bluuebunny/crossref_metadata_2025 huggingface dataset:
An evaluation of the Abbott IMx sirolimus assay in relation to a high-performance liquid chromatography-ultraviolet method
Authors: Johnson Roger N , Sargon Russell , Woollard Gerald , Davidson James
Published: September 2005

Background: Sirolimus is an immunosuppressive agent used after organ transplantation. Monitoring its concentration is clinically relevant, but current methods of measurement using high-performance liquid chromatography (HPLC) are demanding. An immunoassay that uses readily available equipment offers a more convenient alternative.

Methods: Blood specimens from transplant patients were assayed for sirolimus by an existing HPLC method with ultraviolet (UV) detection and by the Abbott microparticle enzyme immunoassay (MEIA). Within-run and between-day precision was assessed with duplicate analyses. Accuracy was assessed by comparison of results from the MEIA and HPLC assays, and from recovery experiments. Specificity was tested in specimens from patients taking alternative immunosuppressants.

Results: Using specimens with sirolimus concentrations between 3.3 and 39.3 µg/L, within-batch and between-batch coefficients of variation (CVs) were 6.8% and 6.3%, respectively. Using control specimens with mean concentrations of 4.1, 12.1 and 25.4 µg/L, the respective CVs were 8.6%, 3.1% and 3.8 %. Using a Passing-Bablok regression technique, the regression equation was MEIA = 14; 1.26 x HPLC-1.97; the mean bias was 0.96 µg/L. Specimens from patients on cyclosporin and tacrolimus as the sole immunosuppressant had apparent sirolimus concentrations of <1 µg/L.

Conclusion: The MEIA assay for sirolimus provides clinically useful information within an accessible format.
Prerecorded telemedicine
Authors: Della Mea Vincenzo
Published: September 2005

In prerecorded telemedicine (also known as asynchronous or store-and-forward), the person sending the information and the person receiving it do not need to do so simultaneously; thus, viewing the information can be done at some later time. Prerecorded telemedicine is therefore not appropriate for emergency consultations. In prerecorded telemedicine systems, the following steps can be distinguished: (1) the acquisition of diagnostic information at the remote site; (2) its storage, which can be at either site, or at both; (3) its delivery to the expert site through an appropriate connection; and (4) its display at the expert site. The types of information transferred include audio, data and text, still images and moving images (i.e. video). An increasingly common way of doing prerecorded telemedicine is by email sent via the Internet. Although there are some problems associated with the Internet, its wide availability and low cost have encouraged its use. Examples where email has been used successfully include teleradiology, telecardiology, teledermatology and telepathology. In some situations prerecorded telemedicine is the only way to provide remote medical services, or the most cost-effective method. Clearly, there are also situations when prerecorded telemedicine is not an appropriate way to deliver health services, for example whenever the sender of the information is not qualified to sample the information acquired or the specialist receiving the information must manipulate it, during acquisition, in some way.
Polyhedral Analysis and Algorithms for a Demand-Driven Refleeting Model for Aircraft Assignment
Authors: Sherali Hanif D. , Bish Ebru K. , Zhu Xiaomei
Published: September 2005

The current airline practice in conducting fleet assignments is to begin assigning aircraft capacity to scheduled flights well in advance of departures. However, the accuracy of the passenger demand forecast improves markedly over time, and revisions to the initial fleet assignment become naturally pertinent when the observed demand differs considerably from the assigned aircraft capacities. The demand-driven refleeting (DDR) approach proposed in this paper offers a dynamic reassignment of aircraft capacities to the flight network, when improved demand forecasts become available, so as to maximize the total revenue. Because of the need to preserve the initial crew schedule, this reassignment approach is limited within a single family of aircraft types and to the flights assigned to this particular family. This restriction makes it computationally tractable to include more relevant path-level demand information into the DDR model. Accordingly, we construct a mixed-integer programming model for this enhanced problem context and study its polyhedral structure to explore ways for tightening its representation and for deriving certain classes of valid inequalities. Various schemes for implementing such reformulation techniques are investigated and tested using a set of simulated and real instances obtained from United Airlines.
Airline Crew Scheduling Under Uncertainty
Authors: Schaefer Andrew J. , Johnson Ellis L. , Kleywegt Anton J. , Nemhauser George L.
Published: September 2005

Airline crew scheduling algorithms widely used in practice assume no disruptions. Because disruptions often occur, the actual cost of the resulting crew schedules is often greater. We consider algorithms for finding crew schedules that perform well in practice. The deterministic crew scheduling model is an approximation of crew scheduling under uncertainty with the assumption that all pairings will operate as planned. We seek better approximate solution methods for crew scheduling under uncertainty that still remain tractable. We give computational results from three fleets that indicate that the crew schedules obtained from our method perform better in a model of operations with disruptions than the crew schedules found via deterministic methods. Under mild assumptions we provide a lower bound on the cost of an optimal crew schedule in operations, and we demonstrate that some of the crew schedules found using our method perform very well relative to this lower bound.
Routing for a Just-in-Time Supply Pickup and Delivery System
Authors: Chuah Keng Hoo , Yingling Jon C.
Published: September 2005

