Insertion Site Research Articles

Incidence of peripheral intravenous cannula induced phlebitis and its determinants among admitted patients in Ethiopia: systematic review and meta analysis, 2024

BackgroundPeripheral venous catheters (PVCs) are frequently used in clinical practice. Nonetheless, individuals who receive intravenous injections frequently have varying degrees of phlebitis. According to pertinent research, the catheter gauge, insertion site, and length of catheterization are strongly correlated with the incidence of phlebitis. However, no meta-analysis on the combined incidence of phlebitis and its contributing factors has been conducted. Thus, the purpose of this meta-analysis was to close the previously identified gaps.MethodA literature survey was conducted using electronic databases (CINAHL, Embassy, Google Scholar, and PubMed), and 4 studies were included they used peripheral intravenous catheters for therapeutic or volumetric infusion and reported phlebitis incidence rates. Random effects meta-analyses were performed to obtain the overall and subgroup phlebitis incidence rates and odds ratio for phlebitis incidence.ResultsThe incidence of phlebitis was 41 per 100 catheters (95% CI 0.22–0.60). There were 1584 patients in the included studies to know the incidence of phlebitis. In the subgroup analysis, the incidence of phlebitis in neonatal and infant patients was 30% (95% CI 0.25–0.34), in pediatrics patients was 34% (95% CI 0.29–0.38), and in adult patients was 50% (95% CI 0.11–0.89) respectively. Joint involvement in the PIVC (AOR: 2.44, 95% CI 1.67, 3.2), longer catheter dwell time (AOR = 3.96, 95% CI 1.59–7.33), and drug and blood administration in one vein (AOR = 1.91, 95% CI 1.67–2.15) were the most common factors associated with the incidence of phlebitis in Ethiopia.ConclusionThis meta-analysis indicates that PIVC-induced phlebitis is highly prevalent in Ethiopia. This meta-analysis identified significant risk factors for the development of phlebitis including medications and blood administered in a single vein, longer cannula dwelling times, and joint involvement in peripheral intravenous cannula insertion. Using the right interventions can lower the chance of developing phlebitis.

First-principles study on the lithiation process of amorphous SiO anode for Li-ion batteries with Bayesian optimization.

Amorphous silicon monoxide (a-SiO), which contains Si atoms with various valence states, has attracted much attention as a high-performance anode material for lithium (Li) ion batteries (LIBs). Although current experiments have provided some information during charge/discharge cycles, further investigation of structural changes at the atomic scale is needed. To investigate the lithiation process of a-SiO using first-principles simulations and machine learning techniques, we developed a computational code employing Bayesian optimization to efficiently identify stable sites for Li insertion in the large search-space of amorphous models to reproduce the actual lithiation process and compared this approach to the conventional random scheme by applying it to an a-SiO model previously generated with neural network potentials. The lithiation process based on Bayesian optimization resulted in lower formation energies compared to the conventional random scheme, indicating a more stable structure. During lithiation, Li atoms tended to enter the silicon (Si) phase after the SiO2 phase, in agreement with experimental results. We analyzed the structural changes and observed significant differences in the structural evolution between the conventional and new schemes. Our study highlights the significant influence of the lithiation process on the structural transformation of a-SiO materials, which in turn affects the reversible capacity of the material. These findings will provide a framework for improving the performance and lifetime of a-SiO materials.

Integration Site Library for Efficient Construction of Plasmid-Free Microbial Cell Factories in Escherichia coli.

Enhanced production stability and efficiency along with a decrease in production costs are required to build efficient microbial cell factories. Target genes can be integrated into the genome to enhance genetic stability, reduce reliance on antibiotics, and alleviate the metabolic burden. However, selecting the optimal insertion site for the desired gene expression levels remains challenging. Therefore, 18 commonly usedEscherichia coliintegration sites were systematically characterized in this study. Promoters of different strengths were combined with integration sites, yielding a differential intensity range of up to 93-fold. This indicated the versatility and precision of this approach for controlling gene expression levels. Referring to the library, pathway genes were strategically integrated into theE. coligenome based on their respective expression levels. Genetically stable and highly efficient engineered strains that could biosynthesize arbutin and p-aminobenzoic acid were constructed.

