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Distraction osteogenesis has been advocated for treatment of the mandibular deformity in patients with hemifacial microsomia (HFM). During the active phase, the force of distraction pushes the distal segment of the mandible down, creating a distraction gap. Because of the abnormal temporomandibular joint anatomy in HFM patients, the proximal segment may not seat in the glenoid fossa and thus may be displaced with distraction. The purpose of this study was to determine the vector(s) of proximal segment movement during mandibular distraction using a semiburied device. Two investigators traced the immediate pre-and postdistraction panoramic radiographs of 12 HFM patients (mean age at operation = 8.4 years, mean distraction = 28 mm) who had mandibular distraction with a semiburied device. Radiographic analysis, based on a vertical maxillary reference line, measured change in condylar position with angular and linear measurements. Inter-rater reliability for the tracing and analysis was shown with a correlation coefficient between 0.89 and 0.99 for all measures. Based on the angular and linear measurements, 10 of the 12 patients had superior movement of the proximal segment with distraction. Sagittal movement of the proximal segment could not be judged adequately. This study was based on measurements made on panoramic radiographs. Direct measurements could not be made; thus, it was not possible to estimate proximal segment movement in millimeters or as a percentage of total movement. Further studies to document proximal segment movement using computed tomography scans may provide more quantitative data. PMID:12000889
Padwa, Bonnie L; Zaragoza, Sandra M; Sonis, Andrew L
In this article, we report successful orthodontic treatment combined with segmentaldistraction osteogenesis after a modified LeFort II osteotomy in a patient with craniosynostosis. An 8-year-old boy diagnosed with craniosynostosis had a dished-in face, an anterior crossbite, and a skeletal Class III jaw relationship because of midfacial hypoplasia. At the age of 13 years 6 months, the maxillary second and mandibular first premolars were extracted, and leveling and alignment of both arches was started with preadjusted edgewise appliances. At age 14 years 11 months, the patient had a modified LeFort II osteotomy, and the maxillarysegment was advanced 7 mm and fixed to the zygomatic bone. At the same time, segmentaldistraction osteogenesis was started with a rigid external distraction system, and the nasal segment was advanced for 20 days at a rate of 1.0 mm per day. The total active treatment period was 40 months. As a result of the modified segmentaldistraction osteogenesis, significant improvement of his severe midfacial hypoplasia was achieved without excessive advancement of the maxillary dentition. Both the facial profile and the occlusion were stable after 1 year of retention. However, the nasal segment relapsed 1.4 mm during the 1.5 years after the segmentaldistraction osteogenesis. Evaluation of the stability and retention suggests that some overcorrection in midfacial advancement is recommended. PMID:23116511
Severe obstructive sleep apnea syndrome (OSAS) threatens patients' lives. To solve ventilation problem, snoring, and avoid another orthognathic surgery for mandibular advancement, bone-anchored rapid maxillary expansion and bilateral interoral mandibular distraction osteogenesis were tried on a 20-year-old Chinese male patient with severe skeletal class II malocclusion and OSAS.The patient had polysomnography (apnea-hypopnea index 54.2), body mass index measurement (19.7 kg/m), and cephalometry before the treatment. Bone-anchored rapid maxillary expansion was performed for the correction of maxillary transverse and minor sagittal deficiency and the improvement of nasal airflow by decreasing nasal resistance. Bilateral interoral mandibular distraction osteogenesis was operated to lengthen the small, retruded mandible by 15 mm. Orthodontic treatment after the maxillary expansion and mandibular distraction osteogenesis can help obtain stable occlusion.The Epworth Sleepiness Scale, a questionnaire for temporomandibular joint, cephalometric analysis, polysomnography, acoustic rhinometry, and multislice spiral computed tomography were performed to evaluate changes from the treatment. All the results showed that the patient had a significantly alleviated OSAS. In addition, an acceptable occlusion was also obtained. PMID:23714918
Maxillary and mandibular bone defects can result from injury, congenital defect, or accident, or as a consequence of surgical procedures when treating pathology or defects affecting jaw bones. The glandular odontogenic cyst is an infrequent type of odontogenic cyst that can leave a bony defect after being treated by aggressive surgical means. First described in 1987 by Padayachee and Van Wyk, it is a potentially aggressive entity, having a predisposition to recur when treated conservatively, with only 111 cases having been reported hitherto. Most reports emphasize its clinical, radiographic, and histologic features, including a few considerations on rehabilitation for these patients. The aim of this article is to present the case of a 24-year-old male patient who, in 2001, was diagnosed with a glandular odontogenic cyst and to focus on the surgical approach and rehabilitation scheme. We performed an anterior partial maxillectomy. The osseous defect was treated using bone transport distraction. Dental and occlusal rehabilitation was achieved with titanium implants over transported bone and an implant-supported overdenture. A 9-year follow-up shows no evidence of recurrence of the pathology, adequate shape and amount of bone, functional occlusal and dental rehabilitation, and patient's satisfaction. PMID:23351767
Secondary autogenous cancellous bone grafting is a widely used method for the treatment of alveolar clefts and oronasal fistulae. However, failure of iliac bone grafting sometimes occurs due to inadequate covering with the surrounding soft tissue and marked scar formation, inappropriate patient age, or large clefts. For alveolar clefts, we developed a method consisting of alveolar bone transportation, closure of the alveolar cleft, and/or grafting of new bone. Transport distraction osteogenesis along the curve of the dental arch is ideal. Alveolar bone was transported in the planned direction using a ready-made bone-borne distractor in combination with an orthodontic arch wire for transport guidance. This method allows simultaneous correction of nasal septal deviation and also correction of maxillary arch deformities and malocclusion since, the dental arch is expanded without donor sacrifice. This method can be regarded as tissue engineering to expand bone tissue. This method can be safely performed not only in patients undergoing initial treatment for alveolar clefts but also in patients in whom bone grafting has failed. Since 1997, we have performed this method in 22 patients and obtained good results. PMID:15927149
We investigated cephalometrically the movement of the proximal segment in the sagittal plane in patients treated with distraction (MD-DOS device) for mandibular lengthening. The proximal segment was anteriorly rotated, whilst the distal segment was posteriorly rotated after the lengthening procedure. Thus the angle of the jaw was advanced half the distance of the advancement of the distal segment. One possible
Kristoffel Hendrickx; Maurice Y. Mommaerts; Walter Jacobs; Johan V. S. Abeloos; Lucas F. Neyt; Calix A. S. De Clercq
In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Surgi-Tec NV, Brugge, Belgium) was applied after osteotomy of the anterolateral walls of the maxillary sinuses, midpalatal suture, and, eventually, separation of the pterygomaxillary sutures. Expansion proceeded at a rate of 0.33-0.66 mm per day and the device was retained for 4-6 months for consolidation. Active orthodontic therapy was started after 8-10 weeks. The increment of arch width and the perimeter were evaluated using dental casts. Tooth thermal sensitivity and the periodontal side effects of treatment were monitored clinically after distraction, at device removal, and after 1 year. Bone healing was also investigated during the procedure using conventional radiological techniques. This experience confirms that transverse maxillarydistraction is an effective technique in adult patients, leading to the formation of new bone. There were no noticeable intraoperative complications, but postsurgical periodontal side effects were documented. The procedure offers advantages over traditional teeth-borne appliances in terms of rapidity of treatment and the absence of mechanical forces acting on the teeth. Further evaluation is required to assess the long-term stability and periodontal consequences of this technique. PMID:16053842
Ramieri, G A; Spada, M C; Austa, M; Bianchi, S D; Berrone, S
Fifteen patients with acute, unstable fractures of the thoracolumbar spine were treated with Harrington distraction rods supplemented with segmental sublaminar wires. This proved to be an effective means of managing these fractures, enhancing stability and decreasing the complication rate. No patients developed hook cut-out, pseudarthrosis or gibbus. The amount and duration of external immobilization is decreased enhancing rehabilitation in spinal cord injuries. PMID:6648702
The goal of this study was to demonstrate the technique and effectiveness of incorporating recombinant human bone morphogenetic protein-2 (rhBMP-2) to the established sandwich osteotomy technique. Although the success of the sandwich osteotomy procedure has been well documented, we hope to show that the addition of rhBMP-2 will enhance bone formation.We performed a sandwich osteotomy technique in patients who had been treated initially by grafting with suboptimal results. Only defects involving the anterior maxilla (3 patients) or the anterior mandible (1 patient) were included. There were 4 patients, 2 men and 2 women, with an age range of 19 to 62 years. The causes of the ridge deficiencies ranged from pathology to trauma. The height (distance) of distracted transport bone segment was measured. The amount of relapse was measured 6 months after the surgery.All patients exhibited a significant increase in bone height. The amount distracted was 6.75 mm (range, 5-11 mm). The amount of relapse was 8.5% (range, 0%-18%). Dental implants were placed in the reconstructed ridges in all patients. There were no instances of permanent paresthesia. Two patients had exposure of a portion of the hardware, which healed uneventfully.The sandwich osteotomy technique has proven to be an effective method for augmenting deficient alveolar ridges. The addition of rhBMP-2 may aid in its success rate by promoting osteogenesis at the osteotomy site, especially in multiple-operated patients where other traditional techniques have failed to gain the desired ridge height. PMID:23851812
Herford, Alan Scott; Tandon, Rahul; Stevens, Timothy W; Stoffella, Enrico; Cicciu, Marco
A total of 61 biomechanical tests were performed on 25 cadaveric spinal segments to investigate the comparative strengths of three instrumentation systems: 1) conventional Harrington distraction instrumentation (HRI), 2) segmentally wired Harrington distraction rods, and 3) Luque segmental spinal instrumentation (SSI). In type I testing in which axial preload was applied to normal specimens, and then progressive rotation until ultimate failure followed, five of six Harrington systems failed at the bone-metal interface. In contrast, all six Luque SSI vertebral segments disrupted in a location removed from the bone-metal interface. In Type-II testing (six specimens) in which axial loading of experimentally produced unstable burst fractures was applied, the most stable fixation in resisting compressive loads was segmentally wired Harrington distraction rods (P less than 0.001). In Type-III testing (six specimens), there was axial preloading, then progressive rotation applied to translational fracture-dislocations and this showed that the ability to resist torsion was lowest with plain HRI, slightly improved by segmentally wired HRI, and the stiffest system was Luque SSI (P less than 0.05). The three methods of testing cadaveric segments provided a relevant laboratory model for investigation of spinal instrumentation systems in thoracolumbar fracture stabilization. The results compare favorably with other biomechanical studies, information derived from in vitro and ex vivo animal models and clinical experience with failures of fixation. The biomechanical advantages of segmentally wired Harrington distraction instrumentation in resisting axial loads seem to justify this method of fixation in unstable burst fractures. Similarly, the use of Luque segmental spinal instrumentation with L-rods coupled together is the best method of achieving rotational stability in translational injuries (fracture-dislocations). However, the above biomechanical considerations should be balanced against the increased operative time, more exacting technical expertise required, and possible risk of iatrogenic neurologic sequelae in implementing segmental fixation in unstable thoracolumbar fracture management. PMID:3992339
The aim of this cohort study was to evaluate the stability after multi-segmentation of the maxilla for correction of anterior open bite deformities. A total of 33 patients who underwent segmentedmaxillary osteotomy between 1994 and 2006 were included in the study. Rigid fixation with plates and postsurgical intermaxillary fixation for 6 weeks was applied to each patient. All patients were then followed in a standardized examination procedure at months 6, 12, 18 and up to 30 months postoperatively. Vertical and horizontal relation of the incisors was measured both clinically and on cast models. The main finding was that statistically significant relapse was found vertically, whereas the horizontal relationship to the mandible was unchanged. The vertical relapses were predominantly seen in patients with severe open bite evident preoperatively. PMID:23321050
Silva, Ingrid; Suska, Felicia; Cardemil, Carina; Rasmusson, Lars
Abstract.Distraction osteogenesis is an alternative method for reconstructing atrophic alveolar bone. Fourteen patients underwent vertical alveolar distraction by the LEAD SYSTEM™-Endosseous Alveolar Distraction System (Stryker Leibinger, Kalamazoo, MI). An alveolar segmental osteotomy was carried out and the vertical distraction device was mounted. In patients with an extensive alveolar defect, two distraction devices were placed in order to better control the
Maxillary skeletal prognathism can involve severe mandibular micrognathia with marked mandibular retrognathism or hypoplasia. For patients with such a condition, a conventional treatment is mandibular advancement by sagittal split ramus osteotomy (SSRO). This procedure has problems such as insufficient advancement, instability of jaw position, and postoperative relapse. Thus, in recent years, mandibular distraction osteogenesis has been used in some patients. Mandibular distraction has many advantages, but an ideal occlusion is difficult to achieve using this procedure. That is, 3-dimensional control cannot be attained using an internal device that is unidirectional. This report describes a case of severe mandibular micrognathia in a 14-year-old girl treated using backward distraction osteogenesis. This procedure was first reported by Ishii et al (Jpn J Jaw Deform 2004; 14:49) and involves a combination of SSRO and ramus distraction osteogenesis. In the present study, intermaxillary fixation in centric occlusion was performed after osteotomy, and proximal bone segments were distracted in a posterosuperior direction. This procedure is a superior surgical technique that avoids the drawbacks of SSRO and conventional mandibular distraction. However, it applies a large load to the temporomandibular joints and requires thorough management. Thus, careful evaluation needs to be made of the indication for backward distraction osteogenesis. PMID:24036745
One hundred and twenty cases of adolescent idiopathic scoliosis were treated surgically using Harrington distraction rod combined with sublaminar wires as an adjunction to spinal fusion. There were 94 female and 26 male patients. Ages ranged from 13-19 years old. There were 90 thoracic curves, 24 thoracolumbar curves and 6 double major curves. Curve severity ranged from 35-90 degrees. The most common one was between 51-75 degrees. Average follow-up period was 5 years ranging from 4-9 years. Average surgical time was two and half hours (range from 2-3 1/2 hrs.) Blood loss was about 600 ml (range from 400-1600 ml) since the operation was performed under hypotensive anaesthesia. Result of the surgical correction ranged from 53-76 per cent depending on the curve severity and the age of the patients, usually with less curve severity in younger patients with thoracic curve a higher percentage of correction would be obtained. We obtained good thoracic kyphosis and lumbar lordosis in all cases. There were no serious complications in our series. It is due to the contoured square and rod combined with sublaminar wiring that could correct and control both sagital plane and rotational deformities. This type of surgical approach is appropriate in patients with low economic status and required a period of external support. PMID:7759971
Chotigavanich, C; Songcharoen, P; Thanapipatsiri, S
Introduction Alveolar distraction is mainly used to increase height and width of the alveolar crest. This technique, however, is not typically\\u000a used for lengthening the perimeter of the dental arch or improving teeth axes. We applied alveolar distraction in a tooth-borne\\u000a manner in the second stage of our original method and obtained favorable results. We therefore present an outline of this
... these distractions can endanger the driver and others, texting while driving is especially dangerous because it combines all three ... highest proportion of distraction-related fatal crashes. 4 Texting while driving is linked with drinking and driving or riding ...
17 patients (14 female; 3 male) were analysed retrospectively for skeletal and dental relapse before distraction osteogenesis (DO) of the mandibular anterior alveolar process at T1 (17.0 days), after DO at T2 (mean 6.5 days), at T3 (mean 24.4 days), at T4 (mean 2.0 years), and at T5 (mean 5.5 years). Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated. Skeletal correction (T5-T1) was mainly achieved through the distraction of the anterior alveolar segment in a rotational manner where the incisors were more proclined. The horizontal backward relapse (T5-T3) measured -0.3mm or 8.3% at point B (non-significant) and -1.8mm or 29.0% at incision inferior (p<0.01). Age, gender, amount and type (rotational vs. translational) of advancement were not correlated with the amount of relapse. High angle patients (NL/ML'; p<0.01) showed significant smaller relapse rates at point B. Overcorrection of the overjet achieved by the distraction could be a reason for dental relapse. Considering the amount of long-term skeletal relapse the DO could be an alternative to bilateral sagittal split osteotomy for mandibular advancement in selected cases. PMID:23153785
Joss, C U; Triaca, A; Antonini, M; Kiliaridis, S; Kuijpers-Jagtman, A M
Soft tissue changes were analysed retrospectively in 17 patients following distraction osteogenesis (DO) of the mandibular anterior alveolar process. Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated at T1 (17.0 days), after DO at T2 (mean 6.5 days), at T3 (mean 24.4 days), at T4 (mean 2.0 years), and at T5 (mean 5.5 years). Statistical analysis was carried out using Kolmogorov-Smirnov test, paired t-test, Pearson's correlation coefficient, and linear backward regression analysis. 5.5 years postoperatively, the net effect for the soft tissue at point B' was 88% of the advancement at point B while the lower lip (labrale inferior) followed the advancement of incision inferior to 24%. Increased preoperative age was correlated (p<0.05) with more horizontal backward movement (T5-T3) for labrale inferior and pogonion'. Higher NL/ML' angles were significantly correlated (p<0.05) to smaller horizontal soft tissue change at labrale inferior (T5-T3). The amount of advancement at point B was significantly correlated with an upward movement (T5-T3) of labrale inferior (p<0.01) and stomion inferior (p<0.05). It can be concluded that further change in soft tissues occurred between 2.0 and 5.5 years postoperatively. The physiological process of ageing and loss of soft tissue elasticity should be considered as possible reasons. PMID:23182400
Joss, C U; Triaca, A; Antonini, M; Kiliaridis, S; Kuijpers-Jagtman, A M
We report the clinical outcome of dental implants placed on vertically distracted fibular free flaps that were used to reconstruct maxillary and mandibular defects after resection. Distraction osteogenesis (DO) of fibular free flaps was used for six patients (5 men, 1 woman) a mean of 19 months (range 11–38) after 5 mandibular and 1 maxillary reconstructions. A mean of 5
Giuseppe Lizio; Giuseppe Corinaldesi; Francesco Pieri; Claudio Marchetti
Distraction osteogenesis is an alternative method for reconstructing atrophic alveolar bone. Fourteen patients underwent vertical alveolar distraction by the LEAD SYSTEM-Endosseous Alveolar Distraction System (Stryker Leibinger, Kalamazoo, MI). An alveolar segmental osteotomy was carried out and the vertical distraction device was mounted. In patients with an extensive alveolar defect, two distraction devices were placed in order to better control the vector of elongation in both bone edges. The distraction was started on the fourth postoperative day at a rate of 0.8 mm/day for 10-16 days, followed by a consolidation period of 60 days. Vertical distraction osteogenesis (VDO) was completed successfully in all patients with segment lengths in the range of 8 to 13 mm and with an average of 10.3 mm. Subsequently, the devices were removed and 23 threaded titanium dental implants were placed for osteointegration. Earlier mineralization in the vertically distracted area was seen radiographically during the consolidation period. In a follow up of 6-20 months after the distraction, 22 implants were successfully osteointegrated while one implant failed due to improper distractedsegment stability. As a result of alveolar distraction, a segment of mature bone was transported vertically in order to lengthen the crest for better implant anchorage, either for aesthetic purposes or for functional prosthetic requirements. The main advantages of VDO are: (1) augmentation of alveolar bone height with new bone formation and simultaneous expansion of the soft tissues; (2) no bone harvesting is necessary; (3) the technique has a lower morbidity rate compared with conventional techniques; (4) it makes the insertion of longer dental implants feasible. PMID:11829233
Surgically assisted rapid maxillary expansion (SARME) is commonly used to correct maxillary transverse deficiency. The aim of this study was to analyse the need for intraoperative liberation of the nasal septum during the procedure. SARME was performed in 25 patients by combining a lateral osteotomy with an inter-radicular maxillary osteotomy. The deviation of the nasal septum after SARME was evaluated by comparing measurements between radiologically defined landmarks on pre- and postoperative computed tomographic images. Two defined angles (angle I, between crista galli-symphysis mandibulae and crista galli-septum nasi; angle II, between maxillary plane and septum nasi) were measured based on four representative planes and septal movement was analysed. The mean changes in angles I (0.03° ± 0.78°) and II (0.25° ± 1.04°) did not differ significantly from zero (p=0.87 and p=0.24, respectively). Observed variations and displacements were considered to be acceptable because they were insignificant in every respect. Intranasal airway function was also examined pre- and postoperatively to evaluate any loss of ventilation. The described surgical technique is a successful method of maxillarysegmentdistraction. The authors found no compelling reason to release the nasal septum in the context of SARME. PMID:23092854
Reinbacher, K E; Wallner, J; Pau, M; Feichtinger, M; Kärcher, H; Quehenberger, F; Zemann, W
In 2011, the National Transportation Safety Board urged all states to ban the use of portable electronic devices while driving, including hand-held and hands-free devices. Texting while driving concerns several Texas legislators, who have filed bills, backed by the Texas Medical Association, to ban the practice. TMA physicians recognize that the use of hand-held and hands-free devices and other factors associated with distracted driving affect their patients' safety. PMID:23546834
The long spring-loaded distractor arms of maxillarydistraction devices can cause pain and ulceration of the upper lip. We describe a simple method to relieve the tension and discomfort on the soft tissues using Silastic tubing. PMID:15544892
This study examined the effects of neuroleptic medication on the allocation of attentional resources to distracting stimuli in patients with schizophrenia. Twenty-five patients were tested twice (medication-free and after medication stabilization) on the Identical Pairs version of the Continuous Performance Test under both distraction and no-distraction conditions. Sixteen patients were chronically ill adults and nine patients were young neuroleptic-naive patients
Andrea Bergman; John O'Brien; Gregory Osgood; Barbara Cornblatt
... radio, CD player, or MP3 player But, because text messaging requires visual, manual, and cognitive attention from the driver, it is by far the most alarming distraction. The best way to end distracted driving is to educate all Americans about the danger ...
This paper discusses the various issues concerned with the precise definition of the term driver distraction. There has been growing interest in driver distraction in the research community due to the development of information and communication technologies for concurrent use whilst driving. Concern has been raised that such technologies may lead to an increase in accidents. In order to reliably
Objective To examine the effects of parenting distractions on supervising behaviors in relation to child risky behaviors. Methods Forty preschool-aged children and their parents were randomly assigned to occupy a simulated home living room for 45min with the parent involved in either (a) no planned distraction, (b) a telephone call distraction, (c) a TV show distraction, or (d) a computer
... and more states banning handheld phone usage and texting while driving, and new technologies being developed to lock keypads ... made about texting. And you’re right, because texting while driving combines all three types of these distractions. When ...
... driving issue; New Hampshire enacted a comprehensive distracted driving law. 3 Texas has banned the use of hand-held phones and texting in school zones. Sources: Insurance Institute for Highway ...
... Affected Crashes Devices/ Controls Integral to the Vehicle Electronic Device Use Not distracted Completely attentive to driving; ... driving discussions and publications, there is reference to electronic device use as well as use of devices ...
Mandibular distraction combining the sagittal split ramus osteotomy and an intraoral curved distractor is efficacious to lengthen the mandibular body and ramus. The sagittal split permits immediate rotation of the proximal segment and lengthening while still providing a large surface interface for regenerative bone. The buried curved distractor enables mandibular lengthening along the normal logarithmic grow spiral as shown by Moss and Rickets. In addition, it is well tolerated by the patient and can remain in place for a long duration to provide support. In summary, this combination of surgical techniques provides certain advantages for distraction of the mandible. PMID:15213543
The current study investigated whether active distraction reduces participants' experience of pain more than passive distraction during a cold pressor task. In the first experiment, 60 participants were asked to submerge their hand in cold (2°C) water for as long as they could tolerate. They did this with no distraction, and then with active (electronic gaming system) and passive (television) distraction, in randomly assigned order. Tolerance time, pain intensity ratings and task absorption ratings were measured for each condition. A second experiment attempted to control for participants' expectations about the effects of distraction on pain. Forty participants underwent the same experimental procedure, but were given verbal suggestions about the effects of distraction by the experimenter before each distraction condition. Participants in both experiments had a significantly higher pain tolerance and reported less pain with the active distraction compared with passive or no distraction. Participants reported being more absorbed, and were significantly more willing to do the task again when they had the active distraction compared with both passive distraction and no distraction. They also had more enjoyment, less anxiety and greater reduction in pain with active distraction than with passive distraction. There was no effect of suggestion. These experiments offer further support for the use of electronic games as a method of pain control. PMID:21369538
The posterior edentulous maxilla is a critical anatomic region for dental implant therapy. Because of severe alveolar bone resorption and maxillary sinus pneumatization, low bone volume is often presented clinically. Although maxillary sinus augmentation has been developed to promote bone reconstruction and oral rehabilitation, complications have been reported. Possible complications include paranasal sinusitis, loss of the graft, and displacement of an implant into the antrum. In this study, we present an observed rare complication of maxillary sinus augmentation, a postoperative maxillary cyst that occurred 10 years after treatment. PMID:24036833
Kim, Jae Jin; Freire, Marcelo; Yoon, Jung-Hoon; Kim, Hak Kyun
Distraction osteogenesis is a well-established method of endogenous tissue engineering. It is a biological process of bone neo-formation between segments subjected to tension. The concept of this study was to investigate the distraction osteogenesis with a device capable of creating a permanent and constant force during the whole process as if a very large number of small elongations were applied constantly. The mechanical testing of the device used to produce the constant force and the in vivo analysis of the bone growth after it was implanted in rabbits are presented on this work. The device consists of a NiTi coil spring, superelastic at body temperature, in order to have a stress plateau during the austenitic retransformation during the unloading. The in vivo analysis was made on six female rabbits of 12 months old. A segmental mandibulectomy at the horizontal arm of the mandible and a corticotomy at 5mm distant from the gap were made. Next, following a latency period of five days, the SMA springs were implanted to induce the bone neo-formation. The displacement at the unloading plateau shows that it is necessary to have longer springs or to use several (available commercially) in series in order to fulfil the requirements of a human distraction. The temperature variations induced changes in the spring force. However, when the temperature returns to 37 degrees C the distraction force recovers near the initial level and does so completely when the distraction process continues. For the in vivo study, all six rabbits successfully completed the distraction. The radiographies showed the gap as distraction advanced. A continuity in the newly formed bone with similar transversal and horizontal dimensions than the original bone can be observed on the histologies. In conclusion, the application of a constant force on distraction osteogenesis, using SMA springs, may be a successful alternative to the conventional gradual distraction. PMID:15332632
Idelsohn, S; Peña, J; Lacroix, D; Planell, J A; Gil, F J; Arcas, A
Seven patients aged six to 25 underwent progressive distraction lengthening of the forearm. Five had lengthening of the ulna and two of the radius. Four cases had multiple exostoses, two had posttraumatic distal epiphyseal arrests and one had dyschondrosteosis. Two methods were used: the Wagner technique of diaphyseal distraction and bone grafting, or diaphyseal corticotomy and callus distraction without bone
|The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered by…
The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered by subliminal stimuli. However, in everyday situations, suprathreshold stimuli
The ability to maintain focus and avoid distraction by goalirrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered by subliminal stimuli. However, in everyday situations, suprathreshold stimuli
A serious health problem is developing from automobile collisions caused by distracted drivers. This is a result of the rapid proliferation of portable cellular telephones and personal organisers used while driving, the development of more sophisticated entertainment systems and instrument panel controls, the advent of navigation and television displays in vehicles and promises of sophisticated wireless e-mail, FAX and Internet services in the vehicle. Preoccupation with electronic gadgets may also degrade human driving performance. Many drivers however, sincerely believe they have the talent to do several things at the same time, such as hold and look at a cellular telephone in one hand and drive with a beverage container in the other hand whilst at the same time, exercise their personal skills. Obviously, they believe that they do not need two hands on the steering wheel and two eyes on the road. This is a unique situation requiring intensive health promotion as distracted or 'offensive driving' may be habit forming and difficult to change, any significant design remedies will be slow to arrive and may be circumvented, and the regulatory laws have proved difficult or impossible to enforce. This special need may require research to determine the most effective techniques for health promotion. PMID:11329694
Distracted driving is a growing problem in the United States. With the integration of wireless devices into everyday life, cell phone use behind the wheel is a distraction requiring increasing concern. Teen drivers are most susceptible to the dangers of distracted driving as made evident in the overrepresentation of teens in distraction-related motor vehicle crashes. This article describes the causes, consequences, and statistics related to distracted driving in teenagers and an injury prevention program for teenagers. PMID:24005117
In 2009, the National Highway Traffic Safety Administration (NHTSA) estimated nearly 6,000 distracted driver fatalities and 515,000 injuries in the United States alone. Distracted driving is a worldwide problem that needs to be addressed. Software is available to disable cell phone usage while driving, but using the advanced technology may require legislation along with a renewed sense of driver responsibility. PMID:23061239
The maxillary sinus is an uncommon site for mucoceles within the paranasal sinuses. In this study nine patients with maxillary sinus mucoceles are presented. Six of these patients were treated by open approaches, and three were treated by endoscopic drainage alone. For uncomplicated maxillary sinus mucoceles, endoscopic drainage appears to be a reasonable approach, whereas for more complicated cases extending
STEVEN C. MARKS; JORGE D. LATONI; ROBERT H. MATHOG
Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adult...
A. A. Garner C. A. Franklin D. Ball D. Stavrinos K. K. Ball P. R. Fine V. Sisiopiku
Patients with unstable thoracolumbar spine fractures greatly benefit from the rapid mobilization made possible by surgical reduction and secure internal fixation. The Harrington distraction method provides excellent hook fixation to the spine but is attached only to the proximal and distal ends of the instrumental segment and is dependent on an intact anterior longitudinal ligament. Because the spine is multisegmented and viscoelastic, a distraction method alone may not provide persistent tension on the anterior longitudinal ligament. Segmental spinal instrumentation (Luque) is less efficient in obtaining reduction because it has no built in distractive mechanism. In addition, the lack of laminar hook attachments is a significant disadvantage in maintaining a distractive force. A combined system consisting of Harrington distraction rods segmentally attached to all available motion segments improves the currently available mechanical construct for obtaining and maintaining reduction in unstable thoracolumbar fractures. PMID:6478707
OBJECTIVE: Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, distraction with a multidirectional extraoral device was performed to gradually lengthen the corpus and ramus of a patient who had a severe hypoplastic mandible. MATERIALS AND METHODS: The patient underwent bilateral extraoral ramus and corpus distraction osteogenesis. After seven days of latency
Kerim Ortakoglu; Seniz Karacay; Metin Sencimen; Erol Akin; Aykut H Ozyigit; Osman Bengi
This report describes a combined orthodontic surgical technique involving vertical alveolar distraction using temporary anchorage devices (TADs) in cases of massive alveolar ridge bone and teeth loss. A combined surgical orthodontic protocol included presurgical orthodontic preparation and a preimplantation surgical augmentation stage for insertion of a vertical distractor. During the active vertical alveolar distraction process TADs were inserted. Intraoral orthodontic elastics were attached to the main orthodontic archwire exerting multidirectional forces to control the vertical distraction vector. After 3 months of vector controlling and active bone moulding, the TADs were removed. Anterior alveolar ridge augmentation using distraction osteogenesis was achieved. The application of TADs for better anterior segment curvature enabled dental implant insertion, better positioning and restoration. A combined surgical orthodontic management protocol involving vertical alveolar distraction osteogenesis for augmentation purposes is an efficient treatment method to improve alveolar ridge volume for the preimplantation stage. PMID:21978932
Aizenbud, D; Hazan-Molina, H; Cohen, M; Rachmiel, A
Distraction osteogenesis (DO) is the application of traction to the callus formed between bone segments and stimulation of bone formation by creating stress on the callus with this traction. Shorten the duration of DO and increasing the capacity of bone formation is important to prevent the possible complications of DO. For this reason, it was considered that low-level laser therapy (LLLT) may affect positively DO and it can decrease the complication range by shortening the period. Unilateral mandibular distractors were applied on 16 female white New Zealand rabbit to prove this hypothesis with micro CT, plain radiograph and histomorphometric analyses. Eight rabbits were applied LLLT with GaAlAs laser on the distraction area during the distraction period. On the post-distraction 28th day, four rabbits from study group and four rabbits from control groups were sacrificed. The rest of the rabbits were sacrificed on post-distraction 56th day. As a result of this study, significant positive effects of LLLT on post-distraction 28th day were revealed with all analyses. In histomorphometrical analyses, new bone formation was significantly higher in short-term laser applied group comparing to that of short-term control group (p?=?0.029). In both microCT and plain radiograph, the highest radioopacity values were observed in short-term laser group when compared with that of the controls (p?=?0.043 and p?=?0.025, respectively). Even though LLLT increased the healing capacity on short-term, it was not sufficient on long-term (post-distraction 56th day) healing. LLLT application on distraction period, activate healing on bone so it may decrease DO period. The result of this study should be supported with clinical studies and the most effective laser source, dose and application time should be revealed with experimental and clinical studies. PMID:23604845
Primary site control, anatomical site of failure, survival, and complications of treatment were determined in a retrospective review of primary maxillary sinus carcinoma. Sixty-one patients were treated by radiation followed by surgery and 35 by radiation alone. Primary tumor control was achieved in 69% of patients receiving combined treatment, 14% of patients treated with radiation alone, and 49% of all patients. Local control did not differ with histological type. Virtually all epidermoid and undifferentiated carcinoma recurrences occurred within 2 years, but 27% of adenocarcinomas recurred after 2 years.
