Personal performance profiles: a useful adjunct to quality assurance in cervical cytology

The purpose of this study was to determine whether the morphology of the midface differed in subjects with a retrognathic midfacial appearance (Class III malocclusions) using a combination of morphometric and cephalometric analyses. After obtaining appropriate consent, lateral cephalographs of 133 children of European-American descent, ages 5-11 years, were compared: 73 had Class III malocclusion, 60 had normal (Class I) occlusion. The cephalographs were traced and subdivided into seven age- and sex-matched groups. Average geometries based upon seven nodes (pterygoid point, PTS; rhinion, RO; posterior nasal spine, PNS; midpalatal point, MPP; anterior nasal spine, ANS; subspinale, A; prosthion, Pr), scaled to an equivalent size, were compared using a Procrustes routine. Euclidean distance matrix analysis (EDMA) was employed to localize differences in morphology. Bivariate analyses on unscaled data utilizing nine linear and six angular measurements were also undertaken. Results from Procrustes and EDMA analyses indicated that although the overall midfacial configurations differed statistically (P < 0.05), only about half of the seven age sub-groups maintained significance. Similarly, only four of the nine linear measures (PNS-MPP, MPP-ANS, A-Pr and PTS-RO) and two of the six angular parameters (PTS-RO-ANS and ANS-A-Pr) tested were significantly different (P < 0.05). Therefore, midfacial morphometric variability and morphological diversity may mask statistical differences. It is concluded that the midface may be the defining craniofacial component in the final appearance of Class III malocclusions compared to other craniofacial components, including the cranial base and mandible.     

Tooth wear and temporomandibular joint morphology in a skull material from the 17th century

Skeletal remnants from the skulls of 69 subjects from the 17th century have been studied focusing on TMJ morphology and tooth wear. Several of the skulls were damaged and altogether 68 condyles and 28 temporal components of the TMJ, and 97 dentate jaws could be examined. Tooth wear was extensive and most of the first molars in both jaws had lost most of their occlusal morphology. This is remarkable with respect to the fact that the great majority of the subjects had died before the age of 35 years, according to the age determination performed. The TMJs showed frequent remodelling but only rarely deformative changes. The frequent observation of a broken up compact bone layer on the condyle was interpreted as a post-mortem artefact. The results indicate adaptive response of the TMJs to the probably heavy masticatory function but do not support the suggested relationship between tooth wear and TMJ osteoarthrosis.     

Average African American three-dimensional computed tomography skull images: the potential clinical importance of ethnicity and sex

The production of average 'normative' three-dimensional (3D) computed tomography surface images of the bony skull has only recently been explored. The authors wish to determine the effect of using sex- and ethnicity-specific adult average 3D skull images for comparisons with patient images at various stages of craniofacial surgical management (i.e., diagnosis, treatment planning, prosthetic design, image-guided operative procedures, and outcomes assessment). Craniofacial surgical reconstruction for abnormal patterns of development, cancer resection, or trauma are most likely to benefit from these comparisons. To morphometrically test the significance of separating normative 3D skull data by sex and ethnicity, the authors collected 52 3D, anatomical landmarks from 3D computed tomography scans of dry skulls of 20 Americans of European ethnicity and 20 Americans of primarily African (i.e., primarily African and some European) ethnicity. A Procrustes-based morphometric analysis of shape detects 1.2 times as much interethnic variance as intersex variance. The African American sample presents 4.2% more dolichocephaly, wider orbits, flatter nasal area, larger gnathic anatomy, and more procumbent dentition. Pooling the sexes across both groups, it is seen that men tend to have less bulbous crania, more protruding brows, noses, and masticatory muscle attachments, and relatively less protrusive palettes and anterior mandibles. Despite a small sample size (N = 40), the authors' results are statistically significant (P approximately 0.001 overall) for both of the main factors, sex and ethnicity, separately.     

Differences in Epstein-Barr virus expression between primary and secondary cutaneous angiocentric lymphomas. French Study Group of Cutaneous Lymphomas

OBJECTIVE: The aim of this investigation was to report on the radiographic interpretation of the hard palate and nasal fossa floor in panoramic radiographs by studying different skulls, x-ray machines, and head positions in relationship to the Frankfort plane before and after ostectomy. STUDY DESIGN: Twenty dry human skulls were radiographed with three different panoramic x-ray machines in three different positions. Three of the skulls were submitted to different ostectomies. RESULTS: Multiple images of the hard palate and nasal fossa floor were present in 96.12% of the radiographs. Single images (3.88%) occurred only in the "chin up" position. CONCLUSIONS: The lower image represents the nasal fossa floor, especially its lateral and anterior limits. The upper images are double real images mainly formed by the junction of the nasal septum with the nasal fossa floor and possibly by posterior parts of the hard palate and nasal fossa floor. All images overlap in the "chin up" position becoming a single image. The most common shape of the anatomic landmark was wide angle "W" (58.33%). Other shapes present in positions "chin up" and "chin down" indicate patient positioning errors. The x-ray machines did not influence the results.     

