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PubMed1989

Anatomic findings in dicephalic conjoined twins: implications for morphogenesis.

The morphogenesis of conjoined twins is incompletely understood. We therefore conducted a postmortem study of dicephalus dibrachii dipus conjoined twins. The twins were born without pertinent history or prenatal diagnosis at 38 weeks and lived for several hours. External genitalia were female and partly duplicated; a caudal appendage was present in the thoracolumbar region. The heart and liver were shared and exhibited major abnormalities in configuration. Four lungs, three kidneys and adrenal glands, and two spleens were identified; biliary and upper gastrointestinal tracts appeared as mirror images. From these findings, we postulate three major sets of consequences arising from the anatomical disposition of the twin notochords ("paleoaxes"). 1) The degree of convergence/divergence of craniocaudal paleoaxes is variable. Convergences are maximal in the upper thoracic and sacral regions, where duplication of organs in minimal because of interaction aplasia. 2) In the horizontal plane, paleoaxes are sufficiently divergent to produce a degree of twin expression posteriorly, whereas anteriorly they converge to form a single, anterior, midline "neoaxis." Interposed between these zones of paleoaxial and neoaxial expression are areas of variable interaction aplasia. 3) The left twin was in situs solitus; the right twin was in situs inversus in a manner resembling polysplenia.

Abnormalities, Multiple↗

PubMed2006

Long-term stability of N1 sources using low-resolution electromagnetic tomography.

The purpose of this study was to investigate the long-term stability of auditory N1 sources using low-resolution electromagnetic tomography (LORETA). Data collected from 72 electrodes in ten young adult female participants were analyzed. For each participant, N1 peak amplitude and latency values at Cz (referred to M2) were compared for right, left, and bilateral stimulation across three separate recording sessions. Further, sources calculated by LORETA were analyzed in three regions of interest: right temporal, left temporal, and frontal. Peak amplitude and latency measurements were stable across session and ear of stimulation. Three-way RM-ANOVAs revealed relatively stable source amplitudes and stable three-dimensional locations of the sources in each region of interest with shifts of up to 2 cm around the mean locations. The 2 cm variability may be attributable both to normal hemispheric asymmetries and electrode placement variability. These results suggest that N1 scalp activity and its underlying sources are stable.

Acoustic Stimulation↗

PubMed2000

Cortical activations during paced finger-tapping applying visual and auditory pacing stimuli.

In order to study neural systems which are involved in motor timing we used whole-brain functional resonance imaging while subjects performed a paced finger-tapping task (PFT) with their right index finger. During one condition, subjects were imaged while tapping in synchrony with tones separated by a constant interval (auditory synchronisation, AS), followed by tapping without the pacing stimulus (auditory continuation, AC). In another condition, subjects were imaged while tapping in synchrony with a visual stimulus presented at the same frequency as the tones (visual synchronisation, VS) followed by a tapping sequence without visual pacing (visual continuation, VC). The following main results were obtained: (1) tapping in the context of visual pacing was generally more variable than tapping in the context of auditory stimuli; (2) during all conditions, a fronto-parietal network was active including the dorsal lateral premotor cortex (dPMC), M1, S1, inferior parietal lobule (LPi), supplementary motor cortex (SMA), the right cerebellar hemisphere, and the paravermial region; (3) stronger activation in the bilateral ventral premotor cortex (vPMC), the left LPi, the SMA, the right inferior cerebellum, and the left thalamus during both auditory conditions (AS and AC) compared to the visual conditions (VS and VC); (4) stronger activation in the right superior cerebellum, the vermis, and the right LPi during the visual conditions (VS and VC); (5) similar activations for the AS and AC conditions; but (6) marked differences between the VS and VC conditions especially in the dorsal premotor cortex (dPMC) and LPi areas; and (7) finally, there were no activations in the auditory and visual cortices when the pacing stimuli were absent. These findings were taken as evidence for a general difference between the motor control modes operative during the auditory and visual conditions. Paced finger tapping in the context of auditory pacing stimuli relies more on brain structures subserving internal motor control while paced finger-tapping in the context of visual pacing stimuli relies on brain structures relying on the subserving processing or imagination of visual pacing stimuli.

Acoustic Stimulation↗

PubMed1999

Augmented destruction test with an electromechanical pulsatile total artificial heart.

