A unique neuroendocrine cell model derived from the human foetal neural crest.

PURPOSE: Nowadays, no human neuroendocrine cell models derived from the neural crest are available. In this study, we present non-transformed long-term primary Neural Crest Cells (NCCs) isolated from the trunk region of the neural crest at VIII-XII gestational weeks of human foetuses obtained from voluntary legal abortion. METHODS AND RESULTS: In NCC, quantitative real-time RT PCR demonstrated the expression of neural crest specifier genes, such as Snail1, Snail2/SLUG, Sox10, FoxD3, c-Myc, and p75NTR. Moreover, these cell populations expressed stemness markers (such as Nanog and nestin), as well as markers of motility and invasion (TAGLN, MMP9, CXCR4, and CXCR7), and of neuronal/glial differentiation (MAP2, GFAP, SYP, and TAU). Functional analysis demonstrated that these cells not only possessed high migration properties, but most importantly, they expressed markers of sympatho-adrenal lineage, such as ASCL1 and tyrosine hydroxylase (TH). Moreover, the expression of TH increased after the induction with two different protocols of differentiation towards neuronal and sympatho-adrenal phenotypes. Finally, exposure to conditioned culture media from NCC induced a mature phenotype in a neuronal cell model (namely SH-SY5Y), suggesting that NCC may also act like Schwann precursors. CONCLUSION: This unique human cell model provides a solid tool for future studies addressing the bases of human neural crest-derived neuroendocrine tumours.

Effect of dietary fiber concentrates on growth performance, gut morphology and hepatic metabolic intermediates in jundiá (Rhamdia quelen) / Efeito de concentrados de fibra alimentar sobre o desempenho de crescimento, morfologia intestinal e intermediários metabólicos hepáticos de jundiás (Rhamdia quelen)

A study was conducted to investigate the effect of Dietary Fiber Concentrates (DFCs) on growth performance, gut morphology, and hepatic metabolic intermediates in jundiá (Rhamdia quelen). At the end of the trial, growth and intestinal villus height was significantly (P< 0.05) higher in fish fed diets supplemented with DFCs. However, the animals in commercial prebiotic group showed higher values for this variable compared to the other treatments. Regarding the thickness of the epithelium bowel, it was greater in the Control group compared to animals supplemented with ß-glucan+mannan. Likewise, treatment with commercial prebiotic showed higher values of epithelium bowel compared to the DFCs. The fish supplemented with DFCs, had higher glycogen storage compared to the control group. These results indicate that DFCs can be considered as a beneficial dietary supplement for improving growth performance, gut morphology, and hepatic metabolic intermediates of jundiá.(AU)

O presente estudo foi conduzido para investigar o efeito de concentrados de fibras alimentares (CFAs) sobre o desempenho de crescimento, a morfologia intestinal e os parâmetros intermediários metabólicos hepáticos de jundiás (Rhamdia quelen). No final do experimento, o crescimento e a altura das vilosidades intestinais foram significativamente (P<0,05) maiores em peixes alimentados com dietas suplementadas com CFAs. No entanto, os animais suplementados com prebiótico comercial apresentaram valores mais elevados para essa variável em comparação com os outros tratamentos. Em relação à espessura do epitélio intestinal, esta foi maior nos animais do grupo controle em comparação com os animais suplementados com ß-glucano + manano. Da mesma forma, os peixes suplementados com prebiótico comercial apresentaram valores mais elevados do epitélio intestinal em comparação com os peixes suplementados com CFAs. Os peixes suplementados com CFAs obtiveram maior armazenamento de glicogênio em relação ao grupo controle. Esses resultados indicam que os CFAs podem ser utilizados como um suplemento alimentar benéfico para melhorar o desempenho do crescimento, a morfologia intestinal e os intermediários metabólicos hepáticos do jundiá.(AU)

The association of anti-platelet factor 4/heparin antibodies with early and delayed thromboembolism after cardiac surgery.

