Los ejercicios técnicos para la mejora del tiro a portería en futbolistas sub 12 / Exercícios técnicos para a melhoria do tiro a portaria em jogadores de futebol sub-12 / Technical exercises for the improvement of the shot on goal in U12 players

RESUMEN La suspensión de los entrenamientos deportivos por causa de la emergencia sanitaria, ocasionada por la COVID 19, ha provocado que se busquen alternativas para contrarrestar los entrenamientos en este contexto. El objetivo de esta investigación consistió en presentar una propuesta de contextualización de ejercicios en casa para mejorar los tiros a portería, en deportistas adolescentes con lineamientos lúdicos. La metodología utilizada fue la fenomenológica-hermenéutica, con lo cual se quiere describir e interpretar la experiencia de diez entrenadores de fútbol de divisiones menores, de diferentes equipos de las ligas barriales en la ciudad de Quito. Para esto, se aplicó la técnica de la entrevista a través del instrumento banco de preguntas, las cuales respondían a dos dimensiones: la primera, al sistema de ejercicios específicos para el tipo a la portería y la segunda, el enfoque lúdico en la realización de ejercicios. Los resultados de las entrevistas se analizaron y sintetizaron en dos componentes: el primero fue el enfoque lúdico en la realización de ejercicios, donde se destaca el diseño de actividades lúdicas y el segundo componente fue el sistema de ejercicios específicos para el tipo a la portería. Se pudo obtener una propuesta contextualizada a las circunstancias vividas por los deportistas adolescentes y sus dificultades en los entrenamientos deportivos, sugiriendo la inclusión del enfoque lúdico, la utilización, adaptación y creación de implementos deportivos y su aplicabilidad en diferentes espacios, todo ello con la práctica de contenidos técnicos específicos para la mejora del tiro a portería, en el contexto de la pandemia.

RESUMO A suspensão do treinamento esportivo devido à emergência sanitária, causada pela COVID 19, provocou a busca de alternativas para contrariar o treinamento neste contexto. O objetivo desta pesquisa consistiu em apresentar uma proposta de contextualização dos exercícios em casa para melhorar os tiros a portaria, em atletas adolescentes com orientações lúdicas. A metodologia utilizada foi a fenomenológico-hermenêutica, com a qual queremos descrever e interpretar a experiência de dez treinadores de futebol de divisões menores, de diferentes equipes das ligas de bairro da cidade de Quito. Para isso, a técnica da entrevista foi aplicada através do banco de instrumentos de perguntas, que respondeu a duas dimensões: a primeira, ao sistema de exercícios específicos para o tipo ao objetivo e a segunda, a abordagem lúdica na realização de exercícios. Os resultados das entrevistas foram analisados e sintetizados em dois componentes: o primeiro foi a abordagem lúdica na realização de exercícios, onde se destaca o desenho das atividades lúdicas e o segundo componente foi o sistema de exercícios específicos para o tipo de objetivo. Foi possível obter uma proposta contextualizada às circunstâncias vividas pelos atletas adolescentes e suas dificuldades no treinamento esportivo, sugerindo a inclusão da abordagem lúdica, o uso, adaptação e criação de implementos esportivos e sua aplicabilidade em diferentes espaços, tudo com a prática de conteúdos técnicos específicos para a melhoria do chute a gol, no contexto da pandemia.

ABSTRACT The suspension of sports training due to the health emergency caused by COVID 19 has led to the search for alternatives to counteract training in this context. The objective of this research consisted of presenting a proposal for the contextualization of exercises at home to improve shots on goal, in adolescent athletes with ludic guidelines. The methodology used was the phenomenological-hermeneutic, with which we want to describe and interpret the experience of ten soccer coaches of minor divisions, from different teams of the neighborhood leagues in the city of Quito. For this, the interview technique was applied through the question bank instrument, which responded to two dimensions: the first, the system of specific exercises for the type of goalkeeping and the second, the playful approach in the realization of exercises. The results of the interviews were analyzed and synthesized into two components: the first was the ludic approach in the realization of exercises, where the design of ludic activities stands out, and the second component was the system of specific exercises for the goal type. It was possible to obtain a contextualized proposal to the circumstances experienced by adolescent athletes and their difficulties in sports training, suggesting the inclusion of the ludic approach, the use, adaptation and creation of sports implements and their applicability in different spaces, all this with the practice of specific technical contents for the improvement of the shot to goal, in the context of the pandemic.