The total artificial heart (TAH) being developed by these authors successfully completed hydrodynamic and hemolysis studies followed by two acute implantations. Before commencing preclinical studies on any device, documentation of the reliability and durability of each component has to be done. This TAH was submitted to a 4 month destruction test under the most severe driving conditions to detect any weak mechanical components of the system. The maximum dP-dt in the left pumping chamber was chosen of more than 15,000 mm Hg/s, which is almost 6 times higher than that of the normal driving condition. The pump was submersed into a water bath that was maintained at 37 degrees C. The TAH was driven in a left master alternative (LMA) variable rate mode at 8 L/min output flow, 15 mm Hg reload, 100 mm Hg left afterload, and 25 mm Hg right afterload. The outflow, pressures, and temperature inside the TAH were monitored. Several stress concentration areas were detected. The connection between the roller nut and support plate proved to be one of the most stressed regions, and a more reliable fixing procedure was required. This portion was redesigned to offer a durable connection. No malfunctions of the actuator or controller were detected throughout the testing duration. No temperature elevation more than 1 degree C on the center piece of the TAH was demonstrated.

Equipment Failure Analysis↗

PubMed1982

Computed tomography findings in senile dementia and normal aging.

Computed tomography (CT) findings in 57 patients with senile dementia of Alzheimer type (SDAT), 19 patients with multi-infarct dementia and 85 controls of similar age and sex were studied. The SDAT patients differed from the controls of ventricular dilatation, frontal horn index, cella media index and the width of the third ventricle, and also in the index of cortical atrophy. Even the least severely demented SDAT patients differed from the controls. In the SDAT group with the increasing degree of intellectual impairment the ventricular dilatation increased, but cortical atrophy did not correlate with the psychological test score. The multi-infarct dementia patients differed from the controls in all CT variables including local changes. The SDAT patients had a more marked ventricular dilatation than the multi-infarct dementia patients. The multi-infarct dementia patients had more frequently local changes in SDAT patients. In the control group age correlated with ventricular dilatation, and the lower test scores correlated with cortical atrophy in the left temporal region.

Aged↗

PubMed1980

The effect of graded coronary flow reduction in the left anterior descending and septal arteries on left ventricular function in the canine heart.

WE quantitatively analyzed the effect of graded left anterior descending and septal coronary flow (LAD + septal flow) reduction on left ventricular function with a left ventricular end-diastolic pressure (LVEDP) of 6 mm Hg and 12 mm Hg. We used an isolated, ejecting, canine heart preparation ( n = 8), the coronary flow of which could be controlled independently of the aortic pressure. We kept the other hemodynamic variables - heart rate, left circumflex coronary flow, right coronary flow and aortic input impendance - constant within their normal physiologic range. We considered this reduction in LAD + septal flow to be analogous to that of the most frequent lesion in ischemic heart disease. There was no plateau in the left ventricular work caused by this reduction of the regional coronary flow. Therefore, the plateau commonly reported in previous studies may be partially a result of the compensatory elevation of LVEDP, which is necessary to maintain the left ventricular work.

Animals↗

PubMed2006

Automated left ventricular segmentation in cardiac MRI.

We present an automated left ventricular (LV) myocardial boundary extraction method. Automatic localization of the LV is achieved using a motion map and an expectation maximization algorithm. The myocardial region is then segmented using an intensity-based fuzzy affinity map and the myocardial contours are extracted by cost minimization through a dynamic programming approach. The results from the automated algorithm compared against the experienced radiologists using Bland and Altman analysis were found to have consistent mean bias of 7% and limits of agreement comparable to the inter-observer variability inherent in the manual method.

Adult↗

PubMed2006

Schooling mediates brain reserve in Alzheimer's disease: findings of fluoro-deoxy-glucose-positron emission tomography.

