Experimental cryosurgery on bone: A light and electron microscopical investigation

Three rabbits were treated with cryosurgery on the lateral surface of the mandible. Osteocytes with normal appearance were not detected in the cortex after 2 or 7 days following cryosurgery. In the marrow cavity, cells appeared more resistant and often showed a normal morphology as studied with both light and electron microscopy. The reason why cells survived in the marrow cavity is probably due to a combination of sheltering bone and the near proximity to an intact circulation due to a patent alveolar artery.The uncertain extension of the cold front beyond the cortex may indicate that cryosurgery alone is not suitable if a tumor has invaded the marrow cavity, while more superficially located tumors can be eradicated. However, tumor invasion itself destroys the cortex and thus the marrow cavity will be more readily exposed to the more extensive cryosurgical techniques used in clinical cryosurgery.     

Augmentation of the nostril splint for retaining the corrected contour of the cleft lip nose

Whatever method is used to correct the deformity of the cleft lip nose, it is important to maintain the corrected contour of the nose for a certain period postoperatively. For this purpose, moldable silicone rubber is used to add volume to a ready-made nostril splint. With this material it is easy to make a splint that fits the individual contour of the nostril. Clinical examples are presented.     

Fixation of a human rib by an intramedullary telescoping splint anchored by bone cement

A novel concept for rib fixation is presented that involves the use of a bioresorbable polymer intramedullary telescoping splint. Bone cement is used to anchor each end of the splint inside the medullary canal on each side of the fracture site. In this manner, rib fixation is achieved without fixation device protrusion from the rib, making the splint completely intramedullary. Finite element analysis is used to demonstrate that such a splint/cement composite can preserve rib fixation subjected to cough-intensity force loadings. Computational fluid dynamics and porcine rib experiments were used to study the anchor formation process required to complete the fixation.     

Phytochrome-regulated growth of excised coleoptile tips of Triticum aestivum induced by blue, red and far-red light

The elongation growth of 5-mm tip sections of 3-day-old etiolatedwheat coleoptiles was promoted by light flashes of 436, 650and 750 nm in comparison with the dark control. As short as7/1,000 sec red light (R) of 14,420 W/m² led to saturation ofthe R-induced growth response. At quantum-identical far-redlight (FR) irradiation, a plateau developed at about 9/1,000sec which, however, was interrupted at longer irradiation periods.Varying dark periods between R or FR activation of growth anda second FR flash, a light-independent period with a half-lifeof 45 to 60 sec was found. Only after this light-independentperiod could R or FR activation of growth be reversed by FR.A second light-independent period was found by the followingirradiation schedule: 1 sec R/100 sec darknees(D)/l sec FR/varied D/l sec R. Our experimental conditions enabled us (a) to distinguish betweenactivation and inactivation by FR, (b) to clarify the reactionchain of different phytochrome forms and (c) to determine thehalf-life of light-independent phytochrome reactions.     

Postharvest behaviour of five Sardinian prune varieties as affected by immersion in heated sodium bicarbonate solution

Storage behaviour of 'Core', 'Core Columbu', 'Fradis' and 'Meloni' white prunes, and a black one ('Sighera') of Sardinian germplasm were evaluated following immersion for 0 (control), 15, 30, 45 or 60 sec in water at 20, 50, 55 or 60 degrees C with or without 2% (w/v) NaHCO3 (SBC). As international varieties, fruit from one white plum ('Shiro') and one black prune ('Stanly') were subjected to the same treatments. Fruit was harvested at commercial maturity, treated and then stored for 1 month at 5 degrees C and 90% RH followed by a simulated marketing period at 20 degrees C and 80% RH for 6 days. Fruit appearance, external damage, firmness and decay percentage were monitored after storage and SMP. Treatments did not induce rind damage (browning or discoloration) to any variety. SBC at 20, 45, 50 or 55 degrees C for 15 or 30 sec was not effective in controlling decay and compared to controls no improvement was observed. Immersion for 45 or 60 sec with SBC at all temperatures improved decay control with respect to controls and best results were obtained at 50 or 55 degrees C. Immersions at 60 degrees C improved decay control, but differences were not significant compared to the control attained with solutions of SBC heated at 55 degrees C. The overall appearance of 'Core', 'Core Columbu', 'Fradis' and 'Shiro' decreased significantly after the SMP period, especially when treated at 55 or 60 degrees C for 60 sec. Fruit shrivel was the main cause of the low rating. SBC did not affect shrivel indicating that heat treatment may be the probable cause. In general, local varieties were less affected by decay than other varieties and they performed well during storage.     

