Is the Assessment of Dental Age by the Nolla Method Valid for Eastern Turkish Children?

The aim of this study was to investigate whether or not the Nolla method is appropriate for Turkish children for the determination of the dental age (DA). A group of 719 children between the ages of 6 and 18 years were included in the study. DAs from orthopantograms by the Nolla method were estimated. The results obtained were compared with chronologic age (CA). Paired t and the Wilcoxon tests were performed. Both genders were underestimated in dental maturity when compared with the reference samples in total (-0.3 years) (p<0.01). The differences in girls were statistically significant in total and in all groups except for 7-7.9. The differences in boys between the CAs and DAs were not statistically significant in total and in all groups except for 7-7.9 and 8-8.9. Although the accuracy of this method was suitable for boys, according to our findings, it was not suitable for girls.     

Identification of unknown bodies by using CT images of frontal sinus

The aim of the study was to define a simple system for the identification of unknown bodies by using CT images of frontal sinus and to discuss whether it was worth to add measurements to the system or not. The system was including simple features as F (presence or absence of frontal sinus), S (intersinus and intrasinus septum) and S (scalloping), and named as FSS system. Measurements selected for the study were width, height, anteroposterior length, total width of two sinuses, the distance between the highest points of the two sinuses and the distance of each sinus to its maximum lateral limit. The study was conducted retrospectively on the paranasal CT scans of 100 cases (38 male and 62 female) who had no apparent sinonasal pathology. All the features and measurements were coded according to the system defined by the authors for each case and coded formulas were compared. At least 93% of the formulas could be eliminated for a case by using FSS system. The rate of success was increased to 98% by adding measurements. Contrary to objective criteria of FSS system, measurements were prone to bias. Therefore, in practice success rate would be expected to be lower than calculated. In the study population, instead of making 100 measurements, eliminating the most of the cases with FSS system and later discriminating the rest by pattern matching was seen logical.     

Origin and development of forensic medicine in the Kingdom of Saudi Arabia

The medicolegal death investigation system in the Kingdom of Saudi Arabia (KSA) is unique in the world. It is exclusively derived from Islamic judiciary based on Shari'ah law, which is the definitive Islamic law or doctrine. This law is applied on Saudi citizens as well as foreigners. This is different from other Islamic countries, which have a combination of Islamic and other judiciary systems.The forensic medicine centers in KSA are related administratively to the Ministry of Health (MOH) and its subdivisions in the different governorates. They are concerned with forensic medical examination and autopsy, as well as the clinical forensic medical examination of sexual assault cases, and those injured in civil and criminal cases. The assisting laboratories (forensic histopathology, microbiology, serology, forensic chemistry) are working independently under the funding of MOH, whereas the DNA laboratory and other departments of forensic sciences, for example, counterfeiting and forgery unit are related administratively to the Ministry of Interior represented by the Administration of Criminal Evidences. Efforts concerning crime scene investigations are shared with Administration of Criminal Evidences' crime scene investigators.Forensic medicine education in KSA developed in the past few years after the foundation of Saudi specialty certificate in forensic medicine. The certificate is a postgraduation qualification equivalent to a doctorate degree in forensic medicine and requires completion of a 4-year training program in both MOH- and Ministry of Interior-related departments, as well as passing annual evaluation and examination.This review is aimed at providing in the next decade the medicolegal centers with national forensic specialists throughout the kingdom and granting skillful headships for the next generations. Moreover, this review suggests more scientific associations with the academic universities in the various fields of forensic sciences through academic cooperation.     

Congenital atrioventricular block: histological aspects

It is known that maternal immunological factors such as systemic disease are involved in the genesis of cardiac conduction problems in the fetus but the histologic changes in the conduction system are less documented. We report the case of a 33-year-old woman with no significant medical history. Her first pregnancy was induced by Clomifene. At 17 weeks of gestation, the fetus presented sonographic abnormalities characteristic of a complete atrioventricular block. Biological investigations found anti-SSA and -SSB antibodies. Clinical history search for systemic disease was positive for photosensitivity, lasting 10 years, suggesting the diagnosis of systemic lupus erythematosus. The patient was treated with prednisone 20 mg per day but fetal death occurred at 29 weeks of gestation. Histological examination of the fetal heart showed an altered atrioventricular node and bundle of His with fibrosis, calcifications, endocardial fibroelastosis and mononucleated inflammatory cells. The search for these specific lesions can be determinant in establishing the disease pathogenesis; also, it is important to eliminate this diagnosis in an unexplained fetal death.     