A novel, new generation drill coating for osteotomy site preparation

Background: Implant success and survival rate ranges from 93% to 97%; however, failures are not very uncommon. These failures can be caused due to a variety of reasons out of which increased heat during drilling of osteotomies is a major contributor.Aim: The aim of this study was to develop a new generation diamond-coated drill and compare the thermal changes between commercially available drills and the experimental diamond coated drill during implant site preparation in artificial bone. Material and Methods: Three types of drills were selected for the study; Group A (Carbide), Group B (Stainless Steel), and Group C (Experimental). A total of 60 implant site preparations were performed with all the drills in artificial bone using a surgical unit linked to a testing device, in order to standardize implant drilling procedures. Bone temperature variations were recorded when drilling at a depth of 10 mm. A constant irrigation of 50 ml/minute and drilling speed of 800 r.p.m. was maintained. Results: The mean temperature of Group A, Group B, and Group C was 35.57°C, 36.83°C and 34.23°C, respectively. The results were assessed and statistically analyzed using ANOVA test and post hoc Bonferroni test. Statistically significant higher temperatures were obtained with stainless steel drill and carbide drill when compared with the experimental diamond coated drill. (P = 0.000). Conclusions: Diamond coated osteotomy drills have shown promising results in reducing heat generation at the osteotomy. Further studies need to be conducted to maximize the potential use of diamond as components of drills in implant dentistry.

Drilling and evaluation of emergency rescue against mass casualties at general hospitals in Tianjin / 中华医院管理杂志

Objective To understand the ability and level of emergency rescue at general hospitals in Tianjin city. Methods Such actions as formulating plans and examination forms, establishing assessment indicators and evaluation criteria, and simulation exercises were performed to evaluate the capacity of 28 general hospitals in terms of their organizational structure, emergency response, event reporting, and summary assessment. Results The emergency response assessment system consisted of 4 level-1 indicators, 19 level-2 indicators and 58 level-3 indicators. 28 hospitals were found high in their overall emergency response capacity, but some were found with setbacks. For example, the " organizational structure" scored the highest in 4 first-level indicators, up to 88. 91％ , while " incident report" scored the lowest, down to 67. 99％ . Among level-2 indicators, professional emergency professional procedures and initial reporting scored the lowest. Conclusions In order to further improve the ability of medical institutions to respond to emergency events, the hospitals are recommended to enhance their backup resources for emergency response, their staff′s awareness of first aid knowledge and first aid skills, as well as their timeliness of initial reports and the completeness of progress reports.

Establishment and exercise of a rapid response team for obstetrics / 中国实用妇科与产科杂志

Because of the mutation,variability and variability of obstetric conditions,it is particularly important to establish a rapid response team in the maternity department that can effectively deal withmaternal conditions at an early stage of development,rather than waiting for their deterioration before resuscitating them.The establishment of obstetric RRT requires the support of hospitals,obstetrics and other departments.Training,drills,and assessments after the completion of the RRT also need to be carried out regularly,so that the RRT team continues to be improved.

Various bio-mechanical factors affecting heat generation during osteotomy preparation: A systematic review

As implant site preparation and bone are critical precursors to primary healing, thermal and mechanical damage to the bone must be minimized during the preparation of the implant site. Moreover, excessively traumatic surgery can adversely affect the maturation of bone tissue at the bone/implant interface and consequently diminish the predictability of osseointegration. So, this study was carried out to evaluate the various biological and mechanical factors responsible for heat generation during osteotomy site preparation to reduce the same for successful osseointegration of dental implants. Study Design: A broad search of the dental literature in PubMed added by manual search was performed for articles published between 1992 and December 2015. Various bio-mechanical factors related to dental implant osteotomy preparation such as dental implant drill designs/material/wear, drilling methods, type of irrigation, and bone quality were reviewed. Titles and abstracts were screened and articles which fulfilled the inclusion criteria were selected for a full-text reading. Results: The initial database search yielded 123 titles, of which 59 titles were discarded after reading the titles and abstracts, 30 articles were again excluded based on inclusion and exclusion criteria, and finally 34 articles were selected for data extraction. Many biological and mechanical factors responsible for heat generation were found. Conclusion: Literatures of this review study have indicated that there are various bio-mechanical reasons, which affect the temperature rise during osteotomy and suggest that the amount of heat generation is a multifactorial in nature and it should be minimized for better primary healing of the implant site.

