Taxonomy and immature stages of the Platystomatidae (Diptera: Tephritoidea) of Israel.

The Platystomatidae fauna of Israel is reviewed. Eleven species in two genera, Platystoma Meigen and Rivellia Robineau-Desvoidy, are recognized. Ten of the eleven species are recorded from Israel for the first time, and six of them are described as new: Platystoma dalia n. sp., P. elizabethae n. sp., P. geula n. sp., P. torridum n. sp., P. trigonum n. sp., and Rivellia israelica n. sp. Detailed descriptions, redescriptions, illustrations, and keys to all local platystomatid taxa are provided. The complete life-cycle of P. torridum n. sp. is reported, with descriptions and illustrations of egg, 3rd instar larva, and puparium.

[BEO'S - physical activity and healthy eating at schools in Oberfranken, Bavaria concept and first results of a resource-oriented, systemic approach in school-based health promotion]. / BEO'S - Bewegung und Ernährung an Oberfrankens Schulen Konzept und Erfahrungen bei der Umsetzung eines ressourcenorientierten, systemischen Ansatzes zur schulischen Gesundheitsförderung.

BACKGROUND: The high prevalence of overweight among children and adolescents has led to an increase in school-based prevention programmes. The aim of the present paper is to present the concept of an initiative called "BEO'S" as well as the experience made with the implementation und acceptance of this programme in the participating schools. METHODS: Different from the majority of school-based projects for healthy eating and physical activity, BEO'S pursues a systemic approach that includes the whole school and is tailored to the school's respective resources. Characteristics are (1) the participation of teachers, students, parents, and caretakers, (2) the motivation and empowerment of schools to plan and implement activities by themselves, (3) the focus on environmental approaches, and (4) addressing and considering the individual school's needs and resources. The university project team supports the schools by individual counselling as well as providing information materials, trainings and workshops for teachers, an internet page, newsletters, and financial support. In the school years 2007/08 and 2008/09, BEO'S was conducted at 14 primary and secondary schools in the district of Oberfranken, Bavaria. It was extended to other schools in 2009/10. The short- and mid-term goals are the improvement of the school's environments as well as the eating behaviour and physical activity of the students. In the long run, it is intended to prevent obesity and improve the students' health and school performance. RESULTS: The implementation processes showed that the teachers for physical education and domestic science as well as the headmasters were especially committed. The participation of the teaching staff, the students and the parents proved to be difficult, however. The schools implemented many activities for healthy eating and physical activity, but the planning process was not very systematic: needs assessment, status quo analysis, identification of successful strategies and definition of aims was difficult for the schools. The provided financial support, training programmes and workshops, and the exchange with other schools were widely used, in contrast to the offered internet-based tools. The acceptance of BEO'S was (very) good by teachers (n=97), students (n=674) and their parents (n=522). The teachers preferred the workshops and trainings to the internet page. The students appreciated the possibilities for physical activity and the emphasis on healthy eating; primary school students and girls more than secondary school students and boys. One third of the parents would like to be involved to a higher degree. CONCLUSION: BEO'S was well received by all the people involved. Yet, there are still deficits concerning the implementation process, especially in the participation of students and parents.

[Cytogenetics of oral solid tumors].

The tumorigenesiss of oral solid tumors is still uncertain. The underlying mechanisms of epithelial or connective tissue proliferation are not yet fully understood. Also, the transformation of a benign tumor into malignant is obscure. Cytogenetics is the study of chromosome number and structure using a light microscope. Human chromosome nomenclature is based on An International System for Human Cytogenetic Nomenclature (ISCN). The normal human somatic cells have 46 chromosomes, including 22 pairs of autosomes and two sex chromosomes, XX in female and XY in male. The chromosome abnormalities can be numerical and structural. Both types can occur concurrently. Numerical abnormalities involve the loss and/or gain of a whole chromosome and can include both autosomes and sex chromosomes. Cells which have lost a chromosome are categorized as a monosomy, while those with an extra chromosome are trisomy. Structural abnormalities include translocations, deletions, inversions and insertions. Cancer, in its various forms is a result of genetic changes. This concept comes from the finding of chromosomal abnormalities. These abnormalities may arise as a consequence of random replication errors; exposure to carcinogens; or damaged DNA repair process. In clinical oncology, the study of chromosome abnormalities in solid tumors provides valuable information for the diagnosis, evaluating treatment response of metastatic cancer, marker for prognosis and targeted therapy. In tumors which histologic features overlap, cytogenetics plays an important role for diagnosis. Cytogenetics has also been used to monitor the surgical margins of the resection in head and neck carcinoma, where the histology was not definitive. The present report will focus on the role of cytogenetics in the diagnosis and prognosis of benign and malignant oral solid tumors.

