Tissue Incision Research Articles

Early postoperative results analysis of standard and mini-incision posterolateral approach in total hip arthroplasty

Background/Aim. Total hip arthroplasty is the replacement of the hip joint with an artificial one. Standard surgical procedures involve a long skin incision and extensive dissection of healthy tissue. Mini-incision surgery is a modification of standard operative approaches. In addition to a significantly smaller skin incision, the main difference is based on much less damage to soft tissues, especially the muscles that move the hip. The aim of this study was to compare the early results of the mini-incision and a standard approach in total hip arthroplasty and to determine the advantages and disadvantages of the mini-incision surgical technique. Methods. A retrospective study analyzed data based on 63 patients who underwent total hip arthroplasty with a mini-incision and standard approach at the Institute of Orthopaedic Surgery ?Banjica?, Belgrade from 2004 to 2010. All the patients suffered from primary coxarthrosis. All operations were carried out by the same surgical team. All patients were clinically evaluated before and after the surgery using the Harris Hip Score (HHS). Results. The group of patients operated on with the mini-incision approach included 32 patients, while 31 patients made up the group of patients operated on with the standard approach. Comparing these groups did not reveal a statistically significant difference in age, body mass index, surgery duration, and HHS before the surgery. A statistically significant difference was determined by comparing intraoperative blood loss, the amount of drainage fluid after the surgery, and the HHS after the surgery. Conclusion. The mini-incision posterolateral approach, compared to the standard approach, apart from an esthetically more acceptable scar, achieves significantly less intraoperative blood loss and better hip function with almost the same risk of complications.

Tracking Tag Stabilization With a Small-Diameter Implant in an Edentulous Mandible to Assist Dynamically Navigated Surgery: A Case Report

This report describes the use of a temporary dental implant to secure a radiographic fiducial marker and patient-tracking tag to an edentulous mandible for dynamically guided implant placement into a fibula microvascular free flap. A small-diameter dental implant was placed into the anterior mandible to secure a radiographic fiducial marker followed by a patient tag. The patient tag allowed for tracking of the patient's mandible during placement of endosseous dental implants. Four endosseous dental implants were successfully placed into the edentulous fibula free flap mandibular reconstruction. Dynamic navigation using a small-diameter implant to secure radiographic fiducial markers and patient tags provides a novel technique to place implants into an edentulous microvascular free flap with minimal incision and reflection of soft tissue.

Recognition of Factors of Postoperative Complications of Knee Osteoarthritis Patients and Comprehensive Nursing Intervention.

Knee osteoarthritis (KOA) is a degenerative joint disease characterized by articular cartilage degeneration, cartilage exfoliation, osteophyte formation, and synovitis. It seriously affects the knee joint function and quality of life of patients. Total knee arthroplasty is now the most frequently used therapy for end-stage knee arthritis because it can successfully modify the line of lower extremities, restore knee joint function, alleviate pain, and enhance patients' quality of life; nevertheless, it may cause significant trauma and bleeding. It can easily lead to infection and anemia. In this study, the control group chose total knee arthroplasty and the observation group chose total knee arthroplasty combined with PRP. The results showed that the knee joint function score, visual analog score, blood transfusion, total blood loss, total postoperative drainage, and complications in the observation group were superior to those in the control group. Total knee arthroplasty takes a long time and needs a lot of soft tissue incision, which leads to a lot of blood loss and can cause a variety of complications. Gel has been shown in studies to successfully decrease blood loss during and after total knee arthroplasty, enhance knee joint function recovery, and improve patient quality of life. In this paper, the complications and causes of knee osteoarthritis after total knee arthroplasty were studied. Combined with comprehensive nursing intervention for postoperative recovery, it helps to improve the formation of thrombin and calcium ion, which can effectively reduce blood loss, relieve pain, and promote the recovery of knee joint function. This study analyzed the application of total knee arthroplasty combined with gel in the treatment of knee osteoarthritis.

Permanent magnet array-driven navigation of wireless millirobots inside soft tissues.