Quantitative complete tooth variation among east Asians and Native Americans: developmental biology as a tool for the assessment of human divergence

The quantification of total tooth structure derived from X-rays of Vietnamese, Southern Chinese, Mongolians, Western Eskimos, and Peruvian pre-Inca (Huari Empire) populations was used to examine dental divergence and the morphogenetics of change. Multivariate derived distances between the samples helped identify a quasicontinuous web of ethnic groups with two binary clusters ensconced within the web. One cluster was composed of Mongolians, Western Eskimos, and pre-Inca, and the other group consisted of the Southern Chinese and Vietnamese. Mongolians entered the quasicontinuum from a divergent angle (externally influenced) from that of the Southeast Asians. The Chinese and pre-Inca formed the polar samples of the distance superstructure. The pre-Inca sample was the most isolated, its closest neighbor being the Western Eskimos. Univariate and multivariate analyses suggested that the pre-Inca, whose ancestors arrived in America perhaps approximately 30,000 years ago, was the least derived sample. Clearly, microevolutionary change occurred among the samples, but the dental phenotype was resistant to environmental developmental perturbations. An assessment of dental divergence and developmental biology suggested that the overall dental phenotype is a complex multigenic morphological character, and that the observed variation evolved through total genomic drift. The quantified dental phenotype is greater than its highly multigenic algorithm and its development homeostasis is tightly controlled, or canalized, by the deterministic organization of a complex nonlinear epigenetic milieu. The overall dental phenotype quantified here was selectively neutral and a good character to help reconstruct the sequence of human evolution, but if the outlying homeostatic threshold was or will be exceeded in antecedents and descendants, respectively, evolutionary saltation occurs.     

Palatal thickening and facial form in Paranthropus: examination of alternative developmental models

Paranthropus is distinctive among hominoids in its possession of a greatly thickened hard palate. Although traditionally considered a structural adaptation to counter high-magnitude masticatory stress, alternative developmental models are equally viable. Three models of palatal thickening were evaluated in this study. A mechanical model interprets palatal thickening as a compensatory response to increased instability of the midpalatal suture effected by an anterior placement of the masseteric muscle mass. This model predicts that palatal thickness is correlated with the length of the palate posterior to the masseteric tubercle. Two non-mechanical models consider the thickness of the hard palate to be structurally related to and therefore correlated with either 1) the degree to which the premaxilla overlaps the hard palate in the subnasal region or 2) the height of the posterior facial skeleton. The correlation of craniofacial variables was assessed intraspecifically in ontogenetic series of great ape and human crania. Tests of correlation were performed for each comparison using both residuals calculated from reduced major axis regression of the variable of interest against a measure of cranial size and shape ratios. A significant correlation of palatal thickness with posterior facial height in Pan suggests that the unusually thick hard palate of Paranthropus is directly related to the increased posterior facial height characteristic of this taxon. Further evaluation suggests that extreme palatal thickening in these specimens occurred by virtue of their possession of a nasal septum morphology in which the vomer extends onto the superior and nasal surface of the premaxilla. Such a morphology would have constrained the palatal nasal lamina to maintain the approximate level of the premaxillary nasal lamina throughout the growth process thereby promoting palatal thickening.     

Growth of the nasal septum in the Snell strain of hypopituitary dwarf mouse

The literature relating to experimental investigation of growth of the nasal septum has been reviewed in detail. A total of 156 skulls from the Snell hypopituitary mouse, six controls and six dwarfs at each age group were radiographed in lateral view to enable measurement of the different components of the nasal septum. By 80 days of age, the snout of the nasal septum in the Snell strain of mice was 56 per cent the size of the snout in normal mice (n = 12, t = 8.07, P = 0.0005). It is concluded that the Snell strain of mouse is an example of a specific genetic defect causing severe growth retardation of cartilaginous tissues, particularly the nasal complex.     

