Mechanobehaviour in dolichofacial and brachyfacial adolescents.

OBJECTIVES: To test whether mechanobehaviour (temporomandibular joint (TMJ) loads, jaw muscle use) was different between facial types and correlated with ramus height (Condylion-Gonion, mm). SETTING AND SAMPLE POPULATION: University of Missouri-Kansas City (UMKC) Orthodontic Clinic. Ten dolichofacial and ten brachyfacial adolescents (Sella-Nasion-Gonion-Gnathion (SN-GoGn) angles ≥37° and ≤27°, respectively) consented to participate. MATERIALS AND METHODS: Numerical models calculated TMJ loads for a range of static biting based on subjects' three-dimensional anatomy. Subjects were trained to record jaw muscle electromyography (EMG) over 2 days and 2 nights in their natural environments. Laboratory EMG/bite-force calibrations determined subject-specific EMG for 20 N bite-force (T20Nave ). Jaw muscle use via duty factors (DF=muscle activity duration/total recording time, %) was determined from day and night recordings for muscle-specific thresholds from ≥5% to ≥80%T20Nave . ANOVA and Tukey's HSD post hoc tests assessed for group differences in mechanobehaviour (TMJ loads, DFs). Regression modelling correlated subjects' normalized TMJ loads, DFs and ramus height. RESULTS: Dolichofacial compared to brachyfacial subjects produced significantly higher (P<.05) TMJ loads, where ipsilateral loads were ≥20% larger for some biting angles, but had significantly less (all P<.05) masseter (day, night) and temporalis (night) DFs. Regression analysis showed a significant relationship amongst normalized TMJ loads, masseter DF and ramus height (R2 =.49). CONCLUSIONS: Mechanobehaviour showed significant differences between facial types and was correlated with ramus height.

Effect of length post and remaining root tissue on fracture resistance of fibre posts relined with resin composite.

To investigate the influence of post length and amount of remaining root tissue on the fracture resistance of roots restored with fibre posts relined with resin composite. Ninety upper canine teeth were divided into nine groups (n = 10). The post spaces were prepared resulting in different lengths, as follows: group 2/3, preparations with lengths of 10 mm; group 1/2, preparations with lengths of 7·5 mm; and group 1/3, preparations with lengths of 5 mm. Each group was divided into 3 subgroups according to amount of remaining root tooth tissue (2, 1 mm or 0·5 mm of thick root). Fibre posts relined with resin composite were cemented, and all teeth were restored with metal crowns. The samples were submitted to the fracture resistance test in a universal testing machine, at an angle of 135° and speed of 0·5 mm min(-1) . Failure modes were observed and the data of fracture resistance were submitted to the anova and Tukey's (α = 0·05). No statistically significant difference in fracture resistance was found among different post lengths (P > 0·05). Remaining dentin thickness of 2 and 1 mm did not differ statistically in fracture resistance (P > 0·05), which was higher than of 0·5 mm dentin thickness (P < 0·05). A prevalence of repairable failure was observed in all groups. It can be concluded that the length of fibre post relined with resin composite did not influence fracture resistance, but thickness was an important factor for the restoration of endodontically treated teeth.

The Cutaneous Lupus Erythematosus Disease Activity and Severity Index: expansion for rheumatology and dermatology.

OBJECTIVE: To evaluate the validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) for use by rheumatologists via reliability testing, and to extend the validation for dermatologists. METHODS: Fourteen subjects with cutaneous lupus erythematosus (CLE; n = 10), a mimicker skin disease only (a cutaneous lesion that may appear clinically similar to CLE; n = 1), or both (n = 3) were rated with the CLASI by academic-based dermatologists (n = 5) and rheumatologists (n = 5). RESULTS: The dermatology intraclass correlation coefficient (ICC) was 0.92 for activity and 0.82 for damage; for rheumatology the ICC was 0.83 for activity and 0.86 for damage. For intrarater reliability, the dermatology Spearman's rho was 0.94 for activity and 0.97 for damage; for rheumatology the Spearman's rho was 0.91 for activity and 0.99 for damage. CONCLUSION: Our data confirm the reliability of the CLASI when used by dermatologists and support the CLASI as a reliable instrument for use by rheumatologists.

