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Rev. bras. oftalmol ; 81: e0012, 2022. graf
Article in English | LILACS | ID: biblio-1360916


ABSTRACT Objective: A unusual case of ocular toxoplasmosis with significant vitreomacular traction is reported. The patient improved significantly following pars plana vitrectomy combined with visual stimulation and occlusion therapy. Methods: The case of a 5-year-old girl with significant unilateral vision loss associated with vitreous condensation and macular traction is described. Results: Pars plana vitrectomy was carried out for vitreomacular traction release. This was followed by visual stimulation and occlusion therapy. Significant improvement was observed. Conclusion: Despite structural damage, the combination of properly indicated surgery and amblyopia management strategies allowed the achievement of maximum vision goals in this case, suggesting structural damage may be associated with functional amblyopia.

RESUMO Objetivo: Relata-se um caso de apresentação atípica de toxoplasmose ocular, com importante tração vitreomacular. A paciente apresentou melhora significativa após vitrectomia via pars plana, com estimulação visual e oclusão. Métodos: Descreve-se o caso de uma menina de 5 anos, com importante perda de visão unilateral associada à condensação vítrea e à tração macular. Resultados: Foi realizada vitrectomia via pars plana para alívio da tração vitreomacular, seguida de estimulação visual e oclusão. Foi observada melhora significativa. Conclusão: Apesar dos danos estruturais, a combinação de cirurgia bem indicada com estratégias de tratamento da ambliopia permitiu alcançar o máximo do potencial visual nesta paciente, sugerindo que os danos estruturais podem estar associados à ambliopia funcional.

Humans , Female , Child, Preschool , Photic Stimulation , Vitrectomy/methods , Tissue Adhesions/surgery , Toxoplasmosis, Ocular/complications , Chorioretinitis/etiology , Epiretinal Membrane/surgery , Epiretinal Membrane/etiology , Traction , Chorioretinitis/complications , Vitreous Detachment/therapy , Vitreoretinal Surgery
Arq. bras. neurocir ; 40(1): 101-106, 29/06/2021.
Article in English | LILACS | ID: biblio-1362259


Traumatic atlantoaxial rotatory subluxation (AARS) is generally found in pediatric patients, rarely found in adults, being a life-threatening condition especially when early diagnosis is not possible, which can lead to severe late neurological deficits.We describe a 38-year-old patient, victim of physical aggression caused by strangulation attempt who developed AARS, an uncommontraumatic cause. During the hospital care, the early diagnosis allowed us to institute a conservative treatment, which made the case uncommon, since most of the time surgical treatment is imperative. With the patient awake and under analgesia, a closed reduction was performed that promoted immediate pain relief, followed by a prescription of wearing a Philadelphia-type collar for 8 weeks. During the follow-up, cervical spine radiographies demonstrated no subluxation after removing the cervical collar. The patient was asymptomatic after 6months of treatment. This case supports the importance of nonoperative management of AARS in selected cases.

Humans , Female , Adult , Atlanto-Axial Joint/injuries , Cervical Vertebrae/injuries , Joint Dislocations/therapy , Spinal Injuries/therapy , Traction/rehabilitation , Manipulation, Spinal/methods , Joint Dislocations/diagnostic imaging
Coluna/Columna ; 20(1): 68-69, Jan.-Mar. 2021. graf
Article in English | LILACS | ID: biblio-1154013


ABSTRACT Halo-gravity traction is an option that can be used in the treatment of severe spinal deformities. The author reports a complication not yet described in the literature in which rapid correction of the deformity triggered the Bezold Jarisch reflex. Level of evidence IV; Case Series.

RESUMO A tração halo-craniana é uma opção que pode ser utilizada no tratamento de deformidades severas da coluna vertebral. O autor relata uma complicação, ainda não descrita na literatura, em que a rápida correção da deformidade desencadeou o reflexo de Bezold Jarish. Nível de evidência IV; Série de Casos.

RESUMEN La tracción halo-craneal es una opción que puede ser usada para el tratamiento de deformidades severas de columna vertebral. El autor relata una complicación, aún no descrita en la literatura, en que la rápida corrección de la deformidad desencadenó el reflejo de Bezold Jarish. Nivel de evidencia IV; Serie de Casos.

Humans , Scoliosis , Spine , Traction
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58(n.esp): e174325, 2021.
Article in English | LILACS, VETINDEX | ID: biblio-1348189


Donkeys have a long history in the development of human societies. Typically referred to as a beast of burden, traditional uses for donkeys have included the transportation of goods and people, use in agricultural and forestry activities, to access water, and provide citizens in low- and middle-income countries a means of making an income for communities. However, the rise of mechanization, the development of modern farming techniques, and the increasing availability of motorized vehicles have led to donkeys and mules becoming redundant from traditional roles in many parts of the world. We provide examples of where donkeys have successfully transitioned from traditional roles to new, non-traditional roles in Europe and North America, and demonstrate that, although the roles and use of donkeys and mules are changing in a rapidly developing world, we can learn lessons from the past and apply them to current challenges. As the need for working equids declines in transport and agriculture, they still hold great value for recreational, therapeutic, and environmentally friendly methods of animal traction.(AU)

