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Contrast sensitivity and color vision with a yellow intraocular len.

OBJECTIVE: To evaluate contrast sensitivity and color vision of yellow ultraviolet (UV) intraocular len (IOL) in cataract patients. DESIGN: Randomized clinical trial. METHODS: Extracapsular cataract extraction was performed in 60 senile cataract patients. The patients were randomly assigned to receive 30 yellow UV IOLs and 30 ordinary UV IOLs. Visual acuity, contrast sensitivity, and color vision were examined up to 6 months postoperatively. RESULTS: The yellow UV IOLs showed statistically significantly higher spatial contrast sensitivity than ordinary UV IOLs in the low and middle frequencies. There was no significant difference between yellow and ordinary UV IOL in color vision. Incidences of photophobia and cyanopsia were less in patients who received the yellow UV IOLs. CONCLUSIONS: Yellow UV IOLs are preferable to ordinary UV IOLs in preserving spatial contrast sensitivity and cause less photophobia and cyanopsia in the early postoperative period.

Aged↗

Unreliability of depopulated bovine ureteric xenograft for infra inguinal bypass surgery: mid-term results from two vascular centres.

INTRODUCTION: We report a two centre experience with a depopulated ureteric xenograft (SGVG 100), CryoLife Inc., GA, USA) for femoropopliteal revascularization in 12 patients with chronic critical limb ischemia. REPORT: Between 7 days and 18 months after implantation, 10 of 12 patients (1 lost to follow-up) had the graft explanted due to aneurysmal enlargement. At 5 years, only one graft was still patent and showed moderate signs of enlargement. CONCLUSION: The SGVG 100 is not a safe conduit for femoropopliteal bypass surgery.

Angiography↗

An in vivo model for studying the local haemodynamics of end-to-side anastomoses.

OBJECTIVES: To develop an in-vivo model to study the anastomotic flow patterns. DESIGN: Prospective, open, animal study. METHODS: Polyurethane grafts with an internal diameter equal to the abdominal aorta (8 mm) of 90 kg pigs were implanted as bypass grafts from the supra-renal to the infra-renal level. A novel technique for constructing anastomoses with different anastomosis angles and only slight dilatation was used. The proximal outflow segment was occluded and the flow rate through the graft controlled by clamping the iliac arteries. Visualisation of the flow-fields at the distal end-to-side anastomosis was achieved by a comprehensive colour Doppler mapping protocol. RESULTS: The angulation of the anastomoses was controllable and reproducible. Gross haemodynamic parameters were stable within physiological ranges and were typical for peripheral bypass grafts. The flow fields at the distal end-to-side anastomosis were visualised and found to be in accordance with those reported by in vitro studies. Using different angles of Doppler insonation the same flow field characteristics were found. CONCLUSIONS: The model is an appropriate tool for studies of the effects of anastomotic geometry on local flow fields in vivo.

Anastomosis, Surgical↗

Organization of the connective tissue barrier around long-term loaded implant abutments in man.

The study aimed to investigate the connective tissue seal and the spatial organization of collagen fibers around long-term loaded implants in man. Block specimens containing smooth titanium implant abutments and the surrounding supracrestal connective tissue were obtained from patients rehabilitated for at least 1 year with implant-retained overdentures or implant-supported fixed prostheses and were histologically investigated. The histological features of the connective tissue around long-term loaded titanium abutments were specific: the tissue was rich in collagen fibers, organized in bundles, presenting a constant spatial arrangement, similar to that reported in animal studies. Circular fibers, the most numerous, were located externally, and longitudinal fibers internally. Radial fibers inserted on the abutment surface, similar to those of the periodontal system, were not observed in any case. No histological differences were found between tissue sampled around implants supporting a fixed restoration and those anchoring an overdenture.

Aged↗

Effect of a fluoride varnish on the margin leakage and retention of luted provisional crowns.