An optimization-based approach is developed for routing a just-in-time (JIT) supply pickup and delivery system. The approach defines routes among suppliers serving a large JIT assembly plant, the timing of these routes, and the frequency that they are run (implicitly defining parts quantities picked up each visit). The solutions satisfy various operational constraints at the JIT facility, including requirements for high-frequency/small-quantity deliveries and limits on space for parts storage. The solution space we consider here is restricted by an operational discipline that the industry calls common frequency routing. Under this system we only consider routing designs where each part source is being served by a single route run at a fixed daily frequency instead of designs where multiple routes visit that supplier, each potentially run at a different frequency. This dramatically reduces dimensionality of the problem and is also known to provide both management and operational advantages in practice. In solving the formulation, column generation and tabu search strategies have been developed, the latter suitable for realistic-sized problems. The utility of the approach is illustrated through a number of examples.
Waiting Strategies for Dynamic Vehicle Routing
Authors: Branke Jürgen , Middendorf Martin , Noeth Guntram , Dessouky Maged
Published: September 2005

Many real-world vehicle routing problems are dynamic optimization problems, with customer requests arriving over time, requiring a repeated reoptimization. In this paper, we consider a dynamic vehicle routing problem where one additional customer arrives at a beforehand unknown location when the vehicles are already under way. Our objective is to maximize the probability that the additional customer can be integrated into one of the otherwise fixed tours without violating time constraints. This is achieved by letting the vehicles wait at suitable locations during their tours, thus influencing the position of the vehicles at the time when the new customer arrives. For the cases of one and two vehicles, we derive theoretical results about the best waiting strategies. The general problem is shown to be NP-complete. Several deterministic waiting strategies and an evolutionary algorithm to optimize the waiting strategy are proposed and compared empirically. It is demonstrated that a proper waiting strategy can significantly increase the probability of being able to service the additional customer, at the same time reducing the average detour to serve that customer.
A Scenario Aggregation–Based Approach for Determining a Robust Airline Fleet Composition for Dynamic Capacity Allocation
Authors: Listes Ovidiu , Dekker Rommert
Published: September 2005

Recently, airlines and aircraft manufacturers have realized the benefits of the emerging concept of dynamic capacity allocation, and have initiated advanced decision support systems to assist them in this respect. Strategic airline fleet planning is one of the major issues addressed through such systems. We present background research connected with the dynamic allocation concept, which accounts explicitly for the stochastic nature of passenger demand in the fleet composition problem. We address this problem through a scenario aggregation–based approach and present results on representative case studies based on realistic data. Our investigations establish clear benefits of a stochastic approach as compared with deterministic formulations, as well as its implementation feasibility using state-of-the-art optimization software.
Decision Support for Consumer Direct Grocery Initiatives
Authors: Campbell Ann Melissa , Savelsbergh Martin W. P.
Published: September 2005

Many companies with consumer direct service models, especially grocery delivery services, have found that home delivery poses an enormous logistical challenge due to the unpredictability of demand coupled with strict delivery windows and low profit margin products. These systems have proven difficult to manage effectively and could benefit from new technology, particularly to manage the interaction between order capture and order delivery. In this article, we define routing and scheduling problems that incorporate important features of this emerging business model and propose algorithms, based on insertion heuristics, for their solution. In the proposed home delivery problem, the company decides which deliveries to accept or reject as well as the time slot for the accepted deliveries so as to maximize expected profits. Computational experiments reveal the importance of an approach that integrates order capture with order delivery and demonstrates the quality and value of the proposed algorithms.
Reliability Models for Facility Location: The Expected Failure Cost Case
Authors: Snyder Lawrence V. , Daskin Mark S.
Published: September 2005

Classical facility location models like the P-median problem (PMP) and the uncapacitated fixed-charge location problem (UFLP) implicitly assume that, once constructed, the facilities chosen will always operate as planned. In reality, however, facilities “fail” from time to time due to poor weather, labor actions, changes of ownership, or other factors. Such failures may lead to excessive transportation costs as customers must be served from facilities much farther than their regularly assigned facilities. In this paper, we present models for choosing facility locations to minimize cost, while also taking into account the expected transportation cost after failures of facilities. The goal is to choose facility locations that are both inexpensive under traditional objective functions and also reliable. This reliability approach is new in the facility location literature. We formulate reliability models based on both the PMP and the UFLP and present an optimal Lagrangian relaxation algorithm to solve them. We discuss how to use these models to generate a trade-off curve between the day-to-day operating cost and the expected cost, taking failures into account, and we use these trade-off curves to demonstrate empirically that substantial improvements in reliability are often possible with minimal increases in operating cost.
Route Choice on Transit Networks with Online Information at Stops
Authors: Gentile Guido , Nguyen Sang , Pallottino Stefano
Published: September 2005

