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PubMedDate not supplied

Reverse Maryland bridges: clinical applications.

The "Maryland Bridge" or the etched metal-composite bonded retainer has experienced a variety of clinical applications since its inception as the etched enamel plastic-bonded Rochette periodontal splint. Through the evolutionary stages of different metals and framework preparation for composite bonding by electrolytic, chemical, and air-abrasive procedures and the improvements in bonding composites, the bridge has been in clinical use for approximately 9 to 10 years. Certain clinical and radiographic criteria must be satisfied prior to using the conventional Maryland bridge, but with the unique application of the basic bridge design modified and placed from the labial or buccal position some previously contraindicated uses of the bridge can be reversed by using a unique, if not provocative, application of the bridge design principles. This article presents two clinical case reports utilizing the Maryland bridge applied from the labial and buccal aspect. Both fixed partial dentures presented have been in place clinically for over 18 months, whereas others of this type have been successfully in place for over 6 years.

Acid Etching, Dental↗
PubMed2004

Apheresis technologies and clinical applications: the 2002 international apheresis registry.

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically motivated. In past apheresis surveys, the statistics have highlighted both the differences by geographic region in clinical practice and in the types of technologies utilized. While a national view of apheresis is very important, an international view may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for scientific and clinical assessment of these apheresis technologies and their clinical outcomes and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2002, reporting on 33 centers on four continents, are presented. The survey collected data, predominantly via an internet website, on 811 patients for a total of 11 428 treatments. Information gathered included patient demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, and equipment usage), side-effects, clinical response, and payment provider. As in the prior International Apheresis Registries for 1983 and 2000, the survey results highlight the regional differences in apheresis usage and treatment specifics, indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.

Adult↗
PubMed2001

Apheresis technologies and clinical applications: the 2000 International Apheresis Registry.

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically driven. In the past, apheresis survey statistics have highlighted both the differences by geographical region in clinical practices and in the types of technologies utilized. While a national view of apheresis is critically important, an international view of apheresis may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for the scientific and clinical assessments of these apheresis technologies and their clinical outcomes and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2000 reporting on 39 centers on 4 continents are presented. This survey collected data on 1,080 patients for a total of 15,257 treatments. Information gathered included patient demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, equipment usage), side effects, clinical response, and payment provider. As in the prior International Apheresis Registry for 1983, the survey results highlighted the regional differences in apheresis usage and treatment specifics, indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.

Adult↗
PubMed2006

Clinical applications of mifepristone.

Mifepristone is a progesterone antagonist that has been studied for a number of clinical applications. It is a well-known abortifacient that is effective for both first- and second-trimester medical abortion when used with a prostaglandin analog. It is also an effective cervical priming agent that can be used to soften the cervix before surgical evacuation. Its clinical efficacy as an emergency contraception has been proven. Other applications including treatment for fibroids, endometriosis and various cancers have been explored. However, its association with abortion limits the applications of mifepristone in many of these areas.

Abortifacient Agents, Steroidal↗
PubMed2006

Megavoltage cone-beam CT: system description and clinical applications.

In this article, we describe a clinical mega-voltage cone-beam computed tomography (MV CBCT) system, present the image acquisition and patient setup procedure, discuss the positioning accuracy and image quality, and illustrate its potential use for image-guided radiation therapy (IGRT) through selected clinical examples. The MV CBCT system consists of a standard linear accelerator equipped with an amorphous-silicon flat panel electronic portal-imaging device adapted for mega-electron volt (MeV) photons. An integrated computer workspace provides automated acquisition of projection images, image reconstruction, CT to CBCT image registration, and couch shift calculation. The system demonstrates submillimeter localization precision and sufficient soft-tissue resolution to visualize structures such as the prostate. In our clinic, we have used the MV CBCT system to detect nonrigid spinal cord distortions, monitor tumor growth and shrinkage, and locate and position stationary tumors in the lung. MV CBCT has also greatly improved the delineation of structures in CT images that suffer from metal artifacts. MV CBCT has undergone significant development in the last few years. Current image quality has already proven sufficient for many IGRT applications. Moreover, we expect the range of clinical applications for MV CBCT to grow as imaging technology continues to improve.

Humans↗
PubMed2000

[The clinical application of different brightness and different saturation D-15 tests].