Numerous theories posit that affectively salient stimuli are privileged in their capacity to capture attention and disrupt ongoing cognition. Two underlying assumptions in this theoretical position are that the potency of affective stimuli transcends task boundaries (i.e., emotional distracters do not have to belong to a current task-set to disrupt processing) and that there is an asymmetry between emotional and cognitive processing (i.e., emotional distracters disrupt cognitive processing, but not vice versa). These assumptions have remained largely untested, as common experimental probes of emotion-cognition interaction rarely manipulate task-relevance and only examine one side of the presumed asymmetry of interference. To test these propositions directly, a face-word Stroop protocol was adapted to independently manipulate (a) the congruency between target and distracter stimulus features, (b) the affective salience of distracter features, and (c) the task-relevance of emotional compared to non-emotional target features. A three-way interaction revealed interdependent effects of distracter relevance, congruence, and affective salience. Compared to task-irrelevant distracters, task-relevant congruent distracters facilitated performance and task-relevant incongruent distracters impaired performance, but the latter effect depended on the nature of the target feature and task. Specifically, task-irrelevant emotional distracters resulted in equivalent performance costs as task-relevant non-emotional distracters, whereas task-irrelevant non-emotional distracters did not produce performance costs comparable to those generated by task-relevant emotional distracters. These results document asymmetric cross-task interference effects for affectively salient stimuli, supporting the notion of affective prioritization in human information processing. PMID:21954389
Odontogenic etiology accounts for 10% to 12% of cases of maxillary sinusitis. Although uncommon, direct spread of dental infections into the maxillary sinus is possible due to the close relationship of the maxillary posterior teeth to the maxillary sinus. If a periapical dental infection or dental/oral surgery procedure violates the schneiderian membrane integrity, infection will likely spread into the sinus, leading to sinusitis. An odontogenic source should be considered in individuals with symptoms of maxillary sinusitis and a history of dental or jaw pain; dental infection; oral, periodontal, or endodontic surgery; and in those people resistant to conventional sinusitis therapy. An odontogenic infection is a polymicrobial aerobic-anaerobic infection, with anaerobes outnumbering the aerobes. Diagnosis requires a thorough dental and clinical evaluation, including radiographs. Management of sinus disease of odontogenic origin often requires medical treatment with appropriate antibiotics, surgical drainage when indicated, and treatment to remove the offending dental etiology. PMID:19348725
Distraction osteogenesis can be used to replace segmental bone loss when treating malignant bone tumors in children and adolescents. These patients often receive cytotoxic chemotherapy as part of their treatment regimen. The effect of cytotoxic drugs on the cellular processes during distraction osteogenesis and the structural and mechanical properties of regenerate bone is unknown. We therefore used a rabbit model of distraction osteogenesis to determine that cytotoxic agents had a detrimental effect on regenerate bone formed by this technique. We administered adriamycin and cisplatinum to 20 rabbits using two different simulated chemotherapy regimens. All rabbits underwent an osteotomy at 12 weeks of age. Distraction osteogenesis began 24 h later at a rate of 0.75 mm a day for 10 days, followed by 18 days without correction to allow for consolidation. Regenerate bone was assessed using plain radiographs, bone densitometry, and mechanical testing. Peri-operative chemotherapy decreased the mechanical properties of the regenerate with regard to yield strain (3.7 × 10(-2) vs. 5.2 × 10(-2)) and energy at yield (2.73 × 10(7) vs. 3.92 × 10(7)). Preoperative chemotherapy in isolation reduced bone mineral density (0.38 vs. 0.5 g/cm(2)), bone mineral content (0.24 vs. 0.36 g), and volumetric bone mineral density (0.57 vs. 0.65 g/cm(2)) with no alterations in the mechanical properties. Conclusions: Preoperative chemotherapy appears to decrease the volume of regenerate bone, without affecting structural integrity, suggesting that the callus formed is of good quality. The converse appears true for peri-operative chemotherapy. PMID:24105429
Monsell, Fergal P; Barnes, James Ralph; Bellemore, M C; Biston, L; Goodship, Allen
Many attempts were made in the past to monitor a driver's visual and cognitive distractions. Yet, most of the techniques did not become a practical application due to their contact-based nature of monitoring. In this paper, we describe research that aims to monitor the driver's distractions from a distance. The proposed method is based on the thermal signature of the
Driver distraction is a research area that continues to receive considerable research interest but the drivers’ perspective is less well documented. The current research focuses on how drivers perceive the risks associated with a range of driver distractions with the aim of identifying features that contribute to their risk perception judgements. Multidimensional scaling analysis was employed to better understand drivers’
A series of experiments were conducted to examine the inhibitory effect of a visual distracter on saccadic eye movements. Participants were presented with a sequence of two critical displays. In one display a red target was presented together with a green distracter. This was followed by a display with a new red target presented in isolation at one of three
Background: Auditory distraction is known to affect serial recall (irrelevant sound effect), but there has been limited study about the effect of distraction on performance of more complex metalinguistic tasks, particularly as cognitive performance declines with normal ageing. The inhibitory deficit theory offers an explanation for this decline in performance with ageing, suggesting that older adults have difficulty limiting access
Distraction and reappraisal are two commonly used forms of cognitive emotion regulation. Functional neuroimaging studies have shown that each one depends upon interactions between pFC, interpreted as implementing cognitive control, and limbic regions, interpreted as mediating emotional responses. However, no study has directly compared distraction with reappraisal, and it remains unclear whether they draw upon different neural mechanisms and have
Kateri McRae; Brent Hughes; Sita Chopra; John D. E. Gabrieli; James J. Gross; Kevin N. Ochsner
Distraction and reappraisal are two commonly used forms of cognitive emotion regulation. Functional neuroimaging studies have shown that each one depends upon interactions between pFC, interpreted as implementing cognitive control, and limbic regions, interpreted as mediating emotional responses. How- ever, no study has directly compared distraction with reappraisal, and it thus remains unclear whether they draw upon different neural mechanisms
Kateri McRae; Brent Hughes; Sita Chopra; John D. E. Gabrieli; James J. Gross; Kevin N. Ochsner
For many years, all the internal fixation devices available for the surgical treatment of thoracolumbar fractures [Harrington rods (HR); Luque rods (LR); Hartshill rectangle (HTR); Roy Camille plates (RCP)] were not always able to distribute all the reductive strains (distraction, compression, derotation), or to guarantee solid stabilization without external supports. In some cases (with HR), only distraction forces might be applied, but stability of the assembly was very poor. Otherwise (with LR, HTR, or RCP), stability was well achieved using segmental fixation systems (with SSW, screws), but reduction was possible only by deflecting the spine towards the rods (or plates), by winging the sublaminar wires (or screws). Restoration of normal sagittal alignment was also very difficult to obtain. The use of internal fixation systems for reduction of thoracolumbar fractures when distraction or compression forces are needed are essential for the spinal surgeon and the patient. In some cases of thoracolumbar fractures (seat belt; flexion-distraction), in fact, the use of distraction forces is not suitable, leading only to overdistraction, not to reduction. The introduction of Cotrel-Dubousset instrumentation (CDI) in 1983, and its subsequent use in spinal traumatology, seems to answer all these unresolved questions. PMID:8003832
Fabris, D; Costantini, S; Nena, U; Gentilucci, G; Ricciardi, A
Research on the effect of distraction has produced conflicting results and competing theoretical explanations. Nonetheless, distraction has been cited as the process by which violations of conversational expectations influence the outcomes of persuasive communications. In this study, results from 38 studies examining distraction were subjected to meta?analysis. The results indicate it is necessary to distinguish between communication relevant distraction (produced
Purpose: In vitro data were collected to measure torque-force values of an internal distraction device. The measurements were correlated with in vivo torque readings in an attempt to better understand the force required to distract the osteogenic bone callus of the human mandible during distraction osteogenesis. Methods and Materials: Five internal craniofacial distraction devices were mounted on an apparatus to
Randolph C. Robinson; Patrick J. O'Neal; Ginger H. Robinson
Objective : Le Fort III osteotomy with distraction osteogenesis (DO) is used to improve the retruded midface in patients with Crouzon or Apert syndrome. This study aimed to evaluate sagittal and vertical preoperative and postoperative cephalometric changes of DO of the midface in patients with Crouzon or Apert syndrome. Design : Population-based case-control study. Patients and Methods : Records of patients with the syndrome of Crouzon (N = 6) or Apert (N = 7) were compared, before and after Le Fort III DO, with a nonsyndromic untreated control group (N = 486). Main Outcome Measures : Sagittal and vertical cephalometric maxillary landmarks and measurements were used to predict and measure midface advancement and rotation after Le Fort III DO. Cephalograms were taken before surgery (T0), 4 months after surgery at removal of the distraction device (T1), and 1 year after removal of the distraction device (T2). Analysis : Z scores were performed to compare cephalometric measures of syndromic patients with control subjects. Results : Cephalograms of 13 patients with Crouzon syndrome (N = 6) or Apert (N = 7) (age range 8.2 to 19.8 years) were evaluated. Treatment changes (T1-T2) showed statistically significant maxillary advancement, with no significant differences between the patients with the Crouzon or Apert syndrome. Conclusions : DO of the midface in patients with Crouzon or Apert syndrome seems to be stable in the sagittal direction after follow-up. Although Crouzon and Apert differ after DO, anteroposterior craniofacial dimensions were significantly improved and were closer to patterns of normal subjects. PMID:22909221
Reitsma, Jacobus H; Ongkosuwito, Edwin M; Buschang, Peter H; Adrichem, Léon N A V; Prahl-Andersen, Birte
Driver distraction represents a significant problem in the public transport sector. Various methods exist for investigating distraction; however, the majority are difficult to apply within the context of naturalistic bus driving. This article investigates the nature of bus driver distraction at a major Australian public transport company, including the sources of distraction present, and their effects on driver performance, through
Paul M. Salmon; Kristie L. Young; Michael A. Regan
Processing speed is often described as a fundamental resource determining individual (e.g., I.Q.) and group (e.g., developmental)\\u000a differences in cognition. However, most tests that measure speed present many items on a single page. Because many groups\\u000a with slowed responding are also distractible, we compared younger and older adults on high-distraction (i.e., standard) versus\\u000a low-distraction versions of two classic speed tasks.
The current study tested whether the effectiveness of distraction using virtual reality (VR) technology in reducing cold pressor pain would maintain over the course of eight weekly exposures. Twenty-eight adults, 18 to 23 years of age, underwent one baseline cold pressor trial and one VR distraction trial in randomized order each week. VR distraction led to significant increases in pain threshold and pain tolerance, and significant decreases in pain intensity, time spent thinking about pain, and self-reported anxiety, relative to baseline. Repeated exposure did not appear to affect the benefits of VR. Implications for the long-term use of VR distraction as a non-pharmacological analgesic are discussed.
Rutter, Charles E.; Dahlquist, Lynnda M.; Weiss, Karen E.
INTRODUCTION: Textilomas have been reported in many locations. We report the first case of textiloma located in the maxillary sinus that mimicked a sinus cyst recurrence on computed tomography images. CASE PRESENTATION: A 60-year-old Caucasian man was referred for persistent infection of the right maxillary sinus. A maxillary sinus benign cyst had been removed three months before. Computed tomography showed
Piezoelectric bone surgery is based on ultrasonic vibration of a device functioning as an osteotome. This device allows precise cuts to be made in bone structures without provoking lesions of adjacent soft tissues and at the same time offering excellent visibility within the surgical field. The use of this technique in alveolar distraction osteogenesis is described. Piezoelectric surgery appears to make the cutting of the transport segment easier and safer. PMID:18271385
González-García, Alberto; Diniz-Freitas, Márcio; Somoza-Martín, Manuel; García-García, Abel
Le Fort I osteotomy of the maxilla continues to be one of the most common techniques used in the surgical correction of a variety of dento-midfacial deformities. Occasionaly, however, surgeons may encounter difficulties during three-pieces Le Fort I procedures because the surgical movements are also prone to adverse movement and subsequent relapse. This case report describes a 26 year old man, who presented with a skeletal Class III malocclusion and a transverse maxillary deficency. The malocclusion was corrected with a bilateral sagittal split osteotomy (BSSO) and a segmental Le Fort I and post-treatment stabilization was achieved with the STABLE (Surgical Tripartition Auxiliary Block Element), a new and innovative device usefull after three-part maxillary Le Fort I surgery. PMID:23756843
Bertossi, D; Albanese, M; Farronato, G; Grendene, E; Picozzi, V; Lucchese, A; Gherlone, E; De Santis, D; D'Agostino, A; Nocini, P F
Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components. The tumor is extremely rare in the sinonasal tract. We report a case of a 62-year-old man with carcinosarcoma involving the maxillary sinus. PMID:23799172
Moon, Jeong-Ki; Kim, Ah-Young; Chang, Dong-Sik; Park, Kyung-You
Driver distraction has become a leading cause of motor-vehicle crashes. Although visual and cognitive distraction has been studied extensively, relatively little research has addressed their combined effects on drivers’ behavior. To fill this gap, a medium-fidelity simulator study examined the driver behavior before, during and after three types of distraction. Driving without distraction was compared to visual distraction, cognitive distraction,
Objective Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, distraction with a multidirectional extraoral device was performed to gradually lengthen the corpus and ramus of a patient who had a severe hypoplastic mandible. Materials and methods The patient underwent bilateral extraoral ramus and corpus distraction osteogenesis. After seven days of latency period, distraction was performed 0.5 mm twice a day. Subsequent consolidation period was 12 weeks. Results The patient's mandible was elongated successfully. Cephalometric analysis revealed that ANB angle decreased from 13° to 6°, overjet of 15 mm decreased to 4 mm, corpus length increased from 49 mm to 67 mm, and ramus length increased from 41 mm to 43 mm. Posterior airway space (PAS) also increased due to advancement of the mandible. In stereolithographic model evaluation it was determined that the distances from condylion to gonion and from gonion to pogonion increased. Conclusion Satisfactory results from both aesthetic and functional standpoints were obtained by distraction osteogenesis of the ramus and corpus.
In 2000, the National Highway Traffic Safety Administration (NHTSA) held a workshop on distracted driving research. In the ten years that followed, electronic devices that have the potential for distraction have changed dramatically. Cell phone usage has ...
The National Highway Traffic Safety Administration conducted its second national survey of distracted driving to monitor the public's attitudes, knowledge, and self-reported behavior about cell phones, texting, and driver choices. The first distracted dri...
...Driving: Countermeasures for Distraction Forum The National Transportation...Driving: Countermeasures for Distraction, which will begin at 8...education and outreach, and technology and design countermeasures...Attitudes and Behaviors Panel 4: Technology and Design...
Purpose Reconstruction of the canine mandible using bone transport distraction osteogenesis has been shown to be a suitable method for correcting segmental bone defects produced by cancer, gunshots, and trauma. Although the mechanical quality of the new regenerate cortical bone seems to be related to the mineralization process, several questions regarding the micro-structural patterns of the new bony tissue remain unanswered. The purpose of this study was to quantify any microstructural differences that may exist between the regenerate and control cortical bone. Methods Five adult American foxhound dogs underwent unilateral bone transport distraction of the mandible to repair 30–35 mm bone defects. Animals were sacrificed 12 weeks after the beginning of the consolidation period. Fourteen cylindrical cortical samples were extracted from the superior, medial, and inferior aspects of the lingual and buccal plates of the reconstructed aspect of the mandible and 21 specimens were collected similarly from the contralateral aspect of the mandible. The specimens were evaluated using histomorphometric and micro-computed tomography techniques to compare their microstructure. Results Except for differences in Haversian canal area, histomorphometric analyses suggested no statistical differences in microstructure between regenerate and control cortical bone. Morphological evaluation suggested a consistent level of anisotropy possibly related to the distraction vector. Conclusions After 12 weeks consolidation, bone created during bone transport distraction osteogenesis is comparable to native bone in microstructure, architecture, and mechanical properties. It is proposed that after enough time, the properties of the regenerate bone will be identical to that of native bone.
Zapata, Uriel; Halvachs, Emily K.; Dechow, Paul C.; Elsalanty, Mohammed E.; Opperman, Lynne A.
Trapeziometacarpal distraction arthroplasty is a surgical technique for the treatment of trapeziometacarpal arthrosis. It consists of distracting the first metacarpal and then anchoring it in suspension to the second metacarpal by means of a tendon graft. Both a reduction of the subluxation of the base of the first metacarpal and an opening or distraction of the trapeziometacarpal joint, with a clear decrease in the forces of attrition on its joint surfaces, are thereby obtained. Compared with the traditional techniques of arthroplasty, this technique avoids trapeziectomy; it is therefore less destructive and is quicker and easier to carry out. It appears to be equally effective regarding pain, correcting the deformity, and recovering grip strength. PMID:17996782
Distraction–conflict theory maintains that findings from social facilitation research result from the fact that the presence of others distracts Ss, thereby creating attentional conflict, which in turn produces drive effects. In support of this position, there already is a large amount of data indicating that presenting various forms of distraction during task settings produces drive effects. The present research demonstrated
Distraction osteogenesis can result in high forces developing in the limb. To determine and control the distraction forces (DF), a motorized distractor driven by feedback from DF was developed and used to lengthen the tibiae of 6 sheep undergoing distraction osteogenesis. The forces were measured continually, and, in 4 of the sheep, a force threshold was set, above which an
Jinyong Wee; Tariq Rahman; Robert E. Akins; Rahamim Seliktar; David G. Levine; Dean W. Richardson; George R. Dodge; Ahmed M. Thabet; Laurens Holmes; William G. Mackenzie
Unobtrusive video camera units were installed in the vehicles of 70 volunteer drivers over 1-week time periods to study drivers’ exposure to distractions. The video data were coded based on a detailed taxonomy of driver distractions along with important contextual variables and driving performance measures. Results show distractions to be a common component of everyday driving. In terms of overall
Jane Stutts; John Feaganes; Donald Reinfurt; Eric Rodgman; Charles Hamlett; Kenneth Gish; Loren Staplin
In studying the effects of distraction on attitude change, Festinger and Maccoby hypothesized that individuals would change their attitudes more if distracted during the presentation of a persuasive communication, since the active process of counterargument was inhibited. McGuire noted that a learning-theory approach would predict opposite results since distraction should inhibit reception of the persuasive material. In an experiment manipulating
The present work aims to establish a greater understanding of the cognitive mechanisms involved in avoiding distraction from speech and nonspeech sounds. Although mixed results have been presented by research investigating the hypothesis that individuals with superior working memory abilities are better able to avoid acoustic distraction, we found that working memory correlated with some aspects of performance during distraction
Emily M. Elliott; Katie M. Barrilleaux; Nelson Cowan
Maxillary antral malignancies are mostly squamous cancers. Sarcomas in this region are rare. The head and neck region houses around 8.9% of all sarcomas and spindle cell sarcomas of the maxillary antrum had rarely been reported.The presentation, pathology, clinical findings, management and short term response to treatment of a left maxillary antral spindle cell sarcoma, in a Muslim, male tobacco chewer is reported here. PMID:23741844
This report primarily focuses on an attempt to document the level of driver distraction existing in Kentucky through analysis of crash data and by conducting an observational survey of drivers. Additional research is cited as a means of comparing other st...
Pursuant to the Moving Ahead for Progress in the 21st Century Act (MAP-21), the Department of Transportation (DOT) announced the availability of funding authorized for distracted driving grants on August 24, 2012. In this notice, DOT is extending the application submission deadline announced in the notice of availability of funding to February 28,...
Cars have become a part of almost everyonepsilas life taking people from one place to another. In such a fast paced mode of transport, there are a variety of ways in which drivers can get distracted while driving. Getting stuck in a traffic jam, doing other tasks simultaneously while driving- for example drinking, reading, talking over the mobile phone are
Amardeep Sathyanarayana; S. Nageswaren; H. Ghasemzadeh; R. Jafari; J. H. L. Hansen
Distraction from cell phones, navigation systems, information/entertainment systems, and other driver-interactive devices now finding their way into the highway vehicles is a serious national safety concern. However, driver distraction is neither well defined nor well understood. In an effort to bring some better definition to the problem, a framework is proposed based on the ideas of control theory. Loci and causes of distraction are represented as disturbances to various functional elements of a control loop involving driver intending (goal setting), sensing, deciding on control response, dynamics of the vehicle, and human body activation and energetics. It is argued that activation should be classed separately from the other functions. Attention switching from environmental observation/control to internal device manipulation is modeled as sampled-data control. Also fit within the control framework are mental modeling and anticipation of events in the driver's preview. The control framework is shown to suggest some salient research questions and experiments. Actual or potential applications of this research include a refined understanding of driver distraction and better modeling and prediction of driving performance as a function of vehicle and highway design. PMID:15709322
|Research on two hypotheses regarding television's possible negative effect on children's academic achievement is reviewed. A lack of support is found for the displacement hypothesis (time spent with television is taken away from more academically beneficial activities) and limited support for the distraction hypothesis (exposure to television…
|Distraction and reappraisal are two commonly used forms of cognitive emotion regulation. Functional neuroimaging studies have shown that each one depends upon interactions between pFC, interpreted as implementing cognitive control, and limbic regions, interpreted as mediating emotional responses. However, no study has directly compared…
McRae, Kateri; Hughes, Brent; Chopra, Sita; Gabrieli, John D. E.; Gross, James J.; Ochsner, Kevin N.
Concepts of distraction developed in nineteenth century research associate it with transformed urban landscapes in nineteenth century modern cultures. But from the 1930s to 50s Britain, it becomes associated with disorders of domestic spatiality, and a disregard of those design principles of order and hygiene, purpose and function, which were understood to define 'problem families'. Researchers drew on psychological models
Knowledge regarding the anatomic morphology of maxillary molars is absolutely essential for the success of endodontic treatment. The morphology of the permanent maxillary first molar has been reviewed extensively; however, the presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. This case report presents a patient with a maxillary first molar with two roots and two root canals, who was referred to the Department of Endodontics, Tabriz University of Medical Sciences, Iran. PMID:23862051
Le Fort III distraction osteogenesis (DO) is a useful procedure for treating midface hypoplasia. The external distraction system has the advantage of allowing modification of the distraction vector during the activation period. This system needs an intraoral splint for the anchorage points. The intraoral splint has an important role in conducting the distraction force to the midface and in forming the advancement vector. The authors developed a modified type of splint to improve the outcome of Le Fort III DO.The intraoral splint is composed of a modified headgear face bow, molar bands, and a palatal acrylic plate without covering the teeth. Four suspension wires were applied to reinforce the stability. The zygomatic bones and the loops of the splint are selected as 4 anchorage points for Le Fort III DO. This procedure was applied to 2 patients.The midface had an advancement of more than 20 mm in both patients. The dental movement of the upper incisors and the upper first molar was minimal.The dental effect was nearly absent. The amount and vector of distraction could be decided under direct observation without blocking the dental occlusion. The vector of distraction could be adjusted during the activation period. The results of DO were satisfactory. PMID:22565908
As in the traditional combined surgical and orthodontic procedures, an Orthodontist can plays vital role in treatment planning and the orthodontic treatment of patient undergoing distraction osteogenesis. This role includes predistraction assessment of the craniofacial skeleton and occlusal function, pre-distraction, and post-distraction orthodontic care. Based on clinical evaluation, dental study models, photographic analysis, cephalometric evaluation, and three-dimensional computed tomographic analysis, the Orthodontist, in collaboration with the Surgeon, plans distraction device placement and the predicted vectors of distraction. Finally, as in other forms of orthognathic surgery, the practice of distraction osteogenesis depends on the cooperation and planning between orthodontist and surgeon as a team. Purpose of this paper is to review biomechanics and orthodontic treatment protocol of distraction osteogenesis in the maxillofacial region.
Recent research indicates that cell phone use can distract drivers from safe vehicle operation. However, estimates of the prevalence of cell phone use while driving have been limited to daytime hours and low-speed roadways. This paper describes the results of a study to estimate rates of cell phone use and other distractions by examining approximately 40,000 high-quality digital photographs of vehicles and drivers on the New Jersey Turnpike. The photographs, which originally were collected as part of a separate study, were taken both during the day and during the night and at different locations across the span of the Turnpike. A radar gun linked to the camera recorded the speeds of vehicles as they passed. This provided us with the speeds of every vehicle photographed, and allowed us to determine population counts of vehicles. A panel of three trained coders examined each photograph and recorded the presence of cell phone use by the drivers or any other distracting behavior. Demographic information on the driver was obtained during previous examinations of the photographs for an unrelated study. A rating was considered reliable when two out of the three coders agreed. Population estimates (and confidence intervals) of cell phone use and other distractions were estimated by weighting the cases by the inverse probability of vehicle selection. Logistic regression was used to predict cell phone use from demographic and situational factors. The results indicated that the most frequent distraction was cell phone use: 1.5% of the drivers on the Turnpike were using cell phones compared to the 3 to 4% use rates reported in the National Occupant Protection Use Survey (NOPUS) surveys conducted during the daytime on lower speed roadways. The Turnpike survey indicated that cell phones were used less on weekends and at night, and when the driver was exceeding the speed limit or had a passenger in the car. PMID:14754669
Johnson, Mark B; Voas, Robert B; Lacey, John H; McKnight, A Scott; Lange, James E
Purpose/Objectives To explore virtual reality (VR) as a distraction intervention to relieve symptom distress in adults receiving chemotherapy treatments for breast, colon, and lung cancer. Design Crossover design in which participants served as their own control. Setting Outpatient clinic at a comprehensive cancer center in the southeastern United States. Sample 123 adults receiving initial chemotherapy treatments. Methods Participants were randomly assigned to receive the VR distraction intervention during one chemotherapy treatment and then received no intervention (control) during an alternate matched chemotherapy treatment. The Adapted Symptom Distress Scale–2, Revised Piper Fatigue Scale, and State Anxiety Inventory were used to measure symptom distress. The Presence Questionnaire and an open-ended questionnaire were used to evaluate the subjects’ VR experience. The influence of type of cancer, age, and gender on symptom outcomes was explored. Mixed models were used to test for differences in levels of symptom distress. Main Research Variables Virtual reality and symptom distress. Findings Patients had an altered perception of time (p < 0.001) when using VR, which validates the distracting capacity of the intervention. Evaluation of the intervention indicated that patients believed the head-mounted device was easy to use, they experienced no cybersickness, and 82% would use VR again. However, analysis demonstrated no significant differences in symptom distress immediately or two days following chemotherapy treatments. Conclusions Patients stated that using VR made the treatment seem shorter and that chemotherapy treatments with VR were better than treatments without the distraction intervention. However, positive experiences did not result in a decrease in symptom distress. The findings support the idea that using VR can help to make chemotherapy treatments more tolerable, but clinicians should not assume that use of VR will improve chemotherapy-related symptoms. Implications for Nursing Patients found using VR during chemotherapy treatments to be enjoyable. VR is a feasible and cost-effective distraction intervention to implement in the clinical setting.
This study explored the nature of errors made by drivers when distracted versus not distracted. Participants drove an instrumented vehicle around an urban test route both while distracted (performing a visual detection task) and while not distracted. Two in-vehicle observers recorded the driving errors made, and a range of other data were collected, including driver verbal protocols, forward, cockpit and driver video, and vehicle data (speed, braking, steering wheel angle, etc.). Classification of the errors revealed that drivers were significantly more likely to make errors when distracted; although driving errors were prevalent even when not distracted. Interestingly, the nature of the errors made when distracted did not differ substantially from those made when not distracted, suggesting that, rather than making different types of errors, distracted drivers simply make a greater number of the same error types they make when not distracted. Avenues for broadening our understanding of the relationship between distraction and driving errors are discussed along with the advantages of using a multi-method framework for studying driver behaviour. PMID:22727884
Young, Kristie L; Salmon, Paul M; Cornelissen, Miranda
Objective?Using a mixed model design, this study examined the effects of interactive versus passive distraction on healthy preschool-aged children’s cold pressor pain tolerance.?Methods?Sixty-one children aged 3–5 years were randomly assigned to one of the following: interactive distraction, passive distraction, or no distraction control. Participants underwent a baseline cold pressor trial followed by interactive distraction trial, passive distraction trial, or second baseline trial. One or two additional trials followed. Children originally assigned to distraction received the alternate distraction intervention. Controls participated in both interactive and passive distraction trials in counterbalanced order.?Results?Participants showed significantly higher pain tolerance during both interactive and passive distraction relative to baseline. The two distraction conditions did not differ.?Conclusions?Interactive and passive video game distraction appear to be effective for preschool-aged children during laboratory pain exposure. Future studies should examine whether more extensive training would enhance effects of interactive video game distraction.
BACKGROUND: Maxillary sinus mucoceles are relatively rare among all paranasal sinus mucoceles. With the introduction of endoscopic sinus surgical techniques, rhinologic surgeons prefer transnasal endoscopic management of sinus mucoceles. The aim of this study is to describe the clinical presentation of maxillary sinus mucoceles and to establish the efficacy of endoscopic management of sinus mucoceles. METHODS: Between 2003 and 2005,
Fatma Caylakli; Haluk Yavuz; Alper Can Cagici; Levent Naci Ozluoglu
Cholesterol granuloma (CG) of the maxillary sinus is very rare. In this study, the searching of the literature was performed with the keywords of cholesterol granuloma and maxillary sinus. All retrieved literature were reviewed throughout to identify and analyze all individual characteristics. Two additional cases in our hospital were also included. The result showed that, in the overall 37 cases,
The etiology of tooth impactions has long been related to an arch-length deficiency. This is valid for most impactions, but not for palatal impaction of the maxillary canine. This study shows that 85 percent of the palatally impacted canines have sufficient space for eruption. The bud of the maxillary canine is wedged between the nasal cavity, the orbit, and the anterior wall of the maxillary sinus. The buds of the lateral incisor and the first premolar are located behind the canine's palatal surface. An arch-length deficiency will not allow the maxillary canine to "jump" the buds, the nasal cavity, or the sinus in order to reappear in the palate. A canine can be palatally impacted if an extra space is available in the maxillary bone. This space can be provided by (1) excessive growth in the base of the maxillary bone, (2) space created by agenesis or peg-shaped lateral incisors, or (3) stimulated eruption of the lateral incisor or the first premolar. In those conditions the canine is free to "dive" in the bone and to become palatally impacted. A dysplasia in the maxillary-premaxillary suture can also modify the direction of the maxillary canine's eruption. PMID:6576636
A rare case of a 5-year-old female with schwannoma of the maxillary sinus is presented. She had complained of painless swelling of the left cheek and hard palate for a duration of one year. Preoperatively, a CT scan strongly suggested it to be a maxillary cyst with an erupted tooth rather than neoplasm. The tumour was completely removed after embolization
Introduction: A malformed mandible and an abnormally positioned mandibular foramen make it difficult to plan an ideal osteotomy line for mandibular distraction. In addition, there have been reports of such complications as nonunion, damage and stretch injury of the inferior alveolar nerve and tooth germ damage when conventional osteotomy or corticotomy are used for mandibular distraction. The authors utilized the original sagittal split ramus osteotomy for mandibular distraction. Patients and Methods: Five patients (three unilateral hemifacial microsomia, one bilateral hemifacial microsomia, and one mandibular retrusion) were included in this study of distraction osteogenesis using the sagittal split ramus osteotomy. Extraoral distraction devices were applied to the first four patients. An intraoral device with mono-cortical screw fixation was used for the fifth patient. Result: In all five cases, the results of the distraction were satisfactory. Complications (as listed) of conventional osteotomy when used for distraction were avoided. Satisfactory results were achieved and these were also well maintained postoperatively (mean follow up: 36 months). Conclusion: The authors believe that sagittal osteotomy for mandibular distraction osteogenesis makes it possible, to avoid injury to the inferior alveolar nerve during operation and stretching injury during distraction and to prevent tooth germ injury. It is also possible to diversify the osteotomy line for various force vectors to enlarge the bony contact surface area. Therefore, we suggest that sagittal split ramus osteotomy should be used as a preferred modification of osteotomy for mandibular distraction. Copyright 2001 European Association for Cranio-Maxillofacial Surgery. PMID:11403554
Choi, Jin-Young; Hwang, Kyung-Gyun; Baek, Seung-Hak; Lee, Jong-Ho; Kim, Tae-Woo; Kim, Myung-Jin; Chang, Young-II
Background The Pierre Robin Sequence features were first described by Robin in 1923 and include micrognathia, glossoptosis and respiratory distress with an incidence estimated as 1:8,500 to 1:20,000 newborns. Upper airway obstruction and feeding difficulties are the main concerns related to the pathology. Mandibular distraction should be considered a treatment option (when other treatments result inadequate). Patiants and methods Ten patients between the ages of 1 month and 2 years with severe micrognathia and airway obstruction were treated with Mandibular Distraction Osteogenesis (MDO). All patients underwent fibroscopic examination of the upper airway and a radiographic imaging and/or computed tomography scans to detect malformations and to confirm that the obstruction was caused by posterior tongue displacement. All patients were evaluated by a multidisciplinary team. Indications for surgery included frequent apneic episodes with severe desaturation (70%). Gavage therapy was employed in all patients since oral feeding was not possible. The two tracheotomy patients were 5 months and 2 years old respectively, and the distraction procedure was performed to remove the tracheotomy tube. All patients were treated with bilateral mandibular distraction: two cases with an external multivector distraction device, six cases with an internal non-resorbable device and two cases with an internal resorbable device. In one case, the patient with Goldenhar's Syndrome, the procedure was repeated. Results The resolution of symptoms was obtained in all patients, and, when present, tracheotomy was removed without complications. Of the two patients with pre-existing tracheotomies, in the younger patient (5 months old) the tracheotomy was removed 7 days postoperatively. In the Goldenhar's syndrome case (2 years old) a Montgomery device was necessary for 6 months due to the presence of tracheotomy-inducted tracheomalacia. Patients were discharged when the endpoint was obtained: symptoms and signs of airway obstruction were resolved, PAS and maxillomandibular relationship improved, and tracheotomy, when present, removed. During the follow-up, no injury to the inferior alveolar nerve was noted and scarring was significant in only the two cases treated with external devices. Conclusion Mandibular Distraction Osteogenesis is a good solution in solving respiratory distress when other procedures are failed in paediatric patients with severe micrognatia.
Twelve metacarpals and two phalanges in 14 patients (nine males and five females) were lengthened between August 1992 and March 1999 by the callus distraction technique using a small external fixator (Orthofix). The indications were traumatic amputation (10 cases), aplasia (three cases) and hypoplasia owing to premature epiphyseal closure of the metacarpal (one case). All patients were reviewed with a median follow-up time of 39 (range, 9-88) months. The median age of the patients was 15 (range, 4-39) years. The median lengthening was 21 (range, 13-34) mm which was a median of 82% (range, 38-162) of the original bone length. The median times for callus distraction and consolidation were 4.5 and 7.5 weeks respectively. All except one patient tolerated the procedure well and were satisfied with the results. Functional improvement was seen in 13 out of 14 patients, but non-union was observed in one patient. PMID:11162007
Pursuant to the recently enacted Moving Ahead for Progress in the 21st Century Act (MAP-21), the Department of Transportation (DOT) announces the availability of funding authorized in the amount of $17.525 million in Federal fiscal year (FY) 2013 funds to provide grants to States for enacting and enforcing distracted driving laws. The FY 2013 funds are subject to an annual obligation limitation......
The purpose of the present study is to develop more precise methods to explore the interaction between contextual factors in teacher instructions in regular classroom settings and students’ abilities to use symbolic information in the instruction. The ability to easily show symbolic behavior could be expected to influence student’s capacity to be active and participate. The present study examines distraction in students’ shifts from the use of “non-symbolic” to “symbolic” behavior in regular classroom settings. The 53 students (29 boys and 24 girls), ages 11–13?years old, who participated in the study were from three classes in the same Swedish compulsory regular school. Based on their test performances in a previous study, 25 students (47%) were defined as showing symbolic behavior (symbolic), and 28 students (53%) as not showing it (non-symbolic). In the present study, new test trials with distractors were added. Students from both the symbolic and non-symbolic groups scored significantly fewer correct answers on the post-training test trials with distraction stimuli (p?0.05) than in post-training test trials without distraction. In the post-training test trials with competing arbitrary distractors, both groups were distracted significantly more than in the post-training test trials with competing non-arbitrary distractors (p?0.05). The results indicate that a relatively easily administered and socially acceptable procedure seems to give observational data about variations in students’ symbolic behavior in relation to contextual factors in regular classroom. The main conclusion to be drawn from the results is that the observational procedure used in this study seems to have a potential to be used to explore the interaction between contextual factors and more complex student behavior such as cognition and the pragmatic use of language in regular classroom.
The goals of mandibular distraction are to restore a normal length but also a normal shape to the hypoplastic mandible. These two goals are related to the elongation vector which is itself related to the location of the cortictomy and of the device. Other factors influence this elongation vector. So it is impossible to precisely predict the elongation vector. With the monodirectional distraction device no modification can be made during the distraction time. With a bidirectional distraction device offering the possibility to modulate the angulation between the two elongation rods it is possible to adjust the elongation vector during distraction. Precise distraction gap modeling is possible. This is particularly important to correct anterior open-bite. This device was tested on animals (pigs). PMID:9697234
Lucas, R; Gounot, N; Cresseaux, P; Breton, P; Freidel, M; Ferez, C; Roger, T; Genevois, J P
Distraction osteogenesis by the Ilizarov method was performed on 20 dogs. Mineralization at the site of the left tibial metaphyseal lengthening was measured by weekly quantitative computer tomography (QCT) using the contralateral tibia as a control. Four dogs each were killed on Days 7, 14, 21, and 28 of distraction in order to correlate QCT with microradiology, nondecalcified histology, quantitative calcium analysis, and scanning electron microscopy. It was consistently found that intramembranous ossification proceeded centripetally from each corticotomy surface toward the central fibrous interzone. Bone columns crystallized along longitudinally oriented collagen bundles, expanding circumferentially to surrounding bundles. As the distraction gap increased, the bone columns increased in length and in diameter, while the fibrous interzone remained about 4 mm long. Histologically, the bone columns resembled stalagmites and stalactites, as seen by microradiography and scanning electron microscopy, that projected from each corticotomy surface toward the center. These cones reached maximum diameters of 150-200 mu at the corticotomy surfaces. Radiodensity (QCT) increased gradually from the central fibrous interzone toward each corticotomy surface. Mineral density, as determined by calcium quantification, reflected the microscopic geometry and radiographic polarity. PMID:2293943
The limb lengthening technique of distraction osteogenesis (DO) used in orthopedic surgery is a well established procedure. DO has been adapted to the facial skeleton to change the anterior-posterior position of the jaws. Historically, the mandibular arch transverse dimension has been considered immutable. Mandibular arch expansion is done with a variety of methods including Schwarz plates, lingual arches, functional appliances and arch wires; these methods produce limited dimensional change with questionable long-term stability. Adapting the Ilizarov treatment protocol to the mandibular symphysis can produce a regenerate bone thereby adding dimension to the innate basal bone. This can then be used to produce a potentially greater effect than the conventional modes of mandibular expansion. The modified mandibular symphyseal distraction device used by the authors is a tooth borne device fabricated with a Schwartz screw and self cured acrylic resin coverage over all the erupted mandibular teeth. The appliance used by the authors has been found to be very economical, easy to fabricate and clinically efficient. The surgical approach used, requiring surgery under local anesthesia in the outpatient department obviates need of hospital admission and the cost and time factors associated with in-patient therapy Mandibular Symphyseal Distraction Osteogenesis (MSDO) with this innovative low cost approach may be compared in a multi centric study with other established methods of MSDO. PMID:23941027
Chopra, S S; Sahoo, Nanda Kishore; Jayan, Balakrishna
Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an
Kelsey R. Thompson; Amy M. Johnson; Jamie L. Emerson; Jeffrey D. Dawson; Erwin R. Boer; Matthew Rizzo
Many studies have documented the performance decrements associated with driver distractions; however, few have examined drivers’ awareness of these distraction effects. The current study measured how well-calibrated drivers are with respect to performance decrements from distracting tasks. In this test track study, 40 younger and older drivers completed a series of tasks on a hand-held or hands-free cell phone while
Organized hematoma of the maxillary sinus is a rare clinical disease. To our knowledge, only a few cases of organized hematoma of the maxillary sinus have previously been published, most coming without bleeding history and disorders. We report three cases of organized hematoma of the maxillary sinus presenting with an enlarging maxillary sinus mass. In the evaluation of a patient
Background Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. Methods The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol + divided attention; placebo; and placebo + divided attention. Results As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Conclusions Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults.
Harrington distraction rod surgery on six female patients with idiopathic scoliosis was simulated in three-dimensional osseoligamentous finite element models with individual geometry taken from preoperative stereo roentgenographic reconstructions of the spine and ribcage and compared with the measured outcome. Boundary conditions at the ends of the spine were used to maintain pelvis and head alignment. Published material and flexibility properties were used. The amount of hook distraction was calculated from measured changes in the distance between the hook sites (range, 13-27 mm). Initial simulations underestimated the Cobb angle correction by an average 6%. They underestimated the spinal elongation by 36% and predicted an average 12 degrees increase in kyphosis angle compared with an actual 10 degrees average decrease. Agreement for sagittal plane changes improved in five cases when the beams representing the motion segments were displaced posteriorly. In the sixth case (with the rod applied over a lordotic spinal region), agreement was improved with the motion segment beams displaced anteriorly. The amount of the beam displacement that gave the best agreement was variable, and we were not able to predict it for each individual. Both measured and simulated changes in vertebral transverse plane rotations and in rib angulations were small. The greatest source of errors in these simulations appeared to be inadequate representation of in vivo motion segment behavior by in vitro measured stiffness properties. PMID:8303449
Cervical fractures can result in severe neurological compromise and even death. One of the most commonly injured segments is the C2 vertebrae, which most frequently involves the odontoid process. In this report, we present the unusual case of a 28-year-old female who sustained a C2 vertebral body fracture (comminuted transverse fracture through the body and both transverse processes) that had both a significant distractive and rotational component, causing the fracture to be highly unstable. Application of halo bracing was unsuccessful. The patient subsequently required a C1-C4 posterior spinal fusion. Follow-up computer tomography imaging confirmed fusion and the patient did well clinically thereafter.
