A case of chronic myeloid leukemia with features of essential thrombocythemia in peripheral blood and bone marrow.

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by overproduction of myeloid white blood cells. Philadelphia chromosome is an essential finding for CML diagnosis. Generally, a clinical diagnosis of essential thrombocythemia (ET) can be established from isolated marked thrombocytosis in peripheral blood. However, Philadelphia chromosome-positivity or bcr/abl rearrangement with isolated thrombocytosis should be diagnosed as CML, not ET, according to World Health Organization diagnostic criteria. Therefore, CML should not be excluded before confirming the presence of the Philadelphia chromosome or bcr/abl rearrangement in cases of isolated thrombocytosis in peripheral blood. We report a case of CML with clinical features of ET in a patient successfully treated with imatinib.

Endoscopic treatment of a symptomatic ileal lipoma with recurrent ileocolic intussusceptions by using cap-assisted colonoscopy.

A 73-year-old woman presented with intermittent abdominal pain and weight loss of 15 kg for 2 years. Colonoscopy revealed an erythematous polypoid tumor with a long and wide stalk in the cecum, but with air inflation, it abruptly went away through the ileocecal valve (ICV). An abdominal computed tomography showed a well-demarcated pedunculated subepithelial mass of 2.6×2.7 cm size with fat attenuation in the terminal ileum. It was an intussusceptum of the ileal lipoma through the ICV. This ileal lipoma was causing her symptoms because repeated ileocolic intussusceptions resulted in intermittent intestinal obstructions. In order to avoid surgical sequelae of ileal resection, snare polypectomy using cap-assisted colonoscopy technique was performed within the ileum without complications. The histopathology report confirmed it as a subepithelial lipoma. After endoscopic resection of the ileal lipoma, the patient has been free of symptoms and was restored to the original weight.

Immediate provisionalization of mini-implants with friction-engaging abutments in the mandibular anterior region: a 1-year retrospective study.

This study evaluated the immediate provisionalization of mini-implants with friction-engaging abutments in the mandibular anterior region. A total of 43 mini-implants placed in 30 consecutive patients had a survival rate of 100% over a follow-up period of 1 to 4 years. The overall change in marginal bone level from definitive restoration delivery to 1 year for a single-tooth mini-implant replacement was -0.17 ± 0.42 mm, demonstrating bone gain. The mean changes in marginal bone level on the mesial and distal aspects were -0.18 ± 0.46 mm and -0.16 ± 0.40 mm, respectively, also representing bone gain. The difference between the mesial and distal change in bone level was not statistically significant (P = .93). The peri-implant soft tissue remained relatively unchanged at 1 year posttreatment.

Prevalence and risk factors of anterior atlantoaxial subluxation in ankylosing spondylitis.

OBJECTIVE: In ankylosing spondylitis (AS), the cervical spine, like other sections of the spine and sacroiliac joints, is vulnerable during the disease process. Atlantoaxial subluxation (AAS) has been studied in connection with AS, but its risk factors and progression have not been clarified. Therefore, this study assessed the prevalence and risk factors of AAS in patients with AS. METHODS: A total of 819 patients with AS who fulfilled the modified New York criteria and were examined with a full-flexion lateral view of the cervical spine by radiograph were enrolled from an outpatient clinic. The medical records of the patients were retrospectively reviewed and the anterior atlantodental interval (AADI) in the lateral flexion view of the cervical spine radiograph was investigated by 2 experienced musculoskeletal radiologists. We defined the AAS as an AADI of > 3 mm, and progression of AADI as a progression rate > 0.5 mm/year. RESULTS: AAS was found in 14.1% (116/819) of patients. Progression of AADI occurred in 32.1% (26/81) patients with AAS and 5.0% (16/320) patients without AAS (p < 0.001). The development of AAS was significantly associated with elevated C-reactive protein [CRP; OR 2.19 (1.36-3.53)], peripheral arthritis [OR 2.05 (1.36-3.07)], use of anti-tumor necrosis factor antagonists because of failure of nonsteroidal antiinflammatory drugs/disease-modifying antirheumatic drugs [NSAID/DMARD; OR 2.28 (1.52-3.42)], and uveitis [OR 1.71 (1.13-2.59)]. These factors were adjusted for age, sex, and disease duration by logistic regression analysis. No clear association was found for HLA-B27, seropositivity, or smoking status with AAS. CONCLUSION: AAS is a frequent complication, and the progression of AADI was more rapid in cases with AAS. The presence of peripheral arthritis, or high disease activity with elevated CRP level or refractory to conventional NSAID/DMARD, independently increased the risk of AAS, suggesting that clinicians should focus on the detection and monitoring of AAS, especially in cases with associated risk factors.

Stress distribution on scalloped implants with different microthread and connection configurations using three-dimensional finite element analysis.

