Multidiciplinary treatment of complicated subgingivally fractured permanent central incisors: two case reports

Abstract – Subgingival crown fractures with pulp exposure in permanent teeth present both endodontic and restorative problems with unfavorable prognosis. Numerous restorative techniques such as resin composite restorations with and without pins, crowns and reattachment of the fractured dental fragment could be listed as the treatment options. There are several successful cases in the literature where advantages of less microleakage and proper gingival biocompatibility in cases with reattachment of the tooth fragment were reported. Two cases of palatinal subgingival crown fractures are reported. Both had been restored by reattachment of the fragment and composite with the help of the flap surgery. Follow up visits (Case 1 for 4 years and Case 2 for 1 year) revealed satisfactory esthetics and function.     

A rare cause of retinal artery embolism: Accessory mitral valve tissue

A 42‐year‐old female patient was referred our clinic for investigation of a history of acute retinal artery occlusion. Transthoracic echocardiography showed a cyst‐like, mobile formation on posterior mitral valve leaflet. 2D and real time 3D transesophageal echocardiography showed a flexible circular mobile structure which was attached to posterior mitral valve leaflet. Echocardiographic appearance and morphological characteristics were suggestive of accessory mitral valve tissue.     

An experimental set-up to test heatmoisture exchangers

Objectives The purpose of this study was to build an experimental set-up to assess continuously the humidification, heating and resistance properties of heat-moisture exchangers (HMEs) under clinical conditions.Design The experimental set-up consists of a patient model, measurement systems and a ventilator.Setting Surgical ICU, University Hospital of Rotterdam.Materials A clinically used HME.Measurements and results The air flow, pressure in the ventilation circuit, pressure difference over the HME, and partial water vapour pressure and temperature at each side of the HME were measured. The resistance, absolute humidity, humidification efficiency and temperature difference at the patient side of the HME were calculated. Measurements were performed during 24h. The temperature output, humidity output and lung mechanics of the patient model were similar to values found in mechanically ventilated patients The measurement system was in agreement with the ISO draft standard and was capable of measuring dynamic variation of water and heat exchange over the range of a clinically used ventilator setting.Conclusion The experimental setup described is reliable for evaluating HMEs and can also be used for future clinical evaluation of HMEs. The main advantages of this set-up over those described previously are: (i) measurements of dynamic variations of water and heat exchange; (ii) on-line measurements of expiratory, as well as inspiratory resistance.     

Fibromuscular Dysplasia-Related Renal Artery Stenosis Associated with Aneurysm: Successive Endovascular Therapy

Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease. FMD of the renal arteries is one of the leading causes of curable hypertension. The simultaneous occurrence of FMD and renal artery aneurysm has been described previously. In this case, we present a fibrodysplastic lesion and an aneurysm in a renal artery treated with a percutanous transluminal angioplasty and coil embolization.     

Outcomes for haematological cancer patients admitted to an intensive care unit in a university hospital

Background

Haematological cancer (HC) patients are increasingly requiring intensive care (ICUs). The aim of this study was to investigate the outcome of HC patients in our ICU and evaluate 5 days-full support as a breakpoint for patients’ re-assessment for support.