Infiltration Group Research Articles

Classification of soil infiltration rate depending on the Hydrological soil group map South East Iraq

The study area is located in the East of Missan governorate, southeast of Iraq between (32°'29.52" – 32°37'30") latitude and (46°46'21.16" – 47°58'53.52")longitude. It encompasses an area of (1858 ) with elevation ranges from 8 to 165m. Soil is a natural body that exists as part of the pedosphere and which performs four important functions. It is a medium for plant growth and a means of water storage, supply and purification. The spatial mapping of soil usually involves delineating soil types that have identifiable characteristics. The delineation is based on many factors such as geomorphologic origin and conditions under which the soil is formed. Hydrologic soil group (HSG) refers to the classification of soils based on their runoff , producing characteristics and their infiltration rate. Soils are assigned to 4 hydrologic groups namely Group A - high infiltration rate when wet, low runoff potential, Group B - moderate infiltration, low runoff potential, Group C - slow infiltration, higher runoff potential, and Group D - very slow infiltration rate, highest runoff potential. According to the USDA soil classification system, four hydrological soil groups are recognized: A, B, C, and D with 19%, 48%, 32%, and 1%, respectively, the high percentage extension of moderately infiltration group (B and C).

A Randomized Controlled Trial of Comparing Ultrasound-Guided Transversus Abdominis Plane Block with Local Anesthetic Infiltration in Peritoneal Dialysis Catheter Implantation

Background: The ultrasound-guided transversus abdominis plane (TAP) block has been demonstrated as a useful analgesia technique in lower-abdomen surgeries. We hypothesized that it could be the principal anesthesia technique for end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD) catheter (PDC) implantation using the open dissection method. Methods: This was a single-center, prospective, randomized, and double-blinded study. All eligible patients were randomized into 2 groups: the TAP block group (n = 20) and the local anesthetic infiltration (LAI) group (n = 20). Results: Compared with the LAI group, the TAP block group revealed a remarkably lower visual analogue score, lower switching rate into general anesthesia, higher satisfaction rate, and less rescuing analgesic consumption during operation (p < 0.05). Both PD- and anesthesia-related complications were rare in the 4-week follow-up. Conclusions: The ultrasound-guided TAP block had better analgesic effect than LAI and can be used as a principal anesthesia technique for PDC implantation in ESRD patients without previous abdominal surgery.

Immunogenic tumor cell death induced by chemotherapy in patients with breast cancer and esophageal squamous cell carcinoma.

It has been reported that chemo-radiotherapy can induce immunogenic tumor cell death (ICD), which triggers T-cell immunity mainly mediated by high-mobility group box 1 protein (HMGB1) and calreticulin. However, there is still limited information to support this theory relating to chemotherapy alone. In the present study, the expression of HMGB1 and calreticulin was evaluated by immunohistochemistry in pre-treatment biopsy specimens and surgically resected specimens, which were obtained from patients with breast cancer (n=52) and esophageal squamous cell carcinoma (ESCC) (n=8) who had been treated with neoadjuvant chemotherapy (NAC). We also analyzed HMGB1 and calreticulin expression in breast cancer cell lines treated with chemotherapeutic drugs. As a result, both HMGB1 and calreticulin expression levels were significantly upregulated after NAC in both breast cancer and ESCC tissues. However, no significant correlation was observed between HMGB1 expression and pathological response after NAC or between HMGB1 expression and patient survival. Furthermore, although overall survival in the high infiltration group of CD8-positive T cells was significantly superior to that in the low infiltration group in breast cancer patients, there were no correlations between the number of CD8-positive T cells and HMGB1 or calreticulin expression levels. In addition, chemotherapeutic drugs induced upregulation of HMGB1 and calreticulin in all tested cell lines. Our findings indicate that chemotherapy alone can significantly induce ICD regardless of the degree of pathological response after chemotherapy.

Comparison between corneal cross-linking, topical antibiotic and combined therapy in experimental bacterial keratitis model

