Management of peri-implant soft tissues between tooth and adjacent immediate implant placed into fresh extraction single socket: a one-year prospective study on two different types of implant-abutment connection design.

AIM: This prospective study has been designed to evaluate the correlation between the presence/absence of the interproximal papilla and the mesio-distal and corono-apical position single-tooth replacement implants inserted immediately following tooth extraction. These distances have been evaluated measuring the horizontal distance between the implant and the adjacent tooth (implant tooth distance, ITD) and the vertical distance between the contact point and the coronal margin of the interproximal bone (contact point-bone distance, CPB). METHODS: Fifty implants (25 Astratech® straight and 25 Straumann®) immediately placed after tooth extraction in highly aesthetic areas have been evaluated by means of clinical and radiographic evaluation. Gingival index (GI) and the presence/absence of the interproximal papilla were clinically measured. A computerized analysis was performed to determine ITD and CPB values after converting perioapical radiographs to digitalized images. were performed to determine: the effect of ITD and CPB on the presence or absence of the interproximal papilla was studied by statistical analysis. RESULTS: The gingival index was 0 in 97% of the areas and 1 in 3%. When ITD was 2.5 to 4 mm, the interproximal papilla was significantly present (P<0.05). CPB of 3 to 5 mm was related (P<0.05) to the papilla presence if ITD was 2.5 to 4 mm, and this finding was valid for Astratech implants only. CONCLUSION: The horizontal distance of 2.5 to 4 mm between an implant and the adjacent tooth is significantly associated to a full interproximal papilla.

Migration and health service delivery.

Migration has positive and integrative effects on health service delivery. This paper presents initiatives promoting circular migration of diaspora health professionals to contribute to health service delivery and capacity development in their countries of origin. The paper will also highlight the contributions that foreign trained and foreign born health professionals can make to the delivery of migrant friendly health services for diverse multi-cultural populations.

The use of short dental implants in clinical practice: literature review.

When anatomic structures and ridge resorption limit the placement of a standard implant, the clinician can apply augmentation techniques or use short implants. A literature review was carried out to evaluate the differences in survival rate and the rational use of short implants. Electronic search (MEDLINE) and manual search have been performed to select papers from 2000 to 2008. Of all the inclusion criteria the most relevant were: 1) studies with data on short implants; 2) studies on humans; 3) prospective, longitudinal, retrospective and multicenter studies; 4) no restrictions were applied about study design; 5) no implant type selection was applied. Exclusion criteria were: 1) studies concerning treatment of patients with conditions possibly affecting survival or success rates of implant treatment; 2) studies concerning treatment of patients with non-treated periodontal disease; 3) implants placed in non-healed ridge, such as postextractive short implants. A total of 13 studies fulfilled the inclusion criteria. Most of the studies have reported different survival rate for short and standard implants. The difference is not significant. The recent literature have demonstrated a similar survival rate for short and standard implants. Older articles have demonstrated a lower survival rate for short implants. The treatment planning is a key factor for success in the use of short implants. Some of the parameters the clinician should consider are: 1) area to rehabilitate as well as bone quality; 2) length of the implant; 3) implant diameter; 4) type of implant and surface treatment; 5) crown to implant ratio of the final prostheses; 6) type of prostheses; 7) connection to other implants; 8) occlusal/ parafunctional load; 9) prosthetic complications. Although in the literature there are no studies that analyze short implant survival from the point of view of each key factors, it can be assumed that a careful treatment planning can lead the clinician to obtain a successful rehabilitation.

Oxygen diffusion and vacancy migration thermally-activated govern high-temperature magnetism in ceria.

Several experimental works currently demonstrate that metallic nano-oxides and carbon nanomaterials expected to be diamagnets, in fact, behave as ferromagnets at room temperature. More than scientifically intriguing, this unconventional and unexpected ferromagnetism pave the way for innovation products and novel nanotechnological applications, gathering the magnetism to interesting functionalities of these nanomaterials. Here, we investigate the non-conventional ferromagnetism observed at high temperatures in nanocrystalline cerium dioxide (CeO2or nanoceria) thin films that are optically transparent to visible light. Nanoceria exhibits several concrete applications in catalytic processes, photovoltaic cells, solid-state fuel cells, among others, which are mostly due to natural presence of oxygen vacancies and easy migration of the oxygen through the structure. The ferromagnetism in non-stoichiometric nanocrystaline ceria can be consistently described by ab initio electronic structure calculations, which support that oxygen vacancies cause the formation of magnetic moments and can provide a robust interconnectivity within magnetic polarons theoretical framework. Additionally, we present a conceptual model to account the oxygen transport to the non-conventional ferromagnetism at temperatures well above room temperature. The approach is complementary to the thermally-activated effective transfers of charge and spin around oxygen vacancy centers.

