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PubMedDate not supplied

Associated congenital abnormalities in Nigeria children with cleft lip and palate.

This is a prospective study of 106 patients with cleft lip and or palate seen over a 5 year period between January 1981 and December, 1985 at the Lagos University Teaching Hospital. Thirty of these patients (28.3 percent) have other associated congenital anomalies which lies within the range of 3 percent to 63.3 percent reported by other authors. The associated anomaly rate was 19 percent in cleft lip only, 35 percent in cleft lip and palate and 28 percent in cleft palate only. All the associated anomalies in the cleft lip cases were single and simple. On the other hand, the multiple and more complex associated anomalies occurred in patients with cleft plate alone and cleft lip and palate combined. Three syndromes were recognised in patients with cleft palate and two in patients with cleft lip and palate.

Abnormalities, Multiple↗
PubMed1985

An ultrastructural and histochemical study of the development of secondary palate in Japanese quail, Coturnix coturnix japonica.

Embryonic development of the secondary palate of the Japanese quail, Coturnix coturnix japonica, was studied. The palatal shelves appeared on day 5 of incubation in a horizontal direction over the dorsal surface of the tongue. Subsequently, unlike those in mammals, the opposing palatal shelves do not fuse, and a physiological cleft persists between them. In comparison with the chick, where the palatal shelves do not fuse and the medial edge epithelium (MEE) becomes orthokeratinized stratified squamous type, the quail MEE differentiates into a parakeratinized stratified squamous type. The basal cells of the quail MEE differentiated from cuboidal to columnar and showed reorganization of their cytoplasmic organelles. In contrast to both the chick and mammalian MEE, quail MEE showed very little ruthenium red (RR) binding at the plasma membrane of both the basal and superficial cells. Initial development in a horizontal direction, lack of fusion, and an absence of programmed cell death in MEE of developing quail palate distinguished it from the mammalian palatogenesis. Also, although the morphogenesis of palate in quail and chick was similar, the pattern of cytodifferentiation in their MEE was different, which may be attributed to their ontogenesis.

Animals↗
PubMed1989

Airway obstruction, palatal vault formation and malocclusion: a cross-sectional study.

A cross-sectional study of one thousand and sixty-five children (508 boys and 557 girls) from the Watertown School System was done in order to determine whether there is a relationship between airway obstruction, palatal vault formation and malocclusion. The age range was 5 to 12 years old with a mean age of 8.5 years. Breathing pattern was based on the lip competency (seal) of each individual. The height of the palatal vault, the Angle's molar classification, cuspid relationship, the anterior and posterior cross-bites, the deep-bites or open-bites were also recorded. Enlarged tonsils were observed and the presence of allergies was noted. High palatal vaults were observed in children with lip incompetency (85.8%), and in children with Class II (73.6%) and Class III (65.3%). Anterior and/or posterior cross-bites accompanied high palatal vaults. From the examined children in this study, 20% presented known allergies. Eighty (80%) percent of the allergic children had high palatal vaults. Enlarged tonsils were also found in children with high palatal vaults.

Airway Obstruction↗
PubMed1987

Secondary palate development in the domestic duck (Khaki Campbell). An electron microscopic, histochemical, autoradiographic and biochemical study.

Prenatal development of the secondary palate in duck was studied using light and electron microscopic, histochemical, autoradiographic and biochemical techniques. The secondary palate of duck develops between Days 7-12 of incubation (HH 25-37). During this period the palatal shelves grow horizontally toward one another but, unlike those in mammals and the alligator, they never fuse, and a physiological cleft persists between them. In contrast to both chick, where the MEE differentiates to orthokeratinisation, and quail, where the MEE becomes parakeratinised, the MEE of duck differentiates to a non-keratinised stratified type. A continuation of DNA synthesis in the MEE, unchanged levels of cyclic AMP in the palatal tissues and an absence of programmed cell death in the MEE during duck palatogenesis distinguish it from the mammalian palate morphogenesis. Also, although the morphogenesis of palate in duck, chick and quail is similar, the cytodifferentiation of their MEE is different.

Animals↗
PubMed1985

Synthesis of prostaglandins and cyclic AMP by cultured embryonic palate mesenchyme at various population densities.

