Long-term stability of conservative orthodontic treatment in a patient with rheumatoid arthritis and severe condylar resorption.

Rheumatoid arthritis is a chronic inflammatory condition that can result in progressive destruction of the articular surfaces of the joints, including the temporomandibular joint. The purpose of this article is to report the conservative correction of a Class II malocclusion in a woman with rheumatoid arthritis. The patient was 32 years 6 months old at the start of treatment. She had a convex profile and a skeletal Class II jaw-base relationship caused by severe condylar resorption. An anterior open bite of -2.0 mm and an excessive overjet of 10.0 mm were observed. Severe crowding was shown in the mandibular incisors. After 8 months of splint therapy, all first premolars were extracted, and 0.018-in preadjusted edgewise appliances were placed in both arches. Class II elastics were used during space closure. After 41 months of active orthodontic treatment, an acceptable occlusion was achieved, and the facial profile was considerably improved. From the cephalometric evaluations, the mandible was rotated counterclockwise, and the mandibular plane angle was significantly decreased. However, the anteroposterior position of the chin was not changed. The condylar resorption was not changed during and after orthodontic treatment. Conclusively, the proper facial profile was maintained, and the occlusion was stable after a 5-year retention period. Our results suggest the possibility of compromised treatment in a Class II malocclusion with an anterior open bite because of rheumatoid arthritis.

[Case of suspected malignant hyperthermia following local infiltration anesthesia].

A 49-year-old man with no past history of malignant hyperthermia (MH) and scheduled for hernia repair was suspected of MH after local infiltration anesthesia at other hospital. Although intravenous diazepam was not effective for increased body temperature, tachycardia, and convulsion, dantrolene was effective for these signs. However, blood test showed no abnormal finding. At our hospital, he was scheduled for hernia repair and muscle biopsy under total intravenous anesthesia. No event occurred intra- and postoperatively. The examination for muscle biopsy revealed that the function of his ryanodine receptor 1 is abnormal. The events which had occurred at other hospital were uncertain of being associated with MH.

Structure and electrochemical properties of (µ-O)2Mn2(iii,iii) and (µ-O)2Mn2(iii,iv) complexes supported by pyridine-, quinoline-, isoquinoline- and quinoxaline-based tetranitrogen ligands.

Seven new bis(µ-oxo)dimanganese complexes with Mn2(iii,iii) or Mn2(iii,iv) oxidation states were prepared using quinoline- and isoquinoline-based tetraamine ligands. The structures of the ligands include ethylenediamine, trans-1,2-cyclohexanediamine and tripodal amine, bearing two or three nitrogen-containing heteroaromatics. Regardless of the skeleton and number of aliphatic nitrogen atoms in the ligands, quinoline complexes stabilize the Mn2(iii,iii) oxidation state, whereas, isoquinoline ligands afford Mn2(iii,iv) complexes. A systematic comparison of the differences in structural parameters and redox potentials of a total of 14 complexes with a (µ-O)2Mn2 diamond core, which includes corresponding pyridine and quinoxaline derivatives as supporting ligands, highlights the distinct deviation of quinoline and tripodal amine motifs in this ligand series.

Adult Class III treatment using a J-hook headgear to the mandibular arch.

OBJECTIVE: To evaluate the treatment effects of high-pull J-hook headgear on the lower dental arch in nongrowing Class III patients. MATERIALS AND METHODS: Fourteen nongrowing Class III patients having an Angle Class III malocclusion and ANB angle of less than 1.0 degree, were treated with high-pull J-hook headgear to the lower arch. Using lateral cephalograms and plaster models obtained before treatment (T1), after active treatment (T2), and after the retention period (T3), the treatment outcome was analyzed. RESULTS: The incisal edge of the lower central incisor moved a mean of 1.2 mm to the lingual and 1.7 mm to the occlusal between T1 and T2. The axis of the lower incisor inclined 4.0 degrees to the lingual. The lower first molar cusp moved 1.5 mm to the distal and the root apex moved 2.0 mm to the mesial. Molar angulations were tipped 9.8 degrees to the distal. The occlusal plane showed 4.5 degrees counterclockwise rotation. The mean intermolar width increased 1.5 mm on average. Comparison of the records between T2 and T3 showed minimal changes. CONCLUSIONS: Distal movement of the lower dental arch using J-hook headgear was clearly demonstrated, confirming that the application of high-pull J-hook headgear to the lower arch was effective for improvement of the Class III occlusion.

