The treatment of epulis fissuratum of the oral cavity by CO 2 laser surgery

A clinical study was conducted on a group of 20 patients who presented with epulis fissuratum caused by denture wearing. CO 2 laser surgery was used to treat these patients and the cases were followed up over a two-year period. The advantage of CO 2 laser surgery on oral tissues was evident by the good response to healing four weeks postoperatively and beyond. No sutures or packing of any kind were used and the wound was allowed to granulate. Re-epithelialization occurred in all patients within 14 days and was complete after about 4 weeks. The lack of wound contraction, scarring, and good re-epithelialization combined with precise tissue destruction make CO 2 laser surgery ideal for this procedure when compared with conventional surgical techniques. The advantage of using CO 2 laser surgery has been demonstrated clinically in the patients treated in this study.     

In vitro behavior of sintered powder injection molded Ti-6Al-4V/HA

This article reports the morphology and mechanical properties of sintered powder injection molded Ti-6Al-4V/HA parts in a simulated physiological environment. Sintered Ti-6Al-4V/HA parts were immersed in a simulated body fluid (SBF) with ion concentrations that were comparable to those of human blood plasma for a total period of 12 weeks. At intervals of 2 weeks, the immersed Ti-6Al-4V/HA parts were analyzed with the use of scanning electron microscopy (SEM), X-ray diffractometry (XRD), and inductively coupled plasma-atomic emission spectroscopy (ICP-AES). Mechanical properties such as flexural strength, flexural modulus, compressive strength, and compressive modulus were also evaluated. Results showed that complete dissolution of the more soluble phases such as tricalcium phosphate (TCP), tetracalcium phosphate (TTCP), and calcium oxide (CaO) were found after 2 weeks of immersion in SBF. ICP analysis showed that high calcium concentration release of around 200 ppm was observed in the SBF solution after 2-4 weeks of immersion, indicating that dissolution has taken place. Next, a gradual decrease in calcium concentration release in the SBF solution was observed after immersion for 4-6 weeks, with increasing amounts of calcium phosphate precipitates being observed on the Ti-6Al-4V/HA surface. Mechanical properties such as strength and modulus were found to deteriorate during 2-4 weeks of immersion, followed by gradual increment as the immersion period increased. This study also showed that parts sintered at 1150 C exhibited faster dissolution and precipitation rates than parts sintered at 1050 C in a physiological environment.     

A technique for respiratory-gated radiotherapy treatment verification with an EPID in cine mode

Respiratory gating based on external surrogates is performed in many clinics. We have developed a new technique for treatment verification using an electronic portal imaging device (EPID) in cine mode for gated 3D conformal therapy. Implanted radiopaque fiducial markers inside or near the target are required for this technique. The markers are contoured on the planning CT set, enabling us to create digitally reconstructed radiographs (DRRs) for each treatment beam. During the treatment, a sequence of EPID images can be acquired without disrupting the treatment. Implanted markers are visualized in the images and their positions in the beam's eye view are calculated off-line and compared to the reference position by matching the field apertures in corresponding EPID and DRR images. The precision of the patient set-up, the placement of the beam-gating window, as well as the residual tumour motion can be assessed for each treatment fraction. This technique has been demonstrated with a case study patient, who had three markers implanted in his liver. For this patient, the intra-fractional variation of all marker positions in the gating window had a 95% range of 4.8 mm in the SI direction (the primary axis of motion). This was about the same (5 mm) as the residual motion considered in the planning process. The inter-fractional variation of the daily mean positions of the markers, which indicates the uncertainty in the set-up procedure, was within +8.3 mm/-4.5 mm (95% range) in the SI direction for this case.     

Evidence for persistence of adenovirus in the tear film a decade following conjunctivitis

Chronic papillary conjunctivitis has been described following adenoviral conjunctivitis. It is unknown however, how long adenovirus is able to persist in the tear film and conjunctiva. To determine if adenovirus persists in the ocular surface following adenoviral conjunctivitis, 304 patients with a history of adenovirus conjunctivitis from whom an adenovirus had been isolated 10 years previously were sent a questionnaire regarding persistent or recurrent symptoms and were invited to attend. Patients were examined and samples of tears and conjunctival cells were collected from both eyes using tear film washes, filter paper, and swabs, the latter for virus isolation. Extracted DNA from the ocular samples was amplified using primers for herpes simplex virus (thymidine kinase) and adenovirus (hexon) genes. Adenovirus amplicons were sequenced and compared to original serotype. Thirty patients attended, 19 of whom had persistent papillary conjunctivitis. Evidence of adenovirus DNA was detected in 17 of 30 patients, 15 of whom also had evidence of a chronic papillary conjunctivitis. Adenovirus DNA was significantly associated with papillary conjunctivitis (P = 0.03). Adenovirus amplicons were successfully sequenced from six patients. Four patients harbored type 3 adenovirus, the same serotype with which they were infected originally 10 years previously. Two patients were infected originally with adenovirus serotype 3 but the current serotype was type 4. Infection of the ocular surface with adenovirus may predispose to the development of a persistent or recurrent conjunctivitis, the presence of which, appears to be associated with evidence of long term persistence of adenovirus DNA.