Durabilidad de las fresas de diamante tras realizar desgastes en dientes naturales, comparando 4 marcas comerciales, analizado en microscopía electrónica / Diomond Burs durability, aer tooth wears, 4 brands compaired. Electronic Microscopy analysis

Antecedentes: Los hallazgos reportados en la literatura no relacionan directamente la efectividad de corte de las fresas de diamante de alta velocidad con la cantidad y calidad de diamantes en la superficie, ni su vida media después de un determinado número de usos. Objetivo: Evaluar la durabilidad de los diamantes de corte de la superficie activa de las fresas después de realizar desgastes en dientes naturales. Métodos: Este estudio ex vivo comparó 4 marcas comerciales de fresas de diamante con granos de 64-126 |zm, de forma troncocónica y punta redonda (norma ISO 850): MDT", Swisstech*, Pointech* y Jota". Se realizaron 5 cortes de 0,16 mm con cada fresa en la corona del diente. Luego se analizaron las fresas en microscopio electrónico de barrido para observar: a) adhesión de diamantes al sustrato en cabeza y cuerpo; b) estado de los diamantes en el sustrato en cabeza y cuerpo, tras los 5 cortes; y c) estadofinal de las fresas. Se realizó un análisis cualitativo y cuantitativo. Resultados: Todas las fresas de las 4 marcas presentaron similar desgaste después de los 5 usos, tanto en la cabeza como el cuerpo. Pese a que todas las muestras presentaban variaciones, en algunas fue más evidente el desalojo y fractura de los diamantes. Conclusión: El estudio sugiere que las fresas deberían cambiarse después de 5 usos clínicos para garantizar un desgaste adecuado y evitar daños pulpares ocasionados por la fricción.

Background: Outcomes reported in the literature do not relate cutting effectiveness of high-speed diamond drills directly to the diamond surface amount and quality, not either their average life after a specific number of uses. Objective: To evaluate the durability of diamond burrs in the drill active surface after doing removal in natural teeth. Methods: This ex vivo study compared dental drills of four different brand names with 64-126 pm, round tip, conical-trunk diamond grit (ISO 850): MDT", Swisstech", Pointech* and Jota". Five 0.16 mm cuts were carried out using each dental drill on a tooth crown. The dental drills were then analyzed under the scanning electron microscope in order to observe: a) any adhesion of diamond to substrate in the head and body; b) condition of the diamonds in the substrate, in head and body, after 5 cuts; and c) final condition of the dental drills. Then a qualitative and quantitative analysis was carried out. ResuJts: The four different dental drills showed a similar worn condition after five uses, both in the head and body. Despite all the samples showed variations, some of them had greater evidence of diamond fracture and displacement. Conclusion: This study suggests that the dental drills should be changed over after 5 clinical uses in order to ensure a desirable worn condition and prevent pulpal damage due to the friction.

Study on the construction of food and drug safety emergency drill and training program / 中国药学杂志

OBJECTIVE: The emergency practice and training program of food and drug safety in China's food and drug administration system is studied. METHODS: The relevant situation of food and drug safety emergency drills and training in European Union and the emergency drills and training of food and drug in our country are learned. RESULTS: The food and drug emergency drills and training programs in our country is explored and prospected, and the related thinking and enlightenment is put forward. CONCLUSION: The food and drug safety emergency drills and training, innovation the exercise form and the content of the exercise should be vigorously strengthened, a hierarchical field emergency drill mechanism, prominent combat emergency drills will be established, and pay attention to emergency response drill assessment.

Accuracy of a direct drill-guiding system with minimal tolerance of surgical instruments used for implant surgery: a prospective clinical study

PURPOSE: A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS: For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (α=.05). RESULTS: The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION: The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.

