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PubMed1984

Portable file management system in FORTRAN.

It has been generally considered that FORTRAN is inferior to MUMPS and other computer languages in its facility to manipulate files and that it is not satisfactorily competent to handle databases. However, it is our finding that FORTRAN is the most widely used language in patient data management systems discussed in recently published papers. Therefore, it now seems appropriate to review and evaluate the validity of this general belief. The objective of this study is to establish a file management system in FORTRAN 77 for use in the construction of a clinical database. Comparative study is conducted on several problems associated with file manipulation, that is, time requirement for file access and access methods for data retrieval.

Computers↗

PubMed1987

Managing research data with self-documenting files.

Processing biomedical research data is frequently complex due to the evolutionary nature of experiments and the requisite modification of analysis software. For the past several years we have been evolving a set of software tools designed to improve our ability to respond to evolving experimental designs. These tools allow the investigator to easily manipulate the research data and specify desired data transformations at run time. Coupling of analysis software to research data files is dependent on data files that are commented in a manner similar to that used in programming languages. The resulting annotated data files are self-documenting, and their use facilitates visual interpretation of displayed data as well as automatic processing of subsets of data. Here we present a formal description of a self-documenting file and describe several software tools that facilitate processing of biomedical research data.

Electronic Data Processing↗

PubMed1983

[Method of file sorting for mini- and microcomputers].

The authors describe a new sorting method of files which belongs to the class of direct-addressing sorting methods. It makes use of a variant of the classical technique of 'virtual memory'. It is particularly well suited to mini- and micro-computers which have a small core memory (32 K words, for example) and are fitted with a direct-access peripheral device, such as a disc unit. When the file to be sorted is medium-sized (some thousand records), the running of the program essentially occurs inside the core memory and consequently, the method becomes very fast. This is very important because most medical files handled in our laboratory are in this category. However, the method is also suitable for big computers and large files; its implementation is easy. It does not require any magnetic tape unit, and it seems to us to be one of the fastest methods available.

Computers↗

PubMed1975

Chairside decontamination of endodontic files.

Chairside decontamination. of files and reamers is attempted during root canal treatment. The purpose of this study was to evaluate some techniques for reducing the number of microorganisms of artificially contaminated endodontic files. Endodontic files were artificially contaminated with about 10,000 colony-forming units of either B. subtilis spores or S. mitis. The files containing the bacteria were then subjected to various decontamination procedures. Although sterilization was not achieved with any procedure, the bead sterilizer was found to be the most effective decontamination method tested. All gauze wipings showed reductions greater than 90 per cent. It was concluded that wiping with 2 by 2 inch gauze is a highly efficient and practical method of chairside decontamination

1-Propanol↗

PubMed1995

The use of unofficial "problem patient" files and interinstitutional information transfer in emergency medicine in Iowa.

The study objectives were to determine the use of "problem patient" files in full-time Emergency Departments (EDs) in the state of Iowa and the frequency of telephone calls made between these departments about drug-seeking patients. The design and setting were a mail survey of 42 EDs in the state of Iowa determined to be staffed full-time by an in-house physician. The participants were the directors of the full time EDs in the state of Iowa. There were no interventions. The measurements and main results are as follows: 38 of 42 sites responded for a response rate of 90%. Of these, 58% keep problem patient lists and consult them an average of 2.6 times per week (range, 0.2 to 7.5). Only 5% have a policy limiting access to the information in these files, and only 14% have any controls over the adding of information. Thirty-seven of the 38 sites reported making and receiving calls to and from other institutions about drug-seeking patients. The mean number of calls made is 23 a year, and the mean number received is 20 per year. Problem patient files are common in EDs in Iowa, as are calls between institutions about drug-seeking patients. These practices compromise patient confidentiality but may be potentially justified in some instances. The lack of controls on access to patient information files and lack of scrutiny of information entered is of concern.

Communication↗

PubMed1992

Canal Master files: scanning electron microscopic evaluation of new instruments and their wear with clinical usage.

Canal Master instruments have a short, fluted cutting area and a small flexible shaft; they may be predisposed to rapid wear and breakage. This study examined new and used files as to tip, flute, and shaft design when new and with increasing time of canal preparation. One hundred files prepared 140 curved canals. Sizes #20, #40, and #60 files were examined unused and after 1, 3, 5, and 7 min of use. Evaluation was for uniformity when new and for deterioration and breakage with usage. The smaller sizes (#20 and #40) had some inconsistencies when new and were most predisposed to wear and breakage with time. Findings suggest that smaller files could have had improved quality control by the manufacturer. Also, they should be used with caution and discarded after short times of use in small, curved canals. This should minimize instrument separation and maximize cutting efficiency.

