Growth of mandibular prognathism after pubertal growth peak

Until recently, the signal transduction pathways involved in the processes of tumor growth have been poorly understood. In the present study, we investigated cell surface receptors which utilize phosphatidylinositol (Pl) turnover/Ca2+ mobilization as a signal transduction pathway to regulate cell growth in a metastatic human lung carcinoma cell line, PG. We found that purinoceptor agonists, including ATP and its analogs, and bombesin, an amphibian tetradeca-peptide of mammalian homology gastrin-releasing peptide, induced rapid transient increase of cytoplasmic-free Ca2+ in PG cells loaded with fura-2. The Ca2+ responses were derived both from release from internal stores and the opening of plasma membrane Ca2+ channels. HPLC analysis of inositol 1,4,5-triphosphate (Ins(1,4,5)P3) and its isomers showed a receptor-linked phospholipase C activation by ATP and bombesin. Although ATP and bombesin were both able to induce Pl turnover and Ca2+ mobilization in PG cells, they had differential growth regulatory effects on PG cells. Treatment with bombesin stimulated PG cell growth while treatment with ATP inhibited significantly PG cell growth. Pharmacological studies showed that the purinoceptors on PG cells were of the P2 subtype. Other hydrolysis-resistant P2 purinoceptor agonists, including ATP gamma S and AMP-PNP, were as effective as ATP in stimulating Pl turnover and Ca2+ mobilization as well as in inhibiting PG cell growth in vitro, suggesting the potential usefulness of such ATP analogs in clinical trials. Preliminary results suggest G protein involvement in the differential regulation of ATP and bombesin signal transduction pathways.     

Indications for reduction of tongue in surgical treatment of mandibular prognathism

It is suggested that there should be available post-graduate training schemes for members of the profession who ultimately wish to work on an Intensive Therapy Unit at Consultant level. The duties of the Medical Unit administrator are described and schemes are suggested for further training of an anaesthetist or physician particularly interested in critical patient care.     

Changes in bite force and occlusal contacts in patients treated for mandibular prognathism by orthognathic surgery

PURPOSE: The purpose of this study was to evaluate changes in bite force and occlusal contacts before and after orthognathic surgery in patients with mandibular prognathism and to compare the findings with those in controls with normal occlusion. PATIENTS AND METHODS: Bite force and occlusal contacts were analyzed in 23 (7 male and 16 female) patients with mandibular prognathism before and after sagittal split ramus osteotomy, and in 20 (10 male and 10 female) controls with normal occlusion. The bite force and occlusal contacts were simultaneously measured by a computerized occlusal analysis system, the T-Scan system, immediately before surgery, and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. RESULTS: Both the bite force and occlusal contacts in the patients were significantly less than those in the controls before surgery. Although both the bite force and occlusal contacts in the patients were improved by the orthognathic surgery, neither approached the level in the controls within 1 year. Bite force was correlated with the number of occlusal contacts in both patient and control groups. CONCLUSION: The postoperative masticatory function does not reach control levels even 1 year after the orthognathic surgery for mandibular prognathism. Therefore, further adjustment of the occlusion should be considered before the end of treatment.     

Surgical rates and operative mortality for open and laparoscopic cholecystectomy in Maryland

BACKGROUND: Since 1989, laparoscopic cholecystectomy has been widely adopted as a treatment for gallstone disease. We analyzed the association between the introduction of this procedure and three variables: the rate at which cholecystectomy was performed in Maryland, the characteristics of patients undergoing cholecystectomy in routine clinical practice, and operative mortality. METHODS AND RESULTS: We used 1985-1992 hospital-discharge data from all 54 acute care hospitals in Maryland, to identify open and laparoscopic cholecystectomies, characteristics of patients undergoing these procedures, and deaths occurring during hospitalizations in which these procedures were performed. The annual rate of cholecystectomy, adjusted for age, rose from 1.69 per 1000 state residents in 1987-1989 to 2.17 per 1000 residents in 1992, an increase of 28 percent (P < 0.001). As compared with patients undergoing open cholecystectomy, patients undergoing laparoscopic cholecystectomy tended to be younger, less likely to have acute cholecystitis or a common-duct stone, and more likely to be white and have private health insurance or belong to a health maintenance organization (P < 0.001). Although the operative mortality associated with laparoscopic cholecystectomy was less than that with open cholecystectomy (adjusted odds ratio, 0.22; 95 percent confidence interval, 0.13 to 0.37) and the overall mortality rate for all cholecystectomies declined from 0.84 percent in 1989 to 0.56 percent in 1992, there was no significant change in the total number of cholecystectomy-related operative deaths because of the increase in the cholecystectomy rate. CONCLUSIONS: In Maryland, although the adoption of laparoscopic cholecystectomy has been accompanied by a 33 percent decrease in overall operative mortality per procedure, the total number of cholecystectomy-related deaths has not fallen because of a 28 percent increase in the total rate of cholecystectomy.     

