Maxillary dental development in complete unilateral alveolar clefts

OBJECTIVE

This study was conducted to determine whether development of individual maxillary teeth in subjects with complete unilateral alveolar clefts was significantly different from that found in unaffected children.

DESIGN

Retrospective, mixed longitudinal.

SETTING

Craniofacial Center, university based.

MATERIALS AND METHODS

A sample of 179 panoramic radiographs obtained during the mixed dentition from 79 subjects (47 males, 32 females) with complete alveolar clefts was analyzed. After visual evaluation of root development of the permanent maxillary teeth from radiographs, a score from 0 to 5 was assigned utilizing a predefined scoring system. Statistical analyses were performed between the cleft and unaffected reference groups available in the literature.

RESULTS

The cleft side dentition was found to be significantly delayed in development relative to the noncleft side (p < .05). Compared to the reference group, the cleft side lateral incisor demonstrated a mean difference in development of 1.59 years followed by the canine (1.39 years), the central incisor (0.96 years), the first premolar (0.94), and the second premolar (0.78).

CONCLUSION

Teeth directly adjacent to the cleft site were shown to be the most delayed. The lateral incisors and canines were observed to be the most variable when compared to their corresponding antimeres. The information obtained from this study may assist the orthodontist in selecting the appropriate time to initiate orthodontic treatment in order to prepare the permanent dentition prior to alveolar bone grafting.

Tumor necrosis factor-alpha, interleukin-6, and interleukin-8 secretion and the acute-phase response in patients with bacterial and tuberculous osteomyelitis

Osteomyelitis, or bone infection, is a major worldwide cause of morbidity. Treatment is frequently unsatisfactory, yet little is known about pathogenesis of infection. Plasma tumor necrosis factor (TNF), interleukin (IL)-6, and IL-8 concentrations were measured before and after lipopolysaccharide stimulation of whole blood from patients with bacterial and tuberculous osteomyelitis and from controls. Patients with bacterial and tuberculous osteomyelitis mounted an acute-phase response and were anemic and febrile. However, plasma IL-6 concentrations were significantly elevated in only tuberculous osteomyelitis patients (vs. controls, P < .05). IL-6 concentrations correlated with erythrocyte sedimentation rate, C-reactive protein level, and plasma albumin concentration, all acute-phase markers. There were no other correlations between cytokine concentrations and clinical data. Following ex vivo stimulation, TNF, IL-6, and IL-8 were secreted equally by patients and controls. In summary, tuberculous osteomyelitis is characterized by elevated systemic IL-6 concentrations associated with an acute-phase response. For further insight into immunopathology of osteomyelitis, studies on infected bone are required.

Influence of magnitude of horizontal and vertical deformation on preference for morphed faces

The purpose of this study was to assess whether the magnitude of the extreme horizontal or vertical deformations of morphed facial features influenced judgments of acceptability or preference of the facial soft tissue profile. Twelve judges responded to 5 changing features of 2 faces with clinically divergent malocclusions under 3 stimulus conditions, i.e., the magnitudes of the distortions were biased in the direction of preferred change, equally distorted in both directions and opposite to preferred change. For each condition, judges responded by pressing a mouse button when the feature became "acceptable" and releasing it when no longer acceptable and by pressing the button when the most pleasing distortion appeared. A small significant shift in the mean acceptability and preference was found for some features. Differences between the faces, however, remained constant, indicating that magnitude of distortion has little effect on acceptability or preference for changes in soft-tissue profiles.

Spectroscopic identification of an amorphous-to-crystalline drug transition in a solid dispersion SCH 48461 capsule formulation

Changes in the dissolution of a solid dispersion capsule formulation composed of amorphous SCH 48461 in a polyethylene glycol 8000 matrix were investigated. SCH 48461 [(3R,4S)-1,4-bis(4-methoxyphenyl)-3-(3-phenylpropyl)-2-azetidinone] is a potent cholesterol absorption inhibitor with low water solubility and low melting point. Several capsule lots placed under controlled storage conditions exhibited a slowing of dissolution as a function of time with large inter-lot and intra-lot dissolution variations. Capsule contents were analyzed by attenuated total reflectance infrared (ATR-IR) microspectroscopy and solid-state cross-polarization, magic angle spinning (CPMAS) 13C-nuclear magnetic resonance (NMR) spectrometry. ATR-IR microspectroscopic analysis showed large IR spectral differences between the lots including the presence of a crystalline drug fraction in lots which exhibited incomplete dissolution. Solid-state CPMAS 13C-NMR analysis confirmed the presence of a crystalline drug fraction in the problematic capsule lots. Both ATR-IR and CPMAS 13C-NMR spectral results produced a rank ordering of the crystalline drug fraction present in the capsule lots that correspond to the dissolution results.

