Needle Point Research Articles

Minimally invasive denervation of the wrist: A cadaveric feasibility study for a single injection that targets both anterior and posterior interosseous nerves under ultrasound-guidance

BackgroundWrist osteoarthritis poses significant challenges in pain management and functional impairment. Current surgical interventions often sacrifice wrist motion and entail long recovery times. Minimally invasive denervation offers a promising alternative by targeting sensory nerves. This study investigates the efficacy of ultrasound-guided chemical ablation with phenol-glycerin for wrist denervation. MethodsUnder ultrasound guidance, 1–3 mL of 1 % methylene blue:8 % phenol:8 % glycerin solution was injected on both side of the interosseous membrane of six unembalmed cadaveric wrists. The entry point of the 22-gauge needle was along the lateral border of the ulna, just proximal to the most proximal aspect of the ulnar head. Dissections of the anterior and posterior compartment of the forearm were performed to visualize the length of both posterior interosseous (PIN) and anterior interosseous (AIN) nerves that were stained. ResultsResults showed a successful dispersion of methylene blue staining along the PIN (2.1 ± 0.82 cm), deep to the fourth extensor compartment of the wrist posteriorly, and along the AIN (2.5 ± 1.10 cm), between the interosseous membrane and pronator quadratus muscle anteriorly. Importantly, this diffusion spared the main motor branches of both nerves. CONCLUSIONS. Minimally invasive denervation of the wrist using ultrasound-guided chemical ablation with phenol-glycerin shows promise in targeting the sensory branches of both interosseous nerves.

A comparative study of the versatility of various entry points for double-puncture TMJ arthrocentesis: A randomized controlled study

Although various authors employed various entry points for the double-puncture technique (DPT) for arthrocentesis, the literature is devoid of any comparative studies. Therefore, the current prospective study aimed to evaluate the versatility of these different points. A total of 144 TMJs in 108 patients were included and randomly divided into two categories according to ID stage: category I (disc displacement without reduction with limitation), and category II (disc displacement without reduction without limitation). Patients in every category were randomly divided into 3 groups according to the site of entry point of the second needle: group 1 (20-10 point: 20 mm anterior to the tragus and 2 mm inferior to the cantho-tragus line), group 2 (20-1 point), and group 3 (7-2 point). For all patients, the first entry point was 10-2, and the upper joint cavity was irrigated with 150 ml of Ringer’s solution without subsequent intra-articular injections. Group 3 had better results than group 2 and further than group 1 in categories I and II with regard to the number of second needle relocations, ease of the procedure, duration of the procedure, and nature of the outflow, as well as pain at rest and pain on function at 1, 3, and 6 post-operative months. For the maximum mouth opining, group 3 had better results than group 2 and further than group 1 only in category I. Therefore, techniques depending on the superior posterior entry points (such as 7-2 point) were recommended.

CLosure of Abdominal MidlineS Survey (CLAMSS): A national survey investigating current practice in the closure of abdominal midline incisions in UK surgical practice.

Incisional herniation (IH) is a frequent complication following midline abdominal closure with significant associated morbidity. Randomized controlled trials have demonstrated that the small bites technique (SBT) and prophylactic mesh augmentation (PMA) may reduce IH compared to mass closure techniques, but data are lacking on their implementation in contemporary surgical practice. This survey aimed to evaluate the use of the SBT and PMA and to identify factors associated with their adoption. Between 22 January 2023 and 16 March 2023, consultant surgeons across the UK were asked to complete a 25-question survey on closure of an elective primary midline incision. Responses were received from 267 of 675 eligible surgeons (39.6%) in 38 NHS Trusts. Respondents were evenly split between tertiary centres (47.6%) and district general hospitals (49.4%). SBT and PMA were used by 19.9% and 3.0% of respondents, respectively. Compared to other techniques, surgeons using the SBT were more likely to close the anterior aponeurotic layer only, use single suture filaments, 2-0 gauge sutures and sharp needle points and routinely dissect abdominal layers to aid closure (all p < 0.001). Attendance at lectures/conferences on SBT (p = 0.043) and basing practice on available evidence (p < 0.001) were independently associated with use of the SBT. The commonest barriers to adopting SBT were a perceived lack of evidence (23.8%) and belief that personal IH rates were low (16.8%). A minority of UK consultant surgeons have adopted the SBT or PMA. Practice change should be driven by more widespread dissemination of current evidence and procedural information.

