Imaging study on safety of deep needling at Dachangshu (BL 25) / 中国针灸

OBJECTIVE@#Based on magnetic resonance imaging technology, the dangerous depth of straight needling and the safety of deep needling at Dachangshu (BL 25) are discussed, and data support is provided for standardizing deep needling at Dachangshu (BL 25).@*METHODS@#The horizontal cross-sectional images of 148 healthy adult subjects under the spinous process of the 4th lumbar vertebra were collected by magnetic resonance instrument, the anatomical structure was analyzed, and the dangerous depth of straight needling at Dachangshu (BL 25) was measured.@*RESULTS@#The dangerous depth of straight needling at Dachangshu (BL 25) was (11.2±1.3) cm and (11.0±1.2) cm on the left and right sides of males, and (9.8±1.3) cm and (9.7±1.3) cm on the left and right sides of females. There was a positive correlation between the dangerous depth of straight needling at Dachangshu (BL 25) and body mass index (BMI). In the case of similar body size, the dangerous depth of straight needling at Dachangshu(BL 25) in males was greater than that in females (P<0.01).@*CONCLUSION@#At present, the deep needling at Dachangshu (BL 25) used in clinic is safe. In clinical application of the deep needling at Dachangshu (BL 25), the depth of needle insertion can be determined according to body size and gender.

Correlation between the Depth of the Left-Sided Double-Lumen Tube and Specific Body Landmarks / 中国医科大学学报

Objective To investigate the correlation between the insertion depth of the left-sided double-lumen tube (DLT) and some specific body landmarks in order to guide left-sided DLT intubation. Methods Ninety-five adult patients who underwent thoracic surgery were chosen, and the age (A), sex (S), height (H), weight (W), distance between the cricothyroid membrane and upper notch of the sternum angle (L), size of the left-sided DLT (F), and predicted depth of intubation (y) were recorded. After anesthesia induction, the final corrected insertion depth of the left-sided DLT (Y) were recorded using fiberoptic bronchoscopy. The Y and y were compared.Linear regression and Pearson's correlation analysis were used to analyze the data. Results There was no difference between the Y and y (P＞ 0.05). The Y was significantly correlated with H, W, and L (P ＜ 0.01), and was not correlated with A (P＞ 0.05). Three linear regression equations for H, L, and Y were obtained. H and L were linearly dependent on Y, and the determination coefficients R2 were 0.43 (Y=7.285+0.128 H) and 0.41 (Y=19.305+0.866 L), respectively. Using both H and L as the independent variables, the determination coefficient R2 was 0.56 (Y=8.127+0.087 H+0.559 L). Conclusion The linear regression equation Y=8.127+0.559 H+0.087 L could be used as a rapid method to assess the insertion depth of the left-sided DLT. However, the ideal insertion depth of the left-sided DLT still needs to be confirmed using fiberoptic bronchoscopy.

Three-dimensional finite element analysis according to the insertion depth of an immediately loaded implant in the anterior maxilla / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the effects of the insertion depth of an immediately loaded implant on the stress distribution of the surrounding bone and the micromovement of the implant using the three-dimensional finite element analysis. MATERIALS AND METHODS: A total of five bone models were constructed such that the implant platform was positioned at the levels of 0.00 mm, 0.25 mm, 0.50 mm, 0.75 mm, and 1.00 mm depth from the crest of the cortical bone. A frictional coefficient of 0.3 and the insertion torque of 35 Ncm were simulated on the interface between the implant and surrounding bone. A static load of 178 N was applied to the provisional prosthesis with a vertical load in the axial direction and an oblique load at 30°with respect to the central axis of the implant, then a finite element analysis was performed. RESULTS: The implant insertion depth significantly affected the stress distribution on the surrounding bone. The largest micromovement value of the implant was 39.34 µm. The oblique load contributed significantly to the stress distribution and micromovement in comparison to the vertical load. CONCLUSION: Increasing the implant insertion depth was advantageous in dispersing the concentrated stress in the cortical bone and did not significantly affect the micromovement associated with early osseointegration failure.