During embryonic development, facial and palate mesenchymal cells exhibit differential growth rates. Normal palatal growth is regulated in part by hormones and growth factors. Because hormonal responsiveness of some cells correlates with their cell density, we have investigated the relationship between embryonic palate mesenchymal cell population density and their ability to synthesize prostaglandins (PGs) and cyclic AMP. Primary cultures of palate mesenchymal cells exhibited typical lag, log, and stationary phases of growth with a doubling time of 32-34 hrs. The ability of cells to produce PGE2 in response to a calcium ionophore (A23187), an activator of phospholipase A2 (melittin), arachidonic acid, or serum was maximal during the period of early exponential growth. Prostaglandin F2 alpha synthesis in response to A23187 or arachidonic acid showed a similar transient increase also corresponding temporally to the period of early exponential growth. The ability to synthesize PGF2 alpha in response to melittin, however, failed to diminish after early exponential growth. The pattern of cAMP synthesis in response to isoproterenol and PGE1 was different from that seen for induced prostaglandin synthesis. A transient increase in sensitivity to isoproterenol and PGE1 was seen that corresponded temporally to the period of late exponential growth just prior to attainment of confluency. Decreased sensitivity to stimulation of either prostaglandin or cAMP production as the cells became confluent was shown to be a density-dependent phenomenon; confluent cultures that were subcultured to reestablish logarithmic growth exhibited density-dependent hormonal responses identical to those seen in primary cultures. The ability of palate mesenchymal cells to synthesize both prostaglandins and cAMP, thought to be critical for proper palatal development, might thus be related to local differential craniofacial growth rates.

Alprostadil↗
PubMed1988

Speech and nasendoscopic evaluation of velopharyngeal incompetence (VPI) in cleft palate patients.

Cleft lip and palate patients exhibit several problems prior to and following surgical repair of their deformities. Hypernasality and speech defects remain one of the outstanding problems. 82 cleft palate patients were subjected to a systematised speech evaluation and an examination of the velopharyngeal mechanism. Nineteen patients did not have any surgery of the palate whilst the remaining 63 had at least one surgical procedure to the palate. 54 had a Veau-Wardill-Kilner (V-W-K) procedure and the remaining had either a second palatal repair or a superiorly based pharyngoplasty. Good correlation of speech assessment to nasendoscopic evaluation was found. An improvement in the speech and nasendoscopic coding was found in patients who had surgical intervention to the palate. A nasendoscopic examination, ideally performed by the surgeon and a speech therapist, is a useful adjunct to speech evaluation.

Adolescent↗
PubMed1988

Cleft lip and palate in Denmark, 1976-1981: epidemiology, variability, and early somatic development.

The present investigation describes the incidence and variability of the primary cleft condition in all Danish infants born with cleft lip, cleft palate, or both, from 1976 to 1981 and analyzes general somatic growth from birth to age 22 months. Because of excellent sampling conditions in Denmark, the study material is nearly complete. Six hundred and seventy-eight infants with facial clefts were born during the period, corresponding to 1.89 per 1,000 of all newborns. Six hundred and two patients were examined--most of them twice: at 2 months and at 22 months. Material uptake included plaster casts of the upper jaw, cephalometric films in three projections, anthropometric registrations, and information from hospital charts. A detailed grading of the clefts according to severity was carried out. Sex distribution was 61% males and 39% females, of whom 34% had isolated cleft lip, 39% combined cleft lip and palate, and 27% an isolated cleft palate. Left-sided clefts were most frequent. In the combined cleft lip and palate group, 90% exhibited subtotal or total clefts, whereas the clefts were less severe in the isolated cleft lip and isolated cleft palate patients. Birth weight and length showed values close to the average for Danish newborns, but a lag was seen in infants in whom severe palatal cleft was included. The extended method of classification was suggested to select subgroups for special care.

Body Height↗
PubMed1988

Simultaneous cleft lip and palate repair: an experimental study in beagles.

This study was designed to test the hypothesis that simultaneous lip and palate repair results in more severe craniofacial growth aberrations than lip repair or palate repair performed separately. Seventy-six purebred beagles were divided into five groups. Two of these groups were controls (unoperated and unrepaired animals); the three remaining groups were experimental (in one group only the lip was repaired, in another only the palate was repaired, and in the last the lip and palate were repaired simultaneously). Cephalometric measurements were analyzed using univariate and multivariate statistical techniques. In multivariate analysis, stepwise multiple regression and discrimination were applied to precisely assess the effects of the various surgical procedures. The results of this study indicate that simultaneous lip and palate repair results in more severe craniofacial growth aberrations than lip repair or palate repair performed separately.

Animals↗
PubMed1986

Cleft lip and palate in Puerto Rico: A thirty-three year study.