Value of digital volume tomography in patients with conductive hearing loss.

Digital volume tomography (DVT) is an extension of panoramic tomography. With this diagnostic technique, characterized by high resolution, a narrow section width (0.125 mm) and three-dimensional display, small pathological processes can be well visualized. Twenty-five patients with the history of a progressive hearing loss were examined with DVT (Accu-I-tomo, Morita, Japan). The results were compared with pre- and intraoperative findings to evaluate the diagnostic value of DVT in cases of erosion of the ossicular chain. With high resolution and artifact-free demonstration of the middle ear and the ossicular chain, it was possible to define its continuity preoperatively by DVT in all 25 cases. An intact ossicular chain was found by DVT in 13 cases and was later confirmed by surgery. The predicted erosion of the ossicles was verified in 12 patients, and a tympanoplasty type III was performed. Digital volume tomography is an excellent technique to examine the middle ear cleft and inner ear, and expands the application of diagnostic possibilities in the lateral skull base. Therefore, improvement in preoperative diagnosis is achieved along with more accurate planning of the surgical procedure. Digital volume tomography delivers a small radiation dose with a high resolution and a low purchase price for the equipment.

The sugar model: catalytic flow reactor dynamics of pyruvaldehyde synthesis from triose catalyzed by poly-l-lysine contained in a dialyzer.

The formation of pyruvaldehyde from triose sugars was catalyzed by poly-l-lysine contained in a small dialyzer with a 100 molecular weight cut off (100 MWCO) suspended in a much larger triose substrate reservoir at pH 5.5 and 40 degrees C. The polylysine confined in the dialyzer functioned as a catalytic flow reactor that constantly brought in triose from the substrate reservoir by diffusion to offset the drop in triose concentration within the reactor caused by its conversion to pyruvaldehyde. The catalytic polylysine solution (400 mM, 0.35 mL) within the dialyzer generated pyruvaldehyde with a synthetic intensity (rate/volume) that was 3400 times greater than that of the triose substrate solution (12 mM, 120 mL) outside the dialyzer. Under the given conditions the final yield of pyruvaldehyde was greater than twice the weight of the polylysine catalyst. During the reaction the polylysine catalyst was poisoned presumably by reaction of its amino groups with aldehyde reactants and products. Similar results were obtained using a dialyzer with a 500 MWCO. The dialyzer method of catalyst containment was selected because it provides a simple and easily manipulated experimental system for studying the dynamics and evolutionary development of confined autocatalytic processes related to the origin of life under anaerobic conditions.

The sugar model: catalysis by amines and amino acid products.

Ammonia and amines (including amino acids) were shown to catalyze the formation of sugars from formaldehyde and glycolaldehyde, and the subsequent conversion of sugars to carbonylcontaining products under the conditions studied (pH 5.5 and 50 degrees C). Sterically unhindered primary amines were better catalysts than ammonia, secondary amines, and sterically hindered primary amines (i.e. alpha-aminoisobutyric acid). Reactions catalyzed by primary amines initially consumed formaldehyde and glycolaldehyde about 15-20 times faster than an uncatalyzed control reaction. The amine-catalyzed reactions yielded aldotriose (glyceraldehyde), ketotriose (dihydroxyacetone), aldotetroses (erythrose and threose), ketotetrose (erythrulose), pyruvaldehyde, acetaldehyde, glyoxal, pyruvate, glyoxylate, and several unindentified carbonyl products. The concentrations of the carbonyl products, except pyruvate and ketotetrose, initially increased and then declined during the reaction, indicating their ultimate conversion to other products (like larger sugars or pyruvate). The uncatalyzed control reaction yielded no pyruvate or glyoxylate, and only trace amounts of pyruvaldehyde, acetaldehyde and glyoxal. In the presence of 15 mM catalytic primary amine, such as alanine, the rates of triose and pyruvaldehyde of synthesis were about 15-times and 1200-times faster, respectively, than the uncatalyzed reaction. Since previous studies established that alanine is synthesized from glycolaldehyde and formaldehyde via pyruvaldehyde as its direct precursor, the demonstration that the alanine catalyzes the conversion of glycolaldehyde and formaldehyde to pyruvaldehyde indicates that this synthetic pathway is capable of autocatalysis. The relevance of this synthetic process, named the Sugar Model, to the origin of life is discussed.

