Features of trisomy 18 and 18p-syndromes in an infant with 46, XY, i(18q)

An isochromosome for the long arm of chromosome number 18 - 46,XY,i(18q) - was found in an infant who had features of both trisomy 18 and 18p- syndromes. Findings compatible with trisomy 18 included postmature delivery, prominent occiput, severe congenital heart disease, overlapping fingers, and rocker-bottom feet. Those of 18p- syndrome, which frequently resembles Turner syndrome, were downward obliquity to the palpebral fissures, short, webbed neck, low posterior hairline, and widely-spaced nipples. The infant died of heart failure at 3.5 months of age. Parental karyotypes were normal.     

Correlation between patient satisfaction with complete dentures and denture quality,oral condition,and flow rate of submandibular/sublingual salivary glands

PURPOSE: The purpose of this study was to examine the correlation between patient satisfaction with complete dentures and parameters of denture quality, oral condition, and flow rate of the submandibular and sublingual salivary glands. MATERIALS AND METHODS: The parameters were evaluated on 50 denture wearers using semiquantitative scales and a recently described submandibular/sublingual saliva collector. RESULTS: Most patients had a medication-induced reduced salivary flow rate (mean 0.024 mL/min/gland; SD 0.040). Submandibular/sublingual salivary flow rate correlated statistically with six denture satisfaction parameters: maxillary denture retention and comfort, mandibular denture retention and comfort, abilities of chewing, and speech. Residual alveolar ridge resilience, maxillary ridge shape, and denture quality did not significantly correlate with denture satisfaction. Characteristics of musculature correlated significantly only with subjective maxillary denture retention, and mandibular ridge shape correlated with comfort. CONCLUSION: Submandibular/sublingual salivary flow rate is an important factor in denture satisfaction. The retention of the maxillary denture was correlated to the oral musculature characteristics, and the mandibular denture comfort was correlated to the mandibular ridge shape. Denture satisfaction was not affected by other anatomic or denture quality-related parameters.     

The effectiveness of computer-aided,self-instructional programs in dental education: a systematic review of the literature

Computer-aided learning (CAL), self-instructional programs provide an accessible, interactive, and flexible way of presenting curriculum material. In order to assess the effectiveness of CAL programs in dental education, a systematic review of the published literature comparing CAL with other teaching methods was performed. A systematic search of the published literature was performed. Articles formally assessed for inclusion had to meet the following criteria: randomized controlled trials comparing CAL with any other method of instruction, and the use of academically homogeneous dental students or dental professionals with objective, predefined outcome criteria measuring performance, time spent, and attitudes. The searches located a total of 1,042 articles; of these, only twenty-seven articles met the inclusion criteria. Further quality assessment identified twelve studies that were included in the final review. Five of the studies documented statistically significant differences in outcome measures (scores on multiple choice, written or oral tests, and clinical performance) favoring CAL over comparison group(s), while six revealed no statistically significant differences. One study documented a greater improvement in test scores in the seminar group over the CAL group. Participants' attitudes towards CAL in the included studies are also discussed. Our study concluded that CAL is as effective as other methods of teaching and can be used as an adjunct to traditional education or as a means of self-instruction.     

Self – perceived and clinically diagnosed dental and periodontal health status among young adults and their implications for epidemiological surveys

Background  

Clinical (normative) and subjective (self-assessment) evaluation of caries and periodontal diseases have been reported to demonstrate a significant disparity. The dental public health team is obligated to recognize and understand this gap. The objectives of the study were to investigate the practical values of using questionnaires (self–perceived assessment) as compared to clinical examinations (normative assessment) and to evaluate the implications of the results in understanding the public's perception of oral health.     

A review of a community program aimed at preventing early childhood caries among Jerusalem infants--a brief communication

Early childhood caries (ECC) has not been adequately investigated in Israel. A previous Jerusalem study has demonstrated a potential effect on toothbrushing among infants. The present study was initiated in order to examine caries prevalence and the potential effect of a community intervention program. OBJECTIVES: This study aims to review an intervention program and assess ECC distribution and associated variables. METHODS: The study sample included 1,500 infants in matched "intervention" and "control" Mother and Child Health centers. The 2-year program, initially including all children at the age of 6 months, focused on the free distribution of toothbrushes and toothpastes. ECC prevalence was determined in a cross-sectional study. RESULTS: At 2.5 years, 596 children were examined (40 percent compliance). About half of the parents reported that they had participated once or not at all over the 2-year period, which demonstrated low program participation. Among the examined children, ECC prevalence was 15.3 percent. No difference in caries levels was found between the program and control groups. The reported level of brushing twice daily was 13.9 percent, while 26.8 percent reported not brushing at all. Eighty-one percent reported going to bed at night with a bottle. Children who drank sugar-sweetened beverages had ECC levels significantly higher than those who drank milk or natural juice (18.8 percent versus 8.9 percent). CONCLUSIONS: The dental health and behavior and lack of intervention success emphasized the need to seek a more effective strategy. Emphasis on toothbrushing might not be the only nor optimal solution for this serious public health problem.     

