Periapical radiographic techniques during endodontic diagnosis and treatment

The objective of this article is to describe various radiographic projections which can be used during endodontic therapy. Changes to the angulation of the X-ray beam in relation to the teeth and film can help diagnosis and treatment by producing images which provide additional information not always visible on radiographs taken with standard angulations. For example, changes in angulation can be useful to determine the number and curvature of roots and canals, to identify superimposed roots and to distinguish between anatomical landmarks and apical pathology. Although use of such techniques increases the diagnostic yield of films, it must be appreciated that such views lead to images that are less distinct because of inherent image distortion. Nevertheless, use of the various techniques during endodontics can provide substantial benefit for clinicians in their daily practice.     

Providing human tissues for research: how to establish a program

The Cooperative Human Tissue Network is a group composed of cooperating academic institutions that supply human tissues to researchers studying a wide range of neoplastic and other diseases. The experience of the Cooperative Human Tissue Network in establishing methods of prospective tissue collection and in developing tumor banks is discussed to aid institutions in establishing tissue resources for their local investigators, who may wish to use human tissues in current or future research projects. The advantages to pathology departments and to associated medical institutions of establishing an organized tissue resource include ensuring proper institutional review board approval of research projects using human tissues, protecting diagnostic specimens, creating new opportunities for extramural research, increasing the speed of diagnostic specimen transport to surgical pathology, and providing educational and research opportunities for pathologists and pathology residents. Methods of tissue collection, processing, storage, data collection, and supply are outlined. Also, resources necessary to begin organized tissue collection, including personnel, space, equipment, and supplies, are discussed.     

Multimodal treatment package for substance abuse treatment programs.

Describes a multimodal treatment design for a short-term, residential, hospital-based program for drug abusers. Each patient is expected to attend all program services with the intent that one or several will provide the corrective emotional experience facilitating change. Services included medical care, individual counseling/psychotherapy, group counseling, health education seminars, milieu/recreational therapy, Narcotics Anonymous meetings, linkage with aftercare components, and ancillary services (vocational rehabilitation, court liaison, and 90-day follow-up). Psychology interns and students are utilized. Results of internal follow-up show that 40% of Ss admitted over 3 yrs stated they were drug-free at 90 days and 1.5 yrs. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

DEFPARAM: a program package for aligning elliptical sections of biological objects containing an n-fold symmetry

BACKGROUND: Oesophageal candidiasis is the most common cause of oesophageal symptoms in patients with AIDS. Antifungal therapy, given as a suspension, may be better tolerated than capsules or tablets in children or patients with oesophageal symptoms. We performed a prospective study of the safety and efficacy of fluconazole suspension. METHODS: Patients with HIV infection; odynophagia, dysphagia, or retrosternal pain; endoscopic evidence of white plaques or exudate in the oesophagus; and microscopic confirmation of fungal infection on biopsy or brushing specimens were eligible. Patients received fluconazole oral suspension (200 mg loading dose followed by 100 mg q.d.s.). Therapy was continued for 2 weeks after symptom resolution. Repeat endoscopy was performed after completion of therapy. RESULTS: Forty-two patients enrolled in the study: 40 were male, mean (+/- s.e.) age was 37 +/- 2 years and mean CD4 cell count was 67 +/- 14/mm3. One patient was not evaluable because he received amphotericin during the first week of therapy. Symptoms resolved in all 41 evaluable patients; 17 (41%) had resolution by 1 week, 37 (90%) by 2 weeks, and 40 (98%) by 3 weeks. Endoscopic resolution occurred in 35 (95%) of 37 patients who underwent repeat endoscopy. Adverse events (skin rash in 1, nausea/vomiting in 2, elevated liver tests in 2) led to early termination of therapy in 5 patients, all of whom had clinical and endoscopic cure. CONCLUSIONS: Symptoms resolved in 100% of patients with AIDS and oesophageal candidiasis receiving an oral suspension of fluconazole, and 90% of patients had symptom resolution within 2 weeks. Determining whether the more rapid clinical cure in this study, compared with a previous trial which employed capsules, is related to an additional topical antifungal effect of the suspension, will require further study.     

Use of MMPI subtypes in predicting completion of a residential alcoholism treatment program.

To obtain data on patient characteristics relevant to treatment outcome, the Minnesota Multiphasic Personality Inventory (MMPI) was administered to 86 men 3–5 days following their admission to a 30-day residential alcoholism treatment program. Cluster analyses yielded three subtypes whose mean MMPI code types were as follows: Type I comprised a 4-2-8 code type, with marked additional pathology; Type II comprised a 4-9/9-4 code type; and Type III comprised a 2-4/4-2 code type. The subtypes differed significantly in their rates of treatment completion, with Type II yielding a greater proportion of program dropouts. To investigate the effect of time of MMPI administration on subtype results, 68 subjects who remained in treatment were readministered the MMPI 14–26 days following admission. A comparison of Time 1 and Time 2 typologies highlights the importance of test administration time and provides some explanation for previous discrepant findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of HIV-positive and HIV-negative crack users enrolled in a residential addiction treatment program

This study compared 96 HIV-Positive (HIV+) and 357 HIV-Negative (HIV-) crack users who were participating in the same drug-free, residential treatment program. Comparisons were made on sociodemographic, health, criminal justice, psychosocial, and recovery motivation variables. As predicted, the HIV(+) participants were more apt than the HIV(-) participants to be female and recently homeless. Also as predicted, HIV(+) participants had poorer subjective health, had more convictions for various criminal offenses, and were less apt to acquire employment during treatment when compared to the HIV(-) participants. Contrary to prediction, HIV(+) participants reported more social support, were not less committed to abstinence or 12-step groups, and were not less apt to complete the treatment program in comparison to the HIV(-) participants. These results suggest that HIV(+) crack users can be successfully treated in a rigorous treatment program. Future research should examine post-treatment outcomes among HIV-infected persons.     

