Does Diamond Stone Grinding Change the Surface Characteristics and Flexural Strength of Monolithic Zirconia?

PURPOSE: The present study evaluated the effect of grinding on the surface morphology, mean roughness, crystalline phase, flexural strength, and Weibull modulus of monolithic (MZ) and conventional (CZ) zirconias. METHODS AND MATERIALS: CZ and MZ bars and square-shaped specimens were distributed into three subgroups, combining grinding (G) and irrigation (W) with distilled water: Ctrl (Control: no grinding, 20 × 4 × 1.2 mm and 12 × 1.2 mm), DG (dry grinding, 20 × 4 × 1.5 mm and 12 × 1.5 mm), and WG (grinding with irrigation, 20 × 4 × 1.5 mm and 12 × 1.5 mm). The grinding (0.3 mm) was performed on a standardized device using a low-rotation wheel-shaped diamond stone. The four-point flexural strength test was performed on the EMIC 2000 machine (5 KN, 0.5 mm/min). Scanning electron microscopy (SEM) was used to evaluate the surface morphology. An X-ray diffractometer (XRD) was used to obtain the crystalline structures that were analyzed by the Rietveld method. Flexural strength (FS) values were subjected to the Shapiro-Wilk test and two-way analysis of variance followed by the Tukey's test (for all tests, α=0.05). RESULTS: Grinding, either with or without irrigation, did not change the FS of the MZ but increased the FS of the CZ. Both MZ and CZ showed similar morphologic patterns after grinding, and in the WG groups, the grinding was more aggressive. The MZ had greater monoclinic content in all groups; grinding without irrigation caused the smallest t→m transformation. CONCLUSION: The grinding, when necessary, should be carried out without irrigation for conventional and monolithic zirconias.

Diagnóstico diferencial entre osteomielitis de pie y artropatía de Charcot aguda / Differential diagnosis between foot osteomyelitis and acute Charcot arthropathy

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Perfil profesional de la enfermería de urgencias, emergencias y desastres / No disponible

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[Study of urease test or breath test (BT) and correlation with gastric biopsy to detect helicobacter pylori (Hp) in dyspeptic patients at "Hospital Nacional Cayetano Heredia hospital" (HNCH)--Lima]. / Estudio de la prueba de la ureasa o test de aliento (TA) y correlación con biopsia gástrica para la detecci ón de helicobacter pylori (Hp) en pacientes dispépticos del Hospital Nacional Cayetano Heredia Lima.

OBJECTIVE: To establish the utility of the IPEN ureasa test or breath test with C14, in the detection of Helicobacter pylori infection in dyspeptic patients at the HNCH. MATERIAL AND METHODS: 31 dyspeptic patients that attended the outpatient GI clinic during September 2004 were included. All of them had an upper endoscopy, gastric biopsies, and a Breath Test with C14, done at the IPEN (Peruvian Institute of Nuclear Energy). The diagnosis of HP infection was based on the histopathology report. RESULTS: Of the 31 Breath Test, one was a false negative and in 30 there was a good correlation with the biopsies results, 23 demonstrated the HP infection and in 7 this was not present. CONCLUSION: The IPEN Breath Test showed in this study a sensibility of 96.6% and a specificity of 100%, demonstrating that is a very useful diagnostic tool for HP infection.

Estudio de la prueba de la ureasa o test de aliento (TA) y correlación con biopsia gástrica para la detección de Helicobacter Pylori (Hp) en pacientes dispépticos del Hospital Nacional Cayetano Heredia-Lima / Study of the test of ureasa or test of breath (TA) and correlation with gastric biopsy for the detection of Helicobaster Pylori (HP) in dyspeptic patients of the Hospital National Cayetano Heredia-Lima

Objetivo: Determinar la utilidad del test de la ureasa o test del aliento con carbono 14 en la detección de la infección por Helicobacter pilory (Hp) en pacientes dispépticos del Hospital Nacional Cayetano Heredia. Material y Método: Se incluyó a 31 pacientes dispépticos que acudieron a la consulta externa del Servicio de Gastroenterología del HNCH en el mes de setiembre de 2004 y que aceptaron voluntariamente participar en este estudio y a los cuales se les indicó endoscopía alta y biopsia gástrica. A todos ellos se les realizó igualmente el TA, que se realizó con cápsulas de urea marcada con carbono 14 (C14) comercializadas por el Instituto Peruano de Energía Nuclear (IPEN) y con reactivos producidos por el mismo instituto. El diagnóstico de Hp se basó en el análisis histológico con coloración de hematoxilina-eosina. Resultados: De los 31 Test del aliento, hubo un falso negativo y 30 estudios correlacionaron de las biopsias, de los cuales 23 estudios fueron positivos y 7 negativos. Conclusiones: El test del aliento realizado en el IPEN con C14 demuestra en este estudio una sensibilidad de 96.6 por ciento y una especificidad del 100 por ciento, que lo hace una herramienta diagnóstica para la infección por Hp muy confiable.