Essentials We evaluated antibody status, thromboembolism and survival after cardiac surgery. Positive antibody tests are common - over 50% are seropositive at 30 days. Seropositivity did not increase thromboembolism or impair survival after cardiac surgery. Results show heparin induced thrombocytopenia antibody screening after surgery is not warranted. SUMMARY: Background Heparin-induced thrombocytopenia (HIT) is a prothrombotic response to heparin therapy with platelet-activating, anti-platelet factor 4 (PF4)/heparin antibodies leading to thrombocytopenia associated with thromboembolism. Objective We tested the hypothesis that anti-PF4/heparin antibodies are associated with thromboembolism after cardiac surgery. Methods This multicenter, prospective cohort study collected laboratory and clinical data up to 30 days after surgery and longer-term clinical follow-up data. The primary outcome variable combined new arterial or venous thromboembolic complications (TECs) with all-cause death until 90 days after surgery. Laboratory analyses included platelet counts and anti-PF4/heparin antibody titers (GTI ELISA), with a confirmatory excess heparin step and serotonin release assay. Chi-square testing was used to test the relationship between our outcome and HIT antibody seropositivity. Results Initially, 1021 patients were enrolled between August 2006 and May 2009, and follow-up was completed in December 2014. Seropositivity defined by OD > 0.4 was common, being almost 20% preoperatively, > 30% by discharge, and > 60% by day 30. Death (1.7% within 30 days) or TECs (69 in total) were more likely if the partient was seronegative (OD < 0.4), but positivity defined by OD > 1.0 or including an excess heparin confirmatory step resulted in equal incidence of death or TECs, whether the patient was seronegative or seropositive. Incorporating the serotonin release assay for platelet-activating antibodies did not alter these findings. Conclusions Seropositivity for anti-PF4/heparin antibodies does not increase the risk of death or thromboembolism after cardiac surgery. Screening is not indicated, and seropositivity should only be interpreted in the context of clinical evidence for HIT. TRIAL REGISTRATION: Duke IRB Protocol #00010736.

Analysis of the Influence of Food Colorings in Esthetic Orthodontic Elastomeric Ligatures.

PROPOSITION: The purpose of this study was to evaluate in vitro the color changes of esthetic orthodontic elastomeric ligatures of different shades when exposed to four food colorings commonly found in the diet of patients. MATERIALS AND METHODS: The sample consisted of esthetic orthodontic elastomeric ligatures in the colors pearl, pearl blue, pearl white and colorless, which were immersed for 72 hours in five different solutions: distilled water (control group), coffee, tea, Coca-Cola ® and wine. The color changes of the esthetic orthodontic elastomeric ligatures were measured with the aid of a spectrophotometer, at T1 - as provided by the manufacturer; and T2 - after colorings process. RESULTS: The results indicated that the esthetic orthodontic elastomeric ligatures of all initial hues are susceptible to pigmentation. Among the evaluated colors, all changed the finished look and the color of the samples tested. In ascending order, the color of the samples was as follows: distilled water, Coca-Cola®, black tea, wine and coffee. CONCLUSION: The substances that have a greater potential for pigmentation in esthetic orthodontic elastomeric ligatures were black tea, wine and coffee, respectively. All shades of esthetic orthodontic elastomeric ligatures are susceptible to color change.

Orthodontic treatment of a mandibular incisor fenestration resulting from a broken retainer.

This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results.

Development and reproduction of Spodoptera eridania (Lepidoptera: Noctuidae) and its egg parasitoid Telenomus remus (Hymenoptera: Platygastridae) on the genetically modified soybean (Bt) MON 87701×MON 89788.

