Complete nucleotide sequence and genome organization of a Cactus virus X strain from Hylocereus undatus (Cactaceae)

The complete nucleotide sequence of a strain of Cactus virus X (CVX-Hu) isolated from Hylocereus undatus (Cactaceae) has been determined. Excluding the poly(A) tail, the sequence is 6614 nucleotides in length and contains seven open reading frames (ORFs). The genome organization of CVX is similar to that of other potexviruses. ORF1 encodes the putative viral replicase with conserved methyltransferase, helicase, and polymerase motifs. Within ORF1, two other ORFs were located separately in the +2 reading frame, we call these ORF6 and ORF7. ORF2, 3, and 4, which form the "triple gene block" characteristic of the potexviruses, encode proteins with molecular mass of 25, 12, and 7 KDa, respectively. ORF5 encodes the coat protein with an estimated molecular mass of 24 KDa. Sequence analysis indicated that proteins encoded by ORF1-5 display certain degree of homology to the corresponding proteins of other potexviruses. Putative product of ORF6, however, shows no significant similarity to those of other potexviruses. Phylogenetic analyses based on the replicase (the methyltransferase, helicase, and polymerase domains) and coat protein demonstrated a closer relationship of CVX with Bamboo mosaic virus, Cassava common mosaic virus, Foxtail mosaic virus, Papaya mosaic virus, and Plantago asiatica mosaic virus.

Ex vivo gene therapy in autologous bone marrow stromal stem cells for tissue-engineered maxillofacial bone regeneration

This study examines the clinical relevance of tissue engineering integrating gene therapy and polymer science to bone regeneration. Bilateral maxillary defects (3 x 1.2 cm(2)) in 20 miniature swine were bridged with a bioresorbable internal splint. Constructs were created using ex vivo adenovirus bone morphogenetic protein (BMP)-2-mediated gene transfer to the expanded bone marrow mesenchymal stem cells (MSCs) 7 days before implantation. Controls were performed using adenovirus beta-galactosidase. The BMP-2 cell/construct displayed white solid bone formation after 3 months. Meanwhile, the hematoxylin and eosin and Von Kossa stains demonstrated exhibited mature woven bone with good mineralization. Additionally, three-dimensional computer tomography imaging revealed a nearly complete infraorbital rim repair. Quantitative analysis demonstrated a significant difference (P<0.001) in bone formation. Finally, biomechanical testing revealed no statistically significant difference in the maximal compressive strength of new bone formed by BMP-2 cell constructs and the normal maxilla. The data evidenced de novo bone formation capable of sustaining axial compressive loads. The measurement results showed that ex vivo replication defective adenovirus-mediated human BMP-2 gene transfer to MSCs enhances autologous bone formation in the repair of maxillary defects.

Detection of septicemia in chicken livers by spectroscopy,

To establish a procedure for differentiating normal chickens from chickens with septicemia/toxemia (septox) by machine inspection under the Hazard Analysis and Critical Control Point-Based Inspection Models Project, spectral measurements of 300 chicken livers, of which half were normal and half were condemned due to septox conditions, were collected and analyzed. Neural network classification of the spectral data after principal component analysis (PCA) indicated that normal and septox livers were correctly differentiated by spectroscopy at a rate of 96%. Analysis of the data established 100% correlation between the spectroscopic identification and the subset of samples, both normal and septox, that were histopathologically diagnosed. In an attempt to establish the microbiological etiology of the diseased livers, isolates from 30 livers indicated that the poultry carcasses were contaminated mostly with coliforms present in the environment, hindering the isolation of pathogenic microorganisms. Therefore, to establish the cause of diseased livers, a strictly aseptic environment and procedure for sample collection is required.

