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DBMAKER: a set of programs to generate three-dimensional databases based upon user-specified criteria.

DBMAKER is a program that, in conjunction with CONCORD, generates three-dimensional structural databases. Numerous user-defined parameters monitor content, composition, size and connectivity information, but allow the program to generate random compounds within the scope of these constraints. SMILES string representations are generated, and conversion to 3D is performed by CONCORD. This assures high-quality 3D structures and portability to numerous proprietary storage formats. Methods are described to maintain compound registration, allowing database expansion as required without duplication.

Computer Simulation↗

Epileptic laughter: electroclinical and cinefilm report of a case.

A woman, aged 30, experienced attacks of pathological laughter which began during the first months of life; they meet the qualifying criteria of epileptic laughter. Several attacks were recorded by polygraphy and cinefilm. The attack begins with a feeling of unreality associated with a forced, involuntary smile progressing to full laughter. The patient tried to mask the laughter which was not accompanied by euphoria but was followed by loss of consciousness and automatisms. Only during the latter phase of the previously normal EEG did an ictal discharge appear over the right hemisphere. On the basis of the electroclinical pattern and of a review of the literature, the seizure is tentatively explained in terms of a progressive ictal involvement of temporodiencephalic structures.

Adult↗

Functional reconstruction after facial paralysis: a survey.

The attempt to achieve symmetrical harmonious facial expression represents a complex surgical challenge, necessitating an individualized approach. Clinical investigations and laboratory experiments have demonstrated how to better reconstruct a "smile." In long-standing deformities, ipsilateral or crossfacial nerve grafting followed by functional muscle transfer in a 2-stage procedure seems to give the most acceptable results; however, hypoglossal-facial anastomosis and dynamic muscle techniques such as temporal muscle transposition and others can result in adequate functional reconstruction. The development of these techniques with special emphasis on those made during the last 10 years is discussed and compared with our own experiences.

Facial Expression↗

Improving dentofacial esthetics while paying attention to the anterior facial height index.

Prior to the pubertal growth spurt, a 12-year-old boy with a long face pattern, upper prognathia and class II,2 relationship was treated with a combination of edgewise appliance, statically determined intrusion base arch and Jasper Jumper. The clinical results show that, with the mechanotherapy presented here, good smile esthetics and normal class I occlusion were achieved. Furthermore, the cephalometric results reveal that, by using an appliance which leaves the extrusive effect on the molars small, the anterior facial height index can be kept constant even during the patient's growth phase, although contrary treatment goals such as incisor intrusion and occlusal correction must be met. Simultaneously, it could be demonstrated that Jasper Jumper treatment may not automatically lead to incisor flaring by individualizing the point of force application. In addition, reducing the deep overbite may prevent its destructive tendency, and the patient's growth pattern can be directed in a more horizontal direction.

Activator Appliances↗

Effects of smoking context on habituation to a repeated cognitive task.

This study assessed the role of smoking-related cues on habituation of electrodermal responding and facial neuromuscular responses in male smokers. In three of the four groups, subjects smoked for the first five trials followed by the laboratory arithmetic task. On the sixth trial one group of subjects continued to smoke nicotine cigarettes, while the context was changed for subjects in the other groups by 1) omitting the pharmacological cues (smoking a non-nicotine cigarette) or 2) omitting both the pharmacological and behavioral cues (not smoking). Subjects in a non-smoking control group did not smoke before any of the six trials. During trials 1-5, smoking significantly increased the rate of habituation of electrodermal activity. On trial 6, electrodermal activity significantly increased for subjects who had a change in smoking context, whether it involved removal of pharmacological or smoking plus pharmacological cues. No differences in electrodermal activity were observed between subjects in these groups compared to non-smoking control subjects. Smoking increased zygomatic activity (predominant during smiling) during trials 1-5, consistent with an interpretation of the positively reinforcing nature of smoking. Corrugator activity (predominant during frowning or concentration) increased for subjects who had both the pharmacological and behavioral smoking cues omitted on trial 6.