Creating wireless milliscale robots that navigate inside soft tissues of the human body for medical applications has been a challenge because of the limited onboard propulsion and powering capacity at small scale. Here, we propose around 100 permanent magnet array–based remotely propelled millirobot system that enables a cylindrical magnetic millirobot to navigate in soft tissues via continuous penetration. By creating a strong magnetic force trap with magnetic gradients on the order of 7 T/m inside a soft tissue, the robot is attracted to the center of the array even without active control. By combining the array with a motion stage and a fluoroscopic x-ray imaging system, the magnetic robot followed complex paths in an ex vivo porcine brain with extreme curvatures in sub-millimeter precision. This system enables future wireless medical millirobots that can deliver drugs; perform biopsy, hyperthermia, and cauterization; and stimulate neurons with small incisions in body tissues.

Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats.

To compare the analgesic effects of two types of spinal manipulation (SM) in acute lumbar radiculopathy (ALR) model rats induced by self-transplantation of autologous nucleus pulposus (ANP), and clarify the therapeutic mechanism. Totally 108 male Sprague-Dawley rats were randomly divided into 6 groups by a random number table (18 rats in each group), including a blank group with no interference, a sham operation group with a surgery by making a local soft tissue incision on the left side of L5-6 vertebral segment, a model group with ALR of L5 extraforaminal nerve by ANP self-transplantation without other interference, a sham manipulation (SMA) group with simulating physical rotation, as well as a mobilization (MOB) group with simulating low-velocity and variable-amplitude rotation and a manipulation (MAN) group with simulating high-velocity and low-amplitude rotation. The interventions in SMA, MOB, and MAN groups started 1 day after modeling followed by another 5 treatments at days 3, 5, 8, 10 and 12. Rats in the other 3 groups did not receive any special intervention. Behavioral pain tests of 50% mechanical pain withdrawal threshold (50% PWT) and paw withdrawal latency (PWL) were conducted 1 day before operation followed by another 10 tests on days 1-7, 10, 12 and 14. Immunohistochemical expression of nitric oxide synthase (NOS) was investigated on days 5 and 12 after operation. After 3 experimental SM interventions, 50% PWT and PWL were higher in the MAN group than the SMA group on days 6 and 7, and higher on days 10, 12 and 14 postoperatively (P<0.05 or P<0.01), while the same indices were significantly higher in the MOB group than MAN group on days 1-4 (P<0.05 or P<0.01). The expression of NOS was lower in the MAN and MOB groups than SMA group on day 12 postoperatively (P<0.01). Both manipulation and mobilization produced better results than sham interference in relieving pain by reducing neuroinflammation possibly. At the early period, compared with manipulation, mobilization presented less sensitive response to pain until later visit. SM may inhibit the overexpression of NOS, thereby alleviating severe radiculopathy.

A New Surgical Technique for Postoperative Trachomatous Trichiasis.

The World Health Organization has identified management of postoperative trichiasis (PTT) as one of the key remaining areas of focus needed to eliminate blinding trachoma as a public health problem. We developed the Bevel-Rotation Advancement Procedure (B-RAP) to treat individuals who need repeat trichiasis surgery. Scarring caused by trichiasis surgery can cause the eyelid to become thick and distorted, making repeat surgery more difficult. To minimize eyelid thickness following B-RAP, a beveled incision of the tarsus is made allowing a marginal rotation of the eyelash fragment. Dissection between the anterior and posterior lamellae above the beveled incision and removal of scar tissue allows the marginal rotation to be combined with a posterior lamellar advancement to treat severely scarred eyelids with PTT and eyelid contour abnormalities (ECAs). Two surgeons performed B-RAP on 44 eyelids of 30 patients with PTT. The number of prior trachomatous trichiasis (TT) surgeries ranged from 2 to more than 4. At the 3-6 months postoperative visit, 37 eyelids (84%) had no recurrence of PTT. Three eyelids had central lashes touching; the remaining eyelids with recurrent PTT had nasal and temporal lashes touching. Fifteen eyelids (34%) had ECAs, but only 1 was severe. B-RAP was developed considering the altered eyelid anatomy found in the postsurgical eyelid with TT. Thinning of the eyelash fragment and removal of postoperative scar tissue improves the ability to advance and stabilize the eyelash fragment after external rotation. B-RAP shows promise as a procedure for improving outcomes of repeat trichiasis surgery.

Local Effects of a 1940 nm Thulium-Doped Fiber Laser and a 1470 nm Diode Laser on the Pulmonary Parenchyma: An Experimental Study in a Pig Model.

