Three-dimensional cone-beam computed technology evaluation of skeletal and dental changes in growing patients with Class II malocclusion treated with the cervical pull face-bow headgear appliance.

Introduction: This study aimed to 3-dimensionally quantify and compare the outcomes of growing patients with Class II malocclusion treated with the cervical pull face-bow headgear appliance in combination with full fixed orthodontic appliances.

Methods: The study sample consisted of 22 patients with Class II malocclusion with the following inclusion criteria: ANB >4.75°, Class II molar relationship, and SN-GoGn <37°.

Complete postsurgical left ventricular-aortic discontinuity and pseudoaneurysm formation.

Background: Left ventricular outflow tract pseudoaneurysm is a rare but potentially fatal complication of aortic valve replacement, infective endocarditis (IE), and suture dehiscence. Left ventricular-aortic discontinuity is a severe and uncommon manifestation of IE. For patients who have a long-standing history of endocarditis, periannular lesions in the aortic valve may rupture, leading to the rare occurrence of complete, or total, left ventricular-aortic discontinuity.

A Lost Bullet in the Coronary Sinus: A Cautionary Tale.

We present a case of venous bullet embolism to the right atrium following a gunshot wound (GSW) to the abdomen. A 53-year-old male presented after a GSW to the abdomen. His workup included a computed tomography (CT) scan demonstrating an aortic injury with aortocaval fistula.

Retrieval and Characterization of a Plutonium-beryllium Source at the University of Utah.

A shielded neutron irradiation facility has been constructed to contain a 74 GBq plutonium-beryllium neutron source at the University of Utah. Due to lack of information and recent use, the GEANT4 Monte Carlo Toolkit was used to perform dose assessments and validation of the designed shield and beam port for storage and operational geometries where the source was to be placed. Borated polyethylene was used as the primary shielding material with a lead-lined beam port to collimate neutrons and reduce gamma rays within the active beam profile.

Swiss cheese interventricular septum presenting with catastrophic stroke: the potential role of ECG-gated CTA.

Ventricular septal defect is a common congenital cardiac condition that presents in a variety of morphologies. Less commonly, when an individual patient is found to have multiple ventricular septal defects, the term "Swiss cheese ventricular septal defect" is applied. Although not routinely utilized in clinical practice, electrocardiogram (ECG)-gated computed tomographic angiography (CTA) has been shown to provide utility in detecting intracardiac shunts, demonstrating promise in preventing acute strokes secondary to a paradoxical embolus from occurring; this is especially important when atypical cardiac septa are suspected.

Rapid 3D reconstruction guided embolization for catastrophic bleeding following vacuum assisted breast biopsy; A case report and review of the literature.

The most clinically significant complication associated with stereotactic core needle biopsy of the breast is hematoma formation, which only occurs in less than 1% of biopsies and may require treatment. Cases of uncontrollable bleeding, refractory to repeated compression, resulting from biopsy are exceedingly rare. We present a case of catastrophic, uncontrollable bleeding and large hematoma formation resulting from stereotactic vacuum-assisted breast biopsy of a breast mass identified in screening mammography.

Outcomes of immunoglobulin-associated mesangiocapillary glomerulonephritis: A South African experience.

Aim: Immunoglobulin-associated mesangiocapillary glomerulonephritis is currently the most common biopsy-confirmed glomerulonephritis in Cape Town, South Africa. We aimed to determine the outcome of patients with a biopsy-confirmed diagnosis of immunoglobulin-associated mesangiocapillary glomerulonephritis at our centre.

Methods: A retrospective cohort study of adult patients was conducted from January 1, 2000 to December 31, 2016.

Pattern of renal amyloidosis in South Africa.

Background: Kidney disease is a serious manifestation of systemic amyloidosis and a major cause of morbidity and mortality. Tuberculosis (TB) occurs up to 27 times more commonly in human immunodeficiency virus (HIV) infected patients and is also an important cause of renal amyloid; there are however no reports of renal amyloidosis in South Africa in the HIV era.

Methods: This was a retrospective record review of cases of amyloidosis diagnosed on renal biopsies at our tertiary referral hospital between January 1985 and December 2016.

Myocardial Ischemia and Anomalous Origin of the Right Coronary Artery From the Pulmonary Artery in the Adult: Management Implications and Follow-Up.

Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare and potentially fatal congenital heart defect due to myocardial ischemia secondary to coronary steal phenomenon. We present a case of an adult presenting with a myocardial infarction who was found to have ARCAPA. Three-dimensional (3D) reconstructed computed tomography angiography (CTA) was utilized preoperatively for surgical planning.

