bluuebunny/crossref_metadata_2025 huggingface dataset:
Efecto de intercalar leguminosas, con diferentes dosis de fósforo sobre el rendimiento de maíz, Zea mays L. en centroamérica
Authors: Zea José L.
Published: October 2018

Twenty four similar trials with corn were conducted throughout Central America during 1989 and 1990. The specific objectives were: i) to evaluate the effect of intercropping legumes with corn, ii) to establish P requirements in a system of intercropping corn with legumes, iii) to evaluate soil coverage by the legume as an indicator of a potential for erosion reduction and iv) evaluate weéd control in the intercropped system. The following legumes were tested: Stizolobium deeringianum Bort (mucuna), Vigna unguiculata L. and Canavalia ensiformis L. each one with P doses of 20 and 40 kg/ha. In general, the results obtained in 1989 were similar to those of 1990. The average corn yield for the different locations varied between 1.8 and 6.0 t/ha in 1989 and 1.0 and 5.6 t/ha in 1990, indicating the great environmental variability of the corn zones of Central America. The corn yield was always lower with legumes than without them, at the same rate of P to both years, C. ensiformis reduced the corn yield by 0.310 (±0.32) t/ha, V. unguiculata by 0.540 (±0.48) t/ha and S. deeringianum by 0.610 (±0.69) t/ha. The response to P was variable and depended on the year, the location and the legume. A positive response to P applied to corn without the legume was observed in both years. The was a positive response to P in corn intercropped with.§, deeringianumin 1982 in corn intercropped and with C. ensiformis in 1990. The legume evaluation as a mulch (average of 8 trials) indicate that at 30 days after the corn planting, V. unguiculata gave the best coverage with 62%, followed by C. ensiformis, with 38% and S. deeringianum with 35%.
Efecto de dosis de urea-N en el rendimiento del maíz bajo un sistema de rotación con leguminosas de cobertura.
Authors: Barreto H. J. , Pérez C. , Fuentes M. R. , Quelme J. L. , Larios L.
Published: October 2018

The economical substitution of nitrogenous fertilizer by biological fixation by a leguminous covering under rotation systems with corn (Zea mays L.), is one of the agricultural research themeswith highest potential for developing technologies aimed to achieve a sustainable corn production in the tropics. An experiment was conducted during twoconsecutive corn cycles at Cuyuta-Guatemala, in order to quantify the equivalence of urea dos es and the N supplied by two legumes (Canavalia ensiformis L. and Mucuna deeringianum Bort). During the first cycle, the corn yield showed a significant response to the N-urea as well as to the incorporation of green manure. During the second cycle, the residual effect of the legumes on the corn yield was markedly lower and the differences among rotation systems depended on the N level and plant population. The rotation effect with green manure and its relation with the doses of urea approved the substitution of N-fertilizer by green manure. The main factors affecting the yield response under the different rotation systems were: doses of N-fertilizer, amount of N in the superficial biomass of the legume and the final plant population.
Evaluación de cultivares amarillos de maíz (Zea Mays L.) para tolerancia al achaparramiento del maíz.
Authors: Ortíz José , Navarro Félix , Celado Ramón , Pierre Rodolfo , Guerra Fidencio
Published: October 2018

Eight yellow corn cultivars from the "Proyecto de Achaparramiento de maiz" (Corn Stunting Project) were evaluated under five environments in Central America and the Caribbean. The specific objectives were to evaluate the degree of tolerance to the stunting, to quantify the progress achieved through selection and to detect the most promissing yellow population. The 'CESDA-88' was the variety showing the lowest stunting percentage (15.6%) and a good yield. Profits due to selection were produced by the population 36, in one locality only. The regression analysis showed that the yield was not significatively affected by the stunting percentage. Because of these results, our Project has decided to increase its efforts on the population CESDA-88.
Efectos de algunas propiedades físicas del suelo y la precipitación sobre la producción de la palma aceitera (Elaeis guineensis) en Centroamérica.
Authors: Durán Norberto , Ortíz Rubén A.
Published: October 2018

The soil aeration and hydric shortage greatly influence oil palm yield in Central America. This assay was conducted to identify and quantify the effect of the physical properties of the soil and rainfall on the yield of oil palm orchards in Coto and Quepos (Costa Rica) and San Alejo (Honduras). The following soil characteristics were evaluated: texture, moisture retention (pF), gravimetric moisture, drain water, total porosity, aerial space, large pore percentage, penetration resistance and tensimeter readings. These evaluations were conducted on 20 fruit bearing plots (in each locality) located within representative soil units; classified as: a) well drained (Fluventic Eutropepts), b) inperfect or moderately drained (Fluvaquentic Eutropepts) and c) poorly drained (Tropaquepts). San Alejo also shows soils with low base saturation (Dystropepts and Psamments). Twenty four additional plots were analyzed in this latter orchard to relate their yield with the catographic units. Regression and corre lation analysis were run for the three localities. The main limiting factors on production were: poor soil aeration en Coto, poor soil aeration and hydric shortage en Quepos, and poor aeration, low base saturation and sandy textures in San Alejo.
Evaluación de herbicidas graminicidas para el combate de gamalote (Paspalumfasciculatum Wild.) en palma aceitera (Elaeis guineensis).
Authors: Fernández O. , Ortíz R. A.
Published: October 2018

