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PubMed1998

Comparison of bioactive glass synthetic bone graft particles and open debridement in the treatment of human periodontal defects. A clinical study.

The purpose of this study was to compare the repair response of bioactive glass synthetic bone graft particles and open debridement in the treatment of human periodontal osseous defects. Fifty-nine defects in 16 healthy adults were selected. Each patient had at least 2 sites with attachment loss of at least 6 mm with clinical and radiographic evidence of intrabony or furcation defects. One to 3 months after cause-related therapy (oral hygiene instructions, scaling and root planing), the following measurements were recorded prior to surgery: probing depths, clinical attachment level, and gingival recession. Each defect was surgically exposed and measurements made of the alveolar crest height and base of osseous defect. The test defects were implanted with bioactive glass. The other sites served as unimplanted controls. Flaps were sutured at or close to the presurgical level. Radiographs and soft tissue presurgical measurements were repeated at 6, 9, and 12 months. At 12 months all sites were surgically re-entered to record osseous measurements. At the 12-month evaluation, significantly greater mean probing depth reduction was noted in the bioactive glass group compared to the controls (4.26 mm versus 3.44 mm; P = 0.028). Clinical attachment level gain was significantly improved (P = 0.0004) in the bioactive glass sites (2.96 mm) compared to the control sites (1.54 mm). There was significantly less gingival recession in the bioactive glass sites (1.29 mm) compared to the control sites (1.87 mm). Defect fill was significantly greater in the bioactive glass sites (3.28 mm) compared to the control sites (1.45 mm). Defect depth reduction was significantly greater in the bioactive glass sites (4.36 mm) compared to the control sites (3.15 mm). In conclusion, bioactive glass showed significant improvement in clinical parameters compared to open flap debridement.

Adult↗
PubMed2000

Guided tissue regeneration associated with bovine-derived anorganic bone in mandibular class II furcation defects. 6-month results at re-entry.

BACKGROUND: The use of graft materials with guided tissue regeneration (GTR) in Class II furcation defects is aimed at improving the outcome of the regenerative technique. In this regard, however, there are a limited number of studies discussing the results obtained when GTR and graft materials are used in the treatment of Class II furcation defects. Furthermore, most studies employ either allogeneic or autogenous materials. The present trial sought to determine whether the use of a bovine-derived anorganic bone (ABB) in conjunction with GTR influenced the outcome of mandibular Class II furcation treatment. METHODS: This study included 14 patients who provided 15 pairs of similar periodontal defects. Each defect was randomly assigned to treatment with either a cellulose membrane in combination with bovine-derived anorganic bone (GTR+ABB) or membrane alone (GTR). Following basic therapy, baseline measurements were recorded including probing depth (PD), clinical attachment level (CAL), and gingival margin position (GMP). Hard tissue measurements were performed during surgery to determine alveolar crestal height (CEJ-AC), and vertical (VDD) and horizontal defect depth (HDD). Membranes remained in position for at least 4 weeks. After 6 months, all sites were re-entered and soft and hard tissue measurements were recorded. RESULTS: Both surgical procedures resulted in statistically significant probing depth reduction and gain in clinical attachment levels, with no significant difference between groups. Gingival recession was more pronounced in the GTR+ABB group (0.87 +/- 0.83 mm), but not statistically different from the GTR group (0.46 +/- 1.19 mm). Vertical defect resolution was significant in both groups (GTR: 1.60 +/- 1.50 mm; GTR+ABB: 1.80 +/- 2.11 mm), without differences between groups. Only horizontal furcation resolution (GTR: 2.47 +/- 0.99 mm; GTR+ABB: 3.27 +/- 1.39 mm) was significantly different between groups (P <0.05). CONCLUSIONS: The use of ABB with GTR techniques improved horizontal defect resolution in mandibular Class II furcation defects, but did not yield superior results regarding soft tissue changes when compared to sites treated with GTR alone. Evaluation of a larger sample could indicate differences and advantages between the evaluated approaches and confirm the real necessity of associating filling materials with GTR.

