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At least 1,765 records · Page 98Linked to original sources
PubMed1993

Different immobilization procedures during irradiation influence the estimation of alpha/beta ratios in mouse lip mucosa.

In previous experiments an anaesthetic gas mixture of enflurane (Ethrane, Abbott, Belgium) and oxygen has been used in our department to position mice for local irradiation. The development of a new immobilization method allowed the investigation of possible dose modifying effects of enflurane with different gases as carrier on the radiation response of mouse lip mucosa. The effect of different immobilization procedures on single dose and fractionated irradiations was examined. The experiments were compared on the basis of the dose associated with 50% incidence of lower lip desquamation (ED50 +/- 95% CI). When mice were breathing air the ED50 value following single dose irradiation was 20.0 (19.6 to 20.5) Gy. For mice receiving an anaesthetic gas mixture of enflurane and oxygen the ED50 was decreased significantly to 17.5 (17.2 to 17.8) Gy, indicating a sensitizing effect of the anaesthetic mixture by a factor of 1.14. The impact of different experimental set-ups on the fractionation sensitivity has been assessed. In order to estimate alpha/beta ratios in different treatment conditions two and ten fraction experiments were performed, additionally to the single dose irradiations. Dose modification factors were 1.09 for two fractions and 0.97 for the ten fraction experiment. This varying dose modification leads to a pronounced shift in alpha/beta ratios (estimated by "direct analysis" and graphically illustrated with a Fe-plot). For air breathing animals an alpha/beta ratio of 16.4 (14.5 to 18.9) Gy was estimated by direct analysis, whereas for the enflurane/oxygen anaesthesia 8.7 (7.3 to 10.2) Gy were calculated. Both these data sets were adequately described with the linear-quadratic formalism, as was shown with Tucker's analysis. The sensitizing effect of oxygen alone in single dose irradiations (DMF: 1.07) suggests moderate physiological hypoxia in mouse lip mucosa. The present data emphasize the effect of different immobilization procedures on the estimation of alpha/beta ratios, especially when large fraction sizes are involved. Data from experiments involving large fraction sizes should be avoided in the estimation of repair parameters. Further experimental work has to be carried out to elucidate the possible dose modifying effects of anaesthetic agents in clinical practice, e.g. for infants and for patients undergoing intraoperative radiotherapy.

Anesthesia, Inhalation↗
PubMed1993

Assessment of the patient with cleft lip and palate. A developmental approach.

Children with cleft lip and palate require interdisciplinary team care from infancy through adolescence. An understanding of developmental stages allows the cleft palate team to adapt and integrate its services into the rapidly changing life of the child. This article discusses the maturational, developmental stages of childhood and the services the child with cleft lip and palate and the child's family deserve through each stage. Health care providers in all settings may continue to provide appropriate care for all patients with cleft lip and palate, despite the challenges of a changing health care environment, by emphasizing the needs of the child in all developmental stages.

Adolescent↗
PubMed1993

Rotation-advancement repair of the unilateral cleft lip. One center's perspective.

Most surgeons agree that the Millard rotation-advancement is the procedure of choice for treatment of the incomplete cleft lip and milder complete cleft forms. It has been found to be an effective procedure for essentially all cleft cases, regardless of width, when the staged approach described is employed. To reach the goal of establishing near-perfect anatomy and function, a protocol, which capitalizes on the strengths of Millard's repair while minimizing its weaknesses, has been adopted. Three aspects of the protocol are emphasized in this article: (1) presurgical manipulation of the maxillary alveolar segments via passive molding appliances; (2) a staged approach to lip repair for wide complete clefts, which includes preliminary lip adhesion; and (3) adherence to a standardized technique, which will allow for a long-term clinical study.

Adolescent↗
PubMed1993

Lip fibromas associated with retrovirus-like particles in angel fish.

Fibromas were observed on the lips of adult female and juvenile angel fish (Pterophyllum scalare) from 3 Florida farm populations. Tumor prevalence in each population was < 1%. Affected fish were clinically normal except for those with large tumors, which had weight loss caused by physical obstruction of food intake. Fibromas originated as elevated masses from the mucocutaneous junction near the midline of the upper and/or lower lips. Characteristic features included dense fibrous stroma covered by thickened, stratified squamous epithelium, numerous intraneoplastic teeth, and scattered foci of stromal inflammation. Electron microscopy revealed intracytoplasmic type-A retrovirus-like particles in stromal cells from all tumors. Attempts to transmit fibromas, using a cell-free tumor ultrafiltrate, were unsuccessful. The relationship of the intraneoplastic viral particles to the development of lip fibromas in angel fish is uncertain.

