• Title/Summary/Keyword: Symptomatic review

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Anesthetic efficacy of supplemental intraligamentary injection in human mandibular teeth with irreversible pulpitis: a systematic review and meta-analysis

  • Gupta, Alpa;Wadhwa, Jitesh;Aggarwal, Vivek;Mehta, Namrata;Abraham, Dax;Aneja, Kritika;Singh, Arundeep
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.1-10
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    • 2022
  • Background: Inferior alveolar nerve block (IANB) is known to have a lower success rate for anesthesia in patients with irreversible pulpitis. This calls for supplementary techniques to effectively anesthetize such patients. This systematic review aimed to evaluate the published literature for determining the success rate of anesthesia induction using post-IANB intraligamentary (IL) injection in the mandibular teeth of patients with symptomatic irreversible pulpitis. The review question was, "What is the success rate of IL injection in the mandibular teeth of patients with irreversible pulpitis as a supplementary technique for endodontic treatment?" Methods: A thorough search of electronic databases and manual searches were performed. The protocol of the review was framed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with a proper criterion for inclusion and exclusion of studies. The included studies were analyzed using the Cochrane Collaboration "Risk of Bias" tool. A meta-analysis that included a comparison of primary nerve block and supplemental IL injection was performed. The success rate was evaluated using the combined risk ratio (RR) with a random risk model. A funnel plot was created to measure publication bias. Results: After all analyses, four studies were included. In the forest plot representation, RRs were 3.56 (95% CI: 2.86, 4.44), which were in favor of the supplemental IL injections. Statistical heterogeneity was found to be 0%. These values suggest that supplemental IL injections provide better success rates for anesthesia. Conclusion: According to the pooled qualitative and quantitative analyses, supplemental IL injections increased anesthetic efficacy.

The Role of Bronchodilators in Preventing Exacerbations of Chronic Obstructive Pulmonary Disease

  • Beeh, Kai M.
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.241-247
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    • 2016
  • Bronchodilators are the cornerstone of symptomatic chronic obstructive pulmonary disease (COPD) treatment. They are routinely recommended for symptom reduction, with a preference of long-acting over short-acting drugs. Bronchodilators are classified into two classes based on distinct modes of action, i.e., long-acting antimuscarinics (LAMA, once-daily and twice-daily), and long-acting ${\beta}2$-agonists (LABA, once-daily and twice-daily). In contrast to asthma management, evidence supports the efficacy of both classes of long-acting bronchodilators as monotherapy in preventing COPD exacerbations, with greater efficacy of LAMA drugs versus LABAs. Several novel LAMA/LABA fixed dose combination inhalers are currently approved for COPD maintenance treatment. These agents show superior symptom control to monotherapies, and some of these combinations have also demonstrated superior efficacy in exacerbation prevention versus monotherapies, or combinations of inhaled corticosteroids plus LABA. This review summarizes the current data on clinical effectiveness of bronchodilators alone or in combination to prevent exacerbations of COPD.

Coronal leakage- The hidden cause of endodontic failure (근관 치료의 숨겨진 실패 원인- Coronal leakage)

  • Kim, Ui-Seong;Kim, Il-Gyu;Choe, Jin-Ho;O, Nam-Sik;O, Seong-Seop;Kim, Hyeong-Don
    • The Journal of the Korean dental association
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    • v.38 no.3 s.370
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    • pp.288-292
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    • 2000
  • Perhaps the most frustrating scenario in dentistry lies in the apparently well-instrumented and well-obturated tooth that, becomes symptomatic after treatment of shows a periapical lesion on recall examination. Conventional root canal treatment demands stringent adherence to asepsis, awareness of canal morphology, and mastery of a variety of clinical techniques. But the risk of endodontic failure does not end with canal obturation. The quality of the coronal restoration may have a greater bearing on the ultimate success of a case than the quality of the root canal treatment itself. This review of the endodontic literature will define coronal leakage, describe its influence on endodontic treatment failures, and make specific recommendations on prevention.

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Large Ossified Rathke's Cleft Cyst -A Case Report and Review of the Literature-

  • Lee, Choong-Hyun;Seo, Eui-Kyo;Cho, Yong-Jae;Kim, Sang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.256-258
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    • 2008
  • We report a rare case of symptomatic Rathke's cleft cyst with thick calcified wall. Brain CT scans revealed a large cystic mass with round thick calcified wall. In this case, we selected the pterional approach instead of transsphenoidal approach due to the possibility of cystic craniopharyngioma. Histopathologically, it was calcified Rathke's cleft cyst with focal epithelial metaplasia. This case illustrates that calcification of the suprasellar cyst does not always suggest craniopharyngioma and the calcification pattern of Rathke's cleft cyst is different from that of the craniopharyngioma.

