bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated Air Trap and Volume Gauge for Axis Translation Systems
Authors: Infante Sedano Julio Ángel , Garga Vinod K. , Vanapalli Sai K.
Published: May 2010

This Technical Note presents the design detail of a combined air trap and volume gauge burette used for flushing air bubbles from under ceramic disks in axis translation systems that are used to measure or apply matric suction to unsaturated soil specimens. Axis translation systems are commonly used in the testing of unsaturated soils to subject soil specimens to matric suction values greater than 1 atm. Diffused air may come out of solution and accumulate below the ceramic disk of the axis translation system, prompting to provide a flushing system to remove them. An apparatus consisting of two concentric glass tubes, alongside a graduated scale, two water vessels permitting the isolation of the water phase to reduce moisture exchange with the surrounding atmosphere, and connected to the flushing groove below the ceramic disk of the axis translation system through two plastic tubes was developed. The apparatus described permits an accurate measurement of the volume of water expelled from the specimen and can allow for the volume of diffused air flushed out.
Modeling of Crack Propagation in Weld Beam-to-Column Connections Submitted to Cyclic Loading with a Cohesive Zone Model
Authors: Lequesne Cédric , Plumier André , Duchêne Laurent , Habraken Anne Marie
Published: May 2010

During the earthquakes in Japan and California in the 1990s, cracks appeared in some weld beam-to-column connections of heavy rigid frame steel buildings. This prompted the necessary assessment of the performance of weld connections in terms of rotation capacity and crack propagation. In the present study, experimental tests were performed where weld connections were submitted to cyclic loadings with increasing amplitude until a macrocrack event was reached. However the crack phenomenon depends on many parameters: The geometry, the material, the welding process…. For this reason, it was interesting to develop a finite element modeling of these connections in order to complete these experiments and perform a parametric study. This paper describes the finite element model development, its material parameter identification, and its comparison with experimental results. The weld connections were modeled by using three-dimensional mixed solid elements. The constitutive laws applied were elastoplastic with isotropic hardening identified for the base metal and the weld metal. Crack propagation was modeled by a cohesive zone model. The parameters of this cohesive zone model were identified by an inverse method with the modeling of three-point bending tests of pre-cracked samples performed on the base and weld metals. The fatigue damage generated by the cyclic loading was computed by the fatigue continuum damage model of Lemaitre and Chaboche, which was coupled with the cohesive zone model.
Selection of Collaborative Technology Used by Software Contractors
Authors: Wu Cheng-Ru , Chang Che-Wei , Liao Chia-Chun
Published: May 2010

Applying collaborative technology in the software technology can shorten the product design cycle and improve competitiveness. The enterprise and suppliers can use this technology to develop a new communication platform, which can bring collaborative effect and improve technological efficacy. Most studies had proposed objective measurements for the evaluation criteria from different types of collaboration technological guidance to provide an overall framework for thinking. This study uses analysis hierarchy process, benefits, opportunities, costs, and risks, and sensitivity analysis to analyze the collaboration software technology in thin film transistor liquid crystal display panel plant and research the software performance. Consequently, the present study may provide a useful reference for enterprises considering the selection of development partners.
Ölsensorsystem zur Echtzeit-Zustandsüberwachung von technischen Anlagen und Maschinen
Authors: Gegner Jürgen , Kuipers Ulrich , Mauntz Manfred
Published: May 2010

Es wird ein neues Ölsensorsystem zur kontinuierlichen Online-Messung der ölqualitätsabhängigen Parameter elektrische Leitfähigkeit und Dielektrizitätszahl für die Bewertung von Bauteilverschleiß und Ölalterung vorgestellt. Die Bestimmung der Kontamination bzw. Abnahme der Schmierstoffqualität erlaubt zeitgerechte, bedarfsabhängige Wartung. Da die Leitfähigkeit des Öls im Vergleich zu den Verunreinigungen wesentlich niedriger ist, besteht ein direkter Zusammenhang mit dem Verschmutzungsgrad. Wassergehalt im Öl bzw. Abbau von Additiven werden über eine genaue Messung der Dielektrizitätszahl verfolgt. Wichtige Anwendungsfelder sind die Echtzeit-Schmierstoffüberwachung in (Industrie-) Getrieben, Hydraulikanlagen, Turbinen, Generatoren und Transformatoren.
Mealtime at a Tibetan Monastery
Authors: rath eric c.
Published: May 2010

With assistance from lay volunteers and using a giant stove, Tibetan monks at Longen monastery in rural Qinghai province China prepare and serve meals for several hundred of their peers during the summer retreat. In the past, rugged geography and the isolation of this monastery above 13,000 feet gave reasons for the monks to eat local meat since other foodstuffs were unavailable in an area unable to support agriculture beyond herding animals, chiefly yaks and cows. However, closer contact with the outside has allowed the monks to adopt a vegetarian diet, but one that still uses local resources such as yoghurt and wild sweet potatoes.
Autoantibody responses in autoimmune ovarian insufficiency and in Addison's disease are IgG1 dominated and suggest a predominant, but not exclusive, Th1 type of response
Authors: Brozzetti Annalisa , Marzotti Stefania , La Torre Daria , Bacosi Maria Luisa , Morelli Silvia , Bini Vittorio , Ambrosi Bruno , Giordano Roberta , Perniola Roberto , De Bellis Annamaria , Betterle Corrado , Falorni Alberto
Published: May 2010

Objective

Steroid-producing cell autoantibodies (SCAs) directed against 21-hydroxylase autoantibodies (21OHAbs), 17α-hydroxylase autoantibodies (17OHAb), and cholesterol side-chain cleavage enzyme (side-chain cleavage autoantibodies, P450sccAb) characterize autoimmune primary ovarian insufficiency (SCA-POI). The aim of the study was to analyze IgG subclass specificity of autoantibodies related to adrenal and ovarian autoimmunity.

