Relationship between Mandibular Ramus Height and Masticatory Muscle Function in Patients with Unilateral Hemifacial Microsomia

2017 ◽  
Vol 54 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Naohiro Suzuki ◽  
Akihiro Miyazaki ◽  
Tomohiro Igarashi ◽  
Hironari Dehari ◽  
Jun-Ichi Kobayashi ◽  
...  

Objective To clarify the relationship between mandibular ramus height and function of masticatory muscles in patients with hemifacial microsomia. Design Retrospective study of imaging and physiological data. Setting Images and physiological data were obtained from the records of Sapporo Medical University Hospital. Patients A total of 29 patients with hemifacial microsomia who showed Pruzansky grades I, II deformity. Main Outcome Measures Mandibular ramus height and masticatory muscle volume were evaluated with multi-detector row computed tomography. The electromyographic value was measured by the K7 Evaluation System. The hemifacial microsomia patients were classified into three groups based on the mandibular ramus height ratio of the affected and unaffected sides: group 0, > 1.00; group 1, 1.00 to 0.85; group 2, < 0.85. The Tukey-Kramer method and Games-Howell method were used to determine correlations between parameters. Results Decreased mandibular ramus height was significantly correlated with both reduced electromyographic values of the masseter muscle (P < .05) and the amount of mandibular lateral deviation at the time of maximum opening (P < .05) on the affected side. These differences were prominent in unilateral hemifacial microsomia patients classified as group 2. Conclusions Decreased mandibular ramus height may cause dysfunction of the masseter muscles but not the temporal muscle on the affected side in patients with hemifacial microsomia.

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Diana Cassi ◽  
Marisabel Magnifico ◽  
Mauro Gandolfinini ◽  
Ilda Kasa ◽  
Giovanni Mauro ◽  
...  

The aim of this paper is to report treatment effects of functional therapy in a growing patient affected by hemifacial microsomia (HM). According to Kaban’s classification, the patient was classified as grade IIa as she presented all mandibular and temporomandibular joint components and a normal shaped, hypoplastic mandible. The therapeutic approach included the use of an asymmetrical functional activator (AFA) to stimulate the growth of the affected side and consequently to improve symmetry of the mandible and maxillary deficiency. Further effects were the lengthening of the mandibular ramus, restoration of occlusion, and expansion of soft tissues.


Author(s):  
Eleonora Porcu ◽  
Maria Lucrezia Tranquillo ◽  
Leonardo Notarangelo ◽  
Patrizia Maria Ciotti ◽  
Nilla Calza ◽  
...  

Abstract Purpose The main purpose and research question of the study are to compare the efficacy of high-security closed versus open devices for human oocytes’ vitrification. Methods A prospective randomized study was conducted. A total of 737 patients attending the Infertility and IVF Unit at S.Orsola University Hospital (Italy) between October 2015 and April 2020 were randomly assigned to two groups. A total of 368 patients were assigned to group 1 (High-Security Vitrification™ - HSV) and 369 to group 2 (Cryotop® open system). Oocyte survival, fertilization, cleavage, pregnancy, implantation, and miscarriage rate were compared between the two groups. Results No statistically significant differences were observed on survival rate (70.3% vs. 73.3%), fertilization rate (70.8% vs. 74.9%), cleavage rate (90.6% vs. 90.3%), pregnancy/transfer ratio (32.0% vs. 31.8%), implantation rate (19.7% vs. 19.9%), nor miscarriage rates (22.1% vs. 21.5%) between the two groups. Women’s mean age in group 1 (36.18 ± 3.92) and group 2 (35.88 ± 3.88) was not significantly different (P = .297). A total of 4029 oocytes were vitrified (1980 and 2049 in groups 1 and 2 respectively). A total of 2564 were warmed (1469 and 1095 in groups 1 and 2 respectively). A total of 1386 morphologically eligible oocytes were inseminated by intracytoplasmic sperm injection (792 and 594 respectively, P = .304). Conclusions The present study shows that the replacement of the open vitrification system by a closed one has no impact on in vitro and in vivo survival, development, pregnancy and implantation rate. Furthermore, to ensure safety, especially during the current COVID-19 pandemic, the use of the closed device eliminates the potential samples’ contamination during vitrification and storage.


