Multi-rooted mandibular premolars: report of case

Differential growth of the epithelial diaphragm is needed for the formation of multiple roots in the primary and permanent dentitions. In most instances, the mandibular premolars possess a single root. It is a very unusual event to find a case of bilateral multi-rooted first and second mandibular premolars. This paper presents such a case.     

Genetic analysis: a diagnostic tool for primary hyperoxaluria type 1

Pediatric Nephrology -     

Adolescent drinking and sex: findings from a daily diary study

CONTEXT: Alcohol consumption often has been cited as increasing adolescents'risk of HIV, and several studies have shown positive relationships between drinking and risky sexual behavior among adolescents. Because most of these studies used global measures of drinking and risky sex, and conducted comparisons across persons, they could not determine whether alcohol use was a cause of risky sex or simply a correlate.
METHODS: A sample of 112 U.S. adolescents completed daily diaries about their health behaviors, including drinking and intercourse, for eight weeks. In analyses using t-tests and hierarchical linear modeling, each respondent's rate of condom use after drinking was compared with his or her rate of use when not drinking, and predictors of condom use were examined.
RESULTS: Rates of condom use did not differ significantly between sexual events preceded by drinking (use in 54% of events) and those not preceded by drinking (use in 52% of events). Condoms were more likely to be used during sexual events with casual partners than in those with steady partners, less likely to be used on occasions when other birth control was used and more likely to be used when the sexual encounter was expected. In the multivariate analyses, the odds of condom use were not associated either with whether a teenager had been drinking before sex or with the quantity of alcohol consumed.
CONCLUSIONS: These findings challenge the widely accepted hypothesis that drinking is a cause of sexual risk-taking. Rather, they underscore the need for interventions to increase teenagers'access to and ability to use condoms.     

Analysis of DQB1 allele frequencies in pulmonary tuberculosis: preliminary report

BACKGROUND: The human leucocyte antigen (HLA) system plays an important role in the modulation of the immune response. An association between HLA and pulmonary tuberculosis (TB) has been examined in several populations but the results have been inconsistent. The aim of this study was to evaluate the correlation of DQB1 alleles with TB patients and healthy controls in the same ethnic group in Poland. METHOD: The DQB1 alleles of 38 patients with TB and 58 healthy university staff volunteers were determined by a PCR-SSP low resolution method. RESULTS: The DQB1*05 allele occurred more frequently (p adjusted for multiple comparison=0.002, OR=2.84, 95% CI 1.57 to 5.15) and the DQB1*02 allele occurred less frequently (p=0.01, OR=0.39, 95% CI 0.21 to 0.71) in patients with TB than in controls. The occurrence of DQB1*03,*04,*06 alleles was similar in the two populations. CONCLUSIONS: The occurrence of specific DQB1 alleles may be linked to susceptibility/resistance to tuberculosis.     

Is there a High Risk of Damaging the External Branch of the Superior Laryngeal Nerve during Thyroid Surgery?

Summary BACKGROUND: Injury to the external branch of the superior laryngeal nerve (EBSLN) during thyroid surgery can have serious consequences for patients who depend on control of pitch and a clear and forceful voice, like singers or professional speakers. METHODS: We used the Neurosign 100^® nerve monitor to identify 165 nerves in 112 patients undergoing thyroid surgery. RESULTS: The EBSLN was successfully identified in 98.2 % of cases. The recording electrode could be placed either into the cricothyroid muscle or into the vocal cord. The latter position proved superior if the recurrent laryngeal nerve had to be identified as well. Fifteen per cent of the nerves crossed the branches of the superior thyroid artery below the upper pole of the gland, posing a high risk of postoperative lesions. Our data confirm the results of smaller studies reporting this type of nerve course in 12 % to 14 % of patients. CONCLUSIONS: The present findings show that intraoperative identification and neuromonitoring of the EBSLN can help prevent its injury during dissection of the upper thyroid pole.     

Coping strategies in laryngectomy patients

BACKGROUND: Over the last few years, paradigms for judging the results of treatment of tumor patients have shifted. In addition to characteristics such as the complete excision of the tumor and the duration of patient survival, restoring the quality of life has become an equally important aim. There is still a lack of systematic (and sufficient) research on coping strategies as a means of dealing with malignant tumors of the head and neck. PATIENTS AND METHOD: In a cross-sectional study, 25 laryngectomees, whose voices had been successfully restored with a Provox voice prosthesis,were examined for their coping strategies and the effects of the illness on their lives. The standardized Trier Scales of Coping Strategies and a custom-made questionnaire, which helped to structure the anamnesis of disease specific functional restrictions and the state of rehabilitation, were used as the means of inquiry. RESULTS: A high percentage of patients were content despite objective and subjective restrictions.Voice replacement was mainly experienced as unproblematic,with psychosocial restraints more commonly being felt in connection with pain and difficulties ingesting food. A correlation between the patients' evaluation of physical,psychological and social experiences and the coping strategies applied could not be verified. The way laryngectomees deal with their illness does not differ from the strategies of patients suffering from malignant or chronic diseases of other organ systems. CONCLUSION: The Trier Scales of Coping Strategies is a suitable means for determining the coping strategies of laryngectomees who have been successfully rehabilitated with the help of voice prostheses.The patients examined here did not apply different coping strategies from groups of patients with other severe illnesses. Obviously, the limitations on communication do not constitute a determining factor in coping with the disease. This finding is useful when planning psychological and social rehabilitation, e.g. by psychosomatic interventions.     

Vocal fold vibration irregularities caused by different types of laryngeal asymmetry

The common symptom of hoarseness is regarded to be caused by (1) turbulences and air loss due to incomplete glottic closure and (2) irregular vibrations of the vocal folds. With real time resolution, the latter can only be observed using high-speed recording techniques (> or =2,000 images/s). In this paper an actual recording method is described, called high-speed glottography (HGG), which quantifies vibration irregularities. It combines imaging and image processing techniques with a functional endoscopy of the disordered voice and delivers motion curves separately for each vocal fold. They are fitted with a computer simulation in order to identify the underlying driving parameters of the vibration. A vocal fold is assumed to vibrate as a system of two coupled oscillators ("two-mass model"). From the model fit to bilateral motion curves, the subglottal pressure, muscular tension and oscillating masses of the vocal folds can be computed with reasonable accuracy. Besides normal voices, HGG has been applied to selected clinical cases of voice disorders. Two types of irregularities have been measured: there is a frequency difference either between left and right vocal folds (horizontal asymmetry) or on one side between the ventral and dorsal third (vertical asymmetry). By modeling, both categories of irregular motion curves can be explained in detail. It is presumed that laryngeal asymmetry (either in mass or tension) causes irregular vibrations.