Impacto da profundidade da agulha de irrigação na remoção de debris dentinários / Impact of the needle insertion depth on the removal of hard-tissue debris

O presente estudo avaliou o efeito da inserção da agulha de irrigação max-i-probe 30G em duas profundidades diferentes na remoção de debris após a instrumentação endodôntica. Raízes mesiais de molares inferiores com a presença de istmos foram escaneadas em um microtomógrafo de raios-X em uma resolução isotrópica de 14.16 µm. Cada dente foi aleatoriamente designado para um dos dois grupos experimentais (n = 10) de acordo com a profundidade de inserção da agulha durante a irrigação do sistema de canais radiculares: 1 ou 5 mm aquém do comprimento de trabalho. Todas as amostras foram instrumentadas com o sistema Reciproc (VDW, Munique, Alemanha) e o mesmo protocolo de irrigação foi usado, diferindo apenas na profundidade de inserção da agulha. O segundo escaneamento foi realizado após os procedimentos de limpeza e modelagem e, depois disso, as imagens registradas, antes e após o preparo, foram examinadas a partir do nível da bifurcação até o ápice para identificar volumetricamente, medir e mapear a quantidade de debris acumulados. O teste de Mann-Whitney comparou estatisticamente o volume percentual de debris acumulados entre os grupos de irrigação. Os resultados mostraram que a profundidade de inserção da agulha teveinfluência relevante na remoção de debris (P< 0,05). Uma redução significativa na percentagem de debris foi observada quando a agulha foi inserida a 1 mm do comprimento de trabalho (P< 0,05). A profundidade de inserção da agulha de irrigação tem uma marcante influênciasobre o montante final de debris acumulados. Infere-se, desta maneira, que quanto mais próximo ao ápice é levada a agulha de irrigação, menor é a quantidade final de debris gerados após a instrumentação endodôntica.

The present study evaluated the effect of the insertion of the irrigation needle (max-i-probe, Smith and Nephew MPL, Franklin Park, IL) at two different depths on the removal of hard tissue debris. Mandibular molarswith isthmuses in the mesial root canalsystem weremicro-CT scanned at an isotropic resolution of 14.16 µm. Each tooth was randomly assigned to 2 experimental groups (n = 10) according to the depth of needle insertion during irrigation of the root canal system: 5 or 1 mm short of working length. All teeth were instrumented with the Reciproc system (VDW, Munich, Germany) and the very same irrigation protocol was used, differing only by the depth of needle insertion. Second micro-CT scans were performed after cleaning and shaping procedures and after that, the matched images, before and after preparation, were examined from the furcation level to the apex to volumetrically identify, measure and map the amount of accumulated hard-tissue debris. Mann-Whitney test was used to statistically compare the percentage volume of accumulated hard tissue debris between the irrigation groups. The result showed a significant influence of the depth of needle insertion on removal of debris (P < .05). A significant reduction in the percentage of hard tissue debris was observed when the needle was inserted up to 1 mm from the apex (P < .05). The depth of needle insertion has a significant influence on the final amount of the accumulated hard-tissue debris. It is fair to conclude that the nearest to the apex the irrigation needle is, the less is the final amount of hard-tissue debris generated.

The Correlation between Insertion Depth of Prodisc-C Artificial Disc and Postoperative Kyphotic Deformity: Clinical Importance of Insertion Depth of Artificial Disc

OBJECTIVE: This study was designed to investigate the correlation between insertion depth of artificial disc and postoperative kyphotic deformity after Prodisc-C total disc replacement surgery, and the range of artificial disc insertion depth which is effective in preventing postoperative whole cervical or segmental kyphotic deformity. METHODS: A retrospective radiological analysis was performed in 50 patients who had undergone single level total disc replacement surgery. Records were reviewed to obtain demographic data. Preoperative and postoperative radiographs were assessed to determine C2-7 Cobb's angle and segmental angle and to investigate postoperative kyphotic deformity. A formula was introduced to calculate insertion depth of Prodisc-C artificial disc. Statistical analysis was performed to search the correlation between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity, and to estimate insertion depth of Prodisc-C artificial disc to prevent postoperative kyphotic deformity. RESULTS: In this study no significant statistical correlation was observed between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity regarding C2-7 Cobb's angle. Statistical correlation between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity was observed regarding segmental angle (p<0.05). It failed to estimate proper insertion depth of Prodisc-C artificial disc effective in preventing postoperative kyphotic deformity. CONCLUSION: Postoperative segmental kyphotic deformity is associated with insertion depth of Prodisc-C artificial disc. Anterior located artificial disc leads to lordotic segmental angle and posterior located artificial disc leads to kyphotic segmental angle postoperatively. But C2-7 Cobb's angle is not affected by artificial disc location after the surgery.

