Tube Technique Research Articles

A novel tube technique enables visualization of the anatomy of the facet joints and accurate placement of the Jamshidi needles with low radiation exposure: Technical note

BackgroundPercutaneous pedicle screws(PPS) have been used for decades. The difficult part of PPS placement is locating the proper entry sites on the facet joints for the Jamshidi needles. The correct positioning is usually ensured by fluoroscopy, which exposes surgeons and patients to extensive radiation exposure. ObjectiveTo describe a novel retractor tube technique used in the placement of PPS, which enables visualization of the anatomy of the facet joints and enables accurate placement of the Jamshidi needles. MethodsA newly designed 15-mm-diameter retractor tube was applied during the placement of Jamshidi needles in 21 operations using PPS to treat thoracolumbar fracture. The anatomy of the entry site could be clearly visualized, and a Kirschner wire was inserted 2 mm into each of the ideal entry sites. When all the Kirschner wires were placed, the annular tubes of the Jamshidi needles were placed along the Kirschner wires into the pedicles. Fluoroscopy was used to confirm the positions of the Jamshidi needles. The rest of the procedure was conducted in the traditional PPS placement technique. ResultsThe entrance sites were successfully accessed through the retractor tube, with only one adjustment needed at most. Only one or two fluoroscopy images were taken during the placement of the Kirschner wires, and another image was taken after all the Jamshidi needles were placed. Fluoroscopy confirmed that the positioning of the PPS was good. ConclusionA retractor tube accurately exposes the entry points on the facet joints in PPS placement, and is technically easy to use.

A COMPREHENSIVE UPDATED REVIEW ON GINGIVAL CREVICULAR FLUID: CHARACTERISTICS, COLLECTION AND ESTIMATION

A COMPREHENSIVE UPDATED REVIEW ON GINGIVAL CREVICULAR FLUID: CHARACTERISTICS, COLLECTION AND ESTIMATION Gajbhiye Pranali, Gholse Yogesh, Kasliwal Rahul, Thakre Anup Priyadarshini J. L. College of Pharmacy, Nagpur, Maharastra, India ABSTRACT Gingival crevicular fluid is an exudate released by the gums that can be found in the split arranged at where the gum line meets the teeth. The centralizations of this fluid are commonly low, anyway during aggravation the GCF stream augmentations and its amalgamation starts to take after that of a provocative exudate. It has an exceptional influence in keeping up the structure of junctional epithelium and the antimicrobial barrier of periodontium. A portion of the speculated periodontal pathogen, for example, Porphyromonasgingivalis and Treponemadenticola produce wide range nonpartisan proteinases as a major aspect of their harmfulness weapons store. These proteinases might be distinguished in plaque and gingival crevicular liquid examples of patients with periodontitis. the liquid part of gingival crevicular liquid is gotten essentially from microvascular spillage. There are particular favourable circumstances and difficulties of utilizing gingival crevicular liquid as an indicative test for periodontal ailment. Because of confinements in its assortment, which incorporates volume size and defilement, gathering strategies need further work. This article targets looking into quickly about the GCF and its job as a symptomatic marker in periodontal sickness. The essential point of the present examination was to research contrasts between gingival crevicular liquid inspecting procedures in particular assortment by Absorbent filter paper strips, micropipettes or capillary tubing technique, pre-weighed twisted thread, crevicular washing technique, and Curette collection technique. Keywords: Gingival crevicular fluid, Periodontitis, Sampling techniques, Estimation of GCF Full Text Article

Effects of Solvent and Reaction Time in Sonochemical Synthesis of Cadmium(II) Compounds and Use them as Template for Synthesis of Cadmium(II) Oxide Nano Structures

Abstract. A cadmium(II) zero‐dimensional supramolecular compound [Cd(L)2(I)2] (1), {L = 2‐picolylamine}, was fabricated by branch tube and sonochemical irradiation techniques. Regardless of the method utilized, the same crystallographic structure is obtained for the complex. To investigate the effects of reaction time and solvent on the creation of [Cd(L)2(I)2] (1) supramolecule compound, certain tests were designed and four specimens of 1 were fabricated through sonochemical process. Less reaction time led to the creation of smaller particles with mixed morphologies. To prepare cadmium(II) oxide micro‐crystals via calcination, four samples were utilized as new precursors. Micro‐ and nano‐sphere of cadmium(II) oxide could be fabricated from 1. The morphology and structure of micro‐ and nano‐crystals were identified by using Scanning Electron Microscopy (SEM), IR spectroscopy, and X‐ray powder diffraction (XRD).

