ABSTRACT
Objective: The aim of this study was to evaluate the transcrestal sinus lift using Osseodensification technique with simultaneous implant placement. Material and Methods: In this case series 7 patients who needed implant placement in the atrophic posterior maxilla were enrolled. In all the cases the residual bone height between the sinus floor and the alveolar crest was 4-6 mm. Transcrestal sinus lift was performed using Osseodensification with simultaneous implant placement. Cone-beam computed tomography (CBCT) were obtained immediately postoperative and 6 months after operation. Implant stability using Osstell® were assessed at the time of implant placement and implant exposure (6 months). Results: The results showed that the mean bone height gain was 5.33±0.83mm at 6 months postoperatively. Mean bone density value was 818.43±109.63 HU. Mean ISQ value was 80.00±3.11 at 6 months postoperatively. The duration of surgical procedure (minutes) ranged between 25-38 minutes with an average of 30.86±4.10 minutes. Conclusion: The crestal maxillary sinus floor elevation using Osseodensification technique with simultaneous implant placement provide superior results regarding bone density and implant stability and less duration of surgical procedure. (AU)
Objetivo: O objetivo deste estudo foi avaliar a elevação de seio maxilar via crista do rebordo com a técnica de Osseodensificação com instalação simultânea de implante. Material e Métodos: Nesta série de casos, participaram 7 pacientes que necessitavam de implantes em região posterior de maxila atrófica. Em todos os casos a altura de remanescente ósseo entre o soalho do seio e a crista alveolar estava entre 4 a 6 mm. A elevação de seio maxilar via crista do rebordo foi realizada com osseodensificação com instalação simultânea de implante. As Tomografias Computadorizadas Cone Beam (TCCB) foram obtidas imediatamente após a cirurgia e 6 meses depois. A estabilidade dos implantes utilizando Osstell® foi avaliada no momento da instalação do implante e no momento da reabertura (6 meses). Resultados: Os resultados mostraram que a média de ganho de altura óssea foi de 5.33±0.83mm após 6 meses da cirurgia. A média da densidade óssea foi de 818.43±109.63 HU. A média de ISQ foi de 80.00±3.11 após 6 meses da cirurgia. A duração do procedimento cirúrgico (minutos) foi entre 25 a 38 minutos com uma média de 30.86±4.10 minutos. Conclusão: A elevação do soalho de seio maxilar via crista do rebordo com instalação simultânea de implante utilizando osseodensificador promove resultados superiores em relação à densidade óssea, estabilidade do implante e menor duração do tempo cirúrgico (AU)
Subject(s)
Humans , Male , Female , Adult , Osteotomy , Alveolar Bone Loss , Bone Substitutes , Dental Implantation , Cone-Beam Computed Tomography , Sinus Floor AugmentationABSTRACT
The emergence of methicillin-resistant Staphylococcus aureus (MRSA) strains possessing virulence genes encoding such toxins as exfoliative toxins (ETs), toxic shock syndrome toxin-1 (TSST-1), is worrying, especially in relation to the increasing frequency of nosocomial infections. The present study aimed to determine the prevalence of genes encoding ETs and TSST-1 in MRSA isolates by polymerase chain reaction (PCR). The results showed that out of 88 investigated MRSA isolates, tst and etb toxin gene were found in 3 (3.4%) and 2 (2.3%) respectively, while none eta toxin genes were detected. It was concluded that the incidence of ET and TSST-1encoding genes among MRSA isolates in Makkah is lower or near to the global prevalence.
