RESUMEN
AIM: To describe the reported incidence of out of hospital cardiac arrest (OHCA) and the characteristics and outcome after OHCA in relation to population density in Sweden. METHODS: All patients participating in the Swedish Cardiac Arrest Register between 2008 and 2009 in (a) 20 of 21 regions (n=6457) and in (b) 165 of 292 municipalities (n=3522) in Sweden, took part in the survey. RESULTS: The regional population density varied between 3 and 310 inhabitants per km(2) in 2009. In 2008-2009, the number of reported cardiac arrests varied between 13 and 52 per 100,000 inhabitants and year. Survival to 1 month varied between 2% and 14% during the same period in different regions. With regard to population density, based on municipalities, bystander CPR (p=0.04) as well as cardiac etiology (p=0.002) were more frequent in less populated areas. Ambulance response time was longer in less populated areas (p<0.0001). There was no significant association between population density and survival to 1 month after OHCA or incidence (adjusted for age and gender) of OHCA. CONCLUSION: There was no significant association between population density and survival to 1 month after OHCA or incidence (adjusted for age and gender) of OHCA. However, bystander CPR, cardiac etiology and longer response times were more frequent in less populated areas.
Asunto(s)
Paro Cardíaco Extrahospitalario/epidemiología , Densidad de Población , Adulto , Anciano , Femenino , Humanos , Incidencia , Masculino , Estudios Retrospectivos , Tasa de Supervivencia , Suecia/epidemiologíaRESUMEN
During the screening of immune-regulated genes from the cabbage looper, Trichoplusia ni, a 3-dehydroecdysone 3beta-reductase homologue (DERH) was cloned. In the course of development, 3-dehydroecdysone 3beta-reductase mediates the conversion of 3-dehydroecdysone (3dE) secreted from the prothoracic glands to ecdysone (E), which is subsequently converted to 20-hydroxyecdysone (20E), the major insect molting hormone. The cloned gene is upregulated in fat body during development and is strongly induced after the larva is challenged with bacteria. The gene codes for a 308 amino acid residue protein which shows 42.5% identity to Spodoptera littoralis 3-dehydroecdysone 3beta-reductase. Using the baculovirus expression system, the recombinant DERH was expressed. The purified protein mediates the reduction of 3-dehydromakisterone A to makisterone A, and requires NADPH as a cofactor. Western blots using an antiserum to T. ni DERH revealed the presence of the protein in larval hemolymph and integument. The data indicate that the protein is regulated developmentally and is induced after a challenge with bacteria. Immunohistochemical studies localized the enzyme exclusively in the epidermis and the cuticle.
Asunto(s)
3-Hidroxiesteroide Deshidrogenasas/genética , Ecdisona/análogos & derivados , Proteínas de Insectos/genética , Proteínas de Insectos/metabolismo , Mariposas Nocturnas/genética , Mariposas Nocturnas/metabolismo , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Clonación Molecular , ADN Complementario/genética , Ecdisona/metabolismo , Cuerpo Adiposo/metabolismo , Expresión Génica , Genes de Insecto , Proteínas de Insectos/química , Intrones , Modelos Moleculares , Datos de Secuencia Molecular , Mariposas Nocturnas/microbiología , Conformación Proteica , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Homología de Secuencia de Aminoácido , Spodoptera/enzimología , Spodoptera/genética , Especificidad por SustratoRESUMEN
By using differential display PCR, we obtained a cDNA clone encoding a gloverin homologue from the cabbage looper, Trichoplusia ni. The expression of the gene was induced by bacterial infections. The gene codes for a 174 amino acid residue protein, including a signal sequence and a prosegment. The deduced mature protein is 14 kDa and shows 58% and 49% identity to P2 from Helicoverpa armigera and to Hyalophora gloveri gloverin, respectively. The protein was detected in hemolymph and hemocytes from bacteria-immunized animals. We expressed gloverin using the baculovirus expression system. N-terminal amino acid sequence analysis showed that the purified protein contained a propart. This progloverin inhibited the growth of E. coli and the activity is comparable to that of H. gloveri mature gloverin. Processing of progloverin was possible in vitro, using human furin.