Modified MACOP-B chemotherapy for intermediate and high grade non Hodgkins lymphomas

The distribution of calcitonin gene-related peptidergic (CGRP) nerve endings in rat nasal mucosa was investigated with immunocytochemical technique (ABC method). The results showed that CGRP endings had a robust localization along the walls of arterioles, venules and around the acini of glands, with the endings near the wall of arterioles being most strongly stained. The typical morphology of CGRP endings could be recognized as multistage-branched terminals with rosary varicosities. CGRP immunoreactive neurons were also found in the trigeminal ganglion (TG). Supported by morphological evidence, we suggest that CGRP endings in rat nasal mucosa are the peripheral fibers originating from the ganglion cells in TG. These fibers may be involved in the perception of mucosal stimuli and the propagation of nerve impulse to the central terminals and will thus release CGRP in the brain stem. There is also possibility that CGRP may be peripherally released following local stimulation in the nasal mucosa and exert influences on the mucosal functions.     

Facial reconstructions on the V?rs-Papkert B Cemetery series

Seven skulls from the V?rs-Papkert B Cemetery were analysed according to the facial reconstruction method of KOLLMANN and GERASIMOV. The degree of expression of sex, metric data of the skull, morphological characteristics of the skull and characteristics of the reconstructed face are presented for each of the skulls.     

Evaluation of the dental status from he viewpoint of denture requirements in the adult population of Hungary]

Authors found a rather high number of missing teeth of the Hungarian population, whereas the claim of the patients to dentures is less than the capacity of the dental professionals. The percentage of the patients wearing fixed and/or removable dentures is only around 50% (mean value), in the aesthetically not disadvantageous cases (i.e.: classes 1/a; 2/a; Fábián-Fejérdy) only 30-40%, but in the aesthetically disadvantageous cases 70-80% (i.e.: classes 1/b; 2/a/1; 3; Fábián-Fejérdy). The percentage of the men wearing dentures is higher than the percentage of the men (61.9% and 44.9% respectively). Authors concluded that, the most important expectations of the patients to dentures are aesthetic. The injurious effects of not reconstructed missing teeth have minor effects on the patients motivation.     

Keratinocyte growth factor protects mice from chemotherapy and radiation-induced gastrointestinal injury and mortality

A total of 963 skeletons (408 Whites and 555 Blacks) from the Terry Collection were studied to examine macroscopic cranial methods of age estimation. The methods of Acsádi and Nemeskéri, Masset, Baker and Meindl and Lovejoy were applied to every skull. The results indicate that the most accurate techniques in this application were those that consider endocranial suture closure. The methods of Acsádi and Nemeskéri and Masset were the most accurate in all the subsamples (by population, sex, sex within population and in total), although the relative accuracy could vary in application to other populations.     

Surgical maxillofacial treatment of obstructive sleep apnea

Obstructive sleep apnea is the most common sleep-related breathing disorder, with a surprisingly high prevalence. The treatment of choice is nasal continuous positive airway pressure (CPAP) ventilation during sleep, which has to be applied throughout the patient's whole life. Because of various underlying pathomechanisms in patients with certain craniofacial disorders--narrow posterior airway space and maxillary-mandibular deficiency--surgical therapy by craniofacial osteotomies seems possible. A series of 38 consecutive patients were treated by 10-mm maxillomandibular advancement by retromolar sagittal split osteotomy and Le Fort I osteotomy, respectively. Obstructive sleep apnea syndrome was improved considerably in all patients; there was no significant difference compared to the results under nasal CPAP. In 37 of 38 patients, the postoperative apnea-hypopnea index was reduced clearly to under 10 per hour, oxygen saturation rose, and sleep quality improved. This was achieved by maxillomandibular advancement of 10 mm without secondary refinements in all but 2 patients. In one patient, the apnea-hypopnea index could only be reduced to 20 per hour, probably because of insufficient maxillary advancement. These results indicate that successful surgical treatment is possible in a high percentage of selected patients with certain craniofacial characteristics. In addition to cardiorespiratory polysomnography, there should be routine cephalometric evaluation of all patients. Maxillomandibular advancement should be offered as an alternative therapy to all patients with maxillary and/or mandibular deficiency or dolichofacial type in combination with narrow posterior airway space.     

Absence of the superior labial frenulum in holoprosencephaly: a new diagnostic sign

The upper lip of 17 consecutive individuals with various forms of holoprosencephaly were examined either at autopsy or during clinical evaluation. A total of 88% of cases were missing the superior labial frenulum regardless of the severity of holoprosencephaly or other associated craniofacial defects. Because the frenulum was found to be missing across a complete clinical spectrum of holoprosencephaly including cases exhibiting only minimal craniofacial features, it should be inspected as part of the craniofacial examination, and its absence should be prompt imaging studies of the brain. Absence of the frenulum in holoprosencephaly also provides evidence that its embryonic origin is that of the medial nasal process.     

