Mandibular anterior ridge extension: a modification of the Kazanjian vestibuloplasty technique

PURPOSE: A modification of the secondary epithelization vestibuloplasty technique described by Kazanjian that eliminates the sharp V in the depth of the extended vestibule and counteracts shallowing of the sulcus is presented. PATIENTS AND METHODS: Ten consecutive patients indicated for anterior mandibular secondary epithelization vestibuloplasty were treated. A bipedicled mucosal flap was developed in the labioalveolar mucosa for lining the extended vestibular depth. A comparison was made of the vestibular depth measured from the crest of the ridge to the junction of the attached mucosa both preoperatively and postoperatively. RESULTS: Healing of raw surfaces was uneventful. The mean preoperative anterior mandibular vestibular depth was 3.5+/-1.1 mm. After 6 months, the mean anterior mandibular vestibular depth was 9.2+/-1.7 mm, a statistically significant difference (P < .05). The mean gain in vestibular depth was 5.7+/-2.2 mm. CONCLUSION: Overcorrection is unnecessary with this modification. Elimination of the sharp V in the extended vestibular depth enables denture fabrication with better flange extension and improved oral hygiene.     

Anterior knee laxity and loss of extension after anterior cruciate ligament injury

This study was performed to examine the relationship between knee extension loss and the length of time after injury. We also wanted to compare anterior laxity in anterior cruciate ligament-injured knees in the early and late stages of injury. Loss of knee extension was measured in 81 patients with anterior cruciate ligament injury using lateral radiography with the injured leg relaxed and elevated. Extension loss was defined as the difference in maximal extension angle between the injured and uninjured knees. Average loss of extension was 3.6 degrees in the 17 knees in which the anterior cruciate ligament had been torn 3 weeks or less before examination (the acute injury group) and 0.6 degree in the 64 knees in which the anterior cruciate ligament had been torn more than 3 weeks before examination (the chronic injury group). The extension loss in the acutely injured knees was significantly greater compared with that in the uninjured knees and in the chronically injured knees. Arthrometric measurements using the KT-1000 arthrometer were reliable to diagnose an acute tear. There was no correlation between the degree of extension loss and arthrometric anterior knee laxity measurements. In 12 patients, the initial extension deficit in the early stage of injury significantly resolved with time, and manual maximum arthrometric measurements of anterior knee laxity improved spontaneously with time.     

Ab initio phase determination and phase extension using non-crystallographic symmetry

Non-crystallographic symmetry (NCS) can be used to improve, extend or find ab initio phases to be associated with a set of observed structure amplitudes, resulting in an interpretable electron-density map. The simplest application is merely to improve the accuracy of the phases by cyclically averaging the electron density, Fourier back-transformation of the modified map, and recomputing a new map with the newly found phases. The first sophistication of this procedure is to phase extend, in successive small steps, the currently available phase information to higher resolution, where only observed amplitudes were previously available. A further sophistication is to initiate the phase extension from very low resolution where a simple geometric model, or an electron microscope image, would be consistent with the chosen resolution. A number of recent examples of virus structure determination exist where such ab initio phasing was successful. The ultimate ab initio phase determination would be to extend phases given only an estimate of the F(000) term.     

Elbow arthroscopy in trauma and reconstruction

Grief and bereavement following the death of a loved one present clients with significant challenges to the physical, emotional, and spiritual health and well-being. The grieving process for the person with HIV infection may be compounded by shame, stigma, and lack of social support. For communities with the highest prevalence of HIV infection, AIDS-related losses have resulted in mounting, and often overlapping, bereavements. Addressing the impact of these bereavements on the physical and emotional health of clients and their survivors is imperative to designing appropriate interventions to alleviate the potential adverse health outcomes associated with epidemic loss. Facilitating the grief work of HIV positive persons and their loved ones serves to assuage unhealthy sequelae, promote effective coping skills, and provide opportunities for personal growth.     

