Right- and left-handed dentists using right- and left-sided dental chairs in treatment of calculus

The aim of the present study was to evaluate the association of hand preference of dentists and the position of dental chairs in treatment of dental calculus. The dentists were last-class students from the School of Dentistry (Erzurum, Turkey). They were directed to dental chairs designed for right- and left-handers (right-sided and left-sided chairs) to remove calculus from the lower anterior teeth in volunteer patients having similar amounts of calculus, which was measured by Calculus index (CI). The right-handed dentists were more successful in right-sided (traditional) chairs than left-sided chairs; the left-handed dentists were more successful on left-sided chairs than right-sided chairs. The highest posttreatment CI (lowest success) was due to the right-handed dentists on the left-sided chairs. The lowest posttreatment CI (highest success) belonged to the left-handers working on the left-sided chairs. The left-handed dentists were better than right-handed dentists in the treatment of the mesial and distal surfaces of teeth, whereas the right-handers were successful only in the treatment of the distal parts of teeth. These results were explained by a better coordination between right and left hands and with higher skill in both hands in left-handers than right-handers.     

Right- and left-handed dentists in periodontal therapy

The purpose of this study was to determine whether successful dental therapy (scaling and root planing) depends upon handedness of dentists in right-handed dental chairs (units) Participants were 28 voluntary dentists (14 female and 14 male, ranging in age from 26 to 34 years). Patients (7 female and 7 male with a mean age of 39.6 years) had advanced periodontitis. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. There were two equal groups of dentists: left-handers (7 female, 7 male) and right-handers (7 female, 7 male). Initial examination of patients was performed using a pressure-controlled periodontal probe. During scaling and root planing, the negative interstroke forces were recorded using a piezo-electric receiver, an electronic transducer, and an analogue writer. The results showed that during scaling, mean negative forces reached a mean of 0.74 N in left-handed dentists and 0.52 N in right-handed dentists. During root planing, these forces were 0.86 N in left-handed dentists, and 0.63 N in right-handed dentists. These differences were statistically significant. The right-handed dentists were more successful than the left-handed dentists at scaling and root planing, provided that both of them used the same right-sided dental chairs. The importance of handedness of the dentists was accentuated in dental practice.     

Losartan-induced hepatic injury

Losartan, an angiotensin II receptor antagonist, is widely used for the treatment of hypertension. Clinical experience with this drug has demonstrated that it is safe. Losartan-induced hepatic toxicity is extremely rare. We report a case of severe hepatic toxicity and fibrosis caused by losartan use, and we review four previously reported cases. Drug-induced hepatic injury may be seen during the treatment of hypertension by losartan and the clinician should be aware of this toxicity, especially during the initial phase of treatment.     

A comparison of the efficacy of cefuroxime axetil and intramuscular benzathine penicillin for treating streptococcal tonsillopharyngitis

Throat cultures were performed on 297 children suspected of tonsillopharyngitis on clinical findings. Group A beta-haemolytic streptococci (GABHS) were isolated from 86 patients (41 males/45 females) aged 6-15 (mean (SD) 7.8 (0.04)) years. They were randomly allocated to receive oral cefuroxime axetil for 10 days (group 1) or one dose of benzathine penicillin by intramuscular injection (group 2) and responses were evaluated 2 weeks later. Clinical cure was observed in 95% of group 1 and 96% of group 2 and bacteriological cure in 86 and 84% of groups 1 and 2, respectively. Our results show that intramuscular benzathine penicillin remains an effective treatment for GABHS and that oral cefuroxime axetil is also effective.     

The effects of minor hip flexion, abduction or adduction and x-ray beam angle on the radiographic joint space width of the hip

OBJECTIVE: Joint pain may cause patients to hold their limbs in mild flexion, abduction or adduction to minimize pain, regardless of the extent of articular pathology, and these positional changes may have substantial effects on the interpretation of radiographic joint space. We aimed to study the impacts of minor degrees of flexion, abduction or adduction of the hip, as well as the angle of the x-ray beam on the radiographic joint space width (JSW) of the hip joint. METHODS: In the first part of the study, 65 patients (44 males, 21 females, mean+/-SD age 49+/-17) without clinical evidence of hip osteoarthritis (OA) who underwent intravenous pyelography (IVP) were studied. The hips were differentially positioned during the sequential radiographs required for the IVP procedure. Baseline radiographs were taken at 15 degrees internal rotation of the hips [the standard position for anteroposterior (AP) pelvis radiography]; additional positions included the hips at 15 degrees and/or 30 degrees flexion, and 15 degrees adduction and/or 30 degrees abduction. Radiographic JSWs were measured at three sites using a dial caliper: superomedial, superolateral, and the point of narrowest JSW. In the second part, 15 patients without clinical evidence of hip OA who underwent supine abdominal radiography for non-rheumatological indications were evaluated by standard (AP) pelvis x-ray in the same setting and JSW measurements were made as described above. RESULTS: When the average of the three measurements of the JSW was taken for each hip, baseline JSW was 4.38+/-0.55 mm (mean+/-SD). Positioning of the hip significantly (P<0.01) affected the radiographic JSW, with apparent widening during adduction and 30 degrees flexion, (JSW 4.56+/-0.51 mm and 4.53+/-0.58 mm, mean+/-SD), respectively, but narrowing during abduction (4.17+/-0.59 mm, mean+/-SD). Fifteen degree flexion of the hip did not result in statistically significant change in JSW measurements. Upon comparison of the AP pelvis view with the supine abdominal view, neither the average JSW nor the point of narrowest JSW differed significantly, although the superolateral JSW was significantly greater on the AP pelvis view (P=0.02). CONCLUSIONS: Subtle positional changes in the hip, such as may occur during pain or in OA, may artifactually alter the measured radiographic JSW. Thus, longitudinal studies which employ hip JSW to assess disease progression may yield biased results due to changes in pain rather than structure unless care is taken to ensure constant positioning of the hip.     

