Search

A retrospective evaluation of maxillary advancement and mandibular setback in class III patients was performed and their aesthetic outcomes compared. Patients with a sella-nasion-A-point angle (SNA) of 80-84° were selected. Pre- and postoperative lateral cephalograms were obtained for 34 class III patients; these were divided into two groups according to the surgical procedure performed: mandibular setback group (n=17) and maxillary advancement group (n=17). The pre- and postoperative cervical length, lip-chin-throat angle, lower/upper lip thickness, distance from the lower/upper lip to the aesthetic line, soft tissue angle, facial contour angle, and nasolabial angle of the two groups were compared. Significant differences were observed for cervical length (P=0.0003) and sex (P=0.003) when comparing maxillary advancement with mandibular setback. Although the preoperative cervical length was similar in the two groups, it increased significantly after maxillary advancement and decreased after mandibular setback. In this study, the differences in aesthetic outcomes depending on the surgical procedure performed were considered. Some aesthetically important parameters proved to be superior after maxillary advancement when compared to mandibular setback, even with the maxilla in the normal position.

Background There is evidence of abnormal cerebral dopamine transmission in nicotine-dependent smokers, but it is unclear whether dopaminergic abnormalities are due to acute nicotine abuse or whether they persist with abstinence. We addressed this question by conducting longitudinal positron emission tomography (PET) examination of smokers before and after 3 months of abstinence. Methods We obtained baseline 6-[ 18 F]fluoro-L-DOPA (FDOPA)-PET scans in 15 nonsmokers and 30 nicotine-dependent smokers, who either smoked as per their usual habit or were in acute withdrawal. All smokers then underwent cessation treatment, and successful abstainers were re-examined by FDOPA-PET after 3 months of abstinence ( n = 15). Uptake of FDOPA was analyzed using a steady-state model yielding estimates of the dopamine synthesis capacity (K); the turnover of tracer dopamine formed in living brain (k loss ); and the tracer distribution volume (V d ), which is an index of dopamine storage capacity. Results Compared with nonsmokers, K was 15% to 20% lower in the caudate nuclei of consuming smokers. Intraindividual comparisons of consumption and long-term abstinence revealed significant increases in K in the right dorsal and left ventral caudate nuclei. Relative to acute withdrawal, V d significantly decreased in the right ventral and dorsal caudate after prolonged abstinence. Severity of nicotine dependence significantly correlated with dopamine synthesis capacity and dopamine turnover in the bilateral ventral putamen of consuming smokers. Conclusions The results suggest a lower dopamine synthesis capacity in nicotine-dependent smokers that appears to normalize with abstinence. Further investigations are needed to clarify the role of dopamine in nicotine addiction to help develop smoking prevention and cessation treatments.

The essential trace element zinc is indispensable for proper immune function as zinc deficiency accompanies immune defects and dysregulations like allergies, autoimmunity and an increased presence of transplant rejection. This point to the importance of the physiological and dietary control of zinc levels for a functioning immune system. This study investigates the capacity of zinc to induce immune tolerance. The beneficial impact of physiological zinc supplementation of 6 mu g/day (0.3 mg/kg body weight) or 30 mu g/day (1.5 mg/kg body weight) on murine experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis with a Th1/Th17 (Th, T helper) cell-dominated immunopathogenesis, was analyzed. Zinc administration diminished EAE scores in C57BL/6 mice in vivo (P

The aesthetic outcome of treatment has become increasingly important to patients having orthognathic surgery. The aim of this observational cohort study based on clinical records was to evaluate the effect of maxillary advancement on changes to the soft tissues. We studied 53 patients with class III malocclusion (29 women and 24 men, mean (SD) age 28 (11) years). We identified all patients treated between 1 January 2002 and 30 December 2013 who could be monitored postoperatively for 6 months. To study the effect of maxillary advancement on changes to the soft tissue we distinguished between patients who had had less than 6 mm, and those with 6 mm advancement or more. In those who had had less than 6 mm, we found no significant changes in the soft tissue in the region of the nasolabial angle. However, the lip-chin- throat angle (p=0.016), cervical length (p=0.002), lower lip (p=0.007) and upper lip distance (p=0.0001) from the aesthetic line changed significantly. On the other hand, the changes to the soft tissue in the submental and nasolabial regions were significant in patients with 6 mm advancement or more, and indicated a clear improvement in the aesthetic outcome of this region. This aesthetic change for the good in the submental and nasolabial regions after maxillary advancement of 6 mm or more should be considered when planning treatment, and reduction in the mandibular setback will reduce the risk of development of a double chin.