Morphology, structure, and magnetism of FeCo thin films electrodeposited on hydrogen-terminated Si(111) surfaces.

In this work we describe the fabrication of FeCo alloy (less than 10 at% Co) thin films from aqueous ammonium sulfate solutions onto n-type Si(111) substrates using potentiostatic electrodeposition at room temperature. The incorporation of Co into the deposits tends to inhibit Fe silicide formation and to protect deposits against oxidation under air exposure. As the incorporation of Co was progressively increased, the sizes of nuclei consisting of FeCo alloy increased, leading to films with a highly oriented body-centered cubic structure with crystalline texture, where (110) planes remain preferentially oriented parallel to the film surface.

[Liposarcoma of the spermatic cord]. / Liposarcoma del funicolo spermatico.

A case of well differentiated liposarcoma of the spermatic cord in a 80 year old man is presented. The preoperative diagnosis of spermatic cord liposarcoma is not easy; however, a careful comparison between clinical and ultrasonographic findings can lead to diagnostic suspicion. The treatment of choice is the excision of the liposarcoma associated with orchiectomy and high ligation of the spermatic cord to reduce the risk of recurrence. Postoperative radiotherapy may be indicated for poor differentiated liposarcomas.

[The role of ERCP in the diagnosis and therapy of Mirizzi's syndrome. Apropos a clinical case]. / Ruolo della ERCP nella diagnosi e terapia della sindrome di Mirizzi. A proposito di un caso clinico.

Mirizzi syndrome is a rare variant of obstructive jaundice due to compression of the hepatic duct caused by a stone inserted in the cystic duct or in the Hartmann recess and it is referred with a prevalence of 0.05-1% of patients with cholelithiasis. These percentages are, nevertheless, unreliable because only an accurate preoperative cholangiography allow to detect a Mirizzi syndrome and so, very often, the real cause of the jaundice remains unacknowledged. Early diagnosis of the syndrome is particularly important because it suggests an accurate and prudential surgical approach considering the frequent fibrotic adherences caused by chronic inflammation. In this paper the authors present a clinical case quickly and successfully cured operative endoscopy, followed by traditional surgery. The authors believe that the study of obstructive jaundices must include an ERCP either for the diagnosis or because operative endoscopy could ameliorate clinical feature and hepatic performance in order to allow a safer surgical operation.

[The "sump syndrome": a case treated by surgical endoscopy. A discussion about biliodigestive diversions and endoscopic sphincterotomies]. / "Sump syndrome": un caso trattato mediante endoscopia operativa. Spunto di discussione in merito a derivazioni biliodigestive e sfinterotomie endoscopiche.

A case of "sump syndrome", occurred in our department, suggested the discussion about the opportunity of endoscopic operative procedures in choledocholithiasis and in biliary tract surgery complications. Improvement of endoscopic operative procedures allow extensive indication of ERCP sphincterotomy instead of traditional choledochoduodenostomy or transduodenal papillosphincterotomy. Additionally, operative endoscopic procedures are good alternative to reoperation for traditional biliary tract surgery complications.

[A case of primary non-Hodgkin's lymphoma of the adrenal gland]. / Su di un caso di linfoma non-Hodgkin primitivo del surrene.

The paper reports a case of non-Hodgkin's primary lymphoma of the adrenal gland which is justified by the rarity of this pathology as can be seen from the literature. Following adrenalectomy and subsequent polychemotherapy, a complete remission of the disease was obtained. The Authors report that, in the absence of particular symptoms, diagnosis is generally based on X-ray examinations performed to clarify the causes of aspecific symptoms such as, for example, fever and asthenia. Lastly, it is underlined that the disease may be diagnosed during surgery when CT reveals the presence of an adrenal mass with a diameter of more than 3 centimetres.

[Spontaneous and postoperative bile peritonitis. Surgical technique]. / Il coleperitoneo spontaneo e postoperatorio. Strategia chirurgica.