Use of paradoxical intention in a behavioral program for sleep onset insomnia.

Sleep onset insomnia seems often to be based on performance anxiety associated with a client's fears of being able to fall asleep; in some cases, a therapeutic program might actually exacerbate this performance anxiety by focusing on the client's efforts to voluntarily control the sleep onset process. Five Ss aged 23–41 yrs and experiencing sleep onset difficulty unusually resistant to a conventional behavioral program for this problem (i.e., deep muscle relaxation and systematic desensitization), were exposed to paradoxical intention suggestions requiring that they try to remain awake as long as possible, rather than attempt to fall asleep. A rapid reduction of sleep onset latency occurred following the shift from the conventional program to the paradoxical intention instructions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concept for a behavior therapy treatment program in primary insomnia

Cutaneous recordings of gastric electrical activity (electrogastrography (EGG)) could become a valuable non-invasive tool for recognising gastric electrical abnormalities. Although signals obtained with internally implanted electrodes deliver quantitative information, this technique cannot be used for diagnostic purposes because of its invasive nature. On the other hand, the objectivity of electrogastrography is still in question. The aims of this work are to develop computer techniques for extracting quantitative information from digital electrogastrograms, and to evaluate quantitatively EGG recordings from healthy volunteers. The dynamics of all four EGG parameters are studied: amplitude, frequency, time shift between different channels, and waveform. Four separate two-dimensional computer plots are developed using specially designed digital signal-processing procedures. Each parameter is evaluated in a study of 20 healthy volunteers. Frequency is found to be the only EGG parameter that shows quantitative consistency and merit.     

Use of trans-tube treatment program in patients with acute intestinal obstruction and peritonitis

In 92 patients with enteral insufficiency syndrome, an acute ileus (AI) and diffuse peritonitis (DP) the prolonged small intestine decompression, the small intestine lavage with solution analogous to the chyme by electrolyte composition, medicinal decontamination, enterosorption and intraluminal electrophoresis of medicinal preparations was conducted. The pH magnitude and the degree of microbial contamination were determined; the toxicity in the probe contents according to paramecium test coefficient value was estimated. The advantage of transtube treatment over passive decompression of small bowel was proved, the hospitalization period reduced in AI on average by 7.5 days, for DP--by 11 days, mortality--by 13.2% and 22.5% accordingly.     

Component analysis and stimulus control assessment of a behavior deceleration treatment package

A treatment package that included two setting condition manipulations and visual occlusion was implemented to gain control over the high-intensity screaming and whining of a 16-year-old female with developmental disabilities. The study included an analysis of the individual and combined components of the treatment package and a stimulus control analysis of three salient features of the visual occlusion apparatus (i.e., opaque screen, secured helmet, and cranial pressure). Results showed that the treatment package occasioned a deceleration in the two targeted vocal behaviors and a reduction in the amount of time the participant was required to wear the occlusion apparatus. An analysis of the apparatus suggested that the critical element needed to control inappropriate vocalizations appeared to be cranial pressure, which was naturally produced by the helmet. Consequently, the helmet was eliminated and cranial pressure was produced by a woman's headband. Follow-up data, collected 1, 2, and 3 months after termination of systematic intervention, revealed near-zero levels of screaming and whining behaviors. A 9-month follow-up investigation involving the removal and subsequent reinstatement of the headband procedure supported the use of the headband for the maintenance of behavioral gains.     

Double oblique MR images of the shoulder: comparison with conventional images

PURPOSE: Because the scapula is not only slanted on transverse sections but also inclines on sagittal section, we now perform shoulder MR imaging using double oblique images (DOI), which are planes perpendicular or parallel to the long axis of the scapula obtained with oblique sagittal scout imaging. The purpose of this study was to evaluate the usefulness of double oblique shoulder MR imaging. MATERIALS AND METHODS: MR images of shoulders with operatively or arthroscopically proven lesions (20 cases) that had been examined on both conventional images (CI) and DOI were retrospectively reviewed. DOI were compared with CI not only in terms of diagnostic performance but also in their ability to identify the details of shoulder anatomy. All MR studies were done with a shoulder coil on a high-field (1.5T) unit. RESULTS: Although the accuracy of DOI in diagnosing shoulder disorders such as rotator cuff tear and labrum injury was not as good as that of CI, DOI were better for identifying or discriminating muscles and tendons of the rotator cuff, labralbicipital junction and anterior band of the inferior gleno-humeral ligament, and for recognizing the correct position of the glenoid labrum. CONCLUSION: MR double oblique imaging of the shoulder provides more detailed information about shoulder anatomy and disorders than conventional imaging.