Adult↗
PubMed2006

Five-year follow-up of regenerative periodontal therapy with enamel matrix derivative at sites with angular bone defects.

BACKGROUND: This prospective case series report aimed at analyzing the long-term (5 years) stability of clinical attachment level (CAL) gains following regenerative therapy with the use of enamel matrix proteins in intrabony defects. METHODS: A total of 114 consecutively treated periodontal patients (mean age: 55.8 years) were initially included. Each subject exhibited at least one deep proximal intrabony defect with the inclusion criteria of 1) probing depth (PD)>or=5 mm, 2) clinical attachment loss>or=6 mm, and 3) radiographic evidence of a >or=3-mm intrabony component. A total of 146 defects met the criteria for inclusion. At least 6 months after the completion of an initial phase of mechanical infection control, a baseline examination was performed to characterize the experimental site. Reconstructive therapy with the use of enamel matrix proteins was subsequently performed. Experimental sites were reexamined 1 and 5 years after reconstructive surgery. Primary efficacy variables were considered to be changes in PD, CAL, soft tissue recession (REC), and radiographic defect depth (RDD). Stepwise regression analysis was employed for evaluation of predicting factors of CAL change between the 1- and 5-year reexaminations. RESULTS: A total of 82 patients (102 defects) were included in the analysis. One year following the regenerative surgery, a mean CAL gain of 4.3 mm (P<0.001), a mean PD reduction of 4.9 mm (P<0.001), and a mean increase in REC of 0.6 mm (P<0.001) were recorded. At the 5-year follow-up, a further mean PD reduction of 0.3 mm (P>0.05), CAL gain of 1.1 mm (P<0.01), and reduction in recession of 0.8 mm (P<0.01) had taken place. Radiographs revealed that the bone defect had been reduced in depth with an average of 2.9 mm at 1 year (P<0.001). No statistically significant alteration in defect depth was observed between 1 and 5 years of follow-up. The stepwise regression analysis identified the degree of REC and residual PD at 1 year as significant predictors of CAL change between 1 and 5 years. CONCLUSION: Results demonstrated long-term (5 years) stability of CAL gains following regenerative therapy with the use of enamel matrix proteins in intrabony defects.

Adolescent↗
PubMed1997

Neural tube defects in embryos of diabetic mice: role of the Pax-3 gene and apoptosis.

Neural tube defects are among the most common of the malformations associated with diabetic embryopathy. To study the molecular mechanisms by which neural tube defects occur during diabetic pregnancy, we have developed a new experimental system using pregnant diabetic mice. In this system, the rate of neural tube defects is about three times higher in embryos of diabetic mice than in embryos of nondiabetic mice. Most of the defects affected presumptive midbrain and hindbrain structures and included open defects (i.e., exencephaly) and gross maldevelopment. By semiquantitative reverse transcription-polymerase chain reaction and in situ hybridization, we found that expression of Pax-3, a gene required for neural tube closure in the area of the midbrain and hindbrain, is significantly reduced in the embryos of diabetic mice. The same regions of the neural tube where Pax-3 had been underexpressed were found subsequently to contain high concentrations of cells undergoing apoptosis. Reduced expression of Pax-3 appears to be responsible for this apoptosis because apoptotic cells were also found at sites of neural tube defects in embryos carrying null mutation of the Pax-3 gene. Finally, mouse strains that carry null mutations in Pax-3 develop neural tube defects that resemble the malformations that occur in embryos of diabetic mice. These results suggest that Pax-3 is an important developmental control gene, expression of which is disturbed in embryos of diabetic mice, and that as a consequence, apoptosis of the neural tube occurs. This pathway may be responsible for many of the neural tube defects resulting from diabetic pregnancy.

Animals↗
PubMed1999

Family cluster of atrial septal defect.

