Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit gr...Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit greenhouse gases and particles contributing to haze,and prevention by constructing fire-break canals to reduce fire spread into forest reserves is crucial.This paper aims to determine peat physical and chemical properties near a fire-break canal at different fire frequency areas.Peat sampling was conducted at two forest reserves in Malaysia which represent low fire frequency and high fire frequency areas.The results show that peat properties were not affected by the construction of a fire-break canal,however lignin and cellulose content increased significantly from the distance of the canal in both areas.The study concluded that fire frequency did not significantly influence peat properties except for porosity.The higher fibre content in the high frequency area did not influence moisture content nor the ability to regain moisture.Thus,fire frequency might contribute differently to changes in physical and chemical properties,hence management efforts to construct fire-break canals and restoration efforts should protect peatlands from further degradation.These findings will benefit future management and planning for forest reserves.展开更多
Middle-mesial canals in mandibular molars are present in the population depending on age, sex and ethnicity. However, limited literature alludes to its prevalence. Troughing procedures may enhance identification, clea...Middle-mesial canals in mandibular molars are present in the population depending on age, sex and ethnicity. However, limited literature alludes to its prevalence. Troughing procedures may enhance identification, cleaning and shaping. This case report expresses the recognition and management of middle-mesial canal in a mandibular second molar of 24 years old Hispanic-Latino male.展开更多
Objective: It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence(SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in...Objective: It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence(SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in SSCD patients compared to a control group.Methods: This was a prospective case-control study performed in a tertiary referral center, university teaching hospital in the UK. It included all new patients with SSCD seen in a dedicated skull base clinic over a 5-year period(2015-2019) compared to a gender and age matched control group. The main outcome of the study was adjusted calcium and Vitamin D levels between the two groups.Results: A total of 31 SSCD patients were recruited with a matched number of control patients. The mean Vitamin D level on the SSCD group was 44.8 nmoL/l(SD: 20.8) compared to 47.5 nmoL/l(SD: 27.4) on the control group(p = 0.702). Mean Adjusted calcium level was 2.34 mmoL/l(SD: 0.7) for SSCD compared to2.41 mmoL/l(SD: 0.11) for controls(p = 0.01), being within normal limits for both the SSCD and the control group.Conclusion: Our study did not identify a link between Vitamin D levels and presence of SSCD. Normal adjusted calcium values were found in both groups. Despite that a statistically significant lower calcium level was found in the SSCD group which could indicate that suboptimal levels of calcium may affect the micro-environment of the otic capsule at the SSC region.展开更多
Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evi...Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.Results:A total of 168 patients were included,of which 118 had imaging-confirmed SSCD.On univariate analysis significant predictors of SSCD presence were:sound/pressure-induced vertigo(p?0.006),disequilibrium(p?0.008),hyperacusis(p?0.008),and autophony(p?0.034).Multivariate analysis enabled a 14-point symptom-weighted tool to be developed,wherein a score of6 raised the suspicion of SSCD(70%likelihood of being present),R2?0.853.Conclusions:The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation.Using the evidenced-based diagnostic tool validated herein,a score6 with any symptom combination justifies ordering a CT scan.展开更多
Nodular fasciitis is a benign reactive soft tissue tumor arising from fibroblasts and myofibroblasts.Its incidence is low and misdiagnosis is frequent especially for malignant lesions.This can lead to inappropriate an...Nodular fasciitis is a benign reactive soft tissue tumor arising from fibroblasts and myofibroblasts.Its incidence is low and misdiagnosis is frequent especially for malignant lesions.This can lead to inappropriate and unnecessary invasive treatment.Nodular fasciitis of the external auditory canal is extremely rare.So far,around fifteen cases have been reported.We present here the case of a 90-year-old patient with nodular fasciitis of the right external auditory canal.The lesion extends anteriorly for 6.5 cm and reaches the posterior wall of the maxillary sinus.To our knowledge,this is the first case in the literature of an external auditory canal nodular fasciitis presenting as an inflammatory ear polyp with such a wide extension.展开更多
BACKGROUND Epithelioid trophoblastic tumor(ETT) is the rarest type of gestational trophoblastic tumor(GTT). It has been reported that more than 50% of ETTs arise in the uterine cervix or the lower uterine segment. Her...BACKGROUND Epithelioid trophoblastic tumor(ETT) is the rarest type of gestational trophoblastic tumor(GTT). It has been reported that more than 50% of ETTs arise in the uterine cervix or the lower uterine segment. Here, we report a case of ETT within the lower uterine segment and cervical canal and discuss its manifestations,possible causes, and related influencing factors.CASE SUMMARY A 35-year-old woman(gravida 7, miscarriage 3, induction 2 with 1 being twins,para 2 of cesarean section, live 2), who had amenorrhea for 9 mo after breastfeeding for 22 mo after the last cesarean section, was diagnosed with ETT. The lesion was present in the lower uterine segment and endocervical canal with severe involvement of the anterior wall of the lower uterine segment and the front wall of the lower uterine segment where the cesarean incisions were made.Laboratory tests showed slight elevation of serum beta-human chorionic gonadotropin. Intraoperative exploration showed the presence of a normal-sized uterus body with an enlarged tumor in the lower uterine segment. The surface of the lower uterine segment was light blue, the entire lesion was approximately about 8cm × 8 cm × 9 cm, with compression and displacement of the surrounding tissue.Histological examination diagnosed ETT. Immunohistochemical analysis showed positive expression of p63, with a Ki-67 proliferation index of 40%.CONCLUSION A search of the PubMed database using the search terms "cesarean section" and "epithelioid trophoblastic tumor" retrieved nine articles, including 13 cases of ETT and ETT-related lesions, all 13 cases had a history of cesarean section, and the lesions were all located at the cesarean section incision on the anterior wall of the lower uterine segment. The present case is the 14th reported case of ETT after cesarean section. Therefore, we deduced that cesarean section trauma had an important effect on the occurrence of ETT at this site.展开更多
