Risk of tendon failure with repeated passage of Kirschner wires or hypodermic needles: an experimental study

2022 ◽  
pp. 175319342110676
Author(s):  
Alastair Kiszely ◽  
Grey Giddins
Keyword(s):  
Tendon Rupture ◽  
Hand Surgery ◽  
Biomechanical Study ◽  
Hypodermic Needle ◽  
Control Group ◽  
Kirschner Wires ◽  
Failure Group ◽  
Group 3 ◽  
Repeated Passage ◽  
K Wires

During hand surgery, tendons may be at risk of damage. This biomechanical study aims to assess the risk of tendon rupture due to passage of Kirschner wires or hypodermic needles. Porcine extensor tendons were divided into four groups. Group 1: a control group was tested to ensure that repeated stress alone did not cause failure. Group 2a: 1.1-mm Kirschner wires were hand pushed through tendons 50 times and then stressed to 40 N, repeated until tendon failure. In Group 2b, K-wires were passed while rotating using a drill. Group 3: the experiment was repeated using a 20 G hypodermic needle. Group 2a tendons required a median of 2450 passes (1150–3500) to propagate failure, Group 2b a median of 2250 (1200–3850) and Group 3a median of 200 passes (150–450). The risk of tendon rupture from wires or hypodermic needles in procedures appears very low.

The Role of the Musculocutaneous and Radial Nerves in Elbow Flexion and Forearm Supination: A Biomechanical Study

2008 ◽  
Vol 33 (2) ◽  
pp. 201-204 ◽  
Author(s):  
S. ROUKOZ ◽  
N. NACCACHE ◽  
G. SLEILATY
Keyword(s):  
Nerve Block ◽  
Tendon Rupture ◽  
Biceps Tendon ◽  
Hand Surgery ◽  
Elbow Flexion ◽  
Biomechanical Study ◽  
Biceps Tendon Rupture ◽  
Before And After ◽  
Flexion Force

The intention of this prospective study was to evaluate the role of the musculocutaneous and radial nerves in elbow flexion and forearm supination. The study included 29 patients having loco-regional anaesthesia for minor hand surgery. Elbow flexion and forearm supination forces were evaluated before and after an isolated musculocutaneous nerve block in one group and an isolated radial nerve block in another group. The results showed that the biceps tendon is responsible for 47% of the forearm supination force and the combination of brachioradialis and the supinator for 64% of this force. It showed also that the musculocutaneous and radial nerves contribute by 42% and 27.5%, respectively, to the flexion force of the elbow. These results are intended to help surgeons in decision making when treating chronic biceps tendon rupture, in repair of traumatic brachial plexus neuropathy and in using tendon transfers, such as the Steindler transfer, around the elbow.

The Effects of the "XGTQ" Medicine in Treating Cirrhosis in Wistar Rats

2020 ◽  
Vol 06 ◽  
Author(s):  
Ngan Nguyen Hoang ◽  
Thang Duong Minh ◽  
Tuan Anh Hoang ◽  
Son Le Ngoc Bich ◽  
Duong Nguyen Huu ◽  
...  
Keyword(s):  
Wistar Rats ◽  
Reference Group ◽  
Control Group ◽  
Plain Water ◽  
Group 4 ◽  
White Rats ◽  
Collagen Accumulation ◽  
Activity Of Enzymes ◽  
Group 3 ◽  
Group 1

