Influence of whitening and regular dentifrices on orthodontic clear ligature color stability.

OBJECTIVES: This study evaluated the effect of brushing orthodontic clear ligatures with a whitening dentifrice containing a blue pigment (Close Up White Now, Unilever, London, UK) on their color stability, when exposed to a staining agent. MATERIALS AND METHODS: Ligatures from 3M Unitek (Monrovia, CA, USA) and Morelli (Sorocaba, SP, Brazil) were tested. Baseline color measurements were performed and nonstained groups (control) were stored in distilled water whereas test groups were exposed for 1 hour daily to red wine. Specimens were brushed daily using regular or whitening dentifrice. Color measurements were repeated after 7, 14, 21, and 28 days using a spectrophotometer based on the CIE L*a*b* system. RESULTS: Decreased luminosity (CIE L*), increased red discoloration (CIE a* axis), and increased yellow discoloration (CIE b* axis) were generally observed for ligatures exposed to the staining agent. Color variation was generally lower in specimens brushed with regular dentifrice, but ligatures brushed with whitening dentifrice were generally less red and less yellow than regular dentifrice. The whitening dentifrice led to blue discoloration trend, with visually detectable differences particularly apparent according to storage condition and ligature brand. CONCLUSIONS: The whitening dentifrice containing blue pigment did not improve the ligature color stability, but it decreased yellow discoloration and increased a blue coloration. CLINICAL SIGNIFICANCE: The use of a whitening dentifrice containing blue pigment during orthodontic treatment might decrease the yellow discoloration of elastic ligatures.

Color stability of five orthodontic clear elastic ligatures.

AIM: In this study the color stability of five commercially available orthodontic clear elastic ligatures daily exposed to a staining agent (red wine) was investigated. METHODS: The commercial brands tested were 3M Unitek, Abzil, American Orthodontics, Dentsply GAC, and Morelli. Baseline color readings (Commission Internationale de l'Eclairage [CIE] L*a*b* parameters) of 20 ligatures for each brand were carried out using a spectrophotometer. The ligatures were divided in two groups (n = 10): one group remained immersed in distilled water (control) throughout the period, while the other group was daily exposed to red wine (1 hour of immersion). Immersion media were daily renewed. Successive color readings were carried out after 7, 14, 21, and 28 days, and the chromatic variations calculated. Color variation data were analyzed by two-way repeated measures analysis of variance and Student-Newman-Keuls test (P < .05). RESULTS: Storage in water increased staining until 14 days, and color receded after this period, irrespective of the brand. After 28 days of immersion in water, no significant difference among the commercial brands was observed. For the groups exposed to red wine, a significant increase in staining over the course of time was detected, irrespective of the brand. Ligatures from GAC and Morelli showed higher staining than the other materials, irrespective of the evaluation time. Ligatures from 3M Unitek and American generally showed lower pigmentation than the other brands. CONCLUSION: Exposure to a staining agent, cumulative exposure time, and commercial brand are factors that influence the color stability of clear elastic ligatures.

One day surgery for pilonidal disease.

BACKGROUND: There are numerous surgical options for pilonidal disease. We practice "D" excision technique with a suction drain under local anesthesia as a 1 day surgery procedure. METHODS: 54 patients had pilonidal surgery between March 2001 and December 2003. "D" excision with a suction drain under local anesthesia was performed. An attention was given not to make a wide excision. Tracks lying outside the excised area were removed by the same technique with small "D" incisions. Subcutaneous tissues were sutured with absorbable interrupted sutures in layers. The wound was closed subcutaneously with running monofilament non-absorbable suture. All the operations were performed as 1 day surgery procedure. 33 of 54 patients had been reached by call on March 2009. RESULTS: Recurrence was seen in four of 54 patients (7.4%). Follow-up of two of these four patients have been uneventful after the second operation. Infection developed in two patients (3.7%) and caused a wound dehiscence. Both patients healed without any problems. All of the patients were able to return to their daily activities on the 3-5 postoperative day. CONCLUSION: "D" excision technique as a 1 day surgery procedure for pilonidal disease is performed with a low complication and recurrence rate (Ref. 19).