Expression of 72-kDa gelatinase (matrix metalloproteinase-2) in the developing mouse craniofacial complex

Tissue remodelling is an important feature during embryogenesis. Although the matrix metalloproteinases are believed to participate in these processes, the relation between matrix metalloproteinases and tissue remodelling during craniofacial morphogenesis remains unclear. The purpose of the study was to look for the presence of enzymes involved in extracellular matrix degradation during craniofacial morphogenesis. Protein expression of the matrix metalloproteinase, 72-kDa gelatinase (matrix metalloproteinase-2, gelatinase A, 72-kDa type IV collagenase) was studied by gelatine zymography and by indirect immunofluorescence with conventional and confocal microscopy. In the anterior region of the developing mouse face, 72-kDa gelatinase was labelled mainly in the tips and peripheral regions of the nasal and facial prominences. Upon contact and fusion of the prominences, the staining was intensely localized to the zone of the fusion and the tips and peripheral regions of the nasal prominences and the maxilla. The labelling of 72-kDa gelatinase was also present in the peripheral regions of the mandible, second branchial arch, and the face around the developing eye. However, during lens vesicle formation, the staining of 72-kDa gelatinase was absent in the invaginated lens ectoderm. After the lens had completely detached from the surface ectoderm, the staining was resumed in the corneal epithelium and mesenchyme. Gelatine zymography was used to confirm the presence of active and latent 72-kDa gelatinase in the developing mouse craniofacial complex. Collectively, these data indicate that 72-kDa gelatinase may play a significant part in localized tissue remodelling during craniofacial morphogenesis and the aberrant expression or function of the enzyme could be involved in causing facial abnormalities.     

Rileyella petauri gen. nov., sp. nov. (Pentastomida: Cephalobaenida) from the lungs and nasal sinus of Petaurus breviceps (Marsupialia: Petauridae) in Australia

A new cephalobaenid pentastome, Rileyella petauri gen: nov., sp. nov. from the lungs and nasal sinus of the petaurid marsupial, Petaurus breviceps, is described. It is the smallest adult pentastome known to date, represents the first record of a mammal as the definitive host of a cephalobaenid and may represent the only pentastome known to inhabit the lungs of a mammal through all its instars, with the exception of patent females. Adult males, non-gravid females and nymphs moulting to adults occur in the lungs; gravid females occur in the nasal sinus. R. petauri is minute and possesses morphological features primarily of the Cephalobaenida but the glands in the cephalothorax and the morphology of the copulatory spicules are similar to some members of the remaining pentastomid order, the Porocephalida. This unusual combination of features distinguish the new genus from other genera in the Cephalobaenida. The occurrence of only seven fully-formed larvae in eggs in the uterus, each representing about 10% of the length of the patent female, and her presence in the nasal sinus of a dependent juvenile P. breviceps (36 gm) implies a direct life cycle.     

The grain refinement of zinc-aluminum alloys by titanium

Abstract

The effect of small additions of titanium in the range 0?0.5 wt% on the primary α′ aluminum grain size in Zn–Al alloys containing 7 and 24 wt% Al has been examined. Marked refinement of the α′. phase was associated with the occurrence of small cubic particles in the microstructure. Electron microprobe and electron diffraction analysis showed that the particles were Al₅Ti₂Zn with a simple cubic symmetry, a = 3.99 ± 0.04Å. In the refined alloys the primary aluminum grains were “non-dendritic” and this morphology has been discussed in relation to the effectiveness of the particles as nuclei and the theory of predendritic solidification.

Additions of not less than 0.04 wt% of titanium to Zn-Al alloys containing 7 to 24 wt% Al are sufficient for complete grain refinement of the primary aluminum phase.

Résumé

Les auteurs ont étudié l'influence de faibles additions de titane (0-0.5% poids) sur la taille des grains d'aluminium (α′ primaire) des alliages Zn–Al. Un affinement marqué de la phase α′. est obtenu lorsqu'il y a présence de petites particules cubiques dans la microstructure. Des analyses à la microsonde et par diffraction électronique révèlent que ces particules sont composées de Al₅Ti₂Zn ayant une structure cubique simple (a = 3.99 ± 0.04Å). Dans les alliages á grains affmés, ces derniers sont “non?dentritiques” et cette morphologie est discutée à la lumiére de l'éfficacité des particules qui agissent comme germes et de la théorie de la solidification pré-dendritique.

