Retention of fissure sealants in young permanent molars affected by dental fluorosis: a 12-month clinical study.

AIM: To evaluate and compare retention and caries occurance following placement of Clinpro and FUJI VII fissure sealants, by two different techniques simultaneously in unsealed, contralateral young permanent molars of 7- to 10-year-old children affected by mild to moderate dental fluorosis at various recall intervals of 1 week, 1, 3, 6 and 12 months. STUDY DESIGN: 80 schoolchildren with mild to moderate dental fluorosis were assigned to Group A and Group B with 40 children in each group. In Group A Clinpro fissure sealant and in Group B Fuji VII fissure sealant was used. In both the groups fissure sealants were applied by conventional fissure sealant technique (CST) on one side and enameloplasty sealant technique (EST) on the other side of the same arch. The applied fissure sealants were evaluated clinically for retention and caries incidence. RESULTS: Clinpro fissure sealant showed a retention rate of 95% when compared with Fuji VII (57.5%) at the end of 12 months, which was statistically significant. Regarding techniques, EST showed better results than CST in both the groups. STATISTICS: Comparison of groups with respect to retention and techniques at different time periods was performed using Mann-Whitney U test (p < 0.05). Comparison of different time periods with respect to retention and technique in all the groups was performed using Wilcoxon matched pairs test by ranks (p < 0.05). CONCLUSION: Clinpro fissure sealant showed better retention at all treatment intervals, when compared with Fuji VII. Further follow-up is required to study the efficacy of the fissure sealant placement techniques.

Paravalvular aortic rupture causing angina following aortic valve replacement.

We report the first encounter of a paravalvular rupture of the aorta 5 years after aortic valve replacement with a #25 Omniscience tilting disc. The rupture involved the circumflex coronary artery causing angina.

Nonionic low-osmolality versus ionic high-osmolality contrast material for intravenous use in patients perceived to be at high risk: randomized trial.

To determine the cost-effectiveness of selective use of nonionic low-osmolality contrast material, the authors randomly assigned 955 patients to receive high-osmolality and 1,158 to receive low-osmolality intravenous contrast material. All patients had one or more of the following perceived risk factors for adverse reactions: prior reaction to contrast material, allergies, asthma, diabetes, cardiac or renal disease, anxiety, severe illness, and age greater than 50 years. The occurrence of any adverse event, need for therapy, or subjective symptoms was assessed in a double-blind fashion. An adverse reaction necessitating the attention of a physician occurred in 3.9% (n = 37) of patients in the high-osmolality and 0.9% (n = 10) of patients in the low-osmolality groups (P less than .000005). Therapy was administered to 1.4% (n = 13) and 0.5% (n = 6), respectively (P = .035). The difference was due to a reduction in urticaria and other mild anaphylactoid reactions. In a multivariate analysis, only prior reactions and allergy were independent risk factors. Selective use of intravenous nonionic contrast material is best justified in those with prior reactions, allergy, or asthma; at least 67% of reactions would be prevented.

Esophageal diverticula.

The clinical and radiological features in four patients with symptomatic mid-esophageal diverticula are reported here. The common clinical symptoms were retrosternal chest pain and dysphagia. Radiologically, three patients had acute obstructions revealed by barium studies and one patient had an esophago-bronchial fistula at the tip of the diverticulum.

Gastric torsion.

We report a seven-week-old baby girl with a one-day history of vomiting and respiratory distress. The radiological findings were those of intrathoracic mesenteroaxial torsion of the stomach complicating a large hiatus hernia which included part of the small bowel and colon with partial colonic obstruction. This is a rare but important cause of alimentary tract obstruction and respiratory distress in infants. Prompt diagnosis and correction are vital.

Retained lead shot in the appendix.

Sixty-two patients with retained lead shot in their appendices, discovered during routine radiographic studies, were followed for periods ranging from two months to 13 years. The number of lead shot in the appendices varied from one to over 200. Twenty patients who had barium studies showed no evidence of luminal obstruction of their appendices. Eight patients who had appendectomies showed no evidence of appendicitis on tissue examination. None of the other patients developed any clinical evidence of appendicitis or lead poisoning. It is concluded that no causal relationship exists between retention of lead shot, their number, the duration of their presence in the appendix, and appendicitis.

Changes in heart size and volume in certain endocrinal and nutritional deficiency diseases. A correlative study in twenty adult patients.

Twenty adult patients selected at random were studied because of a reduction in heart size, seen on routine chest radiographs. I analyzed etiologic factors, clinical, biochemical, and pathological abnormalities and cardiovascular status in relation to the radiographic findings and response to treatment. Reduction in heart size can occur as part of a wide spectrum of changes in certain endocrinal and nutritional deficiency diseases. Clinically there may be weakness as well as changes in heart rate, blood pressure, electrolytes, electrocardiograms, and loss of weight. All of these parameters improve with appropriate treatment.

Bilateral renal cell carcinoma--unusual occurrence in three members of one family.

Bilateral renal cell carcinoma occurred in a father and his two sons. Other reported instances of familial renal cell carcinoma are reviewed and the possibility that renal cell carcinoma might have a familial tendency is discussed. Radiological investigation and screening of suspected families is stressed.

Peritoneal mesothelioma.

The clinical and radiological features of peritoneal mesothelioma in four patients with an industrial history of asbestos exposure are described. The radiological features of intestinal obstruction, soft tissue masses and displacement and infiltration of bowel are stressed. A normal chest radiograph does not exclude the diagnosis. More sensitive diagnostic imaging and perhaps the use of laparoscopy may help to improve the accuracy of pre-mortem diagnosis.

Pyeloduodenal fistula: a case report and review of the literature.

A case of the rare condition of pyeloduodenal fistula is presented--the thirty-second case so far recorded in the literature. The authors consider that this instance shows some of the features typical of the cases so far reported. The literature is reviewed and the aetiology, presentation, diagnostic methods and treatment are briefly discussed.