Adolescent↗

[Identification of possible cognizance parameters of "mimic disintegration" in schizophrenia using facial electromyography].

UNLABELLED: The aim of this study was to identify signs of "mimic disintegration" in schizophrenics using a facial electromyographic (EMG) method. We compared a group of 20 unmedicated schizophrenics with a group of 20 healthy subjects, measuring the activity of three joy-relevant facial muscles (zygomaticus major, orbicularis oculi, levator labii superioris) and two nonjoy-relevant facial muscles (frontalis, corrugator supercilii) as control muscles during two consecutive presentations of an erotic slide from the International Affective Picture System. RESULT: Schizophrenics show significantly less activity of joy-relevant facial muscles and a lower smile frequency than healthy subjects. Two signs of mimic disintegration" could be identified: 1. undefined mimic reactions and 2. lack of mimic consistency. CONCLUSION: Facial EMG is a state-of-the-art method for analyzing possible signs of mimic disintegration as described by Heimann and Spoerri. We suggest further examination of the two mimic disintegration signs regarding other emotions, necessarily including more facial muscles in the testing.

Adult↗

[Bilateral anterior operculum syndrome].

Characteristically, patients with anterior operculum syndrome (AOS), also known as Marie-Foix-Chavany syndrome cannot perform voluntary movements of the face, jaw, tongue, and pharynx. As a result, they are unable to speak, swallow, grimace, smile, or carry out any other voluntary facial masticatory or linguopharyngeal movement. At the same time, involuntary movements of the aforementioned muscles are fully preserved. Laughing, yawning, and coughing, as well as mimicking movements accompanying emotions, eye closure during sleep, or the blink reflex are unaffected. The pathoanatomic substrate of this voluntary-involuntary dissociation is a bilateral lesion of the frontoparietal operculum usually caused by ischemic strokes. The prognosis is usually poor, especially concerning the ability to speak and eat. The name Marie-Foix-Chavany for this syndrome is fully established, although the characteristic voluntary-involuntary dissociation is not mentioned in the original French publication of 1926. We present a case and discuss clinical features, pathophysiology, and differential diagnosis of AOS. In a 7-year follow-up, we observed better functional outcome than is commonly described in the literature.

Adult↗

Mimetic muscles and emotions: Hans Memling's fifteenth century masterpiece, "Last judgment," as a study for aesthetic surgery.

As the most recognizable part of the body, the face has always interested, not only artists, but doctors as well. Each has had their own perception of facial beauty. The task for plastic and aesthetic surgery regarding the face is to reconstruct, not only traumatic lesions, but also to prevent the effects of facial tissue aging. It is also important to preserve the aesthetic values of the face in different emotional conditions. Those conditions are partially represented by mimetic or facial muscles. One might suggest that the perception of human beings portrayed by the artists could be very helpful in the realm of plastic and aesthetic surgery. Take, for example, Hans Memling, a fifteenth century Flemish artist whose masterpiece "Last Judgment" is exhibited at Gdańsk National Museum in Poland. The fortunate individuals on the left side of the painting are queuing at heaven's gate to receive their reward. Their faces are smooth with smiles, displaying blessings and happiness. The right-hand side of the painting exemplifies the expression of fear and the drama of the situation. These sinners have been damned and sentenced to hell by evil creatures. The fear, pain, and tragedy of condemnation fill their faces. For plastic and cosmetic surgeons, studying the works of great artists has not been as valuable as using the emotionless and intangible figures of an anatomy book. Undoubtedly, the only useful paintings and sculptures are those that are full of expression with the face displaying a plethora of emotions. In all surgical approaches where mimetic muscles are concerned, one has to remember and be conscious of the fact that the face is a very significant part of our body.

Belgium↗

Anatomy of the median part of the septum depressor muscle in aesthetic surgery.

