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PubMed2000

Sib-pair linkage analysis of longitudinal changes in lipoprotein risk factors and lipase genes in women twins.

Based on longitudinal twin data in women, we have previously demonstrated a genetic influence on changes in lipoprotein risk factors, blood pressure measurements, and body mass index over a decade. The present study examined the linkage between changes in lipoprotein variables and candidate genes encoding the hormone-sensitive lipase (HSL), hepatic lipase (HL), and lipoprotein lipase (LPL). The sample consisted of 126 dizygotic (DZ) pairs of women twins who participated in the two examinations of the Kaiser Permanente Women Twins Study, performed a decade apart. Using quantitative sib-pair linkage analysis, a linkage was demonstrated between the locus for hormone-sensitive lipase and age-adjusted changes in plasma triglyceride (P = 0.015), which became more significant after adjustment for environmental factors and the exam-1 level (P = 0.005). There was also evidence suggesting linkage between the locus for hepatic lipase and changes in triglyceride (P = 0.023), but no linkage was detected for lipoprotein lipase and changes of lipid levels with time. These findings suggest that variation at these candidate gene loci may underlie a portion of the intraindividual variations in these coronary heart disease (CHD) risk factors, and that studies to identify the functional variants could provide new insights into genetic susceptibility to cardiovascular disease.

Adult↗
PubMed2000

Longitudinal change in hippocampal volume as a function of apolipoprotein E genotype.

The epsilon4 allele of the apolipoprotein E (APOE) gene confers an increased risk for the development of AD. The authors compared longitudinal rates of change in hippocampal volume as a function of APOE genotype in nondemented elderly individuals. Rate of volumetric loss was significantly greater among epsilon4+ compared with epsilon4- individuals. These results indicate that individuals positive for the APOE epsilon4 allele may show a greater rate of hippocampal atrophy than their epsilon4- counterparts, even in the absence of a diagnosis of AD.

Age Factors↗
PubMed1990

The fate of early experience following developmental change: longitudinal approaches to individual adaptation in childhood.

2 strategies were used to investigate the continued impact of early experience and adaptation given subsequent experience and/or developmental change in a poverty sample (N = 190). Groups were defined whose adaptation was similar during the preschool years but consistently different earlier; then these 2 groups were compared in elementary school. In addition, a series of regression analyses was performed in which variance accounted for by near-in or contemporary predictors of adaptation in middle childhood was removed before adding earlier adaptation in subsequent steps. Children showing positive adaptation in the infant/toddler period showed greater rebound in the elementary school years, despite poor functioning in the preschool period. Regression analyses revealed some incremental power of early predictors with intermediate predictors removed. The results were interpreted as supporting Bowlby's thesis that adaptation is always a product of both developmental history and current circumstances. While this research cannot resolve such a complicated issue, it does point to the need for complex formulations to guide research on individual development.

Adaptation, Psychological↗
PubMed2001

Relationship of serum sex steroid levels to longitudinal changes in bone density in young versus elderly men.

Estrogen appears to play an important role in determining bone mineral density in men, but it remains unclear whether estrogen primarily determines peak bone mass or also affects bone loss in elderly men. Thus, we assessed longitudinal rates of change in bone mineral density in young (22-39 yr; n = 88) vs. elderly (60-90 yr; n = 130) men and related these to circulating total and bioavailable estrogen and testosterone levels. In young men bone mineral density increased significantly over 4 yr at the mid-radius and ulna and at the total hip (by 0.32-0.43%/yr), whereas it decreased in the elderly men at the forearm sites (by 0.49-0.66%/yr), but did not change at the total hip. The rate of increase in bone mineral density at the forearm sites in the young men was significantly correlated to serum total and bioavailable estradiol and estrone levels (r = 0.22-0.35), but not with total or bioavailable testosterone levels. In the elderly men the rates of bone loss at the forearm sites were most closely associated with serum bioavailable estradiol levels (r = 0.29-0.33) rather than bioavailable testosterone levels. Moreover, elderly men with bioavailable estradiol levels below the median [40 pmol/liter (11 pg/ml)] had significantly higher rates of bone loss and levels of bone resorption markers than men with bioavailable estradiol levels above 40 pmol/liter. These data thus indicate that estrogen plays a key role both in the acquisition of peak bone mass in young men and in bone loss in elderly men. Moreover, our findings suggest that age-related decreases in bioavailable estradiol levels to below 40 pmol/liter may well be the major cause of bone loss in elderly men. This subset of men is perhaps most likely to benefit from preventive therapy.