Author(s):  
Haemi JEE ◽  
Jaehyun PARK

Background: The clinical gender-dependent characteristics of visuospatial neglect between men and women have not been elucidated in Korean patients with cognitive impairment. The goal of this study was to observe the asymmetric lateralization in patients using a novel e-pen based cognitive assessment system. Methods: A total of 31 patients, 16 men and 15 women, with early stage hemispheric cerebral dysfunction were recruited for the assessment of unilateral neglect suing a novice paper-and-pencil based electronic evaluation system from a rehabilitation center of Inha University hospital in 2016. Results were assessed for degrees of deviations, and numbers of neglected lines. Degree of deviation was assessed using the positions and distances from the horizontal line centers. Effect sizes were calculated to assess proximities between the assessed results. Results: Comparatively greater left and rightward biasness for the right-sided and left-sided horizontal lines were observed for the male patients, respectively. Moreover, greater degree of left to rightward biasness was observed as the horizontal lines shortened in both groups. However, the magnitude of biasness in female patients showed comparatively less directional bias, indicating greater prevalence for the center of mass effect in male patients. Conclusion: Gender difference in visuospatial neglect seems to exist with less accuracy in recognition for the bisecting center for the female and asymmetrical lateralization and magnitude of deviation for the male patients.


2021 ◽  
Author(s):  
Wan-Ching Lien ◽  
Chih-Heng Chang ◽  
Kah-Meng Chong ◽  
Meng-Che Wu ◽  
Cheng-Yi Wu ◽  
...  

Abstract Background: This study aimed to investigate the clinical utilization of PoCUS of the first post-graduate year residents after a PoCUS curriculum. Methods: It was conducted at the emergency department of the National Taiwan University Hospital between July 2015 and October 2017. Every resident had one-month ED training and a curriculum was implemented during the first week. The post-training objective structured clinical examination (OSCE) global ratings were obtained, as well as the sonographic examinations by the residents. The participants were categorized into 4 groups: group 1 performed PoCUS before and after the curriculum; group 2 performed only after the curriculum; group 3 performed only before the curriculum; the last did not perform any examinations. Results: Two hundred and thirty-nine residents participated. The median global rating was 4 (interquartile ranges, 4-5). A significantly increasing number of residents integrated PoCUS into patient care (64 vs. 170, p=0.037) with acceptable image quality after the curriculum. Nearly 30% of residents did not use PoCUS although no differences existed in the OSCE global ratings. Group 1 performed more cases with better image quality and using ≥2 ultrasound applications (8/100 vs. 82/359, p=0.0009) after the curriculum. Group 1 performed more cases with better image quality than group 2 after the curriculum. In groups 3 and 4, “no suitable cases” (25/69), and “choosing other imaging priorities” (43/69) were the main feedbacks for not performing PoCUS. Conclusions: A focused training had a substantial positive impact on the utilization of PoCUS of the residents. The global ratings could not predict whether to integrate PoCUS into clinical practice. Further studies would be needed for the sustained effects of the curriculum and how to encourage these residents in groups 3 and 4 to use PoCUS.Clinical trial registration: NCT03738033.


2021 ◽  
pp. 33-37
Author(s):  
А. В. Kostyshyn

Abstract. The relevance of the topic is related to the need to improve methods of preparation of dentitions for orthopedic treatment, taking into account the defects of dentitions in patients with reduced occlusion height, taking into account the condition of the masticatory muscles and temporary use of plastic dentures, which provide gradual lifting of occlusion to normalize the masticatory group muscles and reorganization of myostatic reflexes. The aim of the research. Improving the effectiveness of preparation for orthopedic treatment of patients with partial tooth loss, with reduced occlusion height, by improving the design of a temporary bridge-based prosthesis. Materials and methods of research. We examined, treated and conducted clinical observation of 93 patients, who were divided into three groups according to the height of the reduction in occlusion, to achieve this goal and solve problems during the dissertation. Group 1 consisted of 32 patients with included dentition defects with reduced occlusion height up to 2 mm (n=32), group 2 - patients with included dentition defects with reduced occlusion height up to 2-4 mm (n=31), group 3 - these are patients with included dentition defects with reduced occlusion height up to 4-6 mm (n=30). All patients of the main groups belonged to the second and third age groups according to the WHO, aged 35-55 years. The control group (n=30) are young people who belonged to the 1st age group according to the WHO with intact dentition, without concomitant somatic and dental pathology, were admitted in one visit. Also, 123 fiberglass-reinforced plastic prostheses were made. Research results. When drawing up a plan for orthopedic treatment of patients with reduced occlusion height, we took into account possible complications, which are characterized by chipping of the facing material, pathological changes in the temporomandibular joint and masticatory muscle group. We have improved the method of manufacturing non-removable temporary plastic orthopedic constructions by reinforcing with fiberglass tapes and beams, to prevent them and gradually raise the bite. Expanded data on the dynamics of changes in myostatic reflexes and the effectiveness of the use of fixed orthopedic constructions, depending on the pathological process, the timing of adaptation of the masticatory muscle group to orthopedic constructions, according to the degree of reduction in occlusion height. The absence of complaints of breakage and other technical defects of the proposed temporary orthopedic constructions in 100% of cases, successfully allows to use it in the clinic of orthopedic dentistry. A new method of preparing patients for permanent orthopedic treatment by combined reinforcement of temporary non-removable bridge constructions with fiberglass tapes and beams is proposed, which differ in that after preliminary modeling of the frame of the bridge constructions, the technology of double reinforcement, model two support platforms with a step-like transition between them, in which fiberglass tapes and beams are fitted with dental tweezers, after which they are polymerized by the generally accepted method with a photopolymer lamp. Complete the modeling of the constructions and polymerize the prosthesis in the pneumopolymerizer with subsequent grinding and polymerize the prosthesis. Conclusion. The results of the research revealed the high efficiency of the improved method of manufacturing non-removable makeshift plastic of orthopedic constructions.


