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A new access site management tool: the Angio-Seal hemostatic puncture closure device.

PURPOSE: Given the increasing number of percutaneously applied endovascular therapies, the incidence of access-related vascular complications can be expected to rise, particularly in association with those techniques requiring large sheaths or anticoagulation. The need exists for a safe, easy to use, and effective hemostatic technique to replace the labor-intensive method of manual compression. METHODS: A bioabsorbable, sheath-delivered vascular device (Angio-Seal) has been developed that deposits a small collagen plug within the arterial wall to mechanically seal the puncture defect. An anchor connected by suture to the plug is first deployed in the arterial lumen and pulled flush against the interior wall to guard against intraluminal deposition of the collagen. RESULTS: The Angio-Seal device was deployed successfully in 80 (96%) of 83 attempts involving common femoral arteries accessed for peripheral angioplasty (n = 30), coronary angiography (n = 30), and coronary angioplasty (n = 16). Three popliteal artery access sites and one femoropopliteal bypass graft were also treated. Hemostasis was immediate in 78 cases (98%); 2 sites required a 5-minute manual compression to effect a secure seal. Three devices failed to deploy, and manual pressure was used to close the puncture. Nondeployment did not cause any sequelae, and no complications were encountered with the technique. CONCLUSIONS: This novel vascular closure device is quick (< 1 minute application time) and simple to use, providing a positive seal of common femoral artery puncture sites for both peripheral and coronary interventions. It appears to be a reliable alternative to standard manual hemostasis.

Angioplasty↗

Persistent organic pollutants in the diet of harbor seals (Phoca vitulina) inhabiting Puget Sound, Washington (USA), and the Strait of Georgia, British Columbia (Canada): a food basket approach.

Harbor seals (Phoca vitulina) inhabiting Puget Sound (WA, USA) recently were found to be seven times more contaminated with polychlorinated biphenyls (PCBs) than those inhabiting the adjacent Strait of Georgia (BC, Canada). We carried out a food basket approach to approximate realistic dietary exposures of both new (e.g., polybrominated diphenyl ethers [PBDEs]) and legacy (e.g., dichlorodiphenyltrichloroethane [DDT]) persistent organic pollutants (POPs) for these harbor seals. Food basket homogenates, each consisting of over 200 individual prey items, were constructed using documented dietary preferences for harbor seals in these basins, and analyzed for organochlorine pesticides, flame retardants, and other persistent contaminants. Concentration rankings for the major contaminant classes in the Puget Sound food basket were sigmaPCBs > sigmaPBDEs > sigmaDDT, and for the Strait of Georgia food basket were sigmaPCBs > sigmaDDT > sigmaPBDEs, highlighting the emergence of PBDEs as a significant concern in the regional environment. Consistent with observations in harbor seals, PCB concentrations in the Puget Sound food basket were seven times higher than in its Strait of Georgia counterpart. Based on our food basket results, the estimated daily intake of sigmaPCB toxic equivalents to dioxin by Puget Sound harbor seals exceeds some wildlife consumption guidelines for PCBs. Our results indicate that both legacy and new POPs present a health risk to these marine mammals.

Animals↗

Chemical and biological pollution contribute to the immunological profiles of free-ranging harbor seals.

