To cite this article:
Lenza MG, Lenza de O. MM, Dalstra M, Melsen B, Cattaneo PM: An analysis of different approaches to the assessment of upper airway morphology: a CBCT study Orthod Craniofac Res ...2010;13:96–105
Structured
Authors – Lenza MG, Lenza de O MM, Dalstra M, Melsen B, Cattaneo PM
Background – Upper airway morphology and respiration have been assigned an important role in the development of the craniofacial complex. Several studies advocate lateral cephalograms to evaluate the upper airway. Although this method has been widely used, a two‐dimensional projection of a three‐dimensional anatomical structure is questionable.
Objective – To correlate linear measurements (sagittal and transversal), cross‐sectional areas, and volumes of the upper airway determined on Cone Beam CT (CBCT) data sets.
Material and Methods – CBCT‐scans of 34 patients were used to perform a 3D evaluation of the upper airway. Linear sagittal measurements reproducing those usually performed on lateral cephalograms, linear transversal measurements, cross‐sectional areas, partial and total volumes (TV) were computed.
Results – The analysis showed a weak correlation (r < 0.8) between most of the linear measurements. The correlations between sagittal, transversal, and cross‐sectional area with partial volumes were weak, except for the lower part of the nasopharynx which was highly correlated (r > 0.9) with sagittal measurement and with area. The upper part of the velopharynx presented a good correlation (0.8 < r < 0.9) between area and volume. Good correlation between most transversal measurements and the corresponding areas was found. Minimal sagittal, minimal transversal, and minimal area were weakly correlated with TV.
Conclusions – Upper airway cannot be accurately expressed by single linear measurements as performed on cephalograms. The TV alone does not depict the morphology of the airway. A CBCT‐based 3D analysis gives a better picture of the anatomical characteristics of the upper airways and therefore can lead to an improvement of the diagnosis.
Upgrades to the LHCb computing infrastructure in the first long shutdown of the LHC have allowed for high quality decay information to be calculated by the software trigger making a separate offline ...event reconstruction unnecessary. Furthermore, the storage space of the triggered candidate is an order of magnitude smaller than the entire raw event that would otherwise need to be persisted. Tesla is an application designed to process the information calculated by the trigger, with the resulting output used to directly perform physics measurements.
The alteration of signaling molecules involved in the general metabolism of animals can negatively influence reproduction. In dairy cattle, the development of follicular cysts and the subsequent ...appearance of ovarian cystic disease (COD) often lead to decreased reproductive efficiency in the herd. The objective of this review is to summarize the contribution of relevant metabolic and nutritional sensors to the development of COD in dairy cows. In particular, we focus on the study of alterations of the insulin signaling pathway, adiponectin, and other sensors and metabolites relevant to ovarian functionality, which may be related to the development of follicular persistence and follicular formation of cysts in dairy cattle. The results of these studies support the hypothesis that systemic factors could alter the local scenario in the follicle, generating an adverse microenvironment for the resumption of ovarian activity and possibly leading to the persistence of follicles and to the development and recurrence of COD.
•Signaling molecules of metabolic processes in ovarian follicular structures can alter reproduction.•Metabolic and nutritional sensors contribute to cystic ovarian disease development in dairy cows.•Ovarian insulin and adiponectin response are determinant in the ovarian functionality.•Systemic factors regulate the biochemical environment in the follicle and influence the resumption of ovarian activity.
Summary
Background
Diagnosis of inherited platelet function disorders (IPFDs) is important for appropriate management and to improve epidemiologic and clinical knowledge. However, there remains a ...lack of consensus on the diagnostic approach.
Objectives
To gain knowledge on the current practices for the diagnosis of IPFD worldwide.
Methods
A 67‐item questionnaire was distributed to the ISTH members and to the members of several national hemostasis and thrombosis societies.