2003 ◽  
Vol 61 (3A) ◽  
pp. 566-573 ◽  
Author(s):  
Tânia A.M.O. Cardoso ◽  
Fernando Cendes ◽  
Carlos A.M. Guerreiro

OBJECTIVE: To investigate the value of leaving seizure-free patients on low-dose medication. METHOD: This was an exploratory prospective randomized study conducted at our University Hospital. We evaluated the frequency of seizure recurrence and its risk factors following complete or partial antiepileptic drug (AED) withdrawal in seizure free patients for at least two years with focal, secondarily generalized and undetermined generalized epilepsies. For this reason, patients were divided into two groups: Group 1 (complete AED withdrawal), and Group 2 (partial AED withdrawal). Partial AED withdrawal was established as a reduction of 50% of the initial dose. Medication was tapered off slowly on both groups. Follow-up period was 24 months. RESULTS: Ninety-four patients were followed up: 45 were assigned to complete (Group 1) AED withdrawal and 49 to partial (Group 2) AED withdrawal. Seizure recurrence frequency after two years follow-up were 34.04% in group 1 and 32.69% in Group 2. Survival analysis showed that the probability of remaining seizure free at 6, 12, 18 and 24 months after randomization did not differ between the two groups (p = 0.8). Group 1: 0.89, 0.80, 0.71 and 0.69; group 2: 0.86, 0.82, 0.75 and 0.71. The analysis of risk factors for seizure recurrence showed that more than 10 seizures prior to seizure control was a significant predictive factor for recurrence after AED withdrawal (hazard ratio = 2.73). CONCLUSION: Leaving seizure free patients on low AED dose did not reduce the risk for seizure recurrence. That is, once the decision of AED withdrawal has been established, it should be complete.


Author(s):  
Christian Reis Lemes ◽  
Carolina Fernandes Tozzi ◽  
Saulo Gribel ◽  
Bruno Frazão Gribel ◽  
Giovana Cherubini Venezian ◽  
...  

Author(s):  
Rafael Vila-Candel ◽  
Anna Martín ◽  
Ramón Escuriet ◽  
Enrique Castro-Sánchez ◽  
Francisco Javier Soriano-Vidal

Background: The WHO recommends the use of the Robson ten-group classification system (RTGCS) as an effective monitoring and analysis tool to assess the use of caesarean sections (CS). The present study aimed to conduct an analysis of births using the RTGCS in La Ribera University Hospital over nine years and to assess the levels and trends of CS births. Methods: Retrospective study between January 1, 2010, and December 31, 2018. All eligible women were allocated in RTGCS to determine the absolute and relative contribution made by each group to the overall CS rate; linear regression and weighted least squares regression analysis were used to analyze trends over time. The risk of CS of women with induced versus spontaneous onset of labor was calculated with an odds ratio (OR) with a 95% CI. Results: 16,506 women gave birth during the study period, 19% of them by CS. Overall, 20.4% of women were in group 1 (nulliparous, singleton cephalic, term, spontaneous labor), 29.4% in group 2 (nulliparous, singleton cephalic, term, induced labor or caesarean before labor), and 12.8% in group 4 (multiparous, singleton cephalic, term, induced or caesarean delivery before labor) made the most significant contributions to the overall rate of CS; Conclusions: In our study, Robson Groups 1, 2, and 4, were identified as the main contributors to the hospital’s overall CS rate. The RTGCS provides an easy way of collecting information about the CS rate, is a valuable clinical method that allows standardized comparison of data, and time point, and identifies the groups driving changes in CS rates.


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