Ancient nuclear genomes enable repatriation of Indigenous human remains.

After European colonization, the ancestral remains of Indigenous people were often collected for scientific research or display in museum collections. For many decades, Indigenous people, including Native Americans and Aboriginal Australians, have fought for their return. However, many of these remains have no recorded provenance, making their repatriation very difficult or impossible.

Egg-and-Banana Sign: A Novel Diagnostic CT Marker for Pulmonary Hypertension.

Objective: The purpose of this study was to retrospectively determine whether the egg-and-banana sign, defined as the visualization of the main pulmonary artery (PA) at the level of the aortic arch, is a sensitive and specific diagnostic marker for pulmonary hypertension.

Materials And Methods: A total of 186 patients who, between January 2014 and July 2017, received right heart catheterizations and underwent CT studies that included the aortic arch within 140 days of catheterization were evaluated in this retrospective study. Of these patients, 127 had pulmonary hypertension (PH), and 59 who did not have PH served as control subjects.

Primary spontaneous pneumothorax in conjunction with Marfan syndrome.

A 25-year-old man with a history of Marfan syndrome, asthma and smoking presented with worsening dyspnoea and right-sided chest pain worsened with deep breathing after a fall 2 days prior. Diagnostic imaging revealed a spontaneous right-sided pneumothorax due to ruptured subpleural bullae in the apex of the right lung. Smaller subpleural bullae were also noted in the apex of the left lung.

The clinical relevance of repeat renal biopsies in the management of lupus nephritis: a South African experience.

Purpose Clinically, repeat renal biopsies (RRBs) have been performed in lupus nephritis to identify changes in class, plan treatment and assist in prognostication. We set out to compare the histopathological features and outcomes of disease flare and protocol biopsy patients. Methods A retrospective descriptive study was conducted on repeat biopsies performed between January 1984 and December 2015 in lupus nephritis patients.

Para-atrial non-acute mediastinal hematoma after left atrial maze procedure mimicking tumor in a patient with treated melanoma.

Introduction: The Cox Maze III procedure is considered the gold standard open surgical procedure for management of atrial fibrillation. This article outlines a unique case of a para-atrial mediastinal hematoma following a bilateral thoracoscopic left atrial Maze procedure mimicking malignancy.

Report: A 60-year-old male, with past history of melanoma, underwent bilateral thoracoscopic left atrial mini maze procedure with radiofrequency energy and exclusion of the left atrial appendage.

Lupus nephritis in the Western Cape, a high prevalence area: an experience over three decades.

Background Systemic lupus erythematosus is a multisystem disease with serious complications, including lupus nephritis. Systemic lupus erythematosus is prevalent in the Western Cape, predominantly affecting women in the prime of their lives. Renal biopsy is an important tool for the management of the lupus patient with kidney disease, guiding treatment and assessing prognosis.

Incidental finding of tracheal bronchus complicating the anesthetic management of a left video-assisted thoracoscopic procedure.

Congenital abnormalities of the large airways are uncommon, but may occasionally pose significant difficulties for anesthesiologists. The tracheal bronchus is an anatomical variant in which an accessory bronchus originates directly from the trachea rather than distal to the carina, as a takeoff from the right mainstem bronchus. Anesthesiologists should be aware of this uncommon anomaly, its different variants, and its management in order to successfully establish one lung ventilation (OLV) for surgical isolation.

The effects of acute waterborne exposure to sublethal concentrations of molybdenum on the stress response in rainbow trout, Oncorhynchus mykiss.

To determine if molybdenum (Mo) is a chemical stressor, fingerling and juvenile rainbow trout (Oncorhynchus mykiss) were exposed to waterborne sodium molybdate (0, 2, 20, or 1,000 mg l-1 of Mo) and components of the physiological (plasma cortisol, blood glucose, and hematocrit) and cellular (heat shock protein [hsp] 72, hsp73, and hsp90 in the liver, gills, heart, and erythrocytes and metallothionein [MT] in the liver and gills) stress responses were measured prior to initiation of exposure and at 8, 24, and 96 h. During the acute exposure, plasma cortisol, blood glucose, and hematocrit levels remained unchanged in all treatments. Heat shock protein 72 was not induced as a result of exposure and there were no detectable changes in total hsp70 (72 and 73), hsp90, and MT levels in any of the tissues relative to controls.