Rhinoplasty: The Nasal Bones - Anatomy and Analysis

Background: The analysis of nasal anatomy, and especially the nasal bones including the osseocartilaginous vault, is significant for functional and aesthetic reasons. Objectives: The objective was to understand the anatomy of the nasal bones by establishing new descriptions, terms, and definitions because the existing parameters were insufficient. Adequate terminology was employed to harmonize the anthropometric and clinical measurements. Methods: A two-part harvest technique consisting of resecting the specimen and then creating a replica of the skull was performed on 44 cadavers to obtain specific measurements. Results: The nasal bones have an irregular, variable shape, and three distinct angles can be found along the dorsal profile line beginning with the nasion angle (NA), the dorsal profile angulation (DPA) and the kyphion angulation (KA). In 12% of cases, the caudal portion of the nasal bones was straight and without angulation resulting in a "V-shape" configuration. In 88% of cases, the caudal portion of the bone was angulated, which resulted in an "S-shape" nasal bone configuration. The intervening cephalic bone, nasion to sellion (N-S), represents the radix while the caudal bone, sellion to r (S-R), represents the bony dorsum. Conclusions: By standardizing and measuring existing nasal landmarks and understanding the different anatomic configurations of the nasal bones, rhinoplasty surgeons can better plan their operations within the radix and bony and osseocartilaginous vaults

Pseudotrombocytopenia caused by EDTA in obstetrics and perinatology: Case report

Introduction: Clinically, the most important pseudothrombocytopenia is described in pregnant women and also in their newborns if blood sample is taken using EDTA. Case report: Patient, 35 years old pregnant woman, 36 weeks of gestation, was admitted to Gynecological and Obstetrics Clinic in the CCS because of pregnancy monitoring. The EDTA thrombocytes result was 34.0 x 10e9/L and patient was without any symptoms of bleeding tendency. Pseudothrombocytopenia was suspected. We decided to check it by examination of blood smear and incubating EDTA sample on 37°C degrees for an hour. The platelets value on 37°C degrees was 32.0 x 10e9/L. Blood smear showed a platelet aggregation. The platelet count with the Sodium Citrate was 253.0 x 10e9/L, with the Ammonium oxalate 266.0 x 10e9/L and with Mg-sulphate 284.0 x 10e9/L. Newborn was healthy. The Complete Blood Count of newborn revealed normal parameters apart from a low platelet count 49.0 x 10e9/L. A blood smear was ordered and it revealed platelet aggregations. Platelet count of newborn blood sample taken on sodium-citrate was 189.0 x 10e9/L which clearly indicated pseudothrombocytopenia. Conclusions: Although PTP does not require clinical-therapeutic intervention, undiagnosed PTP can lead to therapeutic intervention (unnecessary administration of platelet concentrate) and seriously deteriorate both mother's and child's health. Therefore, the authors suggest examination of blood smear in every case when thrombocytopenia is diagnosed

Accurate Reconstruction of the 12-Lead Electrocardiogram From a 3-Lead Electrocardiogram Measured by a Mobile Device

Clinical outcomes of several acute conditions, including myocardial infarction (MI), the most common cause of death, can be improved by timely diagnostics based on electrocardiography (ECG). However, current diagnostic technologies include a large number of wired ECG electrodes, which require accurate placement by trained personnel. The ideal ECG device would be suitable for self-measurement, i.e., would have a small number of electrodes, be mobile or portable, and provide an accurate diagnosis. However, these aims have not been met using the same device. A recently developed handheld ECG device with three quasi-orthogonal leads opened the door for mobile assessment of the three-dimensional cardiac vector by self-measurement. We hypothesize that the information provided is sufficient for accurate reconstruction of the 12-lead ECG. We propose a reconstruction algorithm based on the segment-by-segment 4-matrix (4M) transformation applied to the P wave, QRS complex, ST segment, and T wave. The accuracy of the 4M method was tested using data obtained from 64 healthy volunteers. The 4M method reconstructed the standard 12-lead ECG with a 0.96 mean cross-correlation for all leads and provided meaningful clinical results. A back-to-back comparative study demonstrated the superiority of the proposed method over the traditional EASI method. In addition, the results provide evidence of the capability of the 3-lead 4M technology to accurately reconstruct the full cardiac vector from a single measurement, which distinguishes it from competition. Although further clinical investigation is necessary, wireless operation and high accuracy make the proposed method potentially suitable for remote monitoring and self-assessment