Surgical Treatment of the Morgagni Hernia: report of one case (Morgagni 탈장증 수술 1예)

  • 김송명
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.429-433
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    • 1979
  • Morgagni hernia is a rare condition of the congenital diaphragmatic hernia which Is located at the anteromedial portion of the diaphragm, and is located immediately posterior to the sternum. Its cause is considered by embryologic defect and the abdominal organs are passed through a defect. The incidence is predirected women over 50 years old. Its synonym is hernia of subcostosternal, retrosternal, parasternal, rectocostoxiphoid, anterior diaphragmatic or Larrey`s. This report presents a symptomatic Morgagni hernia of ten months old male child on whom the diagnosis was established and was operated at the Busan Gospel Hospital. This patient was admitted with the chief complaints of mild cyanosis, frequent upper respiratory infections and protrusion of the right lower anterior chest. Herniorrhaphy was performed through the upper abdominal midline incision, hernial contents of the omentum and the colon, and sac as noticed from the Larrey`s space measuring 4 x 2 cm. in diameter and oval in shape. Interrupted sutures without difficulty repaired the defect. The cyanosis was disappeared and the patient had uneventful course of post-operative period. The patient was discharged at 7th. postoperative day. This case presentation with a brief review of literatures is given.

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A Case of Pituitary Metastasis from Breast Cancer That Presented as Left Visual Disturbance

  • Kim, Young-Ha;Lee, Beom-Jun;Lee, Kyung-Jin;Cho, Jin-Hee
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.94-97
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    • 2012
  • Tumors that metastasize to the pituitary gland are unusual, and are typically seen in elderly patients with diffuse malignant disease. The most common metastases to the pituitary are from primary breast and lung cancers. We report a 65-year-old woman with pituitary metastasis from breast cancer who presented with recent-onset left progressive deterioration of visual acuity and visual field. The clinical diagnosis was made after brain and sellar magnetic resonance imaging showed a large sellar mass compressing the optic chiasm and invading the pituitary stalk. An otorhinolaryngology and neurosurgery team removed the tumor via a transsphenoidal approach, and this procedure obtained symptomatic relief. Postoperatively, metastasis from breast invasive ductal adenocarcinoma was confirmed histologically. We report this unusual case with a review of the relevant literature.

Intestinal lipoma near the ileocecal calve Report of 3 cases and review of the literature (회맹판 주위 장관 지방종)

  • Shim, Min-Chul;Lee, Su-Jeong;Min, Hyun-Sik;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.333-337
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    • 1986
  • Three cases of intestinal lipoma near the ileocecal valve are described. In patients of cecal and ileocecal valve lipoma, they had right lower quadrant abdominal pain secondary to partial intestinal obstruction. In rarely developed segmental lipomatosis of the ileum, the patient had right abdominal mass and pain to fecal impaction of the diverticula. Diagnosis may be made by an abnormal roentgenographic pattern and confirmed by colonoscopy. Surgical removal of the affected segment results in cure in symptomatic patients.

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A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia

  • Yun, Dong Joo;Choi, Han Na;Oh, Gun-Sei
    • The Korean Journal of Pain
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    • v.26 no.3
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    • pp.303-306
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    • 2013
  • Postural orthostatic tachycardia syndrome (POTS) refers to the presence of orthostatic intolerance with a heart rate (HR) increment of 30 beats per minute (bpm) or an absolute HR of 120 bpm or more. There are sporadic reports of the autonomic nervous system dysfunction in migraine and fibromyalgia. We report a case of POTS associated with migraine and fibromyalgia. The patient was managed with multidisciplinary therapies involving medication, education, and exercise which resulted in symptomatic improvement. We also review the literature on the association between POTS, migraine, and fibromyalgia.

Sporadic Hemangioblastoma in the Pituitary Stalk : A Case Report and Review of the Literature

  • Lee, Gun-Ill;Kim, Jae-Min;Choi, Kyu-Sun;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.465-468
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    • 2015
  • Hemangioblastomas in the pituitary stalk are especially rare. Most pituitary stalk hemangioblastomas reported in the literature were associated with von Hippel-Lindau (VHL) disease. Here, we report only the 3rd case of sporadic pituitary stalk hemangioblastoma diagnosed in a 60-year-old woman. Despite the danger of potential complications due to excessive vascularity or proximity to important neural structures, the tumor in our case was successfully removed while preserving pituitary function. In this case, complete surgical excision was shown to be an effective treatment option for symptomatic pituitary stalk hemangioblastoma, and we suggest careful evaluation of any highly enhancing mass with a signal void in the pituitary stalk preoperatively, even if no VHL disease is evident.

Chordomas Involving Multiple Neuraxial Bones

  • Lim, Jae-Joon;Kim, Sang-Hyun;Cho, Ki-Hong;Yoon, Do-Heum;Kim, Se-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.35-38
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    • 2009
  • We present a patient with multifocal symptomatic osseous chordomas having unusual growth patterns with review of the pertinent literature. The patient was 62-year-old male and had multiple osseous chordomas located in sacral, thoracic, and paraclival jugular foramen areas. There was no metastasis in other organs. All affected sites were osseous. The multicentric chordomas are extremely rare. This case could be considered as a chordoma involving multiple neuraxial bones. But, the possibility of multicentricity could also be thought. In such cases radical resection should be performed for each lesion at the initial diagnosis. If complete surgical resections are infeasible or impossible, preoperative or postoperative radiation therapy should be planned for the highest possibility of successful treatment.