Dialkyl phosphate metabolites of organophosphorus in applicators of agricultural pesticides in Majes – Arequipa (Peru)

Background  

Organophosphorus (OPs) pesticides are the most commonly used pesticides in Peruvian agriculture. The population at risk for OPs exposure includes formulators, applicators and farmers. Majes Valley is the most important agricultural center of the Southern region of Peru. The present study was aimed to determine the knowledge about using OPs, safety practice and urinary dialkylphosphate metabolites on OP applicators in the Majes Valley, Peru.     

Minimizing aortic manipulation during OPCAB using the symmetry aortic connector system for proximal vein graft anastomoses

BACKGROUND: Since minimal invasive techniques have become increasingly common in coronary artery bypass grafting (CABG), there has been renewed interest in facilitated mechanical anastomoses devices that might have the potential of replacing the standard suturing techniques in vascular anastomoses. We report our initial experience with the successful creation of mechanical proximal vein graft anastomoses in off-pump coronary artery bypass operations. METHODS: From August to December 2000, we investigated the first 20 consecutive patients who underwent CABG on the beating heart without extracorporeal circulation and who received at least one mechanical proximal vein graft anastomosis with the St. Jude Medical Symmetry aortic connector system without side-clamping of the aorta. We evaluated the different components of the system, the feasibility of such anastomoses, and the intraoperative flow measurements of the grafts using transit time methods. RESULTS: A total of 32 proximal vein graft anastomoses were performed with the aortic connector system. Hemostasis was instantaneous in all cases except one, in which the connector was removed and the anastomosis was hand-sewn without complications. All other vein grafts were patent at the end of the procedure; intraoperative flow measurements were 39 +/- 25 mL/min for single vein grafts (n = 20) and 69 +/- 25 mL/min for sequential grafts (n = 11). CONCLUSIONS: The St. Jude Medical Symmetry aortic connector system is a user-friendly, effective, quick, and reliable device for sutureless proximal vein graft anastomosis in CABG. This system allows the construction of uniform and geometrically perfect anastomoses and does not require aortic side-biting. This technology is attractive for all CABG procedures because aortic manipulation is reduced. In off-pump surgical procedures the connector system allows aortic manipulation to be minimized, potentially reducing embolization from aortic wall debris.     

Some technical considerations on the opacification of capillaries and veins in vertebral angiography

Summary The authors think that the spasm of the vertebral artery, which so many publications have mentioned for years, occurs only as an exception and that what is described under that name is often in fact only a hydrodynamic phenomenon due to the special configuration of the vertebral and basilar arteries: a phenomenon of blocking of the progress of the contrast medium by the blood flow of the opposite side when this one is more important than in the injected side. — This phenomenon can be avoided in almost all cases by injecting saline immediately after the contrast medium in order to maintain a slight hyperpressure in the arteries injected for a sufficient length of time. — This method provides a completely reliable means of obtaining an excellent opacification of the vertebral and basilar arteries and subsequently, of course, of the capillaries and veins in vertebral angiography.

---

Zur Technik der Darstellung der Capillaren und Venen der Angiographia vertebralis

Zusammenfassung Eine ausreichende Quantität von Kontrastmittel ist als Hauptbedingung für eine gute Darstellung der Capillaren und Venen des Vertebralis-Kreislaufes anzusehen. Es kommt jedoch in einigen Fällen immer wieder zu einer ungenügenden Kontrastmitteldarstellung, die teilweise durch einen sogenannten Spasmus der A. vertebralis bedingt wird. Dieser Spasmus tritt sowohl bei der direkten Punktion als auch bei einer Katheteruntersuchung auf. Er findet sich in der Mehrzahl der Fälle an der Stelle, an der beide Vertebrales zusammentreffen. Die Verfasser kommen daher zu der Ansicht, daß es sich dabei nicht um einen echten Spasmus, sondern um ein hämodynamisches Phänomen handelt. Die Injektion von Spasmolytika verhindert diesen Spasmus nicht. Sie beschreiben eine Technik, bei der durch eine dem Kontrastmittel nachfolgende Injektion von physiologischer Kochsalzlösung ein ausreichend langer Überdruck besteht. Bei dieser Untersuchungsmethode kommt es in allen Fällen zu einer optimalen Darstellung der Vertebralis-Gefäße.

---

Considérations techniques sur l'opacification des artères et des veines en angiographie vertébrale

Résumé Les auteurs pensent que ce qu'on a décrit comme spasme de l'artère vertébrale est en fait un phénomène hydrodynamique qu'on peut éviter en injectant du sérum physiologique immédiatement à la suite du contraste opacifiant.

---

---

Contribution of the 1st European Colloquium for Neuroradiology, September 6, 1969, Colmar.     

Corrosion at the marginal gap of implant-supported suprastructures and implant failure

PURPOSE: Late failure, which occurs after successful osseointegration, is usually attributed to prosthodontic determinants. Corrosion of metallic suprastructures and incorrectly handled materials are often primary causes of late implant failure. In this study, 6 implants whose failure was related to suprastructure metal corrosion and adjacent bone were investigated. MATERIALS AND METHODS: Six implants as well as their suprastructures were analyzed for surface corrosion using light and scanning microscopy. Metal alloys and soldering compounds were analyzed using energy-dispersive x-ray analysis. Bone adhering to the implants was removed and analyzed for metal content using atom absorption spectroscopy. RESULTS: Extensive corrosion lesions and areas of oxidation were detected on all 6 of the implants and inner crown surfaces. Bone tissue collected from 5 of the implants showed higher contents of metal ions in comparison to physiologic baseline values detected in healthy bone. DISCUSSION: In spite of the high gold content of the suprastructure, corrosion occurred. Bonding oxides necessary for the process of fusing porcelain to gold will initiate corrosion. Apparently, once corrosion is initiated it rapidly progresses at the gap crevices, and toxic metal ions are released. These toxic ions diffuse into the peri-implant bone, causing bone structure breakdown and hastening osseodisintegration. CONCLUSION: Biocompatible metals, alloys, and ceramics should be used for implant-supported suprastructures. It is also essential that gaps between the implant and its suprastructure be avoided by cementing the suprastructure or sealing the gap.     