A computed tomography study for the dangerous depth of the thoracic area with acupuncture treatment to avoid adverse clinical conditions / 全日本鍼灸学会雑誌

[Objective]Traumatic pneumothorax in acupuncture treatment should be avoided. This study was designed to detect the safe depth of the thoracic area with acupuncture and was compared with other studies in the past. <BR>[Methods]The Subjects were 187 cases, male: 90, female: 97, mean age: 67.8 (min-max: 23-91) and classified into 3groups (thin, normal, fatty) from BMI. MultiCT images were filmed in 3anatomical levels (the tracheal point (TP), scapular point (SP), shortest point (MsP) of the thoracic area and the distance between the skin and lung tissue on the display was measured (Osirixver3. statistics:ANOVA). <BR>[Results]The distance between the skin and lung tissue were, average ±SD, TP 3.01 ± 0.79, SP 2.34 ± 0.65, MsP 2.14 ± 0.61 cm. The longest distance was 5.5 cm (TP), and the shortest was 0.9 cm (MsP). The differences between the body depths and TP and SP, and MsP were statistically significant (TP >SP >MsP). There was a positive correlation between BMI and body depth, and a negative correlation between age and body depth. From an anatomical point of view, TP seemed to coincide with BL38, SP seemed to coincide with BL40, and MsP seemed to coincide with BL41 or BL42.<BR>[Conclusions]MultiCT was very useful for a measurement of the distance between skin and lung tissue scientifically. The results of this study were almost in agreement with other studies in the past. The results are informative in showing that the risk of traumatic pneumothorax might be reduced clinically. But it is too difficult to confirm what is a safe depth, and it is recommended to measure the body depth under the conditions that include clinical problems, for example, the positioning in the treatment of acupuncture. The concept of safe depth should be changed to a dangerous depth with acupuncture treatment.

A new approach of estimating insertion depth with double-balloon enteroscopy / 中华消化内镜杂志

Objective The aim of this study was to evaluate the accuracy of calculating the insertion length of the overtube for estimating the insertion depth of the scope at double-balloon enteroscopy (DBE).Methods Patients with intestinal lesions found at DBE and confirmed by surgery were included. The advancing distance of the enteroscope at DBE was estimated by either cumulative length of push/pull cycle or calculation of the overall insertion length of the overtube. The accuracy of these two methods was evaluated with reference to surgery. Results Data from 51 patients who had their lesions found at DBE and treated by surgery were included in the study. DBE included 41 antegrade and 10 retrograde procedures. The average difference in the evaluation of the length of enteroscopic insertion between the two methods was 17 cm ( range 0-60 cm) on antegrade DBE and 12 cm (range 0-30 cm) on retrograde DBE. Furthermore, regardless of insertion route of DBE procedure, the mean differences between the insertion length evaluated by the two methods and surgical findings were 19 cm (range 0-50 cm) and 17 cm (range 0-60 cm), respectively, which was not significantly different ( P ＞ 0. 05 ). Conclusion The new method of calculating the length of the overtube passage is the same accurate and much simpler than the traditional method in estimating the insertion depth of the enteroscope at DBE, which is appliable in clinical practice.

A Temporal Bone Study of Insertion Trauma and Intracochlear Position of Straight Type Electrode for Cochlear Implant / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The goal of this study was to examine insertion depth, intracochlear position and insertion trauma with the stimulation electrode of the Nurobiosys cochlear implant. SUBJECTS AND METHOD: Four electrodes were implanted in fresh temporal bones of the human cadavers using realistic surgical procedures. Plain film X-ray images were taken from the electrode inserted in the specimens to estimate the insertion depth. After the electrode implantation, all human temporal bones were trimmed to extract the cochleae. The extracted cochleae from the temporal bone were immersed in acrylic resin to fix the position of electrode placed in the scala tympani. The resin treated cochleae were cut in radial section and polished. All crosssections were imaged with a microscope to assess the trauma by the electrode implantation. RESULTS: The mean insertion depth was about 300degrees with the cochlea angle. The insertion trauma was observed in one section of a temporal bone. The mean distance from electrode to modiolus was about 0.75 millimeter. CONCLUSION: The incidence, severity of trauma and insertion depth of the studied electrode showed similar results with that of other straight type electrode in literature.

