Survival rate of disk and screw-type implants used for the retention of extraoral prostheses.

STATEMENT OF PROBLEM: Implant-supported and implant-retained extraoral prostheses are reliable treatment options for patients with craniofacial defects. They provide stable retention and therefore enhance the patient's appearance and quality of life. Despite studies on survival rates of extraoral implants, little attention has been paid to the design of the implants used to support and retain extraoral prostheses. PURPOSE: The purpose of this longitudinal clinical study was to assess the long-term survival rate (1 to 12 years, mean 6 years) of 2 different designs of implants (disk: single, double, and triple and screw-type) used for extraoral epithesis anchorage. MATERIAL AND METHODS: Twenty-six participants with orbital and nasal defects, 10 of whom had had radiation treatment, were included in the study. Disk implants and extraoral (EO) screw implants were used and placed in the periorbital (15 participants) and perinasal regions (11 participants). Data were analyzed by using the Chi-square test and the Fisher Exact test for qualitative variables and the Mann-Whitney U test for comparison of quantitative variables. Implant survival rates were calculated by Kaplan-Meier analysis. RESULTS: The overall 12-year survival rate of all implants was 90.3% (mean=79 months), with 92.9% for nasal (mean=84 months) and 88.2% for orbital (mean=75 months) implants. Related to the implant design, survival rates were as follows: for single-disk implants, 90.2%; for double disks, 94.6%; for triple disks, 88.3%; and for screw implants, 83.3%. In nonradiated participants, the implant survival rate was 97.6%, and for radiated participants, 76.1%. CONCLUSIONS: Survival rates for implant-retained craniofacial prostheses are limited. The nasal site seems to be a more predictable implant site than the orbital site, with a higher overall survival rate. Also, implants inserted in radiated tissues have lower survival rates for both anatomic sites, with statistically significantly lower results in the orbital region. The most reliable type of implant among the disk implants used was the double disk in the orbital site and the single disk in the nasal site, which may indicate the advantages of some designs in specific areas.

[Characterization and antimicrobial activity of the bioactive metabolites in streptomycete isolates].

Twenty different streptomycete isolates were obtained from soils of southeast Serbia. Five isolates identified as Streptomyces hygroscopicus (SH100, SH101, SH102, SH103, and SH104) showed strong activity against Botrytis cinerea, a parasite found in domestic vines. These isolates were extensively studied for their in vitro antimicrobial activity against Gram-positive bacteria, Gram-negative bacteria, yeasts and fungi, and also antiviral activity against Herpes simplex. The results indicated that the obtained isolates were highly active against Botrytis cinerea, Candida albicans, and Herpes simplex, with an inhibition zone of approximately 31 mm. The structure of the bioactive components was determined using elemental analysis, as well as UV/VIS, FTIR, and TLC.

Can a patient be successfully prepared for pheochromocytoma surgery in three days? A case report.

The case of a patient who insisted on urgent surgical removal of a pheochromocytoma is presented. Rapid preparation started with continuous infusion of urapidil 3 days before surgery. On the evening before the operation, an additional infusion of magnesium sulphate was started. The target of preoperative optimization was to maintain blood pressure <140/90 mm Hg and heart rate <100 beats min(-l). Anesthesia was induced with fentanyl, propofol and rocuronium and maintained with sevoflurane in 100% oxygen and continuous infusion of fentanyl. Hypertensive events were treated by continuous infusions of urapidil and magnesium sulphate. Just before tumor resection, additional boluses of urapidil and MgSO4 were administered; both fentanyl infusion and end tidal concentration of sevoflurane were increased. Blood pressure was well maintained through the anesthesia; no transient periods of hypotension after tumor removal were observed. The patient's peroperative course was uneventful. He was discharged home without antihypertensive medication on the 5th postoperative day. This case demonstrates that with urapidil and magnesium sulphate administration rapid preparation for pheochromocytoma resection can be successfully achieved within 3 days.

[Evaluation of the value of local protective methods using latex prosthesis and fibrin glue in colonic anastomoses]. / Procena vrednosti lokalnih protektivnih metoda latex proteze i fibrinskog lepka na anastomoze kolona.

In this experimental study on small animals (Wister rats) performed evaluation of local protective methods--latex prosthesis and fibrine adhesives--on colon anastomosis healing--prevention of dehiscency. Ninety experimental animals in whom segmental left colon resection was done, were divided into three groups of 30 animals. In the control group after segmental resection termino-terminal anastomosis with single-layer continuous suture was performed. In the second and third group with the same animals, anastomosis protection was performed with endoluminal latex prosthesis and extraluminal application of fibrine adhesives. In the postoperative course where the animals were monitored for 21 days in the control group, 3 (10%) died of acute diffuse peritonitis the cause of which was anastomosis dehiscency, in the latex prosthesis 2 animals (6.6%) died, while in the extraluminally applied fibrine glue group all animals survived. The results of this experiment demonstrate that local protective measures for colon anastomoses may produce better results, with fibrine adhesive administration as the best modality.

Enteroaggregative Escherichia coli associated with an outbreak of diarrhoea in a neonatal nursery ward.

Over a 9-day period in February 1995, 16 newborn babies (age range 2-11 days) and 3 infants (24, 47 and 180 days of age) in a neonatal nursery ward developed diarrhoea accompanied by pyrexia and weight loss. Known enteropathogens were not detected in their stools but Escherichia coli displaying aggregative adherence to HEp-2 cells (enteroaggregative E. coli) were found in 12 (63%) ill infants and in none of 5 well neonates (P = 0.02). The illness lasted 3-9 days (mean 5.2) in 16 babies, whereas in 3 neonates it showed a protracted course of 18-20 days. The source of infection and the mode of transmission remained unclear. The outbreak isolates manifested properties common in this new group of diarrhoeagenic E. coli: mannose-resistant haemagglutination, haemolysis on blood agar, and clump formation in liquid culture medium. They belonged to the O4 E. coli serogroup and expressed multiple antibiotic resistance.