涎腺肿块的细针吸取细胞学诊断研究

目的 通过对细针吸取细胞学(fine needle aspiration cytology,FNAC)与病理诊断的比较,评价本组细针吸取细胞学在涎腺肿块术前诊断的价值.方法 采用"友谊式"细针穿刺器,对81例涎腺肿块进行FNAC检查,将其结果与术后组织病理结果对照,得出FNAC诊断准确率,同时计算微小组织病理学诊断的准确率.结果 本组FNAC定性诊断准确率达92.59%,误诊率7.41%;组织学分类完全符合率达67.90%,基本符合率24.69%,不符合率7.41%;微小组织病理学诊断准确率达85.71%,误诊率14.29%.结论 FNAC对涎腺肿块的定性诊断的准确性较高,对术前诊断有重要的参考意义.由于FNAC诊断不同类型涎腺肿块的完全符合率不同,其临床可参考性也不同.     

116例口服颌面颈部肿块细针吸取细胞学诊断分析

研究细针吸取细胞学检查对口腔颌部肿块的诊断价值。方法运用“友谊式细地穿刺器”对１１６例口腔颌面部颈部肿块进行ＦＮＡＣ检查，将其结果与肿块术后病理组织学诊断结果对比。结果：ＦＮＡＣ检查定性诊断的准确率为９０．５２％，误诊率 为９．４８％，假阳性仅１例；ＦＮＡＣ检查所定肿块组织类型与病理组织学诊断结果完全一致者达５０％；     

116例口腔颌面颈部肿块细针吸取细胞学诊断分析

目的：研究细针吸取细胞学检查（ＦＮＡＣ）对口腔颌面颈部肿块的诊断价值。方法：运用“友谊式细针穿刺器”对１１６例口腔颌面颈部肿块进行ＦＮＡＣ检查，将其结果与肿块术后病理组织学诊断结果对比。结果：ＦＮＡＣ检查定性诊断的准确率为９０５２％，误诊率为９４８％，假阳性仅１例；ＦＮＡＣ检查所定肿块组织类型与病理组织学诊断结果完全一致者达５０％；ＦＮＡＣ检查后无１例并发症发生，至今未发现肿块转移与复发。结论：①“友谊式细针穿刺器”吸取细胞诊断口腔颌面颈部肿块，简便安全，实用快捷。②口腔颌面颈部肿块ＦＮＡＣ检查定性诊断的可靠性较高，在确定肿块具体类型方面，仅供参考。     

细针吸取细胞学检查对腮腺肿物的诊断价值

目的探讨细针吸取细胞学检查(FNAC)对腮腺肿物的诊断价值。方法回顾性分析2013—2016年首都医科大学附属北京友谊医院口腔科98例行FNAC的腮腺肿物的病历资料,以最终组织病理学诊断结果为金标准。计算FNAC对各腮腺肿物诊断的准确率,对非肿瘤性病变及恶性肿瘤诊断的灵敏度、特异度、阳性预测值及阴性预测值。结果 FNAC诊断腮腺肿物的准确率依次为:非肿瘤性病变(88.9%)>良性肿瘤(74.0%)>恶性肿瘤(56.3%);FNAC诊断非肿瘤性病变灵敏度:88.9%,特异度为:91.0%,阳性预测值:50.0%,阴性预测值:98.8%;FNAC诊断腮腺恶性肿瘤灵敏度:87.5%,特异度为:97.6%,阳性预测值:87.5%,阴性预测值:97.6%,假阳性病例为1例腮腺囊肿和1例多形性腺瘤,假阴性病例为2例恶性淋巴瘤误诊为沃辛瘤。结论 FNAC对腮腺非肿瘤性病变及良性肿瘤的诊断准确率高,恶性肿瘤的灵敏度特异度好,是一种有较好诊断价值的诊断手段,假阳性及假阴性病例,需要结合超声引导下穿刺、免疫组化及术中冰冻结果。     

右颌下栅状肌纤维母细胞瘤1例

栅状肌纤维母细胞瘤是一种罕见的疾病 ,我科收住 1例 ,现报告如下。患者 ,女 ,6岁 ,因右颌下无痛性包块 1个月于 2 0 0 2年 8月 2 6日入院。查体在右颌下扪及一 1 0cm× 2 0cm× 2 .0cm的活动性包块 ,界清 ,质中等 ,无压痛 ,口腔及全身检查未见异常 ,细针穿刺细胞学检查示“淋巴结炎”。以“右颌下慢性淋巴结炎”在静脉复合麻醉下行“淋巴结摘除术” ,术中见右颌下、胸锁乳突肌前缘及深面有大小不等淋巴结样包块 6枚 ,有鸽蛋至黄豆大小 ,包膜清楚与周围组织无黏连 ,切面呈实性 ,灰白及灰红色 ,质脆 ,手术切口 1期愈合 ,术后诊断 :恶性淋巴…     