PurposeThis study was conducted to investigate the effects of an experimental bacterial keratitis model on the corneal collagen cross-linking treatment (CXL), and also to compare topical antibiotic treatment with the combined treatment. MethodsThe study involved 40 young adult female Sprague Dawley rats, which had a 2 mm scraped defect of the central corneal epithelium in both eyes. The rats were divided into two equal groups. The first group was inoculated in both eyes with standard Pseudomonas Aeruginosa (PA) from a strain suspension prepared from 0.05 ml (Group 1), and the second group was inoculated with standard Methicillin Resistance Staphylococcus Aureus (MRSA) strains from a suspension prepared from 0.05 ml (Group 2). Group 1 was divided into four sub-groups: Group 1A was treated by collagen cross-linking (CXL), Group 1C was treated with topical tobramycin drops CXL and also treated by collagen cross-linking (CXL), Group 1D was treated with topical tobramycin drops, and Group 1B was left untreated in order to create a control group. Similarly, Group 2 was also divided into four sub-groups: Group 2A was treated by CXL, Group 2C was treated with topical 5% fortified vancomycin drops CXL and also treated by CXL, Group 2D was treated with topical 5% fortified vancomycin drops, and Group 2B was left untreated in order to create a control group. CXL was performed on the third day following the inoculation and topical drop therapy. Biomicroscopy and microbiologic assessments were performed on the third and seventh days following the inoculation of microorganisms. ResultsIn the treatment, which compared baselines in all groups before treatment, the diameter of keratitis infiltrations, corneal clouding, and corneal swab samples were obtained from the reduction in reproduction. The results were statistically significant (p < 0.01). Keratitis infiltration groups were conducted on the seventh day for Groups 1C and 1D according to Group 1B, whilst Groups 2A, 2C and 2D were conducted according to Group 2B, which showed a significant statistical reduction (p < 0.01). On the seventh day, focal groups were conducted in corneal clouding Group 1D according to Group 1B and in Groups 2A, 2C and 2D according to Group 2B, which revealed a significant statistical reduction (p < 0.01). On the seventh day, reproduction in culture was obtained from corneal swab samples in Groups 1C and 1D according to Group 1B; in Groups 1C and 1D according to Group 1A; in Groups 2A, 2C and 2D according to Group 2B; and in Group 2C according to Group 2A, where a significant statistical reduction was observed (p < 0.01). ConclusionsThe clinical and microbiological efficacy of the CXL treatment is evaluated in our study. In accordance with the conclusion reached an effective reduction in the density and severity of (infection), occurred as a result of CXL treatment, CXL treatment combined with topical antibiotic treatment and topical antibiotic treatment of Pseudomonas Aeruginosa (PA) and Metisilin Rezistant Staphylococcus Aureus (MRSA) keratitis infections. From these results, it is shown that topical antibiotics and CXL potentiate each other’s effects in the treatment of resistant bacterial keratitis.

Terapia de ondas de choque frente a infiltración corticosteroidea en el tratamiento de la fascitis plantar crónica

BackgroundChronic plantar fasciitis (CPF) is a painful condition where the primary goal of treatment is relieve the pain and restore function. Extracorporeal shockwaves therapy (ESWT) has shown efficacy in the treatment of plantar fasciitis with reported few side effects compared to other conservative methods. The purpose of the study is to compare the response to treatment of ESWT against corticosteroid infiltration for PF using VAS (Visual Analogue Scale) and AOFAS (American Orthopedic Foot and Ankle Society's) hind foot scales. Materials & methodsSixty patients with PF were randomized to receive ESWT (group A, n=36) or corticosteroid infiltration (group B, n=24) through a program of random number generation. They were evaluated with VAS and AOFAS hind foot scales before treatment, immediately after treatment and at 3, 6 and 12 months post treatment. ResultsThe two groups were similar in demographic characteristics. Both groups improved during treatment and follow-up period. The mean VAS decreased from 8 to 1.68 (p <0.001) in group A and 6.75 to 1.31 (p <0.001) in group B and presented a mean increase in AOFAS scale from 50.3 to 67.8 (p <0.001) in group A and 51.3 to 66 (p <0.001) in group B at 12 months follow up. At 3 months, the B group presented a lower average score in VAS when compared with patients in group A (1.12 vs 1.96; p=0.035). Finally, follow-up improvement was seen in both groups with no significant differences. DiscussionESWT and corticosteroid injections are both effective in reducing symptoms and increased functionality when applied to patients diagnosed with CPF. Evidence levelII.