ABSTRACT
Purpose: to determine the diagnostic yield and efficacy of CT-guided percutaneous biopsy of sclerotic bone lesions
Materials and Methods: we performed a prospective study of 26 patients with sclerotic bone lesions whom underwent CT-guided percutaneous biopsy over a 20- month period. A tryphine Ostycut needle, combined Ostycut/Trucut, or combined Ostycut/ fine needle aspiration biopsy [FNAB] were used to obtain a specimens for histopathological examination. Bone biopsy results were analyzed to yield diagnostic efficacy according to needle type, site of the lesion as well as final pathological diagnosis
Results: all twenty-six sclerotic bone lesions were biopsed under CT guidance. Ten of them affected the axial skeleton and 16 affected long bones. Metastatic deposits were detected in five patients, oestosarcoma [n = 7], chnodrosarcoma [n = 2], Ewing's [n = 3], osteomyelitis [n= 4] and lymphoma, chordoma, synovioma, bone infarcts, and oestoblastoma each [n = 1]. The diagnostic efficacy according to used needle was Ostycut needle 83%, combined Ostycut/ Tru-cut needles 100% and combined Ostycut/ FNAB 80%. Diagnostic efficacy according to site of the lesion was 80% in the axial skeleton and 93.7% in the long bones. Efficacy of CT-guided bone biopsy according to pathological type of lesion was 83% for metastatic deposits, 83% for oestosarcoma and 50% for chordoma. It was I 00 for chondrosarcoma, lymphoma , Ewing's, synovioma, bone infarcts, osteomyelitis, and Ostoblastoma. The overall diagnostic efficacy and yield for CT-guided bone biopsy of sclerotic bony lesions was 85% after 1st biopsy and increased to 86.6% after 2nd biopsy
Conclusion: percutaneous CT- guided biopsy of sclerotic bone lesions is an important tool in the evaluation of sclerotic bone lesions. It is a reliable procedure and yields diagnostic information in a high proportion of patients. It has several advantages over an open bone biopsy
ABSTRACT
Zineb is one of the ethylene-bis-dithiocarbamate fungicides which are widely used for the plant protection especially grains, vegetables and fruits. Potential exposure to zineb can occur in workers engaged in the production and use of the fungicide, people living in agricultural areas where the compound is sprayed and people consuming polluted products. Zineb can produce toxic effects on the testes and chromosomes. This study was performed to evaluate the possible protective role of vitamin [E] against zineb-induced toxicity on the testicular structure and chromosomal pattern of adult male albino rats. Ninety six albino rats equally divided into six groups were used; the first group was used as a negative control. The second group: each rat was given l C.C. distilled water orally once daily for 3 months and the third group: each rat was given I C.C. com oil orally once daily for 3 months were used as positive control groups. The fourth group: each rat was given 1/10 LOSO of zineb which is 5 gm/Kg. body weight once daily orally for three months. The fifth group: each rat was given vitamin [E] I 00 mg/kg once daily orally for three months. The six group: each rat was given both zineb and vitamin [E] for three months. At the end of the study [after 3 months]. The tests of zineb-treated rats [group 4] showed significant histopathological alterations in the form of distorted 1>eminiferous tubules with irregular contour. The tubules were shrunken and attain different shapes and separated from each- other by wide interstitial spaces. These changes were confirmed by electron microscope that showed marked loss of spennatogenic cells, the distorted spennatids had an irregular outline and their nuclei showed densely packed chromatin material. Their cytoplasm was poor with organoids. Leydig cells appeared with irregular outlined nuclei. The rats of group 6 [zineb and vitamin E group] showed less histopathological changes when compared with group 4 [zineb group]. Moreover, chromosomal study of zineb-treated rats showed a significant increase in the frequency of structural and numerical chromosomal aberrations when compared with groups 1, 2 and 3 and group 6 [zineb and vitamin E group]. It could be concluded that chronic zineb exposure can induce testicular and chromosomal abnormalities, while simultaneous administration of vitamin [E] can ameliorate such toxic effects, indicating that vitamin [E] can play a protective role against the toxic effects of zineb on the testis and chromosomal pattern of adult male albino rats
ABSTRACT
