Nd∶YAG激光防治根管治疗期间急症发生的效果分析

目的分析激光消毒根管,防治根管治疗期间急症(endodonticinterappointmentemergencies,EIAE)发生的效果。方法慢性根尖周炎、慢性牙髓炎、牙髓坏死患者189例,随机分为激光组94例和对照组95例。激光组用激光消毒根管后一次性完成根管治疗;对照组直接行一次性完成根管治疗。对激光防治EIAE的效果进行临床评估。结果EIAE的发生率激光组为9.6%,对照组为35.8%,两组比较差异有显著意义(P<0.01)。结论运用激光消毒根管能有效地预防和降低根管治疗期间急症的发生。     

Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix

The aim of our study was to determine the incidence, timing, and severity of vaginal stenosis in patients with carcinoma of the cervix who had received pelvic and/or vaginal radiotherapy as part of their treatment. We also sought to determine if there were any predisposing factors for the development of stenosis. A retrospective chart review was undertaken for all the patients diagnosed with carcinoma of the cervix between January 1, 1990, and December 31, 2000 and treated with pelvic and/or vaginal radiation at Westmead Hospital. Since January 1, 1990, data regarding vaginal stenosis has been prospectively recorded on all the patients. Data collected included patient demographics, stage of disease, treatments administered, and incidence, timing, and severity of vaginal stenosis. One hundred and eighty-eight patients were treated. Mean age was 58.6 years. Thirteen percent of patients had stage IB disease, 45% had stage II disease, 39.5% had stage III disease, and 1.5% had stage IV disease. One hundred and seventy-nine patients returned for follow-up, and data regarding vaginal toxicity were available in 98%. Twenty-seven percent had grade 1 toxicity (partial stenosis or shortening but not complete occlusion), and 11% had grade 2 (complete occlusion). Stenosis of any grade was noted at a mean of 9.6 months and median of 7.5 months (range, 26 days-5.6 years) from completion of treatment. The only prognostic factor associated with increased risk of stenosis was age greater than 50 years (odds ratio 2.26). Vaginal stenosis is a common complication of pelvic and vaginal radiotherapy, occurring in 38% of patients. Stenosis occurs most often in the first year after treatment. Patients over the age of 50 are most at risk.     

Precise and limited decompression for lumbar spinal stenosis

Summary Fifty-eight consecutive patients with lumbosacral nerve root entrapment due to spinal stenosis were treated with modified microsurgical decompression. Only the clinically relevant sides and levels were decompressed while the spinous processes, the interspinous ligaments, the medial portion of ligamentum flavum and the functionally important parts of the facet joints were preserved. The reviewers rated recovery as good or excellent in 71% of patients while patient self-assessment indicated 76% good or excellent outcome. These data suggest that microsurgical decompression of spondyloarthritic changes can effectively relieve the signs and symptoms of nerve root compression and that with careful evaluation of all available data the number of nerve roots requiring decomperession is often fewer than what is suggested by diagnositic images alone.     

The value of the acoustic analysis of pathological infant cry and breathing noise in everyday practice

During a period of twenty years [1969-1988] the author has observed 614 cases of congenital malformations and noninflammatory diseases of the larynx in infants and young children, Budapest. He summarizes the most characteristic symptoms of laryngeal pathology in infants, and discusses the diagnostic possibilities. Among the latter, spectrographic analyses complemented by auditory evaluation of pathological cry and different breathing noises play an important role. Based on his investigation author differentiates 20 kinds of pathological crying sounds and 4 basic forms of stridor. He describes the acoustic attributes of different pathological sound phenomena and summarizes characteristic voice changes.     

Smoking and hypertension: risk factors for carotid stenosis

Summary The prevalence of smoking, hypertension and diabetes mellitus was assessed in 221 patients suffering from internal carotid stenosis and compared with the prevalences in two sex- and age-matched control groups composed of subjects having normal Doppler findings and from non-neurological outpatients. Of the subjects with carotid stenosis 27.6% were hypertensive smokers in comparison with 9.5% and 17.2% in the two control groups. The difference of the stenosis cohort from the two control groups was significant (P<0.01 and P=0.016 respectively). There was no statistically significant differences between the occurrence of diabetes and hypertension in non-smokers and patients who smoked. In 394 investigated patients suffering from carotid stenosis or occlusion an obstruction index, based on the Doppler shift frequency, was calculated. This index was lowest in the normotentive non-smokers. It was only insignificantly higher in the hypertensive non-smokers but significantly so in the normotensive smokers. The index was highest in the hypertensive non-smokers. It was concluded that cigarette smoking, especially if associated with hypertension, is a determinant risk factor for carotid stenosis and occlusion.     

喉罩全麻在颈动脉狭窄造影及介入治疗术中的应用

目的：观察喉罩全麻下行颈动脉狭窄的造影诊断及介入治疗术的临床效果。方法：择期DSA下颈动脉狭窄患者23例，年龄42-78岁，无明显肺部疾患及喉罩禁忌症患者，异丙酚（Pmpofol）泵入静脉全麻下插入喉罩完成手术，观察其不同时段的BP（MAP）、SpO2、HR、ECG（ST-Ⅱ）。结果：各时段的BP（MAP）、Sp02、HR、ECG（ST-Ⅱ）比较无显著性差异。结论：喉罩全麻在行颈动脉狭窄的造影诊断及介入治疗术的临床效果是肯定的。喉罩全麻颈动脉狭窄造影介入治疗     

氢氧化钙预防根管治疗期间急症的临床观察

目的 观察氢氧化钙根管内封药对预防根管治疗期间急症的临床疗效。方法 使用氢氧化钙及传统根管内消毒药物樟脑对氯酚、甲醛甲酚根管内封药，观察疼痛指数并比较其根管治疗期间急症的发生率。结果 氢氧化钙封药后根管治疗期间急症的发生率最低，与传统药物相比，其差异有统计学意义。结论 氢氧化钙根管内封药。对预防根管治疗期间的急症有较好的作用。