Immersion of 'Coscia' pear fruit in water at 55 degrees C for 60 sec controls Penicillium expansum decay and delays ripening during short storage

'Coscia' is an early ripening pear with a short postharvest Life (1 month) and chemical treatments to prevent decay are generally not undertaken. This, along with the fast deterioration under shelf-life conditions, makes it difficult to contain postharvest moulds. 1-methylcyclopropene (1-MCP) has been employed with success to delay ripening and, as a co-effect, the development of decay was contained, but this treatment is not allowed for organically grown crops. Here we report the results of an alternative approach employing immersion treatments in water at 45, 50, 55 or 60 degrees C for 0 (control), 15, 30, 45 or 60 sec. Fruit was harvested after the climacteric peak, immediately subjected to the heat treatment and stored for 2 weeks at 1 degrees C followed by a 3 days of a simulated shelf-life at 17 degrees C and 75% RH. Half of the fruit was wounded (3 x 3mm) and inoculated with Penicillium expansum (20 microL of 10(4) conidia mL(-1). Decay inhibition and fruit appearance, rated from 0 to 3 (0 = excellent; 1 = good; 2 = scarce; 3 = not marketable), were monitored and compared to the control after storage and shelf-life. All heat treatments affected the mould development when performed for 45 or 60 sec. The best result in terms of decay control and appearance after storage and shelf-life occurred when fruit was immersed at 55 degrees C for 60 sec with a decay reduction of about 85% compared to control (75% decay) and with a good appearance.     

Paget’s disease of the nipple treated successfully with cryosurgery: A series of cases report

Introduction

Paget’s disease of the nipple is a rare form of breast malignancy. Underlying breast cancer, either in situ or invasive accompanies lesions of the nipple in most of the cases. The connection between both entities and their exact origin remains unclear. Nevertheless, underlying ductal breast cancer is often confined to the central, subareolar part of the breast. Radical mastectomy, although successful, seems to be too mutilating treatment in the era of breast sparing surgery. Studies describing breast conserving surgery performed without adjuvant treatment are rare and the patients not numerous. Due to low incidence of the disease, there are no randomised trials conducted which could show the optimal method of treatment.

Materials and methods

We performed cryosurgery of the affected nipple-areola complex (NAC) in treatment of six patients with Paget’s disease of the nipple who presented general contraindications or lack of consent for surgery.

Results

With a follow up ranging from 60 to 121 months (average 94) we obtained very good results in terms of disease specific survival: there were two cases of recurrent disease, confined to the scar and treated successfully with cryosurgery again; four patients are alive without disease. Death was not related to cancer in the remained two cases.

Conclusions

Cryotherapy is successful form of treatment of localised Paget’s disease of the nipple – especially in face of contraindications for surgery or lack of patient’s agreement for operational treatment.     

A new dynamic lumbrical simulating splint for claw hand deformity

The claw hand deformity, resulting from low ulnar or combined low ulnar and median nerve palsy, is an incapacitating situation. The splint described herein reverses the clawing by substituting for the lumbricals and interossei. If started early, it not only prevents the permanent stiffness of fingers in the claw position, but also effectively restores function without hampering day to day work because it is a surface splint.     

Adjustable dynamic external splint for control of first web contracture

A method is presented to overcome problems of first web space contracture by means of a dynamic, continuously adjustable, wedge-shaped splint. The device is easily constructed of inexpensive material by physician or hand therapist. The splint is custom-tailored to the individual patient and is lightweight and comfortable, promoting good patient compliance. Its continuously adjustable nature maximizes its effects throughout therapy, and the even distribution of the pressure makes for a high surface area of patient/splint contact for even pressure distribution and eliminates the problems of skin necrosis, even with lengthy applications.     