Case Report: Osteosynthesis-associated infection with Ochrobactrum intermedium after acetabular fracture

Ochrobactrum intermedium (O. intermedium) is a gram-negative, non-fermenting bacterium closely related to Brucella genus. O. intermedium resembles an emergent human pathogen that has rarely been detected in both immunocompetent and immunodeficient patients. A musculoskeletal infection with O. intermedium has not been described in the literature. We present the first case of an osteosynthesis-associated infection (OAI) with O. intermedium in an 80-year-old female patient after osteosynthesis of an acetabular fracture. The patient was admitted to the emergency department 6 months after osteosynthesis of a posterior column acetabular fracture treated via open reduction and internal plate fixation of the posterior column. The patient demonstrated tenderness, redness and swelling at the insertion site as well as a fistula. The radiological controls showed femoral head necrosis and partial protrusion of the head into the pelvis. The laboratory parameters showed no pathological findings. OAI was assumed and a two-stage revision with implant removal and resection arthroplasty in the first stage and hip arthroplasty in the second stage was performed. All microbiological specimens taken at the osteosynthesis site and the hip joint grew O. intermedium. The pathogen was determined using the matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) method. Antibiotic regime consisted of intravenous (IV) meropenem for two weeks followed by oral ciprofloxacin and cotrimoxazole. Implantation of the hip prosthesis was performed 6 weeks after the index surgery using a cementless revision cup and a cemented stem. Meropenem and vancomycin IV were given for one week followed by ciprofloxacin and doxycycline for another 5 weeks. 24 months after the surgery, the patient is infection free and satisfied with the result. With this case report we would like to increase awareness of possible implant-associated bacterial infections caused by O. intermedium.

Expanding the BonnMu sequence-indexed repository of transposon induced maize (Zea mays L.) mutations in dent and flint germplasm.

The BonnMu resource is a transposon tagged mutant collection designed for functional genomics studies in maize. To expand this resource, we crossed an active Mutator (Mu) stock with dent (B73, Co125) and flint (DK105, EP1, and F7) germplasm, resulting in the generation of 8064 mutagenized BonnMu F2-families. Sequencing of these Mu-tagged families revealed 425 924 presumptive heritable Mu insertions affecting 36 612 (83%) of the 44 303 high-confidence gene models of maize (B73v5). On average, we observed 12 Mu insertions per gene (425 924 total insertions/36 612 affected genes) and 53 insertions per BonnMu F2-family (425 924 total insertions/8064 families). Mu insertions and photos of seedling phenotypes from segregating BonnMu F2-families can be accessed through the Maize Genetics and Genomics Database (MaizeGDB). Downstream examination via the automated Mutant-seq Workflow Utility (MuWU) identified 94% of the presumptive germinal insertion sites in genic regions and only a small fraction of 6% inserting in non-coding intergenic sequences of the genome. Consistently, Mu insertions aligned with gene-dense chromosomal arms. In total, 42% of all BonnMu insertions were located in the 5' untranslated region of genes, corresponding to accessible chromatin. Furthermore, for 38% of the insertions (163 843 of 425 924 total insertions) Mu1, Mu8 and MuDR were confirmed to be the causal Mu elements. Our publicly accessible European BonnMu resource has archived insertions covering two major germplasm groups, thus facilitating both forward and reverse genetics studies.

Upcycling polyethylene into closed-loop recyclable polymers through titanosilicate catalyzed C-H oxidation and in-chain heteroatom insertion

Polyolefins are the most widely produced type of plastics owing to their low production cost and favorable properties. Their polymer backbone consists solely of inert C-C bonds, making them resistant and durable materials. Although this is an extremely useful attribute during their use phase, it complicates chemical recycling. In this work, different types of polyethylenes (PEs) are converted into ketone-functionalized PEs with up to 3.4% functionalized carbon atoms, in mild conditions (≤100 °C), using a titanosilicate catalyst and tert-butyl hydroperoxide as the oxidant. Subsequently, the introduced ketones are exploited as sites for heteroatom insertion. Through Baeyer-Villiger oxidation, in-chain esters are produced with yields up to 73%. Alternatively, the ketones can be converted into the corresponding oxime, which can undergo a Beckmann rearrangement to obtain in-chain amides, with yields up to 75%. These transformations allow access to polymers that are amenable to solvolysis, thereby enhancing their potential for chemical recycling.