Nine hundred and eighty-eight cleft patients born between 1950 and 1983 were registered in the Cleft Palate Clinic file at the University Pediatric Hospital, Medical Sciences Campus, University of Puerto Rico. The entire cleft population was studied to establish relationships among place of birth, sex, age, type of cleft, severity of cleft involvement, and lip side preference and to determine prevalence. The distribution of registered cleft patients by geographic region in Puerto Rico was similar to the distribution of the total population. Cleft patients occurred most frequently in the Northeast regions which have the greatest population density in the Island. Among the 988 cleft patients who were studied, the sex ratio (males to females) was slightly higher than one (1.06). This ratio was found to be similar to the sex ratio for births in Puerto Rico. The sex ratio varied among the different types of clefts: unilateral cleft lip and palate had the highest male to female sex ratio (1.7) and cleft palate alone had the lowest (0.6). Unilateral clefts of the primary and secondary palates were more common than bilateral clefts by a two-to-one ratio. Left sided cleft was more common than right sided cleft in unilateral cleft of the primary palate alone or combined with cleft of the secondary palate. A significant increase in prevalence of the cleft defect per year was observed until 1971. For all types of clefts the increased rate per year was 2.10 per hundred thousand.

Cleft Lip↗
PubMed1987

Human embryonic palatal epithelial differentiation is altered by retinoic acid and epidermal growth factor in organ culture.

Reports of adverse human pregnancy outcomes including cleft palate have increased as the clinical use of isotretinoin (13-cis-retinoic acid) and other retinoic acid (RA) derivatives have increased, but the mechanisms by which their effects are exerted are not understood. Research in craniofacial development is generally performed in rodents, and mouse palatal shelves exposed in organ cultures to retinoids and epidermal growth factor (EGF) display altered medial epithelial cell morphology blocking normal union of apposing shelves. In the present study, precontacting human palatal shelves were maintained in organ culture for 2, 3, or 6 days and exposed to labeled thymidine (3H-TdR) during the last 16 hr. Retinoids and EGF were included in the media so that each shelf was exposed to one of the following: control, EGF, trans-RA at 10(-5)M, cis-RA at 10(-7) or 10(-9) M, or RA + EGF. After exposure of cultured human embryonic palatal shelves to 13-cis-RA and trans-RA with or without EGF, medial epithelial cells do not degenerate, cell surface morphology shifts toward a nasal type, glycogen deposits decrease, smooth endoplasmic reticulum (SER) increases, and basal lamina appear altered. In shelves exposed to EGF and trans-RA early in their development, DNA synthesis appears to terminate prematurely as compared to shelves cultured in control media, and this effect is accompanied by excessive mesenchymal extracellular space expansion. Exposure of shelves to EGF alone is sufficient to block degeneration and induce hyperplasia of the medial epithelial cells but does not induce other ultrastructural changes seen with both EGF and RA. The observed alterations in medial cell morphology could interfere with adhesion of the palatal shelves and may play a role in retinoid-induced cleft palate in the human embryo.

Cell Differentiation↗
PubMed1983

Palate cell motility and substrate interaction.

To elucidate the mechanism by which palate shelves reorient during embryogenesis, migration of palate mesenchymal cells has been studied employing various substrates. When palate explants were cultured in a hydrated collagen lattice, it was observed that bipolar spindle-shaped cells migrated out of each explant toward the other. These cells were aligned parallel to each other and to the fibrous tracks that formed. The cells appeared to move along and through the fibrous tracks. Cell migration was dependent on the presence of serum and fibronectin. The fibrous tracks viewed by phase microscopy were sensitive to collagenase. Scanning electron microscopy revealed that the collagen fibers of the hydrated lattice had coalesced into larger bundles. Pretreatment of explants with serotonin stimulated cell migration out of the explant into the hydrated collagen lattice. This effect was specific, since the antagonist methysergide blocked the stimulation produced by serotonin. Employing other substrates, it was noted that palate cells migrating out of double explants toward each other produced large wrinkles in a polysiloxane substratum. Similarly, cultured monolayer cells also produced wrinkles that disappeared as cells rounded up after trypsin treatment. Finally, monolayer cells pulled on and distorted collagen films when cultured on the substrate. It is concluded that migrating palate cells can interact with their substrate producing tractional forces. Serotonin-induced modulation of cell motility and its relationship to palate reorientation are discussed.

Animals↗
PubMed1978

Palatal shelf elevation in the Wistar rat fetus.