Objective: To establish the utility of the IPEN ureasa test or breath test with C14, in the detection of Helicobacter pylori infection in dyspeptic patients at the HNCH. MATERIAL AND METHODS: 31 dyspeptic patients that attended the outpatient GI clinic during September2004 were included. All of them had an upper endoscopy , gastricbiopsies, and a Breath Test with C14, done at the IPEN (Peruvian Institute of Nuclear Energy) . The diagnosis of HP infection was based on the histopathology report. RESULTS: Of the 31 Breath Test , one was a false negative and in 30 there was a good correlation with the biopsies results , 23 demonstrated the HP infection and in 7 this was not present. CONCLUSION: The IPEN Breath Test showed in this study a sensibility of 96.6 per centand a specificity of 100 per cent , demonstrating that is a very useful diagnostic tool for HP infection.

Prostatectomía radical retropúbica / Radical retropubic prostatectomy

Serie cooperativa que demuestra experiencia de 6 años en prostatectomía radical retropúbica. Se presentan 62 pacientes portadores de cáncer prostático que fueron etapificado como clínicamente localizado entre mayo de 1994 y diciembre de 2001. La edad promedio fue de 61 años (48-73) y los estadíos preoperatorios fueron A en 9 pacientes, B en 43 pacientes y C en 10 pacientes. Se utilizó la misma técnica en los 62 pacientes y sé protocolizaron los parámetros A estudiar en una base de datos. El 95 por ciento se operó con anestesia regional y en el 100 por ciento se efectuó linfadenectomía pelviana. El tiempo operatorio promedio es de 135 minutos (100-200). El 18 por ciento fue transfundido y el promedio de pérdidas fue de 320 cc (150-3000cc). Los estadíos patológicos finales fueron de 13 pacientes con (T1N0MX), 35 (T2N0M0), 8 (T3N0M0) y 5 con (T3N1M0). La sobrevida específica es de 100 por ciento y la sobrevida libre de recidiva bioquímica es de 80 por ciento a 3 años y de 75 por ciento a 4 años. La incontinencia total se presentó en un paciente que requirió esfínter y en otros 4 pacientes se presentó una IOE GII que requiere más de 3 paños. La disfunción eréctil sin respuesta a sildenafil o prostaglandinas es de un 85 por ciento. Nuestra experiencia repite los buenos resultados de la prostatectomía radical en Cáncer Prostático con baja morbilidad y nula mortalidad como consecuencia de una mayor experiencia y de tratar cánceres en su gran mayoría órgano localizado. La principal morbilidad es la importancia sexual. El análisis costo beneficio de esta técnica es necesario al compararla con otras técnicas emergentes en el cáncer prostático localizado

Utility of intrarenal Doppler ultrasound in the diagnosis of renal artery stenosis.

PURPOSE: To determine the utility of intrarenal Doppler parameters and waveform analysis in a hypertensive population screened for renal artery stenosis (RAS). MATERIALS AND METHODS: Sixty five patients were studied (122 kidneys) with intrarenal Doppler sonography. Doppler waveforms of three different areas from each kidney were obtained (superior, middle and inferior level). Waveform morphology, acceleration time (AT), acceleration (Ac) and resistive index (RI) were evaluated in each kidney, comparing retrospectively the Doppler findings with the angiographic results. RESULTS: Arteriography demonstrated 33 (27.2%) renal arteries with stenosis (18 with RAS>75%). Statistically significant differences for AT and Ac were found among the patients with RAS>75% and the other groups (P<0.01). An AT>80 ms and an Ac< or =1 m/s(2) showed a sensitivity of 89% and a specificity of 99%, for the diagnosis of RAS>75%. Better results were obtained in patients less than 50 years old (100% of sensitivity and specificity). The morphologic analysis of the Doppler waveform had poor results but the detection of a waveform grade 0 had a high specificity (98%). An additional comparison of both kidneys didn't improve the results. CONCLUSION: Intrarenal Doppler waveform analysis using quantitative measurements (AT and Ac) is an adequate technique for the diagnosis of severe RAS in previously selected patients, especially in younger patients (<50 years).

