bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Vestibular Schwannoma: Dependence on Stakeholder's View for Small and Medium-Sized Tumors
Authors: Zisiopoulou Maria , Gouveris Haralampos , Mann Wolf J
Published: May 2011

Management options for patients with vestibular schwannoma include observation and active treatment, namely surgical resection, gamma knife stereotactic radiosurgery or fractionated radiation therapy. Although for large tumors microsurgery remains the mainstay of treatment, management of the small- and medium-sized vestibular schwannomas has been the matter of considerable controversy. Computerized clinical decision support systems have been developed to assist clinicians in this demanding task. Nonetheless, the complexity of the problem requires adaptation of the decision strategy to specific circumstances arising within a particular clinical scenario which can not always be modeled with adequate precision or addressed adequately within a mathematical framework. We present a set of clinical, neurophysiologic and radiologic parameters and the respective evidence which may guide carers’ decisions. These parameters include the size, growth rate and localization of the tumor, the age, general medical condition, facial nerve function, hearing and hearing deterioration rate, balance, vestibular and trigeminal nerve function of the affected individual, the estimated risk of malignant transformation and radiation-induced tumors, the health-related quality of life measures, the patient's and surgeon's preference and the issue of cost-effectiveness. A complex decision analysis, guided by evidence and tailored to each individual patient is required.
Jugular Foramen Tumors
Authors: Rayappa C
Published: May 2011

Jugular foramen tumors are rare cranial base lesions that present diagnostic and management difficulties. Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. These tumors have characteristic radiological features. Radical resection of these tumors with preservation of the lower cranial nerves is the treatment of choice. Despite the advances in skull base surgery, new postoperative lower cranial nerve deficits still represent a challenge.
The Role of Radiotherapy in the Management of Paraganglioma
Authors: Trombetta Mark
Published: May 2011

Paragangliomas or glomus tumors are usually low-grade hypervascular tumors occurring in various sites of the autonomic nervous system including the carotid body, glomus vagale and glomus tympanicum. Although the grading of the tumor suggests a benign clinical course, the tumor can be locally malignant and surgical management is sometimes difficult because of postoperative functional loss and local recurrence. In addition, the operative field is generally very bloody and tissue planes are not always well-defined.

Though the optimal management of paraganglioma occurs in a multidisciplinary setting, considering the excellent local control rates with primary irradiation alone, a nonsurgical definitive approach should initially be considered.
Transmastoid Repair of Temporal Meningoencephaloceles and Cerebrospinal Fluid Otorrhea
Authors: Garavello Werner , Gaini Lorenzo , Zanetti Diego
Published: May 2011

This paper reviews the diagnosis and treatment of temporal bone meningoencephaloceles, defined as the herniation of meninges or brain tissue into empty spaces within the temporal bone, i.e. tympanic or mastoid cavity, through the tegmen tympani or antri respectively. It also describes the current methods of control of cerebrospinal fluid (CSF) leaks, which commonly present as serous otorrhea or rhinorrhea in addition to a variety of symptoms, such as conductive hearing loss. Imaging is the mainstay of the diagnostic process. Management of the condition is surgical, and this review outlines the surgical options with special emphasis on the transmastoid approach and the materials applicable for repair of the bony dehiscences.
MRI of Lateral Skull Base Lesions
Authors: Patkar Deepak P , Yanamandala Rama , Pardhi Mukesh , Pungavkar Sona A , Gaikwad Vishal , Pawar Sudarshan Vijay
Published: May 2011

This article reviews the role of magnetic resonance imaging (MRI) in the evaluation of lateral skull base lesions. Due to superior soft tissue resolution and multiplanar capability, MRI provides accurate information and exquisite anatomical detail. Thus, it guides the surgeon in proper preoperative planning regarding the approach of a lesion. MRI is also useful in post-treatment follow-up to assess the therapeutic response and to identify potential complications. We discuss the relevant anatomy, indications of MRI and MR pulse sequences used in the diagnosis of lesions of lateral skull base. Characteristic MRI findings of various lesions which help to arrive at a specific diagnosis as well as pitfalls of MRI which may confound the diagnosis are described. Newer MR pulse sequences enable image-guided surgery, which assist the surgeon intraoperatively, are briefly discussed. In summary, this article emphasizes the role of MRI in providing a specific answer to a clinical problem and its ability to guide the clinician for better management of patients.
Gamma Knife Radiosurgery for Vestibular Schwannomas
Authors: Liscak Roman
Published: May 2011

The current gamma knife radiosurgery technique involves the use of magnetic resonance imaging for targeting, the application of a low marginal dose (usually between 12 and 13 Gy) and highly conformal treatment planning using multiple small isocenters. This technique achieves an average tumor control rate of 95% and open surgery is needed in fewer than 2 to 3% of patients treated by gamma knife. Facial nerve function preservation is achieved in up to 99% of cases and chance of preserving serviceable hearing is usually between a 70 to 80%. The introduction of ventriculoperitoneal drainage after radiosurgery is required for 1 to 8% of patients. Gamma knife radiosurgery can be treatment of choice for the patients, where the diameter of the tumor is less than 3 cm.
Avoidance of Facial Nerve Injury in Lateral Skull Base Surgery
Authors: Sughrue Michael E
Published: May 2011

