Upper airway changes in Pierre Robin sequence from childhood to adulthood.

OBJECTIVES: To investigate pharyngeal airway changes in patients with Pierre Robin sequence (PRS) longitudinally from childhood to adulthood. SETTING AND SAMPLE POPULATION: Cleft Lip and Palate Unit, Clinic of Orthodontics, University of Zurich. Twenty-four patients born between 1970 and 1990 with non-syndromic PRS. MATERIALS AND METHODS: Lateral cephalograms at age 5 (T1), 10 (T2), 15 (T3) and 20 (T4) years were available. Variables describing pharyngeal airway dimensions, soft palate morphology, tongue and hyoid position, skeletal morphology and head posture were assessed. RESULTS: A significant increase in nasopharyngeal depth was found over the entire observation period (T1 10.7 to T4 19.1 mm, p < 0.001), especially between T2 and T3 (change 3.8 mm, p < 0.001), and was mainly due to adenoid recession (r = -0.75, p < 0.001; variation explained by 56%). Increase in velopharyngeal depth mainly took place between T3 and T4 (change 2.3 mm, p < 0.01). It was due to more anterior tongue posture (r = 0.65, p < 0.001; 42.5% of variation explained), in turn allowing the soft palate to take a more vertical position (r = -0.52, p < 0.001). Increase in oropharyngeal depth was associated with head extension and anterior mandibular positioning (36% of variation explained). However, significance was not reached (T1 8.3 to T4 9.8 mm, p > 0.05). CONCLUSIONS: Upper airway dimensions in children with PRS improve with time, except for the oropharyngeal airway. Despite large interindividual variation, the mean remained in the lower reaches of normality described in other studies. Thus, further research should investigate the prevalence of obstructive sleep apnoea in adults with PRS.

Modeling the impact of climate change in Germany with biosphere models for long-term safety assessment of nuclear waste repositories.

Biosphere models are used to evaluate the exposure of populations to radionuclides from a deep geological repository. Since the time frame for assessments of long-time disposal safety is 1 million years, potential future climate changes need to be accounted for. Potential future climate conditions were defined for northern Germany according to model results from the BIOCLIM project. Nine present day reference climate regions were defined to cover those future climate conditions. A biosphere model was developed according to the BIOMASS methodology of the IAEA and model parameters were adjusted to the conditions at the reference climate regions. The model includes exposure pathways common to those reference climate regions in a stylized biosphere and relevant to the exposure of a hypothetical self-sustaining population at the site of potential radionuclide contamination from a deep geological repository. The end points of the model are Biosphere Dose Conversion factors (BDCF) for a range of radionuclides and scenarios normalized for a constant radionuclide concentration in near-surface groundwater. Model results suggest an increased exposure of in dry climate regions with a high impact of drinking water consumption rates and the amount of irrigation water used for agriculture.

The use of calf circumference measurement as an anthropometric tool to monitor nutritional status in elderly inpatients.

OBJECTIVE: The objective of this study was to identify the nutritional status of hospitalized elderly and verify if calf circumference can be a tool to monitor nutritional status in this population. METHODS: A total of 170 inpatients (79 men and 91 women) aged more than 60 years were assessed. Anthropometric and dietary assessments were done according to standard procedures. The software STATISTICA 6.0 was used for the statistical analysis. The confidence interval was set at 95% and significance level at 5% (p < 0.05). RESULTS: Body mass index assessment revealed a high rate of underweight patients (45.3%), and arm circumference and triceps skinfold revealed a high prevalence of depletion. Males had more lean mass according to the mid-arm muscle circumference (p=0.017) and mid-arm muscle area (p=0.01), and females presented higher triceps skinfold values (p < 0.001). There was a positive correlation between calf circumference and Body Mass Index (p < 0.001), arm circumference (p=0.001), triceps skinfold (p=0.001), mid-arm muscle circumference (p=0.001), and mid-arm muscle area (p=0.001). CONCLUSION: This study found a positive correlation between calf circumference and nutritional status of assessed patients indicating that this measurement can be used as a complementary tool for monitoring the nutritional status of elderly inpatients.

Light curing time reduction: in vitro evaluation of new intensive light-emitting diode curing units.