Genetically modified crops with insect resistance genes from Bacillus thuringiensis Berliner (Bt-plants) are increasingly being cultivated worldwide. Therefore, it is critical to improve our knowledge of their direct or indirect impact not only on target pests but also on non-target arthropods. Hence, this study evaluates comparative leaf consumption and performance of Spodoptera eridania (Cramer), a species that is tolerant of the Cry1Ac protein, fed with Bt soybean, MON 87701×MON 89788 or its near [corrected] non-Bt isoline. Using this species as a model, we assessed [corrected] the comparative performance of the egg parasitoid Telenomus remus Nixon on eggs of S. eridania produced from individuals that fed on these two soybean genotypes [corrected] as larvae. Results showed that Bt soybean did not affect pest foliage consumption, but did reduce larvel duration by two days despite larvae in both treatments having six instars. Nevertheless, survival of S. eridania larvae, pupal weight, sex ratio, fecundity and longevity of female moths, and egg viability did not differ between Bt and non-Bt soybeans. Adult longevity of S. eridania males was increased when caterpillars were fed with Bt soybean versus the near isoline. No adverse effects of this technology were observed for the egg parasitoid T. remus. [corrected].

Surfactant administration during spontaneous breathing via a thin endotracheal catheter.

In the past two decades exogenous surfactant administration has been a cornerstone of therapy for preterm infants and is known to be effective either given prophylactically in the delivery room or later as selective therapy to infants with estabilished respiratory distress syndrome. Its introduction in neonatal practice in the early 90s was followed by a significant decrease in overall neonatal mortality. With the evolution and refinement of intensive care for preterm infants, the role of exogenous surfactant therapy is changing. The more widespread use of nasal continuous positive airway pressure (n-CPAP) as a primary mode of respiratory support means that many preterm infants now avoid intubation in the delivery room or in early post-natal life. Still, about 50% of them, will require intubation for surfactant delivery for evolving respiratory distress syndrome (RDS) during the course of hospitalization. In view of the difficulties and side effects that may be associated with intubation for surfactant delivery, less invasive ways of surfactant administration have been pursued. The rationale and the available evidences inherent the administration of surfactant via a thin endotracheal catheter during spontaneous breathing will be discussed.

Baseline susceptibility to Cry1Ac insecticidal protein in Heliothis virescens (Lepidoptera: Noctuidae) populations in Brazil.

The tobacco budworm, Heliothis virescens (F.), is one of the target pests of genetically modified cotton expressing Cry1Ac insecticidal protein (Bt cotton) derived from Bacillus thuringiensis Berliner. This study was conducted to evaluate the susceptibility of field-collected populations of H. virescens to Cry1Ac to establish a baseline for use in an insect resistance management program for Bt cotton in Brazil. Insects were sampled from the main Brazilian cotton-growing regions (Bahia, Mato Grosso, Mato Grosso do Sul, and Goiás) during the cropping seasons of 2007/08 and 2008/09. Cry1Ac susceptibility was estimated by using diet incorporation bioassays. H. virescens was highly susceptible to Cry1Ac protein. The estimated LC50 values varied from 0.18 to 0.66 microg of Cry1Ac/ml of diet among the 2007-2008 populations (approximately 3.7-fold variation). Similarly, the EC50 values based on growth inhibition ranged from 0.0053 to 0.0161 microg of Cry1Ac/ml of diet for the 2007-2008 populations (approximately 3.0-fold variation). A joint analysis of the mortality data across all tested populations was used to develop and validate the diagnostic concentrations of 3.1 and 5.6 microg of Cry1Ac/ml of diet, the upper bound of the confidence interval and twice the LC99 were selected, for resistance monitoring programs of H. virescens to Cry1Ac protein in Brazil.

Microsatellite markers for genetic studies of the fall armyworm, Spodoptera frugiperda.

We developed six microsatellite markers for the fall armyworm Spodoptera frugiperda (Lepidoptera: Noctuidae). The SSR loci were isolated with enriched genomic library protocol by using native individuals as a genome source for markers. These loci were characterized in 48 individuals and they were tested for the ability to identify candidate migrants exchanged among the samples. The number of alleles per locus ranged from 5 to 18 (10.8 on average). The observed polymorphism information content ranged from 0.172 to 0.891. Beside the lower efficiency to obtain SSR loci, the six microsatellites were polymorphic and sufficiently discriminant for the genetic studies of S. frugiperda; it allowed us to identify migrants with both NJ clustering and the Bayesian methods. These markers will be useful for molecular ecology studies of this highly polyphagous species in order to understand the processes that determine genetic differentiation in the complex agro-ecosystems that it infests and improve local integrated pest management practices.