Atrial septal defect is one of the most common congenital cardiac defects, occurring in 9% to 15% of live births. This defect has been reported to have a genetic etiology in some cases, although the full extent of genetic involvement in atrial septal defect is not known. Because symptoms are often lacking in childhood and manifest primarily in adulthood and because physical findings may be lacking, it is important to take a family history in patients in whom the defect is suspected. When evaluating children, a family history of atrial septal defect should raise suspicion of increased risk so that early diagnosis and treatment can be made. The author reports a cluster of 11 diagnosed atrial septal defects within one 32-member family group, 6 of whom required surgery to repair the defects. It is significant that most of the individuals were lacking in objective findings on physical examination, notably a murmur, as well as in subjective complaints. Diagnoses were made by use of two-dimensional echocardiography with color-enhanced Doppler ultrasonography in all but two cases--one diagnosed with transesophageal echocardiography and one, serendipitously, during cardiac catheterization. Echocardiography also revealed mitral valve prolapse, thin atrial septal wall, with aneurysm in some cases, and regurgitation of mitral or tricuspid valves in several individuals. Cardiac enlargement, usually of the right atrium, was seen in most of the individuals.

Adolescent↗
PubMed1999

Maternal risk factors and major associated defects in infants with Down syndrome.

More than 50% of infants with Down syndrome have associated defects that cause considerable morbidity and mortality. We evaluated the hypothesis that the trisomic genome interacts with environmental factors to increase the risk for specific associated defects. We evaluated risk factors present during early pregnancy in a multiracial population of 687 infants with Down syndrome. Mother's cigarette smoking was associated with the grouped cardiac defects [odds ratio (OR)=2.0; 95% confidence interval (CI) = 1.2-3.2]. When adjusted for other cardiac defects and maternal race, the following specific defects were associated with smoking: atrioventricular canal (OR = 2.3; 95% CI = 1.2-4.5), tetralogy of Fallot (OR = 4.6; 95% CI = 1.2-17.0), and atrial septal defects without ventricular septal defect (OR = 2.2; 95% CI = 1.1-4.3). Hirschsprung disease was associated with mother's daily consumption of more than three cups of coffee (OR = 6.02; 95% CI = 1.2-29.7) and with mother's fever (OR = 3.4; 95% CI = 0.7-16.4), but the number of cases was small. Use of alcohol was not associated with any defect. Mother's race, age, parity, income, or education did not confound the associations. Results suggest that environmental factors can modify the occurrence of associated anomalies in the embryo with Down syndrome.

Abnormalities, Multiple↗
PubMed2000

[Occurrence of cleft defects of the central nervous system in the Czech Republic 1961-1999. Incidence, prenatal diagnosis and prevalence based on maternal age].

OBJECTIVE OF STUDY: Presentation of the incidence of neural tube defects (anencephaly, spina bifida, encephalocele) in the Czech Republic in 1961 to 1999. Analysis of the prevalence of these defects in different groups by maternal age. TYPE OF STUDY: Retrospective demographic-epidemiological study. METHOD: Epidemiological analysis of the incidence of neural tube defects diagnosed prenatally and postnatally in the Czech Republic in 1961-1999. Mathematical and statistical analysis of these defects by maternal age, the method of 95% confidence probability interval was used. Data from the nationwide register of inborn defects were used assembled in the Institute of Health Information and Statistics of the Czech Republic and data on the prenatal diagnosis from different departments of medical genetics. RESULTS: In the Czech Republic in 1961-1999 4629 cases of neural tube defects were recorded. This number comprised 1812 cases of anencephaly, 2420 cases of spina bifida and 397 cases of encephalocele. Of this total number of notified defects 386 cases of anencephaly were diagnosed prenatally and pregnancy was terminated. In spina bifida thus 261 pregnancies were terminated prematurely, in encephalocele 67 cases. CONCLUSION: A significant reduction of the incidence of anencephaly, spina bifida and encephalocele in the Czech Republic was found during the last decade of the investigation period (1961-1999). This decline is most probably due to advances of primary and secondary prevention. When evaluating maternal age as one of the risk factors for the development of neural tube defects, this risk was neither unequivocally confirmed nor ruled out.