Passengers on a transit network with common lines are often faced with the problem of choosing between either to board the arriving bus or to wait for a faster one. Many assignment models are based on the classical assumption that at a given stop passengers board the first arriving carrier of a certain subset of the available lines, often referred to as the attractive set. In this case, it has been shown that, if the headway distributions are exponential, then an optimal subset of lines minimizing the passenger travel time can be easily determined. However, when online information on future arrivals of buses are posted at the stop, it is unlikely that the above classical assumption holds. In this case, passengers may choose to board a line that offers the best combination of displayed waiting time and expected travel time to their destination once boarded. In this paper, we propose a general framework for determining the probability of boarding each line available at a stop when online information on bus waiting times is provided to passengers. We will also show that the classical model without online information may be interpreted as a particular instance of the proposed framework, this way achieving an extension to general headway distributions. The impact of the availability of information regarding bus arrivals and that of the regularity of transit lines on the network loads, as well as on the passenger travel times, will be illustrated with small numerical examples.
In Situ Detection of Starvation-induced Autophagy
Authors: Martinet Wim , De Meyer Guido R.Y. , Andries Luc , Herman Arnold G. , Kockx Mark M.
Published: September 2005

Autophagy is a regulated bulk degradation process involved in many different human pathologies. Transmission electron microscopy (TEM) is currently the only reliable method for monitoring autophagy in situ. Because TEM is labor intensive, we questioned whether useful marker proteins can be found for unambiguous detection of autophagy in tissue via routinely used colorimetric, immunohistochemical, or fluorescent techniques. Starved HepG2 hepatocytes and nutrient deprived liver tissue were used as a model for the initiation of autophagy. Our findings indicate that starvation-induced autophagy in HepG2 cells was associated neither with differential mRNA gene expression nor with changes in the expression level of known autophagy-related proteins. On the contrary, both transcription and translation were inhibited, suggesting that the identification of autophagy-specific biomarkers for tissue is highly compromised. Light chain 3 (LC3) protein, which is an attractive marker of autophagosomes, revealed a relatively low expression level in tissue and cultured cells, but could be detected via immunohistochemistry in liver from GFP-LC3 transgenic mice. The number of LC3 immunopositive dot-like structures was significantly upregulated in liver tissue from nutrient-deprived GFP-LC3 mice as compared with nonstarved control tissue. Our results suggest that LC3 immunostaining can be used as an alternative detection method for autophagy in situ, but only when this protein is overexpressed.
Computerized Morphometric Analysis of Pathological Prion Protein Deposition in Scrapie-Infected Hamster Brain
Authors: Maximova Olga A. , Taffs Rolf E. , Pomeroy Kitty L. , Piccardo Pedro , Asher David M.
Published: September 2005

Transmissible spongiform encephalopathies (TSEs or prion diseases) are characterized by a constellation of typical though variable pathological changes in the brain. Deposition of disease-associated abnormal prion protein (PrPSc) is the pathological feature of TSEs most consistent and accessible for quantification. However, the evaluation of PrPSc deposits detected by immunohistochemical techniques has been traditionally based on arbitrarily assigned semiquantitative scores. This approach is limited by its subjectivity and bias, yielding considerable variability. In this study, we used MetaMorph 6.1 image analysis software for quantitative analysis of immunostained PrPSc deposits in the CNS of hamsters infected with the 263K strain of scrapie agent. Computerized morphometric analysis (CMA) allowed unambiguous detection of even minimal amounts of immunostained PrPSc. CMA values for intensity of staining and area stained correlated well with semiquantitative scores, providing reproducible quantitative data and objective criteria for analyzing PrPSc deposition. CMA provides a simple and reliable method for improved and consistent diagnosis of TSEs that may also be used to quantify other immunostained biomarkers.
Proteohistography–Direct Analysis of Tissue with High Sensitivity and High Spatial Resolution Using ProteinChip Technology
Authors: Ernst Günther , Melle Christian , Schimmel Bettina , Bleul Annett , von Eggeling Ferdinand
Published: September 2005

On the proteomic level, all tissues, tissue constituents, or even single cells are heterogeneous, but the biological relevance of this cannot be adequately investigated with any currently available technique. The analysis of proteins of small tissue areas by any proteomic approach is limited by the number of required cells. Increasing the number of cells only serves to lower the spatial resolution of expressed proteins. To enhance sensitivity and spatial resolution we developed Proteohistography. Laser microdissection was used to mark special areas of interest on tissue sections attached to glass slides. These areas were positioned under microscopic control directly on an affinity chromatographic ProteinChip Array so that cells were lysed and their released proteins bound on a spatially defined point. The ProteinChip System, surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS), allows the laser to be steered to up to 215 distinct positions across the surface of the spot, enabling a high spatial resolution of measured protein profiles for the analyzed tissue area. Protein profiles of the single positions were visually plotted over the used tissue section to visualize distribution proteohistologically. Results show that the spatial distribution of detectable proteins could be used as a Proteohistogram for a given tissue area. Consequently, this procedure can provide additional information to both a matrix-assisted laser desorption/ionization (MALDI)-based approach and immunohistochemistry, as it is more sensitive, highly quantitative, and no specific antibody is needed. Hence, proteomic heterogeneity can be visualized even if proteins are not known or identified.
Histopathology and Immunohistochemistry in the Diagnosis of Bioterrorism Agents
Authors: Guarner Jeannette , Zaki Sherif R.
Published: September 2005