The effect of maxillary first molar derotation on arch length

In the correction of Class II malocclusions, derotation of the maxillary first molars is required to obtain an idealized Class I relation. Because of its trapezoidal shape, the maxillary first molar is believed to provide an arch length gain attendant to its derotation, which may subsequently be used to resolve deficiencies mesial to it. Two commonly used mechanisms for maxillary first molar derotation and its associated centers of rotation were studied. A transpalatal arch, when accompanied by distal force equivalent at the level of the maxillary first molar center of resistance, can provide a center of rotation approximating the lingual attachment. This produces an arch length gain of 2.1 mm anterior to the molar, while simultaneously impinging on the maxillary second molar space 1.2 mm (per side). In reality, this may be a transference of a problem in one area of the dental arch to another. The 2 x 4 and 2 x 6 arch wires provide for various centers of rotation along an axis from the molar center of resistance--as projected to the occlusal surface--to the region of the maxillary first molar distal marginal ridge. These centers of rotation do not provide any meaningful alteration in arch length. These arch wires are useful, however, for maxillary first molar derotation necessary to achieve an idealized Class I molar occlusion. It is evident that the arch length gain related to derotation of the maxillary first molars, irrespective of the center of rotation, is insufficient to achieve Class I premolar intercuspation. Additional factors as growth, surgical intervention, or extractions are needed to achieve Class I premolar articulation.

Gastric acid secretion and enteric infection in Bangladesh

In developing countries many enteric infections are caused by acid-sensitive pathogens. Failure of the gastric acid barrier to infection has been reported in cholera but gastric acid secretion has been little studied in other enteric infections. We therefore studied basal and stimulated gastric acid in 185 Bangladeshi men admitted to hospital for the treatment of enteric infection. Patients with dysentery (amoebiasis, n = 24 and shigellosis, n = 19) and culture-negative diarrhoea (n = 69) had similar mean gastric acid levels (basal, 3-5 mmol/h; stimulated, 11-17 mmol/h), which remained stable in those patients studied throughout 12 weeks of convalescence. In contrast, patients with secretory diarrhoea caused by cholera or enterotoxigenic Escherichia coli (ETEC) had low gastric acid levels (P < 0.05 compared with other groups) (cholera, n = 34: basal mean 1.8 mmol/h [SD = 2.2], stimulated mean 7.9 mmol/h [SD = 6.4]; ETEC, n = 39: basal mean 2.7 mmol/h [SD = 2.8], stimulated mean 9.4 mmol/h [SD = 7.5]). Cholera patients' gastric acid level rose during convalescence to similar levels to the dysentery patients'. Low gastric acid level was associated with severe disease in patients with cholera (P < 0.02) or ETEC (P < 0.05). Gastric acid level fell with increasing age (P < 0.007) but this did not account for the differences between groups. Gastric acid levels were not associated with Giardia duodenalis or Strongyloides stercoralis co-infection, fever, use of tobacco, or chewing betel nut. Cholera and secretory diarrhoea caused by ETEC may, therefore, partly result from a reduction in gastric acid level which does not occur during dysentery. Factors which impair gastric acid secretion may predispose to diarrhoeal disease in developing countries.

Origin of the correlation time dependence of coherence transfer distortions in rotating frame cross-relaxation spectra

HOHAHA distortions in conventional (CW) ROESY experiments are known to be prominent when the frequency of the spin-lock field is near the midpoint between the resonance frequencies of a pair of coupled spins. That the disappearance of these distortions with offset from the midpoint is more rapid for large molecules than smaller ones is less widely known, and less well understood. We provide a quantitative explanation of the latter phenomenon using a combination of theory and numerical simulations. The cause of this effect can be found in the differential relaxation of the various magnetization modes which are involved in HOHAHA transfer. These modes experience enhanced relaxation far from a Hartmann-Hahn match. This enhancement is larger for molecules which have long correlation times.

