Oblique Technique Research Articles

Angled Screws With Locking Plates-An Alternative Fixation for Minimally Invasive Mandibular Orthognathic Surgery.

The purpose of this study was to evaluate the short-term behavior of angled screws with locking plates after bilateral sagittal split osteotomy using the anterior oblique technique within the concept of minimally invasive orthognathic surgery (MIOS). Twenty patients who underwent bimaxillary surgery with mandibular advancement were included in this preliminary and retrospective study. All patients underwent computed tomography preoperatively and 1 day postoperatively. The incidence of neurosensory dysfunction, clinical evaluation of the occlusion and temporomandibular joint, and overall complications were recorded during a minimum follow-up of 4 months. The mean extent of sagittal mandibular advancement movements was 7.2mm (2.5-13.2mm). All patients had stable occlusion without evidence of temporomandibular joint dysfunction. None of the patients presented with dysaesthesia, hyperaesthesia, or anesthesia after four months of follow-up. The overall results of this study are very satisfactory with no major or minor complications. The new design of mandibular plates with locking screws can be an alternative in all orthognathic surgeries, but especially interesting for minimally invasive approaches where stronger fixation is needed. Long-term studies are needed to draw further conclusions.

Comparison of Radiation Doses for Different Techniques in Fluoroscopy-Guided Lumbar Facet Medial Branch Blocks: A Retrospective Cohort Study.

Chronic lumbar facet pain is commonly treated with fluoroscopy-guided facet medial branch blocks (FMBBs). However, the associated radiation exposure of both patients and clinicians is a growing concern. This study aimed to compare radiation doses and fluoroscopy times between two techniques, i.e., oblique and posterior-anterior (PA) fluoroscopic approaches, while also examining the impact of physician experience on these metrics. A retrospective analysis was conducted on 180 patients treated at Mersin University Hospital Pain Clinic between January and July 2024. Patients were divided into two groups: 90 received the oblique technique (Group O) and 90 received the AP technique (Group A). Radiation dose and fluoroscopy time data were collected for each patient. The AP technique was associated with significantly lower radiation doses (mean 66 mGy) and shorter fluoroscopy times (mean 28 s) compared to the oblique technique (mean radiation dose of 109 mGy and fluoroscopy time of 46 s) (p < 0.001). Physician experience also influenced these outcomes, with more experienced physicians consistently using less radiation. The AP technique should be considered for FMBBs, as it reduces radiation exposure while maintaining procedural efficiency, highlighting the importance of experience in optimizing outcomes.

Obturator inlet and iliac oblique technique for safe, convenient, and reliable iliac screw placement

BackgroundThere are many described techniques for the placement of posterior iliac screws for extension of lumbar posterior spinal instrumentation to the pelvis. However, each one has its limitations. We describe our technique for fluoroscopic guidance of iliac screw placement utilizing the obturator inlet (OI) and iliac oblique (IO) views as well as a detailed review of how to obtain and interpret these views for safe iliac screw placement. MethodsRetrospective chart review of patients undergoing iliac screw placement utilizing the obturator inlet (OI) and iliac oblique (IO) views as part of spine instrumentation between January 2019 and March 2022. Screw length and bony breaches are reported utilizing this technique Results12 patients underwent posterior lumbopelvic fixation with a total of 23 screws placed via either open or percutaneous technique. The mean screw length was 96.5 mm (Range 80 - 110, standard dev 7.75). There were no recorded breaches or recannulation attempts. ConclusionsWe show how this technique is a much more convenient alternative to placement of iliac screws under the obturator outlet oblique (“teardrop” view) which necessitates that the C-arm be in line with instruments being placed. These described views can be used to place screws with either open or percutaneous techniques and with either the posterior superior iliac spine (PSIS) or S2 alar iliac (S2AI) starting points.