Angiomyoma of buccal vestibule: a rare case with a normal karyotype.

Angiomyoma is an uncommon, benign, soft tissue tumour characterised by bundles of smooth muscle cells intermixed with numerous vascular channels, which usually develops in the lower extremities. Oral manifestations are quite rare. Most oral cases occur in the lips and tongue; angiomyoma affecting the buccal vestibule is very rare. A case of angiomyoma in the buccal vestibule with a normal karyotype is reported.

Dermoid cyst of the maxilla.

Dermoid cysts of the jaw bones are very rare. A case of an intraosseous dermoid cyst of the maxilla of a 5-year-old-male is reported. The possible origins are described.

Eruption cyst in the adult--a case report.

A case of eruption cyst in the right maxilla of a 40-year-old female is reported.

Following treatment of myogenous TMD patients with the temporomandibular opening index: an initial report.

Limitation of mandibular movement is one of the cardinal signs of temporomandibular disorders (TMD), usually assessed by measurement of maximum voluntary mouth opening. A new measure of assessing mandibular mobility, the temporomandibular opening index (TOI), is less dependent on variables such as age, gender and ramus length. It has also been found to be useful to categorize patients. This study examined changes in TOI as treatment progressed in a group of myogenous TMD patients. Seven patients with myogenous TMD were included in the study and the TOI determined at 0 and 2 weeks, 1 and 6 months after initiation of treatment. Treatment outcome was assessed on a 4 point scale, 0=none, 1=mild, 2=moderate, and 3=severe. Headache, neckache, pain (joints and muscles) and joint sounds were assessed. Nine patients with no signs or symptoms of TMD were included to obtain a normal TOI. The mean TOI of the patient group was 16.4% (s.d.=11.2%) initially and 3.95% (s.d.=1.0%) at 6 months, while mean treatment scores changed from 12.57 (s.d.=3.05) to 1.43 (s.d.=1.90). The mean TOI of the control group was 3.63 (s.d.=0.74). A paired t-test showed that the TOI decreased significantly with time (P=0.02) while there was a concomitant decrease in treatment score (P=0.0003) over the same period. The TOI may be a useful method of following treatment of this group of myogenous TMD patients.

[Metastatic tumor of the jaw--diagnosis and management].

Metastatic tumors to the oral region are not common. The most common primary sources of metastatic tumors to the oral region are the breast, lung and kidney. The breast is the most common primary site for metastatic tumors to the jawbone, whereas the lung is the most common source for metastases to the oral soft tissues. In the jawbones, the most common location is the mandible, with the molar area being the most frequent involved site. In nearly 30% of the cases, the metastatic lesion in the oral region is the first indication of an unknown malignancy at a distant primary site. The diagnosis and management of a case with metastatic tumor to the mandible is described.

Image accuracy of plain film radiography and computerized tomography in assessing morphological abnormality of impacted teeth.

This study compares the image accuracy of computerized tomography (CT) with that of plain film radiography (PFR) in analyzing the 3-dimensional shape of impacted teeth suspected of being malformed. Eighteen patients with 22 malformed teeth were studied by PFR and CT. Crown shape, root shape, crown/root relationship, and tooth inclination and structure were assessed by PFR and CT. CT was found to be superior to PFR in showing the multiplanar shape of tooth crown and root, crown/root relationship, and tooth inclination (P <.001). No difference was found in the representation of tooth structures. The findings demonstrate that CT imaging is useful to diagnose and plan treatment for patients with unerupted and malformed teeth.

[The use of cultured mucosal graft for preprosthetic surgery].

