Sex prediction by geometric morphometric analysis of the hard palate.

OBJECTIVE: The hard palate participates in the construction of the oral and nasal cavities and represents the bony barrier between them. Morphological differences of the hard palate are important for forensic medicine, anthropology, anatomy, as well as scientific branches dealing with the study of evolutionary development, populations differences. The aim of this study was to determine sexual dimorphism of hard palate on three-dimensional (3D) models of human skulls using geometric morphometry. MATERIALS AND METHODS: The research was conducted on 3D models of 209 human skulls from Bosnian population (139 male, 70 female). On the obtained 3D models, we marked landmarks on the palate using Landmark editor program. Using MorphoJ program we analyzed sex differences of shape and size on hard palate. RESULTS: The principal component analysis showed that the first two components (PC1 and PC2) described 55.503% of the total morphological variability of the hard palate. The results of the discriminant analysis showed predictive power for male with 66.91% accuracy and for female with 58.57% accuracy based on the shape and size of the hard palate. The influence of size of the hard palate on its shape was statistically significant (p<0.0001). The results of discriminant analysis based on shape of hard palate showed predictive power for male with 68.34% accuracy and for female with 64.29% accuracy. CONCLUSIONS: Sex differences of hard palate are statistically significant and can be used for sex determination in skeletal remains. The percentage of accuracy for determining sex based on the hard palate was higher for men in this study.

Analysis of gender differences on pyriform aperture of human skulls using geometric morphometric method.

BACKGROUND: Piriform aperture is anterior opening of the nasal cavity formed by bones of the viscerocranium and knowledge about differences between genders is important for forensic scientists, anthropologists, orthopaedists, neurosurgeons and vascular surgeons. The aim of this study was to examine gender differences of piriform aperture on three-dimensional (3D) models of human skulls originating from Bosnian population using the geometric morphometric method. MATERIALS AND METHODS: The study was conducted on 211 3D models of human skulls of known gender. 3D models were obtained by laser scanning. We analysed the gender differences of piriform aperture using geometric morphometrics method. On 3D models we marked four landmarks on piriform aperture in the Landmark Editor programme, after which we analysed its gender differences in MorphoJ programme. RESULTS: The first principal component analysis axis described 40.398% of total variability of piriform aperture. The greatest gender variability was present in the position of the landmark rhinion. Discriminant functional analysis of the shape and size of the piriform aperture allowed the gender determination with 64.03% accuracy for male and 70.83% accuracy for female gender. The size of the piriform aperture showed a statistically significant difference between genders. Discriminant functional analysis of the shape of the piriform aperture without affecting size enabled gender determination with 59.71% accuracy for male and 62.5% accuracy for female. CONCLUSIONS: Analysis showed statistically significant differences in the shape and size of piriform aperture between genders. The accuracy for gender determination based on piriform aperture was higher in females.

Clinical features and therapeutic outcomes of patients with acromegaly: single-center experience.

The aim of this study was to review the outcome of acromegaly treatment, as well as co-morbidity and mortality in a series of patients with acromegaly attending a single center in the last 10 yr. In that period, 53 patients were treated for acromegaly. Transsphenoidal operation was applied as the first-line therapy in 94.3% of patients and it led to disease remission in 59.2% of them. The remission criteria included a nadir GH<1 µg/l after glucose load, and normal age-related IGF-I levels. The remission rate after transsphenoidal surgery was significantly higher in the group of patients with microadenoma (76.9%), than in the group of patients with macroadenoma (52.8%). Patients with invasive tumors had remission rate of 16.7% after transsphenoidal surgery. There were no perioperative deaths. As the second-line treatment somatostatin analogues, radiotherapy, and dopaminergic agonists were used. Hypertension and diabetes were the most frequent co-morbidities in the group of patients. After successful treatment, 30% of patients with diabetes or impaired glucose tolerance had significant improvement of glycemic control. Transsphenoidal surgery is the appropriate firstline therapy in patients with somatotropinoma. Medical and radio-therapy should be reserved as the second-line therapy after surgery failure.

The dental caries and periodontal disease experience of patients with early onset insulin dependent diabetes.

Diabetes mellitus is common in the Maltese. Patients in whom diabetes was first diagnosed before the age of 25 years were examined to determine their oral status and to compare their levels of disease with oral disease in non-diabetic age-matched control subjects. No patient was older than 29 years. Compared with control subjects, the diabetic patients showed differences in both caries and periodontal disease experience. Those with poor metabolic control of their diabetes showed oral disease patterns different to the stable diabetics.