Posterior oblique technique for sacroiliac joint fusion leads to greater pain relief and similar improvement in function compared to the lateral technique: A retrospective, comparative study

BackgroundManagement of chronic sacroiliac joint (SIJ) pain among patients who do not respond to nonsurgical treatment is increasingly turning toward minimally invasive SIJ fusion. There are different techniques available to perform this procedure, with the lateral technique being more commonly studied than the posterior oblique technique. This study examined the effects of these techniques on pain relief and functional improvement, both preoperatively and at a 12-month follow-up. MethodsThis retrospective cohort study analyzed data from 45 patients who underwent SIJ fusion. Included patients were ≥50 years old, nonresponsive to conservative treatment. Subjects were divided into 2 cohorts based on the SIJ fusion technique. Primary outcomes were pain relief, measured by Visual Analog Scale (VAS), and functional improvement, determined by the Oswestry Disability Index (ODI); both were recorded and assessed at baseline, postoperative, and the change from pre- to postoperative. Additionally, data regarding patient demographics, previous lumbar fusion, operative time, and duration of hospital stay were collected and analyzed. ResultsBaseline demographic and clinical variables exhibited no significant differences in distribution between groups. The posterior oblique cohort demonstrated a substantial reduction in operative time (over 50%) and duration of hospital stay compared to lateral cohort. Pain relief (postoperative VAS: lateral 3.5±1.7 vs. posterior oblique 2.4±1.5 [p=.02]) and functional improvement (postoperative ODI: lateral 29.6±7.3 vs. posterior oblique 21±5.7 [p≤.001]) were significantly better in the posterior oblique group. Pre- to postoperative improvement analysis indicated greater reduction in pain (VAS: lateral −4.4±1.9 vs. posterior oblique −6.1±1.5 [p=.002]) in the posterior oblique group. ConclusionsCompared to the lateral technique group, patients undergoing minimally invasive SIJ fusion through the posterior oblique technique experienced greater pain relief and demonstrated a trend toward better functional improvement, with shorter operative times and duration of hospital stay. The posterior oblique technique may be more efficient and beneficial to manage patients suffering from chronic SIJ pain through joint fusion.

Randomized trial of an oblique versus standard fluoroscopic-guided micropuncture technique for femoral arterial access: The Micropuncture-CFA trial

BackgroundThe anterior-posterior fluoroscopic guidance (the AP technique) is a standard method for common femoral artery (CFA) access, but the rate of CFA access with ultrasound vs. the AP technique was not significantly different. We have shown an oblique fluoroscopic guidance (the oblique technique) with a micropuncture needle (MPN) resulted in CFA access in 100 % of patients. The outcome of the oblique vs. AP technique is unknown. We compared the utilities of the oblique vs. AP technique for CFA access with a MPN in patients undergoing coronary procedures. MethodsA total of 200 patients were randomized to the oblique vs. AP technique. Using the oblique technique, a MPN was advanced to the mid pubis in the 20° ipsilateral right-or left anterior oblique view with fluoroscopic guidance and the CFA was punctured. In the AP technique, a MPN was advanced to the mid femoral head in the AP view with fluoroscopic guidance and the CFA was punctured. The primary endpoint was the rate of successful access to the CFA. ResultsThe rates of first pass and CFA access were higher with the oblique vs. AP technique (82 % vs. 61 %, and 94 % vs. 81 %, respectively; P < 0.01). The number of needle punctures was lower with the oblique vs. AP technique (1.1 ± 0.39 vs. 1.4 ± 0.78, respectively; P < 0.01). In high CFA bifurcations, the rate of CFA access was higher with the oblique vs. AP technique (76 % vs. 52 %, respectively; P < 0.01). Vascular complications were lower with the oblique vs. AP technique (1 % vs. 7 %, respectively; P < 0.05). ConclusionsOur data suggest that the oblique technique, compared with the AP technique, significantly increased the rates of first pass and access to the CFA, and decreased the number of punctures and vascular complication. Trial registrationClinicalTrials.gov Identifier: NCT 03955653.