The lungs are a common site of metastases from malignant tumors. Their removal with a minimal but safe tissue margin is essential for the long-term survival of patients. The aim of this study was to evaluate the usefulness of a 1940 nm thulium-doped fiber laser (TDFL) and a 1470 nm diode laser (DL) in a pig model of lung surgery that involved the incision and excision of lung tissue. Histopathological analysis was performed on days 0 and 7 after surgery. Neither TDFL nor DL caused significant perioperative or postoperative bleeding. Histological analysis revealed the presence of carbonized necrotic tissue, mixed fibrin–cellular exudate in the superficial zone of thermal damage and bands of deeper thermal changes. The mean total width of thermal damage on day 0 was 499.46 ± 61.44 and 937.39 ± 109.65 µm for TDFL and DL, respectively. On day 7, cell activation and repair processes were visible. The total width of thermal damage was 2615.74 ± 487.17 µm for TDFL vs. 6500.34 ±1118.02 µm for DL. The superficial zone of thermal damage was narrower for TDFL on both days 0 and 7. The results confirm the effectiveness of both types of laser in cutting and providing hemostasis in the lungs. TDFL caused less thermal damage to the lung parenchyma than DL.

Histotopographic and morphometric characteristics of the oral mucosa postoperative wounds healing, depending on the method of connecting the wound edges

Implementation of high-quality tissue connections and hemostasis in oral surgery is an urgent problem of modern dentistry, due to the lack of available universal methods that would help to facilitate the work of oral surgeon and reduce wound healing time.&#x0D; The aim of the research. To investigate and study the regeneration processes in the oral mucosa after high-frequency electric welding, suturing and medical adhesive composition.&#x0D; Materials and methods. This study compared the effect of three connection methods and hemostasis: high-frequency electric welding (EKVZ-300M1 “PATONMED®”, Ukraine), suture method (nylon 5/0 “PIRUS®”, China), adhesive composition (“Histoacryl®”, Germany). 72 rabbits were involved in experiment. An incision of the soft tissues of the vestibulum of the oral cavity of the maxilla with a length of 1.3–1.5 cm was made. On days 3, 7, 14 and 21, tissue samples were excised, histological and morphometric examination of the material were performed.&#x0D; Results. By statistical data processing of 72 rabbits was found that the reliability of differences in the levels of morphometric parameters between groups on each day is very high, as evidenced by the calculated values ​​of the U-test. In 38 cases (90.5 %), the significance level was p≤0.01, in the other 4 cases – p≤0.05. The lowest value level of neutrophilic granulocytes was in rabbits of group No.1 (electric welding). In rabbits of group No. 1 GFBC were not observed in the 8 fields of view throughout the experiment.&#x0D; Conclusions. High-frequency electric welding of soft tissues can be used for effective intraoperative hemostasis and connection of the intraoral wound edges.&#x0D; Due to the absence of a foreign body (adhesive masses, filaments) and moderate alterative effect, histological examination indicates accelerated activation of regenerative processes in the early stages of observation in rabbits of group No. 1.

Tissue effects of a newly developed diode pumped pulsed Thulium:YAG laser compared to continuous wave Thulium:YAG and pulsed Holmium:YAG laser

PurposeThe objective of this study is to evaluate the laser-tissue effects of laser radiation emitted by a newly developed high frequency pulsed Tm:YAG laser in comparison to the continuous wave Tm:YAG laser and the pulsed Ho:YAG laser.MethodsEx-vivo experiments were performed on freshly slaughtered porcine kidneys in a physiological saline solution. Experiments were performed using two different laser devices in different settings: A Tm:YAG laser was operated in a pulsed mode up to 300 Hz and in a continuous wave (CW) mode. Results were compared with a 100 W standard pulsed Ho:YAG laser system. Comparative tissue experiments were performed at 5 W, 40 W and 80 W. The incision depth and the laser damage zone were measured under a microscope using a calibrated ocular scale.ResultsIncreased laser power resulted in increased incision depth and increased laser damage zone for all investigated lasers in this set-up. The Ho:YAG created the largest combined tissue effect at the 5 W power setting and seems to be the least controllable laser at low power for soft tissue incisions. The CW Tm:YAG did not incise at all at 5 W, but created the largest laser damage zone. For the new pulsed Tm:YAG laser the tissue effect grew evenly with increasing power.ConclusionAmong the investigated laser systems in this setting the pulsed Tm:YAG laser shows the most controllable behavior, insofar as both the incision depth and the laser damage zone increase evenly with increasing laser power.