Dental Cavity Preparation↗

PubMed1990

Machining efficiency of endodontic files: a new methodology.

The ability of endodontic files to effectively remove hard tissues is difficult to assess as results from published investigations often vary considerably. An analysis is presented of errors occurring during efficiency assessments. It was found that the machining property varies around the circumference of a single file as well as between various files of the same brand. A new method is proposed for the assessment of the quantity and quality of the machining properties of an endodontic file.

Dental Cavity Preparation↗

PubMed1996

A new ultrasonic canal preparation system with electronic monitoring of file tip position.

A new ultrasonic root canal preparation system has been developed that electronically monitors the location of the file tip during all instrumentation procedures. The Root ZX has been adapted for this purpose, and its filter circuit effectively cuts out the large spike noise of the ultrasonic unit. During enlargement of the canal, the ultrasonic vibration of the file can be stopped at any desired position on the meter. Extracted human tooth models with electronically measurable canals were used to test the device. Pre- and postoperative shapes of the root canals were evaluated using contact microradiography. The autostop mechanism worked correctly. Using a weak power and fine files, straightening, ledge formation, and file breakage were minimal. It seems that this system minimized the danger of overinstrumentation and could be safely applied in clinical practice.

Dental Instruments↗

PubMed1996

A comparison of curved canal instrumentation using nickel-titanium or stainless steel files with the balanced-force technique.

The Flex-R file was compared with the Onyx nickel-titanium file in respect to canal center movement and final canal area after balanced-force instrumentation. Forty-two root canals in extracted human molars were divided into two equal groups of 21, in all of which the angle of curvature ranged from 20 to 40 degrees. After mounting in a mold, each root was sectioned at two locations, providing an apical and a coronal section. Pre- and postinstrumentational 35-mm photographic slides of each section were superimposed, projected, traced, and then scanned into a computer. From these computerized pre- and postinstrumentation images, the movement of the canal center and the area of each canal were computed at both the apical and coronal sections. Results showed no significant difference in canal center movement or postinstrumentation area when Flex-R or Onyx files were used at the apical section. Coronally, the Flex-R files demonstrated more movement of the canal center. No significant correlation was found between the angle of root curvature and canal movement or the angle of root curvature and postinstrumentation canal area.

Dental Instruments↗

PubMed1996

The sterilization of endodontic hand files.

Several different methods of file sterilization were analyzed to determine the best method of providing complete file sterility, including the metal shaft and plastic handle. Six test groups of 15 files were studied using Bacillus stearothermophilus as the test organism. Groups were "sterilized" by glutaraldehyde immersion, steam autoclaving, and various techniques of salt sterilization. Only proper steam autoclaving reliably produced completely sterile instruments. Salt sterilization and glutaraldehyde solutions may not be adequate sterilization methods for endodontic hand files and should not be relied on to provide completely sterile instruments.

Colony Count, Microbial↗

PubMed1997

Effect of heat sterilization on the torsional properties of rotary nickel-titanium endodontic files.

The purpose of this study was to determine whether heat sterilization adversely effects the torsional properties of rotary nickel-titanium files, making them more prone to fracture under torsional stress. Nine hundred sizes 2 through 10 Profile Series 29.04 taper files were divided into groups of 10 files each and sterilized 0, 1, 5, or 10 times in the steam autoclave, Statim autoclave, or dry heat sterilizer. Then, they were subjected to torsional testing in a Torquemeter Memocouple. Complete data were collected for sizes 2 through 7, but not for sizes 8 through 10 because their torque resistance exceeded the testing limits of the Torquemeter Memocouple. A one-way analysis of variance was used to compare all experimental groups in sizes 2 through 7 with their unsterilized controls (p < 0.05). Fifty-four comparisons were made for torsional strength and 54 for rotational flexibility. Ten significant changes occurred for torsional strength and 10 for rotational flexibility. Eight of 10 changes in torsional strength were increases. Fifty-two of 54 (96.3%) comparisons for torsional strength and 47 of 54 (87%) for rotational flexibility showed a significant increase or no change. Therefore, heat sterilization of rotary nickel-titanium files up to 10 times does not increase the likelihood of instrument fracture.