Polychlorinated biphenyls and other persistent organic pollutants have been associated with immunotoxicity and outbreaks of (infectious) disease in marine mammals by rendering them vulnerable to infection by pathogens such as viruses and bacteria. In an immunotoxicological study of free-ranging harbor seals (Phoca vitulina), we obtained samples of blood and blubber from seal pups that were live-captured from two remote and two near-urban sites in British Columbia, Canada, and Washington state, USA. Using these samples, we quantified hematology, innate immune function, adaptive immune function, and polychlorinated biphenyl accumulation. While controlling for confounding factors (age, sex, and condition), univariate correlations between phagocytosis (r2 = 0.30, p = 0.002), respiratory burst (r2 =0.45, p= 0.000), T-lymphocyte function (r2 = 0.16, p = 0.028), lymphocyte signaling (r2 = 0.17, p = 0.025), and lymphocyte counts (r2 = 0.29, p = 0.002), and polychlorinated biphenyl concentrations suggested chemical-associated immunotoxicity. Principal component analysis of immunological endpoints provided additional evidence of immunotoxic effects in seals. However, principal component analysis also identified a noncontaminant-related factor by distinguishing between seals inhabiting urban versus remote sites, with results being consistent with increased pathogen exposure. Elevated fecal coliform concentrations in water, and observations of terrestrial spill-over pathogens in local seals, further support the notion of biological pollution at these sites. Although our study highlights the role that environmental contaminants might play in rendering marine mammal populations vulnerable to disease through immunotoxicity, it also suggests that biological pollution represents an emerging conservation concern.

Animals↗

In vitro pesticide degradation in turfgrass soil incubated under open and sealed conditions.

Degradation of selected pesticides was conducted in a turfgrass soil from a golf course under open (i.e., allowing gas exchange with atmosphere) and sealed systems. The time required for 50% of the initial dose of fenitrothion (O,O-dimethyl O-4-nitro-m-tolyl phosphorothioate), diazinon (O,O-dimethyl O-2-isopropyl-6-methylpyrimidin4-yl phosphorothioate), iprodione [3-(3,5-dichlorophenyl)-N-isopropyl-2,4-dioxo-imidazolidine-1-carboxamide], mecoprop [(RS)-2-(4-chloro-otolyloxy)propionic acid], and asulam (4-aminophenylsulfonyl-carbamate) to dissipate (half-life, t 1/2) was less than 2 wk under both conditions. The t 1/2 values of dithiopyr (S,S'-dimethyl 2-difluoromethyl-4-isobutyl-6-trifluoro-methylpyridine-3,5-dicarbothioate) were 324 and 185 d under the open and sealed conditions, respectively. The t 1/2 values of isoprothiolane (di-isopropyl 1,3-dithiolan-2-ylidene-malonate), flutolanil (alpha,alpha,alpha-trifluoro-3'-isopropoxy-o-toluanilide), and benefin (N-butyl-N-ethyl-alpha,alpha,alpha-trifluoro-2,6-dinitro-p-toluidine) under the open conditions were 154, 336, and 47 d, respectively. The t 1/2 values of these pesticides increased slightly under the sealed conditions. The t 1/2 values of terbutol (2,6-di-tert-butyl-4-methylphenyl N-methycarbamate) and one of the major degradation products, N-demethyl-terbutol (2,6-di-tert-butyl-4-methylphenyl carbamate), were 182 and 291 d under the open conditions and increased by six- and threefold under the sealed conditions, respectively. The degradation system under the sealed conditions could characterize the persistence of terbutol and N-demethyl-terbutol, which were the most persistent in the field.

Biodegradation, Environmental↗

Hb Seal Rock [(alpha 2)142 term-->Glu, codon 142 TAA-->GAA]: an extended alpha chain variant associated with anemia, microcytosis, and alpha-thalassemia-2 (-3.7 Kb).

Hb Seal Rock was first reported in a young African-American women and her 2-year-old daughter (1). It is an extended alpha chain variant which, like Hb Constant Spring, is present in small quantity and is expressed as an alpha-thalassemia. The mutation, TAA-->GAA affects codon 142 of the alpha 2 gene. In this family, the index case was a compound heterozygote for Hb Seal Rock trait and for alpha-thalassemia trait (-3.7 kb). Her hematologic expression was similar to mild Hb H disease, presumably because the Seal Rock mutation affects the alpha 2 gene that is normally responsible for approximately 70% of alpha-globin synthesis. Her daughter had only Hb Seal Rock trait, but was phenotypically alpha-thalassemia-2 trait due to the expression of the Seal Rock mutation on one of her alpha 2-globin genes, the other three alpha-globin genes being unaffected.

