Epinephrine plus argon plasma or heater probe coagulation in ulcer bleeding

AIM:To compare the effectiveness of argon plasma coagulation (APC) and heater probe coagulation (HPC) in non-variceal upper gastrointestinal bleeding.METHODS:Eighty-five (18 female,67 male) patients admitted for acute gastrointestinal bleeding due to gastric or duodenal ulcer were included in the study.Upper endoscopy was performed and HPC or APC were chosen randomly to stop the bleeding.Initial hemostasis and rebleeding rates were primary and secondary end-points of the study.RESULTS:Initial hemostasis was...     

Management of an Adult with Spaced Dentition, Class III Malocclusion and Open-bite Tendency

The aim of this case report was to present the orthodontic treatment of an adult with spaced dentition, Class III malocclusion, and open-bite tendency. A 28.4-year-old adult woman was concerned about the unesthetic appearance of her spaced dentition localized at both upper and lower arches while smiling. She had a mild tongue thrust, hypertropic upper frenum, and mild speech difficulty while pronouncing "s". Her profile was straight with prominent lips. Molar relationship was Class III on both sides. Anterior teeth were in an end-to-end relationship. Lower dental midline was deviated to the left side. Cephalometric analysis revealed a skeletal Class III relationship with hyperdivergent facial pattern. The treatment plan included myotherapeutic exercises for the tongue thrust habit and a diagnostic set-up for closure of diastemas. A strict retention protocol was followed combined with gingivoplasty, fiberotomy, and frenectomy procedures. All spaces were closed successfully, adequate overbite and overjet relationships were obtained, and tongue thrust habit and speech difficulty while pronouncing "s" were eliminated. Clinical and cephalometric results indicated the maintenance of the treatment outcome at 6-months post-retention period.     

Hypermobility in women with fibromyalgia syndrome

The purpose of this study was to evaluate the relationship between hypermobility and fibromyalgia syndrome (FS) in women. Ninety-three women with FS who met the American College of Rheumatology criteria for FS and 58 healthy women without FS were included in this study. All women were examined for hypermobility by blinded observers using the Beighton criteria. The mean age was 43.5±9.9 (21–68) and 40.2±11.1 (21–63) years in the FS and control groups, respectively, and the two groups were statistically similar (p>0.05). The mean Beighton total score was 4.7±2.1 and 2.9±2.4 in the FS and control groups, respectively (p<0.0001). The frequency of joint hypermobility was 64.2% in the FS group and 22% in the control group. In accordance with the Beighton criteria (p<0.05), we found that the joint hypermobility ratio was significantly higher in patients with FS than in subjects without FS. Additionally, we evaluated the correlation between the total Beighton score and the age and number of trigger points. There were negative correlations between the total Beighton score and the age (r=−0.42, p<0.001) and number of trigger points (r=−0.24, p=0.03) in all patients. Hypermobility syndrome is more common in women with FS than in those in the control group. Therefore, the relationship between hypermobility and FS should be taken into consideration in the diagnosis and follow-up of women, especially those with widespread pain.     

Airway Pressure Release Ventilation: An Alternative Ventilation Mode for Pediatric Acute Hypoxemic Respiratory Failure

Airway pressure release ventilation (APRV) is a relatively new mode of mechanical ventilation. The use of this model of ventilation in pediatrics has been limited. The authors describe their experience with this mode of ventilation in a series of pediatric hypoxemic respiratory failure patients. Three patients with acute hypoxemic respiratory failure (AHRF) were treated with APRV, when oxygenation did not improve with pressure control ventilation (PCV). The mean age of the patients was 5.8 ± 1.3 months. Fractional oxygen concentration decreased from 0.97 ± 0.02 for PCV to 0.68 ± 0.12 for APRV, peak airway pressure fell from 36.6 ± 11.5 cm H₂O for PCV to 33.3 ± 5.7 cm H₂O for APRV, mean airway pressure increased from 17.9 ± 5.9 cmH₂O for PCV to 27 ± 2.6 cmH₂O for APRV and release tidal volume increased from 8.3 ± 1.5 mL/kg for PCV to 13.2 ± 1.1 mL/kg for APRV after 1 h. APRV may improve oxygenation in pediatric AHRF when conventional mechanical ventilation fails. The APRV modality may provide better oxygenation with lower peak airway pressure.     