Design

We studied 29 women with SCA-POI, 30 women with autoimmune Addison's disease (AAD) without POI, and 14 patients with autoimmune polyendocrine syndrome type 1 (APS1). 21OHAb isotypes were also analyzed in 14 subjects with preclinical AAD. Samples from 30 healthy women served as control group to determine the upper level of normality in the isotype assays.

Methods

Immunoradiometric assays with IgG subclass-specific secondary antibodies.

Results

In 21OHAb-positive sera, IgG1 isotype was detected in 90% SCA-POI and non-POI AAD sera and 67% APS1 patients. IgG1 isotype was found in 69% 17OHAb-positive SCA-POI and 100% 17OHAb-positive APS1 sera, and in 60% P450sccAb-positive SCA-POI and 80% P450sccAb-positive APS1 sera. For 21OHAb, IgG4 isotype was detected in 17% SCA-POI, 7% non-POI AAD, and 8% APS1 sera. None of the 17OHAb-positive sera was positive for IgG4. In P450sccAb-positive sera, 15% POI and 20% APS1 sera were positive for IgG4. Two 21OHAb-positive SCA-POI (7%), one 21OHAb-positive AAD (3%), three P450sccAb-positive SCA-POI (15%), and two P450sccAb-positive APS1 (20%) sera were positive for IgG4, in the absence of IgG1. All preclinical AAD sera resulted as positive for IgG1-21OHAb, but not for IgG4-21OHAb.

Conclusions

The autoantibody responses in POI and AAD are IgG1 dominated, which suggests a predominant Th1 response. Selective IgG4 isotype specificity identified a small subset of patients with Th2-oriented response.
Cortisol, DHEA sulphate, their ratio, and all-cause and cause-specific mortality in the Vietnam Experience Study
Authors: Phillips Anna C , Carroll Douglas , Gale Catharine R , Lord Janet M , Arlt Wiebke , Batty G David
Published: May 2010

Objectives

The aim of the present analyses was to examine the association between cortisol, DHEA sulphate (DHEAS) and the cortisol:DHEAS ratio and mortality.

Design

This was a prospective cohort analysis.

Methods

Participants were 4255 Vietnam-era US army veterans. From military service files, telephone interviews and a medical examination, occupational, socio-demographic and health data were collected. Contemporary morning fasted cortisol and DHEAS concentrations were determined. Mortality was tracked over the subsequent 15 years. The outcomes were all-cause, cardiovascular disease, cancer, other medical mortality and external causes of death. Cox proportional hazard models were tested, initially with adjustment for age, and then with adjustment for a range of candidate confounders.

Results

In general, cortisol concentrations did not show an association with all-cause or cause-specific mortality. However, in age-adjusted and fully adjusted analyses, DHEAS was negatively related to all-cause, all cancers and other medical mortality; high DHEAS concentrations were protective. The cortisol:DHEAS ratio was also associated with these outcomes in both age-adjusted and fully adjusted models; the higher the ratio, the greater the risk of death.

Conclusions

DHEAS was negatively associated, and the ratio of cortisol to DHEAS was positively associated with all-cause, cancer and other medical cause mortality. Further experimental study is needed to elucidate the mechanisms involved in these relationships.
Genetic Evidence that the Acetylation of the Smc3p Subunit of Cohesin Modulates Its ATP-Bound State to Promote Cohesion Establishment in Saccharomyces cerevisiae
Authors: Heidinger-Pauli Jill M , Onn Itay , Koshland Douglas
Published: May 2010

Sister chromatid cohesion refers to the process by which sister chromatids are tethered together until the metaphase-to-anaphase transition. The evolutionarily conserved cohesin complex mediates sister chromatid cohesion. Cohesin not only ensures proper chromosome segregation, but also promotes high-fidelity DNA repair and transcriptional regulation. Two subunits of cohesin (Smc1p, Smc3p) are members of the structural maintenance of chromosomes (SMC) family. The SMC family is recognized by their large coiled-coil arms and conserved ATP-binding cassette-like ATPase domain. While both Smc1p and Smc3p ATP binding and hydrolysis are essential for cohesin function in vivo, little is known about how this core enzymatic activity is regulated to facilitate sister chromatid cohesion. Here we use SMC mutant proteins to block specific steps in cohesin's ATPase cycle in Saccharomyces cerevisiae. We show that blocking Smc3p-mediated ATP binding or Smc3p ATP hydrolysis traps unique functional states in cohesion. Finally, we provide evidence that Smc3p acetylation, which has an essential role in cohesion establishment, modulates the Smc3p ATP-bound state.
Paralogous Genes Involved in Juvenile Hormone Action in Drosophila melanogaster
Authors: Baumann Aaron , Barry Joshua , Wang Shaoli , Fujiwara Yoshihiro , Wilson Thomas G
Published: May 2010

