Arnett Facial Soft-tissue Cephalometric Analysis Norms for Mongolian Children

Objectives: This study aimed to determine norms cephalometric norms of Mongolian children and compare their development in boys and girls between 6 and 15 years of age. Methods: Lateral cephalograms were performed on 541 subjects (225 male and 316 females) having normal occlusion between the ages of 6 to 15 years.All radiographs were digitized on a computer using a cephalometric software program. A total of 6 angular, 38 linear measurements were measured by a radiologist for skeletal hard and soft tissue analysis. Results: Mx-ocdusal plane angle, Md1 to Md occlusal plane angle. Nasolabial angle decreased with age. Mx1, Mx occlusal plane angle, and overbite were stable with age. In contrast, the other measurements typically increased with age. No statistically significant gender differences were observed. Some distinct ethnic differences were found between Caucasians and Mongolian children with Mongolian children having thinner and shorter lips compared to Caucasians. Conclusions: No significant differences were observed in any of the dentoskeletal factors representing hard tissue to hard tissue measurements. Results were similar to those found in Caucasian males and females

Lateral Cephalometric Linear Measurement Standards of Mongolian Children with Normal Occlusion from 6-7 Years of Age

Objectives: The aim of this study was to analyze craniofacial linear dimensions in subjects with normal occlusions to establish age and gender-specific lateral cephalometric linear measurement norms for Mongolian children. Methods: 161 six year old children and 122 seven year old children were recruited for this study. Digital cephalograms of 75 six year old children (34 male and 41female), 49 seven year old children (22 male and 27 female) were selected to establish lateral cephalometric linear measurement norms. Anatomic landmarks were identified directly on the digital images. The means and standard deviations of linear measurements were calculated using 18 variables. Student’s t-test was employed to test for gender differences in each age. Results: Anterior cranial base length and midfacial length were significantly larger in six year old male subjects. Mo-Ms and A-Ptm were significantly larger in seven year old male subjects. Conclusion: Our results showed that linear craniofacial dimension of the hard tissue was gender-dependent. Therefore, gender-specific differences of craniofacial distances should be taken into account during diagnosis and treatment planning. The results from this study can be used as reference values for 6-7 years old children of Mongolia

Facial Soft Tissue Profile Analysis in Mongolian Children

Objectives: The present study aimed to evaluate the specific variables of facial soft tissue changes in Mongolian children using angular and linear measurements. Methods: We studied the lateral cephalograms of 541 subjects (228 male and 313 females) having normal occlusion between the ages of 6 and 15 years. Two orthodontists read all radiographs to determine their cerebral vertebral maturation index (CVMI). The radiographs were digitized and cephalometric measurements were made. Results: The Gl\u27-Sn-Pg\u27 angle for all participants was 170.2 ± 5.4°. The Nasofrontal Gl’-N’-Tn’ angle was 147.2 ± 7.6° for all participants. It decreased with CVMI stage for girls (p = 0.000). The Nasofacial angle Tn- N\u27- Pog\u27 angle averaged 20.4 ± 7.7° for all participants. The Nasomental angle N\u27- Tn-Pog\u27 angle on averaged 144.9 ± 4.3° for all participants. It decreased with the CVMI stage for girls (p = 0.000). The Mentocervical Tn-Pog Me-NTP angle was significantly larger in boys than girls (107.8 ± 8.6° vs. 105.3 ± 7.8°, p = 0.001). The Nasolabial angle Ls-Sn-Col angle averaged 100.8 ± 10.6° for all subjects. It decreased with the CVMI stage for both boys (p = 0.043) and girls (p = 0.021). The distance between the E line and TUL was significantly larger in boys than girls (1.7 ± 2.1 vs. 1.2 ± 2.0 mm, p = 0.004). It also significantly decreased with the CVMI stage for both boys (p = 0.033) and girls (p = 0.000). The space between the E line and TLL averaged 1.9 ± 2.0 mm for all subjects. It did not differ by gender. However, it decreased with the CVMI in both boys (p = 0.022) and girls (p = 0.006). Conclusions: We have provided important results for comparing cephalometric soft-tissue values in Mongolian children in this study. These results provide a valuable guide for orthodontic diagnosis and treatment in our country