Abortion, Eugenic↗
PubMed2001

Spontaneous closure of ventricular septal defects in the first year of life.

BACKGROUND AND PURPOSE: The recent increase in the prevalence of ventricular septal defect (VSD) has been ascribed to the improved detection of small defects with echocardiography and the wider use of screening. The aim of this study was to determine the prevalence and timing of spontaneous closure of specific types of VSD in neonates using echocardiographic screening and follow-up. METHODS: Two-dimensional color Doppler echocardiography was performed in 3,472 clinically normal full-term neonates born at Cathay General Hospital to detect isolated VSD. The relative prevalence of muscular versus perimembranous defects and their outcome in the first year of life were evaluated. RESULTS: VSD was found in 74 neonates (34 male, 40 female), resulting in a prevalence of 21.3/1,000 live births. There were 48 muscular, 25 perimembranous, and one subpulmonic defects. Of the 74 patients, 11 were lost to follow-up. Within the observation period of 12 months, spontaneous closure occurred in 40 patients in the muscular group and in six patients in the perimembranous group. The overall rate of spontaneous closure was 73% by the end of the first year. Only five patients with perimembranous defects received digoxin therapy. CONCLUSIONS: The prevalence of VSD in this series of neonates was 21.3/1,000 live births. The most common location of VSD in the neonatal period was in the region of the muscular septum. Muscular defects were more likely to close spontaneously than perimembranous defects. Most muscular defects underwent spontaneous closure during the 12-month follow-up period.

Age Factors↗
PubMed2001

Sizing of atrial septal defects to predict successful closure with transcatheter cardioSEAL device.

We conducted this retrospective study to compare methods for measuring atrial septal defects and to identify factors affecting echocardiographic measurement of such defects before transcatheter closure with the CardioSEAL'Septal Occluder. We reviewed the records of patients considered for device placement at our institution from January 1997 to April 1999. Atrial septal defect size was measured by transthoracic and transesophageal echocardiography; the stretched diameter was measured during catheterization by fluoroscopy and transesophageal echocardiography. The stretched-diameter fluoroscopic measurement was used for device size selection. Analysis of variance was used to calculate the effect of size, age, and size-by-age interaction. Thirty-one patients (3.3 to 72 years of age) underwent transthoracic and transesophageal echocardiography One patient was excluded from catheterization because of a 25-mm septal defect as indicated by transesophageal echocardiography (our maximum diameter, 15 mm). Thirty patients underwent transcatheter stretched-diameter sizing; 5 were excluded from device implantation because of defects >20 mm by stretched-diameter fluoroscopy (4) or septal length insufficient for device support (1). Implantation was successful in 23/25 patients; 2/23 had a residual shunt. In patients with available results (26/30), the stretched diameter was the same whether measured by stretched-diameter fluoroscopy or transesophageal echocardiography (P=0.007 R square=0.963). Compared with stretched-diameter fluoroscopy, precatheterization transthoracic and transesophageal echocardiography underestimated defect size by a mean of 22% and 13.2%, respectively. When data from those same tests were compared in defects of < or =0 mm and > 10 mm, transthoracic and transesophageal echocardiography were reliable predictors (P=0.003 and P=0.05, respectively) of stretched-diameter size in defects < or =0 mm.

Adolescent↗
PubMedDate not supplied

Autologous right atrial patch for closure of atrial septal defect.