In the radiosurgery era, the treatment strategies for vestibular schwannoma have changed at most centers. This new paradigm holds that rational CPA tumor therapy requires balancing often competing goals of therapy, and the associated risks and benefits of different therapies or combination of therapies. The present review discusses this new paradigm and its specific implications for CPA tumor surgery. Inevitably, such a review will focus largely on minimizing facial nerve morbidity, as this is both the most modifiable risk, and the risk that is most reduced with the use of adjuvant therapies, such as stereotactic radiosurgery (like Gamma knife). The facts about facial nerve preservation in CPA tumor surgery will be reviewed, and methods for avoiding facial nerve morbidity will be discussed.
Should Gamma Knife be Offered as a Primary Treatment for a Resectable Glomus Jugulare Tumor?
Authors: Sankhla Suresh , Morwani KP , Jayashankar Narayan
Published: May 2011

Attempted total resections is the preferred treatment option in the management of glomus jugulare tumors in most subjects. In the elderly patients, it may be advisable to leave a tiny residue over the involved cranial nerve to preserve function. In a medically unfit and anesthetically high-risk subject observation with serial MRI scans is the preferred line of management. If in such a patient there occurs brainstem compression, it is prudent to only operate the intracranial part to relieve the compression explaining the very high-risk in this group. Radiotherapy is not to be offered as a primary treatment for glomus jugulare tumors.
Fetal and Gynecological 3D Ultrasound in Daily Practice
Authors: Baba Kazunori
Published: May 2011

Three-dimensional ultrasound has many functions, and is a little complicated to use perfectly. But by starting from easy cases, objects and display modes in daily practice, 3D ultrasound would be a powerful diagnostic tool when and after some abnormalities are suspected with 2D ultrasound. Some tips to use 3D ultrasound easily and efficiently are demonstrated for those who are not familiar with 3D ultrasound.
Doppler Velocimetry in the Human Fetus
Authors: Satoh Shoji
Published: May 2011

Doppler velocimetry has recently become an informative procedure for the real-time and noninvasive evaluation in fetal hemodynamics. The analysis of flow velocity waveforms in various kinds of vessels has been made for not only clarifying fetal physiology and pathophysiology of various disorders but also for determining the most appropriate intervention from the viewpoint of the integrated management protocol. The unique change in both the arterial and venous flow in normal and compromised fetuses has been demonstrated. Clinical applications of the Doppler technique in monitoring the fetus are reviewed.
Fetal Neuroimaging by Transvaginal 3D Ultrasound and MRI
Authors: Pooh KyongHon
Published: May 2011

Three-dimensional (3D) ultrasound is one of the most attractive modality in the field of fetal ultrasound imaging. In multiplanar imaging of the brain structure, it is possible to demonstrate not only the sagittal and coronal sections but also the axial section of the brain, which cannot be demonstrated from parietal direction by a conventional 2D transvaginal sonography. Parallel slicing provides a tomographic visualization of internal morphology similar to MR imaging. Fetal neuroimaging with advanced 3D ultrasound technology is easy, noninvasive and reproducible methods. It produces not only comprehensible images but also objective imaging data. It has been controversial whether ultrasound or MRI is more practical and effective in prenatal assessment of fetal CNS abnormalities.

In the assessment of enlarged ventricles, no significant difference between dedicated neurosonography and MRI in detection of intracranial structure. However, MRI is superior to ultrasound in evaluation of the brainstem, posterior fossa and cortical development especially in the late pregnancy. Meanwhile, transvaginal high-frequent 3D ultrasound has superiority to MRI in detection of intracranial calcification, vascular anatomy, intratumoral vascularity, bony structure.

For CNS anomaly screening scan, ultrasound is no doubt the first modality, and once CNS abnormality is suspicious, after considering each advantage and disadvantage of transvaginal 3D ultrasound and MRI, it is suggested to use those different technologies according to what to be detected and evaluated in each abnormal CNS case. Of course, those two technologies should be utilized as alternatives and complementaries as well. In terms of fetal neurological function analysis, four-dimensional ultrasound research on fetal behavior have been launched in multicenters, and it will be greatly expected to elucidate relations between antenatal behavior and postnatal neurological prognosis.
Screening of Fetal Heart for the Congenital Heart Diseases
Authors: Maeno Yasuki , Hirose Akiko
Published: May 2011

Screening of the congenital heart disease (CHD) is one of the most important techniques in prenatal ultrasonographic examination. Step by step screening methods for taking account for the level of screener, especially in the area with poor detection rate, is needed for starting effective fetal CHD screening. In this review, the fetal cardiac screening is divided into two methods accounting for steps for learning screening technique; the basic screening and the advanced screening. Basic screening is a simple method even for the one who is not familiar to the cardiac anatomy. The goal of this basic screening is to detect most of the ductal dependent lesions including transposition of the great arteries. For the basic screening, ‘location’ and ‘size’ of the heart and vessels are checked in standard fourchamber view and three-vessel view. Advanced screening is a screening for detecting all fetal CHDs, including total anomalous pulmonary venous return. For the advanced screening, the side of the heart is defined, and then the ‘detail anatomy’ and the ‘function and blood flow’ are assessed in all standard screening views, including one fetal abdominal transverse view and three fetal chest transverse views, such as four-chamber, three-vessel and three-vessel and trachea view.
Ultrasonic Diagnosis of Fetal Bone and Small Parts
Authors: Murotsuki Jun , Sekiya Takao , Nishizawa Haruki , Udagawa Yasuhiro
Published: May 2011

