三种测量技术应用于口腔正畸模型测量中的比较研究

目的 对应用于正畸治疗中的三种正畸模型测量技术进行可靠性对比研究,并分析三种方法的差异.方法 采用手工直接测量、数码近摄测量、三维激光扫描测量三种方法对100副牙颌模型上每个牙的牙冠近远中径分别测量,并将三种测量值进行统计学分析.结果 三种测量技术之间无显著性差异;但三维激光扫描测量方法具有其他两种测量方法所不具有的优点.结论 三种测量技术都可进行准确的模型测量,三维激光扫描技术因其具有的优点而有广泛的临床应用前景.     

Accuracy of three electronic apex locators in anterior and posterior teeth: an ex vivo study

Introduction

The aim of this study was to determine in anterior teeth, bicuspids, and molars (1) the accuracy of 3 different electronic apex locators (EALs) in detecting the apical foramen and (2) the accuracy of digital radiography in determining the working length (WL), compared with visible control under a microscope.

Methods

By using radiovideography (RVG), we measured the lengths of 120 root canals with 3 different EALs (Endex, ProPex II, and Root ZX) and compared them with the actual lengths. The accuracy of EALs and RVG was related to each dental category. An endodontic training kit (Pro-Train) was used during experimental procedures.

Results

Statistical analysis showed that the 3 EALs and RVG were less accurate in anterior teeth and molars than in bicuspids. The paired-sample t test showed no statistically significant difference between mesiodistal plane and buccolingual plane digital radiography in all groups.

Conclusions

The 3 EALs tested were more accurate in detecting the apical foramen in bicuspids than in both molars and anterior teeth. Radiographic measurements were not reliable for determining WL in all dental groups in both radiographic planes.     

Computed dental radiography system versus conventional dental X-ray films for detection of simulated proximal caries

The diagnostic accuracy of intraoral images obtained with a first generation Computed Dental Radiography (CDR) digital dental imaging system is compared with the diagnostic accuracy of conventional dental x-ray film images using a receiver operating characteristics (ROC) analysis. Fifteen dentition phantoms were constructed. Each contained 4 teeth, consisting of premolar and molar teeth with 6 proximal surfaces. Mechanical defects were created randomly on the proximal surfaces and plugged with dentine powder to simulate caries. Fifteen images of each modality were rated by nine dentists in separate sessions according to their confidence in their ability to detect the simulated caries. The images examined were as follows: original CDR images, CDR images magnified 2×, CDR images magnified 4 ×, Ektaspeed Plus dental x-ray film images, and Ultraspeed dental x-ray film images, both unmagnified and magnified 2 ×. A series of ROC curves indicated the limited usefulness of magnification for the CDR system, and consistently similar success in detecting simulated proximal caries for original CDR images and original film images. The magnification of original film images did not always promote greater success than that obtained with the original film images.     

The correlation of DIFOTI to clinical and radiographic images in Class II carious lesions

BACKGROUND: The authors conducted a study to evaluate the correlation between digital imaging fiber-optic transillumination (DIFOTI) (KaVo Dental, Lake Zurich, Ill.) and clinical and radiographic images in estimating the true clinical axial extension of Class II carious lesions. METHODS: The authors examined 51 Class II carious lesions visually, imaged them by means of DIFOTI and radiographed them with D-speed film and a complementary metal oxide silicon (CMOS)-based digital radiographic sensor. They validated axial extension of the lesions clinically. They compared the clinical and radiographic depths of the carious lesion with the size of the lesion on the DIFOTI images. RESULTS: The authors detected 84 percent of the lesions with DIFOTI, and 82 percent showed a visible dark shadow under the marginal ridge when examined clinically. DIFOTI correlated significantly with the clinical depth of decay (Pearson r = 0.43189). The combination of a CMOS digital sensor and DIFOTI (R2 = 0.7210) provided readings closer to the clinical measures than did the combination of D-speed film and DIFOTI (R2 = 0.6215). CONCLUSIONS: DIFOTI images correlated with clinical depth, especially in smaller lesions, and improved the estimation of lesion size when used in conjunction with the CMOS digital sensor and D-speed images. CLINICAL IMPLICATIONS: Using radiographs in combination with DIFOTI images could help clinicians determine the presence and, to some extent, the size of proximal caries, especially in smaller lesions.     

数字医疗在舰船外科的应用展望

信息技术和通信技术的发展推动着医疗信息技术蓬勃发展及数字化技术和应用软件的使用,促进了医疗的精准化、移动化、远程化.数字医疗在舰船外科的应用充满着巨大的潜能.本文主要分析了舰船外科及其目前面临的困难,并提出了运用数字医疗技术来解决舰船外科所面临的问题,提供一个促进我国舰船外科领域更加科学、快速发展的思考方向.     