Asunto(s)
Antibacterianos , Proteínas de Insectos/genética , Mariposas Nocturnas , Proteínas/genética , Secuencia de Aminoácidos , Animales , Antibacterianos/farmacología , Línea Celular , Escherichia coli/efectos de los fármacos , Furina , Expresión Génica , Genes de Insecto , Humanos , Proteínas de Insectos/farmacología , Péptidos y Proteínas de Señalización Intercelular , Larva , Datos de Secuencia Molecular , Mariposas Nocturnas/genética , Precursores de Proteínas/genética , Precursores de Proteínas/metabolismo , Procesamiento Proteico-Postraduccional , Proteínas/farmacología , Pupa , Proteínas Recombinantes de Fusión/genética , Homología de Secuencia de Aminoácido , Spodoptera , Subtilisinas/metabolismoRESUMEN
Due to earlier contradictory results regarding the localization of the putative Helicobacter pylori adhesin A (HpaA), we aimed to compare the gene and protein expression and surface localization of HpaA in different H. pylori strains. Five H. pylori strains were cultivated for 11 days and analysed by Northern blot analysis, flow cytometry (FCM), semi-quantitative dot blot, colony blot, immuno-electron microscopy (IEM), and phase-contrast microscopy. The highest transcriptional activity of the hapA gene as observed after 3-4 days of cultivation and two mRNA transcripts of 1600 and 3100 nucleotides, respectively, were detected in all five strains with the hpaA probe. We also showed by reverse transcription-polymerase chain reaction (RT-PCR) that the hpaA gene is co-transcribed with the downstream omp18 gene. The highest total HpaA protein production in bacteria occurred between day 3 and 7, as determined by semi-quantitative dot blot, and was similar in the different strains. The maximal proportion of cells with HpaA on the bacterial surface, detected by FCM, was for strain SS1, 90%; Hel 344, 60%; CCUG 17875, 61%; CCUG 17874, 86% and for strain AH 244 only 35%. By IEM HpaA was detected in all strains both on the bacterial surface and on the flagellar sheath.
Asunto(s)
Helicobacter pylori/clasificación , Helicobacter pylori/metabolismo , Hemaglutininas/genética , Hemaglutininas/metabolismo , Transcripción Genética , Adhesinas Bacterianas , Proteínas de la Membrana Bacteriana Externa/genética , Proteínas de la Membrana Bacteriana Externa/metabolismo , Northern Blotting , Recuento de Colonia Microbiana , Medios de Cultivo , Helicobacter pylori/genética , Helicobacter pylori/crecimiento & desarrollo , Humanos , Microscopía Inmunoelectrónica , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
BACKGROUND: The 26 kDa protein, which is an alkyl hydroperoxide reductase (AhpC) homologue, has earlier been described as specific for Helicobacter pylori. The aims of this study were to analyse whether this protein, or the corresponding gene, could be identified in other Helicobacter species. MATERIALS AND METHODS: Two different monoclonal antibodies (Mabs), which recognise the 26 kDa protein in H. pylori, were used in immunoblots to determine the presence of the protein in 10 Helicobacter species. PCR was performed in order to analyse whether the gene was detectable and the PCR products were sequenced. Southern and Northern blot analyses were done on chromosomal DNA and total RNA, respectively, isolated from some selected Helicobacter species in order to compare the genes and mRNA transcripts to H. pylori. RESULTS: The 26 kDa protein was identified in H. nemestrinae (primate), H. acinonychis (cheetah), H. bilis (mouse), H. felis (cat) and H. salomonis (dog) but not in H. mustelae (ferret), H. cinaedi (human), H. canis (dog), H. fennelliae (human) or H. pullorum (poultry). By PCR the gene was also recognised in H. mustelae, H. cinaedi and H. pullorum. The PCR products showed high sequence homology (66-98%) compared to H. pylori. The gene was also highly conserved in four H. pylori strains (94-99% homology). Southern blot showed that the H. nemestrinae and H. acinonychis chromosomal DNA contained a single copy of the gene and the Northern blot analyses indicated mono-cistronic transcription of the gene in these two species, as has been found in H. pylori. CONCLUSIONS: A gene similar to ahpC was found in eight out of 10 Helicobacter species analysed.
