Effect of red wine and red grape extract on blood lipids, haemostatic factors, and other risk factors for cardiovascular disease.

OBJECTIVE: Some epidemiological studies found a lower risk of cardiovascular disease among wine drinkers than among drinkers of other types of ethanol. This difference might be due to an effect of nonalcohol compounds in wine on important cardiovascular risk factors. The objective of this study was to compare the effect of red wine, nonalcohol compounds of red wine and placebo on established cardiovascular risk factors. DESIGN: A parallel, four-armed intervention study. SUBJECTS: A total of 69 healthy 38-74-y-old men and women. INTERVENTIONS: Subjects were randomised to either 1: red wine (males: 300 ml/day, 38.3 g alcohol/day, female subjects: 200 ml/day, 25.5 g alcohol/day), 2: water + red grape extract tablets (wine-equivalent dose), 3: water + red grape extract tablets (half dose), or 4: water + placebo tablets for a period of 4 weeks. No other sources of alcohol or anthocyanin were allowed. Plasma high-density lipoprotein (HDL)-cholesterol (HDL-C), low-density lipoprotein (LDL)-cholesterol (LDL-C), HDL-C/LDL-C-ratio, very-low-density lipoprotein (VLDL)-triacylglycerol, total cholesterol, fibrinogen, factor VII coagulant activity (FVIIc), blood pressure, and body weight were determined before and after intervention. RESULTS: Wine consumption was associated with a significant 11-16% increase in fasting HDL-C and 8-15% decrease in fasting fibrinogen relative to not drinking wine. There were no significant treatment effects on fasting LDL-C, HDL-C/LDL-C-ratio, VLDL-triacylglycerol, total cholesterol, FVIIc, or blood pressure. Drinking wine was associated with relative body weight increments closely corresponding to the energy contributed by the alcohol component. CONCLUSION: Moderate red wine consumption for 4 weeks is associated with desirable changes in HDL-C and fibrinogen compared with drinking water with or without red grape extract. The impact of wine on the measured cardiovascular risk factors thus seems primarily explained by an alcohol effect. Our finding suggests that the putative difference in cardiac risk associated with wine vs other alcoholic beverages might be rather explained by other life-style confounders than by red wine contents of nonalcohol components.

A three-dimensional evaluation of the upper airway in adolescents.

The link between the facial growth and airway function has been a subject of controversy in orthodontics for many years. This study investigates how well lateral cephalometric headfilms depict three-dimensional upper airway structures. Subjects are 11 normal adolescent children, ages 7-16 years old. Airway information over the same anatomic area in the nasopharynx is compared between lateral cephalometric headfilms and three-dimensional cone beam computed tomography (CT) scans. Intra-subject proportion of airway volume to area shows moderate variability. CT airway volume shows more variability than corresponding headfilm airway area.

Primary hypoparathyroidism in two horses.

Two Thoroughbred horses were presented with various clinical signs which included sweating, agitation, muscle twitching and synchronous diaphragmatic flutter. These signs were associated with profound hypocalcaemia. A diagnosis of primary hypoparathyroidism was made on the basis of low serum ionised calcium concentration, hyperphosphataemia and markedly reduced serum immunoreactive parathyroid hormone concentrations in the presence of normal renal function. Treatment with a combination of intravenous calcium and subsequently oral calcium, magnesium and a vitamin D analogue (dihydrotachysterol) for up to 65 days resulted in complete remission of clinical signs. Horse 1 was euthanased 12 months after the initial recognition of signs. Results of necropsy were unremarkable apart from an absence of detectable parathyroid tissue. Horse 2 returned to athletic activities while receiving only maintenance doses of oral calcium carbonate.

Characteristics of jaw growth in cleidocranial dysplasia.