Tyrosine iminoxyl radical formation from tyrosyl radical/nitric oxide and nitrosotyrosine

The quenching of the Y(D)(.) tyrosyl radical in photosystem II by nitric oxide was reported to result from the formation of a weak tyrosyl radical-nitric oxide complex (Petrouleas, V., and Diner, B. A. (1990) Biochim. Biophys. Acta 1015, 131-140). This radical/radical reaction is expected to generate an electron spin resonance (ESR)-silent 3-nitrosocyclohexadienone species that can reversibly regenerate the tyrosyl radical and nitric oxide or undergo rearrangement to form 3-nitrosotyrosine. It has been proposed that 3-nitrosotyrosine can be oxidized by one electron to form the tyrosine iminoxyl radical (>C=N-O*). This proposal was put forth as a result of ESR detection of the iminoxyl radical intermediate when photosystem II was exposed to nitric oxide (Sanakis, Y., Goussias, C., Mason, R. P., and Petrouleas, V. (1997) Biochemistry 36, 1411-1417). A similar iminoxyl radical was detected in prostaglandin H synthase-2 (Gunther, M. R., Hsi, L. C., Curtis, J. F., Gierse, J. K., Marnett, L. J., Eling, T. E., and Mason, R. P. (1997) J. Biol. Chem., 272, 17086-17090). Although the iminoxyl radicals detected in the photosystem II and prostaglandin H synthase-2 systems strongly suggest a mechanism involving 3-nitrosotyrosine, the iminoxyl radical ESR spectrum was not unequivocally identified as originating from tyrosine. We report here the detection of the non-protein L-tyrosine iminoxyl radical generated by two methods: 1) peroxidase oxidation of synthetic 3-nitroso-N-acetyl-L-tyrosine and 2) peroxidase oxidation of free L-tyrosine in the presence of nitric oxide. A newly developed ESR technique that uses immobilized enzyme was used to perform the ESR experiments. Analysis of the high resolution ESR spectrum of the tyrosine iminoxyl radical generated from free tyrosine and nitric oxide reveals a 28.4-G isotropic nitrogen hyperfine coupling and a 2.2-G proton hyperfine coupling assigned to the proton originally ortho to the phenoxyl oxygen.

Endoscopically assisted repair of orbital floor fractures

Traditionally, orbital floor fractures are repaired with standard transcutaneous or transconjunctival approaches. Complications such as external scarring, eyelid edema, ectropion, entropion, and granuloma formation have been associated with these open lid techniques. The endoscope has been used to assist in orbital floor exploration, to reduce entrapped orbital tissue, and to identify the posterior shelf for implant placement. However, an open lid incision is inevitable when implant placement is necessary. We present our experiences in repairing orbital floor fractures using transantral endoscopy without open lid incision.A 0-degree, 4-mm endoscope was placed through a 2 x 1.5-cm2 maxillary antrostomy to dissect the sinus roof. The endoscope was used to assist in the reduction of the floor fractures and prolapsed orbital tissue into the orbital cavity, if present. The orbital floor defect was reconstructed with titanium mesh or Medpor through the antrostomy under endoscopic control. This technique was applied to nine patients who had orbital floor fractures. Two of the patients had zygomatico-orbital fractures, whereas the rest had isolated orbital floor fractures. Three patients received Medpor reconstruction and the remaining six underwent titanium mesh reconstruction. The patients were followed up for 10 months on average. The enophthalmos was corrected in all patients but one, who suffered from mild enophthalmos because of uncorrected orbital medial wall fractures. Diplopia occurred in three patients preoperatively, which was resolved in two of them and improved in the other postoperatively. There have been no complications apart from transient anesthesia in the dermatome of the infraorbital nerve. The technique successfully reconstructed the orbital floor defects, minimized ocular globe manipulation, and eliminated a lower eyelid incision.

Removal of the pro-domain does not affect the conformation of the procaspase-3 dimer

We have investigated the oligomeric properties of procaspase-3 and a mutant that lacks the pro-domain (called pro-less variant). In addition, we have examined the interactions of the 28 amino acid pro-peptide when added in trans to the pro-less variant. By sedimentation equilibrium studies, we have found that procapase-3 is a stable dimer in solution at 25 degrees C and pH 7.2, and we estimate an upper limit for the equilibrium dissociation constant of approximately 50 nM. Considering the expression levels of caspase-3 in Jurkat cells, we predict that procaspase-3 exists as a dimer in vivo. The pro-less variant is also a dimer, with little apparent change in the equilibrium dissociation constant. Thus, in contrast with the long pro-domain caspases, the pro-peptide of caspase-3 does not appear to be involved in dimerization. Results from circular dichroism, fluorescence anisotropy, and FTIR studies demonstrate that the pro-domain interacts weakly with the pro-less variant. The data suggest that the pro-peptide adopts a beta-structure when in contact with the protein, but it is a random coil when free in solution. In addition, when added in trans, the pro-peptide does not inhibit the activity of the mature caspase-3 heterotetramer. On the other hand, the active caspase-3 does not efficiently hydrolyze the pro-domain at the NSVD(9) sequence as occurs when the pro-peptide is in cis to the protease domain. Based on these results, we propose a model for maturation of the procaspase-3 dimer.

