Successful Single-Lung Transplant for Severe Lung Graft-Versus-Host Disease Two Years After Sibling Allograft for Acute Lymphoblastic Leukemia: A Case Report.

Bone marrow transplantation (BMT) has been performed as a successful life-saving treatment for hematological and neoplastic diseases. Despite the predictable long-term survival rates in BMT, pulmonary complications reduce the survival rates significantly mainly because of chronic graft-versus-host disease (GVHD). This report briefly discusses a successful lung transplantation case for severe lung GVHD after allograft for acute lymphoblastic leukemia. This case report supports the scarce evidence in the literature for the importance of lung transplantation as a therapeutic option for patients who develop respiratory failure secondary to BMT.

The endodontically treated tooth. Restorative concepts and techniques.

There is not one post, core, or final restoration that can be used in all clinical situations. If this were the case, there would not be the need for the numerous books on restoration that have been written over the last 3 decades. This article has not discussed the merits and shortcomings of the numerous restorative concepts and techniques that exist, but rather has concentrated on those that we feel are valid and have application today. Dentistry, like the other health professions, does not have the luxury of being able to limit those variables that occur daily in our clinical practice. We must learn to work with these variables and spend less time trying to find the one that applies to all cases: the ideal restoration that can be produced for the masses. When we understand the basic concepts of how to retain the various restorative components and how to protect remaining tooth structure, our ability to answer the numerous questions that arise during the restorative process will be facilitated and will result in final restorations that are based on sound design principles.

What determines the start of prenatal care? Prenatal care, insurance, and education.

The effects of financial coverage, education, race, age, and marital status on the start of prenatal care was studied in this analysis of 85,000 live births that occurred in New York City in 1981. Log-linear models were selected for the three variables prenatal care, coverage, and education after the data had been partitioned by race, age, and marital status. An overall model for the six variables was also selected to determine the relationship between race, age, and marital status and the three principal variables named above. Late or no prenatal care was found to be associated with Medicaid and an education of less than 12 years. For the most part, the association of race and age with late or no prenatal care was mediated by coverage and education. Hispanics, blacks, and teenagers who experienced greater odds of incomplete education and Medicaid insurance experienced greater odds of late or no prenatal care.

Type III gold alloy complete crowns cast in a phosphate-bonded investment.

A phosphate-bonded investment and a calcium sulphate-bonded investment were evaluated for the surface smoothness and marginal fit they impart to type III gold castings. The phosphate-bonded investment was used with burnout temperatures of 900 degrees F and 1,300 degrees F. The results of this study lead to the following conclusions: 1. The marginal fit with the phosphate-bonded investment method was superior to that obtained with the calcium sulphate-bonded investment. 2. Surface roughness was greater for the castings made with the phosphate-bonded investment when measured with SEM photographs and visual observation. 3. The phosphate bonded-investment increased the incidence of nodules on the surface of the castings. 4. No correlation was demonstrated between marginal fit and surface roughness or the incidence of nodules on the castings.

Surface smoothness and marginal fit with phosphate-bonded investments.

Two phosphate-bonded investments and one calcium sulfate investment were evaluated for the surface smoothness and marginal fit they impart to gold castings. A modified technique was also evaluated for each phosphate-bonded investment, where the silica sol was not diluted and the spatulation time was reduced. The results of this study lead to the following conclusions: 1. The marginal fits obtained with all four phosphate-bonded methods were comparable to each other and superior to that obtained with the calcium sulfate investment. 2. The presence of nodules on the surface of the castings was more prevalent with the phosphate-bonded investments. However, this effect was not statistically significant. 3. Clinical assessment of the roughness of the castings revealed that all the methods tested produced clinically acceptable castings. 4. Visual observation by five dentists revealed that both the recommended and modified techniques for one of the phosphate-bonded investments (Ceramigold) produced a smoother surface than any other investment tested. Rating of scanning electron microscope photographs (X600) revealed no difference in the surface roughness between any of the castings. Consequently, no definitive relation between investment type or technique and surface roughness was established. 5. No correlation was demonstrated between surface roughness, as evaluated by either clinical observation or scanning electron microscope photography, and marginal fit of the castings.

Evaluation of ceramic margins for metal-ceramic restorations.

This study evaluated various techniques for forming ceramic margins on metal-ceramic restorations. Marginal openings were measured using a scanning electron microscope on replicas derived from elastomeric impressions. Ceramic margins formed with a platinum foil backing showed significantly better fit than those formed with direct-lift techniques. With the platinum foil method these ceramic margins displayed a marginal fit comparable to that obtained with cast metal margins.

Defining predoctoral prosthodontic curriculum: a workshop sponsored by the American College of Prosthodontists and the prosthodontic forum.

Prosthodontic educators participated in a workshop held at The American College of Prosthodontists annual session in Kansas City, MO, in October 1996. Their goal was to review elements of the predoctoral prosthodontic curriculum to establish a consensus on the levels of expected skill and knowledge. Skill components were designated at the competency and exposure levels, while knowledge components were designated at the understanding and familiarity levels. The workshop recommendations were distributed to American and Canadian dental schools and the communities of interest for comments in January 1997. The workshop recommendations were reviewed and finalized at the American Association of Dental Schools annual meeting in Orlando, FL, in March 1997. The recommendations may be used by dental educators to prioritize curricular elements in relation to limited time dedicated to the prosthodontic curriculum. Outcomes assessment methods will be needed to ensure competency in the new dentist.