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  • Author: Victor Suciu x
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Original Research. Correlation Between Cranial Base Morphology And Various Types Of Skeletal Anomalies

Abstract

Background: Previous studies regarding various types of malocclusions have found correlations between the angle of the base of the skull and prognathism. Aim of the study: This cephalometric study sought to investigate the function of the cranium base angle in different types of malocclusion on a group of Romanian subjects. Materials and methods: Forty-four cephalometric radiographs were selected from patients referred to orthodontic treatment. The cephalometric records were digitized, and with the CorelDRAW Graphics Suite X5 software 22 landmarks have been marked on each radiograph. A number of linear and angular variables were calculated. Results: The angle of the base of the skull was found to be higher in Class II Division 1 subjects compared to the Class I group. The cranial base lengths, N-S and S-Ba, were significantly larger in both categories of Class II malocclusion than in Class I patients, but measurements were comparable in Class I and Class III. The SNA angle showed no considerable variation between Class I subjects and the other groups. SNA-SNP was significantly increased above Class I values in Class II Division1 and Class II Division 2 groups. No significant dissimilarities were observed for these lengths between Class I and Class III patients. Conclusions: The angle of the cranium base (S-N-Ba, S-N-Ar) does not have a major role in the progression of malocclusion. In Angle Class II malocclusion the SNA angle is increased, and SNB is increased in malocclusion Class III. The anterior skull base length is increased in Class II anomalies. The length of the maxillary bone base is increased in Class II malocclusions type; in Class III type of malocclusion the length of the mandible bone is increased.

Open access
Coronary Sinus Lactate as Marker of Myocardial Ischemia in Cardiac Surgery: Correlation with Morbidity and Mortality after Cardiac Surgery / Lactatul din sinusul coronarian - marker al ischemiei miocardice în chirurgia cardiacă: corelaţii cu morbiditatea şi mortalitatea postoperatorie

Abstract

Introduction. Perioperative myocardial injuries are one of the most frequent causes of morbidity and mortality after cardiac surgery, the most common etiology being the poor myocardial protection during aortic crossclamp. During aortic crossclamp progressive accumulation of lactate and intracellular acidosis are well-known phenomena, and are associated with alteration of myocardial contractile function. Our objective was to study the coronary sinus lactate levels as a predictor of postoperative hemodynamic outcome in open-heart surgical patients.

Material and methods. We performed a prospective clinical trial, including 142 adult patients with elective cardiac surgery. Anterograde cardioplegia was administered in 82 patients, retrograde cardioplegia in 60 (in 30 patients it was administrated intermittently and in 30 continuously). Blood was collected simultaneously from the aortic cardioplegic line (inflow) and from coronary sinus or the aortic root (outflow) before aortic crossclamp, after crossclamp at every 10 minutes and after crossclamp removal at 0 and 10 minutes. All patients were operated on cardiopulmonary bypass with cardiac arrest, using warm-blood cardioplegia for cardioprotection.

Results. Lactate levels showed increasing values during aortic crossclamp, and a rapid decline after crossclamp removal. The incidence of low cardiac output was significantly higher in patients with lactate levels that exceeded 4 mmol/L. In patients who died in the postoperative period, lactate level was even higher (5 mmol/L), with only a modest recovery after crossclamp removal.

Conclusion. Monitoring lactate level in coronary sinus blood is a reliable method and has a good prognostic value regarding postoperative morbidity and mortality in open heart surgery

Open access