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1.
Am J Orthod Dentofacial Orthop ; 120(6): 598-607; quiz 676, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11742304

RESUMO

The purpose of this study was to investigate dentoalveolar changes related to mandibular forward growth in persons with Class II malocclusions. The longitudinal cephalometric films of 40 subjects with untreated Class II malocclusions from mean age 8.8 to 17.8 years (before and after pubertal growth) were analyzed and compared with the Bolton norms. There was no statistically significant difference in mandibular growth between the Class II samples and the Bolton norms upon cross-sectional comparison. In the Class II subjects, forward growth of the mandible was greater than that of the maxilla by 4.36 mm on average; the dentoalveolar complex moved forward relative to the maxillary basal bone (point A) 2.16 mm and moved backward relative to the mandibular basal bone (pogonion) 2.28 mm; a strong linear relationship (almost a 1:1 ratio) existed between mandibular forward growth and dentoalveolar complex movement (r = 0.881; y = 0.976 x + 0.183). Results indicated that the effect of forward growth of the mandible, which could potentially bring the lower dentition forward, vanished into the adaptation movements of the dentoalveolar complex through intercuspal locking. Disarticulating the occlusion to minimize the effects of the adaptive mechanism and taking advantage of normal mandibular forward growth could be fundamental biological bases in treating Class II malocclusions in growing patients.


Assuntos
Má Oclusão Classe II de Angle/fisiopatologia , Mandíbula/crescimento & desenvolvimento , Adaptação Fisiológica , Adolescente , Estudos de Casos e Controles , Cefalometria , Criança , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Má Oclusão Classe II de Angle/complicações , Movimento Mesial dos Dentes/complicações , Movimento Mesial dos Dentes/fisiopatologia , Odontometria , Estatísticas não Paramétricas
2.
Am J Orthod Dentofacial Orthop ; 111(5): 510-7, 1997 May.
Artigo em Inglês | MEDLINE | ID: mdl-9155810

RESUMO

The purpose of this study was to establish a nonnumeric graphic approach to the evaluation of facial form. By using a centroid-based pattern of orientation, skeletal, dental, and soft-tissue morphologic characteristics can be identified that more reliably represent the uniqueness of the person and are not dependent on nonrepresentative group-based numerical standards. The CentroGraphic Analysis (CGA) cephalomorphically demonstrates vertical and horizontal balance or disharmony in skeletal, dental, and soft-tissue form and position. The Facial Centroid Axis (FCA) provides a relatively stable reference plane that can be used for longitudinal cephalomorphic superimposition.


Assuntos
Cefalometria/métodos , Face/anatomia & histologia , Adolescente , Adulto , Envelhecimento , Criança , Pré-Escolar , Ossos Faciais/anatomia & histologia , Humanos , Lactente , Estudos Longitudinais , Desenvolvimento Maxilofacial , Reprodutibilidade dos Testes , Dente/anatomia & histologia
5.
Am J Orthod Dentofacial Orthop ; 104(2): 162-9, 1993 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8338069

RESUMO

Forty-one patients with clinically diagnosed Class II, Division I malocclusions with midface prognathism were treated with Kloehn-type cervical headgear. All cases included both longitudinal series of lateral cephalometric radiographs and hand-wrist films taken before, during, and after treatment. Skeletal and dental changes were related to specific maturational periods and compared with their related chronologic age to evaluate optimum timing for maximum treatment response. As determined by this study, timing of cervical headgear treatment on the basis of skeletal maturation is a more statistically significant means of obtaining the maximum desirable orthopedic effect than chronologic age. More favorable results were demonstrated during maturational periods that were associated with a higher degree of incremental growth velocity.


Assuntos
Desenvolvimento Ósseo , Aparelhos de Tração Extrabucal , Má Oclusão Classe II de Angle/terapia , Desenvolvimento Maxilofacial , Planejamento de Assistência ao Paciente , Adolescente , Fatores Etários , Análise de Variância , Cefalometria , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Mandíbula/anormalidades , Prognatismo/terapia , Puberdade , Análise de Regressão , Fatores de Tempo
6.
Angle Orthod ; 62(3): 185-90, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1416237

RESUMO

The relative stage of maturity of a child may be determined by comparing the child's hand-wrist radiograph to known standards of skeletal development. Hand-wrist radiographs of 70 adolescents were used to categorize the individuals by skeletal maturation into early, average and late maturation groups using the Fishman SMA method of assessment. The rates of mandibular and maxillary growth relative to the last stages of the pubertal growth spurt were measured. Statistical evaluation of the data was performed using an analysis of variance. The magnitude of change in growth increments of the mandible was greater in the late maturers than in the early or average maturers. Incremental differences in growth between the maxilla and mandible during the last stages of puberty were noted, with the mandible growing significantly more than the maxilla.