The prenatal diagnosis of fetal bone and small parts is a challenging task to the variable disorders and large number of possible diagnosis. Fetal limb anomalies may be congenital or acquired in utero. The former occur as anomalies either systemically or, in some limbs, due to hereditary or sporadic impairment in the formation or development of bone, cartilage or soft tissue. Acquired anomalies are caused by mechanical factor of an amniotic band or oligohydramnios. Both types present functional and cosmetic abnormalities, and skeletal dysplasia in particular includes lethal diseases, which makes prenatal diagnosis in such cases highly important, both medically and societally. Diagnostic imaging for prenatal diagnosis is accomplished by ultrasound, MRI and CT scan, and chromosomal and genetic diagnosis is also performed as needed. We focus on skeletal dysplasia to review prenatal diagnosis of fetal bone and small part anomalies by noninvasive ultrasound. For the authors as perinatologists, this is the imaging modality of choice.
Ultrasonic Diagnosis in Preterm Labor
Authors: Ichizuka Kiyotake , Hasegawa Junichi , Matsuoka Ryu , Okai Takashi
Published: May 2011

Ultrasound diagnosis of the preterm birth was discussed in the measurement of uterine cervical length, its significance for the prediction of preterm birth, fetal growth estimation for the study on fetal maturity and fetal lung immaturity assessment with noninvasive ultrasonic techniques for the prediction and treatment of neonatal respiratory distress syndrome.
Ultrasonography in Multiple Pregnancies
Authors: Nakata Masahiko
Published: May 2011

Multiple pregnancies have a higher risk of both maternal and fetal prognosis. Accurate diagnosis of chorionicity and amnionicity plays an important role for optical perinatal management. In monochorionic pregnancies, there may be several unique pathological complications derived from vascular anastomoses on monochorionic placentation. Twin-twin transfusion, twin-reversed arterial perfusion sequence and single fetal demise have several issues on both perinatal prognosis and management. Recent investments of medical instruments have allowed intervention during prenatal period, such as fetoscopic laser photocoagulation of communicating vessels. These interventions provide more favorable perinatal prognosis. Another risk in multiple pregnancies is congenital anomaly, which is apparently higher than in singleton pregnancy. Therefore, detailed ultrasound examination is necessary for optical management.
Ultrasonic Studies on Amniotic Fluid Umbilical Cord and Placenta
Authors: Ichizuka Kiyotake , Hasegawa Junichi , Matsuoka Ryu , Okai Takashi
Published: May 2011

Detail evaluation of amniotic fluid, umbilical cord and placenta has been obtained by means of ultrasound new technology, including 3D color Doppler imaging. This paper summarizes fetal membrane anatomy and disorders using many ultrasound images taken by not only 2D gray scale ultrasound but also 3D color Doppler images.
Sonogenetics: A Breakthrough in Prenatal Diagnosis
Authors: Choy Kwong Wai , Yeung Leung Tak , Lau Tze Kin
Published: May 2011

G-band and rapid FISH/QF-PCR are regarded as the gold standards for prenatal chromosomal diagnosis. Numerous microdeletion/ microduplication syndromes, however, are not detectable by conventional karyotyping. So far, we had a dilemma between fetal developmental/structural abnormalities with strong suspicion of chromosomal abnormalities and normal karyotype results. Fetal DNA chip includes more than 6,450 genetic loci and covers more than 100 common genetic diseases with numeric, structural chromosomal anomalies.

In April 2009, we launched prenatal diagnosis by fetal DNA chip of amniotic fluid samples or chorionic villi samples in the selected fetuses with sonographic abnormalities and suspicion of familial genetic disorders. We had seven cases with both abnormal ultrasound findings and pathologic copy number variations by DNA chip. In all cases, normal karyotype was confirmed by G-banding analysis.

Fetal DNA chip (array CGH) may become a strong modality to solve some part of this dilemma. Although we have to be prudent to select the patients, deal with DNA chip results and parental counseling, “sonogenetics” is one of the breakthroughs in prenatal diagnosis, and the further accumulation of case studies will be required in this new field.
Knowledge, Attitudes and Practice of Dental Infection Control and Occupational Safety in India: 1999 and 2010
Authors: Puttaiah Raghunath , Shetty Sadashiva , Shetty Deepthi , Dubey Sumit , Walters Scott , Bernstein Ira , Froelich-Grobe Katherine
Published: May 2011

The objective was to study knowledge, attitudes, practice (KAP) and needs regarding infection control measures using two cross-sectional surveys from 1999 and 2010 conducted in India. Both data collection instruments had only about 35 comparable variables in common. In 1999, there were 456 respondents (dentists) who used a self-administered survey instrument compared to 272 respondents in 2010. Both the 1999 and 2010 samples were mutually independent with no overlap, had regional differences, and therefore were not directly compared for changes in KAP over time. While almost all respondents from both surveys felt that education in dental safety was needed and wanted mandatory dental safety curriculum in dental schools, severe inadequacies in dental safety knowledge, protection against immunizable diseases, and practice of universal precaution were noted. Data from the study demonstrated that there is a substantial opportunity to improve the knowledge, attitude and practice of dental infection control and occupational safety in India. Respondents reported that infectious disease status of a patient is always known and a significant number reported that they had the right to refuse care for patients of known infectious disease status. Stigma in treating HIV/AIDS patients was still a concern, an ethically troubling response suggesting the need for a stronger focus on educating dentists in subjects, such as dental safety, stigma and infectious disease. Information obtained from this study could be utilized for developing policies oriented towards increasing dental safety educational efforts, in both dental schools as curriculum, and for practicing dentists through professional updates or continuing dental education.
Influence of Er: Yag Laser on Shear Bond Strength of Self-etching Adhesives to Bovine Enamel: In vitro Study
Authors: Barcellos Daphne Câmara , Borges Alessandra Buhler , Torres Carlos Rocha Gomes , de Paiva Gonçalves Sergio Eduardo , Pavanello Marcella Batista , Souza Ana Carolina
Published: May 2011

