N-Methylmorpholine-N-oxide ring cleavage registration by ESR under heating conditions of the Lyocell process.

Thermal cleavage processes of N-methylmorpholine-N-oxide monohydrate (NMMO) were observed in pure NMMO as well as in cellulose/NMMO solutions by ESR at temperatures of the industrial Lyocell process ( approximately 370K). Generated radicals were attributed to the alkylnitroxyl type radicals -CH(2)-NO-CH(3) in NMMO and additional (and dominated) -CH(2)-NO-CH(2)- in cellulose/NMMO solutions. Formation of both radical types formed due to NMMO ring scission is suggested.

Rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury.

Rectal foreign body insertion is a common condition in emergency surgery, which often requires surgical intervention. Here we report a clinical case of rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury. A 72-year-old man presented to the emergency department complaining of acute bilateral paraplegia with loss of sensation in both legs, as well as total urinary retention. The patient underwent abdominal computed tomography, which showed a rectal foreign body measuring 13 × 11.5 × 10 cm in the lower abdomen and pelvis. Extraluminal assistance through a median laparotomy was required after unsuccessful attempts at transanal recovery alone. After removal of the foreign body, the rectal wall and anorectal sphincter were massively dilated, with severe bruising of the rectal mucosa on proctoscopy. A protective loop-ileostomy was performed. The sacral plexus is located posteriorly in the pelvis. Physiologically, the nerves are well protected by surrounding anatomical structures. Post-traumatic lumbosacral plexus injuries with paraplegia, urinary retention and anorectal sphincter insufficiency occur quite frequently after heavy traffic accidents. Lumbosacral plexus injury as a result of rectal foreign body insertion is rare. Severe neurological deficits through rectal foreign body insertion are rare but known medical conditions. To the best of our knowledge, this is the first reported case of severe and persistent post-traumatic lumbosacral plexus injury through a rectal foreign body.

Urokinase. A cost-effective alternative treatment of superior vena cava thrombosis and obstruction.

Venous thrombosis and subsequent obstruction of the superior vena cava may be life threatening and therefore warrant immediate attention. This case report represents the successful treatment of superior vena cava thrombosis with urokinase in a patient with an indwelling Hickman catheter. Patency of the occluded vessel and resolution of clinical symptoms were achieved within 24 hours of initiation of a 12-hour urokinase infusion.

Thrombolytic therapy for acute myocardial infarction.

Numerous factors must be considered when determining the formulary status of thrombolytic agents for the treatment of acute myocardial infarction. Defined treatment options, predicted outcomes, and the economic consequences of this disorder continue to evolve from clinical trials. Pharmacists have a major role in delivering patient care, with responsibility for evaluating, procuring, and monitoring thrombolytic agents and drug therapy in general. By participating in the development and implementation of treatment guidelines, evaluating economic and therapeutic outcomes, providing timely optimal drug therapy, and educating health care providers and the public, they contribute significantly to the health care team.

Prevalence of medical problems in periodontal patients obtained from three different populations.

Data from three different sources of periodontal patients were collected and examined to find if there was a significant difference between these groups relative to the prevalence of medical problems. Data were evaluated to show if age and sex were significantly related to the existence of medical problems and to determine which problems were the most prevalent. A total of 581 periodontal patients' records were obtained. Results of the evaluation showed that the private office group had 27.6% medical problems, the academic dental center had 46.3%, and the hospital dental clinic had 74.1%. Cardiovascular disease was the most prevalent medical problem in all groups and orthopedic disease or injury was second. Within each group, sex was not significantly related to the presence of a medical problem. Age was a highly significant factor, with the prevalence of medical problems increasing with advancing age.

[Budd-Chiari syndrome in liver echinococcosis]. / Budd-Chiari-Syndrom bei Leberechinokokkose.

In two female patients a diagnosis of Budd-Chiari syndrome secondary to hepatic echinococcosis was established by CT. One patient developed acute Budd-Chiari syndrome secondary to E. granulosus lesions of the liver. The second patient presented with a picture of chronic Budd-Chiari syndrome secondary to alveolar echinococcosis. CT findings of Budd-Chiari syndrome included ascites, low density areas in the liver parenchyma, hypertrophy of the caudate lobe, non visualisation of the hepatic veins, occlusion of the retrohepatic inferior vena cava and enlarged retroperitoneal veins.

Oral health of airmen: analysis of panoramic radiographic and Polaroid photographic survey.

An oral health survey of 5,783 basic airmen was conducted. In this study, emphasis was placed on detection of periodontal disease. Numerous pathologic conditions were found and recorded. In addition, the presence or absence of evidence of previous dental care and its nature were reported. We believe that panoramic radiographs and Polaroid intraoral photographs have merit in mass screening of large numbers of persons for the detection of periodontal disease. Through the use of these diagnostic aids, various degrees of periodontal disease could be diagnosed. Other pathologic entities that might have been missed with routine dental radiographs were observed. However, although the diagnostic aids used in this report are a helpful adjunct, in their present state of development they should not be used to replace standard dental radiographs and clinical examination.

Early diagnosis and successful management of periodontosis.

A brief review of the literature regarding the recognition, causes, and different therapeutic approaches of periodontosis was presented. Two cases of periodontosis in the early stages were reported, and a successful treatment plan using modalities similar to those used for other forms of periodontitis was described. Early diagnosis of the condition was critical to the success of both cases. Both patients were taught good oral hygiene, which, along with scaling, root planning, and conservative periodontal surgery, not only resulted in arresting the disease process, but also encouraged osseous regeneration. These examples emphasize the necessity of routine periodontal examinations for all children, especially at the circumpubertal period because periodontosis is often passed unnoticed until there has been massive periodontal destruction. The management of the advanced conditions is more challenging and seldom successful.

Endodontic involvement resulting from dental abrasion or erosion.

A case is presented of extreme loss of tooth substance, most probably as a result of dentifrice abrasion. The lesions resulted in many instances of pulpal death and periapical pathosis. In most instances, an opening into the pulp chamber could not be demonstrated using an explorer. In two instances, an opening into the pulp chamber was present and probable. This communication with the oral cavity resulted in pulpal pathosis and an accompanying periapical lesion. In most cases of dental abrasion and erosion, or both, pulpal pathosis and periapical pathosis do not occur because of the ability of the pulp to lay down dentin as the pulp recedes. The findings in this case are not typical.

Management of the nonerupted maxillary anterior tooth.

The noneruption of maxillary anterior teeth, particularly the canine, is a common problem. The cause of the noneruption is multifactorial but almost always involves a lack of space. The literature presents an active and a passive form of orthodontic treatment and has recently stressed the periodontal management of these teeth. Two cases are presented. In both cases the orthodontic techniques of regaining space and providing traction on the unerupted tooth are described. A free gingival graft is used in one case and an apically repositioned flap in the other to achieve a healthy periodontium. The advantages and disadvantages of the techniques used as well as their rationale are discussed.