Influência das fresas rotatórias e expansores ósseos na estabilidade primária dos implantes dentários em situações de pouca espessura óssea: estudo in vitro / Influence of drilling burs and bone expanders on primary implant stability in sites with reduced bone thickness: an in vitro study

Objetivos: avaliar a estabilidade primária dos implantes instalados em leitos cirúrgicos utilizando fresas rotatórias e dois tipos de expansores ósseos em condições de pouco volume ósseo (largura). Material e métodos: costelas de osso bovino fresco receberam implantes cilíndricos de hexágono externo (3,75 mm x 13 mm), formando os grupos de fresas rotatórias (I), Kit Expansor Master (II) e Kit de expansão óssea Split Control (III). Em cada grupo foram instalados sete implantes. As estabilidades primárias foram avaliadas por dois torquímetros manuais e pelo registro dos valores ISQ através da frequência de ressonância nos sentidos anteroposterior (A1) e mesiodistal (A2). Resultados: as variações nos torques foram: grupo I (10-80 Ncm), grupo II (10-45 Ncm) e grupo III (20-45 Ncm). As variações nas frequências A1 e A2 foram: grupo I (48-81 ISQ; 68-87 ISQ), grupo II (52-76 ISQ; 52-81 ISQ) e grupo III (52-63 ISQ; 67-82 ISQ). Não houve relação entre a frequência de ressonância e o torque de inserção. O número de roscas expostas nos grupos I, II e III foi seis, três e três, respectivamente. No grupo I, as fresas rotatórias subtrairam o tecido ósseo, deixando as paredes mais finas. No grupo II, a dificuldade de expansão foi frequente nas regiões mais corticais. No grupo III, a expansão óssea foi autorrosqueante. Conclusões: dentro dos limites de estudo, concluiu-se que nos três grupos estudados todos os implantes alcançaram estabilidades primárias, quando avaliadas pelo torque de inserção e pelo coeficiente de estabilidade do implante.

Objectives: to evaluate primary implant stability in surgical sites through drilling burs and two types of bone expanders under bone volume conditions. Material and methods: fresh bovine ribs received external hex, cylindrical implants (3.75 mm x 13 mm) and were divided according surgical protocols: drilling burs (group I), expansor Master Kit (group II), and Split Control (group III). Seven implants were placed in each group. Primary stability was evaluated by means of two torque meters and resonance frequency (Ostell) in the antero-posterior (A1) and mesio-distal (A2) directions. Results: the obtained torque ranges were: group I (10-80 Ncm), group II (10-45 Ncm), and group III (20-45 Ncm). Resonance frequency ranges at A1 and A2 were: group I (48-81 ISQ; 68-87 ISQ), group II (52-76 ISQ; 52-81 ISQ) and group III (52-63 ISQ; 67-82 ISQ). No relationship was found between insertion torques and resonance frequencies. The number of exposed implant threads for groups I, II, and III was 6, 3, and 3, respectively. In group I, drilling burs removed tissue generating thinner bone walls. In group II, diffi culties on bone expansion were frequent at more cortical regions. In group III, a self-tapping effect was achieved. Conclusions: within the limits of this study, it can be concluded that all implants reached primary stability according insertion torque and resonance frequency analyses.

Strategic planning and designing of a hospital disaster manual in a tertiary care, teaching, research and referral institute in India / 世界急诊医学杂志（英文）

BACKGROUND:As per the "Disaster Management Act, 2005" of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders. METHODS:A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a final disaster manual. RESULTS:The prepared departmental standard operating procedures involved 116 people (doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the final hospital disaster manual. CONCLUSIONS:The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills.

Atención primaria en salud, con enfoque preventivo, desde primeros auxilios, brigadas de emergencia y simulacros de evacuación Herlinda Torres-Nieto / Primary health care with preventive approach from first aid brigades, emergency evacuation drills / Atenção Primária à Saúde com abordagem preventiva de primeiros socorros brigadas exercícios de evacuação de emergência