Analysis of Variance↗

PubMed1998

Precurving of nickel-titanium files affects transportation in simulated canals.

Instrumentation studies comparing nickel-titanium with stainless-steel files have been performed without precurving the nickel-titanium files. It is unknown what influence the precurving of nickel-titanium files would have on transportation in small curved canals of varying curvatures. One hundred-sixty resin blocks with simulated canals were used. Eighty blocks had gradual (gradual curve (GC)) 30-degree curves; the remainder had abrupt (abrupt curve (AC)) 30-degree curves. Ten blocks for each curvature and for each degree of precurving (0, 15, 20, 25, 30, 35, 40, and 45) were instrumented with a machine that imparted only an in and out motion. Simulated canals were a size 30 at the apex, and size 30 nickel-titanium files were used to instrument the canals. A transportation "t" index was determined at two levels: T1 (1 mm from the apex) and TB (a line bisecting the curve of the canal). For GC at T1 and TB, 45- and 25-degree curved instruments, respectively, produced significantly less transportation (p < 0.0001). For AC at T1 and TB, 35- and 0-degree curved instruments, respectively, produced significantly less transportation (p < 0.0001). Comparing GC and AC, the transportation for GC was significantly less (p < 0.0015).

Dental Alloys↗

PubMed1995

An evaluation of nitinol and stainless steel files used by dental students during a laboratory proficiency exam.

Eighty-one dental students instrumented two curved canals in acrylic blocks with the use of stainless steel files in one block and nitinol files in the other. Overlay tracings were made of photographs taken before and after instrumentation of the acrylic blocks and differences between the tracings were measured along the canal walls. The canals instrumented with nitinol files were shaped better than those instrumented with stainless steel files; working length was maintained more often without ledging the canal walls and with less zipping of the apical foramen.

Alloys↗

PubMed1994

How to find a wombmate: validation of an algorithm to identify twin pairs in Linked Birth/Infant Death Files.

Linked Birth/Infant Death Files available from the National Center for Health Statistics identify an infant as a twin, but do not identify twin pairs. An algorithm based on maternal, paternal, and infant characteristics has been used to identify twin pairs, but the validity of this algorithm has never been tested. The Missouri linked birth/infant death file from 1980 to 1990 identifies twin pairs by a sequence number. The authors tested the rate and accuracy with which the algorithm identified true pairs in the Missouri file and whether estimates of risk and possible risk factors calculated from pairs of twins identified by the algorithm agreed with these characteristics as calculated from known twin pairs. The algorithm identified 96% (8,273 of 8,620) of true pairs and one false pair. Despite incomplete pair identification, and even identification of a false pair, estimates from the subset identified by the algorithm generally agreed well with characteristics measured from all twin pairs. Nonetheless, incorporation of a multiple birth sequence number into Linked Birth/Infant Death Files would enhance their utility.

Algorithms↗

PubMed1998

Agreement between administrative files and written medical records: a case of the Department of Veterans Affairs.

OBJECTIVES: This study examined the reliability of Department of Veterans Affairs' health information databases concerning patient demographics, use of care, and diagnoses. METHODS: The Department of Veterans Affairs' Patient Treatment files for Main, Bed-section (PTF) and Outpatient Care (OCF) were compared with medical charts and administrative records (MR) for a random national sample of 1,356 outpatient visits and 414 inpatient discharges to Department of Veterans Affairs' facilities between July 1 and September 30, 1995. Records were uniformly abstracted by a focus group of utilization review nurses and medical record coders blinded to administrative file entries. RESULTS: Reliability was adequate for demographics (kappa approximately 0.92), length of stay (agreement=98%), and selected diagnoses (kappa ranged 0.39 to 1.0). Reliability was generally inadequate to identify the treating bedsection or clinic (kappa approximately 0.5). Compared with medical charts, Patient Treatment Files/Outpatient Care Files reported an additional diagnosis per discharge and 0.8 clinic stops per outpatient visit, resulting in higher estimates of disease prevalence (+39% heart disease, +19% diabetes) and outpatient costs (+36% per unique outpatient per quarter). CONCLUSIONS: In the absence of pilot work validating key data elements, investigators are advised to construct health and utilization data from multiple sources. Further validation studies of administrative files should focus on the relation between process of data capture and data validity.