OBJECTIVE: The purpose of this pilot study was to assess craniofacial morphology in young and adult individuals with cleidocranial dysplasia (CCD). DESIGN: Craniofacial morphology in young individuals (primary dentition) and in young adults was compared with control data using ratios and angles obtained from lateral head films. SETTING: The CCD individuals were referred to the Center for Craniofacial Anomalies for diagnostic workup and treatment recommendations. SUBJECTS: The sample consisted of 14 Caucasians. The inclusion criterion for the young, prepubertal group (A) was complete primary dentition, and for the adult, postpubertal group (B), the eruption of all four first molars was required. INTERVENTIONS: No treatment other than extraction or surgical removal of selected primary or supernumerary teeth was performed. RESULTS: Both groups showed significantly smaller anterior upper face height compared with controls. Group B subjects demonstrated significantly smaller face height values than the controls in the A point-nasion-B point (ANB) angle, facial axis, mandibular plane angle, palatal plane/mandibular plane angle, and gonial angle. No significant differences were found between group A individuals and the controls for these measurements. The older group had shorter anterior lower face height compared with both anterior upper face height and posterior lower face height. CONCLUSIONS: Whereas young CCD subjects showed relatively normal jaw proportions and morphology of the mandible, older CCD individuals tended to have short lower face height, acute gonial angle, anterior inclination of the mandible, and mandibular prognathism. These differences can be attributed to pronounced horizontal mandibular growth resulting from lack of vertical maxillary growth and impaired eruption of permanent teeth.

Ossification of the distal phalanx of the first digit as a maturity indicator for initiation of orthodontic treatment of Class III malocclusion in Japanese women.

The influence of mandibular growth on the stability of orthodontic treatment has been well established. A particular problem is late mandibular growth in patients with Class III malocclusions, because of skeletal jaw discrepancies that may influence the timing and course of treatment, as well as the stability of posttreatment. We have used the ossification of the distal phalanx of the first digit as an indicator of the skeletal maturity of the patient and of their potential for further growth. Our previous studies have shown that fusion of the epiphysis and the diaphysis of the distal phalanx of the first digit occurs from 1 to 3 years after the pubertal growth maximum in Japanese women. In these case reports, the orthodontic treatment of two female patients with mild Class III skeletal malocclusions is presented to show the possible clinical application of the ossification of the first digit as an indicator of the completion or near cessation of mandibular growth in the timing of treatment of Class III malocclusions. The case reports show that, although both patients experienced some mild degree of mandibular growth after treatment, this method can be helpful in determining residual mandibular growth potential in Japanese female patients with Class III malocclusions and mild skeletal discrepancies.

Guiding occlusal development with functional appliances.

Functional appliances have been used in orthodontics since their introduction by Pierre Robin almost one hundred years ago, however, our understanding of how they bring about orthodontic correction is still limited. This article is a brief overview of their history, mode of action, advantages and disadvantages, and includes the results of a study of attempts to control and minimise their side-effects using a recent development in functional appliances: the 'Teuscher Appliance'. This appliance combines a high-pull headgear with the activator, and is designed to reduce the often reported side-effects of functional appliances. The skeletal and dentoalveolar effects of treatment with the Teuscher Appliance on 40 consecutively-treated patients are reported and illustrated with four individual case reports. The results showed that the skeletal effect on the maxilla was a retardation of the normal forward and downward growth in 80 per cent of the cases, and that mandibular growth in 70 per cent of cases was forward. In patients whose mandibular growth was primarily in a vertical direction, such growth could be ascribed mainly to posterior rotation of the maxilla and/or the fact that the acrylic covering the lower posterior teeth to correct a deep bite was removed, promoting the eruption of these teeth and increasing the anterior vertical development. The dentoalveolar changes were characterised by retroclination of the maxillary incisors in 90 per cent of the patients, and were due to insufficient torque control by the built-in torque springs, which need further development. The mandibular incisors were well controlled by capping. The statistical analysis showed an inverse correlation between the initial incisor inclination and the change during treatment. This suggests that proclination of the lower incisors, as previously reported, is not a contra-indication to functional appliance treatment, provided the appliance is correctly designed. Overall, this study showed considerable individual response to treatment, and that the occlusal correction occurred through a combination of skeletal and dentoalveolar changes.

Guiding occlusal development with functional appliances.

Orthodontic treatment with functional appliances has been available since the beginning of this century. One of the first known functional appliances, 'the Monobloc', was introduced at a conference in Paris in 1926 by Pierre Robin. This appliance had been developed at the beginning of the century for the treatment of patients with Pierre Robin syndrome. Patients with this syndrome have extreme retrognathia of the mandible at birth and, as a result, the tongue is so far back in the pharynx that there is a risk of suffocation. Several years later, the same appliance was modified by Pierre Robin himself for the treatment of patients with Class II malocclusions which are in combination with extreme overjet.