Adult↗
PubMed2000

Longitudinal changes in bone in men with spinal cord injury.

INTRODUCTION: Quantitative bone assessment today is primarily based on the analysis of bone mineral density (BMD). The geometric and structural properties of bone, which are important parameters for skeletal strength, are generally not considered in the routine clinical assessment of spinal cord injury-related osteopenia. OBJECTIVE: To study changes in structural and geometric properties of tibia bone longitudinally by means of peripheral quantitative computerized tomography and a biomechanical test method (bone stiffness measurement device Swing) in 12 subjects with spinal cord injury. DESIGN: Measurements were conducted in the 5th week and around the 104th week after the spinal cord injury in a university hospital. RESULTS: Paired Student's t-tests showed a significant decrease in trabecular (p < 0.05) and cortical bone (p < 0.05), as well as a significant decrease in geometric properties of tibia bone (p < 0.05) within two years after the spinal cord injury. Phase velocity propagation changed in three subjects within two years following the spinal cord injury. CONCLUSIONS: This study indicates that beside changes in tissue composition, changes in bone geometric indices and in structural properties occur in the lower extremity after a spinal cord injury. In the tibia, consideration of geometric and biomechanical parameters of bone combined with bone mineral density measurements could result in an improved screening for spinal cord injury-related osteopenia and the prediction of fracture risk in spinal cord injury.

Adult↗
PubMed2004

Longitudinal changes in aerobic power in older men and women.

The purpose of this study was to describe the longitudinal (10 yr) decline in aerobic power [maximal O(2) uptake (Vo(2 max))] and anaerobic threshold [ventilatory threshold (T(Ve))] of older adults living independently in the community. Ten years after initial testing, 62 subjects (34 men, mean age 73.5 +/- 6.4 yr; 28 women, 72.1 +/- 5.3 yr) achieved Vo(2 max) criteria during treadmill walking tests to the limit of tolerance, with T(Ve) determined in a subset of 45. Vo(2 max) in men showed a rate of decline of -0.43 ml.kg(-1).min(-1).yr(-1), and the decline in Vo(2 max) was consequent to a lowered maximal heart rate with no change in the maximum O(2) pulse. The women showed a slower rate of decline of Vo(2 max) of -0.19.ml.kg(-1).min(-1).yr(-1) (P < 0.05), again with a lowered HR(max) and unchanged O(2) pulse. In this sample, lean body mass was not changed over the 10-yr period. Changes in Vo(2 max) were not significantly related to physical activity scores. T(Ve) showed a nonsignificant decline in both men and women. Groupings of young-old (65-72 yr at follow-up) vs. old-old (73-90 yr at follow-up) were examined. In men, there were no differences in the rate of Vo(2 max) decline. The young-old women showed a significant decline in Vo(2 max), whereas old-old women, initially at a Vo(2 max) of 19.4 +/- 3.1 ml.kg(-1).min(-1), showed no loss in Vo(2 max). The longitudinal data, vs. cross-sectional analysis, showed a greater decline for men but similar estimates of the rates of change in women. Thus the 10-yr longitudinal study of the cohort of community-dwelling older adults who remained healthy, ambulatory, and independent showed a 14% decline in Vo(2 max) in men, and a smaller decline of 7% in women, with the oldest women showing little change over the 10-yr period.

Aged↗
PubMed1991

[Longitudinal changes in the acoustic temporomandibular symptoms due to different procedures of orthognathic surgery].

A longitudinal study of TMJ sounds prior to and after combined orthodontic-orthognathic surgical procedures was carried out. The relative frequency of such sounds two days prior to operation (T0) and three months (T1), eight months (T2), 14.5 months (T3), and 25.5 months (T4) postoperatively remained--treatment-independently--largely unchanged. Chances in frequency between T0 and T4 showed only a nonsignificant tendency to differ in comparison with changes seen after orthodontic treatment (A) only. An analysis of individual changes revealed that after Le Fort I osteotomy (B) and bimaxillary procedures/posterior mandibular repositioning (D), no change in the preoperative sounds is to be expected. In contrast, following mandibular advancement (C) TMJ sounds first disappeared, in particular in the period immediately following operation (T0-T1), but also subsequently reappeared. The difference vis-a-vis group B (Le Fort I osteotomies) was statistically significant (group B vs. group C: p less than or equal to 0.01.

