AIM To focus on procedure-related complications,evaluate their incidence,analyze the reasons and discuss the solutions.METHODS Overall,628 endoscopic gastric variceal obturation(EGVO) procedures(case-times) with NBC w...AIM To focus on procedure-related complications,evaluate their incidence,analyze the reasons and discuss the solutions.METHODS Overall,628 endoscopic gastric variceal obturation(EGVO) procedures(case-times) with NBC were performed in 519 patients in the Department of Endoscopy of the Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2016. The clinical data of patients and procedure-related complications of EGVO were retrospectively analyzed.RESULTS In the 628 EGVO procedures,sticking of the needle to the varix occurred in 9 cases(1.43%),including 1 case that used lipiodol-diluted NBC and 8 cases that used undiluted NBC(P = 0.000). The needle was successfully withdrawn in 8 cases. Large spurt bleeding occurred in one case,and hemostasis was achieved by two other injections of undiluted glue. The injection catheter became blocked in 17 cases(2.71%) just during the injection,and 4 cases were complicated with the needle sticking to the varix. Large glue adhesion to the endoscope resulted in difficulty withdrawing the endoscope in 1 case. Bleeding from multiple sites was observed in the esophagus and gastric cardia after the endoscope was withdrawn. Hemostasis was achieved by 1% aethoxysklerol injection and intravenous somatostatin. The ligation device stuck to the varices in two cases during the subsequent endoscopic variceal ligation. In one case,the ligation device was successfully separated from the esophageal varix after all bands were released. In another case,a laceration of the vein and massive bleeding were observed. The bleeding ceased after 1% aethoxysklerol injection.CONCLUSION Although EGVO with tissue glue is usually safe and effective,a series of complications can occur during the procedure that may puzzle endoscopists. There is no standard operating procedure for addressing these complications. The cases described in the current study can provide some reference for others.展开更多
The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate（MTA） was studied by scanning electron microscopy（SEM）. Single-rooted huma...The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate（MTA） was studied by scanning electron microscopy（SEM）. Single-rooted human premolars（n560） were instrumented to an apical size #50/0.06 using ProF ile and treated as follows： Group 1（n510） was filled with phosphate buffered saline（PBS）; Group 2（n510） was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3（n520） was obturated orthograde with a paste of OrthoM TA（BioM TA, Seoul, Korea） and PBS; and Group 4（n520） was incubated with E. faecalis for 3 weeks and then obturated with OrthoM TA–PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material（IRM）, and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoM TA-filled roots（Groups 3 and 4）. Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots（Group 4）. Therefore, the orthograde obturation of root canals with OrthoM TA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.展开更多
Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the acces...Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the accessory salivary glands, are rarer. We report a case of a pleomorphic adenoma of the posterior palate which posed management problems. Observation: This is an 85-year-old patient who consulted for a tumor of the posterior palate that had been evolving for 3 years. The examination revealed a globular tumor of the posterior palate extending beyond the midline by approximately 7 cm in long axis, shooting towards the oropharynx and hindering breathing, speech and eating, indicating a life-saving tracheotomy. A CT scan of the facial area revealed a well-circumscribed tumor at the expense of the soft palate, with multiple sites of bone lysis. The biopsy performed was in favor of a pleomorphic adenoma. The patient underwent total surgical excision of a huge tumor on the palate. The aftermath of the operation was marked by a loosening of the sutures with an oronasal fistula requiring the creation of an obturator plate due to the patient’s refusal to have another operation. Conclusion: Large pleomorphic adenoma of the posterior palate is a rare entity that can cause respiratory problems and surgical difficulties. His prognosis is generally good.展开更多
A 83-year-old woman was admitted to our hospital because of intermittent abdominal colicky pain and vomiting for 26 h.The pain localized over the periumbilical area with radiation along the medial side of the thigh.Co...A 83-year-old woman was admitted to our hospital because of intermittent abdominal colicky pain and vomiting for 26 h.The pain localized over the periumbilical area with radiation along the medial side of the thigh.Computed tomography scan with three-dimensional reconstruction revealed a loop of small bowel protruding into the left obturator canal. Incarcerated obturator hernia was diagnosed and emergency laparotomy was arranged immediately. Unfortunately,her family refused surgery because of her worsening condition.On the third evening after admission,the patient developed peritonitis and sepsis. Perforation of small bowel due to the incarceration was noted during laparotomy.Bowel resection and an endileostomy were performed.She recovered well despite of the complication of multiple organ dysfunction syndrome.Literature is reviewed,and the pathogenesis,clinical manifestation,imaging features and treatment are discussed.展开更多