Assuntos
Envelhecimento/fisiologia , Desenvolvimento Maxilofacial/fisiologia , Puberdade/fisiologia , Adolescente , Determinação da Idade pelo Esqueleto , Cefalometria , Feminino , Humanos , Masculino , Mandíbula/anatomia & histologia , Mandíbula/crescimento & desenvolvimento , Maxila/anatomia & histologia , Maxila/crescimento & desenvolvimento
7.
J Child Neurol ; 6(2): 128-33, 1991 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2045628

RESUMO

Cerebrovascular disease involving large and medium-size vessels is thought to be an uncommon sequela of treatment of childhood brain tumors. We reviewed 11 children who developed cerebrovascular disease manifested by strokes or transient ischemic attacks 6 months to 4 years after treatment of brain tumors, while their tumors were in remission. All had received radiation therapy, and seven had received chemotherapy. One child died of acute bilateral cerebral infarctions due to carotid occlusion on one side and marked stenosis on the other 2 years after receiving radiation therapy for an incompletely resected craniopharyngioma. Pathologically, there was marked subendothelial fibrosis of the vessels of the circle of Willis, with inflammatory changes surrounding some of the vessels. In addition to the widely recognized small-vessel damage caused by radiation and chemotherapy in children (mineralizing microangiopathy), damage to medium and large intracranial vessels may result in late sequelae, manifested by stroke or transient ischemic attacks.


Assuntos
Neoplasias Encefálicas/radioterapia , Transtornos Cerebrovasculares/etiologia , Adolescente , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/patologia , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/patologia , Criança , Pré-Escolar , Círculo Arterial do Cérebro/diagnóstico por imagem , Círculo Arterial do Cérebro/patologia , Feminino , Humanos , Masculino , Radioterapia/efeitos adversos , Tomografia Computadorizada por Raios X
9.
Neurology ; 38(7): 1035-40, 1988 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3386819

RESUMO

Status epilepticus refractory to initial anticonvulsant therapy is a serious condition with a high morbidity and mortality. We present 50 cases with refractory status epilepticus (RSE) treated with very-high-dose phenobarbital (VHDPB) without reference to a predetermined maximum level or dose. Maximum serum levels ranged from 70 to 344 micrograms/ml (median, 114 micrograms/ml). VHDPB controlled seizures in all cases where no limits were imposed upon maximum dose (47/50). We found no maximum dose beyond which further doses are likely to be ineffective. Forty patients were intubated prior to VHDPB, but recovered respiratory drive and could be removed from the ventilator despite very high serum levels. This is explained by acute drug tolerance. Hypotension was unusual, related to the highest levels, and easily controlled. VHDPB has many relative advantages over other therapies presently used for RSE.


Assuntos
Fenobarbital/uso terapêutico , Estado Epiléptico/tratamento farmacológico , Pressão Sanguínea/efeitos dos fármacos , Criança , Relação Dose-Resposta a Droga , Humanos , Injeções Intravenosas , Fenobarbital/administração & dosagem , Fenobarbital/sangue , Respiração/efeitos dos fármacos , Estado Epiléptico/fisiopatologia
10.
Angle Orthod ; 57(3): 178-93, 1987 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3477966

RESUMO

A mixed longitudinal study of Skeletal Maturation Indicators (SMI) from the hand-wrist radiograph as a means for evaluating maturational status.


Assuntos
Determinação da Idade pelo Esqueleto , Crescimento , Adolescente , Fatores Etários , Criança , Ossos Faciais/crescimento & desenvolvimento , Feminino , Previsões , Humanos , Estudos Longitudinais , Masculino , Caracteres Sexuais , Crânio/crescimento & desenvolvimento
11.
Cancer ; 56(12): 2804-8, 1985 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-3876878

RESUMO

Primary central nervous system lymphoma is a rare presentation of lymphoma and is usually seen in adults, often in association with immunodeficiency. Evaluation of these patients classically shows discrete intracranial lesions, and long-term prognosis despite treatment is poor. The case of a child is presented who had no identifiable predisposing factors, no radiologic evidence of intracranial mass, no evidence of systemic disease, and in whom the diagnosis of primary CNS lymphoma was made based on documentation of a monoclonal population of malignant B-cells in the cerebrospinal fluid. The patient, in whom irreversible blindness developed, was treated with a combination of cranial radiation, and intrathecal and systemic chemotherapy, and is currently alive and disease-free 15 months after diagnosis.


Assuntos
Anticorpos Monoclonais , Neoplasias Encefálicas/diagnóstico , Linfoma/diagnóstico , Linfócitos B/imunologia , Neoplasias Encefálicas/líquido cefalorraquidiano , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/terapia , Contagem de Células , Líquido Cefalorraquidiano/citologia , Pré-Escolar , Terapia Combinada , Humanos , Linfoma/líquido cefalorraquidiano , Linfoma/complicações , Linfoma/terapia , Masculino , Atrofia Óptica/etiologia
12.
J Neurooncol ; 3(3): 263-9, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-3903064