细针穿吸细胞学检查在腮腺区肿块诊断中的价值

目的评价细针穿吸细胞学检查(FNAC)在腮腺区肿块诊断中的应用价值。方法应用细针穿吸方法,对121例腮腺区肿块患者进行细胞学检查,其中男性62例,女性59例;年龄5～95岁,平均年龄57.88岁。将细胞学检查结果与术后组织病理和随访资料进行比较研究。结果FNAC的定性诊断准确率为92.56%(112/121),诊断准确率为89.26%。肿瘤的敏感性为91.25%,特异性为100%;7例患者为假阴性,假阴性率为8.75%;良、恶性病变的敏感性为70.97%,特异性为100%;9例患者为假阴性,假阴性率为29.03%,无假阳性患者。无临床并发症。结论FNAC在腮腺区肿块的诊断中有重要作用,是一种经济、快速、安全、并发症少见和诊断准确率高的细胞学诊断手段。     

口腔颌面颈部恶性淋巴瘤46例临床分析

目的:回顾性分析口腔颌面颈部恶性淋巴瘤的流行病学状况、临床特点、常见误诊原因以及提高临床早期诊断的要点.方法:对46例经病理确诊的口腔颌面颈部恶性淋巴瘤的临床资料进行回顾性分析.结果:46例恶性淋巴瘤中非霍奇金淋巴瘤39例(84.8%),霍奇金淋巴瘤7例(15.2%).首发症状依次为无痛性包块、疼痛性包块、感染、溃疡.首发部位依次为颈部、颌下、颏下、口腔、腮腺区.不伴发全身症状者40例(87%).首诊诊断不明者38例(82.6%).1次病理诊断的确诊率为84.8%.治疗主要为手术 化疗.患者5年生存率58%.结论:结外型恶性淋巴瘤的临床表现呈多样化,容易被临床误诊.应提高对其认识,对高度怀疑为该病的患者应反复多次病检加免疫组化检查以明确诊断.     

下颌切迹入路细针穿吸细胞学检查在面侧深部肿物诊断中的应用价值

目的:评价经下颌切迹入路的细针穿吸细胞学检查(FNAC)在面侧深部肿物诊断中的应用价值。方法:应用细针穿吸方法,对40例面侧深部肿物患者进行细胞学检查。男24例,女16例;年龄3～75岁,平均年龄43.28岁。将细胞学检查结果与术后组织病理学检查结果或随访资料进行比较,计算FNAC诊断准确率及在区别肿瘤与非肿瘤、恶性肿瘤与良性病变上的敏感度和特异度。结果:FNAC诊断准确率为80.00%;诊断肿瘤与非肿瘤的敏感度为80.77%,特异度为100.00%,5例患者为假阴性,假阴性率为19.23%,假阳性率为0;诊断恶性肿瘤与良性病变的敏感度为80.00%,特异度为88.00%。3例患者为假阴性,假阴性率为20.00%,3例患者为假阳性,假阳性率为12.00%。结论:FNAC是一种安全性好,操作简单,患者易于接受的诊断方法,在不易做切除及切取活检的面侧深部肿物的定性诊断中有较高的准确率,能准确区别肿瘤与非肿瘤、恶性肿瘤与良性病变,为临床治疗提供依据。     

左侧颌后区巨大表皮样囊肿1例

荆门市第二人民医院口腔颌面外科于2006年10月30日收治左侧颌后区巨大表皮样囊肿患者1例,报告如下. 临床资料 患者,男,42岁,因左侧面颈部无痛性包块逐渐增大13年入院.现病史: 13年前发现左侧面后部1个黄豆大小包块,逐渐增大.近5年包块增大明显,影响面部及口腔功能.无家族史.常规检查未见异常.     

颈侧的恶性囊肿:是鳃裂癌还是转移癌

作者通过自己处理治疗的1例左颈部恶性囊肿病例,从诊断不明到最终作出诊断,而对Martin等提出的鳃裂癌(BCCA)的诊断标准进行分析讨论. 病例报告:1名58岁男性,左颈部二腹肌区有一3cm包块4个月,无痛、坚硬、可活动。患者不嗜烟、酒。既往史中值得注意的是在儿童期作过扁桃腺切除术。CT扫描显示包块为囊性,细针吸取活检为非典型     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

颌骨动静脉畸形的栓塞治疗

目的：总结直接穿刺结合经血管内介入栓塞治疗颌骨动静脉静脉畸形的经验。方法：收治凳骨动静脉畸形患者6例,均进行了介入栓塞治疗。采用的栓塞材料为附凝血棉纤毛的螺圈,聚乙烯醇泡沫微粒和二氰基丙烯酸对丁酯。数字减影颈动脉造影在PHILIPSV300下完成。结果6例颌骨动静脉畸形患者中4,例急性出血得到了快速、有效控制,1例慢性渗血的右下 骨动静脉畸形患者,介入栓塞治疗,拔除松动的右下凳第一磨牙,有效地控制了出血,另1例伴局部软组织搏动性膨隆的上凳骨动静脉畸形患者,介入治疗后膨隆的搏动性得到明显改善,栓塞治疗后分别随访3－24个月,均未发现有口腔内渗血或出血。随访的X线片上,病灶区可见新骨形成。结论：局部穿刺结合经血管内介入栓塞治疗颌骨动静畸形是一种安全、有效的治疗方法。     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

鼻测量法的进展

唇裂术后继发畸形是指唇裂修复术后,仍遗留或继发于手术操作和生长发育变化而表现出来的一类畸形[1]。包括唇畸形、鼻畸形和颌骨畸形。其修复较原发性唇裂修复更复杂,更灵活多变。而导致其修复复杂性的一个重要原因即是局部组织结构复杂变异和缺乏可靠的三维测量手段[2],鼻畸形