Juvenile hormone (JH) is critical for multiple aspects of insect development and physiology. Although roles for the hormone have received considerable study, an understanding of the molecules necessary for JH action in insects has been frustratingly slow to evolve. Methoprene-tolerant (Met) in Drosophila melanogaster fulfills many of the requirements for a hormone receptor gene. A paralogous gene, germ-cell expressed (gce), possesses homology and is a candidate as a Met partner in JH action. Expression of gce was found to occur at multiple times and in multiple tissues during development, similar to that previously found for Met. To probe roles of this gene in JH action, we carried out in vivo gce over- and underexpression studies. We show by overexpression studies that gce can substitute in vivo for Met, alleviating preadult but not adult phenotypic characters. We also demonstrate that RNA interference-driven knockdown of gce expression in transgenic flies results in preadult lethality in the absence of MET. These results show that (1) unlike Met, gce is a vital gene and shows functional flexibility and (2) both gene products appear to promote JH action in preadult but not adult development.
Multiple Functions for Drosophila Mcm10 Suggested Through Analysis of Two Mcm10 Mutant Alleles
Authors: Apger Jennifer , Reubens Michael , Henderson Laura , Gouge Catherine A , Ilic Nina , Zhou Helen H , Christensen Tim W
Published: May 2010

DNA replication and the correct packaging of DNA into different states of chromatin are both essential processes in all eukaryotic cells. High-fidelity replication of DNA is essential for the transmission of genetic material to cells. Likewise the maintenance of the epigenetic chromatin states is essential to the faithful reproduction of the transcriptional state of the cell. It is becoming more apparent that these two processes are linked through interactions between DNA replication proteins and chromatin-associated proteins. In addition, more proteins are being discovered that have dual roles in both DNA replication and the maintenance of epigenetic states. We present an analysis of two Drosophila mutants in the conserved DNA replication protein Mcm10. A hypomorphic mutant demonstrates that Mcm10 has a role in heterochromatic silencing and chromosome condensation, while the analysis of a novel C-terminal truncation allele of Mcm10 suggests that an interaction with Mcm2 is not required for chromosome condensation and heterochromatic silencing but is important for DNA replication.
BUD22 Affects Ty1 Retrotransposition and Ribosome Biogenesis in Saccharomyces cerevisiae
Authors: Dakshinamurthy Arun , Nyswaner Katherine M , Farabaugh Philip J , Garfinkel David J
Published: May 2010

A variety of cellular factors affect the movement of the retrovirus-like transposon Ty1. To identify genes involved in Ty1 virus-like particle (VLP) function, the level of the major capsid protein (Gag-p45) and its proteolytic precursor (Gag-p49p) was monitored in a subset of Ty1 cofactor mutants. Twenty-nine of 87 mutants contained alterations in the level of Gag; however, only bud22Δ showed a striking defect in Gag processing. BUD22 affected the +1 translational frameshifting event required to express the Pol proteins protease, integrase, and reverse transcriptase. Therefore, it is possible that the bud22Δ mutant may not produce enough functional Ty1 protease to completely process Gag-p49 to p45. Furthermore, BUD22 is required for 18S rRNA processing and 40S subunit biogenesis and influences polysome density. Together our results suggest that BUD22 is involved in a step in ribosome biogenesis that not only affects general translation, but also may alter the frameshifting efficiency of ribosomes, an event central to Ty1 retrotransposition.
Avaliação da adequação das informações de mortalidade e nascidos vivos no Estado de Pernambuco, Brasil
Authors: Frias Paulo Germano de , Pereira Pricila Melissa Honorato , Andrade Carla Lourenço Tavares de , Lira Pedro Israel Cabral de , Szwarcwald Célia Landmann
Published: May 2010

O Ministério da Saúde tem realizado importante investimento na melhoria da qualidade dos sistemas de informação sobre mortalidade e nascidos vivos. Entretanto, na maioria dos estados brasileiros a mortalidade infantil ainda é calculada por métodos indiretos, sem levar em consideração os avanços ocorridos nessa área. O objetivo deste artigo é avaliar a adequação das informações de óbitos e nascimentos nos municípios de Pernambuco, Brasil, utilizando indicadores de cobertura e regularidade dos sistemas. Os resultados evidenciaram as inconsistências na série temporal das estimativas por métodos indiretos da cobertura de óbitos infantis no estado. Os indicadores de adequação apontaram uma importante melhora da cobertura e regularidade das informações vitais. A proporção de óbitos por causas mal definidas, indicador da qualidade dos dados, mostrou também melhoras, embora em grau menor. A evolução observada em Pernambuco aponta para a importância de uma reflexão acerca da utilização de métodos diretos para o cálculo da mortalidade infantil, pelo menos nos municípios com informações adequadas.
Acessibilidade aos serviços de saúde em um município do Estado da Bahia, Brasil, em gestão plena do sistema
Authors: Cunha Alcione Brasileiro Oliveira , Vieira-da-Silva Ligia Maria
Published: May 2010

Com o objetivo de analisar a implantação de ações voltadas para a acessibilidade à atenção básica em um município da Bahia, Brasil, foi realizado estudo de caso único a partir de dois níveis de análise: organização do sistema e dos serviços. Os dados foram obtidos por intermédio de entrevistas semi-estruturadas, da observação das rotinas de atendimento e da análise documental. Das quatro unidades analisadas, três apresentaram nível intermediário de implantação de ações voltadas para a acessibilidade. As unidades de saúde da família tiveram melhor desempenho devido à presença de ações voltadas para o acolhimento e a referência a serviços especializados, porém apresentaram problemas para a marcação de consultas. Apesar do estabelecimento da atenção básica como porta de entrada ao sistema e da implantação da central de marcação de consultas especializadas, persistem barreiras organizacionais no município estudado. Recomenda-se a formulação de política específica para melhoria da acessibilidade voltada para a organização da oferta na perspectiva de mudança do modelo assistencial.
Relação entre depressão pós-parto e disponibilidade emocional materna
Authors: Fonseca Vera Regina J. R. M. , Silva Gabriela Andrade da , Otta Emma
Published: May 2010

