Load transmission in implant superstructures supported by natural teeth and osseointegrated dental implants. A preliminary report

There is considerable debate as to the effects of using bridges which are supported simultaneously by teeth and implants, due to the marked differences in their displaceability. This in-vivo experiment was carried out on three subjects, and measured the vertical and horizontal movement of implants and teeth, linked with a fixed superstructure, when this was loaded. The results suggest that natural abutment teeth may contribute significantly to bridge support in these circumstances.     

The regeneration of soft tissue and bone around implants with and without membranes

The popularity of osseointegration for the replacement of anterior teeth has placed an increased demand on the preservation of normal gingival anatomy. This has led to the development of a variety of soft-tissue and bone-augmentation techniques that either prevent tissue collapse or restore previously damaged areas of the alveolus. With bone grafts, barrier membranes, and autogenous connective-tissue grafts used in combination with each other or separately, lost structures can be reconstructed into a normal configuration for optimum esthetic restorations.     

Persistent trigeminal artery associated with aneurysm of the middle cerebral artery. Case report and review of the literature

The authors report a case of persistent primitive trigeminal artery angiographically demonstrated as an incidental finding. The persistent primitive trigeminal artery was associated with an aneurysm arising from the circle of Willis in the middle cerebral artery territory. The literature is reviewed and the embryology involved is related.     

Pulmonary valve cyst in an adult. Case report

A case is described of an asymptomatic woman who had typical findings of mild pulmonic stenosis. Right heart catheterization revealed a 44 mm. Hg gradient across the pulmonary outflow tract, and a filling defect was discovered by angiography. On surgical exploration, the defect was found to be a benign cyst attached to the anterior leaflet of the pulmonary valve.     

Congenital methemoglobinemia found in an adult. Case report

Cyanosis in a 36 year old patient which persisted 20 years after a successful surgical closure of her patent foramen ovale has been finally diagnosed as due to congenital methemoglobinemia: a 28% level of methaemoglobin and no activity od NAD-dependent methaemoglobin reductase were found. Erythrocyte antioxidative system was studied i.e. glutathione peroxidase, reductase, transferase, superoxidase dismutase and glucose-6-phosphate dehydrogenase. Increased activity was disclosed of superoxide dismutase and glucose-6-phosphate dehydrogenase in erythrocytes in comparison to normal individuals as well as increased concentration of lipid peroxidation products coexisting with methaemoglobin reductase deficiency.     

High-dose epirubicin is not an alternative to standard-dose doxorubicin in the treatment of advanced soft tissue sarcomas. A study of the EORTC soft tissue and bone sarcoma group

The activity and toxicity of single-agent standard-dose doxorubicin were compared with that of two schedules of high-dose epirubicin. A total of 334 chemonaive patients with histologically confirmed advanced soft-tissue sarcomas received (A) doxorubicin 75 mg m(-2) on day 1 (112 patients), (B) epirubicin 150 mg m(-2) on day 1 (111 patients) or (C) epirubicin 50 mg m(-2) day(-1) on days 1, 2 and 3 (111 patients); all given as bolus injection at 3-week intervals. A median of four treatment cycles was given. Median age was 52 years (19-70 years) and performance score 1 (0-2). Of 314 evaluable patients, 45 (14%) had an objective tumour response (eight complete response, 35 partial response). There were no differences among the three groups. Median time to progression for groups A, B and C was 16, 14 and 12 weeks, and median survival 45, 47 and 45 weeks respectively. Neither progression-free (P = 0.93) nor overall survival (P = 0.89) differed among the three groups. After the first cycle of therapy, two patients died of infection and one owing to cardiovascular disease, all on epirubicin. Both dose schedules of epirubicin were more myelotoxic than doxorubicin. Cardiotoxicity (> or = grade 3) occurred in 1%, 0% and 2% respectively. Regardless of the schedule, high-dose epirubicin is not a preferred alternative to standard-dose doxorubicin in the treatment of patients with advanced soft-tissue sarcomas.     

Baseball implant. A method of secondary insertion of an intraorbital implant

A surgical technique for secondary emplacement of an orbital implant is described in which a spherical implant encased in a scleral homograft is placed in the orbit through a transconjuctival incision and sutured to the superior part of the periosteum.     

Rectosigmoid lipoma an unusual colonic lipoma. Case report and review of the literature

This is a case report of a male patient admitted with a huge rectosigmoid mass that had eroded into the lumen, causing persistent rectal bleeding. Special procedures such as double contrast Barium Enema, abdomino-pelvic CT-Scan and proctosigmoidoscopy addressed us to identify it as an intramural lipoma. Rectosigmoid lipoma with its differential diagnosis and surgical approach is reviewed together with the most pertinent literature.     

Case report: an unusual presentation of gout

The efficacy of ear canal flushing and ear canal and mouth swabbing methods for the isolation of mycoplasmas was investigated in 39 goats. Of the 19 goats positive for Mycoplasma spp., 14 (73.7%) were positive with the ear canal flushing method, 4 (21.0%) were positive with both ear canal flushing and mouth swabbing methods, and 1 (5.3%) was positive by the mouth swabbing method. Mycoplasma arginini, M. mycoides subsp. mycoides, and M. mycoides subsp. capri were identified by direct immunofluorescence and growth inhibition tests. Previous reports on the isolation of M. arginini from the ear canal of goats were not found in the literature.     

