Pulp and periodontal healing of laterally luxated permanent teeth: results after 4 years

Abstract – Aim: To evaluate the pulp and periodontal healing of laterally luxated permanent teeth. Material and methods: Patients presenting with lateral luxation of permanent teeth during 2001–2002 were enrolled in this clinical study. Laterally luxated teeth were repositioned and splinted with a TTS/composite resin splint for 4 weeks. Immediate (prophylactic) root‐canal treatment was performed in severely luxated teeth with radiographically closed apices. All patients received tetracycline for 10 days. Re‐examinations were performed after 1, 2, 3, 6, 12 and 48 months. Results: All 47 laterally luxated permanent teeth that could be followed over the entire study period survived. In 10 teeth (21.3%), a prophylactic root‐canal treatment was performed within 2 weeks following injury. The remaining 37 teeth showed the following characteristics at the 4‐year re‐examination: 19 teeth (51.4%) had pulp survival (no clinical or radiographic signs or symptoms), nine teeth (24.3%) presented with pulp canal calcification, and pulp necrosis was seen in another nine teeth (24.3%), within the first year after trauma. None of the teeth with a radiographically open apex at the time of lateral luxation showed complications. External root resorption was only seen in one tooth. Conclusions: Laterally luxated permanent teeth with incomplete root formation have a good prognosis, with all teeth surviving in this study. The most frequent complication was pulp necrosis that was only seen in teeth with closed apices.     

Osteochondral Fracture of the Fourth Metatarsal Head Treated by Open Reduction and Internal Fixation

Fracture of the metatarsal head is uncommon, and reports of isolated osteochondral fracture of the metatarsal head are rare. Because of the distal location of the fracture, it is difficult to achieve and maintain reduction, and potential complications include avascular necrosis and subchondral fatigue fracture. The authors present a case of an osteochondral fracture in a 40-year-old man, which was treated by open reduction and internal fixation with a single twist-off screw, with good results 12 months postoperatively.     

FR-Ⅲ型矫治器治疗上颌骨发育不足型Ⅲ类错的临床分析

目的　探讨替牙中期FR Ⅲ型矫治器矫治上颌骨发育不足型Ⅲ类错牙合患者骨骼、牙齿参数变化。方法　选择15例安氏Ⅲ类错牙合患者 ,在替牙中期使用FR Ⅲ型矫治器 ,治疗前、结束后均拍摄头颅侧位片 ,并对其进行测量分析。结果　通过上切牙唇倾、下切牙舌倾、下颌向后向下旋转 ,前牙可建立正常覆盖覆牙合关系。结论　替牙中晚期 ,FR Ⅲ型矫治器是治疗上颌骨发育不足型Ⅲ类错牙合的一种有效方法。     

4例SRY阳性的46,XX男性综合征患者临床及细胞分子遗传学研究

目的:探讨SRY阳性的46,XX男性综合征患者的临床及细胞分子遗传学特征。方法:分析4例SRY阳性的46,XX男性综合征患者的临床特点,并进行染色体核型分析、荧光原位杂交(FISH)、SRY基因检测、Y染色体微缺失等细胞和分子遗传学检测。结果:4例患者社会性别均为男性,身材低于正常男性均值。均因不育就诊,双侧睾丸体积小、质地软,精液检查均为无精子症。阴茎发育正常。性激素检查示高促性腺激素性性腺功能不全。染色体核型均为46,XX,Y染色体微缺失检测示AZFa,b,c区域均缺失。SRY基因均存在,FISH结果3例患者显示SRY基因易位于X染色体短臂。结论:SRY阳性的46,XX男性综合征患者常为男性表型,但睾丸发育不良,多伴有身材矮小和不育。患者的男性表型是由于基因组中存在SRY基因。无精子表型是由于缺失AZF。Y染色体长臂上可能存在与身高相关的基因。深入进行细胞、分子遗传学研究有助于揭示46,XX男性综合征基因型-表型的关系。     

Use of a Parathyroid Hormone Peptide (PTH1−34)‐enriched Fibrin Hydrogel for the Treatment of a Subchondral Cystic Lesion in the Proximal Interphalangeal Joint of a Warmblood Filly

To describe the treatment of a subchondral bone cyst in the proximal phalanx with parathyroid hormone peptide‐enriched fibrin hydrogel in a warmblood filly. The cyst was localized with computer‐assisted orthopaedic surgery, then curetted and finally filled with parathyroid hormone fragment peptide 1–34 (PTH₁₋₃₄) covalently attached to a fibrin hydrogel. The cyst healed quickly without any complications. This result supports the hypothesis that PTH₁₋₃₄ delivered locally in a fibrin hydrogel may improve the postoperative prognosis of surgical management of subchondral bone cysts in horses. Subchondral bone cysts are fairly common in horses. Especially in older horses, the prognosis is poor, even after surgical curettage. Therefore, different management protocols have been investigated in conjunction with surgical curettage to improve prognosis. Locally delivered PTH₁₋₃₄ seems to be a new method in the treatment of subchondral bone cysts.     

Autonomy and modernisation: the management of change in an English primary care trust

Recent New Labour policy for the ‘modernisation’ of Government places a good deal of emphasis on decentralisation. This emphasis is particularly marked in relation to the organisation of primary care. However, like hospitals and other National Health Service institutions, primary care trusts (PCTs) are subject to a substantial raft of centrally established performance targets and indicators, including those which contribute to the public award of between zero and three performance ‘stars’. This raises questions about the extent to which employees can exercise autonomy in the context of rigid top‐down directives. This paper presents findings from a study using participant observation and interviews to examine the impact of a training course aimed ostensibly at increasing employee autonomy in an English PCT. The suggestion is that attempts to make employees more autonomous can be seen as a strategy for increasing central control based upon the internalisation by the employees of centrally promulgated values. The attraction of such strategies is that they may be potentially more effective and less costly than alternative strategies of direct control. However, the study suggests that the outcome of attempts by such methods as programmes to increase employee autonomy may be very different from those intended.     

A Complication of Stellate Ganglion Block?

Abstract: Stellate ganglion block is commonly used to treat the sympathetically maintained pain which may occur in one‐third of patients with complex regional pain syndrome type 1. A complication that followed a single block and presented a diagnostic dilemma for the ophthalmologist is reported.     

Role of cell-cell contact in the preservation of differentiation and response to thyrotrophin in cultured porcine thyroid cells

Cultured porcine thyroid cells did not reassociate into functional follicles in the presence of TSH unless the initial seeding density was adequate. At 0.2 X 10(6) cells/35 mm diameter culture dish the cells rapidly formed a monolayer even in the presence of TSH (128 microunits./ml), and radioiodide uptake was not significantly increased compared with that in control cells. Seeding densities of 1-3 X 10(6) cells/dish resulted in cultures which responded to TSH with follicular development and increased radioiodide uptake. A cell-free membrane fraction of thyroid homogenate restored the ability of cultures seeded at low densities to respond to TSH with development of follicular morphology and increased radioiodide uptake. Delaying the addition of TSH by 48 h markedly reduced the stimulation of follicular development and radioiodide uptake of cultures. Addition of membrane fractions, or an alkali-soluble fraction of membranes, at zero time improved the responses to TSH added after a 48-h delay. It was concluded that maintenance of differentiation and of TSH-responsiveness in cultured thyroid cells was influenced by cell-cell contact.