Evaluation of the internal anatomy of paramolar tubercles using cone-beam computed tomography.

PURPOSE: To evaluate the internal anatomy of paramolar tubercles (PTs) on molars, determine the existence of root canals in these structures that either communicate with or are isolated from the main root canals of teeth, and analyze the prevalence of root fusion and a C-shaped canal configuration using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Twenty-six molars with PTs from the study group and 664 molars without PTs from the control group were evaluated using CBCT. The locations and sizes of tubercles were noted. The existence of root canals in PTs was detected. All teeth were evaluated according to the presence or absence of root fusion and a C-shaped canal configuration. Statistical analyses were performed with Pearson Chi square and Fisher's exact tests (p < 0.05). RESULTS: Eleven (42.3%) PTs with their own canals communicated with the main root canals of teeth, and 10 of 11 PTs (90.9%) were larger than 4 mm in size. No PT possessed its own canal independent from the other canals. Teeth with PTs tended to have more root fusions than teeth without PTs. A statistically significant correlation was observed between PTs and the C-shaped canal configuration (p < 0.01). Maxillary second molars with PTs were the major teeth showing variations in the internal morphology. CONCLUSIONS: PTs are an uncommon anatomical variation that is specific to the coronal and radicular morphology. Therefore, clinicians should be aware of its unpredictable and complex internal anatomy, particularly in cases requiring endodontic treatment. CBCT is recommended for teeth with PTs, particularly maxillary second molars, to improve the prognosis of the teeth.

Evaluation of risk factors in predicting coronary artery disease in patients with left bundle branch block.

This retrospective study examined whether classical risk factors for coronary artery disease (CAD) could also be used to predict CAD in patients with left bundle branch block (LBBB). Clinical and demographic features were studied in patients with/without CAD who presented with LBBB on their surface electrocardiograms and had undergone coronary angiography. Of the 312 patients with LBBB, 161 (51.6%) had CAD. Patients with CAD were more likely to be older, male, have CAD risk factors and to be taking acetylsalicylic acid or angiotensin-converting enzyme inhibitors. A model with six independent variables (family history, smoking, angina, advanced age, hypertension and total cholesterol levels) was statistically significant in predicting CAD in patients with LBBB, with an ability to predict patients with and without CAD of 87.1% and 90.6%, respectively. Predictors of CAD in patients with LBBB are consistent with classical risk factors and may help the accurate prediction of patients with CAD.

Effects of semen characteristics on IUI combined with mild ovarian stimulation.

To determine the influence of sperm parameters inseminated on the outcome of intrauterine insemination (IUI) in patients undergoing ovarian stimulation with clomiphen citrat (CC) or human menopausal gonadotropin (HMG) therapy, a retrospective review was performed for 2 years on data from the IUI program. 190 couples underwent a total of 268 IUI cycles in which CC or HMG was used for ovulation induction. The initial sperm concentration (mil/ml), motility (percent), preprocessing total motile sperm (TMS) count (million), fast motile sperm (percent) and postprocessing sperm concentration (mil/ml), motility (percent), TMS count, fast motile sperm (percent), sperm morphology, hypoosmotic swelling (HOS) scores, semen leuocytes, and bacteria were analyzed. 268 inseminations were followed by a pregnancy rate of 12% and couple pregnancy rate of 17%. On multivariable logistic regression analysis, total motile sperm (TMS) count, percent motility, and percent of fast motile sperm were independent prognostic factors of fertility. The impact of the preprocessing and postprocessing sperm parameters on pregnancy outcome after IUI was evaluated. There was a trend toward an increasing percent of conception with increasing TMS count, motility, and percent of fast motile sperm. The TMS count, motility and percent of fast motile sperm independently predict success with IUI. Patients with original sperm motility > or = 30% had a higher cumulative pregnancy rate (74%) than patient with motility < 30% (p < 0.005). Pregnancy rate increased 4 times with motility of > or = 30%.