Objectives: Evaluate the effects of "XGTQ" in the treatment of cirrhosis induced by Carbon tetrachloride (CCL4) in combination with alcohol and high-fat diet on Wistar rats. Materials and methods: Cirrhosis on white rats was induced by subcutaneously injecting CC14 at an initial dose of 5,0ml/kg, followed by 1,2ml/kg once a week in 10 weeks. Then, fed with synthetic food, added 20% fat, and 0.05% cholesterol and iron oxalate. Rats were administered every day with plain water and 1 day with water mixed with 30% ethanol. The rats were randomly divided into 5 groups and given distilled water (group 1 and 2 or control group), silymarin (group 3 or reference group) or the "XGTQ" drug extract (group 4, 5) for 4 weeks. Collected blood for biochemical test and liver were dissected to evaluate weight, morphology and quantified 4-hydroxyproline to evaluate fibrosis and collagen accumulation. Results: In cirrhotic wistar rats, "XGTQ" drug at 19.6 g/kg/24h and 58.8 g/kg/24h showed the ability of reducing the activity of enzymes AST, ALT in the blood (p<0.01), increasing plasma albumin and decreasing prothrobin time (p<.05); improving physical condition, macroscopic and microscopic images of H&E-stained liver; decreasing the concentration of hydroxyproline in the liver and reducing the level of cirrhosis on the masson-stained templates. The effects of "XGTQ" increased with the dose, and was equivalent to silymarin at the dose of 70 mg/kg/24h. Conclusion: The extract of "XGTQ" drug is effective in treating cirrhosis in Wistar rats.

scholarly journals CXCL13 concentration in latent syphilis patients with treatment failure

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 635-643
Author(s):  
Yan Zhang ◽  
Jun Wang ◽  
Yingnan Wei ◽  
Huili Liu ◽  
Chunli Wu ◽  
...  
Keyword(s):  
Nervous System ◽  
Treatment Failure ◽  
Leukocyte Count ◽  
Inflammatory Diseases ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
System Control ◽  
Failure Group ◽  
Latent Syphilis ◽  
Hiv Negative

AbstractWe aimed to investigate the CXCL13 concentration of the serum and cerebral spinal fluid (CSF) in human immunodeficiency virus (HIV)-negative latent syphilis patients with treatment failure and explore the change in CXCL13 after treatment. Sixty-eight latent syphilis patients with treatment failure (failure group), 68 syphilis patients with successful treatment (seroconversion group) and 18 patients with non-inflammatory diseases of the nervous system (control group) were included and serum and CSF were collected. Enzyme-linked immunosorbent assay was employed to detect the CXCL13 in the serum and CSF. Results showed that the serum CXCL13 concentration was comparable among three groups, and the CSF leukocyte count, IgG index and CXCL13 concentration in the failure group were significantly higher than those in the seroconversion group and control group (P < 0.05, P < 0.01). CSF CXCL13 concentration in the failure group was positively related to the CSF leukocyte count (r = 0.3594, P < 0.001). Of the 68 patients in the treatment failure group, neurosyphilis was found in 17 (25.0%). In conclusion, involvement of nervous system is one of the reasons for the treatment failure in patients with latent syphilis. Detection of CSF CXCL13 concentration is helpful for the diagnosis and therapeutic evaluation of HIV-negative latent syphilis patients with treatment failure and neurosyphilis.

scholarly journals Effect of Achilles Tendon Rupture on Player Performance and Longevity in Women’s National Basketball Association Players

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198998
Author(s):  
Joseph S. Tramer ◽  
Lafi S. Khalil ◽  
Patrick Buckley ◽  
Alexander Ziedas ◽  
Patricia A. Kolowich ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
National Basketball Association ◽  
Return To Play ◽  
Control Group ◽  
Healthy Controls ◽  
Career Longevity ◽  
Women's National Basketball Association ◽  
Player Performance

Background:Women’s National Basketball Association (WNBA) players have a greater incidence of lower extremity injury compared with male players, yet no data exist on functional outcomes after Achilles tendon rupture (ATR).Purpose:To evaluate the effect of Achilles tendon repair on game utilization, player performance, and career longevity in WNBA athletes.Study Design:Cohort study; Level of evidence, 3.Methods:WNBA players from 1997 to 2019 with a history of ATR (n = 12) were matched 1:2 to a healthy control group. Player characteristics, game utilization, and in-game performance data were collected for each athlete, from which the player efficiency rating (PER) was calculated. Statistical analysis was performed comparing postinjury data to preinjury baseline as well as cumulative career data. Changes at each time point relative to the preinjury baseline were also compared between groups.Results:Of the 12 players with ATR, 10 (83.3%) returned to play at the WNBA level at a mean (±SD) of 12.5 ± 3.3 months. Four players participated in only 1 WNBA season after injury. There were no differences in characteristics between the 10 players who returned to play after injury and the control group. After return to play, the WNBA players demonstrated a significant decrease in game utilization compared with preinjury, playing in 6.0 ± 6.9 fewer games, starting in 12.7 ± 15.4 fewer games, and playing 10.2 ± 9.1 fewer minutes per game ( P < .05 for all). After the index date of injury, the players with Achilles repair played 2.1 ± 1.2 more years in the WNBA, while control players played 5.35 ± 3.2 years ( P < .01) Additionally, the players with Achilles repair had a significant decrease in PER in the year after injury compared with preinjury (7.1 ± 5.3 vs 11.0 ± 4.4; P = .02). The reduction in game utilization and decrease in PER in these players was maintained when compared with the matched controls ( P < .05 for both).Conclusion:The majority of WNBA players who sustained ATR were able to return to sport after their injury; however, their career longevity was shorter than that of healthy controls. There was a significant decrease in game utilization and performance in the year after return to play compared with healthy controls.