Adult↗

PubMed1989

Shaping of simulated root canals in resin blocks using the step-back technique with K-files manipulated in a simple in/out filling motion.

A total of 60 simulated root canals in clear resin blocks of various lengths and degree of curvature were prepared by hand with K-files using a step-back enlargement technique. The instruments were manipulated exclusively with a simple in/out filing or rasping motion with no attempt at rotation or twisting. The preparation technique was assessed by instrumentation time, deformation and fracture of instruments, and loss of working distance. The shape of the prepared canals was assessed by direct inspection and from composite photographic prints produced by superimposing negatives of the canals obtained before and after preparation. In general, the preparations were time-consuming and tedious to complete. Deformation and separation of instruments occurred mainly in those canals with short, severe curves. Loss of working distance was a universal finding and was associated to a degree with the straightening of curved canals inherent in their preparation. Prepared straight canals displayed a continuously tapering form being narrowest at their end-point. On the other hand, prepared curved canals were invariably hourglass in shape. Under the conditions of this study the manipulation of K-files in a simple in/out filing motion proved an unsatisfactory method of preparing simulated curved root canals in resin blocks.

Dental Pulp Cavity↗

PubMed1996

Intra-canal cutting ability of MM1500 files.

The aims of this study were to develop a model system capable of monitoring lateral forces during root canal preparation and to measure the cutting ability of files activated by the MM1500 sonic handpiece. Forces were monitored by a calibrated model system which utilized a combination of spring steel beams fitted with strain gauges, these were interfaced through two strain gauge amplifiers to an x-y recorder. Single rooted canine teeth (n = 36; 32 experimental, four control) were mounted in a two-part acrylic mould (which was an integral part of the model system) prior to sectioning horizontally 11 mm from the tooth apex. A 2(4) full factorial experiment with two replications was performed. Four variables were selected for evaluation, load (50 and 100 g), power (air inlet ring half or fully open), file type (Heliosonic or Shaper) and stroke rate (1 or 2 cycles per second). A new file (size 25) was used for 1 min in each canal with water irrigation. The control group was not instrumented. The cross-sectional root canal area was measured before and after instrumentation using image analysis and increase in area was used as an indication of cutting ability. The results showed that the increase in load, power and the Shaper file all produced a significant increase in cutting ability (ANOVA, P < 0.001). However, stroke rate was not found to have a significant effect (P > 0.05). None of the interactions between the variables were significant and there was no significant difference in the control group (P > 0.05). In conclusion, this work has developed a model system to monitor lateral forces and has shown that instrument design and operator usage affect dentine removal from a root canal wall.

Analysis of Variance↗

PubMed1997

Shaping ability of the M4 handpiece and Safety Hedstrom files in simulated root canals.

The aim of this study was to assess the shaping ability of the M4 reciprocating handpiece and Safety Hedstrom files in simulated canals. A total of 40 simulated canals of various angles and positions of curvature were prepared with an M4 handpiece using Safety Hedstrom files oriented with the ground, flattened surface towards the inner aspect of the curve. A standard regimen was adopted throughout. Pre- and post-operative longitudinal images of the canals were taken with a video camera and stored and manipulated in a computer with image analysis software. The presence of canal aberrations and the amount and location of resin material removed as a result of preparation were determined from composite images of superimposed pre- and post-operative views. Preparation time varied significantly (P < 0.001) between the canal types; overall, 20 degrees canals were prepared more quickly than 40 degrees canals. Zips and elbows were observed in 16 out of the 40 canals with most (11) being created in 40 degrees specimens. Ledges were found in 19 canals and perforations in only 1. There were no significant differences between canal shapes for these aberrations. Excessive removal of material from the inner aspect of the canal at the curve to create a danger zone was found in 20 canals, but only in those with 40 degrees curves. Significant differences in total canal width between the canal types were seen at the zips (P < 0.05), elbows (P < 0.05) and danger zones (P < 0.001). Transportation at the danger zones varied significantly (P < 0.001) between canal types. Under the conditions of this study, the M4 handpiece and Safety Hedstrom files created hour-glass preparations in a substantial proportion of canals. In reality, the Safety Hedstrom file with its one flattened surface was ineffective at reducing removal of material along the inner aspect of canal curves in severely curved specimens and clearly has the potential to create strip perforations in teeth.

Analysis of Variance↗