Purpose

The aim of this study was to evaluate the influence of the enamel treatment with Er:YAG laser on the bond strength of self-etching adhesives.

Materials and methods

One-hundred bovine incisors were ground to obtain flat enamel surfaces. The bond area was delimited with 3 mm diameter adhesive tape. Specimens were divided in two groups: Group L: Enamel surface received Er:YAG laser application (Kavo KEY 3) at 300 mJ/6 Hz in sweeping mode for 30 seconds; Group N: Enamel surface received no additional treatment. Each group was divided into five subgroups according to self-etching adhesive: S&E (Self & Etch), FB (Futurabond NR), XE (Xeno III), OU (One-Up bond F), CL (Clearfil SE Bond). Cylinders of Z250 composite were fabricated on the bonding area using a teflon matrix. The teeth were stored in water at 37°C/ 24 hours and submitted to shear testing at a speed of 1 mm/min.

Results

The results were analyzed by two-way ANOVA and Tukey's test, obtaining p-value = 0.001. The mean values (±SD) in MPa for each group/subgroup were: N/FB—19.65(±3.87)a; N/CL—19.55(±3.78)a; N/OU—15.57(±2.85)ab; N/XE—15.32(±4.00)b; L/CL— 13.91(±2.54)b; L/OU—13.16(±2.17)bc; L/XE—9.74(±1.65)cd; N/S&E—8.83(±2.63)d; L/FB—8.30(±2.27)d; L/S&E—6.56(±1.55)d.

Conclusion

It was concluded that the enamel surface treatment with Er:YAG laser reduced the bond strength significantly for most of the self-etching adhesives tested.
Kitchen Microwave-Assisted Accelerated Method for Fixation and Processing of Oral Mucosal Biopsies: A Pilot Study
Authors: Shashidara Raju , Sridhara Sudheendra Udyavara
Published: May 2011

Background and aim

Conventional protocols of formalin fixation and processing add time and cost to histoprocessing. This study aims to evaluate an indigenously developed protocol for microwave histoprocessing and compare it with the routine protocol for histoprocessing.

Materials and methods

A total of 40 human buccal mucosal specimens were processed according to the microwave and the routine protocol. Sections obtained were coded and evaluated for the following: Section quality, staining quality, artifacts, cellular details in epithelium, nuclear detail and diagnostic ability. Parameters were graded as suboptimal, optimal and good, and results were statistically analyzed.

Results

The number of good and optimal specimens in both the protocols were almost similar for all parameters assessed with better results for cellular detail, nuclear detail, staining and sectioning quality seen in microwave-fixed samples. Artefacts were lesser in routine processing protocol.

Conclusions

Microwave alcohol fixation protocol provides good and faster fixation compared to routine fixation.
Analysis of the Pulp Chamber Temperature of Teeth Submitted to Light Activation with and without Bleaching Gel
Authors: Barcellos Daphne Câmara , Borges Alessandra Buhler , Torres Carlos Rocha Gomes , Batista Graziela Ribeiro
Published: May 2011

Purpose

This study evaluated the temperature of the pulpal chamber (PC) of teeth submitted to the light activation with and without bleaching gel, using different types of light sources.

Materials and methods

A digital thermometer, thermocouple K type, was located in the PC of human upper central incisors and the specimens received light activation from the following sources: G1—Laser, G2—Halogen light, G3—progressive intensity halogen lamp, G4—LED/Laser. The light was applied for 3 minutes, with and without the use of bleaching gel. The data were collected after every 30 seconds and analyzed by three-way ANOVA and Tukey's test.

Results

The mean values were: Use of the gel—with gel: 3.09a, without gel: 2.79b; Type of light source—G1: 0.60a, G2: 2.38b, G3: 4.16c, G4: 4.63d; Time of activation 30 seconds: 1.15a, 1 minutes: 2.20b, 1 minutes 30 seconds: 2.97c, 2 minutes: 3.44d, 2 minutes 30 seconds: 3.81e, 3 minutes: 4.09e.

Conclusions

The use of bleaching gel associated with light activation resulted in higher heating of the PC. LED/LASER light and progressive intensity halogen lamp showed highest levels of heating. The increase of irradiation time significantly increased the temperature.
Comparing the Efficacy of Plaque Removal between Salvadora persica (Miswak) and Manual Toothbrush in 12 to 15 Years School Children
Authors: Devi Aruna M , Hampannavar Pooja , Radha G , Kadanakuppe Sushi , Nagashree SR , Kumar Vinod A
Published: May 2011

Aim

To compare the efficacy of plaque removal between chewing stick (Miswak—Salvadora persica) and manual toothbrush in 12 to 15 years old school children.