Bipolar ionization rapidly inactivates real-world, airborne concentrations of infective respiratory viruses.

The SARS-CoV-2 (COVID-19) pandemic has highlighted the urgent need for strategies that rapidly inactivate airborne respiratory viruses and break the transmission cycle of indoor spaces. Air ions can reduce viable bacteria, mold, and virus counts, however, most studies use small test enclosures with target microbes and ion sources in close vicinity. To evaluate ion performance in real-world spaces, experiments were conducted in a large, room-size BSL-3 Chamber. Negative and positive ions were delivered simultaneously using a commercially available bipolar air ion device. The device housed Needle Point Bipolar ionization (NPBI) technology. Large chamber studies often use unrealistically high virus concentrations to ensure measurable virus is present at the trial end. However, excessively high viral concentrations bias air cleaning devices towards underperformance. Hence, devices that provide a substantial impact for protecting occupants in real-world spaces with real-world virus concentrations are often dismissed as poor performers. Herein, both real-world and excessive virus concentrations were studied using Influenza A and B, Human Respiratory Syncytial Virus (RSV), and the SARS-CoV-2 Alpha and Delta strains. The average ion concentrations ranged from 4,100 to 24,000 per polarity over 60-minute and 30-minute time trials. The reduction rate was considerably greater for trials that used real-world virus concentrations, reducing infectivity for Influenza A and B, RSV, and SARS-CoV-2 Delta by 88.3-99.98% in 30 minutes, whereas trials using in-excess concentrations showed 49.5-61.2% in 30 minutes. These findings strongly support the addition of NPBI ion technology to building management strategies aimed to protect occupants from contracting and spreading infective respiratory viruses indoors.

Dynamic peeling process of IC chip from substrate based on a 3D analytical model

A 3D analytical approach is proposed to investigate the peeling mechanism of IC chip from substrate, which is important for reliable electronic packaging. Chip-adhesive-substrate system is considered as a composite structure composed of a rectangular plate of free edges and a clamped circular plate bonded with an interfacial layer. Peeling a chip from substrate is treated as the interfacial fracture of this structure. Based on the theory of elasticity, the problem of interfacial fracture is reduced to a set of coupled integral and differential equations. An analytical scheme is developed to solve these equations. With the approach, dynamic evolution process of peeling is analyzed due to various needle ejecting and vacuum absorption. Stress distributions of both chip and adhesive at different stages of peeling process are obtained. It is shown that stresses of both chip and adhesive are nonuniformly distributed in the whole region. As a result, peeling initiates from four corners, and propagates toward the center of interface with a very complex advancing front. For a definite displacement of needle point, peeling process is determined by both the magnitude and application time of vacuum absorption. When these two parameters locate in a specific region, a chip can be separated completely from substrate without damage. Furthermore, peeling process is sensitive to the position deviation of needle point. In case the position deviation is beyond a certain range, peeling process is incomplete.

A model on stitch tightening process of lockstitch machine

A model of stitch tightening process in lockstitch machine is formulated to predict the needle thread peak tension during stitch tightening and the position of needle and bobbin thread crossover point i.e. y-value. This y-value is then used to predict the thread consumption in a lockstitch seam. A computer program in C language is developed based on the model formulated in lockstitch machinery to predict needle thread stitch tightening tension and the position of needle and bobbin thread crossover point i.e. y-value. The developed model is validated qualitatively by studying the effect of different variables on peak value of needle thread tension. The model is also validated quantitatively by comparing the experimental and predicted values of peak tension and stitch length. A satisfactory predictive power of the model is observed which validates the developed model.

