The association of cystic nephroma with pulmonary sequestration: is it a coincidence or not?

Cystic nephroma (CN) is a rare, presumably benign, multilocular cystic renal tumor. Pulmonary sequestration (PS) also presents as cystic masses of non-functioning primitive lung tissue. We describe a 15-month-old girl with CN and PS. Although some rare associations of renal and pulmonary lesions have been reported, this is the first case report in the English literature that shows the association of CN with PS.     

Treatment algorithm in synovial tuberculosis of the hand and wrist: a report of three cases

Three patients with synovial tuberculosis are presented. Involvement was in the hand in one patient, and in the wrist in two patients. None of the patients had pulmonary tuberculosis or a family history of tuberculosis. Tuberculosis treatment was initiated only after histologic verification. The cultures remained negative. The patients received a 12-month course of multidrug chemotherapy for tuberculosis, resulting in symptomatic improvement and healing. There were no recurrences during a follow-up period of 16 to 26 months. Our clinical observations showed that tuberculosis tenosynovitis benefited well from antituberculosis chemotherapy.     

Giant unilateral abdominoscrotal hydrocele in an adult: Case report

Abdominoscrotal hydrocele (ASH) is an apparently highly uncommon clinical entity especially in childhood. While hydrocele is among the commonest inguinal anomaly in adult, its extreme form ASH is infrequently reported form. ASH consists of two large sacs, both abdominal and scrotal, connecting with the inguinal canal. Surgical correction is mandatory. We present a 34-year-old man with giant ASH. He was treated with excision of hydrocele sac through an inguinal approach.     

The effect of short- versus long-term administration of alpha tocopherol on the survival of random flaps in experimental diabetes mellitus

The effects of short- versus long-term alpha tocopherol administration on oxidative stress and survival of dorsal random flaps were studied in diabetic rats. Seven groups, with 20 rats in each, were constructed: (1) control, (2) noncontrolled diabetes, (3) noncontrolled diabetes+short-term alpha tocopherol, (4) noncontrolled diabetes+long-term alpha tocopherol, (5) insulin treatment, (6) insulin+short-term alpha tocopherol, and (7) insulin+long-term alpha tocopherol. After 3 months of diabetes, dorsal McFarlane flaps were raised. Flap viability and free-radical measurements with histopathological examination were investigated. Mean flap survival in Groups I to VII were 84.0+/-2.2%, 55.0+/-2.4%, 57.0+/-2.5%, 57.8+/-3.7%, 64.1+/-4.1%, 70.0+/-4.9%, and 77.0+/-6.6%, respectively. Free-radical concentration, as assessed with luminol- and lucigenin-enhanced chemiluminiscence, was inversely correlated with flap survival. The results for viability and free-radical concentrations were significant between Groups 1, 2, 5, 6, and 7. Random flaps in diabetic animals showed significantly greater necrosis compared with controls. Among the diabetic animals, group receiving combination of insulin and long-term alpha tocopherol treatment had the greatest flap viability and least tissue free-radical concentration. Histopathological studies showed a hyalinization of arterioles in diabetics with long-term alpha tocopherol treatment protecting the vessel wall. In conclusion, random flaps in experimental diabetes mellitus show greater tissue oxidative stress and necrosis, which is only partially corrected with insulin treatment. Long-term antioxidant supplementation as an adjunct to insulin further lowers the oxidative stress, protects vessel structure and function, and therefore increases flap survival.     

Low-level laser therapy of dentin hypersensitivity: a short-term clinical trial

The aim of this study was to evaluate low-level laser therapy in cervical dentin hypersensitivity. A randomized controlled clinical trial was conducted with a total of 64 teeth. Dentin desensitizer and diode laser were applied on the cervical dentin surfaces. Distilled water and placebo laser was used as the placebo groups. The irradiance used was 4?J/cm² per treatment site. The baseline measurement of hypersensitivity was made by using visual analog scale (VAS). Twenty-four hours and 7?days after the application of desensitizer, diode laser and placebo groups, a new VAS analysis was conducted for the patients?? sensitivity level. The mean pain scores of placebo groups were significantly higher than the desensitizer??s and diode laser??s mean scores (ANOVA, p?<?0.05). The VAS analysis revealed a significant decrease in dentin hypersensitivity in 7?days with the use of the desensitizer and low-level laser therapy and no statistically significant difference was observed between these two treatments (p?>?0.05). Although low-level laser and glutaraldehyde containing desensitizer present distinct modes of action, experimental agents caused a significant reduction of dentin hypersensitivity without showing secondary effects, not irritating the pulp or causing pain, not discoloring or staining the teeth, and not irritating the soft tissues at least for a period of 1?week with no drawbacks regarding handling and/or ease of application. Low-level laser therapy and desensitizer application had displayed similar effectiveness in reducing moderate dentin hypersensitivity.     

