Electrocardiographic criteria of left ventricular hypertrophy in the presence of left bundle branch block

When left bundle branch block (LBBB) is present on the electrocardiogram, the diagnosis of left ventricular hypertrophy (LVH) may be difficult. The left ventricular mass in 70 patients with LBBB was estimated by echocardiography, and was compared to the QRS configuration on the electrocardiogram. We found that there was agreement between a monophasic R pattern in lead 1 or V6 (sensitivity 79.3%, 70.7%) and left ventricular hypertrophy. We suggest that a monophasic R pattern in L1 and V6 may provide a useful simple index of left ventricular hypertrophy in the presence of left bundle branch block.     

Profiles of faecal output of rare earth elements and stable isotopic tracers of iron and zinc after oral administration

The objectives of this study were to confirm the non-absorbability and the reproducibility of faecal excretion kinetics of orally administered rare earth elements, and to investigate the excretion profiles of rare earth elements and stable isotopic tracers of Fe and Zn to establish the extent to which rare earth element markers duplicate the behaviour of isotopic tracers. Two investigations were performed: (1) six healthy subjects consumed a solution containing five rare earth elements in amounts varying from 1 to 10 mg; (2) seven healthy subjects were given a standard solution labelled with Sm marker and (57)Fe tracer, and a meal labelled with Yb marker and (58)Fe and (70)Zn tracers. Individual faecal samples were collected and analysed to determine recoveries of rare earth elements and unabsorbed isotopic tracers. The mean values for recoveries were 94.1 (sd 4.5) % for the five rare earth elements, and 103 (sd 3.0) % and 99.8 (sd 2.8) % for Sm and Yb respectively. For Fe consumed with the solution, excretion kinetics of the rare earth element marker and unabsorbed tracers with cumulative collections of the first two and three faecal samples were identical, but endogenous excretion of Fe was significant in stools collected after the third. For Fe and Zn consumed with the meal, the excretion kinetics for the first two individual faecal samples and composites of sequential outputs were identical. Rare earth elements can be used as markers in studies of measurement of absorption. The dose of tracer required for the measurement of absorption would be reduced proportionally to the reduction of the period of faecal sampling, so that studies with stable isotopes would be more economical, thus enabling epidemiological investigations.     

Fibrodysplasia ossificans progressiva without characteristic skeletal anomalies

Fibrodysplasia ossificans progressiva (FOP) is a rare but extremely disabling genetic disease of the skeletal system. This disease is characterized by progression of heterotopic ossification within skeletal muscles, ligaments and tendons. Most patients with FOP are misdiagnosed early in life before the appearance of heterotopic ossification and undergo diagnostic procedures such as biopsy that can cause lifelong disability. Almost all of the patients have some peculiar congenital anomalies, including short great toes, hallux valgus, short thumbs and hypoplasia of digital phalanges. These congenital defects support the diagnosis of FOP, but are not constantly observed in the totality of patients. If necessary, genetic studies can be performed to confirm the diagnosis. Once diagnosed, patients should be advised in order to avoid unnecessary traumas, surgical procedures, biopsies, intramuscular injections and vaccinations. Here, we describe a patient with FOP without characteristic congenital skeletal anomalies.     

The Factors Contributing to Death Anxiety in Cancer Patients

Suffering comes in many ways for patients confronting cancer. One of these is an unspecifiable fear about death, which is an existential issue. The aim of this study was to investigate the relationship between death anxiety and its correlates in cancer patients. Seventy cancer patients were assessed using SCID-I, Templer's Death Anxiety Scale, the Hospital Anxiety (A) and Depression (D) Scale, the Distress Thermometer, the Visual Analogue Scale for pain (VAS), the Global Assessment of Functioning, and Glock and Stark's Dimensions of Religious Commitment scales, and these assessments were compared between cancer patients with and without death anxiety. Multiple regression analysis was conducted after correlation analysis between death anxiety and sociodemographic and clinical variables. Axis I psychiatric diagnosis, pain scores, and negative believes about what will happen after death were found to be higher in patients having death anxiety than patients not having death anxiety. Also life expectancy was perceived as shortened in patients with death anxiety. Death anxiety was associated with anxiety, depressive symptoms, and beliefs about what will happen after death. In conclusion, death anxiety could not be regarded as a natural consequence of having cancer; it is associated with the unresolved psychological and physical distress.     