Total arterial off-pump versus on-pump coronary revascularization: comparison of early outcome

BACKGROUND AND AIM: To assess differences in the early outcome after complete arterial myocardial revascularization with (ONCAB) or without cardiopulmonary bypass (OPCAB). METHODS: Out of 870 consecutive CABG procedures 58 OPCAB and 91 ONCAB patients receiving exclusive arterial grafts were analyzed. OPCAB patients had more single-vessel (p < 0.0001), less triple-vessel (p < 0.0001) or left main disease (p = 0.0021), higher angina class (p = 0.003), unstable angina (p < 0.0001) or previous PTCAs (p < 0.0001). RESULTS: ONCAB was associated with longer operations (182.5 +/- 38 vs. 147 +/- 56 min; p = 0.0001) and more anastomoses/patient (3.2 +/- 1 vs. 2 +/- 0.9; p < 0.0001), but incomplete revascularization was similar in both groups (11% vs. 17%; p = ns). ITA use was identical, whereas single left internal thoracic artery (LITA) use (25.9% vs.1%; p < 0.0001) and LITA jump anastomoses (10.3% vs. 7.7%; p < 0.0001) were more frequent in OPCAB. Radial artery (RA) use (89% vs. 46.6%; p < 0.0001) and RA jump anastomoses (57.1% vs. 12.1%; p < 0.0001) were more frequent in ONCAB. Mortality, arrhythmias, cerebro-vascular accidents (CVA), and renal failure were similar, but ventilatory support shorter (8.8 +/- 11.8 vs. 15.6 +/- 9.4 h; p < 0.0001) and cardiac enzyme release smaller (p < 0.0001) after OPCAB with a trend toward less myocardial infarction (1.7% vs. 7.7%; p = 0.12) and low output (1.7% vs. 8.8%; p = 0.089), and more respiratory complications (10.3% vs. 2.2%; p = 0.056). CONCLUSIONS: Arterial OPCAB patients have less extensive CAD, but more severe symptoms. Early outcome is similar concerning mortality, arrhythmias, CVA, renal failure, or ICU and hospital stay, but with shorter ventilatory support and lower cardiac enzymes with a trend toward lower myocardial infarction and low output, but higher respiratory complication rates after OPCAB.     

Metastatic basal cell carcinoma: rapid symptomatic response to cisplatin and paclitaxel

BACKGROUND: Basal cell carcinoma (BCC) is the most common cancer in the community, although it rarely metastasizes. The literature reports less than 100 patients who have received chemotherapy for metastatic BCC. A further case of this rare disease is reported here. The pattern of disease in the reported patient was similar to that described in the literature, but the patient experienced a long period with untreated metastatic disease compared with that in the literature. METHOD: The patient was treated with cisplatin in combination with paclitaxel. Literature review suggests this to be the first report of this combination. RESULTS: Rapid symptomatic response was achieved though late neurotoxicity occurred. CONCLUSION: This regimen is an active combination for the rare patient with metastatic BCC. The combination of carboplatin and paclitaxel causes less neurotoxicity and may therefore be a superior regimen.     

Quality of life after mitral valve surgery: differences between reconstruction and replacement

BACKGROUND AND AIMS OF THE STUDY: Quality of life (QoL) is of increasing interest in major surgical procedures. Mitral valve reconstruction (MRr) is assumed to be better tolerated than mitral valve replacement (MVR). The study aim was to assess mid-term QoL in patients undergoing isolated mitral valve surgery. METHODS: QoL was monitored in 115 consecutive patients who had isolated mitral valve surgery (62 with MVR, 53 with MRr). Mid-term survival was assessed after a mean of 37 +/- 18 months using the SF-36 health survey questionnaire. RESULTS: Patients undergoing MVR were younger (61.9 +/- 12.7 versus 64.9 +/- 12.5 years; p <0.01) and had significantly more frequently a history of left heart failure (43.5% versus 13.2%; p <0.01) than patients with MRr. No significant difference was found between the two groups when considering preoperative NYHA functional class and left ventricular function. In-hospital mortality was significant higher in MVR than in MRr patients (6.4% versus 0%; p <0.01). QoL was significantly impaired in patients with MVR in physical function (PF), role function (RF) and general health (GH) compared with patients undergoing MRr. Nevertheless, only slight impairments in two of eight aspects in MVR, and in one of eight aspects in MRr, were found compared with an age- and sex-matched standard population. Mid-term survival was similar in both groups. CONCLUSION: Outcome after MVR was excellent, though these patients had a more advanced stage of the disease preoperatively than MRr patients. Mid-term outcome and QoL was, however, similar in the two groups.     

Light-polymerized materials for custom impression trays

Custom trays are indispensable for making impressions with elastomeric products. Previous studies have demonstrated that certain autopolymerized materials are particularly suitable, but had some limitations. The recently introduced halogen-light-polymerized resins permit fabrication of custom trays that have the needed physical properties for accuracy and strength. No storage period is necessary for completion of polymerization, and the trays are not subject to distortion in moisture, making them suitable for use in the electroforming of casts.