Migration of a broken steinman pin into the posterior compartment of the leg 12 years after total hip arthroplasty

This report is on a migration of a Steinman pin into the posterior com Department of the calf. It was used to fix a greater trochanteric osteotomy in a total hip arthroplasty. The puzzling note is how this metal piece passed through the anterolateral compartment of the thigh to the posterior compartment of the calf. According to our literature review, migration of fixation pins through the knee joint is an extremely rare occurrence and could be missed by an inattentive physician

Hodgkin's disease with hyperferritinemia, hepatic and heart failure

Diffuse hepatic infiltration is an unusual form of Hodgkin's disease [HD]. Its manifestation as progressive hepatitis or with hepatic failure is even rarer and can be difficult to diagnose. We aim to describe an unusual case of liver failure due to HD. A middle-aged woman with a 10 month history of daily febrile episodes, constitutional symptoms and strikingly high levels of serum ferritin was admitted to our hospital with pancytopenia and jaundice. The patient rapidly deteriorated, and developed hepatic and heart failure. A liver biopsy revealed infiltration of the liver with mixed cellularity type HD that was confirmed by lymph node biopsy. HD must be considered in the differential diagnosis of obstructive jaundice in adults. Liver biopsy early in the course of liver dysfunction may establish this diagnosis without a higher risk of bleeding complications seen once liver failure sets in

Role of stem cell and new regenerative therapies in endodontics

Millions of teeth are saved each year by root canal therapy. Although current treatment modalities offer high levels of success for many condition, an ideal form of therapy might consist of regenerative approach in which a biologically based procedures designed to replace damaged structures, including dentin, root structure and pulp-dentin complex. The aim of this study was to collect information about the stem cell and their role in new regeneration therapies in endodontics. Data was collected by searching Pubmed and Cochrane data bases using key words such as stem cell, regenerative endodontics, pulp revascularization and tissue engineering. Selected reference text books were searched using the same search strategy. The search results were categorized according to methodological strength; they also selected only if qualified for our inclusion criteria. Although regenerative endodontic procedures are much more effective in regeneration of pulp-like tissues, [pulp-dentin complex], and despite these applications and considerable evolution of certain medical procedures of tissue regeneration, there has not been significant translation of these therapies into clinical endodontic practice. More studies are required to overcome technical and clinical limitations of pulp and dentin tissue regeneration both to result in pulp-dentin tissue regeneration, and to form the functional structure of the tooth from stem cells

Contributing risk factors for orthopedic device related infections, Tehran, Iran

In spite of decreasing incidence of orthopedic device-related infections to 1%, nowadays, device-related infection still remains a diagnostic, therapeutic and cost-related problem. The objective of this study is to evaluate the contributing risk factors for orthopedic device-related infections in Sina Hospital, Tehran, Iran. Three hundred and thirty patients who underwent orthopedic device implantation from 2002- 2006 were enrolled; among them, 110 patients were complicated with infection. Descriptive and logistic regression analyses were performed to determine the risk factors for device related infections. Patients with infection were older compared to those without infection. The Staphylococcus aureus was the commonest organism. A correlation was observed between wound infection and external fixation, an underlying health condition, and addiction which were independent risk factors for a device related infection. Orthopedic device-related infection puts a great financial burden on patients and hospital resources and could lead to morbidity and mortality in patients. So, appropriate pre and postoperative wound care for dirty wounds, especially when external fixators are used, and in patients with poor conditions or addiction should be done with more caution

healing effect of vitreous body on repair of cartilage defects of knee joint in dog as an animal model

To investigate the healing effects of vitreous body in repair of cartilage defects of the knee joint in dog as an animal model. Ten mature cross-bred female dogs weighing 20-35 kg entered our study. The right and left knees underwent a medial parapatellar incision arthrotomy. A cartilage defect was created by a six mm drill to subchondral bone in the right knee and the two borders of the fascia were fixed to the space of the joint defect. The vitreous was provided through a clear corneal incision to completely fill the joint defect. In the left knee, the cartilage defect was left untreated. The dogs were sacrificed after 3 months post-operation and the samples were studied for any sign of repair. The defects of the right knee showed more signs of repair compared to the left knee after 12 weeks. Fibrous and hyaline tissues, new bone and blood vessels formation were significantly more visible in the right knee. Modified histological scoring scale in the right and left knees were 5.8 and 11, respectively. The results imply the promising effect of vitreous body implantation in the healing of a cartilage defect in the knee joint