Therapeutic targeting of Chk1 in NSCLC stem cells during chemotherapy.

Cancer stem cell (SC) chemoresistance may be responsible for the poor clinical outcome of non-small-cell lung cancer (NSCLC) patients. In order to identify the molecular events that contribute to NSCLC chemoresistance, we investigated the DNA damage response in SCs derived from NSCLC patients. We found that after exposure to chemotherapeutic drugs NSCLC-SCs undergo cell cycle arrest, thus allowing DNA damage repair and subsequent cell survival. Activation of the DNA damage checkpoint protein kinase (Chk) 1 was the earliest and most significant event detected in NSCLC-SCs treated with chemotherapy, independently of their p53 status. In contrast, a weak Chk1 activation was found in differentiated NSCLC cells, corresponding to an increased sensitivity to chemotherapeutic drugs as compared with their undifferentiated counterparts. The use of Chk1 inhibitors in combination with chemotherapy dramatically reduced NSCLC-SC survival in vitro by inducing premature cell cycle progression and mitotic catastrophe. Consistently, the co-administration of the Chk1 inhibitor AZD7762 and chemotherapy abrogated tumor growth in vivo, whereas chemotherapy alone was scarcely effective. Such increased efficacy in the combined use of Chk1 inhibitors and chemotherapy was associated with a significant reduction of NSCLC-SCs in mouse xenografts. Taken together, these observations support the clinical evaluation of Chk1 inhibitors in combination with chemotherapy for a more effective treatment of NSCLC.

Hepatic left lobe volume is a sensitive index of metabolic improvement in obese women after gastric banding.

BACKGROUND: Nonalcoholic fatty liver disease is a common finding in obese subjects. Increasing evidence has been provided suggesting that it represents the hepatic component of the metabolic syndrome. OBJECTIVE: Aim of this longitudinal study was to evaluate the relationships between several anthropometric measures, including the hepatic left lobe volume (HLLV), and various indicators of the metabolic syndrome in a cohort of severely obese women before and after laparoscopic adjustable gastric banding (LAGB). STUDY DESIGN AND RESULTS: Seventy-five obese women (mean age 45 ± 10 years and body mass index (BMI) 42.5 ± 4.8 kg m(-2)) underwent LAGB and completed an average (± s.d.) post-surgical follow-up of 24 ± 6 months. Determination of HLLV, subcutaneous and intra-abdominal fat (IAF) was based on ultrasound. The principal component statistical analysis applied to pre-operative measurements, highlighted HLLV as a parameter that clustered with serum insulin, IAF, serum glucose and uric acid, along with triglycerides (TGs), alkaline phosphatase and high-density lipoprotein cholesterol. After LAGB, the average reduction of BMI was 23%, 12% for subcutaneous fat (SCF), 42% for HLLV and 40% for visceral fat. Among body weight, BMI, SCF, IAF and HLLV, reduction of the latter was an independent predictor of reduction of serum transaminases and γ-Glutamyltransferase, glucose, insulin and TGs. CONCLUSIONS: In severely obese women: (i) HLLV is a sensitive indicator of ectopic fat deposition, clustering with parameters defining the metabolic syndrome; (ii) weight loss achieved by LAGB is associated with a reduction of liver volume as estimated by HLLV; (iii) among various anthropometric parameters measured, reduction of HLLV that follows LAGB represents the best single predictor of improvement of various cardiometabolic risk factors.