Caspase-mediated cleavage of actin-binding and SH3-domain-containing proteins cortactin, HS1, and HIP-55 during apoptosis

Reorganization of the actin cytoskeleton occurs during apoptosis. We found that actin-binding and Src homology 3 (SH3)-domain-containing proteins cortactin, hematopoietic-specific protein 1 (HS1), and hematopoietic progenitor kinase 1-interacting protein of 55 kDa (HIP-55, also called SH3P7 and Abp1) were degraded in a caspase-dependent manner during apoptosis. Cortactin, HS1, and HIP-55 were direct substrates of caspase 3. Cortactin and HS1 have two clusters of potential caspase cleavage sites; one is in their actin-binding domains, and the other is close to their carboxy-terminal SH3 domains. HIP-55 has one caspase recognition site, EHID(361). The HIP-55 (D361A) mutant was resistant to caspase cleavage. Cleavage of HIP-55 by caspases dissociated its actin-binding domain from its SH3 domain. The cleavage of these actin-binding and SH3 domain-containing proteins may affect cell signaling to and from the actin cytoskeleton and may be involved in the morphological change of cells during apoptosis.

Sheathless capillary electrophoresis/electrospray mass spectrometry using a carbon-coated tapered fused-silica capillary with a beveled edge

A tapered capillary tip containing a beveled edge was developed for use in sheathless capillary electrophoresis/electrospray mass spectrometry (CE/ESI-MS). The optimal flow rate of a 75-microm-i.d., 90-microm-o.d. beveled tapered capillary tip was similar to a conventional flat tapered tip with a 25-microm orifice. Using a mixture of coptisine, berberine, and palmatine chloride, the sheathless CE/ ESI-MS sensitivity of a beveled 75 microm tapered tip capillary was found to be similar to a 25 microm flat tip. Although both tips offer similar CE/ESI-MS sensitivity, the beveled tapered capillary tip is more rugged and durable than a conventional 25-microm tapered capillary because of the larger outside diameter and inside diameter. To make electrical contact, the capillary tip was smeared with paint marker followed by the application of a carbon coating using a graphite pencil. Using this refined carbon-coating procedure, the capillary tip can be operated with aprotic solvents.

Comparison of speech results after Furlow palatoplasty and von Langenbeck palatoplasty in incomplete cleft of the secondary palate

BACKGROUND

Due to many confounding factors, it is not easy to answer which method of cleft repair is superior to others. The purpose of this study is to try to compare the treatment result of different types of palatoplasty in patients who had the same cleft type and same treatment protocol besides the method of cleft repair. We selected nonsyndromic patients with incomplete cleft of the secondary palate. The speech results after the two palatoplasties were compared.

METHODS

Ninety-six children with nonsyndromic incomplete clefts of the secondary palate who received palatoplasty at the Craniofacial Center of Chang Gung Memorial Hospital from 1989 to 1997 were studied. Forty-six patients received Furlow palatoplasty and 50 patients received von Langenbeck palatoplasty. Velopharyngeal function was evaluated by speech pathologists periodically after the patient was two and half years old. Adequacy of velopharyngeal function was used as a measurement of speech outcome.

RESULTS

The Furlow palatoplasty group showed excellent results with 98% (45/46) adequacy in velopharyngeal function. In the von Langenbeck palatoplasty group, only 70% (35/50) of the patients had adequate velopharyngeal function. Statistical analysis with Fisher's exact test showed a significant difference (p < 0.0001, p < 0.05). Only one patient had an oronasal fistula after Furlow palatoplasty. After von Langenbeck palatoplasty, one patient had an oronasal fistula and one had wound dehiscence.