[Abdominal fat assessment by magnetic resonance: comparison with biometric profiles and cardiovascular risk markers]. / Estudio de la grasa abdominal mediante resonancia magnética: comparación con parámetros antropométricos y de riesgo cardiovascular.

BACKGROUND: Obesity is associated with numerous metabolic complications and cardiovascular disease. Magnetic Resonance (MR) imaging provides fair resolution of fat distribution, its quantification by semiautomatic methods being feasible. Our purpose was to analyze abdominal fat deposition by MR imaging and quantify its relative distribution in 50 obese patients. RESULTS were then related to anthropometric measures and cardiovascular risk markers. PATIENTS AND METHOD: Six axial T1-weighted abdominal images were obtained from each patient and transferred to a PC. A software (ASYMED 3.0; Valencia) was used to analyze the images and quantify relative fat deposition. Comparison of MR results with several cardiovascular risk markers was performed using unpaired data Student t-test. Significance level was defined as a P < 0.05. RESULTS: 12% of patients showed predominant intra-abdominal fat deposition.Significant differences were found with regard to age, waist-hip ratio and average serum levels of total cholesterol, LDL, VLDL,triglycerides and apoprotein B between intra-abdominal deposition versus subcutaneous fat deposition. CONCLUSION: MR imaging allows estimation of abdominal fat deposition and its relative distribution. There is a significant relationship between a predominant intra-abdominal fat deposition and an atherogeniclipid profile.

CMY-2-producing Salmonella enterica, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis and Escherichia coli strains isolated in Spain (October 1999-December 2000).

CMY-2 plasmid-mediated AmpC beta-lactamase (CMY-2) was detected in 21 isolates from two hospitals located in different geographical regions of Spain between October 1999 and December 2000. The isolates comprised two Salmonella enterica serovars (Mikawasima and Montevideo), 16 Escherichia coli, one Klebsiella pneumoniae, one Klebsiella oxytoca and one Proteus mirabilis. In addition to the expected resistance to beta-lactams, including extended-spectrum cephalosporins and cefoxitin, all isolates showed a broad spectrum of associated resistance. All were resistant to sulfamethoxazole, chloramphenicol, tetracycline and streptomycin, and all but two were also resistant to gentamicin. Five isolates were studied in detail and all transferred CMY-2 and other resistance determinants by conjugation. Genomic DNA restriction pattern analysis of the E. coli isolates excluded the dissemination of a single clone. To the best of our knowledge this is the first time that CMY-2 has been detected in P. mirabilis, K. oxytoca and S. enterica serovars Mikawasima and Montevideo. It is also the first time that CMY-2 has been described in Spain.

Fertlidad inmediata post vasectomía / Immediate fertility post vasectomy

La vasectomía es una técnica simple y eficiente en el objetivo de controlar la natalidad por medios quirúrgicos en el varón. Nosotros estudiamos a pacientes fértiles que deseaban ser sometidos a esta técnica con el fin de regular su natalidad en forma definitiva. Los espermiogramas post operatorios a la semana, dos semanas y al mes, demostraron presencia de espermios pero de escasa motilidad con lo cual concluimos que el efecto esterilizador de la vasectomía es inmediato, independientemente del número de espermios encontrados.

Diphyllobothriosis humana por infección por Diphyllobotrhium pacificum en un niño de 3 años en Antofagasta, Chile / Human diphyllobothriosis by diphyllobotrhium pacificum infection in a 3 years old boy at Antofagasta, Chile

La diphyllobothriosis constituye una zoonosis relacionada con el consumo de carnes crudas o insuficientemente cocida de peces de agua dulce o mar. Se presenta un caso de diphyllobothriosis por Diphyllobothrium pacificum diagnosticado en Antofagasta en un niño de tres años, residente permanente en esta ciudad-puerto del Norte de Chile. El paciente eliminó espontáneamente una estróbila de 55 cm, a partir de la cual se realizó estudio morfométrico de proglótidas y huevos, concluyéndose que se trataba de un ejemplar de D. pacificum. Se administró tratamiento con praziquantel sin que se eliminaran nuevos ejemplares ni huevos, como tampoco se presentó anemia. Se investigó al grupo familiar constituido por cuatro personas sin encontrar otros infectados. Se destaca que los 16 casos de diphyllobothriosis por D. pacificum documentados en Chile, tres corresponden a niños entre 7 y 3 años