ABO blood grouping discrepancies in the donor population

Background and ObjectivesABO discrepancies occur when the reactions in forward grouping are not corroborative to those in the reverse grouping due to weak subgroups of A and/or B, missing or weak ABO antibodies or unexpected alloantibodies. We aimed to determine the prevalence of ABO discrepancies in our donor population and to know the causes by using a standard classification.Materials and MethodsIt was a retrospective study on donor samples. For all the discrepant samples, the ABO and RhD grouping was repeated using tube technique. Adsorption–elution testing was done for detecting weak subgroups of A and B. Antibody screen (3‐cell) and identification (11‐cell) were done by gel technique (Bio‐Rad, Switzerland).ResultsWe detected 93 (0·064%) ABO discrepancies out of the total 144279 donor samples tested. The ABO discrepancies were due to weak anti‐B antibody (33/93; 35·5%), weak anti‐A antibody and weak subgroups of A (24 each; 25·8% each) and weak subgroups of B (5/93; 5·4%). Agglutination with O cells was observed in 7 (7·5%) samples at room temperature testing. The alloantibodies identified in these samples were anti‐M (5) and anti‐Lea in (1), while the remaining 1 sample was of ‘Bombay’ (Oh) phenotype. The autologous control was negative for all the samples.ConclusionThe prevalence of ABO discrepancies in our donor population is 0·064%.

Nitratation in pilot-scale bioreactors fed with effluent from a submerged biological aerated filter used in the treatment of dog wastewater

ABSTRACT Nitrification is a biochemical process that allows oxidation of ammonium ion to nitrite, and nitrite to nitrate in a system. Aerobic processes, such as use of submerged biological aerated filter (SBAF), enable nitrification. However, some variables that are entirely unavailable or not available at the required concentration range may hamper the process. In this study, nitratation under high dissolved oxygen (DO) concentrations was evaluated in laboratory-scale bioreactors containing 10% inoculum (0.5 kg kg−1) fed with affluent from a SBAF that receive the sewage generated from washing the bays of a dog kennel. The following variables were monitored over time: ammoniacal nitrogen (12.44–29.62 mg L−1), nitrite (0.28–0.54 mg L−1), nitrate (1.75–3.55 mg L−1), pH (8.11 ± 0.62), temperature (21.61 ± 1.24°C) and DO (9.69 ± 0.36 mg L−1). Quantification of nitrifying bacteria by the multiple tube technique showed the value of 1.4 × 1012 MPN mL−1for ammonia-oxidizing bacteria (AOB) and 9.2 × 1014 MPN mL−1 for nitrite-oxidizing bacteria. These values were higher than those found in a synthetic medium, which can be explained by the greater availability of ammonium and nitrite in the effluent. By the extraction of genomic DNA, and PCR, with specific primers, the presence of the AmoA (Ammonia monooxygenase) gene for AOB and of the Nitrobacter was detected in the bioreactor samples. By PCR-DGGE, the sequenced bands showed high similarity with denitrifying bacteria, such as Pseudomonas, Limnobacter, Thauera, Rhodococcus, and Thiobacillus. Thus, the saturation of dissolved oxygen in the system resulted in improvement in the nitratation step and allowed detection of bacterial genera involved in the process.