Elbow, forearm and wrist injuries in the athlete

Competitive and recreational athletes sustain a wide variety of soft tissue, bone, ligament, tendon and nerve damage to their upper extremities. Most such injuries are related to direct trauma or repetitive stress, and account for a significant amount of 'down time' for athletes participating in a wide range of sports, particularly those in which the arm is utilised for throwing, catching or swinging. Overuse injuries to the elbow include musculotendinous injuries, ulnar nerve injuries and ligamentous injuries. Osteochondrol lesions of the capitellum and posterior impingement injuries in the joint are frequently seen in athletes as well. Acute traumatic injuries to the elbow include tendon ruptures, elbow dislocations and intra-articular fractures. Forearm overuse injuries in athletes include fracture of the carpal scaphold, fracture of the hook of the hamate, Kienbock's syndrome and pisoquetral syndromes. ligamentous injuries include scapholunate, lunotriquetral and midcarpal instability injuries. Injuries to the distal radio-ulnar joint and triangular fibrocartilage are also quite common in athletes, and require careful evaluation and treatment.     

In vivo mapping of nucleosomes using psoralen-DNA crosslinking and primer extension

By the use of psoralen crosslinking and primer extension, a method was developed which allows the analysis of chromatin structure in vivo. Using a yeast minichromosome, >9 nucleosomes were mapped with a resolution of at least +/-30 bp.     

Tendon transfer to restore extension of the thumb using abductor pollicis longus

20 patients with rupture or division of extensor pollicis longus (EPL) underwent tendon transfer using abductor pollicis longus (APL). All patients except one were reviewed and examined between 6 and 80 months after surgery. The subjective and objective results were satisfactory and are presented with details of the technique and its advantages and limitations.     

Severe diabetic scleredema with extension to the extremities and effective treatment using prostaglandin E1

This report concerns an apparently healthy woman who presented simultaneously with acute massive bilateral pulmonary embolism and mitral regurgitation, subsequently, a month later, resulting in pulmonary edema secondary to chordae rupture of the mitral valve. The authors believe that massive pulmonary embolism predisposed to chordal rupture in this case. It is suggested that increased awareness of ruptured chordae tendineae as a cause of mitral regurgitation and the prompt use of transesophageal echocardiography will facilitate the early recognition of this potentially fatal, but treatable, cause of mitral regurgitation in patients with pulmonary embolism.     

Occipitocervical fixation using hooks and screws for upper cervical instability

OBJECTIVES: Occipitocervical fixation is used for the treatment of nontraumatic upper cervical instabilities. To date, plates have been fixed with screws or wires. However, these devices are not indicated in the treatment of patients with severe osteoporosis or in instances of significant thinning of the occipital bone. We performed a clinical trial of a new type of fixation that uses cervical interlaminar hooks and occipital claws with hooks or with screws (CCD type; Sofamor-Danek, Roissy, France) for the treatment of nontraumatic upper cervical instabilities. METHODS: Five women and one man ranging in age from 28 to 72 years (average age, 54 yr) were thus treated. The CCD type material had two rod plates and hooks allowing the proper placement of interlaminar and occipital claws. The occipital plate can also be directly screwed to the bone. Occipital hooks were used in four patients. The other two patients, who had occipitocervical congenital abnormalities that required an occipitocervical opening and an additional dural enlargement, underwent occipital screw fixation because of the previous opening of the foramen magnum. A cancellous iliac autograft allowed the usual fusion. RESULTS: No postoperative complications were observed, and all patients experienced significant improvement of their neck pain. Four patients had neurological symptoms. The condition of two patients improved, and the condition of the other two stabilized. CONCLUSION: This report confirms the interest of the CCD method to correct all types of upper cervical instabilities, even in cases of unusual thinning of the occipital bone or in osteoporotic states.     