Auscultation↗
PubMed1995

Longitudinal change of sonographic ovarian aspects and endocrine parameters in irregular cycles of adolescence.

We longitudinally studied clinical endocrine and ultrasound parameters of the ovaries in 73 healthy adolescents having persistent menstrual irregularities. After the first examination, they were reexamined after a variable period ranging from 2 to 7 y. During the first examination, three basic features of the ovaries were observed: homogeneous (36%), multifollicular (23%), and polycystic (41%). Polycystic ovaries were most frequent, and they generally exceeded the normal adult range. During the last examination, in the entire group of irregular adolescents, homogeneous ovaries decreased (-14%), polycystic ovaries increased (+18%), and a further higher number of subjects exceeded the normal adult range (+10%). The subjects with enlarged ovaries had the highest values of LH, testosterone, and androstenedione. Fourteen subjects out of 46 (30%), with normal ovarian volume in the first examination, registered an ovarian enlargement in the last examination, exceeding the normal range. Moreover, a change from the homogeneous or multifollicular structure to the polycystic one was observed. Twenty-one subjects out of 27 (78%) with enlarged ovaries in the first examination confirmed the high ovarian volume and the unchanged structure in the last examination, whereas six subjects (22%) showed ovaries within the normal adult range; the polycystic structure was substantially confirmed. These results indicate the following. 1) Homogeneous, multifollicular, and polycystic ovaries can usually be found in the postmenarcheal period. 2) Enlarged ovaries, polycystic structure, hyperandrogenemia, and high LH values are strongly linked, and they are frequent in irregular cycles even in the absence of signs of hyperandrogenism. These characteristics may all persist or in various aggregations become a permanent feature. 3) Only a few subjects may lose ovarian enlargement and show a change in the polycystic structure; however, they frequently maintain hyperandrogenemia. 4) During the postmenarcheal period, normal ovarian characteristics may suddenly change, and the ovaries may take on a polycystic structure and increase in volume. Moreover, some endocrine parameters may reach pathologic levels.

Adolescent↗
PubMed1985

Longitudinal changes in three normal facial types.

The purpose of this study was to describe and compare the dentofacial relationships of three normal facial types (long, average, and short). Comparisons of the absolute and incremental changes between 5 years and 25.5 years of age were made both longitudinally and cross-sectionally. The subjects consisted of 20 males and 15 females for whom complete sets of data were available for the period of this study. All subjects had clinically acceptable occlusion and had not undergone previous orthodontic treatment. Descriptive statistics summarized the changes in 48 parameters, including that of height for males and females at 5, 10, 15, and 25.5 years of age. Longitudinal comparisons of the growth curves evaluated the curve profiles and curve magnitudes for the three facial types for both males and females. The analysis of variance was also used to compare the absolute and incremental changes at ages 5, 10, 15, and 25.5 years. The investigation resulted in the following findings. (1) Most persons (77%) have been categorized as having the same facial type at 5 and at 25.5 years of age. There is a strong tendency to maintain the original facial type with age. (2) Comparisons of the growth curves of the different parameters--with the exception of the incremental curves for MP:SN and Pog:NB in males--consistently demonstrated parallelism of the curves, regardless of the facial type. On the other hand, comparisons of curve magnitude indicated significant differences among the three facial types. (3) The persons within each facial type expressed a relatively large variation in the size and relationships of the various dentofacial structures. (4) Significant differences in the dentofacial parameters were present between males and females with the same facial type. The differences among facial types were not identical in males and females. (5) Longitudinal analysis of the data lends more consistent and, therefore, more meaningful results than cross-sectional comparisons when facial growth trends need to be evaluated. This is because growth changes are often subtle and of magnitudes not readily observed when the data are evaluated cross-sectionally. Standards that are age-, sex- and facial type-specific are presented.

Adolescent↗
PubMed1994

Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study.