Application value of immunoglobulin G4 detection in unexplained liver injuries

Objective To investigate the expression level of immunoglobulin G (IgG)4 cells in patients previously diagnosed as unexplained liver injuries, and to analyze whether these patients could be diagnosed as immunoglobulin G4-related disease (IgG4-RD). The clinical characteristics of patients with IgG4 positive cells infiltration in liver tissues who did not met IgG4-RD diagnosis criteria were also analyzed. Methods From August 2010 to July 2016, 33 patients with unexplained liver injuries even after liver biopsy were enrolled. Immunostaining of IgG and IgG4 in liver tissue slices was performed. Whether the patients met the IgG4-RD diagnosis criteria was analyzed. Also, the relation between IgG4 positive cell infiltration in liver tissues and serum parameters (alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptadase (GGT), IgG), the classification of liver inflammation and stage of liver fibrosis were analyzed. Chi-square, Fisher exact probability method, t test and Wilcoxon rank and inspection were used for statistical analysis. Results Among 33 patients with unexplained liver injuries, average age of onset of the disease was (50.48±14.52) years old. Ten patients (30.3%) presented with different degree of IgG4 positive cells infiltration in liver. In one patient, the IgG4 positive cell number in liver tissue was over 10/high-powered field (HPF), IgG4+ /IgG+ ratio was over 40%, the serum IgG4 increased and low density nodules in the left hepatic lobe level, which met the diagnostic criteria of IgG4-RD. Serum parameters of liver function of this patient were as follows: ALT 948 U/L, AST 658 U/L, ALP 176 U/L, GGT 197 U/L, TBil 21.5 μmol/L, DBil 10.0 μmol/L. According to whether there were IgG4 positive cells infiltration in liver tissues, 33 patients were divided into IgG4 positive cells infiltration group (IgG4 positive group, 10 cases) and no IgG4 positive cells infiltration group (IgG4 negative group, 23 cases). The medium levels of ALT, AST, ALP and GGT in the IgG4 positive group and the IgG4 negative group were 26.0 U/L vs 31.0 U/L, 28.5 U/L vs 32.0 U/L, 114.0 U/L vs 77.0 U/L, 65.0 U/L vs 36.0 U/L, respectively and there were no statistically significant differences (Z=-0.098, -0.216, -0.862, -0.705; all P>0.05). The serum IgG level of the IgG4 positive group was higher than that of the IgG4 negative group (17.15 g/L vs 13.65 g/L), and the difference was statistically significant (Z=-1.776, P=0.035). Conclusions IgG4-RD may be the reason of liver injury. There are no significant differences in clinical charateristics, serum parameters and inflammation degree in liver tissue between patients with or without IgG4 positive cells infiltration. Key words: Unexplained liver injury; Immunoglobulin G4; Immunoglobulin G4-related disease

Does tumor size have its prognostic role in colorectal cancer? Re-evaluating its value in colorectal adenocarcinoma with different macroscopic growth pattern

BackgroundFew previous studies have taken the growth pattern into consideration when analyzing the prognostic value of tumor size in colorectal cancer (CRC). ObjectiveWe sought to reveal the prognostic role of tumor size in different macroscopic growth patterns of CRC. Materials and methodsUsing Cancer Center datasets, we identified 4057 cases with colorectal adenocarcinoma treated with curative resection. Macroscopic growth patterns of tumors were classified into three types: infiltrative, ulcerative and expansive types based on tumor gross appearance. Univariate and multivariate Cox regression analyses were performed to evaluate the prognostic factors for overall survival (OS) and disease-free survival (DFS). ResultsIn whole cohort, tumor size was an independent factor for OS (HR 1.10, 95%CI 1.04–1.16, p < 0.001). Subgroup analysis based on macroscopic growth pattern suggested that tumor size was an independent factor for OS both in the infiltrative (HR 1.37, 95%CI 1.12–1.66, p = 0.002) group and ulcerative group (HR 1.08, 95%CI 1.00–1.16, p = 0.044) and tumor size (HR 1.22, 95%CI 1.06–1.40, p = 0.004) was found as an independent factor for DFS only in infiltrative group. ConclusionsTumor size is an independent factor for OS and DFS in patients with colorectal adenocarcinoma of infiltrative type, while only for OS in patients of ulcerative type.

