Cast syndrome

The term cast syndrome is used to denote duodenal obstruction occurring after application of a corrective plaster cast to patients with scoliosis. We report a classical case in a 14-year-old female who required surgical intervention after conservative treatment failed. Six months later the patient had no further gastrointestinal symptoms. Clinical, radiological, and pathological details as well as the surgical treatment are described and discussed. Offprint requests to: M. E. Martín Hortigüela     

Exposure to soluble barium compounds: an interventional study in arc welders

Summary Soluble barium (Ba) compounds are well-known toxicants. Intoxications are mainly known in an acute form from casual or suicidal oral ingestion. No scientifically based data are available on possible health effects of inhalative exposure to soluble Ba salts at the workplace. Therefore, we investigated 18 welders in an interventional study over 1 week. They performed welding of Ba-containing stick electrodes and self-shielded flux cored wires under conditions similar to real working conditions. The welding fumes contained 31%–37% Ba, more than 90% of which was soluble in acids. Without appropriate preventive measures, a high rate of measurements exceeded the TLV values for total welding fumes of 5 mg/m³ and for soluble Ba of 0.5 mg/m³. The median fume concentrations were 13.2 mg/m³ in stick electrode welding and 12.3 mg/m³ in flux cored wire welding. The median Ba concentrations were 4.4 and 2.0 mg/m³ respectively. An integrated exhaust system built into the gun proved to be efficient in flux cored wire welding. The internal exposure to Ba reached median urine levels up to 101.7 g/l (normal: below 20 g/l) and median plasma concentrations of up to 24.7 g/l (normal: below 8 g/l). No health impact on the welders could be proven, but hypokalemia may have occurred as a result of the Ba exposure.     

铸铁和镀铬水龙头对过夜自来水水质的影响

[目的]探讨水龙头等涉水管件对生活饮用水水质的影响，为避免黄浊水对人体的危害，为制定生活饮用水涉水产品卫生安全标准提供科学依据。[方法]2004年在滨卅l市市区选择不同区域居室，采集铸铁水龙头和镀铬水龙头的水头水（自来水），检测铁、锌、锰、铜、铅、六价铬含量及色度、浑浊度。[结果]2种水龙头的水头水的色度、浑浊度均高于中段水；2种水龙头水头水和中段水中锰、铜、铅、六价铬含量的差异无统计学意义；2种水龙头水头水的铁、锌含量分别高于中段水；2种水龙头过夜水头水中铁、锌含量均与出水量呈负相关关系。[结论]水龙头的材质影响水头水中色度、浑浊度及铁、锌含量，建议使用卫生安全的供水管材和水龙头。     

两种方法检测尿沉渣中管型结果对比分析

目的：比较UF-1000i尿沉渣分析仪与尿沉渣显微镜两种检查方法在尿液管型检测中的优缺点。方法收集600例患者的尿液标本,用UF-1000i尿沉渣分析仪与显微镜两种仪器检测尿沉渣中的管型,比较分析结果。结果 UF-1000i尿沉渣分析仪检测尿中管型的检出率为12.7%,特异度为94.9%,灵敏度为92.3%,假阴性率5.1%,假阳性率7.7%;尿沉渣显微镜检查尿中管型的阳性率为8.7%。结论 UF-1000i尿沉渣分析仪检测尿中管型时存在较多的假阳性和假阴性,如果将尿沉渣分析仪与显微镜检查联合应用,可以提高管型检测的准确率,为临床诊断提供可靠依据。     

Cast index in predicting outcome of proximal pediatric forearm fractures

Background:Many pediatric forearm fractures can be treated in plaster following closed reduction. The cast index (CI, a ratio of anteroposterior to lateral internal diameters of the cast at the fracture site) is a simple, reliable marker of quality of molding and a CI of >0.8 correlates with increased risk of redisplacement. Previously, CI has been applied to all forearm fractures. We hypothesize that an acceptable CI is more difficult to achieve and does not predict outcome in fractures of the proximal forearm.Results:The mean CI was 0.77. Remanipulation was required in five cases (6%), all distal half fractures – mean CI 0.79. CI was higher in proximal half forearm fractures (0.83 vs. 0.76, P = 0.006), nonetheless these fractures did not re-displace more than distal fractures.Conclusion:Cast index is useful in predicting redisplacement of manipulated distal forearm fractures. We found that in proximal half forearm fractures it is difficult to achieve a CI of <0.8, but increased CI does not predict loss of position in these fractures. We therefore discourage the use of CI in proximal half forearm fractures.     

