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The International Journal of Angiology... Dec 2018The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present...
The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffbox AVF. A 10-year prospective study (2006-2016) involving 31 patients whose distal cephalic vein diameter was ≥3 mm with a normal Allen's test was conducted. Patients were excluded if the radial artery in the wrist was highly calcified, the cephalic vein did not dilate more than 3 mm with proximal compression, and there was previously failed AVF of the limb or previous trauma to the limb. The procedure was performed under local anesthetic, and the anastomosis performed with a 6.0 polypropylene suture in an end-to-side fashion. Thirty-one patients with end-stage renal disease underwent distal vascular access using the distal-to-snuffbox (Hitchhiker's) AVF (HAVF). During follow-up, eight patients died with an adequately functioning HAVF. The primary patency rates at 12, 24, 48, and 60 months were 90, 87, 85, and 82%, respectively. Failure occurred in six (19%) cases over the follow-up period, two in the first 2 weeks and four over a span of 60 months. The creation of radiocephalic AVFs in the first web space, distal to the tendon of the extensor pollicis longus, serves as a viable option with acceptable success rates. This allows the surgeon more options with proper patient selection for this procedure.
PubMed: 30410295
DOI: 10.1055/s-0038-1660803 -
International Journal of Sports... Apr 2019Distal biceps rupture is less common than injury to the proximal biceps; however, injury distally has profound functional implications on activities which rely on power...
BACKGROUND AND PURPOSE
Distal biceps rupture is less common than injury to the proximal biceps; however, injury distally has profound functional implications on activities which rely on power during elbow flexion and forearm supination. The majority of distal biceps ruptures can be treated with surgical repair of the distal biceps utilizing either a single or two-incision technique; both of which achieve comparable improved outcomes and reported minimal pain and disability at two years. Safe and effective rehabilitation following distal biceps repair is accomplished through a phased progression, with avoidance of premature stress to the healing soft tissue repair.The purpose of this clinical commentary is to provide a concise review of distal biceps tendon injury, including relevant anatomy, etiology, diagnosis, and operative intervention as well as post-operative factors influencing the pursuit of a criterion based, progressive rehabilitation program after distal biceps tendon repair. This commentary seeks to provide an update on current treatment strategies used in distal biceps rehabilitation with accompanying scientific rationale.
LEVEL OF EVIDENCE
5.
PubMed: 30997282
DOI: No ID Found -
The Angle Orthodontist Jul 2020To determine three-dimensional treatment changes produced by the Class II Carriere Motion appliance (CMA) in Class II adolescent patients with Class I and Class II...
OBJECTIVES
To determine three-dimensional treatment changes produced by the Class II Carriere Motion appliance (CMA) in Class II adolescent patients with Class I and Class II skeletal relationships.
MATERIALS AND METHODS
The sample included 59 adolescents (16 boys and 43 girls) with unilateral or bilateral Class II molar and bilateral Class II canine relationship. They were divided into group 1 with skeletal Class I (N = 27; ANB 2.90° ± 1.40°; 13.30 ± 1.53 years) and group 2 with skeletal Class II (N = 32; ANB 6.06° ± 1.64°; 13.26 ± 1.76 years). Cone beam computed tomography images were traced with Invivo software pretreatment (T1) and post-CMA usage (T2). The treatment changes in 36 measurements were calculated in each group, and the changes in 16 measurements were compared between them.
RESULTS
In group 1 and 2, maxillary first molars underwent significant distal movement (1.92 mm ± 0.80 mm and 1.67 mm ± 1.56 mm, respectively) with distal tipping and rotation, maxillary canines underwent significant distal movement (2.34 mm ± 1.07 mm and 2.24 mm ± 1.91 mm, respectively) with distal tipping and rotation, and mandibular molars underwent significant mesial movement (-1.37 mm ± 1.23 mm and -2.51 mm ± 1.51 mm, respectively) with mesial tipping. Between the groups, there were significant differences in mandibular molar mesial movement and the U1-SN changes (P < .05).
CONCLUSIONS
The CMA corrected Class II malocclusion through distal tipping and rotational movement of maxillary canines and molars and corrected mesial tipping of mandibular molars. Significantly more mandibular molar mesial movement and maxillary incisor flaring were observed in patients with skeletal Class II.
Topics: Adolescent; Cephalometry; Female; Humans; Incisor; Male; Malocclusion, Angle Class II; Maxilla; Molar; Orthodontic Appliance Design; Tooth Movement Techniques
PubMed: 33378493
DOI: 10.2319/080919-523.1 -
Progress in Orthodontics Dec 2023The aim of this study was to evaluate the distal movement, vertical movement, distal tipping and crown buccal torque of maxillary molars after the completion of...
