RESUMO
OBJECTIVE: This study aimed to evaluate the differences in the accuracy of immediate intraoral, immediate extraoral, and delayed dental implant placement with surgical guides (static computer-aided implant surgery) in patients treated with mandibular reconstruction. METHODS: This was a retrospective study. The patients were divided into three groups: immediate intraoral placement (IIO), immediate extraoral placement (IEO), and delayed placement (DEL). Four variables were used to compare the planned and actual implant positions: angular deviation, three-dimensional (3D) deviation at the entry point of the implant, 3D deviation at the apical point of the implant, and depth deviation. RESULTS: The angular deviation was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .05) groups. The 3D deviation at the entry point was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .01) groups. The 3D deviation at the apical point was significantly higher in the IIO group than in the IEO (p < .01) and DEL (p < .01) groups. The depth deviation was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .05) groups. There was no statistical difference between the IEO and DEL group in angular and 3D deviation. CONCLUSION: With surgical guides, among the different approaches for implant placement, delayed implant placement remains the most accurate approach for patients treated with mandibular reconstruction.
Assuntos
Implantes Dentários , Reconstrução Mandibular , Cirurgia Assistida por Computador , Humanos , Implantação Dentária Endóssea/métodos , Estudos Retrospectivos , Cirurgia Assistida por Computador/métodos , Desenho Assistido por Computador , Imageamento Tridimensional , Tomografia Computadorizada de Feixe CônicoRESUMO
According to Klein's classification system, the symptomatology of eosinophilic gastroenteritis (EG), a rare disease, differs based on the affected tissue layer. Patients with subserosal EG often have peritoneal effusion. Hemorrhagic ascites due to EG is extremely rare and has not been reported in the literature. Here, we report a 57-year-old woman with EG and massive hemorrhagic ascites. Laboratory investigations showed elevated peripheral eosinophils with significant eosinophilia (65.6%). Ultrasonography showed massive abdominal ascites. Abdominal paracentesis revealed hemorrhagic peritoneal fluid and microscopy showed predominant eosinophils. Upper gastrointestinal endoscopy revealed erosions, exudates, and mucosal rings in the duodenal mucosa; histological examination indicated eosinophilic infiltration. EG presenting with hemorrhagic ascites was diagnosed by histologic examination of eosinophilic infiltration. She was empirically treated with ketotifen 1 mg bid po with rapid resolution of ascites and a remarkable decline in peripheral eosinophil counts. Clinicians should consider the differential diagnosis of unexplained hemorrhagic ascites.
Assuntos
Obstrução da Saída Gástrica/etiologia , Hematoma/etiologia , Hemostase Endoscópica/efeitos adversos , Úlcera Péptica Hemorrágica/terapia , Idoso , Anastomose Cirúrgica , Epinefrina/administração & dosagem , Gastrectomia , Obstrução da Saída Gástrica/terapia , Hematemese/terapia , Hematoma/terapia , Humanos , Masculino , Melena/terapia , Vasoconstritores/administração & dosagemRESUMO
Plexiform neurofibroma (PN) of the digestive tract is very rare and usually part of the generalized syndrome of neurofibromatosis type 1 (von Recklinghausen disease). Solitary PN of the stomach is extremely rare and has not been reported in the literatures. Here we present a case of solitary PN of the stomach, which was not associated with von Recklinghausen disease. A 38-year-old male presented abdominal pain and distention for 7 d. The patient underwent endoscopy of the upper gastrointestinal tract, which revealed a 3.5 cm protruding and cauliflower-shaped mass with a shallow 1 cm central ulcer in the greater curvature of the stomach. The lesion was removed by laparoscopic surgery. Histological examination demonstrated characteristic histological findings of spindle-shaped cells. Immunohistochemical analysis showed that the tumor cells were positive for S-100 protein, but negative for CD34, KI-67, CD117, and actin. Based on histological findings, gastrointestinal stromal tumor could be excluded, and thus the case was confirmed as PN. We described the clinical features, physical examination, endoscopic findings, and histopathological examination of this case.
Assuntos
Neurofibroma Plexiforme/patologia , Neoplasias Gástricas/patologia , Adulto , Biomarcadores Tumorais/análise , Biópsia , Gastroscopia , Humanos , Imuno-Histoquímica , Laparoscopia , Masculino , Neurofibroma Plexiforme/química , Neurofibroma Plexiforme/cirurgia , Valor Preditivo dos Testes , Neoplasias Gástricas/química , Neoplasias Gástricas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
An novel and convenient electrochemical approach was developed for the synthesis of indole derivatives from catechols and alpha-oxoheterocyclic ketene N,O-acetals. This method provides an environmentally benign access to fused indole derivatives containing active hydroxyls and carbonyl under mild reaction conditions.