Asunto(s)
Genes Bacterianos , Helicobacter/genética , Peroxidasas/genética , Animales , Anticuerpos Monoclonales , Secuencia de Bases , Northern Blotting , Southern Blotting , Western Blotting , ADN Bacteriano/análisis , Electroforesis en Gel de Poliacrilamida , Helicobacter/metabolismo , Helicobacter pylori/genética , Helicobacter pylori/metabolismo , Humanos , Datos de Secuencia Molecular , Peso Molecular , Peroxidasas/metabolismo , Peroxirredoxinas , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADN , Homología de Secuencia de Ácido NucleicoRESUMEN
The aim of the present study was to examine the periodontal conditions in an age cohort of 70-year-old women and compare an osteoporosis group with a control group with normal bone mineral density. 210 women 70 years old and randomly sampled from the population register of the community of Linköping were examined. Bone mineral density (BMD) of the hip was measured by dual energy X-ray absorptiometry. 19 women were diagnosed with osteoporosis (BMD below 0.640 g/cm2 in total hip). 15 of them accepted to participate in the study. As a control group 21 women with normal bone mineral density (BMD exceeding 0.881 g/cm2) were randomly selected from the initial population. The clinical examination included registration of the number of remaining teeth, dental plaque and periodontal conditions. The radiographic examination included a dental panorama and vertical bite-wing radiographs. The subjects also answered a questionnaire about their general health, age at menopause, concurrent medication, smoking and oral hygiene habits. The results from this study showed no statistically significant differences in gingival bleeding, probing pocket depths, gingival recession and marginal bone level between the women with osteoporosis and the women with normal bone mineral density. In conclusion, the present randomly selected and controlled study of osteoporotic and non-osteoporotic women, showed no statistically significant differences in periodontal conditions or marginal bone level. As periodontitis as well as osteoporosis are associated with age, our study of a well-defined age cohort is of interest, but the results should be interpreted with caution since the compared groups are small.
Asunto(s)
Osteoporosis Posmenopáusica/complicaciones , Enfermedades Periodontales/complicaciones , Absorciometría de Fotón , Factores de Edad , Anciano , Pérdida de Hueso Alveolar/complicaciones , Densidad Ósea , Estudios de Cohortes , Índice de Placa Dental , Quimioterapia , Femenino , Hemorragia Gingival/complicaciones , Recesión Gingival/complicaciones , Estado de Salud , Articulación de la Cadera , Humanos , Arcada Parcialmente Edéntula/clasificación , Higiene Bucal , Índice Periodontal , Bolsa Periodontal/complicaciones , Periodontitis/complicaciones , Radiografía de Mordida Lateral , Radiografía Panorámica , Fumar , Estadísticas no Paramétricas , SueciaRESUMEN
The 26 kDa protein of Helicobacter pylori, with 67% amino acid identity to alkyl hydroperoxide reductase (AhpC) of Campylobacter jejuni, was studied. We wanted to evaluate it the protein has AhpC activity. Therefore, an Escherichia coli mutant defective for alkyl hydroperoxide reductase and a plasmid expressing the 26 kDa protein from H. pylori were used in complementation studies. The complemented E. coli mutant showed a decreased sensitivity to cumene hydroperoxide indicating that the 26 kDa protein of H. pylori has AhpC activity and could be of importance in the defence against oxidative stress. Furthermore, Northern blot analysis detected one mRNA transcript of approximately 700 bp which is in agreement with the gene being transcribed as a single gene with its own promoter. This promoter region was further characterized by primer extension experiments. Additional studies on how environmental factors, such as long term growth and pH, can affect the transcription of the gene were performed on two H. pylori strains. We found that low pH and long term growth repressed transcription of the gene. Attempts to construct a mutant deficient for the gene in H. pylori were unsuccessful.