BACKGROUND: Bile peritonitis has a diversified aetiology that can present in clinical pictures of variable gravity depending on whether the bile is uncontaminated or activated by other secretions (intestinal, pancreatic) or actually infected. The consequent treatment is therefore eclectic. In our opinion, however, the therapeutic strategy proves effective if modulated on the basis of certain priority elements that should be carefully considered. The type of treatment adopted in relation to immediate and long-term results has been evaluated. METHODS: The investigation was carried out retrospectively on the series of bile peritonitis treated at the Surgical Clinic of the University of Modena from 1980 to 1998. 45 cases of bile peritonitis are reported of which: 32 postoperative, 2 post-traumatic, 2 following transparietohepatic injection, 7 during acute necrotic cholecystitis, 2 following spontaneous perforation of the biliary tree. As regards the type of treatment, in 13 cases (well-drained postoperative forms) a conservative solution was adopted; in another 13 cases (9 septic and 4 with mixed bile supply) surgery was resorted to again, in the remainder transparietohepatic drainage was carried out in association almost always with the application of a transpapillary endoprosthesis. RESULTS: Morbility was 26.6% (12 cases); 4 patients (8.8%) were reoperated for late complications with mortality of 50%. Total mortality was 20% (9 patients). CONCLUSIONS: Treatment of bile peritonitis may be eclectic but the complex forms benefit from early surgical or parasurgical treatment for a definitive resolution of this feared complication.

[Postoperative peritonitis. The criteria for a reintervention]. / Le peritoniti postoperatorie. I criteri di reintervento.

BACKGROUND: Postoperative peritonitis is a pathologic condition with a sometime nuclear clinical occurrence and therefore with an uncertain timing for reoperation. Aim of this paper is to identify the type and frequency of the digestive and systemic symptoms in relation to the anatomo-pathologic peroperative picture. METHODS: Between 1980 and 1996, 119 patients were reoperated for a postoperative peritonitis (PPO) in the Surgical Department of Modena University. PPO was due to a lesion situated above the mesocolon in 33 patients, from the small bowel in 18, postappendicectomy in 25 and from the colon in 40. The first operation (for benign disease in 66.4%, for malignancy in 33.6%) was performed in emergency in 47 cases (39.5%) and as elective surgery in 72 (60.5%). RESULTS: The global mortality was of 33.6% (40 patients). An attempt is made to identify, the earlier and the most important bioclinical parameters for a correct indication to surgery. Twenty symptoms have been identified that, with different frequency, are strictly related with the onset of a PPO (in average 5 symptoms were positive). A research of these parameters, each 4-6 hours, allow to identify a subclinical PPO. CONCLUSIONS: During the decisional timing, it is important to check these general and digestive symptoms, apparently not serious, in order to avoid the onset appearance of an abdominal tenderness or a multiorgan failure that make the prognosis more severe.

[Ventrolateral hernias of the abdominal wall. The anatomicopathologic, clinical and therapeutic considerations]. / Le ernie ventro-laterali della parete addominale. Considerazioni anatomopatologiche, cliniche e terapeutiche.

Ventral lateral hernias of the abdominal wall are rare. On the basis of their location we can classify them as follows: hernias of the aponeurosis of the transversus muscle, hernias of the rectal sheath and transmuscular hernias of the iliac region. In a group of 3134 hernias of the abdominal wall observed in a period of 16 years, 11 ventral lateral hernias have been encountered (0.3%). The diagnosis often presents great difficulties as the symptoms and the clinical findings are not typical. They must be differentiated from hematomas of the rectus sheath, abscess or intra-abdominal processes. Echography and Computed Tomography have an important role in their detection. Nevertheless in some patients the true diagnosis is reached only intraoperatively. The treatment generally consists in surgical correction by layer closure of the fascial or muscular defect. In selected cases the use of prosthetic material and video laparoscopic repair are indicated.

[Myofibroblastoma of the male breast. Apropos of a case]. / Miofibroblastoma della mammella maschile. A proposito di un caso.

A case of male breast myofibroblastoma, personally observed, is described. Preoperative examinations have a limited diagnostic value. Only histological study, with immunohistochemical stain, allows to make a right diagnosis and to distinguish this tumor from other, benign or malignant mesenchymal neoplasms.

[Natural history of breast cancer: lobular carcinoma versus ductal carcinoma in our experience]. / A proposito della storia naturale del cancro della mammella: carcinoma lobulare versus carcinoma duttale nella nostra esperienza.

Aim of the study is to evaluate the biology, the clinical evolution and the prognosis of lobular carcinoma of the breast. We retrospectively evaluated the patients treated in our institution during the last 13 years. 117 patients with lobular carcinoma of the breast and 117 patients, randomized out of 397 patients with 'classical' pattern of ductal carcinoma were compared. Age distribution, type of surgery, tumor size, TNM stage, axillary lymph node involvement, multifocality, multiple breast cancers, local and distant recurrences, overall survival and disease-free survival have been evaluated. There was not a significant difference in tumor size, lymph node involvement, stage distribution, estrogens and progesterone receptors status, local and distant recurrences. The only significant differences were found in multifocality and multiple breast cancers. The said difference does not seem to modify the overall survival and the disease-free survival that are the same in the two groups. Our research shows that tumor size and axillary lymph node status are the only elements that have to be considered in the choice of the surgical treatment and prognosis. It seems that the difference in distant metastatic pattern between lobular and ductal carcinoma is the distinctive feature in the follow-up of these patients.

