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Diagnostic Errors↗
Biomedical subjects
J Axler
Publications and source records attributed to J Axler.
Multiple familial gastrointestinal autonomic nerve tumors and small intestinal neuronal dysplasia.
Multiple small intestinal stromal tumors were removed from mother and natural daughter within 15 months of each other. Both had long histories of recurrent iron deficiency anemia and upper gastrointestinal bleeding. Light microscopy revealed that the tumors had arisen in conjunction with diffuse hyperplasia/ dysplasia of Auerbach's myenteric plexus. Immunohistochemistry generally did not show myogenic or paraganglionic phenotypes; CD34 was positive in most tumors. Electron microscopy confirmed the association with the abnormal Auerbach's plexus and showed the structure of gastrointestinal autonomic nerve tumors (GANTs). These findings provide information as to the origin and evolution of GANTs, and also have implications for the clinical management of these tumors which appear to occur more frequently than previously thought.
Aged↗
One-stage surgery with a nonsubmerged implant system.
Although nonsubmerged implant surgery can reduce patient trauma and costs by eliminating the uncovering procedure, one-piece implants cannot be shortened for esthetic results. However, a new implant design that comes preattached on a multipurpose collar is used for insertion, nonsubmerged healing, and as an abutment base. For submucosal margins, the collar can be replaced by an esthetic abutment that connects directly to the implant. Surface treatments include midsections roughened by hydroxyapatite or titanium plasma spray coatings, with smoother, acid-etched necks and self-tapping apical ends. Screw-retained, friction-fit abutments offer prosthodontic stability and uniformity, despite the submucosal implant type.
Dental Abutments↗
Breath pentane analysis as an index of lipid peroxidation: a functional test of vitamin E status.
Pentane, which evolves from the reaction involving omega-6 fatty acids, is a good index of lipid peroxidation. We describe a method for measuring breath pentane excretion in adult humans. After a 4-minute washout period, expired air was analyzed by gas chromatography. Breath was passed through a cooled loop of alumina to adsorb, concentrate, and release, on heating, pentane. Pentane was analyzed by a Porasil-D column with a derived calibration curve. The mean excretion of pentane in 10 normal adults was 6.34 +/- 0.96 pmol X kg-1 X min-1 (mean +/- SEM) and was significantly higher in five patients with plasma vitamin E deficiency (15.39 +/- 1.84 pmol X kg-1 X min-1). There was a significant negative correlation between pentane output and plasma vitamin E levels (r = -0.66, p less than 0.01). Moreover, breath pentane excretion was significantly decreased after a 10-d supplementation with vitamin E in five normal subjects. We conclude that breath pentane output is a sensitive, noninvasive, functional test for assessing vitamin E status.
Adult↗