BACKGROUND Prevotella oris-induced meningitis and Prevotella oris-induced meningitis concomitant with spinal canal infection are extremely rare.To the best of our knowledge,only 1 case of Prevotella oris-induced centr...BACKGROUND Prevotella oris-induced meningitis and Prevotella oris-induced meningitis concomitant with spinal canal infection are extremely rare.To the best of our knowledge,only 1 case of Prevotella oris-induced central system infection has been reported.This is the second report on meningitis combined with spinal canal infection due to Prevotella oris.CASE SUMMARY We report a case of a 9-year-old boy suffering from meningitis and spinal canal infection.The patient presented to the neurosurgery department with lumbosacral pain for 1 mo and headache and vomiting for 1 d.He had been treated with cephalosporin and nonsteroidal anti-inflammatory drugs for fever,otalgia and pharyngalgia in a local hospital 2 mo prior to this admission.During hospitalization,magnetic resonance imaging suggested meningitis and L3-S1 lumbosacral dural sac infection.The cerebrospinal fluid and blood cultures were negative,but the cerebrospinal fluid specimen indicated the presence of Prevotella oris by metagenomic next-generation sequencing.Previous cases of Prevotella oris infection were retrieved from PubMed to characterize the clinicopathological features and identify the prognostic factors and related antimicrobial treatment of infection due to Prevotella oris.CONCLUSION This report shed light on the characteristics of Prevotella oris infection and highlighted the role of metagenomic next-generation sequencing in pathogen detection.展开更多
Background: The aim was to evaluate the nonsurgical Root Canal Treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treat...Background: The aim was to evaluate the nonsurgical Root Canal Treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treated by undergraduates at the University of Caxias do Sul School of Dentistry (UCS-SD), Brazil, between 2019 and 2021. Materials and Methods: Data from the endodontically treated cases were retrieved, and the patients were recalled for a follow-up appointment at the university. The endodontic diagnosis, radiographs, and the presence of definitive restorations were analyzed in the clinical records. During the follow-up appointment, endodontically treated teeth were classified as present or absent. The nRCT was classified as successful (complete or incomplete healing) or failure (uncertain or unsatisfactory healing). Coronal restoration was classified as absent or present. When it was present, it was classified as permanent or temporary, and its quality as adequate or inadequate restoration. The results were presented as percentages. Results: A total of 257 teeth were endodontically treated. The most prevalent diagnosis was Chronic Apical Periodontitis (33.33%) and the most commonly treated teeth were premolars (46.15%). A total of 52 (21%) treated teeth were clinically and radiographically reexamined. The success rate for the nRCT was 98.08%. About 61.54% of this sample had a definitive composite resin restoration. Conclusion: The nRCT success rate was high. Special attention should be given to the presence and quality of the definitive restoration. Clinical Implications: There was no statistically significant impact between the coronal restoration and the nRCT success (P > 0.05).展开更多
Objective:To analyze the correlation between the amplitude changes of motor evoked potential(MEP),the 3D volume changes of spinal canal measuring by postoperative CT and the improvement rate of clinical symptoms after...Objective:To analyze the correlation between the amplitude changes of motor evoked potential(MEP),the 3D volume changes of spinal canal measuring by postoperative CT and the improvement rate of clinical symptoms after the spinal canal decompression in minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF),and to explore the predictive value of the changes of both MEP amplitude and spinal canal volume in the assessment of long-term clinical prognosis in MIS-TLIF.Methods:A retrospective study of 68 patients with L4/5 spinal stenosis treated with MIS-TLIF was performed.The changes of both intraoperative MEP amplitude and 3D spinal canal volume during the spinal canal decompression,as well as the visual analogue scale(VAS)and Oswestry dysfunction index(ODI)scores in the long-term follow-up were all recorded.Results:The values of intraoperative MEP amplitude was 159.04%higher in 68 patients with MIS-TLIF after spinal canal decompression(P<0.01).The 3 postoperative 3D spinal canal volume(4.89±1.27)cm increased by 31.22%in comparison 3 with preoperative date(3.78±1.08)cm(P<0.01).The VAS and ODI scores were improved to 78.55%and 80.60%,respectively at the last follow-up(P<0.01).The improvement rate of MEP amplitude on the decompression side was positively correlated with the improvement rate of postoperative spinal canal volume(r=0.272,P=0.025).The improvement rate of postoperative spinal canal volume was positively correlated with the improvement rate of VAS and ODI at the last follow-up(r=0.656,r=0.490,P<0.01).Moreover,the improvement rate of MEP amplitude on the decompression side was also positively correlated with the improvement rate of VAS and ODI at the last follow-up(r=0.322 and 0.235,respectively,P<0.05).Conclusion:The increase of MEP amplitude after spinal canal decompression in patients with lumbar spinal stenosis treated by MIS-TLIF was closely correlated with both of the increase of spinal canal volume and the improvement of clinical symptoms.Therefore,MEP amplitude monitoring was not only the one of the important monitoring methods for predicting the prognosis of MIS-TLIF but also the reliably predictive value in the long-term clinical prognosis in MIS-TLIF.展开更多
Guided by the ternary leadership theory from the perspective of social psychology,this paper explores the impacts of authoritarian,benevolent,and moral leadership on the top design of the Grand Canal of China in terms...Guided by the ternary leadership theory from the perspective of social psychology,this paper explores the impacts of authoritarian,benevolent,and moral leadership on the top design of the Grand Canal of China in terms of its water management practice,while providing reference for resolving the“Matteo Ricci Puzzle”.The research findings are threefold:first,authoritarian as it is,the central government of China formulates relevant laws and regulations to provide legal system insurance for the construction of the Grand Canal Cultural Belt,thus providing the blueprint for constructing the“bright cultural belt,green ecological belt and colorful tourism belt of the Grand Canal”.Second,led by the Central Government,sticking to benevolent and moral leadership,China advocates scientific water management concepts and methods,and gives long-term and comprehensive care to the well-being of the people along the banks of the Grand Canal.Finally,the top-level design of the Grand Canal of China is based on the ternary leadership theory rooted in social psychology and has formulated a set of properly-scheduled,reasonably-coordinated,and flexibly-operated management system for the fundamental interests of the people and long-term goals of the country.展开更多