Objetivo: Identificar la capacidad de respuesta de los estudiantes de enfermería de la Fundación Universitaria del Área Andina, ante las situaciones de emergencia, con el fin de instaurar la asignatura electiva, para fomentar la estrategia de Atención Primaria en Salud (APS) a nivel escolar. Materiales y Métodos: Se desarrolló un estudio descriptivo y se utilizó el programa Excel para el análisis de la información. Se elaboró una encuesta sobre la capacidad de respuesta frente a situaciones específicas de emergencia. La población sujeto de estudio fueron 300 estudiantes de primero y segundo semestre del programa de enfermería. La muestra estuvo constituida por 39 estudiantes tomados en forma aleatoria. Este trabajo se desarrolló desde el programa de enfermería de la Fundación Universitaria del Área Andina a partir del trabajo desarrollado en instituciones de educación básica y media en el servicio social obligatorio. Resultados: El 100% de los estudiantes encuestados conoce el Número Único de Emergencias, línea 123, para todo el territorio nacional. El 100% de los estudiantes encuestados, considera necesario incluir la asignatura de primeros auxilios en el plan de estudios de enfermería. Conclusión: El tema de primeros auxilios, compete a todos los integrantes de las comunidades educativas, es necesario el trabajo intersectorial con las entidades que manejan la temática en forma práctica, para el desarrollo del ejercicio de simulacro de evacuación.

Goal: To identify the responsiveness of nursing students of the "Fundación Universitaria del Area Andina", in situations of emergency, in order to establish the elective, to promote the strategy of Primary Health Care (PHC) at the school level. Materials and Methods: A descriptive study was conducted and the Excel program for data analysis was used. A survey on the capacity to respond to specific emergency situations was developed. The subject of study population was 300 students in first and second semester of the nursing program. The sample consisted of 39 students drawn randomly. This work was developed from the nursing program at the "Fundación Universitaria del Area Andina" from institutions developed in primary and secondary education in the mandatory social service work. Results: 100% of students surveyed know the Single Emergency Number, line 123, for the entire national territory. 100% of the students surveyed, considered necessary to include first aid course in the nursing curriculum. Conclusions: The subject of first aid, responsibility of all members of the educational community, it is necessary intersectional work with organizations dealing with the issue in a practical way for the development of evacuation simulation exercise.

Objetivo: Para identificar a capacidade de resposta dos estudantes de enfermagem da "Fundacion Universitaria del Área Andina", em situações de emergência, a fim de estabelecer a eletiva, para promover a estratégia de Atenção Primária à Saúde (APS) no nível da escola. Materiais e Métodos: Foi realizado estudo descritivo eo programa Excel para análise de dados foi usado. Um inquérito sobre a capacidade de responder a situações de emergência específicas foi desenvolvida. O tema da população do estudo foram 300 alunos no primeiro e segundo semestre do curso de enfermagem. A amostra foi composta de 39 alunos sorteados. Este trabalho foi desenvolvido a partir do curso de enfermagem da "Fundación Universitaria del area Andina" de instituições desenvolvidas no ensino primário e secundário no trabalho de serviço social obrigatório. Resultados: 100% dos alunos pesquisados chamado o número único de emergência, linha 123, para todo o território nacional. 100% dos alunos pesquisados, considerado necessário incluir curso de primeiros socorros no currículo de enfermagem. Conclusão: O assunto de primeiros socorros, a responsabilidade de todos os membros da comunidade educativa, é necessário o trabalho intersetorial com as organizações de lidar com a questão de uma forma prática para o desenvolvimento do exercício de simulação de evacuação.

A influência de diferentes métodos de ampliação cervical na obtenção do comprimento de trabalho em canais mesiovestibulares de primeiros molares superiores / The influence of different methods of cervical magnifying in the attainment of the lenght of work in first mesio-vestibular canals tests of superior molar

