Biliary obstruction due to duodenojejunal intussusception in Peutz-Jeghers syndrome

We reported an operative case of bilateral coronary artery fistulae to pulmonary artery associated with a giant saccular aneurysm, the largest of which measured 30 x 30 mm. The patient was a 75 year old female who had anginal pain due to coronary steal phenomenon. A continuous murmur was detected. After establishing total cardiopulmonary bypass, two distal orifices of the fistula connected to the main pulmonary artery were closed with 5-0 polypropylene plegeted sutures. Aneurysmorrhaphy was then performed for giant saccular aneurysm. Postoperative course was uneventful.     

Residual Stress Evolution in Repair Welds

Abstract: The aim of this paper is to study the influence of the repair procedure on the evolution of residual stress distribution in butt welds. C-Mn steel coupon plates of 11 mm thickness were prepared, subjected to stress relief heat treatment and welded with two beads, using the gas metal arc welding process. After the deposition of two weld beads, two successive repair welds were made on the middle length of the second bead. Longitudinal and transverse residual stresses were measured in the vicinity of the weld, after deposition of the two weld beads and after each repair weld. Residual stress evaluation was conducted using an X-ray diffraction method. The repair welds caused a decrease in magnitude of the initial longitudinal residual welding stresses, and an increase of the transverse residual stress magnitude, in tension at points within the repair length, and in compression at points outside the repair length.     

IL-1 in gingival crevicular fluid following closed root planing and papillary flap debridement

Interleukin (IL)-1 alpha and beta are cytokines which can mediate inflammatory, bone resorbing, and reparative effects in the periodontium, but few longitudinal data exist exploring their role following periodontal therapy. This study examined gingival crevicular fluid (GCF) concentrations of IL-1 alpha and IL-1 beta at sites with shallow sulci (SS) or inflamed moderate/advanced pockets (M/AP) before and 6 months after treatment with closed scaling/root planing (SC/RP) or papillary flap debridement (PFD), all in the same subject (n = 14 patients). No significant differences were noted in IL-1 alpha or beta concentrations (determined with two-site enzyme-linked immunosorbent assays) between SS and M/AP sites at baseline. While both therapies improved clinical parameters of periodontal disease, IL-1 alpha concentration increased significantly (p < 0.05) in M/AP-PFD sites 6 months after treatment, but were unchanged in other groups. IL-1 beta concentrations were numerically lower after therapy, except for a significant increase (p < 0.05) in M/AP-PFD sites. These data suggest that surgical wound healing in an inflamed, plaque-infected site (M/AP-PFD) results in prolonged production of IL-1, which may be a reflection of the extent of tissue trauma and delayed wound healing. In spite of increased IL-1 levels, these sites demonstrated significant short-term improvement in clinical attachment level (+ 1.8 mm, p < or = 0.001) postoperatively.     

Validation of the Lifestress Inventory for people with a mild intellectual disability

The Subjective Stress Scale (SSS; Bramston & Bostock, 1994) was developed to measure stress in people with a mild intellectual disability. In previous research, the SSS was found to measure two broad dimensions of stress (a) a General Worry factor and (b) a factor that tapped concerns about Negative Interpersonal Relations (Bramston & Fogarty, 1995). The present study sought to continue this line of research by introducing a slightly modified form of the SSS, to be known as the Lifestress Inventory (LI) and examining the psychometric properties of the scale when administered to a new sample of 221 people with mild intellectual disabilities. Confirmatory factor analysis indicated that three underlying factors corresponding to General Worry, Negative Interpersonal Relations, and Coping were sufficient to account for the correlations among the items in the LI. Rasch analysis indicated some improvements to the scoring format for the LI and also showed that the most easily experienced stressors were associated with the Negative Interpersonal Relations dimension. The refinements introduced by the LI and the further demonstration that some of the broad stress dimensions identified in the general population can also be found in people with an intellectual disability represent important milestones for researchers interested in exploring reactions to stress among this population.