Animals↗
PubMed1996

[Prenatal ultrasonic diagnosis of cleft lips and palates].

The purpose of this communication is to demonstrate the possibility of prenatal diagnosis of cleft lips and palates by routine ultrasound screening. As obstetrical ultrasound improves, anomalies of the fetal face can be diagnosed more and more frequently in utero. From 1991 to 1994 9 cases with cleft face syndrome were detected prenatally. In 8 cases the presence of cleft lip and palate was isolated. In one case the cleft lip and palate was associated with phocomelia. In cases with cleft palate the widening of nasal cavity was observed. In cases with bilateral cleft palate polyhydramnions were observed twice and undulating movements of the tongue were also seen.

Adult↗
PubMed1996

Facial development in unilateral cleft lip and palate prior to the eruption of permanent incisors after primary bone grafting and periosteal flap surgery.

Roentgencephalometric studies were carried out at the age of five years in 27 boys with unilateral cleft lip and palate after primary bone grafting, as well as in 25 boys with the same type of cleft after primary periosteoplasty and in 27 normal boys who served as a group of controls. Both series with clefts differed from the group of controls by a reduced upper face height, maxillary dentoalveolar retroinclination, posterior position of the maxilla and by the shortening of mandibular body and ramus. There was a slight reduction of maxillary depth only in the series with bone grafts. The other skeletal deviations were secondary. The soft profile showed in both series with clefts a reduction of the upper lip height and of the nasal prominence. In patients with bone grafts was recorded in addition a reduced prominence of the upper lip. A comparison of both series with clefts disclosed that primary bone grafting reduced the vertical growth of the upper face and increased the dentoalveolar retroinclination of the maxilla resulting in a larger impairment of overjet and in a more marked retrocheilia. A better prominence of the nose in the series with periosteal flap surgery was produced by the primary reposition of the nasal septum, which was not performed during osteoplasty.

Bone Transplantation↗
PubMedDate not supplied

Postpubertal growth and development of the face in unilateral cleft lip and palate as compared to the pubertal period: a longitudinal study.

X-ray cephalometry was used for the assessment of 22 boys and 23 girls with complete unilateral cleft lip and palate who were treated with the same surgical method. They were examined at the age of 10 years and in adulthood. In the group of 13 boys and 15 girls, examined also at the age of 15 years, were analysed intersexual differences of facial growth and development during the postpubertal period and the results were compared with those obtained during the pubertal period. The data showed that in boys facial growth persists after the age of 15 years and in the region of the upper face attains about half the values recorded in the period of puberty, while mandibular growth attains almost the same values as during puberty. In girls the growth is almost terminated but for the lower jaw, where it is still significant though several times slighter than during puberty. In both sexes there is only a minimum growth of maxillary depth and of upper lip height during the postpubertal period, as well as during the pubertal period. The highest growth rate shows the depth of the nose. Because of the intersexual differences in the amount of postpubertal growth, developmental changes in facial configuration do not occur in girls during this period, while in boys a further deterioration of maxillary protrusion, of sagittal jaw relations, and of the upper lip prominence continues, as well as an increase of the flattening of the face. In contrast to the pubertal period in both sexes, a proclination of upper incisors and an improvement of overjet was not attained. Contrary to the pubertal period, in the postpubertal period, intersexual differences in the amount of growth and of the developmental changes in the shape and position of facial characteristics were recorded. Therefore during studies of the growth and development of the face, it is not possible to pool both sexes without some reservations. This holds true in particular in the postpubertal period.

Adolescent↗
PubMed1997

Maxilla dimension in patients with unilateral and bilateral cleft lip and palate. Changes from birth until palate surgery at age three.

This study traces the changes in maxillary dimension in 44 unilateral cleft lip and palate (UCLP) patients and 28 bilateral cleft lip and palate (BCLP) patients from birth up to the time of palate surgery at age 3. Measurements on dental casts were carried out at 4 defined registration stages. The results revealed a continuous reduction in cleft dimension parallel to an increase in the transversal and sagittal maxillary dimensions. The inclination of the palatal slope displayed such a high degree of variability that no statement regarding the development in this variable could be made. Differences between the 2 types of cleft patients were found only in the maxillary sagittal dimension. Wearing an orthopedic plate after surgery appears to prevent transversal collapse in the anterior region and to counteract external transversal and sagittal forces. Only temporary inhibition of growth in the sagittal dimension of the maxilla was observed after lip surgery.

Aging↗
PubMed1977

[Anatomy of the upper and lower lips between the 4th intrauterine month and labor].

