[Determinants of quality of life in chronic obstructive pulmonary disease]

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is considered as a systemic disease with pulmonary starting point. The use of spirometry alone is certainly not the best way to reflect the impact of disease on quality of life for patients.

PATIENTS AND METHODS

Prospective study concerning 70 patients treated for COPD. Quality of life was assessed using the French version of the Saint-George questionnaire.

RESULTS

Our population was predominantly male (97%) with a mean age of 63 years. All patients were smokers with an average of 46 pack-years. The total score of the Saint-Georges respiratory questionnaire was 50.7%. The mean scores of different fields were 68% for the field activities, 49% for impact and 26% for the item of symptoms. The multidimensional BODE index was correlated with the quality of life and its various fields were more powerfully than the forced expiratory volume per second, the number of exacerbations, the six-minute walking test and dyspnea score.

CONCLUSION

It is important to integrate the multidimensional classification indices in assessing the severity of the disease because only these indices can reflect the systemic aspect of the disease.

[Pseudotumor phenotype of sarcoidosis: about two cases]

INTRODUCTION

Sarcoidosis is a multisystem benign granulomatous disease of unknown etiology. It can sometimes cause diagnostic confusion by presenting in the form of a pseudotumor, thus constituting a trap for the unwary.

COMMENTS

The authors report two cases of pseudotumor sarcoidosis. In the first, the pseudotumor occurred in the context of multisystem disease in a 48-year-old man. The response to treatment with systemic corticosteroids was complicated by the development of disseminated tuberculosis, which was rapidly fatal. The second case, by contrast, was about a 58-year-old woman and the disease was self-limiting, resolving spontaneously in less than 3 months.

CONCLUSION

Through these two cases, the authors focus on the particularities of the pseudotumor manifestation of pulmonary sarcoidosis. The diagnosis is often difficult. The mismatch between the clinical picture and the extent of radiological lesions should, however, suggest the diagnosis. Histological evidence is needed to eliminate other etiologies including malignant tumors. The condition usually resolves either spontaneously or after treatment with systemic corticosteroids. However, relapses are possible, including on discontinuation of corticosteroid therapy.

The accuracy of three-dimensional prediction planning for the surgical correction of facial deformities using Maxilim

The motivation for orthognathic surgery is to improve facial appearance and quality of life. This study aimed to validate a three-dimensional (3D) orthognathic planning programme (Maxilim) for predicting soft tissue changes following Le Fort I advancements. Cone beam computed tomography (CBCT) scans were taken before surgery (T(1)) and at 6-12 months after surgery (T(2)) for 13 patients. For each patient the 3D hard tissue changes between T(1) and T(2) were determined by CBCT superimposition on the cranial vault. Using Maxilim, each patient's skeletal movements were used to generate a 3D soft tissue prediction. The actual soft tissue mesh at T(2) was compared to the predicted mesh. The face was divided into areas: nose, right and left nares, right and left paranasal regions, upper and lower lip, and chin. The absolute distance between meshes for each region was calculated. A one-sample t-test showed the distances between the meshes for all of the areas were within 3 mm (P<0.05), except for the upper lip which was greater than 3 mm (P=0.577). Using Maxilim, 3D soft tissue predictions for Le Fort I advancements were clinically satisfactory in the regions assessed, but associated with marked errors around the region of the upper lip.

A new method for automatic tracking of facial landmarks in 3D motion captured images (4D)

The aim of this study was to validate the automatic tracking of facial landmarks in 3D image sequences. 32 subjects (16 males and 16 females) aged 18-35 years were recruited. 23 anthropometric landmarks were marked on the face of each subject with non-permanent ink using a 0.5mm pen. The subjects were asked to perform three facial animations (maximal smile, lip purse and cheek puff) from rest position. Each animation was captured by the 3D imaging system. A single operator manually digitised the landmarks on the 3D facial models and their locations were compared with those of the automatically tracked ones. To investigate the accuracy of manual digitisation, the operator re-digitised the same set of 3D images of 10 subjects (5 male and 5 female) at 1 month interval. The discrepancies in x, y and z coordinates between the 3D position of the manual digitised landmarks and that of the automatic tracked facial landmarks were within 0.17mm. The mean distance between the manually digitised and the automatically tracked landmarks using the tracking software was within 0.55 mm. The automatic tracking of facial landmarks demonstrated satisfactory accuracy which would facilitate the analysis of the dynamic motion during facial animations.