BACKGROUND: Prosthetic or pericardial patches used for the closure of atrial septal defects are associated with infrequent but definite problems. As an alternative, we used a right atrial free-wall patch in 12 patients, 7-54 years of age. METHODS AND RESULTS: The presence of a large secundum atrial septal defect (n=2). associated mitral valve regurgitation (n=7), primum atrial septal defect (n=2) and sinus venosus defect (n=1) necessitated the use of a patch. The mitral valve was repaired in 9 patients (including 2 with a primum defect). One patient with a primum defect who was in congestive heart failure preoperatively died after 3 weeks due to refractory ventricular fibrillation. The remaining patients were discharged 5 to 7 days post procedure. No flow was detected across the septal patch on predischarge echocardiography. One patient underwent reoperation for failed mitral valve repair one month postprocedure. At reoperation, the patch was found to be intact with normal texture and without any suture dehiscence. Histopathological examination of the explanted patch revealed viable endothellum and subendothelial muscle on both surfaces of the patch. Follow-up ranged from 6 to 36 months. Echocardiography performed after 6 to 32 months post procedure showed an intact patch with no residual defect. All the patients are in sinus rhythm. Holter monitoring performed in 6 patients was normal in all of them. Electrophysiological study was performed in 2 patients using a mapping catheter 4 and 6 months post-procedure, respectively, and recorded normal atrial potentials from the site of the patch. CONCLUSIONS: The use of an autologous free right atrial wall as a patch for atrial septal defect closure is a viable option.

Adult↗
PubMedDate not supplied

Long-term outcome of patients operated for large ventricular septal defects with increased pulmonary vascular resistance.

BACKGROUND: There is a paucity of data regarding the long-term outcome of patients operated for ventricular septal defect with severe pulmonary arterial hypertension and elevated pulmonary vascular resistance. METHODS AND RESULTS: We evaluated the long-term follow-up results of a selected cohort of patients with nonrestrictive ventricular septal defect and elevated pulmonary vascular resistance (>6 Wood units). Thirty-eight patients, median age 7.5 years (range 6 months-27 years), with nonrestrictive ventricular septal defect with severe pulmonary hypertension were operated between 1985 and 1996 at our institute. Preoperative pulmonary vascular resistance, ratio of pulmonary blood flow to systemic blood flow, and ratio of pulmonary vascular resistance to systemic vascular resistance were 7.63+/-1.8 Wood units, 1.9+/-0.48, and 0.41+/-0.12, respectively. The majority (68.4%) had perimembranous ventricular septal defect. Thirty patients (79%) had a good outcome and were asymptomatic at a mean follow-up of 8.7 years, with significant reduction in pulmonary artery pressures. Eight patients (21%) had a poor outcome, which included 5 immediate postoperative deaths, 1 late death and 2 surviving patients with persistent severe pulmonary arterial hypertension. There was no significant difference regarding hemodynamic parameters at baseline between those who had a good outcome and those who did not. Eleven patients with a preoperative pulmonary blood flow to systemic blood flow ratio of <2:1. who had a good outcome following surgery, underwent repeat catheterization at follow-up. There was a significant reduction in their mean pulmonary vascular resistance (8.03+/-1.4 v. 4.16+/-1.6 Wood units, p=0.001) and pulmonary vascular resistance to systemic vascular resistance ratio (0.41+/-0.12 v. 0.19+/-0.06, p=0.05). CONCLUSIONS: The late results of surgery on this selected group of patients with nonrestrictive ventricular septal defect with high pulmonary vascular resistance are encouraging. Operative correction of the ventricular septal defect should be actively considered in all children presenting with nonrestrictive ventricular septal defect with a significant left-to-right shunt, despite moderately elevated pulmonary vascular resistance. Even among older patients with ventricular septal defect and moderately elevated pulmonary vascular resistance, there is a specific group that does well after operation.

Adolescent↗
PubMed1992

Genotype-phenotype relationships in human red/green color-vision defects: molecular and psychophysical studies.