The opening of the Panama Canal in 1913 increased the availability of internationally traded goods and transformed ocean-shipping by shortening travel time between the Atlantic Ocean and Pacific Ocean. The canal spark...The opening of the Panama Canal in 1913 increased the availability of internationally traded goods and transformed ocean-shipping by shortening travel time between the Atlantic Ocean and Pacific Ocean. The canal sparked the growth of port authorities and increased ship tonnage on both coasts of Panama. Since the construction of the Panama Canal, in the 1910s, pesticides, herbicides and chemicals, including arsenic, have been essential for controlling wetland vegetation, including hyacinth, which blocked rivers, lakes, and the canal as well as managing mosquitoes. Pesticides and chemicals flowed into Lake Gatun (reservoir) either attached to sediment or in solution during the monsoon season. Lake Gatun was the drinking water source for most of the people living in the Panama Canal Zone. The United States military base commanders had the ability to order and use cacodylic acid (arsenic based) from the Naval Depot Supply Federal and Stock Catalog and the later Federal Supply Catalog on the military base grounds in the Panama Canal Zone. Cacodylic acid was shipped to Panama Canal Zone ports, including Balboa and Cristobal, and distributed to the military bases by rail or truck. The objective of this study is to determine the fate of arsenic: 1) applied between 1914 and 1935 to Panama Canal shipping lane hyacinth and other wetland vegetation and 2) cacodylic acid (arsenic) sprayed from 1948 to 1999 on the US military base grounds in the Panama Canal Zone.展开更多
Introduction: Gout is defined as an arthritic condition resulting from the deposition of monosodium urate crystals in and/or around joints, following long-standing hyperuricemia. This may cause gouty arthritis in join...Introduction: Gout is defined as an arthritic condition resulting from the deposition of monosodium urate crystals in and/or around joints, following long-standing hyperuricemia. This may cause gouty arthritis in joints and tophi in soft tissues. Spinal gout is rare and never mentioned in our context. It can appear as acute back pain, radiculopathy, spinal cord compression, spondylodiscitis or neoplasic/infectious epiduritis. Our aim was to share our surgical experience and proceed of a Literature review. Cases Presentation: Between January and August 2022, two patients male were surgically cared, aged of 42 and 60 years old. The gout was unknown in the youngest and poorly followed in the eldest. There was no past medical history of tuberculosis or immunodeficiency in both. The early diagnosis retained was unspecific lumbar spondylodiscitis due to clinical features: Patients complained both of lower back pain with initial fever. It was of a progressive left L5S1 deficit with erectile defect and dysuria in the first case and a progressive paraplegia without sphincter disorders in the second case. We proceeded with a lumbar laminectomy with a biopsy on both patients. The spinal tophus was ligamentous in one case and arthro-ligamentous in the other. There was a progressive motor recovery from postoperative Day-2 till postoperative Month-1. A probabilistic antituberculosis treatment was promptly initiated postoperatively based on radioclinic features while waiting for histologic proof. The Polymerase Chain Reaction (PCR) of Mycobacterium tuberculosis was negative and the histology was of a chronic calcified osteitis with dense fibrosis in both. The anti-gout treatment was implemented after 15 days with blood test evidence. A rheumatologic follow-up was also initiated and adjuvant physio-therapy. The results were very satisfactory from 4 - 6 months with independent walking. Discussion Conclusion: Spinal Gout may be suggested in 40-male-old faced with any acute rachialgia with neuro deficit with dubious neuro-imaging.展开更多
The 84 km Panama Canal connecting the Atlantic and Pacific oceans has historically been a strategic waterway for shipping and the location of United States (US) military bases. Since the construction of Lake Gatun res...The 84 km Panama Canal connecting the Atlantic and Pacific oceans has historically been a strategic waterway for shipping and the location of United States (US) military bases. Since the construction of Lake Gatun reservoir, canal locks and navigation channel through the Isthmus of Panama tropical forests in the 1910s, chemicals, pesticides, and herbicides have been essential for controlling upland and wetland vegetation as well as managing mosquito-borne diseases. Chemicals and pesticides flowed into Lake Gatun via land surface runoff and subsurface drainage either attached to the sediment or in solution during the rainy season. Lake Gatun and the Panama Canal was the drinking water source for most of the civilian and military population living in the Panama Canal Zone. Between 1948 and 1999, US military base commanders had the ability to order, from the Federal Supply Catalog, commercially available herbicide 2,4,5-T with unknown amounts of dioxin TCDD for use on the military base grounds in the Panama Canal Zone. The herbicide 2,4,5-T was transported to Panama Canal Zone ports, including the ports Cristobal on the Caribbean and Balboa on the Pacific, and distributed to the US military bases in Panama by rail or truck. The US National Toxicology Program and the International Agency for the Research on Cancer listed dioxin and TCDD as known human carcinogens. Dioxins are endocrine disrupters and can cause certain chloracne, cancers, developmental and reproductive effects. In 1985, the United States government banned the manufacture of the herbicide 2,4,5-T, with unknown amounts of dioxin TCDD, after it was shown to cause cancer in animals. The objectives of this study are to determine: 1) the fate of dioxin TCDD, a contaminant in the herbicide 2,4,5-T, sprayed on the US military base vegetation in the Panama Canal Zone from 1948 to 1999, 2) the transport of dioxin TCDD rich sediment via soil erosion and overland flow into Lake Gatun and Panama Canal waterways and 3) the human health impacts of dioxin TCDD, a known carcinogen, on US military and Panamanian civilians exposed to dioxin TCDD in the Panama Canal Zone.展开更多
Background: For decades, traditional open surgical techniques were used to treat lumbar disc herniation and lumbar canal stenosis (LCS). However, seeking for better outcomes for patients and avoiding extensive bony lo...Background: For decades, traditional open surgical techniques were used to treat lumbar disc herniation and lumbar canal stenosis (LCS). However, seeking for better outcomes for patients and avoiding extensive bony loss with its sequences had raised minimally invasive technique for treating these disorders as an alternative surgery. Methods: This is a retrospective study in which 54 patients of LCS were operated upon via unilateral minimally invasive technique to decompress the canal in a 360 degrees fashion through laminotomy, deroofing of opposite laminar side, sublaminar ligamintectomy, bilateral foraminotomies and discectomy. We used VAS scores and ODI to assess clinical outcomes with a period of one year follow-up. Results: Our results demonstrated that minimally invasive techniques for treating these disorders are effective procedures. Minimally invasive 360 degrees decompression for treating LCS had better outcomes regarding postoperative back pain, smaller incisions, less bony loss and early ambulation. Conclusion: Minimally invasive techniques for treating lumbar canal stenosis of different causes could be considered a better option instead of traditional full laminectomy with better outcomes as regards respecting the anatomical layers such as posterior spinal integrity and musculature, postoperative pain, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods.展开更多