Lau, Darryl; Shin, Samuel S; Patel, Rakesh; Park, Paul
Mesiodens is the most common type of supernumerary tooth found in the premaxilla. It might be discovered by the orthodontist by chance on a radiograph or as the cause of an unerupted maxillary central incisor. The genetic transmission of supernumerary and impacted teeth is poorly understood. The occurrence of identical unerupted maxillary central incisors and mesiodentes in monozygotic twins suggests that genetic factors might influence the etiology of this problem. In this case report, we discuss the treatment of unerupted maxillary permanent incisors caused by mesiodentes in monozygotic twins. PMID:20889057
The aims of this study were to examine the effect of implant neck design and cortical bone thickness using 3D finite element analysis and to analyse the stability of clinical evidence based on micromotion and principal stress. Four commercial dental implants for a type IV bone and maxillarysegments were created. Various parameters were considered, including the osseointegration condition, loading
The purpose of this study was to compare retrospectively postoperative differences in maxillary stability after Le Fort I osteotomy and fixation with an unsintered hydroxyapatite (u-HA)/poly-l-lactic acid (PLLA) plate with or without self-setting ?-tricalcium phosphate (Biopex(®)) as interpositional material. Subjects comprised 45 patients diagnosed with mandibular prognathism with maxillary retrognathism and mandibular prognathism with bimaxillary asymmetry. All patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with fixation by uHA/PLLA plates. Patients were divided into 4 groups consisting of 9 maxillary impaction cases with Biopex(®) (group 1) to fill the gap between the bone segments, 14 maxillary advancement cases with Biopex(®) (group 2), 8 maxillary impaction cases without Biopex(®) (group 3) and 14 maxillary advancement cases without Biopex(®) (group 4). Changes in cepahalometric parameters at time intervals (1, 3 and 12 months) between the groups were compared. Results showed that stability did not depend on the use or otherwise of Biopex(®). PMID:23200322
Ueki, K; Okabe, K; Marukawa, K; Mukozawa, A; Moroi, A; Miyazaki, M; Sotobori, M; Ishihara, Y; Yoshizawa, K; Ooi, K; Kawashiri, S
Pierre Robin sequence is a pathology derived from alteration in the first and second branchial arch. Patients have breathing problems due to micrognathia and glossoptosis, causing severe upper airway obstruction. One surgical treatment is distraction osteogenesis. Three patients with Pierre Robin sequence (case 1, 3 months old; cases 2 and 3, 1 month old) with severe upper airway obstruction requiring mechanical ventilator assistance, underwent mandibular distraction osteogenesis prematurely with a new anchoring system, thus avoiding tracheostomy and its consequences. An intraoral approach was used to avoid scarring. A new anchoring device with transfixing Kirschner wire in the proximal (mandibular ramus) and distal segment (chin zone) was used. This diminishes the risk of distractor device displacement, guaranteeing optimal stability. A more anterior installation reduces the risk of damaging tooth buds in the mandibular body and the inferior alveolar nerve. The more anterior the fixation, the more horizontal the distraction vector becomes. The position and stability of the device are crucial. In these three patients the placement of two transfixing Kirschner wires using an intraoral approach showed good results and stability during the period of distraction and consolidation, with optimal results on the upper airway, avoiding tracheostomy. PMID:21330107
Fariña, R; Castellón, L; Nagelash, E; Valladares, S
Driver distraction is regarded as a significant contributor to motor-vehicle crashes. One of the important factors contributing to driver distraction was reported to be the handling and reaching of in-car electronic equipment and controls that usually requires taking the drivers' hands off the wheel and eyes off the road. To minimize the amount of such distraction, we present a new control scheme that senses and decodes the human muscles signals, denoted as Electromyogram (EMG), associated with different fingers postures/pressures, and map that to different commands to control external equipment, without taking hands off the wheel. To facilitate such a scheme, the most significant step is the extraction of a set of highly discriminative feature set that can well separate between the different EMG-based actions and to do so in a computationally efficient manner. In this paper, an accurate and efficient method based on Fuzzy Neighborhood Discriminant Analysis (FNDA), is proposed for discriminant feature extraction and then extended to the channel selection problem. Unlike existing methods, the objective of the proposed FNDA is to preserve the local geometrical and discriminant structures, while taking into account the contribution of the samples to the different classes. The method also aims to efficiently overcome the singularity problems of classical LDA by employing the QR-decomposition. Practical real-time experiments with eight EMG sensors attached on the human forearm of eight subjects indicated that up to fourteen classes of fingers postures/pressures can be classified with <7% error on average, proving the significance of the proposed method. PMID:23290462
Abnormal involuntary attention leading to enhanced distractibility may account for different behavioral and cognitive problems in children with attention deficit hyperactivity disorder (ADHD). This was investigated in the present experiment by recording event-related brain potentials (ERPs) to distracting novel sounds during performance of a visual discrimination task. The overall performance in the visual task was less accurate in the ADHD
V. Gumenyuk; O. Korzyukov; C. Escera; M. Hämäläinen; M. Huotilainen; T. Häyrinen; H. Oksanen; R. Näätänen; L. von Wendt; K. Alho
The 2012 National Survey on Distracted Driving Attitudes and Behaviors (NSDDAB) is the second in a series of surveys on distracted driving that have provided data to help further the understanding of driving behavior and to contribute to the development o...
In 2009, 5,474 people were killed on U.S. roadways and an estimated additional 448,000 were injured in motor vehicle crashes that were reported to have involved distracted driving (FARS and GES). Of those people killed in distracted-driving-related crashe...
BackgroundRecognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations,
Distracted driving is a major problem that leads to unnecessary accidents and human casualties everywhere in the world. The ubiquity of mobile phones is one cause of distracted driving. In United States alone, operating mobile phones while driving has been cited as a factor in crashes that have led to 995 deaths and 24,000 injuries in 2009. To mitigate the
Distraction during driving has been recognized as a significant cause of traffic accidents. The aim of this study is to investigate Electroencephalography (EEG) -based brain dynamics in response to driving distraction. To study human cognition under specific driving tasks in a simulated driving experiment, this study utilized two simulated events including unexpected car deviations and mathematics questions. The raw data
Chin-Teng Lin; Shi-An Chen; Li-Wei Ko; Yu-Kai Wang
Driver distraction represents a well-documented and growing contribution to the road safety problem. This study used a naturalistic, observational approach to examine if children in vehicles are a significant source of driving distraction. Families with children aged between 1 and 8 years drove an instrumented “study vehicle” on their regular trips for 3 weeks. A discrete video recording system in
Sjaan Koppel; Judith Charlton; Chelvi Kopinathan; David Taranto
Drivers attending to primary driving tasks show specific eye and head movement behaviours, while the distracted drive generally covers the states including drivers' eyes off the road and long-term eye closure. This paper presents a distraction detection system by using the strategy of ``attention budget''. The states of eyes off the road and face with closed eyes are used to
Although alcohol and distraction are often cited as significant risk factors for traffic crashes, most research has considered them in isolation. It is therefore necessary to consider the interactions between alcohol and distraction impairment sources, especially when examining the relationship between behavior and crash risk. In a driving simulator, the primary goal was to maintain a safe headway to a
Michael E. Rakauskas; Nicholas J. Ward; Erwin R. Boer; Edward M. Bernat; Meredith Cadwallader; Christopher J. Patrick
As the impairment of older drivers is especially found in perception and attention, one could assume that they are especially prone to distraction effects of secondary tasks performed while driving. The aim of the study was to examine the effect of age on driving performance as well as the compensation strategies of older drivers under distraction. 10 middle-aged and 10
Driver distraction has been recognized as a significant cause of traffic incidents. Therefore, the aim of this study was to investigate electroencephalography (EEG) dynamics in response to distraction during driving. To study human cognition under specific driving task, we used virtual reality (VR) based driving simulation to simulate events including unexpected car deviations and mathematics questions (math) in real driving.
Tasks that are easily interrupted under intermittent viewing conditions may be less distracting while driving because they allow drivers greater control over task sharing decisions. This paper investigates the reliability and sensitivity of the occlusion paradigm as a potential means of measuring task interruptability and distraction. Twenty-four participants, between the ages of 21 and 34, completed two separate experimental sessions.
Y. Ian Noy; Tracy L. Lemoine; Christopher Klachan; Peter C. Burns
Objectives: An experiment was conducted to assess the effects of distraction mitigation strategies on drivers? performance and productivity while engaged in an in-vehicle information system task. Background: Previous studies show that in-vehicle tasks undermine driver safety and there is a need to mitigate driver distraction. Method: An advising strategy that alerts drivers to potential dangers and a locking strategy that
Introduction: A malformed mandible and an abnormally positioned mandibular foramen make it difficult to plan an ideal osteotomy line for mandibular distraction. In addition, there have been reports of such complications as nonunion, damage and stretch injury of the inferior alveolar nerve and tooth germ damage when conventional osteotomy or corticotomy are used for mandibular distraction. The authors utilized the
The paper provides a critical review of distraction for pediatric immunizations in order to determine clinical practicality and efficacy of this commonly employed intervention. The MEDLINE and PsycINFO databases were searched to identify papers that included an evaluation of a distraction intervention as a method of pediatric immunization pain management. Fifteen papers were included in this review. Effect sizes were
Correction of a relapsed clubfoot deformity by distraction with an external fixator is a recognized alternative to open surgery. Most published series report a good outcome but none are prospective observational studies using the scoring system of the International Clubfoot Study Group (ICFSG). We present a series of 9 relapsed club feet treated with closed gradual distraction using this scoring method.
The process of osteogenesis in the periodontal ligament during orthodontic tooth movement is similar to the osteogenesis in the midpalatal suture during rapid palatal expansion. A new concept of “distracting the periodontal ligament” is proposed to elicit rapid canine retraction in 3 weeks. It is called dental distraction. Fifteen orthodontic patients (26 canines, including 15 uppers and 11 lowers) who
In 2 experiments, 84 and 162 undergraduates listened to a discrepant communication while they were distracted by having to call out a series of lights which flashed with systematically manipulated frequency. Rate of flash increased acceptance of the communication and decreased postcommunication production of counterarguments. Removal of the effect of counterarguing by covariance analysis eliminated the relationship between distraction and
Previous treatments of eyewitness lineups have focused exclusively on the importance of homogeneity (similarity of common features) in the physical characteristics of lineup members. This has led to some confusion about the proper way to select distracters. We argue that distracters should not be selected for their similarity to the suspect but rather for their similarity to the witness's description
Engaging in an irrelevant, distracting activity while simultaneously processing a persuasive communication has a salutary effect upon attitude change if the audience is set to attend primarily to the message, but the opposite effect if they are set toward the distracting activity. The conditions necessary for demonstrating this relationship are sensitive to operational details which were not sufficiently well controlled
|Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27…
Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.
Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27…
Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.
Objective: Posterior vault remodeling by distraction osteogenesis is a relatively new technique used for initial correction of turribrachycephaly in children with bicoronal craniosynostosis. We present a new potential complication from this procedure; a case of pan-suture synostosis subsequent to posterior vault distraction. Methods: We report an infant girl who presented with bicoronal synostosis in the setting of Saethre-Chotzen syndrome. She underwent posterior vault distraction and was distracted a total of 34 millimeters, with successful osteogenesis at the site. Results: One year postoperatively, the patient was found to have incidental, asymptomatic pan-suture synostosis on computed tomography. Conclusions: To our knowledge, this is the first reported case of delayed craniosynostosis after posterior vault distraction in the literature. The possible pathogenesis and significance of this case are discussed with a review of the current literature.
Chu, Katrina F.; Sullivan, Stephen R.; Taylor, Helena O.
Segmental odontomaxillary dysplasia (SOD) is a rare developmental disorder of the maxilla, characterized by variability of its clinical and radiological features and may mimic other fibro-osseous lesions. Clinically, the disorder is often diagnosed in early childhood due to a unilateral buccolingual expansion of the posterior alveolar process, gingival enlargement, absence of one or both premolars in the affected region, delayed eruption of the adjacent teeth, and malformations of the primary molars. We describe a rare case of a SOD in a 19-year-old female comprising findings similar to earlier reports, but for the first time SOD is reported along midline. She presented with pre-maxillary enlargement and abnormal pattern of eruption of anterior maxillary permanent teeth. Radiographic imaging showed abnormal bony trabeculation. Histopathologic findings showed characteristic features of SOD. We herein report a case of this rare unusual anomaly and review the literature. Clinicians should be aware of its presence when encountering patients presenting with facial asymmetry unresponsive to treatment.
Although, in everyday life, patients with attention deficit hyperactivity disorder (ADHD) are frequently distracted by goal-irrelevant affective stimuli, little is known about the neural and behavioral substrates underlying this emotional distractibility. Because some of the most important brain responses associated with the sudden onset of an emotional distracter are characterized by their early latency onset and short duration, we addressed this issue by using a temporally agile neural signal capable of detecting and distinguishing them. Specifically, scalp event-related potentials (ERPs) were recorded while 20 boys with ADHD combined type and 20 healthy comparison subjects performed a digit categorization task during the presentation of three types of irrelevant, distracting stimuli: arousing negative (A-), neutral (N) and arousing positive (A+). Behavioral data showed that emotional distracters (both A- and A+) were associated with longer reaction times than neutral ones in the ADHD group, whereas no differences were found in the control group. ERP data revealed that, compared with control subjects, boys with ADHD showed larger anterior N2 amplitudes for emotional than for neutral distracters. Furthermore, regression analyses between ERP data and subjects' emotional ratings of distracting stimuli showed that only in the ADHD group, emotional arousal (ranging from calming to arousing) was associated with anterior N2: its amplitude increased as the arousal content of the visual distracter increased. These results suggest that boys with ADHD are more vulnerable to the distracting effects of irrelevant emotional stimuli than control subjects. The present study provides first data on the neural substrates underlying emotional distractibility in ADHD. PMID:23867737
López-Martín, Sara; Albert, Jacobo; Fernández-Jaén, Alberto; Carretié, Luis
Recalling information involves the process of discriminating between relevant and irrelevant information stored in memory. Not infrequently, the relevant information needs to be selected from among a series of related possibilities. This is likely to be particularly problematic when the irrelevant possibilities not only are temporally or contextually appropriate, but also overlap semantically with the target or targets. Here, we investigate the extent to which purely perceptual features that discriminate between irrelevant and target material can be used to overcome the negative impact of contextual and semantic relatedness. Adopting a distraction paradigm, it is demonstrated that when distractors are interleaved with targets presented either visually (Experiment 1) or auditorily (Experiment 2), a within-modality semantic distraction effect occurs; semantically related distractors impact upon recall more than do unrelated distractors. In the semantically related condition, the number of intrusions in recall is reduced, while the number of correctly recalled targets is simultaneously increased by the presence of perceptual cues to relevance (color features in Experiment 1 or speaker's gender in Experiment 2). However, as is demonstrated in Experiment 3, even presenting semantically related distractors in a language and a sensory modality (spoken Welsh) distinct from that of the targets (visual English) is insufficient to eliminate false recalls completely or to restore correct recall to levels seen with unrelated distractors . Together, the study shows how semantic and nonsemantic discriminability shape patterns of both erroneous and correct recall. PMID:23661190
Beaman, C Philip; Hanczakowski, Maciej; Hodgetts, Helen M; Marsh, John E; Jones, Dylan M
Entering a new millennium seems a good time to challenge some old ideas, which in our view are implausible, have little supportive evidence, and might best be left behind. In this essay, we summarize a decade of work, raising four issues that involve toxicology, nutrition, public health, and government regulatory policy. (a) Paracelsus or parascience: the dose (trace) makes the poison. Half of all chemicals, whether natural or synthetic, are positive in high-dose rodent cancer tests. These results are unlikely to be relevant at the low doses of human exposure. (b) Even Rachel Carson was made of chemicals: natural vs. synthetic chemicals. Human exposure to naturally occurring rodent carcinogens is ubiquitous, and dwarfs the general public's exposure to synthetic rodent carcinogens. (c) Errors of omission: micronutrient inadequacy is genotoxic. The major causes of cancer (other than smoking) do not involve exogenous carcinogenic chemicals: dietary imbalances, hormonal factors, infection and inflammation, and genetic factors. Insufficiency of many micronutrients, which appears to mimic radiation, is a preventable source of DNA damage. (d) Damage by distraction: regulating low hypothetical risks. Putting huge amounts of money into minuscule hypothetical risks damages public health by diverting resources and distracting the public from major risks. PMID:10686303
Surgical repositioning of the downward displaced premaxilla in bilateral cleft lip and palate patients remains a controversial and perplexing issue because of its detrimental effects on the growth of the premaxilla. The purpose of this prospective clinical study was to introduce and evaluate the treatment results of an innovative technique for nonsurgically intruding the downward displaced premaxilla. Eight consecutive cases of bilateral cleft lip and palate at the age of mixed dentition were included for the correction of their premaxillary deformities. A pair of intraoral tooth-borne distraction devices was used for the orthopedic intrusion. Serial lateral and posteroanterior cephalometric radiographs were taken periodically for evaluating the growth of the premaxilla 1 year before the intrusion, changes during the intrusion, and growth/relapse up to 1 year after the intrusion. There was no overgrowth of the premaxilla or overeruption of the maxillary incisors during the 1-year observing period before the orthopedic intrusion. The treatment results revealed that the downward displaced premaxillae were all corrected within 1 month. Cephalometrically, 46 percent of the correction resulted from a true orthopedic intrusion and another 54 percent from a dentoalveolar effect in which the maxillary incisors were intruded and the premaxillary dentoalveolus was shortened. The cephalometric evaluations also implied that what occurred during the orthopedic intrusion was mostly the sutural contraction osteogenesis/osteolysis in the vomeropremaxillary suture combined with slightly mechanical upward displacement of the vomeronasal septum complex and nasal bones. The orthopedic intrusion of the premaxilla with distraction devices is an effective nonsurgical method for correcting the downward displaced premaxilla before alveolar bone grafting in patients with bilateral cleft lip and palate, and the results remained stable after 1 year. PMID:15108871
Liou, Eric Jein-Wein; Chen, Philip K T; Huang, C Shing; Chen, Y Ray
The maxillary central incisor is the tooth most often affected by trauma, especially in the age range of 7 to 10 years, when high-impact sports are prevalent. The options for conservative treatment should be prioritized in these patients, aiming to achieve a biologic response that might provide continuity of growth of the alveolus, to provide functional and esthetic development of the affected region. This case report describes a patient with a history of trauma during the deciduous dentition with consequent intrusion, root dilaceration, and retention of the maxillary left central incisor. The treatment involved extraction of the traumatized tooth and mesial movement of the lateral incisor and posterior segments. PMID:22920706
Rizzatto, Susana Maria Deon; Closs, Luciane Quadrado; Freitas, Maria Perpétua Mota; Rizzatto, Laura Escobar
Interruptions (gaps) and unfamiliar events (distracters) during a timed signal delay the timed response of humans and other animals. To explore this phenomenon, we manipulate the intensity of auditory distracters (Experiment 1), and we dissociate the role of distracter intensity, distracter similarity with the intertrial interval, and dissimilarity from the timed auditory signal (Experiment 2). When the intertrial interval and
Background Management of post trauma tibia bone gap varied with orthopedic surgeons’ experience and tools available. Study aims to determine predictive factors for distraction by a monotube fixator (DMF) outcome in post tibia trauma limb length discrepancy. Methods A prospective descriptive cross sectional study of post traumatized tibia bone gap and limb length discrepancy patients at tertiary hospitals. Patient’s informed consent and institutional ethical committee approval were obtained. Bio-data, clinical and healing indexes were documented. DMF was applied for patient that met inclusion criteria. The Statistic tests used included the Chi-square, the Student’s two-tailed t test, and the Wilcox on rank-sum test when appropriate. Mantel-Haenszel Common Odds Ratio (OR) and 95% confidence intervals for poor outcome potential risk factors were recorded. Bivariate correlation and logistic regression were evaluated. Significance level was set at a p value <0.05. Results Thirty-six patients with mean age, 37.2?±?10.3 year and male/female ratio of 1:1.25 had DMF applied. Motorcycle accident accounted for 50.0% of patients and diaphyseal segment was most commonly affected 25 (69.4%). The mean bone lengthened was 10.1?±?4.0 cm (range: 5-21 cm) and mean duration of bone transport was 105.6?±?38.2 days. The means of rate of distraction, healing index and percentage of lengthening were 0.99?±?0.14 mm/day, 15.6?±?4.3 days/cm and 38.0?±?14.3 respectively. The mean follow up was 9.7 ±4.9 months (range: 2–17.0). Per operative complications varied and outcome was satisfactory in 30 (83.3%). Obesity (p <0.0001), multiple surgery (p?=?0.012) and transfusion (p?=?0.001) correlated to poor outcome. Percentage lengthening???50%, bone gap >10 cm, anemia, blood transfusion, general anesthesia administration, distraction rate >1 mm/day, osteomyelitis and prolong partial weight bearing were significant predictive factors for poor outcome in post traumatic tibia distraction. Conclusion Distraction by a monotube fixator appears effective in achieving correction >38.0% original tibia lengthening following traumatic bone gap. Predictive factors for poor outcome were useful for prognostication.
We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants) were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n = 4). A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80) after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation.
To document drivers’ exposure to potential distractions and the effects of these distractions on driving performance, inconspicuous video camera units were mounted in the vehicles of 70 volunteer subjects. The camera units automatically recorded a closeup view of the driver’s face, a broader view of the interior of the vehicle, and the roadway immediately ahead of the vehicle whenever it was powered on. Three hours of randomly selected data per subject were coded based on a taxonomy of driver distractions (talking on cell phone, eating, tuning radio, etc.), contextual variables (whether vehicle stopped or moving, road type, traffic level, etc.) and observable measures of driver performance (eyes directed inside or outside vehicle, hands on or off steering wheel, and vehicle position in travel lane). Results were analyzed descriptively and using nonparametric bootstrap analysis techniques. The most common distractions in terms of overall event durations were eating and drinking (including preparations to eat or drink), distractions inside the vehicle (reaching or looking for an object, manipulating vehicle controls, etc.), and distractions outside the vehicle (often unidentified). Although many of the distractions were also associated with negative driving performance outcomes, further research is needed to clarify their impact on driving safety.
Summary Background When the incisors do not erupt at the expected time, it is crucial for the clinician to determine the etiology and formulate an appropriate treatment plan. Aim The aim of this report is to provide useful information for immediate diagnosis and management of impacted maxillary incisors using the interceptive treatment: removal of obstacles and rapid maxillary expansion (RME). Design An accurate diagnosis may be obtained with clinical and radiographic exam such as panoramic radiograph, computerized tomography (CT) and cone beam computerized tomography (CBCT). It’s important to know the predictive measurements of eruption evaluated on panoramic radiograph: distance from the occlusal plane, maturity, angulation and vertical position of the unerupted incisors. Early diagnosis is important and interceptive orthodontic treatment, such as removal of obstacles and orthopedic rapid maxillary expansion (RME), may correct disturbances during the eruption through recovering space for the incisors and improving the intraosseus position of delayed teeth. Results RME treatment following the surgical removal of the obstacle to the eruption of maxillary incisors leads to an improvement of the intraosseus position of the tooth. Conclusions The angulation and the vertical position of the delayed tooth appear to be important in trying to predict eruption. The improvement of the intraosseus position of the unerupted incisor, obtained by removal of the odontoma and rapid maxillary expansion, permits a conservative surgery and the achievement of an excellent esthetics and periodontal result.
Maintaining a selective attention set allows us to efficiently perform sensory tasks despite the multitude of concurrent sensory stimuli. Unpredictably occurring, rare events nonetheless capture our attention, that is, we get distracted. The present study investigated the efficiency of control over distraction as a function of preparation time available before a forthcoming distracter. A random sequence of short and long tones (100 or 200 ms with 50-50 % probability) was presented. Independently from tone duration, occasionally (13.3 % of the time), the pitch of a tone was changed. Such rare pitch variants (distracters) usually lead to delayed and less precise discrimination responses, and trigger a characteristic series of event-related potentials (ERPs) reflecting the stages of distraction-related processing: starting with negative ERPs signaling the sensory registration of the distracter; a P3a-usually interpreted as a reflection of involuntary attention change and finally the so-called reorienting negativity signaling the restoration of the task-optimal attention set. In separate conditions, 663 or 346 ms before each tone (long or short cue-tone interval), a visual cue was presented, which signaled whether the forthcoming tone was a distracter (rare pitch variant), with 80 % validity. As reflected by reduced reaction time delays and P3a amplitudes, valid cues led to the prevention of distraction, but only in the long cue-tone interval condition. The analyses of the cue-related P3b and contingent negative variation showed that participants made more effort to utilize cue information to prevent distraction in the long cue-tone than in the short cue-tone interval condition. PMID:23975153
BACKGROUND: We report a rare case of fatty tissue within the maxillary sinus in a 21-years-old woman, with a history of several previous punctures of the maxillary sinus. CASE PRESENTATION: Clinical data of the patient was analysed retrospectively. The patient presented with symptoms of left-sided chronic maxillary sinusitis and had undergone several punctures of the left maxillary sinus 18 months
A wide variety of lesions and not necessarily a malignant tumour can cause maxillary swelling. Non-specificity of clinical\\u000a and radiological features of these maxillary lesions makes their diagnosis difficult. Review of literature adds a little regarding\\u000a the aetiopathological distribution of the various lesions causing maxillary swelling. We present our finding regarding the\\u000a relative distribution of various conditions causing maxillary swelling.
This case report describes the surgical-orthodontic guided-eruption of a deeply impacted macrodontic maxillary central incisor in a 10-year-old patient with Alagille syndrome (ALGS). In the first stage, orthodontic treatment with fixed appliance on deciduous teeth allowed to create enough space for the eruption of the maxillary right central incisor. The second stage included closed surgical exposure and vertical traction. After impacted tooth erupted in the proper position, accessory periodontal treatment and dental reshaping procedures may be indicated to camouflage macrodontic incisor with the adjacent teeth. This is the first report that presents a patient with ALGS undergoing orthodontic and surgical treatment.
Maxillary ameloblastomas can extensively expand into the paranasal sinuses or even the nasal cavity due to a slow growth pattern. Sinusitis is rarely the first tumor-related complaint. Due to the various growth forms of ameloblastomas the challenging histological differential diagnosis includes several other odontogenic as well as benign and malignant non-odontogenic tumors, e.g. tumors from the mucosa of the paranasal sinuses, salivary glands and Rathke's pouch. Despite the radical surgical approach a complete resection with wide margins cannot always be achieved. Maxillary ameloblastomas show the highest recurrence rates. PMID:23436120
Geddert, H; Runge, S; Werner, U; Walendzik, H; Dimmler, A
The development of intranasal ectopic teeth is rare. Although they are more commonly seen in the palate and maxillary sinus, they can also be found in the mandibular condyle, coronoid process, and nasal cavity. A 30-year-old male patient presented with a complaint of headache. Computed tomography of the paranasal sinuses showed a bony mass in the right maxillary sinus wall, 1 cm in size. He did not have any history of maxillofacial trauma or operation. The mass was removed via a Caldwell-Luc procedure. It looked like a tooth. Histopathologic diagnosis was made as ectopic molar tooth. The patient was asymptomatic two weeks after the operation. PMID:18187979
Altun, Hüseyin; Teker, Ay?enur Meriç; Ceran, Murat; Gedikli, Orhan
Concha bullosa is a common anatomic variation of the middle turbinate; however, sinusitis secondary to the concha bullosa is rare. A 52-yr-old woman presented with nasal obstruction and posterior nasal drip. Computed tomography and examination of the nasal cavity revealed septal deviation on the left side, and a massive concha bullosa and maxillary sinusitis on the right side. The lateral lamella of the affected turbinate was removed and the inspissated material was drained. Histopathologic examination of the excised lesion in the concha bullosa revealed bacterial colonies in the mucus plug. We report here on a massive concha bullosa with secondary maxillary sinusitis.
The process of rapid canine distalization through the distraction of the periodontal ligament is similar to the process in the midpalatal suture during rapid palatal expansion. Rapid canine distalization can be achieved in three weeks with this technique. The aim of this research was to evaluate the effects of rapid canine distalization on dentoalveolar tissues during the rapid distalization of canine teeth with semirigid, individual tooth-borne distractors. The study was carried out on 43 canine teeth in 18 (seven male and 11 female) patients who required first premolar extractions. The mean age of the patients was 16.7 years. The second premolars and first molars were used as anchor units. Orthodontic models, cephalometric and panoramic radiographs, and standard photographs of all the patients were taken before treatment and after the consolidation period. Periapical radiographies of the canines and anchor units were obtained once a week during the distalization period. The distractors were activated 0.25 mm three times a day, and the canines were distalized efficiently an average of three weeks. The within-group differences were evaluated with the Wilcoxon test. The maxillary canines were distalized an average of 5.76 mm with 11.47 degrees distal tipping. The maxillary first molars moved mesially 0.56 mm and extruded 0.64 mm. The maxillary incisors showed 1.44 degrees of palatal tipping. The mean distal movement of the mandibular canines was 3.5 mm with 7.16 degrees distal tipping. Anchorage loss was not observed in the mandibular first molars. PMID:15264639
Sayin, Seher; Bengi, A Osman; Gürton, A Umit; Ortako?lu, Kerim
An experiment was conducted to assess the distraction potential of secondary tasks performed using in-vehicle systems (radio tuning, destination entry) and portable phones (10-digit dialing, selecting contacts, text messaging) while driving. One hundred p...
E. Parmer E. N. Mazzae G. H. S. Baldwin J. Martin T. A. Ranney
College students whose test anxiety was measured completed a working memory-intensive math exam with televised distractions. Students were provided with implementation intentions (if–then plans; Gollwitzer, 1999) designed to either help them ignore the distractions (i.e., temptation-inhibiting plans) or focus more intently on the math exam (i.e., task-facilitating plans). Regression analyses showed that as test anxiety increased, the effectiveness of temptation-inhibiting
Elizabeth J. Parks-Stamm; Peter M. Gollwitzer; Gabriele Oettingen
Soft tissue distraction (STD) is an increasingly accepted operation in all fields of hand surgery from elbow contracture release\\u000a to PIP joint release. Current techniques reported lack the ability to distract the joints of the fingers or the hand, maintain\\u000a the length of released contractures, and hold them in a position while active and passive physiotherapy is possible. We describe
Shahram Nazerani; Mohammad Hosein Kalantar Motamedi
A magnetic flux distraction effect caused by a nearby metallic material was investigated for Metglas/Pb(Mg1/3Nb2/3)O3-PbTiO3 laminated magnetoelectric (ME) sensors. Using flux distraction, a ME sensor can perform an accurate search for metallic targets of different dimensions at various distances. Detection results and simulations were in good agreement. The findings demonstrate an effective means to employ stationary ME sensors and gradiometers for magnetic search applications.
Event-related potential (ERP) correlates of distraction are usually investigated in the oddball paradigm following a discrete, trial-by-trial stimulation protocol. In this design, participants perform a discrimination task while oddball stimuli deviate in a task-irrelevant stimulus feature. In our experiment, participants detected gaps in a continuous tone while infrequent frequency glides served as distracting events.Glides preceding a gap by 150ms delayed
Distraction osteogenesis presents an alternative procedure for augmentation of atrophic alveolar bone prior to inserting dental\\u000a implants. The aim of this retrospective study was to evaluate complications of this method with specific focus on bone resorption\\u000a during the consolidation period and the follow-up period after dental implant insertion into distracted bone. Thirty partially\\u000a edentulous patients underwent a total of 36
Tobias Ettl; Till Gerlach; Thomas Schüsselbauer; Martin Gosau; Torsten E. Reichert; Oliver Driemel
This study compared 220 college men and 237 college women on two types of self?reported cognitive distraction during sex, performance? and appearance?based. We assessed affect, psychological distress, sexual knowledge, attitudes, fantasies, experiences, body image, satisfaction, and sexual function with the Dewgatis Sexual Functioning Inventory and the Sexual History Form to determine associations with distraction. Between?gender analyses revealed that women reported
The maxillary ameloblastoma presents clinically as a potent-ally more dangerous lesion than its mandibular counterpart. The microscopic appearance of this locally aggressive neoplasm challenges the diagnostic acumen of the pathologist and its variable bio...
Selective attention involves the exclusion of irrelevant information in order to optimize perception of a single source of sensory input; failure to do so often results in the familiar phenomenon of distraction. The term 'distraction' broadly refers to a perceptual phenomenon. In the present study we attempted to find the electrophysiological correlates of distraction using an auditory discrimination task. EEG and event-related potential responses to identical stimuli were compared under two levels of distraction (continuous broad-band noise or continuous speech). Relative to broad-band noise, the presence of a continuous speech signal in the unattended ear impaired task performance and also attenuated the N1 peak evoked by nontarget stimuli in the attended ear. As the magnitude of a peak in the event-related potential waveform can be modulated by differences in intertrial power but also by differences in the stability of EEG phase across trials, we sought to characterize the effect of distraction on intertrial power and intertrial phase locking around the latency of the N1. The presence of continuous speech resulted in a prominent reduction of theta EEG band intertrial phase locking around the latency of the N1. This suggests that distraction may act not only to disrupt a sensory gain mechanism but also to disrupt the temporal fidelity with which the brain responds to stimulus events. PMID:22314684
Ponjavic-Conte, Karla D; Dowdall, Jarrod R; Hambrook, Dillon A; Luczak, Artur; Tata, Matthew S
Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean = 72.5 years, SD = 5.0 years) and 51 middle-aged drivers (mean = 53.7 years, SD = 9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to “freeze up”, spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load.
Thompson, Kelsey R.; Johnson, Amy M.; Emerson, Jamie L.; Dawson, Jeffrey D.; Boer, Erwin R.
Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean=72.5 years, SD=5.0 years) and 51 middle-aged drivers (mean=53.7 years, SD=9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to "freeze up", spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load. PMID:22269561
Thompson, Kelsey R; Johnson, Amy M; Emerson, Jamie L; Dawson, Jeffrey D; Boer, Erwin R; Rizzo, Matthew
Fibrous dysplasia is usually a slowly progressive, benign disease that develops over several years and presents with deformity or mild symptomatology. Five of 34 patients (ages 4-21 years), who were subsequently diagnosed histologically as having fibrous dysplasia of the maxillary sinus, rapidly developed soft tissue masses of the malar region over a period of less than 4 months with accompanying pain (2 patients) and nasal obstruction and exophthalmos (2 patients). Each was clinically suspected of having a sarcoma; two had been thought to have an "osteofibrosarcoma" on initial biopsy at outside hospitals. After resection, all lesions developed regrowth. At histopathologic examination, both initial and recurrent masses proved to be typical fibrous dysplasia with spicules of woven bone in cellular, sometimes vascular, fibrous tissue. No malignant degeneration was found. On conventional radiography, aggressive fibrous dysplasia produced opacification and expansion of the maxillary sinus and apparent disruption of its wall with an associated soft tissue mass. Computed tomography (CT) demonstrated voluminous heterogeneous masses with "ground glass appearance", calcifications, areas of enhancement, low attenuation, cystic areas, and a thinned, sometimes interrupted, maxillary wall. Despite the aggressive clinical course for both initial and recurrent lesions, the CT findings of a "ground glass" mass with calcifications surrounded by a maxillary sinus wall, even if incomplete, can suggest the diagnosis of aggressive fibrous dysplasia. PMID:8291007
Shapeero, L G; Vanel, D; Ackerman, L V; Terrier-Lacombe, M J; Housin, D; Schwaab, G; Sigal, R; Masselot, J
Podoplanin expression has been reported in oral squamous epithelium, myoepithelia of the salivary glands, and odontogenic lesions, and has been linked with inflammatory and neoplastic conditions. We hypothesized that inflamed respiratory mucosa of the maxillary sinus also express podoplanin, especially in cases with odontogenic sinusitis. We retrospectively investigated podoplanin expression in biopsies from maxillary sinus with inflammatory changes. Cases with chronic rhinosinusitis with polyp formation (n=5), chronic rhinosinusitis without polyps (n=5), chronic rhinosinusitis with eosinophilia (n=5), and odontogenic chronic rhinosinusitis (n=5) were investigated immunohistochemically using an established antibody for podoplanin (D2-40). Respiratory epithelium in chronic maxillary sinusitis with polyp formation did not exhibit enhanced podoplanin expression. However, D2-40 positivity was detected in the basal cells in all cases with chronic sinusitis associated with inflammatory infiltrations as well as in the parabasal epithelial layer in chronic sinusitis without polyp formation. We observed podoplanin expression in non-neoplastic maxillary sinus epithelium exhibiting inflammatory changes. We suggest that podoplanin is involved in the pathogenesis of chronic rhinosinusitis, particularly in the intraepithelial migration of inflammatory infiltrates. PMID:23812230
Zustin, Jozef; Scheuer, Hanna A; Knecht, Rainald; Friedrich, Reinhard E
Fobrous Histiogytoma is an uncommon neoplasm of the Head and Neck region and quite rare in the paranasal sinuses. We are reporting\\u000a a case of Benign Fibrous Histiocytoma in the Maxillary sinus from the Department of Otorhinolaryngology of Bolani Hospital,\\u000a Bolani with a description of clinical and histological features of the neoplasm.
Fibrous Histiocytoma is an uncommon neoplasm of the Head and Neck region and quite rare in the paranasal sinuses. We are reporting\\u000a a case of Benign Fibrous Histiocytoma in the Maxillary sinus from the Department of Otorhinolaryngology of Bolani Hospital,\\u000a Bolani with a description of clinical and histological features of the neoplasm.
