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This study investigated relationships between child/parent dissatisfaction with child facial appearance and the self-concept/social competence of 8- to 15-year-old children with (N = 34) and without (N = 34) oral clefts. Children in both groups had normative psychosocial adjustment, but also reported moderate dissatisfaction with facial appearance. Cleft group parents were more likely to agree with their child's dissatisfaction. When cleft group parents were more dissatisfied with child facial appearance, their children reported better quality of life. Results suggest that parents of children with clefts reporting greater dissatisfaction may respond in positive ways that enhance quality of life.  相似文献   
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192Ir sources besides being widely utilized in the field of conventional brachytherapy also find use in contemporary peripheral and coronal intravascular applications. In this study, the same Monte Carlo simulation code and input data were used to investigate differences between the dose rate distributions of the most commonly used 192Ir sources in the cm and mm distance range. Findings are discussed in view of differences in source and encapsulation dimensions as well as structural details. Results are presented in the AAPM TG-43 formalism, as generalized by AAPM TG-60, for five 192Ir HDR source designs as well as an LDR seed and an LDR wire source. Dose rate constants of the sources at r0 = 1 cm and r0 = 2 mm were found proportional to the corresponding geometry factors along the transverse source bisectors and an equation of the form lambda r0(cGyh(-1) U(-1)) = 1.12 x G(r0,90 degrees) provides results within clinical accuracy (less than 2%) for any 192Ir source. Radial dose functions do not depend significantly on source and encapsulation geometry and agree within 2% with that of a point 192Ir source. Anisotropy is of importance for accurate dosimetry at the cm distance range but it does not affect dose rate in the mm distance range significantly. At such short radial distances the source geometry factor defines the shape of isodose lines. Dose uniformity at given distances from the sources is strongly dependent on source dimensions as indicated by dose rate profiles in polar and Cartesian coordinates.  相似文献   
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Many unbalanced large copy number variants reviewed in the paper are associated with syndromic orofacial clefts, including a 1.6 Mb deletion on chromosome 3q29. The current report presents a new family with this recurrent deletion identified via whole-exome sequencing and confirmed by array comparative genomic hybridization. The proband exhibited a more severe clinical phenotype than his affected mother, comprising right-sided cleft lip/alveolus and cleft palate, advanced dental caries, heart defect, hypospadias, psychomotor, and speech delay, and an intellectual disability. Data analysis from the 3q29 registry revealed that the 3q29 deletion increases the risk of clefting by nearly 30-fold. No additional rare and pathogenic nucleotide variants were identified that could explain the clefting phenotype and observed intrafamilial phenotypic heterogeneity. These data suggest that the 3q29 deletion may be the primary risk factor for clefting, with additional genomic variants located outside the coding sequences, methylation changes, or environmental exposure serving as modifiers of this risk. Additional studies, including whole-genome sequencing or methylation analyses, should be performed to identify genetic factors underlying the phenotypic variation associated with the recurrent 3q29 deletion.  相似文献   
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According to the literature, straddle injuries of the perineum may result in arteriosinusoidal fistula and secondary high-flow priapism. We report a case of a 23-year-old man who developed a traumatic pseudoaneurysm of the cavernosal artery, secondary to straddle injury, and presented with painless priapism. It was treated successfully with superselective microcoil embolization and the priapism resolved.  相似文献   
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INTRODUCTIONDisorders of the oesophagus have been linked to surgical bariatric procedures and obesity. However the relationship between achalasia and gastric bypass is not clearly understood and has only recently been reported following gastric bypass.PRESENTATION OF CASEWe present the case of a 53-year-old woman who re-presented following a gastric bypass with a new diagnosis of achalasia. This was treated successfully with laparoscopic Heller's Myotomy with discharge from hospital 10 days post operatively.DISCUSSIONIt is not clear whether achalasia is a complication of gastric bypass procedures. This is only the second reported case of the condition developing after this operation. The mechanism by which it may develop is yet to be clearly established.CONCLUSIONThis case highlights the need to investigate further a possible link between achalasia and gastric bypass and to manage susceptible patients accordingly in the pre-operative stage.  相似文献   
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Objective: To evaluate the effectiveness double cervical cerclage in reducing antenatal complications and improve perinatal outcomes.

Methods: We searched Medline, Scopus, Clinicaltrials.org, The Cochrane Central Register of Controlled Trials and Google Scholar search engines.

Results: Six studies were included that involved 880 women. Double cerclage was significantly superior to single cerclage in reducing preterm births <34?weeks (734 cases, OR 0.59, 95% CI 0.40, 0.86) and preterm births <28?weeks (645 cases, OR 0.43, 95% CI 0.26–0.73). It also significantly increased the gestational age (380 cases, MD 2.63, 95% CI 0.87, 4.39). However, as a technique, it failed to improve the rates of preterm births <37?weeks (740 cases, OR 0.98, 95% CI 0.72, 1.34) the incidence of chorioamnionitis (740 cases, OR 0.83, 95% CI 0.51, 1.36) and the occurrence of preterm premature rupture of the membranes (796 cases, OR 1.32, 95% CI 0.95, 1.82).

Conclusions: It seems that double cerclage effectively increases the gestational age at delivery and decreases the rates of extremely premature births. However, as a procedure, it does not reduce the incidence of antenatal morbidity or the neonatal death rates. Further research is needed in the field as our meta-analysis is limited by the small number of enrolled studies.  相似文献   

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