Two-colour microarray experiments form an important tool in gene expression analysis. Due to the high risk of missing observations in microarray experiments, it is fundamental to concentrate not only on optimal designs but also on designs which are robust against missing observations. As an extension of Latif et al. (2009), we define the optimal breakdown number for a collection of designs to describe the robustness, and we calculate the breakdown number for various D-optimal block designs. We show that, for certain values of the numbers of treatments and arrays, the designs which are D-optimal have the highest breakdown number. Our calculations use methods from graph theory.

Purpose The objective of this study is to characterize the donor-site morbidity after harvesting of nonvascularized and vascularized iliac bone grafts. Patients and Methods Clinical data of 353 patients were collected for analysis. In addition, a questionnaire was sent to all patients asking about their perceptions of different parameters. In an individual age-matched layout, we compared 34 patients with nonvascularized iliac bone grafts with 34 patients with vascularized iliac bone grafts. Results Transplantation of vascularized bone grafts has been increasingly performed at our institution. The mean age was 41.5 years in the nonvascularized group and 48.6 years in the vascularized group. The main reason for the bony defect in the vascularized group was malignancy. The majority of postoperative functional problems were observed in obese patients. No patient had serious or long-term complications at the donor site. The amount of bone graft taken affected postoperative sensitivity disturbance and caused postoperative functional problems and pain. Conclusions We conclude that the iliac crest is a suitable site for harvesting both vascularized and nonvascularized bone grafts measuring up to 10 × 3 cm. For larger defects that require a larger bone graft, a vascularized bone graft is more suitable with a better predictable healing capability. No significant differences in donor-site morbidity were found between the vascularized and nonvascularized bone grafts if a similar amount of bone was taken for transplant.

Objective The aim of this study was the development of an experimental cardiomyopathy induced with Adriamycin (Pharmacia & Upjohn, Erlangen, Germany) with selective toxic damage of the left ventricular myocardium that avoided an ischemic component. Methods An intracoronary catheter was implanted directly into the left main stem in pigs and connected to a percutaneous access port that was used for repetitive Adriamycin administration (3–5 × 25 mg weekly over a 1-hour period). Hemodynamic and echocardiographic variables were measured before Adriamycin administration, 1 week after, and at 4 weeks. Thereafter, all hearts were autopsied for detailed histologic examination. Statistical analysis was done by an analysis of variance for multiple parameters. Results All pigs had normal baseline cardiac function. Measurements after Adriamycin administration and 4 weeks later demonstrated a continued increase of the central venous pressure, pulmonary artery pressure, pulmonary wedge pressure, and pulmonary vascular resistance, whereas cardiac output, stroke volume index, and left ventricular stroke work index decreased. These results were supported by the echocardiographic data depicting an increase of left ventricular diameters and volumes, accompanied by a decrease of intraventricular and left ventricular posterior wall thickness as well as left ventricular ejection fraction. Right ventricular volumes and function did not change during the trial. The histologic examination of the hearts revealed a selective toxic damage of the left ventricular myocardium with multifocal necroses and advanced tissue reorganization. Conclusion This animal model creates a selective left ventricular damage that avoids ischemic damage of the myocardium. Both aspects can improve research on Adriamycin-induced cardiomyopathy, especially preventive or therapeutic strategies.

A large variety of new treatment options for different forms of age-related macular degeneration (ARMD) are becoming available. Not all new therapies may meet the expectations of patients and ophthalmologists. Despite the given statistical significant priority of treatment investigations, the endpoints may not be relevant to the patient's requirements. Therefore, questions inevitably arise regarding patient's benefit and the validity of the randomized controlled trials. The randomized controlled trial is regarded as the "gold standard" in terms of evaluating the effectiveness of interventions. The external validity of randomized controlled trials may be compromised, if, for example, patients assigned to the study group are unrepresentative of the reference population. This review aims to analyze problems with external validity in the randomized controlled trials on ARMD and surveys the endpoints of clinical studies with respect to the patient benefit.