Internal Adaptation of Cusp-weakened Class I Preparations Restored with Bulk-fill, Bi-layered, and Incremental Restorative Techniques: A Micro-CT Analysis

The aim was to evaluate the internal adaptation of composite restorations in cusp-weakened Class I preparations restored by incremental, bi-layered, and bulk-fill techniques using a microcomputed tomography analysis (micro-CT). Sixty sound extracted human third molars were prepared with standardized cusp-weakened Class I cavity preparations and divided into six groups (n=10). Two groups were restored using an incremental oblique technique with a nanofilled (Filtek Supreme XT, 3M Oral Care, St Paul, MN, USA) and a nanohybrid composite (GrandioSO, VOCO, Cuxhaven, Germany). The other two groups were restored using a bi-layered technique with a bulk-fill flowable composite base (Filtek Bulk Fill Flowable, 3M Oral Care; X-tra Base bulk-fill flowable, VOCO) covered with the conventional composite of the same type. In the remaining groups, teeth were restored with a single-increment technique using bulk-fill full-body composites (Filtek Bulk Fill Posterior, 3M Oral Care; Admira Fusion, VOCO). All teeth were subjected to thermocycling (20,000 cycles, 5°C and 55°C) and mechanical loading (250,000 cycles, 2.5 Hz, 50 N) before analysis of internal adaptation by micro-CT. One-way analysis of variance (ANOVA) and the Games-Howell test were used to analyze the percentage and volume of internal gaps (p<0.05). There was found to be significantly higher internal adaptation for the nanofilled composite used incrementally or associated with a flowable base compared with the nanohybrid composite used incrementally (p=0.002). Bulk-fill and bi-layered techniques performed similarly in terms of internal adaptation for both types of composites. The incremental technique with the nanofilled composite demonstrated a higher internal adaptation than with the nanohybrid composite.

THE TRANSLATION OF ARABIC LEGAL DOCUMENTS: A CASE STUDY OF PALESTINE DIVORCE DOCUMENTS

This study is about the translatability of Arabic religious legal terms in Palestinian divorce documents. It is a qualitative descriptive study which aims at exploring the translator’s choices and decisions in dealing with divorce terminologies to determine the determinant norms that can affect or enhance divorce terminologies in Arabic-English translation. In doing so, Vinay and Darbelnet’s translation procedures are followed to assess the translations. The study has looked into the translations of divorce terminologies in Palestinian divorce documents. Translated texts of Palestinian divorce documents have been selected from Palestinian sworn translators and certified translation offices to be representative of this text type. A set of specified divorce terms have been analysed. As a result, it is discovered that the translators rely highly on the direct strategy to translate general terms such as ‘nafaqa, dukhul, ibra’ while the oblique technique is used to translate culture-specific terms such as: khalwa, raji, baen baynona sughra and kubra’. The research reveals also that the translations decisions depend not only on translation norms, but also on language norms related to culture- specific terms.

The effect of filling technique on the cuspal strain, polymerization shrinkage stress, enamel crack formation and depth of cure of restored molars

ObjectiveEvaluate the effect of different restorative filling techniques on the residual shrinkage stress (ShrS), cuspal strain (CS), depth of cure (DC), and enamel crack formation (Ec) in molars with MOD restorations. MethodsPost-gel shrinkage, elastic modulus, compressive and diametral tensile strength of the Filtek One Bulk Fill composite were calculated. Sixty molars with MOD preparations were restored using four filling techniques: Bulk; Horizontal; Oblique; Natural enamel and dentin substitution (NEDS) technique. CS was measured using a strain gauge (n = 10). The DC (n = 5) was measured using Knoop hardness. Shrinkage stress/strain was analyzed using 3D finite element analysis. The Ec analysis was carried out by transillumination. Two-way ANOVA with repeated measures and Tukey’s HSD test (α = 0.05) was performed for the CS data. Two-Way ANOVA and Tukey’s HSD test was performed for the DC data (α = 0.05). ResultsCS was higher at the lingual cusp for the horizontal and NEDS technique. No statistical difference was found between the buccal and lingual CS values for the Bulk (p = 0.367) or Oblique techniques (p = 0.192). CS values were lower for the Bulk. More enamel cracks were found for the Bulk. DC was lower at 4 mm regardless the filling technique. The Horizontal showed the highest ShrS values. The Bulk generated the lower ShrS values. SignificanceA Bulk technique caused the lowest shrinkage stress/strain. An Oblique technique yielded the best balance between stress, strain and crack formation. NEDS technique is a good alternative to decrease the number of increments while maintaining the stress levels nearby the Oblique technique.