Ammonium molybdate is an essential trace element in plants and animals as a cofactor for enzymes and also, it is an environmental pollutant. Sixty adult male albino rats were used to investigate the adverse effects of ammonium molybdate on the bone, brain, spinal cord and chromosomes. The rats were equally divided into 3 groups. The 1[st] group was left without treatment and used as a negative control group, the 2[nd] group was daily intragastrically administered saline for 30 days and was used as a positive control group and the 3[rd] group was daily intragastrically administered ammonium molybdate in a dose of 33 mg /kg body weight [1/10 of the lethal dose fifty] for 30 days. At the end of the study ten rats from each group were sacrificed, necropsied and specimens from the bone, brain and spinal cord were collected for histopathological examination. The remaining ten rats of each group were used for studying the chromosomal pattern of bone marrow cells. Histopathological examination of the rats of the 3[rd] group [ammonium molybdate group] showed reduction in the thickness of the bone trabeculae with formation of numerous osteoid fractures and fissures of the epiphysis and necrotic osteocytes. There is also separation between the cortical bone from the periosteum and the endosteum. The bone marrow cavity contains numerous large fat cells with lacked hemopoietic activity. The brain showed congestion of meningeal and cerebral blood vessels, edema, gliosis and neuronophagia. The spinal cord showed satillitosis, gliosis in the grey matter and encephalomalacia and demyelination in the white matter. Regarding cytogenetic study of the bone marrow cells, molybdenotic rats showed a significant increase in the incidence of chromosomal aberrations as terminal chromatid deletions, chromosomal fragments and ring chromosomes when compared with the control group. It could be concluded that, ammonium molybdate is genotoxic and can produce toxic effects on the bone, brain and the spinal cord of adult male albino rats
ABSTRACT
This prospective study was designed to evaluate using titanium elastic nails [TEN] in our children between 5 and 15 years old with femoral shaft fractures, their compliance with it, its complications, and the impact of early removal. Twenty children, 5-15 years of age, with femoral shaft fractures were studied prospectively in the department of El-Minia University Hospital in the period from February 2004 to April 2005. TEN were introduced retrograde with no postoperative external splint. The nails were removed early just after clinical union and good callus, in an average period of 2.1 months. The results were evaluated according to the scoring system proposed by Flynn et al., 2001[26]. The mean follow-up period was 8.8 months [range 6 to 12 months]. According to Flynn et al., 2001[26] the results were excellent in 16 fractures [80%], successful in 4 [20%], and no poor cases. The mean time to union was 1.9 months [range 1.5 to 5 months]. No intra-operative or post-operative complications that affect the final outcome. Only one case needed another operative interference in the form of closed reduction and application of external fixator. All fractures healed with acceptable alignment and non-significant length inequality. The use of TEN may be the preferred method for the treatment of femoral fractures in children aged 5 to 15 years as it allows early mobilization and fast return to functions. Early removal of the nails did not lead to additional complications or affection of the final outcome
Subject(s)
Humans , Male , Female , Nails , Titanium , Child , Follow-Up Studies , Postoperative Complications , Treatment Outcome , Fracture Fixation, InternalABSTRACT
For spine surgery, placing the anesthetized patient in the prone position increases the risk of improper ventilation. These effects may be more pronounced in obese patients because pressure on the abdominal wall may further accentuate the restrictive nature of the pulmonary disease common in this patient population. In this study, the cardio-pulmonary response to the seated prone [knee-chest] position will be investigated as influenced by the weight of the patients [obese versus normal weight patients]. The changes in respiratory mechanics, gas exchange and hemodynamics will be investigated in patients undergoing elective posterior lumbar spine surgery under general anesthesia. Patients: After approval of our local ethics committee and informed consent was obtained forty patients [19 males and 21 females], ASA I or II, who were scheduled for posterior lumbar spine surgery in the knee-chest position under general anesthesia were included in this study. They were randomly allocated into two groups according to body mass index [BMI] which was calculated as weight [kg] divided by the square height [m2]. Group I [20 patients]: Non obese patients with normal BMI of <25 kgm- 2. Group II[20 patients]: Obese patients with BMI >30 kgm-2. Method: After anesthesia-paralysis, patients were mechanically ventilated using closed circuit anesthesia and were turned into the knee-chest position with the abdomen hanging freely. Patients were continuously monitored for ECG, HR, Sa02, ETCO2 and MAP. The investigated hemodynamics, HR and MAP, were measured prior to induction of anesthesia and 15 min, after induction of anesthesia in the supine position. They were also recorded at 30, 45 and 60 min. after knee-chest positioning. Arterial blood samples for blood gases analysis were withdrawn via a radial artery catheter for measurement of pH, PaCO2, PaO2, SaO2, HCO3 and BE at the previously mentioned periods. The investigated respiratory mechanics: pleural pressure, peak airway pressure, static lung compliance and exhaled tidal volume were measured from the BICORE. They were recorded 15 min. after induction of anesthesia in the supine position, also