Pseudomonas monteilii bacteremia and sepsis following insertable cardiac monitor implantation: a case report

BackgroundInsertable cardiac monitor implantation is a simple and safe procedure commonly performed in patients with embolic stroke with undetermined source. Routine periprocedural antibiotic use is not recommended, because infection rate is very low, although some local infection or gram-positive bacteremia have been reported. We report a case of Pseudomonas monteilii sepsis immediately after insertable cardiac monitor implantation.Case presentationA 55-year-old Korean male with embolic stroke of undetermined source presented with gram-negative sepsis immediately after implantable cardiac monitor implantation as a first reported complication after the procedure. Pseudomonas monteilii was identified in the blood culture, and no other infection source was seen. He was treated with intravenous antibiotics without removing the device.ConclusionsPrompt diagnosis and adequate management is required in such a patient with sepsis post-insertable cardiac monitor implantation procedure. It can be managed with adequate antibiotic treatment without device removal if there is no sign of inflammation at the insertion site. Further reports or studies should be investigated to reinforce this finding.Learning objectivesThe infection rate after insertable cardiac monitor insertion is extremely low; however, sepsis may occur without pocket infections. Physicians should be aware of signs of systemic infection, particularly when the procedure is performed outside the catheterization room. Sepsis after insertable cardiac monitor implantation can be managed with adequate antibiotic treatment without device removal if there is no sign of inflammation at the insertion site.

Open Dorsal Closing-Wedge Calcaneal Osteotomy for Haglund Exostosis-Related Heel Pain.

Dorsal closing-wedge calcaneal osteotomy (DCWCO) is a treatment option for persistent Haglund exostosis-related heel pain after failed conservative management. In modifying the orientation of the calcaneal tendinous insertion site and reducing mechanical stress, the consequences of DCWCO-associated biomechanical changes on everyday foot function remain unknown. This retrospective cohort study analyzed routinely collected clinical data as well as data from our foot and ankle registry. One hundred twenty patients (66 males, 54 females, 17-77 years) who underwent DCWCO from January 2016 to December 2019 were included. Adverse events were collected from the patient files. Foot Function Index (FFI) scores were collected before (baseline) and at 6, 12, and 24 months postsurgery. Radiographic parameters including the Achilles tendon moment arm and X/Y ratio were evaluated from standard preoperative and 6-week postoperative radiographs. Correlations between FFI and biomechanical changes were calculated for men and women separately with the Pearson correlation coefficient and Bonferroni correction. One intra- and 18 postoperative adverse events were documented. Mean baseline FFI pain decreased from 47.9 ± 17.2 to 12.0 ± 17.5 points at 24 months with an average decrease of -21.8 ± 21.3 points occurring within the first 6 months postsurgery. A similar trend was also seen with the FFI disability score (49.6 ± 20.3 to 12.8 ± 17.6 points). The mean decrease in Achilles tendon moment arm was -8.1 ± 3.8 mm and mean X/Y ratio increased from 2.6 ± 0.3 to 3.8 ± 1.0. There were no significant correlations between the FFI score and radiographic changes. DCWCO effectively alleviates exostosis-related heel pain and associated disabilities. Improvements can still be expected up to 2 years after surgery. Radiographic changes of the foot and ankle are significant but do not correlate with patient-reported outcome measures.

Virtual thoracoscopic imaging for accurate pulmonary nodule localization: clinical experience.