History of head and neck radiology: past, present, and future.

Head and neck radiology has evolved during the century since the discovery of the x ray in 1895 by Wilhelm Conrad Roentgen. In the first few decades, conventional radiography was the diagnostic modality for evaluation of head and neck diseases. Special radiographic projections were designed to demonstrate abnormal processes in the paranasal sinuses, temporal bones, base of the skull, and neck. Barium examination with fluoroscopy was used for assessment of the pharynx and esophagus. Linear tomography, introduced in 1932, allowed the acquisition of sections that depicted abnormalities that were not clearly defined at conventional radiography. Linear tomography was further enhanced with the introduction of thin-section polytomography, especially of the temporal bone, in 1954. Computed tomography in 1972 and magnetic resonance imaging in 1982 improved our diagnostic capabilities by enabling location and characterization of tumors, cysts, and inflammatory processes in the head and neck and aiding in earlier diagnosis and treatment. Teaching of residents and fellows by an expanding staff of head and neck radiologists developed. The formation of the American Society of Head and Neck Radiology in 1977 provided a forum for postgraduate education and scientific exchange.

CT and MR imaging evaluation of neck infections with clinical correlations.

Infection of the neck is a common clinical problem in all age groups, especially children and young adults. The clinical symptoms and signs are often suggestive of the diagnosis. Imaging studies including CT and MR imaging are frequently required to confirm the diagnosis but more importantly to localize the infectious process and search for and delineate an abscess cavity. Ultrasound has also been used in the evaluation of superficial neck infections, especially to determine fluid accumulation. Conventional films consisting of an anteroposterior and lateral view were the examination before the introduction of CT in 1972. Conventional films can still be used for a preliminary survey, especially of the retropharyngeal space when there is a question of a retropharyngeal phlegmon or abscess.

Neurogenic tumors of the neck.

Neurogenic tumors of the neck occur in children and adults. Important parameters to aid in the differential diagnosis are age at presentation, location, and a history of NF or multiple endocrine neoplasia. Schwannoma is the most common solitary neurogenic tumor in the neck and is usually seen in patients between 20 and 50 years of age. The plexiform neurofibroma and multiple localized neurofibromas are characteristic of NF1. MPNSTs are uncommon aggressive lesions that can arise de novo in patients with NF (10% to 30%) and postirradiation. Neuroblastic tumors consist of neuroblastoma, ganglioneuroblastoma, and ganglioneuroma. These tumors typically arise in the chest and abdomen but occasionally present as a primary neck mass. A neck mass with a histologic diagnosis of neuroblastoma is, however, more commonly metastatic from an abdominal neuroblastoma.

Imaging of benign and malignant soft tissue tumors of the neck.

Soft tissue tumors of the neck are a heterogeneous group of neoplasms arising from adipose, muscular, and fibrous tissue. With the exception of lymphomas, they account for only a small fraction of neck masses. Nevertheless, accurate diagnosis is important since the behavior of these neoplasms differs markedly from each other and from other head and neck masses. Noninvasive imaging, usually with CT and MR imaging, plays an important role in diagnostic evaluation and treatment planning for these tumors. In some cases, imaging features may be suggestive of a single entity. In most cases, imaging is needed to assess the location and extent of the tumor prior to biopsy or excision. This article discusses imaging techniques used for such assessment, the imaging features that help to separate these neoplasms from other head and neck tumors, and the behavior and imaging features of each of the more common benign and malignant soft tissue tumors that occur in the neck.