Lateral pterygoid muscle and the temporomandibular disc.

This anatomic study examines the attachment of the lateral pterygoid muscle to the capsule and disc of the temporomandibular joint. The anatomy of the temporomandibular joint and its surroundings, in particular the insertion of the superior head of the lateral pterygoid muscle, was studied by dissection and conventional histologic techniques. The material consisted of 16 cadaver specimens from individuals 60 years or older. The results showed that only a part of the superior head of the lateral pterygoid muscle is attached to the anterior portion of the capsule, which, in turn, is firmly attached to the disc, giving the impression that the muscle and the disc are directly connected. All specimens showed attachment of the superior head of the lateral pterygoid muscle to the anterior medial portion of the capsule, but they showed varying degrees of attachment to the lateral aspect of the temporomandibular joint capsule. The remaining part of the superior head of the lateral pterygoid muscle attached to the mandibular condyle. Serial sectioning in no instance showed direct insertion into the disc of the fibers of the superior head of the lateral pterygoid muscle.

The role of procaine in adverse reactions to procaine penicillin in horses.

Procaine penicillin is a commonly used antibiotic in equine medicine but its use is associated with a substantial incidence of adverse reactions. Soluble procaine concentrations were determined by HPLC in several commercially available procaine penicillin preparations, including some that were involved in adverse reactions. The mean (+/- SEM) soluble procaine concentrations in the veterinary preparations was 20.18 +/- 5.07 mg/ml, which was higher than the concentration in the only procaine penicillin preparation for use in humans in Australia of 7.3 mg/ml. Heating the veterinary procaine penicillin preparations to 50 degrees C for 1 day led to a significant (P less than 0.01) increase in the amount of soluble procaine. Heating to 50 degrees C for 7 days also produced a significant (P less than 0.02) increase. Soluble procaine tended to return to baseline concentrations when veterinary procaine penicillin preparations were heated to 50 degrees C for 2 days then stored for 7 days at room temperature. Administration of procaine HCl intravenously (IV) at 2, 5, and 10 mg/kg produced behavioural, locomotor and vascular reactions, which were clinically similar to those reported in adverse reactions to procaine penicillin. The more severe reactions occurred at higher doses, although different horses responded variably at the same dose. Some adverse reactions lead to recumbency but none were fatal. The blood procaine concentrations 1 min after IV administration averaged 19.0 +/- 12.6 and 25.3 +/- 16 micrograms/ml at 2.5 mg/kg and 5 mg/kg, respectively. Ten min after administration, blood procaine concentrations were significantly higher (P less than 0.001) in the 5 mg/kg group than in the 2.5 mg/kg group. Intramuscular (IM) procaine HCl at 5 mg/kg produced significantly lower (P less than 0.001) blood concentrations than similar IV doses, and, in contrast to the IV doses, the amount of procaine in the blood was significantly higher 5 and 10 min after administration than it was after 1 min. Mild excitatory reactions in 4/5 horses were noted 5 to 10 min after IM administration. Administration of diazepam 20 s before procaine HCl prevented the excitatory adverse reaction in 2/2 horses, but administration after the procaine did not influence the outcome.

[Individual response to treatments using Teuscher activator]. / Individuel respons på behandling med Teuscher-aktivatoren.

Variations in facial growth and dentoalveolar development were studied in a group of 40 patients treated with the Teuscher appliance, a functional appliance which is a combination of an activator and a high-pull headgear. Patients were selected for this study on the basis of an initial Class II Division 1 malocclusion and on being consecutively treated with this appliance. The results showed that in 80% of the patients the maxilla either remained unchanged in it's relationship to the anterior cranial base (NSL) or became more retrusive during the treatment period. The mandible in 70% of the patients became more prognathic, only in four cases did the mandible become slightly more retrognathic. The analysis further showed that no statistically significant change occurred in the inclination of the mandible during treatment. Correlation analysis of the association between pretreatment mandibular plane angle and the changes during treatment showed no association. The dentoalveolar changes were characterized by retroclination of the maxillary incisors in 90% of the patients which occurred in spite of the torque springs, intended to maintain the inclination of these teeth. In contrast, the mandibular incisors on average showed no statistically significant change during treatment. This may be attributed to the capping of these teeth. Analysis of the association between the pretreatment inclination and the change during treatment of the mandibular incisors showed an inverse relationship. Mandibular incisors, that initially were proclined, tended to become more upright which is in contrast to previous studies indicating that functional appliance treatment generally increases the inclination of these teeth. The results of this study suggest that the correction of the skeletal component of the Class II malocclusion with the Teuscher appliance in most instances takes place by restriction of forward development of the maxilla in combination with downward-forward growth of the mandible, but with wide individual variations. The control of the incisor inclination in the maxilla with this appliance, however, is not adequate and further development in this area is needed. In contrast, the control of the lower incisors by capping helps effectively control these teeth against undesirable proclination during treatment.