OBJECTIVE: To examine the longitudinal associations between a pregnancy and persistent changes in adiposity in young black and white women. DESIGN: Prospective cohort study with 5 years of follow-up. SETTING: Participants recruited by community-based sampling (Birmingham, Ala; Chicago, Ill; and Minneapolis, Minn) and through the membership of a large prepaid health care plan (Oakland, Calif). PARTICIPANTS: A total of 2788 women (53% black) aged 18 through 30 years were assessed at baseline (1985 through 1986) and reassessed at examination 2 (91% retention; 1987 through 1988) and examination 3 (86% retention; 1990 through 1991). Women who remained nulliparous (n = 925) during the 5-year follow-up were compared with women who had a single pregnancy of 28 weeks' duration during that period and who were at least 12 months postpartum at follow-up (primiparas, n = 89; multiparas, n = 114). MAIN OUTCOME MEASURES: Change in body weight and in waist-to-hip ratio during the 5-year period. Analyses were adjusted for demographic factors (age and education), behavioral variables (smoking and physical activity), and baseline level of adiposity. RESULTS: Primiparas within both race groups gained 2 to 3 kg more weight during the 5-year period than did nulliparas in both adjusted and unadjusted analyses. Primiparas also had greater increases in waist-to-hip ratio that were independent of weight gain. Multiparas did not differ from nulliparas in adiposity change in either race group. At each level of parity, black women demonstrated greater adverse changes in adiposity than did white women. CONCLUSIONS: These data suggest that women experience modest but adverse increases in body weight and fat distribution after a first pregnancy and that these changes are persistent.

Adipose Tissue↗
PubMed2004

Longitudinal changes in exercise capacity after stroke.

OBJECTIVE: To determine if stroke patients without specific aerobic training experience a change in the first 6 months after stroke. DESIGN: Descriptive, longitudinal study with repeated measures of exercise capacity at 1, 2, 3, and 6 months after stroke. SETTING: Exercise testing laboratory in a tertiary care hospital. PARTICIPANTS: Consecutive sample of 25 patients (mean age +/- standard deviation, 64.1+/-13.6 y) 1 month after first ischemic stroke. INTERVENTIONS: Not applicable. Main Outcome Measures Peak oxygen consumption (Vo(2)peak) was measured by open-circuit spirometry during maximal effort treadmill walking with 15% body-weight support. RESULTS: Mean Vo(2)peak increased from 14.8+/-5.3 mL x kg(-1). min(-1) at 1 month to 17.3+/-7.0 mL x kg(-1).min(-1) at 6 months after stroke (P=.003) or from 61.7%+/-16% to 71.3%+/-23% of age- and sex-related normative values for sedentary healthy adults (P=.008). CONCLUSIONS: Despite improvements in Vo(2)peak and other indices of cardiovascular training between 1 and 6 months poststroke, substantial limitations in exercise capacity persisted. Further study is needed to determine the extent to which these limitations can be modified through aerobic conditioning.

Age Factors↗
PubMed1988

Low-level cigarette smoking and longitudinal change in serum cholesterol among adolescents. The Berlin-Bremen Study.

The current study was conducted to determine if smokers and nonsmokers differ in serum concentrations of high-density lipoprotein cholesterol (HDL-C) before smoking initiation and if a decline in HDL-C levels could be detected among adolescents during the first two years of smoking. Changes in HDL-C levels and smoking were observed longitudinally in 1983, 1984, and 1985 among 691 seventh and eighth graders (age range, 12 to 14 years) from two German cities; 82% were nonsmokers at baseline. For these baseline nonsmokers, no differences in baseline HDL-C concentrations were found between those who became smokers and those who remained nonsmokers. In contrast, those who became light (one to 39 cigarettes per week) or moderate (greater than or equal to 40 cigarettes per week) smokers by one or two years after the initial examination evidenced lower mean HDL-C concentrations relative to persistent nonsmokers at follow-up, constituting a decrement of -0.016 mmol/L [SE = .035] (-0.6 mg/dL) [SE = 1.4] for light smokers and -0.114 mmol/L [SE = .064] (-4.4 mg/dL) [SE = 2.5] for moderate smokers. These findings suggest that short-term exposure to cigarette smoke at low levels may have atherogenic consequences.

Adolescent↗
PubMed2004

Assessment of longitudinal changes in HIV-specific effector activity in subjects undergoing untreated primary HIV infection.

