Survival of cylindrical implants in composite grafted maxillary sinuses

PURPOSE: This retrospective study investigated the survival of dental implants placed in the maxilla after composite grafting of the sinus and an average of 55 months of loading. PATIENTS AND METHODS: Maxillary sinuses of 88 patients were grafted with autogenous cancellous bone combined with dense hydroxyapatite particles. After an average healing period of 3.4 months, hydroxyapatite-coated titanium endosseous implants were placed. A total of 388 implants were placed in grafted sinus floors, and 82 were placed in onlay grafted nonsinus position in the canine region. The implants were loaded with overdentures and fixed bridges 4 months (mean) after implantation, with a follow-up for a mean of 55 months. RESULTS: The cumulative implant survival was calculated according to the Kaplan-Meier method. Implant survival from the time of loading was 89% in full reconstructed cases and 90% in partially edentulous cases. The overall cumulative implant survival rate, including the loss in the surgical stage, was 82%. CONCLUSION: Implant loss in composite grafted maxillae after 70 months of follow-up was similar to loss in nongrafted maxillae.     

Abdominal compartment syndrome

PURPOSE: Two cases of abdominal compartment syndrome are described and the pathophysiology associated with it is reviewed. CLINICAL FEATURES: The first patient was a 46-yr-old man who sustained extensive blunt abdominal injuries following a fall. The second was a 54-yr-old man involved in a motor vehicle accident with blunt abdominal trauma. In both cases, the patients developed an extremely tense abdomen, increasing peak inspiratory pressures, hypercarbia and oliguria. Both demonstrated improvement in cardiac performance and ventilatory variables following an emergency decompressive celiotomy. CONCLUSION: Abdominal compartment syndrome results in impairment of organ function secondary to increased intraabdominal pressure. These patients require emergency decompressive celiotomy to relieve the symptoms. However, the incidence of intractable asystole and hypotension during this procedure is high and vigilance must be maintained during the release of the increased intraabdominal pressure.     

Health effects of methyl tertiary butyl ether (MTBE) in gasoline in Alaska

OBJECTIVES: This ecologic study assessed whether there was a change in health status in Alaska in the winter of 1992-93 after the introduction of MTBE in gasoline. Methyl tertiary butyl ether(MTBE) is used as a fuel oxygenate in the United States and in Europe. In the winter of 1992-93 MTBE was added to gasoline in the cities of Fairbanks and Anchorage, Alaska. The program was discontinued in Fairbanks in December, 1992, but continued in Anchorage until February 28, 1993. METHODS: Outpatient visits for state employees and dependents (n = approximately 28,000) living in Alaska were compared over three winters by analyzing health insurance claims. RESULTS: Odds ratios were calculated. The odds ratios indicated that the winter of 92-93 was not statistically different from previous winters in numbers of claims for upper respiratory illness, bronchitis, headache, or asthma in either Anchorage or Fairbanks. CONCLUSION: There was no increase in claims for respiratory illness in either city after introduction of MTBE.     

Determination of selenium in serum by hydride generation atomic absorption spectrometry for calculation of daily dietary intake

Hydride generation atomic absorption spectrometry was used to determine the selenium concentrations in 130 samples of human serum from a control group of inhabitants in the southern part of the province of Granada (Spain). The mean selenium concentration in serum was 74.9 micrograms/l. This concentration did not vary significantly (P > 0.05) in relation to the sex of the subject, with concentrations of 80.6 micrograms/l in men and 70.7 micrograms/l in women. These mean values correspond to a mean daily dietary selenium intake of 50.4 micrograms per day in men and 44.6 micrograms per day in women. A considerable number of the individuals in the study area therefore have a daily selenium intake lower than the recommended dietary allowance of 70 micrograms per day for men and 55 micrograms per day for women. Likewise, the measured selenium concentrations in the basic health zones of the area were not statistically different (P > 0.05). The differences in selenium concentration between subjects in coastal zones and mountainous zones are therefore not significant.     

Aphysiologic performance on dynamic posturography

The remarkable ability of the body to maintain balance is the result of central nervous system integration of sophisticated inputs from the vestibular, visual, and somatosensory systems. Strategies by patients with balance dysfunction are aphysiologic when their performance is relatively better on more difficult conditions of sensory conflict than on easier ones. Twenty-two aphysiologic patterns on computerized dynamic posturography were compared with age-matched normal and vestibular patterns. The aphysiologic group performed significantly better than the patients in the vestibular dysfunction group on the most difficult subtests of computerized dynamic posturography, conditions 5 and 6, yet significantly poorer on the easier subtests, conditions 1 through 4. In addition, patients in the aphysiologic group tended to show greater intertrial variability compared with patients in both normal and vestibular system dysfunction groups. A stepwise linear discriminant analysis was used to determine a set of conditions that had significant value in discriminating between the three patient groups. Case studies are presented to further illustrate the clinical usefulness of computerized dynamic posturography testing in the evaluation of patients suspected of having a functional component to their on-feet balance problems.