Crescimento de juvenis de jundiá (Rhamdia quelen) com diferentes proporções de amilose: amilopectina na dieta / Growth of jundiá juveniles (Rhamdia quelen) with different proportions of amylose:amylopectin in diet

Crescimento e características de carcaça do jundiá (Rhamdia quelen) foram avaliados após 60 dias de alimentação com diferentes proporções de amilose:amilopectina na dieta. Foram criados 240 peixes (peso inicial de 34,3±4,3g) em sistema de recirculação de água constituído de 12 unidades experimentais de 280L. Foram testadas três dietas com as proporções amilose:amilopectina de: T417 = com 26 por cento de amilose, T416 = com 16 por cento de amilose e TMOCHI = com 0 por cento de amilose. Os peixes foram alimentados duas vezes por dia, às 8h e 30min e às 16 horas. A cada 15 dias, foram feitas biometrias para ajuste da quantidade de alimento ofertado. A proporção amilose:amilopectina no amido das dietas não influenciou o crescimento, os rendimentos de carcaça e a composição corporal dos peixes. Conclui-se que o jundiá tem potencial para utilizar fontes de amido compostas por até 26 por cento de amilose sem alterar a digestibilidade dos nutrientes e a deposição de gordura.

The growth and carcass traits of jundiá (Rhamdia quelen) after 60 days being fed with different amylose:amylopectin ratio in diet were evaluated. Two hundred and forty fish (initial weight of 34.3±4.3g) were raised in water re-use system with 12 units of 280L. Three diets were tested with amylose:amylopectin ratios: T417 = 26 percent amylose, T416 = 16 percent amylose and TMOCHI = 0 percent amylose. The fish were fed twice a day at 8:30 and 16:00h. Every 15 days the amount of food offered was ajusted. The amylose:amylopectin ratio in the starch of the diet did not affect growth, carcass and body composition of fish. This demonstrates that the jundiá has the potential to use starchy sources consisting of up to 26 percent amylose without altering the digestibility of nutrients and fat deposition.

Permanent genetic resources added to Molecular Ecology Resources Database 1 August 2010-30 September 2010.

This article documents the addition of 229 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Acacia auriculiformis × Acacia mangium hybrid, Alabama argillacea, Anoplopoma fimbria, Aplochiton zebra, Brevicoryne brassicae, Bruguiera gymnorhiza, Bucorvus leadbeateri, Delphacodes detecta, Tumidagena minuta, Dictyostelium giganteum, Echinogammarus berilloni, Epimedium sagittatum, Fraxinus excelsior, Labeo chrysophekadion, Oncorhynchus clarki lewisi, Paratrechina longicornis, Phaeocystis antarctica, Pinus roxburghii and Potamilus capax. These loci were cross-tested on the following species: Acacia peregrinalis, Acacia crassicarpa, Bruguiera cylindrica, Delphacodes detecta, Tumidagena minuta, Dictyostelium macrocephalum, Dictyostelium discoideum, Dictyostelium purpureum, Dictyostelium mucoroides, Dictyostelium rosarium, Polysphondylium pallidum, Epimedium brevicornum, Epimedium koreanum, Epimedium pubescens, Epimedium wushanese and Fraxinus angustifolia.

Influência de variáveis metodológicas na resistência de união ao cisalhamento / The influence of the methodological variables on the shear bond strength

OBJETIVO: avaliar a influência de diferentes variáveis metodológicas sobre a resistência de união ao cisalhamento em estudos in vitro. MÉTODOS: foram utilizados 105 incisivos permanentes bovinos, seccionados ao nível do colo dentário. A porção coronária foi inclusa em tubos de PVC, com resina acrílica autopolimerizável, e com face vestibular voltada para cima. Todos os corpos de prova foram preparados para a colagem com profilaxia e condicionamento ácido na região central das coroas, onde foram posicionados braquetes Morelli® de incisivos centrais superiores, com resina Concise® Ortodôntico (3M/Unitek). Foram determinados três grupos de acordo com a variável estudada: (Grupo 1) - meio de armazenamento dos dentes, previamente à inclusão e à colagem, com solução de timol 0,1 por cento (a), água destilada (b) e congelamento (c); (Grupo 2) - velocidade da célula de carga da máquina de ensaio de 0,5 (a), 1,0 (b) e 2,0mm/min (c) e (Grupo 3) - diferentes marcas comerciais de ácidos fosfóricos a 37 por cento, 3M/Unitek (a), AcidGel (b) e Attack Tek (c). Os corpos de prova foram submetidos ao ensaio mecânico de resistência ao cisalhamento através da máquina Emic DL2000®. Os dados foram analisados estatisticamente por meio do Teste t Student para amostras independentes. RESULTADOS: os resultados demonstraram que no Grupo 1 o subgrupo de congelamento apresentou maiores valores em relação aos outros dois subgrupos, porém sem diferença estatisticamente significativa (p > 0,05). No Grupo 2, a força no momento da ruptura foi menor à medida que era aumentada a velocidade da célula de carga, porém sem diferença significativa entre os subgrupos. No Grupo 3, o ácido da 3M/Unitek apresentou a maior média em MPa, no entanto, também sem diferença significativa entre os subgrupos. CONCLUSÕES: conclui-se, portanto, que as variáveis analisadas neste trabalho não apresentaram influência suficiente para determinação de diferenças estatisticamente significativas...