[Epidemiology, classification and clinical aspects of hyperandrogenemia]. / Epidemiologija, klasifikacija, klinicka slika hiperandrogenemije.

Hyperandogenemia in women is manifested typically by clinical features that may include hirsutism, acne, central obesity, male pattern baldness, increased waist-to-hip ratio, clitoral hypertrophy and deepening of the voice. The differential diagnosis include Cushing syndrome, PCO and iatrogenic hirsutism. Complications include cardiovascular disease, intravascular disease and insulin resistance. An interdisciplinary approach to management is strongly recommended. Risk reduction strategies include correction of dyslipidemias, low-dose aspirin for primary prevention of myocardial infarction, maintenance of ideal weight, smoking cessation, use of oral contraceptives with low progestin, and postmenopausal estrogen replacement.

[Polycystic ovary syndrome: a disorder of insulin action and an increased risk for onset of non-insulin-dependent diabetes]. / Sindrom policisticnih jajnika: poremecaj djelovanja inzulina i povecan rizik nastanka inzulin-neovisne secerne bolesti.

Hyperandrogenemia may be the most common endocrinopathy in women, affecting up to 10% of all women and as many as 30% of certain subgroups. Women with polycystic ovary syndrome have a unique disorder of insulin action and are at increased risk to develop NIDDM. NIDDM in women with PCOS has earlier age of onset than it does in the general population. Insulin-induced receptor autophosphorylation is diminished in 50% of PCOS women. PCOS may be a disease of abnormal protein tyrosine kinase receptor signaling. IGF-I and IGF-II play an important role in regulating ovarian androgen production via receptors.

[Low-renin hypertension and inherited mineralocorticoid diseases]. / Niskoreninska hipertenzija i nasljedne bolesti mineralokortikoida.

Liddle's syndrome, apparent mineralocorticoid excess (AME) and glucocorticoid remediable aldosteronism (GRA) are inherited diseases characterized by hypertension and low plasma renin activity. Constitutive activation of distal renal epithelial sodium channel (Liddle's syndrome), defect in 11 beta-hydroxysteroid dehydrogenase activity (AME) and unequal crossing over, fusing regulatory sequences of 11 beta-hydroxylase gene to coding sequences of aldosterone synthase gene and forming a new chimeric gene (GRA), cause apparent or real mineralocorticoid excess. This diseases are often being unrecognized and classified as essential hypertension, especially in patients with normal serum potassium level. Family history of hypertension and characteristic serum and urine++ steroid profile direct us to diagnosis, and genetic analysis will confirm it.

[The effect of menopause and age on bone mineral density in women living in an urban environment in northern Croatia]. / Utjecaj menopauze i dobi na mineralnu gustocu kosti zena urbane sredine u sjevernoj Hrvatskoj.

The results of measurement of bone mass in three areas (lumbar spine, femoral neck and radius) where osteoporotic fractures most commonly occur are presented. The sample of 103 women was divided into three groups: premenopausal, early menopausal (up to 5 years of menopause) and late menopausal (more than 5 years of menopause). Both menopausal groups were additionally divided in two subgroups regarding the previous fractures. A statistically significant difference (p < 0.01) was found between bone mineral density (lumbar spine, femoral neck) and bone mineral content (radius) among all the groups. No difference was established for bone mass between postmenopausal women with and without fractures (> 0.05) by using the Kruskal-Wallis analysis of variance. A significant negative correlation (p < 0.01) was found between bone mass in all three tested regions on one side vs age of women as well as the period of menopause on the other. These results indicate that bone mass is significantly decreased in postmenopausal women. Therefore, the authors recommend densitometry to be employed in all postmenopausal women.

[Importance of the CRH (corticotropin releasing hormone) test in the differential diagnosis of Cushing's syndrome]. / Vrijednost CRH-testa u diferencijalnoj dijagnozi Cushingova sindroma.

In the group of 13 patients with Cushing's syndrome (CS) CRH test was performed by sampling the blood from peripheral vein and in eight patients also after inferior petrosal sinus catheterization (IPSC) to resolve the disease etiology. In the group of patients with Cushing's disease (CD, n = 11), which was proven by surgery and adenoma immunohistochemistry, 10/11 had in CRH test the significant increase of cortisol and ACTH in the peripheral blood. Among two patients with ectopic ACTH syndrome one had the significant increase of both hormones in CRH test. After IPSC the ratio of ACTH in the petrosal sinus and in the peripheral vein was significant in 4/8 patients before, and in 6/8 after CRH administration. The intersinus gradient was significant in 3/8 patients before, and in 4/8 after CRH test. According to our results we can conclude that the determination of ACTH in the blood from peripheral veins after CRH administration is a very sensitive method for differential diagnosis of CS, while the results after IPSC were less sensitive in our conditions than those described in the literature.