Methods

A randomized, examiner-blind, parallel design study was conducted over a 2-month period, among 12 to 15 years old students of Sri Sajjan Rao Vidya Samasthe, Bengaluru. A sample size of 60 subjects was randomly allocated into two groups, 30 subjects in group A (manual toothbrush) and 30 subjects in group B (chewing stick). The plaque index (Turesky et al, modified Quigley Hein plaque index) was used for base line, pre- and postintervention assessment. Then the data was collected and subjected to statistical analysis and the test used was Student-t test.

Results

The results were given separately for between and within group comparison. The difference in mean PI score between toothbrush users and tooth stick users is found to be statistically significant (p < 0.01). Higher mean PI score was found in tooth stick users compared to toothbrush users and the mean difference was statistically significant. The difference in mean PI score in both the groups, before and after intervention was statistically significant (p < 0.001).

Conclusion

Manual toothbrush and Miswak tooth sticks (Salvadora persica) both are effective in removal of plaque, but manual toothbrush was more effective than Miswak tooth stick, which was statistically significant.
Radioactive Isotope Evaluation of Coronal Leakage after Endodontic Treatment in Teeth Restored with Three Different Intracoronal Restorative Materials: An in vitro Study
Authors: Keshava Prasad BS , Sudhakaran Sunu
Published: May 2011

The aim of this study was to compare and evaluate the coronal microleakage following endodontic treatment of teeth restored with three different intracoronal restorations using calcium-45 radioisotope and autoradiography. A total of 48 extracted human mandibular premolars with single canals were divided into three experimental groups of 16 specimens each. The teeth were sectioned horizontally at the cementoenamel junction and at the middle-third of the root, orifices and canals were enlarged with Gates Glidden bur and finished using K files, and obturated with gutta-percha cones using lateral condensation technique. 3 mm of gutta-percha were removed from the coronal part of the teeth to prepare a clean 3 mm deep cavity for the coronal restorative material. Group 1 consisted of teeth restored with Ketac Molar Easymix; group 2 with Miracle Mix and group 3 with Filtek Z350. The teeth were then thermocycled and tested for microleakage using calcium-45 radioisotope. The results were analyzed using Kruskal-Wallis test and Mann-Whitney test. Filtek Z350 exhibited the least leakage followed by Ketac Molar Easymix and Miracle Mix, and the microleakage among the three restorative materials was statistically significant.
General Disturbances and their Correlation to the Eruption of Primary Dentition in Children between 5 and 30 Months Age Group of Belgaum City: An Epidemiological Study
Authors: Deshpande Shobha , Sholapurmath Santosh M , Anand Shigli L
Published: May 2011

Background and objective

The effect of teething on infants health has been debated for at least 5000 years and traditional beliefs on issue have still not been entirely supplemented by scientific finding. This study has tried to gather scientific information of systemic/clinical signs and symptoms in scientific manner. The objectives of this study were: (1) To describe the most frequent objective clinical manifestation during the eruption of primary teeth, e.g. fever, diarrhea, drooling, fever-drooling, fever-diarrhea, drooling-diarrhea. (2) To assess the correlation between systemic symptoms and eruption of various group of teeth, e.g. incisor, canine, molar.

Methods

The survey was conducted in 500 children between 5 and 30 months and registered at child development center, KLES's Hospital and Medical Research Center, Nehru Nagar, Belgaum, Karnataka. A specially structured questionnaire was applied with face-to-face interview. Information was relayed in yes or no manner of objective manifestation during eruption of primary incisor, canine and molar which included drooling, diarrhea, fever and combination of these symptoms. Data were analyzed by descriptive statistic and Chi-square analyses.

Results

The study showed more number of children in group A (less than 12 months) manifested drooling symptoms. As the ages advances with group B (between 12 and 18 months), group C (between 18 and 24 months) and group D (above 24 months), clinical manifestation of saliva found to be reduced. The results of study showed that 87.78%; 57.8%; 57.55%; 25.7%; of children with erupting teeth demonstrated general clinical symptoms like drooling, diarrhea and fever. The presence of fever-diarrhea in this study within group A, group B, group C and group D showed highest number of children by the manifestation than any other codes evaluated in the study.

Interpretation and conclusion

Present data demonstrate association between fever-diarrhea observed in all group consistently when marked numerically. As the age advances the fever-diarrhea from group C (between 18 and 24 months) and group D (above 24 months) rank second and third. This ranking in group A (less than 12 months) and group B (between 12 and 18 months) at its highest position and attributable to lower immunity of infants. Further, virology study should be conducted on subjects to demonstrate any possible occurrence of systemic disturbances.
Management of Non-Vital Teeth with Open Apices using MTA as an Apical Plug: Two Case Reports
Authors: Patil Sanjana A , Patil Avinash A , Dodwad Preeti K
Published: May 2011

Management of non-vital teeth with open apices is a challenge to dental practitioners. In this clinical scenario, it is difficult to maintain the obturation material within the confines of root canal without encroaching into periapical area. Also, thin dentinal walls of canal is a matter of concern. These cases cannot be managed by conventional endodontic treatment and need customized treatment plan. Treatment of such teeth with calcium hydroxide may demand long time and patient compliance. But with MTA same treatment can be done in reasonably less time with predictable results. Hence, these two case reports present the use of MTA to form an apical plug in open apex followed by complete root canal obturation using thermoplasticized gutta-percha under operating microscope.
Paget's Disease of Maxilla
Authors: Rajkumar GC , Ramesh Bindu , Shashikala R , LNU Manjunath
Published: May 2011