Results
A total of 202 laboratories from 37 countries participated in the survey. The most frequent criterion to define patients with a suspected IPFD was a history of mucocutaneous bleeding and no acquired cause, but heterogeneity on the identification criteria was evident. Only 64.5% of respondents performed a direct clinical interview. On average, each laboratory studied 72 patients per year. The most commonly used laboratory equipment were the light‐transmission aggregometer, the Platelet Function Analyzer‐100, and the flow cytometer. Screening tests were platelet count, peripheral blood smear, light‐transmission aggregometry, and Platelet Function Analyzer‐100. Second‐step tests were flow cytometry, molecular genetic analysis, and electron microscopy. Methodologies varied widely. In total, ~ 14 000 patients were investigated yearly and 60% turned out to not have a defect. Of the remaining 40%, only 8.7% received a diagnosis at a molecular level.
Conclusions
Many laboratories worldwide are involved in the diagnosis of IPFD. A large fraction of the patients studied remain without a diagnosis. A high variability in the diagnostic approaches is evident.
In addition to their well characterized and established role in haemostasis and thrombosis, platelets contribute to the pathogenesis of inflammation. Adenine nucleotides are signalling molecules that ...regulate the function of virtually every cell in the body, by interacting with P2 receptors. Their important role in inflammation is well established. In the last few years, the pro-inflammatory roles of adenine nucleotides interacting with their platelet P2 receptors has emerged. In particular, it was shown that the platelet P2Y12 receptor for ADP significantly contributed to the pro-inflammatory effects of cysteinyl leukotrienes (CysLT) in experimental models of asthma in mice. More importantly, it was recently shown that P2Y12 variants were associated with lung function in a large family-based asthma cohort and that the P2Y12 antagonist prasugrel tended to decrease bronchial hyper-reactivity to mannitol in patients with allergic bronchial asthma in a randomized, placebo controlled trial.
These data strongly suggest that P2Y12 may represent an important pharmacological target for the treatment of patients with allergic bronchial asthma.
Objective We hypothesized that most relapses in patients with esophageal cancer having neoadjuvant chemoradiation therapy would occur outside of the surgical and radiation fields. Methods Recurrence ...patterns, time to recurrence, and median survival were examined in 267 patients who had esophagectomy after neoadjuvant chemoradiation therapy at Johns Hopkins over 19 years. Results Of 267 patients, 82 (30.7%) showed complete response to neoadjuvant therapy, with 108 (40.4%) and 77 (28.8%) showing partial response or no response, respectively. Recurrence developed in 84 patients (patients with complete response 18/82, 21.4%; patients with partial response 39/108, 36.1%; patients with no response 27/77, 35.1%; P = .055, respectively). Most patients had recurrences at distant sites (65/84;77.4%) regardless of pathologic response, and subsequent survival was brief (median 8.37 months). Median disease-free survival was short (10 months) and did not differ based on recurrence site for patients with partial response or no response, but was longer for patients with complete response with distant recurrence, whose median disease-free survival was 27.3 months ( P = .008). By multivariate analysis, no other factor except for pathologic response to neoadjuvant therapy was associated with disease recurrence or death. Patients with partial response or no response were 1.97 and 2.23 times more likely to have recurrence than patients with complete response ( P = .024 and P = .012, respectively). Conclusions Most esophageal cancer recurrences after neoadjuvant therapy and surgery are distant, and survival time after recurrence is short regardless of pathologic response. Fewer patients achieving complete response had recurrences, and distant recurrences in these patients manifest later than in patients showing partial response and those showing no response. Only pathologic response is significantly associated with disease recurrence, suggesting that tumor biology and chemosensitivity are critical in long-term patient outcome.