The Effects of Hot Water Treatments on Survival of Heterodera schachtii

Cysts of Heterodera schachtii were treated in a water bath at constant temperatures ranging from 45 - 62.5 C for 1 sec to 28 hr. Treated and untreated cysts were incubated 8 weeks in sugarbeet root diffusate at 24 C to measure emergence of surviving larvae. Within the temperature range of 49 - 54 C, the minimum lethal temperature was proportional to the log time of treatment. No larvae emerged from cysts exposed 10 sec at 60 C. Although treatment of cysts for 8 hr at 45 C significantly reduced emergence, increasing the treatment period to 28 hr did not completely suppress emergence.     

Resorbable internal splint: an adjunct to primary correction of unilateral cleft lip-nasal deformity

There is usually some relapse in position of the alar cartilage after primary repair of unilateral cleft lip. Therefore, preoperative or postoperative external splinting has been recommended to supplement either closed or open suspension of the alar cartilage. The authors present a method using a resorbable internal nostril splint to shield the positioned alar cartilage from deformational forces caused by scar, and thus avoiding the problems associated with external splinting. An internal nasal splint was placed in 15 infants during repair of unilateral complete cleft lip and nasal deformity. The nasal morphology was compared with that of 15 control patients who had the same nasolabial procedure without internal splinting. Average follow-up time was 20.4 months (range, 4 to 30 months). Photogrammetric analysis showed that asymmetry of the alar contours averaged 8.6 percent in the splinted patients, as compared with 23 percent for controls (p <0.01). Thus, alar asymmetry was decreased two-thirds in the splinted group. An internal resorbable nasal splint is an adjunct to open alar suspension in primary repair of the unilateral cleft lip nasal deformity. An internal nasal splint protects the corrected alar cartilage longer than an external splint and eliminates drawbacks, such as necrosis, cutaneous depression of the nostril sill, and patient noncompliance. This strategy of temporary internal support of healing cartilage has other applications.     

Antitumor immunologic reactivity in the relatively early period after cryosurgery: Experimental studies in the rat

An experimental investigation was performed on antitumor immunity in the relatively early postoperative period after cryosurgery, using a metastasizing rat's mammary tumor, MRMT-1. Two weeks after its inoculation, surgical excision of the tumor, cryosurgery, surgical excision plus inoculation with freezing-thawing produced vaccine, or surgical excision plus fasting for 72 hr was performed, and postoperative follow-up was done on incidences of metastases, those of metastatic death, etc. Specific immunologic reactivity was examined in the surgical excision (SE) and cryosurgery (CR) groups.The FTV and fasting groups showed more metastatic deaths as compared with the SE group. The CR and SE groups did not differ significantly from each other in incidences of lung and lymph node metastases.Specific footpad reactivity at 2 and 3 weeks after treatment was lower in the CR group than in the SE group.Winn's neutralization assay showed an inhibition of tumor growth at 1 and 3 week(s) after treatment both in the SE and in the CR groups, the inhibitory effect tending to be lower in the latter.Inactivated serum obtained at 1 week after treatment showed a facilitation of tumor growth in the SE group and a tendency of tumor suppression in the CR group, showing a significant difference between them.A mild reduction in antitumor immunity seen in the relatively early postoperative period following cryosurgery probably was not due to a blocking effect by superfluous antigens. Rather it was considered to be due to activation of suppressor cells, consequent on cryosurgical stress, and/or slow and steady absorption of antigens.     