[Primary lymphoma of the breast. Three cases of non-Hodgkin lymphoma]. / Il linfoma primitivo della mammella. A proposito di 3 casi di linfoma non-Hodgkin.

Primary and sole breast lymphoma is a very rare disease. With the review of our series of 616 cases operated on for breast cancer, only 3 cases (0.48%) of primary breast non-Hodgkin lymphoma (LNH) have been observed. The authors outline the problems concerning diagnosis and therapy of this rare disease: pathological and immunohistochemical aspects are discussed. They stress the importance of staging in order to plan a correct multidisciplinary approach.

[Our experience in the surgical treatment of early breast cancer. Results of a prospective study of 204 cases]. / La nostra esperienza nel trattamento chirurgico del carcinoma mammario iniziale. Risultati di uno studio prospettico su 204 casi.

The authors report the results of a prospective study on 204 patients (1980-1993) affected by early infiltrating breast cancer (size pounds 2 cm) as a part of a surgical series of 608 cases. 53 cases who underwent QUART (25.9%) and 151 cases (74.1%) who underwent mastectomy modified according to Patey have been collected. 10 years actuarial survival has been respectively 79% after extensive surgery and 78% after conservative treatment. Local recurrences have been observed in 9 cases after meticulous follow-up (median 74.8 months, range 12-178): 3 (5.66%) patients after QUART and 6 (3.97%) after mastectomy; furthermore 1 patients after a conservative treatment (1.88%) has developed a second tumor at the same side probably dependent on the presence in the primary tumor of an extensive intraductal component. No correlations between histological features, grading, positive nodes, receptor status and local recurrences have been found. Only the age of patients looks significantly correlated with frequency of recurrences: 44.45% of local recurrences have been observed in patients less than 45 years old. Local recurrences after QUART have obliged, in all cases, to a radical mastectomy. Furthermore, frequency of distant metastases has been considered: after QUART percentage is lower (9.43%) than after radical mastectomy (13.9%). This consideration looks correlated with the longer follow-up of the later group. A multidisciplinary approach is advised but the most important role is played by surgery. In conclusion it is outlined that conservative surgery is addressed to selection and consenting patients.

[Mechanical staplers in our surgical practice]. / Le suturatrici meccaniche nella nostra practica chirurgica.

On the basis of our experience from 1981 to 1989, advantages of staplers in digestive surgery are reported. Complications such as bleeding and stenosis are not clinically important, however, in most cases, they can be avoided if the instruments are properly used.

The role of magnetoelastic and magnetostrictive energies in the magnetization process of MnAs/GaAs epilayers.

In this work we present a detailed study of the anisotropic magnetic behavior of MnAs epilayers grown by molecular beam epitaxy on GaAs(001) and GaAs(111)B substrates. An extended approach of the Stoner-Wohlfarth model is used to simulate magnetic hysteresis loops of MnAs epilayers for temperatures around the magnetostructural phase transition. We demonstrate that magnetoelastic and magnetostrictive energy contributions to the magnetic free energy density are crucial to correctly describe the magnetization of both kinds of MnAs epilayers.

Ferromagnetism induced by oxygen and cerium vacancies above the percolation limit in CeO2.

We studied the structural, chemical and magnetic properties of non-doped ceria (CeO(2)) thin films electrodeposited on silicon substrates. Experimental results confirm that the observed room temperature ferromagnetism is driven by both cerium and oxygen vacancies. We investigated ceria films presenting vacancy concentrations well above the percolation limit. Irradiation experiments with neon ions were employed to generate highly oxygen defective CeO(2-δ) structures. X-ray photoelectron spectroscopy and x-ray absorption near-edge structure spectroscopy were used to estimate the concentration of Ce(3+) sites in the films, which can reach up to 50% of Ce(3+) replacing Ce(4+), compared to a stoichiometric CeO(2) structure. Despite the increment of structural disorder, we observe that the saturation magnetization continuously increases with Ce(3+) concentration. Our experiments demonstrate that the ferromagnetism observed in ceria thin films, highly disordered and oxygen-deficient, preserving the fluorite-type structure only in a nanometer scale, remains intrinsically stable at room temperature.