Implant retained overdentures in mandibular reconstruction: a case report

This case report describes the clinical and laboratory procedures used in the rehabilitation of a patient treated for oral cancer with surgery and radiation therapy. During surgery, a large portion of the mandible was removed and reconstructed with a bone graft. Following therapy, the patient was left with poor esthetics and difficulties with mastication and speech. The goal of prosthodontic treatment was to improve esthetics and restore function. This was successfully achieved through the placement of dental implants and the construction of an implant retained overdenture. A bar was employed to split the implants together and an O-ring system was chosen for retention. The decision to use this type of prosthesis and attachment selection was based on the patient's dental history, esthetic demands, and the need for stress distribution.     

Retrievable cemented crown options on implant-supported angled abutments: a case report

Nonaxial implant alignment often predicates the use of cemented of screw-retained angled abutments with inherent disadvantages, including reduced retrievability on screw loosening. The purposes of this article are to review the relative merits of cemented and screw-retained angled abutments and to present a method of ensuring retrievability of cemented angled abutments.     

Retained pieces of wood in the retromaxillary space: a case report

Detection and operative removal of wood as a foreign body in the cranio-maxillary area has received frequent attention in the literature. However, as a rule, most of the cases described are related to the orbit or the orbito-neurocranial space. Almost no literature exists on the detection and treatment of wooden foreign bodies in the retromaxillary space. The authors present an unusual case of long-term retained wood in this area in a child. The case inspires discussion of the general problem of detecting retained retromaxillary wood, even using modern diagnostic tools in this area and the question of the operative therapy, especially the most favourable surgical access.     

Exophthalmos and facial swelling: a case of limited Churg-Strauss syndrome

We report a case of vasculitis causing facial swelling and exophthalmos which on clinical and histological grounds is thought to be limited Churg-Strauss syndrome. An excellent response was achieved to high doses of systemic steroids and cyclophosphamide.     

Pseudopneumoperitoneum: a case report

A case of post-traumatic pseudocyst of the pancreas is presented. The elevated and compressed stomach showed an appearance on X-ray film which might be interpreted as free peritoneal air. The term pseudopneumoperitoneum is defined and other causes of this condition are mentioned.     

Hemangiopericytoma: a case report

We describe one case of hemangiopericytoma touching a 44-year-old man. It is a rare vascular tumor originating from pericytes surrounding capillaries. The main typical features of it are the difficulty in doing an histologic diagnosis and the impossibility to make out a reliable prognosis. The therapy of choice is a surgical procedure sometimes in combination with radio- and/or chemotherapy.     

Porcelain veneers for primary incisors: a case report

A 4-year-old boy with severely discolored primary maxillary incisors was treated with bonded porcelain veneer restorations. Two years previously, the child had been treated with topical application of sodium fluoride-silver nitrate solution to arrest dental caries associated with a nursing bottle habit. With minimal chair time, the incisors were restored with laboratory-processed porcelain veneer restorations that were bonded with resin cement. This is perhaps the only report to date of the use of porcelain veneer restorations for primary anterior teeth.     

Sarcoidosis-tuberculosis association: a case report

BACKGROUND: The effects of abrupt discontinuation and tapering of total parenteral nutrition (TPN) on glucose concentration were compared in patients < 3 years of age. METHODS: Serial glucose concentrations were measured over 120 minutes after abrupt discontinuation as compared with tapering (decreasing infusion rate by 50% for 1 hour before discontinuation). Serial insulin concentrations were measured after abrupt discontinuation. RESULTS: There was a significantly greater decrease in glucose concentration from baseline at 30 minutes after abrupt discontinuation as compared with tapering. Fifty-five percent (6/11) of the patients developed hypoglycemia (glucose concentration < 40 mg/dL) after abrupt discontinuation. Age, glucose infusion rate, and serum insulin concentrations were not predictive of the development of hypoglycemia. The tapering regimen did not prevent hypoglycemia, which developed in 20% (2/10). CONCLUSION: The high incidence of hypoglycemia after TPN discontinuation in children < 3 years of age requires monitoring of serum glucose concentration when initiating intermittent TPN until tolerance is documented.     

Bacterial tracheitis: a case report

The SR Ca-ATPase in skeletal muscle SR vesicles isolated from young adult (5 months) and aged (28 months) rats was analyzed for nitrotyrosine. Only the SERCA2a isoform contained significant amounts with approximately one and four nitrotyrosine residues per young and old Ca-ATPase, respectively. The in vitro exposure of SR vesicles of young rats to peroxynitrite yielded selective nitration of the SERCA2a Ca-ATPase even in the presence of excess SERCA1a. No nitration was observed during the exposure of SR vesicles to nitric oxide in the presence of O2. These data suggest the vivo presence of peroxynitrite in skeletal muscle. The greater nitrotyrosine content of SERCA2a from aged tissue implies an age-associated increase in susceptibility to oxidation by this species.     