Bullgrass (Paspalum fasciculatum wild.) is one of the most prevalent weeds in the oil palm crop. The objective of the experiment was to compare its control with five herbicides. Three experiments were conducted to evaluate the herbicides haloxyfop-methyl (Galant 240 y Galant 75), fenoxaprop-pmethyl (Excel) and fluazifop-butyl (Fusilade II) at the rates of 50, 75, and 100 g ai/ha-1 and glyphosate (Round up) at the rate of 960 g ai/ha-1 during the first experiment; Galant 240, Galant 75 and Fusilade II at 100 g ai/ha-1 during the second experiment; Galant 240, Fusilade II at the rates of 75 and 100 g ai/ha-1 and glyphosate at 960 g ai/ha-1 during the third trial. A Completely Randomized Block design with four replications was used. Galant 240, Galant 75, and Fusilade II showed the best results as measured by weight of fresh weed, number of affected nodes (herbicide transport), and weed control efficiency percentage. Galant 240 at 100 g ai/ ha-1 was the most profitable option.
Resistencia genética y control químico de la roya del frijol en el trópico húmedo de México.
Authors: Becerra Enrique , López Ernesto , Acosta Jorge
Published: October 2018

The rust (Uromyces appendiculatus var. typica) is one of the main bean diseases in the humid Mexican tropics. The objective of this experiment is to present the results from the research conductedby the bean breeding program and the test of fungicides for controlling bean rust. Advanced lines’ evaluation, preliminary trials and regional yield trials have been conducted since 1980 and as result, the rust tolerant "Negro Veracruz" and the rust resistant "Negro Huasteco-81" varieties were released in 1981. The rust resistant "Negro Cotaxtla-91" was released in 1991. Chemical rust control trials with fungicides were started at several localities in 1990. The application of fungicides on susceptible varieties like Jamapa inereased yields by over 200 kg/ha. The fungicides which best controlled bean rust were; Hexaconazole (0.5 l/ha), Maneb (3kg/ha), and Tebuconazole (0.5 kg/ha), when applied twice before blooming. The cost of the fungicide application was paid back by 75 kg/ha of bean yield increase.
Comparación de sorgos (Sorghum bicolor L.) isogénicos para dos tipos de citoplasma, aptitud combinatoria general y específica.
Authors: Williams Héctor , Rodríguez Raúl
Published: October 2018

The purpose of this study was to compare estimates of relati ve general and specific combining ability effects on isogenic hybrids in two different cytoplasm types (A1 and A2), and observe the possibility of use the A2 system for the commercialproduction of sorghum hybrids. Genotypes were evaluated in ten environments located in northern Mexico. Grain yield, days to flowering, grain moisture content at harvest, plant height, panicle lenght and panicle excertion were recorded from the experiments. Combining ability was estimated ac-cording to the model suggested by Beil and Atkins in 1967. Although in all studied, the characteristics generally, the best SCA and GCA were for A2 cytoplasm, there was no relation between cytoplasm type and combining ability. These results indicate that A2 cytoplasm can be used for commercial hybrid sorghum seed production, as an alternative to Al cytoplasm.
Combate de sontol (Cyperus iria L.) en arroz.
Authors: Herrera Franklin , Agüero A. Renán
Published: October 2018

This experiment was conducted in a highly C. iria infested plot at "El Pelon" rice farm in Liberia, Costa Rica, to determine the control effectiveness of this weed by several hormonal and sulfonylurea herbicides and their selectivity to the rice crop, and to preliminarily estimate the negative effect of C. iria on the crop. The evaluated treatments included three new sulfonylureas, six herbicides recommended for cyperaceous and dicotyledonous control and an unweeded control. The herbicides were app!ied following each of the manufacturer's recommendations. The rice cultivar used was CR 1821 and the ground was kept saturated during the whole trial. The sulfonylurea herbicides, bensulfuron-ethyl and pyrazosulfuron-methyl, were the most effective in controlling C. iria, and they also were the highest yielding treatments. The herbicides commonly used for the cyperaceous control, showed intermediate control percentages of these weeds. When C. iria was not controlled, at approximately 30 days after planting, it completely covered the rice plants, completed its !ife cycle at 70 days and reduced the rice yield by 50%.
Efecto de un bioestimulante húmico extraído del raquis de banano (Pinzote) sobre el crecimiento de plántulas de banano (Musa AAA subgrupo "Cavendish" clon 'Gran enano).
Authors: Russo Ricardo , Lugo José , Arreola Oscar , Rango Omar A.
Published: October 2018

The main objective of this assay was to evaluate the effect of a humic extract, obtained from previously composted banana rachises, on the growth of banana seedlings under nursery conditions and compare it with a commercial humic acid. The results show that the humic extract at 1% significantly promoted the growth ofroots, foliar area, and biomass of leaves and pseudo-stalk of banana seedlings under nursery conditions.
Siete preguntas de actualidad sobre el manejo inte. grado de plagas en América Latina.
Authors: Hilje Luko
Published: October 2018

