Face shape of unaffected parents with cleft affected offspring: combining three-dimensional surface imaging and geometric morphometrics.

OBJECTIVE: Various lines of evidence suggest that face shape may be a predisposing factor for non-syndromic cleft lip with or without cleft palate (CL/P). In the present study, 3D surface imaging and statistical shape analysis were used to evaluate face shape differences between the unaffected (non-cleft) parents of individuals with CL / P and unrelated controls. METHODS: Sixteen facial landmarks were collected from 3D captures of 80 unaffected parents and 80 matched controls. Prior to analysis, each unaffected parent was assigned to a subgroup on the basis of prior family history (positive or negative). A geometric morphometric approach was utilized to scale and superimpose the landmark coordinate data (Procrustes analysis), test for omnibus group differences in face shape, and uncover specific modes of shape variation capable of discriminating unaffected parents from controls. RESULTS: Significant disparity in face shape was observed between unaffected parents and controls (p < 0.01). Notably, these changes were specific to parents with a positive family history of CL/P. Shape changes associated with CL/P predisposition included marked flattening of the facial profile (midface retrusion), reduced upper facial height, increased lower facial height, and excess interorbital width. Additionally, a sex-specific pattern of parent-control difference was evident in the transverse dimensions of the nasolabial complex. CONCLUSIONS: The faces of unaffected parents from multiplex cleft families displayed meaningful shape differences compared with the general population. Quantitative assessment of the facial phenotype in cleft families may enhance efforts to discover the root causes of CL/P.

[Post-traumatic dissecting aortic aneurysm in adolescents]. / Anévrysme disséquant post-traumatique de l'aorte chez l'adolescent.

The authors report a case of chronic post-traumatic dissecting aneurysm associated with myocardial contusion in a 13 year old adolescent. They stress the rarity of this condition in children and discuss the diagnostic contribution of various imaging techniques.

Venous involvement in Takayasu's disease: does it exist?

We describe the case of a 46-year-old man with an isolated superior vena cava syndrome, which was relieved by surgery. Pathologic examination revealed segmental involvement of the superior vena cava with dense collagen sclerosis. Histiomonocytic inflammatory transmural infiltration of all layers was histologically compatible with lesions described in Takayasu's disease. Although not previously described, this pathologic aspect suggests the possibility of venous involvement in this disease.

[Perineal gangrene secondary to abscesses of the anal margin. Apropos of 9 cases]. / Les gangrènes périnéales secondaires aux abcès de la marge anale. A propos de 9 cas.

Of 9 patients with perineal gangrene secondary to abscess of anal margin, 7 presented deficiency states. Diagnosis was established after an average of 7.4 days following onset of signs, although the clinical picture was obvious and the lesions extended beyond the perineum towards the genital organs, buttocks or thigh. Essential therapy consisted of antibiotic cover, immediate and repeated surgical excision (average number of operations per patient = 6) and stools bypass by colostomy for severe perineal lesions. This resolutely aggressive treatment reduced mortality of this reputedly serious affection to 2 cases (22%), but morbidity was high and a perineoplasty was necessary in a third of the patients.

[Popliteal artery entrapment. Contribution of ultrasonography]. / Artère poplitée piégée. Apport de l'exploration ultrasonographique.

Ultrasounds contribute significantly to the diagnosis of popliteal artery entrapment. The haemodynamic data obtained by Doppler's velocimetry and the parietal and morphological data obtained by ultrasonography make it possible to proceed beyond a diagnosis of "presumption" based on clinical and arteriographic findings and to reach directly a positive diagnosis of entrapment, even in cases with arterial obstruction. Between December, 1979 and December, 1983, 12 cases of popliteal artery entrapment (5 of type I, 1 of type II and 6 of type III) were diagnosed by ultrasonic methods in 8 patients. In each of these patients the data thus obtained concerning the diagnosis, the type of lesion and the arterial complications were fully confirmed by a subsequent arteriography and at surgery.