The relationship between the molecular structure of the X-linked red and green visual pigment genes and color-vision phenotype as ascertained by anomaloscopy was studied in 64 color-defective males. The great majority of red-green defects were associated with either the deletion of the green-pigment gene or the formation of 5' red-green hybrid genes or 5' green-red hybrid genes. A rapid PCR-based method allowed detection of hybrid genes, including those undetectable by Southern blot analysis, as well as more precise localization of the fusion points in hybrid genes. Protan color-vision defects appeared always associated with 5' red-green hybrid genes. Carriers of single red-green hybrid genes with fusion in introns 1-4 were protanopes. However, carriers of hybrid genes with red-green fusions in introns 2, 3, or 4 in the presence of additional normal green genes manifested as either protanopes or protanomalous trichromats, with the majority being protanomalous. Deutan defects were associated with green-pigment gene deletions, with 5' green-red hybrid genes, or, rarely, with 5' green-red-green hybrid genes. Complete green-pigment gene deletions or green-red fusions in intron 1 were usually associated with deuteranopia, although we unexpectedly found three carriers of a single red-pigment gene without any green-pigment genes to be deuteranomalous trichromats. All but one of the other deuteranomalous subjects had green-red hybrid genes with intron 1, 2, 3, or 4 fusions, as well as several normal green-pigment genes. The one exception had a grossly normal gene array, presumably with a more subtle mutation. Amino acid differences in exon 5 largely determine whether a hybrid gene will be more redlike or more greenlike in phenotype. Various discrepancies as to severity (dichromacy or trichromacy) remain unexplained but may arise because of variability of expression, postreceptoral variation, or both. When phenotypic color-vision defects exist, the kind of defect (protan or deutan) can be predicted by molecular analysis. Red-green hybrid genes are probably always associated with protan color-vision defects, while the presence of green-red hybrid genes may not always manifest phenotypically with color-vision defects. Four subjects who were found to have 5' green-red hybrid genes in addition to normal red- and green-pigment genes had normal color vision as determined by anomaloscopy. These were discovered among a group of 129 Caucasian males who had been recruited as volunteers for a vision study.(ABSTRACT TRUNCATED AT 400 WORDS)

Base Sequence↗
PubMed2004

Transcatheter closure of secundum atrial septal defects with complex anatomy.

The aim of this study was to evaluate the feasibility, safety and efficacy of transcatheter closure of secundum atrial septal defects (ASD) in patients with complex anatomy. From September 1997 to July 2003, a total of 40 patients (median age, 34 years; 65% female) with complex ASDs, defined as the presence of a large defect (stretched diameter >26 mm) associated with a deficient rim (n=23); multiple defects (n=8); a multi-fenestrated septum (n=5); and defects associated with an aneurysmal septum irrespective of their size (n=4) underwent closure. The Helex device was used in 4 patients and the Amplatzer in the remaining. Two devices were implanted in 2 patients each. Implantation was unsuccessful in 5 patients, with 4 having large defects associated with a deficient anterior rim and a floppy posterior septum. Occlusion was observed in 22 of 35 patients (63%) immediately after implantation and in 31 (89%) at a mean follow-up of 18+/-9 months. No major complications occurred. Right ventricular end-diastolic dimensions (indexed for body surface area) decreased from 135+/-25% before closure to 124+/-15% 24 hours after closure, and to 92+/-12% after 12 months. Two patients with 2 distant defects and 2 patients with large defects remained with shunts (<4 mm) at the latest visit. Transcatheter closure of complex secundum ASDs was feasible, safe and effective; however, large defects associated with a deficient anterior rim and a floppy posterior septum may not be suitable for this approach.

Adult↗
PubMed2005

Congenital heart defects and chromosomal anomalies including 22q11 microdeletion (CATCH 22).