Asunto(s)
Helicobacter pylori/enzimología , Peroxidasas/metabolismo , Secuencia de Bases , Derivados del Benceno/farmacología , Northern Blotting , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Proteínas de Escherichia coli , Prueba de Complementación Genética , Helicobacter pylori/genética , Helicobacter pylori/crecimiento & desarrollo , Concentración de Iones de Hidrógeno , Datos de Secuencia Molecular , Mutación , Oxidantes/farmacología , Peroxidasas/genética , Peroxirredoxinas , Plásmidos , Regiones Promotoras Genéticas , ARN Mensajero/análisis , Factores de Tiempo , Transcripción GenéticaRESUMEN
Molecular mechanisms involved in the rapid attachment of the human breast cancer cell line MDA-MD-231 to cortical bone matrix were studied. The attachment of MDA-MD-231 cells to cortical bone disks could be blocked by 75% when cells were pretreated with a monoclonal antibody to the beta1-subunit of the integrin family. Monoclonal antibodies against the alpha2, alpha3, and alpha5 integrin subunits inhibited the attachment by 76, 26, and 8 % respectively. Collagenase type I and collagen type I antibody blocked the cell attachment by 45 and 50 % whereas pretreatment of the cells with soluble collagen type I blocked the attachment by 85 %. Our study with a panel of cancer cell lines further showed a close correlation between alpha2 beta1 and alpha3 beta1 integrin receptor expression and the capability to attach to cortical bone. These receptors appear to be the key receptors utilized by cancer cells for the initial attachment to cortical bone, and this could facilitate the localization of alpha2 beta1 and alpha3 beta1 expressing cancer cells to the skeleton.
Asunto(s)
Matriz Ósea/patología , Neoplasias de la Mama/patología , Integrinas/fisiología , Animales , Bovinos , Adhesión Celular/efectos de los fármacos , Adhesión Celular/fisiología , Colagenasas/farmacología , Femenino , Humanos , Integrina alfa3beta1 , Receptores de Colágeno , Células Tumorales CultivadasRESUMEN
Innate nonself recognition must rely on common structures of invading microbes. In a differential display screen for up-regulated immune genes in the moth Trichoplusia ni we have found mechanisms for recognition of bacterial cell wall fragments. One bacteria-induced gene encodes a protein that, after expression in the baculovirus system, was shown to be a peptidoglycan recognition protein (PGRP). It binds strongly to Gram-positive bacteria. We have also cloned the corresponding cDNA from mouse and human and shown this gene to be expressed in a variety of organs, notably organs of the immune system-i.e., bone marrow and spleen. In addition, purified recombinant murine PGRP was shown to possess peptidoglycan affinity. From our results and the sequence homology, we conclude that PGRP is a ubiquitous protein involved in innate immunity, conserved from insects to humans.
Asunto(s)
Inmunidad/genética , Proteínas de Insectos/genética , Proteínas de Insectos/inmunología , Mariposas Nocturnas/genética , Mariposas Nocturnas/inmunología , Peptidoglicano/inmunología , Proteínas/genética , Proteínas/inmunología , Secuencia de Aminoácidos , Animales , Bacterias/inmunología , Baculoviridae/genética , Secuencia de Bases , Secuencia Conservada , Humanos , Proteínas de Insectos/metabolismo , Masculino , Ratones , Datos de Secuencia Molecular , Peptidoglicano/metabolismo , Reacción en Cadena de la Polimerasa , Unión Proteica , Proteínas/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Proteínas Recombinantes/genética , Proteínas Recombinantes/inmunología , Homología de Secuencia de Aminoácido , Distribución TisularRESUMEN
A method for analysing the horizontal and vertical proportions of the face is described, based on natural head orientation (NHO). It demonstrates how individual deviations from the mean proportions can be quantified both horizontally and vertically. Correlation between facial depth to height (index 1) and the mandibular plane angle was determined and found to be fairly strong and highly significant (r = 0.5, P < 0.001). Facial depth to height and lower facial height to total facial height (index 2) relationships were found to be strongly correlated at each age between 10 and 16 years, with only small mean differences. For this reason the norm values presented for 12-year-old children for indices 1 and 2 should be applicable to orthodontic patients within this age range. The relationship between mandible and maxilla (index 3) increases continually between 10 and 16 years in boys, and between 10 and 14 years in girls, about 0.3 units a year. It can provide supplementary information for individual case analysis. For boys the increase was 2.2 units per year between 14 and 16 years of age.