The increasing detection of small pulmonary nodules on computed tomography (CT) warrants simple and effective nodule localization methods. We describe our clinical experience using an experimental computer that displays virtual thoracoscopic images. This device constructs three-dimensional images from preoperative CT scans and simulates the deflated lung parenchyma in the lateral decubitus position. Five patients underwent lung resection using this technology. The device provided images that closely resembled actual thoracoscopic images in all cases. This method addresses the limitations of other localization techniques such as allergic reactions and mechanical marker-related complications. The method only requires preoperative CT images, and the process is semi-automatically performed by specifying the nodule location, thoracoscopic camera insertion site, and camera angle. This study is still in the preliminary phase and has several limitations. However, this method has the potential to accurately predict nodule locations and eliminate the many risks associated with other techniques.

Impact of medical adhesives on persistent fluid extravasation at needle injection sites in patients with severe edema: a randomized controlled trial.

To investigate the efficacy of medical glue in halting fluid extravasation at needle insertion sites in patients with severe edema. Sixty patients with severe edema were recruited between June 2022 and June 2023 and randomly allocated into either the control group or the experimental group, with 30 cases in each. In the experimental group, after intramuscular injection, medical glue was administered at the needle insertion site, and covered with gauze dressing upon curing, and subsequently subjected to pressure bandaging. Patients were instructed to limit their activity. Meanwhile, the control group received conventional nursing procedures involving pressure bandaging and activity restriction. The effectiveness of nursing interventions in halting exudation, duration of hospitalization, duration of exudation, nursing expenses, skin complications (infection, rash, abrasion, abnormal sensation, etc.), and patient satisfaction with nursing care were monitored. Comparison between the two groups revealed statistically significant differences in several aspects: the success rate of halting exudation, duration of exudation, total skin complication rate, and overall satisfaction [83.3% vs. 20.0%, (2.20 ± 2.76) days vs. (7.33 ± 3.28) days, 6.67% vs. 33.33%, 80.00% vs. 36.67%, P < 0.05]. However, there were no statistically significant differences in hospitalization time and nursing expenses [(14.50 ± 5.17) days vs. (14.00 ± 3.95) days, (537.53 ± 264.19) yuan vs. (661.97 ± 305.55) yuan, P > 0.05]. Medical glue demonstrates effectiveness in halting fluid extravasation at needle insertion sites among patients experiencing severe edema. Additionally, it reduces the duration of exudation, diminishes skin complications resulting from exudation, and significantly enhances patient satisfaction with nursing care. Given these benefits, its clinical adoption and application are highly recommended.

Effect of transition and alkali metals on Mo2C/Al2O3 catalysts for syngas to higher alcohols

Direct production of higher alcohols remains a great challenge in syngas conversion process. Herein, MMo2C/Al2O3 and KMMo2C/Al2O3 catalysts promoted by different transition metals M (M=Co, Fe, Cu, Ni, Zn, Nb) and alkali metal (K) were prepared by impregnation method to investigate the effect on CO hydrogenation to higher alcohols under milder reaction conditions (300°C, 3.0 MPa). The catalysts were characterized with XRD, H2-TPR, and XPS. It was found that the addition of transition metals and K resulted in the decrease of low-valent Mo species on the catalyst surface, which facilitated the generation of Mo4+ during the reaction. Increase in Mo4+ content facilitates the conversion of CO to CO*, which provides more CO insertion sites for the generation of alcohols. Moreover, the introduction of K also enhances the interaction of transition metals with Mo, which accelerates the formation of alcohols in the reaction. Meanwhile, the transition metal and Mo2C work together to promote the dissociative adsorption of CO. The production of higher alcohols is facilitated by the synergistic effect of the two mentioned above. Overall, the KCoMo/Al2O3 and KFeMo/Al2O3 catalysts exhibited high selectivity for higher alcohols, reaching 73.9 % and 71.3 % for C2+OH in the alcohol products, respectively. CO conversion of KFeMo/Al2O3 catalyst can reach 84.9 % with excellent stability in the reaction. Moreover, the possible pathways of the reaction were obtained by in-situ DRIFT characterization.