Spontaneous Pregnancy in Postoperative Microperforated Hymen: A Case Report

Abstract: Female genital tract anomalies have important effects on reproductive function, and usually recognized after puberty. The membrane canalization process end to various hymenal forms. Microperforate hymen appears as a partial obstruction depending on its size. Most often, patient will present with menstrual disorders, dyspareunia, and infertility. The aim of this research was to report a case of spontaneous pregnancy in postoperative microperforated hymen in form of case report. A 27-year-old woman, P0A0, complained of pain during intercouse. Patient had been married for 1,5 years, had reguler menstrual cycles without any contraceptive method, but not conceived yet. Inspection showed an obstructed vaginal introitus with a small opening laterally at 3 o’clock, consistent witn microperforate hymen. During surgery, short vaginal introitus was observed and no vaginal canal was seen. A sound was inserted through a small opening of 1 mm in diameter laterally at 3 o'clock, followed by sufficient incision and excision of the distal vaginal tissue. Interrupted suture of the proximal and distal mucosa was performed. The vaginal portion as well as uterus appeared normal. Postoperative tissue healing was good. A spontaneous pregnancy occurred 56 days after the surgery and a healthy term baby was born by caesarean section. In the case of microperforated hymen, menstrual flow can be normal. The patient complained of dyspareunia or impaired sexual penetration leading to infertility, although the presence of a small opening may allow passage of sperm and spontaneous pregnancy may occur before the surgery. Surgery can reduce psychological stress and improve reproductive function, allowing pregnancy to occur. Keywords:Abstract: Female genital tract anomalies have important effects on reproductive function, and usually recognized after puberty. The membrane canalization process end to various hymenal forms. Microperforate hymen appears as a partial obstruction depending on its size. Most often, patient will present with menstrual disorders, dyspareunia, and infertility. The aim of this research was to report a case of spontaneous pregnancy in postoperative microperforated hymen in form of case report. A 27-year-old woman, P0A0, complained of pain during intercouse. Patient had been married for 1,5 years, had reguler menstrual cycles without any contraceptive method, but not conceived yet. Inspection showed an obstructed vaginal introitus with a small opening laterally at 3 o’clock, consistent witn microperforate hymen. During surgery, short vaginal introitus was observed and no vaginal canal was seen. A sound was inserted through a small opening of 1 mm in diameter laterally at 3 o'clock, followed by sufficient incision and excision of the distal vaginal tissue. Interrupted suture of the proximal and distal mucosa was performed. The vaginal portion as well as uterus appeared normal. Postoperative tissue healing was good. A spontaneous pregnancy occurred 56 days after the surgery and a healthy term baby was born by caesarean section. In the case of microperforated hymen, menstrual flow can be normal. The patient complained of dyspareunia or impaired sexual penetration leading to infertility, although the presence of a small opening may allow passage of sperm and spontaneous pregnancy may occur before the surgery. Surgery can reduce psychological stress and improve reproductive function, allowing pregnancy to occur. Keywords: hymen, microperforate, infertility, spontaneous pregnancy

Nociceptive Sensitization by Activation of Protease-Activated Receptor 2 in a Rat Model of Incisional Pain

Postoperative pain and consequent inflammatory responses after tissue incision adversely affects many surgical patients due to complicated mechanisms. In this study, we examined whether activation of protease-activated receptor 2 (PAR-2), which is stimulated by tryptase from mast cells, elicits nociception and whether the PAR-2 antagonist could reduce incisional nociceptive responses in vivo and in vitro. The effects of a selective PAR-2 antagonist, N3-methylbutyryl-N-6-aminohexanoyl-piperazine (ENMD-1068), pretreatment on pain behaviors were assessed after plantar incision in rats. The effects of a PAR-2 agonist, SLIGRL-NH2, on nociception was assessed after the injection into the hind paw. Furthermore, the responses of C-mechanosensitive nociceptors to the PAR-2 agonist were observed using an in vitro skin–nerve preparation as well. Intraplantar injection of SLIGRL-NH2 elicited spontaneous nociceptive behavior and hyperalgesia. Local administration of ENMD-1068 suppressed guarding behaviors, mechanical and heat hyperalgesia only within the first few hours after incision. SLIGRL-NH2 caused ongoing activity in 47% of C-mechanonociceptors in vitro. This study suggests that PAR-2 may support early nociception after incision by direct or indirect sensitization of C-fibers in rats. Moreover, PAR-2 may play a regulatory role in the early period of postoperative pain together with other co-factors to that contribute to postoperative pain.

