Miracle-dz/UniFAR-FTUs huggingface dataset:
Timing of Hard Palate Closure and Dental Arch Relationships in Unilateral Cleft Lip and Palate Patients: A Mixed-Longitudinal Study

In a mixed longitudinal study, dental arch relationships of 88 consecutive UCLP patients treated at the Nijmegen Cleft Palate Centre were evaluated using the Goslon Yardstick. On the basis of timing of hard palate closure, the patients were divided into four groups. Mean age of hard palate closure in group A (n = 18) was 1.5 years, in group B (n = 26) 4.6 years and in group C (n = 18) 9.4 years. In group D (n = 26, no patient older than 10 years) the hard palate was still open. Four stages of dental development were distinguished; deciduous dentition, early mixed dentition, late mixed dentition and permanent dentition. Reproducibility of scoring with the Goslon Yardstick was good for all stages of dental development. No differences in dental arch relationships were found between the four groups. In 86% of the cases, the dental arch relationships of UCLP patients treated in Nijmegen were acceptable. Pharyngeal flap surgery had minor unfavorable effects on dental arch relationships.
Speech Development of Children with Cleft Palate before and after Palatal Surgery

Objective: This study examined the speech production abilities of children with cleft palate before and after palate repair. Participants: Twenty-eight children participated in the study, 14 with cleft palate and 14 without clefts matched for age, gender, and mothers’ educational level. Main Outcome Measures: Comparisons were made between the children with cleft palate before and after surgery for canonical babbling ratios, size of consonant inventories, place and manner characteristics, and early developing sounds [p, b, t, d, k, g, m, n, ]. Also, comparisons were made between the n children with cleft palate and their peers without clefts at postsurgery/17 months for the measures described above. Results: Paired t tests revealed differences in preand postsurgery performance of the children with cleft palate for production of canonical syllables and size of consonant inventories. Although no significant differences were noted for place and manner features, production of oral stops doubled from the time before surgery to that after surgery. Specifically, production of the bilabial stop [b] showed significant change over time. Results of independent t tests indicated no difference between groups for production of canonical syllables and size of consonant inventories at 17 months. However, significant group differences were noted for production of stops, oral stops, nasals, glides, and alveolars. The children without clefts produced more stops, oral stops, and alveolars. In contrast, more nasals and glides were seen in the vocalizations of the children with cleft palate. Conclusions: Children with cleft palate made gains in production of canonical syllables and size of consonant inventories postsurgery; however, they continued to show deficits in production of stops and alveolar place features.
Nasoalveolar Molding and Gingivoperiosteoplasty versus Alveolar Bone Graft: An outcome Analysis of Costs in the Treatment of Unilateral Cleft Alveolus

Objective: The purpose of this study was to compare the financial impact of two treatment approaches to the unilateral cleft alveolus. The recently advocated nasoalveolar molding (NAM; Grayson et al., 1999) and gingivoperiosteoplasty (GPP; Santiago et al., 1998) at the time of lip repair were compared with the traditional approach of secondary alveolar bone graft. Design: The records of all patients (n 5 30) with unilateral cleft lip and alveolus treated by a single surgeon during 1985 through 1988 were examined retrospectively. The patients were divided into two groups: group 1 patients (n 5 14) were treated by lip repair, primary nasal repair, and secondary alveolar bone graft prior to eruption of permanent dentition; group 2 patients (n 5 16) were treated by NAM, GPP, lip repair, and primary nasal repair. Patients who required secondary alveolar bone graft after GPP were noted. The cost of treatment by each protocol was calculated in 1998 dollars. Results: The average cost of treatment for a patient treated by lip repair, primary nasal repair, and secondary alveolar bone graft prior to eruption of permanent dentition was $22,744. Of the 16 patients treated by NAM, GPP, lip repair, and primary nasal repair, 10 required no further treatment of the unilateral cleft alveolus; six patients required secondary alveolar bone graft. The average per-patient treatment cost in this group was $19,745. The average cost savings of NAM and GPP, compared with alveolar bone graft is $2999. Conclusions: The treatment of unilateral cleft alveolus by nasoalveolar molding and gingivoperiosteoplasty results in substantial cost savings, compared with treatment by secondary alveolar bone graft.
Vascular Anatomy