多层螺旋CT在肺内≤1 cm纯磨玻璃结节浸润性腺癌与浸润前病变鉴别诊断中的价值

Objective To analyze CT imaging features of lung pure ground-glass nodule (pGGN) of 1 cm or less, and to discuss the differential diagnosis value of multi-slice spiral CT (MSCT) of lung pGGN of 1 cm or less in lung infiltrating adenocarcinoma and before infiltration. Methods A total of 103 patients with lung pGGN≤1 cm admitted to the First Hospital of Handan from January 2012 to August 2016 were selected. Of the 103 lung pGGN lesions, there were 67 preinvasive lesions (the preinvasive lesion group) confirmed by operation, including 28 atypical adenomatous hyperplasia and 39 adenocarcinoma in situ. There were 36 invasive lesions (the infiltration group), including 21 minimally invasive adenocarcinoma and 15 invasive adenocarcinoma. All the patients underwent MSCT scanning, and the lesion location, size, CT value, internal density, edge, peripheral vessel and lung-tumor interface were compared between the two pathological types. The receiver operating characteristic curves of the size of the infiltrating lesion and before infiltration were drawn, and the boundary values of the size of the two kinds of pGGN were analyzed and identified. Results The differences of the lesion location (χ2=0.529, P=0.746), vacuole sign (χ2=1.581, P=0.209), aerated bronchus sign (χ2=1.639, P=0.201), edge of the lesion (χ2=0.614, P=0.722) between the two groups were not statistically significant. The proportion of clear lung-tumor interface in infiltration group was higher than that in preinvasive lesion group (86.11% vs. 44.78%; χ2=16.568, P<0.001). The proportion of type Ⅰ in the classification of pulmonary vascular relationships in infiltration group was lower than that in preinvasive lesion group (5.56% vs. 41.79%; χ2=14.894, P<0.001), and the proportion of type Ⅲ in infiltration group was higher than that in preinvasive lesion group (38.89% vs.1.49%; χ2=26.320, P<0.001). The average maximum diameter of the infiltration group [(0.85±0.17)cm] was greater than that of the preinvasive lesion group [(0.76±0.16)cm], and the difference was statiscally significant (t=2.663, P=0.009). The boundary value to identify the size of the preinvasive and invasive lesions was 0.81 cm, and its sensitivity and specificity rates were 62.1% and 63.5%, and the area under the curve was 0.622. Conclusion Of lung pGGN≤1 cm, invasive lesions are larger, lung-tumor interface is more clear, and the proportion of type Ⅲ in the classification of pulmonary vascular relationships is bigger. MSCT can present the above imaging characteristics of lesions, and it has the important value in differential diagnosis of lung pGGN≤1 cm in infiltrating adenocarcinoma and before infiltration. Key words: Lung neoplasms; Coin lesion, pulmonary; Tomography, spiral computed; Carcinoma in situ; Infiltration

Abstract 2945: Impact of intratumoral mature dendritic cells on prognosis of the patients with esophageal squamous cell carcinoma

Abstract [Background] Promising efficacy of the immunotherapy with anti-PD-1 antibody for esophageal squamous cell carcinoma (ESCC) is expected. Tumor-infiltrating lymphocytes (TILs)have been found to be associated with favorable outcome of patients in many cancers including ESCC. However, the contributing factor of TILs in the primary tumor remains unclear. Dendritic cells (DCs) are the most potent antigen-presenting cells to induce cytotoxic T lymphocytes. [Purpose] The aim of this study was to examine the correlation of mature dendritic cells with CD8+ cells in the tumor in order to clarify the impact of DCs on locally infiltrated lymphocytes in ESCC. [Object and Methods] Formalin-fixed, paraffin-embedded blocks of primary lesions were collected from 80 patients with ESCC who underwent surgical treatment at Osaka City University Hospital. Immunohistochemical analysis using anti-LAMP-3 antibody and CD8 antibody was used to evaluate intratumoral DCs and TILs. The number of LAMP-3+DCs and TILs were counted at ×400 magnification. We divided the 80 cases into two groups according to the median number of intratumoral DCs and TILs to examine the clinicopathological features. [Results] LAMP-3+DCs were predominantly observed in peritumoral area and sparsely found in intratumoral area, whereas CD8+T cells distributed between both peritumoral and intratumoral areas. The number of DCs was significantly associated with increasing TNM stage. For example, the median number of DCs was 59.9 in pathological T1, 34.2 in T2/3, 62.4 in pN1, 34.1 in pN1/2/3. In addition, many patients with high infiltaraion of DCs had positive lymphatic invasion (Ly). The number of intratumoral DCs was significantly correlated with the number of TILs which were observed in intratumoral regions. Patients in the high infiltration of DCs group showed a significant better prognosis than patients in the low infiltration group. Double staining showed that LAMP3+DC-CD8+T cell clusters were seen in peritumoral area. Citation Format: Junya Nishimura, Hiroaki Tanaka, Yuichiro Miki, Tatsuro Tamura, Tatsunari Fukuoka, Go Ohira, Masatsune Shibutani, Sadaaki Yamazoe, Kenjiro Kimura, Takahiro Toyokawa, Hisashi Nagahara, Ryosuke Amano, Kazuya Muguruma, Kiyoshi Maeda, Kosei Hirakawa, Masaichi Ohira. Impact of intratumoral mature dendritic cells on prognosis of the patients with esophageal squamous cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2945. doi:10.1158/1538-7445.AM2017-2945

Visual outcomes after balanced salt solution infiltration during lenticule separation in small-incision lenticule extraction for myopic astigmatism.