Neurofibroma is a benign tumor of the connective tissue of the peripheral nerves, developed mainly at the endoneurium. The most common localizations are the extremities of the limbs and the head and neck region. Neuro...Neurofibroma is a benign tumor of the connective tissue of the peripheral nerves, developed mainly at the endoneurium. The most common localizations are the extremities of the limbs and the head and neck region. Neurofibromas are often associated with neurofibromatosis type 1. An isolated localization in the auditory canal is exceptional. We report the case of a 45-year-old female patient presenting with a neurofibroma of the auditory canal which had previously caused hearing loss. Examination revealed a tissue mass firm, painless and covered with normal skin obstructing the external auditory canal. The patient’s skin examination revealed no café-au-lait spots. A CT scan of the ear showed a hypodense tissue mass. Surgical removal via the ear canal gave good results. In conclusion, an isolated neurofibroma of the external auditory canal is a rare benign tumor with a good prognosis. The surgical approach depends on the exact location of the mass and the surgeon’s experience.展开更多
BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars loca...BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars located at the end of the dental arch.However,advancements in digital dental diagnosis and treatment techniques can solve these problems.Here,we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel“inlay-guided endodontics”technique based on improved computer-generated programs.CASE SUMMARY A 63-year-old man complained of a defect in the maxillary left second molar.The tooth,diagnosed with post-treatment endodontic disease,was initially treated by conventional methods,which were ineffective.Our“inlay-guided endodontics”technique was subsequently adopted,with the establishment of a precise integrated three-dimensional(3D)plate model of cone-beam computed tomography data and a digital impression of the dentition.An optimal root canal approach was generated for the“virtual file”in the 3D model.The plate data were imported into a 3D printer and printed.With the help of the guide plate,the file was accurately placed into the cervical third of the distal root canal.The root canal and prosthodontic treatments successfully proceeded subsequently.CONCLUSION Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.展开更多
The aim of this study was to investigate the root canal configuration, accessory canals and number of main foramina of 123 maxillary second molars by means of micro-computed tomography. The teeth were scanned and repr...The aim of this study was to investigate the root canal configuration, accessory canals and number of main foramina of 123 maxillary second molars by means of micro-computed tomography. The teeth were scanned and reproduced with 3D software imaging. The root canal configuration and number of main foramina were evaluated by means of a four-digit system. The morphological complexity of human maxillary second molars is depicted by the number of accessory and connecting canals. The most frequently observed root canal configurations in the mesiobuccal root were 2-2-2/2(19.5%), 2-2-1/1(14.6%) and 2-1-1/1(13.0%). A 1-1-1/1 configuration was observed in 93.5% and in 96.7% in the distobuccal and palatal roots, respectively. The MB1 root canal had one accessory canal(18.7%), and 8.9% of the MB2 root canal had one or two accessory canals. The distobuccal(11.3%) and palatal(14.6%) root canals had at least one accessory canal, and connecting canals were observed in16.3% of mesiobuccal roots. The MB1, MB2, distobuccal and palatal root canals had one main foramen in 99.2%, 43.1%,98.4% and 99.2% of samples, respectively. In the mesiobuccal root, one accessory foramen was detected in 14.6%, two were detected in 7.3%, and three were detected in 5.7%. The distobuccal root showed one or two accessory foramina in 9.1% of samples. The root canal configuration of maxillary second molars is quite heterogeneous; the mesiobuccal root has predominantly two root canal entrances(58.4%, 1 in 41.1%) with one main foramen(54.4%). Two main foramina were observed in 43.0%. Morphological variations, connecting and accessory canals were observed in all apical thirds.展开更多
Acquired atresia of the external auditory canal(EAC)is a rare cause of conductive hearing loss.It has been traditionally classified into 4 categories:traumatic,post-operative,neoplastic and inflammatory.Post-inflammat...Acquired atresia of the external auditory canal(EAC)is a rare cause of conductive hearing loss.It has been traditionally classified into 4 categories:traumatic,post-operative,neoplastic and inflammatory.Post-inflammatory acquired auditory canal atresia is thought to be the result of chronic and repetitive infectious bouts affecting the auditory canal.Nevertheless,the underlying pathophysiology of this disorder is yet to be fully elucidated.Current data fail to clearly state the impact that certain underlying systemic disorders may have on the EAC.The possible association to metabolic disturbances such as iron deficiency is also emphasized.In the light of these findings,this analysis can be used to improve the classification of this entity thereby standardizing the assessment of therapeutic approaches.展开更多
AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients wit...AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients with medically uncontrolled OAG. All the patients underwent modified viscocanalostomy with injection of viscoelastic material in the surgically created ostia of Schlemm's canal(SC). The modifications included peeling of the inner wall of SC and the juxtacanalicular meshwork, use of mitomycin C, and loosely suturing the superficial scleral flap. Intraocular pressure(IOP), visual acuity, number of medications, laser goniopuncture data and complications were recorded. The definition of complete(qualified) success was an IOP equal to or lower than 21, 18, 16 mm Hg without(with or without) anti-glaucoma medications. RESULTS: The mean IOP was 33.5±9.9 mm Hg before surgery, 15.2±3.6 mm Hg(mean IOP reduction of 51%) at 5 y after surgery, and 15.6±2.8 mm Hg(mean IOP reduction of 49.9%) at 10 y after surgery(P<0.001). The number of anti-glaucoma medications dropped from 2.39±0.5 preoperatively to 0.47±0.8 at 5 y and 0.67±0.8 at 10 y postoperatively(P<0.001). The follow-up period was 104.5±37.0 mo. The qualified success rate for an IOP of 21, 18 or 16 mm Hg or less was 84% [95% confidence interval(CI): 0.80-0.88], 73%(95%CI: 0.68-0.78), and 59%(95%CI: 0.52-0.66) after 5 y, and 80%(95%CI: 0.76-0.84), 69%(95%CI: 0.64-0.74), 51%(95%CI: 0.44-0.58) after 10 y, respectively. There was a relationship between age, preoperative IOP and success rate(P<0.01, P<0.05). A total of 31 eyes(31.3%)in 31 patients underwent laser goniopuncture, decreasing the IOP from 22.9±4.3 mm Hg to 16.3±2.5 mm Hg(P<0.01). Neither blebitis nor endophthalmitis occurred.CONCLUSION: Modified viscocanalostomy could be performed to lower IOP, decrease multiple anti-glaucoma drops use as well. It's a safe procedure with less complications over 10 y in Chinese individuals with OAG.展开更多