Feelings of Guilt in the Psychoanalyst†

Abstract

The current diathesis-stress model of schizophrenia proposes that a genetic deficit creates a predisposing vulnerability in the form of oversenstivity to stress. This model positions all psychosocial events on the stress side of the diathesis-stress equation. As an example of hypotheses that emerge when consideration is given to repositioning adverse life events as potential contributors to the diathesis, this article examines one possible explanation for the high prevalence of child abuse found in adults diagnosed schizophrenic. A traumagenic neurodevelopmental (TN) model of schizophrenia is presented, documenting the similarities between the effects of traumatic events on the developing brain and the biological abnormalities found in persons diagnosed with schizophrenia, including overreactivity of the hypothalamic-pituitary-adrenal (HPA) axis; dopamine, norepinephrine, and serotonin abnormalities; and structural changes to the brain such as hippocampal damage, cerebral atrophy, ventricular enlargement, and reversed cerebral asymmetry. The TN model offers potential explanations for other findings in schizophrenia research beyond oversensitivity to stress, including cognitive impairment, pathways to positive and negative symptoms, and the relationship between psychotic and dissociative symptomatology. It is recommended that clinicians and researchers explore the presence of early adverse life events in adults with psychotic symptoms in order to ensure comprehensive formulations and appropriate treatment plans, and to further investigate the hypotheses generated by the TN model.     

Agrin-signaling is necessary for the integration of newly generated neurons in the adult olfactory bulb

In the adult forebrain, new interneurons are continuously generated and integrated into the existing circuitry of the olfactory bulb (OB). In an attempt to identify signals that regulate this synaptic integration process, we found strong expression of agrin in adult generated neuronal precursors that arrive in the olfactory bulb after their generation in the subventricular zone. While the agrin receptor components MuSK and Lrp4 were below detection level in neuron populations that represent synaptic targets for the new interneurons, the alternative receptor α3-Na(+)K(+)-ATPase was strongly expressed in mitral cells. Using a transplantation approach, we demonstrate that agrin-deficient interneuron precursors migrate correctly into the OB. However, in contrast to wild-type neurons, which form synapses and survive for prolonged periods, mutant neurons do not mature and are rapidly eliminated. Using in vivo brain electroporation of the olfactory system, we show that the transmembrane form of agrin alone is sufficient to mediate integration and demonstrate that excess transmembrane agrin increases the number of dendritic spines. Last, we provide in vivo evidence that an interaction between agrin and α3-Na(+)K(+)-ATPase is of functional importance in this system.     

Morphological and functional effects of altered cysteine string protein at the Drosophila larval neuromuscular junction

The synaptic vesicle-associated cysteine string protein (CSP) is critical for neurotransmitter release at the neuromuscular junction (NMJ) of Drosophila, where the approximately 4% of mutant flies lacking CSP that survive to adulthood exhibit spastic jumping and shaking, temperature-sensitive paralysis, and premature death. Previously, it has been shown that CSP is also required for nerve terminal growth and the prevention of neurodegeneration in Drosophila and mice. At larval csp null mutant NMJs of Drosophila, intracellular recordings from the muscle showed that evoked release is significantly reduced at room temperature. However, it remained unclear whether the reduction in evoked release might be due to a loss of synaptic boutons, loss of synapses, and alterations in trafficking of vesicles to synapses. To resolve these issues, we have examined synaptic structure and function of csp null mutant NMJs at the level of single boutons. csp null mutations proportionally reduce the number of synaptic boutons of both motor neurons (1s and 1b) innervating larval muscles 6 and 7, while the number of synapses per bouton remains normal. However, focal recordings from individual synaptic boutons show that nerve-evoked neurotransmitter release is also impaired in both 1s and 1b boutons. Further, our ultrastructural analyses show that the reduction in evoked release at low stimulation frequencies is not due to a loss of synapses or to alterations in docked vesicles at synapses. Together, these data suggest that CSP promotes synaptic growth and evoked neurotransmitter release by mechanistically independent signaling pathways.