Adult↗

Prospective comparison of collagen plug (Angio-Seal) and suture-mediated (the Closer S) closure devices at femoral access sites.

OBJECTIVE: Rapid and effective hemostasis at femoral puncture sites minimizes both the hospital stay and patient discomfort. Therefore, a variety of arterial closure devices have been developed to facilitate the closure of femoral arteriotomy. The objective of this prospective study was to compare the efficacy of two different closure devices; a collagen plug device (Angio-Seal) and a suture-mediated closure device (the Closer S). MATERIALS AND METHODS: From March 28, 2003 to August 31, 2004, we conducted a prospective study in which 1,676 cases of 1,180 patients were treated with two different types of closure device. Angio-Seal was used in 961 cases and the Closer S in 715 cases. The efficacy of the closure devices was assessed, as well as complications occurring at the puncture sites. RESULTS: Successful immediate hemostasis was achieved in 95.2% of the cases treated with Angio-Seal, and in 89.5% of the cases treated with the Closer S (p < 0.05). The rates of minor and major complications occurring between the two groups were not significantly different. In the Closer S group, we observed four major complications (0.6%), that consisted of one massive retroperitoneal hemorrhage (surgically explored) and three pseudoaneurysms. In the Angio-Seal group, we observed three major complications (0.3%) that consisted of one femoral artery occlusion, one case of infection treated with intravenous antibiotics and one pseudoaneurysm. CONCLUSION: The use of Angio-Seal was found to be more effective than that of the Closer S with regard to the immediate hemostasis of the femoral puncture sites. However, we detected no significant differences in the rate at which complications occurred.

Adolescent↗

A real-time approach to detect seal defects in food packages using ultrasonic imaging.

The microbial integrity of many types of flexible food packages depends on a zero defect level in the fused seam seal. Human inspection for defects in these seals is marginal at best, and secondary incubation protocols are often used to spot packages with compromised integrity before releasing product for sale. A new type of inspection method has been developed and is being evaluated for robustness. The purpose of the study was to evaluate a new raster scanning geometry to simulate continuous motion, online ultrasonic inspection of the seal region in flexible food package seals. A principal engineering tradeoff of scanning inspection systems is between increased line speed that results from decreased spatial sampling (less acquired data to process) and decreased image quality. The previously developed pulse-echo Backscattered Amplitude Integral (BAI) mode imaging technique is used to form ultrasound images using the new scanning geometry. At an ultrasonic frequency of 22.9 MHz, 38- and 50-microm-diameter air-filled channel defects in all-plastic transparent trilaminate are evaluated. The contrast-to-noise ratio (CNR) of the processed BAI-mode image is used to quantify image quality as a function of spatial sampling. Results show seal defects (38- and 50-microm diameter) are still detectable for undersampled conditions, although image quality degrades as spatial sampling decreases. Further, it is concluded that the raster scanning geometry is feasible for online inspection.

Food Contamination↗

Uncinariasis in northern fur seal and California sea lion pups from California.

Northern fur seal (Callorhinus ursinus) (n = 25) and California sea lion (Zalophus californianus) (n = 53) pups, found dead on rookeries on San Miguel Island (California, USA), were examined for adult Uncinaria spp. Prevalence of these nematodes was 96% in fur seal pups and 100% in sea lion pups. Mean intensity of Uncinaria spp. per infected pup was 643 in fur seals and 1,284 in sea lions. Eggs of Uncinaria spp. from dead sea lion pups underwent embryonation in an incubator; development to the free-living third stage larva occurred within the egg. This study provided some specific information on hookworm infections in northern fur seal and California sea lion pups on San Miguel Island. High prevalence rate of Uncinaria spp. in both species of pinnipeds was documented and much higher numbers (2X) of hookworms were present in sea lion than fur seal pups.

Ancylostomatoidea↗

Paper/plastic pouch heat seals.