The aim of the present in vitro study was to establish the minimum necessary curing time to bond stainless steel brackets (Mini Diamond Twin) using new, intensive, light-emitting diode (LED) curing units. Seventy-five bovine primary incisors were divided into five equal groups. A standard light curing adhesive (Transbond XT) was used to bond the stainless steel brackets using different lamps and curing times. Two groups were bonded using an intensive LED curing lamp (Ortholux LED) for 5 and 10 seconds. Two more groups were bonded using another intensive LED curing device (Ultra-Lume LED 5) also for 5 and 10 seconds. Finally, a high-output halogen lamp (Optilux 501) was used for 40 seconds to bond the final group, which served as a positive control. All teeth were fixed in hard acrylic and stored for 24 hours in water at 37 degrees C. Shear bond strength (SBS) was measured using an Instron testing machine. Weibull distribution and analysis of variance were used to test for significant differences. The SBS values obtained were significantly different between groups (P < 0.001). When used for 10 seconds, the intensive LED curing units achieved sufficient SBS, comparable with the control. In contrast, 5 seconds resulted in significantly lower SBS. The adhesive remnant index (ARI) was not significantly affected.A curing time of 10 seconds was found to be sufficient to bond metallic brackets to incisors using intensive LED curing units. These new, comparatively inexpensive, curing lamps seem to be an advantageous alternative to conventional halogen lamps for bonding orthodontic brackets.

Volumetric measurements of bacterial cells and extracellular polymeric substance glycoconjugates in biofilms.

In this study an enrichment culture developed from activated sludge was used to investigate the architecture of fully hydrated multispecies biofilms. The assessment of biofilm structure and volume was carried out using confocal laser scanning microscopy (CLSM). Bacterial cell distribution was determined with the nucleic acid-specific stain SYTO 60, whereas glycoconjugates of extracellular polymeric substances (EPS) were stained with the Alexa-488-labeled lectin of Aleuria aurantia. Digital image analysis was employed for visualization and quantification of three-dimensional CLSM data sets. The specific volumes of the polymeric and cellular biofilm constituents were quantified. In addition, gravimetric measurements were done to determine dry mass and thickness of the biofilms. The data recorded by the CLSM technique and the gravimetric data were then compared. It was shown that the biofilm thicknesses determined with both methods agree well for slow-growing heterotrophic and chemoautotrophic biofilms. In addition, for slow-growing biofilms, the volumes and masses calculated from CLSM and the biomass calculated from gravimetric measurements were also comparable. For fast-growing heterotrophic biofilms cultivated with high glucose concentrations the data sets fit to a lesser degree, but still showed the same common trend. Compared with traditional gravimetric measurements, CLSM allowed differential recording of multiple biofilm parameters with subsequent three-dimensional visualization and quantification. The quantitative three-dimensional results recorded by CLSM are an important basis for understanding, controlling, exploiting, and modeling of biofilms.

Computer-based intraoral image analysis of the clinical plaque removing capacity of 3 manual toothbrushes.

BACKGROUND: (I) Introducing an intraoral camera system with a special positioner to allow computer-based analysis of reproducible images on lingual tooth surfaces and (II) comparing plaque removal by three manual toothbrushes with different brushhead designs (convex, multilevel and flat trimmed) on lingual mandibular tooth surfaces. METHOD: In a clinical single-blind, crossover, 24-h plaque-regrowth study on 25 subjects, a computer-based index (PPI) was used to evaluate pre- and postbrushing plaque on lingual surfaces of mandibular premolars and molars. Subjects brushed their teeth under standardized conditions at three visits, each time with a different, randomly assigned toothbrush. RESULTS: The intraoral camera system allowed a reproducible and relatively convenient access to the lingual surfaces of the mandibular teeth and provided an increase in objectivity. Overall, each brush achieved statistically significant plaque removal, however, none reached clinical relevance. The multilevel brush was superior at specific sites, but failed to show statistically significant superiority in terms of overall plaque reduction. Without regard of the toothbrush used, the right handed subjects were less efficient in removing plaque from the right side compared to the left. CONCLUSIONS: The method is able to detect even small differences in plaque reduction. None of the different brushhead designs was able to compensate an insufficient brushing techniques.

[Coronary transluminal angioplasty after the use of thrombolytic therapy in acute myocardial infarction]. / Angioplastia transluminal coronária após o uso de trombolítico no infarto agudo do miocárdio.

PURPOSE: To present the Cardiology Institute of Rio Grande do Sul experience with percutaneous coronary angioplasty (PTCA), after thrombolytic therapy in acute myocardial infarction (AMI). METHODS: Fifty-three patients with transmural AMI in whom early successful intravenous streptokinase recanalization was followed by PTCA. The mean age was 50 years, male patients were more frequent, the predominant area of infarct was anterior wall and more frequently the "culprit" coronary was the left anterior descendent. The main indication of PTCA was uniarterial lesion with less than 20 mm of length. RESULTS: The success comes out in 44 patients (81.5%). Ten patients (18.5%) were considered unsuccessful and were referred to emergency bypass graft surgery. The in-hospital AMI rate after PTCA was 5.5%. In the follow-up the reestenoses rate was 11% and reocclusion was 3.7%. New PTCA was necessary in 3 patients (5.5%) and in one, by-pass graft (1.8%). CONCLUSIONS: PTCA is an important and secure modality of complementary therapy after thrombolytic therapy with low morbidity and mortality.