BACKGROUND The presence of dens invaginatus(DI)complicates treatment of any tooth,from diagnosis to access cavity and biomechanical preparation and obturation.Reports of successful non-surgical management of DI type I...BACKGROUND The presence of dens invaginatus(DI)complicates treatment of any tooth,from diagnosis to access cavity and biomechanical preparation and obturation.Reports of successful non-surgical management of DI type IIIB in maxillary lateral incisor are rare.Here,we report such a case,with three root canals and a long follow-up.CASE SUMMARY A 13-year-old female patient presented with mild pain in the maxillary right lateral incisor(#7)for 10-15 d.On examination,the tooth was slightly rotated,with slight tenderness on percussion and grade I mobility but with no caries,pockets or restorations and non-vital pulp(via vitality tests).Radiographic examination revealed unusual configuration of the tooth’s root canals,with an enamel-lined invagination extending to the apex,suggesting the possibility of DI Oehler’s type IIIB and a periapical radiolucency.Widening the access cavity lingually revealed one distinct buccal orifice and two distinct palatal orifices;under higher magnification of a dental operating microscope(DOM),the mesio palatal and disto-palatal orifices were observed as connected by a C-shaped groove.The root canals were prepared with hand K-files following a step-back technique,and obturated using a combination technique of lateral condensation and vertical compaction.At the 6-year follow-up,the patient was asymptomatic,and the periapical radiography displayed significant healing around the apical end of the root.CONCLUSION Proper knowledge of unusual root canal anatomy is required in treating DI.Conventional methods of root canal treatment can successfully resolve such complex cases,facilitated by DOM and cone-beam computed tomography.展开更多
基金This research was funded by the Ministry of Higher Education Malaysia via the Fundamental Research Grant Scheme(FRGS/1/2020/WAB03/UPM/02/1)。
文摘Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit greenhouse gases and particles contributing to haze,and prevention by constructing fire-break canals to reduce fire spread into forest reserves is crucial.This paper aims to determine peat physical and chemical properties near a fire-break canal at different fire frequency areas.Peat sampling was conducted at two forest reserves in Malaysia which represent low fire frequency and high fire frequency areas.The results show that peat properties were not affected by the construction of a fire-break canal,however lignin and cellulose content increased significantly from the distance of the canal in both areas.The study concluded that fire frequency did not significantly influence peat properties except for porosity.The higher fibre content in the high frequency area did not influence moisture content nor the ability to regain moisture.Thus,fire frequency might contribute differently to changes in physical and chemical properties,hence management efforts to construct fire-break canals and restoration efforts should protect peatlands from further degradation.These findings will benefit future management and planning for forest reserves.
文摘Middle-mesial canals in mandibular molars are present in the population depending on age, sex and ethnicity. However, limited literature alludes to its prevalence. Troughing procedures may enhance identification, cleaning and shaping. This case report expresses the recognition and management of middle-mesial canal in a mandibular second molar of 24 years old Hispanic-Latino male.
文摘Objective: It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence(SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in SSCD patients compared to a control group.Methods: This was a prospective case-control study performed in a tertiary referral center, university teaching hospital in the UK. It included all new patients with SSCD seen in a dedicated skull base clinic over a 5-year period(2015-2019) compared to a gender and age matched control group. The main outcome of the study was adjusted calcium and Vitamin D levels between the two groups.Results: A total of 31 SSCD patients were recruited with a matched number of control patients. The mean Vitamin D level on the SSCD group was 44.8 nmoL/l(SD: 20.8) compared to 47.5 nmoL/l(SD: 27.4) on the control group(p = 0.702). Mean Adjusted calcium level was 2.34 mmoL/l(SD: 0.7) for SSCD compared to2.41 mmoL/l(SD: 0.11) for controls(p = 0.01), being within normal limits for both the SSCD and the control group.Conclusion: Our study did not identify a link between Vitamin D levels and presence of SSCD. Normal adjusted calcium values were found in both groups. Despite that a statistically significant lower calcium level was found in the SSCD group which could indicate that suboptimal levels of calcium may affect the micro-environment of the otic capsule at the SSC region.
文摘Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.Results:A total of 168 patients were included,of which 118 had imaging-confirmed SSCD.On univariate analysis significant predictors of SSCD presence were:sound/pressure-induced vertigo(p?0.006),disequilibrium(p?0.008),hyperacusis(p?0.008),and autophony(p?0.034).Multivariate analysis enabled a 14-point symptom-weighted tool to be developed,wherein a score of6 raised the suspicion of SSCD(70%likelihood of being present),R2?0.853.Conclusions:The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation.Using the evidenced-based diagnostic tool validated herein,a score6 with any symptom combination justifies ordering a CT scan.
文摘Nodular fasciitis is a benign reactive soft tissue tumor arising from fibroblasts and myofibroblasts.Its incidence is low and misdiagnosis is frequent especially for malignant lesions.This can lead to inappropriate and unnecessary invasive treatment.Nodular fasciitis of the external auditory canal is extremely rare.So far,around fifteen cases have been reported.We present here the case of a 90-year-old patient with nodular fasciitis of the right external auditory canal.The lesion extends anteriorly for 6.5 cm and reaches the posterior wall of the maxillary sinus.To our knowledge,this is the first case in the literature of an external auditory canal nodular fasciitis presenting as an inflammatory ear polyp with such a wide extension.
文摘BACKGROUND Epithelioid trophoblastic tumor(ETT) is the rarest type of gestational trophoblastic tumor(GTT). It has been reported that more than 50% of ETTs arise in the uterine cervix or the lower uterine segment. Here, we report a case of ETT within the lower uterine segment and cervical canal and discuss its manifestations,possible causes, and related influencing factors.CASE SUMMARY A 35-year-old woman(gravida 7, miscarriage 3, induction 2 with 1 being twins,para 2 of cesarean section, live 2), who had amenorrhea for 9 mo after breastfeeding for 22 mo after the last cesarean section, was diagnosed with ETT. The lesion was present in the lower uterine segment and endocervical canal with severe involvement of the anterior wall of the lower uterine segment and the front wall of the lower uterine segment where the cesarean incisions were made.Laboratory tests showed slight elevation of serum beta-human chorionic gonadotropin. Intraoperative exploration showed the presence of a normal-sized uterus body with an enlarged tumor in the lower uterine segment. The surface of the lower uterine segment was light blue, the entire lesion was approximately about 8cm × 8 cm × 9 cm, with compression and displacement of the surrounding tissue.Histological examination diagnosed ETT. Immunohistochemical analysis showed positive expression of p63, with a Ki-67 proliferation index of 40%.CONCLUSION A search of the PubMed database using the search terms "cesarean section" and "epithelioid trophoblastic tumor" retrieved nine articles, including 13 cases of ETT and ETT-related lesions, all 13 cases had a history of cesarean section, and the lesions were all located at the cesarean section incision on the anterior wall of the lower uterine segment. The present case is the 14th reported case of ETT after cesarean section. Therefore, we deduced that cesarean section trauma had an important effect on the occurrence of ETT at this site.