Bond strength of visible light-cured glass ionomer orthodontic cement

In this in vitro study, tensile strength tests were conducted with a visible light-cured glass ionomer cement (Fuji Ortho LC, GC America Inc.) bonded to extracted teeth under six different enamel surface conditions: (1) dry nonetched, (2) moist etched, (3) moist nonetched, (4) moist nonetched rebonded, (5) moistened with saliva substitute, and (6) moistened with human saliva. Two resin adhesives (Rely-A-Bond and Phase II, Reliance Orthodontic Products) were applied to dry and etched enamel and served as control agents. The glass ionomer cement approached the strength observed for resin adhesives and required the presence of moisture on the enamel surface for optimal performance.

Ras oncoprotein inhibitors: the discovery of potent, ras nucleotide exchange inhibitors and the structural determination of a drug-protein complex

The nucleotide exchange process is one of the key activation steps regulating the ras protein. This report describes the development of potent, non-nucleotide, small organic inhibitors of the ras nucleotide exchange process. These inhibitors bind to the ras protein in a previously unidentified binding pocket, without displacing bound nucleotide. This report also describes the development and use of mass spectrometry, NMR spectroscopy and molecular modeling techniques to elucidate the structure of a drug-protein complex, and aid in designing new ras inhibitor targets.

Immunotherapy for porcine cysticercosis: implications for prevention of human disease. Cysticercosis Working Group in Peru

Taenia solium cysticercosis is an important cause of human disease in many developing countries. Porcine cysticercosis is a vital link in the transmission of this disease and impairs meat production. A treatment for porcine cysticercosis may be an effective way of preventing human disease that would also benefit pig farmers, facilitating control programs in disease-endemic regions. Previous research suggests that reinfection with cysticercosis or immunotherapy with cysticercal antigens may cause degeneration of cysticerci, potentially curing porcine cysticercosis. Therefore, a blinded, randomized, controlled study to assess the efficacy and safety of immunotherapy in 28 naturally parasitized pigs was performed. Four groups of pigs with similar weights were inoculated twice with membrane-enriched cysticercal antigens (MA), saline, aqueous-soluble crude cysticercal antigens (AA) in adjuvant (Freund's complete then incomplete), or adjuvant alone. Immunotherapy was well tolerated but had no consistent effect on the macroscopic appearance of cysticerci or eosinophil count. Histopathologic findings were variable, with both severe and minimal inflammatory reactions seen in adjacent cysticerci in all pigs. Nine (64%) of 14 pigs given immunotherapy developed new antibody bands on electroimmunotransfer blot compared with one (7%) of 14 control pigs (P < 0.01). Treatment with AA in adjuvant caused a significant increase in the proportion of cysticerci that failed to evaginate and were, therefore, not viable for infecting humans (34% for pigs given AA in adjuvant compared with 10% for adjuvant alone; P < 0.04). Although immunotherapy caused a statistically significant decrease in the viability of cysticerci, this immunologic reaction was not great enough to prevent human disease.

Evaluation of cervical spine abnormalities on cephalometric radiographs

Cephalometric radiographs, a key element of orthodontic diagnosis, contain useful information related to the cervical spine often neglected by orthodontists and medical specialists. This article reviews cervical spine anatomy in a manner that will enable the clinician to trace the cervical spine accurately and detect cervical spine abnormalities. Examples of syndromic, nonsyndromic, and idiopathic anomalies of the cervical spine are presented and their significance discussed. Cephalometric radiographs can be used by clinicians as a potential resource for screening for pathologic abnormalities of the cervical spine and potentially averting some pathologic complications.

Comparison of two computer animated imaging programs for quantifying facial profile preference

To establish the physical basis of subjective judgements of facial appearance, two novel computer-imaging programs differing in method of preparation and presentation of 5 features of the facial soft-tissue profile of 4 faces representing 4 different classifications of dental occlusion were compared. Images of facial soft tissue of 5 features were digitized and "animated" from 16 discrete distortions or morphed from the two extremes of each feature. 12 volunteer judges responded to both the "animated" and morphed presentations by pressing the computer mouse button when the image became acceptable and releasing the button when the image was no longer acceptable. They also pressed the mouse button when the most pleasing distortion appeared from either direction. Aggregating responses to counterbalanced trials and features across judges yielded high correlations between the programs for midpoint of acceptability. Although both programs provide reliable and valid measures of subjective acceptability of present and proposed changes in facial morphology, the new morphing program is more user-friendly than the "animated" method.