From October to November 2001, the inhalational and cutaneous anthrax cases that occurred in the U.S. underscored the importance of recognizing the clinical and pathological features of infectious agents that can be used in acts of terrorism. Early confirmation of bioterrorist acts can only be performed by making organism-specific diagnosis of cases with clinical and pathologic syndromes that could be caused by possible bioterrorism weapons. Recognition and diagnosis of these cases is central to establish adequate responses. This review will examine the events that occurred during the anthrax bioterrorist attack with specific emphasis on the role of pathology and immunohistochemistry and will describe the histopathologic features of category A bioterrorism agents (anthrax, plague, tularemia, botulism, smallpox, and viral hemorrhagic fevers).
Pathogen Control in Complex Fluids with Water‐coupled Excimer Lamps at 282 and 308 nm
Authors: Coogan John J.
Published: September 2005

Water‐coupled excimer lamp systems have been developed to inactivate microorganisms within complex, low–optical quality, fluids. Monochromatic lamps were selected to minimize UV‐B and UV‐C absorption within the carrier fluids while maximizing deposition within specific chemical targets. Fundamentals, system scaling and power supply design are discussed. This work used two large‐surface area excimer lamps as intense sources of near monochromatic radiation at 308 and 282 nm. Data are presented for two distinct fluid systems: flow‐through processing of large‐volume metalworking fluids used in heavy industry and batch irradiation of human blood plasma and platelet suspensions used in transfusion medicine. In the first, a 200–600 L/min reactor is used to control bacterial concentrations within metalworking fluids used in large‐scale metal machining processes. Control is defined as the maintenance of 103 to 104 CFU/mL in fluids that without treatment would have concentrations over 107 CFU/mL. The second is a batch process for viral inactivation in undiluted blood bank products. Samples of fresh frozen plasma and platelet suspensions were spiked with high titers of porcine parvovirus (PPV) and irradiated at 308 and 282 nm. Although both wavelengths were effective at reducing PPV levels, 308 nm light resulted in both higher rates of viral inactivation (greater than 6 log units) and lower rates of fluid degradation.
Audiological Profile in Older Children and Adolescents with Unrepaired Cleft Palate
Authors: Ramana Yamani Venkata , Nanda Vipul , Biswas Gautam , Chittoria Ravi , Ghosh Shakuntala , Sharma Ramesh K.
Published: September 2005

Objective

To study the audiological profile in the cleft population comprising older children and adolescents with unrepaired cleft palate and to arrive at a consensus regarding management of otitis media with effusion in this unique group.

Setting

Tertiary care institute in Chandigarh, Punjab, India.

Design

Prospective study based on all patients older than 7 years with unrepaired cleft palate, attending the plastic surgery outpatient department, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India, from January 2001 to December 2002. Patients with submucous cleft were excluded from the study. General characteristics, otoscopic findings, pure tone audiometry, and impedence audiometry of all patients were recorded.

Results

Patients’ ages ranged from 8 to 18 years, with a mean of 10.5 years. Regarding otological complaints, 86.7% were asymptomatic. Otoscopic findings revealed mild retraction as the most common finding in 50% of the ears. Type B curve was the most common tympanometric finding. The highest and lowest hearing thresholds recorded were 45 db and 15 db, respectively, with a mean of 27.11 db.

Conclusion

The audiological profile of this unique group, which neither had undergone palatoplasty nor had received treatment for the ear condition, demonstrates a mild to moderate hearing impairment. This definitely requires treatment, but owing to the lack of a prospective control group, it is difficult to conclude whether these patients are benefited by conservative treatment alone or by an early aggressive surgical treatment for otitis media with effusion (OME).
Perceptions, Expectations, and Reactions to Cleft Lip and Palate Surgery in Native Populations: A Pilot Study in Rural India
Authors: Weatherley-White R. C. A. , Eiserman William , Beddoe Marie , Vanderberg Richard
Published: September 2005

Objective

Many charitable organizations conduct overseas missions to correct cleft lip and palate where surgical care is unavailable. However, little is known about cultural and societal attitudes regarding the cleft deformity.

Method

A 15-item questionnaire was designed to elicit from parents general knowledge concerning cleft lip and palate, beliefs regarding its causation, and expectations of what surgery would accomplish. Shorter second and third questionnaires were administered after the screening process and after surgery. The initial phase of this project was undertaken in Deesa, a midsized rural town in India. Fifty-two families were selected randomly for the initial questionnaire. These interviews were conducted verbally, assisted by translators. Children in 25 of these 52 families subsequently underwent surgery.