A depressão pós-parto é um transtorno de alta prevalência que pode comprometer a qualidade da relação mãe-criança. Este estudo pretende determinar a prevalência do referido transtorno, comparar a interação mãe-bebê nos grupos com e sem depressão e verificar a relação entre depressão, apoio social e estilos de relacionamento e disponibilidade emocional maternos. As participantes eram gestantes que pretendiam dar à luz no Hospital Universitário da Universidade de São Paulo entre dezembro de 2006 e dezembro de 2008. A prevalência de depressão pós-parto em nossa amostra foi 28%. Não houve diferença significativa na relação mãe-criança no grupo com e sem depressão. Encontrou-se correlação positiva entre sensibilidade materna e escolaridade e entre sensibilidade e certas dimensões de apoio social e estilo de relacionamento. Conclui-se que a prevalência de depressão pós-parto em nossa amostra é mais alta que a média mundial, mas a sintomatologia depressiva não interfere significativamente na qualidade da interação mãe-bebê. A sensibilidade materna é influenciada por fatores sócio-cognitivos e afetivos.
Como a posição social influencia a auto-avaliação do estado de saúde? Uma análise comparativa entre 1998 e 2003
Authors: Rodrigues Cristina Guimarães , Maia Alexandre Gori
Published: May 2010

O objetivo deste trabalho é analisar de que forma a posição social das famílias está associada ao estado de saúde individual auto-avaliado. As informações foram extraídas dos suplementos de saúde da Pesquisa Nacional por Amostra de Domicílios (PNAD/IBGE) de 1998 e 2003. A análise baseou-se em estatísticas descritivas e regressão logística para captar a relação condicional entre estado de saúde, posição social e demais variáveis de controle, como idade, sexo, raça/cor, renda, escolaridade e região de residência. Os resultados mostram que a hierarquia de classes ocupacionais reproduz-se na auto-avaliação do estado de saúde. Há um aumento das desigualdades entre 1998 e 2003, com redução na prevalência de saudáveis nos grupos de base e aumento no topo da pirâmide social. Embora a prevalência de saudáveis seja maior nas classes não agrícolas, a probabilidade de declarar-se saudável é maior para os agrícolas, depois de adicionadas as demais variáveis de controle. Os resultados reforçam a necessidade de se analisar as desigualdades em saúde sob a perspectiva da estratificação social.
Consensus Summary of Aerosolized Antimicrobial Agents: Application of Guideline Criteria
Authors: Le Le Jennifer , Ashley Elizabeth Dodds , Neuhauser Melinda M. , Brown Jack , Gentry Chris , Klepser Michael E. , Marr Ann Marie , Schiller Daryl , Schwiesow Joshua N. , Tice Sally , VandenBussche Heather L. , Wood G. Christopher ,   Society of Infectious Diseases Pharmacists Aerosolized Antimicrobials Task Force
Published: May 2010

Aerosolized delivery of antimicrobial agents is an attractive option for management of pulmonary infections, as this is an ideal method of providing high local drug concentrations while minimizing systemic exposure. With the paucity of consensus regarding the safety, efficacy, and means with which to use aerosolized antimicrobials, a task force was created by the Society of Infectious Diseases Pharmacists to critically review and evaluate the literature on the use of aerosolized antiinfective agents. This article summarizes key findings and statements for preventing or treating a variety of infectious diseases, including cystic fibrosis, bronchiecstasis, hospital acquired pneumonia, fungal infections, nontuberculosis mycobacterial infection, and Pneumocystis jiroveci pneumonia. Our intention was to provide guidance for clinicians on the use of aerosolized antibiotics through evidence based pharmacotherapy. Further research with well designed clinical trials is necessary to elucidate the optimal dosage and duration of therapy and, of equal importance, to appreciate the true risks associated with the use of aerosolized delivery systems.
Drug‐Induced Black Hairy Tongue
Authors: Thompson Dennis F. , Kessler Tiffany L.
Published: May 2010

Black hairy tongue (BHT) is a benign, self‐limiting disorder characterized by abnormally hypertrophied and elongated filiform papillae on the surface of the tongue. The prevalence of BHT is quite variable, ranging from 0–53.8% depending on the population. Many predisposing factors to BHT exist, and several drugs and drug classes have been implicated in causing this disorder. A modified Naranjo adverse drug reaction probability nomogram specific for BHT was used to rate causality for the available published case reports of drug‐induced BHT. From the available data, antibiotics and drugs capable of inducing xerostomia are the drug classes that have modest evidence of causality and a rational mechanism. The presence of underlying predisposing factors in these cases along with the variable prevalence of BHT make drawing firm conclusions difficult. Treatment for BHT involves eliminating any predisposing issues and practicing scrupulous oral hygiene. Drug therapy and physical removal of the elongated filiform papillae are available for resistant cases. Clinicians should be aware of the prevalence, the predisposing factors and drug classes that may play a role in the development, and the treatment of BHT.
Incretin‐Based Therapies for Type 2 Diabetes Mellitus: Current Status and Future Prospects
Authors: Drab Scott R.
Published: May 2010