PURPOSE: The objective of this study was to investigate the effects of different microthread designs and implant-abutment connection configurations of scalloped implants on stress distribution in bone using three-dimensional finite element analysis. MATERIALS AND METHODS: Three different designs of scalloped implants (two different microthread designs and one without microthreads) with two different connection systems and two flat-top implants with similar connection systems were compared in a bone model that mimicked the anterior maxilla. Vertical and oblique (30-degree) loading with 100 N of force was applied to eight models. Peak stress levels and the distribution of stress were observed. RESULTS: The stress pattern of scalloped implants was distinctively different from that observed on flat-top implants. Scalloped implants showed peak stresses in the proximal cortical bone as well as in the buccal and palatal cortical bone, whereas flat-top implants showed peak stresses mainly in the buccal and palatal cortical bone and limited stress in the proximal bone. The scalloped implant without microthreads and a conical platform-switched connection demonstrated the lowest peak stress levels. The scalloped implant with a straight platform connection generally showed peak stress that was two to three times higher than that seen in the conical platform-switched model. CONCLUSIONS: Peak stress levels in scalloped implants varied with microthread designs, connection configurations, and the direction of loading. The conical platform-switched connection seemed more important for a scalloped implant than the microthread design in reducing loading stresses exerted on the surrounding bone. Scalloped implants without microthread and a with a conical platform-switched connection or closed microthreads and a conical platform-switched connection showed consistently lower buccal bone stress than the flat-top implants in areas where the bone had a sloping and scalloping shape.

Study of an experimental microthreaded scalloped implant design: proximal bone healing at different interimplant distances in a canine model.

PURPOSE: The aim of the present study was to evaluate the validity of a new experimental microthreaded scalloped (MTS) implant design in comparison to a conventional flat-top (FT) implant by measuring the proximal bone loss at different interimplant distances in a canine model. MATERIALS AND METHODS: MTS implants were placed in one side of the posterior mandible and conventional flat-top (FT) implants were placed in the other side of the mandible in 10 beagle dogs. In five dogs, four each of the MTS and FT implants were placed with an interimplant distance of 2 mm. In another five dogs, three each of the MTS and FT implants were placed at an interimplant distance of 5 mm. All 70 implants (35 MTS and 35 FT implants) were placed in a nonsubmerged (one-stage) manner. The animals were sacrificed 4 months after implant placement, and the crestal bone levels around the MTS and FT implants were measured and compared on radiographs and histologic sections. RESULTS: The experimental MTS implants showed significantly less crestal bone loss (0.81 ± 0.34 mm) than the FT implants (1.60 ± 0.42 mm) on radiographs (P < .001). Histologic measurement also demonstrated that there was significantly less (P < .001) marginal bone loss around the MTS implants (0.74 ± 0.41 mm) than around the FT implants (1.53 ± 0.52 mm). There was no statistically significant difference in bone loss between the 2-mm and 5-mm interimplant distances for either MTS or FT implants (P > .05). CONCLUSION: The experimental MTS implant was more effective in preserving the proximal bone than the conventional FT external-hex implant with the same surface. In this canine model, placement of the implants at either a 2-mm and or a 5-mm interimplant distance did not result in significant differences in marginal bone loss for both MTS and FT implants. This experiment demonstrated a potential benefit of the microthread design on a scalloped implant.

Effects of abutment screw coating on implant preload.

PURPOSE: The aim of the present study was to investigate the effects of tungsten carbide carbon (WC/CTa) screw surface coating on abutment screw preload in three implant connection systems in comparison to noncoated titanium alloy (Ta) screws. MATERIALS AND METHODS: Preload of WC/CTa abutment screws was compared to noncoated Ta screws in three implant connection systems. The differences in preloads were measured in tightening rotational angle, compression force, initial screw removal torque, and postload screw removal torque after 1 million cyclic loads. Preload loss percent was calculated to determine the efficacy of maintaining the preload of two abutment screw types in relation to implant connection systems. RESULTS: WC/CTa screws provided 10 degrees higher tightening rotational angle than Ta screws in all three connection systems. This difference was statistically significant (p < 0.05). External-hex butt joint implant connections had a higher compression force than the two internal conical implant connections. WC/CTa screws provided a statistically significantly higher compression force than Ta screws in all three implant connections (p < 0.05). Ta screws required statistically higher removal torque than WC/CTa screws in all three implant connections (p < 0.05); however, Ta screws needed statistically lower postload removal torque than WC/CTa screws in all three implant connections (p < 0.05). Ta screws had a statistically higher preload loss percent than WC/CTa screws in all three implant connections (p < 0.05), indicating that WC/CTa screws were superior in maintaining the preload than Ta screws. CONCLUSIONS: Within the limits of present study, the following conclusions were made: (1) WC/CTa screws provided higher preload than noncoated Ta screws in all three implant connection systems. (2) The initial removal torque for Ta screws required higher force than WC/CTa screws, whereas postload removal torque for Ta screws was lower than WC/CTa screws. Calculated Ta screw preload loss percent was higher than for WC/CTa screws, suggesting that WC/CTa screws were more effective in maintaining the preload than Ta screws. (3) Internal conical connections were more effective in maintaining the screw preload in cyclic loads than external-hex butt joint connections.