Effect of cryoprotectant concentration, equilibration time and thawing procedure on survival and development of rapid frozen-thawed mature mouse oocytes

Experiments were conducted to develop a simple rapid-freezing protocol for mature mouse oocytes that would yield a high proportion of oocytes with developmental potential. The effects of concentration (3.5, 4.5 and 6.0 M dimethyl sulfoxide (DMSO) all with 0.5 M sucrose) and the duration of exposure (2.5 min vs 45 sec) of oocytes to the cryoprotectant and its extraction after thawing in 2, 3 or 4 steps of descending sucrose concentration were studied. The most effective of the rapid-freezing and thawing protocols (4.5 M DMSO; 45 sec exposure and 3-step thawing) was compared to slow freezing protocols using 1.5 M DMSO and 1.0 M 1,2 propanediol as cryoprotectants. The DMSO concentrations had an effect on survival, fertilization and embryo development using short (45 sec) but not long (2.5 min) exposure. The rate of morphological oocyte survival was significantly higher using 4.5 M DMSO than 3.5 or 6.0 M (92% vs 82 and 73%, respectively). The development of fertilized embryos to blastocysts was also significantly higher at 4.5 M than at 3.5 or 6.0 M (68% vs 42 and 53%, respectively). The extraction of cryoprotectant in 3 or 4 steps of descending sucrose concentration resulted in higher survival (P < 0.01) and fertilization than in 2 steps. The best survival, fertilization and development was achieved with the 3-step procedure. Optimal combinations of conditions were 4.5 M DMSO at 45 sec prefreeze exposure and 3-step extraction of the cryoprotectant. Oocytes frozen by conventional methods had a survival, fertilization and development to blastocyst rate significantly lower than those frozen under the optimal rapid conditions. Thus rapid freezing of mature mouse oocytes with 4.5 M DMSO + 0.5 M sucrose and short prefreeze exposure is effective and has the additional advantage of being less time-consuming than slow freezing methods.     

Effects of intraoral splint wear on proteoglycans in the temporomandibular joint disc

Intraoral splints are a common dental treatment for dysfunctions of the temporomandibular joint (TMJ), but their effects on the structures of the joint, specifically the disc, have not been well investigated. This study examined proteoglycans (PGs) of the TMJ disc of the miniature pig and tested for alterations resulting from intraoral splint wear. Sixteen female pigs were divided into three groups: control (C), control splint (CS), and protrusive splint (PS). Splinted groups received chrome-cobalt ramp splints which were worn continuously for 2 months. PG content within various disc locations was determined by colorimeteric assay. PG synthesis and type were examined by labeling with (35)S-sulfate and SDS-PAGE analysis. Average water content of the disc was 77.1%, which places it at the high end of the normal range for collagenous biomaterials (60-80%). PGs migrating to the positions typical of aggrecan, biglycan, and decorin on SDS-PAGE were present in all locations of all groups. The highest content and synthesis of PGs were always found in the intermediate band of the disc regardless of group (P < 0.05), supporting the notion that this band encounters heavy compressive loading during function. The joints of animals from both splinted groups showed a high frequency of gross pathology. Biglycan synthesis was increased in both splinted groups (P < 0.05). Newly synthesized biglycan had a shorter migration distance in the intermediate bands of the CS group, suggesting increased hydrodynamic size. These findings suggest that intraoral splint wear may cause disc damage or remodeling.     

A nipple splint

An easily constructed, inexpensive splint for postoperative maintenance and protection of corrected flat, depressed, or inverted nipples and the method of its use are described.     

The vacuum splint: an aid in emergency splinting of fractures

The vacuum splint has been shown to be a simple, safe and effective method of emergency splinting of fractured extremities. The splint is simply constructed from clear vinyl sheeting and contains 2-mm. expanded polystyrene balls. Evacuation of air causes the splint to become rigid, thereby providing stability and immobilization of the limb. The splint is radiolucent, containing no obstructive metal components that would interfere with the radiographic appearance of the injured limb. The ease of application of this splint makes it especially effective for the emergency splinting of fractures in children.     

Design of a protective splint for nonhuman primate extremities

A splint was designed that effectively protected a nonhuman primate extremity following an injury or experimental procedure. The splint was fabricated from a thermoplastic material. Fabrication was simple, rapid, inexpensive, and versatile.     

Influence of the Lower Jaw Position on the Running Pattern

Introduction

The effects of manipulated dental occlusion on body posture has been investigated quite often and discussed controversially in the literature. Far less attention has been paid to the influence of dental occlusion position on human movement. If human movement was analysed, it was mostly while walking and not while running. This study was therefore designed to identify the effect of lower jaw positions on running behaviour according to different dental occlusion positions.