The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings.

Thyroid imaging approach is based on the preliminary clinical evaluation. Lesions that are smaller than 2 cm should be assessed with US, which is capable of discriminating masses as small as 2 mm and distinguishing solid from cystic nodules. US-guided FNAB provides tissue for cytologic examination of thyroid nodules. CT and MR imaging are indicated for larger tumors (greater than 3 cm diameter) that extend outside the gland to adjoining structures, including the mediastinum, and retropharyngeal region. Metastatic lymph nodes in the neck and invasion of the aerodigestive tract are also in the realm of CT and MR imaging. Thyroid nodules are categorized on scintigraphy as hot or cold nodules. Hot nodules are rarely malignant, whereas cold nodules have an incidence of 10% to 20% of malignancy. Calcifications (amorphous, globular, nodular, and linear) occur in adenomas and carcinomas and have no differential diagnostic features except for psammomatous calcifications, which are a pathognomonic finding in papillary carcinomas and a small percentage of medullary carcinomas. Papillary carcinoma is the most common malignant tumor (80%) followed by follicular (20% to 25%); medullary (5%); undifferentiated; anaplastic carcinomas (< 5%); lymphoma (5%); and metastases. Lymph node metastases are common in papillary carcinoma, 50% at presentation, and less common in follicular carcinomas. The metastatic nodes in papillary carcinoma may enhance markedly (hypervascular); show increased signal intensity on T1-weighted images (increased thyroglobulin content or hemorrhage); and reveal punctate calcifications. Localized invasion of the larynx, trachea, and esophagus occurs predominantly in papillary and follicular carcinomas; the incidence is less than 5%. Ectopic thyroid tissue may be encountered in the tongue (foramen cecum); along the midline between posterior tongue and isthmus of thyroid gland; lateral neck; mediastinum; and oral cavity. Goiter and malignant tumors, notably papillary carcinoma, may develop in ectopic thyroid tissue. Carcinomas may also arise in thyroglossal duct cysts, which develop from duct remnants between the foramen cecum and thyroid isthmus. Infectious disease of the thyroid gland is not common and the CT and MR imaging findings are similar as described under neck infection. Other types of inflammatory disorders including Hashimoto's thyroiditis, granulomatous thyroiditis, and Riedel's struma display no specific imaging features. Imaging studies may, however, be indicated to confirm a suspected clinical diagnosis and assess compromise of the airway (Riedel's struma). HPT is a clinical diagnosis in which hypercalcemia is the most important finding. Parathyroid hyperplasia, adenoma, and carcinoma represent underlying lesions. To relieve the patient's symptoms surgical extirpation is indicated. The surgical success rate without imaging is 95%. The indications for imaging studies vary but it is generally agreed that reoperation after a previous failed surgical attempt and suspicion of an ectopic parathyroid adenoma should be investigated by imaging. These consist of US, nuclear medicine studies, CT and MR imaging. US and technetium sestamibi scanning have the highest accuracy rate for localizing an adenomatous gland at and near the thyroid gland. Ectopic adenomas, particularly if they are located in the mediastinum, are preferrably investigated with CT and MR imaging with gadolinium and fat suppression. Carcinomas and parathyroid cysts are optimally evaluated by CT and MR imaging. On MR imaging adenomas are low in signal intensity on T1-weighted images, high in signal intensity on T2-weighted images, and enhance post introduction of gadolinium.

Sugars as the optimal biosynthetic carbon substrate of aqueous life throughout the universe.