文摘BACKGROUND Prevotella oris-induced meningitis and Prevotella oris-induced meningitis concomitant with spinal canal infection are extremely rare.To the best of our knowledge,only 1 case of Prevotella oris-induced central system infection has been reported.This is the second report on meningitis combined with spinal canal infection due to Prevotella oris.CASE SUMMARY We report a case of a 9-year-old boy suffering from meningitis and spinal canal infection.The patient presented to the neurosurgery department with lumbosacral pain for 1 mo and headache and vomiting for 1 d.He had been treated with cephalosporin and nonsteroidal anti-inflammatory drugs for fever,otalgia and pharyngalgia in a local hospital 2 mo prior to this admission.During hospitalization,magnetic resonance imaging suggested meningitis and L3-S1 lumbosacral dural sac infection.The cerebrospinal fluid and blood cultures were negative,but the cerebrospinal fluid specimen indicated the presence of Prevotella oris by metagenomic next-generation sequencing.Previous cases of Prevotella oris infection were retrieved from PubMed to characterize the clinicopathological features and identify the prognostic factors and related antimicrobial treatment of infection due to Prevotella oris.CONCLUSION This report shed light on the characteristics of Prevotella oris infection and highlighted the role of metagenomic next-generation sequencing in pathogen detection.
文摘Background: The aim was to evaluate the nonsurgical Root Canal Treatment (nRCT) outcome, the restorative condition and the relationship between the coronal restoration quality and the outcome of teeth endodontic treated by undergraduates at the University of Caxias do Sul School of Dentistry (UCS-SD), Brazil, between 2019 and 2021. Materials and Methods: Data from the endodontically treated cases were retrieved, and the patients were recalled for a follow-up appointment at the university. The endodontic diagnosis, radiographs, and the presence of definitive restorations were analyzed in the clinical records. During the follow-up appointment, endodontically treated teeth were classified as present or absent. The nRCT was classified as successful (complete or incomplete healing) or failure (uncertain or unsatisfactory healing). Coronal restoration was classified as absent or present. When it was present, it was classified as permanent or temporary, and its quality as adequate or inadequate restoration. The results were presented as percentages. Results: A total of 257 teeth were endodontically treated. The most prevalent diagnosis was Chronic Apical Periodontitis (33.33%) and the most commonly treated teeth were premolars (46.15%). A total of 52 (21%) treated teeth were clinically and radiographically reexamined. The success rate for the nRCT was 98.08%. About 61.54% of this sample had a definitive composite resin restoration. Conclusion: The nRCT success rate was high. Special attention should be given to the presence and quality of the definitive restoration. Clinical Implications: There was no statistically significant impact between the coronal restoration and the nRCT success (P > 0.05).
基金National Natural Science Foundation of China(No.82160435)。
文摘Objective:To analyze the correlation between the amplitude changes of motor evoked potential(MEP),the 3D volume changes of spinal canal measuring by postoperative CT and the improvement rate of clinical symptoms after the spinal canal decompression in minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF),and to explore the predictive value of the changes of both MEP amplitude and spinal canal volume in the assessment of long-term clinical prognosis in MIS-TLIF.Methods:A retrospective study of 68 patients with L4/5 spinal stenosis treated with MIS-TLIF was performed.The changes of both intraoperative MEP amplitude and 3D spinal canal volume during the spinal canal decompression,as well as the visual analogue scale(VAS)and Oswestry dysfunction index(ODI)scores in the long-term follow-up were all recorded.Results:The values of intraoperative MEP amplitude was 159.04%higher in 68 patients with MIS-TLIF after spinal canal decompression(P<0.01).The 3 postoperative 3D spinal canal volume(4.89±1.27)cm increased by 31.22%in comparison 3 with preoperative date(3.78±1.08)cm(P<0.01).The VAS and ODI scores were improved to 78.55%and 80.60%,respectively at the last follow-up(P<0.01).The improvement rate of MEP amplitude on the decompression side was positively correlated with the improvement rate of postoperative spinal canal volume(r=0.272,P=0.025).The improvement rate of postoperative spinal canal volume was positively correlated with the improvement rate of VAS and ODI at the last follow-up(r=0.656,r=0.490,P<0.01).Moreover,the improvement rate of MEP amplitude on the decompression side was also positively correlated with the improvement rate of VAS and ODI at the last follow-up(r=0.322 and 0.235,respectively,P<0.05).Conclusion:The increase of MEP amplitude after spinal canal decompression in patients with lumbar spinal stenosis treated by MIS-TLIF was closely correlated with both of the increase of spinal canal volume and the improvement of clinical symptoms.Therefore,MEP amplitude monitoring was not only the one of the important monitoring methods for predicting the prognosis of MIS-TLIF but also the reliably predictive value in the long-term clinical prognosis in MIS-TLIF.
基金the research funding from the National Planning Office of Philosophy and Social Science Grant of P.R.China(18BGJ086).
文摘Guided by the ternary leadership theory from the perspective of social psychology,this paper explores the impacts of authoritarian,benevolent,and moral leadership on the top design of the Grand Canal of China in terms of its water management practice,while providing reference for resolving the“Matteo Ricci Puzzle”.The research findings are threefold:first,authoritarian as it is,the central government of China formulates relevant laws and regulations to provide legal system insurance for the construction of the Grand Canal Cultural Belt,thus providing the blueprint for constructing the“bright cultural belt,green ecological belt and colorful tourism belt of the Grand Canal”.Second,led by the Central Government,sticking to benevolent and moral leadership,China advocates scientific water management concepts and methods,and gives long-term and comprehensive care to the well-being of the people along the banks of the Grand Canal.Finally,the top-level design of the Grand Canal of China is based on the ternary leadership theory rooted in social psychology and has formulated a set of properly-scheduled,reasonably-coordinated,and flexibly-operated management system for the fundamental interests of the people and long-term goals of the country.
文摘The opening of the Panama Canal in 1913 increased the availability of internationally traded goods and transformed ocean-shipping by shortening travel time between the Atlantic Ocean and Pacific Ocean. The canal sparked the growth of port authorities and increased ship tonnage on both coasts of Panama. Since the construction of the Panama Canal, in the 1910s, pesticides, herbicides and chemicals, including arsenic, have been essential for controlling wetland vegetation, including hyacinth, which blocked rivers, lakes, and the canal as well as managing mosquitoes. Pesticides and chemicals flowed into Lake Gatun (reservoir) either attached to sediment or in solution during the monsoon season. Lake Gatun was the drinking water source for most of the people living in the Panama Canal Zone. The United States military base commanders had the ability to order and use cacodylic acid (arsenic based) from the Naval Depot Supply Federal and Stock Catalog and the later Federal Supply Catalog on the military base grounds in the Panama Canal Zone. Cacodylic acid was shipped to Panama Canal Zone ports, including Balboa and Cristobal, and distributed to the military bases by rail or truck. The objective of this study is to determine the fate of arsenic: 1) applied between 1914 and 1935 to Panama Canal shipping lane hyacinth and other wetland vegetation and 2) cacodylic acid (arsenic) sprayed from 1948 to 1999 on the US military base grounds in the Panama Canal Zone.