Polymorphism in the first intron of interferon-gamma gene [+874T/A] in patients with BCG adenitis

Cytokines and specially interferon-gamma [IFN- gamma] are largely responsible for the regulation of the protective immune response against mycobacterial infections. Several studies have clarified the importance of common variants of IFN-gamma gene regarding the susceptibility to tuberculosis. Bacille Calmette-Guerin [BCG] vaccine that is used to prevent severe forms of tuberculosis could produce local and systemic side effects. In this study we hypothesized that the IFN-gamma [+874T/A] polymorphism was associated with development of BCG adenitis. Thirty patients with BCG adenitis [18 males and 12 females] and 30 age and sex-matched healthy children, vaccinated with BCG during the first two days of life were chosen. All the patients and controls were of Iranian Fars origin and the study was conducted from 2005 to 2007. DNA samples were obtained from 30 patients with BCG adenitis and 30 age and sex matched healthy vaccines. Polymorphism at +874 was identified using allele specific polymerase chain reaction. Allele and genotype frequencies in cases and controls were compared using the chi [2] test and odds ratios [OR] and their 95% confidence intervals [CI] were calculated. The minor allele [T] frequency was significantly lower in patients with BCG adenitis compared to controls [35%vs 55%, P=0.02, OR =0.441, 95% CI= 0.211-0.919]. The Armitage trend test revealed a gradually increasing protection from the AA genotype through AT to TT [common odds ratio= 0.49; P=0.037]. Our data suggest that in an Iranian population, the IFN-gamma [+874T/A] polymorphism is associated with development of BCG adenitis in the vaccines

Effect of diabetes mellitus on pulp and periradicular infections: a literature review

Diabetes Mellitus [DM] has destructive effects on various tissues and organs including the dental puro and periodontal tissues. The aim of this study was to collect information about the influence of DM on pulpal and periradicular tissues in healthy and diabetic cases. Data was collected by searching PUBMED and Cochrane databases using keywords such as diabetes, periradicular infection, periradicular lesion, periapical infection, periapical lesion, pulp, periodontium. Selected reference textbooks were searched using the same search strategy. The search results were categorized according to methodological strengths and selected only if qualified for our inclusion criteria. In diabetic patients numerous histopathologic changes happen in dental pulp and periodontium, accompanied by qualitative and quantitative alterations in normal oral microflora and disturbances in immune system. Usually these three factors accompany each other just like the three sides of a triangle. These cases are not only vulnerable to pulpal necrosis and periradicular disease, but also cause the infection to follow an unusual pathway which requires different treatment regimens compared to nondiabetic patients. Pulpal and periapical infections in diabetics have a completely different pattern which affects the treatment outcomes in these cases compared to nondiabetic individual

[Comparison of Guttaflow and Gutta-percha cytotoxicity on rat's L929 cells]

A new root filling material, GuttaFlow, has been introduced by adding gutta-percha to RoekoSeal playing the role of gutta-percha and sealer simultaneously. The present study evaluated the cytotoxicity of two root filling materials GuttaFlow and gutta-percha on mouse fibroblast cell line L929. GuttaFlow and gutta-percha were prepared according to manufacturer's instruction and exposed to UV radiation under the hood. After passage of mouse L929 fibroblast cells for 4 times, their vitality was assessed by tripan blue and counted by neobar devices. The counted cells were placed in the 24-well plates. The cell and dimethyl methacrylate were used as negative and positive controls. The fibroblasts were cultured at 37°C in a humidified atmosphere of%95 air and%5 CO[2] in Dulbecco's MEM supplemented with%10 FBS containing penicillin [10 IU/ ml] and streptomycin [10 micro g/ml solution. 10 specimens of each experimental and control groups were brought into contact with the culture medium and incubated after 24 hours under sterilized condition. The cytotoxicity of each samples were assessed by MTT test after 1 hour, 24 and 72 hours. The results were analyzed using one-way and two-way ANOVA and Tukey multiple comparison interval. There were a significant effect of material, assessment time and their interaction on optical density of material's cytotoxicity [p<0.0001 in all conditions], also it was revealed that assessment time had a significant influence on optical density of both materials. In GuttaFlow, the most and least cytotoxicity was observed at 24 and 72 hours while cytotoxicity of Gutta-percha increased with time