• The common carotid artery arises from the aortic arch on the left side and from the brachiocephalic trunk on the right side at its bifurcation behind the sternoclavicular joint. The common carotid artery lies in the medial part of the carotid sheath lateral to the larynx and trachea and medial to the internal jugular vein with the vagus nerve in between. The sympathetic trunk is behind the artery and outside the carotid sheath. The artery bifurcates at the level of the greater horn of the hyoid bone (C3 level? ). • The external carotid artery at bifurcation lies medial to the internal carotid artery and then runs up anterior to it behind the posterior belly of digastric muscle and behind the stylohyoid muscle. It pierces the deep parotid fascia and within the gland it divides into its terminal branches the superficial temporal artery and the maxillary artery. As the artery lies in the parotid gland it is separated from the ICA by the deep part of the parotid gland and stypharyngeal muscle, glossopharyngeal nerve and the pharyngeal branch of the vagus. The I JV is lateral to the artery at the origin and becomes posterior near at the base of the skull. • Branches of the ECA: A. From the medial side one branch (ascending pharyngeal artery: gives supply to glomus tumour and petroclival meningiomas) B. From the front three branches (superior thyroid, lingual and facial) C. From the posterior wall (occipital and posterior auricular). Last Page 437 and picture page 463.
Effect of Alveolar Bone Grafting in the Mixed Dentition on Maxillary Growth in Complete Unilateral Cleft Lip and Palate Patients

Objective: This study was conducted to evaluate the effects on facial growth of alveolar bone grafting in the mixed dentition for patients with UCLP. Design: Retrospective cephalometric study. Setting: Craniofacial Treatment and Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. Patients: The 58 patients participating in the study had a history of complete unilateral cleft lip and palate, all of which were repaired by the same plastic surgeon. Interventions: Twenty-one patients received an iliac-crest alveolar bone graft at a mean age of 10.3 years, while 37 did not receive an alveolar bone graft. Lateral cephalometric radiographs were obtained on all patients at two different times: at a mean age of 9.4 years (prior to bone grafting in the grafted group) and at a mean age of 15.2 years. Main Outcome Measures: All radiographs were traced and digitized by the same person, using cephalometric computer software. Superimposition and cephalometric analysis was undertaken to investigate the differences between the two groups in the 5.6-year experimental period. A two-way analysis of covariance was used for evaluation of the statistical significance of the results. Results: No statistically significant differences were found in 14 of the 15 cephalometric measurements performed. Harvold's maxillary unit length was statistically significantly shorter in the grafted group, although a lack of correlation with angular measurements and inherent problems with this specific measurement raise doubts in this finding. Conclusion: Mixed dentition bone grafting does not affect subsequent vertical and A-P development of the maxilla in complete unilateral cleft lip and palate patients during the first several postoperative years.
Changes Produced by Presurgical Orthopedic Treatment before Cheiloplasty in Cleft Lip and Palate Patients

Objective The purpose of this study was to test the hypothesis that, with the use of preoperative treatment, the dimensions of the upper part of the oral cavity of an infant with unilateral cleft lip and palate (UCLP) become more similar to those of a noncleft infant. Design This was a retrospective study of upper dental casts taken at birth and prior to lip repair at 6 months of age. A treated group, an untreated group, and a group of noncleft contemporaries were compared cross-sectionally and longitudinally. Models were analyzed by the trigonometric method. Setting The study was performed at a maxillofacial center servicing a population of two million. Participants The treated group consisted of 24 babies born after 1990 with UCLP that started presurgical treatment within 20 days of life. The untreated group consisted of 25 randomly selected UCLP casts taken at birth and 25 casts taken just before lip surgery. The noncleft group consisted of 25 full-term infants whose mothers participated in the longitudinal growth study. All participants belonged to the same ethnic group. Interventions Presurgical treatment consisted of the babies constantly wearing a thin, passive acrylic plate mimicking the normal palate and a slim adhesive tape fixed to the lip segments to bring them slightly together. Results The upper oral cavity in a newborn with UCLP was significantly larger than in a noncleft infant, the only exception being in the sagittal dimension. After presurgical treatment, the upper oral cavity was remodeled and slightly enlarged; there was a lesser difference from the noncleft at 6 months than at birth. The cleft in the alveolus reduced significantly, and the position of the incisive point improved. The group without presurgical treatment had no remodeling, and the growth dynamics were similar to the noncleft so that the dimensional differences from the normal remained the same as at birth. Conclusion The morphological characteristics of the upper part of the mouth change if the functional conditions in the oral cavity are changed. Infants with presurgical orthopedics become more similar to noncleft contemporaries than those without presurgical orthopedics.
Nasometric Discrimination of Hypernasality and Turbulent Nasal Airflow

