Nasolabial morphology following nasoalveolar molding in infants with unilateral cleft lip and palate

Yilmaz, R.B.N. | Germeç Çakan, D.

Article | 2018 | Journal of Craniofacial Surgery29 ( 4 ) , pp.1012 - 1016

Aim: The aim of the present study is to evaluate the effects of nasoalveolar molding (NAM) therapy on nasolabial morphology three dimensionally, and compare the nasolabial linear and surface distance measurements in infants with unilateral cleft lip and palate. Methods: Facial plaster casts of 42 infants with unilateral cleft lip and palate taken at the onset (pre-NAM) and finishing stage (post-NAM) of NAM were scanned with 3dMDface stereophotogrammetry system (3dMD, Atlanta, GA). Nineteen nasolabial linear and surface distance measurements were performed on three-dimensional images. In addition to standard descriptive statistical c . . .alculations (means and SDs), pre- and post-NAM measurements were evaluated by paired t test. Results: All measurements except lip gap, nostril floor width, and nostril diameter increased between pre-NAM and post-NAM. Nostril and lip height increased significantly on the cleft side (P < 0.05). No differences were present between linear and surface distance measurements except for nasal width measurement. Conclusions: Nasal and lip symmetry improved with NAM. The use of surface distance measurements may be advised particularly for continuous and curved anatomic structures in which circumference differences are expected. © 2018 by Mutaz B. Habal, MD Daha fazlası Daha az

177Lu-DOTATATE therapy in patients with neuroendocrine tumours including high-grade (WHO G3) neuroendocrine tumours: Response to treatment and long-term survival update

E. Demirci | L. Kabasakal | T. Toklu | M. Ocak | O.E. Şahin | N. Alan-Selcuk | A. Araman

Article | 2018 | Nuclear Medicine Communications39 ( 8 ) , pp.789 - 796

Purpose Upon diagnosis, distant metastases are encountered in 21-50% of neuroendocrine tumours (NETs). However, few systemic treatment options are available for the well-differentiated NETs in the metastatic stage. 177Lu-DOTATATE is one of the most effective treatments in this limited patient group. We retrospectively investigated its efficacy and effect on the survival in patients with both well-differentiated and grade III NETs who had high uptake in pretherapeutic 68Ga-DOTATATE PET/computed tomography scans. Patients and methods Patients with metastatic NETs treated with 177Lu-DOTATATE between January 2010 and November 2015 in ou . . .r department were included in this retrospective cohort. Toxicity and adverse effects were evaluated according to SWOG criteria. Progression-free survival (PFS) and overall survival (OS) rates were calculated considering the first date of treatment. Response was evaluated according to RECIST criteria. Potential predictors of survival and response were analysed. Results Patients (n=186) with metastatic NETs originating from various primary sites (bronchial, pancreatic, nonpancreatic gastroenteropancreatic-NETs, pheochromocytoma-paraganglioma and unknown primary) were treated with 1107 courses of 177Lu-DOTATATE treatment (median: 6; range: 3-12). Among 160 patients whose responses to treatment could be evaluated according to the RECIST criteria, 28.1% (n=45) had a progressive disease, 21.9% (n=35) had a stable disease, 46.9% (n=75) had a partial response and 3.1% (n=5) had a complete response. Median follow-up was 30.6 months. The Kaplan-Meier estimated median PFS was 36.4 months, mean PFS was 38 months and the mean OS was 55 months. The disease control rates in patients with WHO grades I, II and III were 74, 73 and 60%, respectively, and the OS rates were 61.9, 52.2 and 38.4 months, respectively. We observed no major renal toxicity except a minor increase (11.1%) in average serum creatinine levels. In 33.9% (n=56) of the patients, grade I toxicity; in 9.1% (n=15), grade II; and in 1.2% (n=2), grade III toxicity were observed. Conclusion 177Lu-DOTATATE therapy is an important treatment option in somatostatin receptor type-2-positive pancreatic, nonpancreatic gastroenteropancreatic-NETs, and lung NETs including metastatic NETs with an unknown primary site and significantly contributed to patients' OS. Additionally, peptide receptor radionuclide therapy may have a role in a selected subgroup of patients with grade III NET with high somatostatin receptor type-2 expression. Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc Daha fazlası Daha az

Dental Anomalies in Different Types of Cleft Lip and Palate: Is There Any Relation?