Sturgeon caviar quality relies not only on the perfect dosage of the ingredients but also on the long sturgeon breeding cycle (about 12-15 years) and the exact timing of the egg extraction. For the ...improvement and the promotion of Italian caviar, the development of an analytical system dedicated to fish products, and caviar, in particular, is fundamental. The use of near-infrared spectrometry (NIRS) technology is auspicious. The aquaphotomics approach proved to be an adequate analytical tool to highlight, in real-time, the differences in caviar quality stored with, or without, borax as a preservative. Seventy-five sturgeon caviar (
) samples underwent spectral NIR characterization using a microNIR1700 in the 900-1700 nm range. Data processing was carried out according to the literature. Tenderometric and sensory analyses were also carried out in parallel. The results suggest that a process line under strict control and monitoring can result in high-quality caviar without any other preservative than salt. The challenge of producing caviar without any potentially-toxic preservatives could now be a reality. NIR spectroscopy and aquaphotomics can be, in the future, non-invasive methods to monitor the whole production chain.
Objective
The aims of this study were (1) to determine the three-dimensional anatomical boundaries of the alveolar bone defect in cleft lip and palate (CLP) patients, (2) to precisely translate these ...anatomical boundaries into reliable cephalometric landmarks and planes that can be used for cone beam computed tomography (CBCT) analysis, (3) to standardize image acquisition and reconstruction parameters, and (4) to test the reproducibility of the proposed protocol for measuring the predefined alveolar bone defect, using a third-party software.
Methods
The alveolar bone defect volume of 10 randomly selected patients with unilateral CLP (UCLP) aged 8 years and 6 months to 11 years and 2 months was evaluated on preoperative and 1-year postoperative CBCT scans using a semiautomatic, standardized protocol. The alveolar bone graft outcome was calculated as a percentage of the bone fill using the formula (VOLpre – VOLpost)/VOLpre) × 100. Intra- and interobserver reliability was assessed.
Results
Intra- and interobserver reproducibility was excellent for volumes and bone fill as no statistically significant difference (P < .001) was seen between the different sets of measurements, and Pearson correlation coefficients were large (intraobserver: r > .9849, interobserver: r > .8784). The Bland-Altman plots indicated that the differences between the plots were not patterned.
Conclusions
Volume determination using CBCT, third-party medical image processing software, and the presently defined image acquisition and reconstruction parameters, including anatomical boundaries, is a reproducible and practical method for assessing the volumetric outcome of secondary alveolar bone grafting in patients with UCLP.
The aim of this paper is to study whether a child's schooling choices are affected by the schooling choices of other children. Identification is based on a randomized targeted intervention that ...grants a cash subsidy conditional on school attendance to a subgroup of eligible children within small rural villages in Mexico (PROGRESA). This policy change spills over to ineligible children if social interactions are relevant. Results indicate that the eligible children tend to attend school more frequently, and the ineligible children acquire more schooling when the subsidy is introduced in their local village. Moreover, the overall effect of PROGRESA on eligible children is the sum of a direct effect due to cash transfers and an indirect effect due to changes in peer group schooling. Interestingly, the social interactions effect is almost as important as the direct effect.
The aim of this study was to evaluate whether there is any difference in the diagnostic information provided by conventional two-dimensional (2D) images or by three-dimensional (3D) cone beam ...computed tomography (CBCT) in subjects with unerupted maxillary canines.
Twenty-seven patients (17 females and 10 males, mean age 11.8 years) undergoing orthodontic treatment with 39 impacted or retained maxillary canines were included. For each canine, two different digital image sets were obtained: (1) A 2D image set including a panoramic radiograph, a lateral cephalogram, and the available periapical radiographs with different projections and (2) A 3D image set obtained with CBCT. Both sets of images were submitted, in a single-blind randomized order, to eight dentists. A questionnaire was used to assess the position of the canine, the presence of root resorption, the difficulty of the case, treatment choice options, and the quality of the images. Data analysis was performed using the McNemar-Bowker test for paired data, Kappa statistics, and paired t-tests.
The findings demonstrated a difference in the localization of the impacted canines between the two techniques, which can be explained by factors affecting the conventional 2D radiographs such as distortion, magnification, and superimposition of anatomical structures situated in different planes of space. The increased precision in the localization of the canines and the improved estimation of the space conditions in the arch obtained with CBCT resulted in a difference in diagnosis and treatment planning towards a more clinically orientated approach.
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