Pregnancy in Morrison Pouch: a case report.

Abdominal pregnancy is a rare form of ectopic pregnancy (accounting for 1% of all ectopic pregnancies). Depending on gestational age and its location various symptoms and signs may be exhibited. This study aimed to report a case of abdominal pregnancy occurring in the Morrison Pouch with a primary presentation of right upper quadrant pain and to highlight complications that may arise in the management of abdominal pregnancy located in the Morrison Pouch. A 22-year pregnant woman at gestation of 22 weeks presented with a right upper quadrant mass and pain. Ultrasound examination revealed a live extrauterine singleton at Morrison Pouch, full blood count showed severe anemia. The patient received a blood transfusion in seven days and underwent emergency laparotomy after experiencing sudden acute internal hemorrhage but died a few hours post laparotomy due to hemorrhagic shock. Abdominal pregnancy carries a high risk of maternal hemorrhage as described in this case.

Laryngeal ulceration and hemoptysis secondary to inadvertent alendronate overdose: case report and review of the literature.

Alendronate is commonly used in the treatment of osteoporosis and other bone diseases. Its drug profile includes many recognized side effects, and the literature includes case reports of esophageal irritation and ulceration. However, little has been published about laryngeal effects. We describe the case of a 77-year-old man who presented with hemoptysis secondary to laryngeal ulceration caused by the inadvertent misuse of alendronate. This case highlights the need for otolaryngologists to be familiar with alendronate and its side effects.

Portable dentistry: a part of general dentistry's service mix.

Portable dentistry is a service that is easy to provide and profitable; the demand is expected to increase as the population ages. The author encourages incorporating portable dentistry as a methodical and planned service, alongside traditional fixed practice, to benefit the patient and the profession. The profession of dentistry is challenged to consider its ethical and moral obligation to homebound and institutional patients, citing instances worthy of consideration. Barriers that prevent access to care are discussed and some are reduced to manageable components of business such as finances or concerns with treating the medically complicated patient. Opportunities and possibilities for personal, professional, and financial growth through the provision of portable dentistry are cited.

Human gingival fibroblasts produce nitric oxide in response to proinflammatory cytokines.

BACKGROUND: Although nitric oxide (NO) synthesis is increased in periodontal disease (PD), little is known about the possible sources of production by gingival tissues. In fact, gingival tissues from patients with periodontitis demonstrate greater levels of inducible nitric oxide (iNOS) expression than healthy tissue. Macrophages are the source of the iNOS expression, with endothelial cells also contributing. In the present study, our hypothesis has been that human gingival fibroblasts (HGF) also have the ability to produce NO. We have established for the first time that HGF express increased levels of iNOS and modulate NO synthesis in response to proinflammatory cytokines that act synergistically. METHODS: NO production under basal conditions or following incubation with tumor necrosis factor (TNF-alpha), interleukin (IL)-1beta, and interferon (IFN)-gamma was assessed by measurement of stable NO metabolites, nitrite, and nitrate, in a microplate adaptation of the Griess assay. Total RNA was isolated from HGF for determination of iNOS mRNA levels. RESULTS: We have shown that NO production is elevated in HGF that are stimulated simultaneously by TNF-alpha, IL-1beta, and IFN-gamma. Northern blot analysis confirmed that the production of iNOS mRNA by HGF is upregulated in the presence of these cytokines. Addition of mercaptoethyl guanidine (MEG), a specific inhibitor of iNOS, profoundly reduced the production of NO in HGF. Non specific inhibitors of iNOS, L-NG-monomethyl arginine (L-NMMA), and L-arginine-methyl ester (L-NAME) had little or no effect on NO produced in HGF. CONCLUSIONS: These results suggest that elevated NO production could be important in the pathogenesis of PD, and also suggest the ability of an iNOS inhibitor to modulate the disease. Treatments with drugs to block the production of nitric oxide or block its effects might be therapeutically valuable.