PURPOSE: To compare the clinical application of different brightness and different saturation D-15 tests. METHODS: Eighteen normal subjects (30 eyes), 19 cases (38 eyes) of congenital color vision defects and 36 cases (59 eyes) of eye diseases were tested with Panel D-15 test, Hann's double D-15 test, middle and low saturation CAS-PI (Psychological Institute, Chinese Academy of Sciences) D-15 tests. RESULTS: A few of the normal eyes made minor errors in the low saturation D-15 tests. All of the protanopes and deuteranopes could be detected correctly. Protanomalias and deuteranomalias showed normal arrange or some type of abnormal arranges in all of the 5 sets of D-15 tests. In sick eyes, the abnormal rates were the highest in the low saturation D-15 tests and the lowest in Panel D-15 test. CONCLUSION: The five sets of different brightness and different saturation D-15 tests had similar efficiencies of detecting congenital color vision defects. The abnormal rates of CAS-PI(4/5)D-15 tests and the CAS-PI(2/5)D-15 tests were similar to those of Panel D-15 test and Hann's Double D-15 test. Both tests can be used in the clinical setting.

Adolescent↗
PubMed2004

Hypoxaemia after cardiac surgery: clinical application of a model of pulmonary gas exchange.

BACKGROUND AND OBJECTIVE: To investigate the clinical application of a mathematical model of pulmonary gas exchange, which ascribes hypoxaemia to shunt and ventilation/perfusion mismatch. Ventilation/perfusion mismatch is quantified by deltaPO2, which is the drop in oxygen pressure from alveoli to lung capillaries. Shunt and deltaPO2 were used to describe changes in oxygenation after coronary artery bypass grafting. METHODS: Fourteen patients were studied 2-4 h after surgery and on postoperative days 2, 3 and 7. On each occasion inspired oxygen fraction was changed in four to six steps to obtain arterial oxygen saturation (SaO2) in the range of 90-100%, enabling construction of FEO2/SaO2 curves. Measurements of ventilation, circulation and oxygenation were entered in a previously described mathematical model of pulmonary gas exchange. RESULTS: We found that oxygenation was most impaired 3 days after surgery. By fitting the mathematical model to the FEO2/SaO2 curve, we found that shunt remained constant throughout the study period. However, deltaPO2 increased from 0.5 kPa (median, range 0-3.8) 2-4 h after surgery, to 3.2 kPa (range 1.2-6.4, P < 0.05) on day 2, and to 4.0 kPa (range 1.2-8.3) on day 3. On day 7, deltaPO2 decreased to 2.2 kPa (range 0-3.5, P < 0.05). CONCLUSIONS: Ventilation/perfusion mismatch (deltaPO2), rather than shunt, explains the changes in postoperative oxygenation. The model of pulmonary gas exchange may serve as a useful and potentially non-invasive clinical tool for monitoring patients at risk of postoperative hypoxaemia.

Aged↗
PubMed1981

Emission computerized tomography: clinical applications.

Single photon emission tomography (SPET) is making its impact on the practice of clinical nuclear medicine. Special purpose and general purpose instrumentation has become available with significantly improved performance capabilities. The advantages to be expected from this new approach to noninvasive medical imaging methodology include improvement of contrast resolution of the image and the ability to quantify the information in the three-dimensional section scan. It has been shown that SPET can replace planar imaging of the brain and that it significantly improves lesion detection in the liver. Organ volume measurements can be achieved and tracer uptake parameters calculated. This field is still at its beginning. Instrumentation will change and significant improvements in reconstruction algorithms will extend the clinical usefulness of these techniques. Even if absolute measurements may not be achievable in the body, it is possible to distinguish an abnormal population from a normal one. Sequential data may then be recorded and integrated into serial treatment protocols. Progress in the labeling of clinically useful tracers with suitable radionuclides [123I, 99mTc, 197Rt, 81mKr, 111In, etc.) is needed in order to achieve further significant progress in the areas of clinical applications.

Brain↗
PubMed1983

Clinical applications of DSM-III in consultation-liaison psychiatry.

The authors examine the clinical application of DSM-III from the perspective of the consultation-liaison psychiatrist. They discuss contributions of DSM-III that have refined psychiatric diagnosis in medical-surgical settings, including the multiaxial system, a broader approach to the organic mental disorders, introduction of the category of psychological factors affecting physical condition, and an improved classification of disorders that present with physical symptoms. However, some areas of continuing ambiguity remain, such as how much discretion a clinician has to discount somatic symptoms related to physical illness in the diagnosis of depression, the implications of exempting bereavement from diagnostic status, and uncertainty about what constitutes evidence of an etiological relationship.

Diagnosis, Differential↗
PubMedDate not supplied

[Clinical application of the V-Y posterior thigh fasciocutaneous flap].