STATEMENT OF PROBLEM: Provisional crowns cemented with provisional luting agents are susceptible to washout, margin leakage, and secondary caries when placed for a prolonged period. PURPOSE: This study was conducted to determine the effect of combining a varnish containing 2.26% NaF with 2 provisional luting agents on the margin leakage and retention of provisional crowns. MATERIAL AND METHODS: Acrylic resin provisional crowns were fabricated for 8 shoulder-prepared molars. The eight provisional (N=24) crowns were luted individually with Temp-Bond (TB), Freegenol (FG), or Duraphat (DU). Specimens were thermocycled 500 times (5 degrees and 60 degrees C) with a 1-minute dwell time, stored in 100% relative humidity at 37 degrees C for 6 days, and then immersed in a 0.5% Gentian violet solution for 24 hours. Seven days after cementation, a removal test of the crowns (shear retention test) was conducted with a universal testing machine at a crosshead speed of 5 mm/min. Retention was determined as the maximum recorded force needed for crown dislodgment. DU varnish was applied to the inner surface of the dislodged crowns with no removal of the cement layer TB, FG (N=16). The crowns were relined with a 0.5-mm layer of acrylic resin and luted with a combination of luting agent and DU (TB, FG) N=16. No luting agent (NC) served as the control (N=8). Results were analyzed with the Wilcoxon matched-pairs signed-ranks test. Leakage at the margins was assessed with a 4-level dye penetration scale, and statistical differences were identified with a chi(2) test. All hypothesis testing was conducted at the 95% level of confidence. RESULTS: The mean 7-day retention forces were as follows: 44.5 N (Temp-Bond), 51.6 N (Freegenol), and 35.9 N (Duraphat). There were no significant differences among these values. Duraphat combined with Freegenol decreased the retention of provisional crowns, but Duraphat combined with Temp-Bond increased the retention of provisional crowns by 69-145%. Duraphat alone and in combination with both provisional luting agents significantly reduced margin leakage (P<.05). The least margin leakage was evident when the provisional crowns were luted with Duraphat alone. CONCLUSION: With regard to retention and margin leakage, the results of this study suggest that Duraphat varnish can be successfully used as provisional luting agent for single provisional crowns.

Acrylic Resins↗

Acute synovitis, fever and rash possibly caused by metallic debris from a loosened knee prosthesis in a patient with rheumatoid arthritis.

A 39-year-old woman with long-standing seropositive rheumatoid arthritis who had a total replacement of her left knee with a modular prosthesis in 1994 presented with fever, pruritic rash, and acute synovitis of that joint following local trauma. Synovial fluid showed a charcoal-like color, and contained abundant phagocytes laden with metal particles. In patients with rheumatoid arthritis who have undergone total joint replacement, metal particle reactions and possible hyper-sensitivity should be added to the list of potential causes of superimposed acute synovitis and systemic manifestations.

Journal Article↗

Histological comparison of early wound healing following dense hydroxyapatite granule grafting and barrier placement in surgically-created bone defects neighboring implants.

The purpose of this study was to examine early wound healing following grafting of dense hydroxyapatite granules (HA granules) and barrier placement in surgically-created bone defects surrounding implants. Eight healthy adult dogs with an average weight of 15 kg were used in this study. Thirty-two bone defects measuring 4 mm x 4 mm were removed with a surgical bur to form continuous bucco-lingual bone defects and 32 implants (16 titanium [Ti]) and 16 hydroxyapatite-coated [HA]) were then placed into the defects. Four implant groups were created: 1) grafting HA; 2) covering with an expanded polytetrafluoroethylene (ePTFE) membrane; 3) grafting HA and covering with ePTFE membrane; and 4) control (no treatment). Animals were sacrificed 28 days after surgery. Histological sections revealed large amounts of newly-formed bone in all bone defects surrounding the implants treated with ePTFE membranes alone. Fibrous encapsulation of HA granules was observed in the defects of the HA granules grafting group. In the group with grafting of HA granules and covering with ePTFE membranes, small amounts of bone tissue were observed among HA granules, but most HA granules were surrounded with fibrous tissue. Bone defects were completely filled with connective tissue in the control group. There were no differences in the histological findings between Ti and HA-coated implants in all cases. Histomorphometric data disclosed that the presence of HA granules in the bone defects significantly arrested bone formation. Our study suggests that the grafting of dense HA into bone defects surrounding implants will result in fibrous healing during the early healing stage.