Gas Gangrene in a Closed Pelvic Injury

Gas gangrene in a closed pelvic injury is very rare phenomenon and we could not find many reported cases in the literature. Radiographs are not enough for diagnosis and computed tomography (CT) is not widely available yet in primary health center. Basic management includes surgical debridement with incision and drainage of necrotic tissue of the involved area, antibiotic therapy, and surgical intensive care. Delay of the surgical debridement for &gt;12 h is associated with higher overall morbidity. The aerobic and anaerobic bacteria with the indigenous commensal of the pelvis results in the production of exotoxins that leads to severe rapid tissue necrosis and the synthesis of insoluble gases characteristic of subcutaneous emphysema or Fournier's gangrene. Although gas gangrene is often diagnosed clinically, emergency CT can support in early diagnosis with accurate assessment of the disease extent. CT not only helps evaluate the pelvic bony structures but also helps assess the spread of disease in the abdomen and pelvis. The mainstay of the management includes surgical debridement with incision and drainage of necrotic tissue of involved area, antibiotic therapy, and surgical intensive care. Early diagnosis remains the mainstay of the treatment of Gas gangrene. It is important to diagnose these life-threatening conditions and treat them as early as possible. Due to the rarity of such events and the unavailability of gold standard diagnostic and treatment modalities, it is very difficult to prevent the mortality for such patients. There is a need for a better treatment plan to diagnose and manage such patients urgently and not to miss the initial phase of disease progression which is critical for saving the life of the patient.

Pathological and Surgical Outcomes of Retropubic Radical Prostatectomy in an Academic Center: A Contemporary Study

Purpose: To report the peri-operative, pathological and oncological outcomes of a contemporary series of open retropubic radical prostatectomy (RRP), performed by one experienced surgeon on RRP technique developed by Barré C. Methods: We analyzed data of consecutive patients who underwent an RRP as first-line treatment for localized prostate cancer, from January 2014 to December 2018, in single French academic center. a) Benign capsular incision (BCI) and b) Benign glandular tissue incision (BGTI) were defined as: presence of inadvertent intraprostatic incisions into benign glandular tissue in regions where capsule was a) present and b) absent. Results: Overall, 312 patients were included. The rates of pT1c, pT2 and pT3 were 0.3% (n=1), 49.0% (n=153) and 50.6% (n=158), respectively. The rates of non-nerve sparing surgery (NSS), unilateral NSS and bilateral NSS were 20.5% (n=64), 31.4% (n=98) and 48.1% (n=150). The median length of hospital stay was 4.0 (3.0-5.0) days and the median estimated blood loss was 250.0 (150.0-180.0) milliliters. The total positive surgical margin (PSM) rate was 11.9% (n=37). The total pT2 PSM and pT3 PSM rates were 0% and 23.4% (n=37) and achieved a statistical difference (p<0.001). The total BCI and BGTI rates were 1.6% and 9.0 %. Biochemical recurrence occurred in 29 (9.3%) patients at median 1.0-year of follow-up. Conclusion: Retropubic radical prostatectomy performed as previously described by Barré C., is reproductible and ensures optimal surgical results, in a predominantly population of intermediate-risk prostate cancer and high-risk prostate cancer.

PENGARUH GEL EKSTRAK BAWANG PUTIH (ALLIUM SATIVUM L.) TERHADAP JUMLAH SEL MAKROFAG PADA PENYEMBUHAN LUKA INSISI GINGIVA MARMUT (CAVIA PORCELLUS)

Surgical with an incision or tissue incision process can cause injury or tissue damage to the oral cavity, especially the gingiva. Wound healing can last a long time, this condition can increase the potential for complications such as infections and less blood supply. Garlic contains several active substances including flavonoids, tannins, phenols and alkaloids, and organosulfur compounds namely allicin. The content is believed to stimulate macrophage cells and help the work of macrophages in cleaning the wound area so that it accelerates into the phase of proliferation and wound healing. The research method was experimental laboratory research with a post-test design group. The results showed that the average number of macrophage cells in the control group CMC-Na 2% 97,50 cells, mean group of 40% garlic extract gel was 58,83 cells, mean group of 50% garlic extract gel was 18,00 cells, mean 60% garlic extract gel group was 7,83 cells. The results showed that there are significant differences (ρ &lt;0,05) in the four study groups. Garlic extract gel concentration of 60% was more effective in reducing the number of macrophage cells in guinea pig gingival incision because of the percentage of active content.