Objectives We aimed to evaluate the performance of a newly designed temporary stent device as a percutaneous emergency treatment of pulmonary embolism. Background If thrombolysis is contraindicated or recanalization by thrombolysis delayed in patients with severe pulmonary embolism who are threatened by acute circulatory failure, percutaneous temporary pulmonary stent placement may represent an additional option before surgical embolectomy is considered. Methods The newly designed temporary pulmonary stent is made from woven Nitinol and has a distal blunt end and a proximal crimped end, which is firmly fixed to a 0.035-inch guidewire. It is delivered through a 9.5-F polytetrafluoroethylene sheath using a pusher tube. Stent placement and removal were examined in 9 anesthetized sheep with experimentally induced pulmonary embolism. Hemodynamic parameters were recorded in 7 animals. Results Delivery and removal of the stent was uneventful and rapidly accomplished. Stent placement was associated with a significant decrease in Miller angiographic index (from 11.2 ± 3.1 to 3.8 ± 1.9; p = 0.0001), heart rate (from 139 ± 35 beats/min to 92 ± 11 beats/min; p = 0.0129), and mean pulmonary artery pressure (from 32 ± 14 mm Hg to 21 ± 14 mm Hg; p = 0.0029) and a significant increase in mean aortic pressure (from 48 ± 14 mm Hg to 61 ± 8 mm Hg; p = 0.0080). Autopsy revealed neither wall damage nor parenchymal hemorrhage. Conclusions Our preliminary study proves the technical feasibility of temporary placement and removal of a newly designed dedicated pulmonary stent to recanalize centrally located embolic occlusions in severe pulmonary embolism. Animal experimental evaluation revealed rapid and significant circulatory improvement after stent placement.

Statement of Problem. Internal discoloration may occur with the intraoral use of resin-based restoration materials. Water storage and light exposure influence the color properties of microfilled and hybrid composites. Purpose. The purpose of this study was to determine color and translucency changes in a hybrid and a microfilled composite after light exposure with and without water storage. Material and Methods. A hybrid (Tetric) and a microfilled composite (Silux Plus) were subjected to artificial daylight with and without water storage. Tristimulus Yxy values were determined colorimetrically against a black or a white background. Differences from baseline were calculated as ΔE * ab for up to 1 month. After 1 month, ΔL * , Δa * , Δb * , and the contrast ratio ΔC were calculated. Data were analyzed with 2-way analysis of variance ( P Results. The ΔE ab * increased over time for wet and dry stored specimens of both materials. Wet storage for 1 month resulted in significantly higher ΔE ab * and ΔC but lower Δb * than dry storage. The Δa * was significantly higher for Tetric compared with Silux Plus. Both materials showed negative ΔL * values under both storage conditions without significant differences between materials or storage conditions. Conclusion. The results of this in vitro study suggest that resin-based restoration materials undergo measurable changes due to daylight exposure. Increased changes occurred under the influence of water storage. (J Prosthet Dent 2002;87:264-70.)

PURPOSE: To describe the indications, surgical technique, and clinical results of 14 eyes in 13 patients with age-related macular degeneration and foveal choroidal neovascularization, in which subretinal surgery was combined with simultaneous transplantation of autologous retinal pigment epithelial cells. METHODS: Between March 1999 and February 2000, in a prospective study, 14 eyes (13 patients) with age-related macular degeneration underwent subretinal surgery because of foveal choroidal neovascularization with simultaneous transplantation of retinal pigment epithelium harvested from the nasal subretinal area of the same eye. Preoperatively, 1 month postoperatively, 3 months postoperatively and at 3-month intervals thereafter, examinations were performed including best-corrected visual acuity, visual field, biomicroscopy of anterior and posterior segment, tonometry, fluorescein and indocyanine angiographies, autofluorescence, scotometry, and fixation tests. RESULTS: Postoperatively, after median observation of 17 months (range, 12 to 24 months) best-corrected visual acuity was improved 2 or more lines in eight eyes (57.1%), remained the same (± 1 line) in five eyes (35%), and decreased by more than 2 lines in one eye (7.1%). Pairwise t test showed significant improvement after 1 month ( P = .0031, P = .0062) as well as 1 year ( P = .0066, P = .0105). Satisfactory reading vision between Jaeger 1 and 4 was achieved in three eyes (21.2%). No significant intraoperative or postoperative complications occurred in any eye. No recurrence of choroidal neovascularization was observed during the observation period. CONCLUSIONS: In eyes with age-related macular degeneration and foveal choroidal neovascularization, autotransplantation of retinal pigment epithelium was performed in addition to conventional removal of the choroidal neovascularization without significant intraoperative or postoperative complications. Visual acuity improvement of 2 or more lines in 57% of the eyes was achieved. No recurrent choroidal neovascularization formation was observed during the observation period. The results of this pilot study suggest that autologous transplantation of retinal pigment epithelium combined with submacular surgery might be a reasonable treatment option for patients with foveal choroidal neovascularization secondary to age-related macular degeneration.