AIM: Evaluate the influence of several methodological variables on the shear bond strength of in vitro studies. METHODS: 105 bovine incisors were sectioned at the cervical level. The coronary portion was included in PVC rings, fulfilled with auto polymerized acrylic resin, with its labial faces turned to the top. All the samples were prepared for bonding, cleaned and acid etched on the central area of the crowns. In this area, central incisors' MorelliÕ brackets were bonded with ConciseÕ (3M/Unitek). Three testing groups were established, according to the studied variable: Group 1 - storage previous to bonding (a-Thymol 0,1 percent; b- distilled water; c- freezing); Group 2 - crosshead speed of the universal testing machine (a- 0,5mm/min; b- 1,0mm/min; c- 2,00mm/min) and Group 3 - commercial brand of 37 percent phosphoric acid (a- 3M/Unitek; b- Acid Gel; c- Attack Tek). The shear bond strength test was performed at the Emic DL2000Õ universal testing machine. Data was analyzed through the Student's t test for independent samples. RESULTS: In Group 1, the freezing group showed the higher values of shear bond strength when compared to the others, although no statistical difference was observed (p>0,05). For Group 2, the higher the crosshead speed, the lower the shear bond strength, with no statistical difference. In Group 3, the 3M/Unitek brand showed the highest average of shear bond strength in MPa, but also no statistical difference was shown. CONCLUSIONS: The variable analyzed in this research had not presented enough influence to determine significant differences between the results.

Tratamento ortodôntico-cirúrgico da má oclusão de Classe III: relato de caso / Orthodontic-surgical treatment of the Class III malocclusion: case report

O presente artigo aborda o diagnóstico, planejamento e tratamento ortodôntico-cirúrgico de uma má oclusão de Classe III em Padrão III mediante a apresentação de um caso clínico. A paciente, com 21 anos de idade ao início do tratamento, foi submetida ao tratamento ortodôntico descompensatório com exodontia de quatro segundos pré-molares visando a cirurgia ortognática de avanço maxilar e mentoplastia.

Association between estrogen receptor gene polymorphisms and breast density in postmenopausal women.

Objectives The aim of this study was to evaluate the association between clinical characteristics and polymorphisms HaeIII, MspI and XbaI of the estrogen receptor gene alpha with postmenopausal mammographic density. Methods A prospective study was performed with 120 women who were not users of hormones and had no identified breast lesions. All of them underwent bilateral mammography; the radiological density was determined by three independent observers, with two subjective evaluations based on the ACR-BIRADS(R) classification of mammographic patterns, 2003, and one computerized evaluation using the gray-scale histogram tool of the Adobe Photoshop(R) 7.0 software. Peripheral blood samples were obtained for DNA extraction, performed according to the GFX(R) Kit protocol (Amersham-Pharmacia). Polymerase chain reaction restriction fragment length polymorphism was carried out for an analysis of the polymorphisms present in intron 1 (HaeIII and XbaI) and in exon 1 (MspI) of the estrogen receptor gene. Results There was a high degree of concordance among the observers in the determination of mammary density (Kappa, Pearson and Spearman, p < 0.001). The associations of clinical characteristics with mammary density were: age (p = 0.04), body mass index (p < 0.0001) and age at menarche (p = 0.02). The relationship between the allele distribution of the polymorphisms and density was: XbaI (p = 0.02), HaeIII (p = 0.65) and MspI (p = 0.65). Conclusions Our data suggested that the polymorphism XbaI may be strongly related to mammographic density.