Vertical malocclusions: etiology, development, diagnosis and some aspects of treatment.

Vertical malocclusions develop as a result of the interaction of many different etiological factors; one of the most important of these factors is mandibular growth. Variations in growth intensity, function of the soft tissues and the jaw musculature as well as the individual dentoalveolar development further influence the evolution of these malocclusions. This article reviews the most common etiological factors and their possible contribution to the development of vertical malocclusions with special emphasis on the role of mandibular growth in the development of open bite and deep bite. The role of the cephalometric morphological analysis in the differential diagnosis of vertical malocclusion is emphasized. Aspects of orthodontic treatment of vertical malocclusions are illustrated with individual cases.

Dental and skeletal contributions to occlusal correction in patients treated with the high-pull headgear-activator combination.

The purpose of this study was to examine dental and skeletal changes in patients treated with the high-pull headgear-activator combination. A group of 40 consecutively treated subjects with a Class II molar relationship and a minimum of 5 mm overjet was used for this study. The results showed that Class II correction often was achieved by distal repositioning of the maxillary teeth (mean, 0.07 mm) and mesial repositioning of the mandibular teeth (mean, 3.3 mm) with a wide range of variation. Correlation of maxillary molar repositioning with total interarch occlusal change showed a positive relationship; however, a weak correlation suggested that other variables were contributing factors, in addition to distal upper molar positioning. The change in mandibular molar position compared with the movement of pogonion strongly suggests that forward growth of the mandible is important to the correction of the Class II malocclusion. When total molar repositioning in the upper jaw was correlated with total molar repositioning in the lower jaw, a strong inverse correlation was found, indicating that upper molar movement parallels lower molar movement.

Patterns of mandibular movements in subjects with craniomandibular disorders.

Mandibular movements were evaluated for border and functional movements in 24 adult normal subjects and 26 adult patients with muscle pain associated with a craniomandibular disorder. The mandibular incisor position was tracked with an electromagnetic system in three planes by use of either a Myotronic Kinesiograph or a Siemens Sirognathograph instrument while the subject sat in an upright position. In the normal subjects, the maximum movements of the mandible in lateral, protrusive, and vertical directions were compared with the envelope of movement during speech and mastication. The range of the rest position was 1 to 5 mm in relation to the intercuspal position; the range of maximum excursion during speech was 30% to 36% of maximum opening; the vertical extent of excursion during mastication was 18% to 90% of the maximum vertical opening dependent on the bolus. Protrusive movements were straight forward, dividing the angle evenly between left and right laterotrusion. Laterotrusive movements were of equal length and similar to the length of protrusion. Twenty-six patients with muscle pain, in many instances, demonstrated asymmetry in the length of laterotrusive movements. Different pathways for moving the mandible away from the intercuspal position and returning to this position could be seen during laterotrusion. Unequal laterotrusive excursions and asymmetrical, nonparallel movement patterns for mandibular protrusion and retrusion were often observed. In contrast, the extent of the speech envelope and the envelope of mastication were similar to that of the controls.

Adaptation of craniofacial muscles in subjects with craniomandibular disorders.