Results

The results of the interviews indicated that 64% of parents did not limit their child's social interaction and were not ashamed to be seen in public. Twenty-six percent exercised some constraints, and 10% kept their children totally isolated, not permitting them to leave the house or attend school. Regarding causation, the vast majority (84%) ascribed the cleft to “God's will” and 10% to sins committed in past lives. Only one parent acknowledged the influence of genetics, although several had a positive family history. Environmental factors were not an issue. Most families expected their child's life to be better when the facial deformity was corrected. Marriage prospects were the main concern, more so for girls than boys. Educational opportunity was a second strong theme.

Conclusions

A greater understanding of the beliefs and expectations in this region was gained by means of this study.
Long-Term Effects of Lip Repair on Dentofacial Morphology in Patients with Unilateral Cleft Lip and Palate
Authors: Liao Yu-Fang , Mars Michael
Published: September 2005

Objective

Lateral cephalograms from the growth archive of the Sri Lankan Cleft Lip and Palate Project were analyzed in a cohort design to study the long-term effects of lip repair on dentofacial morphology in patients with unilateral cleft lip and palate.

Methods

A total of 71 patients were recruited, including 23 adult patients with nonsyndromic unilateral cleft lip and palate without surgical repair and 48 adult patients with nonsyndromic unilateral cleft lip and palate who had lip repair, but without management of alveolus or anterior vomer. The design utilized exact matching on ethnicity and statistical control for gender and age.

Results and Conclusions

The data support the hypothesis that lip repair primarily produces a bone-bending effect on the anterior maxillary alveolus (alveolar molding), accompanied by controlled uprighting of maxillary incisors, and secondarily produces a bone-remodeling effect (bone resorption) in the base of the anterior maxillary alveolus. When analyzed by the age at lip repair and the surgeon who performed lip repair, early lip repair produced a greater bone-remodeling effect than did late lip repair, and variation in the surgeon who performed lip repair had an insignificant impact on dentofacial morphology after adjusting for covariates.
Changes of Vertical Skeletal Morphology in Patients with Complete Unilateral and Bilateral Cleft Lip and Palate
Authors: Lisson Jörg A. , Hanke Ilka , Tränkmann Joachim
Published: September 2005

Objective

The aim of this retrospective investigation was to qualify and quantify changes of the vertical skeletal morphology during puberty in cleft patients compared with an age-matched noncleft control.

Methods

Patients with unilateral cleft lip and palate (UCLP; n = 12) and bilateral cleft lip and palate (BCLP; n = 11) who fulfilled strict inclusion criteria according to the Hanover treatment protocol were evaluated by means of cephalometric analysis. Lateral cephalograms were analyzed for each cleft patient at age 10 and 15 and compared with corresponding data of a noncleft control (n = 20).

Results and Conclusions

It was concluded that a vertical growth impairment of the maxilla is found in patients with cleft lip and palate. The maxilla of cleft patients shows a significant clockwise rotation, whereas the inclination of the mandible shows little difference. Consequently, there is a skeletal superposition of the jaws. The posterior height of the maxilla is significantly shorter in patients both with UCLP and BCLP at T0 and T1. An increase of the anterior height of the mandible is found in the cleft groups.
Hypoplasia and Hypodontia in Van der Woude Syndrome
Authors: Oberoi Snehlata , Vargervik Karin
Published: September 2005

Objective

The purpose of this study was (1) to assess maxillary development in cleft individuals with Van der Woude syndrome (VWS) and (2) to compare hypodontia in VWS and nonsyndromic cleft matched controls.

Design and Setting

Retrospective case-control study from the Center for Craniofacial Anomalies, University of California, San Francisco, California.

Patients and Participants

The sample consisted of 15 individuals with Van der Woude syndrome and 15 nonsyndromic cleft lip and/or palate controls paired for age, gender, and cleft type in the age range of 5 to 13 years.

Main Outcome Measures

Cephalograms were digitized, and 31 linear and angular measurements were made. Serial panoramic radiographs were used to assess the presence or absence of permanent teeth.

Results

The maxillary sagittal position represented by midface length (Co-A) was significantly shorter in the Van der Woude syndrome subjects than in the matched controls (p = .031), suggesting a trend towards greater maxillary hypoplasia, particularly in Van der Woude syndrome with bilateral cleft lip and/ or palate. Measurements indicating sagittal jaw relationship (ANB angle and the Wits) were significantly smaller in the children with Van der Woude syndrome than in matched controls (p = .008 and p = .006). A significantly larger number of individuals with Van der Woude syndrome than matched controls had missing teeth (p = .014). The mandibular second premolar was missing more frequently in children with Van der Woude syndrome than in the matched controls (p = .031). The differences concerning both maxillary hypoplasia and hypodontia were most marked in the more severe cleft type, represented by bilateral cleft lip and/or palate.