[TURP syndrome with severe hyponatremia (98 mEq x l(-1)): a report of a case].

We report a case of transurethral resection of prostate (TURP) syndrome with severe hyponatremia (98 mEq x l(-1)). A relatively healthy 71-year-old man (167 cm and 61 kg) with benign prostatic hypertrophy was scheduled for transurethral resection of the prostate under general anesthesia. Ninety minutes after starting the operation, electrolyte analysis revealed a decrease in serum Na concentration (Na 98 mEq x l(-1), BE -6.4), and 7% NaHCO3 60 ml + saline 500 ml were rapidly administered, and saline 500 ml + 10% NaCl 60 ml were administered at a rate of 100 ml per hour (Na 32 mEq x hr(-1)). One hour later, serum Na concentration was 111 mEq x l(-1). No ECG changes were observed during TURP. No neurological signs were observed, postoperatively. Central pontine myelinolysis (CPM) has been associated with excessively rapid correction of chronic hyponatremia. However, the pathophysiology of chronic hyponatremia is different from that of acute hyponatremia. Central pontine myelinolysis has not yet been reported after correction of acute hyponatremia in the TURP patient. Acute hyponatremia during TURP should be corrected rapidly, because acute hyponatremia can cause neurological complications.

Nonextraction treatment of upper canine-premolar transposition in an adult patient.

This article reports the successful treatment of a unilateral maxillary canine and first premolar transposition without the extraction of the premolar in an adult patient. A female patient, 21 years and three months of age, had moderate crowding in the upper arch with complete transposition of the canine and first premolar. After distal movement of the upper molars with a lingual arch and headgear appliance, the upper left first premolar and canine were transposed. Thirty-eight months after the placement of preadjusted appliances, the transposed canine and premolar were reordered in the proper positions. The total active treatment period was 49 months. After two years of retention, the occlusion is generally stable.

Quinoline-based fluorescent zinc sensors with enhanced fluorescence intensity, Zn/Cd selectivity and metal binding affinity by conformational restriction.

Two cyclohexanediamine-based tetrakisquinoline derivatives, N,N,N',N'-tetrakis(2-quinolylmethyl)-trans-1,2-cyclohexanediamine (TQDACH) and N,N,N',N'-tetrakis(1-isoquinolylmethyl)-trans-1,2-cyclohexanediamine (1-isoTQDACH), have been prepared and their zinc-induced fluorescent response was investigated. In DMF-H2O (1 : 1) solution, TQDACH exhibits increase of fluorescence at 455 nm in the presence of 1 eq. of zinc ion (λ(ex) = 317 nm, φ = 0.010). Similarly, 1-isoTQDACH exhibited fluorescence enhancement upon binding with zinc (λ(ex) = 325 nm, λ(em) = 352 and 475 nm, φ = 0.032). The fluorescence intensity ratio induced by cadmium relative to zinc (I(Cd)/I(Zn)) for these 1,2-cyclohexanediamine probes is lower than those for the corresponding ethylenediamine derivatives, TQEN and 1-isoTQEN. Crystal structures of the zinc and cadmium complexes of TQDACH and 1-isoTQDACH reveal the superior metal binding ability of the 1,2-cyclohexanediamine and isoquinoline moieties in comparison to ethylenediamine and quinoline. The conformational restriction afforded by the 1,2-cyclohexanediamine skeleton upon zinc binding leads to enhanced fluorescence intensity and strong metal binding affinity.