Technique for realistic anterior crowns using the IPS Empress porcelain system

Modern notions on the morphology and function of the epithelial barrier of the buccal mucosa are discussed. The basis of this barrier is the epithelial layer, partially covered with horny layer, of a regular thickness and permeability, constantly regenerating, and casting off the injured superficial layers. Nonspecific antibacterial humoral factors (produced by the epithelium and salivary glands) play an important role in the barrier mechanisms, as well as nonspecific cellular mechanisms of defense, due to the presence of intraepithelial granulocytes and monocytes, specific immune humoral and cellular mechanisms including the system of antigen-presenting dendrite cells and lymphocytes, and flow of the saliva containing nonspecific and specific antibacterial factors. The barrier function of the epithelium is provided for by constant interactions between various specific and nonspecific cellular and humoral defense mechanisms.     

School readiness and later achievement: Replication and extension using a nationwide Canadian survey.

In this article we replicate and extend findings from Duncan et al. (2007). The 1st study used Canada-wide data on 1,521 children from the National Longitudinal Survey of Children and Youth (NLSCY) to examine the influence of kindergarten literacy and math skills, mother-reported attention, and mother-reported socioemotional behaviors on 3rd-grade math and reading outcomes. Similar to Duncan et al., (a) math skills were the strongest predictor of later achievement, (b) literacy and attention skills predicted later achievement, and (c) socioemotional behaviors did not significantly predict later school achievement. As part of extending the findings, we incorporated a multiple imputation approach to handle missing predictor variable data. Results paralleled those from the original study in that kindergarten math skills and Peabody Picture Vocabulary Test—Revised scores continued to predict later achievement. However, we also found that kindergarten socioemotional behaviors, specifically hyperactivity/impulsivity, prosocial behavior, and anxiety/depression, were significant predictors of 3rd-grade math and reading. In the 2nd study, we used data from the NLSCY and the Montreal Longitudinal-Experimental Preschool Study (MLEPS), which was included in Duncan et al., to extend previous findings by examining the influence of kindergarten achievement, attention, and socioemotional behaviors on 3rd-grade socioemotional outcomes. Both NLSCY and MLEPS findings indicated that kindergarten math significantly predicted socioemotional behaviors. There were also a number of significant relationships between early and later socioemotional behaviors. Findings support the importance of socioemotional behaviors both as predictors of later school success and as indicators of school success. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What would you do? Acute extension block caused by anterior cruciate ligament tear: a case report

Acute knee locking is usually attributed to a displaced meniscus tear. This case involved late diagnosis of mechanical extension block caused by anterior displacement of a torn anterior cruciate ligament (ACL) with impingement in extension. Definitive reconstruction was delayed after debridement of the ACL stump to improve preoperative range of motion. Despite this, the patient still had difficulty regaining extension after surgery. Early treatment of mechanical extension block may facilitate motion recovery after ACL reconstruction.     

The value of cervical mediastinoscopy combined with anterior mediastinotomy in the peroperative evaluation of bronchogenic carcinoma of the left upper lobe

METHODS: From January 1990 to July 1994, 85 patients who were otherwise thought to have an operable tumour within the left upper lobe underwent left anterior mediastinotomy supplemented by cervical mediastinoscopy in 75 cases. This combined approach allowed assessment of nodal involvement within the superior and anterior mediastinal areas, the detection of direct tumour invasion into the mediastinum and the determination of resectability by bidigital examination of the area around the aortic arch and sub-aortic fossa. RESULTS: It was found that 27 (31.8%) patients were inoperable, either because of nodal involvement at cervical mediastinoscopy (4 patients) or because of extension into the mediastinum at left anterior mediastinotomy (14 patients), or because of positive results from both methods (9 patients). The inoperability determined by this examination for patients with adenocarcinoma (8/18, 44.4%) is higher than for patients with squamous carcinoma (12/52, 23.1%). All of the 58 patients with negative findings proceeded to thoracotomy and complete resection was possible in 54 patients (93.1%). CONCLUSION: We conclude that this combined approach is better than using either technique alone in the preoperative staging and the evaluation of resectability of left upper lobe tumours.     

提高夹送辊弯管使用寿命的措施

针对轧制φ6．5mm线材时夹送辊弯管使用寿命短、消耗高、不利于生产组织等问题，进行了多次试验和摸索，找出影响夹送辊弯管使用寿命的因素，介绍对夹送辊弯管在设计上、材质上及使用方法上的优化措施。