Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient.

OBJECTIVE: This article examines the success of mini-dental implants (MDI'S) by assessing four subjective measures of patient satisfaction for MDI's in the edentulous maxilla and mandible: comfort, retention, chewing ability and speaking ability. Success rates, surgical techniques, and financial advantages of the MDI's are reviewed. STUDY DESIGN: Thirty consecutive patients received four MDI's between the mental foramen of the mandible from 9/18/2003 to 10/22/2004. Questionnaires were sent to all thirty patients an average of 5 months postoperatively. The patients ranked comfort, retention, chewing ability, and speaking ability from 1 to 10 (1=poor and 10=excellent). RESULTS: A total of 116 MDI's were placed in 13 months and 113 remain stable for a 97.4% implant success rate. Pre-operatively patients rated their retention at 1.7+/-0.42 and post-operatively at 9.6+/-0.37, for a difference of 7.9 (p=3.6-19). Comfort was the next greatest improvement, with a pre-operative rating of 2.2+/-0.63 and a post-operative rating of 9.4+/-0.45, for a difference of 7.2 (p=3.5-15). Chewing ability also improved, with a difference of 7.0 (p=2.9e-16). In the final category of speaking ability, the pre-operative to post-operative difference was 3.2 (p=1.1e-5). CONCLUSION: MDI's are a highly successful implant option for patients with poor tolerance to maxillary and mandibular prosthesis. The implants are relatively affordable and overall patient satisfaction is excellent.     

Irregularly shaped small shadows on chest radiographs, dust exposure, and lung function in coalworkers' pneumoconiosis.

The predominant shapes of small opacities on the chest radiographs of 895 British coalminers have been studied. The aims were to determine whether irregular (as distinct from rounded) small opacities can be identified reproducibly, whether their occurrence is related to dust exposure, and whether they are associated with excess prevalence of respiratory symptoms or impairments of lung function. Six of the doctors responsible for regular radiological surveys of all British coalminers each classified all 895 radiographs twice and independently, using the International Labour Organisation's 1980 classification system. The majority view was that 39 films showed predominantly irregular small opacities, 131 showed predominantly small rounded opacities, and 587 showed no small opacities. Readers' opinions varied about the presence and shapes of shadows on the other 138 films. In general, consistency between readers (and within readers on repeated viewings) was satisfactory. The occurrence and profusion of irregular shadows were related significantly both to the men's ages and additionally to their cumulative exposure to respirable coalmine dust as determined from 15 years' dust monitoring close to where the miners had worked. For any given level of exposure, the average level of profusion of the small irregular opacities was less than the corresponding profusion of small rounded opacities. The prevalence rates of chronic cough and phlegm, and of breathlessness, were higher in those with small irregular opacities than in those with no small opacities (category 0/0), but the differences were not statistically significant after adjustment for other factors including smoking habits. The presence of irregular (but not rounded) small shadows was associated with an impairment in respiratory function averaging about 190 ml deficits in both FEV1 and FVC. These deficits were not explicable in terms of the men's ages, body sizes, and smoking habits and they were in addition to the lung function losses attributable to the miners' dust exposure as such. It is concluded that the presence and profusion of small irregular opacities should be taken into consideration when assessing the severity of coalworkers' simple pneumoconiosis.     

Commutability of the CRM 470 C-reactive protein value in the Dade Behring N High Sensitivity CRP assay.

Certified Reference Material 470 (CRM 470) demonstrates commutability with both the manufacturer's calibrator and with dilutions of serum pools in the Dade Behring N High Sensitivity assay for C-reactive protein (CRP). Both regression and back calibration show similar nonlinearity for all materials, largely due to the method of calibration curve fitting used in this assay. Significant differences in values among the currently available commercial assays can be largely overcome by using appropriate calibration curve fitting and the recommended value transfer protocol, which includes a minimum of two assay runs on each of at least 3 separate days, with weight correction of all reconstitutions and dilutions. An initial weight-corrected dilution should be made each day because of the relatively high level of CRP in CRM 470. In our opinion, the degree of nonlinearity, imprecision, and differences in values in currently available assays renders the use of fixed clinical decision cut-points questionable for high-sensitivity CRP. An alternative approach is suggested.     

Comparison of the potential therapeutic effects of interleukin 2 or interleukin 4 secretion by a single tumour.