BACKGROUND
The aim of this study was to evaluate the distal movement, vertical movement, distal tipping and crown buccal torque of maxillary molars after the completion of distalization by comparing the predicted movement with the achieved movement using palatal rugae registration.
METHODS
The study included 22 clear aligner patients (7 males and 15 females), and 79 molars were measured. Two digital models were generated before treatment and after molar distalization and were superimposed after selecting the palatal rugae area for registration in GOM inspect suite software 2022 (GOM; Braunschweig, Germany). The predicted and achieved movements of molar distalization, intrusion, distal tip and crown buccal torque were measured and compared.
RESULT
The achieved distalization (1.25 ± 0.79 mm vs. 2.17 ± 1.03 mm, P < 0.001; 1.41 ± 1.00 mm vs. 2.66 ± 1.15 mm, P < 0.001), intrusion (0.47 ± 0.41 mm vs. 0.18 ± 0.54 mm, P < 0.01; 0.58 ± 0.65 mm vs. 0.10 ± 1.12 mm, P < 0.01), distal tip (5.30 ± 4.56° vs. 1.53 ± 2.55°, P < 0.001; 4.87 ± 4.50° vs. - 1.95 ± 4.32°, P < 0.001) and crown buccal torque (1.95 ± 4.18° vs. - 1.15 ± 4.75°, P < 0.001; 0.43 ± 4.39° vs. - 4.27 ± 6.42°, P < 0.001) were significantly different from the predicted values in the two groups (first molar, second molar). Significant regression relationships were found between the achieved distal movement and deviational intrusion (R = 0.203, P < 0.0001), distal tip (R = 0.133, P < 0.001) and crown buccal torque (R = 0.067, P < 0.05). There was a significant correlation between the deviational movements of intrusion and the distal tip (R = 0.555, P < 0.0001).
CONCLUSION
Approximately 2 mm maxillary molar distalization was achieved in this study. Deviational movement of intrusion, distal tip and crown buccal torque beyond the clear aligner virtual design appeared to a certain degree after distalization. Thus, more attention should be given to molar intrusion and distal tip and crown buccal torque as the designed distalization increases.
Topics: Male; Female; Humans; Torque; Malocclusion, Angle Class II; Maxilla; Molar; Crowns; Orthodontic Appliances, Removable; Tooth Movement Techniques
PubMed: 38151662
DOI: 10.1186/s40510-023-00500-4 -
Developmental Biology Sep 2017Vertebrate limb development relies on the activity of signaling centers that promote growth and control patterning along three orthogonal axes of the limb bud. The... (Review)
Review
Vertebrate limb development relies on the activity of signaling centers that promote growth and control patterning along three orthogonal axes of the limb bud. The apical ectodermal ridge, at the distal rim of the limb bud ectoderm, produces WNT and FGF signals, which promote limb bud growth and progressive distalization. The zone of polarizing activity, a discrete postero-distal mesenchymal domain, produces SHH, which stimulates growth and organizes patterning along the antero-posterior axis. The dorsal and ventral ectoderms produce, respectively, WNT7A and BMPs, which induce dorso-ventral limb fates. Interestingly, these signaling centers and the mechanisms they instruct interact with each other to coordinate events along the three axes. We review here the main interactions described between the three axial systems of the developing limb and discuss their relevance to proper limb growth and patterning.
Topics: Animals; Body Patterning; Extremities; Models, Biological; Signal Transduction
PubMed: 28283405
DOI: 10.1016/j.ydbio.2017.03.006 -
Clinical Oral Investigations Jan 2024The study endeavors to undertake a bibliometric analysis on molar distalization, with the objective of illuminating its evolutionary trajectory, current status, and... (Review)
Review
OBJECTIVES
The study endeavors to undertake a bibliometric analysis on molar distalization, with the objective of illuminating its evolutionary trajectory, current status, and prognosticating future research hotspots and trends.
MATERIAL AND METHODS
A comprehensive exploration of the literature on molar distalization was carried out by conducting a search in the Web of Science (WOS) core database of the University of Hong Kong Electronic Library. The search for topic terms employed included "molar distalization," "molar distalisation," "move molar distally," "molar distal movement," and "molar backwards." The search results were subsequently subjected to meticulous analysis using CiteSpace software. This analysis encompassed various facets such as the citation count; the geographical distribution of the countries, institutions, and journals responsible for publishing the articles; the distribution of the authors; the utilization of keywords within the articles; and the analysis of references.