Incretin‐based therapies encompass two new classes of antidiabetic drugs: glucagon‐like peptide‐1 (GLP‐l) receptor agonists (e.g., liraglutide, exenatide, and exenatide long‐acting release), which are structurally related to GLP‐l, and the dipeptidyl peptidase‐4 (DPP‐4) inhibitors (e.g., sitagliptin and saxagliptin), which limit the breakdown of endogenous GLP‐l. To evaluate the safety and effectiveness of incretin‐based therapies for the treatment of type 2 diabetes mellitus and the role of these therapies in clinical practice, a MEDLINE search (January 1985‐November 2009) was conducted. Relevant references from the publications identified were also reviewed. Of 28 studies identified, 22 were randomized controlled trials. Data show that these therapies affect insulin secretion in a glucose‐dependent manner, achieving clinically meaningful reductions in hemoglobin A1c levels, with very low rates of hypoglycemia. In addition, reductions in body weight have been observed with GLP‐l receptor agonists, which also exert a pronounced effect on systolic blood pressure. Various human and animal studies show that GLP‐l improves β‐cell function and increases β‐cell proliferation in vitro, which may slow disease progression. Thus, incretin‐based therapies represent a promising addition to the available treatments for type 2 diabetes.
Coping with a Cleft II: Factors Associated with Psychosocial Adjustment of Adolescents with a Cleft Lip and Palate and Their Parents
Authors: Berger Zoe E. , Dalton Louise J.
Published: May 2010

Objective

To explore the factors that predict psychosocial adjustment in young people with a cleft and their parents.

Design, Participants, Setting

The study used a cross-sectional postal questionnaire design involving young people aged between 11 and 16 and their parents from two cleft services. Data are presented for 91 adolescents and their mothers.

Main Outcome Measures

Participants completed measures of psychological adjustment, coping, social experiences, satisfaction with appearance, stressful life events, cleft-related factors, and demographic information.

Results

Psychosocial adjustment in adolescents was predicted by their social experiences and maternal well-being. Satisfaction with appearance, perceived speech problems, and the use of avoidant coping strategies were also important factors relating to their adjustment. For mothers, adjustment was predicted by use of coping strategies such as self-blame, venting, and acceptance, in addition to perceived problems with their child's hearing and the number of stressful life events experienced.

Conclusions

The findings are discussed in relation to the concepts of adjustment, coping, satisfaction with appearance, and maternal mental health. Directions for future research are outlined, and a number of opportunities and challenges for cleft services regarding the provision of timely interventions for this age group and their families are discussed.
Survival of Dental Implants in the Cleft Area—a Retrospective Study
Authors: De Barros Ferreira Samuel , Esper Luis Augusto , Sbrana Michyele Cristhiane , Ribeiro Ingrid Webb Josephson , De Almeida Ana Lúcia Pompéia Fraga
Published: May 2010

Objective

To evaluate the survival rate of dental implants placed in the cleft area.

Design

Retrospective study.

Setting

Hospital for Rehabilitation of Craniofacial Anomalies, Brazil. Institutional Tertiary Healthcare Center.

Patients

120 patients who received dental implants in the grafted cleft area in the years 1999 to 2005.

Interventions

Clinical data were evaluated from the records of 120 patients according to the following criteria: placement grafted, cleft area, and age at surgery; age at placement of dental implants; site and dimension of implants; interval between placement of implants and the last clinical follow-up; and interval between placement and removal or indication for removal of implants.

Main Outcome Measures

Percentage of survival rate of implants.

Results

Mean age at placement of the bone graft was 17.6 years and 21 years at placement of implants. A total of 123 cleft areas received secondary bone graft and bone graft to install implants (regraft). The mean survival rate was 34 months since placement of the implant to the last clinical follow-up and 26 months since placement of the prosthesis. Seven dental implants were removed. The survival rate since placement to the last clinical follow-up was 94.3%.

Conclusion

Rehabilitation of the cleft area with dental implants is a viable and secure alternative, with good prognosis.
Impact of a Cleft Lip and/or Palate on Maternal Stress and Attachment Representations
Authors: Despars Josée , Peter Camille , Borghini Ayala , Pierrehumbert Blaise , Habersaat Stéphanie , Müller-Nix Carole , Ansermet François , Hohlfeld Judith
Published: May 2010

Objective

The announcement, prenatally or at birth, of a cleft lip and/or palate represents a challenge for the parents. The purpose of this study is to identify parental working internal models of the child (parental representations of the child and relationship in the context of attachment theory) and posttraumatic stress disorder symptoms in mothers of infants born with a cleft.

Method

The study compares mothers with a child born with a cleft (n = 22) and mothers with a healthy infant (n = 36).

Results

The study shows that mothers of infants with a cleft more often experience insecure parental working internal models of the child and more posttraumatic stress symptoms than mothers of the control group. It is interesting that the severity or complexity of the cleft is not related to parental representations and posttraumatic stress disorder symptoms. The maternal emotional involvement, as expressed in maternal attachment representations, is higher in mothers of children with a cleft who had especially high posttraumatic stress disorder symptoms, as compared with mothers of children with a cleft having fewer posttraumatic stress disorder symptoms.

Discussion

Mothers of children with a cleft may benefit from supportive therapy regarding parent-child attachment, even when they express low posttraumatic stress disorder symptoms.
Inclusion Mucous Cysts of the Nose: A Late Complication after Septorhinoplasty in Two Cleft Lip Patients
Authors: Pausch Niels Christan , Bertolini Julia , Hemprich Alexander , Hierl Thomas
Published: May 2010

Background

Mucous cysts of the nose are a rare complication of rhinoplasty. They may develop as a result of implantation or herniation of mucosa. The entrapped epithelium may proliferate, forming a subcutaneous cyst.