Cross-section modified and highly elastic sutures reduce tissue incision and show comparable biocompatibility: in-vitro and in-vivo evaluation of novel thermoplastic urethane surgical threads.

Surgical sutures are indispensable for a vast majority of operative procedures. An ideal suture is characterized by high tissue compliance without cutting into the mended tissue and optimal biocompatibility. Therefore, we assessed these mechanical and biological properties for novel elastic thermoplastic polyurethane (TPU) and cross-sectional modified "snowflake" sutures. Circular and "snowflake"-shaped TPU threads were manufactured and compared to similar surface modified polyvinylidene fluoride (PVDF) sutures. Regular PVDF sutures were used as the control group. Single-axis tensile test with and without gelatinous tissue surrogates were performed to evaluate the suture incision into the specimens. Biocompatibility was evaluated by subcutaneous implantation (n = 18) in rats for 7 and 21 days. Histology and immunohistology was conducted for assessment of the foreign body reaction. Regular and modified TPU threads showed a significant reduction of incision into the tissue surrogates compared to the control. Both TPU sutures and the modified PVDF sutures achieved comparable biocompatibility versus regular PVDF threads. Detailed histology revealed novel tissue integration into the notches of the surface modified sutures, we termed this newly shaped granuloma "intrafilamentous" granuloma. Elastic TPU threads showed a significant reduction of tissue surrogate incision and suture tension loss. Biocompatibility did not significantly differ from standard PVDF. Histology demonstrated tissue ingrowth following the surface modification of the suture referred to as "intrafilamentous" granuloma. Further in vivo studies are required to illuminate the exact potential of the new sutures to optimize intestinal anastomosis.

Перспективы использования микрохирургического устройства из никелида титана в хирургии осложненной катаракты

Purpose. To examine the possibility of using a tool with variable shape geometry of the operational section of titanium nickelide for small incision surgery to remove complicated cataract. Material and methods. Cadaveric eyes of 7 patients with complicated cataract were used for the study. Nickel titanium alloy was selected as the material for lens destruction, as it meets the medical requirements for design solutions of this class of surgical tools in cycles of their deformation in active and transportation conditions. The instrument operational mechanism is shaped as a loop of superelastic thin thread of titanium nickelide with a diameter of 60 microns with a porous surface coating, is used for mechanical fragmentation of the lens nucleus in complicated cataracts. Results. The size of tissue incision in the access zone is reduced. There is a decrease in capsular bag mobility at the stages of nucleus lens fragmentation. The risk of complications caused by a negative energy and other impacts on eye structures related to ultrasound fragmentation of lens nucleus in complicated cataracts is reduced. Conclusion. Use of such opportunities as material superelasticity, plasticity and strength, and its cutting properties when changing the shape of operational part of titanium nickelide micro-tool contributes to improving the intervention efficiency under complicated cataracts in small incision surgery.

Preclinical Investigation of Goniotomy Using Four Different Techniques.

PurposeTo evaluate the tissue-level effects of goniotomy techniques on human trabecular meshwork (TM).DesignLaboratory investigation.MethodsThe TM from human cadaveric corneal rim tissue was treated using 4 techniques: (1) microvitreoretinal (MVR) blade; (2) 360° trabeculotomy with 5-0 prolene suture; (3) the Kahook Dual Blade (KDB) Glide® device; (4) TrabEx™ device; tissue samples underwent standard histologic processing with H&E stain followed by comparative analyses.ResultsThe MVR blade exhibited incision of TM extending into the scleral wall. The TrabEx device removed a small portion of TM with large leaflet tissue remnants in all treated areas. 360° suture trabeculotomy resulted in incision of the TM proximate to Schwalbe’s line with no excised tissue evident in all treated areas. Areas treated with the KDB Glide device resulted in nearly complete excision of TM without injury to surrounding tissues.ConclusionThe various methods used for performing goniotomy or trabeculotomy resulted in varying degrees of incision or excision of TM. Only the KDB Glide device resulted in reliable excision of TM with the other devices producing incision or variable excision of tissue. Clinical correlation is required to better understand the implications of the current findings when using these methods to lower intraocular pressure in eyes with glaucoma.

