A bite by the Twin-Barred Tree Snake,Chrysopelea pelias (Linnaeus, 1758)

Introduction.?The Twin-Barred Tree Snake, Chrysopelea pelias, is a colubrine that, like other members of the genus Chrysopelea, is able to glide in the arboreal strata. Little is known about the effects of its bite. This report is the first clinically documented bite by this relatively uncommon rear-fanged species.?Case report.?The patient was a 19-year-old female who arrived at the Emergency Department (ED) of an urban teaching hospital 6 h after being bitten by a snake that was later provisionally identified as a C. pelias. Noted on presentation were bite marks on the right middle toe with minimal inflammation and tenderness. There was slight numbness over the dorsum of the right foot and discomforting sensation radiating up the thigh that persisted for several days. There was mild pyrexia, but no evidence of any systemic effects. The full blood count did show neutrophil leucocytosis, and transient hemoglobinuria was noted in an initial urine analysis. Discussion?.?The properties of Duvernoy's secretion of C. pelias remain uncharacterized. In this case, the clinical course featured only the local effects noted above. However, the significant local pain reported by the patient suggests that bites by C. pelias are not necessarily trivial and do require full evaluation and observation in a medical facility. Discussed also is the importance of the establishment of a national registry for animal bites and stings in Malaysia.?Conclusion.?Such a facility could expedite safe and appropriate management of envenomed patients.     

循环毒毒蛇咬伤患者外周血Th1/Th2细胞因子的表达及意义

目的分析外周血Th1/Th2细胞因子在循环毒毒蛇咬患者中的表达,探讨其在病情评估中的意义。方法收集2016年3月至2017年10月循环毒毒蛇咬伤患者108例,根据国际蛇伤诊断标准分为轻度蛇咬伤组82例与重度蛇咬伤组26例,另外选择同期体检健康者30例为对照组。通过流式细胞术检测并比较分析各组患者T淋巴细胞亚群的分布情况及外周血Th1/Th2细胞因子的表达。结果与对照组比较,重度蛇咬伤组CD3^+、CD4^+T淋巴细胞水平偏低(P<0.01);细胞因子IL-4、IL-6、IL-10、TNF-α表达水平升高(P<0.05)。蛇咬伤组两两比较,重度蛇咬伤组CD3^+、CD4^+T淋巴细胞水平低于轻度蛇咬伤组(P<0.05),IL-4、IL-6、TNF-α表达水平均高于轻度蛇咬伤组(P<0.05)。结论循环毒毒蛇咬伤患者中存在有明显的T淋巴细胞数量的改变和Th1/Th2细胞因子表达紊乱,且与病情严重程度相关。     

Snake bite induced cellulitis leading to infected open dislocation of the first metacarpophalangeal joint – A rare complication

Non-traumatic open dislocation of the first metacarpophalangeal joint is a rare phenomenon. We present a rare such occurrence secondary to snake bite induced cellulitis. A 22-year-old girl presented with pain and instability of her right thumb two months. She had snake bite two months back following which she developed cellulitis which gradually became infected. She presented with raw area over her dorsal aspect of the thumb with active infection. Radiographs revealed metacarpophalangeal joint dislocation. She underwent debridement, stabilisation and soft tissue coverage. At final follow up, she was pain free and the wound healed completely.     

Temporomandibular disorders with skeletal open bite treated with stabilization splint and zygomatic miniplate anchorage: A case report

This case report describes the treatment of a patient with temporomandibular disorder (TMD) and skeletal open bite. First, the patient was treated with a stabilization splint to stabilize the condyles in centric relation and to alleviate TMD signs and symptoms. After making a definitive diagnosis from postsplint records, orthodontic treatment was initiated. Titanium miniplates were placed at bilateral zygomatic buttresses and used as orthodontic anchorage for molar intrusion and distalization. The treatment was completed after 30 months. Satisfactory appearance and function were achieved for this patient.     