Conclusions

Based on these findings, the expectation is that there will be maxillary hypoplasia and hypodontia of greater severity in Van der Woude syndrome than in nonsyndromic clefts.
Dental Development of the Permanent Lateral Incisor in Patients with Incomplete and Complete Unilateral Cleft Lip
Authors: Pioto Nádia Rodrigues , Costa Beatriz , Gomide Marcia Ribeiro
Published: September 2005

Objective

This study aimed to evaluate a possible delay in root development of the permanent lateral incisor on the cleft side compared with its contralateral tooth in patients with incomplete and complete unilateral cleft lip.

Design

Retrospective.

Setting

Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, São Paulo, Brazil.

Patients

A sample of 95 panoramic radiographs of patients with incomplete and complete unilateral cleft was obtained from the files of HRAC/USP. The patients were both boys and girls of various races, aged 5 to 11 years, and did not have any syndrome or associated congenital malformation. The sample was divided into three groups according to the severity of the cleft lip.

Main Outcome Measure

Radiographs were analyzed to compare root development stage of the lateral incisor on the cleft side with the noncleft side according to the classification of Nolla.

Results

The mean delay in root development of the permanent lateral incisor on the cleft side ranged from 0.5 to 1.6 scores for all three groups investigated.

Conclusions

Root development of the permanent lateral incisor on the cleft side was delayed compared with the noncleft side.
Quantification of Plagiocephaly and Brachycephaly in Infants Using a Digital Photographic Technique
Authors: Hutchison B. Lynne , Hutchison Luke A. D. , Thompson John M. D. , Mitchell Ed A.
Published: September 2005

Objectives

The aims of the study were: (1) to develop a technique to quantify plagiocephaly that is safe, accurate, objective, easy to use, well tolerated, and inexpensive; and (2) to compare this method with tracings from a flexicurve ruler.

Design

A case-control study of 31 case infants recruited from outpatient plagiocephaly clinics and 29 control infants recruited from other pediatric outpatient clinics.

Participants

Infants in the study had been diagnosed with nonsynostotic plagiocephaly or brachycephaly and were between 2 and 12 months old.

Interventions

Infants’ head shapes were measured using (a) digital photographs of a head circumference band and (b) a flexicurve ruler. Flexicurve tracings were scanned, and both the digital photos and the scanned flexicurve tracings were analyzed using a custom-written computer program.

Main Outcome Measures

The oblique cranial length ratio was used to quantify cranial asymmetry, and the cephalic index was used to quantify the degree of brachycephaly.

Results

The infants tolerated the photo technique better than the flexicurve. Also, mothers preferred the photo technique. There was less within-subject variance for the photos than for the flexicurve measurements. The results suggested that an oblique cranial length ratio of ≥ 106% can define plagiocephaly and that a cephalic index of ≥ 93% can define brachycephaly.

Conclusions

The photographic technique was better accepted and more repeatable than the flexicurve measuring system. We propose that “normal” head shape is indicated in infants with both an oblique cranial length ratio of less than 106% and a cephalic index of less than 93%.
Parenting Stress in Infancy and Psychosocial Adjustment in Toddlerhood: A Longitudinal Study of Children with Craniofacial Anomalies
Authors: Pope Alice W. , Tillman Karen , Snyder Heather T.
Published: September 2005

Objective

To evaluate the association between parenting stress during infancy and child psychosocial adjustment during toddlerhood, within a sample of children with craniofacial anomalies (CFAs).

Design

Retrospective chart review.

Setting

Urban medical center department of reconstructive plastic surgery.

Participants

Parents of 47 children aged birth to 24 months at time 1 and 24 to 46 months at time 2.

Main Outcome Measures

Parenting Stress Index/Short Form completed at times 1 and 2; Child Behavior Checklist completed at time 2.

Results

Relative to norms, more parents of children with CFAs experienced serious levels of parenting stress at times 1 and 2; however, fewer children with CFAs experienced serious levels of adjustment problems. Parenting stress during infancy predicted psychosocial adjustment in toddlerhood but was mediated by parenting stress in toddlerhood. Parents high on stress at both assessments showed clinical levels of total parenting stress and parent-child dysfunctional interaction when their children were infants; their toddlers showed higher levels of maladjustment than those with parents elevated on parenting stress during only infancy.

Conclusions

Elevated levels of parenting stress during infancy may be stable through toddlerhood for families having a child with a CFA. The relation between parenting stress and child adjustment is likely to be reciprocal. These findings should be replicated with a larger sample and multiple informants.
Psychosocial Adjustment in Adolescents with Craniofacial Anomalies: A Comparison of Parent and Self-Reports
Authors: Snyder Heather T. , Bilboul Monica J. , Pope Alice W.
Published: September 2005

Objective

To assess rates of psychosocial adjustment problems in adolescents with craniofacial anomalies (CFAs) and to evaluate the correspondence between adolescent and parent reports of adjustment.