Our previous analysis of the energetics of metabolism showed that both the biosynthesis of amino acids and lipids from sugars, and the fermentation of organic substrates, were energetically driven by electron transfer reactions resulting in carbon redox disproportionation (Weber, 1997). Redox disproportionation--the spontaneous (energetically favorable) direction of carbon group transformation in biosynthesis--is brought about and driven by the energetically downhill transfer of electron pairs from more oxidized carbon groups (with lower half-cell reduction potentials) to more reduced carbon groups (with higher half-cell reduction potentials). In this report, we compare the redox and kinetic properties of carbon groups in order to evaluate the relative biosynthetic capability of organic substrates, and to identify the optimal biosubstrate. This analysis revealed that sugars (monocarbonyl alditols) are the optimal biosynthetic substrate because they contain the maximum number of biosynthetically useful high energy electrons/carbon atom while still containing a single carbonyl group needed to kinetically facilitate their conversion to useful biosynthetic intermediates. This conclusion applies to aqueous life throughout the Universe because it is based on invariant aqueous carbon chemistry--primarily, the universal reduction potentials of carbon groups.

Microaspiración del esperma para estudio seminal en ratas / Microaspiration of sperm for seminal studies in rats

Los intentos de medir la función exócrina testicular en modelos animales de experimentación resultaron en una diversificación de métodos de muy difícil comparación y reproducibilidad.La presente investigación tiene como objetivo verificar el valor de la técnica de muicroaspiración del esperma en la cola del epido de la rata,evaluando sus parámetros seminales.Fueron utilizadas 35 ratas albinas,de la variedad de Wistar de 150 días de edad.Se desarrolló una técnica para la microaspiración del esperma en la cola del epidimo.La motilidad y concentración de los espermatozoides de ambos testículos de cada animal fueron analizados con el test T de Student para las muestras dependientes(p<0.05)según la concentración y motilidad espermática.La técnica de microaspiración de la cola del epídimo permite un adecuado acceso,confiable y de fácil ejecución

Microaspiración del esperma para estudio seminal en ratas / Microaspiration of sperm for seminal studies in rats

Los intentos de medir la función exócrina testicular en modelos animales de experimentación resultaron en una diversificación de métodos de muy difícil comparación y reproducibilidad.La presente investigación tiene como objetivo verificar el valor de la técnica de muicroaspiración del esperma en la cola del epido de la rata,evaluando sus parámetros seminales.Fueron utilizadas 35 ratas albinas,de la variedad de Wistar de 150 días de edad.Se desarrolló una técnica para la microaspiración del esperma en la cola del epidimo.La motilidad y concentración de los espermatozoides de ambos testículos de cada animal fueron analizados con el test T de Student para las muestras dependientes(p<0.05)según la concentración y motilidad espermática.La técnica de microaspiración de la cola del epídimo permite un adecuado acceso,confiable y de fácil ejecución

Organization and outcomes of inpatient AIDS care.

OBJECTIVE: To compare differences in AIDS patients' 30-day mortality and satisfaction with care in dedicated AIDS units, scattered-bed units in hospitals with and without dedicated AIDS units, and in magnet hospitals known to provide good nursing care. METHODS: Data were obtained on 1,205 consecutively admitted patients in 40 units in 20 hospitals and on 820 of their nurses. RESULTS: Mortality was lower and satisfaction was higher for AIDS patients in dedicated AIDS units and in nursing magnet hospitals. Primary nursing, end-of-life care counseling, and discharge planning were also more common. Higher nurse to patient ratios and AIDS physician specialty services were strongly associated with lower mortality. Patient satisfaction was strongly associated with organizational control of care by bedside nurses. Homosexuals were more likely to be admitted to dedicated AIDS units, which largely explains the under-representation of minorities and women. CONCLUSIONS: Dedicated AIDS units and magnet hospitals offer important benefits to AIDS patients, including lower odds on dying within 30 days of admission, higher patient satisfaction, and care meeting professional standards. Better nurse staffing, AIDS physician specialty services, and more organizational control by bedside nurses improve patient outcomes.