Assessing Empathy in Anesthesia Residents with the Chinese Version of the Consultation and Relational Empathy: A Pilot Standardized Patient Program

Objectives To validate the reliability of the Chinese version of the Consultation and Relational Empathy (CARE) in physician-standardized patient (SP) encounter. We also tried to examine the agreement between video-based ratings and in-room ratings, as well as the agreement between the faculty ratings and SP ratings. Methods The CARE was translated into Chinese. Forty-eight anesthesia residents were recruited to make preoperative interview in SP-counter. Performance of each resident was graded by in-room raters, video raters and SP raters. Consistency between different raters was examined. Results The Chinese-CARE measure demonstrated high scale reliability with a Cronbach's alpha value of 0.95 and high consistency in the in-room ratings in intraclass correlation (coefficient=0.888, P<0.001). Despite a good consistency in intraclass correlation, video ratings were significantly higher than in-room ratings (39.6±7.1 vs. 24.0±10.0, P<0.001), and Wilcoxon signed-rank test indicated that the pass/fail rate was significantly higher based on video ratings than based on in-room ratings (45/48 vs. 22/48, P<0.001). SP ratings had a moderate consistency with in-room faculty ratings (coefficient=0.568, P<0.001), and there was no significant difference between the pass/fail rates based on the in-room ratings and SP ratings (22/48 vs. 28/48, P=0.12). Conclusions The Chinese-CARE measure is reliable in the assessment of empathy during preoperative anesthesia interview. In-room and video ratings are not equivalent, while SP may provide a feasible alternative for the faculty rater in the assessment of communication skills with an appropriate measure.     

三维路径图技术在支架辅助栓塞颅内宽颈动脉瘤中的应用

目的探讨三维路径图技术在支架辅助栓塞颅内宽颈动脉瘤治疗中的应用。方法回顾性分析利用三维路径图技术对10例颅内宽颈动脉瘤患者进行介入栓塞治疗的过程和效果。结果10例动脉瘤均成功栓塞,术后即刻栓塞结果按改良的Raymond分级：动脉瘤完全栓塞7例（Ⅰ级）,瘤颈残留2例（Ⅱ级）,瘤体显影1例（Ⅲ级）。术后随访1～6个月,临床无再出血,急性缺血1例表现为下肢单瘫。结论三维路径图技术具有实时跟踪、高清晰度和精确度等优势,对栓塞治疗起着重要的指导作用。     

数字化成形三维钛网在颅骨缺损修补手术中的应用

目的比较预塑球形钛网和数字化成形三维钛网修补颅骨缺损的临床效果,探讨数字化成形三维钛网在颅骨修补手术中的操作要点及应用价值。方法回顾性分析我院2001年8月至2009年1月155例采用预塑球形钛网行颅骨修补术的患者临床资料,与2009年2月至2013年3月83例采用数字化成形三维钛网行颅骨修补术的患者临床资料进行比较。结果手术时间:预塑钛网组(125±8)min,三维钛网组(98±6)min,预塑钛网组平均手术时间明显长于三维钛网组(P0.05);使用钛钉数量:预塑钛网组(11.8±1.5)个,三维钛网组(8.3±1.2)个,预塑钛网组平均使用钛钉数量明显多于三维钛网组(P0.05);外观满意度:预塑钛网组(7.30±0.21)分,三维钛网组(10.00±0.00)分,预塑钛网组外观满意度明显低于三维钛网组(P0.05);术后并发症:预塑钛网组共19例,发生率12.26%,三维钛网组共3例,发生率3.61%,预塑钛网组术后并发症明显高于三维钛网组(P0.05)。结论采用数字化成形三维钛网修补颅骨缺损具有手术时间短,使用钛钉数量少,外观满意度高,术后并发症少优点,是目前颅骨修补手术的首选材料,应该在临床推广应用。     

The sexual offender: Monster,victim, or everyman?

The nature of sexual offending is considered and it is concluded that offenders are more like other people than they are different. It is concluded that they are neither monsters nor victims and should, as a consequence, be treated like all other clients. Treatment implications are considered and it is suggested that we shift our focus away from a preoccupation with procedures and instead give attention to process features of treatment. Various therapist styles are discussed and it is proposed that a style that enhances the offender's self-esteem may be best. The value of this approach is outlined and tentative data are offered suggesting its value. Considerations for future developments are noted.Keynote address at the 14th Annual Research and Treatment Conference of the Association for the Treatment of Sexual Abusers, New Orleans, October 1995.