Design

Retrospective chart review.

Setting

Reconstructive plastic surgery department in urban medical center.

Participants

Sixty-four adolescents aged 14 to 18 years with CFAs and their parents.

Main Outcome Measures

Child Behavior Checklist, Youth Self-Report.

Results

Adolescent and parent reports were compared with published norms. Adolescents with CFAs did not differ from norms on rates of self-reported problems in the clinical range. Parents of sons and daughters with CFAs reported elevations in the clinical range for deficits in social and scholastic competence; parents of daughters also reported higher clinical rates of withdrawn and somatic problems. Correlations between adolescent and parent reports were generally higher than seen in norms, especially for boys. Parents and adolescents did not differ in reported rates of problems in the clinical range.

Conclusions

Adolescents with CFAs showed elevated risk for problems with academics and peer relationships; there was limited evidence for clinical levels of other adjustment problems. When parent and adolescent reports differed, parents reported more problems.
Three Cases of Oculo-Facio-Cardio-Dental (OFCD) Syndrome
Authors: Tsukawaki Hiroyuki , Tsuji Michiko , Kawamoto Tatsuo , Ohyama Kimie
Published: September 2005

Objective

Oculo-facio-cardio-dental (OFCD) syndrome is a rare condition with ocular, facial, cardiac, and dental disorders. The purpose of this report is to describe three Japanese female patients by using facial measurements, tooth measurements, and cephalometric analysis.

Design

Facial measurements, tooth measurements, and the results of cephalometric analyses were compared with Japanese standards using panoramic roentgenograms, dental casts, and lateral cephalograms.

Results

A long face and thick upper and lower lips were noted for all cases from facial measurements, and a long crown length and long dental root were noted for all cases from tooth measurements. Relative mandibular protrusion and a large anterior lower facial height, accompanied by a steep mandible and large gonial angle, were seen from the cephalometric analyses.

Conclusions

The results of a long face and long dental root were in accordance with previous reports. In addition, thick upper and lower lips, relative mandibular protrusion, large anterior lower facial height accompanied by a steep mandible, and a large gonial angle may be characterized as specific features of this syndrome.
Community Orthodontists and Craniofacial Care: Results of a Washington State Survey
Authors: Lewis Charlotte W. , Ose Marsha , Aspinall Cassandra , Omnell Mai Lena
Published: September 2005

Background

Little is known about community orthodontists’ previous training in, experience with, or receptivity to caring for children with craniofacial disorders.

Objectives

(1) To characterize the current level of participation by Washington state orthodontists in craniofacial care; and (2) to identify factors that promote or impede community orthodontists’ involvement in caring for children with craniofacial conditions.

Design

Mail survey.

Methods

A 26-item questionnaire was designed and mailed to all active orthodontists in Washington state (N = 230). Question topics included practice characteristics, training and experience with craniofacial conditions, concerns related to public and private insurance, and communication with craniofacial teams.

Results

Of eligible respondents, 68% completed the survey. Most orthodontists’ patient panels were made up of patients who either have private insurance or pay cash for services. On average, 2% of respondents’ patients were Medicaid beneficiaries. Only 20% of respondents had seen more than three patients with cleft lip and/or palate in the past 3 years. Although a minority of orthodontists receive referrals from (27%) or are affiliated with (11%) craniofacial teams, most orthodontists perceived craniofacial care positively and were interested to learn more about craniofacial care and to accept additional patients with these conditions.

Conclusions

Results of this survey can inform potential strategies to increase access to orthodontic care for children with craniofacial disorders. These would include developing an organized training, referral, and communication system between community orthodontists and state craniofacial teams and considering a case-management approach to facilitate this process.
Spontaneous Verbal Labeling: Visual Memory and Reading Ability in Children with Cleft
Authors: Richman Lynn C. , Wilgenbusch Tammy , Hall Thomasin
Published: September 2005

Objective

The purpose of this study was to examine different types of short-term memory deficits (visual versus verbal) of children with cleft and to determine what type of memory deficits were associated with reading disorders.

Design

The study examined memory and reading in 48 consecutive cases of children with cleft, aged 7 to 9 years. A memory test designed to assess memory modalities (verbal-visual) was administered, along with tests of reading ability.

Results

Visual and verbal memory were examined with a one-way analysis of variance (ANOVA). The memory pattern indicated greatest deficit in visual memory. Two subgroups were formed, according to whether or not there was evidence of visual memory impairment. A hit rate predicting reading disability based on group membership was calculated to be 65%. Visual memory was significantly correlated with reading ability (r = .48).

Conclusion

A brief visual memory test was almost as good as Full Scale IQ in predicting reading disability.
Treatment Outcome after Two-Stage Palatal Closure in Unilateral Cleft Lip and Palate: A Comparison with Eurocleft
Authors: Nollet Pieter J. P. M. , Katsaros Christos , van't Hof Martin A. , Semb Gunvor , Shaw William C. , Kuijpers-Jagtman Anne Marie
Published: September 2005

Objective

To evaluate dental arch relationships of patients with unilateral cleft lip and palate (UCLP) treated with a two-stage palatal closure and to compare them with the six centers from the Eurocleft study that used various treatment protocols.