To evaluate the refractive outcomes of balanced salt solution infiltration during small-incision lenticule extraction (SMILE).This randomized prospective study enrolled 52 patients (104 eyes) with myopic astigmatism. Patients underwent SMILE to correct the myopic astigmatism in Daping Hospital of the Third Military Medical University between January and July 2013. One eye of each patient received traditional SMILE (control group) and the other received a modified SMILE procedure (liquid infiltration group). The corrected distance visual acuity (CDVA), postoperative uncorrected distance visual acuity (UDVA), refraction, wavefront aberration, intraocular pressure (IOP), modulation transfer function (MTF) cut-off frequency, and objective scattering index (OSI) were evaluated.UDVA in the liquid infiltration group was significantly higher than that in the control group at 1 day postoperatively, but not at 1 month after surgery. Moreover, OSI and MTF cut-off frequency in the liquid infiltration group were higher than those in the control group at early follow-up. However, no significant intergroup difference was observed in the OSI and MTF cut-off frequency at 3 months after surgery. In addition, the predictability was better in the liquid infiltration group than in the control group. The changes of horizontal coma in the liquid infiltration group were lesser than those in the control group. However, no intergroup difference was observed in the reduction of IOP at 1 month after surgery.The modified SMILE procedure results in better visual outcomes than did the traditional SMILE procedure when used for treating myopic astigmatism.

Effect of resin infiltration on the color and microhardness of bleached white-spot lesions in bovine enamel (an in vitro study).

The aim of this study was to investigate both the effect of resin infiltration on the color and microhardness of white spot lesions (WSLs) that treated with bleaching and to analyze the penetration of the infiltrant. In each of 135 bovine enamel specimens, WSLs were produced. The samples were then randomly divided into three groups (n = 45): group I, bleached; group II, resin-infiltrated; group III, bleached and resin-infiltrated. The specimens were subjected to a pH-cycling regime for four weeks. The color and microhardness were measured at the baseline, after production of WSLs, after the treatments. The color alteration (ΔE*) and the percentage of surface microhardness recovery (SMHR) were calculated. The penetration of the infiltrant was evaluated by scanning electron microscopy. Results were analyzed with analysis of variance, Shapiro-Wilk, Tukey's, Kruskal-Wallis and Conover-Dunn tests (P = .05). The SMHR% in resin infiltration groups was significantly higher than that of the bleached group only (P < .05). Bleaching treatment prior to resin infiltration produced no significant change in the microhardness (P > .05). Using a bleaching treatment prior to resin infiltration produced significant color alteration (P < .05). The penetration of the resin infiltrant was deepest in-group II. The resin infiltration enhanced the microhardness of the WSLs regardless of whether or not a bleaching treatment was used. Using a bleaching treatment before resin infiltration resulted in color alteration, and it was also found to negatively influence the penetration of the infiltrant.

Nitrous Oxide Versus Lidocaine for Pain Relief During Episiotomy Repair: A Randomized Trial

Objectives: Since pain management is an important concern in childbirth. This study was designed to evaluate the effects of nitrous oxide in comparison with lidocaine in terms of pain relief, during episiotomy repair in primiparous women. Materials and Methods: In this prospective randomized controlled trial, 120 pregnant women were recruited. The intervention group received nitrous oxide 2 minutes before starting episiotomy repair, until the end of the procedure. The control group received 5 mL of lidocaine (2) before starting the episiotomy. The results of 2 groups were compared with regard to the pain intensity using a visual analog scale (VAS). Mann-Whitney, student’s t test, and chi square test were used to analyze the data. Results: Sixty women were studied in each group. Nine participants (15) in nitrous oxide group, as opposed to 23 (38.4) in lidocaine group, had moderate, severe or extremely severe pain (P = 0.005). In terms of satisfaction level, there was no significant difference between 2 groups (P = 0.713). Conclusion: The results of this study showed that pain intensity in the nitrous oxide group was significantly lower than that in the lidocaine infiltration group. Application of nitrous oxide at least 2 minutes before repair may be an effective method for pain management in episiotomy repair. © 2018 The Author (s).

Transversus Abdominis Plane Block Versus Wound Infiltration for Analgesia After Cesarean Delivery: A Randomized Controlled Trial

Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single-shot local anesthetic wound infiltration for analgesia after cesarean delivery performed under spinal anesthesia. We hypothesized that the TAP block would decrease postoperative cumulative fentanyl consumption at 24 hours. Eligible subjects were American Society of Anesthesiologists physical status II parturients with full-term singleton pregnancies undergoing elective cesarean delivery under spinal anesthesia. Exclusion criteria were: <19 years of age or >40 years of age; height <150 cm, weight <60 kg, body mass index ≥40 kg/m; contraindications to spinal anesthesia; history of recent opioid exposure; hypersensitivity to any of the drugs used in the study; significant cardiovascular, renal, or hepatic disease; and known fetal abnormalities. Eighty subjects were randomly allocated to 2 equal groups. In the infiltration group, participants received 15 mL of bupivacaine 0.25% in each side of the surgical wound (total 30 mL); and in the TAP group, participants received 20 mL of bupivacaine 0.25% bilaterally in the TAP block (total 40 mL). The TAP block and wound infiltration were performed by the primary investigator and the operating obstetrician, respectively. All participants received postoperative standard analgesia (ketorolac and paracetamol) and intravenous fentanyl via patient-controlled analgesia. Patients and outcome assessors were blinded to the study group. The primary outcome was the cumulative fentanyl consumption at 24 hours. Secondary outcomes were the time to the first postoperative fentanyl dose, cumulative fentanyl consumption at 2, 4, 6, and 12 hours, pain scores at rest and on movement at 2, 4, 6, 12, and 24 hours, the deepest level of sedation, the incidence of side effects (nausea and vomiting and pruritis), and patient satisfaction. Data from 78 patients (39 patients in each group) were analyzed. The mean ± SD of cumulative fentanyl consumption at 24 hours was 157.4 ± 63.4 μg in the infiltration group and 153.3 ± 68.3 μg in the TAP group (difference in means [95% confidence interval] is 4.1 [-25.6 to 33.8] μg; P = .8). There were no significant differences between the 2 groups in the time to the first postoperative fentanyl dose, cumulative fentanyl consumption at 2, 4, 6, and 12 hours, pain scores at rest and on movement at 2, 4, 6, 12, and 24 hours, the deepest level of sedation, and patient satisfaction. The incidence of side effects (nausea and vomiting and pruritis) was low in the 2 groups. TAP block and wound infiltration did not significantly differ regarding postoperative fentanyl consumption, pain scores, and patient satisfaction in parturients undergoing cesarean delivery under spinal anesthesia.

DENTIN BOND EFFICACY OF COMPOSITE RESIN RESTORATIONS USING RESIN INFILTRANT

Aim: To evaluate the bond efficacy of direct resin composite restorations bonded by three different dentin adhesives an etch-and-rinse, self-etch and resin infiltrant (ICON) using microtensile bond strength testing and Analyze their failure mode. Methodology: Thirty molar teeth were selected and thoroughly cleaned. Each tooth was vertically embedded into self-curing acrylic resin up to the level of the cervical line. The occlusal enamel of teeth was removed perpendicular to the long axis of teeth to expose flat dentin surface at a standardized depth. The teeth were divided into three main groups of 10 teeth each; using Etch and rinse adhesive system control group A1 (All-bond Universal, Bisco), self-etch adhesive system group A2 (All-bond Universal, Bisco) and resin infiltrant group A3 (Icon). Direct resin composite nano-hybrid universal composite (FiltekTM Z250 XT, 3M ESPE) cores were build up on the flat dentin surfaces treated with different adhesive systems. The restored teeth were subjected to thermo-cycling at 5°C and 55°C for 2000cycle. Then each tooth was mounted on the cutting machine, sectioned into a series of 1 mm thick. The sticks were stressed to failure under tension using Universal Testing Machine to record the microtensile bond strength. The fractured sticks were evaluated for bond failure mode under a stereomicroscope at 40X magnification to detect the mode of failure. The collected data were submitted to ANOVA and Tukey’s test. Results: Etch-and-rinse (A1) control group showed the highest significant mean Microtensile bond strength (MPa) followed by Self-etch adhesive (A2) followed by Resin infiltrant (ICON) (A3) at p≤0.001. The result of the stereomicroscopic examination revealed adhesive and cohesive failure mode in composite. The predominant mode of failure using resin infiltrant group A3 (Icon) and self-etch adhesive system group A2 group was adhesive failure with a higher percentage in resin infiltrant A3 (Icon) group 100%. On the other hand cohesive in composite is the predominant mode of failure using the Etch and rinse adhesive system group A1 80%. Conclusion: The use of resin infiltrant (Icon) as an adhesive material impaired efficacy of the microtensile bond strength of direct resin composite to sound dentin .

Comparison of the effect of resin infiltrant, fluoride varnish, and nano-hydroxy apatite paste on surface hardness and streptococcus mutans adhesion to artificial enamel lesions.

