Schoolchildren's food consumption and dietary intake during the dry season in north-west Namibia

The diet of school-aged children in north-west Namibia was investigated. Data on food consumption were collected using the 24-h recall interview method. The field study was conducted during the dry season. The subjects were schoolchildren aged between 8 and 15 years living in either a small town (n=43) or a rural area (n=10). In town, the main sources of energy were maize porridge and wheat bread, and for the rural children, sour milk and maize. The consumption of vegetables, fruit and legumes was very low in both groups. The mean intakes of energy were 6.7 MJ/day for children living in town and 4.7 MJ/day for rural subjects. The intakes of vitamin A, vitamin C and folate were inadequate in both groups. Our findings show that during the dry season, the diets of Namibian school-aged children are monotonous.     

Effect of mandibular setback surgery on the posterior airway size

Treatment of dentofacial deformities with jaw osteotomies has an effect on airway anatomy, and therefore, mandibular setback surgery has the potential to diminish airway size. The purpose of this study was to evaluate the long-term effect of mandibular setback surgery on the airway size. The material consisted of pre- and postoperative (minimum 1 year) lateral radiograms of 22 individuals (18 females and 4 males) with a mean age of 30 years, who had undergone mandibular setback surgery to correct skeletal Class III discrepancies. Hard and soft tissue points were digitized with a Numonics Accugrid digitizer and analyzed with Xmetrix software. A paired t test was used to evaluate the difference between pre- and postoperative measurements. In addition, Pearson's coefficient correlation was calculated to reveal the possible association between the skeletal change in relation to the change in airway size. The mean value for the initial SNA was 81.3 degrees, 85.4 degrees for SNB, 36.9 degrees for S-Na/MP, and for the posterior airway, 10.5 mm and 12.0 mm retropalatinally and retrolingually, respectively. At the postoperative evaluation, SNB was 80.7 degrees, S-Na/MP 41.0 degrees, and the posterior airway retropalatinally 8.3 mm and retrolingually 9.8 mm. Statistical analysis revealed a highly significant correlation between the change in the ANB angle and in the S-Na/MP angle versus the change in the upper airway size, both retropalatinally and retrolingually. Mandibular setback surgery with posterior rotation may gradually result in increased upper airway resistance in cases where neuromuscular adaptation is insufficient to compensate for the reduction in the airway size. Therefore, large anteroposterior discrepancies should be corrected by combined maxillary and mandibular osteotomies.     

Phacoemulsification and vitrectomy with the erbium:YAG laser and phacoemulsification with the neodymium:YAG laser

There are an increasing number of possible applications for the use of Erbium:YAG and Neodymium:YAG lasers in opthalmology. Laser-phacoemulsification as well as Erbium-laser vitrectomy is of major interest. We report on the underlying technology and more than 1-year-experience using the PHACOLASE (Asclepion-Meditec, Jena, Germany, 10–100 Hz frequency, 5–50 mJ single pulse energy) for phacoemulsification and pars plana vitrectomy and the Lyla-Dodick laser photolysis (A.R.C. Laser, Eckental-Forth, Germany, 1–20 Hz, up to 8 mJ single pulse energy). The Erbium:YAG-laser as well as the Neodymium:YAG-laser enabled us to extract lenses with up to medium hard nuclei. Moreover, the Erbium laser enabled fast vitrectomy with little mechanical traction. In many of our initial surgical operations we had to change to mechanical vitrectomy due to initial technical problems. No new complications occurred intra- or postoperatively. The handpiece worked well in removing vitreous bodies, but was not feasable for cutting membranes. Modified handpieces for this purpose are under development.     

A role for decorin in the structural organization of periodontal ligament

Decorin is a small leucine-rich proteoglycan that interacts with several matrix molecules, including various types of collagen and growth factors, and suppresses the growth of neoplastic cells by an epidermal growth factor (EGF) receptor-mediated pathway. Decorin is abundantly expressed in the periodontal connective tissues during development and tissue maintenance. In periodontal disease, which is one of the most common diseases in the human kind, the level of decorin is decreased in the periodontal connective tissue. Abnormal expression of decorin may also associate with certain inherited disorders that involve increased susceptibility to severe periodontal disease in the early childhood. Therefore, we investigated the periodontal tissues of mice with targeted disruption of the decorin gene. Gross and microscopic analyses showed that decorin-deficient mice appeared to have normal tooth development and eruption, and there were no signs of periodontal disease. However, electron microscopic analysis revealed abnormal morphology and organization of the collagen fibrils in the periodontal ligament. The number of periodontal ligament fibroblasts in the decorin-deficient mice was also increased about two-fold as compared with the wild-type mice. In cell culture, ectopic overexpression of decorin in NIH 3T3 fibroblasts or decorin added exogenously to periodontal fibroblasts suppressed cell growth. However, blocking the EGF receptor tyrosine kinase activity did not prevent the decorin-elicited growth suppression in periodontal fibroblasts. Additionally, decorin did not induce a marked increase in the relative expression of p21 mRNA in periodontal fibroblasts. Therefore, decorin appeared to regulate growth of normal periodontal fibroblasts by a mechanism distinct from that reported for neoplastic cells. The findings demonstrate that decorin plays a role in the organization of collagen fibrils and regulates cell proliferation in the periodontal ligament.     

P53 overexpression as an indicator of overall survival and response to treatment in osteosarcomas

The p53 gene located at chromosome 17pl3 is found to be altered (allelic loss or other mutation) in multiple human cancers, including osteosarcomas. The mutated gene produces a protein with a prolonged half-life thus rendering it detectable by conventional immunohistochemistry. We examined the correlation between p53 expression and clinical prognosis as well as response to therapy. Twentyone patients with previously untreated and histologically verified highly malignant osteosarcoma were used for this study. Biopsy material taken both prior to the start of COSS 91 protocol and at the time of surgery (ten weeks later) was examined for alterations in p53 protein expression and drug resistance. Two patients who had strong (+++) p53 protein expression and three others who became positive during the chemotherapy had significantly worse prognosis (all of them died within one year) than those who showed no p53 expression both at biopsy and after chemotherapy (all 11 patients are alive, average follow-up time: 3.5 years). All patients who showed any kind of positive p53 protein expression on initial biopsy were non-respon-ders to chemotherapy. In contrast, 69% (9 out of 13) of those who exhibited no p53 expression on initial biopsy were responders or intermediate responders to chemotherapy. We concluded that p53 expression may be a useful prognostic factor in osteosarcomas. The direct correlation between p53 positive expression and resistance to therapy can help in identifying patients who are in need of a more vigorous or different chemotherapeutical protocol.     

Aktuelle Diagnostik und Therapie der Migräne

While caring for patients with chronic low back pain, a standardized measurement of pain and pain-related reduction of the quality of life is needed. Easy application and data collection are decisive for routine use. The Oswestry Low Back Pain Disability Questionnaire is an internationally widely used instrument, which was now scrutinized in 148 patients in two orthopedic hospitals. A higher pain disability was related to age, female gender, limitations experienced in social life, impact of pain, use of analgetics, low net income, and patients in Eastern Germany. The available German version of the questionnaire is suitable for daily use to measure the intensity of pain and pain-related disability in everyday life, including social impairment due to low back pain.