Comparación entre los parámetros seminales de la rata y la fertilidad / Comparative study between seminal parameters in the rat and fertility

La fertilidad en el hombre es evaluada pór las características seminales.Experimentalmente el test de fertilidad se acepta como el máas confiable pero imposible de reproducir en humanos porque implica la capacidad de gestación.La técnica simplificada de microaspiración del esperma,resultó muy práctica pero había que verificar si los parámetros seminales así obtenidos tenían correlación con el test de apareamientoSe utilizaron 20 ratas y 20 ratas albinas del linaje Wistar,con edades durante el test de apareamiento de 70 días y peso medio de 260 g.Para el procedimiento de microaspiración del esperma del epidídimo,fueron utilizados las 40 ratas Wistar(20+20)con edad de 70 días y un peso medio de 200 g para el test de apareamiento.Para la microaspiración,las mismas ratas tenían 160 días,con un peso medio de 368,4 g.En el test de apareamiento se utilizó el método Poiley,se observaron el número de embarazos y de crías.Se utilizó la técnica de microaspiración de esperma de la cola del epidídimo para evaluar la motilida y concentración espermática.El test T de Student fue utilizado en la evaluación de los parámetros seminales.Se correlacionó el número de crías con la motilidad y la concentración espermática obteniéndose un nivel de significancia de 0,5(p<0,05)No hubo diferencias estadísticas en el número de embarazos,número de hijos,motilidad y concentración espermática

Comparación entre los parámetros seminales de la rata y la fertilidad / Comparative study between seminal parameters in the rat and fertility

La fertilidad en el hombre es evaluada pór las características seminales.Experimentalmente el test de fertilidad se acepta como el máas confiable pero imposible de reproducir en humanos porque implica la capacidad de gestación.La técnica simplificada de microaspiración del esperma,resultó muy práctica pero había que verificar si los parámetros seminales así obtenidos tenían correlación con el test de apareamientoSe utilizaron 20 ratas y 20 ratas albinas del linaje Wistar,con edades durante el test de apareamiento de 70 días y peso medio de 260 g.Para el procedimiento de microaspiración del esperma del epidídimo,fueron utilizados las 40 ratas Wistar(20+20)con edad de 70 días y un peso medio de 200 g para el test de apareamiento.Para la microaspiración,las mismas ratas tenían 160 días,con un peso medio de 368,4 g.En el test de apareamiento se utilizó el método Poiley,se observaron el número de embarazos y de crías.Se utilizó la técnica de microaspiración de esperma de la cola del epidídimo para evaluar la motilida y concentración espermática.El test T de Student fue utilizado en la evaluación de los parámetros seminales.Se correlacionó el número de crías con la motilidad y la concentración espermática obteniéndose un nivel de significancia de 0,5(p<0,05)No hubo diferencias estadísticas en el número de embarazos,número de hijos,motilidad y concentración espermática

Pseudotumor of the orbit. Clinical, pathologic, and radiologic evaluation.

Pseudotumor, Graves' disease, and lymphoproliferative disease are the most common ophthalmologic disease entities requiring evaluation by CT and MR imaging. A history of acute onset, pain, swelling, proptosis, and response to steroids are the classical findings. The radiologic findings are categorized according to location into dacryoadenitis, myositis, and sclerouveitis, with and without associated infiltrations. The inflammatory infiltrate, which is composed of polymorphic leukocytes, lymphocytes, and plasma cells interspersed with a variable amount of fibrovascular tissue, may be diffuse or localized. The preferred radiologic method used for assessment of pseudotumor is CT. MR imaging, however, is indicated for evaluation of the Tolosa-Hunt syndrome, which is characterized by an inflammatory infiltrate in the orbital apex and cavernous sinus leading to cranial nerve involvement with ophthalmoplegia. The clinical and radiologic constellation of findings allows a definitive diagnosis in most cases.

Organization and outcomes of inpatient AIDS care.

The establishment of AIDS hospitals and AIDS units within hospitals has been controversial. Unlike other specialty care, AIDS care arrangements were initially developed as much to segregate AIDS patients from other patients and staff as to provide the best possible care. Ten years after many of these units opened, little evidence was available about whether the benefits of aggregating AIDS patients outweighed the potential hazards of segregating people from the mainstream of hospital care. This Issue Brief describes a national study to determine how different organizational settings affect the outcomes of inpatient AIDS care.