IntroductionDental caries is a major public health problem, and Streptococcus mutans is considered the main causal agent of dental caries. This study aimed to compare the effect of three re-mineralizing materials: resin infiltrant, fluoride varnish, and nano-hydroxy apatite paste on the surface hardness and adhesion of Streptococcus mutans as noninvasive treatments for initial enamel lesions.MethodsThis experimental study was conducted from December 2015 through March 2016 in Babol, Iran. Artificial enamel lesions were created on 60 enamel surfaces, which were divided into two groups: Group A and Group B (30 subjects per group). Group A was divided into three subgroups (10 samples in each subgroup), including fluoride varnish group, nano-hydroxy apatite paste group (Nano P paste), and resin infiltrant group (Icon-resin). In Group A, the surface hardness of each sample was measured in three stages: First, on an intact enamel (baseline); second, after creating artificial enamel lesions; third, after application of re-mineralizing materials. In Group B, the samples were divided into five subgroups, including intact enamel, demineralized enamel, demineralized enamel treated with fluoride varnish, Nano P paste, and Icon-resin. In Group B, standard Streptococcus mutans bacteria adhesion (PTCC 1683) was examined and reported in terms of colony forming units (CFU/ml). Then, data were analyzed using ANOVA, Kruskal-Wallis, Mann-Whitney, and post hoc tests.ResultsIn Group A, after treatment with re-mineralizing materials, the Icon-resin group had the highest surface hardness among the studied groups, then the Nano P paste group and fluoride varnish group, respectively (p = 0.035). In Group B, in terms of bacterial adhesion, fluoride varnish group had zero bacterial adhesion level, and then the Nano P paste group, Icon-resin group, intact enamel group, and the de-mineralized enamel group showed bacterial adhesion increasing in order (p < 0.001).ConclusionAccording to the study among the examined materials, the resin infiltrant increased the tooth surface hardness as the intact enamel and fluoride varnish had the highest reduction level for bacterial adhesion. Nano P paste had an effect between the two materials, both in increasing surface hardness and reducing bacterial adhesion.

Comparison of bilateral transversus abdominis plane block and wound infiltration with bupivacaine for postoperative analgesia after cesarean delivery.

Objective:The study aimed to compare efficacy, safety, pain intensity and analgesic consumption in patients receiving either bilateral transversus abdominis plane (TAP) block or wound infiltration with bupivacaine after cesarean delivery (CD).Material and Methods:A total of 216 parturient women undergoing CD under general anesthesia were randomly allocated into five groups: i) controls (group 1), ii) TAP placebo (group 2), iii) TAP (group 3), iv) wound infiltration placebo (group 4), and, v) wound infiltration (group 5). Pain intensity was assessed using a visual analogue scale (VAS). Analgesic consumptions were recorded by a blinded nurse at 6, 12, and 18 hours postoperatively.Results:The baseline characteristics of the five groups were similar in terms of age, history of CD, and body mass indices (p>0.05). There were significant intergroup differences in VAS scores between all groups at the zero time-point (p=0.03), at the 6th hour (p=0.02), 12th hour (p=0.02), and at the 18th hour (p=0.02). Group 3 patients had lower pain scores and consumed less diclofenac than group 2 patients only within 12 hours postoperatively whereas pain intensity and analgesic consumption were not different between group 5 and group 4 patients. Group 5 patients received significantly less pethidine than group 4 and group 1 patients (p<0.001).Conclusion:TAP block provided better pain relief and less analgesic requirement than bupivacaine wound infiltration early after CD. Given the similar amounts of diclofenac but lower amounts of pethidine administered in the wound infiltration group, wound infiltration of bupivacaine seems promising in terms of reducing opioid use after CD under general anesthesia, especially when TAP block is not used.

Efficacy of postsurgical ultrasound guided serratus intercostal plane block and wound infiltration on postoperative analgesia after female breast surgeries. A comparative study

ObjectiveThe serratus intercostal plane block is successfully performed for pain management after breast surgeries. To assess the efficacy and safety of serratus intercostals plane block in comparison with local wound infiltration in women under-going breast surgery.MethodsThis prospective study was conducted on 46 female patients undergoing breast surgeries.Patients were divided into two groups: serratus block (SB) group (n = 23): patients received induction with serratus intercostal plane block with 0.4 ml/kg bupivacaine 0.25% plus fentanyl 20 μg, infiltration group (n = 23) received induction with the borders of the surgical wound were infiltrated with 0.4 ml/kg of bupivacaine 0.25% and 20 μg fentanyl at the end of surgery.VAS pain scores, postoperative patient satisfaction score, time to the first analgesic requirement, total dose of rescue analgesic and the incidence of postoperative complications as vomiting were all recorded.ResultsIntraoperative pain scores and postoperative patient satisfaction scores were significantly lower in group SB compared with infiltration group. Total dose of rescue analgesic was significantly lower in SB group compared with Infiltration group. Significant difference between the study groups regarding the incidence of vomiting. Time to the first analgesic dose was significantly longer in group SB compared to Infiltration group.ConclusionThere is considerable evidence that serratus intercostal plane block in addition to general anesthesia provide better postoperative pain control with little adverse effects compared with wound infiltration, indicating that a perioperative serratus intercostal plane block is a feasible and effective method for an improved postoperative pain treatment after breast surgery.

Preoperative Lymphocyte-Monocyte Ratio Ameliorates the Accuracy of Differential Diagnosis in Non-Metastatic Infiltrative Renal Masses.