Dentoskeletal effects of maxillary protraction in cleft patients with repetitive weekly protocol of alternate rapid maxillary expansions and constrictions.

OBJECTIVE: To evaluate the amount of maxillary protraction with face mask in complete unilateral cleft lip and palate patients submitted to two distinct rapid maxillary expansion (RME) protocols. MATERIAL AND METHODS: The sample consisted of 20 individuals (nine boys and 11 girls; mean age of 10.4 +/- 2.62 years) with unilateral complete cleft lip and palate who had a constricted maxilla in the vertical and transverse dimensions. Ten patients underwent 1 week of RME with screw activation of one complete turn per day, followed by 23 weeks of maxillary protraction (group 1). The other 10 patients underwent 7 weeks of alternate rapid maxillary expansion and constriction, with one complete turn per day, followed by 17 weeks of maxillary protraction (group 2); both groups underwent a total of 6 months of treatment. Cephalometric measurements were taken at different times: pretreatment (T1), soon after RME (T2), and after 6 months of treatment (T3). Each measurement was analyzed with mixed models for repeated measures, and the covariance structure chosen was compound symmetry. RESULTS: The maxilla displaced slightly forward and downward with a counterclockwise rotation; the mandible rotated downward and backward, resulting in an increase in anterior facial height; the sagittal maxillomandibular relationship was improved; the maxillary molars and incisors were protruded and extruded; and the mandibular incisors were retroclined. CONCLUSION: There was no significant difference between the groups in evaluation time.

Surgically assisted rapid maxillary expansion combined with maxillary protraction in an adult: a patient report.

The aim of this article is to discuss an alternative treatment for adult patients who have a dental or skeletal Class III relationship. A 20-year-old woman presented with a dental and skeletal Class III relationship and a transverse maxillary deficiency. Surgically assisted rapid maxillary expansion was followed by maxillary protraction with a face mask and orthodontic treatment with standard edgewise technique. At the end of treatment, a Class I molar and canine relationship was attained with an adequate transverse intercuspation and improvement of the patient's facial profile.

Molar changes with cervical headgear alone or in combination with rapid maxillary expansion.

OBJECTIVE: To test the hypothesis that there is no difference in the distal movement of the maxillary first permanent molars when cervical headgear is used alone or in combination with rapid maxillary expansion. MATERIALS AND METHODS: The sample was composed of 36 subjects (aged 9 to 13 years), treated in the Faculty of Dentistry, Pontifícia Universidade Cat;aaolica, Rio Grande do Sul, Brazil. The individuals were in good health and in their pubertal growth period. All had Class II division 1 malocclusion. The patients were divided into two groups: group 1 (22 subjects), Class II, with a normal transverse maxilla treated with cervical traction headgear (HG) 400 g 12 h/d, and group 2 (14 subjects), Class II maxillary transverse deficiency treated with rapid maxillary expansion plus cervical traction headgear (RME + HG). An additional group 3 (17 subjects) served as a control group and included individuals with the same characteristics. All subjects had two lateral cephalograms: initial (T1) and progress (T2), taken 6 months later. Differences between T1 and T2 were compared with the Student's t-test, and three groups were compared by the analysis of variance and Tukey multiple comparison test. RESULTS: Results showed greater distal tipping and greater distal movement of the first permanent molars in group 1 (HG) than in group 2 (RME + HG), P < .05. No extrusion of first permanent molar occurred in either group (P > .05). CONCLUSION: The hypothesis was rejected. Cervical traction headgear alone produced greater distal movement effects in maxillary first permanent molars when compared with rapid maxillary expansion associated with cervical headgear.