Palatogenesis in the Wistar rat fetus was studied macroscopically, microscopically, ultrastructurally and experimentally between days 13 and 19. The developmental ages of the fetuses were calculated from the smear age of the litter adjusted for individual variations in crown-rump lengths. Palatal shelf elevation occurs at day 16.4 +/- 0.1. Experimentally induced shelf elevation in freshly delivered fetuses was sluggish at day 14, but by day 16.3 it occurred in less than 1 second. Both shelf elevation and shelf fusion begin anteriorly where the shelves show a marked convexity of their margins, and proceed posteriorly. The extreme posterior part of each shelf (future soft palate) is horizontal from the beginning. The matrix of the shelf mesenchyme (especially in the region of the anterior convexities) shows an increasing accumulation of mucopolysaccharides from day 14 to day 16.3 and becomes increasingly oedematous. The shelf attachment to the main maxillary process is progressively undercut by epithelial invagination, producing a fulcrum for shelf elevation. The maxillary and palatine osteogenic blastemata are present at the base of the shelf prior to elevation and rapidly invade the shelves after the event. The elevated palatal shelves fuse with the nasal septum anteriorly, but posteriorly the palate is not attached to the septum. The posterior septum at first has a free lower edge, but then it develops lateral flanges which fuse with corresponding bulges on the lateral nasal walls. In this way two sphenoethmoidal recesses are formed above the fused flanges, while a common nasal passage is formed above the palate, roofed anteriorly by the septal flanges and posteriorly by the cranial base. The space needed to create (simultaneous with shelf elevation) the common nasal passage is made available by flattening of the tongue and protrusion of its tip out of the oral cavity--this protrusion being facilitated by the sloping bulge of the primary palate and nasal septum. Many existing theories of shelf elevation are inconsistent with these observations. It was concluded that shelf elevation occurs very rapidly at a rather precise developmental stage and that turgor (due to binding of water to mucopolysaccharides) is the intrinsic force which elevates the shelves, a force which at 16.4 days reaches a threshold level enabling the shelves to force their way up and over the intervening tongue.

Animals↗
PubMed1983

The frog palate for studying mucus transport velocity and mucociliary frequency.

The palate of the frog possess a pseudostratified epithelium with mucus secreting cells and numerous ciliated cells covered with a continuous mucus blanket of 4 to 8 micron thickness. This palate can be used as a simple model for studying mucus transport and giving rapid information on the transportability of pathological bronchial secretion by the ciliary mechanism. The analysis of the relationship between the rheological properties of sputum an their transport rates on the frog palate showed that the highest transport rates were obtained with sputum samples characterized by a high spinability (Sp greater than 70 mm) and an intermediate range of viscosity (25-180 P) and elasticity (SR = 4-12 units). The mucociliary frequency (Fm) of the frog palate was measured by a photoelectric method and analyzed as a distribution function of the ciliary frequencies by the Fast Fourier Transform method. Fm decreased significantly after mucus depletion and was restored when adding a drop of frog mucus collected on a freshly excised frog palate. On the other hand, it remained about 20% lower than the original predepleted value, when adding purulent sputum collected in patients with chronic bronchitis and cystic fibrosis. The frog palate appears as a valuable model for analyzing the mucociliary transport rate and also for studying the effect of pathological secretions on the ciliary beating frequency.

Animals↗
PubMed1982

Complications of cleft palate repair in large animals.

Seven foals, 2 horses, and 2 calves were presented to the George D. Widener Hospital for Large Animals at New Bolton Center and the Large Animal Clinic at Auburn University for surgical repair of cleft palate. All animals had preexisting pneumonia. Initial repair of cleft palate in 6 foals, 2 horses, and 2 calves was performed via mandibular symphysiotomy. Primary repair of cleft soft palate in a foal was attempted through a pharyngotomy incision after fracture of the basal hyoid bone; however, exposure was inadequate and mandibular symphysiotomy had to be done. Dehiscence of a portion of the cleft palate occurred in all cases (10 of 11) that survived the immediate postoperative period. A 2nd repair was attempted in 3 foals; however, dehiscence of the palate recurred. Osteomyelitis of the mandibular symphysis developed in 6 animals; dehiscence of the lower lip occurred in 3 animals. Serious complications after surgery led to euthanasia or death of 5 animals. Of the 6 surviving animals, 4 did not grow normally. All survivors experienced chronic nasal discharge often contaminated with food material. Although mandibular symphysiotomy provided adequate exposure for surgical repair of cleft palate, serious complications have not been overcome.

Animals↗
PubMed1981

Folate deficiency and in vitro palatogenesis I: effects of a folate-deficient culture on rabbit palate fusion and folate pools.