Subphrenic abscess resulting in resection of the lower basal segment of the right lung: a severe complication following laparoscopic appendectomy

We report the case of an 18-year-old boy who developed an intrathoracic abscess with rupture of the diaphragm following a laparoscopic appendectomy (LA) for a perforated appendicitis. LA is an established procedure in the treatment of appendicitis. It is a safe and efficacious technique, but several complications can occur with this procedure, and surgeons should be aware of the potential dangers. Herein, we present a previously unreported thoracic complication following an LA.     

Traumatic Injuries to the Subclavian and Axillary Arteries: A 13-Year Review

Purpose By reviewing our experience, we evaluated the presentation, management, and long-term outcome of patients with subclavian and axillary artery injuries resulting from trauma.Methods We retrospectively reviewed the data of 38 patients who received treatment for subclavian or axillary artery injuries in the Emergency and Trauma Department of Medical Faculty of Istanbul, Istanbul University between January 1989 and July 2002.Results Arterial injuries were repaired with an end-to-end anastomosis in 10 (26.3%) patients, primary repair in 6 (15.7%), autologous vein graft interposition in 16 (42%), ligation in 5 (13.1%), and a proximal subclavian-brachial artery bypass in 1 (2.6%). One (2.6%) of the arterial reconstructions failed in the perioperative period. Fourteen (36%) patients presented with a neurological deficit, which recovered after the intervention in 2 (5.2%) patients. A wound infection developed in 8 (21%) patients and 2 (5.2%) patients died of concomitant injuries. Thirteen (36.1%) of the remaining 36 patients were followed up for a mean period of 7 months.Conclusion Successful management of subclavian and axillary artery injuries requires prompt diagnosis because the occult nature of these injuries necessitates a high index of suspicion. Although revascularization procedures are often successful, it is the associated neurological, orthopedic, and soft tissue injuries that affect the functional outcome of the limb.This work was presented at the 5th European Congress of Trauma and Emergency Surgery. October 1–5, 2002 in Istanbul, Turkey     

Anatomical dimensions of anterior bundle of ulnar collateral ligament and its role in elbow stability

OBJECTIVE: To study the anatomical dimensions of the anterior bundle of ulnar collateral ligament and its role in elbow instability. METHODS: We studied 20 elbows of 10 cadavers. Anterior bundle of ulnar collateral ligament was dissected in all elbows and its anatomical length and width were measured. After measuring it, we assessed the role of the anterior bundle of ulnar collateral ligament in the medial elbow joint stability, with the capsule, the radial head and anterior bundle of ulnar collateral ligament being cut. RESULTS: The mean right length of the anterior bundle of ulnar collateral ligament was 21.10 +/- 6.29 mm and the mean left length was 21.70 +/- 5.31 mm. The mean right width of the anterior bundle of ulnar collateral ligament was 12.70 +/- 2.79 mm and the mean left width was 13.90 +/- 2.37 mm. Anterior bundle of ulnar collateral ligament was found to be the main stabilizer of the valgus stress. The anterior capsule and the radial head also make contributions to this stability. However, when anterior bundle of ulnar collateral ligament is cut, the radial head and the anterior capsule fails to maintain the stability against valgus stress. CONCLUSIONS: The anatomical dimensions of the anterior bundle of ulnar collateral ligament are important for a surgeon when graft is used in reconstructing this ligament. Our study is an initiator of this topic and we believe that with larger series, more reliable anatomical measurements can be obtained. We also showed that the anterior bundle of ulnar collateral ligament is the main medial stabilizer of the elbow joint.     

The effect of topical corticosteroid on basic fibroblast growth factor in nasal polyp tissue

BACKGROUND: The etiology of nasal polyposis and pathophysiological mechanisms of polyp formation is still poorly understood. Experimental models have suggested that nasal polyp growth requires extracellular matrix formation and is associated with fibroblast proliferation. Intranasal corticosteroids appear to be useful in reducing nasal polypoid lesions and the likelihood of polyp recurrence after surgery. Basic fibroblast growth factor (bFGF) is a potent angiogenesis factor and is mitogenic for a wide range of cell types. We investigated the alteration of bFGF levels in nasal polyp tissue after administration of topical corticosteroid. METHODS: Nasal polyp tissues were obtained from 36 patients with diffuse nasal polyposis before and after topical nasal steroid treatment. As a topical nasal steroid mometasone furoate was given for 4 weeks in a dosage of 200 microg/day. The bFGF levels were measured by competitive enzyme immunoassay method. RESULTS: The mean levels of tissue bFGF, before and after topical nasal steroid treatment, were 1485 +/- 826 ng/mg protein (range, 416-3434 ng/mg) and 1340 +/- 749 ng/mg protein (range, 330-3288 ng/mg), respectively. The levels of bFGF in nasal polyps were significantly lower than those before treatment after administration of topical nasal steroid (p = 0.011). CONCLUSION: Administration of topical nasal steroid decreases bFGF levels of nasal polyp. It may be suggested that one of the effects in diminishing the size of nasal polyps is by decreasing the bFGF.