Engineering of a variety of rodent tumour cells to secrete either interleukin 2 (IL-2), or interleukin 4 (IL-4), has been demonstrated to reduce their tumorigenicity. However the mechanisms of action of secreted IL-2 and IL-4 have not been compared in a single rodent tumour. Here we demonstrate that the weakly immunogenic murine fibrosarcoma FS29 had reduced growth rate and in some cases was rejected by syngeneic animals, when modified to secrete either IL-2 or IL-4, but not IL-5. Immunohistochemical analysis of tumour nodules undergoing regression showed stimulation of a largely lymphocytic infiltrate by IL-2 and a macrophage and granulocyte infiltrate, with a small number of lymphocytes by IL-4. Indeed, secretion of low levels of IL-2 and IL-4 in combination resulted in optimal rejection, suggesting that the two cytokines might mobilise different and complementary effector cell mechanisms. Both IL-2 and IL-4-secreting cells failed to induce the rejection of admixed, unmodified FS29 cells. The loss of cytokine secreting cells from such admixtures occurred more rapidly for IL-2-secreting cells. Injection of IL-4-secreting, but not IL-2-secreting FS29 cells could protect mice from a delayed challenge with unmodified FS29 cells. These data suggest that IL-4 secretion stimulates the better long-term host anti-tumour response.     

Synthesis, chemical, and biological properties of vinylogous hydroxamic acids: dual inhibitors of 5-lipoxygenase and IL-1 biosynthesis.

Vinylogous hydroxamic acids (3-(N-hydroxy-N-alkylamino)-2-propen-1-ones, VHA) were prepared as antiinflammatory agents. The synthesis, chemical properties, and in vitro biological activities of these relatively unexplored compounds are described. The VHAs were prepared by condensation of the appropriate N-substituted hydroxylamine with any of the three reagents: a 1,3-dicarbonyl compound (method A); a vinylogous amide (method B); or an alkynone (method C). The VHAs exist as one or more tautomers in solution with the relative proportions of each being dependent upon the structure of the VHA, solvent, and pH. VHAs undergo some of the typical reactions of hydroxamic acids as well as those of vinylogous amides. VHAs are active as inhibitors of 5-lipoxygenase and of IL-1 biosynthesis in vitro, which do not inhibit other enzymes of the arachidonic acid cascade. They have been shown by ESR studies to bring about inhibition of soybean type 1 15-lipoxygenase by reduction of the active site iron.     

Muscle hypertrophy in men and women

It is widely believed that women experience less skeletal muscle hypertrophy consequent to heavy-resistance training than men. The purpose of this study was to test this hypothesis using both traditional indirect indicators as well as a direct measure of muscle size. Seven male experimental (ME), 8 female experimental (FE), and 7 control subjects were studied before and after a 16-wk weight training program, in which ME and FE trained 3 days.wk-1 at 70 to 90% of maximum voluntary contraction using exercise designed to produce hypertrophy of the upper arm and thigh. Strength increased significantly (P less than 0.05) in ME and FE, respectively, on elbow flexion (36.2 and 59.2%), elbow extension (32.6 and 41.7%), knee flexion (12.8 and 24.4%), and knee extension (28.8 and 33.9%) tests. Absolute changes were significantly greater in ME than FE in 2 of the 4 tests, whereas percentage changes were not significantly different. Substantial muscle hypertrophy occurred in the upper arms of both ME and FE as evidenced by significant increases in upper arm circumference (7.9 and 7.9%), bone-plus-muscle (B+M) cross-sectional area (CSA) estimated by anthropometry (17.5 and 20.4%), and muscle CSA determined from computed tomography scanning (15.9 and 22.8%). Changes by ME and FE were not significantly different, except for the absolute increase in estimated B+M CSA, which was significantly greater in ME (11.2 vs 7.4 cm2). No muscle hypertrophy occurred in the thigh of either ME and FE as evidenced by non-significant changes in thigh circumference (1.7 and 2.3%), B+M CSA (4.9 and 6.1%), and muscle CSA (2.9 and 2.9%). Changes by ME and FE in body weight, fat-free weight, and fat weight were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)     

Directional instability of rear caster wheelchairs

Although less common than conventional front caster wheelchairs, rear caster wheelchairs are still in use for several reasons. Many people find manual rear caster wheelchairs easier to maneuver indoors at slow speeds. This is especially true when the user attempts to maneuver the wheelchair very close to an object, such as a table. Electric wheelchairs often have rear casters to accommodate for front wheel drive. If the larger drive wheels are located at the front of the wheelchair, obstacles such as a curb can be negotiated much more easily. However, a major disadvantage of rear caster wheelchairs is that they are generally known to be directionally unstable, especially at high forward speeds. This paper presents the results of a study to determine specific measures that can be employed to improve the stability of this type of wheelchair. The instability of rear caster wheelchairs is due primarily to road forces that act on the tires when the wheelchair is displaced from its line of motion by a bump or other irregularity in the road surface. The paper discusses the experimental investigation of these road forces as well as a dynamic model used to study the instability problem. The results of a computer simulation program used to perform a parametric study of different design variables are discussed. Center of gravity position, caster trail distance, and caster pin friction are found to have a dominant influence on rear caster wheelchair directional control. Several simple but significant design recommendations are presented.