Nasal cavity shape in unilateral choanal atresia and the role of fetal ventilation in facial growth.

OBJECTIVE: The respiratory movements of fetal amniotic fluid areconsidered by certains cleft surgery teams to contribute to the growth of the nasal cavities (NC). To assess this functional hypothesis, we considered a group of patients with unilateral choanal atresia (CA) as a model of unilateral absence of amniotic fluid flux in the NC, and compared their NCs shape to age-matched controls. MATERIAL AND METHODS: Three-dimensional reconstructions of NC were performed using Avizo 9.7 (Thermo Fisher Scientific, MA, USA), based on CT-scans of 32 patients with unilateral CA and 96 age- and gender-matched controls. Landmarks were placed on anatomical structures of NC. Procrustes superimpositions and principal component analysis were performed. Anatomically relevant Euclidean distances were computed using the coordinates of selected landmarks - maxillary length, piriform orifice width, choanal width - and tested using multivariate analysis. Growth rates between patients and controls for these distances were screened for correlations. RESULTS: The atretic NC was significantly deformed when compared to the control cases: Procrustes distance was 0.28 (P<0.0001). The maxillary length and width of the atretic choana were significantly decreased compared to controls (-2.95mm and -1.35mm respectively, P<0.001). There were no differences in growth rates between CA and controls, except for the choanal width on the atretic side. CONCLUSION: NCs in CA were significantly different from controls. More precisely, the maxillary length was significantly reduced in the CA group. There was no other major shape difference between the NC in CA and controls. NC seems to develop despite abnormal fetal ventilation.

Short-term methionine supplementation during the early post-partum period in primiparous rabbits improves prolificacy associated with an increase in serum concentrations of IGF-I.

The aim of this study was to evaluate the effects of methionine supplementation on energy metabolism and reproductive performance during the early post-partum period in primiparous does. Forty nulliparous New Zealand White does were used. Females were randomized in two groups at calving: the control group (n = 20) was fed with the basal diet, and the methionine group (n = 20) was fed the basal diet plus 1 g/animal/day of methionine from the day of calving to 4 days post-partum. Results showed that methionine supplementation increased (p = 0.032) the concentration of insulin-like growth factor-1 with respect to control group 4 days post-partum. It similarly increased the prolificacy (p = 0.03), the number of kits born alive per litter (p = 0.06) and the body gain weight of the litter during supplementation (p = 0.035). These results were observed despite the does in the methionine group having a deeper negative energy balance than the does in the control group. Finally, methionine supplementation did not affect receptivity (p = 0.23), fertility (p = 0.49), the number of kits born dead per litter (p = 0.86) insulin and metabolites as glucose, non-esterified fatty acids and triglycerides. In conclusion, our results show that methionine supplementation during the first 4 days of the post-partum period in rabbits increases total litter size and the corporal weight of kits and is associated with an increase in blood concentration of IGF-1.

Custom implant design for large cranial defects.

PURPOSE: The aim of this work was to introduce a computer-aided design (CAD) tool that enables the design of large skull defect (>100 [Formula: see text]) implants. Functional and aesthetically correct custom implants are extremely important for patients with large cranial defects. For these cases, preoperative fabrication of implants is recommended to avoid problems of donor site morbidity, sufficiency of donor material and quality. Finally, crafting the correct shape is a non-trivial task increasingly complicated by defect size. METHODS: We present a CAD tool to design such implants for the neurocranium. A combination of geometric morphometrics and radial basis functions, namely thin-plate splines, allows semiautomatic implant generation. The method uses symmetry and the best fitting shape to estimate missing data directly within the radiologic volume data. In addition, this approach delivers correct implant fitting via a boundary fitting approach. RESULTS: This method generates a smooth implant surface, free of sharp edges that follows the main contours of the boundary, enabling accurate implant placement in the defect site intraoperatively. The present approach is evaluated and compared to existing methods. A mean error of 89.29 % (72.64-100 %) missing landmarks with an error less or equal to 1 mm was obtained. CONCLUSION: In conclusion, the results show that our CAD tool can generate patient-specific implants with high accuracy.

[Bifid mandibular condyle: position of the supernumerary condyle]. / Bifidité du condyle mandibulaire: position du condyle surnuméraire.

INTRODUCTION: Bifid condyles are uncommon and include post-traumatic aberrant reorganization of the temporomandibular joint (TMJ) and congenital forms. CASE REPORT: We report two cases of unilateral bifid condyles, responsible for functional dysfunction of the TMJ. The first case, probably of congenital origin, was oriented frontally. The second case, oriented in the sagittal plane, was probably post-traumatic. Functional treatment was used for both patients. DISCUSSION: Bifid condyles is asymptomatic in most cases. Their most frequent clinical consequence is TMJ pain. Surgical treatment is rarely indicated. Determining the congenital or post-traumatic origin of bifid condyles is often difficult. The orientation of the supernumerary condyle head could help for the etiological diagnosis.

