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Comparison between urinary oestrogen assay and serial ultrasonic cephalometry in assessment of fetal growth retardation.

Urinary oestrogen assay and serial ultrasonic cephalometry were performed on 284 patients who were considered on clinical grounds to be at risk of having a growth-retarded fetus. It was found that ultrasonic cephalometry was significantly better than oestrogens in diagnosing the small-for-dates baby, but that there was no significant difference between the two methods in predicting perinatal asphyxia. Of the 14 stillbirths, three were in the normal ultrasonic growth rate group and five had normal oestrogen excretion. Both methods were found to be of value in the diagnosis of fetal growth-retardation, although cephalometry would seem to have some advantages, especially in distinguishing between fetal growth-retardation and mistaken maturity.

Adult

[Antenatal assessment of fetal maturity--a comparison of ultrasound-cephalometry and radiology (author's transl)].

334 ultrasound-cephalometries and 231 X-ray fetographies were performed for antenatal assessment of fetal maturity as well as for exact estimation of gestational age in women with unknown date of donfinement. The accurance of the predictions was compared. Ultrasound-cephalometry gave best results when performed until the 20th week of gestation. A correct prediction was obtained in 80.4% of cases. After the 20th week of gestation, the accuracy of prediction decreased. Radiology on the contrary gave optimal results at the end of pregnancy. A correct prediction of the date of confinement was obtained in 73.8% of cases, when the X-ray fetography was performed between the 37th and 40th week of gestation. At the end of gestation radiography should be performed, if there is a discrepancy between ultrasound and clinical estimation or if ultrasound-cephalometry was not carried out in early pregnancy--especially if induction of labour is necessary.

Cephalometry

Dolichocephaly--a source of error in serial cephalometry.

Two patients are presented in whom ultrasonic cephalometry suggested intrauterine fetal growth retardation. The respective newborn infants were normally grown and had dolichocephaly with a normal head circumference. Dolichocephaly should be considered when cephalometry alone suggests a diagnosis of placental insufficiency.

Adult

Somnofluoroscopy, computed tomography, and cephalometry in the assessment of the airway in obstructive sleep apnoea.

BACKGROUND: Assessments of the upper airways in patients with the obstructive sleep apnoea syndrome are usually carried out on awake patients who are upright. The dynamics of the airway in a patient who is asleep and lying down may be different. METHODS: Somnofluoroscopy, computed tomography of the upper airway, and cephalometry were carried out in 11 patients with the obstructive sleep apnoea syndrome (10 male; mean (SD) age 53 (10) years) to examine the airway while they were awake and asleep. RESULTS: At somnofluoroscopy 10 patients were in stage 2 sleep and only one in REM sleep. At least five obstructive events were visualised by lateral fluoroscopy in each patient. Imaging allowed observation of the dynamics of airway collapse, which began in the oropharynx in all cases, progressing to the hypopharynx in 10 cases and to the laryngopharynx in five. At fluoroscopy the soft palate was seen to hook up during airway occlusion in 10 patients, thereby increasing its cross sectional area. It was then sucked down into the hypopharynx. Somnofluoroscopic and cephalometric findings agreed, eight of the 10 patients with hypopharyngeal collapse shown by somnofluoroscopy having an inferiorly placed hyoid bone according to cephalometry (distance from the mandibular plane to the hyoid bone (MP-H distance) increased); the one patient with no hypopharyngeal collapse had a normal MP-H. By contrast, six of the 11 patients had a normal or supranormal hypopharyngeal cross sectional area of the airway on the computed tomogram. CONCLUSIONS: Somnofluoroscopy allows examination of the dynamics of airway closure in this disorder and shows the important role of the soft palate in acting as a plug in the oropharynx. Dynamic studies are required to determine the pattern of pharyngeal obstruction in obstructive sleep apnoea.

Adult

[Serial determinations of serum oxytocinase and ultrasonic biparietal cephalometry in normal and high-risk pregnancies].

The value of sonor biparietal cephalometry and serum oxytocinase that we have obtained with weekly simultaneous determinations in 14 females with normal pregnancy and in 5 with pathological pregnancy, from 24th to 39th week, show a statical positive relation. Serum oxitocinase determination against hormonal tests of the phetoplancental function (urinary oestriol, pregnandiol, serum HCS, ecc.) give advantages: it is the easyer, faster and less espandove determination. Therefore we think that it is helpful to determin togheter serial values of sonar biparietal cephalometry and serum oxytocinase to anticipate the endouterine fetal growth retardation.

Aminopeptidases

Amniotic fluid phosphatidylglycerol and real-time ultrasonic cephalometry.

The fetal biparietal diameter (BPD) was measured at the time of real-time ultrasound-directed amniocentesis in 159 cases and a phospholipid profile was obtained from the amniotic fluid. BPD measurements of 9.0, 8.7, and 9.2 cm were then compared with a lecithin/sphingomyelin (L/S) ratio greater than or equal to 2.0 for the ability to predict the presence of phosphatidylglycerol (PG) in the profile. The data from the diabetic and nondiabetic patients were analyzed separately. The results demonstrated that in the presence of a L/S ratio greater than or equal to 2.0 the BPD does not aid in the identification of amniotic fluid samples which contain PG in either the diabetic or nondiabetic groups. The data also confirmed previous findings that the BPD is not a reliable predictor of the L/S ratio. It is concluded that for the detection of PG in amniotic fluid, the use of real-time ultrasonic cephalometry cannot substitute for the performance of the phospholipid profile.