Os jumentos têm uma longa história no desenvolvimento das sociedades humanas. Normalmente referidos como bestas de carga, seus usos tradicionais incluem o transporte de pessoas e bens, atividades agrícolas e florestais, acesso a água, assim como oferecer uma forma de rendimento para comunidades em países de rendimento baixo e médio. No entanto, o aumento da mecanização, o desenvolvimento de técnicas agrícolas modernas e maior disponibilidade de veículos motorizados fizeram com que os jumentos e os muares se tornassem desnecessários nos seus papéis tradicionais em muitas partes do mundo. Neste artigo os autores fornecem exemplos onde os jumentos fizeram a transição, com sucesso, dos papéis tradicionais para novos papéis não tradicionais, tanto na Europa como na América do Norte; e demonstramos que, embora o papel e o uso de jumentos e muares estejam mudando num mundo em rápido desenvolvimento, podemos aprender lições com o passado e aplicá-las aos desafios atuais. À medida que diminui a necessidade de equídeos de trabalho no transporte e na agricultura, eles ainda têm grande valor no que toca a fins recreativos, terapêuticos e ecológicos no uso de tração animal.(AU)

Animals , Traction , Equidae/anatomy & histology , Equidae/growth & development
Article in Chinese | WPRIM | ID: wpr-943020


Endoscopic full-thickness resection (EFTR) allows completely resecting deep submucosal tumors (SMTs) in the gastrointestinal wall, which has a broad application prospect in clinic. However, its application and promotion are limited by complex surgical procedures and high surgical risk. Various auxiliary traction techniques are expected to reduce the operation difficulty and risk of EFTR and improve its operative success rate. To provide a reference for clinicians, we summarize various auxiliary traction techniques in EFTR in this article. The clip-with-line method is simple to operate and widely used, whereas its traction is limited and there is a risk of clip falling off. The snare traction method and the clip-snare traction method has advantage of large traction force, but its thrust is affected by the hardness of snare. The traction point of the grasping forceps traction method is flexible and easy to adjust. Nevertheless, it requires the use of a dual-channel upper endoscope, which is difficult to operate. The transparent cap traction method and the full-thickness resection device traction method takes a short time and is easy to promote, whereas the resectable lesion is limited, and the size of the lesion may affect the success rate. In contrast, the suture loop needle-T-tag tissue anchors assisted method has a large resection range, but the operation is complicated and the feasibility has not been verified. The robot-assisted method has flexible operation and excellent visualization, whereas it is expensive and difficult to operate. There is no report of the application of magnetic anchor technology in EFTR, but it may have good application prospects in the auxiliary traction of EFTR.

Endoscopic Mucosal Resection , Gastroscopy , Humans , Traction
Article in Chinese | WPRIM | ID: wpr-942609


Objective: To compare the therapeutic efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This is a multicenter randomized controlled trial. From March 2017 to July 2019, moderate to severe OSAHS patients from three clinical center in Shanghai who were intolerant to continuous positive airway pressure (CPAP) and with velopharyngeal and glossopharyngeal plane obstruction were enrolled in this study. According to the surgical type, they were 1∶1 randomized to HUPPP plus radiofrequency ablation of tongue base group (Ablation group) or HUPPP plus traction of tongue base group (Traction group). All patients completed over-night standard Polysomnography (PSG), upper-airway assessment (Friedman classification, Müller test, CT and cephalometric examination), preoperative routine examination, Epworth Sleepiness Scale (ESS) and Quebec sleep questionnaire (QSQ). Six to 12 months after operation, all the above-mentioned examinations were repeatedly performed. Changes of aforementioned variables before and after operation were assessed. Results: A total of 43 patients with moderate to severe OSAHS were enrolled in this study. One patient lost to follow-up, the remaining 21 were allocated to Ablation group and 21 were allocated to Traction group. The total therapeutic efficacy of all patients was 69.05% (61.90% in Ablation group and 76.19% in Traction group), but there was no statistical significance between the two groups (P= 0.317). The value of sleep scale score (ESS and QSQ), objective sleep variables (apnea-hypopnea index, oxygen saturation, percentage of time with blood oxygen less than 90% in total sleep time, oxygen desaturation index and micro-arousals) and upper airway cross-sectional area (palatopharyngeal and retrolingual area) of the two groups were improved (P<0.05), but the differences between the two groups were not statistically significant (P>0.05). Conclusion: For moderate to severe OSAHS who had glossopharyngeal plane obstruction, both HUPPP plus radiofrequency ablation of tongue base or HUPPP plus traction of tongue base are effective treatment for OSAHS, and the curative effect is similar. The choice of surgical type could be selected according to patient's or surgical conditions.

China , Humans , Oxygen Saturation , Radiofrequency Ablation , Sleep Apnea, Obstructive/surgery , Tongue/surgery , Traction
Article in Chinese | WPRIM | ID: wpr-879380


