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Background: Smear layer is always formed during the instrumentation process due to the action of endodontic instruments during the shaping process and it should be removed as it might decrease the overall success of endodontic therapy. Aim of the study: To compare the cleaning efficiency of different rotary Ni-Ti systems: ProTaper Next, Xpendo Shaper and WaveOne Gold by assessing their ability to remove the smear layer from root canals walls. Methods and materials: A total of 24 palatal roots of maxillary molars were used in this study and randomly assigned into 3 groups (n=8) as follows: Group 1: instrumentation with ProTaper Next system (Dentsply Maillefer, Switzerland), Group 2: instrumentation with Xp-endo Shaper system (FKG Dentaire, Switzerland) and Group 3: instrumentation with WaveOne Gold system (Dentsply Maillefer, Switzerland). The samples were irrigated with 5.25% NaOCl. All samples were then examined by scanning electron microscope (SEM) at the center of the coronal, middle and apical thirds. The data was statistically analyzed using Kruskal Wallis and Mann-Whitney U tests. Results: ProTaper Next files showed a lower average mean of smear layer when compared to WaveOne Gold and Xp-endo Shaper files at the coronal third. No significant differences between the average means of smear layer were found at the middle and apical thirds. Conclusion: None of the tested groups showed a completely smear layer free root canal walls. In general, ProTaper Next files showed the best performance at the coronal third. All the files showed comparable performance at the middle and apical thirds.
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Debridement of necrotic tissue can be done by mass, dermatome(hand, electrical), laser, or ultrasound. The authors aims to introduced the another way of debridement of necrotic tissue using sterilized peeler.
Sujets)
DébridementRésumé
Objective To investigate the management of retroperitoneal infected necrotic tissues in pelvic cavity in patients with severe acute pancreatitis (SAP).Methods The clinical data of 5 patients with SAP complicated with retroperitoneal infected necrotic tissue in the pelvic carvity who were admitted to the General Hospital of Nanjing Military Area from December 2009 to February 2012 were retrospectively analyzed.Systemic comprehensive treatement combined with local management were applied to all the patients.Results Systemic comprehensive treatment:all the 5 patients were treated by enteral nutrition,3 by mechanical ventilation and 3 by continuous blood purification.All the retroperitoneal infected necrotic tissues in the pelvic carvity were treated by computed tomography (CT)-guided percutaneous catheter drainage,and then the patients were converted to open surgery for further drainage.Four patients had complication of infected pancreatic necrosis bleeding,and they were treated by arterial embolism and (or) sandwich therapy.Local management:5 patients with retroperitoneal infected necrotic tissues received CT-guided percutaneous catheter drainage via buttocks.The average time of puncturation after illness was 38.4 days,and the average CT density of infected necrotic tissue was 24.4 Hu (20-28 Hu).Catheterization was successfully done in the open surgery for all the 5 patients,and the average time of abdominal drainage was 21 days.The body temperature and white blood cell count were decreased after puncturation.The average duration of intensive care unite stay,the average time of hospital stay and the average cost of hospitalization were (47 ± 20 )days,(88 ±34 )days and (186 342 ± 15 467 )yuan.All the patients were followed up till May 2012,no recurrece of the retroperitoneal infected necrotic tissue was detected.Conclusion CT-guided percutaneous catheter drainage via buttocks is effective for the treatment of retroperitoneal infected necrotic tissue in the pelvic cavity in SAP patients.
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Infected pancreatic necrosis is a fatal complication of severe acute pancreatitis ( SAP),while traditional laparotomy has many disadvantages,such as great trauma and many complications,in recent years,minimally invasive treatment has got great progress in clearing the necrotic tissue of pancreas,but its drainage effect is not optimal.From January 2010 to December 2011,19 patients with infected pancreatic necrosis complicated by SAP who were admitted to the Nanjing General Hospital of Nanjing Military Area were implemented computed tomography or ultrasound-guided Seldinger puncture.Along the puncture needle,a guide wire was inserted into the necrotic tissue,and then the sinus was expanded,in which a tube was placed for negative pressure irrigation and drainage.By continuous postoperative negative pressure irrigation and drainage,the necrotic tissue gradually dropped off and disappeared in 12 patients,and the other 7 patients were performed endoscopic necrotic tissue removal and drainage along the sinus.Systemic symptons of infection obviously improved in all of the 19 patients,and no organ dysfunction or complications occurred.Finally,16 patients were cured and 3 patients died.Continuous percutaneous negative pressure irrigation and drainage combined with the endoscopic necrotic tissue removal could become an important choice to treat the infected pancreatic necrosis.
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PURPOSE: During the follow-up period of the patient who was diagnosed as rhabdomyosarcoma and treated between 1991 and 1992 in Kyungpook National University Hospital (KNUH), the residual mass lesion on computerizing tomography (CT) was suspected as tumor progress. But, it was diagnosed as necrotic tissue by excisional biopsy and he has survived without recurrence until now. So, we have the necessity of the method that is able to differentiate the remnant tumor with necrotic tissue during or after treatment. The objective of this study was to evaluate prospectively the effectiveness of thallium (Tl-201) scan in detecting the bioavailability of tumor at diagnosis and after treatment. METHODS: CT and/or magnetic resonance imaging (MRI) and Tl-201 scan at diagnosis, during the treatment and after treatment were conducted in 19 solid tumor patients treated for their diseases from December 1996 to June 1998, in Pediatric Department of KNUH. And we evaluated the recurrence of solid tumors following them up to March 2001. RESULTS: In the cases of the presence of solid tumor in CT or MRI at diagnosis, we could also find them on Tl-201 scan in all of them. During the treatment, PNET patient had the mass lesion on MRI and Tl-201 scan, we kept going on the chemotherapy and radiotherapy. And retinoblastoma patient also had continued chemotherapy after confirming the mass lesion on MRI, not Tl-201 scan. Six cases (alveolar soft part sarcoma, medulloblastoma, Ewing sarcoma, Non-Hodgkin's lymphoma, rhabdomyosarcoma, neuroblastoma) in which no mass lesion were found in CT or MRI and Tl-201 scan had their final therapy. After finishing the treatment, high-grade anaplastic astrocytoma patient confirmed the mass lesion on MRI and Tl-201 scan and expired irrespective of retreatment after 19 months of diagnosis. In 2 cases of solid tumor on CT scan, not on Tl-201 scan, germ cell tumor patient has been followed up until now without recurrence with normal alpha-FP level, and NHL patient has survived without recurrence. Four cases (Non-Hodgkin's lymphoma; 2 cases, medulloblastoma; 1 case, ependymoma; 1 case) with negative finding on CT or MRI and Tl-201 scan also has survived without recurrence. CONCLUSION: Although CT or MRI is used commonly in the follow-up period of childhood solid tumor, Tl-201 scan can be the useful method of differentiating viable tumor with necrotic tissue in the view of cost-effectiveness and availability.