Little or no differences were found in overall performance quality between solid 3/8" wide seals and a triple 11/16" wide seal provided they are made on the same material, on the same machine, and at equivalent temperature and dwell settings. This test demonstrated that actual voids in a solid seal are of no consequence. Seal design appears to have little bearing on strength and quality. Remember, this test was not of competitive products. Its only purpose was to test the intrinsic qualities of each type of seal. Consistency of manufacture, materials, and QC testing should be the criteria for selecting a paper/plastic peel pouch. Performance in your hospital should be the ultimate test.

Hospitals↗

Comparison of sealing efficacy of materials placed in lateral root perforations--an in vitro study.

An endodontic perforation interferes with the principal goal of sealing the root canal system. An in vitro study was conducted on comparative efficacy of three materials-Dispersalloy, Cavit and Prisma VLC Dycal when placed in lateral root perforations in cervical third areas. Root canals were prepared and irrigated thoroughly. Perforations were made with No. 2 round bur and sealed with Dispersalloy, Cavit and Prisma VLC Dycal. Dispersalloy Group I showed best sealing ability. Prisma VLC Dycal Group I too was comparable to Dispersalloy Group I in its sealing ability, followed by Cavit Group II, Prisma VLC Dycal Group II, Dispersalloy Group II in that order. Cavit Group I was least effective in sealing perforations.

Analysis of Variance↗

Long-term evaluation of a fissure sealing programme in Public Dental Service clinics in Sweden.

The aim of the present study was to evaluate the long-term results of a systematic fissure sealing programme of the occlusal surfaces of newly erupted permanent first molars. All 15-year-olds (n=815) who had been regularly treated at seven Public Dental Service clinics in Jönköping County, Sweden, since the eruption of their permanent first molars participated in the study. Data on fissure sealing and restorative treatment were extracted from the dental records of the patients. When the patients were 15 years of age, it was found that 6% of the original 2456 sealed occlusal permanent first molars had received Class II restorations. Seventy-eight per cent of the remaining 2322 sealed occlusal surfaces were judged to be caries-free by the child's ordinary dentist. This long-term retrospective study indicates that a structured fissure sealing programme is of great benefit for oral health.

Adolescent↗

Comparison of the resistance to infection of rifampin-bonded gelatin-sealed and silver/collagen-coated polyester prostheses.

PURPOSE: The purpose of this study was to compare the efficacy of rifampin-bonded gelatin-sealed and silver acetate/collagen-coated knitted polyester prostheses for the prevention of bacteremic graft infection in an animal model. METHODS: Eighteen 6.0-mm polyester grafts (length, 5.0 cm) were implanted in dogs end-to-end into the infrarenal aorta. The dogs were divided into four groups as a function of type of prosthesis implanted. The dogs in groups I (n = 3) and II (n = 3) received control gelatin-sealed or collagen-coated polyester prostheses, respectively. In group III (n = 6), the dogs received rifampin-bonded gelatin-sealed polyester prostheses. In group IV (n = 6), the dogs received silver/collagen-coated polyester prostheses. Two days after implantation, the grafts were challenged with 6 x 10(9) Staphylococcus aureus intravenously. One week after implantation, the grafts were harvested with sterile technique. Quantitative cultures were obtained from all the harvested grafts. The results were expressed as colony-forming units per cm(2) of graft material. Bacteriologic study was also performed on various tissue samples. The chi(2) test was used to compare the culture proven infection of control and antimicrobial grafts. RESULTS: All the control grafts were infected with S aureus at the time of removal. Five of the six silver/collagen-coated grafts were infected, whereas none of the six rifampin-bonded gelatin-sealed grafts grew S aureus (P <.01). There was no significant difference in the number of positive culture results of organ samples between the different groups of dogs. CONCLUSION: These results indicate that rifampin-bonded gelatin-sealed polyester grafts are significantly more resistant to bacteremic infection than are silver/collagen-coated polyester grafts in a highly challenging model.