Patients and Methods

Two patients with unilateral cleft lip nose deformity had previously undergone corrective rhinoplasty. Years after the operation, they noticed a growing mass in the nasal dorsum and presented for revision rhinoplasty. Complete surgical removal was performed by an open approach, and plastic reconstruction was performed with a rib cartilaginous graft.

Results

In both cases, histopathological investigation revealed a mucous cyst. No recurrence of disease was observed over 2 years of monitoring.

Conclusion

Nasal mucous cysts are not specific complications of corrective surgery for cleft lip nose. Displacement of fragments of epithelium should be avoided to prevent this unwanted sequela. For complete removal, open rhinoplasty is recommended.
Treatment Modalities of Infants with Upper Airway Obstruction—Review of the Literature and Presentation of Novel Orthopedic Appliances
Authors: Kochel Janka , Meyer-Marcotty Philipp , Wirbelauer Johannes , Böhm Hartmut , Kochel Michael , Thomas Wolfgang , Bareis Ute , Hebestreit Helge , Speer Christian , Stellzig-Eisenhauer Angelika
Published: May 2010

Objective

To present a new orthopedic method for treatment of infants with Pierre Robin sequence (PRS) and upper airway obstruction (UAO) as an alternative to other established nonsurgical and surgical techniques such as positioning, nasopharyngeal or endotracheal intubation, tongue-lip adhesion, extension, distraction, or tracheostomy.

Design

Review of the literature and presentation of novel orthopedic appliances.

Setting

Department of Orthodontics, Dental Clinic, Medical Faculty of the University of Wuerzburg, Germany, Department and Clinic of Pediatrics, Medical Faculty of the University of Wuerzburg, Germany, 2005 to 2008.

Patients

Seven patients with significant respiratory and feeding difficulties between 0 and 6 months of age. Both patients with nonsyndromic PRS and patients with syndromic PRS were included.

Interventions

The type of respiratory tract obstruction was defined by nasopharyngoscopy. Patients with type 1 obstruction received a plate with an epiglottic spur; whereas, patients with obstruction type 2, 3, or 4 received a plate with a pharyngeal tube.

Results

All patients were successfully treated with orthopedic appliances alone. Under plate therapy they showed good oxygen saturation and could consequently be better nourished orally.

Conclusions

The presented novel method is a noninvasive technique in treatment of infants with UAO.
Maxillary Movement in Distraction Osteogenesis Using Internal Devices in Cleft Palate Patients
Authors: Tomita Daisuke , Omura Susumu , Ozaki Shusaku , Shimazaki Kazuo , Fukuyama Eiji , Tohnai Iwai , Torikai Katsuyuki
Published: May 2010

Objective

The purpose of this cephalometric study was to compare the actual movement with the planned movement of the maxilla by using internal maxillary distraction in cleft lip and palate patients.

Patients

Twelve patients, including eight with unilateral and four with bilateral cleft lip and palate, underwent maxillary advancement with internal maxillary distractors.

Main Outcome Measures

Lateral cephalometric radiographs obtained preoperatively, predistraction, and postdistraction were used for analysis. The movement of the maxilla, angular change of the internal devices and rotation of the mandible were measured at each stage, and the planned vector of advancement predicted from the placement vector of the distractors was compared with the actual vector.

Results

Internal maxillary distractors were rotated in a clockwise direction during the distraction period. The angular change of the distractors was 7.7°. The amount of actual advancement at anterior nasal spine with distraction was 6.3 mm, which represented about 70% of the distance of activation of distraction. The actual advanced vector at anterior nasal spine was 9.7 smaller than the planned vector. The mandible underwent a clockwise rotation of 3.5°.

Conclusion

In the internal distraction technique, the maxilla was advanced inferiorly to the planned vector and with a slight clockwise rotation. These results are useful for surgical planning when using internal distractors.
Congenital Syngnathia: Case Report and Review of Literature
Authors: Naikmasur Venkatesh G. , Sattur Atul P. , Joshi S.K. , Rai Arpita
Published: May 2010

Congenital bony fusion of the maxilla and mandible, especially as an isolated occurrence, is a very rare condition. The very few cases reported in the literature are mostly inadequate in description and confusing in nomenclature. An isolated case of syngnathia in a 60-year-old female patient with unilateral bony fusion (synostosis) of the maxilla and mandible associated with fibrous adhesions (synechiae) of the opposite site is reported. The existent literature is also reviewed.
Objective Three-Dimensional Assessment of Lip Form in Patients with Repaired Cleft Lip
Authors: Tanikawa Chihiro , Takada Kenji , Van Aalst John , Trotman Carroll Ann
Published: May 2010

Objectives

To measure and compare three-dimensional lip form in participants with a repaired cleft lip and noncleft control participants.

Design

Retrospective study. Three-dimensional facial images of each participant were obtained.

Participants

The sample consisted of two groups: a repaired cleft lip group (n = 57) and a noncleft “normal” group (n = 28).

Main Outcome Measures

Thirty-four variables that described the features of each participant's lip form were extracted from the image data. A t test was used for each variable to test for significant differences between the groups, and a mathematical technique was used to categorize the lip forms in both groups.

Results

Seventeen variables showed significant between-group differences. The differences were focused on the free edges of the upper and lower lip vermilion borders, upper and lower lip protrusion, and lip symmetry. Lip forms were described by seven categories. Participants with cleft lip were represented in all categories but fell mainly into two categories at one extreme. Noncleft participants were represented in five categories but also exclusively in two categories at the other extreme from participants with a repaired cleft lip. The findings show greater variation in lip form for the participants with a cleft lip.