The purpose of this study was to examine muscle function in subjects with muscle pain. Forty-three subjects with pain in the craniomandibular muscles, clinically determined by manual palpation, were studied for alteration in recruitment of temporalis, masseter, and suprahyoid muscles during a series of phasic movements. Seventeen normal subjects were used as controls. The subjects with muscle pain were divided into three subgroups: (1) those with pain in both mandibular and neck muscles; (2) those with pain in these two muscle groups with joint degeneration; and (3) those subjects with pain only in mandibular muscles. Surface electromyographic (EMG) recordings were taken as each subject performed 16 different responses in which mandibular incisor movement was tracked simultaneously. The results show that the subjects with muscle pain use their anterior temporalis muscles with less frequency (i.e., probability) and with less intensity in several responses than normal subjects. These responses include rapid vertical closing movements, retrusion, ipsilateral laterotrusion, and natural as well as contralateral mastication. The masseter muscle is impaired much less in its function, and the recruitment of the suprahyoid muscles is not affected in the patients with muscle pain. Comparison of the bilateral activity in the anterior temporalis muscles during intercuspal clenching shows that the subjects with muscle pain often demonstrate a more severe asymmetrical recruitment of these muscles than the more symmetrical recruitment seen in normal subjects. Similar observations were made for the masseter muscle. These studies demonstrate that subjects with muscle pain in craniomandibular muscles alter the recruitment of their jaw muscles, thus supporting the concept that the neuromuscular system is altered in patients with craniomandibular disorders.

Normal maxillary and mandibular growth and dentoalveolar development in Macaca mulatta. A longitudinal cephalometric study from 2 to 5 years of age.

Normal maxillary and mandibular growth and dentoalveolar development were examined in a longitudinal study of 10 male Macaca mulatta monkeys. Metallic implants were placed in the jaws of the monkeys as markers, and head films were taken semiannually from 2 to 5 years of age. The results showed that maxillary and mandibular growth is associated with rotational changes that are mostly in an anterior direction and are about twice as great in the mandible (9.4 degrees) as in the maxilla (4.2 degrees). These rotations are largely masked--about 75% in the maxilla and 90% in the mandible--by modeling within the jaws. Similarly, differential vertical dentoalveolar development almost completely masked the rotation of the occlusal plane that results from the rotation of the jaws, which created the impression that the occlusal plane is stable during growth. Peak growth velocity was reached on average at 3 years of age in the maxilla and mandible, with some individual variation. No major growth changes occurred after 3.5 to 4 years of age.

Changes in facial morphology in Macaca mulatta: a cephalometric study from 1.5 to 5 years of age.

A cross-sectional and longitudinal (3.5 years) study on the craniofacial growth of 10 male rhesus monkeys, using metallic implants and a radiographic cephalometric technique based mainly on angular measurements, led to the following observations. (1) Maxilla and mandible were displaced in a forward and downward direction during growth, the sagittal changes being predominant over the vertical changes. (2) Maxillary and mandibular prognathism increased continuously during the whole time span. This increase was twice as great for the maxilla as for the mandible. (3) The inclination of the palatal plane and the mandibular plane changed very little over time. (4) Mandibular form remained constant, but the cranial base showed a significant flattening between approximately 1.5 and approximately 3 years of age. (5) Upper and lower occlusal plane angles changed little over time. (6) The interincisal angle decreased significantly until approximately 3 years of age in relation to the increase in proclination of the permanent incisors in the maxilla and mandible. The intermolar angle remained fairly constant. Changes in some of the variables reported (maxillary and mandibular prognathism, sagittal jaw relationship, mandibular length, interincisal angle, proclination of the upper and lower incisors, and opening of the cranial base angle) occurred as a function of age. The use of angular measurements allowed us to develop a series of templates that will provide a useful tool for a quick check of normal craniofacial morphology at three representative time points.

Maxillary superimposition: a comparison of three methods for cephalometric evaluation of growth and treatment change.

Two anatomic methods are statistically compared with the implant method for superimposing serial head films in 18 subjects with metallic implants. Findings showed that the "best fit" method--that is, superimposition along the palatal plane registered at ANS--traditionally used by orthodontists, significantly underestimates the eruption of the teeth by 30% to 50%. The "structural method," which is based on the use of stable structures in the maxilla, showed no significant differences in vertical displacement of selected landmarks in comparison with the implant method.

Adverse reaction to procaine penicillin G in horses.

Adverse reactions to intramuscular injections of procaine penicillin G are reported in 11 horses, five of which died. The clinical findings are presented and suggest central nervous involvement in most cases. Post mortem findings in one horse were consistent with anaphylaxis whereas in other cases the clinical findings, duration of treatment, speed of onset and subsequent completion of treatment supports diagnosis of an acute procaine toxicity syndrome.