OBJECTIVE: To analyze the frequency of chromosomal anomalies or 22q11 microdeletion in patients with congenital heart defects and other congenital anomalies; to describe the clinical phenotype of children with the 22q11 microdeletion and with chromosomal anomalies; to evaluate patients' clinical evolution; and to provide genetic counseling for families. METHODS: The study included 46 patients with congenital heart defects and other anomalies and patients with a phenotype consistent with 22q11 microdeletion observed between 1999 and 2001. Confirmation of the heart defect was accomplished through echocardiography, magnetic resonance angiography or cardiac catheterization. Karyotyping with high resolution banding and detection of 22q11 microdeletion with FISH techniques were performed. We excluded patients with trisomy 21, 13 and 18, 45,X and deletion of 7q11.23. Patients with 22q11 microdeletion underwent immunology studies and evaluation of parathyroid function. Clinical evolution was evaluated. Chromosome and FISH studies were performed on parents of affected children (25 couples). RESULTS: Forty-six children were included, of whom twelve (26.1%) had chromosomal anomalies (group A), fourteen (30.4%) had 22q11 microdeletion (group B) and the remaining twenty (43.5%) had normal karyotype and negative FISH studies (group C). In group A septal heart defects predominated. This group had significant morbidity, with surgical correction in three patients, early development of pulmonary hypertension, failure to thrive and serious neurological problems. Two patients died. In group B conotruncal heart defects (7/14) and ventricular septal defects (5/14, two associated with cervical aortic arch) predominated. The most significant morbidity was related to cardiac pathology, with surgical correction in seven cases (50%). Immune function defects and parathyroid function problems were mild, requiring no therapeutic measures. One patient died. CONCLUSION: In the presence of heart defects associated with other congenital anomalies, karyotyping is mandatory and if clinical features are compatible, 22q11 microdeletion should be specifically sought with FISH techniques. Detection of chromosomal anomalies has a significant impact on prognosis and follow-up of patients, as well as on genetic counseling of families.

Child, Preschool↗
PubMed2005

[Prevalence of major external birth defects in high and low risk areas in China, 2003].

OBJECTIVE: To study the prevalence rates of birth defects in high and low risk areas in China. METHODS: A population-based surveillance system on birth defects was used to obtain the prevalence rates of 24 kinds of major external birth defects from > or = 20 weeks of gestation to 7 days of life in selected areas in Shanxi and Jiangsu provinces. RESULTS: The birth prevalence of birth defects (232.4 per 10,000 births) and neural tube defects (NTDs) (138.7 per 10,000 births) in four counties of Shanxi province were significantly higher than that in Taiyuan city (75.3 and 28.2 per 10,000 births, respectively). There was no significant difference for all selected birth defects between Wuxi city and Xishan counties in low risk areas. There was a 6.1-fold of higher prevalence for NTDs in Taiyuan city compared with that in Wuxi areas (4.6 per 10,000 births). In four counties of Shanxi province, the prevalence rates of anencephaly, spina bifida, hydrocephaly, cleft palate alone and polydactyly were significantly higher than in Wuxi areas. The NTDs prevalence rate in four counties of Shanxi was 30.2 times higher than in Wuxi areas. When compared with previous surveillance data, the NTDs prevalence rate did not present obvious declining trend in high risk areas. The birth prevalence rate had a 31.8% decrease when births were calculated after 28 gestational weeks and compared with those from 20 gestational weeks. CONCLUSION: NTDs remained to be the most common birth defect seen in Shanxi province. The birth prevalence rate of NTDs in some areas of Shanxi province was among the highest that ever reported in the world in comparison with data from other countries and regions. The current prevalence rate in high risk areas in Shanxi province did not clearly show a declining trend. Programs on surveillance and prenatal diagnosis were proved to have made big impact on the rates of major external birth defects.

China↗
PubMed2006

A clinical evaluation of anorganic bovine bone graft plus 10% collagen with or without a barrier in the treatment of class II furcation defects.