Agreement between nasalance measures and perception of nasality during speech is not consistently strong. A possible reason may be the complicating combined effects of nasal turbulent airflow and nasal resonance. The purpose of this preliminary study was to examine nasalance measures obtained during production of a low pressure speech sample designed to minimize or eliminate the effects of turbulent nasal airflow. The results showed that nasalance measures obtained as some of the subjects produced the new speech sample were significantly different from those obtained when the standard high pressure speech sample was used. Use of both the new low pressure samples and the standard high pressure samples may result in improved agreement between nasalance measures and ratings of speech nasality as well as assist in the identification of subgroups of patients with marginal velopharyngeal insufficiency.
Orthodontic Treatment of the Patient with Complete Clefts of Lip, Alveolus, and Palate: Lessons of the past 60 Years

This review paper summarizes 60 years of progress in the orthodontic care of patients with complete clefts of the lip, alveolus, and palate. The progress and evolution of orthodontic treatment for patients with complete clefts has taken a slow and sometimes circuitous route to present-day standards. Nonetheless, in spite of this history of slow and inefficient scientific and clinical progress, review of the literature of the past 60 years does, in fact, reveal that progress has been made. This progress has not only been in the area of improved surgical and orthodontic techniques but also relative to the scientific weaknesses of past decades. The investigations of more recent years seem to be moving in a direction of better documentation, stricter methodologies, longer-term follow-up, larger sample sizes, etc. However, there remains much work to be done. Only by adopting a more critical approach will protocols be defined that can achieve optimal outcomes, while minimizing the burden of the orthodontic treatment through elimination of superfluous intervention.
Use of Antidepressants in Breastfeeding Mothers

A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
Intra-Catheter Leukocyte Culture to Monitor Hemodialysis Catheter Colonization. a Prospective Study to Prevent Catheter-Related Bloodstream Infections

The most serious problem related to the use of tunneled catheters in hemodialysis is bacteremia. The aim of this study was to detect hemodialysis catheter colonization and, establish a preemptive therapy based on a catheter antibiotic lock in order to prevent development of catheter-related bloodstream infections. During a 24-month period, all patients with tunneled catheters in our hemodialysis unit were evaluated by extracting a through-catheter leukocyte culture every 15 days. There were 28 episodes of catheter colonization occurring in 13 patients (2.2 colonization episodes per 1000 catheter patient-days). At the time of colonization, catheters had been in place for a mean of 562 days (range: 16 to 1475 days). Coagulase negative staphylococci (CNS) were the most common microorganisms to be isolated. A preemptive therapy consisting in teicoplanin locks (10 mg/mL) for 21 days was able to eradicate catheter colonization in 89% of the cases when CNS were isolated. However, relapse of colonization occurred in 61.2% of these cases. The mean duration of catheter use was 239 days (range: 9 to 483 days) after treatment of a colonization episode. The incidence of catheter-related bloodstream infection in our population was 0.78 episodes per 1000 catheter patient-days (IC 95%: 0.374–1.434). This study shows the utility of intra-catheter leukocyte culture for early detection of hemodialysis catheter colonization. Moreover, it establishes that the eradication of biofilm-related CNS is possible without the removal of the catheter, thus enabling a longer catheter lifespan. (Int J Artif Organs 2008; 31: 820–6)
Ultrasound Diagnosis of Craniosynostosis