The sensitivity of involuntary attention to top-down modulation was tested using an auditory-visual distraction task and a working memory (WM) load manipulation in subjects performing a simple visual classification task while ignoring contingent auditory stimulation. The sounds were repetitive standard tones (80%) and environmental novel sounds (20%). Distraction caused by the novel sounds was compared across a 1-back WM condition
Ectopic eruption of maxillary canines can be associated with root resorption of adjacent teeth. This case report describes and discusses an interesting case of a 15-year-old girl with a Class III malocclusion and an impacted maxillary canine. Because of the unfavorable position of the ectopic canine and the severe root resorption of the maxillary left central and lateral incisors, the treatment options included extraction of the maxillary permanent canines. The mandibular first premolars were extracted to compensate for the Class III malocclusion. A panoramic radiograph taken earlier in the mixed dentition already indicated a possible eruption disturbance of the maxillary left permanent canine. The importance of early diagnosis of maxillary canine ectopic eruption is highlighted in this case report. The early identification of radiographic signs of an ectopic pathway of eruption should be followed by deciduous canine extraction to prevent canine retention and maxillary incisor root resorption. PMID:22858336
Garib, Daniela Gamba; Janson, Guilherme; Baldo, Taiana de Oliveira; dos Santos, Patrícia Bittencourt Dutra
Background In visual processing, there are marked cultural differences in the tendency to adopt either a global or local processing style. A remote culture (the Himba) has recently been reported to have a greater local bias in visual processing than Westerners. Here we give the first evidence that a greater, and remarkable, attentional selectivity provides the basis for this local bias. Methodology/Principal Findings In Experiment 1, Eriksen-type flanker interference was measured in the Himba and in Western controls. In both groups, responses to the direction of a task-relevant target arrow were affected by the compatibility of task-irrelevant distractor arrows. However, the Himba showed a marked reduction in overall flanker interference compared to Westerners. The smaller interference effect in the Himba occurred despite their overall slower performance than Westerners, and was evident even at a low level of perceptual load of the displays. In Experiment 2, the attentional selectivity of the Himba was further demonstrated by showing that their attention was not even captured by a moving singleton distractor. Conclusions/Significance We argue that the reduced distractibility in the Himba is clearly consistent with their tendency to prioritize the analysis of local details in visual processing.
de Fockert, Jan W.; Caparos, Serge; Linnell, Karina J.; Davidoff, Jules
Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adults operating a driving simulator while engaged in various distractions (i.e., cell phone, texting, and undistracted) and driving conditions (i.e., free flow, stable flow, and oversaturation). Seventy five participants 16-25 years of age (split into 2 groups: novice drivers and young adults) drove a STISIM simulator three times, each time with one of three randomly presented distractions. Each drive was designed to represent daytime scenery on a 4 lane divided roadway and included three equal roadway portions representing Levels of Service (LOS) A, C, and E as defined in the 2000 Highway Capacity Manual. Participants also completed questionnaires documenting demographics and driving history. Both safety and traffic flow related driving outcomes were considered. A Repeated Measures Multivariate Analysis of Variance was employed to analyze continuous outcome variables and a Generalized Estimate Equation (GEE) Poisson model was used to analyze count variables. Results revealed that, in general more lane deviations and crashes occurred during texting. Distraction (in most cases, text messaging) had a significantly negative impact on traffic flow, such that participants exhibited greater fluctuation in speed, changed lanes significantly fewer times, and took longer to complete the scenario. In turn, more simulated vehicles passed the participant drivers while they were texting or talking on a cell phone than while undistracted. The results indicate that distracted driving, particularly texting, may lead to reduced safety and traffic flow, thus having a negative impact on traffic operations. No significant differences were detected between age groups, suggesting that all drivers, regardless of age, may drive in a manner that impacts safety and traffic flow negatively when distracted. PMID:23465745
Stavrinos, Despina; Jones, Jennifer L; Garner, Annie A; Griffin, Russell; Franklin, Crystal A; Ball, David; Welburn, Sharon C; Ball, Karlene K; Sisiopiku, Virginia P; Fine, Philip R
Objective: To investigate the role of reducing resistance and distraction in rapid teeth movement and its reliability by establishing the Beagle dogs' experimental model. Methods: The left or right sides in mandibles of 20 beagles were randomly operated with different treatments: distraction twice a day through reducing resistance; distraction 6 times a day through reducing resistance; conventional distraction through reducing resistance; and conventional distraction (the control group). Each treatment was carried out in 10 sides. The pulp vitality, tooth mobility and distance of teeth transportation were evaluated at different time points: before the distraction, distraction after 15 days, retaining 30 days after 15 days of distraction. The degree of inclination, root resorption and alveolar bone density of the compressive areas were evaluated by cone-beam computed tomography images. Results: The distance of teeth transportation was similar in groups distraction twice daily and 6 times a day through reducing resistance (P>0.05), but their speed of transportation was significantly higher than that of conventional distraction through reducing resistance. The conventional distraction group had the lowest speed of transportation. The pulp vitality of distracted teeth was normal, and no root comprehensive resorption and periodontal defect were found. Distracted teeth in the reduced resistance and distraction groups (13.9°±3.5°) tipped more that in the conventional distraction group (6.6°±1.3°) (P<0.05). Conclusion: Reducing resistance and distraction are inseparable factors to realize fast teeth moving. The rate of orthodontic tooth movement can be accelerated through resistance reduction and periodontal distraction without obvious unfavorable effects but at minimal acceptable teeth inclination. PMID:24071693
Distraction osteogenesis has been shown to be an effective method of lengthening and augmenting endochondral bone. It has also been applied effectively in the reconstruction of the membranous bones of the craniofacial skeleton. With the accumulation of clinical experience in mandibular distraction, the differences between endochondral and membranous bone distraction have become apparent, especially in the limitations of uniplanar distraction for the three-dimensional reconstruction of the deficient mandible. Distraction of the mandible in a single plane cannot satisfy fully the functional and structural requirements of the patient with malocclusion as well as deficiency of the skeletal and soft tissue. This study reports the development and clinical use of a multiplanar mandibular distraction device with the ability to achieve linear distraction (Z-plane or sagittal), angular distraction (Y-plane or vertical), and transverse distraction (X-plane or coronal). The device contains two independent gear arrangements attached to two arms that extend from the central unit. Therefore, the trajectory of the regenerated bone may be changed during the distraction process. The device also allows manipulation of the various planes of movement independent of each other. Furthermore, the rotational points for the multiplanar distraction devices are located at a single point; therefore only a single osteotomy and two pin sites are required. The multiplanar distraction device allows the surgeon to customize and contour the dimensions of the distraction process by controlling the trajectory of the translation of the regenerated bone. PMID:9780926
McCarthy, J G; Williams, J K; Grayson, B H; Crombie, J S
Introduction Wrist distraction is a common treatment maneuver used clinically for the reduction of distal radial fractures and mid-carpal dislocations. Wrist distraction is also required during wrist arthroscopy to access the radiocarpal joint and has been used as a test for scapholunate ligament injury. However, the effect of a distraction load on the normal wrist has not been well studied. The purpose of this study was to measure the 3-D conformational changes of the carpal bones in the normal wrist as a result of a static distractive load. Methods The dominant wrists of 14 healthy volunteers were scanned using computed tomography at rest and during application of 98N of distraction. Load was applied using finger traps and volunteers were encouraged to relax their forearm muscles and to allow distraction of the wrist. The motions of the bones in the wrist were tracked between the unloaded and loaded trial using markerless bone registration. The average displacement vector of each bone was calculated relative to the radius as well as the interbone distances for 20 bone-bone interactions. Joint separation was estimated at the radiocarpal, midcarpal and carpal-metacarpal joints in the direction of loading using the radius, lunate, capitate and 3rd metacarpal. Results With loading, the distance between the radius and 3rd metacarpal increased an average of 3.3±3.1mm in the direction of loading. This separation was primarily located in the axial direction at the radiocarpal (1.0±1.0mm) and midcarpal (2.0±1.7mm) joints. There were minimal changes in the transverse direction within the distal row, although the proximal row narrowed by 0.98±0.7mm. Distraction between the radius and scaphoid (2.5±2.2mm) was 2.4 times greater than between the radius and lunate (1.0±1.0mm). Conclusions Carpal distraction has a significant effect on the conformation of the carpus, especially at the radiocarpal and midcarpal joints. In the normal wrist, external traction causes twice as much distraction at the lunocapitate joint than at the radiolunate joint.
Leventhal, Evan L.; Moore, Douglas C.; Akelman, Edward; Wolfe, Scott W.; Crisco, Joseph J.
Background: Lengthening the maxillary dental arch as a treatment approach for patients with maxillary deficiency and dental crowding is seldom reported. The pur- pose of this study was to assess dental and skeletal changes in the maxilla in the correction of maxillary deficiency associated with a retruded maxillary arch using a surgically assisted rapid maxillary anterior-posterior expansion appliance. Methods: Predistraction
Cheng-Ting Ho; Lun-Jou Lo; Eric JW Liou; Chiung Shing Huang
The National Highway Traffic Safety Administration is responsible for reducing vehicle-related fatalities and injuries on our Nations highways. This digest reports the status of State laws that are concerned with distracted driving offenses. Distracted dr...
This report summarizes literature on the issues of distraction, attention, aggression and fatigue as they relate to driving behavior and traffic crashes. There are three sections to this report: Distraction and Attention, Aggression, and Fatigue. Informat...
Background: After lumbar or lumbosacral fusion for various spine disorders, adjacent segment disease has been reported. Most of the studies have focused on proximal segment disease. The author has reported sacroiliac joint degeneration in these patients. Based on our own experiences with an increasing number of patients with sacroiliac joint (SIJ) arthralgia after multi-level lumbar or lumbosacral fusion procedures, we evaluated a surgical procedure called distraction arthrodesis of the SIJ for patients with refractory severe pain of the SIJ. Materials and Methods: Nineteen (19) consecutive patients were recruited and evaluated prospectively after undergoing distraction arthrodesis of the SIJ. The inclusion criteria for the surgical procedure were degeneration of the SIJ and failed conservative treatment. Magnetic resonance imaging (MRI) scans and CT scans were performed in all cases. The clinical outcome was assessed using the Visual Analog Scale and the Oswestry Disability Index (ODI). CT scans were performed postoperatively and again at the final followup to evaluate assess fusion. The data was analyzed using the SPSS software (version 10.0; SPSS, Chicago, IL) and statistical analysis was performed. The P values were based on the Student t-test. Results: The mean followup was 13.2 months. All patients had an instrumented lumbar or lumbosacral fusion. The overall fusion rate of SIJ was 78.9% (15/19 joints). All patients demonstrated significant improvement in VAS and ODI scores compared to preoperative values. The mean VAS score was 8.5 before surgery and was 6 at final followup, demonstrating 30% improvement. The mean ODI scores were 64.1 before surgery and 56.97 at the final followup, demonstrating 12% improvement. Conclusions: Refractory sacroiliac pain as a result of multi-level fusion surgery can be successfully treated with minimally invasive arthrodesis. It offers a safe and effective treatment for severe SIJ pain. Careful patient selection is important.
The technical details of a modified procedure for separation of the pterygoid plates in low-level maxillary osteotomies is described. The cut is made through the tuberosity and ends at the posterior aspect of the hard palate, medial and anterior to the pterygomaxillary fissure. This technique provides several advantages over the more classically described posterior vertical cut through the pterygomaxillary suture. The major advantages are that it is anatomically less hazardous and allows greater mobility of the segments. It also permits a larger vascular pedicle to be maintained. PMID:6575160
Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI
Even though the doubled foramen rotundum (FR) can be identified once within the literature, there are no details of the contents\\u000a at that level. We present here an anatomical case demonstrating the maxillary nerve (MN) duplication at the level of an unilateral\\u000a doubled FR: the accessory nervous trunk of the MN separately left the trigeminal ganglion on the outer side
Juvenile angiofibromas are benign fibro-vascular tumours of the nasopharynx that develop in prepubertal and adolescent males. Typical symptoms are longstanding unilateral nasal obstruction occasionally followed by epistaxes and frequent severe intraoperative haemorrhage of the discovered mass. We report the case of a 14-year-old boy histologically diagnosed with a juvenile angiofibroma in spite of the atypical localisation of the polyploid mass of the left maxillary sinus. PMID:23397786
Odontogenic keratocyst are known for there recurrence and local bone destruction. They have bimodal age presentation. OKC\\u000a is common in lower jaw than upper jaw. They are usually asymptomatic and diagnosed during radiological investigation. We are\\u000a reporting this case because of its age presentation (70 years), site of presentation (maxillary canine region) and mode of\\u000a presentation (chronic palatal pus discharging sinus).
Objective The present study sought to establish an animal model to study the feasibility and safety of rapid retraction of maxillary anterior teeth en masse aided by alveolar surgery in order to reduce orthodontic treatment time. Method Extraction of the maxillary canine and alveolar surgery were performed on twelve adult beagle dogs. After that, the custom-made tooth-borne distraction devices were placed on beagles' teeth. Nine of the dogs were applied compression at 0.5 mm/d for 12 days continuously. The other three received no force as the control group. The animals were killed in 1, 14, and 28 days after the end of the application of compression. Results The tissue responses were assessed by craniometric measurement as well as histological examination. Gross alterations were evident in the experimental group, characterized by anterior teeth crossbite. The average total movements of incisors within 12 days were 4.63±0.10 mm and the average anchorage losses were 1.25±0.12 mm. Considerable root resorption extending into the dentine could be observed 1 and 14 days after the compression. But after consolidation of 28 days, there were regenerated cementum on the dentine. There was no apparent change in the control group. No obvious tooth loosening, gingival necrosis, pulp degeneration, or other adverse complications appeared in any of the dogs. Conclusions This is the first experimental study for testing the technique of rapid anterior teeth retraction en masse aided by modified alveolar surgery. Despite a preliminary animal model study, the current findings pave the way for the potential clinical application that can accelerate orthodontic tooth movement without many adverse complications. Clinical Relevance It may become a novel method to shorten the clinical orthodontic treatment time in the future.
Ectopic eruption with impaction of maxillary permanent canine teeth is a frequently encountered clinical problem. Surgical exposure and attachment of a gold chain to impacted maxillary canines is often required in order to bring them into the dental arch and to allow good alignment. The principle of radiographic parallax is employed to determine whether the impacted canine is placed buccal or palatal to adjacent teeth. Good flap design allows adequate access to the impacted tooth. Bone removal should be adequate to free the impacted crown to its greatest circumference. An orthodontic eyelet with a gold chain is then bonded to the crown of the impacted tooth. Use of a good bonding technique will minimize chances of bond failure necessitating a second surgical procedure. A traumatic surgical procedure will allow minimal postoperative complications and a rapid recovery. Clinical Relevance: This article describes a surgical technique to expose impacted maxillary canines and attach gold chains, to facilitate orthodontic alignment into the dental arch. The principle of radiographic parallax to determine the bucco-palatal position of impacted canines is also discussed. PMID:23094569
Symbrachydactyly describes a spectrum of congenital hand differences consisting of digital loss resulting in fused short fingers. As the principles for distraction lengthening have evolved, the technique of nonvascularized toe phalangeal transfer to the hand with shortened digits has provided patients with improved outcomes. Nonvascularized toe phalanx to hand transplant with distraction lengthening restores functional length to a skeletally deficient, poorly functioning hand while maintaining an overlying layer of vascular and sensate tissue. The primary goal is improvement of digital length to enhance mechanical advantage and prehension. We describe the technique of nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly, including the following steps: nonvascularized proximal toe phalanx harvest, toe phalanx transfer to hand, pin placement, osteotomy, and closure. PMID:20353864
When facing penalty kicks in football (soccer), goalkeepers frequently incorporate strategies that are designed to distract the kicker. However, no direct empirical evidence exists to ascertain what effect such visual distractions have on the attentional control, and performance, of footballers. Eighteen experienced footballers took five penalty kicks under counterbalanced conditions of threat (low vs. high) and goalkeeper movement (stationary vs. waving arms) while wearing eye-tracking equipment. Results suggested that participants were more distracted by a moving goalkeeper than a stationary one and struggled to disengage from a moving goalkeeper under situations of high threat. Significantly, more penalties were saved on trials when the goalkeeper was moving and shots were also generally hit closer to the goalkeeper (centrally) on these trials. The results provide partial support for the predictions of attentional control theory and implications for kickers and goalkeepers are discussed. PMID:20568032
OBJECTIVES: The purpose of this study was to determine the possible role of nasal septal deviation on volume of maxillary sinuses and its relationship with development of maxillary sinusitis. MATERIALS AND METHODS: Between May 2010 and September 2012, paranasal sinus computed tomography (CT) findings of 825 patients (470 males, 355 females), who admitted to Ear Nose and Throat Department of Bozok University Medical Faculty were retrospectively analyzed. By excluding the other co-existent sino nasal pathologies, 109 consecutive patients (47 males, 62 females mean age 36 ± 13.4 years; range 18-71 years) with isolated nasal septal deviations were recruited for the study. The convex side of the septal curvature was accepted as the direction of deviation. The findings were grouped according to the radiologically measured angle of nasal septal deviations. The deviation angle of the nasal septum was described as; mild (<9°), moderate (the angle between 9° and 15°), or severe (15° and up). The volume of each maxillary sinus (ipsi- and contralateral to the deviation side) was also calculated using the computer program. Sinusitis was defined as any evident thickening of the maxillary sinus mucosa. RESULTS: There were 62 females and 47 males with a mean age of 36 ± 13.4. Nasal septal deviation angles were found to range between 5° and 27.2° (mean 13° ± 3.4°). The right sided deviations included 19 mild (<9°, Group I), 16 moderate (9°-15°, Group II), and 16 severe (15° and up, Group III) cases. The left sided deviations included 19 mild (<9°, Group I), 19 moderate (9°-15°, Group II), and 20 severe (15° and up, Group III) subjects. Maxillary sinus volumes were compared between right and left sided deviation groups. We could not demonstrate a statistically significant difference between the right maxillary sinus volumes of Groups I and II in left sided deviation cases (p = 0.77). In the same side, comparison of Groups I-III and Groups II-III, the maxillary sinus volume differences were found to be significantly meaningful (p = 0.001 and p = 0.013, respectively). Identical results were yielded in the right sided septal deviation group related to the maxillary sinus volumes of Groups I and II and Groups I-III and Groups II-III compartments (p = 0.99, p = 0.004 and p = 0.003, respectively). In both right and left deviation groups, ipsi and contralateral maxillary sinus volume comparements produced statistically significant results (p = 0.002 and p = 0.04, respectively). The presence of maxillary sinusitis findings were significantly increased in both group (p = 0.00). Statistical significance was set at p < 0.05. CONCLUSION: Our findings suggest that maxillary sinus volumes tend to be higher at the contralateral side of the severe septum deviations. In addition, the chance of finding maxillary sinusitis findings on ipsilateral to the severe septum deviation was significantly increased. PMID:23512432
Distracted driving, a significant public safety issue, is typically categorized as cell phone use and texting. The increase of distracted driving behavior (DDB) has resulted in an increase in injury and death. The purpose of this study was to identify the frequency and perception of DDB in adults. A 7-question SurveyMonkey questionnaire was distributed to a convenience sample of adults. Standard demographics included age, gender, and highest levels of education. Primary outcome questions were related to frequency of DDB, and overall perceptions specific to distracted driving. Results were compared on the basis of demographics. Chi-square testing and the Kruskal-Wallis analysis of variance were applied, with statistical significance defined as P ? .05. There were 1857 respondents to the survey: 1721 were aged 23-64 years (93%); 1511 were women (81%); 1461 had high school education or greater (79%). A total of 168 respondents (9%) reported being involved in a car accident while distracted. The highest reported frequency of DDB included cell phone use (69%), eating/drinking (67%), and reaching for an object in the care (49%). Younger age (18-34 years) and higher level of education (bachelor's degree or greater) were statistically associated with these DDB; gender demonstrated no statistical significance. Text messaging was reported by 538 respondents (29%), with a statistically significant association with age (18-34 years), higher education (bachelor's degree or greater), and gender (males). A total of 1143 respondents (63%) believed that they could drive safely while distracted. This study demonstrates that DDB in adults is not restricted to reading and sending text messages. Moreover, these results indicated that people fail to perceive the dangers inherent in distracted driving. Prevention and outreach education should not be limited to texting and cell phone use but should target all forms of DDB. The age group 18-34 years should be the primary target in the adult population. PMID:23459429
Hoff, Jane; Grell, Jennifer; Lohrman, Nicole; Stehly, Christy; Stoltzfus, Jill; Wainwright, Gail; Hoff, William S
The mechanotransduction mechanisms linking distraction device activation to new bone formation remain unknown. We hypothesize that the tension stress of activation during distraction osteogenesis is transmitted through lacunocanalicular fluid flow to initiate the osteogenic signaling cascade. Adult Sprague-Dawley rats (N = 24) were subjected to mandibular osteotomy and application of an external distraction device. After a 3-day latency period, half the animals (n = 12) underwent device activation at 0.25 mm twice daily for 6 days (total activation, 3 mm), and the other half (n = 12) had no activation. On day 10, the animals were injected with fluorescent reactive red lacunocanalicular tracer before killing. Mandibles were harvested, embedded, and sectioned, and reactive red epifluorescence lacunocanalicular flow was measured. Protein was harvested for focal adhesion kinase 1 (FAK1), NESPRIN1, SUN1, LAMIN A/C, and SMAD1 Western blotting as well as for bone morphogenetic protein (BMP)-2 enzyme-linked immunosorbent assay and alkaline phosphatase assay. Lacunocanalicular fluid flow was significantly greater in the distracted samples (60.5 ± 14 vs 10.3 ± 4 molecules of equivalent soluble fluorochrome per megapixel, P = 0.01). Flow distribution demonstrated the highest lacunocanalicular flow near the center of the distraction gap. Increased lacunocanalicular flow resulted in increased FAK1 (P = 0.009), NESPRIN1 (P = 0.01), SUN1 (P = 0.01), and LAMIN A/C (P = 0.008) expression. Focal adhesion kinase 1 activation in the presence of BMP-2 protein expression (P = 0.001) resulted in increased intranuclear SMAD1 phosphorylation (P = 0.04) and alkaline phosphatase activity (P < 0.0001). These findings suggest that activation of the distraction osteogenesis device affects cellular response through changes in lacunocanalicular fluid flow. PMID:24036726
Davidson, Edward H; Sultan, Steven M; Butalala, Parag; Knobel, Denis; Warren, Stephen M
|The present study investigated the effect of cognitive distraction on the endorsement of gender role stereotypes in one sample of African American female participants. Participants' awareness and endorsement of gender role stereotypes for male and females was assessed. Following random assignment to distraction or no distraction conditions, they…
To examine whether social interaction processes can trigger naturally-occurring identity negotiation, the current research manipulated perceiver distraction and valence of perceivers' expectations about targets. Nondistracted perceivers corrected their behaviors and impressions for the influence of their expectancies. Distracted perceivers corrected their overt information-gathering behaviors, but appeared to exhibit their biases in subtle ways. Targets detected distracted perceivers' negative expectancies, and
As use of in-vehicle information systems (IVISs) such as cell phones, navigation systems, and satellite radios has increased, driver distraction has become an important and growing safety concern. A promising way to overcome this problem is to detect driver distraction and adapt in-vehicle systems accordingly to mitigate such distractions. To realize this strategy, this paper applied support vector machines (SVMs),
In this article, we consider the legal and policy implications of distracted driving (the tendency of people to use electronic devices while operating a motor vehicle). After reviewing the empirical evidence showing that distracted driving has serious adverse consequences, we discuss the legal basis for governmental interventions to reduce distracted driving. These interventions include laws restricting the use of electronic
Distraction from pain reduces pain perception, and imaging studies have suggested that this may at least partially be mediated by activation of descending pain inhibitory systems. Here, we used the nociceptive flexor reflex (RIII reflex) to directly quantify the effects of different distraction strategies on basal spinal nociception and its temporal summation. Twenty-seven healthy subjects participated in 3 distraction tasks
Ruth Ruscheweyh; Annette Kreusch; Christoph Albers; Jens Sommer; Martin Marziniak
OBJECTIVE: (1) To examine the effects of attentional distraction on running time in an incremental treadmill test in obese youngsters; (2) to investigate whether distraction works at the same extent at the beginning and at the end of residential treatment; and (3) to explore the underlying mechanisms of the possible distraction effects.METHODS: Thirty severely obese youngsters (10 boys, 20 girls,
I De Bourdeaudhuij; G Crombez; B Deforche; F Vinaimont; P Debode; J Bouckaert
Popular music distracted a group of subjects significantly on the paragraph section of the Nelson-Denny Reading Test. Classical music showed no evidence of distraction in either the vocabulary or paragraph section of the test, nor did the popular music show evidence of distraction upon vocabulary.
Purpose: Long treatment protocols currently limit the application of distraction osteogenesis (DO). The purpose of this study was to develop a porcine model for DO and to define the effects of latency and distraction rate on bone formation.Materials and Methods: Distractors were placed through submandibular incisions. For analysis of latency, mandibular osteotomies were distracted after 0 (n = 3) or
Maria J. Troulis; Julie Glowacki; David H. Perrott; Leonard B. Kaban
An oral distraction was investigated as a way to reduce struggle and heart rate of beef cattle undergoing freeze branding. Oral distraction reduced the struggle of steers, regardless of branding treatment. No effect on heart rate was found. Distractions may provide a way to reduce struggle by animals during restraint. PMID:24155450
Aitken, Brooke L; Stookey, Joseph M; Noble, Scott; Watts, Jon; Finlay, Don
Effective joint distraction is crucial in arthroscopic ankle surgery. We describe an effective and controlled intra-articular ankle distraction technique that we have studied by means of a fresh-frozen cadaver model. Using a kyphoplasty balloon, which is currently used in spine surgery, we tried to achieve a controlled distraction. After the fixation of the cadaver model, standard anteromedial and anterolateral portals
Ahmet T. Aydin; Haluk Ozcanli; Yetkin Soyuncu; Tayyar K. Dabak
Past research has shown that rumination exacerbates dysphoric mood whereas distraction attenuates it. This research examined whether the practice of mindfulness meditation could reduce dysphoric mood even more effectively than distraction. A dysphoric mood was induced in 139 female and 38 male participants who were then randomly assigned to a rumination, distraction, or meditation condition. As predicted, participants instructed to
The present study investigated the effect of cognitive distraction on the endorsement of gender role stereotypes in one sample of African American female participants. Participants' awareness and endorsement of gender role stereotypes for male and females was assessed. Following random assignment to distraction or no distraction conditions, they…
Two experiments were conducted to test competing accounts of the distraction-persuasion relationship, thought disruption and effort justification, and also to show that the relationship is not limited to counterattitudinal communication. Exp I, with 132 undergraduates, varied distraction and employed 2 discrepant messages differing in how easy they were to counterargue. In accord with the thought disruption account, increasing distraction enhanced
Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cell phones in the pedestrian population. In this report, an older gentleman suffered extensive facial trauma requiring surgery as a direct effect of cell phone use at the time the trauma occurred. This case highlights the role that portable electronic devices can play as a cause of ocular trauma.
Edell, Aimee R; Jung, Jesse J; Solomon, Joel M; Palu, Richard N
Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cell phones in the pedestrian population. In this report, an older gentleman suffered extensive facial trauma requiring surgery as a direct effect of cell phone use at the time the trauma occurred. This case highlights the role that portable electronic devices can play as a cause of ocular trauma. PMID:23579597
Edell, Aimée R; Jung, Jesse J; Solomon, Joel M; Palu, Richard N
The human visual system observes and understands a scene/image by making a series of fixations. Every fixation point lies inside a particular region of arbitrary shape and size in the scene which can either be an object or just a part of it. We define as a basic segmentation problem the task of segmenting that region containing the fixation point. Segmenting the region containing the fixation is equivalent to finding the enclosing contour- a connected set of boundary edge fragments in the edge map of the scene - around the fixation. This enclosing contour should be a depth boundary. We present here a novel algorithm that finds this bounding contour and achieves the segmentation of one object, given the fixation. The proposed segmentation framework combines monocular cues (color/intensity/texture) with stereo and/or motion, in a cue independent manner. The semantic robots of the immediate future will be able to use this algorithm to automatically find objects in any environment. The capability of automatically segmenting objects in their visual field can bring the visual processing to the next level. Our approach is different from current approaches. While existing work attempts to segment the whole scene at once into many areas, we segment only one image region, specifically the one containing the fixation point. Experiments with real imagery collected by our active robot and from the known databases 1 demonstrate the promise of the approach.
When dealing with significant sensory stimuli, performance can be hampered by distracting events. Attention mechanisms lessen such negative effects, enabling selection of relevant information while blocking potential distraction. Recent work shows that preparatory brain activity, occurring before a critical stimulus, may reflect mechanisms of attentional control aimed to filter upcoming distracters. However, it is unknown whether the engagement of these filtering mechanisms to counteract distraction in itself taxes cognitive-brain systems, leading to performance costs. Here we address this question and, specifically, seek the behavioral signature of a mechanism for the filtering of potential distraction within and between sensory modalities. We show that, in potentially distracting contexts, a filtering mechanism is engaged to cope with forthcoming distraction, causing a dramatic behavioral cost in no-distracter trials during a speeded tactile discrimination task. We thus demonstrate an impaired processing caused by a potential, yet absent, distracter. This effect generalizes across different sensory modalities, such as vision and audition, and across different manipulations of the context, such as the distracter's sensory modality and pertinence to the task. Moreover, activation of the filtering mechanism relies on both strategic and reactive processes, as shown by its dynamic dependence on probabilistic and cross-trial contingencies. Crucially, across participants, the observed strategic cost is inversely related to the interference exerted by a distracter on distracter-present trials. These results attest to a mechanism for the monitoring and filtering of potential distraction in the human brain. Although its activation is indisputably beneficial when distraction occurs, it leads to robust costs when distraction is actually expected but currently absent. PMID:22984954
Distraction is a common cause of accidents (e.g. NHTSA, 2009), and different distraction conditions influence the driving behaviour in a specific way. Despite a lot of research in this area, most studies concentrate on perception errors as a result of visual distraction. The effects of different distraction conditions on higher cognitive processes are still unclear. The fact that accidents happen
When a dentist replants an avulsed tooth, the repair process sometimes results in the cementum of the root and the alveolar bone fusing together, with the replanted tooth becoming ankylosed. When this occurs, the usual process of tooth movement with bone deposition and bone resorption at the periodontium cannot function. If dental ankylosis occurs in the maxillary incisor of a growing child, the ankylosed tooth also cannot move vertically with the subsequent vertical growth of the alveolar process. This results in the ankylosed tooth leaving the plane of occlusion and often becoming esthetically objectionable. This report describes a 12-year-old female with a central incisor that was replanted 5 years earlier, became ankylosed, and left the occlusal plane following subsequent normal vertical growth of the alveolar process. When growth was judged near completion, the tooth was moved back to the occlusal plane using a combination of orthodontics, surgical block osteotomy, and distraction osteogenesis to reposition the tooth at the proper vertical position in the arch. This approach had the advantage of bringing both the incisal edge and the gingival margin of the clinical crown to the proper height in the arch relative to their antimeres. Previous treatment procedures for ankylosed teeth have often involved the extraction of the affected tooth. When this is done, a vertical defect in the alveolar process results that often requires additional bone surgery to reconstruct the vertical height of the alveolar process. If the tooth is then replaced, the replacement tooth must reach from the final occlusal plane to the deficient ridge. This results in an excessively long clinical crown with a gingival height that does not match the adjacent teeth. PMID:11605877
Isaacson, R J; Strauss, R A; Bridges-Poquis, A; Peluso, A R; Lindauer, S J
Recently, surgeons have begun to treat serious congenital craniofacial deformities including craniosynostoses with mechanical devices that gradually distract the skull. As a prospective means of treatment planning for such complex deformities, FE models derived from routine preoperative CT scans (CT\\/FEA) would provide ideal patient specific engineering analyses. The purpose of this study was to assess the dimensional and predictive accuracy
Daniel Remmler; Lorraine Olson; Ralph Ekstrom; Derek Duke; Aurelio Matamoros; David Matthews; Christopher G Ullrich
Teaching in a classroom configured with computers has been heralded as an aid to learning. Students receive the benefits of working with large data sets and real-world problems. However, with the advent of network and wireless connections, students can now use the computer for alternating tasks, such as emailing, web browsing, and social networking. Do these distractions diminish the benefits
Background: Craniosynostosis compromises the cranial vault volume, severely impede growth, and may lead to increased intracranial pressure (ICP). Posterior cranial vault (PCV) distraction osteogenesis (DO) offers an excellent treatment opportunity for this condition. This article intends to describe the outcomes of PCV DO. Materials and Methods: Nine males and seven female children indicated for PCV DO were included in the study. The single vector distraction devices with quick-disconnect distraction rods, a type of miniaturized hardware, was used in all cases. Result: Seven of the 16 patients had a history of one or more prior cranioplasty. All reoperations in this series were performed for the indication of raised ICP including five of the scaphocephaly patients and the syndromic patients. Clinical signs of raised ICP were present in all patients with either measured raised intracranial pressure or those with clinical signs of raised ICP preoperatively. There was substantial decrease in the ICP postoperatively. Discussion: The outcomes of this study were encouraging. Placing the distractor stems as flat as possible against the outer layer of the cranial bone seems to be a very important maneuver. This keeps the distractor stem less proud and less likely to sustain future trauma. Removal of the distractor stems keeps the devices further away from the risk of later traumatic dislodgement. Moreover, miniaturized distractors allow precise control of the rate and the amount of distraction.
Ylikontiola, Leena P.; Sandor, George K.; Salokorpi, Niina; Serlo, Willy S.
The aim of this study was to ascertain the nature of the interaction between the affective value of musical distraction, personality type and performance on the cognitive tasks of reading comprehension, free recall, mental arithmetic and verbal reasoning in children aged 11-12 years. It was hypothesized that the cognitive performance of extraverts…
Sensory flooding, particularly during auditory stimulation, is a common problem for patients with schizophrenia. The functional consequences of this impairment during cross-modal attention tasks, however, are unclear. The purpose of this study was to examine how auditory distraction differentially affects task-associated response during visual attention in patients and healthy controls. To that end, 21 outpatients with schizophrenia and 23 healthy comparison subjects performed a visual attention task in the presence or absence of distracting, environmentally relevant “urban” noise while undergoing functional magnetic resonance imaging at 3T. The task had two conditions (difficult and easy); task-related neural activity was defined as difficult – easy. During task performance, a significant distraction (noise or silence) by group (patient or control) interaction was observed in the left dorsolateral prefrontal cortex, right hippocampus, left temporoparietal junction, and right fusiform gyrus, with patients showing relative hypoactivation during noise compared to controls. In patients, the ability to recruit the dorsolateral prefrontal cortex during the task in noise was negatively correlated with the effect of noise on reaction time. Clinically, the ability to recruit the fusiform gyrus during the task in noise was negatively correlated with SANS affective flattening score, and hippocampal recruitment during the task in noise was positively correlated with global functioning. In conclusion, schizophrenia may be associated with abnormalities in neural response during visual attention tasks in the presence of cross-modal noise distraction. These response differences may predict global functioning in the illness, and may serve as a biomarker for therapeutic development.
Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.
As more drivers take their cell phones into their vehicles, distracted driving continues to grow as a traffic safety issue. Most U.S. States responded by enacting some sort of cell phone or texting ban. In November and December 2010, NHTSA conducted a nat...
... of these can endanger the driver and others, texting while driving is especially dangerous because it combines all three ... Licensing (GDL) laws that include cell phone and texting bans for young ... to distraction-free driving. Set a positive example for your teen by ...
Driver's distraction in driving is one of the major causes of the traffic accidents. The abnormal behavior of the driver's head movement and the facial expressions were studied in detail in order to get the characteristics of the inattention status. With real-time monitoring on the driver's attention characteristics: the position and movement status information of eyes and mouth, the detection
Distinct from other forms of driver inattention, distraction occurs when a drivers attention is diverted away from driving by a secondary task that requires focusing on an object, event, or person not related to the driving task. Although existing data is...
We longitudinally investigated the development of endogenous control of attention in 2 types of tasks that involve competition for attentional focus at 7, 9, and 31 months of age. At all 3 sessions, children participated in a multiple object free play task and a distractibility task. The results revealed both developmental differences and…
Kannass, Kathleen N.; Oakes, Lisa M.; Shaddy, D. Jill
...distracted driving grant in a fiscal year, a State shall submit the assurances in Part 4 of Appendix D...services vehicle and engaged in the performance of their...motor vehicle driver or a school bus driver who uses...educate the public through advertising containing...
|Five experiments demonstrate auditory-semantic distraction in tests of memory for semantic category-exemplars. The effects of irrelevant sound on category-exemplar recall are shown to be functionally distinct from those found in the context of serial short-term memory by showing sensitivity to: The lexical-semantic, rather than acoustic,…
Marsh, John E.; Hughes, Robert W.; Jones, Dylan M.
|Unexpected and task-irrelevant sounds can capture our attention and may cause distraction effects reflected by impaired performance in a primary task unrelated to the perturbing sound. The present auditory-visual oddball study examines the effect of the informational content of a sound on the performance in a visual discrimination task. The…
We sought to determine if attentional distraction in adolescents can modulate event-related desynchronization or synchronization (ERD or ERS) of the theta band during emotion regulation. Event-related theta oscillations were collected from 48 adolescents and young adults as they performed a distraction (counting) task while viewing affective pictures. Consistent with data from adult participants, positive and negative pictures elicited a larger theta ERS than did neutral pictures within a 100-400 ms window, indicating that early theta ERS is indicative of motivated attention to biologically salient stimuli. Counting as a distraction strategy attenuated early affective modulation of theta ERS. Moreover, theta ERS increased with age in the anterior regions of the brain regardless of valence; however, no age differences were found in the posterior regions. These results suggest that distraction depends on a top-down attentional mechanism that disrupts theta ERS for affective pictures at an early stage. Furthermore, adolescents undergo a developmental increase in oscillatory brain reorganization. PMID:23827226
The effect of age on bone formation in the limb lengthening model of distraction osteogenesis (DO) was investigated in two studies using Sprague-Dawley (SD) rats from two colonies at various ages (CAMM: 9 vs. 24 months, Harlan : 4 vs. 24 months). External fixators were placed on the right tibiae of...