Anatomical study of the technique of the axis laminar screws and development of guide

PurposeTo develop a bidirectional slide guide to assist screw placement in the axial lamina and to preliminarily discuss the accuracy and feasibility of auxiliary screw placement.MethodsCT data from 40 randomly selected patients were imported into the software for modelling, and cross-pinning was used to simulate pinning. According to the different crossing methods of the upper and lower laminar screws, they are divided into two groups. In the software, the position of the needlepoint of each screw is accurately measured, and the needle point is kept unchanged to simulate the movable range of the screw tail under the condition that the body does not penetrate the cortical bone. The data were compared by grouping and gender. Finally, the guide was designed by combining the screw exit point and fine adjustment angle data of all patients with the centripetal principle of the slide rail.ResultsThe needle exit data L1/L2/L3/L4 were 6.44 ± 0.52 mm, 7.05 ± 0.48 mm, 3.55 ± 0.75 mm and 5.09 ± 0.74 mm, respectively, and the fine adjustment angle of the slide rail was 10.51° ± 0.87°. There was no significant difference between the two groups or between men and women (p > 0.05).ConclusionIn this experiment, using the data obtained from the simulation of screw insertion, a two-way slide guide was designed to assist the insertion of axial laminar screws. The guide locks the screw outlet point to position and guides the screw inlet point, which improves the accuracy and safety of screw placement.

Front Cover: Tuning Directed Photooxidation‐Induced Conversion of Pyrrole‐Based Styryl Coumarin Dual‐Color Photoconverters (Chem. Eur. J. 20/2023)

The tunability of the DPIC mechanism. A yellow-emitting coumarin is connected to a “conversion meter” indicating the efficiency of conversion. The needle points at the different groups that have been attached to the pyrrole moiety. These groups are sorted from left to right according to the conversion yield, with a corresponding background ranging from dark to illustrate photo-bleaching to blue to illustrate the photo-conversion. More information can be found in the Research Article by M. Collot and co-workers. (DOI: 10.1002/chem.202203933).

Surgical suture needles.

Have a needle thre cornered…and the lippis of the wound schal be sowid togideris Lanfranc of Milan (1250−1315) The original date of the first needle-and-thread insertion for wound closure is uncertain. Ancient terminology referred to the sutura cruenta, or the ‘bloody’ or ‘true’ suture. Organic needles preceded those made of metal. Bronze needles for stitching bandages into position were employed by the Romans and the Sushruta Indian texts of 800 Bc are said to have described iron triangular and pointed needles. Creating an eye in needles made of any early organic or inorganic material always proved challenging and some proximal needle ends had notches, spring, or slot eyes rather than the usual complete standard excavated eyes (Fig. 1) Onwards of the sixteenth century, the eye for threading sutures was sometimes placed near to the point of a (broader) needle, mounted on a handle. As the point pierced the pedicle, the thread was carried through and was then slid out of the eye, to be tied.

Needle holders.

In previous centuries, surgical needles were hand held. Suturing was inevitably crude and hand-threaded needles were used to close wounds using silk, linen or, later, catgut stitches. Hand-held needles were curved or straight, as discussed in the next article. In Victorian times and into the mid-20th century, many surgeons performed wound closure, suture transfixion, tissue repair, and anastomoses with skills, employing hand-held needles. A few earlier needle holders were designed to grip straight or J-shaped needles end on, so as to push the needle points into tissues by a forward movement. However, with finer work in the evolving craft, requiring more accurate placement of sutures, instruments grasping a needle at right angles to the shafts of the holders became the preferred way of controlling smaller curved needles. Straight needles remain mainly hand-wielded and are pushed or dragged through the tissues. The correct positioning of the modern curved needle in the jaws of the holder should ideally be at two-thirds of the distance from the point of the needle. This is to allow adequate penetration by the needle and to prevent its buckling if placed too close to the non-working end. Care is always needed when mounting or dismounting the needle to avoid stick injuries.