The following topics related to the integrated pest management (IPM) are discussed: the integration concept, the low practical value of economic thresholds, the IPM relationship with sustainability and biodiversity, the agri-chemical industry potential within the IPM, hindrance to implement IPM and restrictions to develop IPM on export crops. Central American examples were used to illustrate the topics.
Psychometric Scale for Measure Mothers’ Self-Efficacy in Diarrhea Prevention
Authors: Githae Dr. M. N.
Published: October 2018

Psychometric  scale  for  measuring  self-efficacy  is  such  a  critical  important  component  of strategies   to   improve   healthy   behaviour.   Social cognitive   theory incorporates outcome expectancy, but emphasizes self- efficacy, or a perception of oneself being capable of performing certain skills to attain some outcome. The theory behind this model builds from the research of Bandura (1977). Self-efficacy scales have been championed as a critical component in many health disease prevention oriented programmes. Maternal, environmental and behavioral factors have been recognized as additional important determinants behavior change modeled in such approach to provide sustainable intervention in promoting self-efficacy to perceived risks. Development of Mother Self-Efficacy scale to measure this ability is critical in Diarrhea prevention and sustaining desired interventions.
Insulin signaling pathway in the masseter muscle of dexamethasone-treated rats
Authors: França Igor Rabelo de , Meneses-Santos Daniela , Moreira Gabriela Virginia , Lima Fábio Bessa , Carvalho Carla Roberta de Oliveira , Marçal Anderson Carlos
Published: October 2018

Background and aims

The treatment with glucocorticoids may induce molecular changes in the level and/or degree of phosphorylation of proteins located downstream of the insulin receptor/insulin-like growth factor receptor (IR/IGF1R) in many tissues. However, few studies have investigated the intracellular insulin pathway in the masseter muscle. Therefore, this study aimed to analyze the IR/IGF1R signaling pathway in the masseter muscle of rats treated with dexamethasone.

Materials and methods

Male Wistar rats were divided into two groups: control group (intraperitoneally injected with 0.9% NaCl solution) and dexamethasone group [intraperitoneally injected with 1 mg/kg (bw) dexamethasone solution] for 10 consecutive days. Sections of the masseter muscle were removed at time zero and after the infusion of regular insulin into the portal vein.

Results

Dexamethasone administration induces body weight loss without changing masseter muscle weight and reduces the expression of total IR and PI3K proteins; total levels of IRS1, Akt, and ERK1 remain unchanged between groups. The degree of phosphorylation/activity of IRS1 after insulin stimulus increased only in the control group; degree of phosphorylation of Akt increased in both groups, but this increase was attenuated in the dexamethasone group.

Discussion and conclusion

The degree of phosphorylation/activity in the masseter muscle is different from that in other muscle territories.
Filipino Explanatory Models of Cleft Lip with or without Cleft Palate
Authors: Daack-Hirsch Sandra , Gamboa Henrietta
Published: October 2018

Objective

To describe beliefs about the cause, prevention, and treatment of cleft lip with or without cleft palate (CL±P) among working class people and health care workers in the Philippines.

Design and Setting

The study was a focused ethnography and took place in the province of Negros Occidental, Philippines.

Participants

Using a stratified purposeful recruitment strategy, 80 individuals were selected for study. They were categorized into three groups: those having a CL±P or a child with a CL±P, those who neither had a CL±P nor child with CL±P, and health care workers.

Methods

Kleinman's explanatory models of illness theory were used to elicit Filipino explanations for CL±P. Data were collected through guided individual and group informant interviews and analyzed through content analysis.

Results

Filipinos reported that inheritance, falls, cravings, environmental factors, and God's will were causes for CL±P. Beliefs about prevention of CL±P included limiting the number of children, being careful not to fall, and avoiding environmental factors. It was found that general causal explanations for CL±P were not always congruent with personal causal explanations, and general/personal causal explanations for CL±P were not always congruent with prevention explanations.

Conclusion

By eliciting patients’ explanations for CL±P and comparing these with their own, clinicians can find commonalities between divergent explanations and use these as a starting point from which to improve health outcomes. Findings from this study will be used to guide the design of health campaigns regarding CL±P in the Philippines.
A Case of Ring Chromosome 18 Syndrome Treated with a Combined Orthodontic-Prosthodontic Approach
Authors: Okuma Mizue , Hamada Takashi , Motohashi Nobuyoshi , Moriyama Keiji
Published: October 2018

Objective

The aim of this study was to report the case of a Japanese subject with ring chromosome 18 syndrome. A cephalometric analysis was performed, and the treatment procedure is described.

Design

Lateral and posteroanterior cephalograms were compared with Japanese norms. Dental anomalies were evaluated by a model analysis. The outcome of orthodontic-prosthodontic treatment was evaluated by comparing cephalograms during the course of treatment.

Results

The cephalometric analysis showed a reduction in the cranial base length and cranial width, midfacial depth, and height and width. Comparison of lateral cephalograms at age 16 years 6 months and 22 years 4 months showed late growth of the mandible. The model analysis showed that all of the teeth, except for the mandibular canine, were small.