Paget's disease is an idiopathic, non-neoplastic affliction characterized by disordered bone formation and resorption. It affects about 3% of the population. Paget's disease affects mainly the skull, femur, tibia and pelvic bones. Facial skeleton is involved in about 17% of the cases. We present a case of Paget's disease involving maxillary and mandibular skeleton which developed osteomyelitis following extraction of maxillary right posterior teeth.
T-Cell-Rich Diffuse Large B-cell Lymphoma Presenting as an Intraosseous Maxillary Neoplasm
Authors: Bheemanagouda Gururaj Patil , Hallikeri Kaveri Satish , Krishna Rekha Pillai
Published: May 2011

Non-Hodgkin lymphomas are a group of highly diverse malignancies with great tendency to affect organs and tissues that do not ordinarily contain lymphoid cells. T-cell/histiocyte-rich large B-cell lymphoma (TCRBCL) is an uncommon histological variant of large B-cell non- Hodgkin lymphoma, morphologically characterized by a minor population of clonal B-cells distributed in a background of prominent reactive T lymphocytes. This is an interesting case of extranodal isolated TCRBCL in jaw bone and to our knowledge this is the first report of its kind in a nonimmune compromised 40-year-old female. An increase in the number of case reports of non-Hodgkin lymphoma in head and neck region definitely makes it to be included as differential diagnosis. The patient has completed 5 years of therapy with no evidence of recurrence.
Langerhans Cell Histiocytosis
Authors: Jayachandran S , Balaji N
Published: May 2011

Langerhans cell histiocytosis (LCH) is rare unique disorder of the reticuloendothelial system characterized by an abnormal proliferation of histiocytes and eosinophilic leukocytes. Lichtenstein gave the term Histiocytosis X in 1953 to include three clinical varieties; Eosinophilic granuloma, Hand-Schüller-Christian disease and Letterer-Siwe disease, which shared some common histologic features and clinical findings. In 1973, the term LCH was introduced as an alternative to histiocytosis X. LCH may manifest orally with single or multiple lesions of the alveolar or basal bone, ulcerated mucosal lesions accompanied by adenopathies and/or periodontal lesions, presenting gingival inflammation, bleeding, recession, necrosis, mobility of teeth and premature loss of teeth. Herewith, we report a case of LCH in a 45-year-old male with a characteristic oral and radiological findings. The purpose of this case report is to highlight the unique and rare presentation of oral and multiple skeletal involvement of Langerhans cell histiocytosis.
A Rare Case of Gorlin Cyst in the Maxillary Anterior Edentulous Region
Authors: Agrawal Rohit , Yadav NS , Guruprasad R
Published: May 2011

The Gorlin cyst (calcifying epithelial odontogenic cyst) is a rare lesion. Its clinical and radiological features are not pathognomonic, and is characterized by histological diversity. Radiographically, it presents as a unilocular or, occasionally, multilocular radiolucency that may contain calcified radiopacities or tooth-like densities. Microscopic appearance of odontogenic epithelium admixed with focal areas of dentinoid formation or calcification along with sheets of ghost cells gives the definitive diagnosis of Gorlin cyst. A rare case of Gorlin cyst, which present as swelling in the maxillary anterior edentulous region along with emphasis on review of literature, is presented in this paper.
Post Endodontic Restoration of Severely Decayed Primary Dentition: A Challenge to Pediatric Dental Surgeon
Authors: Srinivas N CH , Jayanthi M
Published: May 2011

Dental caries is the single most common chronic childhood disease. In early childhood caries, there is early pulpal involvement and gross destruction of the maxillary anterior teeth. This leads to decreased masticatory efficiency, difficulty in speech, psychological problems due to compromised esthetics, development of abnormal tongue habits and subsequent malocclusion. The restoration of severely decayed primary incisors is often a procedure that presents a special challenge to dentists, particularly in an uncooperative child. This case presents the clinical sequence of rehabilitation of upper anterior primary teeth, where endodontic treatments were done chairside followed by the construction of root post using stainless steel and the fabrication of crowns composed of resin.
Sialolipoma of Hard Palate: A Rare Variant of Lipoma
Authors: Manjunath M , Sharada P , Smitha T , Rakesh N
Published: May 2011

The designation 'sialolipoma’ is given to a recently described histologic variant of lipoma characterized by well-demarcated proliferation of mature adipocytes with secondary entrapment of salivary gland elements. Nagao et al from Japan first described this new variant. These tumors have been observed in both the major and minor salivary glands with around 35 cases being reported in the English literature. The most common site for the tumor is the parotid (17 cases, 60.7%) followed by the hard palate (four cases, 14.2%). We report a similar case of sialolipoma arising in the hard palate presenting in a 45-year-old male. Diagnosed as an ordinary lipoma of the hard palate, complete surgical removal of the tumor was done. The histopathological features showed a well-encapsulated lesion exhibiting both adipose tissue and glandular epithelium, and based on the recent criteria of histological findings of sialolipoma, the tumor was diagnosed as sialolipoma of the hard palate. Because of its rarity, it was fitting to report this entity.
Ligation of Blocked-Out Incisors Simplified
Authors: Goel Sumant , Kodali Kiran Kumar , Tanveer Shameem , Srihari V
Published: May 2011

