BACKGROUND Woven coronary artery is an extremely rare disease with unknown etiology.This condition is difficult to diagnosis by traditional methods.CASE SUMMARY A 67-year-old male presented to the cardiology departmen...BACKGROUND Woven coronary artery is an extremely rare disease with unknown etiology.This condition is difficult to diagnosis by traditional methods.CASE SUMMARY A 67-year-old male presented to the cardiology department with a history of mild chest pain for 6 mo.Coronary computed-tomography angiography revealed a soft plaque with a 40%stenosis in the right coronary artery(RCA).A linear shadow was seen both on left circumflex(LCX)and RCA.Further coronary angiography showed an 80%regional stenosis in the area proximal of LCX and RCA,and it was divided into different channels with diffuse stenosis.Intravascular ultrasound(IVUS)and optical coherence tomography(OCT)were performed in RCA.These confirmed a woven coronary artery.No stent was implanted.He remained asymptomatic during the 5-year follow-up period.CONCLUSION Woven coronary artery can be distinguished from spontaneous dissection and revascularization of thrombosis.IVUS and OCT are useful in obtaining a definite diagnosis,which decreases chances of unnecessary intervention.展开更多
Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument ...Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument fracture is reported to range between 0.28% and 16.2%. This article presents an overview of the prevention and management of instruments fractured during endodontic therapy on the basis of literature retrieved from Pub Med and selected journal searches. Instrument fracture occurs because of reduced metal fatigue and/or torsional resistance. The reasons include canal morphology and curvature, manufacturing processes and instrument design, instrument use times and technique, rotational speeds and operator experience. With the development of various equipment and techniques, most of the retained instrument separations can be removed safely. However, in canals without associated periapical disease not every fractured separation should be removed from difficult locations because of the increased risk for root perforation and fracture. In difficult cases, either retain or bypass the fragment in the root canal and ensure regular follow-up reviews. Fractured instruments retained in the presence of periapical disease reduce significantly the prognosis of endodontically treated teeth, indicating a greater need to attempt the removal or bypass of the file separations. Apical surgery might be required in some instances, emphasizing the importance of preventing instrument fracture.展开更多
基金the Top-level Clinical Discipline Project of Shanghai Pudong District,No.PWYgf2018-02。
文摘BACKGROUND Woven coronary artery is an extremely rare disease with unknown etiology.This condition is difficult to diagnosis by traditional methods.CASE SUMMARY A 67-year-old male presented to the cardiology department with a history of mild chest pain for 6 mo.Coronary computed-tomography angiography revealed a soft plaque with a 40%stenosis in the right coronary artery(RCA).A linear shadow was seen both on left circumflex(LCX)and RCA.Further coronary angiography showed an 80%regional stenosis in the area proximal of LCX and RCA,and it was divided into different channels with diffuse stenosis.Intravascular ultrasound(IVUS)and optical coherence tomography(OCT)were performed in RCA.These confirmed a woven coronary artery.No stent was implanted.He remained asymptomatic during the 5-year follow-up period.CONCLUSION Woven coronary artery can be distinguished from spontaneous dissection and revascularization of thrombosis.IVUS and OCT are useful in obtaining a definite diagnosis,which decreases chances of unnecessary intervention.
文摘Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument fracture is reported to range between 0.28% and 16.2%. This article presents an overview of the prevention and management of instruments fractured during endodontic therapy on the basis of literature retrieved from Pub Med and selected journal searches. Instrument fracture occurs because of reduced metal fatigue and/or torsional resistance. The reasons include canal morphology and curvature, manufacturing processes and instrument design, instrument use times and technique, rotational speeds and operator experience. With the development of various equipment and techniques, most of the retained instrument separations can be removed safely. However, in canals without associated periapical disease not every fractured separation should be removed from difficult locations because of the increased risk for root perforation and fracture. In difficult cases, either retain or bypass the fragment in the root canal and ensure regular follow-up reviews. Fractured instruments retained in the presence of periapical disease reduce significantly the prognosis of endodontically treated teeth, indicating a greater need to attempt the removal or bypass of the file separations. Apical surgery might be required in some instances, emphasizing the importance of preventing instrument fracture.