Cost-effectiveness of preoperative sestamibi scan for primary hyperparathyroidism is dependent solely upon the surgeon''s choice of operative procedure

Identified and developed a scale to assess problematic interpersonal situations among urban adolescents. In Study 1, problematic situations were identified by focus groups of 6th graders (N = 43). Their relevance was verified in Study 2 by assessing their reported frequency and difficulty in a sample of 6th graders (N = 457) that included mostly African American youth from low-income families. Scales representing 3 dimensions, peer provocation, perceived injustice, and environmental stressors were verified by confirmatory factor analyses. In Study 3, the internal consistency and structure of these scales were cross-validated in a sample of 7th graders (N = 459). All 3 scales were correlated with self-reported violent behavior, drug use, and anxiety and uniquely accounted for 11% to 19% of the variance. These findings have implications for identifying youth at risk for emotional and behavioral problems and for designing more relevant interventions.     

Surgical correction of sagittal craniosynostosis: complications of the pi procedure

BACKGROUND: Although numerous anecdotal reports are being offered about the growing number of unfilled faculty positions in US family medicine departments, virtually no literature exists on faculty recruitment. The objective of this study was to define the scope and nature of current faculty recruitment needs in family medicine. METHODS: A national survey was sent to all family medicine department chairs and family practice residency program directors concerning faculty positions unfilled at their sites and positions for which recruitment would occur within the next 5 years. The survey asked for information on currently available positions; academic title of position; percentage of time to be devoted to clinical, educational, administrative, and research activities; primary focus of the position; date when the position became available; and the length of time the position has been unfilled. Similar information was collected on positions anticipated to be available within the next 5 years. RESULTS: A total of 364 surveys were returned, for an overall response rate of 70%. Information from the survey revealed a current, substantial demand for family medicine faculty throughout the country, with an even greater demand anticipated for the near future. Respondents reported 496 currently unfilled positions for family medicine faculty and another 677 positions anticipated to be available within the next 19.5 months on average. A total of 89.7% of those anticipated positions were reported as either "certain" or "somewhat certain," in terms of likelihood of availability. CONCLUSIONS: The demand for family medicine faculty is increasing, and much of the demand is financially motivated. Clinical expectations appear to be higher among departments than for residencies. Finally, it was revealed that most positions had minimal allotments for research time. Family medicine must recommit itself to the development of a scholarly agenda as it recruits new faculty.     

Surgical treatment of difficult patent ductus arteriosus and related operative complications]

Data of health surveillance from 1970 to 1989 for the workers employed in dipterex packaging were collected and statistically analyzed with a microcomputer by scoring their whole blood choline esterase activities and symptoms and signs. Results showed working environment improved and air pollution and absorption of pollutants via skin decreased with technology innovation and longterm hygienic supervision, monitoring and health surveillance in the factory. Incidence of dipterex poisoning in workers employed in the department of pesticide packaging lowered significantly, from 25.26% in the early 1970's to 5.17% in late 1970's and to 1.85% during 1980's, with periodical physical examinations for them, and timely management of the patients with poisoning and the cases at high risk.     

