Novel method for endovascular fenestration using radiofrequency transseptal needle for aortic dissection with malperfusion syndrome.

Malperfusion syndrome is considered one of the most significant adverse events in aortic dissection disease and often requires invasive strategies to improve ischemia. We report the case of a patient who was presented with worsening claudication and leg rest pain due to malperfusion syndrome of type B aortic dissection. We successfully performed endovascular fenestration therapy to relieve the symptom by using a NRG radiofrequency transseptal needle (Baylis Medical, Montreal, Canada). We suggest that this novel method would be available for the patients with malperfusion syndrome of aortic dissection.

Gender difference in tooth autotransplantation with complete root formation: a retrospective survey.

Gender-related risk factors in the survival of transplanted teeth with complete root formation have not yet been identified. The purpose of this study was to investigate gender differences in tooth autotransplantation at dental clinics. We asked participating dentists to provide information on transplantations they had undertaken from 1 January 1990 to 1931 December 2010. The data were screened to exclude patients who underwent more than one transplantation, smokers or those whose smoking habits were unknown, patients under 30 or who were 70 years old and over, cases where the transplanted teeth had incomplete root formation or multiple roots and those with fewer than 20 present teeth post-operation. We analysed 73 teeth of 73 males (mean age, 47.2 years) and 106 teeth of 106 females (mean age, 45.3 years) in this study. The cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method. The cumulative survival rate for males was 88.3% at the 5-year mark, 64.8% at 10 years and 48.6% at 15 years; for females, it was 97.2% at the 5-year mark, 85.9% at 10 years and 85.9% at 15 years. A log-rank test indicated the difference between males and females to be significant (P = 0.011). There was also a significant difference in the main causes for the loss of transplanted teeth: males lost more transplanted teeth due to attachment loss than females (P < 0.05). These results indicate that males require more attention during the autotransplantation process, particularly at the stage of pre-operation evaluation and that of follow-up maintenance.

Influence of age on tooth autotransplantation with complete root formation.

The aim of this study was to investigate risk factors with age in the long-term prognosis of autotransplantation of teeth with complete root formation at dental clinics. Participating dentists were asked to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. The data were screened to exclude patients who were under 25 or 70 years of age and over, those who were smokers or whose smoking habits were unknown, those whose transplanted teeth had incomplete root formation or multiple roots and those with fewer than 25 present teeth post-operation. The participants in this study were 71 men (74 teeth) and 100 women (107 teeth) ranging from 25 to 69 years of age. Third molars were used as donor teeth in 89·0% of the cases. The participants were divided into three age groups of 25-39, 40-54 and 55-69. Survival analysis was conducted using the Kaplan-Meier method, and a log-rank test revealed that there were no significant differences in age groups for men or women. Cox regression analysis indicated that the survival of transplanted teeth was not influenced by age. However, although not statistically significant, the clinical success rate was lower in the 55-69-year-old group than that in the younger groups. These results indicate that if suitable donor teeth are available and the conditions are right, autotransplantation is a viable treatment for missing teeth regardless of the age of the patient.

Desorption of cluster ions from solid Ne by low-energy ion impact.

We investigated Ne(+) ions and Ne(n)(+) (n = 2-20) cluster ions desorbed from the surface of solid Ne by 1.0 keV Ar(+) ion impact. Kinetic energy analysis shows a considerably narrower energy distribution for Ne(n)(+) (n ≥ 3) ions than for Ne(n)(+) (n = 1, 2) ions. The dependence of ion yields on Ne film thickness indicates that cluster ions (n ≥ 3) are desorbed only from relatively thick films. We conclude that desorbed ions grow into large cluster ions during the outflow of deep bulk atoms to the vacuum.

Potential sputtering of ionic species from rare gas solids by multiply charged ion impact.

The interaction of low-energy multiply charged Ar(q +) (q ≤ 7) ions with a solid Ne surface is experimentally studied. Desorption of very large cluster ions Nen (+) (n > 100) is observed. The size distribution of smaller (n = 1-3) cluster ions depends strongly on the charge state of the incident ion, whereas that of larger (n > 7) cluster ions exhibits no dependence on the charge state, indicating that desorption of large cluster ions is due to kinetic sputtering. The potential sputtering yield is estimated by analyzing the size distribution of the desorbed cluster ions. The results suggest that the ion desorption mechanism, which is known as desorption induced by electronic transitions, can also be applied to explain the present results.

