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Biomedical subjects

A J Nowak

Publications and source records attributed to A J Nowak.

At least 19 recordsLinked to original sources

Craniofacial development in myotonic dystrophy.

Anthropometric, cephalometric, and dental data from 23 subjects (12 males and 11 females) afflicted with myotonic dystrophy were compared to similar data from normal subjects who participated in the Iowa Facial Growth Study. A two by two analysis of variance showed that myotonic subjects differed from normal subjects in headlength, head breadth, cephalic index, bizygomatic face width, nosebreadth, maxillary arch widths, palatal depth, anterior and posterior face heights, cranial base lengths, cranial base angles, and other cephalometric measures. Sex differences were observed for many of the variables. It is hoped that these findings will assist clinicians who treat patients having this disorder.

Adolescent

Electrical stimulation of brainstem nuclei: elicitation, modification, and conditioning of the rabbit nictitating membrane response.

Electrical stimulation of the reticular formation, pars oralis of the spinal trigeminal, abducens, and accessory abducens nuclei was used to assess the role of these sites in the elicitation, reflex modification, and classical conditioning of the rabbit's nictitating membrane response (NMR). Although electrical brain stimulation of the targeted sites revealed comparable levels of unconditioned responses, the spinal trigeminal nucleus was the only site at which reflex modification and conditioned response acquisition occurred reliably. These findings suggest that a locus of conditioned stimulus and unconditioned stimulus interaction, mediating either or both reflex modification and NMR conditioning, is on the sensory side of the reflex arc, at the pars oralis of the spinal trigeminal nucleus.

Abducens Nerve

Oropharyngeal lesions and their management in epidermolysis bullosa.

Unique oral problems are usually encountered in the patient with epidermolysis bullosa affecting both soft and hard oral tissues. Bulla formation leading to scarring, ankyloglossia, and microstomia restricts normal oral activities. In addition, food retention on hypoplastic enamel increases tooth breakdown. Management of routine dental care is complicated by the fears of both the patient and dentist. Preventive dental therapy should be initiated as early as possible to reduce dental diseases. Early intervention along with frequent evaluation by the dentist are indicated to ensure optimal dental health and oral functioning.

Dental Restoration, Permanent

Rumination and vomiting in Prader-Willi syndrome.

Inability to vomit has been cited as characteristic of Prader-Willi syndrome (PWS). Although post-prandial vomiting after gastric by-pass surgery has been reported, neither vomiting under "typical" circumstances or rumination have been described. Prompted by the discovery of several cases of vomiting and rumination, a questionnaire was sent to members of the PWS Association. Approximately 36% (113/313) of affected individuals reportedly experienced at least one episode of vomiting. Induced vomiting was unsuccessful in 9 of 14 cases in whom results were known. However, no complications of Ipecac were reported. We suggest that there is an alteration in the physiologic set-point at which vomiting occurs, leading to a decreased propensity to vomit. Liberal and strict definitions of rumination yielded 15.7% and 10.2% positive responses, respectively. Rumination was associated with a history of vomiting. Enamel deterioration consistent with rumination has been observed, and such changes should be looked for in all PWS children. In several instances, rumination was found to decrease when very strict weight control was lessened. Certain individuals may ruminate under too strict a weight control program, and weight control goals should be evaluated to achieve a reasonable compromise between ideal weight and obesity. Vomiting and rumination do not rule out the diagnosis of PWS.

Adolescent

Palatal groove formation in neonates and infants with orotracheal tubes.

Long-term use of orotracheal tubes has been associated with palatal groove formation, acquired cleft palate, and defective primary dentition. To determine the incidence of palatal groove formation, maxillary impressions were made of 63 neonates and infants who required orotracheal intubation for one to 62 days. A palatal groove was present in 47.6% of these neonates and infants. The incidence of palatal groove formation increased with a longer use of tubes, being 87.5% in those neonates and infants requiring tubes for more than two weeks.

Body Weight

Appliance for stabilizing orogastric and orotracheal tubes in infants.

The long-term use of orotracheal tubes in infants has been associated with airway damage, palatal groove formation, acquired cleft palate, and defective primary dentition. Nasotracheal intubation is associated with trauma to the nasal septum and deformities of the nares. Because the infant is an obligatory nose-breather, nasogastric feeding tubes obstruct the nares and cause mucosal edema. We have developed an intraoral appliance designed to stabilize orogastric feeding and orotracheal tubes, and prevent obstruction to the nares and trauma to the palate and alveolar ridge.

Enteral Nutrition

Communicating with the family of the child with a developmental disability.

As more and more families of handicapped children seek dental care, increased demands will be placed on the dentist and staff to communicate effectively and humanely, not only with the child but with the parents. Increased training is currently being provided through doctoral programs and continuing education to deal with special human needs of the patient and family in a dental setting. The dentist should address the thoughts and feelings of the parents as well as those of the child. The child and family present special problems but also special opportunities to fulfill professional responsibilities and experience personal and professional gratification.

Adolescent

An unusual triad: microdontia, taurodontia, and dens invaginatus.

A 12 1/2-year-old white boy was examined and found to have permanent teeth that were smaller than those of the average adult. The microdontia was accompanied by taurodontia of the mandibular molars and several teeth with dens invaginatus. The patient was normal in appearance and had no other illness. The pedigree was compatible with X-linked recessive inheritance.

Child