Reduction of paraphimosis the simple way--the Dundee technique.
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Humans↗
Biomedical subjects
P A King
Publications and source records attributed to P A King.
Adhesive techniques.
This paper describes the use of adhesive techniques to restore teeth previously affected by tooth surface loss so avoiding the need to remove sound tooth tissue.
Dental Cements↗
Sewing-pin perforation of the appendix into the bladder.
We report a 2.5-year-old child who presented with an acute abdomen caused by the perforation of a sewing pin through her appendix that had started to penetrate the wall of the bladder.
Abdomen, Acute↗
Multiple atresias in a low-birth-weight twin.
This report describes a case of 16 small bowel atresias in a twin who was born at 31 weeks' gestation, weighing 1,690 g. All atresias and intestinal segments of 5 cm or less in length were resected, resulting in nine primary anastomoses, preserving 75% (107 cm) of his initial small bowel length. The baby went home on full oral feedings after 10 weeks. Multiple anastomoses in the low-birth-weight neonate can be tolerated with the functional benefit of maximal bowel length. The time taken to tolerate feedings appears to be independent of the number of anastomoses. Vascular anastomoses associated with monochorionic twinning may place both fetuses at risk of intestinal atresia in the event of an ischemic insult, either concurrently or with the demise of one affecting the other. Prenatal ultrasound scan appears to be useful for monitoring the evolution of intestinal atresia. However, the risks of extreme prematurity preclude the delivery of the affected baby at the time of initial diagnosis, and as yet it is unknown whether early delivery will alter the number, type, or prognosis of multiple atresias.
Diseases in Twins↗
The use of adhesive restorations in the management of localised anterior toothwear.
Toothwear appears to be increasingly common, particularly in the younger age groups, and will often require restorative intervention to provide satisfactory appearance and function. Well established conventional restorative techniques can be relatively complex and time-consuming and as a consequence may not be accessible for many patients. This paper, with the help of the literature, discusses the alternative application of a variety of adhesive materials and techniques used in the restoration of moderate to severe anterior toothwear.
Composite Resins↗
Empowering and protecting patients: lessons for physician-assisted suicide from the African-American experience.
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Black or African American↗
An in vitro evaluation of a carbon fiber-based post and core system.
STATEMENT OF PROBLEM: A self-contained post and core system, Composipost, comprising an epoxy-based carbon fiber post, a composite core material, and a low viscosity Bis-GMA bonding resin, has recently been marketed for the restoration of pulpless teeth. PURPOSE: This study compared the in vitro performance and the failure characteristics of the Composipost system against existing post and core combinations. MATERIAL AND METHODS: Using extracted human teeth, three post and core test groups and one control group were then tested to failure with an obliquely applied compressive load at 130 degrees in a Hounsfield testing-machine with a crosshead speed of 5 cm/minute. RESULTS: The mean stress values at failure (MNm.2) with standard deviations for each group were as follows: Composipost system 8.89, SD 2.40; stainless steel post and composite core 14.18, SD 3.49; cast gold alloy post and gold alloy core 15.25, SD 4.07; and endodontically treated tooth only 24.84 SD 4.58. CONCLUSION: The specimens restored with the Composipost system exhibited inferior strength properties in comparison to the other post and core systems tested (p < 0.01). Teeth without post and core foundations tested significantly stronger than the other comparison groups (p < 0.01).
Bisphenol A-Glycidyl Methacrylate↗
Embryo research: the challenge for public policy.
Complete moral consensus on the status of the human embryo is neither feasible nor necessary for the formulation of ethically acceptable public policy for human embryo research. Significant consensus on permissible human embryo research can rest upon diverse but overlapping moral traditions. Thus, human embryo research policy should do more than reflect mere abstract assertions about the moral status of human embryos. Rather, the moral underpinnings of human embryo research should be derived from a range of values, including the facilitation of human procreation, the advancement of applied scientific knowledge, the reduction of human suffering, and the protection of vulnerable persons from coercion and exploitation.
Abortion, Induced↗
Intravesical therapy for the treatment of neurogenic bladder in children.
BACKGROUND: Oral pharmacotherapy has been commonly used as an adjunct to clean intermittent catheterization (CIC) in the treatment of neurogenic bladder in order to achieve continence, but may be associated with unacceptable side effects. The authors' experience with sterile intravesical preparations of oxybutynin hydrochloride and ephedrine in children is reported here. METHODS: Patients requiring CIC for neurogenic bladder but with incontinence that was unresponsive to standard oral therapy or that was associated with severe systemic side effects were studied over a 1-year period. Clinical, radiological and urodynamic assessments were made prior to commencing treatment with intravesical oxybutynin hydrochloride. Patients who remained incontinent with poor internal sphincter muscle tone had intravesical ephedrine added. RESULTS: Seven patients were involved in the study over a 1-year period. Two patients became continent and one patient had an improvement in upper tract dilatation. One patient had a limited improvement with oxybutynin alone but became continent with the addition of ephedrine. Three patients had no response to treatment. There were few side effects. CONCLUSION: Intravesical agents have a role in the management of paediatric neurogenic bladder for those children with significant adverse sequelae from oral pharmacotherapy who would otherwise require surgical intervention. Intravesical therapy is a safe technique in children with sterile preparations. Further investigation of this modality should be pursued.