Report on the histological development of the lips between the 4th and 10th month of intrauterine life with a survey of the literature. It is proposed to classify the different segments of the lip into 5 zones: Pars cutanea--Pars glabra--Pars intermedia--Pars villosa--Pars mucosa. Special interest is given to the arising of the papillae which are first to be seen around the 4th month. From the 8th month forward, they become villi which rise above the surface of the epithelium. Due to proliferation of the epithelium there is found between the 4th and 7th month a torus at the end of the Pars Villosa which ought to be named "Torus labialis internus". Beside this a so called "Torus labialis externus" is described stipulating the typical doublelip of the newborn infant. The function of the villi is discussed in connection with the bloodvessels. Because of their number and location there is likely to be a swelling-function of the lips. Finally a case is presented dealing with a sebaceous gland in the Pars mucosa.

Epithelium↗
PubMed1997

[A retrospective assessment of spinocellular carcinomas of the lip treated by roentgenotherapy].

From December 1965 to December 1987 (22 years), 279 patients with histologically confirmed squamous cell carcinoma of the lip were treated in this Department with roentgenotherapy. All the patients that had completed the treatment were evaluated with a follow-up time of 5 years (n=255). Distribution by age, sex, occupation, residence, evolution time of the lesion, localization (upper lip, lower lip and commissure), tumoral size and histological grade were analysed. Concerning technical conditions and fractionation, we evaluated the type and which dose of radiation elicit acute reactions as well as the results of radiotherapy (local and cosmetic control). A relation is made between the size of the lesion and outcome after treatment. The survival rate at 3 years was 76,6% and at 5 years (the usual follow-up period for these patients) was 66%. Disease-free survival rate at 3 years was 79% and at 5 years was 77,6%.

Adult↗
PubMed1997

[A retrospective assessment of spinocellular carcinomas of the lip treated by roentgenotherapy].

From December 1965 to December 1987 (22 years), 279 patients with histologically confirmed squamous cell carcinoma of the lip were treated in this Department with roentgenotherapy. All the patients that had completed the treatment were evaluated with a follow-up time of 5 years (n = 255). Distribution by age, sex, occupation, residence, evolution time of the lesion, localization (upper lip, lower lip and commissure), tumor size and histological grade were analysed. In what concerns technical conditions and fractionation, we evaluated the type of acute reactions and the dose of radiation which elicited them as well as the results of radiotherapy (local and cosmetic control). A relation is made between the size of the lesion and outcome after treatment. The survival rate at 3 years was 76.6% and at 5 years (the usual follow-up period for these patients) 66%. Disease-free survival rate at 3 years was 79% and at 5 years 77.6%.

Adult↗
PubMedDate not supplied

Association between non-right-handedness and cleft lip with or without cleft palate in a Chinese population.

The etiology of non-syndromic cleft lip with or without cleft palate (CL +/- P) is unclear, although both familial and environmental factors are implicated. Because CL +/- P occurs at approximately the time of brain lateralization and is most often unilateral, developmental asymmetry effects have been postulated in CL +/- P etiology. Handedness is frequently used as an indicator of brain lateralization; therefore, several studies have examined the relationship between cleft laterality and handedness. However, these studies have had conflicting results. The present study investigated handedness in a Chinese sample of 211 non-syndromic CL +/- P surgical probands (ascertained in Shanghai for family studies of CL +/- P), 221 population-based but unmatched controls, and 272 first-degree relatives of the probands. Handedness was assessed by means of laterality quotients (LQ) calculated from questionnaire data. Mean LQ's were compared, as were various arbitrary definitions of handedness based on the LQ, for cases versus controls, males versus females, right-sided versus left-sided clefts, and cleft lip alone versus cleft lip plus cleft palate. CL +/- P cases had a significantly higher proportion of non-right-handedness (NRH) than controls, regardless of the definition of NRH (P values < or = .001). There were no statistically significant differences for any of the other comparisons. Familiarity of NRH was tested by comparing first-degree relatives of cases to controls; first-degree relatives were found to have a significantly higher proportion of NRH than controls, supporting familial effects in NRH. These results support the concept of a common etiology and/or developmental pathway for CL +/- P and handedness.

Case-Control Studies↗
PubMed1998

[Improved treatment of cleft lip and palate is now available].