Acetates↗

The non-hermetically sealed pacemaker myth, or, Navy-Ribicoff 22,000-FDA-Weinberger o.

Although the Secretary of Health, Education and Welfare recently stated that hermetic sealing of all implanted cardiac pacemakers, as recommended by the Navy in 1969, is inadvisable, several small manufacturers are already marketing hermetically sealed devices (CPI, Pacesetter), all of the over 600 nuclear pacers implanted to date have been hermetically sealed, and belatedly the major manufacturers are developing hermetically sealed units. Total hermetic sealing of all implantable electronic devices has been technically feasible for years, and it is essential that device legislation include mandatory encapsulation standards.

Biomedical Engineering↗

[Treatment of traumatic soft tissue defect by vacuum sealing].

OBJECTIVE: To investigate the clinical effect of vacuum sealing in treatment of traumatic soft tissue defect. METHODS: From 1998. 8 to 2001. 2, 49 patients with 55 traumatic soft tissue defects were treated by vacuum sealing after debridement. Among them, there were 39 males and 10 females with mean age 38. 4 years. The wound area varied from 10 cm x 10 cm to 30 cm x 30 cm. In the experimental group, the wound surfaces or cavities were filled with polyvinyl alcohol foams with embedded drainage tubes connected with vacuum bottle (negative pressure of 50-60 kPa). Wound closure was performed with secondary suturing, or skin transplantation, or local flap grafting after 5-7 days. Besides, 126 patients were managed by traditional dressing as the control group. RESULTS: Out of 51 traumatic soft tissue defects (45 patients), the wound closure was performed with a free flap in 4, with local flap in 8, with skin grafting in 27, with secondary suturing in 6, and with vacuum sealing directly in the other 6 defects. Forty-five patients recovered and no complications (systemic and located) occurred. There were significant differences in time of secondary suturing, times of dressing, wound shrink and total therapeutic cost between two groups (P < 0.01). CONCLUSION: Vacuum sealing can protect the wound against contamination, evacuate the wound exudates completely, stimulate the growth of granulation tissue, and facilitate the wound healing; so vacuum sealing is a simple and effective method in treatment of traumatic soft tissue defect.

Adult↗

Dentin permeability: sealing the dentin in crown preparations.

Provisional restorations of full crown preparations may permit more microleakage of bacteria and their products than the final castings do. However, most investigations of the sealing qualities of cemented castings have reported that they too permit dye leakage. One approach to the problem is to seal the dentin with dentin bonding agents at the completion of the crown preparation. This study evaluated the ability of six different dentin bonding agents to seal the dentin of crown preparations of human teeth in vitro using two independent techniques. The first technique quantitated fluid filtration across dentin before and after treatment with dentin bonding agents at one hour, one day, one week, and one month and after thermocycling. The second method measured silver nitrate penetration of the thin veneers of dentin bonding agents into the dentin. Both methods correlated well with each other. The best seals were obtained with Prisma Universal Bond 2 or Superbond powder plus liquid. The worst seals were found using Gluma and Superbond liquid only. Clearfil PhotoBond, Amalgambond, and Scotchbond 2 gave intermediate results. Although the dentin bonding agents tend to accumulate on chamfers, thereby increasing their thickness to 200-300 microns, the method looks promising as a simple way to protect the pulp from the consequences of microleakage.

Analysis of Variance↗

Sealing properties of a self-etching primer system to normal caries-affected and caries-infected dentin.