OBJECTIVE@#To explore clinical effects of pulley suspension traction reduction combined with self-made splint fixation in treating extended distal radius fracture.@*METHODS@#From December 2017 to December 2019, 60 patients with extended distal radius fractures were divided into observation group and control group, 30 patients in each group. In observation group, there were 12 males and 18 females, aged from 50 to 75 years old with an average of (59.63±8.08) years old;according to AO classification, 25 patients were type A2 and 5 patients with type A3;fractures were fixed by pulley suspension traction and self-made splint. In control group, there were 11 males and 19 females, aged from 52 to 76 years old with an average of (59.77±8.03) years old;according to AO classification, 24 patients were with type A2 and 6 patients were type A3;fractures were treated by conventional manipulation with self-made splint fixation. The radius height, ulnar angle and palmar angle between two groups were compared before and after treatment, and clinical effects were evaluated by advanced Green and O'Brien wrist joint scoring after treatment.@*RESULTS@#All patients were followed up from 11 to 13 months with an average of (11.90± 0.80) months. The splint was removed for 42 to 60 days with an average of (50.20±4.94) days. After removal of splint, X-rays indicated that all patients obtained bone healing with smooth of joint surface. In observation group, radius height was (4.57± 1.16) mm, ulnar angle was (12.83±3.25) °, palmar angle were (-21.17±3.36) ° respectively before treatment, (10.10± 1.75) mm, (24.30±3.16) °, (9.40±2.13) ° respectively at 8 weeks after treatment;in control group, radius height, ulnar angle, palm angle were (4.50±1.43) mm, (12.83±3.10) °, (-21.50±3.38) ° respectively before treatment, and (8.90±1.24) mm, (21.20±2.91) °, (6.16±2.94) ° respectively at 8 weeks after treatment;there were no significant difference in radius height, ulnar deviation angle and palmar inclination between two groups before treatment (@*CONCLUSION@#Compared with conventional manual traction and reduction, pulley suspension traction reduction combined with self made splint fixation for the treatment of extended distal radius fracture has more advantages with stable and reliable traction, good reduction, and better wrist joint function. It could be selected and applied according to the actual situation of patients.

Aged , Bone Plates , Female , Fracture Fixation, Internal , Humans , Male , Middle Aged , Radius Fractures/surgery , Splints , Traction , Treatment Outcome
Rev. bras. ortop ; 55(6): 771-777, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156205


Abstract Objective To evaluate different femoral fixation devices for medial patellofemoral ligament reconstruction and compare their effectiveness regarding fixation strength up to failure in porcine knees. Methods Thirty porcine knees were used, divided into three groups of 10 knees. The removed grafts were dissected from the extensor tendons of porcine feet. In each group, the graft was fixed to the femur with an interference screw, an anchor, or adductor tenodesis. The three methods were subjected to biomechanical tests using a universal Tensile testing machine at a speed of 20 mm/minute. Results The highest average linear resistance under lateral traction occurred in group 1, "screw fixation" (185.45 ± 41.22 N), followed by group 2, "anchor fixation" (152.97 ± 49, 43 N); the lower average was observed in group 3, "tenodesis fixation" (76.69 ± 18.90 N). According to the fixed error margin (5%), there was a significant difference between groups (p < 0.001); in addition, multiple comparison tests (between group pairs) also showed significant differences. Variability was small, since the variance coefficient was lower than 33.3%. Conclusion Interference screws in bone tunnels and mountable anchors fixation with high resistance wire are strong enough for femoral fixation in porcine medial patellofemoral ligament reconstruction. Adductor tenodesis, however, was deemed fragile for such purpose.

Resumo Objetivo Avaliar diferentes dispositivos de fixação femoral na reconstrução do ligamento patelofemoral medial para comparar sua eficácia quanto à força de fixação até a falha em joelhos suínos. Métodos Foram ensaiados 30 joelhos de suínos subdivididos em 3 grupos de 10 joelhos. Os enxertos retirados foram dissecados de tendões extensores das patas dos suínos. Cada grupo teve o enxerto fixado ao fêmur com parafuso de interferência, âncora, ou tenodese no tendão adutor. Os 3 métodos foram submetidos à testes biomecânicos utilizando uma máquina universal de ensaio de tração com uma velocidade de 20 mm/min. Resultados Verificamos que a média mais elevada da resistência linear sob tração lateral (185,45 ± 41,22 N) ocorreu no grupo 1: "fixação por parafuso," seguido do grupo 2: "fixação por âncora" (152,97 ± 49,43 N), e a média foi menor no grupo 3: "fixação por tenodese" (76,69 ± 18,90 N). Para a margem de erro fixada (5%), comprovou-se a diferença significativa entre os grupos (p < 0,001) e também através dos testes de comparações múltiplas (entre os pares de grupos) verificou-se a ocorrência de diferenças significativas. A variabilidade expressada por meio do coeficiente de variação mostrou-se reduzida, já que a referida medida foi inferior a 33,3%. Conclusão O uso de parafusos de interferência no túnel ósseo de joelhos porcinos é suficientemente forte para fixação femoral na reconstrução do ligamento patelofemoral medial, assim como a fixação com âncoras montáveis com fio de alta resistência. Entretanto, a tenodese no tendão adutor mostrou-se frágil para essa finalidade.

Animals , Orthopedic Fixation Devices , Swine , Tendons , Traction , Effectiveness , Biomechanical Phenomena , Bone and Bones , Suture Techniques , Transplants , Models, Animal , Tenodesis , Patellofemoral Joint , Femur , Ligaments , Methods
Int. j. morphol ; 38(4): 947-955, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124881


