received two to four sequential scans (spaced 3-12 months apart). The coronal plane wedge angles of each vertebra and disc in the major curve were measured to capture any changes that occurred during their adolescent growth phase. Results Seventeen patients had at least two scans. Mean patient age was 12.9 years (SD 1.5 years). Sixteen were classified as right-sided major thoracic Lenke Type 1 (one left sided). Mean standing Cobb angle at initial presentation was 31° (SD 12°). Six received two scans, nine three scans and two four scans, with 65% showing a Cobb angle progression of 5° or more between scans. Overall, there was no clear pattern of deformity progression of individual vertebrae and discs, nor between patients who progressed and those who didn’t. There were measurable changes in the wedging of the vertebrae and discs in all patients. In sequential scans, change in direction of wedging was also seen. In several patients there was reverse wedging in the discs that counteracted increased wedging of the vertebrae such that no change in overall Cobb angle was seen. Conclusion Sequential MRI data showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.
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INTRODUCTION. Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured to investigate coronal plane deformity progression with growth. METHODS. A 0.49mm isotropic 3D MRI technique was developed to investigate the level-by-level changes that occur in the growing spine of a group of Adolescent Idiopathic Scoliosis (AIS) patients, who received two to four sequential scans (spaced 3-12 months apart). The coronal plane wedge angles of each vertebra and disc in the major curve were measured to capture any changes that occurred during their adolescent growth phase. RESULTS. Seventeen patients had at least two scans. Mean patient age was 12.9 years (SD 1.5 years). Sixteen were classified as right-sided major thoracic Lenke Type 1 (one left sided). Mean standing Cobb angle at initial presentation was 31° (SD 12°). Six received two scans, nine three scans and two four scans, with 65% showing a Cobb angle progression of 5° or more between scans. Overall, there was no clear pattern of deformity progression of individual vertebrae and discs, nor between patients who progressed and those who didn’t. There were measurable changes in the wedging of the vertebrae and discs in all patients. In sequential scans, change in direction of wedging was also seen. In several patients there was reverse wedging in the discs that counteracted increased wedging of the vertebrae such that no change in overall Cobb angle was seen. CONCLUSION. Sequential MRI data showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.
Resumo:
Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured to investigate coronal plane deformity progression with growth. Sequential MRI data in this project showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.
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This paper describes a method for analyzing scoliosis trunk deformities using Independent Component Analysis (ICA). Our hypothesis is that ICA can capture the scoliosis deformities visible on the trunk. Unlike Principal Component Analysis (PCA), ICA gives local shape variation and assumes that the data distribution is not normal. 3D torso images of 56 subjects including 28 patients with adolescent idiopathic scoliosis and 28 healthy subjects are analyzed using ICA. First, we remark that the independent components capture the local scoliosis deformities as the shoulder variation, the scapula asymmetry and the waist deformation. Second, we note that the different scoliosis curve types are characterized by different combinations of specific independent components.
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Scoliosis is a 3D deformity of the spine and rib cage. Extensive validation of 3D reconstruction methods of the spine from biplanar radiography has already been published. In this article, we propose a novel method to reconstruct the rib cage, using the same biplanar views as for the 3D reconstruction of the spine, to allow clinical assessment of whole trunk deformities. This technique uses a semi-automatic segmentation of the ribs in the postero-anterior X-ray view and an interactive segmentation of partial rib edges in the lateral view. The rib midlines are automatically extracted in 2D and reconstructed in 3D using the epipolar geometry. For the ribs not visible in the lateral view, the method predicts their 3D shape. The accuracy of the proposed method has been assessed using data obtained from a synthetic bone model as a gold standard and has also been evaluated using data of real patients with scoliotic deformities. Results show that the reconstructed ribs enable a reliable evaluation of the rib axial rotation, which will allow a 3D clinical assessment of the spine and rib cage deformities.