Ligation of archwire into bracket by conventional method when the incisors are lingually or palatally placed is cumbersome, time consuming and is even worse when there is vertical discrepancy between the slots of adjacent brackets. In this article, we suggested a new method of ligating the blocked-out incisors. This method can also be used effectively to ligate the lingually tipped tooth due to bond failure during retraction phase.
Maxillofacial Injuries in the Pediatric Patient: An Overview
Authors: Singh Ranjit B , Prakash Jeevan V , Chaitan SN , Tandur Prakash S , Kokate Shilpa
Published: May 2011

Children are uniquely susceptible to craniofacial trauma because of their greater cranial mass-to-body ratio. The pediatric population sustains 1 to 14.7% of all facial fractures. The majority of these injuries are encountered by boys (53.7-80%) who are involved in motor vehicle accidents (up to 80.2%). The incidence of other systemic injury concomitant to facial trauma is significant (10.4-88%). The management of the pediatric patient with maxillofacial injury should take into consideration, the differences in anatomy and physiology between children and adults, the presence of concomitant injury, the particular stage in growth and development (anatomic, physiologic and psychological), and the specific injuries and anatomic sites that the injuries affect. The greatest concern when treating the pediatric patient is the effect of the injury or treatment on growth and development. This is both anatomically and psychologically important and may have various effects on management for the different stages of psychological development.
Estimate of anthropogenic halocarbon emission based on measured ratio relative to CO in the Pearl River Delta region, China
Authors: Shao M. , Huang D. , Gu D. , Lu S. , Chang C. , Wang J.
Published: May 2011

Abstract. Using a GC/FID/MS system, we analyzed the mixing ratio of 16 halocarbon species in more than 100 air samples collected in 2004 from the Pearl River Delta (PRD) region of southern China. The results revealed that there are elevated mixing ratios for most of halocarbons, especially for HClC = CCl2 (trichloroethylene, TCE), CH2Cl2 (dichloromethane, DCM), CH3 Br (bromomethane), HCFC-22, CHCl3 (trichloromethane), CCl4 (tetrachloromethane), Cl2C = CCl2 (perchloroethylene, PCE), CH3CCl3 (methyl chloroform, MCF), and CFC-12. Comparisons were done with the data from TRACE-P and ALE/GAGE/AGAGE experiments, we found that the large variability in mixing ratios (relative standard deviation ranged from 9.31 % to 96.55 %) of the halocarbons suggested substantial local emissions from the PRD region in 2004. Correlations between the mixing ratio of each species and carbon monoxide (CO) was examined, and then the emission of each halocarbon was quantified based on scaling the optimized CO emission inventory with the slope of the regression line fitted to each species relative to CO. The calculated results revealed that mass of CH2Cl2 (7.0 Gg), CH3CCl3 (6.7 Gg), and Cl2C = CCl2 (2.3 Gg) accounted for about 62.9 % of total halocarbon emissions, it suggested a significant contribution from solvent use in the PRD region. Emissions of HCFC-22 (3.5 Gg), an alternative refrigerant to chlorofluorocarbons (CFCs), were about 2.3 times greater than those of CFC-12 (1.6 Gg). CFC-12 and HCFC-22 accounted for 21.5 % of total emissions of halocarbons, so that the refrigerant would be the second largest source of halocarbons. However, the ratio approach found only minor emissions of CFCs, such as CFC-11, and the emission of CFC-114 and CFC-113 were close to zero. Emissions of other anthropogenic halocarbons, such as CCl4, CHCl3, CH3Br, and CH3Cl, were also estimated. Where possible, the emissions estimated from the measured ratios were compared with results from source inventory techniques, we found that both approaches gave emissions at similar magnitude for most of the halocarbons, except CFC-11. The comparison suggested that the ratio method may be a useful tool for assessing regional halocarbon emissions, and emission uncertainty could be further reduced by incorporating both longer-term and higher-frequency observations, as well as improving the accuracy of the CO inventory.
Optimal estimation of tropospheric H2O and δD with IASI/METOP
Authors: Schneider M. , Hase F.
Published: May 2011

Abstract. We present an optimal estimation retrieval for tropospheric H2O and δD applying thermal nadir spectra measured by the instrument IASI (Infrared Atmospheric Sounding Interferometer) flown on EUMETSAT's polar orbiter METOP. We document that the IASI spectra allow for retrieving H2O profiles between the surface and the upper troposphere as well as middle tropospheric δD values. A theoretical error estimation suggests a precision for H2O of better than 35 % in the lower troposphere and of better than 15 % in the middle and upper troposphere, respectively, whereby surface emissivity and atmospheric temperature uncertainties are the leading error sources. For the middle tropospheric δD values we estimate a precision of 15–20‰, with the measurement noise being the dominating error source. We compare our IASI products to a large number of quasi coincident radiosonde in-situ and ground-based FTS (Fourier Transform Spectrometer) remote sensing measurements and find no significant bias between the H2O and δD data obtained by the different techniques. Furthermore, the scatter between the different data sets confirms our theoretical precision estimates.
O+ heating associated with strong wave activity in the high altitude cusp and mantle
Authors: Slapak R. , Nilsson H. , Waara M. , André M. , Stenberg G. , Barghouthi I. A.
Published: May 2011