Non-adult dental age assessment: correspondence analysis and linear regression versus Bayesian predictions.

This study focuses on the evaluation of factors influencing the quality (accuracy and reliability) of non-adult dental age assessment from radiographic stages of permanent teeth (excluding the third molar). We used four distinct cross-sectional samples of 1,528 healthy children: 3 of known geographic origin (Ivory Coast, Iran and France) and 1 additional sample of children whose grandparents originated from a different continent. Two different methods of calculations are compared: the correspondence analysis combined with linear regression (CAR) and Bayesian predictions (with no independence assumption). Our results indicate that the quality of age assessment does not seem to depend predominantly on the use of geographic-specific standards. In the case of Bayesian predictions, we observed a clear trend in favour of significantly higher accuracy and reliability levels when using non-geographic-specific standards. One of the main advantage of Bayesian predictions over maximum likelihood methods of estimation is an overall increase in accuracy with high levels of reliability on a fraction of the test sample and, importantly, across all age categories (contrary to methods based on regression analysis). Importantly, in the case of Bayesian non-adult predictions, and contrary to age estimation techniques based on regression, a better quality does not depend on age.

[The impact of socioeconomic status in the estimation of non-adult dental age]. / Impact du niveau socioéconomique dans l'estimation de l'age dentaire des non-adultes.

The aim of this study is to observe the possible impact of socioeconomic level on stages of macroscopic dental development. The sample consists of 456 children from European origin, aged 3.5 to 16 years (242 girls and 214 boys). We apply a radiographic method of non-adult dental age estimation based on Bayes' theorem. Both socioeconomic level and geographic origin of grandparents are given in a questionnaire devised by the first author. First, results obtained with the Bayesian dependent method (BD method) are compared to those obtained with a more commonly used method of dental age estimation based on Correspondence Analysis and linear Regression (CAR method). Second, two approaches are proposed in order to test potential relationships between socioeconomic level and stages of macroscopic dental development. Both are based on observed shifts between dental age and chronological age with regard to socioeconomic level. Results obtained with the BD method are better, in terms of quality, than those obtained with the CAR method. We observed no influence of socioeconomic level on stages of macroscopic dental development.

[Tongue metastasis from esophageal adenocarcinoma. A case report]. / Métastase linguale d'un adénocarcinome de l'oesophage. A propos d'un cas.

Metastasis within the buccal cavity is a relatively uncommon finding observed in about 1% of malignant tumors in this region. Mandibular or maxillary bones are usually involved as well as soft tissues. Tongue involvement is rare. Secondary localizations arising from the esophagus are exceptional. These metastatic disseminations occur at advances stages. We report a case of tongue metastasis from an esophageal adenocarcinoma in a 73-year-old man who had undergone surgery for lower esophageal adenocarcinoma a few months earlier. The clinical presentation in this context was suggestive of a metastatic process confirmed at histology. Careful pathology examination is required to distinguish primary from secondary localizations and establish the diagnosis of metastasis.

[Difficult surgical management of facial neurofibromatosis type I or von Recklinghausen disease in children]. / Difficultés de la prise en charge chirurgicale des manifestations faciales de la neurofibromatose de type I ou maladie de von Recklinghausen chez l'enfant.

We report a case of predominantly facial neurofibromatosis type I in a 7-year-old girl, exposing the difficulties encountered in surgical management. Infiltration of facial soft tissues by plexiform neurofibroma is difficult to control. Resection of large areas of facial skin is unconceivable, facial functions must be preserved. Orbitocranial surgery is reserved for orbital manifestations of neurofibromatosis with osseous sphenoid dysplasia and pulsatile exophthalmos. Despite progress in tumor imaging and surgery, facial neurofibromatosis remains a challenge for the surgeon. We discuss surgical technique and indications for surgery in these cases.

Identification and androgen regulation of a 156-kDa hemeprotein in the harderian gland of the Syrian hamster.

An abundant cytosolic protein from hamster Harderian glands was partially purified by ultracentrifugation and analyzed on SDS-PAGE. This 156-kDa protein occurs in male but not in female glands. Castration of adult males for different time periods resulted in a gradual disappearance of the protein over 5 weeks. Daily administration of testosterone, 5 alpha-dihydrotestosterone, 3 alpha- or 3 beta-androstanediol (0.5 mg/day/15 days), to castrated males maintained the levels of the protein. In females, the protein was induced with the same compounds but not with 17 beta-estradiol. These observations indicate an androgen-mediated hormonal regulation. In developing animals, the 156-kDa protein was detectable in glands of 2-week-old males and females; it was not detected in 4-week-old females. Its specific reactions to 3,3',5,5'-benzidine derivatives strongly suggest heme groups associated with this Harderian gland protein.