Asunto(s)
Cefalometría/métodos , Desarrollo Maxilofacial/fisiología , Adolescente , Factores de Edad , Cefalometría/estadística & datos numéricos , Niño , Presentación de Datos , Huesos Faciales/anatomía & histología , Femenino , Humanos , Masculino , Valores de Referencia , Dimensión VerticalRESUMEN
The mRNA differential display method was used to isolate antibacterial defense genes from Trichoplusia ni. The mRNA population in last-instar T. ni larvae injected with bacteria was compared to that of untreated larvae. Using a PCR amplified probe corresponding to an induced mRNA, we were able to clone an attacin homolog from a lambda cDNA library from vaccinated larvae. The corresponding protein showed 63% identity to Hyalophora cecropia acidic attacin. The induction kinetics of T. ni attacin A gave optimal mRNA levels at 20 h post-infection. Genomic analysis showed this to be a single-copy gene with two introns.
Asunto(s)
Hormonas de Insectos/genética , Proteínas de Insectos , Mariposas Nocturnas/genética , Secuencia de Aminoácidos , Animales , Infecciones Bacterianas/inmunología , Secuencia de Bases , Southern Blotting , Clonación Molecular , Regulación de la Expresión Génica , Biblioteca de Genes , Intrones , Larva/genética , Larva/inmunología , Larva/microbiología , Datos de Secuencia Molecular , Mariposas Nocturnas/inmunología , ARN Mensajero/genética , Alineación de Secuencia , Homología de Secuencia de AminoácidoRESUMEN
Retrospective estimations of dental care costs of periodontal and prosthodontic treatment and evaluation of oral health in 37 patients with advanced periodontal disease were carried out. Measures of their subjective evaluation of oral health 7-10 yr after the treatment are presented as a health profile and as indices in single numbers. The relations between oral health as an index and the dimensions in the health profile are analyzed. Dental care costs for treatment in the mandible was SEK 35 550, for the maxilla SEK 45 380 and for both jaws SEK 74 230. After the treatment oral health as well as general health were in excess of 75 on a 0 to 100 scale. Chewing ability, comfort and aesthetics were the variables found to significantly affect the subjective oral health. Oral health in terms of periodontal and prosthodontic conditions was maintained over the observation period.
Asunto(s)
Análisis Costo-Beneficio/métodos , Dentadura Parcial Fija/economía , Enfermedades Periodontales/economía , Adulto , Anciano , Dentadura Parcial Fija/psicología , Estética Dental , Femenino , Costos de la Atención en Salud , Humanos , Masculino , Masticación , Persona de Mediana Edad , Satisfacción del Paciente , Enfermedades Periodontales/terapia , Índice Periodontal , Calidad de Vida , Análisis de Regresión , Encuestas y CuestionariosRESUMEN
A random sample of 79 British 12-year-old children was studied from tracings registered in the natural head position (NHP). The angle between the Frankfort horizontal (FH) and the horizontal at right angles to the plumb line was measured. Two experienced assessors checked every tracing; for those children perceived to show unnatural head position this was adjusted to what they considered to be the natural head orientation (NHO). The NHO was defined as the head orientation of the subject perceived by the clinician, based on general experience, as the NHP in a standing, relaxed body and head posture, when the subject is looking at a distant point at eye level. The FHK horizontal angle was then measured, now related to the corrected head position. The standard deviation for the latter angle was smaller than that of the uncorrected, but still too large for the FH to be considered reliable as a basis for clinical cephalometric analysis. No statistically significant difference in variability as found between FH and the sella-nasion line. The extracranial horizontal plane related to NHO was recommended as the least variable of the references studied.