Trans-sutural distraction is a biological process that induces the formation of new bone and changes the position of bone by pulling on growing suture under the action of external forces. Currently, therapy to midfacial hypoplasia treated by trans-sutural distraction has been applied. In this study, Beagle dogs were selected as experimental animals, and a traction device designed by ourselves was applied to Beagle dogs to simulate the treatment process of trans-sutural distraction in human face, so as to provide a basis for the subsequent research on the related mechanism of trans-sutural distraction. The objective is that the animal model can provide the basis for the follow-up study of transsutural distraction. 45 month beagle dogs were randomly divided into two groups 3 in experiment group and 3 in control group. Implant nails were implanted as the bone marker in the bilateral zygomatic temporal suture, zygomandibular maxillary suture and palatine transverse suture in experimental group. The traction of the maxilla was carried out by the external cranial traction frame with canine fossa as bearing point, 800g force each side, elastic traction for 15 days. The control group only implanted the implant nail as the bone marker on both sides of the bone suture. The distance between two implant nails was measured by vernier calipers and X-ray examination, compared with preoperative and postoperative changes. X-ray and cephalometric measurements were used to measure change in the cranial basal angle. HE staining was used to observe the width of the bone seams, the morphology and structure of the cells and the tissue of the new bone under the phase contrast microscope. Then descriptive statistical analysis and t-test between two independent samples are carried out for the measurement data. The experimental group had a good retention of the beagle traction frame. In the experimental group, the maxillaries of dogs were protrudent in the process of traction gradually and the occlusal relationship changed to type II malocclusion. When the traction is 15 days, the coverage distance is about 8~9 mm. Before and after the traction, the distance between landmark points indicated that the spacing between the transverse palatine suture was the largest (experimental group: 5.52±0.19 mm control group 1.31±0.06 mm P<0.05), and zygomaticotemporal suture was the second (experimental group: 3.12±0.15 mm, control group 0.73±0.04 mm, P<0.05), and zygomaticomaxillary suture was less (experimental group: 2.60±0.34 mm, control group 0.53±0.05 mm, P<0.05). The cranial basal angle was no change before and after operation (controlgroup: 32.3±1.3°, experimental group: 33.2±1.1° P>0.05. Histology showed that the collagenous fibers in the suture of the control group were denser and the osteoblasts were visible on the edge of the suture, showing osteogenic activity. The experimental group significantly widened suture (experimental group: 1209.388±42.714 µm, control group 248.276±22.864 µm, P<0.05), the number of fibroblasts increased significantly with loose collagen fiber. The direction of cell and fiber arrangement were parallel to the traction force. There were many small blood vessels and marrow cavities, and the bone trabecula around the bone suture was thin (experimental group: 23.684±3.774 mm, control group: 86.810±9.219 mm, P < 0.05), showing active osteogenic activity. The growing beagle dog can be used to establish a suture traction animal model for experimental study. In the experiment, Kirschner wire was used to penetrate the bottom plane of the piriform hole of the maxilla (about the position of the canine fossa at the back) and the traction direction was basically the same as the growth direction, and the maxilla was basically parallel and moved forward.

La distracción trans-sutural es un proceso biológico que induce la formación de hueso nuevo y cambia la posición del éste al tirar de la sutura en crecimiento bajo la acción de fuerzas externas. Actualmente, se ha aplicado la terapia para la hipoplasia de la cara media tratada por distracción trans-sutural. En este estudio, fueron seleccionados perros Beagle como animales experimentales, y un dispositivo de tracción fue instalado a los perros para simular el proceso de tratamiento de la distracción trans-sutural en el rostro humano. El objetivo fue proporcionar una base para la investigación posterior sobre mecanismos relacionados con la distracción trans-sutural. El modelo animal puede proporcionar la base para este tipo de estudio de seguimiento de la distracción trans-sutural. Perros Beagle de 45 meses de edad se dividieron aleatoriamente en dos grupos: 3 en el grupo experimental y 3 en el grupo control. Los clavos de implante se usaron como marcadores óseos en la sutura temporal cigomática bilateral, la sutura maxilar cigomandibular y en la sutura transversal palatina en el grupo experimental. La tracción del maxilar se realizó mediante el marco de tracción craneal externo con fosa canina como punto de apoyo, 800 g de fuerza a cada lado, tracción elástica durante 15 días. En el grupo control solo se implantó el clavo del implante como marcador óseo en ambos lados de la sutura. La distancia entre dos clavos de implante se midió mediante calibradores de vernier y examen de rayos X, en comparación con los cambios preoperatorios y postoperatorios. Se utilizaron mediciones cefalométricas y de rayos X para medir el cambio en el ángulo basal craneal. La tinción con HE se usó para observar el ancho de las suturas óseas, la morfología y la estructura de las células y el tejido del hueso nuevo bajo el microscopio de contraste de fase. Luego se realizó un análisis estadístico descriptivo y una prueba t entre dos muestras independientes para los datos de medición. El grupo experimental tuvo una buena retención del cuadro de tracción del Beagle. En el grupo experimental, los maxilares de los perros sobresalieron gradualmente en el proceso de tracción y la relación oclusal cambió a maloclusión tipo II. Cuando la tracción era de 15 días, la distancia de cobertura fue de aproximadamente 8 ~ 9 mm. Antes y después de la tracción, la distancia entre los puntos de referencia indicaba que el espacio entre la sutura palatina transversal era más grande (grupo experimental: 5,52 ± 0,19 mm, grupo de control 1,31 ± 0,06 mm, P <0,05), y la sutura cigomáticotemporal fue la segunda. (Grupo experimental: 3,12 ± 0,15 mm, grupo control 0,73 ± 0,04 mm, P <0,05), y la sutura cigomaticomaxilar fue menor (grupo experimental, 2,60 ± 0,34 mm, grupo control 0,53 ± 0,05 mm, P <0,05). El ángulo basal craneal no cambió antes ni después de la operación (grupo control 32,3 ± 1,3, grupo experimental, 33,2 ± 1,1 ° , P> 0,05). La histología mostró que las fibras colágenas en la sutura del grupo control eran más densas y los osteoblastos se observaron en el margen de la sutura, mostrando actividad osteogénica. En el grupo experimental se amplió significativamente la sutura (1209,388 ± 42,714 µm, grupo control 248,276 ± 22,864 µm, P <0,05), el número de fibroblastos aumentó significativamente con fibras colágenas dispersas. La dirección de la disposición de la celda y las fibras era paralela a la fuerza de tracción. Se observó gran cantidad de vasos sanguíneos pequeños, cavidades medulares, y trabéculas óseas alrededor de la sutura ósea (grupo experimental: 23,684 ± 3,774 mm, grupo control: 86,810 ± 9,219 mm, P <0,05), que mostró actividad osteogénica activa. El perro Beagle en crecimiento se puede utilizar para estudios experimentales y así establecer un modelo animal de tracción de sutura. En el proceso, se usó alambre de Kirschner para penetrar en el plano inferior del foramen piriforme del maxilar (aproximadamente en la posición de la fosa canina en la parte posterior) y la dirección de tracción fue básicamente la misma que en el crecimiento.