PurposeDistinguishing infiltrative renal cell carcinoma (RCC) from transitional cell carcinoma (TCC) is a challenging issue due to their radiologic similarities. We evaluated systemic inflammatory biomarkers as parameters for distinguishing tumor types.Materials and MethodsA computerized search of medical records from November 2005 to October 2015 identified 116 patients with infiltrative renal masses who were difficult to diagnose confirmatively in radiological study. We investigated the diagnostic efficacy among these patients with their preoperative absolute neutrophil counts (ANC), absolute lymphocyte counts (ALC), absolute monocyte counts (AMC), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR).ResultsThe infiltrative RCC group demonstrated significantly lower ALC {1449/µL (1140–1896), median [interquartile range (IQR)]} than the TCC group [1860/µL (1433–2342), p=0.016]. LMR [median (IQR)] also was lower in the infiltrative RCC group [2.98 (2.32–4.14) vs. TCC group 4.10 (2.86–6.09); p=0.011]. In subgroup analysis, non-metastatic infiltrative RCC showed lower ALC and LMR and higher NLR than non-metastatic TCC. Within non-metastatic infiltrative renal masses, multivariate logistic regression analysis revealed that younger patient age and lower LMR were associated with infiltrative RCC [odds ratios (OR) 0.874, p=0.024 and OR 0.461, p=0.048, respectively]. Receiver operating characteristic curve analysis showed that younger age and lower LMR were highly predictive of non-metastatic RCC (area under the curve=0.919, p<0.001).ConclusionAge and LMR were significantly different between patients with infiltrative renal mass. These are potential markers for distinguishing between infiltrative RCC and TCC without metastasis.

Comparison of onset anesthesia time and injection discomfort of 4% articaine and 2% mepivacaine during teeth extractions.

Objective:To investigate the speed of action and injection discomfort of 4% articaine and 2% mepivacaine for upper teeth extractions.Materials and Methods:Forty-five patients were included in the articaine 4% group, and 45 in the mepivacaine 2% control group. After all injections, soft and hard tissue numbness was objectively gauged by dental probe at intervals of 15 s. Furthermore, the discomfort of the injections were recorded by the patients after each treatment on standard 100 mm visual analog scales, tagged at the endpoints with “no pain” (0 mm) and “unbearable pain” (100 mm).Results:There were significant differences in the meantime of first numbness to associated palatal mucosa and tooth of patients between mepivacaine and articaine buccal infiltration (BI) groups P = 0.01 and 0.01. Patients in the articaine group recorded earlier palatal mucosa and teeth numbness than those in the mepivacaine group. With regards to the discomfort of the needle injections, palatal injection was significantly more painful than BI (t-test: P < 0.001). Articaine buccal injection was significantly more painful than mepivacaine buccal injection (t-test: P <0.001). However, articaine palatal injection was less painful than articaine BI. Clinically, anesthesia onset time was faster in anterior upper teeth than upper middle and posterior teeth.Conclusions:BIs with 4% articaine was faster in achieving palate and teeth anesthesia than 2% mepivacaine for extraction of upper maxillary teeth. Patients in mepivacaine BI and articaine palatal injection groups reported less pain with needle injection. Failure of anesthesia was noticeable with maxillary multiple-rooted teeth.

Microhardness and Penetration of Artificial White Spot Lesions Treated with Resin or Colloidal Silica Infiltration.

Infiltration of early enamel lesions by materials having remineralizing capacity seems to improve aesthetics and arrests caries progression. To evaluate and compare the surface microhardness and penetration depth of a low viscosity resin and colloidal silica nanoparticle infiltrates into artificially created white spot lesions. Forty extracted human central incisors were embedded in acrylic resin blocks exposing the labial surfaces of the crowns. The specimens were immersed in demineralizing solution for 96 hours to create white spot lesions on labial surfaces. The samples were then divided into two groups (n=20 each), where in Group 1-resin infiltration (ICON DMG, Hamburg, Germany) and Group 2-colloidal silica infiltration (Arrow Fine chemicals, Rajkot, Gujarat, India) was done. Samples were subjected to vicker's microhardness testing at baseline, after demineralization and after treatment with resin or colloidal silica infiltrates. Then, the crowns were sectioned longitudinally and penetration depth of the infiltrants was measured using confocal laser scanning microscope and compared the readings to lesion depth. All the collected data was subjected to statistical analysis using t-test. Resin infiltration group showed significantly greater increase in microhardness compared to colloidal silica infiltration (p=0.001). The percentage of penetration of the resin group was 67.14% and that of colloidal silica group was 54.53% indicating significant difference between the two. Resin infiltrates performed better in regaining the baseline microhardness and penetrating deep into the porous white spot lesions, when compared to colloidal silica infiltrates.