Identification of a new Clostridium perfringens variant with a chromosomally encoded enterotoxin gene in a suspected persistent food poisoning outbreak in Eritrea

Clostridium perfringens is a causative agent of various human and animal enteric diseases including food poisoning. In this study, we describe an interesting case of a persistent food poisoning outbreak among Finnish peacekeepers in Eritrea, possibly caused by Clostridium perfringens carrying a new variant of the chromosomally encoded enterotoxin gene. C. perfringens strains causing food poisoning carry the enterotoxin gene, cpe, in its chromosome (c-cpe) or on a plasmid (p-cpe). PCR assays are widely used for toxinotype C. perfringens strains. The integration sites for the cpe gene are highly conserved, and PCR assays targeting the cpe gene and the adjacent IS elements (the IS1470 in c-cpe and the IS1470-like or IS1151 in p-cpe strains) are used to further determine the genetic location of the cpe gene. We sequenced nine enteropathogenic C. perfringens strains related to a persistent food poisoning outbreak among Finnish peacekeepers in Eritrea. Six of these strains produced non-typeable cpe results in the standard PCR assay due to divergence in the enterotoxin integration site. The gene order of the new variant of the chromosomal cpe insertion site with an additional IS1470 element impairing genotyping PCR assay for the location of cpe is described. In addition, variant c-cpe strains carried 58–81 copies of IS1470 in their genomes, compared to 9–23 copies found in previously described c-cpe strains. Thus, the present study represents an untraditional type of C. perfringens food poisoning caused by variant c-cpe strains, and the sequenced strains bring geographic variation to the existing strain collection of sequenced C. perfringens.

EVE-X: Software to Identify Novel Viral Insertions in Wild-Caught Arthropod Hosts From Next-Generation Short Read Data.

Eukaryotic genomes harbour sequences derived from non-retroviral RNA viruses, known as endogenous viral elements (EVEs) or non-retroviral integrated RNA virus sequences (NIRVS). These sequences represent a record of past infections and have been implicated in host anti-viral response. We have created a program to identify viral sequences integrated in a host genome. It begins with a specimen BAM file and outputs candidate NIRVS, along with putative host insertion sites and overlapping genomic features of the host genome in XML and visual formats, with minimal intermediary intervention. We ran through this software short-read data derived from the genomes of 222 wild-caught A. aegypti mosquitoes, from a dozen geographical regions, and located putative NIRVS from seven virus families. This program is as accurate as currently available software for NIRVS detection, and represents a significant improvement in adaptability and user-friendliness. Furthermore, the flexibility of this pipeline allows the user to search for sequence integrations across the genome of any organism, as long as a query sequence database and a reference genome is provided. Potential extended applications include identification of integrated transgenic sequences used for research or vector control strategies.

Viral coexistence and insertional mutations in the ORF8 region of SARS-CoV-2: A possible mechanism of nucleotide insertion

The virus obtained from a swab sample ID: S66 in Hiroshima was reported to have a single T-base insertion in the ORF8 coding region. However, no T insertion was observed when we determined the genomic sequence using another method. We then extracted RNA from the S66 swab sample and sequenced the insertion site using the Sanger method. The resulting waveform was disrupted beyond the insertion site, suggesting the presence of a mixed population of viruses with different sequences. Through plasmid cloning of RT-PCR amplification fragments and virus cloning by limiting dilution, along with TIDE analysis to determine the ratio of components from the Sanger sequencing waveform, it was confirmed that the sample contained a mixture of viruses with varying numbers of T-base insertions. The virus with one T insertion (T1+) was predominant in 70–75 % of the genomes, and genomes with T0, T2+, T3+, T4+, and T5+ were also detected. No T-base insertion mutations were observed in the ORF8 region in three other SARS-CoV-2 samples. In the S66 sample, a C27911T point mutation near the insertion site in the ORF8 region resulted in a sequence of seven or more consecutive T bases, which was the cause of the T-base insertion. When the cloned S66 virus (T1+) was passaged in cultured cells, there was a tendency for viruses with more insertion bases to become dominant with successive generations, suggesting that the T-base insertion was due to polymerase stuttering. The insertion of T bases resulted in synthesis of deletion mutants of the ORF8 protein, but no significant change was observed in the proliferation of the viruses in cultured cells. A search of the GenBank database using NCBI BLAST for viruses similar to S66 with T-base insertion mutations revealed hundreds of viruses widely distributed on the molecular phylogenetic tree. These base insertion viruses were thought to have occasionally arisen during the virus infection process. This study suggests one mechanism of insertion mutations in SARS-CoV-2, and it is important to consider the emergence of future mutant strains.