PURPOSE: To compare the ability of an experimental antibacterial self-etching primer adhesive system to seal exposure sites in normal, caries-affected and caries-infected human dentin. METHODS: 30 extracted human third molars were used within 1 month of extraction. 10 intact normal teeth comprised the normal group. 20 teeth with occlusal caries that radiographically extended halfway to the pulp were excavated using caries-detector solution (CDS) and a #4 round carbide bur in a slowspeed handpiece. Half of those teeth were fully excavated free of CDS-stained material without exposing the pulp, and were designated as the caries-affected dentin group. The remaining 10 teeth were excavated as close to the pulp as possible without obtaining an exposure, but whose dentin continued to stain red with CDS; this group was designated as the caries-infected dentin group. The remaining dentin thickness in all of the specimens in the other two groups was then reduced to the same extent as the caries-infected group. Direct exposures of the pulp chamber were made with a 1/4 round bur in the normal dentin or a 25 gauge needle in the other two groups. After measuring the fluid flow through the exposure, the sites were then sealed with an experimental antibacterial fluoride-containing self-etching primer adhesive systems (ABF). Fluid conductance was remeasured every week for 16 weeks. RESULTS: The fluid conductance through the exposure fell 99% in all groups following resin sealing. The seals of normal and caries-affected dentin remained relatively stable over the 16 weeks, while the seals of caries-infected dentin gradually deteriorated, reaching significance at 8 weeks. TEM examination revealed very thin (ca. 0.5 mm) hybrid layers in normal dentin, 3-4 microm thick hybrid layers in caries-affected dentin and 40 microm thick hybrid layers in caries-infected dentin. The tubules of caries-infected dentin were enlarged and filled with bacteria. Resin tags passed around these bacteria in the top 20-40 microm thereby encapsulating them in resin.

Acid Etching, Dental↗

A comparison of sealing capabilities of amalgum, GIC and zinc oxide eugenol cement when used as retro grade filling materials (in vitro study).

BACKGROUND: The objective of this study was to compare sealing capabilities of different filling materials when used as retrograde filling materials following apiceotomy (to check their sealing abilities as retro filling). In this study apical seal obtained following reverse retrograde root filling with amalgam, was compared with those obtained with, Glassinomer (GIC) and Zinc oxide eugonal (ZnO2E) cement. METHODS: The root canals of 50 extracted single rooted upper anterior human teeth were used in this study. The root canals were instrumented and obturated with laterally condensed, gutta-percha and zinc oxide sealer. Each tooth was a pically resected at 90 degrees to its long axis and the root surface isolated with two coats of nail polish. Teeth were divided into 4 groups, the 1st group received amalgam retrograde filling, the 2nd and 3rd group was retro filled with GIC and ZnO2E cement respectively and the 4th control group received no retrograde root filling. All these teeth were suspended in 1% methylene blue dye at room temperature for 72 hours, the roots were sectioned and dye penetration measured by using (stereomicroscope) microscope. The sealing abilities of these materials were determined by their ability to inhibit dye penetration. RESULTS: The result of this study has shown that GIC is just as effective as amalgam but ZnO2E cement showed poor sealing abilities. CONCLUSION: GIC is just as effective as Amalgam as a retro-sealer and on some instance, better then it, but a long term in vivo study is required to prove it.

Dental Amalgam↗

[The sealing effects of three desensitizers on tubule:an SEM investigation].

PURPOSE: The purpose of this in vitro study was to evaluate the sealing effects on tubule by three different dentin desensitizers. METHODS: 48 freshly extracted human premolars were selected. Their buccal dentin was exposed and a standardized circular area was isolated. They were randomly divided into three experiment groups and one control group. Dentin desensitizers included Systemp desensitizer, Seal&protect desensitizer and Gluma desensitizer. Twelve teeth were prepared for each test group (36 teeth total), and the other twelve teeth were selected as a control group. After the removal of cement, the dentin surfaces were cleaned, treated. Then the teeth were vertically cleaved into two sections. The surface and section of these teeth were observed by means of a scanning electron microscope. RESULTS: All 3 desensitizers could seal the tubules on dentin surface. Systemp desensitizer's dentin permeability was better than Seal&protect, but Gluma had no dentin permeability. CONCLUSION: 3 desensitizers had sealing effect on tubule, systemo desensitizer was the best one.

Bicuspid↗