BACKGROUND: Despite the failure of HIV-specific cell-mediated immune responses to clear the virus, these cells play a critical role in the control of viral replication throughout HIV infection. OBJECTIVE: To characterize the natural evolution of the HIV-specific immune response in HIV primary infection (PI). METHODS: Untreated individuals, recruited in HIV PI, were monitored for the evolution of HIV-specific immune responses starting in early HIV disease. Longitudinal analysis of changes in the magnitude and breadth of HIV-specific responses to a panel of MHC class I-restricted peptides was performed using the quantitative interferon-gamma ELISPOT assay. RESULTS: Although immune responses were detected in all individuals at all times tested, the pattern of the immune responses differed significantly from that seen in subjects treated in PI. Untreated PI subjects exhibited dramatic changes with time in the frequency of individual HIV peptide-specific T-cell responses. In contrast HIV-specific immunity was stable in subjects treated in early PI or decreased in intensity and breadth in individuals treated later in PI. In untreated subjects the overall magnitude of HIV-specific reactivity persisted over at least 12 months whereas the number of peptides recognized declined. CONCLUSION: Given that a significant relationship existed between the magnitude of the HIV-specific response and viral load, it is likely that these effector cell expansions and contractions are driven by changes in antigen load.

Adolescent↗
PubMed2006

Longitudinal changes in corneal curvature in keratoconus.

PURPOSE: This study was designed to identify factors that predict longitudinal increases in corneal curvature as measured by the First Definite Apical Clearance Lens (FDACL) and flatter keratometric reading (Flat K) in keratoconus. METHODS: The Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study is a long-te rm evaluation of the natural history of keratoconus involving 1209 patients. This report uses 8 years of follow-up data from 1032 patients who had penetrating keratoplasty in neither eye at baseline and who provided enough data to compute the slope of the change with time in the FDACL or the Flat K. Outcome measures included the aforementioned slopes and whether the FDACL or the Flat K increased by 3.00 or more diopters (D) in at least 1 eye. RESULTS: At CLEK Study entry, patients were aged 38.9 +/- 10.8 years. Overall, 44.3% of them were women, and 69.3% of them were white. The slope of the change in FDACL (0.18 +/- 0.60 D/y) and Flat K (0.20 +/- 0.80 D) during 8 years translates into expected 8-year increases of 1.44 D in FDACL and 1.60 D in Flat K. Increases of > or = 3.00 D in either eye had an 8-year incidence of 24.8% for FDACL and 24.1% for Flat K. Independent predictors of increased FDACL included younger age, poorer baseline high-contrast manifest refraction visual acuity, and non-white race. Younger age and poorer high-contrast manifest refraction visual acuity were independent predictors of a >3.00-D increase for both FDACL and Flat K. CONCLUSION: CLEK patients exhibited a slow but clear increase in corneal curvature. Younger age and poorer high-contrast manifest refraction visual acuity at baseline predicted the rate of change in corneal curvature.

Adult↗
PubMed1999

Longitudinal changes in radial bone density in older men.

OBJECTIVE: To examine changes in radial bone density and biochemical status, with particular reference to calcium, over 18 months in a group of older men. SUBJECTS: Thirty-six healthy men (aged 66 76 y) were recruited to the study during July and August, 1993. These men were free-living residents of Edmonton who were recruited through local organizations for the retired and semi-retired. Data for the younger group of men (age 29-60 y) were taken from a previous study conducted in our laboratory. DESIGN: using special-purpose computed tomography (gammaCT), trabecular (TBD), cortical (CBD) and integral (IBD) bone densities (gm/cm3) were measured in the ultra-distal radius at 6-month intervals over 18 months. At baseline, and at each subsequent study visit, serum was obtained from each subject for determinations of calcium, phosphate, 25-hydroxyvitamin D, alkaline phosphatase, and immunoreactive parathyroid hormone. A 24-h urine sample was also obtained at each study visit for determination of urinary calcium, phosphate and creatinine. RESULTS: In repeated measures analysis of variance of the data for the older men serum 25-hydroxyvitamin D was significantly decreased (P<0.001) over time, while TBD was increased (+0.60% per year, P<0.01). Longitudinal rates of change for TBD, CBD and IBD were: -0.94%, 0.92% and 0.74% per year respectively when bone density data at baseline for the older men and the historical data for younger men were combined. However, separate analyses of the data for the younger and the older men indicated no significant age-related changes in bone density for men aged 29-60 y, or for men aged 66-76 y. However, differences in TBD, CBD and IBD between the younger and older groups of men were significant (P < 0.001). CONCLUSIONS: In a group (n = 36) of older men (mean age 71.7 y) studied longitudinally over 18 months, bone density in the distal radius did not decrease over time. Mean bone density in this group of men was, however, significantly (P < 0.001) lower than in a group of younger men (n = 17, mean age 46.7 y). Regression analysis using cross-sectional bone density data at baseline for the older male group, and historical data for the younger male group, indicates that bone loss occurs with increasing age at a rate of about 1% per year averaged over ages 29-76 y. Bone density variables were not correlated with either height or weight, or with any biochemical or hormonal variable measured in this study.

