The single-tooth implant: a viable alternative for single-tooth replacement

BACKGROUND: The use of dental implants for single-tooth replacement cases introduces a challenge to the performance of these restorations. Clinical data suggest that single-tooth implant restorations do not benefit from lateral support from the surrounding dentition as do bridged implants, and that these restorations are subjected to greater masticatory forces. Therefore, single-tooth implants are exposed to an increased risk of failure. This prospective clinical trial was designed to evaluate the cumulative success rate of dual acid-etched single-tooth replacement implants in two clinical centers. METHODS: The study protocol included 59 patients between 19 and 73 years. Implants were evaluated for mobility, infection, and crestal bone loss from 30.9 to 60 months. RESULTS: Seventy-one (71) implants were placed in 59 patients, 20 male and 39 female. Forty-seven (47) were placed in the maxilla and 24 in the mandible. The percentages of anterior and posterior implants were 45.1% and 54.9%, respectively. A total of 13 (18.4%) implants were placed in soft, poor quality (Type IV) bone. Beginning 1 month post-implant placement, cases were followed for 30.9 to 60 months with a mean follow-up of 45.9 months. One implant failed (peri-implant infection) yielding an overall success rate of 98.6%. CONCLUSIONS: This success rate for single-tooth replacement dual acid-etched implants compares favorably with bridged implants and with success rates of other single-tooth implant studies. Dual acid-etched implants performed well even under conditions of poor quality bone, where concomitant bone augmentation was performed, and when used for immediate replacement of extracted teeth.     

High-resolution whole organ imaging using two-photon tissue cytometry

Three-dimensional (3-D) tissue imaging offers substantial benefits to a wide range of biomedical investigations from cardiovascular biology, diabetes, Alzheimer's disease to cancer. Two-photon tissue cytometry is a novel technique based on high-speed multiphoton microscopy coupled with automated histological sectioning, which can quantify tissue morphology and physiology throughout entire organs with subcellular resolution. Furthermore, two-photon tissue cytometry offers all the benefits of fluorescence-based approaches including high specificity and sensitivity and appropriateness for molecular imaging of gene and protein expression. We use two-photon tissue cytometry to image an entire mouse heart at subcellular resolution to quantify the 3-D morphology of cardiac microvasculature and myocyte morphology spanning almost five orders of magnitude in length scales.     

The effects of hypertension and body mass index on diffusion tensor imaging in schizophrenia

Recently, the negative effects of hypertension and elevated body mass index on cognitive functioning in schizophrenia have been reported (Friedman et al., 2010). Data suggests that cognitive changes in hypertensive patients from the general population may be mediated, in part, by white matter damage. Therefore, we performed diffusion tensor imaging (DTI) in the same subjects studied by Friedman et al. (2010) to investigate the effects of hypertension and elevated body mass index on the fractional anisotropy (FA) of several major white matter tracts. Significant interactions between a diagnosis of schizophrenia and hypertension on FA in several white matter regions were detected. Hypertension was associated with lower FA in the schizophrenic group and higher FA in the same tracts in the non-schizophrenic subjects. These results suggest hypertension-induced compensatory mechanisms in the brains of non-schizophrenic patients with hypertension which may be impaired in persons with schizophrenia.     

Recalcitrant trigger finger managed with flexor digitorum superficialis resection

Although trigger finger is a condition commonly treated by orthopedic surgeons, we have not found sufficient studies in the literature addressing the treatment of trigger finger that persists following A1 pulley release. We identified 12 fingers in 11 patients with symptoms of trigger finger following A1 pulley release who subsequently underwent resection of 1 or both slips of the flexor digitorum superficialis tendon. Ten patients (11 fingers) presented for follow-up at a mean of 21 months after surgery. All patients had resolution of their symptoms with a mean visual analog score of 1.5 and a mean DASH score of 17. Grip and pinch strength were comparable to the contralateral side. Mean total active range of motion of the affected digit was 252°. Resection of 1 or both slips of the flexor digitorum superficialis is an effective method for treatment of recalcitrant trigger finger.     

Complications with the use of Artelon in thumb CMC joint arthritis

Background  

Complications with the use of the Artelon spacer in thumb carpometacarpal (CMC) joint arthritis include inflammation, osteolysis, and persistent pain. We evaluated our short-term results and complications.     

A randomized phase II study of PX-12, an inhibitor of thioredoxin in patients with advanced cancer of the pancreas following progression after a gemcitabine-containing combination

Purpose

This study evaluated PX-12, a novel small molecule inhibitor of the proto-oncogene (Trx-1), in patients with previously treated advanced pancreatic cancer (APC).

Methods

PX-12 (54 or 128?mg/m²) was administered by 3-hour IV infusion daily ×5?days every 21?days (n?=?17). Patients were randomized to either 54 or 128?mg/m² and then stratified based on CA 19-9 level (??1,000 vs. <1,000?U/ml) and SUV values on PET scans (??7.0 vs. <7.0). The primary endpoint was based on a progression-free survival (PFS) at 4?months in ??40% of patients, and required 40 patients in each arm. An amendment required elevated Trx-1 levels (>18?ng/ml) as an entry criteria after the first 17 patients were accrued.

Results

Plasma Trx-1 levels were elevated in 3/28 (11%) patients screened for study. The grade of the expired metabolite odor was higher in the 128?mg/m² arm. Therapy was well tolerated, and Grade ??3 adverse events were uncommon. The best response was stable disease in 2 patients. There was no consistent decrease in SUV, Trx-1 levels or CA 19-9 levels with therapy. No patients had a PFS of >4?months. Median PFS and survival were 0.9?months (95% CI 0.5?C1.2) and 3.2?months (95% CI 2.4?C4.2), respectively.

Conclusions

Due to the lack of significant antitumor activity and unexpectedly low baseline Trx-1 levels, the study was terminated early. PX-12 does not appear to be active in unselected patients with previously treated APC.     

Pulmonary Hypertension in Children and Adolescents with Sickle Cell Disease

The prevalence of pulmonary hypertension (PHTN) in the pediatric sickle cell disease (SCD) population is not known despite its high prevalence in adult patients. Our hypothesis was that increased pulmonary artery pressures (PAPs) would be found in SCD children and adolescents, especially those with a history of pulmonary complications: acute chest syndrome, obstructive sleep apnea, asthma, and reactive airway disease. Fifty-two SCD children, 23 of whom had underlying pulmonary disease, were screened for PHTN, which was defined as a tricuspid regurgitant jet velocity (TRV) of at least 2.5 m/s. Twenty-four (46.15%) SCD patients had increased PAP (i.e., TRV ≥2.5 m/s), and 6 (11.5%) had significant PHTN (i.e., TRV ≥3.0 m/s). Pulmonary disease was marginally associated with PHTN (odds ratio 2.80 and confidence interval 0.88 to 8.86; p = 0.0795). As in adult SCD patients with PHTN, this complication was correlated with the degree of hemolysis as manifested by significantly higher lactate dehydrogenase and bilirubin, lower hemoglobin and hematocrit levels, and a strong association with Hb-SS phenotype. However, after statistical adjustment for age and sex, increased serum LDH was not associated with the development of PHTN. Further studies are needed to clarify the prevalence and mechanisms of PHTN in pediatric and adolescent patients with SCD.