Sneddon syndrome: a case report

Doxorubicin is cardiotoxic and its use must be monitored carefully. Incidence of refractory cardiac failure is shown to increase once the cumulative dose exceeds 450 mg/m2. However, significant decline of ejection fraction (EF) may occur even at lower dose levels. EF was monitored using Multigated Radionuclide Angiography (MUGA) scan of all consecutive lung cancer patients, treated with Doxorubicin based regimens. Thirteen of 82 patients showed a significant (more than 15%) decline of left ventricular EF. The dose of doxorubicin producing this decline ranged between 91-180 mg/m2. Actual decline in EF ranged between 16-45%. Only 5 of 13 patients developed symptoms attributable to the cardiac disease. Doxorubicin can alter EF significantly in lung cancer patients at levels well below which are considered 'safe'. The reason for massive decline in ejection fraction in these patients has been hypothesized.     

Intramedullary tuberculoma: a case report

A fifty-year-old Portuguese man presented with a six-month history of low back pain, which initially was mechanical and slowly became inflammatory. Secondarily, he complained of right atypical sciatalgia. He did not report any fever, loss of weight, cough nor personal or familial history of tuberculosis. General examination was normal. Neurologic examination showed weakness of the extensors of the right leg, with a symmetric increased reflexes of the lower extremities suggesting a pyramidal syndrome without Babinski's sign. Laboratory data were normal as well as chest radiographs. Dorsolumbar gadolinium enhanced MRI revealed an intramedullary ringlike enhancing mass at T12 level. Lumbar puncture showed 11 WBC/mm3 (95 p. 100 lymphocytes), a normal protein and glucose content. PCR and culture for Mycobacterium tuberculosis were negative. Within a few days, he developed meningoencephalitis with fever, CSF examination revealed then 360 WBC/mm3 (65 p. 100 lymphocytes and 17 p. 100 neutrophils), a protein content of 7 g/l and a glucose level of 1.7 mmol/l. The clinical picture was then suggestive of tuberculosis and a specific therapy with rifampin, izoniazid, pyrazinamid, ethambutol and steroids was started. Clinical improvement and a second CSF culture that revealed one month later Mycobacterium tuberculosis complex confirmed this diagnosis. Ten months later, the patient was asymptomatic with a normal MRI. To our knowledge, this is the first total recovery of an intramedullary tuberculoma on medical therapy alone, confirmed by MRI normalization. We reviewed also 19 recent cases of tuberculomas in the literature, intending a therapeutic attitude when discovering an intramedullary ringlike enhancing mass on MRI.     

Captopril-induced agranulocytosis: a case report

1,000 refugees living in Strasbourg have had a stoll parasitologic exam between 1986 and 1990. We have not retained results of South America and other areas of Asia subjects because of their scarce total number. Proportionally, the most numerous are the South East Asia Nationals (51.7%); followed by those from Middle East and Africa (20 and 15.5%) and more recently by those from East of Europe (5.2%). Their parasitic infestation's rate remains important (60.9%) but variable depending on their origin. Thus, people coming from Middle East and Africa are parasited mainly by protozoan, although those from South East Asia are parasited by helminths. It's interesant to notify that the prevalence of D. fragilis is ten times higher among East European people than in the common people.     

Enchondroma protuberans: a case report

Epidemiologic studies suggest that moderate amounts of ethanol may reduce cardiovascular risk. The mechanisms of the alcohol-associated risk reduction are not known exactly. Vascular smooth muscle cell proliferation represents an important phenomenon in the pathogenesis of atherosclerosis. Recently, it was suggested that metabolic changes during the postprandial phase may be important in the pathogenesis of atherosclerosis. Therefore, we evaluated the effect of postprandial plasma with and without ethanol on the proliferation of rat vascular smooth muscle cells. Identical meals containing 1 g fat/kg body wt were given with and without ethanol (38 +/- 0.5 g) to eight healthy young men. Blood was drawn hourly during an 8-h postprandial period; the plasma was separated and added to the cell cultures (0.3%, by vol). The proliferative response (DNA synthesis) of these cells was assessed by measuring the incorporation of [methyl-3H]thymidine. The maximal blood ethanol concentration of 11.5 +/- 0.6 mmol/L (mean +/- SEM) was attained within the first hour. The ingestion of the meal with ethanol led to a 20% reduction in the capacity of postprandial plasma to induce thymidine incorporation into smooth muscle cells compared with the meal without ethanol (P < 0.05). These results suggest that ethanol may reduce cardiovascular risk by modulating vascular muscle cell growth during the postprandial period. Considering the amount of time humans spend in the postprandial state during their lifetimes, these findings may be of great importance in the pathogenesis of atherosclerosis.     

Autoerotic asphyxia: a case report

Autoerotic asphyxia is the induction of a state of oxygen deficiency to enhance sexual excitement and orgasm. It has been practiced for centuries, and there are many reports of fatalities. The authors report a case of a living participant that shows a number of characteristics different from those of fatalities. The case study also raises doubt about the conventional view that participants have no wish to die. We feel that further case studies of living participants will lead to a greater understanding of the practice and will facilitate treatment.