Role of sagittal - oblique technique of MRI in diagnosis of anterior cruciate ligament injuries

Abstract Background Sagittal-oblique technique clearly shows partial rupture because its’ double angulation follows the specific course of the patient’s ligament, due to approximate orientation of the external rotation of the foot. Sagittal-oblique technique provides a higher number of slices presenting the whole course of ACL Objective To value the role of sagittal- oblique technique of MRI adding to the standardized MRI technique in the diagnosis of anterior cruciate ligament injuries. Patients and Methods The study was approved by the hospital ethical committee and all patients agreed to participate in the study. We prospectively evaluated 20 patients with MRI examination of the knee. Patients presented with painful knee joint due to trauma of knee soft tissue structures. They were 9 females and 11 males, ranging in age from 26 to 67 years. Mean age is 39.80 years. Results Accuracy of standard MRI protocol of the knee comparing to additional technique is identical in detection of a complete ACL rupture. Presentations of the partial ruptures of ACL using sagittal-oblique technique were more sensitive than presentation using standard MR protocol. There was statistically significant difference between MRI detection of the ruptured ACL between additional techniques. Sagittal-oblique technique provides a higher number of MRI slices showing the whole course of the ACL and requires a shorter scan time. Conclusion The addition of oblique sagittal technique to the standard MRI imaging improved diagnostic accuracy for detecting partial tear of the ACL. However, oblique sagittal technique is just as precise as the standard MR technique for the evaluation of a complete rupture of the ACL, so it should be used in cases of suspicion of partial rupture of the ACL

Nematic Structures under Conical Anchoring at Various Director Tilt Angles Specified by Polymethacrylate Compositions.

Dependence of the director tilt angle of nematic liquid crystal (LC) under conical anchoring from the two-component polymer mixture composition has been studied. We varied the ratio of poly(isobutyl methacrylate) (PiBMA), which specifies a conical anchoring for the nematic liquid crystal LN-396, and poly(methylmethacrylate) (PMMA) assigning a tangential alignment for the same nematic. An oblique incidence light technique to determine a tilt angle has been used. It has been shown that the tilt angle increases from to when PiBMA:PMMA ratio changes in the range 30:70 to 100:0. The specific optical textures viewed under the polarizing microscope and proper orientational structures have been considered for various compositions of the polymer films. An electric field action on the formed orientational structures has been investigated. The obtained results are promising for the application in various electro-optical LC devices with a conical anchoring in which the director tilt angle is a crucial parameter: a controlled diffraction gratings, an electrically operated achromatic rotators of linear light polarization, etc.

A4 Pulley Reconstruction Using the Superficialis Oblique Flap and the Transverse Double Loop Techniques: A Biomechanical Evaluation Using a Chicken Model.

The pulley system plays an important role in flexion mechanism. Reconstruction after trauma can be challenging. Numerous techniques have been described with several drawbacks. Herein, we describe the superficialis flap oblique technique for A4 pulley reconstruction using an animal model. Forty-two fresh legs of 21 eight-week-old chickens were used to evaluate the maximum flexion angle (MFA) and force at maximum flexion (FMF) in intact and sectioned A4 pulley equivalents of the third digit after reconstruction with the transverse double loop (TDL) technique and the superficialis oblique flap (SOF) technique. Biomechanical measurements were obtained in an exclusively designed instrument. Descriptive statistics were reported, and mean differences between the reconstructive techniques were analyzed. Intact and severed A4 pulley equivalent average MFA were 96.50° ± 1.70° and 115.60° ± 1.50°, respectively. Average FMF were 8.16 ± 0.23 psi with the intact pulley and 6.92 ± 0.20 psi with the sectioned pulley (P < 0.001). After reconstruction with TDL and SOF techniques, the legs reached an average MFA at the distal interphalangeal joint of 98.13° ± 1.20° and 96.90° ± 1.30°, respectively. Mean MFA difference was 1.23° (P = 0.03). Force at maximum flexion was 8.12 psi and 8.10 psi for the TDL and SOF techniques (P = 0.6), respectively. The authors believe that SOF technique for A4 pulley reconstruction can be used as first option when available, taking into account its theoretical advantages and its proven biomechanical characteristics. Long-term functional results should be assessed to translate these results into the clinical setting.