BACKGROUND: Functional imaging studies report that higher education is associated with more severe pathology in patients with Alzheimer's disease, controlling for disease severity. Therefore, schooling seems to provide brain reserve against neurodegeneration. OBJECTIVE: To provide further evidence for brain reserve in a large sample, using a sensitive technique for the indirect assessment of brain abnormality (18F-fluoro-deoxy-glucose-positron emission tomography (FDG-PET)), a comprehensive measure of global cognitive impairment to control for disease severity (total score of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery) and an approach unbiased by predefined regions of interest for the statistical analysis (statistical parametric mapping (SPM)). METHODS: 93 patients with mild Alzheimer's disease and 16 healthy controls underwent 18F-FDG-PET imaging of the brain. A linear regression analysis with education as independent and glucose utilisation as dependent variables, adjusted for global cognitive status and demographic variables, was conducted in SPM2. RESULTS: The regression analysis showed a marked inverse association between years of schooling and glucose metabolism in the posterior temporo-occipital association cortex and the precuneus in the left hemisphere. CONCLUSIONS: In line with previous reports, the findings suggest that education is associated with brain reserve and that people with higher education can cope with brain damage for a longer time.

Aged↗

PubMed2002

ECG-gated 18F-FDG positron emission tomography.

AIM: 18F-fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET) provides information about myocardial glucose metabolism to diagnose myocardial viability. Additional information about the functional status is necessary. Comparison of tomographic metabolic PET with data from other imaging techniques is always hampered by some transfer uncertainty and scatter. We wanted to evaluate a new Fourier-based ECG-gated PET technique using a high resolution scanner providing both metabolic and functional data with respect to feasibility in patients with diseased left ventricles. METHODS: Forty-five patients with coronary artery disease and at least one left ventricular segment with severe hypokinesis or akinesis at biplane cineventriculography were included. A new Fourier-based ECG-gated metabolic 18F-FDG-PET was performed in these patients. Function at rest and 18F-FDG uptake were examined in the PET study using a 36-segment model. RESULTS: Segmental comparison with ventriculography revealed a high reliability in identifying dysfunctional segments (> 96%). 18F-FDG uptake of normokinetic/hypokinetic/akinetic segments was 75.4 +/- 7.5, 65.3 +/- 10.5, and 35.9 +/- 15.2% (p < 0.001). In segments > or = 70% 18F-FDG uptake no akinesia was observed. No residual function was found below 40% 18F-FDG uptake. An additional dobutamine test was performed and revealed inotropic reserve (viability) in 42 akinetic segments and 45 hypokinetic segments. CONCLUSION: ECG-gated metabolic PET with pixel-based Fourier smoothing provides reliable data on regional function. Assessment of metabolism and function makes complete judgement of segmental status feasible within a single study without any transfer artefacts or test-to-test variability. The results indicate the presence of considerable amounts of viable myocardium in regions with an uptake of 40-50% 18F-FDG.

Adult↗

PubMedDate not supplied

Mathematical three-dimensional solid modeling of biventricular geometry.

The characterization of regional myocardial stress distribution has been limited by the use of idealized mathematical representations of biventricular geometry. State-of-the-art computer-aided design and engineering (CAD/CAE) techniques can be used to create complete, unambiguous mathematical representations (solid models) of complex object geometry that are suitable for a variety of applications, including stress-strain analyses. We have used advanced CAD/CAE software to create a 3-D solid model of the biventricular unit using planar geometric data extracted from an ex vivo canine heart. Volumetric analysis revealed global volume errors of 4.7%, -1.3%, -1.6%, and -1.1% for the left ventricular cavity, right ventricular cavity, myocardial wall, and total enclosed volumes, respectively. Model errors for 34 in-plane area and circumference determinations (mean +/- SD) were 5.3 +/- 6.7% and 3.8 +/- 2.7%. Error analysis suggested that model volume errors may be due to operator variability. These results demonstrate that solid modeling of the ex vivo biventricular unit yields an accurate mathematical representation of myocardial geometry which is suitable for meshing and subsequent finite element analysis. The use of CAD/CAE solid modeling in the representation of biventricular geometry may thereby facilitate the characterization of regional myocardial stress distribution.

Animals↗

PubMed1991

Coil placement in magnetic brain stimulation related to skull and brain anatomy.