An STS-based map of the human genome

A physical map has been constructed of the human genome containing 15,086 sequence-tagged sites (STSs), with an average spacing of 199 kilobases. The project involved assembly of a radiation hybrid map of the human genome containing 6193 loci and incorporated a genetic linkage map of the human genome containing 5264 loci. This information was combined with the results of STS-content screening of 10,850 loci against a yeast artificial chromosome library to produce an integrated map, anchored by the radiation hybrid and genetic maps. The map provides radiation hybrid coverage of 99 percent and physical coverage of 94 percent of the human genome. The map also represents an early step in an international project to generate a transcript map of the human genome, with more than 3235 expressed sequences localized. The STSs in the map provide a scaffold for initiating large-scale sequencing of the human genome.

Suppression of apoptosis by v-ABL protein tyrosine kinase is associated with nuclear translocation and activation of protein kinase C in an interleukin-3-dependent haemopoietic cell line

We previously demonstrated that activation of v-ABL protein tyrosine kinase resulted in suppression of apoptosis following interleukin-3 removal using an interleukin-3-dependent haemopoietic cell line transfected with a temperature-sensitive mutant of the v-abl oncoprotein (IC.DP). Cellular signalling events associated with the activation of v-ABL included increased levels of sn-1,2-diacylglycerol, an activator of protein kinase C. Calphostin C, a PKC inhibitor, restored apoptosis to interleukin-3-deprived IC.DP cells expressing active v-ABL. However, chronic exposure to the phorbol ester, 12-O-tetradecanoyl phorbol 13-acetate to downregulate protein kinase C did not attenuate the survival of IC.DP cells expressing active v-ABL. Translocation of a classical protein kinase C isozyme(s) to the nuclear fraction was observed 6 hours after activation of v-ABL, when nuclear protein kinase C activity was increased approximately 2-fold. The protein kinase C isozyme responsible, which was only partially downregulated by 12-O-tetradecanoyl phorbol 13-acetate, was identified as protein kinase C beta II. This translocation of protein kinase C beta II to the nucleus was inhibited by calphostin C. Taken together, these results suggest that nuclear translocation and activation of PKC beta II may play a role in v-ABL-mediated suppression of apoptosis.

A novel nuclear magnetic resonance (NMR) imaging method for measuring the water front penetration rate in hydrophilic polymer matrix capsule plugs and its role in drug release

An NMR imaging method was developed to estimate the rate of water movement in slow-release capsule matrices of pseudoephdrine HCl and hydroxypropyl cellulose (HPC). Test capsules were first placed in a USP method 2 (paddles, 50 rpm) dissolution apparatus. Each plug was removed from the dissolution medium at predetermined times, blotted dry, and placed within the magnetic field of a General Electric 400-MHz wide-bore NMR spectrometer equipped with a microimaging accessory. Images were recorded along the transverse plane of each plug. The water penetration rate was determined by comparison of the cut and weighed contour plots of the images acquired. After 1 hr, the plugs tamped to 200 N exhibited water penetration to the center, while only 45% of the drug was released. The percentage dry matrix was fitted to the Jost equation to obtain a diffusion coefficient of 4.15 x 10(-6) cm2/sec. NMR imaging is set forth as an important and practicable technique to investigate drug formulations. In the HPC matrix system of this study, the NMR imaging results convincingly revealed the rate of hydration front penetration not to be a rate-limiting step in the drug release process.

Cytokine-mediated protein kinase C activation is a signal for lineage determination in bipotential granulocyte macrophage colony-forming cells

Granulocyte macrophage colony-forming cells (GM-CFC) have the potential to develop into either macrophages and/or neutrophils. With a highly enriched population of these cells we have found that although GM-CFC are equally responsive to macrophage colony stimulating factor (M-CSF) and stem cell factor (SCF) in terms of DNA synthesis, M-CSF stimulated the development of colonies containing macrophages in soft gel assays, while SCF promoted neutrophilic colony formation. When SCF and M-CSF were combined, mainly macrophage development was stimulated both in soft agar colony-forming assays and liquid cultures. An analysis of some potential signaling mechanisms associated with cytokine-mediated developmental decisions in GM-CFC revealed that M-CSF, but not SCF, was able to chronically stimulate phosphatidylcholine breakdown and diacylglycerol production, indicating that protein kinase C (PKC) may be involved in the action of M-CSF. Furthermore, M-CSF, but not SCF, can increase the levels of PKC alpha (PKC alpha) expression and stimulate the translocation of PKC alpha to the nucleus. When the PKC inhibitor, calphostin C, was added to GM-CFC cultured in M-CSF then predominantly neutrophils were produced, conversely PKC activators added with SCF stimulated macrophage development. The data indicate a role for PKC in M-CSF-stimulated macrophage development from GM-CFC.

