Minimal invasive plate osteosynthesis for the dislocated humeral head fracture associated with ipsilateral humeral shaft fracture: A case report

The condition combining a dislocated humeral head fracture and an ipsilateral humeral shaft fracture is seen to be rare in literature, which is limited to case report or case series. Furthermore, effective management of these coexistent injuries is still a subject of debate. The essential purpose of this article is to report another treatment method for this condition. We present a case of a 79-year-old female patient who suffered a three-part humeral head fracture-dislocation associated with the ipsilateral humeral shaft fracture. The combined injuries were managed by minimal invasive plate osteosynthesis (MIPO) through the deltopectoral approach with the eventual result of bone healing and good function after thirty-three months of follow-up. In conclusion, MIPO should be considered a safe and effective option, however, the risk of traumatic osteonecrosis of the humeral head is taken into account before operation decision-making.

Isolation and genetic characterization of canine distemper virus in domestic dogs from central and northern provinces in Vietnam

Canine distemper virus (CDV) is a pathogen causing fatal disease in a wide range of carnivores. Sequence analysis of CDV strains has been classified into several geographically-related lineages, and the evolution and emergence of these strains are not fully yet investigated. In this study, the complete H gene sequences of 15 CDV strains isolated on Vero DST cell culture from clinical samples of vaccinated domestic dogs in Vietnam were investigated. Fifteen CDV isolates belonging to Asia-1 CDV variants were predominant antigenic type circulated in Central and Northern Vietnam with notable differences regarding the region and some genetic variation, and the most closely related Asia-1 variants lineage reported in Vietnam, China, Taiwan, and Japan. All identified CDV isolates clustered into 2 novel clades Asia-1-C1 and Asia-1-C2. The major amino acid mutation variants of Vietnamese Asia-1 CDV strains were found at sites 51, 157, 159, 160, 171, 178, 186, 235, 245, 277, 288, 313, 324, 330, 337, 345, 358, 359, 365, 383, 446, 475, 517, 530, 584, 598 which include N-glycosylation sites and neutralizing epitope regions in H gene. The results of the virus neutralization titer (VNT) assay showed that the dogs vaccinated with commercial vaccines had significantly low VNT (4.89 and 12.8) against field CDV isolate strains (VNUA NA04, HN18, and NB05) isolated in northern and central Vietnam, respectively. These data may suggest the need for further research in CDV monitoring and development of preventative measures against CDV in Vietnam.

Isolated bilateral, large, basal ganglia haemorrhage following a traumatic brain injury: A case report

Traumatic basal ganglia haemorrhage is rarely seen in clinical practice. Bilateral basal ganglia hematoma without any other cerebral lesions due to trauma is extremely uncommon and has been reported only in a few cases. Although the mechanisms of this condition are unclear, haemorrhagic contusions are thought to arise as a consequence of a shearing strain on cranial blood vessels due to high-velocity forces at the time of the injury. Here we describe a 63-year-old female patient with an isolated bilateral, large, basal ganglia haemorrhage secondary to a road traffic accident. The patient was promptly diagnosed and conservatively treated and had fully recovered after two months.

Simulation of orthodontic tooth movement during activation of an innovative design of closing loop using the finite element method

INTRODUCTION

Although many attempts have been made to study the mechanical behavior of closing loops, most have been limited to analyses of the magnitude of forces and moments acting on the end of the closing loop. The objectives of this study were to simulate orthodontic tooth movement during the activation of a newly designed closing loop combined with a gable bend and to investigate the optimal loop activation condition to achieve the desired tooth movement.

METHODS

We constructed a 3-dimensional model of maxillary dentition reproducing the state wherein a looped archwire combined with a gable bend was engaged in brackets and tubes. Orthodontic tooth movements were simulated for both anterior and posterior teeth while varying the degree of gable bend using the finite element method.

RESULTS

The incorporation of a 5° gable bend into the newly designed closing loop produced lingual crown tipping for the central incisor and bodily movement for the first molar. The incorporation of 10° and 15° gable bends produced bodily movement and root movement, respectively, for the central incisor and distal tipping for the first molar.

CONCLUSIONS

Torque control of the anterior teeth and anchorage control of the posterior teeth can be carried out effectively and simply by reducing by half the thickness of a teardrop loop with a height of 10 mm and a 0.019 × 0.025-in cross-section, to a distance of 3 mm from its apex, and by incorporating various degrees of gable bend into the loop corresponding to the treatment plan.