When a person smiles and talks, everyone in his or her own specific way, it can be noticed that the tip of the nose drops and the upper lip shortens, making the nasolabial angle more acute. The importance of the upper lip in the dynamics of the nose makes necessary a more detailed study of the morphology and anatomical relations of the median part of the nasal septum depressor muscle, contributing in this way to new techniques in plastic surgery. The authors proposed to study the anatomy of the nasal septum depressor muscle and its relationship with the dermocartilaginous ligament of Pitanguy and the upper lip, important components of the nasal dynamics of facial expression. In this way they seek to contribute to the treatment of the nasal tip in aesthetic rhinoplasties.

Dissection↗

What distinguishes autism spectrum disorders from other developmental disorders before the age of four years?

The increasing recognition of the benefits of early intervention for children with autism spectrum disorder (ASD) stresses the importance of early identification of children who might benefit from those programs. However, in the early years of life it may be difficult to distinguish children with ASD from children with other developmental disorders. The aim of the present study was to identify behavioural patterns that could facilitate this differentiation. Prior to diagnostic assessment, 2- and 3-year-old children (n=30), all referred to a clinic for "possible autism", were observed in a semi-structured play interaction, and their parents were interviewed about the children's early development from 0 to 24 months. Following diagnostic assessment, the 17 children fulfilling the ICD-10 criteria for ASD were compared to the 13 children diagnosed with other developmental disorders (outside the autism spectrum). On the basis of parent reports only a few distinguishing signs of ASD were found before 24 months of age. On the basis of professional observations in a semi-structured play interaction several distinguishing signs were found for the 2- and 3-year-olds; smiles in response, responds to name, follows pointing, looks to "read" faces, initiates requesting verbal and nonverbal behaviours, and functional play.

Age Factors↗

The concept of bimaxillary transverse osteodistraction: a paradigm shift?

Severe crowding due to narrow upper and lower apical bases can be corrected by the extraction of four premolars, or by bimaxillary transverse osteodistraction. The first strategy is prone to unaesthetic changes in lip posture, nasolabial angle and buccal corridors. Life-long retention is necessary because of the known correlation between increased intercanine distance and relapse of crowding. The second strategy involves surgery and the final outcome regarding stability is not yet known. Theoretically, because the canines have not been moved outside of the skeletal envelope, and because the functional matrix positively influences the dental arches, relapse of crowding should be less. Facial appearance is improved because of the reduction of the buccal corridors and the fullness of the mouth both at rest, and upon smiling.

Adolescent↗

On intersubjective engagement in autism: a controlled study of nonverbal aspects of conversation.

Does autism involve a deficit in intersubjective engagement with other persons? We studied nonverbal communication in children and adolescents with and without autism (n = 12 per group), group-matched for chronological age and verbal mental age, during 3 min of a videotaped interview. In keeping with previous studies, there were only subtle but potentially revealing group differences on behavioral ratings. Participants with autism made fewer head-shakes/nods (but not smiles) when the interviewer was talking, and the interviewer made fewer head-shakes/nods when participants were talking. Yet there were marked group differences on reliable 'subjective' ratings of (a) affective engagement and (b) the smoothness of reciprocal interaction. We interpret the findings in terms of a group difference in identification between conversational partners.

Adolescent↗

Early social, imitation, play, and language abilities of young non-autistic siblings of children with autism.

Studies are needed to better understand the broad autism phenotype in young siblings of children with autism. Cognitive, adaptive, social, imitation, play, and language abilities were examined in 42 non-autistic siblings and 20 toddlers with no family history of autism, ages 18-27 months. Siblings, as a group, were below average in expressive language and composite IQ, had lower mean receptive language, adaptive behavior, and social communication skills, and used fewer words, distal gestures, and responsive social smiles than comparison children. Additionally, parents reported social impairments in siblings by 13 months of age. These results suggest that the development of young non-autistic siblings is affected at an early age and, thus, should be closely monitored, with appropriate interventions implemented as needed.