In an in vitro study, the bacterial adherence of a slime-producing strain (RP 62 A) was compared with its isogenic slime-negative mutant (M7). Standardized biomaterial discs were incubated under growth conditions in tryptic soy broth containing either strain RP 62 A or M7. After 24 h of incubation, the attached bacteria were removed by sonication and the colony-forming units were counted after plating of serial dilutions. We observed a significantly increased adherence and accumulation of the slime-producing strain (RP 62 A). In contrast to the slime negative mutant (M7) (p = 0.0001). The highest colony counts were found for the slime-producing strain on polyethylene and polymethylmethacrylate. The slime-negative mutant lacked the ability of accumulation. Our in-vitro results show the relevance of slime production by S. epidermidis for in-vitro colonisation of biomaterials, with a preference for polyethylene and polymethylmethacrylate.

PURPOSE: To assess the efficacy and safety of adjunctive daunorubicin during vitrectomy surgery in eyes with idiopathic proliferative vitreoretinopathy (PVR). METHODS: Two hundred eighty-six eyes (286 patients) with stage C2 (Retina Society Classification, 1983) or more advanced preoperative PVR in which surgery with silicone oil was planned were enrolled in a multicenter, prospective, randomized, controlled clinical trial. Standardized surgery plus adjunctive daunorubicin perfusion was compared with surgery alone. Outcomes assessed were retinal attachment without additional vitreoretinal surgery 6 months after standardized surgery, number of and time until vitreoretinal reoperations within 1 year of standardized surgery, and change in visual acuity 1 year after standardized surgery, evaluated by photodocumentation, number of reoperations, and measurement of best-corrected visual function. Outcomes were determined 6 months after operation and reevaluated after 1 year of follow-up. RESULTS: Six months after standardized surgery, complete retinal reattachment without additional vitreoretinal surgery was achieved in 62.7% (89/142) of eyes in the daunorubicin group vs 54.1% (73/135) in the control group ( P = .07, one-sided). However, in the daunorubicin group, significantly fewer vitreoretinal reoperations were performed within 1 year postoperatively ( P = .005, one-sided) to achieve the same overall 1-year retinal reattachment rate (80.2% [105/131] vs 81.8% [103/126]). The rate of patients with no vitreoretinal reoperations was 65.5% (95/145) in the daunorubicin group vs 53.9% (76/141) in the control group. There was no difference in the best-corrected visual acuity. No severe adverse effect related to daunorubicin was identified. CONCLUSIONS: Although the rate of anatomic success after 6 months failed to show significance, some benefit of the adjunctive treatment exists, especially a tendency toward increased rate of reattachment and a significant reduction in the number of reoperations. This shows that human PVR is amenable to pharmacologic treatment.

Statement of problem. The success rate of resin-bonded fixed partial dentures is directly related to the adhesive system and the tooth preparation design for good retention. Purpose of study. This in vitro study evaluated the effect of various tooth preparation designs on the bond strength of retainers for adhesive fixed partial dentures. Material and methods. Molar teeth were prepared in the conventional form or with occlusal coverage and opposing grooves and retainers were silicoated and bonded to etched enamel by a bis-glycerol methacrylate adhesive. Bond strengths were determined after water storage and thermocycling. Results. The least mean bond strength was recorded for the conventional form of tooth preparation ( p Conclusion. A combination of 180-degree opposing groove placement at line angles "wraparound" and occlusal coverage resulted in the greatest bonding values.(J Prosthet Dent 1997;77:243-9.)

D-optimal designs for (generalized) tic polynomials in q variables on the simplex are derived. The simplex is an appropriate factor space in mixture experiments, where the response also depends on the total amount of the components. In particular it is shown that the known results for D-optimality on the unit simplex can be generalized to the extended factor space.