The presence of a large palatal or maxillary defect after partial or total maxillectomy for tumor, trauma or congenital deformation poses a challenge to prosthodontists, particularly when the use of an implant cannot ...The presence of a large palatal or maxillary defect after partial or total maxillectomy for tumor, trauma or congenital deformation poses a challenge to prosthodontists, particularly when the use of an implant cannot be considered. This case report described the use of an air valve in a hollow silicone obturator to manufacture an inflatable obturator that could be extended further into undercut area to retain itself. The inflatable obturator exhibited adequate retention, stability and border sealing, thereby improving the masticatory, pronunciation and swallowing functions of patients. It may be a suitable alternative treatment option to an implant-retained obturator.展开更多
Objective To assess stresses produced by different obturator prostheses. Methods Three-dimensional finite clement models of unilateral maxillary defects rehabilitated with different obturators were constructed. The di...Objective To assess stresses produced by different obturator prostheses. Methods Three-dimensional finite clement models of unilateral maxillary defects rehabilitated with different obturators were constructed. The different stresses were analyzed by three-dimensional finite element method under different load angle. Results The Von Mises stress values obtained for the remaining tissues adjacent to defect cavity were higher when rehabilitated by inferior hollow obturator in comparison with by superior hollow obturator. The maximum of Von Mises were higher when rehabilitated by resilient hollow obturator than by rigid hollow obturator. It was also observed that in the rigid type stress distribution contours formed in the remaining tissues adjacent to defect cavity, while in resilient hollow obturator prostheses the stress distributed mainly in the prosthesis itself. The oblique load shows the most maximum of Von Mises among all types of obturator prostheses. Conclusions A high lateral wall of an obturator may be more better in preserving the remaining structures than a shorter prosthesis lateral wall. A soft liner may be incorporated to reduce the pain of the residual maxillary structures and mucosa. When load on defect, higher stress would be generated to the residual maxillary structures. The adjustment of occlusual relationship is very important.展开更多
基金Supported by Guangdong Science and Technology Program,No.2016A020216012
文摘AIM To focus on procedure-related complications,evaluate their incidence,analyze the reasons and discuss the solutions.METHODS Overall,628 endoscopic gastric variceal obturation(EGVO) procedures(case-times) with NBC were performed in 519 patients in the Department of Endoscopy of the Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2016. The clinical data of patients and procedure-related complications of EGVO were retrospectively analyzed.RESULTS In the 628 EGVO procedures,sticking of the needle to the varix occurred in 9 cases(1.43%),including 1 case that used lipiodol-diluted NBC and 8 cases that used undiluted NBC(P = 0.000). The needle was successfully withdrawn in 8 cases. Large spurt bleeding occurred in one case,and hemostasis was achieved by two other injections of undiluted glue. The injection catheter became blocked in 17 cases(2.71%) just during the injection,and 4 cases were complicated with the needle sticking to the varix. Large glue adhesion to the endoscope resulted in difficulty withdrawing the endoscope in 1 case. Bleeding from multiple sites was observed in the esophagus and gastric cardia after the endoscope was withdrawn. Hemostasis was achieved by 1% aethoxysklerol injection and intravenous somatostatin. The ligation device stuck to the varices in two cases during the subsequent endoscopic variceal ligation. In one case,the ligation device was successfully separated from the esophageal varix after all bands were released. In another case,a laceration of the vein and massive bleeding were observed. The bleeding ceased after 1% aethoxysklerol injection.CONCLUSION Although EGVO with tissue glue is usually safe and effective,a series of complications can occur during the procedure that may puzzle endoscopists. There is no standard operating procedure for addressing these complications. The cases described in the current study can provide some reference for others.