Animals , Dogs , Craniofacial Abnormalities/surgery , Osteogenesis, Distraction/methods , Facial Bones/surgery , Sutures , Traction , Disease Models, Animal , Malocclusion/surgery
Dent. press endod ; 10(2): 34-41, maio-ago.2020. Tab, Ilus
Article in English | LILACS | ID: biblio-1344542


Objetivo: Avaliar a influência de diferentes plugs de proteção, acomodados sobre o remanescente da obturação após preparo para pino, na retenção de pinos metálicos fundidos. Métodos: Cinquenta dentes bovinos foram decoronados, manualmente instrumentados até a lima manual Kerr #80 e obturados. A desobturação parcial de 10mm do conduto foi realizada com uma broca Largo e os grupos foram divididos de acordo com os diferentes materiais utilizados como plugs (n=10): Grupo I (Controle, sem plug); Grupo II (plug de Coltosol®); Grupo III (plug, em consistência de massa, de Sealapex® + óxido de zinco); Grupo IV (plug de etil-cianoacrilato); e Grupo V (plug de fosfato de zinco). Uma camada de 1mm de espessura dos diferentes plugs (Grupos II, III, IV ou V) foi acomodada sobre a obturação remanescente. Os espécimes foram selados e armazenados em 100% de umidade, por 7 dias. Após moldagem do conduto, foram confeccionados pinos metálicos fundidos e cimentados com fosfato de zinco. Os espécimes permaneceram em câmara úmida por 45 dias antes do teste de tração, realizado em uma máquina universal de ensaios. Os valores foram expressos em Mega pascal (MPa) e submetidos aos testes ANOVA e Tukey (p<0,05). Resultados: O etilcianoacrilato diminuiu a retenção dos pinos metálicos fundidos (p<0,01). Não houve diferença entre os outros grupos (p>0,05), semelhante- mente ao controle. Conclusão: A proteção da obturação com plugs confeccionados com etil-cianoacrilato prejudica a retenção de pinos metálicos fundidos cimentados com fosfato de zinco, enquanto Sealapex® acrescido de óxido de zinco, fosfato de zinco endurecido ou Coltosol® não interferem na adesividade (AU).

Animals , Cattle , Cementation , Dental Pulp Cavity , Endodontics , Traction , Zinc Oxide , In Vitro Techniques , Adhesiveness
Rev. bras. ciênc. vet ; 27(1): 14-18, jan./mar. 2020. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1379231


O objetivo desse trabalho foi descrever um caso de pólipo inflamatório em ouvido médio de um felino e sua resolução cirúrgica através da avulsão e tração da massa após abordagem lateral. Um felino, fêmea, de 2 anos de idade, foi atendido no Hospital Veterinário Professor Sylvio Barbosa Cardoso, apresentando prurido intenso, dor e secreção fétida em região auricular. Pelo exame físico foi possível observar um nódulo em região de ouvido médio esquerdo. Associado a isso, o animal apresentava "headtilt" (inclinação da cabeça para o lado afetado). Foram solicitados exames hematológicos, radiografia de crânio e citologia da massa. O animal foi encaminhado para cirurgia de extirpação da massa. Foi feita uma incisão na pele sob o canal auditivo vertical palpável. A cartilagem foi liberada até o nível da junção entre as cartilagens auricular e anular. Com o auxílio de um fórceps, o pólipo foi agarrado e delicadamente girado até ser completamente extirpado de sua origem. A cartilagem e o subcutâneo foram fechados com material de sutura monofilamentar 4-0 e a pele foi fechada em um padrão de sutura subdérmica usando o mesmo material. A peça foi encaminhada para exame histopatológico, pelo qual confirmou-se a suspeita de pólipo inflamatório, através da observação de epitélio colunar ciliado. Utilizando a técnica cirúrgica TALA (avulsão e tração após abordagem lateral) foi possível obter melhora do quadro clínico do animal referido, rápida recuperação pós-cirúrgica e sem nenhuma complicação decorrente da técnica. Essa técnica, portanto, se mostrou satisfatória, melhorando significativamente a qualidade de vida do animal.

The aim of this study was to describe a case of inflammatory polyp in the middle ear of a cat and its surgical resolution through avulsion and mass traction after lateral approach. A female feline, two year old, was admitted at the Hospital Veterinário Professor Sylvio Barbosa Cardoso, presenting intense itching, pain and fetid discharge in the ear region. Physical examination revealed a nodule in the left middle ear region. Associated with this, the animal presented head tilt (inclination of the head to the affected side). Hematological examinations, skull radiography and mass cytology were requested. The animal was referred for polyp removal surgery. A skin incision was made under the palpable vertical ear canal. The cartilage was released to the level of the junction between the auricular and annular cartilages. With the help of a forceps, the polyp was grasped and gently rotated until completely removed from its origin. The cartilage and subcutaneous tissue were closed with 4-0 monofilament suture material and the skin was closed in a subdermal suture pattern using the same material. The piece was referred for histopathological examination, which confirmed the suspicion of inflammatory polyp by observing ciliated columnar epithelium. Using the TALA surgical technique (avulsion and traction after lateral approach) it was possible to obtain improvement of the clinical 3 picture of the referred animal, rapid postoperative recovery and without any complications resulting from the technique. This technique therefore proves satisfying, significantly improving the quality of life of the animal.