Epidemiología de la hidatidosis humana en la IX Región de La Araucanía Chile: 1991-1998 / Epidemiology of human hydatidosis in the IX Región of La Araucanía Chile: 1991-1998

In the region of la Araucania, locate in the south of Chile (37º24ï-39º34ï South lat.), the economy is based in cattle raising and agriculture. The case of human hydatidosis, mortality and notification registered in la Araucania 1991-1998 are reviewed. The rate for hydatid disease is 38.5 per 100,000 population. Liver (47.1 percent) and lung (40.7 percent) were the most affected viscera. Days in hospital, 11-20 the 56.1 percent. Disease in female is 51.1 percent. The mortality rate is 0.8 per 100,000, the most frecuently affected county is Imperial. The age 15-44 years is the most affected. The notification rate is 8.74 per 100,000 population. The rate for hydatid disease is higher than the rate of notification, then necessarily there exist a subnotification. We think that it is necessary to investigate the serological prevalence of hydatidosis in the population of the IX Región Araucania

Prevalencia de Neisseria gonorrhoeae y Chlamydia trachomatis en gestantes atendidas en el Instituto Materno Perinatal de Lima Perú, 1997-1998 / Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis in pregnant attendant in the Maternal Perinatal Institute from Lima Peru, 1997-1998

Durante los meses de agosto 1997 a febrero 1998, se realizó un muestreo sistematizado a 410 gestantes que acudieron a su control al Instituto Materno Perinatal de Lima, con la finalidad de realizar un estudio de prevalencia de infección por Neisseria gonorrhoeae y Chlamdia trachomatis. Las muestras consistieron en hisopados de la región endocervical, que fueron procesados para la búsqueda del Neisseria honosshoeae, mediante cultivo en agar Thayer Martin modificado, y detección de Chlamydia trachomatis, mediante las técnicas de ELISA de captura de antígeno, inmunofluorescencia directa y cultivo celular. No se halló Neisseria gonorrhoeae en las gestantes estudiadas, pero se encontró. Chlamydia trachomatis en un 34,8, siendo más frecuente en las edades comprendidas entre 33-37 años. Además, se observó que 80,5 de las gestantes infectadas por Chlamydia no presentaron molestias en la región genital, lo que indica que la población infectada por dicha bacteria puede pasar inadvertida por mucho tiempo,antes de ser diagnosticada, que por lo regular ocurre cuando la infección alcanza cierta complicación o cuando el recien nacido tiene problemas a nivel de las vías respiratorias o presenta tracoma

Diagnosis of pulmonary sequestration by spiral CT angiography.

The diagnosis of pulmonary sequestration traditionally requires arteriography to identify abnormal systemic vessels feeding the abnormal portion of the lung. Non-invasive imaging techniques have recently been used to replace arteriography. Conventional computed tomographic (CT) scanning is, however, at a disadvantage because of its inability to obtain multiplanar images. The combination of slip ring CT scanning and computerised three-dimensional reconstruction (spiral CT angiography) can be used to visualise the anatomical detail of a wide range of vessels within the lung. Four cases of pulmonary sequestration are reported which were successfully diagnosed using spiral CT angiography. Spiral CT scanning allows simultaneous imaging of anomalous vessels and lung parenchyma in a single examination and is particularly useful in the diagnosis and assessment of pulmonary sequestration.

Characteristics of urinary luteinizing hormone (LH) during the induction of LH surges of different magnitude in blood.