Des additions d'au moins 0.04% poids de titane aux alliages Zn-Al, contenant de 7 à 24% poids d'aluminium, sont suffisantes pour obtenir un affinement complet du grain de la phase prima ire riche en aluminium.     

The origin of the dog-like borhyaenoid marsupials of South America

Dog-like marsupials (superfamily Borhyaenoidea) were the largest predacious mammals during the Tertiary period in South America. They are critical to our understanding of marsupial origin, phylogeny and palaeobiogeography because they have been related to various marsupial lineages of several continents: didelphoids (mainly New World, but also Europe, Asia and Africa), pediomyid, stagodontids (North America), dasyuroids (Australia) and deltatheroidans (predominantly Asian). These relationships, based mainly on dental morphology, have been discussed and rejected several times. Here we report the discovery of exceptionally well preserved skulls and skeletons, referrable to the didelphoid Andinodelphys, which shed new light on the phylogenetic and palaeobiogeographic origin of dog-like marsupials. The skulls of Mayulestes (boryhyaenoid), Andinodelphys and Pucadelphys (didelphoids) from the early Palaeocene epoch of Bolivia are the oldest known for American marsupials. Comparison of their basicranial anatomy suggests that dog-like marsupials are closely related to an early didelphimorphian radiation in South America, rather than to Asiatic (deltatheroidan), North American (stagodontid), or Australian (dasyuroid) lineages.     

Finite element morphometry of the midfacial complex in subjects with Angle's Class III malocclusions

The purpose of this study was to determine whether the morphology of the midface differed in normal (Class I) and midfacially-retrognathic (Class III) prepubertal subjects, and to localize differences morphometrically. Lateral cephalographs of 133 European-American children between 5-11 years of age were traced and average geometries, scaled to an equivalent size, were generated based upon seven nodes (pterygoid point, PTS; rhinion, RO; posterior nasal spine, PNS; midpalatal point, MPP; anterior nasal spine, ANS; subspinale, A; and prosthion, Pr). The samples also were subdivided into seven age- and sex-matched groups for morphometric comparisons. Procrustes analysis indicated that the overall midfacial configurations differed statistically (P < 0.05). Therefore, a color-coded finite element (FEM) program was used to localize differences in morphology graphically. Comparing Class I and III groups for size-change, FEM revealed that negative allometry was evident in the posterior half of the midfacial configuration localized between PTS, PNS, and MPP. The anterior half was more isotropic, however, but the anterior-most aspect of the configuration between Pr and RO showed some positive allometry particularly in the premaxillary and incisor regions. For shape-change, major differences in shape over the entire midface were not as evident, with an isotropic midfacial morphology for normal and Class III subjects. It is concluded that an identifiable pattern of deformation is evident for the Class III subjects during the prepubertal growth period. Therefore, midfacial retrognathia associated with Class III malocclusions results, at least in part, from deficient anteroposterior elongation of the midfacial complex allied with deformation of the premaxillary region.     

Transnasal approach to the orbit, the interorbital space, and the nasopharynx

We present a surgical procedure that provides exposure to the medial part of the orbit, the interorbital space, and the nasopharynx. A midline incision of the nose is followed by a pedicled osteotomy of the lateral nasal wall and the medial wall of the orbit in one piece. This transnasal approach provides good exposure to the medial parts of the craniofacial junction to remove foreign bodies or benign tumors.     

Transcriptional repression: lessons from thyroid hormone action and promyelocytic leukaemia

We report seemingly unique craniofacial malformations and deglutition dysfunction in a sib pair. The boy had right maxillomandibular alveolar synechae, ankylosis of right temporomandibular joint, hypoplasia of the zygomatico-maxillary region, nasal deviation to the left, choanal stenosis, and exophthalmos due to shallow orbita. His ears were apparently low-set with prominent lobules. He had severe gastroesophageal reflux and increasing respiratory problems and died at age 11 months. Psychomotor development was normal. His 10-year-old sister had similar craniofacial malformations and a cleft soft palate. She also had a severe deglutition dysfunction and developed a thoracolumbar kyphoscoliosis. Psychomotor development was normal. The parents were healthy and non-consanguineous. The malformations in the sibs do not fit any reported craniofacial malformation syndrome and may represent a previously unrecognized monogenic disorder. This may be an autosomal recessive or dominant trait with gonadal mosaicism in one of the parents.