Design

Repeated-measures study.

Setting

Cleft Palate Craniofacial Unit of Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.

Patients

Records of 9-year-old children with complete unilateral cleft lip and palate (n = 43) were included.

Interventions

The dental arch relationships of these patients were assessed by applying the Goslon Yardstick and subsequently compared with the Goslon outcome of the six-center Eurocleft study.

Mean Outcome Measures

Statistics of intra- and interexaminer agreement.

Results

For the Nijmegen UCLP group, 9% of dental arch relationships had a Goslon score of 1, 52% had a score of 2, 30% has a score of 3, 9% had a score of 4, and none had a score of 5. The mean Nijmegen Goslon score showed no significant differences with Eurocleft centers A, B, and E, which achieved the best treatment results, but did significantly differ from Goslon outcomes of Eurocleft centers D (p < .001), C, and F (p < .01), which had relatively poor treatment outcome.

Conclusions

Treatment outcome of the patients in the Nijmegen UCLP group treated with two-stage palatal closure was comparable with the results of the Eurocleft centers with the best outcome. Treatment protocol could not explain differences in the quality of treatment results.
Spinal Anomalies in Goldenhar Syndrome
Authors: Anderson Peter J. , David David J.
Published: September 2005

Objective

Goldenhar syndrome consists of the triad of craniofacial microsomia, occular dermoid cysts, and spinal anomalies. The exact nature of the spinal anomalies remains poorly defined in the existing craniofacial literature, possibly due to these anomalies being managed by orthopedic surgeons rather than by craniofacial surgeons. The aim of this study was to clarify the nature and extent of these spinal anomalies.

Method

Review of case notes of patients who had their diagnosis confirmed following review by a clinical geneticist and in conjunction with radiographs (supplemented by three-dimensional computed tomographic [CT] scans where available).

Results

Seven patients fulfilled the entry criteria and had material available for study. A wide range of anomalies was present, including butterfly vertebrae; hemivertebrae, which produced secondary scoliosis; kyphosis; and rib anomalies. Anomalies occurred at all levels within the spine.

Conclusion

The possibility of spinal anomalies at all levels of the spine should be considered by those treating cases of Goldenhar syndrome, because these anomalies cannot be predicted from the severity of the facial malformation.
Nerve Supply to the Soft Palate Muscles with Special Reference to the Distribution of the Lesser Palatine Nerve
Authors: Shimokawa Takashi , Yi Shuangquin , Tanaka Shigenori
Published: September 2005

Objective

Descriptions of the innervation of the soft palate muscles in previous studies have varied according to the author. In the present study, distribution of the lesser palatine nerve, through which motor fibers of the facial nerve are considered to reach soft palate muscles, and that of the pharyngeal plexus in the soft palate were investigated in order to reexamine the innervation of the soft palate muscles according to anatomical evidence.

Results

Observations suggested that the levator veli palatini and palatopharyngeus were doubly innervated by branches of the lesser palatine nerve and pharyngeal plexus, and that the musculus uvulae was innervated by only the lesser palatine nerve.

Conclusion

The soft palate is considered to be located in the border region between the areas of distribution of the lesser palatine nerve and pharyngeal plexus. This may be why controversies exist in previous studies about the innervation of the soft palate muscles.
Molecular study of WISP3 in nine families originating from the Middle‐East and presenting with progressive pseudorheumatoid dysplasia: Identification of two novel mutations, and description of a founder effect
Authors: Delague Valérie , Chouery Eliane , Corbani Sandra , Ghanem Ismat , Aamar Suhail , Fischer Judith , Levy‐Lahad Ephrat , Urtizberea J. Andoni , Mégarbané André
Published: September 2005

Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive syndrome characterized by the presence of spondyloepiphyseal dysplasia associated with pain, stiffness, and swelling of multiple joints, osteoporosis, and the absence of destructive bone changes. The disorder is caused by mutations of the WISP3 gene located on chromosome 6q22. We hereby report the molecular study of the WISP3 gene in nine unrelated consanguineous families originating from the Middle‐East: three from Lebanon, five from Syria, and one from Palestinian Bedouin descent, all affected with PPD. Five different sequence variations were identified in the WISP3 gene, two of them being new mutations: the c.589G → C transversion at codon 197, responsible for a splicing defect (A197fsX201); and the c.536_537delGT deletion (C179fsX), both in exon 3. In all other families, the affected patients were homozygous for a previously described nonsense mutation, namely c.156C → A (C52X). Interestingly, in the latter families, the C52X mutation was always found associated with a novel c.248G → A (G83E) variation, suggesting the existence of a founder effect. © 2005 Wiley‐Liss, Inc.