Adult↗
PubMed2003

Hypertension, diabetes, and longitudinal changes in intraocular pressure.

PURPOSE: Diabetes and hypertension are recognized risk factors for raised intraocular pressure (IOP). This report examines the longitudinal relationship of hypertension and diabetes to a 4-year IOP change in a black population with high prevalence of these conditions. DESIGN: Population-based cohort study of a simple random sample of residents of Barbados, West Indies, aged >/=40 years. PARTICIPANTS: A total of 2996 persons without open-angle glaucoma or receiving IOP-lowering medication at baseline. METHODS: Participants underwent standardized examinations including applanation tonometry, measurement of blood pressure, and anthropometric indices; a detailed interview; various ocular measurements; and venipuncture for glycosylated hemoglobin (GHb). Diabetes was defined by self-reported physician diagnosis and hypertension by blood pressure >/=140/90 mmHg and/or treatment history. MAIN OUTCOME MEASURES: The 4-year person-based IOP change between baseline and follow-up was defined as the more positive IOP difference in either eye. RESULTS: An IOP >21 mmHg at baseline was more likely in black and in mixed (black and white) participants (age-gender adjusted odds ratio [OR], 3.9 and 3.8, respectively) than in whites. Similarly, these groups had more hypertension (age-gender adjusted OR, 2.4 and 2.1, respectively) and diabetes (age-gender adjusted OR, 3.9 and 1.7, respectively) than did whites. Mean IOP in black participants increased by 2.5 (standard deviation, 3.9) mmHg over 4 years. Multiple regression analyses showed that baseline diabetes history and hypertension, as well as older age, elevated GHb, higher blood pressures, and lower baseline IOP were associated with a 4-year increase of IOP. The association between diabetes history/GHb and IOP increase became borderline/nonsignificant when persons who underwent cataract surgery during follow-up were excluded. CONCLUSIONS: This report provides new data on the relationship of systemic factors to longitudinal increases in IOP in an African-origin population. Results highlight the increased risk of elevated IOP in populations with high prevalences of diabetes and hypertension.

Adult↗
PubMed2000

Longitudinal changes in the contribution of genetic and environmental influences to symptoms of depression in older male twins.

Genetically informative longitudinal data on self-reported symptoms of depression allow for an investigation of the causes of stability and change in depression symptoms throughout adult life. In this report, the authors investigated the relative contribution of genetic and environmental influences to symptoms of depression in 83 monozygotic and 84 dizygotic male twin pairs from the National Heart, Lung, and Blood Institute (NHLBI) Twin Study. Participants first completed the Center for Epidemiologic Studies-Depression (CES-D) scale in 1985-1986 and again during 1995-1997. Mean age of twins at baseline was 63 years, range 59 to 70. From cross-sectional genetic analyses we estimated the heritability of CES-D to be 25% (95% confidence interval [CI], 11%-39%) at baseline and 55% (95% CI, 40%-71%) at follow-up. Fitting longitudinal genetic models to the two-wave data, we found that stability of symptoms over the 10-year follow-up was due primarily to continuity of genetic influences.

Adult↗
PubMed1989

[Longitudinal changes in amounts of maxillary growth].

The purpose of this study is to investigate postnatal developmental changes in the shape of the maxilla. Normal maxillary form at each development stage and amounts of growth were analyzed by longitudinally measuring 136 Indian skulls. Maxillary growth changes were assumed on the basis of mean values and growth rates of each region measured. Results 1) Vertical growth Vertical growth of the maxilla (N-Pr) at the fifth (permanent-dentition) stage approximately doubled growth in the first (pre-eruption) stage. The corpus of the maxilla and its alveolar process lay beneath the foramen infraorbit. Vertical growth in this region (m-Pr) increases rapidly during the period of eruption of deciduous and permanent teeth. In permanent dentition, the vertical dimensions of the upper (N-m) and lower (m-Pr) parts of the foramen infraorbit were almost the same. 2) Growth in width As the eyes grow, the upper face widens. Resulting development in the tensed zygomatic-maxillary suture at the inferior margin of the orbit expands the upper surface of maxilla. Maxillary width increased by approximately 1.8 times between the first and fifth stages.

Cephalometry↗