Conclusion

Three-dimensional lip form in participants with a repaired cleft lip was found to have greater variation and to be significantly different from that in noncleft participants. This method can be used to assess surgical outcomes of lip form.
The Relationship between Nasalance Scores and Nasality Ratings Obtained with Equal Appearing Interval and Direct Magnitude Estimation Scaling Methods
Authors: Brancamp Tami U. , Lewis Kerry E. , Watterson Thomas
Published: May 2010

Objectives

To assess the nasalance/nasality relationship and Nasometer test sensitivity and specificity when nasality ratings are obtained with both equal appearing interval (EAI) and direct magnitude estimation (DME) scaling procedures. To test the linearity of the relationship between nasality ratings obtained from different perceptual scales.

Stimuli

Audio recordings of the Turtle Passage.

Design

Participants' nasalance scores and audio recordings were obtained simultaneously. A single judge rated the samples for nasality using both EAI and DME scaling procedures.

Participants

Thirty-nine participants 3 to 17 years of age. Across participants, resonance ranged from normal to severely hypernasal.

Main Outcome Measures

Nasalance scores and two nasality ratings.

Results

The magnitude of the correlation between nasalance scores and EAI ratings of nasality ( r= .63) and between nasalance and DME ratings of nasality ( r= .59) was not significantly different. Nasometer test sensitivity and specificity for EAI-rated nasality were .71 and .73, respectively. For DME-rated nasality, sensitivity and specificity were .62 and .70, respectively. Regression of EAI nasality ratings on DME nasality ratings did not depart significantly from linearity.

Conclusions

No difference was found in the relationship between nasalance and nasality when nasality was rated using EAI as opposed to DME procedures. Nasometer test sensitivity and specificity were similar for EAI-and DME-rated nasality. A linear model accounted for the greatest proportion of explained variance in EAI and DME ratings. Consequently, clinicians should be able to obtain valid and reliable estimates of nasality using EAI or DME.
Finite Element Analysis of Eustachian Tube Function in Cleft Palate Infants Based on Histological Reconstructions
Authors: Sheer F.J. , Swarts J.D. , Ghadiali S.N.
Published: May 2010

Introduction

The prevalence of otitis media with effusion approaches 100% in infants with cleft palate (CP), and disease pathogenesis is believed to be caused by eustachian tube (ET) dysfunction.

Objectives

Quantify the functional consequences of ET anatomy in infant CP specimens, and identify the relative importance of various tissue biomechanical properties on ET function in infants with CP.

Methods

Finite element models of ET anatomy and physiology were developed by using image analysis and three-dimensional (3D) reconstruction techniques. Models were developed using histological images of ET structures obtained from five infant CP specimens. The models were parameterized, and the effects of varying model parameters, which included tensor veli palatini and levator veli palatini force, ET cartilage, periluminal mucosal compliance, and hamular position on resistance to airflow through the tubal lumen, were determined.

Results

Of the evaluated parameters, only applied tensor veli palatini muscle force and compliance of the periluminal mucosa and cartilage tissues were significant predictors of resistance to airflow through the ET during muscle-assisted opening.

Conclusions

Finite element models of ET function in the CP infant identified tensor veli palatini muscle force as a direct predictor and mucosal/cartilage compliance as an indirect predictor of ET opening during muscle-assisted lumen dilations. Hamular position and levator veli palatini force were not found to have an effect on ET function in CP infants.
Disruption of the Murine Ap2β1 Gene Causes Nonsyndromic Cleft Palate
Authors: Li Wei , Puertollano Rosa , Bonifacino Juan S. , Overbeek Paul A. , Everett Eric T.
Published: May 2010

Development of the secondary palate in mammals is a complex process that can be easily perturbed, leading to the common and distressing birth defect cleft palate. Animal models are particularly useful tools for dissecting underlying genetic components of cleft palate. We describe a new cleft palate model resulting from a transgene insertion mutation. Transgene insertional mutagenesis disrupts the genomic organization and expression of the Ap2β1 gene located on chromosome 11. This gene encodes the β2-adaptin subunit of the heterotetrameric adaptor protein 2 complex involved in clathrin-dependent endocytosis. Homozygous cleft palate mutant mice express no Ap2β1 messenger RNA or β2-adaptin protein and die during the perinatal period. Heterozygous mice are phenotypically normal despite expressing diminished β2-adaptin messenger RNA and protein compared with wildtype. Remarkably, the paralogous β1-adaptin subunit of the adaptor protein 1 complex partially substitutes for the missing β2-adaptin in embryonic fibroblasts from homozygous mutant mice, resulting in assembly of reduced levels of an adaptor protein 2 complex bearing β1-adaptin. This variant adaptor protein 2 complex is, therefore, apparently capable of maintaining viability of the homozygous mutant embryos until birth but insufficient to support palatogenesis. Nonsyndromic cleft palate in an animal model is associated with disruption of the Ap2β1 gene.
A Case of 3q29 Microdeletion Syndrome Involving Oral Cleft Inherited from a Nonaffected Mosaic Parent: Molecular Analysis and Ethical Implications
Authors: Petrin Aline L. , Daack-Hirsch Sandra , L'heureux Jamie , Murray Jeffrey C.
Published: May 2010

Objective

The objective of this study was to use array comparative genomic hybridization to detect causal microdeletions in samples of subjects with cleft lip and palate.