Caring for the confused geriatric surgical patient

Postoperative confusion in elderly patients is generally a temporary and reversible condition. The causes and contributing factors are numerous. The number of elderly surgical patients will continue to increase as this age group continues to grow. Our role as nurses is to provide the care that will not only focus on early recognition, assessment, and treatment of postoperative confusion, but will also recognize factors that preoperatively place a patient at increased risk and provide care that will prevent or minimize postoperative confusion.

Cellular signaling events elicited by v-abl associated with growth factor independence in an interleukin-3-dependent cell line

A temperature-sensitive mutant of the v-abl oncoprotein has previously been shown to have markedly reduced tyrosine protein kinase activity in interleukin 3 (IL-3)-dependent cells grown at restrictive (39 degrees C), compared to permissive (32 degrees C) temperatures. Transfection of this mutant v-abl into the IC2.9 cell line, generated the IC.DP subclone which was dependent on IL-3 for survival at 39 degrees C, but not at 32 degrees C. Furthermore, IC.DP cells cultured at 32 degrees C exhibited IL-3-independent thymidine incorporation, which was not apparent at 39 degrees C. Switching cells from the restrictive to the permissive temperature resulted in an increase in cellular inositol-1,4,5-trisphosphate, choline phosphate and diacylglycerol levels in the IC.DP cell line. These increases were only observed after a lag period of 4 h. Within 2 h of switching IC.DP cells previously maintained at 32 to 39 degrees C, there was a significant decrease in all three metabolites. Temperature switches had no effect upon these metabolites in the parent IC2.9 cell line. Down-regulation of protein kinase C inhibited v-abl-stimulated DNA synthesis in IC.DP cells cultured at 32 degrees C. IC.DP cells cultured at 32 degrees C were found to have a constitutively activated Na+/H+ antiport, although this activation was inhibited by the down-modulation of protein kinase C. These data indicate a role for phospholipid hydrolysis and protein kinase C activation in V-ABL-mediated abrogation of IL-3 dependence.

Activation of the Abelson tyrosine kinase activity is associated with suppression of apoptosis in hemopoietic cells

A chromosomal translocation uniquely associated with chronic myeloid leukemia leads to the formation of a chimeric gene, bcr-abl, on the Philadelphia chromosome. The BRC-ABL protein displays an uncontrolled tyrosine kinase activity similar to that seen with the transforming oncogene of the Abelson murine leukemia (ABL) virus (v-abl). An interleukin 3 dependent cell line, IC.DP, has been transfected with a gene encoding a temperature sensitive v-ABL. In the absence of interleukin 3 at the restrictive temperature for ABL tyrosine kinase activity IC.DP cells died via apoptosis. At the permissive temperature ABL tyrosine kinase activity promoted IC.DP cell survival but not proliferation. ABL therefore can specifically suppress apoptosis.

Public health impact of the 1992 Los Angeles civil unrest

The Los Angeles civil unrest in April 1992 stunned the nation. The days of violence resulted in 53 deaths, 2,325 reported injuries, more than 600 buildings completely destroyed by fire, and approximately $735 million in total damages. The purpose of this paper is to give an overview of the activities of the Public Health Programs and Services Branch of the Los Angeles County Department of Health Services during and after the civil unrest and to illustrate the types of public health issues and problems that may result from large-scale civil disturbance. Public health agencies and jurisdictions should consider these issues in their disaster planning. Public Health Programs and Services Branch activities were directly affected by the violence and destruction. Women, Infants and Children Program vouchering sites and 20 drug program and alcohol recovery sites were damaged or burned and 15 county health centers closed during the unrest. At least 38 private medical and dental offices and 45 pharmacies were destroyed or damaged. County health authorities offered facilities to house relocated private care providers and filled prescriptions for medications where needed. The environmental health impact required the inspection of 2,827 burned and damaged sites for hazardous waste including asbestos; at 9 percent of the inspected sites, waste required special disposal. More than 1,000 food facilities suffered damage and required inspection before reopening. In the 3 months following the unrest, a 20-percent increase in disposal capacity was authorized at four county landfills to accommodate the disposal of debris. Violence was a public health issue of particular concern. The Centers for Disease Control and Prevention sent a team to study the violence from an epidemiologic perspective. The Federal agency also provided funding for televised children's talk shows dealing with reactions to the violence.