Impact of landmark crater creation on improving accuracy of pedicle screw insertion in robot-assisted scoliosis surgery.

This study evaluated the impact of the Landmark Crater (LC) method on pedicle perforation rates in robot-guided surgery for pediatric scoliosis for each pedicle diameter. Seventy-six scoliosis patients underwent robot-assisted posterior spinal fusion. The cohort consisted of 19 male and 57 female patients, with a mean ± standard deviation age of 17.5 ± 7.7 years and a preoperative Cobb angle of 57.0 ± 18.5°. The LC method is a method in which craters that serves as a landmark are created in advance at the planned PS insertion site of all pedicles within the intraoperative CT imaging area. The patients were divided into the LC group, in which PS insertion was performed using the LC method, and the control group using the conventional PS insertion method. Overall and pedicle perforation rates for each pedicle outer diameter were compared between the groups by Fisher's exact test. The LC group exhibited a significantly lower pedicle major perforation rate than did the control group (2.7% vs. 6.2%, P = 0.001). The perforation rates in pedicles with a pedicle outer diameter > 6mm, 4-6mm, 2-4mm, and < 2mm were 0.61%, 1.6%, 5.1%, and 21%, in the LC group and 0.75%, 4.1%, 12%, and 50% in the control group, respectively. In robot-assisted surgery for pediatric scoliosis, the LC method enabled significantly lower pedicle perforation rates over the conventional method. Both the LC and conventional methods exhibited higher perforation rates for smaller pedicle diameters.

Diagnosis and Analysis of Vasa Previa Types With Flow HD Glass Body.

To explore the value of applying flow high definition (HD) glass body in prenatal diagnosis of vasa previa and to preliminarily discuss the types of vasa previa. Two-dimensional ultrasound, flow HD, and flow HD glass body were used to image the umbilical cord insertion site and placenta, observe the cervical internal os and surrounding areas, and retrospectively analyze cases of vasa previa. There were 15 cases of vasa previa, including 14 cases of singleton pregnancies and 1 case of twin pregnancy, with a total of 22 vasa previa, including 10 veins and 12 arteries. There was 1 case with 3 vessels, 5 cases with 2 vessels, and 9 cases with a single vessel. Among them, in 3 cases of vasa previa detected at 12, 14, and 24 weeks, respectively, the vasa previa were relocated to a normal position at 24, 29, and 35 weeks of gestation when re-examined. Routine 2-dimensional ultrasound examination in this group showed tubular or circular hypoechoic areas near the cervical internal os, but vasa previa could not be confirmed. Flow HD could display color blood flow at and near the cervical internal os in 15 cases, but it was difficult to continuously show the course and source of the blood vessels under the chorion. Flow HD glass body from multiple angles could display the relationship between 15 cases of 22 vasa previa and the placenta and cervix. Combined with color Doppler blood flow spectra, flow HD glass body could determine the types of vasa previa. Flow HD glass body imaging can clearly display vasa previa, showing their origin and the spatial relationship with the cervix and placenta in a 3-dimensional manner, displaying the course and attachment points of umbilical vessels under the chorion. It can observe the area of interest at any angle, and combined with color Doppler blood flow spectra, it can judge the vasa previa of the umbilical vein, providing a more definite imaging basis for clinical management.

Review of the technology used for structural characterization of the GMO genome using NGS data

The molecular characterization of genetically modified organisms (GMOs) is essential for ensuring safety and gaining regulatory approval for commercialization. According to CODEX standards, this characterization involves evaluating the presence of introduced genes, insertion sites, copy number, and nucleotide sequence structure. Advances in technology have led to the increased use of next-generation sequencing (NGS) over traditional methods such as Southern blotting. While both methods provide high reproducibility and accuracy, Southern blotting is labor-intensive and time-consuming due to the need for repetitive probe design and analyses for each target, resulting in low throughput. Conversely, NGS facilitates rapid and comprehensive analysis by mapping whole-genome sequencing (WGS) data to plasmid sequences, accurately identifying T-DNA insertion sites and flanking regions. This advantage allows for efficient detection of T-DNA presence, copy number, and unintended gene insertions without additional probe work. This paper reviews the current status of GMO genome characterization using NGS and proposes more efficient strategies for this purpose.