Effect of Layering Techniques on Polymerization Shrinkage Stress of High- and Low-viscosity Bulk-fill Resins.

The use of layering techniques is still advisable with many bulk-fill resins and should be the default unless a particular resin is known to not need it. Objective: The purpose of this study was to investigate how layering techniques affect polymerization shrinkage stresses of high-and low-viscosity bulk-fill resins.Method: Six high-viscosity and six low-viscosity bulk-fill resins were evaluated. Aluminum blocks with a mesial-occlusal-distal (MOD) cavity were machined and randomly divided into groups for different filling techniques (bulk-fill vs horizontal layering vs oblique layering) and further subdivided according to type of resin (high- vs low-viscosity). The cuspal deflection resulting from the polymerization of bulk-fill resin bonded to a MOD cavity within an aluminum block was measured with a digimatic micrometer. Scanning electron microscopy analyses of tested resins were also conducted.Results: In the high-viscosity bulk-fill resins, cuspal deflection of the MOD cavity ranged from 11.2 to 18.2 μm with the bulk-filling technique, from 10.7 to 15.5 μm with the horizontal layering technique, and from 10.9 to 15.2 μm with the oblique layering technique. In the low-viscosity bulk-fill resins, cuspal deflection of the material ranged from 9.2 to 19.8 μm with the bulk-filling technique, from 8.2 to 15.7 μm with the horizontal layering technique, and from 8.4 to 16.4 μm with the oblique layering technique.Conclusion: Cuspal deflections for some high-and low-viscosity bulk-fill resins were significantly reduced by using layering techniques, but the resultant improvement of layering techniques was not applicable to all the bulk-fill resins used in this study.

Oblique schlieren image construction from three-dimensional numerical simulations

The experimental visualisation of compressible flows has undergone significant development to the point that a large number of optical techniques exist for extracting both qualitative and quantitative information from these flow fields. However, the visualisation, and importantly, validation, of three-dimensional flows requires further attention. This work details the development of a novel validation tool for three-dimensional compressible flows. Oblique experimental imaging techniques used to visualise three-dimensional flow features in a compressible medium are computationally simulated, and corresponding images are constructed from numerical models. The construction technique can be used to generate images for optical orientations in roll, yaw, pitch and any combination of these. Both shadowgraphs and schlieren images may be obtained, with the latter used in this work. Results are presented as a comparison of constructed images with experimental images and discussed for cases in which a range of features are simultaneously present in a three-dimensional flow field, thus thoroughly examining the applicability of the technique to a flow field of significant importance in gas dynamics research.

Concurrent use of oblique sagittal and oblique coronal MRI: does it enhance the specificity and the accuracy of diagnosing complete and partial ACL tears?

BackgroundThe aim of the study was to evaluate the diagnostic efficacy of utilization of oblique sagittal and oblique coronal MRI techniques separately and concurrently in improving the diagnosis of anterior cruciate ligament (ACL) complete and partial tears. Between December 2017 and November 2018, 71 patients, with suspected ACL injury, were examined by MRI using four diagnostic approaches: standard routine images only (approach A), standard and oblique coronal images (approach B), standard and oblique sagittal images (approach C), and standard images with both oblique coronal and sagittal images (approach D). Two experienced musculoskeletal radiologists evaluated the MRI images separately and in a random order using the four methods, and findings were compared with arthroscopy results as a gold standard.ResultsThe diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for approach A in diagnosis of partial ACL tear was significantly lower than that for approaches B, C, and D (p value < 0.05). The PPV and NPV for approaches B (82% and 85%) and C (83% and 87%) in diagnosis of partial ACL tear which were significantly lower than that for approach D (94% and 95%). The four approaches revealed no significant difference in diagnosis of complete ACL tear (p value > 0.05). Approach D demonstrated highest interobserver agreement (94% in complete and 88% in partial ACL tears) in comparison to B (79% in complete and 66% in partial) and C (85% in complete and 71% in partial) when combining oblique sagittal and oblique coronal images in identifying both complete and partial ACL tearsConclusionThe addition of oblique sagittal and coronal images improved diagnostic accuracy of detection of complete and partial ACL tears. The concurrent use of sagittal and coronal oblique images enhanced the diagnostic efficacy of diagnosis of partial ACL tears only.

