Anesthesia, Local ; Dentistry ; Drainage ; Hematoma ; Hemorrhage ; Hydrocarbons, Iodinated ; Oral Hygiene ; Rubber ; Seroma ; Splints ; Stress, Psychological ; Tooth ; Wound Infection

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.
Adult ; Airway Obstruction ; Blood Platelets ; Cerebral Palsy ; Drainage ; Emergencies ; Glycosaminoglycans ; Hemorrhage ; Humans ; Hydrocarbons, Iodinated ; Infection Control ; Male ; Mentally Disabled Persons ; Purpura, Thrombocytopenic ; Rubber ; Scurvy ; Shock ; Sutures ; Wound Infection

The purpose of this study was two-fold. First was to evaluate whether the molecular sieving model was appropriate for ionic dissociation experiment. Second was to compare the dissociation of calcium and hydroxyl ions from five types of calcium hydroxide pastes (Pure calcium hydroxide paste, DT temporary dressing(R), Metapaste(R), Chidopex(R), Metapex(R)) in three vehicles (aqueous, viscous and oily) and the antibacterial effect. Each calcium hydroxide pastes was placed into 0.65ml tube with cap and then 15% polyacrylamide gel was placed onto calcium hydroxide pastes. After the gel was hardened, the tubes were filled with tridistilled water (pH 7.14) and closed with cap. The tubes were stored in 37degrees C, 100% incubator. The pH reading and the concentration of calcium ions were taken at 1, 4, 7, 10, and 14 days. The brain heart infusion agar plates with S. mutans and A. actinomycetemcomitans were used for antibacterial activity test. Middle of agar plate was filled with the calcium hydroxide pastes. The plates were incubated at 37degrees C and observations were made to detect the zones of inhibition. These data were evaluated statistically by use of the analysis of variance and duncan test. The results were as follows. 1. In fresh mixing state, the pH of five types of calcium hydroxide pastes were measured between 12.5 and 12.8. 2. The pH was increased in all five types of calcium hydroxide pastes compared with control group. In 14 days, Pure calcium hydroxide paste (11.45) and DT temporary dressing(R) (11.33) showed highest pH, followed by Metapaste(R) (9.49), Chidopex(R) (8.37) and Metapex(R) (7.59). 3. Calcium was higher in all five types of calcium hydroxide pastes compared with control group. In 14 days, Pure calcium hydroxide paste (137.29 mg%) and DT temporary dressing(R) (124.6 mg%) showed highest value, followed by Metapaste(R) (116.74 mg%), Chidopex(R) (111.84 mg%) and Metapex(R) (60.22 mg%). 4. The zones of bacterial inhibition were seen around all five types of calcium hydroxide pastes. Chidopex(R) and Metapex(R) groups which include iodoform were observed significantly larger zone of inhibition in A. actinomycetemcomitans compared with the other calcium hydroxide groups (p<0.05). However, Metapex(R) showed the least antibacterial effect on S. mutans compared with other groups (p<0.05). The molecular sieving model was found to be acceptable in dissociation experiment of hydroxyl and calcium ions when compared with the previous tooth model study. But this model was not appropriate for the antibacterial test.
Acrylic Resins ; Agar ; Brain ; Calcium ; Calcium Hydroxide ; Dissociative Disorders ; Heart ; Hydrocarbons, Iodinated ; Hydrogen-Ion Concentration ; Hydroxides ; Incubators ; Ions ; Ointments ; Tooth ; Water

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.
Avitaminosis ; Bandages ; Blood Platelets ; Capillaries ; Dehydration ; Drainage ; Dry Socket ; Female ; Fibrinogen ; Gelatin ; Gelatin Sponge, Absorbable ; Hemophilia B ; Hemorrhage ; Hemostasis ; Humans ; Hydrocarbons, Iodinated ; Liver ; Liver Cirrhosis ; Porifera ; Purpura, Thrombocytopenic ; Rubber ; Scurvy ; Thrombin ; Tooth ; Veins

The various special diagnostic procedures have been used for the cervical cord injuries. The author describes a new technique of pantopaque cervical myelography based on the lateral C1-2 puncture.
Iophendylate* ; Myelography* ; Punctures*