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Study Design. Reliability study. Objectives. To assess between-acquisition reliability of new multilevel trunk cross sections measurements, in order to define what is a real change when comparing 2 trunk surface acquisitions of a same patient, before and after surgery or throughout the clinical monitoring. Summary of Background Data. Several cross-sectional surface measurements have been proposed in the literature for noninvasive assessment of trunk deformity in patients with adolescent idiopathic scoliosis (AIS). However, only the maximum values along the trunk are evaluated and used for monitoring progression and assessing treatment outcome. Methods. Back surface rotation (BSR), trunk rotation (TR), and coronal and sagittal trunk deviation are computed on 300 cross sections of the trunk. Each set of 300 measures is represented as a single functional data, using a set of basis functions. To evaluate between-acquisition variability at all trunk levels, a test-retest reliability study is conducted on 35 patients with AIS. A functional correlation analysis is also carried out to evaluate any redundancy between the measurements. Results. Each set of 300 measures was successfully described using only 10 basis functions. The test-retest reliability of the functional measurements is good to very good all over the trunk, except above the shoulders level. The typical errors of measurement are between 1.20° and 2.2° for the rotational measures and between 2 and 6 mm for deviation measures. There is a very strong correlation between BSR and TR all over the trunk, a moderate correlation between coronal trunk deviation and both BSR and TR, and no correlation between sagittal trunk deviation and any other measurement. Conclusion. This novel representation of trunk surface measurements allows for a global assessment of trunk surface deformity. Multilevel trunk measurements provide a broader perspective of the trunk deformity and allow a reliable multilevel monitoring during clinical follow-up of patients with AIS and a reliable assessment of the esthetic outcome after surgery.
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Besides the spinal deformity, scoliosis modifies notably the general appearance of the trunk resulting in trunk rotation, imbalance, and asymmetries that constitutes patients' major concern. Existing classifications of scoliosis, based on the type of spinal curve as depicted on radiographs, are currently used to guide treatment strategies. Unfortunately, even though a perfect correction of the spinal curve is achieved, some trunk deformities remain, making patients dissatisfied with the treatment received. The purpose of this study is to identify possible shape patterns of trunk surface deformity associated with scoliosis. First, trunk surface is represented by a multivariate functional trunk shape descriptor based on 3-D clinical measurements computed on cross sections of the trunk. Then, the classical formulation of hierarchical clustering is adapted to the case of multivariate functional data and applied to a set of 236 trunk surface 3-D reconstructions. The highest internal validity is obtained when considering 11 clusters that explain up to 65% of the variance in our dataset. Our clustering result shows a concordance with the radiographic classification of spinal curves in 68% of the cases. As opposed to radiographic evaluation, the trunk descriptor is 3-D and its functional nature offers a compact and elegant description of not only the type, but also the severity and extent of the trunk surface deformity along the trunk length. In future work, new management strategies based on the resulting trunk shape patterns could be thought of in order to improve the esthetic outcome after treatment, and thus patients satisfaction.
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A vitamina C é essencial para dietas de peixe porque muitas espécies não conseguem sintetizá-la. Esta vitamina é necessária par a formação de cartilagem e matriz óssea. Além disso, age como antioxidante e melhora as resposta do sistema imunológico. O presente trabalho investigou os efeitos da suplementação de vitamina C em dietas para alevinos de pintado (Pseudoplatystoma corruscans) pela incidência de deformidades na estrutura óssea e cartilaginosa. O ascorbil polifosfato (AP) foi utilizado como fonte de vitamina C em dietas para alevinos de pintado durante o período de três meses. Seis dietas foram formuladas: uma dieta controle (0 mg de vitamina C / kg) e cinco dietas 500, 1.000, 1.500, 2.000 e 2.500 mg de AP / kg. Os peixes alimentados sem suplementação de vitamina C apresentaram deformidades óssea na cabeça e mandíbula e fragilidade de nadadeiras. Assim, a dieta de 500 mg de AP/kg foi suficiente para prevenir a ocorrência de deformidades, e a ausência desta vitamina prejudica o desenvolvimento ósseo de juvenis de pintados.
