A Prosthesis Retention System for Full‐Arch,Fixed, Implant‐Supported Prosthesis

Full‐arch, fixed, implant‐supported prostheses can be designed to be cement‐ or screw‐retained. Both retention mechanisms have a few inherent disadvantages. A fixed attachment system has been introduced to circumvent the disadvantages of both screw and cement retention. This system eliminates the screw access holes and the use of cement. The number of intraoral procedures required is also reduced. The purpose of this article is to report a case using the Locator F‐Tx Attachment System to facilitate fabrication of an esthetic, clinician‐retrievable, full‐arch implant‐supported fixed dental prosthesis.     

The effect of respiratory motion on the echocardiogram.

The effects of respiratory movements on the ultrasonic echoes of the cardiac structures were recorded and analyzed in 50 consecutive patients. Deep inspiration in cooperative patients resulted in a considerable increase of dense anterior echoes, with blotting out of any distal or posterior echoes in 12 of 44 patients (group A). In the second or larger series (32 of 44 patients; group B), a posterior displacement of most of the identifiable intrinsic cardiac echoes was seen with deep inspiration, particularly those of the posterior wall of the left ventricle. Forced expiration produced an opposite or anterior displacement of the cardiac echoes. Normal respirations showed similar but smaller excursions.     

Clinical features and investigative findings in presence of mitral leaflet prolapse. Study of 85 consecutive patients.

In a 14-month period mitral leaflet prolapse was diagnosed in 85 patients by echocardiography or cineangiography. Chest pain alone was the presenting complaint in 30 patients and linked with palpitation, dyspnoea, or syncope in 9. Eleven presented with major neurological disturbances (9 had transient ischaemic attacks), 10 with palpitation, 4 with undue and persistent fatigue, 2 with dyspnoea, and 2 with dizziness. Seventeen were referred not because of symptoms but because of clicks and murmurs. Overall, chest pain affected 61 patients and unless associated with coronary artery disease was not anginal. Palpitation was admitted by 42 patients; dizziness, lightheadedness, or paraesthesiae by 15, and syncope by 12. Systolic auscultatory abnormalities were noted in 69: 25 had single clicks, 3 had multiple clicks, 19 had both click(s) and murmur, and 22 had a murmur alone. Electrocardiography revealed ST segments flat for greater than 0-10 s in 21, prolonged QTc in 18, and T wave flattening or inversion in inferior limb and lateral chest leads in 14. The exercise stress test was abnormal in 13 of 27 patients. Mitral valve echograms showed definite mitral leaflet prolapse in 61, 'possible' prolapse in 14, and were normal in 8 patients with angiographic proof of mitral leaflet prolapse. Cardiac catheterization with left ventriculography showed prolapse of posterior mitral leaflet in 36, of both leaflets in 2, and left ventricular wall motion abnormalities in 16 cases. Selective coronary arteriography in 31 cases showed major vessel narrowing of larger than or equal to 80 per cent lumen diameter in 4, all with angina. This consecutive series indicates that the physical event of mitral leaflet prolapse is more common than hitherto appreciated, is priminently associated with non-anginal chest pain, palpitation, and neurological disturbances, and in 90 per cent of cases could be shown echocardiographically.     

Concatenated and parallel optimization for the estimation of T1 map in FLASH MRI with multiple flip angles

Most traditional methods for T₁ map estimation in MRI with fast low‐angle‐shot sequences are aimed at high efficiency by compromising the fitting accuracy. In this paper, the fundamental problem of parameter estimation in fast low‐angle‐shot MRI was re‐examined, and an accurate and fast optimization approach, named concatenated optimization for parameter estimation, was proposed for the regression of data points acquired with multiple flip angles. The initial estimation of T₁ was obtained from the linear regression, followed by the constrained nonlinear regression based on the initial estimates. This heterogeneous initialization strategy improves the fitting accuracy and reduces the computational time. A computationally efficient implementation of concatenated optimization for parameter estimation was achieved based on the graphic processing unit, named as concatenated optimization for parameter estimation graphic processing unit. In experimental comparison with Fram's method and the Fitter Tool in Jim, the proposed methods are capable of achieving significantly higher efficiency and more accurate estimations. Magn Reson Med 63:1431–1436, 2010. © 2010 Wiley‐Liss, Inc.     

Compton profiles and electronic structure of HgBr2 and HgI2

In this paper, we present the first-ever experimental Compton line shapes of HgBr₂ and HgI₂ using ¹³⁷Cs Compton spectrometer. To compare our experimental momentum densities, we have computed the Compton profiles using Hartree–Fock and density functional theory within linear combination of atomic orbitals. We have also computed the energy bands and density of states using the linear combination of atomic orbitals and full potential linearized augmented plane wave method. On the basis of equal-valence-electron-density profiles, it is seen that HgI₂ is more covalent than HgBr₂ which is in agreement with the valence charge densities. The experimental isotropic profiles are found to be relatively in better agreement with the Hartree–Fock data. We have also discussed the photoluminescence and detection properties of both the halides.     