[National consensus on hyperandrogenemia]. / Nacionalni konsenzus o hiperandrogenemiji.

Croatian Endocrine Society and Croatian Academy of Medical Sciences organized Symposium on Hyperandrogenaemia on March 22nd, 1996. Different aspects of this syndrome were discussed: epidemiology, classification and clinical features, steroid biosynthesis in the adrenal gland and ovarium, the genetics of polycystic ovarian syndrome (PCOS), clinical significance of testosterone and dihydrotestosterone metabolism, androgen excess and metabolic syndrome (syndrome X), insulin disturbances in PCOS, increased risk for development of non insulin dependent diabetes mellitus, androgen effects on serum lipoproteins, insulin like growth factors and function of ovarium, Doppler parameters in PCOS, treatment of hyperandrogenaemia, skin changes in PCOS, tests for adrenal and ovarial function, arterial hypertension and hyperinsulinism. National Board of Hyperandrogenaemia has been elected.

Massive osteolysis in a girl with agenesis of thyroid C cells.

A rare case of massive osteolysis affecting the pelvis of a young girl is presented. The clinical, radiographic, and histopathological features are described in detail. Septicemia complicated the clinical course and the patient eventually died. Histopathological examination of the pelvic lesion revealed massive osteolysis characterized by prominent osteoclastic activity with extensive bone resorption. A thorough post-mortem histological examination of the thyroid gland showed no C cells. This is an interesting observation, since it is known that thyroid C cells are the primary source of calcitonin. Since the main biological effect of calcitonin is to inhibit osteoclastic bone resorption, there is a possibility that massive osteolysis in our case could have been related to the lack of this hormone. There is a clear need for further investigation regarding the role of thyroid C cells and calcitonin in this puzzling disease.

Effects of ritanserin, a novel serotonin-S2 receptor antagonist, on the secretion of pituitary hormones in normal humans.

The availability of a new potent and selective serotonin-S2 antagonist, ritanserin (RIT), encouraged us to further investigate the effect of serotonin on the basal secretion of anterior pituitary hormones in normal humans. Administered in a single 30-mg dose to group 1 consisting of 10 normal women, RIT failed to affect the baseline LH, FSH, GH or TSH levels. In group 2 consisting of 20 normal subjects (ten males and ten females), the same dose of RIT decreased in parallel both ACTH and cortisol levels but only at 180 min. Group 3 consisting of 8 normal men was studied on three separate occasions seven days apart: each subject received graded doses of 10 mg, 20 mg and 30 mg RIT. The mean baseline PRL concentration at 180 min as well as the net integrated area under the hormone curve (nAUC) decreased only after the highest dose, while the baseline cortisol concentrations at 180 min as well as the corresponding nAUC values displayed a clear dose-dependent response. The findings indicated the serotonin-S2 receptors to be only partially involved in the basal secretion of ACTH in normal humans.

Effects of ritanserin, a specific serotonin-S2 receptor antagonist, on the release of anterior pituitary hormones during insulin-induced hypoglycemia in normal humans.

The role of serotonin in the insulin hypoglycemia (IH) stimulated secretion of prolactin (PRL), growth hormone (GH), adrenocorticotropin (ACTH) and cortisol (F) was studied in a group of 12 normal subjects during the control period after placebo and a consecutive six-day treatment with 20 mg ritanserin (RIT) per day. RIT failed to affect the baseline levels of all the four hormones as well as the PRL response to IH (p > 0.5). The serum GH response to IH was moderately diminished after RIT, the reduction of integrated trapezoidal area under hormone curves (nAUC) being 50.7% +/- 6.9% (p < 0.005). Furthermore, RIT was found to slightly decrease the plasma ACTH response to IH, the reduction of nAUC being 36.3% +/- 2.6% (p < 0.005). Decrease in the corresponding plasma F response to IH was accompanied by 29.1% +/- 2.4% reduction of nAUC (p < 0.005). According to our results, serotonin-S2 receptors appeared to be moderately involved in IH-induced release of GH, but slightly in that of ACTH, leaving unaffected that of PRL.