Virtual setup: application in orthodontic practice.

BACKGROUND: A plaster dental model is a patient's traditional three-dimensional (3D) record. If the dental crowns from a plaster model are separated and positioned in wax, this setup of the crowns can be used to simulate orthodontic treatment. The traditional way to make this dental setup requires significant time by the orthodontist and in the orthodontic lab. New developments in dentistry and orthodontics include the possibility of virtual setups. AIM: In this article, the differences between conventional setups with plaster models and virtual setups are discussed. METHODS: A clinical patient is described for whom two different setups were made and compared by model superimposition with Geomagic Qualify software. RESULTS: According to the literature and the results from this study, virtual setups and conventional setups with plaster models are equally accurate. CONCLUSION: Virtual setups present several advantages, e.g., digital storage, digital models cannot be damaged, the same model can undergo several treatment simulations, and communication between dental and surgical professionals and between dental professionals and patients is facilitated. Despite these advantages, considerable time and training are needed for dental professionals to master and adopt the general use of digital models and virtual setups in dentistry.

Beamline BL-07 at Indus-2: a facility for microfabrication research.

The X-ray lithography beamline on Indus-2 is now operational, with two modes of operation. With a pair of X-ray mirrors it is possible to tune the energy spectrum between 1 and 20 keV with a controlled spectral bandwidth. In its 'no optics' mode, hard X-rays up to 40 keV are available. Features and performance of the beamline are presented along with some example structures. Structures fabricated include honeycomb structures in PMMA using a stainless steel stencil mask and a compound refractive X-ray lens using a polyimide-gold mask in SU-8.

Técnica de confecção de pônticos estéticos temporários associados a aparelhos ortodônticos / Technique to make temporary esthetic pontics for orthodontic appliances

A demanda estética dos pacientes durante o tratamento ortodôntico vem aumentando ao longo dos anos. O desenvolvimento de novas técnicas como os aparelhos linguais ¬¬4 e o sistema Invisalign 6 são exemplos de abordagens que buscam privilegiar o aspecto estético da aparelhagem ortodôntica. Do mesmo modo, pacientes usando aparelhos labiais também desejam uma aparência agradável 7. Em casos em que se fazem necessárias exodontias, pônticos estéticos devem ser adaptados ao aparelho 4,6,7. Os pônticos estéticos adaptados a bráquetes convencionais proporcionam uma solução para este problema, fechando os espaços negros gerados pelas extrações dentárias. O que se torna clinicamente significante na medida que aumenta a aceitação do tratamento por parte dos pacientes, em especial dos que necessitam de exodontias.

Patient's demand for aesthetics during orthodontic treatment has increased over the years. The development of new methods such as Lingual braces 4 and the Invisalign System 6 are examples of approaches which focus on the aesthetic aspect of orthodontic appliances. Nevertheless, patients using labial braces also seek a pleasing appearance 7. Where the orthodontic treatment requires dental extractions, temporary aesthetic pontics should be adapted to these appliances 4,6,7. The aesthetic pontics attached to conventional braces also provides a solution to this problem by closing blank spaces due to dental extractions. The latter is clinically significant as it finds great acceptance in treatments, especially those requiring extractions.

DNA binding and pairing activity of OsDmc1, a recombinase from rice.

A cloned cDNA corresponding to OsDMC1 from rice anther tissue was expressed in Escherichia coli. The OsDmc1 protein was largely present in the inclusion bodies of the cell lysatE., which was solubilized by 8.0 M urea containing buffeR., purified to homogeneity by Ni-CAM agarose column chromatography, followed by renaturation to its native state through stepwise dialysis against reduced concentrations of urea. The purified protein cross-reacted with anti-yeast Dmc1 antibodies. The binding efficiency observed with circular single-stranded DNA (ssDNA) was similar to that with circular double-stranded DNA (dsDNA). The binding to either DNA showed no ATP dependencE., but required 5-10 mM Mg2+ in the presence of ATP. Even though the protein binding to dsDNA was as efficient as it was to ssDNA, the former induced no DNA dependent ATPasE., whereas the binding to ssDNA stimulated a significant level of DNA dependent ATPase activity. OsDmc1-ssDNA complex, with its ATPase proficiency, also mediated renaturation of homologous complementary strands as well as assimilation of single strands into homologous supercoiled duplexes leading to D-loop formation. The D-loop formation was lowered by excess of OsDmc1 protein. This D-loop formation activity was promoted by non-hydrolyzable ATP analog, AMP-PNP and was not observed in absence of ATP or presence of ADP/ATP-gamma-S. These properties reflected the classical hallmarks of a recombinase and represented the first biochemical characterization of a plant Dmc1 protein.

Attention-deficit/hyperactivity disorder.

ADHD continues to be one of the most common psychiatric disorders in children and is recognized increasingly as a common psychiatric disorder in adults. Diagnosis of the disorder requires careful consideration of other psychiatric and medical disorders that may mimic symptoms of ADHD. Comorbid disorders are common in patients with ADHD and require careful attention. A recommended diagnostic evaluation for children and adults includes the completion of a psychiatric interview, rating scales from multiple informants, and often individually tailored psychologic testing. Pharmacologic treatment options include the first-line stimulant agents for adults and children and TCAs and atypical antidepressants as second-line agents. Behavioral interventions may help reduce ADHD symptoms and address comorbid conditions in children. Future research is needed to identify the optimal psychosocial treatment for adults with ADHD.

[Primary management of polytrauma. Comparison of a German and American air rescue unit]. / Primärversorgung des Polytraumas. Vergleich eines deutschen und amerikanischen Luftrettungssystems.