Asunto(s)
Cefalometría/normas , Cara/anatomía & histología , Postura , Niño , Femenino , Cabeza/fisiología , Humanos , Masculino , Estándares de Referencia , Reproducibilidad de los Resultados , MuestreoRESUMEN
Natural head position (NHP) provides the key for meaningful cephalometric analysis because an extracranial reference line is used instead of intracranial reference lines, known to be subject to considerable biological variation in their inclination. Although the principle of natural head position is being recognized in the orthodontic literature, its registration may contain an element of unavoidable error that requires correction. A new concept of natural head orientation (NHO) has been introduced to maximize the contribution of NHP to cephalometrics. It is defined as the head orientation of the subject perceived by the clinician, based on general experience, as the natural head position in a standing, relaxed body and head posture, when the subject is looking at a distant point at eye level. The present study was designed to determine the accuracy and validity of NHO, using lateral profile photographs cut in a circular shape, obtained from 27 orthodontic patients, 10-14 years old. Findings among four investigators showed a high correlation (r = 0.82-0.96), in orientating these profile photographs in estimated natural head position (NHP). Moreover, investigators showed good correlation (r = 0.57-0.84) in head orientation after a 3-week interval. Mean differences for the same period varied between 0.1 and 2.9 degrees. The validity of NHO was supported also by a panel investigation. Clinicians as well as auxiliary personnel can be trained to make a critical judgement of the recorded natural head position and correct head orientation, whenever indicated, to enhance the reliability of cephalometric analysis in clinical practice and research.
Asunto(s)
Cefalometría/normas , Cabeza/fisiología , Postura , Adolescente , Niño , Humanos , Fotograbar , Valores de Referencia , Reproducibilidad de los ResultadosRESUMEN
Hereditary palmoplantar keratoderma is characterized by hyperkeratosis of the skin of palms and soles. An autosomal dominant form of diffuse non-epidermolytic palmoplantar keratoderma, frequently complicated by fungal infections, is encountered in northern Sweden with a prevalence of 0.3-0.55%. We have examined two families with this type of palmoplantar keratoderma and localized the causative genetic defect to a 14 cM interval on chromosome 12q11-q13, a region known to contain the keratin type II gene cluster as well as the retinoic acid receptor gamma gene. The palmoplantar keratoderma variant investigated in this study is thus genetically different from epidermolytic palmoplantar keratoderma, which recently has been shown to result from mutations in the gene for the type I keratin 9.
Asunto(s)
Cromosomas Humanos Par 12 , Queratinas/genética , Queratodermia Palmar y Plantar Difusa/genética , Familia de Multigenes , Receptores de Ácido Retinoico/genética , Mapeo Cromosómico , ADN/sangre , Familia , Femenino , Genes Dominantes , Ligamiento Genético , Marcadores Genéticos , Humanos , Masculino , Linaje , Suecia , Receptor de Ácido Retinoico gammaRESUMEN
Corneodesmosin, defined as the protein recognized by the monoclonal antibody G36-19, is a recently described late differentiation protein of human cornified epithelium. In the stratum corneum it is localized in the extracellular parts of modified desmosomes (corneodesmosomes) and adjacent parts of the cornified cell envelope. The aim of the present study was to investigate whether corneodesmosin undergoes changes in the stratum corneum which can be related to the cohesive state of the tissue and to desquamation. Extracts of plantar stratum corneum from various tissue levels and tape-stripped non-palmoplantar stratum corneum were analysed by immunoblotting with G36-19. In addition, the fate of corneodesmosin during shedding of surface cells in a recently described in vitro model of desquamation in plantar stratum corneum was investigated and compared with the degradation of the desmosomal protein desmoglein I in this system. The apparent molecular weights of the major G36-19-positive components in plantar stratum corneum ranged between 33 and 48 kDa. The components with the highest molecular weights were predominant in the deepest tissue layers. In the intermediate tissue layers G36-19-positive components of molecular weight 33-36, 39 and 44-48 kDa were found. There seemed to be a further degradation of the 33 to 36-kDa components in the most superficial parts of the tissue. In surface cells dissociated in vivo as well as in vitro no G36-19-positive components with molecular weights above 36 kDa were detected. Results from analyses of nonpalmoplantar stratum corneum suggested that corneodesmosin is degraded in this tissue in a way that may be similar to that in plantar stratum corneum.