Management of Neglected Upper Cervical Spine Injuries

BackgroundInjuries involving upper cervical spine are serious and fatal injuries which are associated with alteration of normal occipital–cervical anatomy. These injuries may result in permanent neurologic deficits or neck deformity if not treated in a timely and appropriate manner.ObjectiveTo evaluate the outcomes of neglected upper cervical spine injuries treated by various methods.Study designRetrospective study.Materials and methodsTwelve patients attending ER or OPD with a history of neck trauma and who were diagnosed with fractures and fracture dislocations C1 and C2 were included in the study. Fresh injuries sustained within a week were excluded from study. The outcomes were measured in terms of improvement in VAS, ODI Scores and correction of the neck deformity. Surgical parameters like duration of surgery and blood loss were also observed.ResultsEleven males and one female. The mean age was 40.9 ± 16.9 (07–67 years). Eleven patients underwent posterior instrumentation, while one patient was treated anteriorly. The mean delay in presentation was 28 ± 8.67 days (15–42 days). The mean duration of surgery was 188.3 ± 34.35 min (120–240 min), average blood loss was 350 ± 111.8 ml (150–600 ml). The mean VAS improved from 8.45 ± 0.89 to 3.9 ± 0.51 (p < 0.05). The mean ODI Pre-operatively was 88.45 ± 5.89 which improved to 31.9 ± 4.01 (p < 0.05). The neck deformity/torticollis was corrected in all the patients.ConclusionsNeglected upper cervical spine injuries are difficult to treat and a posterior approach is helpful in reducing the subluxations indirectly and to obtain a posterior fusion.     

Detection of New Delhi Metallo‐beta‐Lactamase and Extended‐Spectrum beta‐Lactamase Genes in Escherichia coli Isolated from Mastitic Milk Samples

In this study, eight Escherichia coli isolates were obtained from milk samples of dairy cattle suffering from clinical/subclinical mastitis. Isolates were characterized for antimicrobial resistance traits and virulence genes. Results revealed that one isolate was harbouring New Delhi metallo‐beta‐lactamase gene (bla_NDM). Cloning and sequencing of the PCR amplicon confirmed the identity of the gene (GenBank accession no. KC769583 ) having 100% homology with bla_NDM‐5 (GenBank accession no. JN104597.1 ), and this isolate was susceptible to colistin, chloramphenicol and tetracycline only. Moreover, another isolate carried extended‐spectrum beta‐lactamase (ESBL) gene – bla_CTX‐M, and all isolates possessed bla_TEM gene. Of the eight isolates, only one isolate was positive for shiga toxin gene (stx2), and none were harbouring stx1 gene. Occurrence of New Delhi metallo‐beta‐lactamase (bla_NDM) in one E. coli isolate and ESBL genes in other isolates poses a potential threat to human health following possible entry and spread through food chain.     

Young Patients Undergoing Resection of Pancreatic Cancer Fare Better than their Older Counterparts

Background

The median age of pancreatic ductal adenocarcinoma (PDAC) patients is 71 years. PDAC rarely affects individuals under the age of 45. We investigated features of PDAC occurring in young patients (≤45 years) who underwent surgical resection in order to determine if any difference exists in comparison to elderly patients (≥70 years).

Methods

A retrospective analysis of patients with PDAC who were?≤?45 years on the date of surgery between 1975 and 2009 was performed. This cohort was compared with PDAC patients whose ages were over 70 years on the date of surgery over the same time interval. Information reviewed included demographics, Charlson Age–Comorbidity Index (CACI), pathological staging, surgical management, and death or last follow-up.

Results

Seventy five patients with PDAC of age?≤?45 years at surgery were identified. The reference group consisted of 870 patients with a median age of 75. The most common symptoms of young patients were jaundice (45 %), abdominal pain (32 %), or weight loss (33 %). This did not differ significantly from older patients. Among the younger patients, 7 (9 %) underwent total pancreatectomy, 60 (80 %) underwent pancreaticoduodenectomy, and 8 (11 %) had distal pancreatectomy. The distribution of type of surgery was similar between two groups. Fifty-two of the young patients (69 %) had an R0 resection and this did not differ from the older age group (n?=?616; 71 %). The rate of lymph node positivity was 68 % for younger patients and 74 % for older patients (p?=?0.27). Of the younger patients, 11, 13, 49, and 2 were classified as stage I, IIA, IIB, and III, respectively, and did not differ from the older age group. The median overall survival for the young patients cohort was 19 months (95 % CI 15–22 months) which is longer than 16 months (95 % CI 14–17 months) of the older group (p?=?0.007). The actual 5- and 10- year survival in young age group (24 and 17 %) was longer than that in old age group (11 and 3 %) (p?<?0.05). The median CACI of the younger patients was 0.5 and was lower than 4.1 of the older patients (p?<?0.0001).

Conclusions

The demographic, pathologic, and treatment characteristics of PDAC patients younger than 45 years were similar to those older than 70 years. Younger patients had fewer complications after curative resections. The better survival among younger patients is likely related to fewer comorbidities in this group. These findings will be useful in counseling young patients with resectable pancreatic cancer.