Hospital-based helicopter services from German and American university-affiliated trauma centers were reviewed. All multitrauma patients transported via helicopter from the scene of the accident to the trauma center during a 1-year period were included. The patients were comparable regarding mechanism of injury, age, flight times, mean ISS, ISS distribution, and number of severe injuries per body region (patients with AIS > 3 for head, thorax and abdomen). Overall mortality for the German system was 21/221 (9.5%) and 21/186 (11.3%) for the American system (not significant). Survivor-based TRISS analysis yielded Z-statistics of +2.459 for the German, and +1.049 for the American system. There were 9 unexpected survivors (Ps < 0.5) in the German, 6 in the American system. There was a significant higher (P < 0.01) number of early deaths (< 6 h) in the American population (12, ISS 56) than in the German (4, ISS 64). Analysis of the prehospital data demonstrated significant differences in the mean volume of IV fluids infused: 1800 cc German, 825 cc American (P < 0.05); rate of intubation: 82/221 (37.1%) German, 24/186 (13.4%) American (P < 0.001); and thoracic decompressions: 20/221 (9.1%) German, 1/186 (0.5%) American (P < 0.001). Pre-hospital care in the German system is directed on-scene by a trauma surgeon member of the flight crew, compared to a nurse/paramedic team with remote medical control in the American system. Compared to an American trauma system, the German system demonstrates improved overall outcome as measured by survivor-based TRISS Z-statistics. More favorable German Z-statistics are in part related to fewer early deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

[Severe thoracic trauma: under what accident and resuscitation conditions can it still be treated?]. / Das schwere Thoraxtrauma: Unter welchen Unfall- und Rettungsbedingungen ist es noch therapierbar?

Severe thoracic trauma is a major cause of early death following road accident. 569 non-surviving and 112 surviving victims of traffic casualties were documented by the Accident Research Unit of the Clinic of Trauma Surgery, Hannover Medical School from 1973 to 1987. Medical data and measures of rescue were evaluated with a view to way of clinical therapies, lethal outcome and time of death. Primary intubation and chest draining seems to be the most successful initial treatment on the scene and during transport.

[First aid at the scene of the accident from the viewpoint of the trauma surgeon]. / Erstmassnahmen am Unfallort aus der Sicht des Unfallchirurgen.

A step-by-step therapy concept for prehospital care of the severely injured is presented. A schedule for effective organization of the rescue procedure is given, after which stress is placed on preservation of the vital functions. A therapy algorithm is explained, according to which the indications for intubation, ventilation and volume replacement depend on both physiological parameters (blood pressure, respiration frequency, Glasgow Coma Scale, capillary refill) and the type of injuries. Initial care of the injuries is discussed in some detail. Competent preclinical management of fractures and joint dislocations is a major topic. A flow chart for the selection of an adequate trauma center is proposed, which takes account of vital signs, the extent of the injuries, how the accident happened, and the force of the impact.

Increased lung capillary permeability after trauma: a prospective clinical study.

Pulmonary dysfunction and permeability were prospectively studied in a group of severely traumatized patients. Ventilatory parameters (i.e., PaO2/FiO2, dynamic compliance, per cent shunt, and A-a DO2) and extravascular lung water (EVLW) measurements were compared with scintigraphic determinations of pulmonary albumin extravasation. Albumin extravasation data demonstrated a pulmonary capillary permeability increase occurring shortly following trauma. The median albumin extravasation value in the patients within 24 hours of trauma was 3.6 X 10(-5)/sec, compared to a control value of -0.1 +/- 0.7 X 10(-5)/sec. Intermediate levels of albumin extravasation were found in patients studied within 48 hours of total hip replacement (1.6 +/- 0.9 X 10(-5)/sec). Eighty per cent of patients studied within the first 48 hours of their trauma had albumin extravasation values exceeding the upper limit of normal as determined by the control value + 2 S.D. In contrast to albumin extravasation values, the PaO2/FiO2, dynamic compliance, per cent shunt, A-a DO2, and EVLW did not begin to deteriorate significantly until at least 48 hours after trauma. We conclude that severe multiple trauma induces an early increase in pulmonary capillary permeability as measured by albumin extravasation scintigraphy. This change is not detectable with other commonly used measures.

[Nuclear medicine diagnosis of pulmonary capillary protein leakage]. / Nuklearmedizinische Diagnostik des "Pulmonary Capillary Protein Leakage".

Pulmonary extravascular albumin extravasation in patients with adult respiratory distress syndrome can be quantified with radionuclide techniques. While imaging procedures with a computerized gamma camera will allow reproducible ROIs, this will be the main limitation in nonimaging measurements with small scintillation probes. Repeated positioning by one operator results in a mean spatial variation of position of about 2 cm and a variation in count rate of 25%. For the estimation of PCPL the small probes must be positioned under scintigraphic control. Under these conditions the results of both techniques are identical. The upper limit of normal was estimated to be 1 x E-5/sec. The standard deviation of abnormal measurements was about 10%. The pulmonary capillary protein leakage can be quantified by radionuclide techniques with good accuracy, using the combination of imaging and nonimaging techniques.

Phenylalanine depletion for the management of phenylketonuria: use of enzyme reactors with immobilized enzymes.

Multitubular enzyme reactors with immobilized phenylalanine ammonia lyase were tested in vitro and in vivo for depletion of phenylalanine in circulating blood. Sustained reduction of phenylalanine was achieved in less than 30 minutes. A 50% decrease of phenylalanine was obtained with a 2-hour application of enzyme reactors and was maintained for more than 2 days. Similar enzyme reactors have therapeutic potential for temporary management of phenylketonuric patients when their circulating phenylalanine becomes exceedingly high because of infection, fever, or pregnancy.