A study of insertion depth of gutta percha cones after shaping by Ni-Ti rotary files in simulated canals / 대한치과보존학회지

The purpose of this study was to evaluate the insertion depth of several brands of master gutta percha cones after shaping by various Ni-Ti rotary files in simulated canals. Fifty resin simulated J-shape canals were instrumented with ProFile, ProTaper and HEROShaper. Simulated canals were prepared with ProFile .04 taper #25 (n = 10), .06 taper #25 (n = 10), ProTaper F2 (n = 10), HEROShaper .04 taper #25 (n = 10) and .06 taper #25 (n = 10). Size #25 gutta percha cones with a .04 & .06 taper from three different brands were used: DiaDent; META; Sure-endo. The gutta percha cones were selected and inserted into the prepared simulated canals. The distance from the apex of the prepared canal to the gutta percha cone tip was measured by image analysis program. Within limited data of this study, the results were as follows 1. When the simulated root canals were prepared with HEROShaper, gutta-percha cones were closely adapted to the root canal. 2. All brands of gutta percha cones fail to go to the prepared length in canal which was instrumented with ProFile, the cones extend beyond the prepared length in canal which was prepared with ProTaper. 3. In canal which was instrumented with HEROShaper .04 taper #25, Sure-endo .04 taper master gutta percha cone was well fitted (p < 0.05). 4. In canal which was instrumented with HEROShaper .06 taper #25, META .06 taper master gutta percha cone was well fitted (p < 0.05). As a result, we concluded that the insertion depth of all brands of master gutta percha cone do not match the rotary instrument, even though it was prepared by crown-down technique, as recommended by the manufacturer. Therefore, the master cone should be carefully selected to match the depth of the prepared canal for adequate obturation.

A study of insertion depth of buchanan plugger after shaping using NI-TI rotary files in simulated resin root canals / 대한치과보존학회지

This study was conducted to evaluate the insertion depth of Buchanan plugger after shaping by various Ni-Ti rotary files. It was conducted to determine which size of plugger are appropriate, when root canals are shaped with Ni-Ti rotary files and obturated by Continuous wave of condensation technique. Two type of eighty simulated resin blocks were used : J-shaped and straight shaped canal. The simulated canals were instrumented by ProTaper and ProFile. Buchanan pluggers were inserted into the canal, and then the image was recorded to scanner. The distance from the apex of the canal to the plugger tip was measured by image analysis program. Data were analyzed by one-way ANOVA followed by Scheffe's test. The results were as follows 1. In straight canal finished up to ProTaper F2 and F3 file, F and FM pluggers were inserted more than 5 mm short of working length. 2. In J-shaped canal finished up to ProTaper F2 file, F pluggers were inserted more than 5 mm short of working length. Finished up to ProTaper F3 file, F and FM pluggers were inserted more than 5 mm short of working length. 3. In straight and J-shaped canal finished up to ProFile .06/#20 and .06/#25, any of Buchanan plugger could not be inserted more than 5 mm short of working length. These results suggest that canals shaped by ProTaper could be obturated by Continuous wave of condensation technique with F and FM size Buchanan plugger.

Evidence in Safety Issue of Acupuncture (1) / 全日本鍼灸学会雑誌

Knowledge and procedures regarding safe acupuncture practices often include conjecture and anecdotes lack-ing scientific evidence. In order to improve the safety standards of acupuncture, we should collect, scrutinize, and apply evidence on the safe management of acupuncture. We, the Committee for Safe Acupuncture, have commenced collecting and reviewing relevant evidence published. Subjects in 2004 were as follows : <BR>1. The present situation of safety education and damages (by Katai) <BR>2. Hand washing and finger disinfection (by Ishizaki) <BR>3. Disinfection of the needle insertion area (by Umeda) <BR>4. Procedures of needle insertion and removal (by Miyamoto) <BR>5. Safe insertion depth (by Yamashita) <BR>6. Environmental sanitation (by Egawa) <BR>We hope that the knowledge and questions which come to light through the present work will influence school education, clinical practice, manual editing and research activities.