CONCLUSION

In this study, there was a better speech outcome after Furlow palatoplasty than von Langenbeck palatoplasty for repair of incomplete cleft of the secondary palate. Also, the number of complications after a Furlow palatoplasty was low. It should be a recommended treatment.

Potential complications of intralesional laser photocoagulation for extensive vascular malformations

Vascular anomalies remain a challenge for both patients and plastic surgeons. Recently, promising results have been reported using intralesional photocoagulation (ILP) to treat extensive vascular lesions. At the authors' center, they have treated more than 300 patients with vascular anomalies in different parts of the body between 1996 and 1999. They describe their operative techniques of ILP. Laser pulses of a 1,064-nm wavelength from the Nd:YAG laser were delivered to the target tissues with a 600-microm optical fiber. They report 2 patients who developed complications after a single session of ILP therapy for their extensive vascular malformations. The first patient had Klippel-Trenaunay syndrome (capillary-lymphaticovenous malformations) with widespread involvement of her buttocks and left lower limb. She had severe leukocytosis, thrombocytosis, and hyperkalemia that resolved with intravenous hydration, antibiotics, and sodium bicarbonate. In their second patient, the entire left upper limb was affected. Her total red cell count diminished by a quarter and her hemoglobin concentration dropped by more than 3 g%. This was corrected gradually with supplemental oral hematinics. Although these complications resolved uneventfully in their patients, they hope that their possible development will caution anyone who may wish to attempt this new method of therapy.

Protein NMR spin trapping with [methyl-13C(3)]-MNP: application to the tyrosyl radical of equine myoglobin

Direct spin trapping studies of protein radical adducts are limited as a consequence of the long rotational correlation times and consequent broadening of the ESR resonances. It can be difficult to determine both the nature and number of adduct species present. NMR detection of reduced spin adducts represents an alternate approach which, however, is subject to the limitations of lower sensitivity and a limited capability for isolating the resonances arising from the reduced adduct from other chemistry involving the spin trap. In the present study, we have utilized [methyl-13C(3)]-MNP for the detection and analysis of tyrosyl spin adducts formed as a result of exposure of equine myoglobin to hydrogen peroxide. The methyl-13C label allows high detection sensitivity in two dimensions, narrow line widths and most significantly, removal by dialysis of unreacted spin trap as well as any nonprotein derivatives that may form. For equine myoglobin, it is found that adduct formation involves a single residue-Tyr-103 and further that adduct formation occurs at the C-3 carbon of the amino acid. HMQC-NOESY experiments further revealed the proximity of the labeled methyl groups to both the three aromatic tyrosyl protons as well as the aromatic protons of the nearby Phe-106 residue.

Transport modeling of copper and cadmium with linear and nonlinear retardation factors

The predictive accuracy of using the one-dimensional advection-dispersion equation to evaluate the fate and transport of solute in a soil column is usually dependent on the proper determination of chemical retardation factors. Typically, the distribution coefficient (Kd) obtained by fitting the linear sorption isotherm has been extensively used to consider general geochemical reactions on solute transport in a low-concentration range. However, the linear distribution coefficient cannot be adequately utilized to describe the solute fate at a higher concentration level. This study employed the nonlinear equilibrium-controlled sorption parameters to determine the retardation factor used in column leaching experiments. Copper and cadmium transportation in a lateritic silty-clay soil column was examined. Through the explicit finite-difference calculations with a third-order total-variation-diminishing (TVD) numerical solution scheme, all results of the theoretical copper and cadmium breakthrough curves (BTCs) simulated by using the Freundlich nonlinear retardation factors revealed good agreement with the experimental observations.

Circumnipple-incision, longitudinal-breast dissection augmentation mammaplasty

A modification of circumnipple breast augmentation is described, which confines the minimal scar to the base of the nipple. Furthermore, a longitudinal breast parenchyma dissection is performed for breast pocket dissection that limits the injury of the lactiferous ducts and nerves to a minimum, and makes dissection and exposure of the pocket easier, even in patients whose nipples are small. This technique is especially useful in small breasts. We have performed this procedure in 57 patients, and the few complications to date are discussed in this paper.