Objective: To retrospectively study prenatal ultrasound images of patients with craniosynostosis to determine the extent to which prenatal diagnosis is possible. Method: Prenatal ultrasound images of 19 patients with postnatally diagnosed metopic or coronal suture craniosynostosis were retrospectively reviewed. The 26 ultrasound examinations obtained were compared with normal images and tables of gestation. Results: It was not possible to diagnose craniosynostosis in the first trimester. In the second trimester, Kleeblattschädel was diagnosed at 20.5 weeks. A multilobular shape to the skull and diastasis of the frontotemporal suture was identified. In a second child with Kleeblattschädel, the cephalic index was above normal 86.4 (normal range 70 to 86), and the head circumference to abdominal circumference was increased. In the third trimester, the head shape deformation was more obvious. Brachycephaly diagnosis was made in the second trimester. In Crouzon syndrome the hypertelorism was identified at 19.9 weeks. Plagiocephaly was diagnosed at 21.4 weeks. In trigonocephaly the reduced cephalic index was noted at 18.8 weeks. In the third trimester, the deformity was diagnosed in all cases. Conclusion: No diagnosis of craniosynostosis was made in the first trimester. In the second trimester, it was possible to diagnose Kleeblattschädel, trigonocephaly, brachycephaly (bilateral coronal suture craniosynostosis), and plagiocephaly (unilateral coronal suture craniosynostosis) in nine of the examinations. In the third trimester and at term, it was possible to diagnose previously listed conditions from six of the seven examinations obtained. Kleeblattschädel was suspected during original examination. A total of 15 examinations of 26 were correctly diagnosed during this investigation.
Knowledge and Beliefs of General Dental Practitioners Regarding Temporomandibular Disorders in Sanandaj, Iran

Statement of the Problem: In Iran and most countries temporomandibular disorders (TMDs) are part of the education curriculum of general dentistry. Most patients with these disorders are first referred to dentists. Therefore, awareness of general dentists’ knowledge in this field is very important. Purpose: The aim of this study was to evaluate knowledge and beliefs of general dental practitioners regarding temporomandibular disorders in Sanandaj, Iran. Materials and Methods: A questionnaire, containing 20 questions about TMD (diagnosis and classification, treatment and prognosis, chronic pain and pain behavior) was given to 80 randomly selected general dental practitioners in Sanandaj as well as to 10 TMD experts (oral and maxillofacial surgeons and prosthodontists) in Hamadan. Results: An overall response rate of 80% was achieved among the participants. The knowledge of general dental practitioners about TMD was similar to that of TMD experts in over half of the questions. Most of the agreements between the two groups were in the treatment domain and most disagreements were in chronic pain and pain behavior. Conclusion: According to the results, there is a need to develop and strengthen undergraduate dental course curriculum and continuous education programs in TMD and orofacial pain.
Normative Values of Craniofacial Measurements in Idiopathic Benign Macrocephalic Children

Objective: To determine normal standard values at each age for head circumference; inner canthal distance; outer canthal distance; near interpupillary distance; distant [far] interpupillary distance; canthal index; and circumference-interorbital index specific for the age, sex, and race in 7to 16-year-old idiopathic benign macrocephalic male and female children. Methods: The measurements of head circumference were obtained in 8736 children (4591 boys and 4145 girls) in the city center of Malatya. From these, macrocephalic children (boys 5 103, girls 5 93) were chosen and invited to our clinic for detailed examination. Mean values for each parameter were obtained at each age from 7 to 16 years. Results: The mean age for male and female children were 11.87 6 2.87 and 11.72 6 2.75 years, respectively. The overall mean values for head circumference, inner canthal distance, outer canthal distance, near interpupillary distance, distant interpupillary distance, canthal index and circumference-interorbital index in boys were found to be 57.43 6 1.46 cm, 31.90 6 2.41 mm, 89.29 6 4.34 mm, 58.79 6 2.97 mm, 62.10 6 3.23 mm, 35.73 6 2.24, and 5.56 6 0.44, respectively. In girls, these values were 56.57 6 1.24 cm, 31.45 6 2.65 mm, 87.71 6 4.11 mm, 58.16 6 3.46 mm, 61.26 6 3.66 mm, 35.84 6 2.31, and 5.56 6 0.43, respectively. Conclusion: Normal values of craniofacial measurements for idiopathic benign macrocephalic healthy children are useful in early identification of some craniofacial syndromes, congenital or posttraumatic telecanthus, epicanthus, and hypo-hypertelorism and of planning surgical intervention. We suggest that the comparison of craniofacial dimensions of macrocephalic healthy children must be performed with normal standards specific for age as well as sex and race.
Experimental Tooth Movement into Bone Induced by Recombinant Human Bone Morphogenetic Protein-2