at 30, 45 and 60 min. after knee-chest positioning of the patients. The results of this study showed that: As regards hemodynamics, there was a significant decrease in the mean values of HR and MAP at all investigated periods of the study as compared with the mean baseline value found prior to induction of anesthesia in the supine position but no statistically significant changes were found in between both groups. Regarding to the investigated respiratory mechanics, both groups showed an increase in mean value of PP after assuming the knee-chest position as compared with the value found when patients were in supine position but statistically insignificant difference was found when mean value of PP during both positions in both groups compared with each other. There was a significant increase in the mean value of PAP after knee-chest positioning as compared with baseline value in both groups. Also, group II showed higher mean value for PAP than group I at all investigated time intervals. Significant changes were found in-between both groups when the mean values were compared with each other. There was a significant decrease in the mean value of Cst, L after knee-chest positioning of the patients as compared with baseline value and the mean value was found to be statistically lower in group II than in group I at all periods of the study. Both groups of patients showed a progressive decrease in mean value Of EVT after seated prone positioning as compared with baseline value and the second group demonstrated a significantly higher mean value of EVT as compared with the first one at all investigated times of the study. As regards arterial blood gases and acid base status, no statistically significant changes were found in both groups and in-between the two studied groups during all investigated periods of the study. From the present results we can conclude that knee-chest position appeared to have minimal adverse effects on the mechanics of breathing system in anesthetized paralyzed subjects in moderately obese patients as compared with non-obese ones. As in this posture, the abdomen is hanging freely and stretching the diaphragm caudally which may counteract the effects of anesthesia-paralysis
Subject(s)
Humans , Male , Female , Anesthesia, General , Prone Position , Risk Factors , Obesity , Body Mass Index , Heterotrophic Processes , Blood Gas Analysis , Lung Compliance , Lumbar VertebraeABSTRACT
Diseases of the thyroid gland are common in our society. Moreover, it constitutes a significant percentage of our practice in the Department of Surgery, Kasr El Aini Hospital, Cairo University. Surgical procedures involving the thyroid gland accounts for about 6 percent of the operation list workload. In this study, we evaluated the pattern of thyroid disease managed in the Department of General Surgery. The diagnostic criteria, investigations, indications for surgery, surgical procedures and histopathological data were analyzed, tabulated and discussed. The study included 307 patients, admitted to the Hospital during 1997. The age range was 18 to 65 years with the mean of 38 +/- 11.4 years and 260[84.7%] of patients were females. Three hundred and seven thyroid operations were performed. Adenomatous goiter was the most common histological finding, it accounted for 61.2% of all specimens included in the study. Benign solitary thyroid pathology was found in 16.3% of the specimens examined and malignancy in 7.2% of the specimens examined. Thyrotoxicosis and Hashimoto's thyroiditis accounted for 13% and 2.3% respectively. Correlation of histological analysis and the type of operation suggested that a variety of operations were performed for the same pathological condition and that some operations were only diagnostic procedures. Forty-two thyroid Fine Needle Aspiration Cytology [FNAC] were performed to evaluate clinically suspicious lesions. From our study, we conclude that, malignancy accounted for a significant percentage among our patients. The role of thyroid function tests and radioactive thyroid scans are well established in our practice. The implementation of neck ultrasonography and FNAC in the management of thyroid disease in Kasr El Aini Hospital is increasing. The predictive values are in continuous improvement and coupled with the international standardized diagnostic protocols
Subject(s)
Humans , Male , Female , Thyroidectomy/pathology , Biopsy, Fine-NeedleABSTRACT
This study prospectively measured soluble interleukin-2 receptor [sIL-2R] levels in 50 neonates [40 with suspected sepsis divided into two groups and ten normal neonates of the same age, weight and sex as controls]. A highly significant difference was demonstrated in the level of sIL-2R between the septicemic groups and the control group, also there was a significant difference between both septicemic groups; but after two weeks of treatment, there was no significant difference between the three groups. The use of sIL-2R level was recommended to help in the early diagnosis of septicemia in neonates. The level of sIL-2R level may be helpful in determining whether therapy is effective during the first two weeks after the evaluation of sepsis