Alveolar Bone Loss↗

Creating esthetic composite restorations: Part II, Crown fabrication.

The purpose of the article is to describe a fabrication technique to assist dental technicians to create an esthetic, indirect, high strength composite crown with fiber reinforcement. After the teeth have been prepared and the models completed the technician can begin the fabrication process. A fiber coping is fabricated on a separate transfer die. Translucent dentin is selected to reduce opacity and enhance the blend with the remaining dentition. High chroma dentin modifiers can then be place into the fossa, cervical, and interproximal areas to replicate dentin seen in natural dentition. Different incisal materials can then be layered into the build-up to regulate the value of the restoration. Special effects such as hypocalcification are placed internally to mimic naturally occurring esthetics. Realistic anatomy is created using a small tipped instrument directly into the final layer of uncured translucent blue enamel material. Fissure characterization is placed in the restoration to match existing dentition. Fit and margins are verified on separate dies to minimize discrepancies. Path of insertion and proximal contacts are established on a solid model to minimize chairside adjustments.

Color↗

Fracture resistance and primary failure mode of endodontically treated teeth restored with a carbon fiber-reinforced resin post system in vitro.

PURPOSE: This study was undertaken to characterize the fracture resistance and mode of fracture of endodontically treated incisors restored with cast post-and-core, prefabricated stainless steel post, or carbon fiber-reinforced composite post systems. MATERIALS AND METHODS: Ten endodontically treated teeth restored with each technique were subjected to a compressive load delivered at a 130-degree angle to the long axis until the first sign of failure was noted. The fracture load and the mode of fracture were recorded. RESULTS: The failure loads registered in the three groups were not significantly different. Between 70%, and 80% of teeth from any of the three groups displayed fractures that were located above the simulated bone level. CONCLUSION: The use of carbon fiber-reinforced composite posts did not change the fracture resistance or the failure mode of endodontically treated central incisors compared to the use of metallic posts.

Adhesiveness↗

Lava zirconia crowns and bridges.

Ceramic restorations--suitable for the anterior as well as the posterior region, simultaneously satisfying the demand for high strength, longevity, and esthetics--are an increasingly important field for the dental professional. Because of its outstanding mechanical properties and esthetics with a proven track record in other industrial areas, zirconium oxide (zirconia) is emerging in the dental industry. As the manufacturing method of choice, CAD/CAM is important for the dental laboratory; however, in the final analysis, the primary focus will be on the material properties and the clinical performance of the result of the CAD/CAM process--in this case, zirconia crowns and bridges. This is especially true since some concepts do not require the acquisition of a CAD/CAM system at all.

Cementation↗

Retrograde aorto-mesenteric by-pass grafting as treatment option of recurrent chronic mesenteric ischemia after thrombosed superior mesenteric artery stenting. Report of a case.

We report a case of early stent failure in a patient with chronic mesenteric ischemia and its treatment with a retrograde aorto-mesenteric by-pass. The patient was initially treated with angioplasty and stenting. Seven months after the procedure complete thrombosis of the stent was achieved. A retrograde aorto-mesenteric by-pass was performed. After two years the patient remains asymptomatic and color Duplex scan confirm the patency of the graft.

Aged↗

[On the topic: Doppler echocardiography].