Black Ecologies (Humanity, Animality, Property)

Black Ecologies (Humanity, Animality, Property)

Preparation of Mn3O4 microspheres via glow discharge electrolysis plasma as a high-capacitance supercapacitor electrode material

Manganic manganous oxide (Mn3O4) microspheres were prepared at 550 V discharge voltage in 2 g L−1 NaNO3 solution by one-step method via cathode glow discharge electrolysis (CGDE) plasma technique for high-capacitance supercapacitor electrode materials, in which Mn foil and Pt needle point were served as anode and cathode, respectively. The structure, phase composition and morphology of as-prepared products were characterized by FT-IR, XRD, XPS, SEM, TEM and BET analysis. A mechanism for the fabrication of Mn3O4 microspheres was proposed. The electrochemical behaviors of the Mn3O4 microspheres were examined in 1.0 mol L−1 Na2SO4 electrolyte. The results showed that Mn3O4 microspheres are composed of small nanospheres with sizes of about 20 nm and large nanospheres with sizes of about 177 nm. Specific surface area of microspheres is 48.03 m2 g−1. The Mn3O4 microsphere as an electrode has an outstanding specific capacitance of 360 F g−1 at 0.5 A g−1 and a superior cycling property of 83.6 % capacity retention after 1000 cycles at 1 A g−1, evidencing the potential as an electrode material for supercapacitor.

Fabrication of Fe3O4 nanoparticles by using cathode glow discharge electrolysis plasma and its electrochemical properties

In this work, Fe3O4 nanoparticles (NPs) were fabricated by one-step method using cathode glow discharge electrolysis (CGDE) plasma technique in 2.0 g L−1 Na2SO4 solution at 600, 650 and 700 V applied voltage, in which Pt needle point and scrap iron wire were served as cathode and anode, respectively. The fabricated products were characterized by FT-IR, XRD, SEM and TEM. A possible fabrication mechanism of Fe3O4 NPs under CGDE was proposed. In addition, electrochemical performance of Fe3O4 NPs as an electrode material for supercapacitors was investigated by cyclic voltammetry, galvanostatic charge–discharge, and electrochemical impedance spectroscopy in 1 mol L−1 Na2SO3 electrolyte. The results showed that the particle sizes of the fabricated products are below 20 nm, Fe3O4 NPs as the electrode material have good reversibility which can reach 247 F g−1 specific capacitance at current density of 0.5 A g−1, and still keep 41.1% capacity retention after 5000 cycles. Fe3O4 NPs can be regarded as a promising and favorable candidate of electrode materials for supercapacitor. Compared with other methods, CGDE has the advantages of simple experimental equipment, no gas supply, mild reaction conditions and no secondary pollution. It is a green synthesis technique without adding alkali, surfactant and ferric salt containing both Fe2+ and Fe3+.

Time to Occurrence of Phlebitis After Continuous Infusion of Total Nutrient Admixture Through Peripheral Veins: An Experimental Animal Study.

ObjectiveTo study the limit time of phlebitis caused by continuous infusion of KabivenTM Pl and TNA (KabivenTM Pl+ alanyl glutamine + potassium aspartate) through a peripheral vein, and to provide a reference for clinical formulation of preventive measures for phlebitis.MethodsWhite rabbits (n = 72) were randomly divided into three groups: group A (Normal saline), group B (Kabiven™ Pl), and group C (TNA). Blood was collected from the ear margin vein before administration and after three hours, four hours, five hours, and six hours of administration. CRP and TNF-ɑ were measured by enzyme-linked immunosorbent assay. Hematoxylin and eosin staining and immunohistochemical staining were performed on tissue samples taken from the insertion point of the indwelling needle, the tip of the indwelling needle, and 1 cm from the tip of the indwelling needle, closer to the heart, to analyze early pathological changes in blood vessels.Results(1) There were no visible inflammatory symptoms in groups A, B, or C within 6 hours. (2) Four hours after starting intravenous administration, the levels of inflammatory markers in groups B and C were higher than in group A, and (3) the degree of inflammatory cell infiltration in groups B and C was more severe than in group A. (4) In all groups, the inflammatory reaction at the tip of the indwelling needle was more severe than at the other two sites.ConclusionWhen the emulsions TNA and Kabiven™ Pl are infused through a peripheral vein, (1) four hours may be considered as the maximum time for continuous intravenous infusion in the same vein before inflammatory changes become evident, and (2) systematic assessment of the tip of the indwelling needle should be considered for inclusion in the nursing plan for phlebitis monitorings.