Distraction osteogenesis is a well-known technique in which new bone tissue is created when a distraction displacement is applied through an external frame. This orthopedic process is nowadays focus of intense research, both experimentally and numerically, as there are still many aspects not well understood. The aim of this study is to simulate bone distraction by means of a combined discrete-continuum approach based on a lattice formulation. Existing computational models simulate the main processes of distraction osteogenesis from a continuum perspective, considering as state variables the population of cells and tissue distributions. Results of the continuum and lattice-based approaches are similar with respect to the global evolution of the different cells but rather different in terms of the type of ossification process. Differences in the size of the soft interzone in the gap have also been found. In addition, the discrete-continuum formulation allows including a more realistic approach of the migration/proliferation process with a discrete random walk model instead of the Fick's law used in continuum approaches. Also, blood vessel growth can be simulated explicitly in this model with the inclusion of the endothelial cells. Further study is needed to provide additional insights to understand coupled phenomena at different scales in the cell-tissue interactions. However this work provides a first preliminary step for improving multiscale models. PMID:23036307
Reina-Romo, E; Gómez-Benito, M J; Domínguez, J; García-Aznar, J M
Recent studies have demonstrated that brief periods of training facilitate the ability to overcome distraction during future performance of a given task, and researchers have proposed that these effects rely on relational memory systems that enable individuals to link specific attentional states to their learned context. In the current work, we examined whether medial temporal lobe (MTL) structures critical for relational and contextual learning contribute to these effects. A group of amnesic patients with bilateral MTL damage and a group of matched comparison subjects both completed an attentional-capture task in which a brief training session typically leads to decreased distraction in a subsequent testing session. Whereas the comparison subjects showed normal training-related decreases in distractibility, the amnesic patients did not. Thus, our results indicate that MTL-mediated learning plays a critical role in the ability to use past experience to overcome distraction. This suggests a tight linkage between MTL-dependent relational-learning mechanisms and cognitive control. PMID:23761926
Nowadays drivers have to get along with an increasing complex visual environment. More and more cars are on the road. There are not only distractions available within the vehicle, like radio and navigation system, the environment outside the car has also become more and more complex. Hoardings, advertising pillars, shop fronts and video screens are just a few examples. For
Interruptions (gaps) and unfamiliar events (distracters) during a timed signal delay the timed response of humans and other animals. To explore this phenomenon, we manipulate the intensity of auditory distracters (Experiment 1), and we dissociate the role of distracter intensity, distracter similarity with the intertrial interval, and dissimilarity from the timed auditory signal (Experiment 2). When the intertrial interval and the timed signal were silent, the delay in response after an auditory distracter increased with its intensity: Rats ignored (ran through) a 40-dB distracter, stopped timing during a 75-dB distracter, and reset after a 100-dB distracter. However, when timing was signaled by a 70-dB noise, rats reset both for 40- and 100-dB distracters, stopped for both 55- and 85-dB distracters, and run for the 70-dB distracter. Data are accounted for by a time-sharing model assuming 2 concurrent processes-time accumulation and memory decay controlled by the discriminability of the interrupting event-whose interplay results in a continuum of responses, from run to reset. PMID:22122061
Interruptions (gaps) and unfamiliar events (distracters) during a timed signal delay the timed response of humans and other animals. To explore this phenomenon, we manipulate the intensity of auditory distracters (experiment 1), and we dissociate the role of distracter intensity, distracter similarity with the inter-trial interval, and dissimilarity from the timed auditory signal (experiment 2). When the inter-trial interval and the timed signal were silent, the delay in response after an auditory distracter increased with its intensity: Rats ignored (ran through) a 40dB distracter, stopped timing during a 75dB distracter, and reset after a 100dB distracter. However, when timing was signaled by a 70dB noise, rats reset both for 40dB and 100dB distracters, stopped for both 55dB and 85dB distracters, and run for the 70dB distracter. Data are accounted for by a time-sharing model assuming two concurrent processes—time accumulation and memory decay controlled by the discriminability of the interrupting event—whose interplay results in a continuum of responses, from run to reset.
We report a case with review of literature of actinomycosis accompanied with aspergillosis arising in unilateral maxillary sinus, in which it was completely cured after endoscopic sinus surgery and short term antibiotic therapy. To the best of our knowledge, this is the first case report in literature reporting actinomycosis in combination with aspergillosis in the paranasal sinus. Also, we suggest short term antibiotic therapy within one month may be sufficient if the surgical opening of paranasal sinus involved by actinomycosis could be well preserved. PMID:22445647
A 66-year-old man with a history of repeated surgery, external radiation and brachytherapy for ameloblastoma presented with a recurrence of the tumor with sinus, intraorbital and skull base infiltration. Histopathologic examination of the resected orbital and sinus tissue confirmed the diagnosis of ameloblastoma. Immunohistochemical staining for CD56 was strongly positive in the tumor cells. Although ameloblastoma is usually a low-grade malignant tumor, it can be locally aggressive with invasion of the surrounding tissue. Maxillary ameloblastomas are more likely to infiltrate the orbit. PMID:22752627
Herwig, M C; Fischer, H P; Moore, C E; Walsh, M D; Olson, J J; Beitler, J J; Grossniklaus, H E
Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature. But the ectopic eruption into the non dentate region is rare and scantly documented. The maxillary sinus is one such a non dentate region, apart from nasal septum, mandibular condyle, coronoid process and the palate, to accommodate such ectopic eruptions of teeth. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature and discussed. Early surgical intervention for removal of ectopic tooth along with enucleation of the associated cyst, if any, is the treatment of choice.
Myeloid sarcoma (MS) is a malignant tumour of myeloblasts rarely occurring in the maxillary bone. The tumour may precede or be concurrent with leukaemic infiltration of the bone marrow or herald blastic transformation of a myelodysplastic syndrome or a chronic myeloproliferative disorder. Myeloid sarcoma is uncommon in the oral cavity, but it can involve the palate, gingiva, extraction socket, and cheek. Recognition and diagnosis of myeloid sarcoma involving the soft tissues of the oral cavity in an otherwise asymptomatic patient is important and mandates an appropriate haematological diagnostic workup. We herein report on a new case without any evidence of haematological disorders. We discuss the pathological diagnosis and the therapeutical approaches. PMID:16519776
Goteri, G; Ascani, G; Messi, M; Filosa, A; Segura-Egea, J J; Rubini, C; Bullon, P
Maintaining incisor alignment is an important goal of orthodontic retention and can only be guaranteed by placement of an intact, passive and permanent fixed retainer. Here we describe a reliable technique for bonding maxillary retainers and demonstrate all the steps necessary for both technician and clinician. The importance of increasing the surface roughness of the wire and teeth to be bonded, maintaining passivity of the retainer, especially during bonding, the use of a stiff wire and correct placement of the retainer are all discussed. Examples of adverse tooth movement from retainers with twisted and multistrand wires are shown. PMID:23269696
Familiarity with the intricacies and variations of root canal morphology is essential for successful endodontic treatment. Maxillary central and lateral incisors are known to be single rooted with one canal. This case report describes endodontic retreatment of maxillary lateral incisors with two root canals, one of which was missed during the initial treatment.
Dexton, Antony Johns; Arundas, D; Rameshkumar, M; Shoba, K
Objective. To present our experience of endoscopic surgery for symptomatic mucus retention cyst of the maxillary sinus. Design. Retrospective study. Setting. Teaching hospital, Israel. Patients. 60 patients with 65 symptomatic cysts of the maxillary sinus who were operated on endoscopically. Only patients with large cysts that filled at least 50% of the sinus space were included. Intervention. A rigid nasal
The calcifying odontogenic cyst is an uncommon lesion that occurs in both jaws, however involvement of the maxillary sinus is rare. The accepted mode of treatment is enucleation with curettage since it is generally believed that recurrence following such treatment is extremely rare. Of the reported cases of recurrent calcifying odontogenic cysts, none have involved the maxillary sinus.This report is
The success of endodontic therapy requires a knowledge of the internal and external dental anatomy and its variations in presentation. The internal anatomy of the maxillary central incisor is well known and usually presents with one root and one radicular canal system. This case report describes an endodontic treatment of a maxillary central incisor with two roots and two canal
Emílio Carlos Sponchiado; Hanan Awwad Abdel Qader Ismail; Márcia Raquel Lima Braga; Fabrício Kitazono de Carvalho; Cláudia Andréa Correa Garcia Simões
The purpose of this investigation was to evaluate the treatment effects of an intraoral appliance used for rapid distal movement of the maxillary molars. The appliance studied, the Jones jig, is designed to deliver a distalizing force to the maxillary molar against an intraoral anchorage unit thereby eliminating the need for patient compliance. A retrospective study was performed comparing before
The third known case of a pneumocele of the maxillary sinus is reported. Radiographic findings included hyperlucency of a maxillary sinus with generalized expansion of its borders. Bone dehiscence was also visible with tomography. The present case emphasizes a gradual onset of clinical signs manifested primarily by proptosis. Possible mechanisms in the production of this deformity are discussed.
Driver distraction is estimated to be one of the leading causes of motor vehicle accidents. However, little is known about the role of emotional distraction on driving, despite evidence that attention is highly biased toward emotion. In the present study, we used a dual-task paradigm to examine the potential for driver distraction from emotional information presented on roadside billboards. This purpose was achieved using a driving simulator and three different types of emotional information: neutral words, negative emotional words, and positive emotional words. Participants also responded to target words while driving and completed a surprise free recall task of all the words at the end of the study. The findings suggest that driving performance is differentially affected by the valence (negative versus positive) of the emotional content. Drivers had lower mean speeds when there were emotional words compared to neutral words, and this slowing effect lasted longer when there were positive words. This may be due to distraction effects on driving behavior, which are greater for positive arousing stimuli. Moreover, when required to process non-emotional target stimuli, drivers had faster mean speeds in conditions where the targets were interspersed with emotional words compared to neutral words, and again, these effects lasted longer when there were positive words. On the other hand, negative information led to better memory recall. These unique effects may be due to separate processes in the human attention system, particularly related to arousal mechanisms and their interaction with emotion. We conclude that distraction that is emotion-based can modulate attention and decision-making abilities and have adverse impacts on driving behavior for several reasons. PMID:23200451
Obstructive sleep apnea (OSA) in pediatric populations is often associated with congenital craniofacial malformations resulting in decreased pharyngeal airway, which in severe cases leads to tracheostomy dependence. The purpose of this study was to use distraction osteogenesis to improve the airway and decannulate the tracheostomy. This study involved 11 OSA tracheostomy-dependent patients (age range, 4 months to 6 years) who underwent bilateral distraction in the mandibular body using extraoral distraction devices. Following a latency period of 4 days, gradual distraction at a rate of 1 mm/d was performed followed by a consolidation period of 10 weeks. Three-dimensional computed tomography reconstruction of the face and neck before and after the mandibular lengthening aided in quantitative volumetric evaluation of mandibular volume and airway volume. The results demonstrated mandibular elongation of a mean of 30 mm on each side, an increase in mandibular volume by an average of 29.19%, and increase in pharyngeal airway by an average of 70.53%. Two to 3 months following the last lengthening, all 11 patients were decannulated with improvement of signs and symptoms of OSA and elimination of oxygen requirement. Mean follow-up was 2.0 years. The oxygen saturation level rose to more than 95%, and the apnea index respiratory disturbance index was less than 2 episodes per hour for all patients. Bilateral mandibular distraction is a useful method in younger children to decannulate permanent tracheostomy expanding the hypoplastic mandible and concomitantly advance the base of tongue and hyoid bone increasing the pharyngeal airway. PMID:22421840
Drosophila melanogaster has an olfactory organ called the maxillary palp. It is smaller and numerically simpler than the antenna, and its specific role in behavior has long been unclear. Because of its proximity to the mouthparts, I explored the possibility of a role in taste behavior. Maxillary palp was tuned to mediate odor-induced taste enhancement: a sucrose solution was more appealing when simultaneously presented with the odorant 4-methylphenol. The same result was observed with other odors that stimulate other types of olfactory receptor neuron in the maxillary palp. When an antennal olfactory receptor was genetically introduced in the maxillary palp, the fly interpreted a new odor as a sweet-enhancing smell. These results all point to taste enhancement as a function of the maxillary palp. It also opens the door for studying integration of multiple senses in a model organism.
Iatrogenic tooth displacement is a rare complication during extraction of impacted molars, but displacement of a maxillary third molar into the maxillary sinus, infratemporal fossa, buccal space, pterygomandibular space, and lateral pharyngeal space has been reported. Currently, 6 published reports describe third molar displacement into the lateral pharyngeal space, only 1 of which involved the loss of a maxillary third molar into this area, which occurred after an attempted self-extraction by the patient. There have been no reported cases of iatrogenic displacement of the maxillary third molar during an extraction procedure. This article describes the recovery, under general anesthesia, of a maxillary third molar from the lateral pharyngeal space after an iatrogenic displacement. PMID:23890786
The purpose of this study was to determine the effects of the pendulum appliance on distalization of maxillary molars and the reciprocal effects on the anchor premolars and maxillary incisors. Initial and follow-up cephalometric radiographs were obtained on 41 subjects (26 girls and 15 boys) who were treated with the pendulum appliance for bilateral distalization of the maxillary first molar teeth, for correction of the Class II molar relationship or for gaining space in the maxillary arch. Dental casts were available on 31 patients. Dental, skeletal, and soft tissue changes were determined. The mean maxillary first molar distalization was 3.37 mm, with a distal tipping of 8.36 degrees. The mean reciprocal mesial movement of the first premolar was 2.55 mm, with a mesial tipping of 1.29 degrees. The maxillary first molar position intruded 0.1 mm, whereas the first premolar extruded 1.7 mm. The transverse width between the mesiobuccal cusps of the first molars increased 1.40 mm. The maxillary second molars were also distalized 2.27 mm, tipped distally 11.99 degrees, and moved buccally 2.33 mm. The effect of distalization on the maxillary third molars was extremely variable. The eruption of maxillary second molars had minimal effect on distalization of first molars. The lower anterior face height increased by 2.79 mm. This increase was greater in patients with higher Frankfort-mandibular plane angle measurements. The pendulum appliance is an effective and reliable method for distalizing maxillary molars, provided the anchor unit is adequately reinforced. Its major advantages are minimal dependence on patient compliance, ease of fabrication, one-time activation, adjustment of the springs if necessary to correct minor transverse and vertical molar positions, and patient-acceptance. PMID:8972811
The sensitivity of involuntary attention to top-down modulation was tested using an auditory-visual distraction task and a working memory (WM) load manipulation in subjects performing a simple visual classification task while ignoring contingent auditory stimulation. The sounds were repetitive standard tones (80%) and environmental novel sounds (20%). Distraction caused by the novel sounds was compared across a 1-back WM condition and a no-memory control condition, both involving the comparison of two digits. Event-related brain potentials (ERPs) to the sounds were recorded, and the N1/MMN (mismatch negativity), novelty-P3, and RON components were identified in the novel minus standard difference waveforms. Distraction was reduced in the WM condition, both behaviorally and as indexed by an attenuation of the late phase of the novelty-P3. The transient/change detection mechanism indexed by MMN was not affected by the WM manipulation. Sustained slow frontal and parietal waveforms related to WM processes were found on the standard ERPs. The present results indicate that distraction caused by irrelevant novel sounds is reduced when a WM component is involved in the task, and that this modulation by WM load takes place at a late state of the orienting response, all in all confirming that involuntary attention is under the control of top-down mechanisms. Moreover, as these results contradict predictions of the load theory of selective attention and cognitive control, it is suggested that the WM load effects on distraction depend on the nature of the distractor-target relationships. PMID:18284343
This hundred and sixteen patients with carcinoma of the maxillary sinus received primary therapy consisting of external beam irradiation alone or in combination with surgery and/or chemotherapy at the Department of Radiology, Tokyo Medical and Dental University Hospital, between 1953 and 1982. In our institution, methods of treating cancer of the maxillary sinus have been changed from time to time and showed different control rates and clinical courses. An actuarial 10-year survival rate of 21% has been obtained by the megavoltage irradiation alone as well as 34% actuarial 10-year survival rate by megavoltage irradiation with surgery. After the introduction of conservative surgery followed by conventional trimodal combination therapy, the local control rate has been improved. The amount of functional, cosmetic, and brain damages have been remarkably decreased by this mode of therapy. The actuarial five year survival rate was 67%. In addition, along with the improvement of the local control rate, the control of nodal and distant organ metastases have been emerging as one of the important contributions to the prognosis of this disease.
Shibuya, H.; Horiuchi, J.; Suzuki, S.; Shioda, S.; Enomoto, S.
Unexpected task-irrelevant changes in the auditory or visual sensory channels have been shown to capture attention in an ineluctable manner and distract participants away from ongoing auditory or visual categorization tasks. We extend the study of this phenomenon by reporting the first within-participant comparison of deviance distraction in the tactile and auditory modalities. Using vibro-tactile-visual and auditory-visual cross-modal oddball tasks, we found that unexpected changes in the tactile and auditory modalities produced a number of functional similarities: A negative impact of distracter deviance on performance in the ongoing visual task, distraction on the subsequent trial (post-deviance distraction), and a similar decrease - but not the disappearance - of these effects across blocks. Despite these functional similarities, deviance distraction only correlated between the auditory and tactile modalities for the accuracy-based measure of deviance distraction and not for response latencies. Post-deviance distraction showed no correlation between modalities. Overall, the results suggest that behavioral deviance distraction may be underpinned by both modality-specific and multimodal mechanisms, while post-deviance distraction may predominantly relate to modality-specific processes. PMID:22750743
This study proposes a procedure to quantitatively estimate auditory distractions that are not accompanied by any visual diversions to clarify the influence of non-visual distractions on driving. In a laboratory experiment, spare mental capacities (measured in bits\\/s) for three arithmetic tasks were estimated for each subject driver, using the functional relation between the reaction time and the number of alternatives
A case is reported of spontaneous bone formation on the maxillary sinus floor associated with the extraction socket of a maxillary impacted tooth. An impacted maxillary second premolar of a 20-year-old male had been pushed into the maxillary sinus during surgical extraction. The tooth was removed using the sinus elevation technique. After 5 months of healing, the space between the
Y.-S. Jung; S.-W. Chung; W. Nam; I.-H. Cho; I.-H. Cha; H.-S. Park
Mandibular bone transport (MBT) distraction osteogenesis devices are used for achieving reconstruction of mandibular defects in a predictable way, with few complications, less complexity than other alternative surgical procedures, and minimal tissue morbidity. However, selection of appropriate MBT device characteristics is critical for ensuring both their mechanical soundness and their optimal distraction function for each patient's condition. This article assesses six characteristics of currently available MBT devices to characterize their design and function and to classify them in a way that assists the selection of the best device option for each clinical case. In addition, the present work provides a framework for both the biomechanical conception of new devices and the modification of existing ones.
Zapata, Uriel; Elsalanty, Mohammed E.; Dechow, Paul C.
Orthognathic surgery is undergone to improve facial and dental aesthetics and to improve function. Three dimensional (3D) soft tissue analysis based on stereophotogrammetry provides a realistic measurement of facial morphology. There is a need for objective assessment of surgery outcomes. The study aim was to evaluate the 3D naso-maxillary complex soft tissue morphology following Le Fort I maxillary advancement and compare the findings with a local reference group. 3D images of 112 volunteers were captured using stereophotogrammetry and viewed by 8 lay people; 40 images (16 males and 24 females) were chosen as the reference group to have harmonious facial appearance. The linear and angular measurements of this group were compared with 35 patients (19 female and 16 male) who had maxillary advancement in the post-surgical group. Facial morphology post-surgery was similar to the reference group, except the nasal base width which was wider by 2.3mm in males and 2.6mm in females. In the orthognathic group, the females had a smaller nasolabial angle by 9.7° than the reference group. In conclusion, 3D imaging is a sensitive tool for analysing facial appearance. Compared with a control group, statistical differences were identified in soft tissue morphology which should be considered in surgical planning and patient consent. PMID:22406234
Maxillary sinus hypoplasia (MSH) is classified into three types depending upon embryological development of the sinus and uncinate process. Type III MSH is characterized by a near-absence of the uncinate process and an almost absent cleft-like sinus. Bilateral maxillary sinus aplasia or severe hypoplasia with associated paranasal sinus abnormalities is extremely rare. Two cases with severe maxillary sinus hypoplasia/aplasia (one of them with other associated paranasal sinus abnormalities) are presented in this article. This extremely rare abnormality should be kept in mind to prevent misdiagnosis and possible complications during endoscopic sinus surgery. PMID:17881601
Tasar, M; Cankal, F; Bozlar, U; Hidir, Y; Saglam, M; Ors, F
Sensory flooding, particularly during auditory stimulation, is a common problem for patients with schizophrenia. The functional consequences of this impairment during cross-modal attention tasks, however, are unclear. The purpose of this study was to examine how auditory distraction differentially affects task-associated response during visual attention in patients and healthy controls. To that end, 21 outpatients with schizophrenia and 23 healthy comparison subjects performed a visual attention task in the presence or absence of distracting, environmentally relevant "urban" noise while undergoing functional magnetic resonance imaging at 3T. The task had two conditions (difficult and easy); task-related neural activity was defined as difficult - easy. During task performance, a significant distraction (noise or silence) by group (patient or control) interaction was observed in the left dorsolateral prefrontal cortex, right hippocampus, left temporoparietal junction, and right fusiform gyrus, with patients showing relative hypoactivation during noise compared to controls. In patients, the ability to recruit the dorsolateral prefrontal cortex during the task in noise was negatively correlated with the effect of noise on reaction time. Clinically, the ability to recruit the fusiform gyrus during the task in noise was negatively correlated with SANS affective flattening score, and hippocampal recruitment during the task in noise was positively correlated with global functioning. In conclusion, schizophrenia may be associated with abnormalities in neural response during visual attention tasks in the presence of cross-modal noise distraction. These response differences may predict global functioning in the illness, and may serve as a biomarker for therapeutic development. PMID:23560100
Smucny, Jason; Rojas, Donald C; Eichman, Lindsay C; Tregellas, Jason R
The experiment, aimed to evaluate the distracting effect of television, was carried out on 122 children, divided into three\\u000a groups. All groups performed the auditory vigilance test (AVT) to assess reaction time (RT) to an auditory stimulus and the\\u000a number of errors in responding to the stimulus. Children in group 1 performed the AVT while in front of a blank
Carlo V. Bellieni; Giulio Fontani; Franco Corradeschi; Lorenzo Iantorno; Marianna Maffei; Silvia Migliorini; Serafina Perrone; Giuseppe Buonocore
Preclinical studies for spinal cord injury (SCI) have utilized transection and contusion injury paradigms even though human SCIs occur by a spectrum of primary injury mechanisms such as spinal cord contusion from vertebral burst fracture, shearing from fracture-dislocation, and stretching from distraction injuries. We contrasted the neuropathology in animal models mimicking these clinically relevant injuries at an early 3-hour time-point in order to relate patterns of secondary pathology to the primary injury mechanism. Axolemma compromise, detected by the intracellular penetration of dextran-conjugated fluorophores, was localized to the contusion epicentre but extended rostrally following dislocation and distraction injuries. Dextran infused post-trauma revealed extensive axolemma resealing whereas only modest membrane recovery was detected in neuronal somata. Fracture-dislocations produced greater axonal degeneration than either contusion or distraction injuries as evidenced by reduced neurofilament immunostaining in ventral tracts, increased beta-amyloid precursor protein accumulation in lateral funiculi, and a longer lesion in the dorsal corticospinal tract. In the gray matter, cytochrome c release from neuronal mitochondria, indicative of early apoptosis, was detected within the penumbrae of the contusion and dislocation injuries only. Neurons positive for the oxidative stress marker 3-nitrotyrosine were most numerous rostral to the dislocation epicentre. Microglial activation was localized to the contusion epicentre, extended rostro-caudally following dislocation, but was similar to surgical controls after distraction injuries. Reactive astrocytes extended rostro-caudally only following dislocation injuries. Hence, the primary injury mechanism alters the pattern of secondary degeneration indicating that different neuroprotective strategies may ultimately be required for treating distinct clinically relevant SCIs. PMID:18561916
Choo, Anthony M; Liu, Jie; Dvorak, Marcel; Tetzlaff, Wolfram; Oxland, Thomas R
The human brain protects the processing of task-relevant stimuli from interference (''conflict'') by task-irrelevant stimuli via atten- tional biasing mechanisms. The lateral prefrontal cortex has been implicated in resolving conflict between competing stimuli by selectively enhancing task-relevant stimulus representations in sensory cortices. Conversely, recent data suggest that conflict from emotional distracters may be resolved by an alternative route, wherein the
College students in four experiments placed their hands in ice water (the cold-pressor task) and reported their distress. They simultaneously engaged in different reaction-time (RT) tasks that varied in the amount of attention required for successful performance. In each experiment, which differed in numerous procedural details, RT, error-rate, and self-report measures all demonstrated that the distraction tasks differed in the
Arhinia is a rare congenital malformation characterized by lack of the formation of external and internal nasal structures. Restricted midfacial growth is secondary to the loss of the midfacial growth centers. Staged reconstruction of the nasal passage and external nose is required. Vertical distraction osteogenesis is a beneficial step in the overall reconstructive program. This provides for additional bone and soft tissue for both improved aesthetic facial proportions and later surgical interventions. PMID:15253197
Feledy, Jules A; Goodman, Cynthia M; Taylor, Terry; Stal, Samuel; Smith, Brian; Hollier, Larry
We used eye-tracking technology to examine young and old adults’ on-line performance in the reading in distraction paradigm. Participants read target sentences and answered comprehension questions following each sentence. In some sentences, single word distracters were presented in either italic or red font. Distracters could be related or unrelated to the target text. On-line measures including probability of fixation, fixation duration, and number of fixations to distracting text revealed no age differences in text processing. However, young adults did have an advantage over older adults in overall reading time and text comprehension. These results provide no support for an inhibition deficit account of age differences in the reading in distraction paradigm, but are consistent with Dywan and Murphy’s (1995) suggestion that older adults are less able than young to distinguish target and distracter information held in working memory.
Misbehaviors occur at a high rate during the toddler years, and parents use a variety of methods to control these behaviors. The present investigation compared the effectiveness of two commonly used strategies, distraction and reprimands. Twenty mothers and their 17- to 39-month-old children were observed in a laboratory setting in which mothers used either distraction then reprimands or reprimands followed by distraction in response to their children's transgressions. When reprimands were used as the initial strategy, they were significantly more effective than distraction in controlling children's transgressions. Distraction was effective in maintaining low rates of transgression when preceded by a period of reprimands. However, when reprimands were instituted following a period of distraction, children's rates of negative affect increased significantly. Implications for the etiology and management of child behavior problems are discussed. PMID:8064031
The clinical and radiological results of distraction lengthening in cases with posttraumatic radial club hand were evaluated. Five patients (3 men and 2 women, with average age of 21 years) with traumatic radial shortening (3 patients had nonunited fracture of distal end radius with bone loss and 2 patients had short radius after malunited fracture of radius or growth arrest of distal radial epiphysis, the average shortening was 4.2 cm) were treated with distraction lengthening using Ilizarov fixator and hybrid fixation technique. Patients were evaluated clinically for hand function and appearance, and radiologically for union. The average follow-up was 25 months. The preplanned length was achieved in all cases with good union and no bone graft was needed, clinically there was much improvement in hand function (the range of motion of the wrist increased and the power of hand grip increased) and appearance. Pin tract infection occurred in 3 cases, broken pin in 1 case, and stiff wrist in 1 case. These complications were treated and did not affect the final results. Acquired radial club hand is difficult to treat. Treatment with distraction lengthening is a good option with excellent results and mild complications that did not affect the overall results. PMID:24126335
In two experiments, we investigated the effect of regulatory focus (Higgins, Am Psychol, 52, 1280-1300, 1997) on people's maintenance and switching behavior. In the experimental tasks, participants were asked to react selectively to one category of stimuli while ignoring the other. After several practice trials, participants had to switch either to new stimuli which were paired with former target stimuli (i.e., in the perseveration condition), or switch to former distracter stimuli which were paired with new stimuli (i.e., in the learned irrelevance condition). Results from both experiments indicated that a promotion focus promoted switching to new stimuli in the perseveration condition, at the cost of poorer performance on switching to former distracters in the learned irrelevance condition. This pattern of results applied to both chronic individual differences in regulatory focus (Experiment 1), and regulatory focus temporarily manipulated in the laboratory (Experiment 2). It suggests that whereas a promotion focus indeed promotes cognitive flexibility, it also incurs a cost in terms of increased likelihood of being distracted. PMID:23187758
High-contrast markings, called distractive or dazzle markings, have been suggested to draw and hold the attention of a viewer, thus hindering detection or recognition of revealing prey characteristics, such as the body outline. We tested this hypothesis in a predation experiment with blue tits (Cyanistes caeruleus) and artificial prey. We also tested whether this idea can be extrapolated to the background appearance and whether high-contrast markings in the background would improve prey concealment. We compared search times for a high-contrast range prey (HC-P) and a low-contrast range prey (LC-P) in a high-contrast range background (HC-B) and a low-contrast range background (LC-B). The HC-P was more difficult to detect in both backgrounds, although it did not match the LC-B. Also, both prey types were more difficult to find in the HC-B than in the LC-B, in spite of the mismatch of the LC-P. In addition, the HC-P was more difficult to detect, in both backgrounds, when compared with a generalist prey, not mismatching either background. Thus, we conclude that distractive prey pattern markings and selection of microhabitats with distractive features may provide an effective way to improve camouflage. Importantly, high-contrast markings, both as part of the prey coloration and in the background, can indeed increase prey concealment.
Dimitrova, Marina; Stobbe, Nina; Schaefer, H. Martin; Merilaita, Sami
Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.
While top executives often advocate being market oriented and customer focused, I have found that few companies (large or small) use target marketing to its maximum potential. In spite of the many advances made in segmentation methodology and technology over its forty year evolution, a majority of firms still base their marketing plans on cursory, incomplete, or intuitive market analyses.
This study investigated the effects of visual status, driver age and the presence of secondary distracter tasks on driving performance. Twenty young (M=26.8years) and 19 old (M=70.2years) participants drove around a closed-road circuit under three visual (normal, simulated cataracts, blur) and three distracter conditions (none, visual, auditory). Simulated visual impairment, increased driver age and the presence of a distracter task
The present study examined 100 lesbian and gay college students and 100 heterosexual students to determine whether group differences\\u000a exist in frequency of a range of non-erotic cognitive distractions during sexual activity. Non-erotic cognitive distraction\\u000a is a descriptive term for both self-evaluative cognitions related to physical performance and body image concerns, as well\\u000a as additional cognitive distractions (e.g., contracting an
Cognitive strategies used in volitional emotion regulation include self-distraction and reappraisal (reinterpretation). There is debate as to what the psychological and neurobiological mechanisms underlying these strategies are. For example, it is unclear whether self-distraction and reappraisal, although distinct at a phenomenological level, are also mediated by distinct neural processes. This is partly because imaging studies on reappraisal and self-distraction have
Raffael Kalisch; Katja Wiech; Katrin Herrmann; Raymond J. Dolan
Distracted driving is now an increasingly deadly threat to road safety. We provide evidence that intoxicated driving is increasingly responsible for recent increases in fatalities from distracted driving crashes. This study describes trends in deaths on U.S. public roads caused by alcohol-involved and distracted drivers using the Fatality Analysis Reporting System (FARS)-a census of fatal crashes on U.S. public roads. Fatality rates per vehicle-miles traveled are calculated using data from the Federal Highway Administration. Alcohol-involved drivers who are simultaneously distracted were responsible for 1750 deaths in 2009, an increase of more than 63% from 2005 when there were 1072 deaths. Alcohol use while driving is increasingly responsible for a growing number of fatalities from distracted driving, accounting for 32% of deaths from distracted driving in 2009 versus 24% in 2005. The fatality rate from these crashes increased from 35.9 to 59.2 deaths per 100 billion vehicle-miles traveled after 2005. Alcohol use is quickly increasing as an important factor behind distracted driving fatalities. This has implications for policies combating distracted driving that do not address the role of alcohol use in distracted driving. PMID:24076300
Wilson, Fernando A; Stimpson, Jim P; Tibbits, Melissa K
|This paper examines the results of research into the learning experiences of a group of adult learners in a university preparation programme in a college of Technical and Further Education in Sydney, NSW, Australia. The research was conducted over a three year period by the author as a teacher-researcher and is grounded in the phenomenological…
Supernumerary paramolars are a rare anomaly of the maxillofacial complex. They are more common in the maxilla than the mandible. This article reports a rare case of bilateral maxillary paramolars, their complications and management.
Odontogenic myxoma (OM) is an ectomesenchyme derived neoplasm, almost exclusively found in jaws. This article presents a maxillary OM with a brief review of the molecular and proteomic antecedents of OMs, capturing its histopathogenesis.
Odontogenic myxoma (OM) is an ectomesenchyme derived neoplasm, almost exclusively found in jaws. This article presents a maxillary OM with a brief review of the molecular and proteomic antecedents of OMs, capturing its histopathogenesis. PMID:24124309
Hypoplastic maxillary sinus is a rare clinical entity that refers to spontaneous enophthalmos and hypoglobus caused by atelectasis of the maxillary sinus. Most of authors suggest that hypoplastic maxillary sinus results from the develop- ment of negative pressure resulting from an obstruction of maxillary sinus ventilation. Treatment is surgical and involves establishing ventilation of the involved maxillary sinus. The purpose
Anna Paula; Batista de Avila Pires; Bruno Hollanda Santos; Lílian Mara Valadares; Felipe de Almeida Assunção
Polymorphous low-grade adenocarcinoma (PLGA) is a rare tumor, mostly affecting the minor salivary glands of the oral cavity. We report a case of PLGA which occurred within the maxillary sinus in a 59-year-old woman. The tumor was resected through a transnasal endoscopic approach with wide margins. To the best of our knowledge, this is the first reported case with primary PLGA of the maxillary sinus. PMID:23714964
Background Rehabilitation of edentulous jaws with dental implants has become a usual practice around the world. A very low incidence\\u000a of complications is associated with this therapy. One of them is migration of dental implants into maxillary sinus. Foreign\\u000a bodies inside maxillary sinus should be removed because they can cause sinusitis, but if any symptoms are present, preservation\\u000a alone can be
Leandro Eduardo Kluppel; Saulo Ellery Santos; Sergio Olate; Francisco Wagner Vasconcelos Freire Filho; Roger William Fernandes Moreira; Márcio de Moraes
The endoscopic sinus surgeons must have a detailed knowledge of inconsistent location of maxillary sinus openings in any interventional\\u000a maxillary sinus surgeries as it relates to the orbital floor, ethmoid infundibulum and the nasolacrimal duct. Forty cadaver\\u000a head and neck specimens had been cut sagittally through the nose, such that the lateral nasal wall had been preserved. The\\u000a findings were
We describe a rare case of traumatic pseudoaneurysm of the maxillary artery following a fall. The patient presented with epistaxis that could not be controlled with anterior and posterior nasal packing. She was urgently taken to the angiography suite for evaluation and ultimately underwent embolization of a left maxillary artery pseudoaneurysm with 500–700?micron Contour PVA followed by coiling with two 3?mm Tornado coils. Bleeding subsided after embolization, and the patient suffered no neurologic sequelae.
Summary PURPOSE: The objectives of this study were to determine whether maxillary molar distalization with a Pendulum appliance affects\\u000a the cervical posture, and whether lateral cephalometry can measure these changes. METHODS: Twenty Dental Class II subjects,\\u000a aged 11.5–15.5, were selected for maxillary molar distalization with a Pendulum appliance. Before treatment, a lateral cephalogram\\u000a was recorded in natural head position. The lateral
Lymphoepithelial carcinoma (LEC) of the maxillary sinus is a very rare neoplasm that shares some characteristics with nasopharyngeal carcinoma. Epstein-Barr virus (EBV) has been reported to be associated with LEC located outside of the nasopharynx in Asian populations.A case report of a 64-year-old Asian female with right-sided cheek mass which was diagnosed preoperatively as a maxillary mass by paranasal sinus
Hyun Jung; Seong Kook Park; Kyung Wook Heo; Mi Seon Kang
We read the article of Kinnunen et al., which evaluated the result of maxillary defects, and feel some objections. We present our considerations of their operative indication and thoughts based on our surgical experiences. Defects after palatectomy, which have left no dentition for the retention of an obturator, require vascularized bone-containing free flaps. Local flaps are available in only small defects of Class 1 and 2a. Most palatomaxillary defects following malignant tumor abrasion are classified as 2b, 2c, 3, or 4, which require microsurgical free flap transfer combined with bony reconstruction. Regarding bony reconstruction, non-vascularized bone grafts tend to be absorbed. Thus, we believe that bony reconstruction should be performed with vascularized bone. We agree with the authors' comment that PTMF may be useful in repairing defects due to complications in microvascular procedures in the palatal area. However, even when bone segment is required for salvage surgery, using a vascularized bone flap is more preferable. A parietal bone-fascial-periosteal flap based on the superficial temporal vessels is a suitable and reliable bone flap for the reconstruction of a maxillary defect following free skin flap transfer to the palate. PMID:23824316
The posterior maxillarysegment frequently suffers from insufficient bone mass to support dental implants. Current bone augmentation methods, including the lateral maxillary approach (ie, hinge osteotomy) and sinus elevation by osteotome, have many shortcomings. The objective of our study was to assess the safety and efficacy of minimally invasive antral membrane balloon elevation (MIAMBE) followed by bone augmentation and implant fixation (executed during the same procedure). Alveolar crest exposure and implant osteotomy were followed by sequential balloon inflations yielding > 10 mm MIAMBE. A mix of autologous fibrin and bone particles with bone speckles was injected beneath the antral membrane. Implants were fixated into the osteotomies, and primary closure was performed during the same sitting. A total of 24 patients were enrolled. Successful conclusion of this procedure was accomplished in 91.6% of the initial 12 patients and 100% in the second dozen cases without significant complications. Patient discomfort was minimal. Long-term follow up revealed satisfactory bone formation, resulting in adequate implant stability. We conclude that the protocol of MIAMBE results in an excellent success rate, low complication rate, minimal discomfort, and long-term safety and durability. Because it requires only basic equipment and a short learning curve, this clinical approach should be widely employed. PMID:16526579
Kfir, Efraim; Kfir, Vered; Mijiritsky, Eitan; Rafaeloff, Ronen; Kaluski, Edo
Background and purpose In clinical practice, achieved lengthening of a callotasis zone should be maintained after the external fixator has been removed. The common understanding has been that the regenerated bone may subside. To investigate this, we used high-resolution radiostereometric analysis (RSA) with accurate measurement of the lengthening zone. Patients and methods We assessed the longitudinal subsidence of a callotasis zone after removal of the external fixator in distraction osteogenesis in 16 patients who underwent 17 segmental lengthening operations on the tibia (n = 9) or femur (n = 8). Median lengthening was 32 (6–80) mm. RSA was performed at the end of the consolidation period before the external fixation device was removed, and this was later repeated at a median time of 11 (4–32) weeks after frame removal. Results A minimal median longitudinal change of 0.01 (–0.28 to 0.60) mm across the lengthening zone occurred in uncomplicated cases. Interpretation Our results indicate that no subsidence of clinical interest occurs after external frame removal.