Germec Cakan, D. | Nur Yilmaz, R.B. | Bulut, F.N. | Aksoy, A.

Article | 2018 | Journal of Craniofacial Surgery29 ( 5 ) , pp.1316 - 1321

Aim: The aims of this study were to evaluate the prevalence of dental anomalies in Turkish patients with different types of cleft lip and palate (CLP) and investigate the relationship between the type of cleft and the dental anomaly. Methods: Eighty-eight patients with cleft lip and/or palate (mean age: 14.1±6.4 years) were enrolled in this retrospective study. Dental models, panoramic radiographs, and intraoral photographs of these patients were evaluated to detect any maxillary dental anomaly (number and size anomalies). Two hundred fifty unaffected subjects (mean age: 15.2±7.2 years) composed the control group. Data were evaluate . . .d using the independent t test, ? 2, Fischer exact test, and the odds ratio. Results: Dental anomaly frequency was significantly higher in the cleft group compared with the control group. Tooth agenesis was the most common dental anomaly, followed by microdontia and supernumerary tooth. Lateral incisor agenesis was seen in 69% of the unilateral CLP, in 78% of the bilateral CLP, and in 18% of the cleft palate patients. A significant association was revealed between the right unilateral CLP and the right lateral incisor agenesis (P=0.0001), the left unilateral CLP and the left lateral incisor agenesis (P=0.002), and the bilateral CLP and the bilateral lateral incisor agenesis (P=0.0001). Conclusion: Dental anomalies are more frequently seen in patients with CLP compared with the general population. There is a relationship between the cleft type and the ipsilateral lateral incisor agenesis. Copyright © 2018 by Mutaz B. Habal, MD Daha fazlası Daha az

Acute food deprivation separates motor-activating from anxiolytic effects of caffeine in a rat open field test model

Schulz, D.

Article | 2018 | Behavioural Pharmacology29 ( 6 ) , pp.543 - 546

Similar doses of caffeine have been shown to produce either anxiolytic or anxiogenic effects in rats. The reasons for these conflicting results are not known. We hypothesized that food deprivation stress interacts with the stimulant effects of caffeine to increase anxiety-like behavior. We tested 32 female Sprague Dawley rats in a dim open field for 10 min. Half of the animals were food deprived for 24 h and injected (intraperitoneal) with caffeine (30 mg/kg; n=7) or deionized water (n=8) 20 min before the open field test. The other half was nondeprived and injected with caffeine (30 mg/kg; n=8) or deionized water (n=9). Results sho . . .wed that nondeprived rats injected with caffeine moved longer distances and at a greater speed in the periphery and moved longer distances and spent more time in the center than rats treated with vehicle, indicative of motor-activating and/or anxiolytic effects of caffeine. Rats that were food deprived and injected with caffeine moved longer distances in the center and tended to spend more time there, indicative of anxiolysis. We conclude that caffeine had two effects on behavior, motor activation and a reduction of anxiety, and that food deprivation separated these effects. © 2018 Wolters Kluwer Health, Inc. All rights reserved Daha fazlası Daha az

The Feasibility of Retrofacial Approach for Cochlear Implantation

Yilmazer, R. | Gerring, R.C. | Sidani, C. | Wolfovitz, A. | Angeli, S.I. | Telischi, F.F.

Article | 2018 | Otology and Neurotology39 ( 7 ) , pp.543 - 546

Hypothesis: The retrofacial approach is a feasible approach to the round window niche and that the Round window-Sigmoid sinus line will help determine the feasibility of retrofacial approach for cochlear implantation unless there is a very high jugular bulb. Background: When the round window cannot be visualized by facial recess approach during cochlear implantation, other conservative techniques can be used to improve visualization such as the retrofacial approach. Methods: Thirteen adult dry cadaveric temporal bones were studied. Computed tomography (CT) scan was obtained on all temporal bones. An imaginary Round window-Sigmoid si . . .nus line was drawn on the axial images. We assessed whether this line is anterior (including intersection) or posterior to the facial nerve (FN). The following closest distances were measured on CT scans: 1) posterior semicircular canal (PSC)-FN, 2) PSC-Stapedius muscle, 3) PSC-Jugular bulb, 4) lateral semicircular canal (LSC)-Jugular bulb, 5) sigmoid sinus-FN. A canal wall-up mastoidectomy, facial recess, and retrofacial approach were performed in all specimens. We have noted whether we need a standard or an extended mastoidectomy. Results: The Round window-Sigmoid sinus line was posterior to the FN in all specimens. The retrofacial approach was feasible and the round window was visualized in all specimens. Extended mastoidectomy was required in seven specimens and the PSC-FN was ? 3 mm in five of them. Conclusion: Retrofacial approach is feasible in cochlear implantation when the Round window-Sigmoid sinus line is posterior to the FN and the jugular bulb is not obstructing the round window. © 2018, Otology & Neurotology, Inc Daha fazlası Daha az