scholarly journals Disorganization of intercalated discs in dilated cardiomyopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yukinobu Ito ◽  
Makoto Yoshida ◽  
Hirotake Masuda ◽  
Daichi Maeda ◽  
Yukitsugu Kudo-Asabe ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Interstitial Fibrosis ◽  
Left Ventricular ◽  
Pathological Diagnosis ◽  
Control Group ◽  
Failure Group ◽  
Intercalated Discs ◽  
Group Reduction ◽  
Group A ◽  
Morphological Differences

AbstractDilated cardiomyopathy (DCM) is a primary myocardial disease, the pathology of which is left ventricular or biventricular dilation and impaired myocardial contractility. The clinical and pathological diagnosis of DCM is difficult, and other cardiac diseases must be ruled out. Several studies have reported pathological findings that are characteristic of DCM, including cardiomyocyte atrophy, nuclear pleomorphism, and interstitial fibrosis, but none of these findings are DCM-specific. In this study, we examined the morphological differences in the intercalated discs (ICDs) between three groups of patients, a DCM group, a chronic heart failure group, and a control group. A total of 22 autopsy cases, including five DCM cases, nine CHF cases and eight control cases, were retrieved from the archives of the Department of Pathology at Akita University, Japan. The morphological differences were examined using multiple methods: macroscopic examination, light microscopy, immunohistochemistry, electron microscopy, and gene expression analyses. We observed disorganized ICDs, clearly illustrated by N-cadherin immunostaining in the DCM group. “Reduction of N-cadherin immunostaining intensity” and “ICD scattering” was DCM-specific. The results suggest that disorganized ICDs contribute to the development of DCM, and that N-cadherin immunostaining is useful for determining the presence of disorganized ICDs and for the pathological diagnosis of DCM.

scholarly journals Preservation of Contractile Reserve and Diastolic Function by Inhibiting the NLRP3 Inflammasome with OLT1177® (Dapansutrile) in a Mouse Model of Severe Ischemic Cardiomyopathy Due to Non-Reperfused Anterior Wall Myocardial Infarction

Molecules ◽  
2021 ◽  
Vol 26 (12) ◽  
pp. 3534
Author(s):  
Joseph Aliaga ◽  
Aldo Bonaventura ◽  
Eleonora Mezzaroma ◽  
Yogesh Dhakal ◽  
Adolfo Gabriele Mauro ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Function ◽  
Nlrp3 Inflammasome ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Control Group ◽  
Contractile Reserve ◽  
Standard Diet ◽  
Group 3 ◽  
Group 1