The influence of coil position on the size of electromyographic responses evoked by transcranial magnetic brain stimulation was systematically evaluated. The position of the stimulation coil (11.6 cm outer diameter, Novametrix) was recorded by constructing individual grids on the skull surface using extracranial bony landmarks and was then related to underlying cerebral sulci by analysis of magnetic resonance images of the brain and skull. The largest responses in the right first dorsal interosseus (FDI) muscle, when using anticlockwise coil currents as viewed from above, were found, on average (5 subjects), to occur with the coil centred 2 cm behind and left of the vertex. For the right tibialis anterior (TA) muscle the largest responses were obtained, on average, with the coil centred around a point 4 cm anterior to and 4 cm left of the vertex. Between individuals, the optimal coil position for responses in a particular muscle varied up to 2 cm. This variability could be explained by the variability in the relationship between the central sulcus and the extracranial bony landmarks of each individual. Responses could be obtained whenever the windings of the coil passed over the appropriate region of the motor cortex, providing evidence that magnetically evoked responses do originate from activation of the precentral gyrus. The size of the cortically evoked responses for a given stimulus intensity depended on the direction of the coil currents passing over the motor area. For FDI muscles, the largest responses were obtained when the coil currents passed over the lateral part of the motor strip from forwards behind and transversely to the central sulcus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1991

Limitation of no reflow injury by blood-free reperfusion with oxygenated perfluorochemical (Fluosol-DA 20%).

This study was designed to assess the effects of blood-free reperfusion with oxygenated or unoxygenated intracoronary perfluorochemical (Fluosol-DA 20%) on myocardial perfusion and to determine its mechanism or mechanisms of limiting no reflow. Twenty-four dogs underwent 90 min of coronary occlusion followed by 210 min of reperfusion and were randomized to either: 1) blood-free reperfusion with intracoronary oxygenated perfluorochemical (20 ml/kg per min) for 20 min followed by blood reperfusion (n = 8); 2) intracoronary unoxygenated perfluorochemical administered as in those treated with oxygenated perfluorochemical (n = 8); and 3) blood reperfusion alone (control) (n = 8). Regional myocardial blood flow was serially determined and global myocardial perfusion was assessed by an intravenous injection of the fluorescent dye (thioflavin-S). Quantitative studies were performed to determine neutrophil infiltration and extent of endothelial injury. Hemodynamic variables were similar in all groups. The zone of impaired perfusion (thioflavin negative), expressed as a percent of the left ventricle, averaged 10 +/- 2%, 6 +/- 2% and 3 +/- 1%, in control and unoxygenated and oxygenated perfluorochemical groups, respectively (control versus oxygenated perfluorochemical p less than 0.004). The reduction in thioflavin-negative area with oxygenated perfluorochemical was associated with a notable recovery of endocardial blood flow (0.97 +/- 0.22 vs. control 0.39 +/- 0.08 ml/min per g; p less than 0.04) at 210 min of reperfusion. The number of capillaries plugged by neutrophils (per 200 capillaries) in thioflavin-negative areas was similar with both oxygenated (5.9 +/- 1.4) and unoxygenated perfluorochemical (5.4 +/- 0.8) treatment and was significantly less than that with the control group (18.9 +/- 3.2, p less than 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1991

Comparison of selective arginine vasopressin V1 and V2 receptor antagonists on burn shock in the rat.

STUDY OBJECTIVE: Two selective V1 and V2 receptor antagonists of arginine vasopressin, d(CH2)5Tyr(Me)AVP and d(CH2)5[D-Ile2, Ile4, Ala9-NH2]AVP, were given intravenously in burn shocked rats to investigate the respective effects of V1 and V2 receptor blockade on the haemodynamic variables in burn shock. DESIGN: Computer assisted on line real time measurements of mean arterial blood pressure, diastolic blood pressure, left ventricular systolic pressure, dP/dtmax, and heart rate were used to study the effects of the receptor antagonists during burn shock. In addition, the radioactive microsphere method was used to measure the changes of cardiac output and regional blood flows to heart, kidney, and liver in response to the antagonists during burn shock. Third degree burns extending over 30% of body surface area were made by dipping the rat's shaved back into water at 100 degrees C for 20 s. EXPERIMENTAL MATERIAL: Male Sprague-Dawley rats (250-300 g) were used in groups of 6-9 per experiment. MEASUREMENTS AND MAIN RESULTS: Mean and diastolic arterial blood pressures, left ventricular systolic pressure, dP/dtmax and heart rate were measured for 8 h after burns. Cardiac output and regional blood flow were measured at 3 h and 8 h postburn. Results showed that blockade of V1 receptor lowered mean and diastolic arterial blood pressures throughout the 8 h period, and raised left ventricular systolic pressure and dP/dtmax only during the early phase of shock. Cardiac output and blood flows to heart, kidney, and liver were increased by the V1 antagonist at 3 h but not at 8 h postburn. The V2 receptor antagonist increased mean and diastolic arterial blood pressures, left ventricular systolic pressure, and dP/dtmax both during the early and during the late phases of burn shock. It also improved cardiac output and blood flows to the heart, kidney, and liver during the early and late phases of burn shock. However, heart rate was not affected by V1 and V2 receptor antagonists. CONCLUSIONS: The V2 like receptor may be the dominating receptor mediating vasopressin's inhibitory effect on the heart. V1 receptor mediated coronary vasoconstriction contributes to the myocardial depression possibly only at the compensatory phase of shock. In addition V1 receptor mediated vasoconstriction is important in maintaining blood pressure during burn shock.