With Doppler echocardiography, in addition to delineation of cardiac structures and their motion, intracardiac pressure and blood flow characteristics can also be assessed. The theoretical basis for this diagnostic method had been formulated by Christian Doppler approximately 100 years prior to its initial use for measuring blood flow in the heart with the aid of ultrasonic waves. The development of continuous-wave Doppler which subsequently yielded the capability for determination of the direction of blood flow, was followed by the development of pulsed Doppler for measurement of blood flow velocity in localized regions of the heart. Inter-currently, combinations of pulsed Doppler together with echocardiography as well as that of pulsed and continuous-wave Doppler were successfully incorporated into a single unit. The most recent development is represented by the realization of color Doppler systems. The possible applications of Doppler echocardiography in cardiology are manifold. Stroke volume and cardiac output determinations are based on measurement of the velocity profile in a specified region of the heart or neighboring great vessels and calculation of the respective area of flow. Intracardiac pressures can be determined in the presence of valvular stenosis, regurgitation or shunt using the pressure differences between contiguous cardiac or vascular structures as calculated by the modified Bernoulli equation and the clinically-measurable or estimable pressure in one of the respective areas. Further methods encompass parameters which can be obtained with the aid of the velocity profile of the pulmonary flow. While two-dimensional echocardiography remains the standard for assessment of systolic left ventricular function, evaluation of diastolic function can be achieved with Doppler echocardiography based on parameters of mitral inflow.(ABSTRACT TRUNCATED AT 250 WORDS)

Color↗

[Color Doppler echocardiography: expanded noninvasive cardiologic diagnosis].

Two-dimensional color Doppler flow mapping (CD) provides actual information concerning the spatial distribution of blood flow within the heart and the great vessels. CD enables the differentiation between physiological and pathological blood flow situations and provides additional information concerning turbulence, velocity and spatial relations. Thus rapid semiquantitative assessment of regurgitant lesions, detection of eccentric jets across stenotic valves and imaging of intracardiac shunts is possible. The development of CD represents an important improvement regarding noninvasive cardiology.

Color↗

Porcine stentless mitral heart valve substitute: short term clinical data.

Beginning March 1992 to February 1994, 65 patients were submitted to mitral valve replacement using the porcine mitral stentless heart valve. This group took in 65 patients, their age ranged from four to 65 with a mean of 26 years. Forty patients were below years of age. The major indication was rheumatic heart disease sequelae in 50 patients, mitral valve endocarditis in six, myomatous degeneration in four and in five previous mitral prosthetic valve was replaced due to tissue failure. The preoperative functional class revealed 35 patients in class III and 30 in class IV. The longest follow-up was 23 months with a mean of 12. The surgical technique used rendered consistent and reproducible results. There was a hospital mortality of two patients or 3.1%. The hospital morbidity revealed full recovery of all patients. There were three patients reoperated because of valve endocarditis in two and in one due to partial dehiscence of the suture at the annular level. All three patients had full recovery after a reoperation. There was a late mortality of two patients, non valve related. The follow-up of these patients revealed full competent stentless mitral valve in 50 patients and in nine minor to mild jets were encountered by color echo-Doppler. Most patients are in functional class I and II. The stenless concept has prove to be outstanding in the mitral position throughout the current follow-up of close to 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A method for scoring denture plaque.

Many studies have reported on the comparative efficiency of denture cleaning materials in their ability to remove deposits from dentures, but because of the variety of scoring methods used it is often difficult to make direct comparisons between materials. It is important that any measurements obtained should not only be accurate, reliable and reproducible but that inter-examiner error should be kept to a minimum. In this work three operators were asked to score 'blind' the total amount of disclosed plaque on a whole denture using a 0-10 scale. The overall conclusions of this test was that of poor inter-examiner agreement. A second test was therefore undertaken at a later date using the same three operators and protocol but on this occasion each surface of the denture was evaluated by reference to a series of standard reference dentures painted to simulate plaque scores in the 0-10 range. This test showed there to be no significant difference in the plaque scores recorded by the three operators and that the plaque scores recorded on the polished surfaces were significantly lower than those on the teeth and fitting surfaces (F = 10.55, P < 0.001).

Aged↗

Composite morphology of the bone and associated support-tissue interfaces to osseointegrated dental implants: TEM and HVEM analyses.