Conclusions

Characteristic craniofacial and dental anomalies were clarified. Successful oral rehabilitation was achieved by combined orthodontic-prosthodontic treatment.
The O.M.E.N.S. Classification of Hemifacial Microsomia
Authors: Vento A. Ronald , Labrie Richard A. , Mulliken John B.
Published: October 2018

The wide spectrum of anomalies associated with hemifacial microsomia (HFM) has made systematic and inclusive classification difficult. We propose a nosologic system In which each letter of the acronym O.M.E.N.S. Indicates one of the five major manifestations of HFM. O for orbital distortion; M for mandibular hypoplasia; E for ear anomaly; N for nerve Involvement; and S for soft tissue deficiency. The O.M.E.N.S. system is easily adapted for data storage, retrieval, and statistical analysis. A retrospective study of 154 patients with HFM classified according to the O.M.E.N.S. system confirmed the concept that the mandibular deformity is the cornerstone of the anomaly. Statistical analysis demonstrated a positive association between mandibular hypoplasia and the severity of orbital, auricular, neural, and soft tissue involvement. This study did not confirm a previously reported predominance of gender or sidedness. Analysis of statistical correlations failed to substantiate a Goldenhar variant as a syndromic entity. Our analysis showed that palatal deviation is probably caused by muscular hypoplasia and not by weakness of a particular cranial nerve.
Reflections on Research
Authors: Bardach Janusz , Kelly Kevin M.
Published: October 2018

The authors present their reflections on several of the major topics related to research. The subjects discussed include the quantity and quality of research; the motivation for research; the research process; research paradigm; restraints of research; and freedom to research. They point out that the haste to achieve success and to publish in most cases has precluded the learning process about the substance and methodology of research. An attempt is made to relate general problems of research and its methodology to research in the area of congenital facial deformities.
Vocalizations of Toddlers with Cleft Lip and Palate
Authors: Chapman Kathy L.
Published: October 2018

This study examined the early vocalizations of toddlers with cleft lip and palate. Ten toddlers, ranging in age from 12 to 14 months, served as subjects: five toddlers with cleft lip and palate and five noncleft toddlers. Samples of the toddler's spontaneous vocalizations were obtained while they interacted with their mothers during an unstructured play session. All speech-like vocalizations were transcribed, and comparisons were made between the cleft and noncleft groups for (1) size of consonant inventory, (2) type and frequency of occurrence of consonants, and (3) frequency and type of multisyllabic productions. Results indicated differences in the consonant inventories and multisyllabic productions of the two groups of toddlers.
Pharyngeal Flap Surgery in Adults
Authors: Hall Craig D. , Golding-Kushner Karen J. , Argamaso Ravelo V. , Strauch Berish
Published: October 2018

The elimination of hypernasal speech in patients with cleft palate following pharyngeal flap surgery in childhood is well established. However, pharyngeal flaps in adults have been considered to yield more modest results. This study reports on 20 adult patients with cleft palate-related hypernasality who underwent pharyngeal flap surgery. Normal nasal resonance was achieved in 15 cases, hyponasality occurred in 3 cases, and hypernasality persisted in 2 cases. However, speech intelligibility was not always dramatically improved. Indications and outcome were found to be highly dependent on preoperative articulation.
Use of Nasometry as a Diagnostic Tool for Identifying Patients with Velopharyngeal Impairment
Authors: Dalston Rodger M. , Warren Donald W. , Dalston Eileen T.
Published: October 2018

A series of 117 patients were studied in an attempt to determine the extent to which acoustic assessments of speech made with a Kay Elemetrics Nasometer corresponded with aerodynamic estimates of velopharyngeal area and clinical judgments of hypernasality. Nasometer data were obtained while patients read or repeated a standardized passage with no nasal consonants. Pressure-flow data were obtained from 96 of these patients during repeated productions of the word “papa.” Listener judgments were made in a clinical setting by the senior author using a 6-point equal-appearing interval scale. Nasometer and pressure-flow results were not known to the senior author when making listener assessments. With a cutoff nasalance score of 32, the sensitivity of Nasometer ratings in correctly identifying the presence or absence of velopharyngeal areas in excess of 0.10 cm2 was 0.78 and 0.79, respectively. The sensitivity and specificity of nasometry in correctly identifying subjects with more than mild hypernasality in their speech was 0.89 while the specificity was 0.95. The results suggest that the Nasometer is an appropriate instrument that can be of value in assessing patients suspected of having velopharyngeal impairment.
Size and Growth Rate of the Tongue in Normal and Cleft Lip and Palate Human Fetal Specimens
Authors: Kimes Kyle R. , Mooney Mark P. , Siegel Michael I. , Todhunter John S.
Published: October 2018