RESULTS
A total of 516 articles were included in the analysis. The top 5 countries in terms of the number of published papers were the United States (USA), South Korea, Turkey, Italy, and Germany, and the top 5 institutions in terms of the number of published papers were Kyung Hee University, A.T. Still University of Health Sciences, Catholic University of Korea, Seoul St. Mary's Hospital, and Universidade de Sao Paulo. The top 5 authors in terms of the number of published papers were Park, Kook, Bayome, Janson, and Lee. There was little cooperation overall. The top 3 journals in terms of the most published related articles were all orthodontic-related journals. After molar distalization and anchorage, the most frequently used keywords were distalization, movement, and pendulum appliance. Kinzinger GSM is the most frequently cited author in references, and one of his articles also has the highest centrality score in references.
CONCLUSIONS
As the tides of time shift and scholars display an ever-growing dedication to unraveling the intricacies of this therapeutic modality, the realm of molar distalization has undergone notable advancements in technology. Initially, the traditional appliance suffered from aesthetic drawbacks and discomfort. However, contemporary iterations of the appliance have transcended these limitations, boasting enhanced elegance and convenience while concurrently elevating their efficacy. Nevertheless, limitations of current appliances, including their durability and propensity for recurrence post-treatment, continue to necessitate further advancement. Hence, the ongoing scientific inquiry aims to delve deeper into refining treatment modalities and fabricating cutting-edge appliances within this realm.
CLINICAL RELEVANCE
This study holds the potential to significantly enhance the ability of orthodontists to devise treatment protocols and offer state-of-the-art clinical recommendations, thereby empowering them to deliver advanced and refined orthodontic interventions.
Topics: Humans; Orthodontic Appliances; Tooth Movement Techniques; Brazil; Esthetics, Dental; Molar; Bibliometrics
PubMed: 38286861
DOI: 10.1007/s00784-024-05520-w -
International Journal of Dentistry 2020Miniscrews have proved quite effective in fixed orthodontic treatment. They can be placed in areas like palatal interradicular zones or midpalatal suture. Despite the...
Characteristics and Dynamics of Full Arch Distalization Using Transpalatal Arches with Midpalatal and Interradicular Miniscrews as Temporary Anchorage Devices: A Preliminary Finite Element Analysis.
INTRODUCTION
Miniscrews have proved quite effective in fixed orthodontic treatment. They can be placed in areas like palatal interradicular zones or midpalatal suture. Despite the value of these methods and their ever-increasing use, their characteristics are not assessed before when implanted in palatal interradicular areas or in the midpalatal suture. We aimed to assess, for the first time, the dynamics of full arch distalization using such miniscrews.
METHODS
A 3D model of maxilla with all permanent dentition was created from a CT scan volume. Tissues were segmented and differentiated. Afterward, miniscrews and appliances were designed, and the whole model was registered within a finite element analysis software by assigning proper mechanical properties to tissues and orthodontic appliances. The full arches were distalized using transpalatal arches with miniscrews as anchorage devices (in two different models). The extents of stresses and patterns of movements of various elements (teeth, miniscrews, appliances, tissues) were estimated. . Comparing the two models, it is obvious that in both models, the stress distribution is the highest in the TPA arms and the head of the miniscrew where the spring is connected. In comparison with the displacement in the , the "mesial in" rotation is seen in the first molar of both models. But there is one exception and that is the "mesial out" rotation of the right second molar. In all measurements, the amount of movement in Model 2 (with palatal interradicular miniscrews) is more than that in Model 1 (with midpalatal miniscrew). In the -axis, more tipping is seen in Model 2, especially the anterior teeth (detorque) and the first molar, but in Model 1, bodily movement of the first molar is more evident. Along the -axis, the mesial intrusion of the first molar and the distal extrusion of this tooth can be seen in both models. Again, the displacement values are higher in the second model (with interradicular miniscrews). In comparison with micromotion and stress distribution of miniscrews, in Model 1, maximum stress and micromotion is observed at the head of the miniscrew where it is attached to the spring. Of course, this amount of micromotion increases over time. The same is true for Model 2, but with a lower micromotion. As for the amount of stress, the stress distribution in both miniscrews of both models is almost uniform and rather severe.