Angiotensin Receptor Antagonists↗

PubMed2001

Diastolic dysfunction is predictive of difficult weaning from cardiopulmonary bypass.

Diastolic function is receiving more attention since echocardiographic measurements were developed and have become widely available. The importance and significance of diastolic dysfunction (DD) observed before cardiac surgery and its relationship with adverse outcomes, such as difficult separation from cardiopulmonary bypass (CPB), have not been fully explored. In this study, we hypothesize that DD can be a predictor for the need of inotropic support to successfully separate from CPB. Ninety-two consecutive patients underwent surgery during the study period. Twenty-six patients were excluded. From the remaining 66 patients, 52 had coronary artery bypass grafting alone and 14 combined procedures, valvular surgery, and reoperations (redo). Systolic and diastolic function was evaluated by two experts blinded as to the clinical data except for the age. The evaluation of diastolic function was done according to published guidelines. The demographic, echocardiographic, and hemodynamic variables were entered in a logistic regression analysis to determine which variables were independent predictors of difficult separation from CPB and the need for postoperative vasoactive support. DD was present in 20 patients (30%). Patients with DD had lower weight (P = 0.046), less frequent coronary artery bypass grafting alone (P = 0.0004), more myocardial infarction before surgery (P = 0.02), higher regional wall motion score index (P = 0.0002), and larger left ventricle (P = 0.03). Total CPB time (P = 0.004) and ischemic time (P = 0.007) were longer in the DD group. Patients with DD required more frequent inotropic support at the end of surgery (P = 0.006) and up to 12 h after surgery (P = 0.003). Multivariate logistic regression identified female sex, DD, and total CPB time as predictive of difficult weaning and inotropic requirements up to 12 h after surgery.

Aged↗

PubMed2025

High-resolution, genotype-free mapping of genetic variation with CRI-SPA-Map.

Genetic variation within species shapes phenotypes, but identifying the specific genes and variants that cause phenotypic differences is costly and challenging. Here, we introduce CRI-SPA-Map, a genetic mapping strategy combining CRISPR-Cas9 genome engineering, selective ploidy ablation (SPA), and high-throughput phenotyping for precise genetic mapping with or without genotyping in the yeast Saccharomyces cerevisiae. In CRI-SPA-Map, a donor strain carrying SPA machinery is mated to a genetically different recipient strain harboring a genome-integrated selectable cassette. In the resulting diploid, CRISPR-Cas9 cuts the cassette for replacement with DNA from the homologous donor chromosome. Donor chromosomes are then removed using SPA to yield haploid recombinant strains. To establish CRI-SPA-Map, we mated a W303 SPA strain to 92 strains from the BY4742 yeast knockout collection that carry gene deletion cassettes on the left arm of chromosome XIV and created 1,451 recombinant isolates. Whole-genome sequencing verified that deletion cassette replacement introduced short donor DNA tracts of variable length, resulting in a finely recombined mapping population. Using only the known location of the gene deletions, which marks where donor DNA is introduced, we identified a 6.5 kb-region shaping yeast growth. Further dissection of this region pinpointed two causal variants in two genes, MKT1 and SAL1. Engineering these variants alone and in combination revealed gene-by-environment interactions at both genes, as well as epistatic interactions between them that were in turn dependent on the environment. CRI-SPA-Map is a cost-effective strategy for creating high-resolution recombinant panels of yeast strains for identifying the genetic basis of phenotypic variation.

Journal Article↗

PubMed2001

Three-dimensional mapping of gyral shape and cortical surface asymmetries in schizophrenia: gender effects.