With the establishment of the anterior cervical approach as the procedure of choice for cervical fracture-dislocation, attention has now turned to refinements of Cloward technique. The purpose of application of the Cloward technique is to achieve early stabilization of the fracture-dislocation, to shorten the recumbency period, and to promote rehabilitation. Recently the authors have experienced with the Cloward technique in the treatment of cervical fracture-dislocation. Our results indicated that anterior interbody fusion has been a satisfactory method for stabilizing one or more segment of the cervical fracture-dislocation. The prevention of dowel fracture or extrusion following fusion has been a important factor in the success. Another advantage obtained is to use the operating microscope for decompression of nerve roots. The chronic locked facets have not been reduced by the application of Cloward technique, but have been managed to achieve stabilization with Smith-Robinson technique. The lateral cervical pucture technique(C1-C2) for pantopaque myelography has been shown to be a valuable adjunct of acute injuries of the cervical spinal cord. A new technique for wiring and fusion of atlanto-axial dislocation has been performed with satisfactory results.
Decompression ; Dislocations* ; Iophendylate ; Myelography ; Rehabilitation ; Spinal Cord

Metrizamide lumbar myelography were performed in 150 patients with suspected herniated lumbar disc. The examination is easier to perform than with gas or iophendylate. The advantage of metrizamide over gas or iophendylate are the improved root sleeve visualization and examination of small structure such as root, root pocket and blood vessel. And then this is a higher percentage of diagnostic accuracy than can be obtained with other myelogram. Most of adverse reactions during and after myelography are mild and transitory, and no serious adverse reactions occured. It probably has a lower neurotoxicity than any other water soluble contrast agent.
Blood Vessels ; Humans ; Iophendylate ; Metrizamide* ; Myelography* ; Water

Teeth and bones are highly mineralized tissues containing inorganic minerals such as calcium phosphate, and a growing number of evidences show that their mineral content is associated with many diseases. Although the quantification of mineral contents by micro-computed tomography(micro- CT) has been used in diagnosis and evaluation for treating bone diseases, its application for teeth diseases has not been well established. In this study, we attempted to estimate a usefulness of a high-resolution micro-CT in analysis of human teeth. The teeth were scanned by using the Skyscan 1172 micro-CT. In order to measure tooth mineral content, beam hardening effect of the machine was corrected with a radiopaque iodinecontaining substance, iodoacetamide. Under the maximum resolution of 6.6 µm, X-ray densities in teeth and hydroxyapatite standards were obtained with Hounsfield unit (HU), and they were then converted to an absolute mineral concentration by a CT Analyzer software. In enamel layer of cusp area, the mean mineral concentration was about 2.14 mg/mm³ and there was a constant mineral concentration gradient from the enamel surface to the dentinoenamel junction. In the dentin of middle 1/3 of tooth, the mean mineral concentration was approximately 1.27 mg/mm³ and there was a constant mineral concentration gradient from the outer of root to the pulp side, ranging from 1.3 to 1.06 mg/mm³. In decay region of dentin, the mineral content was gradually decreased from the intact inner side to the decayed surface. These results suggest that high-resolution micro-CT can be as a useful tool for non-invasive measurement of mineral concentration in teeth.
Bone Diseases ; Calcium ; Dental Enamel ; Dentin ; Diagnosis ; Durapatite ; Humans ; Iodoacetamide ; Minerals ; Miners* ; Tooth*

The virtues of the pantopaque myelography in the study of the herniated intervertebral disc have been generally accepted. As expected, it shows the presence of ruptured disc in the accuracy over 80%. But it is open to discussion whether the myelographic defects can indicate the exact location and type of herniated discs or not. In this article, we attempted to find out some correlation between the myelographic defect and the operative finding in viewing the size and shape of myelographic defects. This consideration may be helpful to make a clear cut diagnosis in the lumbar disc disease. One hundred and sixtytwo operative cases undergoing pantopaque myelography were subjected. Some obtained results will be presented.
Diagnosis ; Intervertebral Disc ; Intervertebral Disc Displacement ; Iophendylate ; Myelography ; Virtues

Traction injuries of the brachial plexus have recognized since the classic descriptions of Duchenne, Erb and Klumpke. The original cases resulted from birth injuries, presumably from traction forces. In recent years, automobile accidents have resulted in and increase in traction or closed injuries to the brachial plexus. This paper reviews our experiences with 3 cases of injuries characteristically demonstrated by Pantopaque myelography.
Automobiles ; Birth Injuries ; Brachial Plexus ; Iophendylate ; Myelography ; Traction*