RESUMO

The chemotherapeutic combination of cyclophosphamide, vincristine, procarbazine, and prednisone (COPP) was used to treat 15 children with recurrent central nervous system tumors and seven children with newly diagnosed brainstem tumors. In patients with recurrent tumors, marginal activity was seen in various histologic types. COPP chemotherapy was clearly ineffective in patients with brainstem tumors. Toxicity consisted of mild to moderate myelosuppression and neurotoxicity.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Encefálicas/radioterapia , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Terapia Combinada , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Feminino , Humanos , Masculino , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Procarbazina/administração & dosagem , Procarbazina/efeitos adversos , Vincristina/administração & dosagem , Vincristina/efeitos adversos
13.
Radiology ; 146(3): 681-6, 1983 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-6338557

RESUMO

Radionuclide and computed tomographic (CT) scanning was performed for the long-term follow-up of 63 patients who had been treated for primary intracranial central nervous system tumors. This group included 23 children with supratentorial lesions and 40 with infratentorial lesions. The results of imaging were correlated with clinical assessment and the results of cytologic evaluation of the cerebrospinal fluid and, when available, surgical or autopsy findings. The sensitivity, specificity, and positive predictive value of both CT and radionuclide scanning were evaluated for each type of tumor. These two modalities play a complementary role in the long-term follow-up of children with primary intra-axial neoplasms.


Assuntos
Neoplasias Encefálicas/diagnóstico , Compostos de Organotecnécio , Tomografia Computadorizada de Emissão , Tomografia Computadorizada por Raios X , Adolescente , Astrocitoma/diagnóstico , Criança , Pré-Escolar , Diatrizoato de Meglumina , Ependimoma/diagnóstico , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Seguimentos , Glioma/diagnóstico , Humanos , Lactente , Masculino , Meduloblastoma/diagnóstico , Ácido Pentético , Açúcares Ácidos , Tecnécio , Pentetato de Tecnécio Tc 99m , Fatores de Tempo
14.
Clin Nucl Med ; 7(11): 502-11, 1982 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-6756739

RESUMO

Thirty-three children who had strokes were studied by dynamic and static scintigraphy, 29 by CT scanning, and 10 by cerebral angiography. The accuracy of dynamic scintigraphy in stroke detection during the first week of clinical symptoms was 94% while CT scanning was 60% accurate and static scintigraphy 11% accurate. During the second week the accuracy of CT scanning increased to 100%, but static scintigraphy improved to only 50%. Fifty percent of scintiangiograms performed during the first week showed either luxuriant perfusion or flip-flop patterns. In some patients these two flow patterns changed to that of cerebral hemispheric ischemia after going through a phase during which perfusion appeared to be equal in the two hemispheres. Dynamic scintigraphy is believed to be the test of choice for stroke detection in children during the first week.


Assuntos
Transtornos Cerebrovasculares/diagnóstico por imagem , Ácido Pentético , Tecnécio , Adolescente , Adulto , Angiografia Cerebral , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Perfusão , Cintilografia , Pentetato de Tecnécio Tc 99m , Fatores de Tempo , Tomografia Computadorizada por Raios X
17.
Am J Pediatr Hematol Oncol ; 4(4): 367-73, 1982.
Artigo em Inglês | MEDLINE | ID: mdl-7168487

RESUMO

To determine the most reliable method of following the progress of disease in children with primary intracranial neoplasms, the noninvasive diagnostic procedures in 92 children were analyzed. Computerized tomographic (CT) scanning was found to be significantly superior to all other testing procedures in sensitivity, specificity, and overall accuracy. This superiority was seen regardless of tumor location or pathological subtype. When results in follow-up were compared to initial findings at diagnosis, the sensitivity of CT scanning was again significantly more reliable than the other procedures. Cerebrospinal fluid analysis was unreliable and added little information to that obtained from simultaneous CT and Radionuclide (RN) scanning. It is recommended that combined CT and RN scanning be used for management of intracranial neoplasms until a reliable method for detecting microscopic disease is available.


Assuntos
Neoplasias Encefálicas/diagnóstico , Cintilografia , Tomografia Computadorizada por Raios X , Adolescente , Encéfalo/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/diagnóstico , Líquido Cefalorraquidiano/análise , Criança , Pré-Escolar , Plexo Corióideo , Ependimoma/diagnóstico , Reações Falso-Negativas , Glioma/diagnóstico , Humanos , Lactente , Neuroblastoma/diagnóstico , Teratoma/diagnóstico
20.
Angle Orthod ; 49(3): 181-9, 1979 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-225970

RESUMO

Skeletal and chronologic ages of both female and male populations were compared relative to the degree of concurrence between the two age-indices at the various age levels. Maxillary and mandibular cephalometric measurements were similarly compared for both sex groups. Individual's comparisons of facial changes were made relative to their respective chronologic and skeletal ages. The significance of a skeletal vs. chronologic age discrepancy and its relationship to the timing of facial growth was demonstrated. Clinical implications were discussed.


Assuntos
Determinação da Idade pelo Esqueleto , Cefalometria , Desenvolvimento Maxilofacial , Adolescente , Estatura , Criança , Cronologia como Assunto , Face/anatomia & histologia , Feminino , Crescimento , Humanos , Estudos Longitudinais , Masculino , Crânio/anatomia & histologia , Crânio/crescimento & desenvolvimento
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