The aim was to determine the fluoride retention in plaque-covered and clean incipient enamel lesions after topical application of a CaF 2 /NaF varnish (Bifluorid 12 ® ). In 50 specimens of bovine enamel an incipient lesion was produced with acidic hydroxyethylcellulose (pH 4.8; 72 h). 40 specimens were fluoride varnished; the 10 remaining specimens were used for measuring baseline fluoride content. Each six of the fluoridated specimens were recessed in the buccal aspects of an intraoral appliance worn for 5 days. During the experimental period one side of the appliance was kept clean, and plaque growth was allowed on the other. KOH-soluble and structurally bound fluoride were determined immediately, I day, 3 days and 5 days after fluoridation, and compared with the baseline fluoride content of the enamel. Immediately after fluoridation, a considerable amount of KOH-soluble fluoride was bound, but after 5 days 80% had been lost. Simultaneously a significant increase of non-KOH-soluble or structurally bound fluoride was detected in both plaque-covered and clean enamel. It is evident that this CaF 2 /NaF varnish deposits more KOH-soluble fluoride on the surface of demineralized enamel than other varnishes, but after 5 days fluoride retention is similar to that from other varnishes.

Long-term follow-up orthopantomographs of 251 adult orthodontically treated former patients showed 113 clinically asymptomatic impacted third molars in 58 patients. Radiographic assessment revealed contact of impacted third molars with the second molars, resorption of maxillary and mandibular second molars, and reduced bone height on the distal side of the maxillary and mandibular second molars, as well as pathologically widened pericoronal spaces of the maxillary and mandibular third molars. The comparison of the sagittal third molar position in 52 impacted teeth revealed a sagittal change in all third molars from post-treatment to follow-up: maxillary and mandibular third molars had rotated to a more upright position and showed an increase in mesio- or distoangulation or a change of axial inclination. The lack of predicting factors such as age, period of impaction, extent of space deficiency, developmental stage, level of eruption, and bone conditions leads the authors to recommend that former orthodontic patients be recalled at regular intervals for assessment of changes in the condition and position of erupting or impacted third molars.

Objective To compare scleral buckling surgery (SB) and primary pars plana vitrectomy (PPV) in rhegmatogenous retinal detachments of medium complexity. Design Prospective randomized multicenter clinical trial (the Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment Study), separated into phakic or aphakic/pseudophakic eyes. Patients were enrolled over a 5-year period. There was 1-year follow up in the study, and the primary outcome was assessed at 1 year. Participants Forty-five surgeons (25 centers, 5 European countries) recruited 416 phakic and 265 pseudophakic patients. Completion of follow-up was achieved in 93% of the phakic and 89% of the pseudophakic patients. Intervention Scleral buckling surgery with the potential use of multiple sponges, encircling elements, drainage, and intraocular injections. Primary vitrectomy included 3-port vitrectomy with sulfur hexafluoride–air tamponade; additional SB was left to the surgeon's decision. Main Outcome Measures Primary study end point: change in best-corrected visual acuity (BCVA); secondary end points: primary and final anatomical success, proliferative vitreoretinopathy, cataract progression, and number of reoperations. Results In the phakic trial, the mean BCVA change was significantly ( P = 0.0005) greater in the SB group (SB, −0.71 logarithm of the minimum angle of resolution [logMAR], standard deviation [SD] 0.68; PPV, −0.56 logMAR, SD 0.76). In the pseudophakic trial, changes in BCVA showed a nonsignificant difference of 0.09 logMAR. In phakic patients, cataract progression was greater in the PPV group ( P P = 0.0020), and the mean number of retina-affecting secondary surgeries (SB, 0.77, SD 1.08; PPV, 0.43, SD 0.85) was lower ( P = 0.0032) in the PPV group. Redetachment rates were 26.3% (SB; 55/209) and 25.1% (PPV; 52/207) in the phakic trial and 39.8% (SB; 53/133) and 20.4% (PPV; 27/132) in the pseudophakic trial. Conclusions The study shows a benefit of SB in phakic eyes with respect to BCVA improvement. No difference in BCVA was demonstrated in the pseudophakic trial; based on a better anatomical outcome, we recommend PPV in these patients.