Methods

Twenty healthy young recreational runners (mean age = 33.9±5.8 years) participated in this study. Kinematic data were collected using an eight-camera Vicon motion capture system (VICON Motion Systems, Oxford, UK). Subjects were consecutively prepared with four different dental occlusion conditions in random order and performed five running trials per test condition on a level walkway with their preferred running shoes. Vector based pattern recognition methods, in particular cluster analysis and support vector machines (SVM) were used for movement pattern identification.

Results

Subjects exhibited unique movement patterns leading to 18 clusters for the 20 subjects. No overall classification of the splint condition could be observed. Within individual subjects different running patterns could be identified for the four splint conditions. The splint conditions lead to a more symmetrical running pattern than the control condition.

Discussion

The influence of an occlusal splint on running pattern can be confirmed in this study. Wearing a splint increases the symmetry of the running pattern. A more symmetrical running pattern might help to reduce the risk of injuries or help in performance. The change of the movement pattern between the neutral condition and any of the three splint conditions was significant within subjects but not across subjects. Therefore the dental splint has a measureable influence on the running pattern of subjects, however subjects individuality has to be considered when choosing the optimal splint condition for a specific subject.     

Intralesional cryotherapy for enhancing the involution of hypertrophic scars and keloids

Although therapeutic management of hypertrophic scars and keloids using contact or spray cryosurgery has yielded significant improvement or complete regression of hypertrophic scars and keloids, it requires one to 20 treatment sessions. This study was designed to assess the clinical safety and efficacy of an intralesional needle cryoprobe method in the treatment of hypertrophic scars and keloids.Ten patients, ranging in age from 3 to 54 years, with a total of 12 hypertrophic scars and keloids of more than 6 months duration and of diverse causes, were included in this study. The 18-month trial evaluated volume reduction of the hypertrophic scars and keloids after a single session of intralesional cryotherapy. Objective (hardness and color) and subjective (pain/tenderness and itchiness/discomfort) parameters were examined on a scale of 0 to 3 (low score was better). Pretreatment and posttreatment histomorphometric studies of the collagen fibers included spectral picrosirius red polarization and fast Fourier transformation orientation index. A specially designed cryo-needle was inserted into the long axis of the hypertrophic scars and keloids so as to maximize the volume of the hypertrophic scars and keloids to be frozen. The cryo-needle was connected by an adaptor to a cryogun filled with liquid nitrogen, which was introduced into the cryoprobe, thereby freezing the hypertrophic scars and keloids. After the hypertrophic scars and keloids were completely frozen, the cryoprobe defrosted and was withdrawn.An average of 51.4 percent of scar volume reduction was achieved after one session of intralesional cryosurgery treatment (average preoperative hypertrophic scars and keloids volume, 1.82 +/- 0.33; average posttreatment volume, 0.95 +/- 0.21; p < 0.0022). Significant alleviation of objective and subjective clinical symptoms was documented. Mild pain or discomfort during and after the procedure was easily managed. Only mild local edema and epidermolysis, followed by a short reepithelialization period, were evident. During the 18-month follow-up period, there was no evidence of bleeding, infection, adverse effects, recurrence, or permanent depigmentation. The histomorphometric analysis demonstrated rejuvenation of the treated scars (i.e., parallelization) and a more organized architecture of the collagen fibers compared with the pretreated scars.This study demonstrated the increased efficacy of this method as a result of increased freezing area of deep scar material compared with that obtained with contact/spray probes. As a result, fewer treatment cycles are needed. Because the reepithelialization period is short, treatment intervals, if any, can be shortened to 2 to 3 weeks. This intralesional cryoneedle method is simple to operate and safe to use, it necessitates less postoperative care of the wound, and it can easily be added to any preexisting cryosurgical unit.     

A custom splint for zygomatic fractures

In the past, various materials have been applied to the zygomatic region to serve as a protective splint during the healing phase. Traditionally, these have been bulky, cumbersome, and non-conforming. This technique involves the application of a precut thermoplastic splint that is site-specific, lightweight, adjustable, low profile and universal and adapts to the anatomy of each patient.