In the present study, the size and rate of growth of the tongue was assessed in human fetuses. For comparative purposes, 29 human fetal specimens (20 “normal” and 9 with cleft lip and palate were celloldin embedded, sectioned, stained with hematoxylin and eosin, and serially photomicrographed. The specimens ranged from 8 to 21 weeks postmenstrual age. The application of a well documented three-dimensional reconstruction technique provided quantification of several aspects of the tongue. Tongue length and volume were larger in the cleft specimens than for the normal specimens, while both length and volume were growing at a faster rate. Growth curves were produced by plotting length and volume against postmenstrual age and a significant difference was noted between the slopes (growth rate) of the growth curves for tongue length and volume for the two groups. Tongue length increase was approximately 2.27 times greater and tongue volume increase was approximately 1.64 times more for the cleft specimens than for the normal specimens from 8 to 21 weeks. In support of these findings, tongue volume was relatively larger expressed as a contribution of total oronasal capsule volume in the cleft specimens. For an initial age category (8 to 12 weeks), tongue volume in the cleft specimens was larger, growing at a faster rate than normal tongue volume and a significant difference was noted between the slopes of the growth curves. No significant difference was observed between the tongue length indices in the initial or the 8 to 21 week age category. The findings suggest that the enlarged, faster growing tongue in fetuses with clefts may be a pathogenetic correlate of secondary palatal clefting.
Symbolic Representation of Cleft Lip and Palate
Authors: Friedman Harold I. , Sayetta Rona B. , Coston Gale N. , Hussey James R.
Published: October 2018

Since the introduction of symbolic representations of cleft lip and palate anomalies in 1964, they have served the clinician as a quick and easy method of recording these disorders. This paper reviews the evolution of the schematic classification systems and evaluates them. It then presents a new scheme that synthesizes what the authors feel are the most advanced of the existing symbolic representations. This proposed new symbolic representation scheme also specifically provides for ratings of severity (including the documentation of microforms) and facilitates computerized data storage and analysis.
Operations for Microforms of Cleft Lip
Authors: Onizuka Takuya , Hosaka Yoshiaki , Aoyama Ryosuke , Takahama Hlromitsu , Jinnai Takao , Usui Yoshihiro
Published: October 2018

Microform cleft lip is a mild expression of cleft lip and may be difficult to repair. Its severity may be defined by the degree of downward depression of the nostril rim, skin striae of the upper lip, notching of Cupid's bow, and deformity of the vermilion border. Variation in surgical repair is reported for each type of microform cleft lip.
Misarticulation Caused by Abnormal Lingual-Palatal Contact in Patients with Cleft Palate with Adequate Velopharyngeal Function
Authors: Yamashita Yukari , Michi Ken-Ichi
Published: October 2018

Misarticulations produced by three patients with cleft palate (2 isolated cleft palate; 1 unilateral cleft lip, alveolus, and palate) who attained adequate velopharyngeal function and normal palatal vault by early surgical repairs were examined using electropalatography (EPG) and sound spectrography (SG). Common characteristics of lingual-palatal contact in which the contact area was broader and/or was more posterior than normal were observed. These misarticulations can be divided into three types based on the direction of the breath emission: palatalized misarticulation (in which air passes along the midline of the palate), lateral misarticulation (in which air flows laterally through the occluded dental arch), and nasopharyngeal misarticulation (in which air flows out the nose). These three are considered to be similar to intractable posterior pattern of articulation in cleft palate patients previously reported. However, these types of misarticulations can be produced by cleft patients who have achieved adequate velopharyngeal function and normal palatal vault.
Partial Trisomy 11q in a Female Infant with Robin Sequence and Congenital Heart Disease
Authors: Wallerstein Robert , Desposito Franklin , Aviv Hana , Schenk Maryann , Wallerstein Donna F.
Published: October 2018

We describe the clinical and cytogenetic findings in a female infant with partial trisomy 11q, Robin sequence, cardiac anomalies, and other minor malformations. We compare the phenotypic similarities of our case to a series by Pihko et al. (1981), who reported on 20 cases with partial trisomy 11q with similar associated craniofacial and cardiac defects. We conclude that genetic etiologies for patients diagnosed with the Robin sequence may be more common than previously believed and that initial karyotyping should be performed to aid both diagnosis and clinical management. In addition, the pattern of Robin sequence and cardiac defects may be specifically suggestive of partial trisomy 11q.
Mechanisms of Airway Obstruction in Robin Sequence: Implications for Treatment
Authors: Sher Aaron E.
Published: October 2018

Though the problems associated with Robin sequence may be numerous, especially if the primary cause of the sequence is a multiple anomaly syndrome, the most acute problems in affected newborns Is upper airway obstruction. Until recently It has been tacitly assumed that glossoptosis is always the cause of the airway obstruction. More recent evidence has shown that the sources of airway obstruction are multiple and the cause of apnea heterogeneous. The purpose of this paper is to report the mechanisms of upper airway obstruction In 53 Infants with Robin sequence. The use of flexible fiber optic endoscopy to specify treatment is discussed in detail.
Evaluation of the Sphincter Pharyngoplasty
Authors: Riski John E. , Ruff Gregory L. , Georgiade Gregory S. , Barwick William J. , Edwards Paul D.
Published: October 2018

The results of the sphincter pharyngoplasty were evaluated In 139 patients with velopharyngeal Incompetence (VPI) who demonstrated active velar elevation. All patients underwent perceptual speech evaluation and lateral phonation radiographic study; select patients underwent multiview videofluoroscopic, flexible nasendoscoplc, and pressure-flow studies. All but one patient demonstrated Improvement and 109/139 (78.42%) demonstrated resolution of VPI. Sixteen of thirty failed pharyngoplasties were revised. Revision was successful In 8/16 patients yielding an overall success rate of 117/139 (84.17%). Success rate was 67.65 percent for patients managed during the first 5 years and improved to 84.78 percent for patients managed during the last 5 years of this 15-year series. Analysis revealed that younger patients were treated more successfully than older patients, large velopharyngeal areas were treated as successfully as smaller ones, and circular closure patterns were treated more successfully than coronal patterns. The primary cause of failure was insertion of the flap below the point of attempted velopharyngeal contact.
Muscle Spindle Distribution in the Levator Veli Palatini Muscle in the Rat
Authors: Yamaoka Minoru , Furusawa Kiyofumi , Kumai Toshifumi
Published: October 2018