Studying The Imaging Properties Of Liver Tumors On Magnetic Resonance Imaging With Primovist - A Hepatospecific Paramagnetic Gadolinium-Based Contrast Agent

The study was performed on 25 patients diagnosed with liver tumors, assigned magnetic resonance imaging (MRI) with Primovist - a hepatospecific paramagnetic gadolinium-based contrast agent at the International Medical Center of Hue Central Hospital. The result is as followed: 11 HCCs, 1 biliary tract malignant tumor, 1 hepatic adenoma, 6 metastates, 2 FNH, 1 hepatic AML, 3 hemangiomas. 47 lesions in total, including 9 lesions smaller than 1cm, 12 lesions 1-2 cm, 26 lesions larger than 2 cm. All 11 HCCs are hypointense on T1W, hyperintense on T2W, intratumoral high signal on DWI, 9 cases have typical enhancement pattern on Dynamic phase (arterial enhancement with washout assessed on the portal venous phase), 10 cases have no enhancement on Hepatocellular phase. Metastasis lesions have peripheral enhancement on both arterial and venous phases, no enhancement on delayed phase due to not having hepatic cells. The the biliary tract tumor is pathologically correct, with minor peripheral enhancement 30 seconds after injection, gradual centripetal enhancement after 60 and 90 seconds, no enhancement on delayed phase due to not having hepatic cells. 3 cases with hemangiomas are hyperintense on T2WI, similar to blood vessels, hypointense on T1WI, pheripherally enhanced 30 seconds after injection, fully centripetal fill-in after 90 seconds, non-enhanced on delayed phase (20 minutes) due to not having hepatic cells. 2 cases with FNH have iso- or mildly hyperintense on T1W, isointense on T2W and hypointense on DWI, isointense on hepatocellular phase due to the reservation of hepatic cells. Liver MRI with Primovist is specific for Hepatic cells, playing a critical role in detecting small lesions and differentiating benign and malignant lesions of the liver, especially those without typical enhancement pattern on Dynamic phase.

Numeric simulation model for long-term orthodontic tooth movement with contact boundary conditions using the finite element method

INTRODUCTION

Although many attempts have been made to simulate orthodontic tooth movement using the finite element method, most were limited to analyses of the initial displacement in the periodontal ligament and were insufficient to evaluate the effect of orthodontic appliances on long-term tooth movement. Numeric simulation of long-term tooth movement was performed in some studies; however, neither the play between the brackets and archwire nor the interproximal contact forces were considered. The objectives of this study were to simulate long-term orthodontic tooth movement with the edgewise appliance by incorporating those contact conditions into the finite element model and to determine the force system when the space is closed with sliding mechanics.

METHODS

We constructed a 3-dimensional model of maxillary dentition with 0.022-in brackets and 0.019 × 0.025-in archwire. Forces of 100 cN simulating sliding mechanics were applied. The simulation was accomplished on the assumption that bone remodeling correlates with the initial tooth displacement.

RESULTS

This method could successfully represent the changes in the moment-to-force ratio: the tooth movement pattern during space closure.

CONCLUSIONS

We developed a novel method that could simulate the long-term orthodontic tooth movement and accurately determine the force system in the course of time by incorporating contact boundary conditions into finite element analysis. It was also suggested that friction is progressively increased during space closure in sliding mechanics.

Endoscopic monitoring of Crohn's disease treatment: a prospective, randomized clinical trial. The Groupe d'Etudes Therapeutiques des Affections Inflammatoires Digestives

A randomized clinical trial was conducted to determine whether colonoscopy is useful in deciding how long to maintain steroid treatment in attacks of Crohn's disease involving the colon. One hundred forty-seven patients with acute attacks of colonic or ileocolonic Crohn's disease were treated by oral prednisolone, 1 mg.kg-1.day-1; 136 achieved clinical remission, but 96 of them still had active endoscopic lesions and were randomized either to immediate start of steroid tapering (group A; n = 46) or to continued prednisolone treatment at the same dosage for 5 more weeks before steroid tapering was begun (group B; n = 50). In the remaining 40 patients (already in endoscopic remission, group C), steroid tapering was begun immediately. After prednisolone discontinuation, patients were followed up for 18 months or until clinical relapse. Prolongation of prednisolone therapy significantly improved the endoscopic scores in group B (30% of endoscopic remission). The frequency of successful steroid weaning was almost identical in groups A and B (82% and 80%, respectively), as was the actuarially calculated relapse clinical rate after steroid withdrawal (P = 0.22). No factor predictive of clinical relapse could be found. The clinical course of patients in group C was similar to that of those in groups A and B. Overall, only 22% of the 147 patients were still in clinical remission and off steroids 18 months after prednisolone discontinuation, outlining the need for maintenance therapy. In conclusion, for patients who have achieved clinical remission, adjustment of steroid treatment duration on the basis of endoscopy results is of no benefit, and the endoscopic aspect has no prognostic value; thus, it appears unnecessary to repeat colonoscopy in such patients before steroid tapering is begun.