Interleukin-1β (IL-1β), a product of the NLRP3 inflammasome, modulates cardiac contractility and diastolic function. We proposed that OLT1177® (dapansutrile), a novel NLRP3 inhibitor, could preserve contractile reserve and diastolic function after myocardial infarction (MI). We used an experimental murine model of severe ischemic cardiomyopathy through the ligation of the left coronary artery without reperfusion, and after 7 days randomly assigned mice showing large anterior MI (>4 akinetic segments), increased left ventricular (LV) dimensions ([LVEDD] > 4.4 mm), and reduced function (LV ejection fraction <40%) to a diet that was enriched with OLT1177® admixed with the chow in the diet at 3.75 g/kg (Group 1 [n = 10]) or 7.5 g/kg (Group 2 [n = 9]), or a standard diet as the no-treatment control group (Group 3 [n = 10]) for 9 weeks. We measured the cardiac function and contractile reserve with an isoproterenol challenge, and the diastolic function with cardiac catheterization at 10 weeks following the MI surgery. When compared with the control (Group 3), the mice treated with OLT1177 (Group 1 and 2) showed significantly greater preservation of their contractile reserve (the percent increase in the left ventricular ejection fraction [LVEF] after the isoproterenol challenge was +33 ± 11% and +40 ± 6% vs. +9 ± 7% in the standard diet; p < 0.05 and p < 0.005 for Group 1 and 2, respectively) and of diastolic function measured as the lower left ventricular end-diastolic pressure (3.2 ± 0.5 mmHg or 4.5 ± 0.5 mmHg vs. 10.0 ± 1.6 mmHg; p < 0.005 and p < 0.009 respectively). No differences were noted between the resting LVEF of the MI groups. These effects were independent of the effects on the ventricular remodeling after MI. NLRP3 inflammasome inhibition with OLT1177® can preserve β-adrenergic responsiveness and prevent left ventricular diastolic dysfunction in a large non-reperfused anterior MI mouse model. OLT1177® could therefore be used to prevent the development of heart failure in patients with ischemic cardiomyopathy.

Minimally Invasive Reduction of Intraarticular Calcaneal Fractures With Percutaneous Fixation Using Cannulated Screws Versus Kirschner Wires: A Retrospective Comparative Study

2021 ◽  
pp. 193864002098775
Author(s):  
Ahmed Shams ◽  
Osama Gamal ◽  
Mohamed Kamal Mesregah
Keyword(s):  
Patient Satisfaction ◽  
Minimally Invasive ◽  
Comparative Study ◽  
Operative Time ◽  
Cannulated Screws ◽  
Kirschner Wires ◽  
Calcaneal Fractures ◽  
K Wires ◽  
Retrospective Comparative Study ◽  
Minimally Invasive Reduction

Background Several minimally invasive techniques were developed for management of intraarticular calcaneal fractures. This study aimed to compare the functional and radiological outcomes of 2 minimally invasive reduction and fixation techniques using cannulated screws or Kirschner wires (K-wires) for fixation. Methods This study was a retrospective comparative review of patients with displaced intraarticular calcaneal fractures, who were treated with cannulated screws or K-wires techniques. Clinical and radiological data were collected and compared between both groups. Functional outcomes and patient satisfaction using the Maryland Foot Score (MFS) and the visual analogue scale (VAS) of pain, in addition to the complications, were compared between both groups. Results In total, 70 patients were included in the study: 34 in the cannulated screws group, with a mean age of 35.2 ± 4 years, and 36 in the K-wires groups, with a mean age of 33.4 ± 3 years. The operative time was shorter in the K-wires group (40.5 ± 5.6 minutes) compared to the cannulated screw group (49.5 ± 4.5 minutes), P < .001. There were no statistically significant differences between both groups regarding the radiological parameters, including Bohler’s angle, angle of Gissane, calcaneal width, height, or length. The mean MFS, mean VAS, and complications were not different between the 2 groups. Conclusion Treatment of displaced intraarticular calcaneal fractures with minimally invasive reduction and fixation using either cannulated screws or K-wires can achieve similar excellent functional and radiological outcomes, with high patient satisfaction. The use of K-wires has the advantage of reduced operative time than cannulated screws. Levels of Evidence: Level III: Retrospective comparative study

A COMPARATIVE BIOMECHANICAL STUDY OF THE LOOPED SQUARE SLIP KNOT AND THE SIMPLE SURGICAL KNOT

Hand Surgery ◽  
2006 ◽  
Vol 11 (01n02) ◽  
pp. 93-99 ◽  
Author(s):  
Surut Jianmongkol ◽  
Geoffrey Hooper ◽  
Weerachai Kowsuwon ◽  
Tala Thammaroj
Keyword(s):  
Ultimate Strength ◽  
Hand Surgery ◽  
Biomechanical Properties ◽  
Biomechanical Study ◽  
Skin Closure ◽  
Significant Difference ◽  
Mode Of Failure ◽  
Repetitive Loading ◽  
Slip Knot