We previously reported that the levator veli palatini muscle (LVP) in the rat is innervated by the glossopharyngeal nerve. The LVP positioned between the mouth and nasopharynx, has important roles in respiration, swallowing, and speech. Muscle spindles, structures scattered through skeletal muscles, appear to function like miniature strain gauges, sensing the degree of tension in the muscle. Muscle spindles were demonstrated in the rat's LVP in our neurophysiology and histologic studies. We think the stretch of LVP modulates the rapid movements of the LVP by the proprioceptive component of the muscle spindle. Our results infer It Is Important to protect the Innervation and the muscle spindles of the LVP from damage during any surgical dissection of the soft palate musculature.
Natal Teeth in Monozygotic Twins with Van der Woude Syndrome
Authors: Hersh Joseph H. , Verdi Gerald D.
Published: October 2018

The second monozygotic twin pair concordant for Van der Woude syndrome Is reported. Clinical manifestations of this autosomal dominant clefting syndrome Included bilateral lower lip pits, cleft lip, and cleft palate. Both sibs were found to have a natal tooth. No other cases of Van der Woude syndrome with this feature have been described previously. It is uncertain whether the presence of a natal tooth in this instance represents a low-frequency association of this disorder. However, it appears more likely that its occurrence was incidental, since natal teeth have been reported before in twin pairs as an isolated finding.
A Preliminary Study of Nasal Airway Patency and Its Potential Effect on Speech Performance
Authors: Dalston Rodger M. , Warren Donald W. , Dalston Eileen T.
Published: October 2018

The relationship between nasal airway size and articulatory performance was studied in a group of cleft palate patients. Articulation analysis revealed that children with bilateral cleft lip and palate were nearly twice as likely to manifest compensatory articulations as children with unilateral cleft lip and palate or with cleft palate only. When subjects were grouped according to speech performance, aerodynamic assessment indicated that children with compensatory articulations had significantly larger nasal cross-sectional areas than children without compensatory articulations. The findings suggest that children with comparatively large nasal airways may be at increased risk for developing abnormal speech patterns. If these findings are confirmed by further research, such children may be candidates for relatively early palate repair.
Maxillary Lateral Incisor of Subjects with Cleft Lip and/or Palate: Part 1
Authors: Suzuki Akira , Takahama Yasuhide
Published: October 2018

As a pilot study, dental casts of 30 patients with unilateral cleft lip and palate were selected and examined from the longitudinal data in the Department of Orthodontics, Kyushu University Dental Hospital. Dental casts of the anterior teeth were sectioned at right angles to the long axis of the tooth 2 to 3 mm below the incisai edge. The teeth were differentiated according to their cross sections. They were classed as lateral incisors or other types by the ratio of labiolingual diameter to mesiodistal diameter and the flatness labiolingually. Dental casts of 309 additional patients with cleft alveolus were examined subjectively based on above findings. In primary dentition, 183 of 184 teeth on the cleft side were incisai type. One tooth was canine type. In permanent dentition, 42 of 78 teeth on the cleft side were conical type, 20 teeth were intermediate type, and 16 teeth were incisai type. As a conclusion, the tooth on the cleft side is almost certain to be a lateral incisor, not a supernumerary canine tooth. As well, their form was normal in the majority of the primary dentition, but malformed in the permanent one.
Operating Safely in an Underdeveloped Country
Authors: Smoot E. Clyde , Johnson Maryann , Graham Donald R. , Draper Gary A.
Published: October 2018

The visiting surgical team doing cleft lip and cleft palate repair in an underdeveloped country may find long hours and adverse conditions. Some of the trips are undertaken for resident education. It is the responsibility of the expedition leader to implement safety precautions for protection of both the patients and the volunteers in the operative party as suggested in this article. Equipment maintenance and modified sterilization techniques are also described.
Importance of Maintaining Normal Nasal Function in the Cleft Palate Patient
Authors: Wetmore Ralph F.
Published: October 2018

The external nose is a structure that provides prominence to the face. The internal nose is a paired nasal cavity that extends from the face to the pharynx. Turbinates are major structures within the lateral walls of the nose. They perform the major functions of the nose that include respiration, humidification, temperature regulation, and filtration of the inspired air. Conditions that obstruct the nose interfere with its optimal function. These range from acute or chronic infection to enlarged tonsils and adenoid tissue to nasal septal deviation. Surgeons caring for patients with clefts must have familiarity with nasal anatomy and function and conditions that alter them. Correction of these conditions may require medical and/or surgical treatment.
Management of Major Craniofacial Anomalies: A Pediatric Perspective
Authors: Reid Cheryl S.
Published: October 2018