When cleft lip and palate treatment was introduced at Gothenburg in 1957, the procedure used was early bone grafting (EBG). By 1965, EBG had been omitted from the regimen, bone grafting being postponed until the appearance of mixed dentition. Analysis of the results of both techniques showed maxillary retrusion of different degrees. Accordingly, this routine was abandoned in 1975, being replaced by a procedure which is characterised by delayed closure of the hard palate (DCHP). Thus, the surgical procedure comprised the following steps: 1, lip closure at 1-2 months of age; 2, soft palate repair at 6-8 months; 3, final lip-nose surgery at 12 months; and 4, closure of the left in the hard palate, and bone grafting to the alveolar process during mixed dentition at about 8-10 years of age. Follow-up has shown the majority of patients to manifest acceptable speech development during childhood, though problems may occur in some cases. Maxillary growth has been found to be improved after DCHP, and at present the need of maxillary advancement surgery has been reduced to approximately 5% of cases, as compared with the former rates of 50% of cases among those treated with EBG, and of 25% among those treated with the vomer flap procedure.

Adolescent↗
PubMed1998

[Physical factors in the combined rehabilitation of children with a congenital cleft of the upper lip].

A total of 551 children with cleft lips and 136 children with secondary deformations of the upper lip and nose were followed up after cheiloplasty. Electrostimulation of the upper lip, total UV exposure, humisol and pelloidine electrophoresis, and total massage before cheiloplasty decreased the incidence of general and local postoperative complications. Reconstructive cheiloplasty was preceded by lidase or iodine ultraphonophoresis or electrostimulation of the perioral muscles. After surgery a course of magnetic and laser exposure or heparin ultraphonophoresis and local troxevasin were prescribed. This improved both the cosmetic and functional result of the operation.

Adolescent↗
PubMed1998

[Cleft lip and palate--prenatal diagnosis and counseling].

The most frequent congenital developmental defect in the orofacial region are, no doubt, facial clefts which are a serious stress for health professionals and the population. Depending on the type of cleft, the prevalence is between 1 : 1000-2800 births. According to contemporary views in the etiology of orofacial clefts participate genetic as well as environmental factors. That means that specific genetic factors create a certain "sensitivity" for specific factors of the external environment which act as a trigger mechanism and combined they produce the cleft. Cleft lip can be diagnosed already during the 13th week of gestation, while a cleft palate is not necessarily apparent till after the 18th week of gestation as the maxilla is in the process of joining. Presentation of the foetal face and its profile is thus important in particular during the second trimester of gestation and should be part of ultrasonographic screening between the 18th and 20th week of gestation. As more than 8% of facial clefts are associated with chromosomal abnormalities, in all affected foetuses karyotyping is done. The prognosis of satisfactory cosmetic and functional repair in cleft lip and in cleft lip and palate is favourable. In case of associated malformations all depends on the type and severity of these associated defects or on the diagnosis of the syndrome. If median clefts are extensive or associated with cerebral anomalies, the prognosis is as a rule poor. Prenatal diagnosis and management of defects of the orofacial area calls for collaboration of the obstetrician, neonatologist and plastic surgeon already in the stage when the defect is detected to give the expectant mother an opportunity to obtain accurate and unbiased information on possible treatment and prognosis for the foetus.

Cleft Lip↗
PubMed1976

Histology and cytochemistry of human skin. XXXVI. The nose and lips.

The skin of the nose is characterized by often conspicuously dilated openings of the ducts of many subaceous follicles. Histological sections are dominated by gigantic sebaceous follicles, but there are also numerous vellus hairs with small sebaceous glands. All hair follicles on the surface of the nose and in the vestibule are completely invested with nerve end organs. In the vestibule, the glabrous upper surface has intraepidermal nerves and a few mucocutaneous end organs. the vermillion zone of the lip, which seperates the skin of the external lip and the mucosa of the inner lip, is keratinizing glabrous epithelium, often with numerous sebaceous glands in the upperlip. The transitional area between the keratinizing epithelium of the vermillion and the nonkeratinizing epithelium of the labial mucosa is abundantly supplied with mucocutaneous end organs, with only a few in the labial mucosa. The mucoserous glands of the labial mucosa are richly innervated.

Adult↗
PubMed2002

Diagnosis and treatment of vascular lesions of the lip.

Many vascular lesions involve the lip. We present the clinical and imaging findings of vascular lesions, including haemangiomas and vascular malformations. We review the changing role of surgery and other treatments in the management of each type of lesion. Haemangiomas are treated surgically only when lip function is substantially impaired. Superselective embolisation is the treatment of choice for arteriovenous malformations, whereas capillary-venous malformations are best treated by operation together with intralesional injection of fibrosing agents. Capillary malformations are usually treated with laser.

Adolescent↗
PubMed1985

Ulceration of the lip associated with a 'calibre-persistent artery'.

A case of ulceration of the lower lip, associated with a 'calibre-persistent artery', is presented. The lesion was diagnosed clinically as squamous cell carcinoma and excised accordingly. 'Calibre-persistent artery' is not a widely known entity, has not been described previously in the dermatological literature and should be sought in any lip ulcer of obscure aetiology.

Aged↗