Animals , Cats , Polyps/veterinary , Otorhinolaryngologic Surgical Procedures/veterinary , Cats/surgery , Ear Canal/surgery , Ear, Middle/surgery , Surgery, Veterinary/methods , Traction/veterinary
Article in Chinese | WPRIM | ID: wpr-828909


OBJECTIVE@#To investigate the effect of orthodontic traction on the microstructure of dental enamel.@*METHODS@#Forty-eight isolated premolars were randomly divided into 6 groups (=8), including Group A (blank control group), in which the teeth were bonded with the orthodontic brackets without any loading force; Groups B1, B2, and B3 where the teeth were bonded with the orthodontic brackets using clinical adhesives and loaded with 50 g force for 6 months, 200 g force for 6 months, and 200 g force for 1 month, respectively; and Groups C1 and C2, where the teeth were bonded with straight wire brackets using light curing bonding and chemical curing bonding techniques, respectively. All the teeth were embedded with non-decalcified epoxy resin. Scanning electron microscope (SEM), atomic force microscope (AFM), and energy spectrometer (EDS) were used to analyze interface morphology and elemental composition of the teeth sliced with a hard tissue microtome.@*RESULTS@#Compared with those in Group A, the teeth in the other 5 groups showed increased adhesive residue index with microcracks and void structures on the enamel surface under SEM; AFM revealed microcracks on the enamel surface with angles to the grinding direction. A larger loading force on the bracket resulted in more microcracks on the enamel interface. The interface roughness differed significantly between Groups A and C2, and the peak-to-valley distance differed significantly between Groups A, C, and C2.@*CONCLUSIONS@#Orthodontic traction can cause changes in the microstructure of normal dental enamel.

Dental Enamel , Materials Testing , Orthodontic Brackets , Resin Cements , Surface Properties , Traction
Article in Chinese | WPRIM | ID: wpr-828290


OBJECTIVE@#To explore the clinical effect of the treatment of Fernandez type Ⅲ fracture of the distal radius with hyperextension traction prying, volar reduction, bone grafting and internal fixation.@*METHODS@#From February 2017 to March 2018, 11 cases of Fernandez type Ⅲ fracture of the distal radius were treated with intraoperative hyperextension traction and volar prying reduction and bone grafting and internal fixation, including 6 males and 5 females, aged 55 to 67 years. Preoperative X-ray and CT evaluated the distal radius fracture dorsal angulation with articular surface compression, collapse. According to Fernandez, all of them were type Ⅲ. After operation, the reduction of articular surface and fracture healing were evaluated. VAS score and Cooney wrist score were used to evaluate the curative effect.@*RESULTS@#All the patients were followed up for 12 to 14 months. All the fractures healed. Cooney wrist score scale was used to evaluate the curative effect, 9 cases were excellent, 1 case was good and 1 case was fair.@*CONCLUSION@#In the operation of Fernandez type Ⅲ fracture of the distal radius, hyperextension traction was used to enlarge the angle, and through the volar fracture end prying reduction and internal fixation with bone graft, the collapsed articular surface could be effectively reduced and fixed. The early functional exercise after the operation had satisfactory clinical effect.

Aged , Bone Plates , Bone Transplantation , Female , Fracture Fixation, Internal , Humans , Male , Middle Aged , Radius , Radius Fractures , General Surgery , Range of Motion, Articular , Traction , Treatment Outcome , Wrist
Article in Chinese | WPRIM | ID: wpr-827238


OBJECTIVE@#To observe the application of modified traction therapy in traumatic atlantoaxial subluxation in adults.@*METHODS@#The clinical data of 31 patients with atlantoaxial subluxation treated from March 2018 to June 2019 were restropectively analyzed. There were 15 males and 16 females, aged from 18 to 68 years old with an average of 39 years old, including 10 cases of 18-40 years, 15 cases of 41-60 years, 6 cases of 51-68 years. The main manifestations of the patients were limited neck movement, pain, and atlantoaxial CT scan showed different degrees of atlantoaxial subluxation. Three dimensional multifunctional traction bed was used for traction for 2 min, relaxation for 10 s. The traction angle starts from the rearward extension of 5°-10° and weight from 3-6 kg. The weight increased by 1 kg every two days until the symptoms were improved. Traction time was 30 min twice a day and 10 days for a course of treatment. One course of treatment was performed in patients with 1-2 mm left and right equal width of atlantoaxial space, and two courses of treatment were performed in patients with 3-4 mm left and right equal width of atlantoaxial space, and the course of treatment could be increased to 3 months in especially patients with serious problems, such as 4 mm left and right equal width of atlantoaxial space and no improvement after conventional treatment. The criteria to evaluate the clinical effect was cure:no pain in the neck, normal range of neck movement, CT showed normal atlantoaxial space and odontoid process was in the middle, patients with normal neck movement were followed up 1 month after the end of treatment;improvement:neck pain was significantly improved and CT showed that the left and right atlantoaxial space was less than 1 mm in equal width.@*RESULTS@#Among the 31 patients, 17 cases were cured by one course of treatment, 11 cases were cured by 2 courses of treatment, and 2 caseswere improved.@*CONCLUSION@#The modified traction therapy has obvious effect on adult traumatic atlantoaxial subluxation, especially the subluxation of 3-4 mm equal width in left and right atlantoaxial space, and this method is safe and reliable with good efficacy and the patients without discomfort.

