ABSTRACT
Background: Mandibular incisors are the smallest among the permanent dentition, with thin enamel and dentin. Intact teeth do not fracture easily while mastication. Objectives: To evaluate the fracture resistance of mandibular incisors after endodontic treatment and metal ceramic crown placement. Materials and methods: Eighty recently extracted intact mandibular incisors were divided into four groups of twenty each based on root canal treatment and crowns, intact natural tooth without RCT and crown preparation was used as control group. Each tooth was mounted separately in acrylic block and subjected to loading in universal load testing machine until fracture, results were analyzed by one-way ANOVA and Turkey’s multiple post hoc procedures. N Sandeep, G. Ramaswamy Reddy, Kancham Kalyan Kumar Reddy, K Subash Chander, Vasanthi Bondugula, Ram B. Basany. Evaluation of fracture resistance of mandibular incisors before and after endodontic treatment and metal ceramic crown placement. IAIM, 2017; 4(11): 18-26. Page 19 Results: The results showed that Fracture resistance of teeth restored with metal ceramic crowns was very high when compared to the teeth without crowns (p<0.05).There was no statistically significant difference between intact and endodontically treated teeth (p>0.05). Conclusion: The study concluded that endodontic treatment and tooth preparation followed by metal ceramic restoration increased the fracture resistance of mandibular incisors.
ABSTRACT
Background: Biliary dyskinesia is a condition where the gallbladder motility is seen as abnormal. Diagnostic imaging studies for biliary dyskinesia usually include a negative or inconclusive abdominal ultrasound or computed tomography followed by a hepatobiliary iminodiacetic acid (HIDA) scan. The HIDA scan is used to visualize the gallbladder and access its motility. The motility is reported in the form of an ejection fraction (EF). Billiary dyskinesia is diagnosed if the EF is less than 35%. However, there are many patients with an EF of greater than 35% but are exhibiting all the signs and symptoms for biliary dyskinesia. Aim: This study evaluated the efficacy of laparoscopic cholecystectomy as a treatment modality in symptomatic patients diagnosed with biliary dyskinesia with three distinct HIDA scan EF results. Materials and methods: They were a total of 654 verified case of laparoscopic Cholecystectomy done between January, 2013 and December 2016 at Westlake and West Suburban Hospital. A total of 163 cases out of the 654 had HIDA scan with calculated EF, therefore meeting the criteria to be included in this study. The patients pre and post-operative course was reviewed from their medical records and resolution of symptoms was determined by in phone interview. Results: A total of 29 (18%) patients were lost to follow up. Out of the 99 cases interviewed in the first group (EF <35%) 91 (92%) cases reported complete symptom resolution post cholecystectomy. Out of the 18 cases interviewed in the second group (EF between 35%-50%) 13 (72%) cases reported Lincey Alexida, Frederick M. Tiesenga. Laparoscopic cholecystectomy for biliary dyskinesia in patient with an extended spectrum of ejection fraction on hepatobiliary iminodiacetic acid scan. IAIM, 2017; 4(11): 14-17. Page 15 complete resolution post cholecystectomy. Out of the 17 cases interviewed in the last group (EF> 75%) 11 (65%) cases reported complete resolution of their symptoms Conclusion: Our study indicates that patient suffering with symptomatic biliary dyskinesia and has a HIDA with EF less than 50% or EF greater than 75% will most likely benefit from laparoscopic Cholecystectomy and could be a reasonable option to offer symptomatic patients.
ABSTRACT
Objective To determine whether SC-435, a new ileal apical sodium-codependent bile acid transporter (IBAT) inhibitor, can alter the gastrointestinal motility in guinea pigs. Methods Sixty guinea pigs received regular diet or IBAT inhibitor (SC-435) diet for 2, 4, and 8 weeks, respectively. At the end of the feeding period, the gallbladder motility was assessed and then four bipolar silver electrodes were implanted on the antrum, duodenum, jejunum, and ileum. Seven days later, migrating motor complex (MMC) was recorded and the total bile acid pool size was measured according to the isotope dilution principle in the meantime. Results After feeding SC-435, the gallbla-dder motility was declined in the 4-week group and the 8-week group. The bile acid pool size decreased by 17.11% (P<0.05) in the 4-week group and 48.35% (P<0.05) in the 8-week group. The places of origin of MMC were changed where antral origins (37%) and duodenal origins (46%) decreased whereas jejunal origins (17%) increased. The MMC cycle period was prolonged in the duodenum (1.16 times in the 4-week group, P< 0.05; 1.38 times in the 8-week group, P<0.05) whereas MMC amplitude fell in the duodenum (10.58% in the 4-week group, P<0.05; 49.17% in the 8-week group, P<0.05). There were not significant differences in all parameters of MMC between the control group and the 2-week group in guinea pigs. Conclusion The IBAT inhibitor (SC-435) reduces the bile acid pool size and inhibits the MMC cycle activity. MMC is related to the enterohepatic circulation of bile acids, which is consistent with the changes of the bile acid pool size in guinea pigs.