[Glutamate-related mechanism of ginsenosides against anoxic-ischemic brain damage]

AIM AND METHODS

To observe the antagonist effect of ginsenosides upon excitatory neurotoxicity of glutamate in rat hippocampal slices, and to observe the inhibitory and facilitated effects of ginsenosides upon glutamate release from cultured mice cortical neurons and upon glutamate uptake by cultured astrocytes, respectively, during simulated ischemia, in order to elucidate whether the protective effect of ginsenosides against anoxic-ischemic brain damage is related to reducing the excitatory neurotoxicity of glutamate.

RESULTS

The orthodromic population spikes (OPS) recorded in hippocampal slice decreased in amplitude and disappeared finally during 20-min glutamate (1 mmol/L) exposure, and recovered less 1 h after the end of this exposure. However, OPS recovered well after the use of ginsenosides at different concentrations, especially at 20 microg/ml. In cultured mice cortical neurons and astrocytes, glutamate released from neurons up to several times of control and its uptake by astrocytes decreased markedly during simulated ischemia, ginsenosides (20 microg/ml) could significantly inhibit glutamate release from neurons and facilitate glutamate uptake by astrocytes during the same ischemia exposure.

CONCLUSIONS

Reducing the excitatory neurotoxicity of glutamate may be an important mechanism of ginsenosides against anoxic-ischemic brain damage.

Craniofacial surgical simulation: application of three-dimensional medical imaging and rapid prototyping models

BACKGROUND

Adequate assessment of the deformity, formulation of good treatment planning, and sufficient rehearsal of procedures before actually performing surgery ensure successful craniofacial surgery. Three-dimensional computed tomography (CT) imaging and facsimile models were used in combination to evaluate their function in craniofacial surgery.

METHODS

Three-dimensional imaging and facsimile models were used for reconstruction of craniofacial deformity. CT data were acquired, processed, and reconstructed to display 3-dimensional images. The images were used for evaluation of the deformity. The images were then manipulated to create multiple osseous objects. Surgical simulation was performed by moving the computer images. The image processing and manipulation were achieved using the AnalyzePC program. The raw CT data were transformed into a readable format and transferred to produce facsimile models using rapid prototyping technology. The skull models were used for evaluation and surgical simulation. Both methods were compared and used to assist in surgery, which was performed according to the simulations.

RESULTS

Three-dimensional CT imaging and facsimile models were helpful for simulation of craniofacial surgery. The actual surgery results were satisfactory without complications. Particular advantages were the unlimited trials with the imaging method, and the feeling of reality with the model method.

CONCLUSIONS

Craniofacial surgery is facilitated by preoperative simulation of procedures. Both 3-dimensional CT imaging and facsimile models are helpful for craniofacial surgical simulation.

Down-regulation of the c-Jun N-terminal kinase (JNK) phosphatase M3/6 and activation of JNK by hydrogen peroxide and pyrrolidine dithiocarbamate

Oxidative stress activates the c-Jun N-terminal kinase (JNK) pathway. However, the exact mechanisms by which reactive oxygen species (ROS) activate JNK are unclear. We found that the ability of hydrogen peroxide (H(2)O(2)) to induce JNK activation varied in different cell types. Pyrrolidine dithiocarbamate (PDTC), a presumed antioxidant, induced JNK activation on its own and enhanced JNK activation by H(2)O(2) in many cell types, including Jurkat, HEK293, and LNCaP and Tsu-Pr1 prostate cancer cells. The activation of JNK by PDTC, in the presence or absence of exogenous H(2)O(2), was dependent on its chelating ability to metal ions, most likely copper ions. Despite the strong JNK-activating ability, H(2)O(2) plus PDTC did not induce significant activation of the upstream kinases, SEK1/MKK4 and MKK7. However, the JNK inactivation rate was slower in cells treated with H(2)O(2) plus PDTC compared with the rate in cells treated with ultraviolet C (UV-C). Treatment of H(2)O(2) plus PDTC significantly decreased the expression levels of a JNK phosphatase, M3/6 (also named hVH-5), but not the levels of other phosphatases (PP2A and PP4). In contrast, UV-C irradiation did not cause the down-regulation of M3/6. These results suggest that JNK activation by H(2)O(2) plus PDTC resulted from the down-regulation of JNK phosphatases. Our data also reveal a necessity to carefully evaluate the pharmacological and biochemical properties of PDTC.

