Evaluation of the Candida albicans removal and mechanical properties of denture acrylics cleaned by a low-cost powered toothbrush

PurposeTo investigate the effects of using a low-cost powered toothbrush for cleaning on dental prostheses made of heat polymerized poly(methyl methacrylate), PMMA.MethodsHeat cured PMMA specimens beam with the dimensions of 45.0 mm × 6.5 mm × 4.5 mm were fabricated. The specimens were kept in water storage at 37 °C constant temperature for 0, 1, 7, 15, 30 and 60 days and randomly assigned for testing or control. Test specimens underwent brushing by using a powered toothbrush at an applied force of 2.00 N for 22 min with water as medium. Surface roughness measurement (R_a), flexural strength and efficacy of brushing to remove coated Candida albicans biofilm were investigated.ResultsThe results of the mean surface roughness value and the flexural strength were analysed by using two-way ANOVA and Tukey post hoc test at 5% significance level. In general, the specimens showed no significant changes in flexural strength after brushing. However, the flexural strength and the surface roughness value were significantly lower in specimens group after 7 days in water storage compared to the control. SEM micrographs of post-brushed specimens revealed satisfactory removal of C. albicans biofilm.ConclusionA low-cost powered toothbrush together with a liquid medium successfully removed C. albicans biofilm on dental acrylic PMMA-based prostheses, without compromising the mechanical properties.     

Clinical development and evolution in plaque removal performance of a battery powered toothbrush

BACKGROUND AND AIM: There is growing evidence that the new generation of electric toothbrushes are more effective than manual toothbrushes. The primary aim of these studies was to compare, as an indication of the stage of development, the plaque removal properties of a prototype battery powered toothbrush with an established product. A secondary aim was to utilise the data to appraise plaque accumulation together with the patterns of removal. METHOD: The three studies presented used the same, single-examiner, randomised, single-blind cross-over design involving up to 24 healthy volunteers. The prototype brushes, E6500 versions s1, s2 and s3 and E8000 with head speeds of 6500 and 8000 oscillations/min were compared with a similar design marketed product (MP) with a head speed of 8800 oscillations/min. All brushes had circular brush heads with oscillating rotating actions. Subjects accumulated plaque over a 4-day period during which no oral hygiene measures were performed. On day 4, the plaque accumulation was scored by index. Subjects then used the allocated toothbrush for 2 min. This was followed by a re-scoring of the remaining plaque. RESULTS: Studies 1 and 2 showed significantly less plaque removed by prototype E6500 (s1) and prototype E6500 (s2), respectively, than by MP. In study 3, prototype E8000 removed similar quantities of plaque to MP (approximately 65%). In contrast prototype E6500 (s3) only removed 60% of accrued plaque. Differences, however, did not reach statistical significance. CONCLUSIONS: The study methodology was appropriate to distinguish between the study toothbrushes and was furthermore able to establish a level of comparability for one of the prototype modifications with a similar MP.     

Lingual tonsillectomy in a child with obstructive sleep apnea: a novel technique

We report on a case of lingual tonsillar hyperplasia contributing to refractory obstructive sleep apnea in a 5-year-old patient. We describe a novel technique utilizing suspension laryngoscopy and a laryngeal angled shaver to remove obstructive lingual tonsillar tissue. We review the available techniques for lingual tonsillectomy and propose theoretical advantages to the novel approach.     

Microdebrider decompression of schwannoma: a novel method of excising a neck mass

OBJECTIVE: This case report describes the excision of a large neck neurofibroma causing compression of the esophagus and airway in a young patient with neurofibromatosis type 2 (NF2). At the conclusion of this article, readers should be able to describe a novel method of excising large encapsulated neck masses using microdebridement for decompression. The safety and efficacy of this method is discussed. STUDY DESIGN: The subject of this report was a 26-year-old woman with NF2. She presented with an enlarging right neck mass extending from the mandible to the clavicle that was compressing both her airway and esophagus. Given her auditory brainstem implant, unipolar cautery was contraindicated. Therefore, it was planned to decompress the patient's neck mass using a microdebrider before attempting to fully dissect out the mass. METHODS: The neck mass was exposed and then entered. Using a Xomed XPS microdebrider (Medtronic Inc., Minneapolis, MN), the mass was debrided and debulked in all directions taking care not to violate the capsule. After this, the entire capsule was dissected out using only bipolar cautery and suture ligatures for hemostasis. RESULTS: Microdebrider decompression of the neck neurofibroma allowed for preservation of the capsule without injuring vital structures in the neck. Postoperatively, the patient's swallowing and laryngeal function improved markedly. CONCLUSION: Microdebrider debulking before dissection of the patient's large neck mass safely relieved compression of the airway and esophagus. This method may be applied to other large benign masses in the neck as well.     