Primary appendicealtumors: clinical imaging and pathological findings. Report of four cases.

Primary appendiceal tumors are rare clinical and radiological entities. We report 4cases including muscinous cystadenoma associated with pseudomyxoma peritonei, muscinous cystadenoma associated with mucocele, low-grade muscinous neoplasia associated with appendicitis in elderly patients, and carcinoid tumor associated with appendicitis in a young adult.

Interoperative frozen section for margin assessment in breast conserving energy.

BACKGROUND AND AIMS: When excisional biopsy or lumpectomy is performed without margin assessment in early breast cancer, further surgery are required if positive margins exist. We evaluated the role of the intraoperative frozen section in breast conserving surgery (BCS). Clinicopathologic factors associated with re-excision were searched. MATERIAL AND METHODS: 190 tumors in 186 patients with early invasive breast cancer treated by BCS. Breast tumor was excised with 2 cm macroscopic margin, and microscopic margins examined by intraoperative frozen section. RESULTS: After frozen section, 160 cases had negative margins (no re-excision), but 30 patients (16%) underwent re-excision because of close/positive margins. Negative margins were obtained in 24 patients but six patients underwent mastectomy due to persistent involved margins. Local recurrence was 2.1% and systematic recurrence was 2.6% with mean 62 months follow up. Tumor type, tumor size, extranodal extension and extensive intraductal component were significant predictors of re-excision by multivariate analysis. Re-excision procedures haven't an impact on local recurrence. CONCLUSIONS: Interoperative frozen section is an effective procedure in reducing the need of second operation. We have observed lower recurrence rates than other studies because of our 2 cm macroscopic margin width and > 2 mm microscopic negative margin which is obtained by interoperative frozen section.

Combined transurethral resection of prostate and inguinal mesh hernioplasty.

We aimed to evaluate the difference among early post-operative morbidities of transurethral resection of prostate (TURP), inguinal herniorrhaphy and their combination in this study. Between 1998 and 2004, 44 patients undergoing combined inguinal herniorrhaphy and TURP (Group I) were compared with 50 consecutive cases of TURP alone (Group II) and 50 consecutive cases of inguinal herniorrhaphy alone (Group III). There were no differences in the mean age and mean prostatic volume between Group I and II. The mean operation time and length of hospital stay were 126.1 +/- 20.9 min, 3.0 +/- 0.7 days for Group I, 61.4 +/- 15.6 min and 2.9 +/- 0.69 days for Group II and 55.0 +/- 15.6 min and 1.2 +/- 0.4 days for Group III, respectively. The mean operation time of Group I was found as longer than Group II and III. There were no significant differences among all groups regarding post-operative complications. No mesh infection was detected. Combined TURP and inguinal herniorrhaphy is a practical, safe and effective procedure.

Total subcutaneous fistulectomy combined with Karydakis flap for sacrococcygeal pilonidal disease with secondary perianal opening.

OBJECTIVE: Flap techniques have been performed with success in the treatment of pilonidal disease. However, some complex cases such as perianal pilonidal disease need special attention. We describe a modification of a well-known flap technique for secondary perianal pilonidal disease and its early results. PATIENTS AND METHOD: Total subcutaneous fistulotomy combined with Karydakis flap was performed on 14 patients. An elliptical incision, described by Karydakis, was made while not including the perianal opening. Both sides of the elliptical incision were deepened down to the gluteal muscle and postsacral fascia. At the level of subcutaneous tissue, attention was directed to the secondary perianal opening. A fine probe was inserted through the perianal skin pit, and the connection site between the fistula and the cyst was observed. A small circular skin incision was made around the probe and the fistula tract was totally excised using electrocautery together with the main cyst. The flap was prepared as described by Karydakis. Before suturing the flap to the other side, perianal subcutaneous tissue was sutured with a fine absorbable material, then, the flap was sutured with 4/0 polypropylene. RESULTS: One patient developed seroma. Neither early failure in wound healing nor recurrence was observed at a mean of 16.2 months (range 4-36 months) follow-up. CONCLUSION: Total subcutaneous fistulectomy plus Karydakis flap as a single-stage procedure is an effective surgical modality for sacroccocygeal pilonidal disease with secondary perianal opening.

