The patent nasopalatine duct: a potential cause of unclear pain in the anterior maxilla

OBJECTIVE The aim of this report is to describe symptoms that can suggest the presence of a patent nasopalatine duct and to illustrate three cases. SUMMARY Patent nasopalatine ducts connecting the oral cavity with the nasal cavity are extremely rare. This malformation can be considered a developmental abnormality. Clinically, patent nasopalatine ducts appear as single or double spherical or oval apertures lateral or posterior to the incisive papilla. This type of anatomical malformation can be associated with an unclear pain sensation in the anterior maxillary region, which may be misinterpreted for example as toothache of endodontic origin. However, persisting nasopalatine ducts can also exist as an asymptomatic abnormality with no clinical sign of discomfort. Accordingly, understanding the differential diagnosis of a possible patent nasopalatine duct can prevent a general practitioner from performing unnecessary interventions, such as endodontic treatments, apical surgeries, or tooth extractions.

An meine lieben Berliner! Durch mein Einberufungs-Patent vom heutigen Tage habt Ihr das Pfand der treuen Gesinnung Eures Königs zu Euch und zum gesammten teutschen Vaterlande empfangen ...

Welsch (Projektbearbeiter): Darstellung der Geschehnisse des 18. März 1848 (Aufstand in Berlin und Barrikadenkämpfe gegen das Militär) aus der Sicht Friedrich Wilhelms IV. Aufruf zur Niederlegung der Barrikaden, Versprechen des Truppenrückzuges von den öffentlichen Straßen und Plätzen

Exaggerated pulmonary hypertension and right ventricular dysfunction in high-altitude dwellers with patent foramen ovale.

BACKGROUND There is considerable interindividual variability in pulmonary artery pressure among high-altitude (HA) dwellers, but the underlying mechanism is not known. At low altitude, a patent foramen ovale (PFO) is present in about 25% of the general population. Its prevalence is increased in clinical conditions associated with pulmonary hypertension and arterial hypoxemia, and it is thought to aggravate these problems. METHODS We searched for a PFO (transesophageal echocardiography) in healthy HA dwellers (n = 22) and patients with chronic mountain sickness (n = 35) at 3,600 m above sea level and studied its effects (transthoracic echocardiography) on right ventricular (RV) function, pulmonary artery pressure, and vascular resistance at rest and during mild exercise (50 W), an intervention designed to further increase pulmonary artery pressure. RESULTS The prevalence of PFO (32%) was similar to that reported in low-altitude populations and was not different in participants with and without chronic mountain sickness. Its presence was associated with RV enlargement at rest and an exaggerated increase in right-ventricular-to-right-atrial pressure gradient (25 ± 7 mm Hg vs 15 ± 9 mm Hg, P < .001) and a blunted increase in fractional area change of the right ventricle (3% [-1%, 5%] vs 7% [3%, 16%], P = .008) during mild exercise. CONCLUSIONS These findings show, we believe for the first time, that although the prevalence of PFO is not increased in HA dwellers, its presence appears to facilitate pulmonary vasoconstriction and RV dysfunction during a mild physical effort frequently associated with daily activity. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01182792; URL: www.clinicaltrials.gov.

Patent Foramen Ovale Closure in Obstructive Sleep Apnea Improves Blood Pressure and Cardiovascular Function.

UNLABELLED Obstructive sleep apnea (OSA) is a frequent syndrome characterized by intermittent hypoxemia and increased prevalence of arterial hypertension and cardiovascular morbidity. In OSA, the presence of patent foramen ovale (PFO) is associated with increased number of apneas and more severe oxygen desaturation. We hypothesized that PFO closure improves sleep-disordered breathing and, in turn, has favorable effects on vascular function and arterial blood pressure. In 40 consecutive patients with newly diagnosed OSA, we searched for PFO. After initial cardiovascular assessment, the 14 patients with PFO underwent initial device closure and the 26 without PFO served as control group. Conventional treatment for OSA was postponed for 3 months in both groups, and polysomnographic and cardiovascular examinations were repeated at the end of the follow-up period. PFO closure significantly improved the apnea-hypopnea index (ΔAHI -7.9±10.4 versus +4.7±13.1 events/h, P=0.0009, PFO closure versus control), the oxygen desaturation index (ΔODI -7.6±16.6 versus +7.6±17.0 events/h, P=0.01), and the number of patients with severe OSA decreased significantly after PFO closure (79% versus 21%, P=0.007). The following cardiovascular parameters improved significantly in the PFO closure group, although remained unchanged in controls: brachial artery flow-mediated vasodilation, carotid artery stiffness, nocturnal systolic and diastolic blood pressure (-7 mm Hg, P=0.009 and -3 mm Hg, P=0.04, respectively), blood pressure dipping, and left ventricular diastolic function. In conclusion, PFO closure in OSA patients improves sleep-disordered breathing and nocturnal oxygenation. This translates into an improvement of endothelial function and vascular stiffening, a decrease of nighttime blood pressure, restoration of the dipping pattern, and improvement of left ventricular diastolic function. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01780207.