Attenuation of x-ray in muscle and alveolar bone during mandibular premolar periapical radiographic procedure

The main purpose of this study is to find out the degree of attenuation when the x-ray entrances the skin and reaches the film at the bone area near the mandibular premolar root apex. In this study we used thermaluminescent dosimeters (TLDs) to measure the entrance dose and exit dose directly at the area of interest and calculated the penetration value P. We also simulated the attenuation process and calculated the P value in similar conditions. The results indicate that the mean P value of direct measurement from patient is 0.071 +/- 0.018 (60kVp, HVL = 1.5mm Al), while that for theoretical calculation is 0.06458 at 27keV. We concluded that P value of direct measurement can match with the theoretical value and further studies in jaw bone density and other related portions is worthwhile.     

Surgical treatment for congenital motive defect nystagmus by the parks (5, 6, 7, 8mm) procedure or the augmented Parks procedure

PURPOSE: The purpose of the surgical treatment for patients with congenital motive detect nystagmus was to correct deviation of the eye and the head tilt, to improve vision and eliminate nystagmus. METHODS: 19 patients underwent the Parks (5, 6, 7, 8mm) or the augmented Parks procedure from 1987 to 1994. For patients with abnormal head turn > or = 30 degrees, We used a 40-60% augmented Parks procedure. RESULTS: A follow up of 19 patients ofr an average of 22 months revealed a marked improvemtnts. After operation, the head turn was decreased form 30.5 degrees to 4.9 degrees, the intensity of nystagmus was decreased from 36.0 to 9.7, 21 eyes (55.3%) of 19 patients improved by two or more lines of Snellen visual acuity. CONCLUSIONS: The Parks (5, 6, 7, 8mm) and the augmented Parks (5, 6, 7, 8mm) procedure produce a marked correction for congenital motive defect nystagmus.     

Evaluating the degree of dependence for a set of correlations.

The rank-adjusted method is provided for evaluating the degree of dependence for a set of 26 correlations which relate the percentage of non-Whites in each of 130 American cities in 1960 with 26 other variables. Expected values are based on the rank-order position of each absolute correlation among the total set. A critical z is determined by summing the conventional critical z with the E( z ) based on rank. Also, a shrunken z ' is calculated by subtracting the E( z ) from the observed z . The results of this approach are compared with the Dunn multiple comparison technique. The method for calculating usable surplus is presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Devaluation of a degree.

Agrees with D. Shakow's (see record 1978-30686-001) article on clinical psychology 50 yrs later that clinical psychology is changing from a scientist-professional model to a professional-scientist or purely professional model. The author argues that without a supervised research experience, the professional-school graduate would be operating under a handicap, and few such students would choose to do research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Construct refinement and confirmation for the Addiction Severity Index.

A series of analyses reconstruct and confirm the validity and reliability of hypothesized scales for the Addiction Severity Index. Using a diverse sample (n?=?990) of methadone maintenance substance abuse patients, a multistage scaling strategy was applied to identify 7 psychometrically integral addiction problem scales. Exploratory item analyses, confirmatory oblique item clustering, and 2nd order factor analysis verified that the scales comprised relatively little common variance and that each retained a substantial amount of unique and reliable variance. Concurrent and predictive validity were supported with a sample of 244 methadone patients assessed throughout treatment. The advantages of the new scales are discussed, including provision of computer code for calculating normalized standard scores for use in clinical practice and treatment outcome research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Surgical repair of male epispadias by the Cantwell-Ransley procedure: technical aspects and functional results in a series of 40 patients]

Exposure to a number of environmental, behavioral and sociodemographic variables has been associated with increased prevalence and severity of adult periodontitis. However, it is not possible easily to identify the individuals most susceptible to this chronic disease. A case control study was conducted among a population of adults to determine what factors were associated with increased prevalence of moderate to advanced periodontitis. Clinical and radiographic data were obtained from dental charts and structured interviews were conducted by telephone to collect sociodemographic and behavioral data. Statistical modeling was completed for the total study population (35-87-year-olds) and for two age-stratified subpopulations. Significant crude disease associations were observed between periodontitis and numerous explanatory variables. However, after adjustment for age and gender, few variables remained significant. Age stratification indicated that young adults (35-54 years) were affected differently from older adults (> or =55 years) by exposures to certain variables. Young moderate smokers had a 3.15 times increased risk of periodontitis and young heavy smokers had a 7.33 times increased risk compared to never-smokers. Older single adults had a 3.07 times increased risk compared to those with partners.