Steady-state multispectral fluorescence imaging system for plant leaves

We present a detailed description of a laboratory-based multispectral fluorescence imaging system (MFIS) for plant leaves. Fluorescence emissions with 360-nm excitation are captured at four spectral bands in the blue, green, red, and far-red regions of the spectrum centered at 450, 550, 680, and 740 nm, respectively. Preliminary experiments conducted with soybean leaves treated with a herbicide (DCMU) and short-term exposures to moderately elevated tropospheric ozone environment demonstrated the utilities of the newly developed MFIS. In addition, with the aid of fluorescence images of normal soybean leaves, several mechanisms governing the fluorescence emissions are discussed. Imaging results illustrate the versatility of fluorescence imaging, which provides information on the spatial variability of fluorescence patterns over leaf samples.

[Studies on metabolite of beta-elemene in rat bile]

AIM

To study the metabolite of beta-elemene in the bile of rat.

METHODS

After i.v. 100 mg.kg-1 beta-elemene, the metabolite in rat bile was extracted by ether. Mass spectrometry, nuclear magnetic resonance, infrared spectrometry and ultraviolet spectrometry were used to analyze the metabolite of i.v. beta-elemene in rat bile.

RESULTS

It was confirmed by nuclear magnetic resonance that the methyl of No. 11 carbon connecting with No. 10 carbon of a metabolite in rat bile was oxidized to be aldehyde. The molecular weight of the metabolite was 218 which detected by mass spectrometry. Infrared spectrometry and ultraviolet spectrometry proved that the aldehyde existed in the metabolite. The structure of the metabolite in bile of rat was identified, that was 1-methyl-1-ethenyl-2-isopropenyl-4-isopropenyl aldehydohexamethylene.

CONCLUSION

The biotransformation of beta-elemene exists in vivo.

Isolation and characterization of phytochelatin synthase in rice seedlings

Rice plants were treated with 50 microM copper sulfate to induce the synthesis of phytochelatins by means of a series of enzymatic reactions, including that of photochelatin synthase. Phytochelatin synthase extracted from 3-week-old rice seedlings was purified through a series of steps including precipitation with ice-chilled acetone, QAE A-50 anion exchange column, Amicon XM-50 ultrafiltration and Polybuffer Exchange (PBE) 94 chromato-focusing. This enzyme had a molecular mass of about 100 kDa with an isoelectric point of 4.0. The temperature and pH optima of this enzyme were 55 degrees C and pH 7.5, respectively. The enzyme was thermal tolerable and unstable under refrigeration at 4 or -20 degrees C. Cadmium was the most effective stimulator, followed by lead, copper, silver, cobalt and other divalent cations. Calcium and magnesium had no effect.

The course of the inferior alveolar nerve in the normal human mandibular ramus and in patients presenting for cosmetic reduction of the mandibular angles

This study was undertaken to quantify the path of the inferior alveolar nerve in the normal human mandible and in the mandibles of patients presenting for cosmetic reduction of the mandibular angles. The goals were: (1) to provide normative information that would assist the surgeon in avoiding injury to the nerve during surgery; (2) to characterize gender differences in the normal population; and (3) to compare the course of the nerve in the normal population to its course in a group of patients who presented with a complaint of "square face." The study was based upon the computerized tomographic scans of 10 normal patients (six men, four women) and 8 patients (all women) complaining of "square face." Using AnalyzePC 2.5 imaging software, the mandibles were segmented and the position of the nerve was recorded within its osseous canal in the mandibular ramus on each axial slice in which it was identifiable. Distances were calculated between the nerve and the anterior, posterior, lateral, and medial cortices. The positions of the lateral ramus prominence and the lowest point on the sigmoid notch were also recorded. The position of the mental foramen was recorded in relation to the nearest tooth, and the three-dimensional surface distances from the foramen to the alveolar bone, the inferior border of the mandible, and the mandibular symphysis were determined. The distances from the entrance of the nerve into the mandible to the lateral ramus prominence and the lowest point on the sigmoid notch were calculated. Summary statistics were obtained, comparing differences in gender. The nerve was identifiable in each ramus over a mean distance of 12.7 mm. On average, the lateral ramus prominence was 0.3 mm higher on the caudad-cephalad axis than the point at which the nerve entered the bone, whereas the location of the lowest point on the sigmoid notch was 16.6 mm above the nerve. The average distances from the nerve to the anterior, posterior, medial, and lateral cortices were 11.6, 12.1, 1.8, and 4.7 mm, respectively. Gender differences were significant for all of these except the medial cortex to nerve distance. On average, the mental foramen exited the body of the mandible immediately below the second premolar and the average surface distances from the foramen to the symphysis, the most cephalad alveolar bone, and the inferior border of the body were 30.9, 14.2, and 19.3 mm, respectively. With regard to the patients presenting for mandibular angle reduction, there were a few statistically significant but small scalar differences from normal controls.