Effect of Resonance Tube Technique on Oropharyngeal Geometry and Voice in Individuals with Parkinson's Disease

To verify the immediate effect of the flexible resonance tube vocal technique on the oropharyngeal geometry and vocal acoustic parameters of individuals with Parkinson's disease (PD) and to study the correlation between oropharyngeal geometry and the intensity and fundamental frequency (f0) parameters of the voice. Forty individuals participated-20 with PD and 20 healthy individuals, with a mean age of 60.95 (± 5.69) years. There were 10 men and 10 women in each group. All underwent pharyngometric analysis of the vocal tract and voice acoustics parameters before and after use of the vocal technique with a flexible resonance tube. After the technique, there was a reduction in pharyngeal cavity volume only in females in the healthy group, a reduction in shimmer values in females in both groups and males in PD group and an improvement in noise parameters in females in the PD group. There was a negative correlation between vocal tract volume and intensity, between f0 and vocal tract volume, between f0 and oropharyngeal junction area, between f0 and oral cavity volume as well as a positive correlation between oral cavity length and f0. The vocal technique with the flexible resonance tube applied to individuals with PD improved the subjects' voice quality in the perceptual and acoustic voice parameters. Regarding the oropharyngeal geometry, it was possible to observe its correlation with the parameters of vocal intensity and frequency in the studied population.

Issues with integrating carbonate sand texture data generated by different analytical approaches: A comparison of standard sieve and laser-diffraction methods

Palaeoenvironmental reconstructive work relies on sediment-texture information as a proxy for particle-transport dynamics. As the integration of data from multiple sources is often sought for studies at the regional scale, a body of work exists that addresses compatibility levels of different analytical approaches. Past insights are derived predominantly from siliciclastic deposits. This study instead addresses standard sieve and laser-diffraction methods of texture analysis on a suite of carbonate beach sands from San Salvador Island, Bahamas. While the near-equant grain shapes of siliciclastic sands generate comparable results between methods, our findings show that laser diffraction tends to overestimate the coarser fractions in carbonate sands, given indiscriminate measurement of elongate particle axes. Peloidal grains that have width-to-length ratios on the order of 0.5 can pass through much smaller mesh sizes when sieved than diffraction would suggest. The resulting deviation in analytical outputs significantly influences measures of skewness, sorting, and other derivative metrics, which vary by up to several Wentworth classes between procedures. Meaningful integration of texture data obtained by different methods is ill-advised when dealing with carbonate beach sands. Similar problems are documented for muddy deposits, wherein platy clay minerals favor size-overestimation by laser diffraction and a size underestimation by settling tube technique. An improved understanding of methodological biases resulting from application of different particle-size methods is needed to help facilitate data-reconciliation efforts. This study provides a glimpse of issues facing the integration of carbonate sand-texture information, troublesome given prevalence of irregular grain shapes.

Comparative Study between Subannular T- Tube and Repetitive Transtympanic T-Tube Technique

Background: Otitis media [OM] is the second most common disease of childhood after upper respiratory tract infection. There was no consensus on the ideal treatment modality yet. Aim of the work: To compare the use of trans-tympanic T tube [TTTT] and subannular T tube [SATT] in recurrent otitis media, recurrent otitis media with effusion or tympanic membrane retraction. Patients and Methods: This is a prospective controlled study, which was conducted at Al-Azhar university hospital [Damietta]. It included 40 patients that were randomly divided into two groups A and B: Group A: include 20 patients who were submitted to trans-tympanic T-tube. Group B included 20 patients who were submitted to sub annular T-tube. Patient data and outcome were documented and compared. Results: The duration that TTTTs and SATTs remained in place ranged from 4 to 19 months with a mean of 10.62 and there was a significant decrease of duration in TTTT in comparison to SATT groups [7.28 vs 14.80 respectively]. Besides, in 14 cases in the SATT group, the tube is still in place. Extrusion was reported in 10 cases [8 in the TTTT group and 2 in the SATT group] and finally removal was reported in 6 patients [2 in TTTT group and 4 in the SATT group. Conclusion: The use of SATTs for long term middle ear ventilation is safe and more efficient than V-T Grommet TTTTs for maintaining middle ear ventilation and prevention of recurrent interventions in children with less otorrhea and plugged tubes.