Outcome of humeral shaft fractures treated by functional cast brace

Background:Functional brace application for isolated humeral shaft fracture persistently yields good results. Nonunion though uncommon involves usually the proximal third shaft fractures. Instead of polyethylene bivalve functional brace four plaster sleeves wrapped and molded with little more proximal extension expected to prevent nonunion of proximal third fractures. Periodic compressibility of the cast is likely to yield a better result. This can be applied on the 1^st day of the presentation as an outpatient basis. Comprehensive objective scoring system befitting for fracture humeral shaft is a need.Results:The results were assessed using 100 point scoring system where union allotted 30 points and 60 points allotted for angulations (10), elbow motion (10), shoulder abduction (10), shortening (5), rotation (5), absence of infection (10), absence of nerve palsy during treatment (10). Remaining 10 points were allotted for five items with two points each. They were the absence of skin sore, absence of vascular problem, absence of reflex sympathetic dystrophy (RSD), recovery of paralyzed nerve during injury and recovery of paralyzed nerve during treatment. Results were considered excellent with 90 and above, good with 80–89, fair with 70–79 and poor below 70 point. Results at 6 months were excellent in 43.94% (n = 29), good in 42.42% (n = 28), fair in 9.1% (n = 6), poor in 4.55% (n = 3). Union took place in 98.48% (n = 65) with an average of 10.3 weeks (range 6–16 weeks). 87.5% (n = 7) paralyzed radial nerve recovered. All wounds healed. Four patients had transient skin problem. One patient with mid shaft fracture had nonunion due to the muscle interposition.Conclusion:Modified functional cast brace is one of the options in treatment for humeral shaft fractures as it can be applied on the 1^st day of the presentation in most of the situations. Simple objective scoring system was useful particularly in uneducated patients.     

Comparative Evaluation of Bond Strengths of Different Core Materials with Various Luting Agents Used for Cast Crown Restorations

The coronal cast restoration continues to be used commonly to restore mutilated, endodontically treated teeth. The tensile bond strength of luting cements is of critical importance as many of failures are at the core and the crown interface. An invitro study with aim to evaluate and compare bond strengths of luting cements between different core materials and cast crowns. A total of 45 extracted identical mandibular second premolars were endodontically treated and divided into 3 groups of 15 each. Specimens in first group were restored with cast post and core (Group C), and specimens in second group were restored with stainless steel parapost and composite core material (Group B) and specimens in third group were restored with stainless steel parapost and glass ionomer core build (Group G). Standardized crown preparation was done for all the specimens to receive cast crowns. Each group was further divided into 3 subgroups and were cemented using 3 different luting cements namely, resin cement, polycarboxylate cement, glass ionomer cement (Type I). The samples of each subgroup (n = 5) were subjected to tensile testing using Universal Testing Machine at a crosshead speed of 2 mm/min till the dislodgement of crown from the core surface was observed. The bond strengths were significantly different according one way ANOVA (F-150.76 and p < 0.0000). The results of the study showed that the specimens cemented with resin cement in cast core, composite core and glass ionomer core exhibited significantly higher bond strengths as compared to specimens cemented with glass ionomer and polycarboxylate cement. Composite resin core and resin cement combinations were superior to all other cement and core combinations tested.     

纤维桩与铸造金属桩核在修复大面积牙体缺损的临床疗效比较

目的：通过比较纤维桩与传统铸造金属桩核在大面积牙体缺损修复中的临床疗效,探讨纤维桩在最大限度地保留残根残冠方面的应用前景。方法：运用随机数字表法对2007年7月1日～2009年7月1日在我院口腔科门诊牙体大面积缺损（残根、残冠）经根管充填治疗后需要桩核冠修复治疗的123例患者（164颗患牙）进行分组,对照组进行传统铸造金属桩核修复,观察组进行纤维桩修复。进行为期2年的随访,对桩核冠脱落、桩核折断、根折、牙龈炎性反应、牙龈边缘色泽、继发根尖周炎等方面的情况进行评价。结果：2组在桩核松动脱落、牙根折、牙龈炎性反应、牙龈边缘色泽改变方面差异有统计学意义（P〈0．05）,而在桩核折断及继发根尖周炎发生上差异无统计学意义。结论：纤维桩在修复大面积牙体缺损的应用中取得了满意的修复效果,优于传统铸造金属桩。     

长爪沙鼠脑底血管红油铸型标本制作及其后交通支变异类型分析

目的制备普通级长爪沙鼠脑底血管红油铸型标本,分析其脑部血管分布,为筛选出可稳定制备脑缺血模型的长爪沙鼠品系奠定基础。方法挑选8～10周龄普通级长爪沙鼠和SPF级SD大鼠各20只(雌雄各半),制备脑血管红油铸型标本,取全脑4%福尔马林溶液固定,解剖显微镜下观察拍照。结果运用血管铸型法可有效地制备长爪沙鼠脑底血管红油铸型标本,与SD大鼠比较认为长爪沙鼠脑底血管后交通支存在4种变异类型。结论通过脑底血管红油铸型标本可直观地分析长爪沙鼠脑底血管分布,为建立长爪沙鼠Willis动脉环缺陷明显品系和制备脑缺血动物模型奠定解剖学基础。