Abstract. We use the Cluster spacecraft to study three events with intense waves and energetic oxygen ions (O+) in the high altitude cusp and mantle. The ion energies considered are of the order 1000 eV and higher, observed above an altitude of 8 earth radii together with high wave power at the O+ gyrofrequency. We show that heating by waves can explain the observed high perpendicular energy of O+ ions, using a simple gyroresonance model and 25–45% of the observed wave spectral density at the gyrofrequency. This is in contrast to a recently published study where the wave intensity was too low to explain the observed high altitude ion energies. Long lasting cases (>10 min) of high perpendicular-to-parallel temperature ratios are sometimes associated with low wave activity, suggesting that high perpendicular-to-parallel temperature ratio is not a good indicator of local heating. Using multiple spacecraft, we show that the regions of enhanced wave activity are at least one order of magnitude larger than the gyroradius of the heated ions.
Statistical evidence for O+ energization and outflow caused by wave-particle interaction in the high altitude cusp and mantle
Authors: Waara M. , Slapak R. , Nilsson H. , Stenberg G. , André M. , Barghouthi I. A.
Published: May 2011

Abstract. We present a statistical study of the low (<1 Hz) frequency electric and magnetic field spectral densities observed by Cluster spacecraft in the high altitude cusp and mantle region. At the O+ gyrofrequency (0.02–0.5 Hz) for this region the electric field spectral density is on average 0.2–2.2 (mV m−1)2 Hz−1, implying that resonant heating at the gyrofrequency can be intense enough to explain the observed O+ energies of 20–1400 eV. The relation between the electric and magnetic field spectral densities results in a large span of phase velocities, from a few hundred km s−1 up to a few thousand km s−1. In spite of the large span of phase velocity, the ratio between the calculated local Alfvén velocity and the estimated phase velocity is close to unity. We provide average values of a coefficient describing diffusion in ion velocity space at different altitudes, which can be used in studies of ion energization and outflow. The observed average waves can explain the average O+ energies measured in the high altitude (8–15 RE) cusp/mantle region of the terrestrial magnetosphere according to our test particle calculations.
Locomotion and postural behaviour
Authors: Schmidt M.
Published: May 2011

Abstract. The purpose of this article is to provide a survey of the diversity of primate locomotor behaviour for people who are involved in research using laboratory primates. The main locomotor modes displayed by primates are introduced with reference to some general morphological adaptations. The relationships between locomotor behaviour and body size, habitat structure and behavioural context will be illustrated because these factors are important determinants of the evolutionary diversity of primate locomotor activities. They also induce the high individual plasticity of the locomotor behaviour for which primates are well known. The article also provides a short overview of the preferred locomotor activities in the various primate families. A more detailed description of locomotor preferences for some of the most common laboratory primates is included which also contains information about substrate preferences and daily locomotor activities which might useful for laboratory practice. Finally, practical implications for primate husbandry and cage design are provided emphasizing the positive impact of physical activity on health and psychological well-being of primates in captivity.
Assessment of climate vulnerability in the Norwegian built environment
Authors: Hygen H. O. , Øyen C. F. , Almås A. J.
Published: May 2011

Abstract. The main trends expected for the change of Norwegian climate for this century are increasing temperatures, precipitation and wind. This indicates a probable increase of climate-related risks to the Norwegian built environment. Through co-operation between the Norwegian Meteorological Institute and SINTEF Building and Infrastructure, building and climate information have been combined to estimate changes in strain to the built environment due to climate change. The results show that the risk of wood decay will increase for the whole country. Almost two million buildings will be subject to an increase in risk of wood decay from medium to high level. Similar analyses have been performed for other climate indices, demonstrating a clear increase in potential damages due to water and humidity, while frost damage probably will decrease.
Eutrophication and warming effects on long-term variation of zooplankton in Lake Biwa
Authors: Hsieh C. H. , Sakai Y. , Ban S. , Ishikawa K. , Ishikawa T. , Ichise S. , Yamamura N. , Kumagai M.
Published: May 2011

Abstract. We compiled and analyzed long-term (1961–2005) zooplankton community data in response to environmental variations in Lake Biwa. Environmental data indicate that Lake Biwa had experienced eutrophication (according to the total phosphorus concentration) in the late 1960s and recovered to a normal trophic status around 1985, and then has exhibited warming since 1990. Total zooplankton abundance showed a significant correlation with total phytoplankton biomass. Following a classic pattern, the cladoceran/calanoid and cyclopoid/calanoid abundance ratio was related positively to eutrophication. The zooplankton community exhibited a significant response to the boom and bust of phytoplankton biomass as a consequence of eutrophication-reoligotriphication and warming. Moreover, our analyses suggest that the Lake Biwa ecosystem exhibited a hierarchical response across trophic levels; that is, higher trophic levels may show a more delayed response or no response to eutrophication than lower ones. We tested the hypothesis that the phytoplankton community can better explain the variation of the zooplankton community than bulk environmental variables, considering that the phytoplankton community may directly affect the zooplankton succession through predator-prey interactions. Using a variance partition approach, however, we did not find strong evidence to support this hypothesis. We further aggregated zooplankton according to their feeding types (herbivorous, carnivorous, omnivorous, and parasitic) and taxonomic groups, and analyzed the aggregated data. While the pattern remains similar, the results are less clear comparing the results based on finely resolved data. Our research suggests that zooplankton can be bio-indicators of environmental changes; however, the efficacy depends on data resolution.