Morphometric analysis of foramen magnum and occipital condyle using CT images for sex determination in a Saudi Arabian population.

OBJECTIVE OF THE STUDY: The objective of this study was to evaluate FM and occipital condyles measurements morphometrically for sex determination by using discriminant function analysis and to note visually the variation in the shape of the foramen magnum in a Saudi Arabian population by using CT scan images. MATERIAL AND METHODS: This study included 472 CT scans (236 males and 236 females; age range, 18-72 years). The foramen magnum shapes were classified into 8 types: oval, egg, round, hexagonal, pentagonal, tetragonal, irregular (A) and irregular (B). The intraobserver and interobserver test was done to calculate the reliability of the measurement. Eight dimensions of the FM and occipital condyle were evaluated to determine the sexual dimorphism using an independent t-test. Sex determination was estimated using discriminate function analysis. RESULTS: The commonest shape of FM was hexagonal and the tetragonal shape was the least common type. Coefficient of reliability (R) was high, ranging between 0.89 and 0.99, which indicates the measurements are reliable and sufficiently precise. All the eight measurements, the FM length and width, FM index, FM area, the width and length of right and left occipital condyles were significantly greater in males than the female. Univariate discriminant function showed an accuracy rate varying from 61% to 66.6% based on FM or occipital condyles measurements. The multivariate analysis of FM and occipital condyle measurements increased the overall accuracy rate of sex determination to 71.6%. CONCLUSION: The univariate analysis of FM and occipital condyle measurements indicates, that the FM area (66.1%), FML (62.5%), FMW (62.5%) and ROCL (62.1%) could be reliable individual variables in sex determination. The multivariate analysis including all the eight variables of FM and occipital condyle increased the accuracy rate of sex determination to 71.6% in determining the sex as male (73.3%) or female (69.9%). The shape of the FM is not useful in sex estimation. The results obtained showed a low degree of sexual dimorphism in the basicranium, the use of this method in forensic anthropology could be helpful for assessment on highly fragmented skull bases.

Integrated Genomic Analysis Identifies ANKRD36 Gene as a Novel and Common Biomarker of Disease Progression in Chronic Myeloid Leukemia.

Background: Chronic myeloid leukemia (CML) is initiated in bone marrow due to chromosomal translocation t(9;22) leading to fusion oncogene BCR-ABL. Targeting BCR-ABL by tyrosine kinase inhibitors (TKIs) has changed fatal CML into an almost curable disease. Despite that, TKIs lose their effectiveness due to disease progression. Unfortunately, the mechanism of CML progression is poorly understood and common biomarkers for CML progression are unavailable. This study was conducted to find novel biomarkers of CML progression by employing whole-exome sequencing (WES). Materials and Methods: WES of accelerated phase (AP) and blast crisis (BC) CML patients was carried out, with chronic-phase CML (CP-CML) patients as control. After DNA library preparation and exome enrichment, clustering and sequencing were carried out using Illumina platforms. Statistical analysis was carried out using SAS/STAT software version 9.4, and R package was employed to find mutations shared exclusively by all AP-/BC-CML patients. Confirmation of mutations was carried out using Sanger sequencing and protein structure modeling using I-TASSER followed by mutant generation and visualization using PyMOL. Results: Three novel genes (ANKRD36, ANKRD36B and PRSS3) were mutated exclusively in all AP-/BC-CML patients. Only ANKRD36 gene mutations (c.1183_1184 delGC and c.1187_1185 dupTT) were confirmed by Sanger sequencing. Protein modeling studies showed that mutations induce structural changes in ANKRD36 protein. Conclusions: Our studies show that ANKRD36 is a potential common biomarker and drug target of early CML progression. ANKRD36 is yet uncharacterized in humans. It has the highest expression in bone marrow, specifically myeloid cells. We recommend carrying out further studies to explore the role of ANKRD36 in the biology and progression of CML.

ESTIMATION OF THE ORGAN AND EFFECTIVE DOSE TO PATIENTS UNDERGOING MEDICAL DIAGNOSTIC X-RAY EXAMINATIONS IN SAUDI ARABIA.

Quantifying the radiological risk from diagnostic radiography is essential for patients' safety. Effective dose is considered the best quantity to determine the stochastic risk associated with the radiological examinations. Therefore, the present work investigated organ and effective dose for adult patients in the most common type of X-ray examinations, such as the chest (PA/LAT), abdomen (AP) and lumbar spine (AP/LAT) projections. The PCXMC version 2 Monte Carlo program was used to estimate the organ and effective dose for 547 patients who underwent a radiographic examination at the King Abdulaziz Hospital, Saudi Arabia. The results showed wide variation in organ doses. The largest organ dose in each X-ray examination were 2.72 mGy for the spleen in the lumbar spine (LAT), 1.98 mGy for the urinary bladder in the lumbar spine (AP), 0.40 mGy for the spleen in the chest (PA), 0.11 mGy for the kidney in the chest (LAT) and 1.78 mGy for the testicles in the abdomen (AP) examinations. Values for the effective dose were estimated for each investigated X-ray examination, and the results were compared with the published values available in the literature. The obtained values for effective dose were relatively lower than those reported by the European Commission and the United Nations Scientific Committee on the Effects of Atomic Radiation for the same examinations. The results presented here will help establish a database that will be useful for future comparisons and monitoring in radiographic procedures.