Subjects

We analyzed DNA samples from a male patient and his parents seen during surgical screening for an Operation Smile medical mission in the Philippines.

Method

We used Affymetrix® Genome-Wide Human SNP Array 6.0 followed by sequencing and quantitative polymerase chain reaction using SYBR Green I dye.

Results

We report the second case of 3q29 microdeletion syndrome including cleft lip with or without cleft palate and the first case of this microdeletion syndrome inherited from a phenotypically normal mosaic parent.

Conclusions

Our findings confirm the usefulness of a comparative genomic hybridization to detect causal microdeletions and indicate that parental somatic mosaicism should be considered in healthy parents for genetic counseling of the families. We discuss important ethical implications of sharing health impact results from research studies with the participant families.
Cephalometric Analysis of Craniofacial Malformations in Newborn Mice with Cleft Palate Induced by Retinoic Acid
Authors: Chen Mu , Huang Hong-Zhang , Zeng Dong-Lin , Wang Da-Wei
Published: May 2010

Objective

To determine changes on craniofacial growth morphometrically in newborn mice with cleft palate induced by retinoic acid.

Design, Setting, Participants, Interventions

Gestation day 10 or 12 pregnant female C57BL/6N mice were given a single dose of all-trans retinoic acid (atRA) by gastric intubations via oral gavage. Sixty newborn mice with cleft palate (CP), 52 without CP from the experimental group, and 30 without CP from the control group were collected, and lateral cephalograms were taken of all of the mice.

Main Outcome Measures

Cephalometric analysis of the craniofacial skeleton was performed by means of a personal computer.

Results

Inhibition of craniofacial growth was found in the experimental groups but not in the control groups. In the maxillary bone and mandible, the amount of growth was significantly reduced.

Conclusions

These results suggest that craniofacial growth is inhibited in newborn mice with cleft palate induced by retinoic acid.
Novel Use of Osmotic Tissue Expanders to Treat Difficult Anterior Palatal Fistulas
Authors: Jenq Tina F. , Hilliard Stuart M. , Kuang Anna A.
Published: May 2010

Objective

Novel use of osmotic tissue expanders to recruit local palatal mucoperiosteum for the treatment of difficult anterior palatal fistulas.

Design

This is a retrospective review of our experience with osmotic tissue expanders for closure of secondary palatal fistulas.

Setting

The study occurred at Oregon Health and Science University, a tertiary care level academic hospital.

Patients, Participants

All patients were treated for combined cleft lip and palate by the Oregon Health and Science University Craniofacial Disorders multidisciplinary team. They were determined to be appropriate candidates due to the anterior location of the fistula and symptomatic nature. Patients complained of significant nasal regurgitation of liquid and solids.

Interventions

All patients underwent a two-stage procedure under general anesthesia. The first stage was placement of the expanders. The second stage was 1 week later, with removal of the expanders, palatal revision, and closure of the oronasal fistula.

Main Outcome Measure

The primary outcome measures determined before data collection were treatment of symptoms and decreased size of fistula.

Results

Seven patients with palatal fistulas were treated with osmotic tissue expanders. Five patients had complete closure of the fistula. Two patients demonstrated slit-like fistulas that were no longer symptomatic and were amenable to closure at time of alveolar bone grafting. No complications were observed.

Conclusions

The use of osmotic tissue expanders is a viable alternative for repair of large anterior palatal fistulas, especially in a scarred or previously operated palate. Patients were also no longer symptomatic.
An Alternative Retainer Design for Cleft Patients: The “Aesthetic” Retainer
Authors: Collins Joanne M. , Witcher Thomas P. , Jones Vaughan S. , Noar Joseph H. , Naini Farhad B.
Published: May 2010

The objective of this report is to describe an original retainer design for retention following orthodontic treatment in cleft lip and palate patients in order to improve the aesthetics of anterior maxillary dentoalveolar cleft defects. The technique incorporates features of both traditional and modern retainer design. The advantages of the technique and fabrication process are described.
Variations in Velopharyngeal Structures between Upright and Supine Positions Using Upright Magnetic Resonance Imaging
Authors: Perry Jamie L.
Published: May 2010

Objective

No studies have used MRI to compare the dimensional changes of the velopharyngeal musculature between upright and supine positions. The purpose of this study is to provide a comparison between structures of the velopharyngeal mechanism while in the supine and upright positions during rest and sustained speech productions of four female subjects.

Methods

Four healthy white female subjects between 30 and 36 years of age (mean, 32.5 ± 1.75 years) were imaged using a 0.6-tesla open-type multi-position MRI scanner. Subjects produced two speech tasks (/i/ and /s/) in the two body positions.

Results

Velar measures (length, thickness, and height), pharyngeal measures (retrovelar and retrolingual), and levator muscle measures (length and angles of origin) demonstrated a small variation between upright and supine positions. Differences in velar height during production of /i/ between the two positions was significant for all subjects. In most cases, the velar thickness remained nearly the same (group mean difference was between –0.2 and 1.2 mm). Group means demonstrated an average levator muscle shortening from upright to supine of 2.8 mm at rest, 2.0 mm during /i/ production, and 2.3 mm during /s/ production. Percentage of levator shortening were 17% for /i/ production and 21% for /s/ production, which were independent of body position.

Conclusions

Overall, gravity had a minimal effect on velar thickness, velar length, velar height, levator muscle length, angles of origin, and pharyngeal dimensions. Differences between the two body positions (upright and supine) were not significant during rest or during production of /i/ and /s/, with the exception of velar height during /i/ production.