Transposition is a dental anomaly manifested by a positional interchange of two permanent teeth. The maxillary permanent canine usually transposes with the first premolar and occasionally with the lateral incisor. These are mainly genetically governed and are treated orthodontically if complete segment of tooth is present; in case of missing teeth, participation of cosmetic dentist is must. The present case report describes a situation where left canine to lateral incisor complete transposition was present along with a missing left central incisor. Esthetic rehabilitation of the "smile zone" was the major concern. Scrupulous treatment planning to esthetically contour transposed teeth according to their normal positions, i.e., transposed left canine to lateral incisor and transposed left lateral incisor to canine with replacement of missing tooth, was a challenge. PMID:22437104
In this experimental animal study the effects of calcitonin and alendronate on distraction osteogenesis are investigated. Forty-five mature female New Zealand type rabbits were used. Rabbits were randomized into three groups, each consisting of 15 animals. Under optimal operating conditions a pre-reconstructed circular external fixator was applied to the right tibia of rabbits, and osteotomy was performed with a Gigli saw just below the tibial tuberosity. During the ten days of distraction, a placebo was administered for group I (control group), group II received 10 U of calcitonin, and group III was treated with alendronate (0.5 mg/kg/day) gavages. Rabbits were examined histologically (at the third and eighth weeks, according to Huddlestone et al.), radiologically (at the third, sixth, and eighth weeks, according to Lane and Sandhu), and mechanically (at the eighth week, as torsional loading). During the first three weeks, the groups did not differ much with regard to radiological parameters. However, in the calcitonin and alendronate groups improved histological scores were detected compared with the control group. Radiological images obtained at the end of six weeks demonstrated improved consolidation in the calcitonin and alendronate groups compared with the control group. At the end of eight weeks postoperatively, radiological and histological parameters did not differ among the groups, while torsional failure load was found to be much improved in the calcitonin group (p=0.006). During the distraction osteogenesis period, calcitonin and alendronate affected the quality of regenerate favourably. This effect is sustained until the end of the consolidation period. However, this finding needs to be supported by experimental and human studies.
Sen, Cengiz; Erdem, Mehmet; Koseoglu, Resid Dogan; Filiz, Nurper Onuk
Response styles theory (Nolen-Hoeksema, 1987)provided the impetus for recent research effortsinvestigating the effects of rumination and distractionon depressed mood. This study elaborates on previous research by examining the sequential effects ofengaging in ruminating and distracting tasks. Resultsfrom two studies indicated that initially engaging in aruminating task maintained postinduction levels of dysphoric mood, whereas initially engagingin a distracting task reduced levels
Sixty cancer chemotherapy patients were randomly assigned to one of six conditions formed by a 3(cognitive distraction, relaxation training, no intervention)×2(high anxiety, low anxiety) factorial design. All patients were followed for five consecutive chemotherapy sessions. Outcome measures included patient reports, nurse observations, and physiological indices. Results indicated that distraction patients reported less nausea prior to chemotherapy and lower systolic blood
Jennifer Vasterling; Richard A. Jenkins; Denise Matt Tope; Thomas G. Burish
|The ability to ignore task-irrelevant information and overcome distraction is central to our ability to efficiently carry out a number of tasks. One factor shown to strongly influence distraction is the perceptual load of the task being performed; as the perceptual load of task-relevant information processing increases, the likelihood that…
|An assessment was made of 5- and 8-year-old children's performance on a short-term memory task under two auditory and two visual distraction conditions, as well as under a nondistraction condition. Performance under nondistraction was found to be superior to that under distraction (p<.001), indicating that the extraneous stimuli had a generally…
...Transportation initiative on distracted driving may be found at http...dangerous practice of distracted driving on our nation's roadways...rulemaking designed to prohibit texting by commercial motor vehicle...the operation of PEDs while driving any motor vehicle. See...
In-vehicle information systems (IVIS) have been shown to increase driver workload and cause distraction, both of which are causal factors for accidents. This simulator study evaluates the impact that two prototype ergonomic designs for a smart driving aid have on workload, distraction and driving performance. Scenario complexity was also manipulated as an independent variable. Results showed that real-time delivery of
Detecting the mental and physical states which occur in a driver immediately before a traffic accident and then providing information to or warning the driver is an effective means of reducing traffic accidents. This study is focused on driver distraction, a state which can easily lead to traffic accidents, and reproduced this distraction in a driving simulator by providing conversation
Masahiro MIYAJI; Mikio DANNO; Haruki KAWANAKA; Koji OGURI
This paper presents a non intrusive approach to obtain driver's face pose estimation based on stereo gray-level image processing. Face pose estimation is based on an automatic and incremental 3D model creation and its correct tracking. From this information, gaze focalization in the scene is calculated in order to detect driver distraction. Different distraction activities are inferred in a realistic
N. Herna?ndez; P. Jime?nez; L. M. Bergasa; B. Delgado; M. Sevillano
Introduction: Little is known about the real-world effect of distractions on driving. We conducted a case-control study in Perth, Western Australia to examine the role of self reported driver distraction in serious road crashes resulting in hospital attendance. Method: Cases were drivers aged 17 years or over who had been involved in a crash and presented to an emergency department.
Lengthening the mandible by distraction osteogenesis (DO) is nowadays a well-recognized technique in maxillofacial surgery. This study compared two different distraction rates and evaluated histological and histomorphometrical properties of the distracted bone in an experimental ovine mandible model with the goal of elaborating a universally accepted distraction protocol. Study Design: Tissue blocks of regenerated bone were harvested from twelve young adult sheep. DO was performed on the mandibular midline after five days of latency period. The sheep were divided into two groups. The first group underwent activation of 0.8 mm÷day during 12 days resulting in 9.6 mm of new bone while the second group followed a geometric rate pattern of 0.2 mm - three days, 0.4 mm - three days, 0.8 mm - three days and 1.6 mm - three days resulting in 9 mm of new bone. The regenerated bone was histologically and histomorphometrically analyzed after 30, 45 and 60 days of consolidation. The relative osteoid volume (OV÷TTV) was significantly increased in the geometric rate distraction group (p=0.015) comparing with linear distraction group while the relative bone volume (BV÷TTV) was significantly increased in the linear distraction group (p=0.019) compared to the geometric distraction group. PMID:21892524
Smoking for negative mood alleviation is a strong predictor of early smoking and early dependence among undergraduates. Little is known about whether adaptive cognitive coping processes (e.g., distraction) may help decrease the likelihood of student smoking for negative mood regulation. The present study tested the hypothesis that distraction would predict (a) greater engagement in adaptive pleasant pastimes and (b) lower
Lee M. Cohen; Dennis E. McChargue; Holly E. R. Morrell
This study compared distraction, an anesthetic (eutectic mixture of local anesthetics [EMLA]), and typical care during pediatric immunizations. Participants were 39 4th graders receiving a 3-injection vaccination series over a 6-month period. Children displayed low distress despite reporting moderate anxiety and pain. Distraction resulted in more nurse coaching and child coping and less child distress than did EMLA or typical
Lindsey L. Cohen; Ronald L. Blount; Rachelle Jansevics Cohen; Elizabeth R. Schaen; Jon F. Zaff
AIM: To measure the forces applied during distraction of growing-rods in early onset scoliosis (EOS), aimed at developing a motorized elongation device. METHODS: A consecutive series of measurements were carried out to analyze the forces applied by the surgeon during distraction of single growing-rods in 10 patients affected by EOS (mean age 8.3 years; range 6 to 10 years) undergoing the first distraction 6 months following implantation of the rods. For each measurement, output from the transducer of a dedicated pair of distraction calipers was recorded at zero load status and at every 1 mm of distraction, up to a maximum of 12 mm for each of the two connected rods. RESULTS: Twenty measurements were obtained showing a linear increase of the load with increasing distraction, with a mean peak force of 485 N at 12 mm distraction and a single reading over 500 N. We did not observe bone fractures or ligament disruptions during or after rod elongations. There was one case of superficial wound infection in the cohort. CONCLUSION: The safe peak force carrying capacity of a motorized device for distraction of growing-rods is 500N.
Sublaminar wiring of Harrington distraction rods enhances stability and resistance to pullout and is an effective means of managing unstable thoracolumbar spine fractures. The incidence of distraction rod-related failure and the duration of postoperative immobilization are reduced. Early return to full activity and successful rehabilitation are facilitated by efficient stabilization of the spinal column. PMID:6478695
Previous research has found that self-focused rumination maintains or increases depressed mood, whereas distraction decreases depressed mood (S. Nolen-Hoeksema & J. Morrow, 1993; S. Nolen- Hoeksema, J, Morrow, & B. L. Fredrickson, 1993). The present series of experiments examined these mood regulation strategies in the context of an angry mood. In Experiments 1 and 3, rumination increased anger, whereas distraction
The ability to ignore task-irrelevant information and overcome distraction is central to our ability to efficiently carry out a number of tasks. One factor shown to strongly influence distraction is the perceptual load of the task being performed; as the perceptual load of task-relevant information processing increases, the likelihood that…
The authors' purpose in this study was to evaluate the role of attention, as a central dimension of temperament, in children's real-time acquisition of novel vocabulary. Environmental distractions were administered to 47 22-month-old children as they acquired novel vocabulary in a fast-mapping task. Two distraction conditions impeded novel word…
Recent research suggests that the recall of positive memories plays an important role in mood regulation. In this study, the authors examined the ability of currently depressed, formerly depressed, and never-depressed participants to regulate sad mood through the recall of positive memories or through distraction. Although improvement in mood was found for all participants in response to distraction, under instructions
Background: Students continue to struggle with homework distraction well into the secondary school years. Recently, the concern over homework distraction has been growing, as new electronic media have offered diverse and nearly ubiquitous forms of diversion to students while they are doing homework. It is surprising to note, however, that a…
An ethnically diverse sample of high and low hypnotizable children (N=27) suffering from cancer or blood disorders were trained along with their parents to use both distraction and hypnosis to reduce pain and anxiety. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. Discusses…
The debate over the merits of pool-based markets as opposed to reliance on bilateral transactions and the invisible hand of competition began without much care taken to define the details of the bilateral alternative. On closer examination, however, it is found that the two approaches have much in common, being more like different pews than different churches. A further debate that emphasizes only the few differences would not inform so much as distract from solving the common problems. We should put the debate to rest and move on.
Hogan, W.W. [Putnam, Hayes & Bartlett, Cambridge, MA (United States)
The following case report describes the successful use of distraction osteogenesis (DO) for the treatment of hypoplasia of the mandible in a patient with muscular dystrophy (MD). While DO has been used for hypoplasia of the mandible, no evidence exists that is it safe in the setting of MD. MD is a disease that primarily affects skeletal muscle; however, pathologic changes in the adjacent bone have been described. Furthermore, the healing of involved bone may be problematic, making DO a potentially unsuccessful technique in this group of patients. This report is the first successful utilization of DO for the treatment of mandibular hypoplasia in a patient with MD. PMID:16258306
Taub, Peter J; Koch, R Michael; Merer, David; Geldzahler, Gerald; Geldzhaler, Gerald
Healthcare settings can be hectic, demanding, time-constrained environments. Within these environments, health care professionals (HCP) are expected to perform tasks that often require their undivided attention. However, HCPs are frequently interrupted, which can distract their attention and add to the complexity of their work. That said, not all interruptions are bad; many interruptions are essential to the patient care process and provide HCPs with necessary information. This paper systematically reviews the peer-reviewed literature on interruptions in healthcare settings to determine the state of the science and to identify gaps. It then provides a complex sociotechnical systems approach to understanding interruptions in healthcare.
Objective: The aim of this investigation was to use 3D (threedimensional) analysis of maxillary casts to document and graphically demonstrate\\u000a the clinically-visible vertical deviation of the premaxilla and lateral segments from a defined reference plane, and to describe\\u000a the effect of presurgical dentofacial orthopedic treatment and cleft lip operation.\\u000a \\u000a \\u000a \\u000a Material and Methods: The maxillary morphology of 17 infants with bilateral cleft lip
Although many studies have investigated the effectiveness of distraction as a method of pain control, the cognitive processes by which attentional re-direction is achieved, remain unclear. In this study the role of executive functioning abilities (inhibition, task switching and working memory) in the effectiveness of distraction is investigated. We hypothesized that the effectiveness of distraction in terms of pain reduction
Katrien Verhoeven; Van Damme Stefaan; Eccleston Christopher; M. L. Van Ryckeghem Dimitri; Legrain Valéry; Crombez Geert
Objective: The current study tested the effectiveness of interactive versus passive distraction that was delivered via a virtual reality type head-mounted display helmet for children experiencing cold pressor pain. Design: Forty children, aged 5 to 13 years, underwent 1 or 2 baseline cold pressor trials followed by interactive distraction and passive distraction trials in counterbalanced order. Main Outcome Measures: Pain
Lynnda M. Dahlquist; Kristine D. McKenna; Katia K. Jones; Lindsay Dillinger; Karen E. Weiss; Claire Sonntag Ackerman
Spinal instrumentation for the correction of spinal deformity began with Harrington and his rod system. The use of the Harrington rods was limited, however, because of the need for long-segment instrumentation, distraction, and the potential for hood dislodgment and construct failure. Luque subsequently introduced the next generation of spinal fixation techniques via the concept of segmental instrumentation; his use of sublaminar wires allowed the construct to be fixated to the spine at every level. This arrangement allowed greater control over correction of spinal deformities and significantly lessened the incidence of hardware dislodgment. Modern instrumentation systems, including the use of pedicle screws, permit even greater control of the spine in multiple planes during deformity correction. Newer strategies have decreased the incidence of neurological injury during implant application and provide greater stability. A review of segmental fixation, including surgical techniques, is provided in this article. PMID:18812915
Steinmetz, Michael P; Rajpal, Sharad; Trost, Gregory
Fourteen veterans with posttraumatic stress disorder (PTSD) and 14 without PTSD participated in a contingent negative variation (CNV)-distraction paradigm. Subjects were instructed to press a button after hearing a high-pitched tone (S2) preceded by a low-pitched tone (S1). One-half of the trials included a white-noise distracter placed in the S1-S2 interval. Posttraumatic stress disorder subjects had larger frontal, but smaller central and parietal CNVs, regardless of condition (distracter, no distracter) or epoch (early CNV, late CNV). In PTSD subjects, the N1/P2 complex was smaller to warning (S1) and distracter stimuli and did not show the extent of facilitation present in non-PTSD subjects. Findings highlight PTSD-related differences in phasic cortical excitability and attention. PMID:14990765
Distraction and inattention are considered to be very important and prevalent factors in the causation of road accidents. There have been many recent research studies which have attempted to understand the circumstances under which a driver becomes distracted or inattentive and how distraction/inattention can be prevented. Both factors are thought to have become more important in recent times partly due to the evolution of in-vehicle information and communication technology. This study describes a methodology that was developed to understand when factors such as distraction and inattention may have been contributors to crashes and also describes some of the consequences of distraction and inattention in terms of subsequent driver actions. The study uses data relating to distraction and inattention from the SafetyNet Accident Causation Database. This database was formulated as part of the SafetyNet project to address the lack of representative in-depth accident causation data within the European Union. Data were collected in 6 European countries using 'on-scene' and 'nearly on-scene' crash investigation methodologies. 32% of crashes recorded in the database, involved at least one driver, rider or pedestrian, who was determined to be 'Inattentive' or 'Distracted'. 212 of the drivers were assigned 'Distraction' and 140 drivers were given the code 'Inattention'. It was found that both distraction and inattention often lead to missed observations within the driving task and consequently 'Timing' or 'Direction' become critical events in the aetiology of crashes. In addition, the crash types and outcomes may differ according to the type and nature of the distraction and inattention as determined by the in-depth investigations. The development of accident coding methodology is described in this study as is its evolution into the Driver Reliability and Error Analysis Model (DREAM) version 3.0. PMID:24176106
OBJECTIVE--To evaluate the diagnostic value of symptoms, signs, erythrocyte sedimentation rate, and C reactive protein for acute maxillary sinusitis. DESIGN--Prospective cohort study. SETTING--Danish general practice in cooperation with the otorhinolaryngology and neuroradiology department at Aalborg County Hospital. SUBJECTS--174 patients aged 18-65 years who were suspected by the general practitioner of having acute maxillary sinusitis. MAIN OUTCOME MEASURE--The independent association of symptoms, signs, erythrocyte sedimentation rate, and concentration of C reactive protein in patients with acute maxillary sinusitis defined as purulent or mucopurulent antral aspirate. RESULTS--Only raised erythrocyte sedimentation rate (P = 0.01) and raised C reactive protein (P = 0.007) were found to be independently associated with a diagnosis of acute maxillary sinusitis. The combination of the two variables had a sensitivity of 0.82 and a specificity of 0.57. CONCLUSION--Erythrocyte sedimentation rate and C reactive protein are useful diagnostic criteria for acute maxillary sinusitis.
Although multiple neuroimaging studies suggest that affect labeling (i.e., putting feelings into words) can dampen affect-related responses in the amygdala, the consequences of affect labeling have not been examined in other channels of emotional responding. We conducted four studies examining the effect of affect labeling on self-reported emotional experience. In study one, self-reported distress was lower during affect labeling, compared to passive watching, of negative emotional pictures. Studies two and three added reappraisal and distraction conditions, respectively. Affect labeling showed similar effects on self-reported distress as both of these intentional emotion regulation strategies. In each of the first three studies, however, participant predictions about the effects of affect labeling suggest that unlike reappraisal and distraction, people do not believe affect labeling to be an effective emotion regulation strategy. Even after having the experience of affect labels leading to lower distress, participants still predicted that affect labeling would increase distress in the future. Thus, affect labeling is best described as an incidental emotion regulation process. Finally, study four employed positive emotional pictures and here, affect labeling was associated with diminished self-reported pleasure, relative to passive watching. This suggests that affect labeling tends to dampen affective responses in general, rather than specifically alleviating negative affect.
Lieberman, Matthew D.; Inagaki, Tristen K.; Tabibnia, Golnaz; Crockett, Molly J.
Previous reports suggest the application of exogenous BMPs can accelerate bone formation during distraction osteogenesis (DO). However, there are drawbacks associated with the use of exogenous BMPs. A possible alternative to the use of exogenous BMPs is to upregulate the expression of endogenous BMPs. Since DO results in spontaneously generated de novo bone formation in a uniform radiographic, histological, and biomechanical temporal sequence, a genetically engineered model lacking endogenous BMP2 should have measurable deficits in bone formation at different time points. We performed DO on BMP2(fl/+) and BMP2(fl/+ cre) mice using a miniature Ilizarov fixator. Distracted samples were collected at various time points and analyzed using real time-quantitative PCR, lCT, radiology, immunohistochemistry, histology, and biomechanical testing. Immunohistochemical studies of 34-day heterozygous samples showed reduced expression of BMP2, BMP7, BMPR1a, ACTR1, and ACTR2b. lCT analysis of 51-day heterozygous samples revealed a decrease in trabecular number and increase in trabecular separation. Biomechanical testing of 51-day heterozygous samples revealed decreased stiffness and increased ultimate displacement. Radiological analysis showed the heterozygotes contained a decreased bone fill score at 17, 34, and 51 days. These data suggest endogenous BMPs are important for bone healing and manipulating endogenous BMPs may help accelerate bone consolidation during DO. PMID:19760469
Driver distraction and safety concerns have been identified for new highway logo sign configurations. This study assessed driver perception of logo signs and distraction under nine-panel, overflow-combination, or standard six-panel formats. A nine-panel sign has nine business panels within a single sign; a six-panel sign has six panels within a sign; an overflow-combination consists of a standard six-panel sign and a six-panel sign displaying two different services (e.g., food and gas). In this study, twenty-four participants searched for target food business logos while driving in a high-fidelity driving simulation under each signage condition. Gas and lodging signs were also displayed along the road in conventional six-panel formats. Dependent variables included signal detection, visual attention allocation, and vehicle control measures. Experiment results showed nine-panel signs drew greater visual attention and produced lower average speed than overflow-combination signs, and produced a lower speeding percentage compared to six-panel signs. However, there was no evidence the new configurations (nine-panel and overflow) caused substantive performance changes with safety implications. This study suggested the use of nine-panel and overflow-combination logo signs may be suitable for interchanges where there are more than six qualifying businesses in a category in terms of driver performance and safety. PMID:23141432
Nowadays drivers have to get along with an increasing complex visual environment. More and more cars are on the road. There are not only distractions available within the vehicle, like radio and navigation system, the environment outside the car has also become more and more complex. Hoardings, advertising pillars, shop fronts and video screens are just a few examples. For this reason the potential risk of driver distraction is rising. But in which way do the advertisements at the roadside influence the driver's attention? The investigation which is described is devoted to this topic. Various kinds of advertisements played an important role, like illuminated and non-illuminated posters as well as illuminated animated ads. Several test runs in an urban environment were performed. The gaze direction of the driver's eye was measured with an eye tracking system. The latter consists of three cameras which logged the eye movements during the test run and a small-sized scene camera recording the traffic scene. 16 subjects (six female and ten male) between 21 and 65 years of age took part in this experiment. Thus the driver's fixation duration of the different advertisements could be determined.
Regional odontodysplasia is an uncommon condition of variable expression and unknown etiology. A case of unilateral maxillary regional odontodysplasia associated with asymmetric maxillary and mandibular development and consequent facial asymmetry is reported. PMID:1656359
Thorough knowledge of root canal morphology is essential for the endodontic therapy. Variations in the root and root canal morphology, especially in multirooted teeth, are a constant challenge for diagnosis and management. The dentist needs to be familiar with the various root canal configurations and their variations for successful endodontic therapy. There are rare variations in canal number and configuration in maxillary molars, which could affect treatment outcome. Two lingual root structures are occasionally found on human permanent maxillary molars. One of these is the normal lingual root, which is always present, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). The purpose of this paper is to review the literature and to demonstrate a case report which describes the successful non-surgical endodontic management of an unusual maxillary first molar with four separate roots and four canals. PMID:23632609
Rajalbandi, Sandeep; Shingte, Sandhya Narayan; Sundaresh, K J; Mallikarjuna, Rachappa
Even though there has been debate over whether a separate premaxilla exists in the human being, it has been suggested that the premaxillary-maxillary suture remains patent into adolescence and provides an explanation for the action of certain orthodontic and orthopedic appliances. To assess whether this suture is pertinent to an understanding of appliance effects, the skulls of 50 subadult subjects were scrutinized to determine patency with regard to age. Remnants of a premaxillary-maxillary suture may be present on the surface of the palate at all ages studied, and often this suture extends deep to the surface. However, in no case was the suture continuous so as to distinguish a distinct premaxilla. These findings disprove the claim that the premaxillary-maxillary suture system provides an explanation for any form of orthodontic or orthopedic therapy. PMID:1986516
This case report presents the clinical features and periodontal findings in a patient with a horizontally impacted maxillary central incisor that had been exposed and aligned after a closed-eruption surgical technique. By combining 3 treatment stages-maxillary expansion, crown exposure surgery, and induced eruption-the horizontally impacted incisor was successfully moved into proper position. The patient finished treatment with a normal and stable occlusion between the maxillary and mandibular arches, and an adequate width of attached gingiva, even in the area surrounding the crown. The 5-year follow-up of stability and periodontal health demonstrated esthetic and functional outcomes after orthodontically induced tooth eruption. Clinical evaluation showed that the treated central incisor had periodontal clinical variables related to visible plaque, bleeding on probing, width of attached gingiva, and crown length that resembled the contralateral incisor. PMID:23810053
Rizzatto, Susana Maria Deon; de Menezes, Luciane Macedo; Allgayer, Susiane; Batista, Eraldo Luiz; Freitas, Maria Perpétua Mota; Loro, Raphael Carlos Drumond
The introduction of trimodal combination therapy (surgery + radiation + intraarterial infusion) for maxillary carcinoma resulted in a change in the sites of recurrence and no satisfactory improvement in the local control rate. To examine the cause of these phenomena, external carotid angiography was performed on 51 patients prior to the start of the therapy and the results of the treatment were studied. Angiographic findings indicated that maxillary carcinoma is fed not only by the maxillary artery, but also by the internal carotid, facial, transverse facial and other arteries from the external carotid artery. The multiplicity of feeders causes irregular distribution of the intraarterially infused antimetabolites. Irregular and local low distribution of antimetabolites may well bring about the high rate of recurrence. The results of intraarterial transcatheter Tc-99m-MAA injection were also in accord with the angiographic findings.
Shibuya, H.; Suzuki, S.; Horiuchi, J.; Takagi, M.; Okuyama, T.; Suzuki, H.; Takeda, M.
Ectopic tooth are rarely found in the maxillary sinus. In rare cases, occlusion of the sinus ostia may predispose a patient to develop a maxillary sinus mucocele. Extraction of the tooth with excision of mucocele resulted in relieving of the symptoms. Here, we present a case of mucocele with an ectopic maxillary tooth located in medial antral wall, over the
The correction of a severe maxillary protrusion in an adult by distal movement of the maxillary molars has been one of the most difficult biomechanical problems in orthodontics. This article reports on the treatment of an adult case of severe maxillary protrusion and a large overjet treated with a skeletal anchorage system. A female patient, age 22 years and 3
Neurons in the primate dorsolateral prefrontal cortex (dlPFC) filter attended [corrected] targets distinctly from distracters through their response rates. The extent to which this ability correlates with the organism's performance, and the neural processes underlying it, remain unclear. We trained monkeys to attend to a visual target that differed in rank along a color-ordinal scale from that of a distracter. The animals' performance at focusing attention on the target and filtering out the distracter improved as ordinal distance between the stimuli increased. Importantly, dlPFC neurons also improved their filtering performance with increasing ordinal target-distracter distance; they built up their response rate in anticipation of the target-distracter onset, and then units encoding target representations increased their firing rate by similar amounts, whereas units encoding distracter representations gradually suppressed their rates as the interstimulus ordinal distance increased. These results suggest that attentional-filtering performance in primates relies upon dlPFC neurons' ability to suppress distracter representations. PMID:21482363
This study tested the effects of distraction using virtual-reality (VR) technology on acute pain tolerance in young adults. Forty-one undergraduate students, aged 18-23 years, used a VR head-mounted display helmet, steering wheel, and foot pedal to play an auto racing video game while undergoing exposure to very cold water (cold pressor set at 1 °C). Two different game views were tested that were hypothesized to affect the degree to which participants felt "present" in the virtual environment: a first-person view, in which the participant saw the virtual environment through the eyes of the game character being manipulated; and a third-person view, in which the participant viewed the game character from a distance. The length of time participants tolerated the cold-water exposure (pain tolerance) under each distraction condition was compared to a baseline (no distraction) trial. Subjects also rated the degree to which they felt "present" in the virtual environment after each distraction trial. Results demonstrated that participants had significantly higher pain tolerance during both VR-distraction conditions relative to baseline (no distraction) trials. Although participants reported a greater sense of presence during the first-person condition than the third-person condition, pain-tolerance scores associated with the two distraction conditions did not differ. The types of VR applications in which presence may be more or less important are discussed. PMID:20950186
Dahlquist, Lynnda M; Herbert, Linda J; Weiss, Karen E; Jimeno, Monica
Individuals differ substantially in their susceptibility to distraction by irrelevant visual information. Previous research has uncovered how individual variability in the goal-driven component of attentional control influences distraction, yet it remains unknown whether other sources of variability between individuals also predict distraction. In this fMRI study, we showed that an individual's inherent sensitivity to passively viewed visual motion predicts his/her susceptibility to distraction by motion. Bilateral MT/V5 was localized in participants during passive viewing of moving stimuli, affording a baseline measure of motion sensitivity. Next, participants performed a visual search task with an irrelevant motion singleton distractor, and both behavioral and neural indices of distraction were recorded. Results revealed that both of these indices were predicted by the independent index of motion sensitivity. An additional analysis of moment-to-moment fluctuations in distraction within individuals revealed that distraction could be predicted by pretrial fMRI activity in several brain regions, including MT+, which likely reflected the observer's momentary propensity to process motion. Together, these results shed light on how variability in factors other than goal-driven processing, both within and between individuals, affects attentional control and one's perception of the visual world.
We present a case of long-standing unilateral cacosmia in a healthy 67-year-old man due to maxillary fungal infestation. Treatment with septoplasty had been attempted 10 years prior but no further investigation or management undertaken and symptoms continued. Subsequent MRI scan revealed significant opacification of the left maxillary sinus. This was readily amenable to treatment by balloon sinuplasty. This yielded viscous grey mucus which grew Scedosporium apiospermum. The case highlights the need for careful investigation of olfactory symptoms, including blood tests to exclude systemic causes, endoscopy and imaging where indicated. PMID:23563684
Erskine, Sally E; Schelenz, Silke; Philpott, Carl M
Auditory distraction is a failure to maintain focus on a stream of sounds. We investigated the neural correlates of distraction in a selective-listening pitch-discrimination task with high (competing speech) or low (white noise) distraction. High-distraction impaired performance and reduced the N1 peak of the auditory Event-Related Potential evoked by probe tones. In a series of simulations, we explored two theories to account for this effect: disruption of sensory gain or a disruption of inter-trial phase consistency. When compared to these simulations, our data were consistent with both effects of distraction. Distraction reduced the gain of the auditory evoked potential and disrupted the inter-trial phase consistency with which the brain responds to stimulus events. Tones at a non-target, unattended frequency were more susceptible to the effects of distraction than tones within an attended frequency band.
Ponjavic-Conte, Karla D.; Hambrook, Dillon A.; Pavlovic, Sebastian; Tata, Matthew S.
Background Distraction osteogenesis (DO) is a technique of bone lengthening that makes use of the body’s natural healing capacity. An osteotomy is created and a rigid distraction device is attached to the bone. After a latency period, the device is activated 2–4 times per day for a total of 1 mm/day of bone lengthening. This technique is used to correct a variety of congenital and acquired deformities of the mandible, midface and long bones. To shorten the treatment period and to eliminate the complications of patient activation of the device, an automated continuous distraction device would be desirable. It has been reported that continuous distraction generates adequate bone with lengthening at a rate of 2 mm/day, thereby reducing the treatment time. Method of Approach The device we describe here uses miniature high-pressure hydraulics, position feedback, and a digital controller to achieve closed-loop control of the distraction process. The implanted actuator can produce up to 40N of distraction force on linear trajectories as well as curved distraction paths. In the paper we detail the spring-powered hydraulic reservoir, controller, and user interface. Results Experiments to test the new device design were performed in a porcine cadaver head and in live pigs. In the cadaver head, the device performed an 11-day/11 mm distraction with a root-mean-squared position error of 0.09 mm. The device functioned for periods of several days in each of five live animals, though some component failures occurred, leading to design revisions. Conclusions The test series showed that the novel design of this system provides the capabilities necessary to automate distraction of the mandible. Further developments will focus on making the implanted position sensor more robust and then carrying out clinical trials.
Magill, John C.; Byl, Marten F.; Goldwaser, Batya; Papadaki, Maria; Kromann, Roger; Yates, Brent; Morency, Joseph R.; Kaban, Leonard B.; Troulis, Maria J.
Medical image segmentation is an important application of image segmentation. However it is the bottleneck that restrains medical image application in clinical practice. In this paper, the aim and significance of medical image segmentation are discussed, the development of medical image segmentation techniques is sketched, and a review of the medical image segmentation techniques is given. PMID:17002132
Pediatric patients are often subjected to procedures that can cause pain and anxiety. Although pharmacologic interventions can be used, distraction is a simple and effective technique that directs children's attention away from noxious stimuli. However, there is a multitude of techniques and technologies associated with distraction. Given the range of distraction techniques, the purpose of this article was to provide a critical assessment of the evidence-based literature that can inform clinical practice and future research. Recommendations include greater attention to child preferences and temperament as a means of optimizing outcomes and heightening awareness around child participation in health care decision making. PMID:21925588
Stabilization of the spinal column with Harrington distraction rods and acrylic fusion was the primary form of treatment in a select group of patients with metastatic carcinoma of the spinal column. Clinical criteria included patients in poor general medical condition with intractable pain originating from metastatic tumor involvement in the ventral components of the thoracic or upper lumbar spinal column and minimal evidence or absence of spinal cord compression. After stabilization, pain relief was almost total and sustained, and neurological status generally remained unchanged from preoperative findings without any evidence of improvement of preexisting abnormalities or occasions of rapid neurological deterioration. This form of spinal stabilization may offer significant relief of debilitating pain, lessen the risk of pathological fracture-dislocation of the thoracic or upper lumbar vertebral column, and reduction in the local compressive effects on the spinal cord caused by ventrally situated metastatic tumor. PMID:6619939
Cusick, J F; Larson, S J; Walsh, P R; Steiner, R E
Histological examination of the deciduous teeth in two cases of segmental odontomaxillary dysplasia (SOMD) showed fibrous enlargement of the pulps, an irregular pulp/dentine interface displaying many pseudoinclusions and pulp stones. There were tubular defects in the coronal dentine from pulp horn to cusp tip, an irregular tubular structure to the circumpulpal dentine of the apical half, a focally deficient odontoblast layer and widespread external resorption. Together with the clinical features of unilateral maxillary enlargement, upper alveolar expansion in the distal segment, increased spacing and delayed eruption of the deciduous molars and absence of premolar teeth, these histological appearances allow distinction of this condition from fibrous dysplasia (FD), segmental hemifacial hypertrophy (SHH) and regional odontodysplasia (ROD). PMID:15061714
Armstrong, Conor; Napier, Séamus S; Boyd, Robert C; Gregg, Terry A
Background: Resistant clubfoot deformities of the foot and ankle remain a difficult problem even for the most experienced surgeon. We report a series of neglected resistant clubfoot deformities treated by limited surgery and Ilizarov distraction histogenesis. Materials and Methods: Twenty one patients with 27 feet having resistant clubfoot deformities were managed by Ilizarov distraction histogenesis from April 2005 to May 2008. The mean age was 12 years (range 8–20 years). A limited soft tissue dissection like percutaneous Achilles sheath tenotomy and plantar fasciotomy were done. Progressive correction of the deformities was achieved through the standard and simple Ilizarov frame construct setting. After removal of Ilizarov frame, a short leg walking cast was used for an additional 6 weeks, followed by an ankle foot orthrosis for 3 months. Results: The mean followup period was 18.7 months (range 20-36 months). The mean duration of fixator application was 3.6 months (range 3–5 months). At the time of removal of the fixator, a plantigrade foot was achieved in 25 feet and gait was improved in all patients. There was residual varus hind foot deformity in two patients. Out of 27 feet, 3 (11.11%) were rated as excellent, 17 (62.96%) as good, 5 (18.51%) as fair, and 2 (7.40%) as poor according to Reinkerand Carpenter scale. Excellent and good results (74.07%) were considered satisfactory, while fair and poor results (25.92%) were considered unsatisfactory. Conclusion: The short term clinical and functional results of resistant clubfoot deformities with Ilizarov's external fixator is promising and apparently a good option.
Makhdoom, Asadullah; Qureshi, Pir Abdul Latif; Jokhio, Muhammad Faraz; Siddiqui, Khaleeque Ahmed
The patent application relates to a segmented annular clutch plate for use in any conventional clutch plate mechanism. The segments are of equal arcuate dimension so that they are interchangeable. Each segment possesses the same annular uniformily serrate...
