Assessing the implant/bone interface by using natural frequency analysis.

OBJECTIVE: A number of techniques have been proposed for detecting the stability of dental implants. However, the clinical applicability of those methods is still limited. The purpose of this study was to evaluate a new innovative, noninvasive, minimum-contact method for the stability assessment of dental implants. STUDY DESIGN: Natural frequency is a physical property of a structure, which is strongly related to its boundary conditions. In this study, a modal testing technique was carried out to measure the natural frequency of dental implants. The implants were fixed by a metal clamp stand and were excited to vibrate by an impulse hammer. A noncontact piezoelectric microphone then acoustically acquired the vibration responses of the implants. Natural frequencies of the tested implants were recorded under various clamping forces and clamping levels. RESULTS: Natural frequencies of the tested implants were concentrated from 8 to 19 kHz under different boundary conditions. On the other hand, the natural frequency values decreased when boundary levels and boundary force were reduced. Linear relationships (P <.005) were found between response frequencies and the degree of implant stability. CONCLUSIONS: Our results show that the boundary status of an implant can be monitored by detecting its natural frequency. A noncontact transducer used in this study can also serve as a useful tool for future clinical investigations.

Diagnosing cytomegalovirus disease in CMV seropositive renal allograft recipients: a comparison between the detection of CMV DNAemia by polymerase chain reaction and antigenemia by CMV pp65 assay.

The optimal diagnostic test for CMV disease in renal allograft recipients in a locality with a high CMV seropositive rate has not been fully determined. We compared the usefulness of the CMV pp65 antigenemia (CMV-Ag) assay with the detection of DNAemia by a nested polymerase chain reaction (PCR) method in diagnosing CMV disease in 56 renal allograft recipients, of whom 50 (89.2%) were CMV seropositive prior to transplant (tx). Positive CMV-Ag assays were found in 126/281 samples (44.8%) of 27 patients (48.2%) of whom five had seven episodes of CMV disease. The remaining 22 patients were asymptomatic. The symptomatic patients had significantly higher median peak CMV-Ag levels than the asymptomatic patients [800 (160-1380) vs. 5 (1-604) per 2 x 10(5) peripheral blood leukocyte (PBL), p < 0.0001]. One hundred and eight samples were tested by both CMV-Ag and PCR methods. Out of the 108 samples, 89 showed concordant results (37 positive and 52 negative for both tests). Seventeen samples of 11 patients were CMV-Ag negative/PCR positive. Out of these 11 patients, two had CMV disease and the discrepancy in the results was due to blood samples taken after the start of ganciclovir therapy. Falsely negative PCR tests were found in two samples of two patients with positive CMV-Ag assays. With a outoff antigenemia level of 100 per 2 x 10(5) PBL, the sensitivity, specificity, positive and negative predictive values for diagnosing CMV disease were 100, 96, 71.4 and 100%, respectively. On the other hand, CMV DNAemia was detected in many asymptomatic patients, and the PCR test results correlated poorly with the clinical manifestations of the disease. In symptomatic patients undergoing ganciclovir therapy, the quantification of antigenemia level allowed the assessment of treatment efficacy. In addition, positive CMV-Ag assays at the end of therapy were associated with the subsequent relapse of CMV disease in two patients. The high specificity, together with the short processing time of 4 h, make the CMV-Ag assay the test-of-choice for diagnosing CMV disease in a renal transplant population with a predominance of CMV seropositive patients.

Haemorrhagic effects of sodium heparin and calcium heparin prophylaxis in patients undergoing mastectomy.

In a double-blind prospective clinical trial 75 consecutive patients undergoing mastectomy were randomly allocated to one of three groups. Twenty-five patients received perioperative anti-thromboembolic therapy with sodium heparin and 25 with calcium heparin. The remaining 25 patients were given anti-embolism stockings but no heparin. The total postoperative blood loss and period of drainage did not differ between the two groups given heparin, but a total of 10 of these 50 patients suffered haemorrhagic complications in the form of severe bruising or haematoma postoperatively. Of the patients given no heparin, none suffered haemorrhagic complications and the blood loss following the first 24-hour postoperative period was significantly less than in the groups given heparin.