基金supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2009-0086835: Dr K Y Kum)the Ministry of Science, ICT and Future Planning (2011-0014231: Dr S W Chang)supported by a grant from the Kyung Hee University in 2013 (KHU-20131045)
文摘The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate（MTA） was studied by scanning electron microscopy（SEM）. Single-rooted human premolars（n560） were instrumented to an apical size #50/0.06 using ProF ile and treated as follows： Group 1（n510） was filled with phosphate buffered saline（PBS）; Group 2（n510） was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3（n520） was obturated orthograde with a paste of OrthoM TA（BioM TA, Seoul, Korea） and PBS; and Group 4（n520） was incubated with E. faecalis for 3 weeks and then obturated with OrthoM TA–PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material（IRM）, and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoM TA-filled roots（Groups 3 and 4）. Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots（Group 4）. Therefore, the orthograde obturation of root canals with OrthoM TA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.
文摘Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the accessory salivary glands, are rarer. We report a case of a pleomorphic adenoma of the posterior palate which posed management problems. Observation: This is an 85-year-old patient who consulted for a tumor of the posterior palate that had been evolving for 3 years. The examination revealed a globular tumor of the posterior palate extending beyond the midline by approximately 7 cm in long axis, shooting towards the oropharynx and hindering breathing, speech and eating, indicating a life-saving tracheotomy. A CT scan of the facial area revealed a well-circumscribed tumor at the expense of the soft palate, with multiple sites of bone lysis. The biopsy performed was in favor of a pleomorphic adenoma. The patient underwent total surgical excision of a huge tumor on the palate. The aftermath of the operation was marked by a loosening of the sutures with an oronasal fistula requiring the creation of an obturator plate due to the patient’s refusal to have another operation. Conclusion: Large pleomorphic adenoma of the posterior palate is a rare entity that can cause respiratory problems and surgical difficulties. His prognosis is generally good.
基金Supported by The Grant of Education Department of Liaoning Province,2009A719
文摘A 83-year-old woman was admitted to our hospital because of intermittent abdominal colicky pain and vomiting for 26 h.The pain localized over the periumbilical area with radiation along the medial side of the thigh.Computed tomography scan with three-dimensional reconstruction revealed a loop of small bowel protruding into the left obturator canal. Incarcerated obturator hernia was diagnosed and emergency laparotomy was arranged immediately. Unfortunately,her family refused surgery because of her worsening condition.On the third evening after admission,the patient developed peritonitis and sepsis. Perforation of small bowel due to the incarceration was noted during laparotomy.Bowel resection and an endileostomy were performed.She recovered well despite of the complication of multiple organ dysfunction syndrome.Literature is reviewed,and the pathogenesis,clinical manifestation,imaging features and treatment are discussed.
文摘The presence of a large palatal or maxillary defect after partial or total maxillectomy for tumor, trauma or congenital deformation poses a challenge to prosthodontists, particularly when the use of an implant cannot be considered. This case report described the use of an air valve in a hollow silicone obturator to manufacture an inflatable obturator that could be extended further into undercut area to retain itself. The inflatable obturator exhibited adequate retention, stability and border sealing, thereby improving the masticatory, pronunciation and swallowing functions of patients. It may be a suitable alternative treatment option to an implant-retained obturator.
文摘Objective To assess stresses produced by different obturator prostheses. Methods Three-dimensional finite clement models of unilateral maxillary defects rehabilitated with different obturators were constructed. The different stresses were analyzed by three-dimensional finite element method under different load angle. Results The Von Mises stress values obtained for the remaining tissues adjacent to defect cavity were higher when rehabilitated by inferior hollow obturator in comparison with by superior hollow obturator. The maximum of Von Mises were higher when rehabilitated by resilient hollow obturator than by rigid hollow obturator. It was also observed that in the rigid type stress distribution contours formed in the remaining tissues adjacent to defect cavity, while in resilient hollow obturator prostheses the stress distributed mainly in the prosthesis itself. The oblique load shows the most maximum of Von Mises among all types of obturator prostheses. Conclusions A high lateral wall of an obturator may be more better in preserving the remaining structures than a shorter prosthesis lateral wall. A soft liner may be incorporated to reduce the pain of the residual maxillary structures and mucosa. When load on defect, higher stress would be generated to the residual maxillary structures. The adjustment of occlusual relationship is very important.