Amniotic Fluid

Fetal cephalometry. An improved method and an evaluation.

A method of fetal cephalometry is described which is an advance on the combined A and B scan technique previously used. A flow chart has been prepared which clearly specifies the procedure to be followed. The criteria used when making an estimation are reported. The method is applicable to various types of machine and it can be taught to a good degree of accuracy in a short time to people with limited obstetric knowledge. There may be a significant difference between operators but this difference is roughly the same from patient to patient and decreases with training. It is considered that the chief source of variation is the failure to measure the same diameter on each occasion.

Analysis of Variance

A comparison of biparietal diameter measurements using a real-time scanner and a conventional scanner equipped with a coded cephalometry system.

In 131 patients a comparison was made between measurements obtained using a real-time scanner and those obtained using a conventional "B" scanner with an attached "coded cephalometry system": 69 per cent of the readings agreed within +/- 2 mm and, when the "B" scan reading was considered "good", 90 percent fell within this range. Between 14 and 28 weeks, gestational age diagnoses using the two methods were within one week of each other in 88 of 89 patients.

Cephalometry

Dynamic fetal cephalometry.

An iterative method of fetal cephalometry for use with real time scanners is described using a flow chart. The method is shown to be capable of yielding measurements having a standard deivation of less than 1 mm and we have found it to be superior to the combined A and B scan technique from which it is derived.

Cephalometry

Ultrasonic cephalometry: Its use in estimating fetal weight.

Data on 100 consecutive patients delivering within 1 week after ultrasonic cephalometry measurement were reviewed to assess the weight-predicting potential of three known formulas. With Thompson's formula, 78% of infant weights fell within a range of 350 g, the absolute mean error for the 100 cases being 267 g. Excluding cases of fetal malnutrition, when the biparietal diameter (BPD) obtained was 8.3 cm or more, all newborn babies weighed more than 2000 g, and with a BPD of 8.7 cm or more they all exceeded 2500 g. Ninety percent of newborn babies in whom the in utero BPD was 9.1 cm or more weighed more than 3000 g. These values compared very favorably with those from other series and, thus, demonstrate the usefulness of this type of assessment.

Birth Weight

[The importance of ultra-sound cephalometry for the prediction of the date of delivery--a contribution to the assessment of duration of pregnancy (author's transl)].

On the basis of some statistical data ultrasound cephalometry for the prediction of term is discussed. These data should be considered when providing socalled test-graphs. The usefulness of the author's own standard graph is examined. Prediction with the biparietal diameter is not much less exact than after the rule of Naegele. Accuracy of prediction can be much improved by using both methods together, starting from the averages of both.

Cephalometry

[Processing of cephalometry: Delaire's architectural and structural analysis].

This work purpose a performing system for the Cephalometry: Cephor a software for Delaire's analysis. From a radiography, we draw outlines on graphic tablet. Following in a short time, we obtain results: precise diagnosis permitting to establish a care plan. This care plan is indicated on the screen where we can simulate correction from a choised therapeutic (osteotomy for example). Moreover, this soft ware allows to survey numerically and graphically a treatment, allows to use others methods (Tweed, Ricketts, Steiner). Technological advantages rest on a hard gain of time and a precision gain. The large handiness of this system allows reproducible measures easily. Therefore, we own with this software an improvement and a performing system.

Cephalometry

Sonar cephalometry in twins: a table of biparietal diameters for normal twin fetuses and a comparison with singletons.

In 123 normal twin pregnancies, 589 biparietal diameter (BPD) measurements were obtained between 16 and 40 weeks' gestation and mean values for each week were computed. A table of BPDs for normal twin pregnancies based on these data is proposed. Mean twin BPDs were consistently smaller than those of singletons, the difference averaging 3.5 mm between 16 and 40 weeks' gestation. The development of a twin BPD table now permits a more accurate assessment of twin gestational age and fetal growth.

Cephalometry

Variability of the craniofacial skeleton. III. Radiographic cephalometry of juvenile Macaca mulatta.

The variability of the craniofacial skeleton of the juvenile Macaca mulatta was studied from lateral radiographic cephalograms of twenty-three animals, using a previously described method based on fourteen lines depicting certain anatomic features. The findings, when compared to corresponding human data, revealed that a number of angular relationships are similar in this monkey and in human childrena and adults. The same is true regarding the variability of individual lines. These similarities suggest that biologic similarities exist in the cranio-facial skeletal architecture in these species. Specifically, the findings in the Macaca mulatta were in agreement with previous findings in human children and adults as regards the parallelism between the anterior parts of the neurovascular canals of the upper and lower jaws and the apparently adaptive role of the ramus and the condyle.

Age Factors

Landmark identification accuracy in xeroradiographic cephalometry.

Identification accuracy of fourteen cephalometric landmarks was compared between xeroradiographic cephalograms and conventional cephalograms. Four landmarks--point A, upper incisor tip, infradentale, and menton--were more accurately determined on the xeroradiograph, while two landmarks--point B and condylion--were more accurately determined on the conventional cephalogram. Although not conclusively demonstrated in this study, the xeroradiograph does appear to offer more clarity and detail than the conventional cephalogram. Further investigation of this new diagnostic medium will be necessary before its true significance to dentistry can be evaluated.

Cephalometry