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Antígenos de Diferenciación/análisis , Antígenos de Diferenciación/fisiología , Desmosomas/química , Desmosomas/fisiología , Epidermis/patología , Epidermis/fisiología , Biopsia , Adhesión Celular/fisiología , Muerte Celular/efectos de los fármacos , Muerte Celular/fisiología , Proteínas del Citoesqueleto/metabolismo , Proteínas del Citoesqueleto/fisiología , Desmogleína 1 , Desmogleínas , Desmoplaquinas , Desmosomas/ultraestructura , Ácido Edético , Electroforesis en Gel de Poliacrilamida , Epidermis/química , Humanos , ImmunoblottingRESUMEN
The clinical application of a proportional soft tissue profile analysis based on natural head position is presented. The analysis provides data concerning the morphological basis of facial disharmony in individual cases. The use of this information during treatment planning and evaluation of treatment results after orthognathic surgery is demonstrated in four patients with severe deviation from midnormal profiles.
Asunto(s)
Cefalometría/métodos , Cara , Maloclusión/cirugía , Procedimientos Quirúrgicos Ortognáticos , Adolescente , Adulto , Femenino , Humanos , Masculino , Maloclusión de Angle Clase III/cirugía , Mandíbula/anomalías , Planificación de Atención al Paciente , Valores de Referencia , Retrognatismo/cirugíaRESUMEN
In a sample of orthodontic patients (27 boys and 25 girls, 10 to 14 years old), natural head position (NHP) was photographically recorded. A vertical axis was recorded on the photographs with a plumb line and transferred to the lateral head radiographs of the patients. Three cephalometric reference lines (sella-nasion, basion-nasion, and porion-orbitale) were compared with regard to their inclination to the horizontal plane. These angles showed standard deviations of between 4.5 degrees and 5.6 degrees. Reproducibility of NHP, assessed as the error of a single observation, was close to 2 degrees. These findings, in combination with the fact that the NHP represents a realistic appearance of patients, support its use as a basis for cephalometric analysis of dentofacial anomalies. A strong correlation was found between the inclinations of the three cephalometric reference lines to the horizontal plane. The close anatomic relationship between these lines, in combination with the small random movements of the head around NHP, were believed to explain the covariation.
Asunto(s)
Cefalometría , Cabeza/anatomía & histología , Postura , Adolescente , Niño , Cara/anatomía & histología , Femenino , Humanos , Masculino , Reproducibilidad de los ResultadosRESUMEN
A proportional soft tissue profile analysis is presented, based on natural head position (NHP) and an extracranial vertical reference line through Porion. Twelve linear soft tissue variables and norms for 11 indices expressing vertical and horizontal soft tissue proportions of the face were obtained from lateral skull radiographs of 40 Swedish adults (20 males, and 20 females) with good occlusion. Sexual dimorphism, with larger dimensions in men than in women, was most pronounced in the vertical plane. With regard to facial soft tissue proportions, significant differences between men and women were found only for those indices which involved measurements of lower jaw prominence and facial height. The means and standard deviations for six indices in the female group were compared with corresponding data obtained from the Peck and Peck sample, which had been selected on esthetic grounds. The results showed a close match between the groups. The proportional soft tissue analysis is recommended for the treatment planning of patients scheduled for orthognathic surgery.