Folate compounds are essential for nucleic acid metabolism and data from in vitro experiments have shown that folatee deficiency during pregnancy induced by dietary deprivation or folate antagonists is teratogenic. The craniofacial complex is a main target of this teratogen, with the lip and palate being especially vulnerable. The direct effect of folate deficiency on a target teratogenic tissue was, therefore, examined in vitro using fetal rabbit palates in an organ culture system. Folate pool sizes in the palates on the 4 days preceding fusion were determined by competitive binding assay. There was a sharp decrease in folate levels from 2.63 +/- 0.86 ng/mg wet wt on Day 15 of gestation to 1.23 +/- 0.35 ng/mg on Day 16 and 0.59 +/- 0.12 ng/mg on Day 17. The folat pool size on Day 14 was found to be quite variable with a mean of 1.93 ng/mg wet wt. Comparable results were obtained when the folate pool sizes were expressed as nanograms of folate per milligram of protein. The effect of a folate-deficiency culture medium on in vitro fusion and folate pool sizes was examined. The results of incubating palatal shelves excised on Days 14, 15, 16, and 17 of gestation for 5, 4, 3, and 2 days, respectively, show that a folate-depleted medium neither prevented nor delayed fusion. An examination of the palatal pool size after incubation in folate-deficient media revealed that while there was some decrease in folate levels, the palates apparently retained sufficient folate to support cellular activity.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Development of the secondary palate in chick embryo: a light and electron microscopic and histochemical study.

Development of the secondary palate was studied in the chick embryo using light and electron microscopic and histochemical techniques. The palatal shelves develop as horizontal outgrowths of the maxilla on day 6 of incubation (HH stage 29). During the next 2 days (HH stages 30-33) the shelves continue their growth toward the midline, and on day 9 (HH stage 34) they approximate. At no time do the approximating shelves form direct contacts. Ultrastructural and histochemical observations indicate that the midline epithelia of the opposite shelves differentiate into a stratified squamous pattern. Unlike rodents and humans, the midline epithelial cells of the chick embryonic palate are not programmed to die. Other features of cellular differentiation such as the appearance of intracytoplasmic tonofilaments and glycogen, seen in species where palatal fusion occurs, were absent during palatogenesis in the chick. It is suggested that morphogenesis of the palate in chick embryos is different from that in the rodents, primates and humans. These differences are attributed to the pattern of subcellular differentiation in the palatal tissues.

Animals↗
PubMed1993

[The prevalence and risk factors of cleft lip and cleft palate in 2 hospitals in the city of Guadalajara, Jalisco, Mexico].

OBJECTIVE: The purpose of this article is to determine the prevalence of the cleft lip and palate and its association with some risking factors. MATERIAL AND METHODS: A retrospective, observational and analytic study, of 44 newborn infants with cleft lip and palate and their controls, in 33,461 consecutive births, with 20 weeks or more, and birth weight more than 500 g, since November of 1988 to June of 1991. The information were obtained from the database of the Congenital External Malformation Register, done by the University of Guadalajara, in four hospitals. The prevalence of the cleft lip and palate was calculated. Of the variables studied their association was searched with congenital malformation in 2 x 2 tables, calculating, its chi square, confidence interval, and old ratio. RESULTS: The prevalence of the cleft lip and palate was of 13.2 x 10,000 births. By categories: cleft lip 2.7 x 10,000, cleft lip and palate 7.8 x 10,000 and cleft palate 2.7 x 10,000. The only statistics differences with control group were the association with antecedent of other malformation in the family and methrorrague during pregnancy. CONCLUSIONS: The found prevalence is similar to the one informed in the literature, with some differences by categories. The association with antecedent of another malformation in the family, support the role of the hereditary role in the multifactorial etiology.

Chi-Square Distribution↗
PubMed1977

In vitro development of palatal tissues from embryonic mice. II. Tissue isolation and recombination studies.

The epithelial and mesenchymal tissues of the secondary palate from 12-, 13-, and 14-day embryonic mice were enzymatically separated and cultured in isolation and in homochronic and heterochronic recombinations. In both homochronic and heterochronic recombinations, epithelial differentiation was similar to that in vivo. In heterochronic recombinations, epithelium differentiated according to a schedule appropriate for the age of the epithelium rather than for the age of the mesenchyme, suggesting that differentiation of palatal epithelium is temporally 'determined' as early as 12 days of gestation. Palatal epithelium cultured in isolation was capable of limited differentiation. Potential for differentiation therefore exists within the isolated palatal epithelium at an early stage of palatal development, and epithelial-mesenchymal interactions are required during palatal development to support full epithelial differentiation.

Agar↗