Adaptation, Psychological↗

Early social and emotional communication in the infant siblings of children with autism spectrum disorders: an examination of the broad phenotype.

Infants with older siblings with Autism Spectrum Disorders (ASD-sibs) are at risk for socioemotional difficulties. ASD-sibs were compared to infants with typically developing older siblings (TD-sibs) using the face-to-face/still-face (FFSF) at 6 months and the Early Social Communication Scale (ESCS) at 8, 10, 12, 15, and/or 18 months. ASD-sibs smiled for a lower proportion of the FFSF than TD-sibs and lacked emotional continuity between episodes. With respect to TD-sibs, ASD-sibs engaged in lower rates of initiating joint attention at 15 months, lower rates of higher-level behavioral requests at 12 months, and responded to fewer joint attention bids at 18 months. The results suggest subtle, inconsistent, but multi-faceted deficits in emotional expression and referential communication in infants at-risk for ASDs.

Adolescent↗

Willem Einthoven's fortuitous invention.

It is usually assumed that Willem Einthoven started out as a young investigator to invent the electrocardiograph and that he succeeded. On the contrary, his career had several false starts. True, fortune smiled on him. But his diligence and clinical interest plus the scientific freedom of his age led to his remarkable discovery.

Cardiology↗

Psychometric properties of the Matson Evaluation of Social Skills with Youngsters (MESSY) with emotional problems and self concept in deaf children.

In Study One the Matson Evaluation of Social Skills with Youngsters (MESSY) was scored by teachers for 96 deaf children ranging from normal intelligence through mentally retarded. Inter-item and split-half correlations were high, and internal consistency of particular items correlated to the scale as a whole was high. Items that were particularly spurious were looking and smiling at others, an interesting finding since these social behaviors are frequently targeted in treatment research. Therefore, re-evaluating behaviors which should receive priority for treatment may need to be considered at least with deaf children. In Study Two, these children were evaluated on social (MESSY) and emotional behavior (AML), and self-concept (Piers-Harris). Correlations between scales showed the greatest relationship between social and emotional responses. The implications of these data are discussed.

Adolescent↗

A brief method for assessing social development: structure, reliability, stability, and developmental validity of the Interpersonal Competence Scale.

The Interpersonal Competence Scale (ICS-T) is a set of brief rating scales for teachers and parents. It consists of 18 items that assess social and behavioural characteristics of children and youths. The ICS-T yields three primary factors: AGG (argues, trouble at school, fights), POP (popular with boys, popular with girls, lots of friends), and ACA (spelling, math). Subsidiary factors include AFF (smile, friendly), OLY (appearance, sports, wins), and INT (shyness, sad, worry). The psychometric properties of the scale (internal structure, reliability, long-term stability) are presented and evaluated over successive ages. The scale factors have been linked to contemporaneous observations of behavior and social network membership. Developmental validity of the ICS-T includes the significant prediction of later school dropout and teenage parenthood. The ICS-T scale is described, along with instructions for use and scoring.

Adolescent↗

The use of adrenocorticotrophic hormone (4-9) analog ORG 2766 in autistic children: effects on the organization of behavior.

In a double-blind placebo-controlled crossover trial, 14 autistic children were treated with the neuropeptide ORG 2766, a synthetic analog of adrenocorticotrophic hormone (ACTH) (4-9). ORG 2766 treatment (20 mg per day during 4 weeks) was associated with an increased amount and an improved quality of the social interaction of the autistic children with a familiar experimenter. These changes in interaction were clinically relevant. Following treatment with ORG 2766 gaze and smile behaviors of child and experimenter showed stronger temporal contingencies. Further, after ORG 2766, stereotypies were temporally disconnected from verbal initiatives. The data supported the notion of a stimulating effect of ORG 2766 on social interaction. The implications of these findings for the endogenous opioid theory of autism are discussed.

Adrenocorticotropic Hormone↗