Reliability of the osstell implant stability quotient and penguin resonance frequency analysis to evaluate implant stability

Buyukguclu, G. | Ozkurt-Kayahan, Z. | Kazazoglu, E.

Article | 2018 | Implant Dentistry27 ( 4 ) , pp.429 - 433

Purpose: To evaluate the reliability of the Osstell implant stability quotient (ISQ) and Penguin resonance frequency analysis (RFA) devices in measuring implant stability. Materials and Methods: Forty implants were embedded in self-curing acrylic resin, soft-lining material, polyvinyl siloxane impression material, and polycarboxylate cement (n ¼ 10). After the initial setting times were completed, the stability of each implant was measured with Osstell ISQ and Penguin RFA with 3 repeated measurements. The “intraclass correlation coefficient” evaluated the correspondence between the measurements (P, 0.05). Results: Polyvinyl siloxane . . . impression material had lower ISQ values than soft-lining material, self-curing acrylic resin, and polycarboxylate cement in both devices (P, 0.05). The intraclass correlation was 1.00 in self-curing acrylic resin and 0.48 in polycarboxylate cement (P, 0.05) for Osstell. This value was 0.95 in self-curing acrylic resin and 0.38 in polycarboxylate cement (P, 0.05) for Penguin. There was no correlation between the repeated measurements in soft-lining material and polyvinyl siloxane impression material for both devices (P . 0.05). The repeatability was 0.90 for Osstell and 0.60 for Penguin (P, 0.05). Conclusions: Osstell ISQ and Penguin RFA are reliable only when the implants are embedded in stiff materials. Osstell ISQ is more reliable than Penguin RFA. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved Daha fazlası Daha az

Aesthetic assessment of infants with different cleft types before, during, and after orthopedic treatment

Nur Yilmaz, R.B. | Çakan, D.G. | Nalbantgil, D.

Article | 2018 | Journal of Craniofacial Surgery29 ( 8 ) , pp.2081 - 2087

Objective: The aim of the present study is to compare the aesthetic assessments of infants with different types of cleft before (T1), during (T2), and after (T3) orthopedic therapy (OT) by orthodontists, dentists, and laypersons. Methods: Photographs of 3 patients (incomplete lip [C1], complete unilateral [C2], and complete bilateral cleft [C3]) at T1 (C1, C2, C3 chronologic age: 5, 2, 2 days), T2 (C1, C2, C3 chronologic age: 32, 28, 35 days; using forehead anchoraged nasal stent or conventional nasoalveolar therapy plates), and T3 (C1, C2, C3 chronologic age: 80, 91, 105 days) were collected from the archive. The nasolabial region . . .at stage T3 were masked and also added to the evaluation form (T4). Fifty-one evaluators (17 orthodontists, 17 dentists, and 17 laypersons; mean age = 30.1 ± 3.63) assessed 21 frontal photographs using Asher-McDade et al’s 5-point scale. Results: The scores of the orthodontists for T1 photographs were statistically lower than the dentists and laypersons (P < 0.05). The scores of T3 and T4 were similar in all groups (P > 0.05). The assessment scores progressively decreased from T1 to T3 (P > 0.05). The scores of both treatment methods were similar in the orthodontist group (P > 0.05), whereas the scores were lower for forehead anchored nasal stent in the other groups (P < 0.05). Conclusion: Orthodontists are familiar with cleft patients. Therefore, the aesthetic of infants at any therapy stage with different treatment methods was not categorized as poor. The enhanced scores at post-OT stage and the similar scores of masked and nonmasked post-OT photographs may underline the recognition of the rehabilitation period by not only specialists but also laypersons. Copyright © 2018 by Mutaz B. Habal, MD Daha fazlası Daha az

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