Fibromatosis of soft tissue type involving the female genital tract: a report of two cases

The presence of a fatty liver often complicates the interpretation of abdominal computed tomography (CT). Abnormalities in or adjacent to the liver, including dilated bile ducts, liver masses and subphrenic collections, may be masked by the fatty liver. Furthermore, normal structures may simulate pathological conditions. Five cases are presented to illustrate some of these diagnostic pitfalls.     

Hemangiopericytoma of the third ventricle. Case report

The authors present the first reported case of a hemangiopericytoma (HPC) occurring in the third ventricle. Most of these lesions are based in the meninges. There is only one other reported case of an intraventricular HPC; in that case the lesion was found in the lateral ventricle. A 40-year-old right-handed man presented with a 3-month history of headaches. Clinical evaluation, including computerized tomography and magnetic resonance imaging studies, revealed a 1-cm enhancing lesion in the third ventricle. Given the findings on the preoperative imaging studies, the lesion was not consistent with some of the more commonly occurring tumors of the third ventricle, namely colloid cysts. A transcortical approach and resection of the lesion was performed without complication. The final pathological findings were consistent with those of an HPC. Hemangiopericytomas rarely occur in the ventricles and may pose a difficult diagnostic dilemma based on their radiographic and gross appearances, as shown in this case. Because of this difficulty, histological confirmation is required to make a definitive diagnosis. These lesions have a propensity to recur and metastasize in the central nervous system and periphery, thus making the goal of treatment a complete surgical resection followed by postoperative radiation therapy in most cases.     

Inflammatory pseudotumor of the orbit. Case report

A case report and a review of the literature of inflammatory pseudotumors of the orbit is presented. The lateral approach, using microsurgical technique, is described. The incidence of this primary granuloma is comparable to other orbital tumors, and the diagnosis is confirmed by histological study of a biopsy specimen. Surgical excision offers the best mode of treatment. Although steroids may help postoperatively, the prognosis is poorer if the tumors are large. Radiotherapy offers no benefit.     

Multifocal glioma of the brain. Case report

A case is presented in which two separate concurrent astrocytomas of the brain in the same patient were successfully operated on. The patient has been followed for 3 years and remains well. The authors believe that the diagnosis of multifocal tumors can be established on clinical grounds when the tumors are remote from each other, and when there has been no recurrence of neoplasm between the lesions after a long follow-up period. It is felt that a more optimistic approach to the treatment of multifocal tumors may yield good results.     

A new animal model for molecular biological analysis of the implant-tissue interface: spatial expression of type XII collagen mRNA around a titanium oral implant

The objective of this study was to develop an animal model to investigate the molecular biological healing events at the tissue-implant surface occurring in the alveolar bone. Newly designed mini-titanium implants (2mm in length and 1 mm in diameter) were placed in the maxilla of retired-breeder male Sprague-Dawley rats. The implants were placed in freshly drilled holes in the maxillary bone, or in an area close to the roots of the maxillary first molar. The healing phase in each group was studied histologically at 28 days and at 56 days by means of non-decalcified polymethylmethacrylate-embedded sections and decalcified paraffin-embedded sections. Initial osseointegration was observed at 28 days, with mature osseointegration seen at 56 days. Specimens with implants placed immediately adjacent to the root showed fibrous healing at the implant-tissue surface. As a pilot study, the expression of type XII collagen, a molecular marker specific to the mature periodontal ligament (PDL), was studied by in situ hybridization. There was an absence of type XII expression close to the implant surface, whereas there was a zone of type XII collagen expression closest to the bony wall. Our preliminary results indicated a significant molecular variation in the fibrous-implant interface. This model will be useful in studies of the wound-healing patterns of the extracellular matrix around oral implants specifically relevant to alveolar bone osseointegration and potential formation of PDL.     

Failure of a carbon fiber implant. A case report

STUDY DESIGN: Case report. OBJECTIVES: Failure of a carbon fiber implant. SUMMARY OF BACKGROUND DATA: To simplify the procedure of posterior lumbar interbody fusion, a carbon-fiber-reinforced polymer implant has been developed. The implant has ridges to resist retropulsion, struts to support weight, and a hollow area to allow packing of autologous bone graft. So far, no complications have been reported from the use of carbon implant as a fusion aid in spine surgery. METHODS: A patient with postoperative infection has been followed with computed tomography images and histologic examination from a reoperation. RESULTS: An entire nonunion across the width of the disc space and a clearly broken cage was visualized with computed tomography. The spinal canal was explored during a reoperation and the tissue surrounding the dura and nerves were all black. Microscopic examination showed a large quantity of carbon particulate debris. The authors have operated on approximately 100 patients so far and no other carbon cage has broken, to their knowledge. CONCLUSIONS: Carbon cages can break if a nonunion occurs and as a result free carbon particles move out to the spinal canal.