ABSTRACT
Objective:To observe the effect of Shuganlidanpaishiwan and its different extractive fractions on gallbladder motility of rabbits. Methods:Establishing 100 rabbit animal models,the rabbits were randomly divided into 10 groups:the low and high dose groups of Shuganlidanpaishiwan,methanolic extract,petroleum ether and ethylacetate,negative and positive control groups,to observe the gallbladder motility of every group of animals. Results:The contraction rate of gallbladder on 30th minute after Adm were(9.40?3.36) ,(10.00?2.00) ,(14.00?2.00) on high dose of Shuganlidanpaishiwan group,methanolice extract group and the low dose of petroleum ether group respectively,which were significantly higher than that of control group. Conclusion:Shuganlidanpaishiwan,methanolice extract and petroleum ether extract could improve the gallbladder contractility.
ABSTRACT
Objective:To investigate the abnormity of arterioles in gallbladder and its relation with gallbladder hypomotility in patients with gallstone and diabetes mellitus.Methods:30 patients with simple gallstone and 30 patients with gallstone accompanied with diabetes mellitus were analyzed.Their gallbladder emptying function was measured with B ultrasound before operation.After operation,the arterioles of gallbladder rinsed with PAS reagent in photos were analyzed in tubular area and stereo system with BEIHANG CM-2000B biological and medical photo system.Results:The gallbladder volumes of fasting(V 0),two hours after eating(V 2) increased (59.3?0.6 vs 37.9?5.4,44.7?6.6 vs 14.3?4.9 respectively),whilethe ejective volume of bile(EV) and the ejective rate of gallbladder two hours after eating[GBEF 2 (%)] decreased in patients with diabetes mellitus(14.5?7.1 vs 23.4?9.3,24.9?12.7 vs 61.5?8.5,respectively).In patients with gallstone and diabetes mellitus,the area ratio of arterioles wall to whole arterioles in cross section was significantly higher than in the patients with simple gallstone(0.81 ?0.09 vs 0.58?0.15, P 0.05).Conclusion:The emptying function is significantly impaired in patients with gallstone and diabetes mellitus.The sedimentation of PAS positive material in the wall of arterioles lead to the stenosis of arterioles,and it is probably the cause for gallbladder hypomotility.
ABSTRACT
PURPOSE: An increased incidence of gallstones has been widely reported in patients who had undergone a gastrectomy. But, there has been little information about the pathophysiologic mechanism for the occurrence of gallstones after gastric surgery. Many investigators have considered the cause to be decreased gallbladder motility due to vagal denervation. We observed higher increase in the incidence of gallbladder stones in patients who underwent a Billroth II gastrojejunostomy than in those who underwent a Billroth I gastrojejunostomy after radical subtotal gastrectomy. METHODS: We prospectively studied the change in the motility of the gallbladder after a gastrectomy. The gallbladder ejection fraction (EF) was compared pre- and postoperatively by using gallbladder scintigraphy with 2,6-diisopropyl-iminodiacetic acid (DISIDA). RESULTS: Twenty patients underwent a Billroth(B) I anastomosis and twelve patients underwent a B-II anastmosis after the gastrectomy. The means of the EF of the B-I group were 75.9%, 46.4%, 68.1% at the preoperative period, at 1 month and 6 months after the gastrectomy respectively. Those of B-II group were 78.2%, 45.3%, 56.3%, respectively. There was no statistically significant difference of EF between the two groups at postoperative 1 month, but the difference at postoperative 6months was statistically significant. The differences of EF between preoperative period and postoperative 1 month, 6 months were significant in the B-I group andthe B-II group. CONCLUSION: At 6 months postoperative period, there was more recovered gallbladder motility after a gastrectomy with B-I anastomosis than with B-II anastomosis.