PubMed: 33381182
DOI: 10.1155/2020/6648526 -
The International Journal of... 2018This review summarizes recent advances in leg regeneration research, focusing on the cricket Gryllus bimaculatus. Recent studies have revealed molecular mechanisms on... (Review)
Review
This review summarizes recent advances in leg regeneration research, focusing on the cricket Gryllus bimaculatus. Recent studies have revealed molecular mechanisms on blastema formation, establishment of positional information, and epigenetic regulation during leg regeneration. Especially, these studies have provided molecular bases in classical conceptual models such as the polar coordinate model, the intercalation model, the boundary model, the steepness model, etc., which were proposed to interpret regeneration processes of the cockroach legs. When a leg is amputated, a blastema is formed through the activation of the Janus-kinase (Jak)/Signal-Transduction-and-Activator-of-Transcription (STAT) pathway. Subsequently, the Hedgehog/Wingless/Decapentaplegic/Epidermal-growth-factor pathways instruct distalization in the blastema, designated as the molecular boundary model. Downstream targets of this pathway are transcription factors Distal-less (Dll) and dachshund (dac), functioning as key regulators of proximodistal pattern formation. Dll and dac specify the distal and proximal regions in the blastema, respectively, through the regulation of tarsal patterning genes. The expression of leg patterning genes during regeneration may be epigenetically controlled by histone H3K27 methylation via Enhancer-of-zeste and Ubiquitously-transcribed-tetratricopeptide-repeat-gene-X-chromosome. For the molecular mechanism of intercalation of the missing structures between the amputated position and the most distal one, Dachsous/Fat (Ds/Ft) steepness model has been proposed, in which the Ds/Ft pathway maintains positional information and determines leg size through dac expression. This model was theoretically verified to interpret the experimental results obtained with cricket legs. Availability of whole-genome sequence information, regeneration-dependent RNA interference, and genome editing technique will have the cricket be an ideal model system to reveal gene functions in leg regeneration.
Topics: Amputation, Surgical; Animals; Body Patterning; Epigenesis, Genetic; Extremities; Gryllidae; Models, Biological; Regeneration; Signal Transduction; Wound Healing
PubMed: 29938767
DOI: 10.1387/ijdb.180048ho -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jan 2016High voltage electrical injuries can cause devastating results especially in distal extremities. Although free flaps are the golden standards for the reconstruction of...
BACKGROUND
High voltage electrical injuries can cause devastating results especially in distal extremities. Although free flaps are the golden standards for the reconstruction of these defects, sometimes local flap alternatives are more useful. One of the most favorable local flap is distally based sural flap (DBSF), which can be used in cross-leg fashion when ipsilateral extremity is affected by a high voltage electrical injury. The purpose of this study was to evaluate long term results of eleven patients who underwent a reconstruction to the lower extremity with cross-leg DBSF due to high voltage electrical burn injury between the years of 2003-2013.
METHODS
Eleven patients suffering from high voltage electrical injury from 2003 to 2013 were evaluated retrospectively. All patients were male and had deep 2nd and 3rd degree electrical burns on many parts of their bodies, including their lower legs and feet. Seven of the defects were located on the right limb and four of them on the left. Defects were located in the ankle area in five patients, dorsum of the foot in four patients, achilles area in one patient, and the plantar region in one patient.
RESULTS
The adaptation of flaps to the recipient site, colour, and quality were all acceptable.
CONCLUSION
As an alternative to free flaps, the cross-leg DBSF has good tissue compliance, provides tissue of adequate quantity and quality, and has low complication rates in the long term in high voltage electrical injuries of the leg and foot.
Topics: Adolescent; Adult; Burns, Electric; Foot Injuries; Free Tissue Flaps; Humans; Injury Severity Score; Leg Injuries; Male; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 27135078
DOI: 10.5505/tjtes.2015.35306 -
The Israel Medical Association Journal... Nov 2017In colon cancer, data regarding proximal and distal metastasis to lymph nodes remains scarce.
BACKGROUND
In colon cancer, data regarding proximal and distal metastasis to lymph nodes remains scarce.
OBJECTIVES
To evaluate lymph node distribution along the longitudinal axis of the colon as related to a tumor to re-examine the common practice of 5 cm proximal and 2 cm distal resection margins.
METHODS
We studied 106 patients (53 males and 53 females, mean age 67.9 ± 10 years) who had undergone left hemicolectomy or sigmoidectomy. Colonic cancer specimens were divided into five zones proximally and distally to the tumor. For each zone, overall lymph node evaluation and ratio was performed.
RESULTS
The mean number of retrieved lymph nodes per patient was 24.3 ± 12, with 54.9% of the nodes concentrated in zone I, 22.1% in zone II, 9.5% in zone III, 10.3% in zone IV, and 3% in zone V. While most positive nodes were found in zone I, significant numbers were also detected in both directions proximally and distally to the tumor.
CONCLUSIONS
It seems that longer colonic segments proximally, and especially distally, should be considered for resection to significantly reduce the chances of finding involved lymph node.
Topics: Aged; Colectomy; Colon; Colonic Neoplasms; Female; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Patient Selection; Prognosis; Risk Assessment
PubMed: 29185284
DOI: No ID Found