ABSTRACT
Abstract Objective: Horizontal semicircular canal site pathology of benign paroxysmal positional vertigo demonstrating three types of nystagmi on positional test were studied. We have attempted to design a protocol for its diagnosis and treatment. Methods: 320 patients of HSC-BPPV were subjected to two types of positional tests. Of these, patients with bilateral steady apogeotropic nysatgmus were treated with VAV modification of Semont's maneuver. Patients with unsteady or changing apo/geotropic signs were converted into steady geotropic ones by repetitive positional tests; followed by barbecue maneuver with forced prolong positioning. Results: Overall 88% of patients had a total recovery. 92% of patients with geotropic nystagmus showed no symptoms after second maneuveral sitting. 85% of patients with apogeotropic nystagmus recovered fully after third maneuveral sitting. Conclusion: Correct identification of subtypes of HSC-BPPV is based on provoked nystagmus by positional tests. After locating the site and side on the basis of nystagmic pattern, physician can apply the appropriate PRM. Level of evidence: II a.
ABSTRACT
Hepatic epithelioid hemangioendothelioma (EHE) is a rare malignant vascular neoplasm with unpredictable clinical behavior. These lesions are frequently misdiagnosed owing to its non-specific symptomatology, ambiguous radiological features, and overlapping histomorphology. We report three cases of hepatic EHE, of which one was male and two were female patients. While all three patients presented with abdominal pain, the male patient gave an additional history of weight loss and was jaundiced. The radioimaging showed multiple nodules in the liver and two of the patients also had pulmonary metastasis. The biopsies of the liver nodules revealed a tumor composed of spindle, epithelioid, and stellate tumor cells, some with characteristic intracytoplasmic vacuolations/lumina surrounded by myxohyaline stroma. Some of these intracytoplasmic vacuoles/lumina showed erythrocytes, suggesting its vascular origin which was confirmed by CD31 and CD34 positivity. The article highlights the importance of histopathology and IHC in the precise diagnosis of EHE.
ABSTRACT
Aim: The aim of this in vitro study was to evaluate the flexural bond strength of porcelain to combinations of used and new nickel-chromium alloy in various proportions. Materials and Methods: Used and new nickel-chromium bonding alloys were combined in various proportions (groups I to V; 10 samples per group) and their flexural bond strengths with porcelain were compared. A three-point loading system was used for the application of load. Load was applied at a constant speed of 0.5 mm/minute and the load required to fracture the porcelain was recorded for each specimen. Statistical Analysis Used: (a) Analysis of variance (ANOVA) and (b) Duncan's multiple range tests. Results: The best bond strength values were seen when 100% new alloy was used. According to the findings of this study, there was no adverse effects noted with up to 75% recast metal, but serious changes were found in the bond strength values when 100% old metal was used. Conclusions: The following conclusions were drawn from the study Fresh nickel-chromium alloy shows the greatest porcelain adherence. There is no significant change in bond strength of ceramic to alloy with up to 75% of used nickel-chromium alloy. At least 25%- of new alloy should be added when recycled nickel-chromium alloy is being used for metal ceramic restorations.