A novel approach to the proximal interphalangeal joint: The volar oblique incision - a retrospective cohort study.

Background:The surgical approach to the volar structures in the digits must be designed to provide adequate exposure of tendons, vessels and nerves but also in a way that prevents flexion contracture of the digit as the scar contracts. This is traditionally done using a zigzag ‘Bruner’ incision, first described by Dr Julian M Bruner in 1967. In this paper, we describe an alternative approach, the Volar Oblique incision, and present a single institutional cohort of patients who have undergone procedures beginning with this approach.Methods:A retrospective cohort study was performed on eight cases that involved a Bruner incision and eight similar cases that involved a volar oblique incision. Charts were reviewed for demographic data. Patients were asked to return to clinic postoperatively for scar assessment using the Patient and Observer Scar Assessment Scale (POSAS), where lower scores correspond to more favourable scar characteristics. The average follow-up period was 22 months. While in clinic, standard joint measurements were taken to assess for any proximal interphalangeal joint contracture. Demographics and questionnaire data were analysed using the Mann–Whitney U test for non-parametric data and quantitative joint measurements were analysed using Student’s t-test.Results:There was no difference in flexion contracture between the two groups. The POSAS patient score for scar irregularity was lower in the volar oblique group compared to the Bruner group, but there was no difference in any of the other subcategories, the total patient score, nor the overall patient opinion. The total POSAS observer score was lower in the volar oblique group compared to the Bruner group, with lower scores in the scar thickness, observed relief and observed pliability subcategories as well as the overall observer opinion.Conclusion:The volar oblique incision appears to be satisfactory alternative to the classic Bruner incision in hand surgery that requires volar exposure of the digits. Future studies are needed to assess the validity of these findings on a larger scale.Lay Summary There are various types of incisions that surgeons use when they operate on fingers. When choosing an incision, it is important that the incision provides good exposure to the deeper structures but does not form a tight scar that limits movement of the finger (contracture).A commonly used incision for the palmar side of the finger is the zig-zag or ‘Bruner’ incision. Some people, however, find this zig-zag scar unappealing. We started using a single diagonal incision, which we have called the volar oblique, instead of the zig-zag Bruner for access to the middle joint of the finger. We wanted to describe the volar oblique technique and then compare the quality of these two scars and also assess if one limits movement of the finger more than the other.Our research found no differences in finger contracture between groups. We did, however, find that patients reported scar irregularity more favourably in the volar oblique group and that surgeons rated scar thickness, relief (roughness) and pliability of the volar oblique scar higher than that of the zig-zag Bruner scar.This research presents a novel surgical technique and compares its results with respect to scar quality and finger contracture to the more traditional zig-zag Bruner approach.

Proximal and Distal Failure Site Analysis in Percutaneous Achilles Tendon Rupture Repair.

Different techniques have been described for percutaneous Achilles tendon rupture repair, but no biomechanical evaluation has been performed separately for proximal and distal suturing techniques. The purpose of this study was to biomechanically analyze proximal versus distal percutaneous Achilles suture configurations during cyclic loading and load to failure. A simulated, midsubstance rupture was created 6 cm proximal to the calcaneal insertion in fresh-frozen cadaveric Achilles tendons. Fifteen proximal specimens were divided into 3 groups: (A1) triple locking technique, (A2) Bunnell-type technique, and (A3) double Bunnell-type technique. Twelve distal specimens were divided into 2 groups: (B1) triple nonlocking technique and (B2) oblique technique. Repairs were subjected to cyclic testing and load to failure. Load to failure, cause of failure, and tendon elongation were evaluated. None of the proximal specimens and 7/12 of the distal ones failed in cyclic testing. The proximal fixation groups demonstrated significantly more strength than the distal groups (P = .001), achieving up to 710 N of failure load in Group A3. Groups B1and B2 failed on average at 380 N with no difference between them (P > .05). The majority of all repairs failed in the suture-tendon interface. Distal groups had more elongation during cyclic testing (13.7 mm) than proximal groups (9.4 mm) (P = .02). The distal fixation site in this Achilles tendon repair was significantly weaker than the proximal fixation site. A proximal modified suture configuration increased resistance to cyclic loading and load to failure significantly. A modification can be suggested to improve strength of the Achilles repair.

