Complex treatment of dens invaginatus type III in maxillary lateral incisor

Abstract— The complex anatomy and diagnosis of dens invaginatus make endodontic treatment of such teeth difficult. This case describes combined nonsurgical and surgical treatment of a maxillary lateral incisor with a normally shaped canal and a dens invaginatus type III with a lateroradicular lesion. The root canal was treated conventionally with gutta-percha and a zinc oxide-eugenol sealer. The root was surgically exposed and the canal of the dens invaginatus was cleaned, instrumented and obturated with gutta-percha and a zinc oxide-eugenol sealer. At follow-up 3 years 6 months later, the tooth was asymptomatic and radiographically showed repair of the lesion in the region of the dens invaginatus.     

Radiotherapy of non-tumoral refractory neurological pathologies

Intracranial radiotherapy has been improved, primarily because of the development of stereotactic approaches. While intracranial stereotactic body radiotherapy is mainly indicated for treatment of benign or malignant tumors, this procedure is also effective in the management of other neurological pathologies; it is delivered using GammaKnife® and linear accelerators. Thus, brain arteriovenous malformations in patients who are likely to experience permanent neurological sequelae can be managed by single session intracranial stereotactic body radiotherapy, or radiosurgery, in specific situations, with an advantageous benefit/risk ratio. Radiosurgery can be recommended for patients with disabling symptoms, which are poorly controlled by medication, such as trigeminal neuralgia, and tremors, whether they are essential or secondary to Parkinson's disease. This literature review aims at defining the place of intracranial stereotactic body radiotherapy in the management of patients suffering from non-tumoral refractory neurological pathologies. It is clear that the multidisciplinary collaboration of experienced teams from Neurosurgery, Neurology, Neuroradiology, Radiation Oncology and Medical Physics is needed for the procedures using high precision radiotherapy techniques, which deliver high doses to locations near functional brain areas.     

西罗莫司治疗复杂性血管畸形的研究进展

血管畸形是一类良性先天性血管性病变的统称,可累及多个系统和脏器。复杂型血管畸形可以引起严重的并发症,导致毁形性损害、功能障碍甚至危及生命。西罗莫司是一种西罗莫司靶蛋白特异性抑制剂,常规应用于器官移植术后抗移植排斥反应。近年来将其用于治疗复杂性血管畸形取得良好疗效。目前报道,西罗莫司口服治疗最小年龄仅为14周龄,治疗的常用剂量为每天1.5～2 mg/m2,所有患者治疗总有效率为20%～80%。常见的生物学不良反应包括血液系统改变,代谢改变。少见且严重的不良反应为间质性肺炎和潜在性免疫抑制。目前研究显示,西罗莫司治疗复杂血管性疾病可能有非常好的前景,但尚需更多循证医学的证据支持。     

小血管硬化剂治疗应用进展

硬化剂疗法是一种治疗血管扩张的有效手段,其通过注射硬化剂使血管成为纤维条索,最终被周围组织吸收,以达到治疗血管异常曲张或美容的目的.硬化剂疗法是治疗皮内小静脉曲张,包括网状静脉曲张和毛细血管扩张的首选疗法,对低流量血管畸形的治疗也有较好疗效.硬化剂的种类、泡沫硬化剂的稳定性、注射方法等因素均会影响临床应用的效果.随着硬化剂在临床的广泛应用,硬化剂泡沫制作的不断改进,对部分硬化剂的使用浓度与剂量已达成了共识,一些关于硬化疗法的研究和影像等新兴技术的应用也使硬化剂疗法取得进展,使得对硬化疗法的有效性及安全性有了更深入的认识.     

颅内纯硬脑膜动静脉瘘的DSA分类与临床症状的相关性研究

目的：通过对１６例经ＤＳＡ证帝的纯硬服膜动一娄的血管造影表现进行描述及分类、临床症状的复习,探讨纯硬脑膜动静脉瘘的ＤＳＡ分类与是下状的相关性。材料与方法：文中１６例纯硬脑膜动静瘘均行双侧颈内、外动脉及椎动脉血管造影检查,通过对其他血管造影表现进行描述及分类,做ＤＳＡ分类与临床症状的对照分析。结果：１６例纯硬脑膜动脉瘘中,Ⅰ型９例,Ⅱ型４例,Ⅲ型２例,Ⅳ型１例。Ⅰ型的临床症状多为非侵袭性的良性表现,     

浅谈肛肠病手术后并发症的中医治疗方法

肛肠病手术不可避免地会出现一些并发症,增加患者的痛苦,并延长创面愈合。如术后疼痛、术后排尿困难、尿潴留、术后并发大出血等等。在此,本文将这几种最常见的并发症原因及中医治疗措施进行探讨。     

Survey of genetic counselors and clinical geneticists regarding recurrence risks for families with nonsyndromic cleft lip with or without cleft palate

Nonsyndromic cleft lip with or without cleft palate (CL/P) is a common congenital malformation affecting about 1/1,000 caucasian infants. Although the familial clustering of CL/P has been studied thoroughly, estimation of recurrence risk for genetic counseling purposes can be difficult. A survey was mailed to 912 board-certified genetic counselors, 542 non-board-certified genetic counselors, and 776 board-certified clinical geneticists to investigate the recurrence risks they would assign to three example families with CL/P. Responses were received from 155 (17%) board-certified genetic counselors, 36 (6.6%) non-board-certified genetic counselors, and 100 (18.5%) board-certified clinical geneticists. No major differences were found in their responses, suggesting that for these three families, geneticists would provide similar estimates of risk, regardless of their amount of experience with oral clefts patients, where they are currently employed, or their board certification status. Am. J. Med. Genet. 79:184–190, 1998. © 1998 Wiley-Liss, Inc.     

Development and developmental disorders of the human cerebellum

The human cerebellum develops over a long time, extending from the early embryonic period until the first postnatal years. This protracted development makes the cerebellum vulnerable to a broad spectrum of developmental disorders. The development of the cerebellum occurs in four basic steps: 1) characterization of the cerebellar territory at the midbrain-hindbrain boundary; 2) formation of two compartments for cell proliferation: first, the Purkinje cells and the deep cerebellar nuclei arise from the ventricular zone of the metencephalic alar plate; second, granule cell precursors are formed from a second compartment of proliferation, i. e. the upper rhombic lip; 3) inward migration of the granule cells: granule precursor cells form the external granular layer, from which (and continuing into the first postnatal year), granule cells migrate inwards to their definite position in the internal granular layer, and 4) formation of cerebellar circuitry and further differentiation. The precerebellar nuclei, i. e. the pontine nuclei and the inferior olive, arise from the lower rhombic lip. Developmental disorders of the cerebellum are often accompanied by malformations of the precerebellar nuclei. In this review the development of the cerebellum and some of its more frequent developmental disorders, such as the Dandy-Walker and related midline malformations, and the pontocerebellar hypoplasias, are discussed.