Effects of glutamine on wound healing

Studies reporting the need for replacing amino acids such as glutamine (Gln), hydroxymethyl butyrate (HMB) and arginine (Arg) to accelerate wound healing are available in the literature. The primary objective of this study was to present the effects of Gln on tissue hydroxyproline (OHP) levels in wound healing. This study was conducted on 30 female Sprague Dawley rats with a mean weight of 230 ± 20 g. Secondary wounds were formed by excising 2 × 1 cm skin subcutaneous tissue on the back of the rats. The rats were divided into three equal groups. Group C (Control): the group received 1 ml/day isotonic solution by gastric gavage after secondary wound was formed. Group A (Abound): the group received 0·3 g/kg/day/ml Gln, 0·052 g/kg/day/ml HMB and 0·3 g/kg/day/ml Arg by gastric gavage after secondary wound was formed. Group R (Resource): the group received 0·3 g/kg/day/ml Gln by gastric gavage after secondary wound was formed. The OHP levels of the tissues obtained from the upper half region on the 8th day and the lower half region on the 21st day from the same rats in the groups were examined. Statistical analysis was performed using the statistics program SPSS version 17.0. No statistically significant differences were reported with regard to the OHP measurements on the 8th and 21st days (8th day: F = 0·068, P = 0·935 > 0·05; 21st day: F = 0·018, P = 0·983 > 0·05). The increase in mean OHP levels on the 8th and 21st days within each group was found to be statistically significant (F = 1146·34, P = 0·000 < 0·001). We conclude that in adults who eat healthy food, who do not have any factor that can affect wound healing negatively and who do not have large tissue loss at critical level, Gln, Arg and HMB support would not be required to accelerate secondary wound healing.     

Effect of premolar extraction on mandibular third molar impaction in young adults

Objective:To test the null hypothesis that orthodontic therapy with or without premolar extraction does not result in any difference in third molar impaction.Materials and Methods:Two groups were formed: 22 patients in one group with first premolar extractions and 22 patients in the other group without extractions. All patients were nongrowing subjects who had normal gonial angles and were skeletal Class I at the beginning of treatment. The available space for third molars, inclination of second and third molars, and angle between the second and third molars were evaluated. Also, the correlation of measured parameters and type of orthodontic therapy with the eruption of third molars was evaluated.Results:Of the third molars, 81.8% were impacted in the nonextraction group and 63.6% were impacted in the extraction group. Impaction of mandibular third molars was significantly correlated to the pretreatment and posttreatment inclination of third molars and the angle between the second and third molars. In the extraction therapy group, the retromolar distance increased significantly with a mean of 1.30 ± 1.25 mm.Conclusions:When the inclination of the third molar is inconvenient, the tooth may remain impacted even if there is enough retromolar space.     

Effects of different irrigation solutions on root dentine microhardness,smear layer removal and erosion

This study aimed to compare the effects of different irrigants on root dentine microhardness, erosion and smear layer removal. A total of 72 root dentine slices were divided into six groups, according to the final irrigants used: Group 1: 17% ethylenediamine tetra‐acetic acid (EDTA) + 2.5% NaOCl, Group 2: 7% maleic acid (MA) + 2.5% sodium hypochloride (NaOCl), Group 3: 1.3% NaOCl + mixture of tetracycline, acid and detergent (MTAD), Group 4: Smear Clear + 2.5% NaOCl, Group 5: 5% NaOCl, Group 6: saline. Vickers microhardness values were measured before and after treatment. In total, 42 root‐halves were prepared for scanning electron microscope to evaluate the amount of smear and erosion in the coronal, middle and apical thirds. Data were analysed using two‐way anova , Duncan and two‐proportion z‐tests. Maleic acid showed the greatest reduction in dentine microhardness (P < 0.05), followed by EDTA and MTAD. EDTA, maleic acid, MTAD and Smear Clear removed smear layer efficiently in the coronal and middle thirds of root canal. However, in the apical region, maleic acid showed more efficient removal of the smear layer than the other irrigants (P < 0.05).