Determination of the location of the needle entry point based on an improved pruning algorithm.

Since the emergence of new coronaviruses and their variant virus, a large number of medical resources around the world have been put into treatment. In this case, the purpose of this article is to develop a handback intravenous intelligence injection robot, which reduces the direct contact between medical staff and patients and reduces the risk of infection. The core technology of hand back intravenous intelligent robot is a handlet venous vessel detection and segmentation and the position of the needle point position decision. In this paper, an image processing algorithm based on U-Net improvement mechanism (AT-U-Net) is proposed for core technology. It is investigated using a self-built dorsal hand vein database and the results show that it performs well, with an F1-score of 93.91%. After the detection of a dorsal hand vein, this paper proposes a location decision method for the needle entry point based on an improved pruning algorithm (PT-Pruning). The extraction of the trunk line of the dorsal hand vein is realized through this algorithm. Considering the vascular cross-sectional area and bending of each vein injection point area, the optimal injection point of the dorsal hand vein is obtained via a comprehensive decision-making process. Using the self-built dorsal hand vein injection point database, the accuracy of the detection of the effective injection area reaches 96.73%. The accuracy for the detection of the injection area at the optimal needle entry point is 96.50%, which lays a foundation for subsequent mechanical automatic injection.

Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis.

Vascular access is a lifeline for hemodialysis patients. Its lifetime is affected by many hemodynamic factors such as pressure, flow regime and wall shear stress. During hemodialysis, changes in hemodynamic parameters occur due to the flow from needles inserted into the vascular system. Primarily, there is a change in shear stress that affects the vascular wall. Pathological effects of high or low WSS are known. The effect of jet from a venous needle on hemodynamics parameters was studied, but the influence of the arterial needle on hemodynamics parameters is not sufficiently studied. To understand its possible effects, we performed in vivo and in vitro studies. Methods. In vivo experiment: The existence of flow reversal around the suction needle was visualized in a group of 12 randomly selected patients using ultrasound velocity profiling (Doppler ultrasonography) during hemodialysis. In vitro experiment: The flow field was measured using the stereo particle image velocimetry method (stereo PIV). Two regimes were studied. In the first regime, the fluid in the extracorporeal circuit was pumped by a peristaltic pump. In the second regime, the continuous pump was used in the extracorporeal circuit. The conditions were set to resemble those in vascular access during a hemodialysis session. Flow volume was set to 600 mL/min for vascular access and 200 mL/min for the extracorporeal circuit. Results. The main finding of this study was that the wall in the region of the arterial needle was stressed by backflow through the arterial needle. Since this was a variable, low-shear stress loading, it was one of the risk factors for the development of stenosis. Cyclic flow reversal was apparent in all of the included hemodialysis patients. The stereo PIV in vitro experiment revealed the oscillating character of wall shear stress (WSS) inside the model. High shear stress was documented upstream of the injection point of the arterial needle. An area of very low WSS was detected right behind the injection point during a pulse of the peristaltic pump. The minimal and maximal values of the WSS during a pulse of the peristaltic pump in the observed area were −0.7 Pa and 6 Pa, respectively. The distribution of wall shear stress with the continual pump used in the extracorporeal circuit was similar to the distribution during a pulse of the peristaltic one. However, the WSS values were continual; the WSS did not oscillate. WSS ranged between 4.8 Pa and 1.0 Pa.