Urinary luteinizing hormone (LH) testing has been proposed as a reliable method for the prediction of ovulation but its accuracy has been challenged by some studies. To check how accurately the oscillations of urinary LH reflected the plasma changes, surges of LH of different magnitude and duration were artificially induced in plasma and the hormone was measured simultaneously in urine. Post-menopausal women (n = 16) were stimulated during 1 week with a combination of transdermal oestradiol (400 micrograms) and i.m. progesterone (25 mg on day 4, 50 mg on day 5) to obtain an LH discharge comparable with the pre-ovulatory LH peak. A short and moderate peak of LH was induced by the i.v. injection of 100 micrograms gonadotrophin-releasing hormone (GnRH) in six premenopausal women, whereas an LH discharge of higher amplitude and longer duration was induced by a single dose of 0.3 mg s.c. buserelin. The total urine production of the day was fractionated into 8 h periods. LH was measured by a commercial radioimmunoassay. Unambiguous peaks of LH were detected in the urine of all the women stimulated with either oestradiol plus progesterone or buserelin, but in only three out of the six women receiving GnRH. The urine LH reproduced the plasma changes of the hormone with short delay since the peaks were mostly detected in the same time fraction in which the serum discharge occurred.

Influence of the ovary on parameters of LH secretion during the recovery from buserelin-induced desensitization.

This study examined the effect of the ovary on LH pulsatility and on the secretory performance of gonadotrophs during the phase of recovery after treatment with buserelin, a GnRH analogue. We included 12 patients, who received buserelin (1.2 mg/day, intranasally for 3 months) as a reductive therapy for uterine leiomyomatosis prior to hysterectomy. Six patients were oophorectomized and the other 6 patients had their ovaries preserved. LH was measured in samples taken basally up to 36 days after suppression of buserelin. LH pulsatility was studied on day 9 along a 24-h cycle, and the response of the hormone to a double-stimulus GnRH test on days 0, 9, 20, and 34. The concentration of LH reached normal premenopausal levels after an average of 2 weeks in women with ovaries but increased until 4-5 weeks in oophorectomized patients. The pulsatility of LH on day 9 was similar for both groups, but parameters related to LH amplitude or to baseline secretory activity of gonadotrophs were higher in the oophorectomized women. The response of LH to the GnRH tests was also significantly higher in the oophorectomized group from day 9. The conclusions are as follows. (1) At the early stage of recovery from desensitization, as represented by day 9, LH pulsatility was not substantially influenced by the presence or absence of the ovary. (2) There was an increase in parameters related to the amplitude of the LH bursts in the oophorectomized women. Although a higher amplitude of the endogenous GnRH pulses cannot be discarded, most probably that difference is due to a higher sensitivity at a pituitary level, as reflected by the GnRH stimulation tests.

Síndrome de Boerhaave: experiencia en cuatro casos / Boerhaave's syndrome: experience in 4 cases

El propósito de este trabajo es analizar 4 casos tratados en un lapso de 15 años y discutir el tratamiento. La mayoría de los autores proponen como tratamiento la sutura primaria del esófago, y sólo algunos preconizan el tratamiento conservador. Pensamos que la sutura directa del esófago debe estar reservada para los casos con diagnóstico precoz y sin mediastinitis. Una vez instalada la mediastinitis el tratamiento debe estar dirigido a tratarla pues ella es la que condiciona el mal pronóstico. Postulamos que sólo una vez controlada la infección mediastinal se debe practicar la yeyunostomía. Basamos nuestro postulado en el hecho que en los primeros días después de realizada una yeyunostomía se observa siempre reflujo bilio-gástrico por la brecha esofágica, hecho que no favorece el control local de la mediastinitis e incluso puede agravar el estado de los tejidos por la acción de los fermentos digestivos. El esófago se debe excluir precozmente por medio de una esofagostomía cervical lateral. Controlada la infección local y general, y normalizada la condición metabólica del paciente, se debe esperar el cierre espontáneo del esófago

Improvement in high-speed, large-area, multiple-exposure holography.

The method of encoding more than one large-area hologram on a single recording medium by changing the angle between the object beam and the reference beam between successive exposures is well established. We report an extension of this technique to record over 16 individual large-area holograms on a single emulsion plate by taking advantage of the characteristics inherent in a solution physical developer. The tests were carried out on 8E75-HD holographic plates with a short-pulse ruby laser for high-speed recording. Multiple-image-plane doubled-exposure holographic interferograms were also obtained, and the results are presented.

Archival and wide exposure latitude process for holography.

A high diffraction efficiency and wide exposure latitude holographic processing method, capable of producing archival quality holograms is presented. It consists of a solution stage physical development on CPA-1, followed by a fixing stage. Holograms thus obtained have a wide exposure latitude and high diffraction efficiency. The method has been tried on 875-HD and 10E75-HD Agfa-Gevaert emulsions.