Le Plan financier de la Commission Lambert: evaluation et mise en oeuvre par le gouvernement fedbderal

Sommaire: Dans cet article, I'auteur analyse, de I'intérieur du gouvernement fédéral, les difficultés techniques, bureaucratiques et politiques auxquelles I'administration Trudeau a dø faire face au moment de la mise en oeuvre du plan financier quinquennal proposé par la Commission royale sur la gestion financière et I'imputabilité. Il conclut que les modifications apportées au plan en question, au moment de sa mise en oeuvre, ont sérieusement diminué le rôle de ce dernier en matière d'imputabilité du gouvernement au Parlement. Abstract: The author of this article analyses - from within the federal government -the technical, bureaucratic and political difficulties the Trudeau government faced when implementing the five-year financial plan proposed by the Royal Commission on Financial Management and Accountability. The author concludes that the amendments made to that plan did, upon implementation, seriously diminish the accountability role of the government with respect to Parliament.     

La planification stratégique à Ottawa et à Québec: une comparaison de quelques ministères

Sommaire: Douze ministères (six à Ottawa et six à Québec) ont fait l'objet d'une recherche visant àétudier le processus de planification stratégique. Cette planification vise d'abord à identifier les enjeux stratégiques et à déterminer les orientations d'un ministère. Elle vise aussi, dans plusieurs ministères étudiés, à introduire un changement culturel, à mieux intéger les diverses parties de l'organisation, à améliorer l'efficacité et la productivité, à accroître la satisfaction et la qualité de vie au travail, ainsi qu'à améliorer les services à la clientèle et les communications. Au niveau de la gestion du processus, les auteurs ont constaté de grandes différences entre les ministères québécois mais une certaine homogénéité au niveau des ministères fédéraux où le processus semble davantage institutionnalisé. Par ailleurs, à Québec, les plans stratégiques donnent lieu à la préparation de plans annuels d'action élaborés pour l'ensemble du ministère, alors qu'à Ottawa, la responsabilité de la mise en application est laissée aux responsables de secteurs. Enfin, les auteurs ont identifié certaines conditions de succès: l'implication personnelle du sousministre et de l'équipe de direction, l'appui du ministre, la stabilité de la direction, un exercice conçu sur mesure, la simplicité du processus, la capacité de gérer les conflits, la volonté de régler les problèmes urgents sans attendre la fin du processus, la consultation et la responsabilisation des gestionnaires et, enfin, l'intégration de la planification stratégique au processus de prise de décision central du ministère. Abstract: This study designed to analyse the strategic planning process covered twelve departments (six in Ottawa and six in Quebec City). This planning effort is designed primarily to identify the strategic stakes and to determine the orientation of a department. In several departments studied, it also aims to introduce cultural change, to better integrate the various components of the organization, to improve efficiency and productivity, and to raise work satisfaction and the quality of working life, thus improving client services as well as communications. Regarding the management of the process, the authors found major differences between Quebec departments, but a certain homogeneity among federal departments, where the process seems more institutionalized. Moreover, in Quebec, strategic plans involve the preparation of annual action plans developed for an entire department, whereas in Ottawa responsibility for implementation is left to sector heads. Finally, the authors identify certain conditions for success: the personal involvement of the deputy minister and the management team, the minister's support, management stability, a custom-designed exercise, the simplicity of the process, the ability to manage conflict, a willingness to solve urgent problems without waiting for the end of the process, consultation and accountability of managers and, finally, integration of strategic planning into the department's central decision-making process.     

Quantification of mitochondrial DNA in human blood cells using an automated detection system

The 4977 bp deletion of mitochondrial DNA (mtDNA) accumulates in postmitotic tissues with advancing age. The purpose of our study was to detect and quantify these deletion even in blood cells with a high turnover activity. Whole venous blood, isolated human platelets and peripheral blood mononuclear cells (PBMCs) were collected from 10 unrelated donors aged 20-71 years and total DNA was extracted. PCR was performed for total and mutated mtDNA using two different primer pairs and two fluorogenic probes labeled with the fluorescent dyes FAM and VIC. Specific PCR products were generated, detected and quantified in a real-time PCR. The amplification products of total and deleted mtDNA could be detected in each sample and did not exhibit any differences in the amount of the deleted mtDNA in whole blood, human platelets or PBMCs. Our data did not show any accumulation of the 4977 bp deletion with increasing age as it was observed for several other tissues.     

Fatal rupture of hepatic adenomatosis: Autopsy case and review of the literature

Hepatic adenomatosis is a rare disease consisting of multiple adenomas in otherwise-normal liver parenchyma. Though the discovery of this entity goes back several years, its diagnosis is still challenging in terms of its definition and pathophysiology. Clinically, patients may be completely asymptomatic and the diagnosis is only made incidentally through imaging tests. The discovery could be made when complications occur such as intraperitoneal hemorrhage with hypovolemic shock due to the rupture of an adenoma. We report a fatal case of a ruptured adenoma in a case of hepatic adenomatosis discovered at autopsy. In order to achieve a better view of this disease, we conducted a literature review on this subject describing the pathogenesis, manifestations, and autopsy contribution to addressing this entity.