MA12.06 PAPILLON: TP53 Co-mutations, Sites of Insertion, and ctDNA Clearance Among Patients with EGFR Ex20ins-Mutated Advanced NSCLC

MA12.06 PAPILLON: TP53 Co-mutations, Sites of Insertion, and ctDNA Clearance Among Patients with EGFR Ex20ins-Mutated Advanced NSCLC

Does the resistive index of the radial artery change after arterial cannulation in patients undergoing abdominal surgery? A prospective observational study.

To evaluate the flow at the cannulation site in the radial artery, the resistive indices (RIs) before cannula insertion and 6 h after decannulation were measured (primary outcome). The secondary outcomes were measurement of the artery size by anteroposterior (AP) diameter at the insertion site, RI and AP diameter at a point 4 cm proximal and in the ipsilateral ulnar artery before insertion and 6 h after cannula removal. In 96 patients requiring an arterial line during surgery, peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured to derive RI using a linear ultrasound transducer. The RI was measured at R1 (insertion point), R2, 4 cm proximal to R1, and U1 on the ipsilateral ulnar artery. The AP diameter of the arteries at baseline R10, R20 and U10 was measured and repeated 6 h after removal of the cannula, R16, R26 and U16. RI or AP diameter in R1 or R2 did not differ pre- and post-cannulation. Mean R10 1.143 [standard deviation (SD: 0.239)] versus R16 1.181 (SD: 0.260) m/sec [mean difference (MD): -0.0372 (95% confidence interval (CI): -0.098, 0.023), P = 0.230]. Mean AP diameter at baseline versus 6 h decannulation 0.177 (SD: 0.042) versus 0.172 (SD: 0.045) cm [MD: 0.005 (95% CI: 0.003, 0.013), P = 0.222] was also similar. The mean PSV in U10 versus U16 was higher: 0.480 (SD: 0.178) versus 0.528 (SD: 0.316) m/sec [MD: 0.120 (95% CI: -0.185, -0.054), P = 0.002] and AP diameter was also higher than baseline (P = 0.001). The flow in the radial artery did not change following cannulation. The PSV and AP diameter in the ulnar artery increased after decannulation, suggesting a compensatory increase in flow.

Evaluation Of Bone Thickness At Different Anatomical Sites In Infrazygomatic Crest For Miniscrew Insertion In Skeletal Class II Patients – A CBCT Study

AIM: To assess infrazygomatic crest bone thickness at different anatomical sites at a distance of 5mm, 7mm, 9mm and 11mm apical to cementoenamel junction, 70 degree to occlusal plane in skeletal class II patients using cone beam computed tomography (CBCT). Materials and Methods: The sample consists of cone beam computed tomography images of 23 class II subjects were evaluated. Infrazygomatic crest bone thickness was evaluated at the six horizontal regions (i) interdental area between maxillary second premolar (PM2) and first molar(M1) (ii) Mesiobuccal root of maxillary first molar (MB root of M1) (iii) Distobuccal root of maxillary first molar(DB root of M1) (iv) interdental area between maxillary first molar(M1) and second molar(M2) (v) Mesiobuccal root of maxillary second molar(MB root of M2) (vi) Distobuccal root of maxillary second molar (DB root of M2) at a vertical distance of 5mm,7mm,9mm and 11mm apical to cementoenamel junction, 70 degree to occlusal plane. Results: The buccal bone thickness increase from mesial surface of maxillary first molar to mesial surface of maxillary second molar from cement enamel junction at the level of 11mm, 70 degree to the occlusal plane. The bone thickness decreases at the second molar level. Conclusion: The safe site for insertion of miniscrews in the infrazygomatic crest were the interdental region between the maxillary first and second molars at the heights of 11 mm from cementoenamel junction and 70 degree to the occlusal plane