Major hematological diseases associated with cleft lip and palate

OBJECTIVE

Cleft lip and palate is among the most common congenital anomalies. Its association with major blood disorders has rarely been reported. The purpose of this study was to report two patients who had major blood diseases associated with cleft lip and palate.

PATIENTS AND RESULTS

From June 1995 to December 1997, there were 2700 patients with cleft lip, cleft palate, or both who received treatment at Chang Gung Memorial Hospital. Two of them were found to have major hematological disorders. In both cases, the disorder was detected by preoperative blood cell counts and white cell differentiation. Case 1 was a 21-year-old woman patient with repaired right cleft lip. She was admitted for alveolar bone grafting and closure of oronasal fistula. Abnormal presentation of blast cells was found, and subsequent bone marrow study confirmed acute lymphocytic leukemia. Case 2 was a 26-year-old man with left secondary cleft lip nasal deformity scheduled to receive staged reconstructive operations. An elevated platelet count was found and subsequently confirmed to represent essential thrombocytosis. In both cases, reconstructive operations for the cleft-related deformities were performed.

CONCLUSIONS

Association of major hematological disorders and cleft lip, palate, or both is rare and is reported herein.

The effect of hamulus fracture on the outcome of palatoplasty: a preliminary report of a prospective, alternating study

OBJECTIVE

To determine whether, in performing palatoplasty, fracture of the pterygoid hamulus is beneficial, detrimental, or neutral with respect to intraoperative and perioperative complications, hearing outcome, and speech outcome.

DESIGN

Prospective, alternating.

SETTING

Institutional, tertiary cleft palate center, Chang Gung Memorial Hospital, Taipei, Taiwan.

PARTICIPANTS

A total of 173 patients enrolled in the study, of whom 161 had charts available for analysis.

INTERVENTIONS

During the performance of palatoplasty, 85 patients received hamulus fracture and 76 patients did not. All palatoplasties were performed by the same surgeon.

MAIN OUTCOME MEASURES

(1) Surgical outcomes, including patient demographic data, palatoplasty type and duration, blood loss, incidences of oronasal fistulae, temporary mucosal dehiscence, and postoperative bleeding; (2) otolaryngological outcomes, including hearing results as judged by auditory brainstem response testing, myringotomy tube data describing rates of tube extrusion, and culture results from sampled effusions; and (3) preliminary speech outcomes as described by judgments of overall velopharyngeal function from perceptual speech samples.

RESULTS

No statistically significant differences in any of the measured surgical, otolaryngological, or preliminary speech outcomes were found between the groups who did and did not receive hamulus fracture.

CONCLUSIONS

On the basis of these results, we are unable to advocate the performance of hamulus fracture as an operative maneuver during the performance of primary palatoplasty. The historical rationale and theoretical advantage of this maneuver have not been demonstrated here nor have any detrimental effects of the maneuver been measured.

Acute life-threatening injuries in facial fracture patients: a review of 1,025 patients

BACKGROUND

The literature on facial fractures has emphasized obstruction of the airway as the most common associated life-threatening problem. Other life-threatening injuries associated with facial fractures are not as well documented. For this reason, we conducted a retrospective study involving 1,025 patients with facial fractures admitted to the trauma center at Chang Gung Memorial Hospital in Taiwan from January 1995 through December 1998.