Lateral Cephalometric Standards for Mongolian 6-15 Year Old Children with Normal Occlusion

Objectives: The aim of this study was to establish the age and gender-specific lateral cephalometric standards for Mongolian children with normal occlusion. Methods: A total of 541 children between 6 and 15 years of age were selected based on the normal occlusion criteria. Lateral cephalograms of each subject were scanned and analyzed with the use of WinCeph version 11.0 software package. Descriptive statistics (mean and standard deviation) were calculated for all measured variables. Independent t-tests were performed to assess the intergender differences. Results: Cephalometric angular measurements remain largely constant, whereas most cephalometric linear measurements change with advancing age, such as anterior facial height (N-Ans, Ans-Me), hard palatal length (Ans-Pns) mandibular ramus height (Cd-Go), mandibular body length (Cd-Gn) were increasing significantly by dental age in both gender. Gender differences were not statistically significant for any of the angular measurement at ages studied, but linear measurements of male subjects had larger average values than female subjects. Conclusion: Our results showed that linear cephalometric dimension of the hard tissue was gender-dependent. Therefore, gender-specific differences of craniofacial distances should be taken into account during diagnosis and treatment planning. The results from this study can be used as reference values for 6-15 years old children of Mongolia

Advances in distraction techniques for craniofacial surgery

Distraction osteogenesis has been applied to the craniofacial skeleton as well as the long bones of the extremities. This technique does not require bone grafting and allows correction of craniofacial deformities with less invasion. Moreover, the distraction procedures can expand the overlying soft tissues simultaneously. We determined the indications of distraction osteogenesis, analyzed the types of devices available, and examined patients treated with distraction for the mandible, midface, and cranium. In all three sites, the devices tended to be the buried type and made of absorbable materials. Administration of some cytokines for shortening the consolidation period may be considered. Among disorders indicated for distraction osteogenesis, there are several syndromic craniosynostoses, which involve mutations in the fibroblast growth factor receptor (FGFR) 2 gene. The FGFR2 mutation was suggested to clinically accelerate osteogenesis at the distraction site. The usefulness and appropriateness of the distraction protocol must be assessed for each individual disorder. Although distraction osteogenesis in the craniofacial skeleton has advanced technologically, all possible risks must be discussed with the patient and family members when obtaining preoperative informed consent, especially until establishment of fully safe distraction procedures

Effect of activated protein C on plasma plasminogen activator inhibitor activity in patients with acute myocardial infarction treated with alteplase Comparison with unfractionated heparin

AbstractObjectivesWe examined whether activated protein C (APC) is an effective conjunctive therapy to thrombolysis in patients with ST-segment–elevated acute myocardial infarction (AMl).BackgroundActivated protein C possesses both systemic anticoagulant and anti-inflammatory properties. It has been also shown to enhance fibrinolysis by inhibiting plasminogen activator inhibitor (PAI) activity in vitro.MethodsAfter successful thrombolysis with alteplase, study patients were assigned to receive one of the two conjunctive therapies for 48 h intravenously: human plasma-derived APC at 0.06 mg/kg per day (APC group, n = 9) or unfractionated heparin at 100 to 400 U/kg per day, adjusted to maintain an activated partial thromboplastin time at 1.5 to 2 times of the control level (heparin group, n = 10).ResultsAdverse events, including reocclusion of the recanalized infarct-related coronary artery and major or minor hemorrhagic complications, occurred more frequently in the heparin group (4 of 10 cases) than in the APC group (none of 9 cases) (p = 0.033). In the heparin group, plasma PAI activity (IU/ml, median value [range]) was increased continuously from 8 to 24 h after thrombolysis and peaked at 24 h (30.9 [11.3 to 38.5]); on the other hand, it was not increased in the APC group at 24 h after thrombolysis (11.3 [0.0 to 31.0], p < 0.01 vs. heparin group).ConclusionsAdministration of APC suppressed increasing of plasma PAI activity observed after thrombolysis in patients with AMI. The effect of APC could be more eligible, compared with heparin, as a conjunctive regimen to thrombolysis in AMI patients