Administration, Intravesical↗
Retrospective survey of resin-retained cast-metal palatal veneers for the treatment of anterior palatal tooth wear.
Anterior palatal tooth wear is easily recognized, but its precise pathogenesis remains unknown. Treatment of this condition with cast-alloy palatal veneers used in combination with an adhesive cement is described. Forty-eight patients, aged 11 to 71, were treated with a total of 210 cast metal veneers over a period of 56 months. Twenty-three of the restorations failed, resulting in an overall success rate of 89%. All failures were confined to 13 patients. A glass polyalkenoate cement was less effective than a chemically active resin composite luting agent. Nickel-chromium veneers cemented with activated resin composite recorded a survival probability of 0.74 at 56 months. Adhesive cast-alloy veneers provided a useful method of restoring maxillary anterior teeth affected by acid erosion.
Acrylic Resins↗
Harms of excluding pregnant women from clinical research: the case of HIV-infected pregnant women.
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Animal Experimentation↗
Pioglitazone treatment for 7 days failed to correct the defect in glucose transport and glucose transporter translocation in obese Zucker rat (fa/fa) skeletal muscle plasma membranes.
Insulin resistance in the obese (fa/fa) Zucker rat is associated with decreased insulin stimulated glucose transport in skeletal muscle, due primarily to a failure of insulin to stimulate GLUT4 translocation to the plasma membrane from an intracellular pool (1). The thiazolidinedione analog Pioglitazone (PIO) has been shown to improve glucose tolerance in this and other animal models of insulin resistance. The current study was designed to determine whether 7 days of Pioglitazone treatment (20 mg/kg/day by gavage) would improve glucose transport and/or glucose transporter translocation and intrinsic activity in plasma membranes prepared from hindlimb skeletal muscle of obese Zucker (fa/fa) rats. Basal plasma glucose and insulin concentrations in these animals were unchanged by Pioglitazone, while basal plasma triglyceride and nonesterified fatty acid concentrations (NEFA) were reduced by Pioglitazone treatment (501 +/- 88 vs 161 +/- 13 mg/dl, P < 0.0001) and (678 +/- 95 vs 467 +/- 75 microM, P < 0.05) respectively. Pioglitazone had no effect on basal or insulin stimulated glucose influx (Vmax or Km) into plasma membrane vesicles determined under equilibrium exchange conditions compared to controls. Plasma membrane glucose transporter number (R0) (measured by cytochalasin B binding) under basal or insulin stimulated conditions was unchange by Pioglitazone and R0 failed to increase following insulin stimulation in either group. Glucose transporter turnover number (Vmax/R0) increased 2-fold with insulin stimulation compared to basal in both control and Pioglitazone groups, similar to turnover numbers observed in normal rats. These data confirm that impaired glucose transporter translocation in muscle of the Zucker rat is a major factor contributing to its insulin resistance. We conclude that the improved glucose tolerance observed in fa/fa rats following Pioglitazone treatment is not due to an improvement in basal or insulin stimulated skeletal muscle plasma membrane glucose transport or glucose transporter translocation and that Pioglitazone treatment does not affect transporter intrinsic activity.
Animals↗
Diagnosis, management, and outcome of cervicofacial teratomas in neonates: a Childrens Cancer Group study.
The management of cervicofacial teratomas in neonates is often complicated and may result in significant morbidity and death. A Childrens Cancer Group (CCG) retrospective study was conducted to evaluate a multiinstitutional experience with the treatment of these extremely rare neoplasms. Twenty neonates with cervicofacial teratomas, presenting from 1971 to 1994, were identified from nine CCG institutions. Fourteen neonates had cervical teratomas, and six had orofacial teratomas. There were 12 males and eight females. A diagnostic prenatal ultrasound examination was performed in six cases. Life-threatening airway obstruction occurred in seven infants (35%) in the early postnatal period. Two neonates died in the delivery room without ever having their airway secured. Two other infants with a prenatal diagnosis survived only because tracheostomies were performed by pediatric surgeons who were in the delivery room. Three other patients were orally intubated, one after sustaining hypoxic cardiac arrest. Eighteen infants had their primary tumor excised. Three patients required tracheostomy. After resection, two patients had evidence of unilateral recurrent laryngeal nerve injury, and two required prolonged thyroid hormone replacement. Histological examination showed eight mature and seven immature teratomas. Four infants (20%) clearly had malignant lesions. Pulmonary metastases occurred in two patients and contributed to one late death at 6 months of age. The overall survival rate was 85%, and the mean follow-up period was 5 years (range, 2 months to 16 years). Twelve of 17 surviving patients (70%) have had an excellent functional and cosmetic outcome. Four children have varying degrees of developmental delay and mental retardation. Hypoxia at birth was believed to have contributed to these problems in two cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Age Factors↗
Oncologic emergencies: assessment, identification, and interventions in the emergency department.