Comparison of direct trocar and veress needle insertion in the performance of pneumoperitoneum in laparoscopic cholecystectomy.

Veress needle insertion, direct trocar insertion and open technique are different methods of establishing pneumoperitoneum to perform a successful laparoscopic procedure. We conducted this study to compare the use of a Veress needle and direct trocar insertion to create pneumoperitoneum. 274 laparoscopic cholecystectomy operations were evaluated. There were no significant differences in the age and gender between Veress needle and direct trocar entry groups. In this study we have seen that the complication rate while performing pneumoperitoneum by direct trocar entrance was less than in Veress needle usage. Direct trocar entrance also reduces the operation time. In laparoscopic cholecystectomy the direct trocar entrance method is a more reliable and less time consuming method than Veress needle usage.

Explosion during diathermy gastrotomy in a patient with carcinoma of the antrum.

Gas explosion during diathermy gastrotomy is a very rare occurrence. We report on an unusual case of gas explosion during diathermy gastrotomy in a patient with carcinoma of the gastric antrum.

Urinary retention after elective cholecystectomy.

BACKGROUND: There are few reports about urinary retention rate after elective cholecystectomy. We designed a prospective study to assess the problem. METHODS: A total of 121 female and 19 male patients were included in the study with a prospective study protocol. Laparoscopic cholecystectomy was performed in 107 patients and open cholecystectomy in 33 patients. RESULTS: Neither gender nor age affected rate. Postoperative micturition difficulty developed in 10 patients. Of these patients, 9 could void with helping measures, and only 1 needed catheterization. Only 1 patient who underwent laparoscopic surgery required catheterization (0.7%). The open approach caused a higher incidence of postoperative micturition difficulty than did the laparoscopic approach (15.2% versus 4.7%; P = 0.04). Only large amounts of perioperative fluid administration and meperidine use had statistically significant effects on micturition problems. CONCLUSIONS: Urinary retention is a rare complication after elective cholecystectomy. Helping measures are very effective and should be tried before inserting a urethral catheter.

Adult intussusception due to a malignant polyp: a case report.

Intussusception is primarily a disease of childhood; only about 5 to 10 per cent of cases occur in adults. In contrast to childhood intussusception 90 per cent of adults have an associated pathologic process, usually a malignant lesion. Adult cases do not have the classical symptoms and diagnosis may be difficult. CT scan and barium studies are the most useful diagnostic methods. We report a very rare case of adult ileocecocolic intussusception caused by a pedunculated malignant polyp of the cecum and review the clinical features of intussusception.

Thyroxine prophylaxis after bilateral subtotal thyroidectomy for multinodular goiter.

In this study, we investigated the value of thyroxine administration to prevent recurrence after bilateral subtotal thyroidectomy for multinodular goiter. Patients that had benign multinodular goiter were operated on with the same surgical principles: ligation of both superior and inferior thyroid arteries on both sides, bilateral subtotal resection of thyroid gland including all visible nodules. On the 3rd postoperative day, the patients were divided into two groups: with 100 microgram 1-thyroxine daily (Thyroxine group) or no therapy (Control group). No recurrences were encountered among 40 patients followed up for 6 months and 20 patients for at least one year. One patient in the control group developed manifest hypothyroidism (5.3%). The mean TSH level of the control group was significantly higher than that of thyroxine group at 1st, 2nd, 3rd, 4th, 5th, 6th, and 12th months. At the end of the first year, the mean TSH level of the control group was four times that of the normal. On the other hand, the mean TSH level of the thyroxine group was within normal limits but not suppressed. In conclusion, we found that the pituitary-thyroid axis did not become normal spontaneously one year after thyroidectomy. Therefore, postoperative thyroxine administration seems to be of value, especially in endemic regions like Turkey.