In visual search, target detection times are relatively insensitive to set size when targets and distractors differ on a single feature dimension. Search can be confined to only those elements sharing a single feature, such as color (Egeth, Virzi, & Garbart, 1984). These findings have been taken as evidence that elementary feature dimensions support a parallel segmentation of a scene into discrete sets of items. Here we explored if relative depth (signaled by binocular disparity) could support a similar parallel segmentation by examining the effects of distributing distracting elements across two depth planes. Three important empirical findings emerged. First, when the target was a feature singleton on the target depth plane, but a conjunction search among distractors on the nontarget plane, search efficiency increased compared to a single depth plane. Second, benefits of segmentation in depth were only observed when the target depth plane was known in advance. Third, no benefit of segmentation in depth was observed when both planes required a conjunction search, even with prior knowledge of the target depth plane. Overall, the benefit of distributing the elements of a search set across two depth planes was observed only when the two planes differed both in binocular disparity and in the elementary feature composition of individual elements. We conclude that segmentation of the search array into two depth planes can facilitate visual search, but unlike color or other elementary properties, does not provide an automatic, preattentive segmentation. PMID:23847304
Finlayson, Nonie J; Remington, Roger W; Retell, James D; Grove, Philip M
Foreign bodies in the paranasal sinuses are rare, being reported sporadically in the literature. Many of these reports are the result of deep trauma following road accidents or other perforating wounds. Although there are reports involving the ethmoidal and sphenoidal sinuses, the frontal and maxillary sinuses are the ones most often involved. This paper reports the case of a young
Nélson Studart Rocha; David Gomes de Alencar; Auremir Rocha Melo
A case of adenocarcinoma, not otherwise specified, was documented, mainly from a radiographic perspective. The lesion, which occurred in the maxillary sinus, destroyed only a moderate amount of bone considering the tumor’s large size. There was no sign of necrosis on either computed tomography or magnetic resonance images. This case demonstrated one of the radiographic characteristics of this type of
The authors describe a case of oncogenic osteomalacia due to a mesenchymal phosphaturic tumour in the maxillary sinus. This is a paraneoplastic syndrome in which a tumour produces a peptide hormone-like substance (phosphatonin) that causes a urinary loss of phosphates resulting in a debilitating systemic condition. In this case, the patient experienced muscle stiffness, reduction of muscle tone, loss of
M. Pedrazzoli; G. Colletti; M. Ferrari; G. Rossetti; L. Moneghini; L. Autelitano
Desmoid tumor in the maxillary sinus is a rare condition. The present case occurred in a 3 7-year-old male complaining of left nasal obstruction and dull pain in the nape of the neck. The clinical picture, pathology, diagnosis and prognosis are discussed and the literature is reviewed.
Dentists have several treatment options when restoring patients with congenitally missing maxillary lateral incisors. Endosseous implant therapy combined with orthodontics can achieve predictable outcomes while meeting patient expectations. This case report exhibits an interdisciplinary approach involving orthodontics, implant surgery, and prosthodontics to resolve this common dental concern. PMID:23611678
Tooth impaction rarely occurs in primary dentition. Most of the primary teeth impactions are seen in second molars. The purpose of this article is to present a 4-year-old girl with bilateral impaction of inverted primary maxillary central incisors which trauma had displaced their tooth germ before erupting.
Seraj, B.; Ghadimi, S.; Mighani, G.; Zare, H.; Rabbani, M.
We report a clinical case of maxillary right second molar with two palatal root canals. The morphology is atypical because it is characterized by two palatal roots with two canals with widely separated orifices and canals. Modifications to the normal access opening and examination of the pulpal floor for additional canals are stressed.
Objective. The purpose of this study was to evaluate the most frequent radiographic appearance of bony lesions associated with vertically fractured roots of endodontically treated maxillary premolars. Study Design. The radiographic features of 102 endodontically treated teeth and their periradicular areas (51 with and 51 without vertically fractured roots) were evaluated and compared. Results. The predominant appearance of the periradicular
Aviad Tamse; Zvi Fuss; Joseph Lustig; Yehuda Ganor; Israel Kaffe
A case is presented in which a mucous retention cyst that obliterated the right maxillary sinus caused symptoms due to pressure on two separate branches of the second branch of the fifth cranial nerve during a chamber dive to 112 feet. The symptoms of pai...
A specimen of juvenile gorilla was found that had the premaxillary-maxillary suture coursing between the lateral deciduous incisor and deciduous canine on one side of the jaw, but between the central and lateral deciduous incisors on the other; in the latter, the suture also separates the alveolus of the lateral deciduous incisor from the crypt of the growing successional lateral
Malignant melanomas develop from malignant transformation of melanocytes that are present in the skin and mucosal linings throughout the body. The overall rate of mucosal melanoma is rare and malignant melanomas developing from turbinates or maxillary sinuses are extremely rare. Symptoms of nasal melanoma are generally nonspecific, and patients often fail to seek prompt medical attention. Diagnosis can be confirmed
Yoon-Seok Choi; Gil Soo Han; Jeong-Seok Choi; Tae Young Jang
Introduction. An antrolith is a calcified mass within the maxillary sinus. The origin of the nidus of calcification may be extrinsic (foreign body in sinus) or intrinsic (stagnant mucus and fungal ball). Most antroliths are small and asymptomatic. Larger ones may present as sinusitis with symptoms like pain and discharge. Case Report. We report a case of a 47-year-old lady who presented with heaviness on the left side of the face and loosening of the left 2nd molar tooth since two months. CT scan of the osteomeatal complex and paranasal sinuses showed an opacification of bilateral maxillary sinus and an amorphous area of bone density in the left maxillary sinus. Because of the size of the mass, benign neoplasms were considered in the differential diagnosis. During an endoscopic sinus surgery, it was found to be an antrolith, which was successfully managed by antrostomy and Caldwell-Luc Surgery. Discussion. Antrolith is a rare condition. Rhinoliths are known to invade into the maxillary antrum, but a localised lesion in the antrum is very unusual. A case of an isolated antrolith is presented for its rarity and for differential diagnosis of localised antral disease. Conclusion. Antrolith should be considered as differential diagnosis of unilateral radio-opaque paranasal sinus lesions. PMID:23476856
Primary clear-cell carcinoma (Hypernephroma) of the nose and maxillary sinus is extremely rare. They are usually metastatic tumours from renal neoplasms. Much less frequently, nasal metastasis occur from neoplasms of the bronchi, breast, urogential ridge, gastro-intestinal tract, thyroid, pancreas, adrenals and melanoma of the skin. Metastatic tumours occur more commonly in the nasal fossae and paranasal sinuses than in any
This study examined the interaction of the cognitive and technological aspects of distracted driving as well as physical health among commercial drivers. Participants (n=55; 5 of which were excluded from analyses) were recruited from Alabama-based truckin...
C. Franklin D. Stavrinos D. Vance G. McGwin K. Heaton P. J. Foster P. R. Fine R. Griffin R. Hanowski
Positive mood states are believed to broaden the focus of attention in younger adults, but it is unclear whether the same is true for older adults. Here we examined one consequence of broader attention that has been shown in young adults: that memory for distraction is greater for those in a positive mood. In the current study, positive and neutral moods were induced in older adults (M?=?67.9) prior to a 1-back task in which participants were instructed to attend to relevant pictures and ignore distracting words. Following a 10-min filled interval, participants performed a word fragment completion task that tested implicit memory for the distracting words from the 1-back task. Older adults in the positive mood group showed greater implicit memory for previous distraction compared to those in the neutral mood group. These findings suggest that affect influences the ability to regulate attention in a similar manner for younger and older adults.
Three patients with joint stiffness caused by trauma or infection are reported. The involved joints are the interphalangeal joint of the thumb, patellofemoral joint, and ankle joint. As an alternative for the indicated arthrodesis in these patients, treatment with articulating joint distraction was performed. By use of adapted Ilizarov external ring fixators, gradual distraction was applied to loosen the joint, followed after loosening by a period of exercise during distraction. In all three patients this experimental approach led to a decrease in pain and improvement of joint function that persisted for at least 2 years after treatment. With the use of Ilizarov joint distraction, joint function in cases of joint stiffness may be restored, and the need for an arthrodesis can be postponed. PMID:9553556
van Roermund, P M; van Valburg, A A; Duivemann, E; van Melkebeek, J; Lafeber, F P; Bijlsma, J W; Verbout, A J
Previous research has found that self-focused rumination maintains or increases depressed mood, whereas distraction decreases depressed mood (S. Nolen-Hoeksema & J. Morrow, 1993; S. Nolen-Hoeksema, J. Morrow, & B. L. Fredrickson, 1993). The present series of experiments examined these mood regulation strategies in the context of an angry mood. In Experiments 1 and 3, rumination increased anger, whereas distraction decreased or had no effect on anger. In Experiments 2 and 4, women were more likely to choose to ruminate when in a neutral mood but to distract themselves following induction of an angry mood. Men were equally likely to choose rumination or distraction, regardless of mood condition. The results are interpreted and discussed within the framework of an associative-network model of anger. PMID:9523420
To determine how distracted and normal driving differ, this report re-examines driving performance data from the advanced collision avoidance system (ACAS) field operational test (FOT), a naturalistic driving study (96 drivers, 136,792 miles). In terms of...
H. Eoh J. Oberholtzer J. Schweitzer P. A. Green P. E. Green T. Wada
National Highway Traffic Safety Administrations mission is to save lives, prevent injuries, and reduce economic costs due to road traffic crashes. Driver distraction is a significant and difficult safety problem to address. This program lays out NHTSAs ef...
Gaps and distracters were presented during the timed signal to examine whether the stop/reset mechanism is activated by (a) changes in the timed signal (switch hypothesis), (b) ITI-like events (ambiguity hypothesis), or (c) processes concurrent with the timing process (time-sharing hypothesis). While the switch and ambiguity hypotheses predict that rats should time through (ignore) distracters, the time-sharing hypothesis predicts that extraneous events (e.g., gaps and distracters) delay timing by causing working memory to decay in proportion to the events' salience. The authors found that response functions were displaced by both gaps and distracters, in accord with the time-sharing hypothesis. Computer simulations show that the time-sharing and memory-decay hypotheses can mechanistically address present data, and reflect different levels of the same model. PMID:16834500
Four hypotheses (switch, instructional-ambiguity, memory decay, and time sharing) were evaluated in a reversed peak-interval procedure with gaps by presenting distracter stimuli during the uninterrupted timed signal. The switch, instructional-ambiguity, and memory-decay hypotheses predict that subjects should time through the distracter and delay responding during gaps. The time-sharing hypothesis assumes that the internal clock shares attentional and working-memory resources with other processes, so that both gaps and distracters delay timing by causing working memory to decay. We found that response functions were displaced both by gaps and by distracters. Computer simulations show that when combined, the memory-decay and time-sharing hypotheses can mechanistically address present data, suggesting that these two hypotheses may reflect different levels of analysis of the same phenomenon. PMID:16413701
Barbels are skin sensory appendages found in fishes, reptiles and amphibians. The zebrafish, Danio rerio, develops two pairs of barbels- a short nasal pair and a longer maxillary pair. Barbel tissue contains cells of ectodermal, mesodermal and neural crest origin, including skin cells, glands, taste buds, melanocytes, circulatory vessels and sensory nerves. Unlike most adult tissue, the maxillary barbel is optically clear, allowing us to visualize the development and maintenance of these tissue types throughout the life cycle. This video shows early development of the maxillary barbel (beginning approximately one month post-fertilization) and demonstrates a surgical protocol to induce regeneration in the adult appendage (>3 months post-fertilization). Briefly, the left maxillary barbel of an anesthetized fish is elevated with sterile forceps just distal to the caudal edge of the maxilla. A fine, sterile spring scissors is positioned against the forceps to cut the barbel shaft at this level, establishing an anatomical landmark for the amputation plane. Regenerative growth can be measured with respect to this plane, and in comparison to the contralateral barbel. Barbel tissue regenerates rapidly, reaching maximal regrowth within 2 weeks of injury. Techniques for analyzing the regenerated barbel include dissecting and embedding matched pairs of barbels (regenerate and control) in the wells of a standard DNA electrophoresis gel. Embedded specimens are conveniently photographed under a stereomicroscope for gross morphology and morphometry, and can be stored for weeks prior to downstream applications such as paraffin histology, cryosectioning, and/or whole mount immunohistochemistry. These methods establish the maxillary barbel as a novel in vivo tissue system for studying the regenerative capacity of multiple cell types within the genetic context of zebrafish.
The prevalence of older drivers’ engagement in distracting activities while driving is largely unexplored. Face-to-face interviews were conducted in the city of Braunschweig, Germany, comparing a sample of older drivers (n=205) to a group of middle-aged drivers (n=209). The drivers were interviewed on their engagement in distracting activities during the last half an hour of their driving trip, including the
Objective: Our research examined the effects of practice on cell-phone—related driver distraction. Background: The driving literature is ambiguous as to whether practice can reduce driver distraction from concurrent cell phone conversation. Methods: Drivers reporting either high or low real-world cell phone usage were selected to participate in four 90-min simulated driving sessions on successive days. The research consisted of two
Attempted to identify the general level of cognitive processing that is especially vulnerable to distraction in schizophrenia. The extent and nature of distraction were compared in 12 schizophrenic patients (mean age, 27.8 yrs), 12 manic patients (mean age, 28.2 yrs), and 12 controls (mean age, 26.7 yrs) using neutral and distractor word-span tests. Also, all patients were evaluated by the
Two experiments investigated the role of distractor characteristics and type of object-directed attention on infants’ distraction latencies during object exploration. In Experiment 1, 7- and 10-month-old infants’ distraction latency was a function of both attention and the characteristics of the distractors. Infants took longer to turn toward distractors during focused object-directed attention than when engaged in more casual attention. In
The objective of this study was to test the efficacy and suitability of virtual reality (VR) as a pain distraction for pediatric intravenous (IV) placement. Twenty children (12 boys, 8 girls) requiring IV placement for a magnetic resonance imaging\\/computed tomography (MRI\\/CT) scan were randomly assigned to two conditions: (1) VR distraction using Street Luge (5DT), presented via a head-mounted display,
Jeffrey I. Gold; Seok Hyeon Kim; Alexis J. Kant; Michael H. Joseph; Albert \\ Rizzo
Background: Numerous studies have investigated the biomechanical properties of meniscal repair techniques. One of the most commonly discussed parameters is the failure load in the axis of insertion, although little is known about the distraction forces actually occurring at repaired bucket-handle lesions.Hypothesis: There are clinically relevant distraction forces on repaired meniscus bucket-handle lesions.Study Design: Controlled laboratory study.Methods: Meniscus bucket-handle lesions
Roland Becker; Olaf Brettschneider; Karl-Heinz Gröbel; Rüdiger von Versen; Christian Stärke
Previous research has found that self-focused rumination maintains or increases depressed mood, whereas distraction decreases depressed mood (S. Nolen-Hoeksema & J. Morrow, 1993;S. Nolen-Hoeksema, J. Morrow, & B. L. Fredrickson, 1993). The present series of experiments examined these mood regulation strategies in the context of an angry mood. In Experiments 1 and 3, rumination increased anger, whereas distraction decreased or
The purpose of this study was to present the method of mandibular distraction osteogenesis in order to improve airway to respiratory distressed patients due to significant mandibular deficiency, and to present the quantitative volumetric evaluation of mandible and upper airway using three-dimensional-CT (3D-CT) before and after distraction.This study involved 12 patients aged 12 months to seven years with various complaints
A. Rachmiel; D. Aizenbud; G. Pillar; S. Srouji; M. Peled
Behavioral and event-related potential measures of distraction and reorientation were obtained from children (6 years), young (19–24 years) and elderly adults (62–82 years) in an auditory distraction-paradigm. Participants performed a go\\/nogo duration discrimination task on a sequence of short and long (50–50%) tones. In children, reaction times were longer and discrimination (d?) scores were lower than in adults. Occasionally (15%),
János Horváth; István Czigler; Emma Birkás; István Winkler; Judit Gervai
Four hypotheses (switch, instructional-ambiguity, memory decay, and time sharing) were evaluated in a reversed peak-interval procedure with gaps by presenting distracter stimuli during the uninterrupted timed signal. The switch, instructional-ambiguity, and memory-decay hypotheses predict that subjects should time through the distracter and delay responding during gaps. The time-sharing hypothesis assumes that the internal clock shares attentional and working-memory resources with
Gaps and distracters were presented during the timed signal to examine whether the stop\\/reset mechanism is activated by (a) changes in the timed signal (switch hypothesis), (b) ITI-like events (ambiguity hypothesis), or (c) processes concurrent with the timing process (time-sharing hypothesis). While the switch and ambiguity hypotheses predict that rats should time through (ignore) distracters, the time-sharing hypothesis predicts that
Acute stress has been shown to impair working memory (WM), and to decrease prefrontal activation during WM in healthy humans. Stress also enhances amygdala responses towards emotional stimuli. Stress might thus be specifically detrimental to WM when one is distracted by emotional stimuli. Usually, emotional stimuli presented as distracters in a WM task slow down performance, while evoking more activation in ventral ‘affective’ brain areas, and a relative deactivation in dorsal ‘executive’ areas. We hypothesized that after acute social stress, this reciprocal dorsal–ventral pattern would be shifted towards greater increase of ventral ‘affective’ activation during emotional distraction, while impairing WM performance. To investigate this, 34 healthy men, randomly assigned to a social stress or control condition, performed a Sternberg WM task with emotional and neutral distracters inside an MRI scanner. Results showed that WM performance after stress tended to be slower during emotional distraction. Brain activations during emotional distraction was enhanced in ventral affective areas, while dorsal executive areas tended to show less deactivation after stress. These results suggest that acute stress shifts priority towards processing of emotionally significant stimuli, at the cost of WM performance.
Veer, Ilya M.; Wolf, Oliver T.; Spinhoven, Philip; Rombouts, Serge A. R. B.; Elzinga, Bernet M.
Pierre Robin sequence is a well known craniofacial entity. There are numerous ways to treat the respiratory insufficiency, but sometimes surgical intervention is needed. Tracheotomy could be associated with morbidity, and distraction osteogenesis has been established as a stable method to obtain a safe airway. Distraction osteogenesis has traditionally been performed with an external device. In this manuscript we describe the feasibility of an internal bioresorbable device. Retrospective descriptive study was performed in a tertiary academic children's hospital. After multidisciplinary team consultation, 12 consecutive patients with Robin sequence were treated with this internal distraction device. The mean age at surgery was 32 days, and the average amount of mandibular distraction was 18 mm. All patients were extubated after an average of 7.5 days after the surgery. The average length of stay in the hospital was 17 days after surgery. There were no major surgical complications. A tracheotomy was prevented in all our patients, and complications were limited. Long-term studies are needed to evaluate the influence that internal distraction has on the growth of the mandible and teeth. The internal distraction system seems safe for infants with micrognathia and has certain benefits when compared to the external distractor. PMID:22009183
Breugem, Corstiaan; Paes, Emma; Kon, Moshe; van der Molen, Aebele B Mink
Objectives. We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. Methods. The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. Results. After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16 000 additional road fatalities from 2001 to 2007. Conclusions. Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving.
Successful campaigns to end distracted driving must understand prevailing social norms for behaviors such as texting and phoning while driving. The current work examined this issue by asking younger drivers to read car crash scenarios and rate the responsibility of the driver for the crash, and to levy fines and assign jail time, as a function of whether the driver was attentive, had been drinking, or was distracted by phoning or texting. In the first experiment, ratings were performed in the absence of injunctive norm information (laws against drunk and distracted driving). In the second experiment, injunctive norm information was included. Impaired drivers were viewed as more responsible in both experiments, with texting drivers viewed as the most responsible. However, drunk drivers received the most fines and jail time. When compared to data from the 1970s, the results show that anti-drunk driving campaigns have changed how younger drivers view drunk driving, but that norms have not yet changed for distracted driving, despite consistent results showing they know the risk of driving distracted. Implications for social norm distracted driving campaigns are discussed. PMID:22664691
Distraction from pain reduces pain perception, and imaging studies have suggested that this may at least partially be mediated by activation of descending pain inhibitory systems. Here, we used the nociceptive flexor reflex (RIII reflex) to directly quantify the effects of different distraction strategies on basal spinal nociception and its temporal summation. Twenty-seven healthy subjects participated in 3 distraction tasks (mental imagery, listening to preferred music, spatial discrimination of brush stimuli) and, in a fourth task, concentrated on the painful stimulus. Results show that all 3 distraction tasks reduced pain perception, but only the brush task also reduced the RIII reflex. The concentration-on-pain task increased both pain perception and the RIII reflex. The extent of temporal summation of pain perception and the extent of temporal summation of the RIII reflex were not affected by any of the tasks. These results suggest that some, but not all, forms of pain reduction by distraction rely on descending pain inhibition. In addition, pain reduction by distraction seems to preferentially affect mechanisms of basal nociceptive transmission, not of temporal summation. PMID:21925793
Ruscheweyh, Ruth; Kreusch, Annette; Albers, Christoph; Sommer, Jens; Marziniak, Martin
Distraction during driving task is one of the most serious problems affecting traffic safety, being one of the main causes\\u000a of accidents. Therefore, a method to diagnose and evaluate Distraction appears to be of paramount importance to study and\\u000a implement efficient counter-measures. This research aims at illustrating our approach in diagnosis of Distraction status,\\u000a comparing some of the widely used
Objective To quantify the prevalence and effects of distracting activities while driving. Design Cross sectional driver survey. Setting New South Wales and Western Australia, Australia. Participants 1347 licensed drivers aged between 18 and 65 years. Data were weighted to reflect the corresponding driving population. Main outcome measures Prevalence of distracting activities while driving; perceived risks and adverse outcomes due to distractions. Results The most common distracting activities during the most recent driving trip were lack of concentration (weighted percentage (standard error, SE) 71.8% (1.4%) of drivers); adjusting in?vehicle equipment (68.7% (1.5%)); outside people, objects or events (57.8% (1.6%)); and talking to passengers (39.8% (1.6%)). On average, a driver engaged in a distracting activity once every six minutes. One in five crashes (21%) during the last three years, involving one in 20 drivers (5.0% (0.7%)), was attributed to driver distraction based on self?report. In the population under study, this equated to 242,188 (SE 34,417) drivers. Younger drivers (18–30?years) were significantly more likely to report distracting activities, to perceive distracting activities as less dangerous, and to have crashed as a result. Conclusions Distracting activities while driving are common and can result in driving errors. Driver distraction is an important cause of crashes. Further research is needed to estimate the risk conferred by different distracting activities and the circumstances during which activities pose greatest risk. These results suggest that a strategy to minimize distracting activities while driving, with a focus on young drivers, is indicated.
Five years (1995-1999) of national Crashworthiness Data System (CDS) data are analyzed to determine the role of driver distraction in traffic crashes and the specific sources of this distraction. Results show that 8.3 percent of the drivers were distracted at the time of their crash; after adjustment for the large percentage of drivers with unknown distraction status, the percentage rose to 12.9 percent. The most frequently cited sources of driver distraction were persons, objects or events outside the vehicle (29.4% of distracted drivers), adjusting the radio, tape or CD player (11.4%), and other occupants in the vehicle (10.9%). Other specific distractions (moving objects in vehicle, other objects brought into vehicle, adjusting vehicle or climate controls, eating and drinking, cell phones, and smoking) were each cited in only one to four percent of the cases. The likelihood of being distracted and the source of distraction varied by driver age but not by gender. Results are discussed in light of the limitations inherent in the CDS and other crash data, and the need for expanded data collection initiatives. PMID:12214356
The biological mechanisms of nerve adaptation to distraction osteogenesis have not yet been elucidated. This study observed response of Schwann cells in the inferior alveolar nerve (IAN) following mandibular lengthening by electron microscopy and immunohistochemistry of S-100 protein, a specific marker of Schwann cells. Unilateral mandibular distraction (10mm elongation) was performed in nine young adult goats. Three animals were sacrificed at 7, 14 and 28 days after completion of distraction, respectively. The distracted IAN specimens and control nerves (from the contralateral sides) were harvested and processed for histological, ultrastructural and immunohistochemical examinations. Wallerian degeneration was observed in the distracted IAN, and Signs of axonal regeneration, as well as many activated Schwann cells were seen in the lengthened nerves. The expression of S-100 protein increased significantly at early stage of distraction osteogenesis, but almost returned to the normal level at 28 days after distraction. This study suggests that Wallerian degeneration caused by mechanical stretching may stimulate Schwann cells to enter a proliferated and activated state. Schwann cells and S-100 protein appear to play crucial roles in axonal regeneration that contributes to nerve adaptation to gradual distraction. Therefore, the IAN injury caused by mandibular gradual distraction was not serious; it seems to recover totally through a complicated repair mechanism. PMID:12767881
Background: In the field of forensic dentistry, secondary changes in teeth with advancing age have been used as reliable predictors of age in various studies. Aim: The purpose of the present study was to present a method for assessing the chronological age based on the relationship between age and morphological parameters of maxillary central incisors. Materials and Methods: Fifty subjects between 20-70 years of age were included in the study. Intraoral periapical radiographs were taken in relation to maxillary central incisors using paralleling technique. The following measurements were recorded: lengths of tooth, pulp, root and width of root and pulp at three different points. Regression formulas were used to calculate the dental age. Results: The mean estimated age showed no statistically significant difference from the actual mean age (P > 0.05). Also, maximum difference was seen for root length variable (-1.035 ± 1.86 years).
A 13-year-old female patient reported with the chief complaint of irregular front teeth. She had a skeletal Class III and Angle's Class I malocclusion with hyperdivergent growth pattern and bilateral impaction of maxillary canines. Surgical exposure of the impacted teeth and orthodontic alignment was planned. The surgical exposure was done by a minimally invasive modified window technique. Orthodontic treatment of impacted canines without causing significant morbidity to the adjacent teeth and periodontium is a challenge. The bilaterally impacted maxillary canines were successfully aligned and leveled. The depth of the gingival sulcus and clinical crown heights of disimpacted teeth were normal post-treatment and after 1 year of retention. PMID:23293502
The gag reflex can be a normal, healthy defense mechanism to prevent foreign objects from entering the trachea. During certain dental procedures, however, gagging can greatly complicate the final result, especially during the maxillary complete denture final impression. A modification can be made to the maxillary custom acrylic resin tray to aid in securing a clinically acceptable elastomeric final impression. This modification involves forming a vacuum chamber at the posterior extent of the custom tray to which a saliva ejector tip is embedded. When the saliva ejector is connected to the low-volume evacuation hose, the chamber will trap any excess impression material that might extrude from the posterior border of the loaded tray. This results in a reduced chance of eliciting the patient's gag reflex. PMID:2664161
This article describes the orthodontic treatment of a 25-year-old Korean female patient with anterior crowding, including palatally displaced lateral incisors. Her facial profile was satisfactory, but 3.5 mm of maxillary anterior crowding was observed. To correct this crowding, we decided to minimize the use of the conventional fixed orthodontic appliances and employed a less bulky and more aesthetic appliance for applying light continuous force. We determined the final positions of the maxillary teeth via a working model for diagnostic set up and achieved space gaining and alignment with simple Ni-Ti spring and stainless steel round tubes. Tooth alignment was achieved efficiently and aesthetically without the conventional brackets. PMID:24015390
Choi, Kyung-Hee; Lee, Yoonjung; Kim, Minji; Chun, Youn-Sic
Agenesis of maxillary lateral incisors and mandibular second premolars is the most frequent form of hypodontia. Its prevalence varies across population from 0.8% to 4.5%. Genetic aberrations and environmental factors may cause agenesis of one or more teeth. The management of child having such a problem is very important since diastema in teeth especially in upper anteriors not only affects child's physical appearance but also its psychological development as the child wants to look like other children. In this article is presented a case of non-syndromic agenesis of maxillary lateral incisors (MLIA) and mandibular central incisors in a 10-year-old boy (patient) in permanent dentition with its management along with the radiographic investigations and photographic presentations of the other members of his family affected with this condition. PMID:23536620
The influence of sagittally contoured rods on thoracic sagittal curves was studied in 19 patients who underwent fusion and instrumentation for right thoracic idiopathic scoliosis. Group I included 13 patients who underwent fusions with contoured rods and no releases. Group II included six patients who had anterior or posterior spinal release procedures in addition to contoured rods and fusion. Harrington distraction rods were contoured to either increase, decrease, or maintain preoperative thoracic kyphosis. The number of kyphotic curves that changed in the intended direction, the degree of change, the relationship of the rod contour to the patient's postoperative kyphosis, and the postoperative rod contour were compared. Thirty-eight percent of the curves in group I underwent change in the unintended direction while 62% of group I curves and 100% of group II curves changed in the intended direction. The curves that demonstrated intended change exhibited variability in the relationship of the postoperative kyphosis to the rod contour. In no case did the postoperative rod kyphosis exceed the measured intraoperative rod kyphosis. PMID:2520063
The optimum positioning of roadside advertisements is recognized by the industry as an important factor in attracting the attention of passing drivers. Less acknowledged is the possibility that the location of an advertisement may distract attention from vital driving-related information. This study compared street-level advertisements (SLAs; predominantly bus shelters) with raised-level advertisements (RLAs) of the same size that were suspended 3 m above the ground, on their ability to attract attention under different task conditions. Participants were split into two groups and watched video clips of driving, rating them for hazardousness while their eye movements were recorded. One of the groups was additionally primed to attend to advertisements. SLAs received the most fixations when participants were solely looking for hazards, and the fewest fixations when primed to look for advertisements. Though SLAs also had longer fixations than the RLAs, they were more poorly recognized in a subsequent memory test. We conclude that SLAs attract and hold attention at inappropriate times compared to raised-level advertisements. PMID:16427019
Crundall, David; Van Loon, Editha; Underwood, Geoffrey
The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs) performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction. PMID:24023587
Gudavalli, M R; Potluri, T; Carandang, G; Havey, R M; Voronov, L I; Cox, J M; Rowell, R M; Kruse, R A; Joachim, G C; Patwardhan, A G; Henderson, C N R; Goertz, C
The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs) performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.
Gudavalli, M. R.; Potluri, T.; Carandang, G.; Havey, R. M.; Voronov, L. I.; Cox, J. M.; Rowell, R. M.; Kruse, R. A.; Joachim, G. C.; Patwardhan, A. G.; Henderson, C. N. R.; Goertz, C.
Control of the human walking pattern normally requires little thought, with conscious control used only in the face of a challenging environment or a perturbation. We have previously shown that people can adapt spatial and temporal aspects of walking to a sustained perturbation generated by a split-belt treadmill. Here we tested whether conscious correction of walking, versus distraction from it, modifies adaptation. Conscious correction of stepping may expedite the adaptive process and help to form a new walking pattern. However, because walking is normally an automatic process, it is possible that conscious effort could interfere with adaptation, whereas distraction might improve it by removing competing voluntary control. Three groups of subjects were studied: a control group was given no specific instructions, a conscious correction group was instructed how to step and given intermittent visual feedback of stepping during adaptation, and a distraction group performed a dual-task during adaptation. After adaptation, retention of aftereffects was assessed in all groups during normal treadmill walking without conscious effort, feedback, or distraction. We found that conscious correction speeds adaptation, whereas distraction slows it. Subjects trained with distraction retained aftereffects longest, suggesting that the training used during adaptation predicts the time course of deadaptation. An unexpected finding was that these manipulations affected the adaptation rate of spatial but not temporal elements of walking. Thus conscious processes can preferentially access the spatial walking pattern. It may be that spatial and temporal controls of locomotion are accessible through distinct neural circuits, with the former being most sensitive to conscious effort or distraction.
Bone augmentation is a vital part of surgical interventions of the oral and maxillofacial area including dental implantology. Prior to implant placement, sufficient bone volume is needed to reduce the risk of peri-implantitis. While augmentation using harvested autologous bone is still considered as gold standard, many surgeons prefer bone substitutes to reduce operation time and to avoid donor site morbidity. To assess the osteogenic efficacy of commercially available augmentation materials we analyzed drill cores extracted before implant insertion. In younger patients, distraction osteogenesis is successfully applied to correct craniofacial deformities through targeted bone formation. To study the influence of mesenchymal stem cells on bone regeneration during distraction osteogenesis, human mesenchymal stem cells were injected into the distraction gap of nude rat mandibles immediately after osteotomy. The distraction was performed over eleven days to reach a distraction gap of 6 mm. Both the rat mandibles and the drill cores were scanned using synchrotron radiation-based micro computed tomography. The three-dimensional data were manually registered and compared with corresponding two-dimensional histological sections to assess bone regeneration and its morphology. The analysis of the rat mandibles indicates that bone formation is enhanced by mesenchymal stem cells injected before distraction. The bone substitutes yielded a wide range of bone volume and degree of resorption. The volume fraction of the newly formed bone was determined to 34.4% in the computed tomography dataset for the augmentation material Geistlich Bio-Oss®. The combination of computed tomography and histology allowed a complementary assessment for both bone augmentation and distraction osteogenesis.
Spherulocytosis (myospherulosis) is an unusual foreign-body reaction usually occurring in tissues exposed to petrolatum-based products. Due to its occasional localization in the maxillary sinus, it is of interest to rhinologists and maxillofacial surgeons. The pathogenesis of spherulocytosis has remained a matter of controversy. We present the case of a 40-year-old female with no previous contact to petrolatum-based substances and suffering
Desmoplastic fibroma (DF) is a benign intra-osseous neoplasm characterized by the formation of abundant collagen fibers. It arises most commonly in the jaws and exhibits local aggressiveness and high recurrence rates after local resection. An uncommon case of expansive DF involving the right maxilla, maxillary sinus, and inferior orbital wall of a 49-year-old man whose initial symptoms were similar to acute sinusitis is presented, and the criteria for diagnosis and clinical management are discussed. PMID:23669201
Gondak, Rogério Oliveira; Corrêa, Marcelo Brum; da Costa, Matheus Vieira; Vargas, Pablo Agustin; Lopes, Márcio Ajudarte
The objective of this clinical case is to suggest a treatment approach for impaction of the maxillary first permanent molars. This approach allows access to the partially erupted tooth for orthodontic bonding and utilization of loops for distalization. An important detail is the non inclusion of the primary second molar in the orthodontic mechanics, in order to reduce the risk of early loss and preserve this tooth until exfoliation. PMID:16491975
Rizzatto, Susana Maria Deon; de Menezes, Luciane Macedo; do Rego, Marcus Vinicius Neiva Nunes; Thiesen, Guilherme; de Araujo, Vanessa Pereira; Freitas, Maria Perpétua Mota
Radicular cyst arising from deciduous teeth is exceedingly rare accounting for <1% of all radicular cysts. A total of 122 cases have been reported to date in the English language literature. We present a rare case of a radicular cyst associated with a decayed deciduous maxillary molar tooth without any history of prior pulp therapy. Our aim is to emphasize the recognition of inflammatory radicular lesions associated with deciduous teeth which may adversely impact underlying permanent successor.