The need to cover denuded mucosal surfaces, is common in oral and maxillofacial surgery. This is particularly a problem in preprosthetic surgery. The surgical options are secondary epithelialization, mucosal graft, skin graft or microvascular graft. The most common are mucosal graft and skin graft, however both have drawbacks. The skin graft displays a marked clinical difference as compared with the mucosa in consistency and color and with occasional hair growth. The mucosal graft is generally more suitable, but is limited by the surface available for harvesting. The purpose of this clinical article is to demonstrate the utility of autologous cultured mucosal sheets in preprosthetic surgery.

Radiologic placement of a low profile implantable venous access port in a pediatric population.

PURPOSE: To evaluate the feasibility and complications of placement of a low-profile venous access port in the chest in children requiring long-term venous access. METHOD: A low-profile peripheral arm port (PAS port; Sims Deltec, St. Paul, MN, USA) was implanted in the chest in 22 children over a 4-year period. The mean age of the study group was 6 years (range: 9 months to 20 years). Ports were placed for the administration of chemotherapy, hyperalimentation and frequent blood sampling. Sonographic guidance was used to access the internal jugular or subclavian vein in each case. A review of all inpatient and outpatient charts was undertaken to assess catheter performance and complications. RESULTS: Access to the central venous circulation was successfully achieved in each case without complication. Ports remained implanted for 6579 catheter-days (mean: 299 days). Ten ports have been removed. Of three patients (13%) experiencing device-related infections (0.45 infections/1000 catheter days), two (9.1%) were unresponsive to antibiotics and removed (0.3 infections/1000 catheter days). One port was removed because of pain in the shoulder adjacent to the port implantation site. One port was removed because of difficult access. The final port was removed in order to place a dual-lumen catheter prior to bone marrow transplant. Twelve ports remain implanted. Aspiration occlusion occurred in four patients (18%). Deep venous thrombosis did not occur in any patient. CONCLUSION: Low-profile chest ports placed by interventional radiologists in the interventional radiology suite can be placed in children as safely as traditional chest ports placed in the operating room. The incidence of infection, venous thrombosis and aspiration occlusion is comparable to that of ports placed operatively.

Peripheral venous access ports: outcomes analysis in 109 patients.

PURPOSE: To perform a retrospective outcomes analysis of central venous catheters with peripheral venous access ports, with comparison to published data. METHODS: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemotherapy, hyperalimentation, long-term antibiotic therapy, gamma-globulin therapy, and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium. Povidone iodine skin preparation was used in the first 65 port insertions. A combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) warfarin sodium beginning the day after port insertion. Three patients received higher doses of warfarin sodium for preexistent venous thrombosis. Catheter performance and complications were assessed and compared with published data. RESULTS: Access into the basilic or brachial veins was obtained in all cases. Ports remained functional for a total of 28,936 patient days. The port functioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of patients. Eleven patients (9.9% of ports placed) suffered an infectious complication (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three patients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfarin sodium and in two patients (3%) not receiving warfarin sodium. This difference was not statistically significant (p = 0.6). Aspiration occlusion occurred in 13 patients (11.7%). Intracatheter urokinase was infused in eight of these patients and successfully restored catheter function in all but two instances. These complication rates are comparable to or better than those reported with chest ports. CONCLUSION: Peripheral ports for long-term central venous access placed by interventional radiologists in the interventional radiology suite are as safe and as effective as chest ports.

Translumbar placement of paired hemodialysis catheters (Tesio catheters) and follow-up in 10 patients.

For lack of other suitable access, 10 consecutive patients received paired hemodialysis catheters for long-term hemodialysis using a translumbar approach to the inferior vena cava (IVC). All attempts were successful. Five paired catheters were placed using the single-puncture technique, and five using the dual-puncture technique. Catheters were in place for a total of 2252 catheter days. The average duration of catheter placement was 250 days (range 30-580 days). All catheters were functioning up to the time the study was completed or the patient died. The most common complication was partial dislodgment of the catheter in 3 of 23 catheters (13%), all occurring in obese patients. One episode of retroperitoneal hemorrhage was noted in a patient having the single-access technique. There were no episodes of infection or IVC thrombosis.

The long-term effect of oromaxillofacial trauma on the function of the temporomandibular joint.