Cardiac Venous Left Ventricular Lead Removal and Reimplantation Following Device Infection: A Large Single‐Center Experience

LV Lead Extraction and Reimplantation. Background: Early series of biventricular device removal have contained mostly younger cardiac venous (CV) left ventricular leads and few have reported on rates of successful reimplantation. Methods and Results: We performed a retrospective analysis of all patients referred to the Cleveland Clinic between February 2, 2001 and July 27, 2011 for removal of a biventricular device with a CV pacing lead for an infectious indication. A total of 173 patients were included. The median age of the CV leads was 22.3 months (interquartile range: 5.2–46.3 months). The complete procedural success rate for all leads was 97.7%, with the remaining 2.3% clinical successes. A total of 76.9% of CV leads were removed using simple traction alone with the remaining leads requiring the use of a laser‐powered sheath. A total of 3.5% of leads required intervention (manual dissection or laser‐powered dissection) within the coronary sinus (CS). Major complications occurred in 1.2% of patients. Minor complications occurred in 7.5% of patients, the majority of which were hematomas requiring drainage (6.9%). CV lead reimplantation was attempted in 107 patients of which 88 (82.8%) were successful. Conclusion: CV lead removal in patients with an infected biventricular device is associated with an extremely high procedural success rate and a low incidence of major complications. The use of a laser‐powered sheath is necessary in roughly one‐quarter of cases with a very small percentage requiring intervention within the CS. Reimplantation of CV leads is achievable in roughly 83% of patients, a figure lower than nationally quoted estimates for de novo implantations. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1213–1216, November 2012)     

透光直视旋切术与腔镜深筋膜下结扎交通支静脉在静脉性溃疡治疗中的疗效比较研究

目的比较透光直视旋切术(TriVex)与腔镜深筋膜下结扎交通支静脉(SEPS)治疗静脉溃疡的效果。方法将我院在2009年1月至2011年6月间收治的静脉溃疡患者根据住院单双号分为TriVex组和SEPS组。TriVex组行大隐静脉高位结扎、抽剥和TriVex静脉旋切系统旋切术,对溃疡周围浅静脉予完全刨除;SEPS组行大隐静脉高位结扎、抽剥和腔镜深筋膜下结扎交通支静脉,对小腿曲张静脉及溃疡周围静脉行点状抽剥术。比较两组患者在溃疡愈合率、愈合时间及术后溃疡复发率的差异。结果两组患者的溃疡愈合率、愈合时间及溃疡复发率比较,差异无统计学意义(P>0.05),且均未发生深静脉血栓形成等严重并发症,但SEPS组术后皮下淤血或局部皮肤麻木感等轻微并发症高于TriVex组,而患者满意率低于TriVex组,两组差异有统计学意义(P<0.05)。结论 TriVex和SEPS均可有效治疗静脉溃疡,但SEPS可能会出现更多的皮下淤血或局部皮肤麻木感等轻微并发症,患者对TriVex的满意度更高。     

The Ventricular-Synchronous, Skeletal-Muscle Ventricle: Preliminary Feasibility Studies

The two requirements for the optimal use of skeletal muscle wrapped around a pouch used to pump blood are.(1) a low poucli diastolic pressure (to assure a iiigh musde capillary blood flow; and (2) a high pouch precontraction pressure (PCP) (to assure a forceful muscle contraction). Both requirements are satisfied with the pumping method described herein. This new type of skeletal-muscle ventricle (SMV) consists of a rectus abdominis muscle wrapped around a pouch connected to the left ventricular apex (with no valve) and to the aorta via a one-way valve. Consequently, the pressure in the SMV pouch is always equal to left ventricular pressure. The high PCP is obtained by stimulating the rectus muscle to contract tt the desired left ventricular pressure. The R (or P) wave of the cardiac electrogram initiates a delayed train of stimuli to cause the rectus muscle to contract tetanically and expel Wood from the pouch. We have designated this pumping configuration the ventricular-synchronous SMV (VS-SMV). In this study, eight ucute anesthetized dogs were used. The muscles were unconditioned and among the items investigated were the importance of the delay (d) between the R (or P) wave and the onset of the stimulus train, the optimal stimulus frequency and train duration, the VS-SMV output with different ratios of VS-SMV to left ventricular contractions, unloading of the left ventricle, Frank-Starling curves for the VS-SMV, pressure-volume loopsforthe VS-SMV with and without contraction of the rectus muscle, and washout characteristics of the VS-SMV. It was found that a stimulus frequency of 40/sec. and a train duration of 250 msec is optimal. It was also found that choice of the proper delay from the R or P wave provided maximal augmentation in stroke volume, typically 20 to 40 mL. Pumping with a ratio of 1:2 provided VS-SMV outputs ranging from 20 to 140 mL/min per kg of body weight. With this same pumping ratio, cardiac output increased by 28% and the post-VS-SMV contraction, left ventricular stroke volume was reduced. The Frank-Starling curves showed that PCPs on the order of aortic pressure are needed for the most forceful muscle contraction. With this new pumping configuration, the left ventricle resembles an atrium which delivers blood to the VS-SMV that is stimulated to contract when the desired PCP is reached. Studies were also conducted in which the VS-SMV outlet (valve end) was closed and filling and emptying occurred through the left ventricle. Saline washout studies were performed to determine the emptying characteristics with and without pumping using the closed-end pouch. A typical emptying was 50% for five VS-SMV contractions with the muscle contracting. However, even without the muscle contracting, there was washout due to the compliant recoil of the pouch which was stretched during ventricular systole. Essentially the same pumping performance was obtained with the closed-end mode of operation.     

An electric tooth pulp vitality tester

A simple battery-powered constant-current pulse generator able to supply up to 200 μA at a maximum of 250 V is described. The tester incorporates a battery status indicator and an overload, incorrect operation and fault condition audible alarm. A simple test routine helps to ensure that the instrument is operating correctly before each application. For enhanced patient co-operation and comfort the tester is activated by the patient.