A cross-sectional survey investigating the care of the primary dentition by general dental practitioners working in Japan and England.

OBJECTIVE: To compare treatment decisions about primary dentistry made by Japanese and English general dental practitioners (GDPs). METHOD: Four clinical scenarios were used to ascertain the clinical opinions of GDPs about what treatment to offer a 6-year-old boy with a carious molar. The first and second scenarios were a single distal and a distalocclusal cavity in a vital tooth without pain. The third was a large distal-occlusal cavity in a non-vital tooth without pain. The fourth was large distal-occlusal cavity in a non-vital tooth with pain. The participants were 234 GDPs in Japan and 322 GDPs in England. RESULTS: In the first scenario, 62.2% of Japanese GDPs preferred traditional restorative care compared with 34.7% of English GDPs. In the second scenario, Japanese participants were less likely to offer atraumatic treatment (16.5% vs. 34.9%). In the third scenario, Japanese dentists displayed a greater tendency to open the pulp chamber (55.2% vs. 7.6%). In the final scenario, 71% of Japanese GDPs would open the pulp chamber, whereas 50.3% of English GDPs favoured extraction. CONCLUSION: Japanese and English GDPs differed substantially in their views about the best treatment for a young child with a carious molar.

Association between lamivudine sensitivity and the number of substitutions in the reverse transcriptase region of the hepatitis B virus polymerase.

This study aimed to identify the viral factors responsible for poor sensitivity to lamivudine (LAM). We analyzed 49 LAM-treated chronic hepatitis B patients infected with hepatitis B virus (HBV) genotype C. Serum HBV DNA reached a level below the detection limit of the sensitive PCR assay in 31 (63.3%) within the first 24 weeks of LAM therapy (good responder group). Of the patients who did not achieve undetectable levels of HBV DNA within 24 weeks (poor responder group), 15 (83.3%) experienced virological breakthrough, whilst only four patients in the good responder group (12.9%) experienced virological breakthrough. Multivariate analysis revealed that failure to achieve a reduction in viral load to undetectable levels within 24 weeks was independently associated with the occurrence of virological breakthrough. Sequence analysis of the HBV genome revealed that point mutations in the precore region (G1896A) and enhancer I (A1287G/C) were observed more frequently in the good responder group than in the poor responder group (P = 0.002 and 0.019 respectively), and the number of substitutions in the reverse transcriptase domain of the polymerase was significantly higher in the good responders than in the poor responders (P = 0.026). In conclusion, determining the sequence of preexisting HBV, especially for enhancer I, the precore region, and the RT domain of the polymerase region, may be useful in predicting sensitivity to LAM therapy.

Bilateral segmental neurofibromatosis with gastric carcinoma.

Neurofibromatosis type 1 (NF1) is an autosomal-dominant disorder characterized by café-au-lait spots, neurofibromas, intertriginous freckles, and Lisch nodules in the iris. Segmental neurofibromatosis is fundamentally a mosaic variant of NF1. A 66-year-old man visited us with bilateral segmental neurofibromatosis (SN) on the torso. He had multiple neurofibromas on the back bilaterally and on the right abdomen, and partial unilateral lentiginosis on the left abdomen and left back. The patient had noticed the development of papules and nodules on the right abdomen and bilaterally on the back 6 years previously, and had been diagnosed with early gastric carcinoma 5 years previously. To our knowledge, this is only the third reported case of SN associated with internal malignant tumours.

A case of acquired smooth muscle hamartoma of the scrotum.

We report a case of acquired smooth muscle hamartoma (ASMH) of tunica dartos, believed to be only the fifth so far reported. A 24-year-old man had a 6-month history of an asymptomatic tight and thickened scrotum. The skin was difficult to pinch. A biopsy specimen from the skin showed increased and proliferated smooth-muscle bundles composed of well-differentiated and uniform spindle cells that showed typical features of acquired smooth muscle hamartoma. Interestingly, dilatations of the lymph vessels were noted in the upper dermis above the proliferated smooth muscles. It has been reported recently that long-standing severe lymphoedema may cause histological features mimicking ASMH. As the present case was not preceded by oedema of the scrotum, we consider this case to be true ASMH.