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Emergencies↗
An immediate resin-bonded bridge using the natural tooth.
Missing anterior teeth are commonly replaced immediately with partial dentures, but this may cause embarrassing problems and a poor aesthetic appearance. This paper describes a technique for replacing anterior teeth using the natural tooth as a pontic with a resin-bonded cast metal framework. The main advantage of this technique is that a fixed restoration is provided on the same day as the tooth is removed, providing a major psychological benefit to the patient and maintaining the aesthetics. The short-term results are promising- and recent advances in adhesive dentistry mean that the long-term result should be equally as good.
Adult↗
A review of pediatric cases of urinary tract calculi.
A retrospective review was performed of the records of 93 children with urinary tract calculi treated during a 10-year period (1983 to 1992). Two distinct groups of patients were identified. One group comprised 63 Aboriginal children, mainly from the northern region of Western Australia, who presented at a young age (average, 2.8 years) with urinary tract infections and failure to thrive. The other group comprised of 30 non-Aboriginal children, mainly from the metropolitan region, who presented at an older age (average, 6.7 years) with abdominal and flank pain. Calculi were located in the upper urinary tract in 85 children (91.4%) and in the bladder in eight (8.6%). Most patients underwent open surgical procedures for removal of their calculi, and the overall success rate was 86%. In recent years, percutaneous nephrolithotomy has been used successfully in selected patients with renal pelvic calculi. This method seems to be the trend for the future.
Adolescent↗
Effects of insulin and exercise on amino acid transport in rat skeletal muscle.
In the present study, the initial rates of amino acid transport by isolated rat skeletal muscle plasma membrane vesicles were investigated. This approach facilitates the study of the transport of naturally occurring amino acids independent of the effects of cellular metabolism. Alanine and glutamine influxes were measured using a rapid filtration technique. Transport was examined in the presence and absence of Na and the properties of membranes from control, insulin-treated, or acutely exercised rats were studied. Both alanine and glutamine were transported by Na-dependent processes. The values for maximum rate of transport (Vmax) for Na-dependent alanine and glutamine transport were 203 and 224 pmol.mg-1.s-1, respectively. The K1/2 values were 2.9 mM alanine and 1.9 mM glutamine. The Vmax for Na-dependent alanine transport was increased by insulin treatment of the animal and by acute exercise. 2-(Methylamino)-isobutyric acid (MeAIB) partially inhibited the control Na-dependent alanine influx and completely inhibited the increase due to insulin or exercise treatment, indicating the importance of both system A and a non-system A, Na-dependent carrier for alanine transport. The Vmax for Na-dependent MeAIB uptake was also increased by insulin or exercise treatments of the rats. Unlike alanine, Na-dependent glutamine transport was not affected by insulin.
Alanine↗
High-fat diet reduces glucose transporter responses to both insulin and exercise.
High-fat diet (HFD) induces skeletal muscle insulin resistance. To investigate associated changes in the plasma membrane glucose transporter, male Sprague-Dawley rats were fed either chow [high-carbohydrate diet (HCD)] or HFD for 3 wk. Plasma membrane vesicles were prepared from hindlimb muscle of control, insulin-stimulated (Ins), and acutely exercised (Ex) rats. Maximal vesicle glucose transport activity (Vmax) increased threefold with Ins and Ex treatment compared with controls in HCD rats; in HFD rats, increases were less than twofold. Transporter numbers (measured by cytochalasin B binding, CB) approximately doubled with Ins and Ex in both diet groups. Intrinsic activity (carrier turnover, Vmax/CB) increased significantly with stimulation in HCD but not HFD rats. Therefore, vesicles from HFD rats showed resistance to both exercise and insulin stimulation of muscle glucose transport. Transporter number increased normally, but intrinsic activity in HFD rats did not respond. Two conclusions are discussed: 1) translocation and activation are distinct, separable steps in transporter stimulation and 2) HFD produces effects that resemble the insulin resistance of starvation.
4-Nitrophenylphosphatase↗