Characterization of multipartite entanglement for one photon shared among four optical modes.

Access to genuine multipartite entanglement of quantum states enables advances in quantum information science and also contributes to the understanding of strongly correlated quantum systems. We report the detection and characterization of heralded entanglement in a multipartite quantum state composed of four spatially distinct optical modes that share one photon, a so-called W state. By randomizing the relative phase between bipartite components of the W state, we observed the transitions from four- to three- to two-mode entanglement with increasing phase noise. These observations are possible for our system because our entanglement verification protocol makes use of quantum uncertainty relations to detect the entangled states that span the Hilbert space of interest.

An unusual success with simultaneous urethral repair and reimplantation of penile prosthesis in a patient with urethral stricture induced by rotated tubing.

INTRODUCTION: Simultaneous urethral repair and reimplantation of penile prosthesis in a patient with urethral stricture induced by rotated tubing of a three piece penile prosthesis has not been reported yet. AIM: The aim of this study was to present our experience, which overcame severe urethral stricture induced by penile prosthesis implantation. MAIN OUTCOME MEASURE: Uroflowmetry, voding cystourethrogram, function of prosthesis, and complications. METHODS: We performed one-stage urethroplasty with pedicle island of penile skin and reimplantation of Titan penile prosthesis without abnormal rotation of the cylinder. RESULTS: The patient voided very well, and the prosthesis worked very well without complications. CONCLUSION: One-stage urethroplasty with pedicle island of penile skin and reimplantation of a three-piece penile prosthesis in simultaneous stage may be another choice to treat the long-segment urethral stricture occurred by three-piece penile prosthesis implantation.

The effects of resorbable membrane on human maxillary sinus graft: a pilot study.

PURPOSE: To investigate the effects of resorbable membrane on new bone formation in human maxillary sinus graft using anorganic bovine bone material histomorphometrically in a split-mouth study design. MATERIALS AND METHODS: This prospective pilot study included six patients who required bilateral sinus augmentations prior to implant treatment. Each patient was grafted with anorganic bovine bone (Bio-Oss). The experimental side was covered with resorbable membrane (Bio-Gide) over the grafted sinus, and the control side was left uncovered. After 8 months of healing (range, 7 to 9 months), implants were placed. Biopsy samples were obtained from each side through the previously grafted sinus window and evaluated. Statistical analysis was performed using the Mann-Whitney U test at a significance level of alpha = .05. RESULTS: The control side appeared to have a significantly greater amount of soft tissue than the experimental side (P = .026), whereas no significant differences in the amount of new bone were observed (P = .937). CONCLUSION: Resorbable membranes significantly reduced the amount of soft tissue formed in the sinus grafted with anorganic bovine bone material but had no effect on new bone formation.

Is warm temperature necessary to prevent urethral stricture in combined transurethral resection and vaporization of prostate?

OBJECTIVES: To compare the effect of warm and room temperature irrigation solution on the incidence of urethral stricture during combined transurethral resection and vaporization of the prostate (CTURVP). Urethral stricture after transurethral surgery of the prostate is a bothersome complication. Warm irrigation improves the blood flow and might decrease the incidence of urethral stricture compared with the use of room temperature irrigation, which decreases the blood flow in the urethral mucosa, resulting in ischemic injury. METHODS: The patients who underwent CTURVP were divided into those receiving only room temperature irrigation solution (group 1, 75 patients) or warm irrigation solution with a system maintaining the temperature of the ventral penile skin at about 36 degrees C continuously (group 2, 78 patients). At follow-up, 1, 3, and 6 months later, the International Prostate Symptom Score and peak urine flow rate were evaluated. RESULTS: The temperature of the ventral penile skin was 20 degrees C and 36 degrees C in groups 1 and 2, respectively. The rate of urethral stricture was 21.3% in group 1 and 6.3% in group 2 at the end of 6 months of follow-up (P = .002). CONCLUSIONS: The results of our study have shown that maintaining the temperature of the urethra with warm irrigation solution during CTURVP probably decreases the incidence of urethral stricture. The temperature in the urethra could be another important factor in stricture formation after CTURVP.

Functional quantum nodes for entanglement distribution over scalable quantum networks.

We demonstrated entanglement distribution between two remote quantum nodes located 3 meters apart. This distribution involves the asynchronous preparation of two pairs of atomic memories and the coherent mapping of stored atomic states into light fields in an effective state of near-maximum polarization entanglement. Entanglement is verified by way of the measured violation of a Bell inequality, and it can be used for communication protocols such as quantum cryptography. The demonstrated quantum nodes and channels can be used as segments of a quantum repeater, providing an essential tool for robust long-distance quantum communication.