Ethical decision-making regarding complex congenital anomalies has evolved along with improvements in neonatal medical and surgical care, but also reflects a changed medical and social environment. The current process is complex and cumbersome, with no guarantee of consensus, and frequently leads to indecision and disagreement. Improvement of the process will require continued professional education, as well as better reconciliation of areas of ambivalence among professionals, families, and society.
Median Cleft of the Lip: Its Significance and Surgical Repair
Authors: Apesos James , Anigian Gregg M.
Published: October 2018

Median cleft lip is a midline vertical cleft through the upper lip in the absence of a prolabial remnant. This may occur as a sporadic event or be part of an inherited sequence of anomalies. A failure of formation or fusion of the medial nasal prominences derived from the frontonasal prominence is ultimately responsible for this aberration. Two categories of dysplasia are associated: (1) frontonasal deformity associated with hypotelorism and (2) median facial cleft syndrome associated with hypertelorism. A patient presents with median cleft lip, mild bifid nose, and hypertelorism. Following surgical reconstruction, a good result is achieved. The embryology, implications for associated abnormalities, and surgical technique for treating these cases are discussed.
Velopharyngeal Sphincter Physiology in Deaf Individuals
Authors: Ysunza Antonio , Vazquez Maria C.
Published: October 2018

Fifty-three deaf subjects with a history of prelingual profound bilateral sensorineural hearing loss, similar language habilitation with hearing aids, and normal velopharyngeal structures underwent a study protocol including speech evaluation, behavioral pure-tone audiometry, videonasopharyngoscopy, multiview videofluoroscopy, and electromyography of the velopharyngeal muscles. Subjects were divided into two groups: the first group included 13 subjects with normal nasal resonance or mild hypernasality (four normals and nine with mild hypernasality); the second group had subjects with severe hypernasality and severe articulation deficits. Pure-tone thresholds, velopharyngeal closure patterns, and electromyographic activity of velopharyngeal muscles were similar for both groups of subjects. However, in subjects with severe hypernasality, despite normal muscle activity as observed by electromyography, velopharyngeal valving activity lacked rhythm and strength during speech. It is concluded that deaf subjects may present a functional disorder of the velopharyngeal sphincter related to absence of auditory regulation during phonation. Visual biofeedback using videonasopharyngoscopy may be useful for treating this disorder.
Maxillary Arch Analysis: Utilizing a Computer-Based Method
Authors: Borić Vladimir , Bagatin Marijo
Published: October 2018

Objective, computerized analysis of the maxillary arch was used for morphologic studies of cleft palate characteristics. A method for maxillary arch analysis was developed and used in 10 randomly selected, cleft palate patients. The computerized analysis procedure is described in detail.
Length of the Cervical Spine as a Factor in the Etiology of Cleft Palate
Authors: Šmahel Zbyněk , Škvařilová Božena
Published: October 2018

The length of the cervical spine in a series of 206 adult males with cleft lip and/or palate and 50 normal controls was measured. The patients were divided into five subgroups according to the type and extent of the cleft. The shortening of the spine was most marked in bilateral cleft lip and palate patients (complete), less marked in unilateral cleft lip and palate patients, and was slight in isolated cleft palate patients. Complete isolated cleft palate and cleft lip was not associated with a shortening of the spine. A shortening of the cervical spine in less extensive types of isolated cleft palate was suggestive of the participation of the spine in their development, while in cleft lip and palate a simultaneous exposure to a teratogenic agent or any other developmental error during early stages of embryogenesis could explain the concomitant occurrence of spine anomalies. Patients with cleft lip and palate associated with a short spine also had a shorter mandibular ramus, which could be suggestive of simultaneous damage to both structures during morphogenesis. This relationship was not demonstrated in isolated cleft palate that developed in later stages of embryogenesis. In these cases a short spine itself could not have impaired the growth potential of the mandible, yet it could have mechanically induced the development of cleft palate. These observations are in agreement with the present state of knowledge on the development of orofacial clefts as shown in experimental animals.
Improved Patient Compliance with Cleft Palate Team Regimes
Authors: Paynter Earlene T. , Wilson Beth M. , Jordan William J.
Published: October 2018

A cleft palate team's prescribed regimen requires prompt and continued compliance to meet the objectives of the clinical management and to achieve the best clinical results for the patient. In a previous study (Paynter et al., 1990), we reported an overall compliance rate of 64% for patients seen by a cleft palate team during its first 8 years of operation. After the study, changes in the team's operational procedures were made in an attempt to provide better service, improve patient compliance, and improve the efficiency of the clinic. The purposes of the current clinical investigation were to determine the degree of compliance with recommendations made by the cleft palate team for the patients seen during the four years after the implementation of the changes and to identify variables that interfered with compliance. A subject was defined as the person(s) who could best respond to questions concerning the management of the team's patient. Each subject was interviewed using a questionnaire based on the Health Belief Model (Becker et al., 1977). The mean patient compliance rate was 82%. Using Jones and Caldwell's (1981) classification, 56.7% of the patients were classified as compilers, 40% as partial compilers, and 3.3% as noncompliers. Compliance with specific recommendations ranged from 58 to 100%. No specific variable was found to interfere with compliance.
Modification of the Traditional Bone Conduction Hearing Aid
Authors: Ross Debbie F. , Vallino Linda D. , Galloway Cheryl , Keller Peter
Published: October 2018