Acute abdomen caused by brucellar hepatic abscess

Brucellosis is a zoonotic infection that is transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or aerosol inhalation. The disease is endemic in many countries, including the Mediterranean basin, the Middle East, India, Mexico, Central and South America and, central and southwest Asia. Human brucellosis is a systemic infection with a wide clinical spectrum. Although hepatic involvement is very common during the course of chronic brucellosis, hepatic abscess is a very rare complication of Brucella infection. We present a case of hepatic abscess caused by Brucella, which resembled the clinical presentation of surgical acute abdomen.     

Effects of intra-abdominal pressure on liver function assessed with the LiMON in critically ill patients

Background

Intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) are associated with significant morbidity and mortality in critically ill patients. Our aim was to assess the effects of IAH on liver function using the noninvasive liver function monitoring system LiMON and to assess the prognostic value of IAP in critically ill patients.

Methods

We conducted a retrospective analysis of critically ill patients who were treated in the intensive care unit (ICU). The IAP and indocyanine green plasma disappearance rate (ICG-PDR) measurements were made within 24 hours after admission to the ICU and repeated 12 hours later. Intra-abdominal pressure was measured via a Foley bladder catheter, and ICG elimination tests were conducted concurrently using the LiMON.

Results

We included 30 critically ill patients (17 women and 13 men aged 28–89 yr) in our analysis. Statistical analysis showed that the baseline IAP values were significantly higher among nonsurvivors than survivors (19.38 [standard deviation; SD 2.08] v. 13.07 [SD 0.99]). The twelfth-hour IAP values were higher than baseline measurements among nonsurvivors (21.50 [SD 1.96]) and lower than baseline measurements among survivors (11.71 [SD 1.54]); the difference between groups was significant (p < 0.001). The baseline ICG-PDR values were significantly lower among nonsurvivors than survivors (10.86 [SD 3.35] v. 24.51 [SD 6.78]), and the twelfth-hour ICG-PDR values were decreased in all groups; the difference between groups was significant (p < 0.001).

Conclusion

Our results suggest that measurement of ICG-PDR with the LiMON is a good predictor of the effects of IAP on liver function and, thus, can be recommended for the evaluation of critically ill patients.     

Evaluation of a metal artifact reduction algorithm and an adaptive image noise optimization filter in the estimation of peri-implant fenestration defects using cone beam computed tomography: an in-vitro study

Objective

The aim of this study is to assess the effects of metal artifact reduction (MAR) and adaptive image noise enhancer (AINO) in CBCT imaging on the detection accuracy of artificially created fenestration defects in proximity to titanium and zirconium implants in sheep jaw.

Methods

Six zirconium and 10 titanium implants were planted on mandibular jaws of three sheep, and artificial defects were created. All images were obtained with a standard voxel size (0.150 mm³) and with 4 scan modes: (1) without MAR/without AINO; (2) with MAR/without AINO; (3) without MAR/with AINO; and (4) with MAR/with AINO during CBCT scanning. A total of 60 CBCT scans were produced.

Results

For all types of implants, intra- and inter-observer kappa values were the highest for MAR filter. The scan mode of with MAR filter was found to have the highest area under the curve (AUC), whereas the scan mode of without both MAR and AINO filters was found to have the lowest AUC values with statistical significance (p?≤?0.05). Titanium implants were found to have higher AUC values than zirconium (p?≤?0.05).

Conclusion

Both MAR module and AINO filters enhance the accuracy of the detection of peri-implant fenestrations; however, the use of MAR filter solely can be recommended for detection of peri-implant fenestrations.