Study on the application of a new type of vertebral plate nail guide

To explore safety and accuracy of novel C2 laminar staple guide through in vitro experiments. From January 2018 to June 2018, 40 patients who underwent three-dimensional CT of cervical spine were selected, including 21 males and 19 females, heighted from 165 to 180 cm with an average of (172.9±9.5) cm, aged from 38 to 55 years old (51.1±12.8) years old, excluding patients with axis lamina defect and hypoplasia. Two sets of 3D printed specimens were made from the three-dimensional CT data of cervical spine of each patient, and both of than were used for the in vitro nailing experiment. According to different nail placement methods, in vitro experimental part of this experiment was divided into guide nail placement group and hand nail placement group, 40 pieces in each group. At the same time, the three-dimensionalmodel of cervical spine of 40 patients was reconstructed on computer, and the ideal needle point data and inclination angle were obtained by computer simulation of the nail placement. This is 3D simulation nail placement group, 40 pieces. With vitro experiment, the risk level of screw placement, the position of needle exit point and inclination angle were measured in guide nail group and hand nail group. Based on the accuracy of needle point and inclination angle of nail path, the data of guide nail group, the hand nail group and 3D simulation nail group were compared, and the data of each group were statistically analyzed to determine the accuracy. In guide nail group, 75 screws were acceptable and 5 were dangerous. The acceptable rate was 94%, and the double cortical rate was 93%. There were 62 position-acceptable screws in hand nail group, and 18 positions were dangerous, with an acceptable rate of 78% and a double cortical rate of 33%. The difference between two groups was statistically significant (P<0.05). There was no significant difference in accuracy of needle exit point and inclination angle of nail path between guide nail group and 3D simulation nail group (P>0.05), but there was significant difference in the accuracy of needle exit point and inclination angle of nail path between hand nail group and 3D simulation nail group (P<0.05). The guide is universal, with stable structure, accurate guidance, and easy operation. It could be placed with bilateral lamina screws at the same time, shortening the time of nail placement, avoiding collision of two way cross screws, increase the rate of double cortex. Ultimately, efficiency and security can be improved.

Air-Assisted Atomization of Beveled Needle Point Injector

Air-Assisted Atomization of Beveled Needle Point Injector

PERFORMANCE PROPERTIES OF THREAD SEAMS OF KNITTED-BASED MEMBRANE MATERIALS

The article is devoted to the study of the strength and wear resistance of thread seams of membrane materials on a knitted basis. The characteristics of the composite membrane three-layer material are given and the modes of its stitching and the test method are substantiated. Investigations of material cutting through with a needle were carried out and the geometry of the sewing needle point was chosen. The results of the study of the strength of thread seams made along of the front layer of the material before and after modelling the operational tensile loads along and across the seam are presented. 15000 load-unload cycles were simulated, stretching the sample by 10 % of the seam length. As a result of a full factorial experiment, it was found that the linear density of the threads and the diameter of the needle have the greatest effect on the strength and wear resistance of the thread seams of the composite material. The influence of the sewing frequency is ambiguous for the parameter of the wear resistance of the seam when stretched along and across the line.

Ten years of clinical observation of olfactory ensheathing cell transplantation in patients with spinal cord injury

Objective:To evaluate the long-term curative efficacy and safety of olfactory ensheathing cell (OEC) transplantation by 10 years of follow-up investigation.Methods:A follow-up observation was done on 13 patients with allograft olfactory bulb-derived OEC transplantation from September 2005 to September 2007 at the Second Affiliated Hospital of Xi’an Jiaotong University. After cell purification, amplification, and identification, a 2 × 107/mL cell suspension was prepared for transplantation. In the posterior horn of the spinal cord 0.5 cm distal and proximal to the spinal cord injury zone, 4 needle points were selected to avoid the blood vessels. The needle depth was 3 mm, and the injection volume per point was 10 μL. Postoperatively and at 1 week, 4 weeks, 12 weeks, 24 weeks, 1 year, 3 years, 5 years, and 10 years after the surgery, the patient’s American Spinal Injury Association (ASIA) score, adverse reactions, and other minor observations were assessed.Results:All the patients did not have serious complications. No gliomas or other new organisms formed during the 10-year observation period. Eight of 13 patients had improvement in sensory function, and 5 patients showed improvement in motor function. The ASIA acupuncture, light touch, and exercise scores improved significantly 1 year after the surgery, and this improvement continued until the 10-year follow-up period. Three of 13 patients had improvement in defecation and urination, and 1 patient had improved neuralgia after spinal cord injury.Conclusion:OEC transplantation is safe and effective in treating spinal cord injury. The observation period of OEC transplantation is 1 to 3 years.