A ampliação da entrada de canais radiculares com o uso de diferentes tipos de métodos e instrumentos é alvo de inúmeras pesquisas na Odontologia. O objetivo deste estudo foi determinar a influência de quatro sistemas distintos de instrumentos rotatórios para alargamento cervical na determinação do comprimento real de trabalho (CRT). Por meio da comparação entre esses quatro tipo de instrumento diferentes que podem ser utilizados pelo profissional, averiguou-se o mais efetivo para a ampliação cervical de canais radiculares curvos. A etapa experimental foi realizada no Laboratório de Endodontia da Faculdade de Odontologia da Universidade de Passo Fundo (FOUPF). O estudo in vitro foi feito com 40 raízes mesiovestibulares de primeiros molares superiores humanos permanentes, obtidas no banco de dentes da FOUPF. As 40 amostras foram divididas aleatoriamente em 4 grupos de 10 dentes cada, os quais foram submetidos ao acesso endodôntico convencional. Após a verificação do CRT, aplicaram-se os métodos de ampliação cervical em cada grupo, com uso de brocas Gates-Glidden (Dentsply Maillefer, Ballaigues, Suíça) no grupo 1, alargadores rotatórios de níquel-titânio Orifice Openers (SybronEndo, Glendora, USA) no grupo 2, instrumentos de níquel-titânio SX e o instrumento S1 (ProTaper ­ Dentsply Maillefer, Ballaigues, Suíça) no grupo 3 e LA Axxess (SybronEndo, Glendora, USA) no grupo 4. Na seqüência verificou-se novamente o CRT. A diferença entre a primeira e a segunda odontometria foi calculada (ANOVA), e o teste de comparações múltiplas de Tukey (p ≤ 5%) identificou diferenças significativas entre os grupos avaliados. Os instrumentos rotatórios de níquel-titânio SX e S1 do sistema ProTaper apresentaram os melhores resultados, e os instrumentos rotatórios de aço inox Gates-Glidden (brocas) tiveram os piores resultados

The magnifying of radicular canals using different types of methods and instruments is focus of innumerable researches in Deontology. The objective of this study was to determine the influence of four distinct systems of rotatory instruments for cervical widening in the determination of the real length of work (CRT). Through the comparison among these four types of possible different instruments to be used by the professional it was possible to evaluate the most effective for the cervical magnifying of arched radicular canals. The experimental stage was carried through in the Laboratory of Endodontia of the College of Odontologia of the University of Passo Fundo (FOUPF). The present in vitro study involved 40 roots of first mesio-vestibular tests of molar permanent human superiors, gotten in the Tooth Bank of the College of Odontologia of the University of Passo Fundo (FOUPF). The 40 samples have been divided randomly in 4 groups of 10 teeth each, which have been submitted to the conventional endodontic access. After the verification of the real CRT, the methods of cervical magnifying in each group have been applied, being group 1 with Gates-Glidden drills (Dentsply Maillefer, Ballaigues, Switzerland), group 2 with rotatory nickel-titanium wideners ORIFICE OPENERS (SybronEndo, Glendora, the USA), group 3 with nickel-titanium instruments SX and the S1 instrument (ProTaper - Dentsply Maillefer, Ballaigues, Switzerland), and group 4 with LA Axxess (SybronEndo, Glendora, USA). After that the CRT was verified again. The difference between the first and the second odontometry has been calculated (ANOVA) and the test of multiple comparisons of Tukey (p ≤ 5%) identified significant differences between the studied groups. The rotatory nickel-titanium instrument SX and S1 of the ProTaper system has presented the best results and the rotatory steel instruments inox Gates Glidden (drills) have presented the worst ones

Treatment of gluteus muscles contracture with small incision insidious lysis and three steps rehabilitative drills / 中国矫形外科杂志

[Objective] To investigate the clinical effects in the treatment of gluteus muscles contracture of small incision insidious lysis and three steps rehabilitative drills.[Method]One hundred and eighteen patients were treated with small incision insidious lysis and three steps rehabilitative drills(treatment group),and fifty-six patents with gluteus maximus lysis(control group)from February 1988 to February 2006.Clinical classification of gluteal muscle contracture,mechanism of crook-lateral and spread-lateral limb cross-leg tests designed by the author,main points of small incision insidious lysis and implement of three steps rehabilitative drills were evaluated.[Result]The cases were followed up for 1~8 years,clinical outcomes were evaluated by the Huang Yao-tian's scoring system.The early clinical effect were evaluated after 45 days of operation.All the results showed statistically significant difference(

A Study On The Temperature Changes Of Bone Tissues During Implant Site Preparation / 대한치과보철학회지