Subject(s)
Humans , Denervation , Gallbladder , Gallstones , Gastrectomy , Gastric Bypass , Gastroenterostomy , Incidence , Postoperative Period , Preoperative Period , Prospective Studies , Radionuclide Imaging , Research PersonnelABSTRACT
OBJECTIVES: Gastric resection may predispose gallstone formation. However, the mechanism has not been clearly understood. To evaluate the relationship between gastric resection and gallstone formation, we compared gallbladder(GB) motility in gastrectomized patients and control subjects. METHODS: We compared the GB volume and ejection fraction of the 46 gastrectomized patients with 37 healthy controls using real time ultrasonography. RESULTS: GB volume increased significantly in the gastrectomized group in fasting (30.2 13.9 ml). The GB volume after a fatty meal was greater in the gastrectomized group (12.6 6.4 ml) than in the control group (4.3 3.3 ml) (p +ADw- 0.01). A significant reduction of ejection fraction was found in gastrectomized patients (56.9 13.0+ACU-) in comparison with the control group (75.5 16.1+ACU-) (p +ADw- 0.01). The GB ejection fraction had a poor correlation to the postoperative period (r +AD0- 0.232). CONCLUSION: A gastrectomy appears to be a risk factor of GB dysmotility, which may play a major role in gallstone formation in gastrectomized patients.
Subject(s)
Adult , Aged , Female , Humans , Male , Cholelithiasis/diagnostic imaging , Cholelithiasis , Comparative Study , Eating , Endosonography , Fasting , Gallbladder/diagnostic imaging , Gallbladder , Gallbladder Emptying , Gastrectomy , Gastrointestinal Motility , Middle Aged , Probability , Prospective Studies , Reference Values , Risk Assessment , Stomach NeoplasmsABSTRACT
BACKGROUND: Several clinical observations suggest that the incidence of gallbladder stone increases after gastric surgery. The mechanism is not clear, but many investigators have proposed that the cause may be decreased gallbladder motility due to vagal denervation. However, the authors observed a increased-incidence of gallbladder stone in Billroth II anastomosis (gastrojejunostomy) and an unchanged- incidence of that in Billroth I anastomosis (gastroduodenostomy) after a radical subtotal gastrectomy. METHODS: We studied the change in the motility of gallbladder after gastrectomy, prospectively. Gallbladder ejection fraction was compared pre- and postoperatively by gallbaldder scintigraphy with DISIDA. RESULTS: 32 patients were involved in this study. They were all thought to have early gastric cancer, preoperatively and received a radical subtotal gastrectomy. 20 patients underwent a Billroth I anastomosis and 12 patients, Billroth II anastomosis after gastrectomy. The mean ejection fractions of the Billroth I group were 75.9% and 46.4%, pre- and postoperatively, and those of the Billroth II group were 78.2% and 45.3%. There were no difference of ejection fractions between the two groups. However a significant difference existed between the preoperative and the postoperative ejection fractions in each group. CONCLUSIONS: These findings may mean that the gastrectomy (it means vagal denervation) may be the major cause of the decreased gallbladder motility and that the reconstruction method after a gastrectomy may have no significant effect on gallbladder motility.
Subject(s)
Humans , Denervation , Follow-Up Studies , Gallbladder , Gallstones , Gastrectomy , Gastroenterostomy , Incidence , Prospective Studies , Radionuclide Imaging , Research Personnel , Stomach Neoplasms , Urinary Bladder , VagotomyABSTRACT
Objective To investigate whether high cholesterol diet (HCD) can cause gallbladder cholesterol calculus and to probe into the mechanism of its influence on gallbladder motility function. Methods Noumenon dissect and B-type ultrasonic apparatus was used to observe condition of gallbladder calculus formation in HCD group and normal control group; gallbladder motility function of the two groups were measured; radioimmunoassay was used to measure plasma CCK level in fast and 30min after fatty meal; colorimetry was used to measure cholesterol concentration in bile; and the pathologic changes of gallbladder specimen were observed. Results The gallbladder cholesterol calculus formation rate and cholesterol concentration in bile of HCD group was remarkably higher than that in normal control group (P