ORTHODONTIC CORRECTION OF COMPLETE TRANSPOSITION BETWEEN MAXILLARY CANINE & LATERAL INCISOR : A CASE REPORT

Transposition of maxillary teeth is not very uncommon nding in clinical practice and poses a challenge to the clinician. Maxillary canine is the most commonly involved tooth in transposition exchanging its place with either lateral incisor or rst premolar. This case report describes successful management of a case of transposition between maxillary canine and lateral incisor involving right side st only with an insight into etiology, treatment alternatives and treatment procedure. This case had been treated with extraction of all four 1 premolars and involved teeth were successfully moved to their clinically normal position without any signicant damage to supporting structures or roots.

Long term radiographic evaluation of a potentially impacted and dilacerated tooth into complete transposition

Background: Anomalies such as ectopic tooth eruption and transposition are challenging situations that may complicate the orthodontic treatment. Some of these anomalies can only be diagnosed and managed by accurate long-term radiographic examination. Delayed diagnosis could impede simple preventive orthodontic measurements and cause more costly and consuming future complicated orthodontic treatment.Case Description: We described in detail the long term follow-up of a young female patient referring with a unilateral ectopic eruption. The patient was under close observation and regular orthodontic treatment to guide a unilateral ectopic eruption into a complete transposition of an upper left canine and first premolar. The long term follow-up revealed stables results.Practical Implications: Early diagnosis and preventive measurements in patients suffering from anomalies such as ectopic eruption is crucial in order to avoid further complications such as tooth impaction and dilaceration formation and adopting the best choice of treatment.

Whipple procedure for ampulla of Vater cancer in a patient with situs inversus (clinical case)

A clinical case of a rare combination of complete transposition of internal organs (situs inversus totalis) with adenocarcinoma of the major duodenal papilla is presented. In addition to situs vicserum inversus, the patient has a special variant of vascular anatomy that is not included in the generally accepted classification of variants of arterial liver anatomy according to Michaels N.A. (1955), namely: separate separation of the left and right hepatic arteries from the ventral trunk. After individual preoperative planning, a patient with a complete reverse position of the abdominal organs and non-standard vascular anatomy was performed Whipple procedure. Non-invasive CT angiography is important in a complex preoperative examination, which allows timely identification and clarification of frequently occurring features of blood supply to the hepatopancreatoduodenal zone in patients with situs inversus totalis. Such surgical interventions should be performed in large multi-specialty medical centers that have extensive experience in performing pancreatoduodenal resections.

Mandibular lateral incisor-canine transposition: A case series

Dental transpositions are rare anomalies, which may present to the general dental practitioner or orthodontist. Transpositions occur less frequently in the mandible compared with the maxilla, with the most common mandibular transposition involving the mandibular lateral incisor and canine. The degree of displacement can vary from a relatively minor deviation to complete transposition of the mandibular lateral incisor with the adjacent canine tooth. Due to their highly visible position at the front of the mouth, treatment, ideally involving alignment of these teeth, is important for aesthetic, social and functional purposes. This case series reports six cases with mandibular lateral incisor-canine transposition. They demonstrate the variety in presentation and subsequent management of the ectopic teeth. The importance of early diagnosis in combination with interceptive treatment is discussed, to reduce the burden of potentially lengthy orthodontic treatment at a later date.

An Un-operated d-TGA Case Holding On To Life

Complete transposition of the great arteries is incompatible with life without corrective surgery in the neonatal period. Even in the presence of large intracardiac shunts, a case of un-operated d-TGA that survived to late adulthood is thought-provoking. We described a case of un-operated d-TGA presenting at 46 years of age who had large secundum type ASD, pulmonary hypertension, pulmonary artery aneurysm, situs inversus, mirror image dextrocardia and abnormal origin of the coronary artery. The management of an un-operated case of d-TGA surviving to late adulthood has made it important to share case-based experiences as there are no evidence-based data.

Pseudomonas putida group species serve as reservoirs of conjugative plasmids disseminating Tn402-like class 1 integrons carrying blaVIM-2 metallo-β-lactamase genes

ABSTRACTThe Pseudomonas putida group (P. putida G) is composed of at least 21 species associated to a wide range of environments, including the clinical setting. Here, we characterized 13 carbapenem-resistant P. putida G clinical isolates carrying blaVIM-2 from different hospitals of Argentina. Multilocus sequencing (MLSA) and phylogenetic analyses based on the 16S rDNA, gyrB and rpoD sequences comparison allowed us to assign them to 7 well-differentiated species. Sequencing analysis revealed that blaVIM-2 genes were carried in these isolates by three different class 1 integrons (In41, In899 and In528) embedded into Tn402-like transposons. Those harboring In41 and In899 were designated Tn6335 and Tn6336, respectively, with the former found among 10 isolates. Both encompassed complete transposition modules and inverted repeats boundaries characteristic of the Tn5053/Tn402 family, whereas the third, bearing In528, exhibited a defective tni module. Tn6335 and Tn6336 were located in conjugative pLD209-type plasmids in P. asiatica, P. juntendi, P. putida G/II, and P. putida G/V isolates, and could be mobilized to Escherichia coli and P. aeruginosa indicating a relevant mechanism of blaVIM-2 dissemination. In other P. asiatica and P. putida G/II isolates, Tn6335 was found inserted into the Tn21 subgroup transposons-res region, indicating capability for intragenomic mobilization and further dissemination associated to Tn3 family transposons. The Tn402-like defective element was also found inserted into the res region of another Tn3 family transposon in a P. monteilii isolate, but in an atypical orientation. Overall findings shed light on the mechanisms by which resistance genes move through environmental and opportunist Pseudomonas species.

Prenatal diagnosis of complete transposition of the great arteries and dextrocardia in the fetus with left juxtaposition of the atrial appendages and subpulmonary ventricular septal defect

The case of prenatal ultrasound diagnosis of complete transposition of the great arteries and dextrocardia in the fetus with left juxtaposition of the atrial appendages and subpulmonary ventricular septal defect in the third trimester is presented. The postnatal echocardiography confirmed the prenatal diagnosis. At 2 months of life, first surgical intervention under extracorporeal circulation was performed: the arterial switch operation and narrowing of the dilated pulmonary artery root, closure of patent foramen ovale, ligation of patent ductus arteriosus. At the age of 8 months, the child underwent a second operation: closure of ventricular septal defect with the transventricular approach and plastic surgery of the pulmonary artery. After an operation third-degree atrioventricular block (bradyarrhythmias) has occurred and 2 weeks later patient's health improvement was achieved, and he underwent implantation of a single-chamber pacemaker. Currently, the child is 2 years old, physical and mental development corresponds to age and he remains under the supervision of specialists.