The purpose of this study is to examine the possibility of thermal injury to bone tissues during an implant site preparation under the same condition as a typical clinical practice of Branemark implant system.All the burs for Branemark implant system were studied except the round bur.The experiments involved 880 drilling cases:50 cases for each of the 5 steps of NP, 5 steps of RP,and 7 steps of WP,all including srew tap,and 30 cases of 2mm twist drill. For precision drilling,a precision handpiece restraining system was developed(Eungyong Machinery Co.,Korea).The system kept the drill parallel to the drilling path and allowed horizontal adjustment of the drill with as little as 1 mu m increment.The thermocouple insertion hole.that is 0.9mm in diameter and 8mm in depth,was prepared 0.2mm away from the tapping bur,the last drilling step.The temperatures due to countersink,pilot drill,and other drills were measured at the surface of the bone,at the depths of 4mm and 8mm respectively. Countersink drilling temperature was measured by attaching the tip of a thermocouple at the rim of the countersink.To assure temperature measurement at the desired depths,''bent-thermocouples'' with their tips of 4 and 8mm bent at 120 were used.The profiles of temperature variation were recorded continuously at one second interval using a thermometer with memory function (Fluke Co.,U.S.A.)and 0.7mm thermocouples (Omega Co.,U.S.A.). To simulate typical clinical conditions,35mm square samples of bovine scapular bone were utilized.The samples were approximately 20mm thick with the cortical thickness on the drilling side ranging from 1 to 2mm.A sample was placed in a container of saline solution so that its lower half is submerged into the solution and the upper half exposed to the room air,which averaged 24.9 degrees C.The temperature of the saline solution was maintained at 36.5 degrees C using an electric heater (J.O Tech Co.,Korea).This experimental condition was similar to that ofa patient's opened mouth. The study revealed that a 2mm twist drill required greatest attention.As a guide drill, a twist drill is required to bore through a '' virgin bone,''rather than merely enlarging an already drilled hole as is the case with other drills.This typically generates greater amount of heat.Furthermore,one tends to apply a greater pressure to overcome drilling difficulty, thus producing even greater amount heat. 150 experiments were conducted for 2mm twist drill.For 140 cases,drill pressure of 750g was sufficient,and 10 cases required additional 500 or 100g of drilling pressure.In case of the former,3 of the 140 cases produced the temperature greater than 47 degrees C,the threshold temperature of degeneration of bone tissue (1983.Eriksson et al.5))which is also the reference temperature in this study.In each of the 10 cases requiring extra pressure,the temperature exceeded the reference temperature.More significantly,a surge of heat was observed in each of these cases.This observations led to addtional 20 drilling experiments on dense bones.For 10 of these cases,the pressure of 1,250g was applied.For the other 10,1,750g were applied.In each of these cases,it was also observed that the temperature rose abruptly far above the thresh-old temperature of 47 degrees C,sometimes even to 70 or 80 degrees C.It was also observed that the increased drilling pressure influenced the shortening of drilling time more than the rise of drilling temperature.This suggests the desirability of clinically reconsidering application of extra pressures to prevent possible injury to bone tissues. An analysis of these two extra pressure groups of 1,250g and 1,750g revealed that the t-statistics for reduced amount of drilling time due to extra pressure and increased peak temperature due to the same were 10.80 and 2.08 respectively suggesting that drilling time was more influenced than temperature. All the subsequent drillings after the drilling with a 2mm twist drill did not produce excessive heat, i.e.the heat generation is at the same or below the body temperature level. Some of screw tap,pilot,and countersink showed negative correlation coefficients between the generated heat and the drilling time,indicating the more the drilling time,the lower the temperature. The study also revealed that the drilling time was increased as a function of frequency of the use of the drill.Under the drilling pressure of 750g, it was revealed that the drilling time for an old twist drill that has already drilled 40 times was 4.5 times longer than a new drill. The measurement was taken for the first 10 drilings of a new drill and 10 drillings of an old drill that has already been used for 40 drillings. ''Test Statistics''of small samples t-test was 3.49,confirming that the used twist drills require longer drilling time than new ones.On the other hand,it was revealed that there was no significant difference in drilling temperature between the new drill and the old twist drill. Finally,the following conclusions were reached from this study: 1.Used drilling bur causes almost no change in drilling temperature but increase in drilling time through 50 drillings under the manufacturer-recommended cooling conditions and the drilling pressure of 750g. 2.The heat that is generated through drilling mattered only in the case of 2mm twist drills,the first drill to be used in bone drilling process;for all the other drills there is no significant problem. 3.If the drilling pressure is increased when a 2mm twist drill reaches a dense bone, the temperature rises abruptly even under the manufacturer-recommended cooling conditions. 4.Drilling heat was the highest at the final moment of the drilling process.