OBJECTIVE: People with schizophrenia exhibit abnormalities in brain structure, often in the left hemisphere. Disturbed structural lateralization is controversial, however, and effects appear mediated by gender. The authors mapped differences between schizophrenic and normal subjects in gyral asymmetries, complexity, and variability across the entire cortex. METHOD: Asymmetry and shape profiles for 25 schizophrenic patients (15 men) and 28 demographically similar normal subjects (15 men) were obtained for 38 gyral regions, including the sylvian fissure and temporal and postcentral gyri, by using magnetic resonance data and a novel surface-based mesh-modeling approach. Cortical complexity was examined for sex and diagnosis effects in lobar regions. Intragroup variability was quantified and visualized to assess regional group abnormalities at the cortical surface. RESULTS: The patients showed greater variability in frontal areas than the comparison subjects. They also had significant deviations in gyral complexity asymmetry in the superior frontal cortex. In temporoparietal regions, significant gyral asymmetries were present in both groups. Sex differences were apparent in superior temporal gyral measures, and cortical complexity in inferior frontal regions was significantly greater in men. CONCLUSIONS: Cortical variability and complexity show regional abnormalities in the frontal cortex potentially specific to schizophrenia. The results indicate highly significant temporoparietal gyral asymmetries in both diagnostic groups, contrary to reports of less lateralization in schizophrenia. Substantially larger study groups are necessary to isolate smaller deviations in surface asymmetries, if present in schizophrenia, suggesting their diagnostic value is minimal.

Adult↗

PubMed2000

[Use of patient-related contrast media protocols in cardiovascular computerized tomography].

PURPOSE: To determine the temporal variability of the time to maximum aortic density after peripheral venous contrast injection in cardiovascular CT studies and to calculate potential contrast agent savings of selecting scan delay from test bolus kinetics. METHODS: A peripheral contrast bolus was administered intravenously in 138 consecutive patients to determine the time to maximum density in a left ventricular or aortic region of interest by electron beam CT. 20 EKG-triggered scans were acquired within 70 heartbeats. The deviation of the time to maximum density from a standard, fixed scan delay was determined. RESULTS: Mean time to maximum density was 22 s, and the average deviation from that mean was 5 s. At an injection rate of 4 cc/s, this deviation implies that determining the individual scan delay from a test bolus injection may potentially save 20 cc contrast per patient. This amount of contrast agent, in turn, is required for the test bolus. CONCLUSION: Deriving the individual scan delay from test bolus kinetics may improve image contrast in cardiovascular CT studies without additional contrast expense.

Adult↗

PubMedDate not supplied

[Repercussion of mental retardation and associated cerebral palsy on skeletal maturation].

INTRODUCTION: Mental retardation (MR) constitutes a clinical and social relevant condition accounting for 3% of the pediatric population. Studies focusing the repercussion of MR on nutritional status are scarce and, in occasions, have produced contradictory results. OBJECTIVE: To evaluate the nutritional status of mentally retarded children in our Region, on the basis of skeletal maturation. PATIENTS AND METHODS: Our sample comprise 128 mentally retarded children (81 boys and 47 girls) aged 0 17 years. In all children a nutritional and social family environment questionnaires and a valuation of a series of nutritional and anthropometric variables were performed. Additionally, bone age was assessed by means of left hand wrist radiograph in a subset of 53 children. A factorial analysis was carried out by means of the statistical package SPSS allowing the obtaining of 2 anthropometric factors and 3 biochemical factors that condensed the most information content. Results of the bone maturation were correlated with age, sex, presence of cerebral palsy (CP), severity of mental retardation, results of nutritional and sociofamilial questionnaire, antiepileptic treatment and nutritional status (anthropometric and biochemical factors). RESULTS: Although a good correlation exists between bone age and chronological age, 50% of mentally retarded children presented delay in their skeletal maturation. The bone maturation was higher in the boys than in the girls. The presence of CP induced an increase of 12% in the delay of the skeletal maturation. The severity of MR induced differences in the bone age. Both quality of diet and score of anthropometric factor I inversely correlated with bone maturation delay. Parent s age and geographical precedence but not antiepileptic therapy affected the bone maturation. CONCLUSIONS: Delay in the bone maturation occurs with high prevalence among mentally retarded children. The presence of CP, severity of MR, quality of the diet and sociofamilial and nutritional factors influenced in an outstanding way in the bone maturation.

Adolescent↗