Comparison of the effects of laparoscopic catheterization and surgical incision catheterization on catheter-related complications and microinflammation in uremic peritoneal dialysis patients

Objective To compare the effects of laparoscopic and surgical catheterization on catheter-related complications and microinflammation in uremic peritoneal dialysis (PD) patients. Methods According to different catheterization methods, 98 uremic patients who were scheduled to undergo peritoneal dialysis in the First People's Hospital of Jiande from January 2014 to March 2019 were divided into group A (38 cases), group B (60 cases). Laparoscopic catheterization was used in group A, and incision catheterization was used in group B. Surgical parameters, catheter complications, microinflammation and survival rate of early catheterization were observed in the two groups. Results The operation time of group A was (35.00±3.14)min, which was shorter than that of group B [(50.00±5.17)min], and the operation cost of group A was (5 800.0±318.9)CNY, which was higher than that of group B [(3 400.0±297.4)CNY], and the visual analogue score (VAS) of group A was (2.33±0.31)points, which was lower than that of group B [(3.25±0.49)points], there were statistically significant differences between the two groups (t=11.540, 9.317, 10.328, 36.578, all P 0.05). After catheterization, the levels of hs-CRP, IL-6 and TNF-alpha in group B were (12.52±3.75)mg/L, (12.02±3.76)ng/L, (15.92±5.72)ng/L, respectively, which were higher than those in group A [(9.63±2.36)mg/L, (9.11±3.54)ng/L, (13.41±5.61)ng/L] (t=4.244, 4.081, 4.510, all P<0.05). After 2 months of follow-up, the survival rate of dialysis tube technique was 89.47%(34/38) in group A and 71.67%(43/60) in group B, there was statistically significant difference between the two groups (χ2=4.382, P<0.05). Conclusion Application of laparoscopic catheterization in uremic PD patients has satisfactory effect, light pain, fewer complications, mild inflammation and high survival rate of early catheterization technology, which is worthy of clinical promotion. Key words: Uremia; Peritoneal dialysis; Laparoscopy; Catheterization; Postoperative complications; C-reactive protein; Interleukin-6; Tumor necrosis factor-alpha

Tube Technique with Light-curing Composite for Removing Fractured Root Canal Instruments: Influence of Polymerization Cycles and Mechanical Exposure

IntroductionThe purpose of this study was to investigate the influence of both polymerization cycles and mechanical exposure procedures on the adhesion of instrument fragments using a modified tube technique with a light-curing composite. MethodsEighty Mtwo instruments (size 15.05; VDW, Munich, Germany) were cut at a diameter of 35/100 mm and clamped in a vice with an overlap of 2 mm. Matching cannulas were filled with SDR composite (Dentsply, York, PA) and placed over the instruments. Prime & Bond Active (Dentsply Sirona, Bensheim, Germany) was used as the bonding material. Glass fiber was inserted from the opposite side into the cannula, and 1, 2, 4, or 6 polymerization cycles of 30 seconds were applied (800 mW/mm2) (n = 20/group). Sixty further identical instruments (n = 20/group) were divided into the following groups: group 1, cut at 10 mm and left unprepared (taper = 5%); group 2, parallelized using diamond instruments (taper = 0%); and group 3, prepared in a way that an inverted conical taper resulted (taper = 2%). Polymerization was performed for 2 minutes. The failure load and mode of failure were determined using a tensile testing device (2 mm/min). Data were statistically analyzed using the Kruskal-Wallis or chi-square test. ResultsThe failure load increased significantly with the number of polymerization cycles (P < .0001). More than 4 polymerization cycles had no further benefit (P > .05). The failure load in the inverted conical group was significantly lower (P < .0001) compared with the parallel and the unprepared groups. Adhesive failure was significantly more frequent in groups 2 and 3 (20/20) than in group 1 (16/20) (P < .05). ConclusionsBoth the number of polymerization cycles and the mechanical exposure procedures had a significant impact on the adhesive force when using the tube technique.

Evaluation of a Nasoenteral Feeding Tube With Balloon to Facilitate Placement.