Thirty patients with temporomandibular disorders (TMD) after trauma to the orofacial region were followed for 6 months. They were assessed at 10 days, 1 month, and 6 months. It was found that patients with combined fractures of the mandible and condyle showed more effects on function of the temporomandibular joint after 1 month than patients with condylar fracture only. This difference was not so apparent after 6 months. Patients with trauma but no fracture showed similar effects to those with non-condylar fractures. There was a tendency for arthrogenous patients to develop myogenous problems with time. A group of patients with TMD but no trauma, showed more favourable long-term response to conservative treatment. Long-term follow-up of these patients for TMD problems is recommended.

Parotid sialolithiasis.

This report documents an unusual case of buccal mucosa swelling due to a giant (25 x 13 mm), parotid duct sialolith. Review of the literature disclosed that this is the largest parotid sialolith ever reported. Diagnostic imaging and treatment are described.

Access to occluded infrainguinal bypass grafts with a loopsnare.

Thrombolysis for the treatment of occluded bypass grafts is used in selected clinical circumstances. Unfortunately, a minority of these procedures are technical failures because of the inability to access the occluded graft. We describe a technique that greatly increases the chances of technical success.

Efficacy of fibrin sealant in patients on various levels of oral anticoagulant undergoing oral surgery.

OBJECTIVE: The purpose of this study was to investigate the efficacy of fibrin sealant in patients on oral anticoagulant therapy undergoing oral surgery with varying degrees of surgical trauma and various intensities of anticoagulation. STUDY DESIGN: A consecutive series of 69 subjects on oral anticoagulant therapy undergoing oral surgery without changing anticoagulation intensity is presented. For each subject, indication for anticoagulation, international normalized ratio on day of treatment (low, 1.0-2.0; medium, 2.1-3.0; high, 3.1-5.0), degree of surgical trauma (on a scale of 1-12), and complications were recorded and correlated. RESULTS: There were 32 (46.4%) patients with prosthetic valves, 23 (33.3%) with atrial fibrillation and rheumatic or ischemic heart disease, and 14 (20.3%) with previous thromboembolism. Twenty (29%) patients were on low-intensity anticoagulation (international normalized ratio, 1.0-2.0), 26 (37.7%) were on medium-intensity anticoagulation (international normalized ratio, 2.1-3.0), and 23 (33.3%) were on high-intensity anticoagulation (international normalized ratio, 3.1-5.0). Each of 39 (56.5%) patients was in surgical trauma category 1, 2, or 3; the remaining 30 (43.5%) patients were in surgical trauma categories 4 through 12. Complications occurred in 3 (4.3%) patients and took the form of minor postoperative bleeding. No correlation was found between complications and international normalized ratio or degree of surgical trauma. CONCLUSIONS: The use of fibrin sealant in oral surgery for patients on oral anticoagulant therapy is safe, and it can be provided in an international normalized ratio range of 1.0 through 5.0 and in a surgical trauma scale range of 1 through 12.

Temporomandibular joint dysfunction in children: evaluation of treatment.

Thirty-eight pediatric patients with temporomandibular joint (TMJ) dysfunction were diagnosed and treated. The etiology for the TMJ dysfunction was trauma in 30 (79%) patients, degenerative joint disease in two (5%) patients, growth disturbances in two (5%) patients and tumor in one (3%) patient. In three (8%) patients the etiology was unclear. The treatment modalities were: non-invasive therapy in 19 (50%) patients, occlusal therapy in 10 (26%) patients and surgical treatment in nine (24%) patients. The reported symptoms of temporomandibular joint dysfunction using the Helkino anamnestic index revealed that, at the initial examination, eight (21%) reported mild symptoms and 30 (79%) severe symptoms. One year later, 33 (87%) reported no symptoms, four (10%) mild symptoms and one (3%) severe symptoms. These differences were significant (P < 0.05-0.01). Maximum mouth opening 1 year after treatment as compared to the initial examination increased (P < 0.05) in all three treatment modalities. Deviation of the mandible on opening, 1 year after treatment as compared to the initial examination, decreased (P < 0.05) in all three treatment modalities. No differences were found between the modalities in both the maximum mouth opening or deviation of the mandible. TMJ dysfunction in children can be effectively treated by non-surgical treatment modalities. Surgery should be considered only when the non-surgical therapies were ineffective.