文摘Introduction: Gout is defined as an arthritic condition resulting from the deposition of monosodium urate crystals in and/or around joints, following long-standing hyperuricemia. This may cause gouty arthritis in joints and tophi in soft tissues. Spinal gout is rare and never mentioned in our context. It can appear as acute back pain, radiculopathy, spinal cord compression, spondylodiscitis or neoplasic/infectious epiduritis. Our aim was to share our surgical experience and proceed of a Literature review. Cases Presentation: Between January and August 2022, two patients male were surgically cared, aged of 42 and 60 years old. The gout was unknown in the youngest and poorly followed in the eldest. There was no past medical history of tuberculosis or immunodeficiency in both. The early diagnosis retained was unspecific lumbar spondylodiscitis due to clinical features: Patients complained both of lower back pain with initial fever. It was of a progressive left L5S1 deficit with erectile defect and dysuria in the first case and a progressive paraplegia without sphincter disorders in the second case. We proceeded with a lumbar laminectomy with a biopsy on both patients. The spinal tophus was ligamentous in one case and arthro-ligamentous in the other. There was a progressive motor recovery from postoperative Day-2 till postoperative Month-1. A probabilistic antituberculosis treatment was promptly initiated postoperatively based on radioclinic features while waiting for histologic proof. The Polymerase Chain Reaction (PCR) of Mycobacterium tuberculosis was negative and the histology was of a chronic calcified osteitis with dense fibrosis in both. The anti-gout treatment was implemented after 15 days with blood test evidence. A rheumatologic follow-up was also initiated and adjuvant physio-therapy. The results were very satisfactory from 4 - 6 months with independent walking. Discussion Conclusion: Spinal Gout may be suggested in 40-male-old faced with any acute rachialgia with neuro deficit with dubious neuro-imaging.
文摘The 84 km Panama Canal connecting the Atlantic and Pacific oceans has historically been a strategic waterway for shipping and the location of United States (US) military bases. Since the construction of Lake Gatun reservoir, canal locks and navigation channel through the Isthmus of Panama tropical forests in the 1910s, chemicals, pesticides, and herbicides have been essential for controlling upland and wetland vegetation as well as managing mosquito-borne diseases. Chemicals and pesticides flowed into Lake Gatun via land surface runoff and subsurface drainage either attached to the sediment or in solution during the rainy season. Lake Gatun and the Panama Canal was the drinking water source for most of the civilian and military population living in the Panama Canal Zone. Between 1948 and 1999, US military base commanders had the ability to order, from the Federal Supply Catalog, commercially available herbicide 2,4,5-T with unknown amounts of dioxin TCDD for use on the military base grounds in the Panama Canal Zone. The herbicide 2,4,5-T was transported to Panama Canal Zone ports, including the ports Cristobal on the Caribbean and Balboa on the Pacific, and distributed to the US military bases in Panama by rail or truck. The US National Toxicology Program and the International Agency for the Research on Cancer listed dioxin and TCDD as known human carcinogens. Dioxins are endocrine disrupters and can cause certain chloracne, cancers, developmental and reproductive effects. In 1985, the United States government banned the manufacture of the herbicide 2,4,5-T, with unknown amounts of dioxin TCDD, after it was shown to cause cancer in animals. The objectives of this study are to determine: 1) the fate of dioxin TCDD, a contaminant in the herbicide 2,4,5-T, sprayed on the US military base vegetation in the Panama Canal Zone from 1948 to 1999, 2) the transport of dioxin TCDD rich sediment via soil erosion and overland flow into Lake Gatun and Panama Canal waterways and 3) the human health impacts of dioxin TCDD, a known carcinogen, on US military and Panamanian civilians exposed to dioxin TCDD in the Panama Canal Zone.
文摘Background: For decades, traditional open surgical techniques were used to treat lumbar disc herniation and lumbar canal stenosis (LCS). However, seeking for better outcomes for patients and avoiding extensive bony loss with its sequences had raised minimally invasive technique for treating these disorders as an alternative surgery. Methods: This is a retrospective study in which 54 patients of LCS were operated upon via unilateral minimally invasive technique to decompress the canal in a 360 degrees fashion through laminotomy, deroofing of opposite laminar side, sublaminar ligamintectomy, bilateral foraminotomies and discectomy. We used VAS scores and ODI to assess clinical outcomes with a period of one year follow-up. Results: Our results demonstrated that minimally invasive techniques for treating these disorders are effective procedures. Minimally invasive 360 degrees decompression for treating LCS had better outcomes regarding postoperative back pain, smaller incisions, less bony loss and early ambulation. Conclusion: Minimally invasive techniques for treating lumbar canal stenosis of different causes could be considered a better option instead of traditional full laminectomy with better outcomes as regards respecting the anatomical layers such as posterior spinal integrity and musculature, postoperative pain, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods.
文摘Neurofibroma is a benign tumor of the connective tissue of the peripheral nerves, developed mainly at the endoneurium. The most common localizations are the extremities of the limbs and the head and neck region. Neurofibromas are often associated with neurofibromatosis type 1. An isolated localization in the auditory canal is exceptional. We report the case of a 45-year-old female patient presenting with a neurofibroma of the auditory canal which had previously caused hearing loss. Examination revealed a tissue mass firm, painless and covered with normal skin obstructing the external auditory canal. The patient’s skin examination revealed no café-au-lait spots. A CT scan of the ear showed a hypodense tissue mass. Surgical removal via the ear canal gave good results. In conclusion, an isolated neurofibroma of the external auditory canal is a rare benign tumor with a good prognosis. The surgical approach depends on the exact location of the mass and the surgeon’s experience.
基金the Youth Development Project of Army Military Medical University,No.2018XQN014the Clinical Innovation Project of Army Military Medical University,No.2019XLC2014the Science and Technology Foundation of Chongqing,China,No.cstc2014jcyjA10092.