Enteral feeding is essential for critically ill, head trauma, and burn patients who are unable to swallow. To evaluate a new nasoenteral feeding tube with distal tip balloon designed to facilitate post-pyloric migration and avoid misplacement in the trachea. A case series was conducted in 50 critically ill patients aged 19 to 89 years receiving mechanical ventilation and requiring enteral nutrition in a teaching hospital. Patients received a soft, flexible, kink-resistant nasoenteral feeding tube with a balloon near the distal tip to enhance postpyloric migration by peristalsis. The feeding tube was inserted with a novel thread technique to reduce posterior nasopharyngeal trauma and tube misplacement. Pulse oximetry provided early detection of misplacement into the trachea. Placement was verified by abdominal radiography performed shortly after the procedure and repeated within 24 hours if needed. Postpyloric placement was achieved at 30 minutes in 24% of patients and by the following morning in 70% of patients. Tracheal intubation occurred in 1 patient but was recognized and corrected without injury. No tube occlusion from kinking occurred. Early gastric or postpyloric feeding can be provided with this novel feeding tube. Its use facilitates quick bedside recognition of accidental misplacement in the trachea, reducing the chance of pneumothorax. The tip balloon reduces deeper placement into a lung and promotes distal migration into the small intestine. The design prevents occlusion from kinking, which is common with conventional feeding tubes. Nurses easily adopted the tube and insertion technique.

Importance of red cell serology in optimizing transfusion strategy for patients undergoing allogeneic hematopoietic stem cell transplant

In ABO-incompatible allogeneic hematopoietic stem cell transplant (HSCT) monitoring for the appearance of donor-derived ABO antigens on red blood cells (RBCs) is a valuable tool for deciding the transfusion strategy. It was a retrospective study (6 months) where the patients undergoing ABO-incompatible (major/minor/bidirectional) allogenic HSCT were followed up for blood grouping, direct antiglobulin test (DAT), and antibody screen (ABS). Blood grouping (ABO and RhD) and ABO antibody titers were done by tube technique; DAT and ABS were done using gel technique (Bio-Rad, Switzerland). A total of six patients underwent ABO-incompatible transplant including three major (1 case AB→B; 2 cases B→O), two minor (A→AB; O→B), and one bidirectional (A→B) transplants. ABS and DAT were negative. In major ABO-incompatible transplants, the recipient anti-A/anti-B titers varied from 2 to 16 (immunoglobulin M [IgM]: 2–8; immunoglobulin G [IgG]: 2–16), and in minor ABO-incompatible transplants, the donor anti-B titer ranged from 8 to 32 (IgM: 8–16; IgG: 8–32). In the bidirectional case, the recipient anti-A titer was 32 (IgM = IgG). No plasma/red cell reduction was done in the product before the transplant. A mixed-field agglutination (MFA) was observed with anti-B on posttransplant day 44 in one major ABO-incompatible transplant, with anti-B on posttransplant day 31 in one minor ABO-incompatible transplant, and with anti-A as well as anti-B on posttransplant day 36 in the bidirectional ABO-incompatible transplant, which indicated RBC engraftment. A total of 30 (median: 4.5) packed RBC units were transfused in the posttransplant phase. In conclusion, pretransplant immunohematology work-up and the monitoring of blood group for MFA are important tools for optimizing the transfusion strategy of patients undergoing ABO-incompatible allogeneic HSCT.

Endoscopy mask for safe extubation in patients with COVID-19.

