Extensive sino-orbital zygomycosis after heart transplantation: a case report.

BACKGROUND: Zygomycosis is an opportunistic fungal infection mainly affecting patients with diabetes mellitus, immunodeficiency, and malignancies. The majority of cases in which it has been reported as a posttransplantation complication have been after renal or liver transplantation. There are few instances of rhino-sinusitis and orbital mucormycosis complicating heart transplantation. CASE REPORT: A 38-year-old diabetic man who had undergone heart transplantation returned to the transplantation follow-up clinic 20 days after a successful operation with unilateral periorbital swelling, nasal discharge, and multiple cranial nerve dysfunctions. Multidisciplinary investigations resulted in detection of mucormycosis in the paranasal sinuses and the orbital space, as well as a thrombosis of the cavernous sinus. Surgical ablation of the infected parts, along with antifungal treatment and adjustment of immunosuppressive maintenance, restricted extension of the craniofacial involvement. Allograft function remained undisturbed. CONCLUSION: Early detection of opportunistic infections in transplant recipients plays a big role in preventing dissemination. Fungal infections, including zygomycosis, should be considered for recipients, especially those with risk factors, such as diabetes, who present with local unusual manifestations. Sinonasal and orbital mucormycosis, if diagnosed in timely fashion, can be managed to reduce mortality. Although devastation of one-side facial and ophthalmic structures was inevitable in this case, the overall outcome was acceptable.

Platform accelerations of three different whole-body vibration devices and the transmission of vertical vibrations to the lower limbs.

Physical whole-body vibration (WBV) exercises become available at various levels of intensity. In a first series of measurements, we investigated 3-dimensional platform accelerations of three different WBV devices without and with three volunteers of different weight (62, 81 and 100 kg) in squat position (150 degrees knee flexion). The devices tested were two professional devices, the PowerPlate and the Galileo-Fitness, and one home-use device, the PowerMaxx. In a second series of measurements, the transmission of vertical platform accelerations of each device to the lower limbs was tested in eight healthy volunteers in squat position (100 degrees knee flexion). The first series showed that the platforms of two professional devices vibrated in an almost perfect vertical sine wave at frequencies between 25-50 and 5-40 Hz, respectively. The platform accelerations were slightly influenced by body weight. The PowerMaxx platform mainly vibrated in the horizontal plane at frequencies between 22 and 32 Hz, with minimal accelerations in the vertical direction. The weight of the volunteers reduced the platform accelerations in the horizontal plane but amplified those in the vertical direction about eight times. The vertical accelerations were highest in the Galileo (approximately 15 units of g) and the PowerPlate (approximately 8 units of g) and lowest in the PowerMaxx (approximately 2 units of g). The second series showed that the transmission of vertical accelerations at a common preset vibration frequency of 25 Hz were largest in the ankle and that transmission of acceleration reduced approximately 10 times at the knee and hip. We conclude that large variation in 3-dimensional accelerations exist in commercially available devices. The results suggest that these differences in mechanical behaviour induce variations in transmissibility of vertical vibrations to the (lower) body.

Repair of newly condensed amalgam restorations.

This study investigated the tensile strength of the newly condensed amalgam repaired with newly triturated amalgam in different times. A separable plexiglass mold with a dumbbell shape "cavity" was prepared. Amalgam was condensed in the "cavity" and allowed to set for one hour before it was removed from the mold and used for control. Five controls were prepared. Five groups with five samples in each group were prepared. Amalgam was condensed in the first half of the "cavity" and 5, 15, 30, 60 minutes and 24 hours later newly triturated amalgam was condensed in the second half of the "cavity" for the 5, 15, 60 minutes and 24 hour group samples. All samples were allowed to set in the mold for one hour then removed and stored in 100% humidity condition at room temperature for 24 hours. Tensile strength was tested on the Instron testing machine. It was found that when the newly condensed amalgam was repaired in five minutes, it has 84% of the tensile strength and was not significantly different from the controls. When it was repaired in 15, 30, 60 minutes and 24 hours, the tensile strength was significantly lower than the controls and significantly different from the controls.