Adolescent , Adult , Aged , Atlanto-Axial Joint , Female , Humans , Joint Dislocations , Male , Middle Aged , Odontoid Process , Spinal Fusion , Traction , Young Adult
Article in Chinese | WPRIM | ID: wpr-942089


OBJECTIVE@#To evaluate the clinical efficacy of short-term halo-pelvic traction (HPT) combined with surgery in the treatment of severe spinal deformities.@*METHODS@#In the study, 24 patients diagnosed as severe spinal deformity accepted the treatment of one-stage short-term HPT and two-stage surgery from January 2015 to May 2018 in our orthopedics department. 24 cases (9 males and 15 females) were retrospectively reviewed. The average age of the cohort was (28.8±10.0) years (12-48 years). The height, scoliosis angle, kyphosis angle, the height difference of shoulders, the height difference of crista iliaca, C7PL-CSVL and the perpendicular distance of S1 and the convex point of the patients were assessed at pre-traction, post-traction and post-surgery. The paired t test was used to analyze the difference among pre-traction, post-traction and post-surgery.@*RESULTS@#The average traction time of 24 cases was (2.5±1.1) weeks (1-5 weeks). The height of pre-traction and post-traction were (141.7±11.2) cm (116-167 cm) and (154.1±9.5) cm (136-176 cm) respectively, showing significant difference (P < 0.05), and the increased height was (12.4±4.6) cm (4-20 cm). The average scoliosis angle before traction was 104.9°±35.0°(25°-158°), and it was significantly decreased in post-traction[64.8°±21.0°(19°-92°)] and post-surgery[39.3°±17.0° (10°-70°)] (P < 0.05). The traction's coronal correction rate was 37.2%±10.9% (11.9%-51.2%) and the total coronal correction rate was 61.9%±12.6%(26.9%-79.0%). The average kyphosis angle before traction was 106.9°±29.2°(54°-163°), and it was significantly decreased in post-traction [63.1°±17.1°(32°-92°)] and post-surgery [39.0°±16.8°(10°-68°)](P < 0.05). The traction's sagittal correction rate was 40.0%±10.7%(16.7%-55.5%) and the total sagittal correction rate was 64.3%±10.7%(49.0%-87.5%). The average C7PL-CSVL before traction was (3.2±2.8) cm, and it was significantly decreased in post-traction [(2.5±2.5) cm] (P < 0.05). The perpendicular distance of S1 and the convex point before traction was (10.5±4.8) cm, and it was significantly decreased in post-traction[(8.4±3.5) cm] (P < 0.05).@*CONCLUSION@#The one-stage short-term HPT combined with two-stage surgery is a safe and effective procedure for severe spinal deformities. The clinical efficacy is satisfactory and the complication is relatively less.

Adolescent , Adult , Female , Humans , Kyphosis/surgery , Male , Retrospective Studies , Scoliosis/surgery , Traction , Treatment Outcome , Young Adult
Article in Korean | WPRIM | ID: wpr-811313


PURPOSE: We investigated the long-term outcomes of vitrectomy with internal limiting membrane (ILM) peeling as treatment for myopic traction maculopathy (MTM).METHODS: The medical records of patients who underwent vitrectomy to treat MTM were retrospectively evaluated. We excluded patients who exhibited macular holes (MHs) or retinal detachment at the time of primary surgery. The best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were analyzed preoperatively, at 3, 6, 12, and 24 months after surgery, and at the final visit. Complications including retinal detachment or an MH were noted during follow-up.RESULTS: Twenty-three eyes of 22 patients were enrolled. At the time of primary surgery, the mean patient age was 64.4 ± 11.1 years and the baseline mean logMAR BCVA and CFT, 0.67 ± 0.50 and 431.8 ± 159.5 µm, respectively. The mean follow-up period was 53.7 ± 19.3 months. The mean logMAR BCVAs at 3, 6, 12, and 24 months postoperatively and at the final visit were 0.42 ± 0.39 (p = 0.001), 0.41 ± 0.38 (p = 0.001), 0.39 ± 0.40 (p < 0.001), 0.42 ± 0.43 (p < 0.001), and 0.51 ± 0.47 (p = 0.016), respectively, thus significantly better than the baseline value. The mean CFT at 3, 6, 12, and 24 months postoperatively and at the final visit were 244.6 ± 72.3, 210.5 ± 79.1, 209.6 ± 91.6, 219.8 ± 93.9, and 217.7 ± 81.3 µm, respectively, thus significantly less than baseline (all p < 0.001). MTM resolved in 18 eyes (78.3%) after primary surgery, without any complication, and remained stable to the final visit.CONCLUSIONS: Vitrectomy with ILM peeling afforded favorable long-term efficacy and safety in MTM patients.