Dear Editor, The risk of spreading coronavirus disease 2019 (COVID-19) virus through aerosol generating procedures (AGPs) is well documented.[1] Intubation and extubation are high AGPs, which are of major concern for an anesthesiologist and intensivists due to proximity to the patient. Recently various recommendations for anesthetic management of COVID-19 patients has been published.[12] These recommendations mainly focus towards safe tracheal intubation with less emphasis on safe extubation techniques. We believe that adequate dose muscle relaxants during laryngoscopy and intubation prevents coughing thus limiting aerosol generation. In contrast, the aerosol generation is much more during extubation than that of intubation due to the high incidence of coughing and bucking. Strategies like avoiding extubation inside the OR or extubation in a negative pressure room may prevent contamination but are not always feasible. Use of portable barrier hood devices[3] mask over the endotracheal tube (ETT) technique[4] and passing the ETT through the port, of a standard face mask,[5] have been described to minimize exposure during extubation, however, these techniques have limitations and are not full-proof. Hence, we describe a technique of extubation using endoscope mask (VBM Medizintechnik GmbH, Germany) [Figure 1], which further minimizes aerosol exposure despite proximity to the patient.Figure 1: Endoscopy mask with the silicon membrane and a small self-sealing hole with a cap (yellow arrow)Extubation Technique All providers managing extubation in COVID-19 patients should wear full personal protective equipment (PPE). Assessment for the readiness of extubation is crucial as rescue strategies are associated with increased risk of exposure. Before extubation, an adequate size endoscopy mask is placed over the patient's face by inserting the ETT through the membrane port of the endoscopy mask, after clamping the ETT at the angle of mouth [Figure 2a and b]. The membrane port of the endoscopy mask has a silicon membrane and a small self-sealing hole with a cap [Figure 1], which ensures a proper seal around the ETT. A viral filter is attached to the airway port of the endoscopy mask [Figure 2c]. At the time of extubation, a proper seal with the endoscopy mask is ensured before the deflation of the ETT cuff [Figure 2d]. The ETT is removed through the hole in the silicon membrane of the endoscopy mask. The hole in the silicon membrane is capped by the assistant and the close circuit is detached from the ETT distal to viral filter [Figure 2e]. The circuit is reattached to the viral filter, which is attached to the airway port of the endoscopy mask [Figure 2f].Figure 2: Extubation with endoscopy mask. (a) ETT clamped at the angle of mouth, (b) The ETT is passed through the small hole of the silicon membrane of endoscopy mask, after detaching the connector, (c) Clamp removed, circuit reattached to the ETT and a viral filter is attached to the airway port of the endoscopy mask (white arrow), (d) Cuff of the ETT deflated while maintaining a proper seal with the mask, (e) ETT removed and the hole in the silicon membrane is closed by its cap by the assistant, (f) The circuit is reattached to the filter attached with airway port of the mask (white arrow)Advantages of using endoscopy mask during extubation in COVID-19 patients are: the small self-sealing hole in the silicon membrane of the mask ensures adequate seal around the ETT and the flexible corrugated airway port of the mask can be diverted away from the person standing at the head-end, during extubation. We found this technique simple and effective and did not find any difficulty in testing this technique in a mannequin and non-COVID patients. The only limitation of this technique is that an additional viral filter is required to ensure adequate protection. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

52. Bougie and Double Tube Technique - A Novel Approach in Unanticipated Difficult Nasotracheal Intubation

52. Bougie and Double Tube Technique - A Novel Approach in Unanticipated Difficult Nasotracheal Intubation

Distribution of antenatal alloimmunization in the southern districts of West Bengal and its significant associated factor.

OBJECTIVES:Detection of maternal irregular antibodies against red blood cell antigen is vital in the management of hemolytic disease of fetus and newborn. There are no uniform guidelines related to antenatal antibody screening and identification in the developing Country like India. This study was aimed to identify such alloimmunization and its associations.MATERIALS AND METHODS:This prospective study was conducted on antenatal mothers at a tertiary care center. The mothers having a history of anti-D administration, blood transfusion, and autoimmune disorders were excluded from the study. Initial indirect antiglobulin test (IAT) was performed in all blood samples by conventional tube technique (CTT) to identify alloimmunization. IAT-positive samples were screened for irregular antibody by column agglutination technology (CAT). Antibody screen-positive samples were further analyzed in 11-cell panel by CAT. Antibody strength was measured by serial double dilution by CTT. The source of isoimmunization was identified by extended Rh phenotype of women, husband, and newborn.RESULTS:A total of 12 (2.3%) women out of 530 were positive for IAT and antibody screen. Antibody could be identified in 11 women, of which anti-D (5) was the most common, followed by anti-C + anti-D (4), anti-C + anti-E (1), and anti-C (1). All four cases of anti-D + anti-C were distinguished from anti-G by differential adsorption and elution. There was a significant association with alloimmunization versus increased gravid status, antepartum hemorrhage, and past history of newborns with neonatal jaundice.CONCLUSION:All pregnant women with history of antepartum haemorrhage, newborn with neonatal jundice should be screened for alloantibody for early detection and better management of HDFN.