文摘BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars located at the end of the dental arch.However,advancements in digital dental diagnosis and treatment techniques can solve these problems.Here,we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel“inlay-guided endodontics”technique based on improved computer-generated programs.CASE SUMMARY A 63-year-old man complained of a defect in the maxillary left second molar.The tooth,diagnosed with post-treatment endodontic disease,was initially treated by conventional methods,which were ineffective.Our“inlay-guided endodontics”technique was subsequently adopted,with the establishment of a precise integrated three-dimensional(3D)plate model of cone-beam computed tomography data and a digital impression of the dentition.An optimal root canal approach was generated for the“virtual file”in the 3D model.The plate data were imported into a 3D printer and printed.With the help of the guide plate,the file was accurately placed into the cervical third of the distal root canal.The root canal and prosthodontic treatments successfully proceeded subsequently.CONCLUSION Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.
文摘The aim of this study was to investigate the root canal configuration, accessory canals and number of main foramina of 123 maxillary second molars by means of micro-computed tomography. The teeth were scanned and reproduced with 3D software imaging. The root canal configuration and number of main foramina were evaluated by means of a four-digit system. The morphological complexity of human maxillary second molars is depicted by the number of accessory and connecting canals. The most frequently observed root canal configurations in the mesiobuccal root were 2-2-2/2(19.5%), 2-2-1/1(14.6%) and 2-1-1/1(13.0%). A 1-1-1/1 configuration was observed in 93.5% and in 96.7% in the distobuccal and palatal roots, respectively. The MB1 root canal had one accessory canal(18.7%), and 8.9% of the MB2 root canal had one or two accessory canals. The distobuccal(11.3%) and palatal(14.6%) root canals had at least one accessory canal, and connecting canals were observed in16.3% of mesiobuccal roots. The MB1, MB2, distobuccal and palatal root canals had one main foramen in 99.2%, 43.1%,98.4% and 99.2% of samples, respectively. In the mesiobuccal root, one accessory foramen was detected in 14.6%, two were detected in 7.3%, and three were detected in 5.7%. The distobuccal root showed one or two accessory foramina in 9.1% of samples. The root canal configuration of maxillary second molars is quite heterogeneous; the mesiobuccal root has predominantly two root canal entrances(58.4%, 1 in 41.1%) with one main foramen(54.4%). Two main foramina were observed in 43.0%. Morphological variations, connecting and accessory canals were observed in all apical thirds.
文摘Acquired atresia of the external auditory canal(EAC)is a rare cause of conductive hearing loss.It has been traditionally classified into 4 categories:traumatic,post-operative,neoplastic and inflammatory.Post-inflammatory acquired auditory canal atresia is thought to be the result of chronic and repetitive infectious bouts affecting the auditory canal.Nevertheless,the underlying pathophysiology of this disorder is yet to be fully elucidated.Current data fail to clearly state the impact that certain underlying systemic disorders may have on the EAC.The possible association to metabolic disturbances such as iron deficiency is also emphasized.In the light of these findings,this analysis can be used to improve the classification of this entity thereby standardizing the assessment of therapeutic approaches.
文摘AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients with medically uncontrolled OAG. All the patients underwent modified viscocanalostomy with injection of viscoelastic material in the surgically created ostia of Schlemm's canal(SC). The modifications included peeling of the inner wall of SC and the juxtacanalicular meshwork, use of mitomycin C, and loosely suturing the superficial scleral flap. Intraocular pressure(IOP), visual acuity, number of medications, laser goniopuncture data and complications were recorded. The definition of complete(qualified) success was an IOP equal to or lower than 21, 18, 16 mm Hg without(with or without) anti-glaucoma medications. RESULTS: The mean IOP was 33.5±9.9 mm Hg before surgery, 15.2±3.6 mm Hg(mean IOP reduction of 51%) at 5 y after surgery, and 15.6±2.8 mm Hg(mean IOP reduction of 49.9%) at 10 y after surgery(P<0.001). The number of anti-glaucoma medications dropped from 2.39±0.5 preoperatively to 0.47±0.8 at 5 y and 0.67±0.8 at 10 y postoperatively(P<0.001). The follow-up period was 104.5±37.0 mo. The qualified success rate for an IOP of 21, 18 or 16 mm Hg or less was 84% [95% confidence interval(CI): 0.80-0.88], 73%(95%CI: 0.68-0.78), and 59%(95%CI: 0.52-0.66) after 5 y, and 80%(95%CI: 0.76-0.84), 69%(95%CI: 0.64-0.74), 51%(95%CI: 0.44-0.58) after 10 y, respectively. There was a relationship between age, preoperative IOP and success rate(P<0.01, P<0.05). A total of 31 eyes(31.3%)in 31 patients underwent laser goniopuncture, decreasing the IOP from 22.9±4.3 mm Hg to 16.3±2.5 mm Hg(P<0.01). Neither blebitis nor endophthalmitis occurred.CONCLUSION: Modified viscocanalostomy could be performed to lower IOP, decrease multiple anti-glaucoma drops use as well. It's a safe procedure with less complications over 10 y in Chinese individuals with OAG.
基金Supported by Deanship of Scientific Research at King Khalid University,Abha,Saudi Arabia through the Small Groups Project,No. RGP. 1/351/43
文摘BACKGROUND The presence of dens invaginatus(DI)complicates treatment of any tooth,from diagnosis to access cavity and biomechanical preparation and obturation.Reports of successful non-surgical management of DI type IIIB in maxillary lateral incisor are rare.Here,we report such a case,with three root canals and a long follow-up.CASE SUMMARY A 13-year-old female patient presented with mild pain in the maxillary right lateral incisor(#7)for 10-15 d.On examination,the tooth was slightly rotated,with slight tenderness on percussion and grade I mobility but with no caries,pockets or restorations and non-vital pulp(via vitality tests).Radiographic examination revealed unusual configuration of the tooth’s root canals,with an enamel-lined invagination extending to the apex,suggesting the possibility of DI Oehler’s type IIIB and a periapical radiolucency.Widening the access cavity lingually revealed one distinct buccal orifice and two distinct palatal orifices;under higher magnification of a dental operating microscope(DOM),the mesio palatal and disto-palatal orifices were observed as connected by a C-shaped groove.The root canals were prepared with hand K-files following a step-back technique,and obturated using a combination technique of lateral condensation and vertical compaction.At the 6-year follow-up,the patient was asymptomatic,and the periapical radiography displayed significant healing around the apical end of the root.CONCLUSION Proper knowledge of unusual root canal anatomy is required in treating DI.Conventional methods of root canal treatment can successfully resolve such complex cases,facilitated by DOM and cone-beam computed tomography.