UNLABELLED: The use of bone replacement grafts with barrier membranes in class II furcation defects are aimed at improving the outcome of the regenerative technique. In this regard, however, there is a paucity of studies comparing the results obtained with bone grafts alone or in combination with barrier membranes. The aim of this study was to clinically compare an anorganic bovine bone graft plus 10% collagen (BO) with or without a bioresorbable collagen barrier (BG) in human mandibular molar class II furcation defects. METHODS AND MATERIALS: Twenty mandibular class II furcation defects (ten patients with bilateral defects) were treated either with BO (group I) or a combination of BO/BG (group II). Each defect was randomly assigned to either group I or group II. The soft tissue and hard tissue measurements including vertical probing depth (VPD), horizontal probing depth (HPD), clinical attachment level (CAL), gingival recession (GR), vertical depth of furcation defect (VDF), and horizontal depth of furcation defect (HDF) were recorded at baseline and six months after surgery. RESULTS: Both treatment procedures resulted in statistically significant reduction in VPD and HPD, gain in CAL, and reduction in VDF and HDF. There was a statistically significant difference between group I and group II in all soft and hard tissue parameters with the exception of VPD reduction and gingival recession. CONCLUSION: The findings of this study suggest superior clinical results with BO/BG treatment when compared to BO treatment in mandibular class II furcation defects.

Absorbable Implants↗
PubMed1992

Late results after repair of aortic insufficiency associated with ventricular septal defect.

The late results of 70 patients aged 1.96 to 35.9 (mean 10.1) years who had repair of ventricular septal defect and aortic insufficiency from 1968 to 1988 were reviewed. The ventricular septal defect was subcristal in 50 and subpulmonary in 20 patients. Two thirds were situated immediately below some part of the right coronary leaflet with prolapse of that leaflet. Most of the remainder were below the right commissure or the anterior part of the noncoronary leaflet with prolapse of one or both adjacent leaflets. Associated structural defects, usually including some fusion at a commissure, were present in 18 of the 70 patients and occurred more often with a ventricular septal defect in or below the commissure between the right and noncoronary leaflets (p less than 0.001). Follow-up ranged from 1.9 to 19.6 (mean 9.8) years. There were no early deaths or cases of atrioventricular block, but there were two late deaths. Patient survival rate was 96% at 10 years. Freedom from valvuloplasty failure and freedom from reoperation were 76% and 85%, respectively, at 10 years. The major predictor for failure by multivariate analysis was the presence of an associated structural defect (p less than 0.01). Age at repair and position of the ventricular septal defect were not significant risk factors. We conclude that aortic valvuloplasty produces good palliation in most children. The few failures occurred early and chiefly in patients with associated structural valve defects that occurred more frequently in children who had a ventricular septal defect in the right commissure, where both the right and noncoronary leaflets may be affected.

Adolescent↗
PubMed1991

Defective provirus form of human T-cell leukemia virus type I in adult T-cell leukemia/lymphoma: clinicopathological features.

Human T-cell leukemia virus type I (HTLV-I) is associated with adult T-cell leukemia/lymphoma (ATLL). To examine the relationship between defective HTLV-I proviruses and clinicopathological features, we examined 95 patients with ATLL showing clonal integration of HTLV-I proviral DNA; 77 patients (81%) showed 1 clonal band, 15 (16%) showed 2 clonal bands, and 3 (3%) showed 3 clonal bands. In addition, the defective proviral form was detected in 28 patients (29%): 23 (30%) of the 77 with 1 clonal band, 4(27%) of the 15 with 2 clonal bands, and 1(33%) of the 3 with 3 clonal bands. The numbers of clonal bands had no association with the presence of defective proviruses. We classified the 95 patients with ATLL into four types according to clinicopathological features (smoldering leukemia, chronic leukemia, acute leukemia, and lymphoma types). The distribution of patients with the defective form was not different among these four types. The HTLV-I genomes must have integrated into the human genome DNA and been deleted partially in the cells. The defective form was kept during the clinical stage. All patients with the defective form showed defect of the gag or/and env region. No patient had a defect of the pX region. These data suggest that the pX region of HTLV-I must have played an important role in ATLL genesis.

Amino Acid Sequence↗