PURPOSE: To analyze the clinical applicability of one-stage treatment of single or multiple sores using the V-Y posterior thigh fasciocutaneous flap. METHODS: Twenty patients were treated, having 25 ulcers in the gluteal and perineal regions, being 23 pressure ulcers, 1 perianal abscess and 1 perineal trauma. In all of the patients the repair was carried out with a fasciocutaneous flap from the posterior region of the thigh. The flap was made with a superior and lateral base, preserving the fasciocutaneous branches of the inferior gluteal arteries, first and second perforating, in the treatment of ischial ulcers. In the associations of the same with sacral ulcer, a fasciocutaneous extension from the gluteal region was added to the flap for a one and only surgical procedure. A superior and medial based flap was made, preserving the fasciocutaneous branch of the inferior gluteal artery in the treatment of the trochanteric ulcers. In the associations with sacral ulcer a fasciocutaneous extension from the gluteal region was added to the posterior thigh flap which permitted the closure of all ulcers in only one surgical procedure. In the associations of trochanteric and ischial ulcers a flap with a superior base was made, preserving the fasciocutaneous branch of the inferior gluteal artery. RESULTS: There was no necrosis of the flap. The immediate complications were 3 infections, 1 dehiscences and 1 hematoma. In a follow-up period of 6 months to 29 months, with one patient being lost to follow up, there were 6 recurrences 6/24 (25.0%) in 5 patients 5/19 (26.32%). CONCLUSION: We conclude that the posterior fasciocutaneous thigh flap, in V-Y, can be used with safety in the treatment of isolated or multiple ulcers in the gluteal and perineal regions.

Adolescent↗
PubMed1998

Superparamagnetic agents in magnetic resonance imaging: physicochemical characteristics and clinical applications. A review.

Superparamagnetic agents in magnetic resonance imaging: physico-chemical characteristics and clinical applications. Superparamagnetic agents have been the subject of extensive research over the last decade. They consist of iron oxide nanoparticles which are highly effective in Magnetic Resonance Imaging (MRI). The particle size varies widely and influences their physicochemical and pharmacokinetic properties. Their main present and future applications by the parenteral route are: imaging of gastrointestinal tract, liver and spleen, lymph nodes. Ultrasmall superparamagnetic iron oxide particles (USPIO) are also blood pool agents which could be used for perfusion imaging (i.e. brain or myocardial ischemic diseases) as well as for imaging of vessels in Magnetic Resonance Angiography. These agents open up an important field of research into more specific agents adapted to clinicians' needs in diagnostic imaging.

Contrast Media↗
PubMed1998

[Clinical applications of island and myocutaneous flaps].

OBJECTIVE: This is to introduce the experience in clinical applications of the island and myocutaneous flaps. METHODS: Since 1985 fifteen types of vascularized island and myocutaneous flaps have been applied in 52 cases (21 positions) for the following purposes: repairing traumatic soft tissue defects on the limb, scar contracture, congenital recto-vaginal fistula, reconstructing congenital nasal deformity and rehabilitating function. The non-major artery island flap was used in 47 cases (90.38%) and the retrograde island flap was used in 24 cases (46.15%). The size of the flap ranged from 2.5 cm x 1.5 cm to 15 cm x 12 cm. RESULTS: All the flaps survived with primary healing. Follow-up for 8 months to 11 years showed aesthetically and functionally satisfactory results in all cases. CONCLUSION: These island and myocutaneous flaps have rich blood supply and are highly anti-infective. The operation is easy and the success rate is high.

Adolescent↗
PubMed1999

[Clinical application of esophageal manometry and 24-hour esophageal pH monitoring].

OBJECTIVE: To evaluate the clinical application of esophageal manometry and 24-hour esophageal pH monitoring. METHODS: From 1990 to 1996, ambulatory esophageal manometry and 24-hour esophageal pH monitoring were performed on 101 patients with different functional esophageal diseases, including Barrett's esophagus 54 patients non-cardiac chest pain (10) and post-cholecystectomy (37). Esophageal motility studies were made to compare the effects of different anti-reflux therapies, to identify primary esophageal motility disorders, to assess the effect of anti-acid drugs, and to study the relationship between esophageal motility disorder and other non-esophageal origin disease. RESULTS: In this study, anti-reflux surgery was better than medical therapy in controlling gastroesophageal reflux (GER) for Barrett's esophagus. Esophageal manometry was the best method for detecting primary esophageal motility disease. Omeprazole was superior to cimetidine in terms of control of GER and reduction of gastric acidity. Cholecystectomy resulted in GER and many symptoms after surgery appeared to have an esophageal origin. CONCLUSIONS: Esophageal manometry and 24-hour esophageal pH monitoring are the most sensitive and specialized methods for detecting esophageal motility disorders. They are superior to other routine diagnostic methods such as radiology and endoscopy.

Antacids↗