Balance and Strength—Estimating the Maximum Prey‐Lifting Potential of the Large Predatory Dinosaur Carcharodontosaurus saharicus

Motivated by the work of palaeo‐art “Double Death (2011),” a biomechanical analysis using three‐dimensional digital models was conducted to assess the potential of a pair of the large, Late Cretaceous theropod dinosaur Carcharodontosaurus saharicus to successfully lift a medium‐sized sauropod and not lose balance. Limaysaurus tessonei from the Late Cretaceous of South America was chosen as the sauropod as it is more completely known, but closely related to the rebbachisaurid sauropods found in the same deposits with C. saharicus. The body models incorporate the details of the low‐density regions associated with lungs, systems of air sacs, and pneumatized axial skeletal regions. These details, along with the surface meshes of the models, were used to estimate the body masses and centers of mass of the two animals. It was found that a 6 t C. saharicus could successfully lift a mass of 2.5 t and not lose balance as the combined center of mass of the body and the load in the jaws would still be over the feet. However, the neck muscles were found to only be capable of producing enough force to hold up the head with an added mass of 424 kg held at the midpoint of the maxillary tooth row. The jaw adductor muscles were more powerful, and could have held a load of 512 kg. The more limiting neck constraint leads to the conclusion that two, adult C. saharicus could successfully lift a L. tessonei with a maximum body mass of 850 kg and a body length of 8.3 m. Anat Rec, 298:1367–1375, 2015. © 2015 Wiley Periodicals, Inc.     

Nonsurgical orthodontic treatment of a hypodivergent adult patient with bilateral posterior scissors bite and excessive overjet

This report illustrates successful nonsurgical orthodontic treatment of a hypodivergent adult patient with bilateral posterior scissors bite (Brodie bite) and excessive overjet. A 26-year-old woman primarily reported maxillary incisor protrusion. She was diagnosed with Class ll division 1 malocclusion with skeletal Class I, short face, low mandibular plane angle and bilateral posterior scissors bite. A lingual arch with anterior bite block and posterior miniscrews with preadjusted edgewise appliances were used to improve the bilateral scissors bite. After achieving molar occlusion, the maxillary first premolars were extracted, and six miniscrews were used to improve the anterior-posterior and vertical discrepancies. After active treatment for 56 months, the convex facial profile with excessively protruded lips was improved and good interdigitation with ideal incisor relationship was achieved. Additionally, the irregular movements of the incisal path and the bilateral condyles during lateral excursion were improved. At 13 months of retention, a satisfactory facial profile, occlusion, and jaw movements were maintained. The treatment results suggest that miniscrews and fixed bite blocks were effective and efficient to facilitate correction of the bilateral scissors bite, excessive overjet, and vertical relationship correction in this nonsurgical orthodontic treatment.     

Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars

This report illustrates the successful nonsurgical and nonprosthetic camouflage treatment of a skeletal Class II open bite malocclusion combined with missing mandibular first molars bilaterally. In the mandible, the second and third molars were uprighted and protracted, substituting for the missing first molars. In the maxilla, anterior bodily retraction and full-arch intrusion were achieved following premolar and second molar extraction, which also induced autorotation of the mandible. The treatment outcome and prognosis were confirmed with three-dimensional superimposition techniques, along with long-term stability.     

Masticatory function and bite force of mandibular single-implant overdentures and complete dentures: a randomized crossover control study

PurposeThe study aimed to compare the mixing ability (MA), comminuting ability (CA), and maximum bite force (MBF) of single-implant overdentures (IODs) and clinically acceptable complete dentures (CDs) through a randomized crossover control trial.MethodsNew CDs were fabricated for 22 patients. One implant was inserted in the middle of the symphyseal region for each patient. The patients were randomly allocated into two groups: group IC received an IOD, whereas group CI received a CD, for 2 months; the treatments were interchanged for the next 2 months. The MA, CA, and MBF were evaluated with the old CDs, new CDs (at the end of CD treatment period), and IODs (at the end of IOD treatment period).ResultsThe MA, CA, and MBF of the IODs were significantly higher than those of the old and new CDs (p < 0.01). New CDs only showed a significant improvement in MA (p < 0.05), while there were no significant differences in CA and MBF between the old and new CDs.ConclusionsCompared with the CD, IOD is more effective in restoring the MA, CA, and MBF of edentulous mandibles.