Correlated transmission electron and high-voltage electron microscopic analyses examined the undecalcified bone and associated support tissues of 60 endosseous titanium blade and titanium and ceramic root-form implants in dogs. The implants supported fixed partial dentures for up to 2 years. Data obtained from this investigation suggest that a range of tissues, both mineralized and unmineralized, support osseointegrated dental implants. This study examined the tissues apposing not just isolated aspects of the implant surface, but the entire length of the implant, and found that mineralized and unmineralized tissues existed concurrently. Much of the implant surface was apposed by mandibular bone, and both root-form and blade implants osseointegrated. The densely mineralized collagen fibril matrix was often separated from the implant by only a 20-nm to 50-nm electron-dense, ruthenium-positive deposit. High-voltage electron microscope stereology demonstrated that cellular processes extended directly to the implant from underlying osteocytes. In the same implants, areas containing an unmineralized collagen matrix interposed between the bone and implant surface were observed. In this region osteoblasts interacted with this matrix, and Howship's lacunae, containing vascular elements and osteoclasts, were also observed. The remodeling activities appear to be a homeostasis of catabolic activity (osteoclasts) and metabolic activity (osteoblasts). The apex of the implant was often apposed by a fibrofatty stroma. The support tissue response appears to be the result of the interrelations of osteoblasts, osteocytes, and osteoclasts in association with vascular elements. Therefore, the support tissue response to osseointegrated implants is a dynamic activity that involves the healthy interaction of these cells and tissues along the entire length of the implant.

Adipose Tissue↗

Intraoral repair of cosmetic restorations.

The longevity of porcelain and composite resin restorations can often be prolonged by using sound principles, up-to-date materials, and judicious attention to repair when fracture problems arise. Careful case selection and correct usage of surface treatment agents, followed by the use of a quality bonding system and restorative materials, can result in a repair that exhibits excellent retention and natural color blending. This article outlines procedures and materials to repair both resin composite and porcelain intraorally.

Acid Etching, Dental↗

Clopidogrel plus long-term aspirin after femoro-popliteal stenting. The CLAFS project: 1- and 2-year results.

The aim of this study was to determine the patency rate after femoro-popliteal stenting followed by oral clopidogrel plus long-term aspirin. In a prospective trial, 31 patients with a total of 33 femoro-popliteal artery lesions (21 stenoses, 12 occlusions; 24 femoral, 9 popliteal) were treated with flexible tantalum stents after unsuccessful percutaneous transluminal angioplasty (PTA) preceded by local fibrinolysis in 5 of 12 patients with total occlusion. Post-interventionally, oral aspirin 100 mg was started simultaneously for the long term and was combined with an oral loading dose of 300 mg clopidogrel, followed by 75 mg clopidogrel daily for 28 days. Patients were followed for at least 12 months (maximum 34 months) by clinical examination, Doppler pressure measurement, color and duplex sonography, and angiography in case of suspicion of restenosis. In a retrospective analysis, the results were compared with those of historical groups of patients having received aspirin only (41 patients) or a long-term high-dose low molecular weight heparin (LMWH)+aspirin treatment (42 patients). Three small puncture aneurysms were treated successfully by conservative means and were categorized as minor bleeding complication. Cumulative primary patency rate (PPR) was 76 +/- 7.5% (1 year), and 70 +/- 9.6% (2 years) in the clopidogrel+aspirin group, thus being tendentiously better than in the aspirin-only group showing 75 +/- 4.6% (1 year), and 50 +/- 8.1% (2 years). Long-term high-dose LMWH+aspirin treatment showed 87 +/- 5.8% (1 year), and 72 +/- 9.1% (2 years), thus being superior to the other treatment regimes, with a statistically significant difference (p<0.05) between the LMWH+aspirin and the aspirin group. Clopidogrel plus aspirin is a safe medication regimen and may be effective in the prevention of early stent thrombosis. Mid- and long-term patency rate seems to be intermediate as compared with other therapeutic regimens. The LMWH+aspirin seems to be superior compared with CLAFS; however, randomized studies with larger patient numbers are recommended.

Administration, Oral↗