METHODS

This study identifies the incidence of facial fractures and establishes a management plan. Life-threatening injuries associated with facial fractures were those that warranted immediate invasive rescue procedures.

RESULTS

Sixty-four (6.2%) of the patients with facial fractures required life-saving intervention; 21 patients had cerebral trauma prompting craniotomy, 19 had hemorrhagic shock, 17 had airway compromise, and 7 had pulmonary injury grave enough to necessitate tube thoracostomy. There were five mortalities, three due to cerebral trauma and two credited to hemorrhagic shock not identified until long after admission.

CONCLUSION

These findings illustrate the need for prompt identification and proper management of the associated life-threatening injuries in facial fracture patients. Clinical assessment should begin with evaluation of cerebral trauma, followed by hemorrhagic shock, airway compromise, and hemopneumothorax. Proper management may require a multidisciplinary and coordinated team approach.

Determination of sibship by PCR-amplified short tandem repeat analysis in Taiwan

BACKGROUND

Sibship determination for any two persons whose parents have died is one of the most fundamental issues of personal identification, second only to those of a parent-child relationship.

STUDY DESIGN AND METHODS

By automated fluorescence analysis of a PCR-amplified short tandem repeat (STR) system in conjunction with capillary electrophoresis, a panel of up to 15 polymorphic, autosomal, unlinked STR loci was used to investigate sibship index (SI) values in a cohort of 126 true sibling pairs. These SI values were then compared with those of 126 random pairs.

RESULTS

The 15-loci STR panel provides a cumulative power of exclusion of 0. 9999997. Of the 126 random pairs, 124 (98.4%) had cumulative sibship indices (CSIs) of <1.0, and none had a CSI of >3.0 (median, 0.0101; range, 0.0000003-2.5376). In contrast, 107 (85%) of the 126 sibling pairs had a CSI of >100 (median, 5,579.9853; range, 0.0747-9,406,829, 249.8461). However, five pairs (4%) of the sibling group had a CSI of <3.0. True sibship was confirmed for this particular group by additional paternity testing and mitochondrial DNA sequence analysis. Among a total of 1890 observations (15 loci x 126 pairs), two alleles per locus were shared 760 times (40.21%) (mean, 6.03 loci; range, 1-10) in the sibling group, but only 192 times (10.16%) in the random group (mean, 1.52 loci; range, 1-5) (p<0.001). No alleles were shared 696 times (36.83%) in the unrelated pairs, as compared to 176 times (9.31%) in the sibling group (p<0.001). A polarized distribution was not noted in the sharing of single alleles in either the random or the sibling group: 1002 observations (53.02%) and 954 observations (50.48%), respectively.

CONCLUSION

Highly polymorphic STR analysis can be discriminative in most sibship determinations, and the sharing of two alleles per locus is most informative in indicating sibship. Complementary mitochondrial DNA sequence analysis is mandatory in a few cases to exclude or establish true sibship when CSIs are equivocal and neither parent is available.

Quantitative measurement on three-dimensional computed tomography: an experimental validation using phantom objects

BACKGROUND

The use of 3-dimensional computed tomography (CT) imaging has been applied to the craniofacial region as well as to many other parts of the human body. Quantitative measurements have frequently been performed on the 3-dimensional images. However, critical validation of the measurement has been insufficient in the literature. This study was designed to evaluate the errors of the 3-dimensional measurements.

METHODS

Four phantom objects, a cube, a sphere, a cylinder, and a life-size adult skull model, were scanned using standard CT acquisition protocol. The data were transferred, reformatted, and displayed on an IBM-compatible personal computer running AnalyzePC 2.5 software. Linear, area, and volume measurements were obtained using one of the two methods. The first was physical measurement of the phantom objects using a caliper for linear measurement and mathematical calculations for area and volume measurements. The second was done by computer measurement on 3-dimensional images using the AnalyzePC 2.5 program. Each measurement was performed twice. The differences were compared between the repeated measurements and between the two methods.

RESULTS

The images were displayed according to standard 3-dimensional CT protocol. The differences between the measurements were insignificant and ranged from 0.00 to 2.57%.

CONCLUSION

This study validated the accuracy of the quantitative measurements on 3-dimensional CT images.