Cervical epidural hematoma following interlaminar epidural steroid injection via the contralateral oblique view in patient taking omega-3 fatty acids

Background and objectivesWe sought to describe a case of an epidural hematoma after a cervical interlaminar epidural steroid injection (ILESI) performed using contralateral oblique view. We also discuss factors that...

Tunable polymer lasers based on metal-dielectric hybrid cavity.

Tunable distributed feedback polymer lasing was achieved in a metal-dielectric hybrid cavity. The laser device consisted of a double-layer grating structure and a polymer membrane. Interference lithography and oblique evaporation techniques were employed in fabricating the cavity. The photoresist grating was fabricated by interference lithography. Silver was obliquely evaporated onto the photoresist grating, forming a double-layer grating structure. Then a free-standing polymer membrane was attached on the structure. Under optically pumped conditions, low-threshold lasing was obtained, due to the plasmonic enhancement. The lasing wavelength can be tuned by changing the silver grating's thickness, which results from the variance of the effective refractive index of the cavity. These results can be used to design high-efficiency laser devices.

A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques.

ObjectiveThe sacroiliac joint can be a primary source of pain or part of multifactorial syndromes. As there is no single historical, physical examination-based, or radiological feature that definitively establishes a diagnosis of sacroiliac joint pain, diagnostic blocks are regarded as the gold standard. The primary aim of this randomized trial was to compare the posteroanterior approach with the classic oblique approach for sacroiliac joint injection based on an assessment of procedure times and patient-reported pain outcomes in subjects scheduled for fluoroscopically-guided sacroiliac joint injections. MethodsThirty patients were randomized into 2 groups of 15 patients each. The endpoints measured included the total length of procedure time, fluoroscopic time, needling time (length of time the needle was maneuvered), and pre- and postprocedure visual analogue scale pain scores. ResultsThe posteroanterior approach was significantly shorter in terms of procedure time (p=0.03) and needling time (p=0.01) than the oblique approach. Adjusting for body mass index, the mean procedure and needling times were significantly shorter in the posteroanterior group than in the oblique group. ConclusionThis study of the posteroanterior approach for fluoroscopic-guided sacroiliac joint injection observed shorter times for fluoroscopy, needling, and the overall procedure than were recorded for the widely prevalent oblique approach. This may translate to lower radiation exposure, lower procedural costs, and enhanced ergonomics of fluoroscopicallyguided sacroiliac joint injections.

USING OBLIQUE TECHNIQUE TO TEACHING TRANSLATION OF THE ELEVENTH GRADE STUDENDS OF SMA NURUL AMAL PALEMBANG

Abstract: In Indonesian educational system, English is one of the compulsory subjects instructed at school. The student learn English for the first time formally when they are still in the kindergarten up to the university as a foreign language, the students finds the difficulties to learn the four skills of English which are listening, speaking, reading and writing, and English also have some aspects in learning such as: structure, vocabulary, and also grammar.The problem of this study was “Is it effective to use oblique technique to the eleventh grade students of SMA NURUL AMAL Palembang”. The objective of this study was to find out whether or not it is effective to use Oblique Technique to the eleventh grade students SMA NURUL AMAL Palembang. The writer used pre-experimental method. The populations of this study were all the eleventh grade students of SMA NURUL AMAL Palembang in academic year 2011-2012. The sample of this study was 42 students, taken by using cluster random sampling method. The written tests were used to collect the data. The data were analyzed through matched t-test.