Prevalence of A2and A2B subgroups along with anti-A1antibody in patients and donor population and its clinical significance

BACKGROUND: The clinical significance of anti-A1antibody among A2and A2B subgroups is controversial. Few case reports have shown clinically significant anti-A1antibody at 37°C, causing hemolysis of donor red cells. The present study aims to find the prevalence of A2and A2B and the clinical significance of anti-A1antibody in these subgroups of A. MATERIALS AND METHODS: This prospective observational study was done in a tertiary care center in the eastern part of India. Gold standard test tube technique was used to determine blood group and distinguish A1from A2based on agglutination reaction with anti-A1lectin. Serum of A2and A2B subgroups was tested with A1red cells to confirm the presence of anti-A1antibodies. Further testing of anti-A1antibody was also performed to determine whether the antibody is IgM or IgG and of any clinical significance. RESULTS: A total of 2874 blood samples of both patients and donors were analyzed. Among A blood group, 98.4% were A1 and, whereas 1.6% were A2, whereas among AB blood group, A1B and A2B were 93.9% and 6.1%, respectively. Only 3 out of 13, A2B patients (23.07%) showed the presence of anti-A1antibody but without any clinical significance. CONCLUSIONS: Our study could not find any clinically significant anti-A1antibodies. Thus, we insinuate any requirement of mandatory testing for the determination of A1, A2,and anti-A1antibodies. Subtyping will help in the use of A2donor for renal transplant in O and B group patients and the use of A2platelets also in O and B group patients.

Can rectal tube be used instead of ileostomy in patients undergoing rectal resection after neoadjuvant chemo-radiotherapy?

Aim: Neoadjuvant chemo-radiotherapy and total mesorectal excision have become the standard treatment for locally advanced middle and distal rectal cancers. These types of patients carry a serious risk of anastomosis leakage. While the commonly technique is diverting ileostomy; rectal tube placement, with lower morbidity, has also been used in recent years. The aim of this study was to compare the results of ileostomy and rectal tube administration following rectal resection after neoadjuvant therapy.Material and Methods: We retrospectively reviewed the data from 25 patients with rectal cancer who received neoadjuvant chemo-radiotherapy between 2013 and 2019. Patients were evaluated in two groups: ileostomy and rectal tube. Demographic data, operative findings, pathological results, and follow-up information were evaluated.Results: Twelve were in the rectal tube group and 13 were in the ileostomy group. There was no difference between the two groups in terms of tumor location in preoperative data. Patients with hepatic metastasis were found in the ileostomy group, while there were no such patients in the rectal tube group. The operation time (452±128 vs. 295±102 min, p=0.002) and blood loss (485±264 vs 105±80 ml, p=0.0001) were higher in the ileostomy group. The intraoperative complications of the patients were similar in the two groups, whereas the postoperative complications were higher in the ileostomy group (69%-25%, p=0.04). The mean follow-up period was 23.2±18.5 months. The total complication rate due to ileostomy was 20% and the stomata of 15% of the patients were not closed. The cosmetic scores of the patients were better in the rectal tube group (9.8±0.3 vs. 6.3±1.7, p=0.0001). Conclusion: The results of the rectal tube technique were not worse than those of the ileostomy technique in rectal cancers receiving neoadjuvant therapy and this technique may be preferred in appropriate cases.