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Este estudo avaliou a ocorrência de más oclusões esqueléticas apresentadas pelos pacientes do Centro de Pesquisa e Tratamento das Deformidades Bucofaciais (CEDEFACE), na cidade de Araraquara, SP, Brasil. Foram avaliados prontuários de 381 pacientes com deformidades dentoesqueléticas, que fizeram tratamento combinado ortodôntico-cirúrgico no período entre 2000 e 2006. Após a seleção da amostra (método de conveniência), baseado nos dados da documentação pré e pós-cirúrgica, o número de pacientes foi reduzido para 171. Para classificação do levantamento, considerou-se a discrepância ântero-posterior (Classe I, II e III), raça, idade, gênero, ausência ou presença de assimetria, excesso vertical maxilar e biprotrusão maxilar, além de determinar em qual base óssea o procedimento cirúrgico foi realizado. As documentações dos pacientes foram analisadas por um examinador previamente calibrado pelo processo de repetição até que o método fosse considerado adequado (correlação intraclasse >0,94). A idade média dos pacientes foi de 23,59 anos (DP 6,93), a maioria do gênero feminino (102 pacientes) e leucoderma (160 pacientes). A má oclusão mais prevalente foi a Classe III (81 pacientes). A assimetria, o excesso maxilar vertical e biprotrusão maxilar estavam presentes em 54, 33, e 7 pacientes, respectivamente. Na maioria dos casos, as cirurgias para correção de deformidades dentoesqueléticas foram combinadas, envolvendo os dois maxilares. Com base nos resultados, conclui-se que a Classe III foi a deformidade esquelética mais prevalente e a Classe I a menos prevalente. em geral, a prevalência de deformidades esqueléticas foi maior entre as mulheres e a maioria dos pacientes apresentou uma combinação de problemas maxilares e mandibulares, o que interfere diretamente na decisão sobre o plano de tratamento mais adequado. Houve uma maior incidência de assimetria na Classe III esquelética; o excesso vertical ocorreu de forma semelhante na Classe II e III e a biprotrusão teve baixa incidência entre as más oclusões avaliadas.
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A vitamina C é essencial para dietas de peixe porque muitas espécies não conseguem sintetizá-la. Esta vitamina é necessária par a formação de cartilagem e matriz óssea. Além disso, age como antioxidante e melhora as resposta do sistema imunológico. O presente trabalho investigou os efeitos da suplementação de vitamina C em dietas para alevinos de pintado (Pseudoplatystoma corruscans) pela incidência de deformidades na estrutura óssea e cartilaginosa. O ascorbil polifosfato (AP) foi utilizado como fonte de vitamina C em dietas para alevinos de pintado durante o período de três meses. Seis dietas foram formuladas: uma dieta controle (0 mg de vitamina C / kg) e cinco dietas 500, 1.000, 1.500, 2.000 e 2.500 mg de AP / kg. Os peixes alimentados sem suplementação de vitamina C apresentaram deformidades óssea na cabeça e mandíbula e fragilidade de nadadeiras. Assim, a dieta de 500 mg de AP/kg foi suficiente para prevenir a ocorrência de deformidades, e a ausência desta vitamina prejudica o desenvolvimento ósseo de juvenis de pintados.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Masticatory efficiency may be impaired in individuals with dentofacial deformities. The objective of the present study was to determine the condition of masticatory efficiency in individuals with dentofacial deformities. 30 patients with class II (DG-II) and 35 patients with class III (DG-III) dentofacial deformity participated in the study, all had an indication for orthognathic surgery. 30 volunteers (CG) with no alterations of facial morphology or dental occlusion and with no signs or symptoms of temporomandibular joint dysfunction also participated. Masticatory efficiency was analysed using a bead system (colorimetric method). Each individual chewed 4 beads, one at a time, over 20 s measured with a chronometer. The groups were compared in term's of masticatory efficiency using analysis of variance (ANOVA), with the level of significance set at P < 0.05. Masticatory efficiency was significantly greater in CG (P < 0.05) than in DG-II and DG-III in all chewing tasks tested, with no significant difference between DG-II and DG-III (P > 0.05). It was observed that the presence of class II and class III dentofacial deformity affected masticatory efficiency compared to CG, although there was no difference between DG-II and DG-III.