Can We Determine an Appropriate Timing to Avoid Thermal Pulp Hazard During Gingivectomy Procedure? An In Vitro Study with Diode Laser.

Objective: Diode laser (DL) is a frequently preferred tool for soft tissue incision and ablation in oral surgery. The aim of this study was to find the most effective irradiation time protocol to avoid potential harmful temperature rise in pulp during DL-assisted gingivectomy. Materials and methods: Ninety human freshly extracted teeth (30 anterior, 30 premolar, and 30 molar) were irradiated using a 940 nm DL with power output of 1 and 2 W and exposure time of 10, 20, 30, 40, 50, and 60 sec per specimen. Intrapulpal temperature was evaluated with thermocouple. Additionally, the effect of dark deposits on root surface for intrapulpal temperature rise was investigated. Temperature differences with every 10 sec were evaluated for three different teeth types, and statistical analyses were performed. Results: Anterior and premolar teeth exceeded the threshold values earlier than molar teeth for both 1 and 2 W. Despite the significant differences among the types of teeth, at 10 sec, temperature rise recorded for all types of teeth was below the critical value of 5.6°C, which cause pulp damage. Dark deposits on teeth surface boosted thermal effect of DLs (p < 0.01). Conclusions: Gingivectomy with DLs at 1 W on anterior, premolar, and molar teeth for 20, 40, and 60 sec, respectively, generates acceptable temperature rise; however, it should be <10, 20, and 40 sec at 2 W, respectively. Especially in the anterior teeth, DLs should be performed with caution to avoid pulp damage.

Foot injury survival in red abalone (Haliotis rufescens)

Recovery of the U. S. Federal Endangered Species Act-listed white abalone (Haliotis sorenseni) in California, USA depends on the success of a captive breeding program, which requires collection of wild broodstock to maintain genetic diversity. Foot damage is frequently sustained during collection and handling, and severe injuries can be fatal. This study used the proxy species red abalone (Haliotis rufescens) to investigate the ability of abalone to survive foot injury by administering foot injuries varying in severity and monitoring subsequent health and survival. In a preliminary study, 6/6 farm-origin 55–70 mm animals survived two types of injury while 5/6 survived a third type of injury. We then conducted a definitive study using 24 wild-origin animals (165–207 mm) and three intensified injury treatments. Five of six animals that received a deep tissue incision were dead the following morning, presumably from acute hemolymph loss, and the remaining animal in that treatment group died on day 41 with a systemic bacterial infection. Nine of twelve abalone that received loss of either 8% or 17% of foot sole epithelium survived until experiment termination at day 90, at which time all survivors were regenerating epithelial tissues, as evident by histology. This study suggests that abalone may be more capable of surviving significant superficial foot damage that can occur during collection and handling, at least in a captive rearing environment, than has been previously recognized.

Embedded upper end of double J stent at the site of renal pelvis injury following percutaneous nephrolithotomy: a rare complication

BackgroundInjury of the renal collecting system is a well-known complication of percutaneous nephrolithotomy (PNL). Large injuries may cause excessive bleeding and fluid extravasation and require adequate drainage using several modalities such placement of JJ stents. Herein, we report on two cases in which the upper coil of the JJ stent got buried in the fibrous tissues which formed due to an injury of the collecting system during PNL.Case presentation40 years old male and 32 years old female underwent standard PNL for partial and total staghorn calculi, respectively. During the procedure in both cases, the renal pelvis was injured. In both cases, JJ stent was used to drain the collecting system. Trial to remove the JJ stent 6 weeks following the procedure failed because the upper coils of the stents were embedded in the fibrous tissues at the perforation site. Laser incision of the fibrous tissues and releasing the upper coil of the stents were performed using percutaneous approach in the first case and flexible ureterorenoscopy (fURS) in the second patient. The procedures were uneventful in both cases.ConclusionThis is the first report of embedded JJ stents which got buried by fibrous tissues at the site of collecting system injury that occurred during PNL. To prevent this complication in such cases, we suggest draining the collecting system using nephrostomy tube instead of JJ stent. Alternatively, the upper coil of the stent should be placed away from the injury site.