A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by Computed Tomography

<p>Abstract</p> <p>Background</p> <p>Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded.</p> <p>Methods</p> <p>The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions) by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan.</p> <p>Results</p> <p>The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult.</p> <p>Conclusion</p> <p>The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis.</p

Somewhat united: primary stakeholder perspectives of the governance of schoolboy football in Ireland

Despite an independent report on the governance and organisational practices of football in Ireland, the National Governing Body continues to face criticism in relation to stakeholder management and communication. As positive outcomes in non-profit organisations are associated with quality relationships between organisations, the purpose of this article is to explore primary stakeholder perspectives of the governance of schoolboy football in the Republic of Ireland. The research questions to be addressed are: do tensions exist between stakeholders and does the FAI display effective governance behaviours in relation to its primary stakeholders. Semi-structured interviews were conducted with seven stakeholders from the football governance system. A lack of congruence across the system was identified, which resulted from ineffective stakeholder management (poor communication practices, perceptions of inaccurate disclosures, perceived lack of inclusion in decision-making, perceptions of organisational injustice, confusion over role clarity and responsibilities). Managing the quality of the relationships with diverse stakeholders within a sport governance system is key for strategic policy formation and implementation, yet this remains a challenging and multi-faceted concept. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group

Isolated giant intrathoracic meningocele associated with vertebral corpus deformity

Published reports of intrathoracic meningocele with vertebral corpus defects in the absence of neurofibromatosis are very rare. We report a 9-year-old male with intrathoracic meningocele. We believe that vertebral corpus defects may play a certain role in the etiology of intrathoracic meningocele. © 2004 Elsevier B.V. All rights reserved

Collateral pathways in superior vena caval obstruction as seen on CT

Purpose: Collateral venous pathways occurring with superior vena cava (SVC) obstruction were examined based on CT scans obtained from the thoracic inlet to the pubic symphysis. Similarities and variations from the prior classification scheme were analyzed. Method: A retrospective review of our database resulted in a cohort comprising 21 CT scans from 19 patients. The location and frequency of each collateral pathway and the level of the SVC obstruction were tabulated. An accepted classification scheme was applied to the collateral patterns in each case. Additional and atypical features were noted. Results: Fifteen common collateral veins were found that could be grouped into one to four collateral pathways. Unusual shunts, including hepatic parenchymal and pulmonary pathways, were found. Thirteen cases (62%) varied from the standard classification owing to different occlusion levels or presence of other collaterals. No statistically significant relationship between the level of occlusion and the number of collateral pathway groups was found. The most common abdominal collateral veins were those along the liver surface (52.3% of cases), although 18 patients (94.7%) had at least one collateral vein visible in the abdomen. Conclusion: The spectrum of venous collateral formations as seen on thoracoabdominal CT scans often includes collaterals at or below the level of the diaphragm, including intrahepatic shunts. Many collateral patterns found in this series could not be classified with the existent classification scheme.link_to_subscribed_fulltex

Reconstruction of the vena cava with the peritoneum: The effect of temporary distal arteriovenous fistula on patency - (An experimental study)

Objective: To determine the effect of increasing inferior vena cava blood flow by means of distal arteriovenous fistula on the patency of a peritoneal tube graft