The looped square slip knot was introduced as a technique for skin closure to avoid the use of sharp instruments in suture removal after hand surgery. We compared the biomechanical properties of this knot with the simple surgical square knot. The ultimate strength of the looped square slip knot was significantly (p = 0.015) higher than the simple surgical knot. There was no significant difference between the two knots in mode of failure. Knot slippage or suture breakage did not occur in any samples when testing security by repetitive loading. Therefore, the looped square slip knot is a safe and convenient alternative to the two-throw surgical knot for use in hand surgery.

Efficacy of Intravitreal Triamcinolone after or Concomitant with Laser Photocoagulation in Nonproliferative Diabetic Retinopathy with Macular Edema

2009 ◽  
Vol 19 (4) ◽  
pp. 630-637 ◽  
Author(s):  
Erdinc Aydin ◽  
Helin Deniz Demir ◽  
Huseyin Yardim ◽  
Unal Erkorkmaz
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Laser Photocoagulation ◽  
Control Group ◽  
Clinical Effects ◽  
Intravitreal Triamcinolone ◽  
Nonproliferative Diabetic Retinopathy ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean

Purpose To investigate the clinical effects and outcomes of intravitreal injection of 4 mg of triamcinolone acetonide (IVTA) after or concomitant with macular laser photocoagulation (MP) for clinically significant macular edema (CSME). Methods Forty-nine eyes of 49 patients with nonproliferative diabetic retinopathy and CSME were randomized into three groups. The eyes in the laser group (n=17), group 1, were subjected to MP 3 weeks after IVTA; the eyes in the IVTA group (n=13), group 2, were subjected to MP, concomitant with IVTA; the eyes in the control group (n=19), group 3, underwent only IVTA application. Visual acuity (VA), fundus fluorescein angiography, and photography were performed in each group. Results In the first group, the mean VA improved from 0.17±0.09 at baseline to 0.28±0.15 (p=0.114) and in the second group, deteriorated from 0.19±0.08 at baseline to 0.14±0.08 at the sixth month (p=0.141), respectively. In Group 3, the mean VA improved from 0.16±0.08 at baseline to 0.28±0.18 (p=0.118) at the end of the follow-up. When VA was compared between the control and study groups, significant difference was detected at the sixth month (p=0.038). Conclusions MP after IVTA improved VA, rather than MP concomitant with IVTA, and only IVTA application for CSME. MP after IVTA may reduce the recurrence of CSME and needs further investigations in a longer period.

Closed Blood Conservation Device for Reducing Catheter-Related Infections in Children After Cardiac Surgery

2014 ◽  
Vol 34 (5) ◽  
pp. 53-60 ◽  
Author(s):  
Menglin Tang ◽  
Mei Feng ◽  
Lijun Chen ◽  
Jinmei Zhang ◽  
Peng Ji ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Bloodstream Infections ◽  
Control Group ◽  
Microbiological Analysis ◽  
Blood Conservation ◽  
Blood Samples ◽  
Potential Sources ◽  
Catheter System ◽  
Group 3 ◽  
Interventional Group

Background Arterial catheters are potential sources of nosocomial infection. Objective To investigate use of a closed blood conservation device in preventing catheter-related bloodstream infections in children after cardiac surgery. Methods Children with an indwelling arterial catheter after cardiac surgery were randomly assigned to 2 groups: a control group with a conventional 3-way stopcock in the catheter system and an interventional group with the conservation device in the catheter system. Catheter tips, catheter intraluminal fluid, and blood samples obtained from the catheter and peripherally were cultured for microbiological analysis. RESULTS Intraluminal fluid contamination was significantly lower (P = .03) in the interventional group (3 of 147 catheters) than in the control group (10 of 137 catheters). The 2 groups did not differ significantly in the rate of tip colonization (9 of 147 vs 12 of 137; P = .40) or in the number of catheter-related bloodstream infections (0 of 147 vs 2 of 137; P = .21). Conclusion Use of a closed blood conservation device could decrease the incidence of catheter-related contamination of intraluminal fluid.

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