Objective: The development of biomaterials for secondary bone grafting to the alveolar cleft, recombinant human morphogenetic protein-2 (rhBMP-2) may have great potential to promote osseous regeneration. The purpose of this study was to investigate the osteoinductive activity of low-dose rhBMP-2 (10 mg/100 mL) and the biological response of newly generated bone to orthodontic stimulation, compared with previous results using high-dose rhBMP-2 (40 mg/ 100 mL). Method: After extraction of the maxillary first premolars, bone defects were surgically created in eight adult beagle dogs using a 5-mm-diameter trepan bar. The rhBMP-2 with a PLGA/gelatin sponge complex (PGS) made of gelatin and polylactic acid polyglycolic acid copolymer was immediately implanted. The osteoinductive activity of rhBMP-2 and tooth movement into the newly generated bone was evaluated based on histological and morphometric examination. Results: Dramatic histological and morphometric differences were found in the time course of bone remodeling between lowand high-dose rhBMP-2. The onset of bone remodeling occurred significantly earlier in low-dose rhBMP-2. During experimental tooth movement, in contrast to high-dose rhBMP-2, with which root resorption occurred, only partial cementum resorption occurred on the pressure side with low-dose rhBMP-2. Conclusion: These results indicated that the proper dosage of rhBMP-2 should be determined for successful clinical application.
Clinical effectiveness of mizoribine on rheumatoid arthritis: a double-blind comparative study using lobenzarit disodium as a standard drug

In order to confirm efficacy, safety and utility of mizoribine (MZR) for treatment of rheumatoid arthritis, we conducted a 24 weeks double-blind controlled study using lobenzarit disodium (CCA) as a control drug and obtained the following results. (1) The study involved 72 cases for MZR group and 77 cases for CCA group. There were no significant differences in patients' backgrounds between the two groups. (2) Final global improvement rate was evaluated as “improvement” or more in 26.8% (15/56) for MZR group vs. 12.3% (8/65) for CCA group, “slight improvement” or more in 55.4% (31/56) for MZR group VS. 36.9% (24/65) for CCA group. There was no significance for any of these differences. (3) The incidence of side effects of MZR group was 31.9% and that of CCA group was 48.7%. No serious side effect was observed in both groups. (4) Radiographic films of 41 patients participating in this study were evaluated in a random order by two readers. Only in the CCA group (21 patients) was a statistically significant increase in the mean value of erosion score as well as damage score. These results show that MZR do retarded radiographic progression of joint destruction in the treatment of rheumatoid arthritis. (5) The utility of MZR group was superior to CCA group. These results indicate that mizoribine is a useful drug for treatment of rheumatoid arthritis.
Calcium and magnesium in male reproductive system and in its secretion. Part II * within-subject variability in human seminal plasma and spermatozoa

This study was undertaken to find out what, if any, within-subject variability exists in semen parameters, and calcium and magnesium levels in seminal plasma and spermatozoa. Significant changes (p<0.05) were found in semen volume and in the percentage of sluggish motile spermatozoa. No other significant changes were seen in semen parameters or in calcium or magnesium in spermatozoa and seminal plasma. (Urologia 2008; 75: 94-6)