Use of a maxillary prosthesis is now considered one of the good methods to ameliorate the crippling caused by the defect in the maxillary palate area after an ablative procedure for a maxillary tumor and it consumes no physical resources from the patient. There has been debate on whether the prosthesis should be made in the very early postoperative days or after the wound is stabilized. In this study, changes in the area of the defect in the palate after surgery were investigated by using plaster models from clinical cases we have experienced. Twenty-one cases were investigated according to the following features: "maxillary sinus cancer "+" more than 1.5 years of follow-up for maxillofacial prosthetics "+" presence of more than two casts of the case". These casts were photographed from a distance of 1.5 m, and the photographs were enlarged to the original size of the cast, then the defect area was measured with a Planimeter (Uchida Co. Ltd). The area of the defect had shrunk in 16 cases. It took over 1 year to get stabilized in 80% of the cases. It is believed to take around 3.5 years for all cases to become stable. This tendency had no relationship with the pattern of the defect, the stroke of the mouth opening, the pattern of the rest of the teeth, or the defect area itself. These findings suggest that it may be advisable to start the prosthetic work as early as possible rather than waiting for stability of the defect wound, to improve the patients's QOL. PMID:9277098
Hemophilic pseudotumors are rare, but well known complications of severe hemophilia A, which most frequently develops at the femur, tibia, pelvic bones, iliac bones, or rarely in the cranium or gnathic bones. This report describes a case of hemophilic pseudotumor of the maxillary alveolar ridge that occurred in a boy with mild hemophilia A (14% factor VIII activity). The lesion, which presented as an alveolar mucosal swelling, responded well to enucleation, curettage, and intralesional fibrin glue injection. PMID:18799938
Objective: To analyze the skeletal features of patients with maxillary canine impaction. Material and Methods: The complete pre-treatment records of 1674 orthodontic patients were examined. From the subjects with maxillary impacted canine 12 patients were excluded , remaining 108. The subjects with maxillary impacted canine were divided into two study groups: a palatally displaced canine group (PDCG) (77 patients) and a buccally displaced canine group (BDCG) (31 patients). The values of the skeletal features measured on the lateral cephalometric radiograph were compared with a control group (CG) of 121 subjects randomly selected from the initial sample without maxillary canine impaction. The statistical analysis of the difference between the study groups and the CG was tested using ?2 test and Fisher's exact test. The level of significance was set at P ?0.05. Results: The CG was characterized by increased values of sella- nasion- A point angle (ANB) and by a retro-positioned or smaller lower jaw. PDCG patients showed normal skeletal features compared to the CG, presenting mainly I class and lower rank of II and III sagittal skeletal features. PDCG subjects presented also normal values of the Steiner vertical skeletal relationship angles with normal facial divergence compared to the CG. PDCG cases were also characterized by horizontal and prognathic growth. BDCG did not present significant differences in skeletal features compared to the CG, except for an increased ANB. Conclusions: Palatally displaced canine (PDC) was frequently the only orthodontic problem of patients and was not associated whit altered skeletal features. The frequent absence of malocclusion in PDC patients explains the delayed identification of this problem. BDCG patients did not present significant differences in skeletal features with respect to the orthodontic population (CG). The presence of both buccally displaced canine (BDC) and malocclusion makes the patient with BDC both aware of the need for, and motivated to undergo, orthodontic treatment. PMID:23722128
Mercuri, E; Cassetta, M; Cavallini, C; Vicari, D; Leonardi, R; Barbato, E
In this author's opinion, the advent of mini implants, or small diameter implants (SDIs) as they are more frequently being called, are becoming in many situations a viable alternative to the more traditional root form implants. They offer advantages of less cost, a more simplified placement technique, usually faster healing times, and generally less post-operative complications. A case presentation is given to demonstrate their usage for a narrow ridge application to restore congenitally missing maxillary lateral incisors. PMID:24015452
Objective: The purpose of this prospective, randomized double-blind study was to evaluate and compare the anesthetic efficacy of 0.5% ropivacaine with 1:200,000 epinephrine, of 0.5% ropivacaine, and of 0.5% bupivacaine with 1:200,000 epinephrine in maxillary lateral incisor infiltrations. Study Design: Forty subjects randomly received, in a double-blind manner, 3 infiltrations at 3 separate appointments, in a repeated-measures design. The injections
Michelle Kennedy; Al Reader; Mike Beck; Joel Weaver
OBJECTIVES: Numerous clinical signs may be indicative of a canine impaction; however, studies determining the efficiency of visual inspection and digital palpation in localizing an impacted maxillary canine are sparse. Of the radiographic techniques, no studies have compared the accuracy of the horizontal and the vertical parallax techniques to determine the location of an impacted canine. Hence, the objectives of this study were to evaluate the efficiency of visual inspection and digital palpation, and to compare the accuracy of the horizontal and vertical parallax techniques in determining the location of an impacted maxillary canine. METHODS: The study sample comprised the records of 522 patients who had attended a dental hospital. The location of an impacted maxillary canine was determined radiographically using the vertical and the horizontal parallax principles. The findings were then confirmed from the surgical records in those cases that had undergone surgical intervention of the impacted canine. RESULTS: The position of the impacted canine was determined successfully by visual inspection and digital palpation in 85.3 and 85.2% of the cases respectively. CONCLUSIONS: The vertical parallax technique demonstrated a higher degree of accuracy (97.7%) and a greater degree of diagnostic capability (98.2%) when compared with the horizontal parallax technique (92.6 and 78.0% respectively). PMID:23239667
The effects of Le Fort I osteotomy on the nasal airway are controversial. This study aimed to evaluate nasal airway changes after Le Fort I. 25 patients underwent conventional Le Fort I osteotomy and were separated into three groups depending on the type of surgery they underwent. 11 patients needed maxillary impaction, 9 underwent maxillary advancement, and 5 had both maxillary impaction and advancement. Rhinological examinations, anterior rhinomanometry and acoustic rhinometry were carried out 1 week before surgery and 3 months after that. Wilcoxon and ?(2) tests were used for data analysis. The samples included 19 females and 6 males with a mean age of 22.4 ± 3.32 years. Rhinomanometric assessment showed that total nasal airflow was increased from 406 ± 202 ml/s to 543 ± 268 ml/s in all three groups. Significant decrease in nasal airway resistance was seen in all three groups. Acoustic rhinometry revealed a significant decrease in total nasal volume but an increase in the cross-sectional areas of isthmus nasi (IN) and inferior concha. The rhinomanometric measurements showed improvements in the total nasal airflow after Le Fort I osteotomy with alar base cinch suture in cases where the impaction was not higher than 5.5mm. PMID:22542078
Pourdanesh, F; Sharifi, R; Mohebbi, A; Jamilian, A
The anatomy of third molars has been described as unpredictable. However restorative, prosthetic, and orthodontic considerations often require endodontic treatment of third molars in order for them to be retained as functional components of the dental arch. The purpose of this study was to investigate and characterize the anatomy of maxillary and mandibular third molars. One hundred fifty maxillary and 150 mandibular extracted third molars were vacuum-injected with dye, decalcified, and made transparent. The anatomy of the root canal system was then recorded. Seventeen percent of mandibular molars had one root (40% of which contained two canals), 77% had two roots, 5% had three roots, and 1% had four roots. Teeth with two roots exhibited highly variable canal morphology, containing from one to six canals, including 2.2% that were "C-shaped." Fifteen percent of maxillary molars had one root, 32% had two roots, 45% had three roots, and 7% had four roots. Teeth with one root demonstrated the most unusual morphology, with the number of canals varying from one to six. An in vivo study of the canal morphology of treated third molars is suggested to provide the practitioner with an understanding of the clinical implications of third molar root anatomy. PMID:11469300
Sidow, S J; West, L A; Liewehr, F R; Loushine, R J
The main objective of this study was to quantify the transverse maxillary dimensions using orthodontic cast models of individuals with natural normal occlusion. Sixty-eight pairs of orthodontic models were evaluated with the respective posteroanterior radiographies of white adults (38 women and 30 men; mean age, 17 years and 5 months). The models were placed in Class I molar occlusion, and on each pair, 4 points were marked on the alveolar buccal ridge (2 on the premolar region and 2 on the molar), determining the upper and lower transverse interpremolar and intermolar dimensions. The variables analyzed in the 3 measurements, obtained from the cephalometric radiographies and the cast models, showed no statistical differences. The upper intermolar distance was 57.20 +/- 2.60 mm; the lower intermolar, 55.16 +/- 2.40 mm; the upper interpremolar, 42.17 +/- 2.19 mm, and the lower interpremolar; 39.67 +/- 1.77 mm. On the posteroanterior cephalograms, the maxillary width was 65.97 +/- 3.42 mm and the mandibular width was 87.92 +/- 4.60 mm. There was intraresearcher and interresearcher correlation. There was no sexual dimorphism. The method proposed in this study can predict the transverse maxillary dimension, applying the formula ym = 8.62 + 0.88xm (ym = expected upper intermolar distance, xm = lower intermolar distance) for the molar region, and ypm = 4.87 + 0.94xpm (ypm = expected upper interpremolar distance, xpm = lower interpremolar distance) for the premolar region. PMID:19098534
de Oliveira, Melchiades Alves; Pereira, Max Domingues; Hino, Claudia Toyama; Campaner, Anelisa Bittencourt; Scanavini, Marco Antonio; Ferreira, Lydia Masako
The purpose of this retrospective study was to examine the location of impacted maxillary anterior supernumerary teeth that subsequently were removed from pediatric patients at Children's Hospital of New York-Presbyterian. The study population consisted of 42 children diagnosed with impacted maxillary anterior supernumerary teeth. The impacted maxillary anterior supernumerary teeth were surgically removed by one faculty member in the hospital operating room with the aid of general anesthesia between 1994 and 2000. The total number of impacted maxillary anterior supernumerary teeth was 51. All were located palatally on either side of the midline and were surgically removed from a palatal access. In the absence of clear imaging evidence to the contrary, it is recommended that the preferred surgical approach for the removal of impacted maxillary anterior supernumerary teeth should be the palatal approach. Relatedly, the term mesiodens is misleading and is generally inaccurate for describing impacted maxillary anterior supernumerary teeth. Palatodens would be a more appropriate descriptive term. PMID:19195233
An osteoma within the paranasal sinuses is a rare benign fibro-osseous tumour. Osteomas occurring in the maxillary sinus are\\u000a exceedingly rare and account for only 5% of the cases. A case of a 38-year-old female with an osteoma of the maxillary sinus\\u000a is presented and the disease and its management are discussed. A 2 cm spherical lesion in her right maxillary
Incidence rate of single root canal in maxillary second molar is very low. The emergence of curved single root canal in maxillary second molar with single root is especially rare. A case of curved single root canal in maxillary second molar with single root was successfully treated and reported in this article. This report also highlighted the role of cone beam computed tomography as an objective method to confirm the three-dimensional anatomy of teeth. PMID:21427914
During open reduction of thoracolumbar fracture-dislocation, the normal constraints to distraction and lengthening may be ruptured and allow instrumentation to exert deleterious traction of the spinal cord. An interspinous wire across the unstable segment together with a Harrington rod may be used to prevent potential overdistribution of the spinal cord. Thirty-six patients with fracture-dislocation of the thoracolumbar spine were treated by open reduction with Harrington rods and interspinous wiring. Of 15 patients with a partial cord lesion, four made complete recovery, and nine of the remaining 11 became ambulators. Six patients with a complete paraplegia did not improve; 15 patients remained neurologically intact following the procedure. The compressive wire and Harrington rods act in concert and enable correction of kyphosis and restoration of vertebral and discal height while protecting the cord against traction. The technique is safe and does not add to operative time. PMID:3698379
Floman, Y; Fast, A; Pollack, D; Yosipovitch, Z; Robin, G C
Executive and attention dysfunctions are common in very preterm children. We studied their involuntary attention process by using behavioral measurements and auditory event-related potentials (AERP) with a distraction paradigm at age five years. The active task was to distinguish between two animal sounds. As an irrelevant feature the sounds were presented from frequent (standard) or infrequent (deviant, 11%) direction from two loudspeakers. Of the 28 preterm children, only 75% could accomplish the task, whereas all full-term children (n=15) could. When distinguishing the animal sounds, the reaction times were longer to the sounds from the deviant than from the standard direction in both groups, indicating involuntary distraction. The hit rates for the sounds from standard and deviant directions were similar in both groups. AERP amplitudes in the P1 interval and in the P3a interval elicited by standard and deviant stimuli were smaller in the preterm than in the control children. Deviants elicited P3a (indicating attentional orienting) and reorienting negativity (indicating attentional reorienting after distraction) in both groups. Comparable involuntary attentional orienting, distraction, and reorienting suggest similar maturation processes in 5-year-old preterm and full-term children. However, smaller AERP amplitudes in P1 and P3a interval suggest altered processing of auditory stimuli in those born preterm. As one-fourth of the preterm children could not accomplish the paradigm, less demanding paradigms should be used in studying children with increased distractibility. PMID:20362015
A signal passed at danger (SPAD) event occurs when a train moves past a stop signal into a section of unauthorised track. SPAD events are frequently attributed to driver distraction and inattention, but few studies have explored the failure mode from the perspective of task demand and the ability of the driver to self-regulate in response to competing activities. This study aimed to provide a more informed understanding of distraction, inattention and SPAD-risk in the passenger rail task. The research approach combined focus groups with a generative task designed to stimulate situational insight. Twenty-eight train drivers participated from 8 different rail operators in Australia and New Zealand. Data were analysed thematically and revealed several moderating factors for driver distraction. Time-keeping pressure and certain aspects of the driver-controller dynamic were considered to distort performance, and distractions from station dwelling and novel events increased SPAD-risk. The results are conceptualised in a succinct model of distraction linking multiple factors with mechanisms that induced the attentional shift. The commonalities and inter-dynamics of the factors revealed insight into driving anxiety in the passenger rail mode, and suggested that SPAD-risk was intensified when three or more factors converged. The paper discusses these issues in the context of misappropriated attention, taxonomic implications, and directions for future research. PMID:24076301
The purpose of this study was to present the method of mandibular distraction osteogenesis in order to improve airway to respiratory distressed patients due to significant mandibular deficiency, and to present the quantitative volumetric evaluation of mandible and upper airway using three-dimensional-CT (3D-CT) before and after distraction. This study involved 12 patients aged 12 months to seven years with various complaints of Obstructive Sleep Apnea (OSA) such as noisy breathing during sleep, waking episodes, pauses in respiration and daytime somnolence. Some of them were considered tracheostomy candidates. All the patients underwent bilateral mandibular distraction under general anesthesia. 3D-CT of face and neck was performed before and after distraction and a quantitative volumetric evaluation of mandibular volume and airway volume was performed. The results reveal successful mandibular advancement with increase of mandibular volume by an average of 28.24% and increase of upper airway volume with a mean of 71.92%. Moreover, there were improved apnea index and oxygen saturation and elimination of OSA symptoms. In conclusion, the results demonstrate that following distraction osteogenesis of hypoplastic mandible the volume of the mandible and upper airway increases, eliminating symptoms of OSA and preventing tracheostomy. PMID:15617961
Rachmiel, A; Aizenbud, D; Pillar, G; Srouji, S; Peled, M
Focal segmental glomerulosclerosis is scar tissue that forms in parts of the kidney called glomeruli. The glomeruli serve as ... The cause of focal segmental glomerulosclerosis is usually ... and adults. Men and boys are affected slightly more often than ...
Comparative molecular, developmental and morphogenetic analyses show that the three major segmented animal groups—Lophotrochozoa, Ecdysozoa and Vertebrata—use a wide range of ontogenetic pathways to establish metameric body organization. Even in the life history of a single specimen, different mechanisms may act on the level of gene expression, cell proliferation, tissue differentiation and organ system formation in individual segments. Accordingly, in some polychaete annelids the first three pairs of segmental peripheral neurons arise synchronously, while the metameric commissures of the ventral nervous system form in anterior-posterior progression. Contrary to traditional belief, loss of segmentation may have occurred more often than commonly assumed, as exemplified in the sipunculans, which show remnants of segmentation in larval stages but are unsegmented as adults. The developmental plasticity and potential evolutionary lability of segmentation nourishes the controversy of a segmented bilaterian ancestor versus multiple independent evolution of segmentation in respective metazoan lineages.
Twenty persons with chronic low back pain participated in a clinical study to evaluate the effects of gravity traction. Each subject was instructed in the use of three devices, two for inversion and one for upright suspension traction. Baseline pulse and rate blood pressure were recorded before and after traction. Periods of traction did not exceed 20 minutes. The order of use of the devices was randomized. Each participant was monitored for significant side effects and was questioned to determine which device was best tolerated, easiest to use, or caused changes in back symptoms. Lateral lumbar spine radiographs were taken with the subject in the standing position and after varying periods of inversion. Observations included the following: An average increase in blood pressure of 17.2 systolic (range 4-34) and 16.4 diastolic (range 2-50) while in the inverted position. An average decrease in heart rate of 16.4 beats per minute (range, 4-32). No significant physiologic changes of blood pressure or pulse were observed in patients using GLR suspension traction; distraction of the lower lumbar intervertebral spaces (range, 0.3 to 4.0 mm) with inverted traction in all cases; side effects including periorbital and pharyngeal petechiae (one patient), persistent headaches (three patients), persistent blurred vision (three patients), and contact lense discomfort (one patient); and improvement of low back symptoms in 13 of the 16 symptomatic patients. Although these devices make lumbar traction practical in a home setting, their use should be under medical supervision because of possible side effects. PMID:3155939
Gianakopoulos, G; Waylonis, G W; Grant, P A; Tottle, D O; Blazek, J V
\\u000a The subject of this chapter is ensemble color image segmentation. This is an image fusion application in which combine several\\u000a simple image segmentation algorithms to obtain a state-of-the-art image segmentation algorithm. The goal of image segmentation\\u000a is to decompose the input image into a set of meaningful or spatially coherent regions sharing similar attributes. The algorithm\\u000a is often a crucial
The Fanniidae is one of four families in the superfamily Muscoidea (Diptera), including some important medical and hygienic flies. There is a paucity of reports on the ultrastructure of olfactory sensilla for the fanniid species. To provide more information on the morphology of the antennal and palpal sensilla of fanniid fly, Fannia hirticeps (Stein, 1892) has been studied using scanning electron microscopy. The first two antennal segments, scape and pedicel, are covered by microtrichiae and several chaetic sensilla. Six distinct morphological types of sensilla are recorded on the antennal funiculus, including one trichoid, two basiconic, two coeloconic sensilla, and one clavate sensilla. The measurement and density of each sensilla type are also provided. The trichoid sensilla tend to be longer and denser toward the apex of antennal funiculus. Basiconic sensilla spread all over the funicular surface. F. hirticeps bears two types of coeloconic sensilla, type 2 coeloconic sensilla distributed on the distal part of the anterior surface, whereas type 1 distributed on the rest of the funiculus. Clavate sensilla are found on the base of antennal funiculus. Only one large sensory pit is located on the posterior surface. Maxillary palps bear one type of basiconic sensilla. These results are compared with eight other muscid flies. Our findings provide a morphological basis for future investigations on olfactory-mediated behavior of this group. PMID:22556028
Reliable and efficient optic disk localization and segmentation are important tasks in automated retinal screening. General-purpose edge detection algorithms often fail to segment the optic disk due to fuzzy boundaries, inconsistent image contrast or missing edge features. This paper presents an algorithm for the localization and segmentation of the optic nerve head boundary in low-resolution images (about 20 ?\\/pixel). Optic
James Lowell; Andrew Hunter; David Steel; Ansu Basu; Robert Ryder; Eric Fletcher; Lee Kennedy
Noradrenalin modulates prefrontal function, such as working memory (WM), and is associated with enhanced distractibility, and enhanced memory for emotional events and stimuli. The beta-blocker propranolol has been shown to reduce memory for emotional stimuli. Herein we describe investigations aimed at assessing whether the administration of propranolol would reduce the interference by emotional distractions during WM performance. In a between-subjects
Nicole Y. L. Oei; Marieke S. Tollenaar; Bernet M. Elzinga; Philip Spinhoven
The relationship between rumination and distraction and Neuroticism (N) and Extraversion (E) was examined in a sample of patients with major depression. Factor analysis of the Response Style Questionnaire produced three factors, one corresponding to distraction and two related to rumination (symptom-focused rumination and self-focused rumination). Neither of the rumination factors nor N were correlated with patient and clinical variables
This paper presents the findings of a simulator study that examined the effects of distraction upon driving performance for drivers in three age groups. There were two in-vehicle distracter tasks: operating the vehicle entertainment system and conducting a simulated hands-free mobile phone conversation. The effect of visual clutter was examined by requiring participants to drive in simple and complex road
Tim Horberry; Janet Anderson; Michael A. Regan; Thomas J. Triggs; John Brown
Objective This study provided the first direct test of the cognitive underpinnings of the attention-allocation model and attempted to replicate and extend past behavioral findings for this model as an explanation for alcohol-related aggression. Method A diverse community sample (55% African-American) of males (N = 159) between 21 and 35 years of age (M = 25.80) were randomly assigned to one of two beverage conditions (i.e., alcohol, no-alcohol control) and one of two distraction conditions (i.e., distraction, no-distraction). Following beverage consumption, participants were provoked via reception of electric shocks and a verbal insult from a fictitious male opponent. Participants’ attention-allocation to aggression words (i.e., aggression bias) and physical aggression were measured using a dot probe task and a shock-based aggression task, respectively. Results Intoxicated men whose attention was distracted displayed significantly lower levels of aggression bias and enacted significantly less physical aggression than intoxicated men whose attention was not distracted. However, aggression bias did not account for the lower levels of alcohol-related aggression in the distraction, relative to the no-distraction, condition. Conclusions These results replicated and extended past evidence that cognitive distraction is associated with lower levels of alcohol-related aggression in highly provoked males and provide the first known cognitive data to support the attentional processes posited by the attention-allocation model. Discussion focused on how these data inform intervention programming for alcohol-related aggression.
This study examined the effect of background music upon performance of creative and non-creative individuals on a reading comprehension task. In the presence of musical distraction and silence, 54 individuals (27 creative) carried out reading comprehension tasks in a repeated measures design. An interaction was predicted, such that musical distraction would have a greater negative effect on the performance of
We report on the therapy of a complete ventrocranial luxation of the knee joint with leg shortening of 20 cm, which had appeared after diaphyseal distraction osteogenesis in the left thigh at the age of 7 years. The patient presented herself in our clinic at the age of 14 years. After application of an llizarov external fixator,first the luxation was gradually repositioned and afterwards arthrodesis of the knee joint was carried out. After consolidation of the arthrodesis, we removed the external fixator and carried out a unilateral, diaphyseal callus distraction in the left femur. The consolidation of the distraction callus of 12 cm was completed after 9 months and the fixator was removed. At the age of 18 years, 2 years after the treatment was completed, the patient was free of pain and able to walk safely. The remaining shortening of the left leg amounted to 2.5 cm and was balanced in the shoe proportionately. PMID:11766634
With limited cognitive resources, suppressing thoughts can be ineffective. The detrimental effects of cognitive load on suppression have typically been attributed to increased accessibility of avoided thoughts. However, little research has examined distracter thoughts and their contribution to these effects. In three studies, participants pursued suppression goals related to social judgments (e.g., avoid negative thoughts about a target's performance) with sufficient or diminished cognitive resources. Compared to suppressors not under cognitive load, suppressors under load drew more negative social inferences when pursuing a negative suppression goal and more positive inferences under a positive suppression goal; load did not similarly disrupt a concentration goal (i.e., focus on positive thoughts). Across studies, load reduced high-quality oppositely valenced distracter thoughts, and these distracter thoughts mediated the detrimental effects of load on social inferences. The discussion focuses on mechanisms underlying the effects of load on suppression, implications, and future directions for research on ironic processes. PMID:18319378
In 11 patients juxta-articular osteosarcoma around the knee was treated by intraepiphyseal excision of the tumour and reconstruction of the bone defect by distraction osteogenesis. Preoperative and postoperative chemotherapy was given to eight patients with high-grade tumours. The articular cartilage of the epiphysis and a maximum of healthy soft tissues were preserved. Distraction osteogenesis was then carried out. The mean gain in length was 9.7 cm. Full function of the limb was preserved in all except one patient, with a mean follow-up of 53.8 months. Treatment of juxta-articular osteosarcomas around the knee with joint preservation and biological reconstruction using distraction osteogenesis can give excellent functional results. PMID:12463663
Tsuchiya, H; Abdel-Wanis, M E; Sakurakichi, K; Yamashiro, T; Tomita, K
The paper describes the coding and analysis of a database of police fatal accident reports to investigate the extent to which in-vehicle distraction is a contributory factor in vehicle crashes. A particular focus has been the involvement of mobile telephones and entertainment systems. Analysis of accidents occurring over the period 1985-1995 shows that in-vehicle distraction is reported as a contributory factor in about 2% of fatal accidents (although this figure may be a conservative estimate). Specific examples of distraction attributed to entertainment systems and telephones have been identified. Electronic driver information systems are also of particular interest, but have not featured in the available data. Work is progressing, on an annual cycle, to obtain, code and analyse further data and this is expected to provide an invaluable source of information for accident researchers. PMID:11426684
esthetic appearance is one of the most important factors for reconstructive surgery. The current practice of maxillary reconstruction chooses radial forearm, fibula or iliac rest osteocutaneous to recreate three-dimensional complex structures of the palate and maxilla. However, these bone flaps lack shape similarity to the palate and result in a less satisfactory esthetic. Considering similarity factors and vasculature advantages, reconstructive surgeons recently explored the use of scapular tip myo-osseous free flaps to restore the excised site. We have developed a new method that quantitatively evaluates the morphological similarity of the scapula tip bone and palate based on a diagnostic volumetric computed tomography (CT) image. This quantitative result was further interpreted as a color map that rendered on the surface of a three-dimensional computer model. For surgical planning, this color interpretation could potentially assist the surgeon to maximize the orientation of the bone flaps for best fit of the reconstruction site. With approval from the Research Ethics Board (REB) of the University Health Network, we conducted a retrospective analysis with CT image obtained from 10 patients. Each patient had a CT scans including the maxilla and chest on the same day. Based on this image set, we simulated total, subtotal and hemi palate reconstruction. The procedure of simulation included volume segmentation, conversing the segmented volume to a stereo lithography (STL) model, manual registration, computation of minimum geometric distances and curvature between STL model. Across the 10 patients data, we found the overall root-mean-square (RMS) conformance was 3.71+/- 0.16 mm
Chan, Harley; Gilbert, Ralph W.; Pagedar, Nitin A.; Daly, Michael J.; Irish, Jonathan C.; Siewerdsen, Jeffrey H.
Thirty consecutive patients who had suffered unstable fractures and dislocations of the thoracolumbar spine mostly associated with neurologic impairment and bony encroachment on the spinal canal were treated either with Harrington distraction rods combined with sublaminar wires or with the Zielke-VDS device. These patients were subsequently assessed for neurologic outcome, spinal canal clearance, sagittal and coronal spinal deformity correction preoperatively and postoperatively with a minimum follow-up of 26 months. In the follow-up evaluation, the patients who underwent surgery with Harrington rods showed an overall improvement of their neurologic function of 90.9%, whereas all patients who underwent the Zielke operation improved. Preoperatively, positive correlations were found between the level of injury and Frankel grades; the cord lesion tended to demonstrate more severe neurologic deficit when compared with cauda equina ones (P < 0.001). Furthermore, dislocation accompanying the injury resulted in a more severe neurological deficit (P < 0.05). Harrington rods and Zielke device offer sufficient initial correction of the frontal spinal deformity but did not significantly either restore or maintain sagittal plane alignment. The Harrington series showed an overall improvement of the segmental kyphosis of 26% (NS), with a subsequent loss of correction of 7.38% (NS) on the follow-up observation. The Zielke device produced an immediate, much better correction of the segmental posttraumatic kyphosis of 45% (NS), but a loss of correction of 22.9% (NS) was measured in the follow-up evaluation. Correction of the anterior and posterior vertebral height was shown to be better for the Zielke patient group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7866860
Korovessis, P; Piperos, G; Sidiropoulos, P; Karagiannis, A; Dimas, T
Pain is described as the fifth vital sign, and inadequate pain management is linked to numerous immediate and long-term negative outcomes. Venipuncture is one of the most painful medical procedures and one of the most frequently performed ones, and children and adolescents on hemodialysis are anxious about repeated venipunctures. Distraction is one of the most effective ways to relieve pain, and nurses are responsible for pain control. The purpose of this quasi-experimental study was to test the effect of programmed distraction on the pain caused by venipuncture among adolescents on hemodialysis. All of the pediatric hemodialysis centers in Tehran (three centers) were assigned to case group (one center with 21 patients) and control groups (two centers with a total of 21 patients) randomly. The Wong-Baker face pain scale was used to assess pain caused by venipuncture. Assessing of pain was done in 12 sessions in both case and control groups. Three first sessions were held without intervention (pretest) and the next nine sessions were held with distraction intervention (posttest). To cause distraction, the adolescents were asked to look at two similar pictures and tell the number of differences between them during venipuncture. Results showed that case and control groups matched in demographic variables and pain intensity. After distraction, pain intensity during venipuncture significantly decreased (p=.003); but this decrease began from the sixth session; at the five first sessions, pain intensity had not changed. This study shows the effect of distraction with a simple, inexpensive, and quick way for decreasing the pain caused by venipuncture. We recommend that the reasons of the intervention's delay in effect be assessed in future studies. PMID:20510838
Low intensity pulsed ultrasound accelerates fracture healing both clinically and experimentally. Based on recently published animal studies, an improvement in regenerative bone maturation after distraction osteogenesis due to low intensity, pulsed ultrasound is also expected. We report on an 18 year-old female patient suffering from an acquired shortening of the right upper arm of 10 cm after humeral osteitis as a baby. The patient was admitted to hospital for corticotomy and distraction osteogenesis at the afflicted humerus. Due to the published experimental results in animals which indicate an improvement in bone regeneration during callotasis with the additional application of low intensity, pulsed ultrasound, we decided to try this procedure. The calculated distraction consolidation index was 21 days/cm, which is below the mean of 30 days/cm reported in the literature for humeral lengthening by distraction osteogenesis. The calculated healing index according to Paley was 0.7 months/cm in our patient. Compared to reference data, in which a range of from 0.87 months/cm to 1.5 months/cm is reported, our patient showed an accelerated maturation of distraction callus. The duration of treatment of the patient was clearly shortened by the additional application of low intensity, pulsed ultrasound. If distraction osteogenesis is correctly indicated, the early use of low intensity, pulsed ultrasound should be considered, since an acceleration of callus formation with consecutive shortening of treatment time could be attained while wearing an external fixator, leading to a decrease in cumulative complications, such as pin tract infections. Further studies from our research group regarding this topic will follow. PMID:15241607
Objectives The objective of the present work was to study the impact of technological and social distraction on cautionary behaviours and crossing times in pedestrians. Methods Pedestrians were observed at 20 high-risk intersections during 1 of 3 randomly assigned time windows in 2012. Observers recorded demographic and behavioural information, including use of a mobile device (talking on the phone, text messaging, or listening to music). We examined the association between distraction and crossing behaviours, adjusting for age and gender. All multivariate analyses were conducted with random effect logistic regression (binary outcomes) and random effect linear regression (continuous outcomes), accounting for clustering by site. Results Observers recorded crossing behaviours for 1102 pedestrians. Nearly one-third (29.8%) of all pedestrians performed a distracting activity while crossing. Distractions included listening to music (11.2%), text messaging (7.3%) and using a handheld phone (6.2%). Text messaging, mobile phone use and talking with a companion increased crossing time. Texting pedestrians took 1.87 additional seconds (18.0%) to cross the average intersection (3.4 lanes), compared to undistracted pedestrians. Texting pedestrians were 3.9 times more likely than undistracted pedestrians to display at least 1 unsafe crossing behaviour (disobeying the lights, crossing mid-intersection, or failing to look both ways). Pedestrians listening to music walked more than half a second (0.54) faster across the average intersection than undistracted pedestrians. Conclusions Distracting activity is common among pedestrians, even while crossing intersections. Technological and social distractions increase crossing times, with text messaging associated with the highest risk. Our findings suggest the need for intervention studies to reduce risk of pedestrian injury.
Thompson, Leah L; Rivara, Frederick P; Ayyagari, Rajiv C; Ebel, Beth E
Rare irregular sounds (deviants) embedded into a regular sound sequence have large potential to draw attention to themselves (distraction). It has been previously shown that distraction, as manifested by behavioral response delay, and the P3a and reorienting negativity (RON) event-related potentials, could be reduced when the forthcoming deviant was signaled by visual cues preceding the sounds. In the present study, we investigated the type of information used in the prevention of distraction by manipulating the information content of the visual cues preceding the sounds. Cues could signal the specific variant of the forthcoming deviant, or they could just signal that the next tone was a deviant. We found that stimulus-specific cue information was used in reducing distraction. The results also suggest that early P3a and RON index processes related to the specific deviating stimulus feature, whereas late P3a reflects a general distraction-related process.
Horvath, Janos; Sussman, Elyse; Winkler, Istvan; Schroger, Erich
Principle strategies and problems encountered by tested methods of segmentation are recalled. Images presenting specific problems are studied and different possible approaches are discussed. An attempt to define the apparent basic problem is made: methods...
Distraction osteogenesis (DO) has been accepted as an effective technique for bone lengthening. However, the long treatment period and possible fibrous union or nonunion hampers its further clinical application. Bone regeneration in DO involves multiple stages of repair and coordinated action of multiple cell types. Consequently, it may be possible to enhance bone regeneration through treatment strategies that target more than one repair process or cell types. The goal of this study was to determine the combined effects of recombinant human bone morephogenetic protein 2 (rhBMP-2) and NEL-like molecule-1 (NELL-1) on bone formation in DO. Unilateral tibiae in 48 rabbits were lengthened for 7days at a rate of 2mm/day after 3-day lag. At the end of distraction, the animals were randomly divided into four groups (n=12) and received phosphate-buffered saline, 50?g rhNell-1 or 50?g rhBMP-2, or both 25?g rhBMP-2 and 25?g rhNell-1 at the lengthened segment, respectively. After 4-week consolidation bony healing was assessed using histology, radiography, dual energy X-ray absorptiometry, micro-CT, and three-point bend testing. Treatment with rhNell-1 and/or rhBMP-2 resulted in better bone formation and higher BMD and BMC than the saline group, whilst excellent bone formation and the highest BMD and BMC was observed in the combined treatment group. Both rhNell-1 and rhBMP-2 groups presented more mature characteristics in the micro-architecture than the saline group, whereas the combined treatment group presented the highest BV/TV, Tb.Th and Tb.N as well as the lowest Tb.Sp. The peak load of the lengthened tibia increased by 71% in the combined treatment group, 54% in the rhBMP-2 group, and 25% in the rhNell-1 group compared to the control group, respectively. This work suggests that BMP-2 and Nell-1 enhance each other's ability and dual delivery of two agents can significantly improve bony healing in tibial DO. PMID:21703614
The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisors using dental implants with angled abutments.
Polyp and mucocele are the commonest sinonasal tumours and schwannoma is rarely found in the paranasal sinuses. We report a case of a 64-year-old man presenting with progressive nasal obstruction and numbness on left cheek for the past 2 months. High-resolution CT found a soft tissue mass in the maxillary antrum with bony destruction. Clinical features, radiological scan and nasal endoscopic examination were suggestive of a malignant tumour. Tumour was excised through Caldwell-Luc's approach and histopathological examination found a mixed schwannoma. PMID:23595193
There are occasions when the patient is missing only one first molar or the first molar is slated for an odontectomy (extraction). Most of the time, there are only four common avenues for replacement: partial removable prosthesis, Maryland bridge, ceramic or ceramic to metal fixed prosthesis and osseo-integrated implant supported crown. In this article, the author discusses the least common avenue for replacement of missing maxillary first molar--an orthodontic closure. He discusses and demonstrates; Maximum, Medium and Minimum Anchorage strategies on acrylic models. Preserving the anchorage is necessary for successful execution of this orthodontic procedure. This demonstration is followed by presentation of the actual case. PMID:23941033
Two adult rhesus monkeys were chosen for the experimental study of maxillary expansion with magnetic force. The duration of experiment was 70 days. The following methods were applied: 1. measuring the width between the two canines and the width between the two first molars on the casts, 2. taking occlusal radiographs for the observation of premaxillary and midpalatal sutures. 3. observing the histological sections under the microscope. The results showed the width of 3 to 3 and the width of 6 to 6 significantly increased, associating with the adaptation of periodontal tissues to the action of magnetic force. PMID:12078180
Rotation of a tooth around an axis which is perpendicular to the occlusal plane through angles which approach 180° is a rare anomaly which is found in the human dentition. Such aberrations present a multi–factorial model in their origin. Both genetic and local factors seem to contribute to this abnormality. If the contribution of local factors could be identified, a way could open to an early treatment and prevention of secondary rotations of opposing and contiguous teeth. A case of a 180° rotation of maxillary left second premolar in a male patient of Indian origin has been described here.
The occurrence of complex odontomas is not considered to be rare in the jaws. But the occurence of large odontomas obscuring the maxillary sinus, or erupting into the oral cavity are considered to be rare. The prognosis is good with surgical excision and recurrence is nil. Most of the times the surgical site can be closed primarily, but sometimes requires local flaps to achieve tension free closure. Here, we report such a case treated by surgical excision trans orally followed soft tissue defect reconstruction with pedicled palatal island flap. PMID:23482681
Odontogenic myxoma comprises 3-6% of all odontogenic tumors. Odontogenic myxomas are relatively rare benign mesenchymal tumors found exclusively in the tooth-bearing areas of the jaw and are usually located centrally in the mandible. Soft-tissue localization is rarely seen and is classified as peripheral myxoma. Peripheral myxoma is slow growing and less aggressive, as compared to the central myxoma. It has a low recurrence rate. Till date, only few cases of maxillary gingival myxomas are reported in the literature. Here, we present an unusual case of primary peripheral odontogenic myxoma occurring in the gingiva of anterior maxilla in a 41-year-old female patient.
Central Giant Cell Granulomas (CGCG) of the jaw are uncommon benign lesions which usually occur in the mandible in young adults. Here we present a case report of a 45-year-old woman who presented with a 5-month history of right nasal obstruction secondary to a large maxillary CGCG. The age, symptoms at presentation, location and radiographic features were not pathognomonic for this lesion. This case helps to demonstrate the wide variation in the clinical, radiological and histopathological features of CGCC and provides an update in current treatment concepts.
\\u000a Abstract\\u000a \\u000a \\u000a Objective:\\u000a The re-alignment of retained maxillary canines was studied in relation to the degree of displacement in panoramic radiographs,\\u000a mesiodistal root deviations, length of treatment and side-effects. The aim was then to determine whether the decision between\\u000a surgical removal and orthodontic re-alignment can be made on the basis of panoramic radiographs alone.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods:\\u000a Forty-seven panoramic radiographs with
This study describes and evaluates a technique to augment the floor of the maxillary sinus and to widen the alveolar crest of the atrophic posterior maxilla with autogenous bone.The subjects were 43 patients whose maxillary alveolar crest was not high enough to permit reliable placement of endosseous implants in the posterior maxilla. Large autogenous cancellous bone grafts (n=37) or smaller
G. M. Raghoebar; A. Vissink; H. Reintsema; R. H. K. Batenburg
We experienced the case of a patient who had a foreign body in the maxillary sinus. The patient complained of recurrent unilateral badly smelling rhinorrhea. The computed tomography and the magnetic resonance images revealed a foreign body in the maxillary sinus. The foreign body was removed via the Caldwell-Luc approach. The foreign body was a plastic tube, which was supposed
Variability of the bony structures located in the maxillary sinus, and of the lateral nasal wall topography, have practical significance during surgical proce- dures conducted by maxillofacial surgeons or otolaryngologists. The retrospective analysis of 111 computed tomography examinations of pa- tients (52 male and 59 female) diagnosed in our institution was made to eval- uate anatomical variations of the maxillary
Objective. The aim of our study was a radiographic, endoscopic, and ultrasound follow-up of the maxillary sinus comparing 2 techniques of sinus floor augmentation. Study design. Sonograms, radiographs (Waters’ view) of the sinuses, and endoscopy served before and during surgery to evaluate the maxillary sinus. One week after the operation, ultrasound and radiograph follow-up (Waters’ view) were carried out. Six
Jörg Wiltfang; Stefan Schultze-Mosgau; Hans-Albert Merten; Peter Kessler; Arwed Ludwig; Wilfried Engelke
Purpose To investigate the prevalence of anatomical and surgical findings and complications in maxillary sinus floor elevation surgery, and to describe the clinical implications. Patients and Methods One hundred consecutive patients scheduled for maxillary sinus floor elevation were included. The patients consisted of 36 men (36%) and 64 women (64%), with a mean age of 50 years (range, 17 to
S. A. Zijderveld; Bergh van den J. P. A; E. A. J. M. Schulten; Bruggenkate ten C. M
The aim of this study was to find a reliable method for the detection and identification of fungi in fungus balls of the maxillary sinus and to evaluate the spectrum of fungi in these samples. One hundred twelve samples were obtained from patients with histologically proven fungal infections; 81 samples were paraffin- embedded tissue sections of the maxillary sinus. In
Birgit Willinger; Alexandra Obradovic; Brigitte Selitsch; Johann Beck-Mannagetta; Walter Buzina; Hannes Braun; Petra Apfalter; Alexander M. Hirschl; Athanasios Makristathis; Manfred Rotter