Evaluation of distortion and fracture of flexmaster and profile files during root canal preparation conducted by endo It control instrument in human molar

Although rotary instruments have been used for cleaning and shaping procedures during root canal preparation; nevertheless, the most effective technique regarding the use of these instruments has not been determined yet. Therefore, this study was carried out to evaluate the distortion and fracture of Flexmaster and Profile files during root canal preparation. This process was carried out by Endo IT Control instruments on human molar teeth. A total of 60 human molar teeth with 10 -30 curved roots were randomly divided in two groups. Flexmaster and Profile files were used in the first and second groups using crown-down technique. The instrumentation speed, time and torque were controlled using Endo IT Control according to manufacturer's instructions. The fracture and distortion of files were evaluated in both groups. There was not any instrument fracture in the study, but 3 distortion cases were observed [2 in Profile group and 1 in Flexmaster one]. The difference between distortions in two groups was not statistically significant. Likewise, no relationship was found between distortion and repeated use of instruments in the sample. There was not any difference regarding fracture between the two groups. However, distortion of files in Profile group was more than Flexmaster group when Endo IT Control instrument was used

[Scleral buckling with and without retinopexy for rhegmatogenous retinal detachment]

Purpose: to compare the anatomical results of scleral buckling with or without retinopexy and to assess the effect of retinopexy on outcomes of the operation

Methods: this interventional case series was performed on 22 patients undergoing scleral buckling [segmental or encircling] with or without subretinal fluid drainage and without any type of retinopexy and 33 patients who received transscleral retinal cryopexy around retinal break[s] in addition to above procedure. The two groups were matched regarding age, sex, myopia, aphakia, and number, size, and location of the break[s] and also stage of proliferative vitreoretinopathy [PVR]

Results: in the non-retinopexy group, 19 patients [86.4%] had complete and 1 patient had partial retinal attachment after 10-24 months of follow up. The cause of failure in two cases was missed breaks out of the buckle area in one and PVR in the other patient. Overall success rate was 90.9% [20 of 22] in this group. In the retinal cryopexy group, 26 patients [78.9%] had complete and 2 had partial attachment after 11-32 months of follow up. Attachment was not achieved in 3 patients and 2 patients developed redetachment 1 and 3 months later because of PVR. Overall success rate was 84.8% [28 of 33]. The anatomical results in this two groups were comparable statistically [P=0.9]

Conclusion: with permanent scleral buckling technique, retinal cryopexy does not seem to increase success rate defined as short term anatomical retinal reattachment

Effect of lactation on postpartum uterine involution in rat

To see the effect of lactation on uterine involution. Setting: Postgraduate Medical Institute, Lahore. Design: Study of uterine weight and extracellular matrix in rat uterine wall. Subjects: Sixty six mature virgin albino rats. Average age 8 weeks. Average weight 156gms. Group A [non pregnant] 06 animals. Group B [postpartum lactating] 30 animals. Group C [postpartum non lactating] 30 animals. Six animals from group B and C each sacrificed daily from day 1-5 after parturition. Uterine weight increased 10-11 folds on first day after parturition [P <0.01]. The uterine wall was thickened. The collagen fibres were increased through out the uterine wall. They were surrounding groups of muscle fibres and individual myocytes also. Collagen degradation and removal resulted in uterine involution which was accelerated by lactation. Lactation accelerates the process of uterine involution

Changes in extracellular matrix in rat uterine wall during pregnancy

To find changes in collagen fibers in extracellular matrix of uterine wall during early and late pregnancy. Settings: Postgraduate Medical Institute, Lahore. Design: Study of extracellular matrix in rat uterine wall. Subjects: Twenty four virgin mature albino rats. Average age 08 weeks. Average weight 155gms. Group A [non pregnant [06 animals. Group B [Pregnant] 18 animals, sacrificed after 1st, and 2nd and 3rd week of pregnancy. A significant rise in the uterine weight [without fetuses] during pregnancy was observed. During early pregnancy the collagen fibres were increased. Collagen degradation was noted during late pregnancy, which was correlated to increased amount of ground substance between the fibers. Thickness of uterine wall increased significant during early pregnancy but at full term it thinned out due to great stretching of the wall. During early pregnancy collagen fibres are increased in extracellular matrix of rat uterine wall, while, during late pregnancy they show degradation