Klippel–Feil syndrome with osteopoikilosis in a young lady and her four female relatives with osteopoikilosis

Osteopoikilosis is a rare, usually asymptomatic, autosomal dominant bone disorder, which is usually found incidentally on X-ray. Klippel–Feil syndrome is a rare disorder characterized by the congenital fusion of any two of the seven cervical (neck) vertebrae. It is caused by a failure in the normal segmentation or division of the cervical vertebrae during the early weeks of fetal development. In this case report, we describe a woman with osteopoikilosis associated with type 2 Klippel–Feil syndrome. Additionally, four female members of her family had osteopoikilosis. We state that possible syndromes that can go with osteopoikilosis must be kept in mind in case of an incidental diagnosis in daily practice.     

Implant-supported prosthetic applications upon development of children and adolescents: a pilot study in pigs

PURPOSE: The purpose of this study is the investigation of the application of implant-supported prosthetic restorations using 2 implants supporting a fixed prosthesis during the physical growth and the development period of growing pigs. MATERIALS AND METHODS: This study was carried out on 6 male farm pigs (1 as a control). The effect of the 2 screw-type endosseous implants inserted into the premolar area on the left mandibular arches of 5 farm pigs upon the jaw was investigated during a 3.5-8-month growth period using cephalometric radiographs. The cephalographs were taken with a specially standardized cephalostat, and a significant test of differences between 2 partners was used to evaluate them. RESULTS: The study suggested that the implants showed alveolar elevation by bone growth but could not keep pace with the natural teeth eruptions and the bone growth in the region. CONCLUSION: Although the sagittal and transverse developments of the neighboring bone region are greater than the implant-inserted region, the difference in this growth can be tolerated by corrections or modifications of implant-supported superstructures.     

Trigeminal nerve involvement in T-cell acute lymphoblastic leukemia: value of MR imaging

A 30-year-old male with T-cell acute lymphoblastic leukemia presented with facial numbness. Neurological examination revealed paresthesia of the left trigeminal nerve. Cerebrospinal fluid (CSF) cytology showed no atypical cells. Gadolinium-enhanced magnetic resonance (MR) imaging demonstrated enlargement and enhancement of intracranial portions of the left trigeminal nerve. The abnormal MR imaging findings almost completely resolved after the chemotherapy. Gadolinium-enhanced MR imaging is not only a useful procedure for the early diagnosis of cranial nerve invasion by leukemia but it might be helpful to follow the changes after the treatment.     

Hearing loss does not occur in young patients undergoing spinal anesthesia

BACKGROUND AND OBJECTIVES: Although uncommon, hearing loss after spinal anesthesia has been described. Vestibulocochlear dysfunction after spinal anesthesia in which 22-gauge and 25-gauge Quincke needles were used was investigated to determine if needle size affected hearing. METHODS: Patients with American Society of Anesthesiologists physical status I and II, aged 20 to 40 years, who were undergoing lower extremity surgery under spinal anesthesia were randomized into 2 groups. After intravenous hydration, 3 mL of 0.5% bupivacaine was administered for spinal anesthesia, which was performed with a 22-gauge Quincke needle in group I (n=30) patients and a 25-gauge Quincke needle in group II (n=30) patients. Before surgery and 2 days after surgery, pure-tone audiometry and tympanometry were performed. Preoperative and postoperative hearing data were obtained in the right and left ears for every frequency. Headache, nausea, and vomiting and cranial nerve III, IV, V, VI, VII, and VIII function were assessed on postoperative day 2. RESULTS: Demographic data were not different between the groups. No hypoacousis was noted at any frequency during the entire testing period in either group. Two patients from group I experienced postdural puncture headache on postoperative day 3, and neither had hearing loss. No patient had cranial nerve dysfunction. CONCLUSIONS: We were unable to induce hearing loss in young patients undergoing spinal anesthesia by injecting the anesthetic with a 22-gauge or a 25-gauge Quincke needle.