The purpose of this technical note is to describe a modification of the traditional bone conduction hearing aid used for the treatment of hearing impairment associated with atresia, microtia, or auditory canal anomalies. This modified unit offers a viable alternative to patients wanting an alternative to the traditional model or an implantable bone conduction aid.
Reorganization of Craniofacial/Cleft Care Delivery: The Massachusetts Experience
Authors: Borah Gregory L. , Hagberg Nancy , Jakubiak Carolyn , Temple Jean
Published: October 2018

Until 1989, the Commonwealth of Massachusetts operated a mandated care program known as Services for Handicapped Children (SHC) for children with cleft lip/palate or craniofacial anomalies. During the mid 1980s, the federal government reduced its block grant funds and encouraged the Commonwealth of Massachusetts to develop Project SERVE to address this changing fiscal reality. The principal outcome of Project SERVE was the recommendation that the SHC direct care programs, Including all craniofacial and cleft palate clinics, should be dismantled over a number of years. However, due to the economic recession, all government funding was suddenly withdrawn from cleft palate teams and the state-run SHC clinics were abruptly dissolved. To treat patients left without coordinated care, former team members reassembled and began a new craniofacial team based at the University of Massachusetts Medical Center. Difficulties with the transition of the clinic included recruiting and retaining team members; remuneration procedures for team members; maintenance of patient records previously kept by the state; coordination of clinical/clerical responsibilities; identifying a physical locale to hold the clinics; and solicitation of referring health care provider referrals and follow-up. All these issues required specific interventions that are presented in this paper. Project SERVE, begun under federal auspices, In the Commonwealth of Massachusetts, has recently been promoted as a model for a new and improved approach to the management of cleft palate and craniofacial care delivery nationwide. Awareness of the potential for abrupt, radical change in funding for federally mandated cleft/craniofacial care is essential, and a successful transition to a medical center-based model is possible using the procedures established at our center.
Insidious Onset of Familial Craniosynostosis
Authors: Cohen Steven R. , Dauser Robert C. , Gorski Jerome L.
Published: October 2018

A mother, son, and daughter are presented, in whom serial photographs document an insidious and late onset of exorbitism and midfacial retrusion consistent with a diagnosis of familial nonsyndromic craniosynostosis. Papilledema was found in the 4.5-year-old daughter because of increased intracranial pressure secondary to a reduction in cranial vault size, whereas optic nerve sheath swelling on CT scan was found in the son.
Genetic Survey of a Group of Children with Clefting: Implications for Genetic Counseling
Authors: Hofstee Yvonne , Kors Nico , Hennekam Raoul C.M.
Published: October 2018

A cleft lip, cleft palate, or both are associated with a high frequency of other anomalies. This study gives an inventory of associated anomalies in a consecutive group of children (n = 36) with clefts, referred to a local multidisciplinary cleft team in the Netherlands. In 47.2% of cleft patients associated anomalies were found, allowing diagnosis of provisionally unique syndromes or known entities. In 17 patients family history was positive for clefting; in five patients (13.9%) this influenced the occurrence risks for siblings. Both findings had an effect on genetic counseling of the parents of these children. Additional evidence is provided that all children with clefting should be carefully evaluated by a trained clinician for additional anomalies, including dysmorphic features.
Psychological Functioning of Children with Craniofacial Anomalies and Their Mothers: Follow-Up from Late Infancy to School Entry
Authors: Speltz Matthew L. , Morton Kathi , Goodell Elizabeth W. , Clarren Sterling K.
Published: October 2018

Twenty-three mothers and their 5- to 7-year-old children with craniofacial anomalies (CFA) who were assessed during the child's infancy were followed. Three types of CFA were Included: cleft lip and palate (CLP), isolated cleft palate (CP), and sagittal synostosis. Measures of child status focused on behavior-problem frequency and self-concept. Mothers completed self-report measures of emotional well-being, marital satisfaction, and social support. Results Indicated that (1) a sizable minority (18%) of the children with CFA had clinically significant behavior-problem scores shown in concordant reports by parent and teacher of behavior problems; (2) Individual differences In child functioning within the CFA group were predicted by observational measures of earlier mother-Infant interaction during play and teaching situations; (3) mothers of children with CLP reported less favorable social support than mothers of children with CP or sagittal synostosis.
Presidents’ Perceptions: An Historic Review of Fifty Years of the American Cleft Palate-Craniofacial Association
Authors: Richman Lynn C.
Published: October 2018

This historic review of the American Cleft Palate-Craniofacial Association was written by the Historian charged by the ACPA Executive Council for the purpose of updating the history of the organization in honor of its 50th Anniversary. The data base for this review was the previously published 36-year history by Historian Charlotte Wells, the minutes of ACPA Executive Council meetings from 1979 to 1993, and a questionnaire survey of the 32 living Past Presidents (with a 90% return rate). This review highlights the important issues and critical decisions as recalled by Past Presidents. It also includes the recollection of humorous anecdotes, since the scholarly debate of this interdisciplinary organization is often brought to a positive interpersonal level through the good natured humor of many of Its members.