成人下凳骨第三磨牙阻生关系的研究

目的 观测成人下颌骨第三磨牙的阻生关系。方法 根据吴氏《人类骨骼测量方法》中规定的年龄估计及性别鉴定的标准,观测成人颌骨的形态结构。结果 302个下颌骨标本的观察结果为,男女混合阻生率为10.60％,女性阻生率高于男性,肉眼见无第三磨牙萌出者106例,经X线拍片验证,5例有埋没牙存在,故实际第三睡缺如率为33.44%。从测量数据可见阻生组（无第三磨牙组）的第二磨牙后间隙、下颌斜长、下颌体长及髁突间宽均较正常组小。结论 无第三磨牙可能是人类进化过程中,下颌骨与牙齿均衡退化的结果,而阻生是人类进化从有第三磨牙向第三磨牙演化的过渡阶段。     

Neonatal Myocardial Infarction: Case Report and Review of the Literature

Myocardial infarction in a neonate is rare. We describe the case of a full‐term male who presented with respiratory distress. A chest radiograph demonstrated cardiomegaly. An electrocardiogram revealed ST segment changes suggestive of ischemia. Cardiac enzymes were elevated and an echocardiogram revealed a regional wall motion abnormality. Cardiac catheterization was performed demonstrating occlusion of the ramus intermedius branch of the left main coronary artery. The patient decompensated, requiring extracorporeal membrane oxygenation (ECMO). The infant was able to be decannulated from ECMO support in 5 days and was ultimately discharged on hospital day 25. We review this case as well as the literature on neonatal myocardial infarction.     

Mandibular bone healing after advancement or setback surgery using sagittal split ramus osteotomy

Purpose

The purpose of this study was to compare mandibular bone healing after advancement or setback surgery using sagittal split ramus osteotomy (SSRO).

Acromegaly and sleep apnea: cephalometric evaluations

Lateral teleradiography is a standard and quick examination. It has enabled us to define differences as regards to the craniofacial morphology between 20 acromegalic patients and 20 control subjects. The height of the mandibular ramus (from the posterior condyle point to the gonion point) increases significantly with the acromegalic patient and the cranial base angle (basion-superior tuberculum sellae-M point) is more extended. As acromegalic patients are more subject to sleep apnea (30% prevailing), the relationship between the amount of sleep apnea and hypopnea (AHI) in an acromegalic patient and his bone, tissue and hormone factors has been researched, in order to act on the causes of sleep apnea. It has emerged that confronting craniofacial bones and soft tissues factors enables a good prediction of the apnea and hypopnea index. Of course, we can find again the potential action of growth hormone (GH) but only in fifth place in importance order. The tongue, which increases in volume with the GH impact, is in a too short “lingual enclosure” (reduced length of the mandibular horizontal branch).     

Pitfalls in comparison of coronary artery measurements of Indian population with different geographical area studies

IntroductionCoronary artery disease (CAD) is the most common cause of morbidity and mortality especially in the developing countries. Coronary artery measurements (CAM) are the most important factor affecting the procedure and outcome of coronary angioplasty (PCI) as well as coronary by-pass operations (CABG). In this study, we aimed to establish a database for the normal CAM as well as for gender difference among the Indian population using quantitative coronary angiography (QCA) with an objective of assessing normal coronary vessel morphology of patients with normal coronaries.Materials and methodsFour thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the pre-selected hospitals of four states in India. Informed consents were obtained. Post CABG, post PCI patients and patient being diabetic for ≥5 years were also excluded from the study.ResultsTen segments from right and left coronary arteries were taken for diameter measurements. These coronary diameters were indexed to body surface area (BSA) (mean diameter mm/m² BSA). Among, 4000 patients, 933(23.3%) [M:F-521:412] had normal coronaries and 3067 (76.7%) were diseased.Discussion and conclusionThe dimensions of the coronary artery segments of Indians were smaller (in BSA indexed and non-indexed data), compared to studies from other continents which can be due to their smaller BSA.     

The lumbosacral ligament (LSL), with special emphasis on the “lumbosacral tunnel” and the entrapment of the 5th lumbar nerve

Summary The lumbo-sacral ligament (LSL) was studied in 42 specimens. It extends from the L5 vertebra to the ala of the sacrum and forms, with the structures to which it is attached, an osteofibrotic tunnel as an extension of the intervertebral foramen. The 5th lumbar nerve root passes through the tunnel over the ala of the sacrum and behind the LSL. A branch of the 4th lumbar nerve root passes in front of the LSL to join the 5th below the ligament to form the lumbo-sacral trunk. The sympathetic ramus communicans to the L5 root always penetrates the LSL at its superior border and reaches the nerve inside the tunnel. Branches of the ilio-lumbar vessels accompany the L5 root. Large osteophytes on the inferior border of L5 and tightness of the LSL were often found to cause entrapment and compression of the L5 nerve root against the ala of the sacrum.

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Résumé Le ligament lombo-sacré (LSL) a été étudié sur 42 spécimens anatomiques. Il s'étend de la 5ème vertèbre lombaire à l'aileron sacré pour former, avec les structures auxquelles il se rattache, un canal ostéo-fibreux qui prolonge le trou de conjugaison correspondant. La 5ème racine lombaire traverse ce canal au-dessus de l'aileron sacré et en arrière du LSL. Un rameau anastomotique de la 4ème racine lombaire passe en avant du LSL et rejoint la 5ème racine lombaire pour former le tronc lombo-sacré. Le rameau sympathique communicant pénètre le bord supérieur du LSL pour s'unir au nerf à l'intérieur du canal. La 5ème racine lombaire est accompagnée par des branches des vaisseaux ilio-lombaires. Des ostéophytes développés à partir du bord inférieur de L5, de même que la tension du ligament sont assez souvent la cause de l'irritation et de la compression de la 5ème racine lombaire contre l'aileron sacré.

     

口内下颌升支矢状劈开截骨矫治偏颌畸形

目的 :探讨一种简便可行的治疗偏颌畸形的手术方法。方法 :选择下颌升支发育过长 ,上颌骨体及升支均发育过长、或者合并下颌前突的病人 36例 (将原有下颌升支矢状劈开截骨术之升支舌侧水平截骨线改成与牙合平面夹 30°～ 45°角的不同方向的斜行截骨线 )。劈开后旋转下颌骨达到左右对称。结果 :36例均为健侧正常 ,患侧发育过长或合并下颌前突的病例 ,施行双侧下颌升支矢状劈开截骨术 ,术后无并发症 ,X光片检查各项指标均在正常范围内 ,术后面形及颏的形态均令人满意。结论 :改进后的口内下颌升支矢状劈开截骨术是一种比较理想的矫治偏颌畸形的手术方法