Removing Fractured Endodontic NiTi Instruments with a Tube Technique: Influence of Pre-Treatment with Various Agents on Adhesive Forces In Vitro

The aim of the study was to evaluate the adhesive forces for removing iatrogenically fractured endodontic nickel-titanium instruments using a modified tube technique with various pre-treatment agents in combination with a light-curing composite. 120 Nickel-Titanium-Mtwo instruments were cut at its parallel shaft and fixed in a vise with an overlap of 2 mm. The surfaces were treated with different agents: A) GC Metalprimer; B) Prime and Bond active; C) NaOCl (3%); D) citric acid (15%); E) phosphoric acid (37%) and group (F) was not pretreated (control). One end of a matching microtube, filled with light-curing composite, was placed over the instrument and a transmitting glass fiber inserted from the opposite side guaranteed polymerization. Pull-out tests (1 mm/min) were performed and failure load was measured digitally. Data were statistically analyzed using the ANOVA and Student–Newman–Keuls tests. Interfaces were subjected to SEM analysis. Prime and Bond active created significant higher pull-out values (mean 30.5 N) compared to all other groups (p < 0.001) and Metalprimer (18.5 N) was significantly superior to the untreated (12.6 N) and NaOCl (11.7 N) group (p < 0.05). No significant differences were obtained between the other groups (p > 0.05). Thus, adhesives improved bonding to fractured NiTi instruments.

A randomized clinical trial of nasogastric tube insertion in intubated patient: comparison between finger method and reverse Sellick maneuver

BACKGROUND Finger method is a new simple technique of nasogastric tube (NGT) insertion for intubated patients which only requires the practitioner’s own fingers. This study was aimed to compare the feasibility of finger method and the standard reverse Sellick maneuver in NGT insertion for intubated patients.&#x0D; METHODS This was a single-blinded, randomized clinical trial that included 210 patients aged 18–65 years old who were intubated under general anesthesia and needed NGT insertion. Initially, subjects were randomly allocated by the third party into two groups: subjects who had NGT insertion with finger method and those with reverse Sellick maneuver. Success rate of NGT insertion at the first attempt, duration of the procedure, and complication rate of blood spots were all recorded. Chi-square test and Mann–Whitney analysis were used to analyze the data.&#x0D; RESULTS Success rate of NGT insertion at the first attempt in finger method group was higher in comparison with reverse Sellick maneuver group (81.6% versus 60%, respectively, p = 0.002). Likewise, the median of NGT insertion duration was longer in finger group compared to reverse Sellick maneuver group (13 sec versus 12 sec, respectively, p &lt; 0.001) but it was not clinically significant. Moreover, the complication rate of blood spots found during the procedure was lower in subjects with finger method than with reverse Sellick maneuver (10.7% versus 28%, respectively, p = 0.003).&#x0D; CONCLUSIONS Using finger method was more feasible than reverse Sellick maneuvers in NGT insertion.

Transition from Crystal to Metallic Glass and Micromechanical Property Change of Fe-B-Si Alloy During Rapid Solidification

The effects of high undercooling and a large cooling rate can be achieved by the use of a containerless drop tube technique, which is conducive to rapid solidification and formation of a metastable phase. Here, the rapid solidification of Fe78Si13B9 (S1) and Fe78Si9B13 (S2) alloys was completed under microgravity condition. Based on theoretical calculations, a maximum undercooling of 433 K (0.29 TL) and 412 K (0.28 TL) was obtained, respectively. The microstructure evolution and the formation of an amorphous-nanocrystalline structure for the two alloys were compared and analyzed. The results show that S2 alloy has better amorphous forming ability and higher hardness. During the solidification of S1 alloy, the primary phase α-Fe grows by the manner of dendrites, and the secondary dendrite arm spacing decreases exponentially with increased undercooling. An amorphous-nanocrystalline structure is developed when the undercooling is increased up to 388 K; S2 alloy forms an amorphous-nanocrystalline structure at an undercooling of 275 K and is completely amorphized after exceeding an undercooling of 402 K. In addition, the hardness and elastic modulus are acquired by nanoindentation technology under different degrees of undercooling. The phase constitution, morphology, distribution, and grain refinement of the alloys have important effects on the micromechanical properties of these alloys.