Denkschrift über die Aufhebung des Gesetzes vom 13. Juli 1836, betreffend die bäuerliche Erbfolge in Westphalen: Nach dem Publikations-Patent vom 9. September 1814, durch welches das Allgemeine Landrecht in die mit dem Staat wieder vereinigten Provinzen eingeführt wurde ...

Welsch (Projektbearbeiter): Die Bevorzugung des Anerbenrechtes zuungunsten der Realteilung verstößt gegen den Grundsatz der staatsbürgerlichen Freiheit und Gleichheit. Da das fragliche Gesetz darüberhinaus - vorzugsweise von bäuerlicher Seite - abgelehnt wird, ist seine Aufhebung die natürliche Folge

Percutaneous closure of the patent foramen ovale, easy does it.

Closure of the patent foramen ovale does not benefit from echocardiographic guidance in the majority of cases. Guiding these procedures with fluoroscopy only reduces procedure time, radiation exposure, and amount of contrast medium. There is a clear trend to abandon echocardiographic guidance for this procedure over time and with growing experience.

Coastal Survey Maps: From Historical Documents to Digital Databases

This paper describes the spatial data handling procedures used to create a vector database of the Connecticut shoreline from Coastal Survey Maps. The appendix contains detailed information on how the procedures were implemented using Geographic Transformer Software 5 and ArcGIS 8.3. The project was a joint project of the Connecticut Department of Environmental Protection and the University of Connecticut Center for Geographic Information and Analysis.

Patent-Schnell-Darre

von J. Keidel

Patent, Daß zu Küstern Und Schulmeistern Auf dem platten Lande, Ausser Schneidern, Rademachern und Zimmerleuten, Sonst keine andere Handwercker angenommen werden sollen

[Fr. Wilhelm]

Patent und Declaration, Daß Die Bürger und Wirthe in denen Städten nicht schuldig seyn sollen, weder der Infanterie noch Cavallerie Das so genandte Sauer und Süß, oder Saltz, Pfeffer und Eßig ohnentgeldtlich zu reichen

[Fr. Wilhelm]

An meine lieben Berliner! : Durch mein Einberufungs-Patent vom heutigen Tage habt Ihr das Pfand der treuen Gesinnung Eures Königs zu Euch und zum gesammten teutschen Vaterlande empfangen ...

Welsch (Projektbearbeiter): Darstellung der Geschehnisse des 18. März 1848 (Aufstand in Berlin und Barrikadenkämpfe gegen das Militär) aus der Sicht Friedrich Wilhelms IV. Aufruf zur Niederlegung der Barrikaden, Versprechen des Truppenrückzuges von den öffentlichen Straßen und Plätzen

Availability of sequences of aquatic and terrestrial taxa in genetic databases (GenBank and BOLD - the Barcode of Life Database) in 2010, 2012 and 2016

Correct species identifications are of tremendous importance for invasion ecology, as mistakes could lead to misdirecting limited resources against harmless species or inaction against problematic ones. DNA barcoding is becoming a promising and reliable tool for species identifications, however the efficacy of such molecular taxonomy depends on gene region(s) that provide a unique sequence to differentiate among species and on availability of reference sequences in existing genetic databases. Here, we assembled a list of aquatic and terrestrial non-indigenous species (NIS) and checked two leading genetic databases for corresponding sequences of six genome regions used for DNA barcoding. The genetic databases were checked in 2010, 2012, and 2016. All four aquatic kingdoms (Animalia, Chromista, Plantae and Protozoa) were initially equally represented in the genetic databases, with 64, 65, 69, and 61% of NIS included, respectively. Sequences for terrestrial NIS were present at rates of 58 and 78% for Animalia and Plantae, respectively. Six years later, the number of sequences for aquatic NIS increased to 75, 75, 74, and 63% respectively, while those for terrestrial NIS increased to 74 and 88% respectively. Genetic databases are marginally better populated with sequences of terrestrial NIS of plants compared to aquatic NIS and terrestrial NIS of animals. The rate at which sequences are added to databases is not equal among taxa. Though some groups of NIS are not detectable at all based on available data - mostly aquatic ones - encouragingly, current availability of sequences of taxa with environmental and/or economic impact is relatively good and continues to increase with time.