Follow-Up Studies , Humans , Medical Records , Membranes , Myopia, Degenerative , Prognosis , Retinal Detachment , Retinal Perforations , Retinoschisis , Retrospective Studies , Traction , Visual Acuity , Vitrectomy
Rev. bras. ortop ; 54(6): 697-702, Nov.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1057951


Abstract Objective Comparative biomechanical analysis of tibial fixation strength for ligament reconstruction with interference screw compared with screw post and washer, and compared with the associated fixation of both methods (hybrid fixation). Method A total of 54 specimens were used (porcine tibias and bovine flexor digital tendons), which were divided into three groups with fixation types similar to those used in anterior cruciate ligament (ACL) reconstruction: 1) fixation with interference screw; 2) fixation with screw post and toothed washer over knot and suture strand; and )- fixation with screw post and washer combined with interference screw (hybrid fixation). The analyses were performed through pull-out biomechanical tensile tests to determine the stiffness and load to system failure (yield load). Results The hybrid fixation group presented a significantly higher final stiffness (59.10 ± 3.45 N/mm) in comparison to the other groups (p < 0.05) and a higher yield load (581.34 ± 33.48 N) compared to the interference screw group (p < 0.05). Conclusion Hybrid fixation had biomechanical advantages over the bovine digital flexor graft fixation system in swine tibia during tensile tests.

Resumo Objetivo Análise biomecânica comparativa da resistência da fixação tibial para reconstrução ligamentar com parafuso de interferência, comparada com parafuso do tipo poste com arruela, e com fixação associada entre os métodos (fixação híbrida). Métodos Foram utilizados 54 corpos de prova (tíbia suína e tendão digital bovino), que foram divididos em 3 grupos com tipos de fixação semelhantes àqueles utilizados na reconstrução do ligamento cruzado anterior: 1) fixação com parafuso de interferência; 2) fixação com parafuso do tipo poste com arruela dentada sobre nó e fios de sutura; e 3) fixação com parafuso do tipo poste com arruela combinada com parafuso de interferência (fixação híbrida). Os testes foram realizados por meio de ensaios biomecânicos de tração tipo pull-out para determinação da rigidez e carga para falha (yield load) do sistema. Resultados O grupo com fixação híbrida apresentou maior rigidez final (59,10 ± 3,45 N/mm) do que os demais grupos (p < 0,05), e carga superior para falha (581,34 ± 33,48 N) em relação ao grupo com parafuso de interferência (p < 0,05). Conclusão A fixação híbrida apresentou vantagens biomecânicas com relação ao sistema de fixação do enxerto de flexor digital bovino em tíbia suína durante os ensaios de tração.

Animals , Swine , Tendons , Tibia , Traction , Cattle , Anterior Cruciate Ligament , Surgical Fixation Devices , Anterior Cruciate Ligament Reconstruction , Ligaments
Rev. odontol. Univ. Cid. São Paulo (Online) ; 31(3): [71,81], set.-dez. 2019.
Article in Portuguese | LILACS | ID: biblio-1102953


O canino é um elemento dental com alta importância para se conseguir uma oclusão balanceada e uma estética favorável, porém existe uma grande prevalência de impactação, podendo causar consequências tanto na estética quanto na fonética do paciente. É importante tracionar os caninos sempre que possível, em função de seu valor morfofuncional e estético, especificamente, nos movimentos funcionais da mandíbula. Este estudo teve como objetivo rever a literatura sobre o tracionamento de caninos inclusos. Concluiu-se que o tracionamento ortodôntico visa trazer o dente impactado para o arco, entretanto deve começar o mais cedo possível. Optando-se pelo tracionamento, o prognóstico desta conduta deve ser definido previamente, assim como seus riscos potenciais devem ser apresentados aos pais e paciente. O resultado do controle dos efeitos colaterais e a montagem de um sistema de ancoragem eficiente, que não afete os tecidos e os dentes adjacentes, é um dos fatores que contribui para o sucesso do tracionamento de caninos inclusos. Diversas técnicas estão disponíveis para tracionar e alinhar caninos inclusos, dentre elas os aparelhos ortodônticos fixos ou removíveis, a utilização de ancoragem na mesma arcada ou na arcada oposta e a utilização de forças provindas de magnetos associados à placa removível. Em alguns casos a utilização de mini-implantes provisórios é necessária para a ancoragem dos dentes inclusos. O ortodontista deve saber que, apesar dos inconvenientes que podem ocorrer durante todo o tratamento, é preciso fazer o possível para realizar uma conduta clínica adequada e evitar extrações dos caninos permanentes, uma vez que estes são importantes para o estabelecimento e manutenção da forma e função do arco dentário.

The canine has a great importance to achieve a balanced occlusion and a favorable aesthetic, but there is a high prevalence of impaction, which can have consequences both in the aesthetics and in the phonetics of the patient. It is important to draw the canines whenever possible, depending on their morphofunctional and aesthetic value, specifically, on the functional movements of the mandible. This study aimed to review the literature on the canine traction included. It was concluded that orthodontic traction aims to bring the impacted tooth to the arch, however it should start as soon as possible. By opting for traction, the prognosis of this behavior must be defined previously, as well as its potential risks should be presented to the parents and patient. The effect of the control of side effects and the assembly of an efficient anchorage system, which does not affect adjacent tissues and teeth, is one of the factors that contributes to the successful canine traction. Various techniques are available for traction and aligning canines included, including fixed or removable orthodontic appliances, the use of anchorage in the same arch or opposite arch and the use of forces from magnets associated with the removable plate. In some cases the use of temporary mini implants is necessary for anchoring the included teeth. The orthodontist should be aware that despite the inconveniences that may occur during the entire treatment, care must be taken to conduct adequate clinical management and avoid extractions of permanent canines, since these are important for establishing and maintaining the shape and function of the canine dental arch.

Humans , Male , Female , Traction , Cuspid