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PubMedDate not supplied

Corrosion casts of convoluted testicular arteries in mice and rats.

The preparation of vascular corrosion casts enables us to observe the minute features of blood vessels. For mice and rats, reports on the macroscopical appearance of testicular arteries with the cast technique have been quite limited. Therefore, in the present study, we tried to prepare corrosion casts of such arteries in order to observe the three-dimensional structures in mice and rats. Vascular casts of testicular arteries were produced by intravenous injection of a polymethylmethacrylate solution, followed by treatment of the whole animal bodies with NaOH. Additionally, the gross appearance of human testicular arteries in cadavers was compared with that of the vascular casts. The results showed that the testicular arteries of humans, mice, and rats run from the abdominal aorta to the testes, with various configurations (straight, meandering, spiral, or coiled forms), and each species exhibits a specific pattern. The specific forms of testicular arteries may play several roles in protection of normal spermatogenesis, such as allowing wide mobility of the testes on physical attack, heat emission with the entwined pampiniform plexus, and reduction of the blood flow rate. The great extension of the testicular arteries during the fetal period from the upper abdomen to the scrotum when the testes descend might be another feature of the specific development of their running configuration.

Animals↗
PubMed2003

Measurement of the consistency of patellar-tendon-bearing cast rectification.

The quality of fit of a trans-tibial patellar-tendon-bearing (PTB) socket may be influenced by consistency in casting, rectification or alignment. This paper quantifies, for the first time, the variations in the rectified casts between two experienced prosthetists and the variation between the rectified casts of each individual prosthetist. Prosthetists A and B observed the hand casting of a typical trans-tibial amputee. Each prosthetist was supplied with 5 previously measured duplicated plaster models. The two prosthetists rectified the supplied plaster models based on their own interpretation of basic rectification guidelines. Both prosthetists operated in isolation. The re-measured rectified plaster model data was compared with the unrectified data. The extent of rectification at each of 1800 locations per plaster model was calculated. In zones of major rectification, the mean difference between prosthetists was quantified as 2mm and the standard deviation (SD) about that mean was +/- 1mm for each prosthetist. The co-ordinates of the apex of the fibular head for the 10 modified casts indicated that the maximum variation was in the axial direction with a SD of 4.3mm for prosthetist A and a SD of 2.8mm for prosthetist B. The lengths of the 5 plaster models rectified by prosthetist A indicated a SD of 0.2mm whereas the lengths of the 5 plaster models rectified by prosthetist B indicated a SD of 2.9mm.

Amputation, Surgical↗
PubMedDate not supplied

Botulinum toxin type-A and plaster cast treatment in children with upper brachial plexus palsy.

BACKGROUND AND PURPOSE: Electrical stimulation, physical therapy and occupational therapy remain the main treatment for children with upper brachial plexus palsy (UBPP), when surgery has been excluded. A pilot study was undertaken to investigate whether botulinum toxin type A (BoNT-A) and plaster casting, as adjunct to the physical therapy, decreased muscle contracture and improved the position and function of the impaired arm. METHOD: Twenty-two children (mean age 5.6 +/- 3.4 years) with mild UBPP who previously underwent serial cast treatment, unsuccessfully, were enrolled. Neurological impairment and functional status were quantified using Medical Research Council (MRC) and Mallet scales and the Nine-Hole Peg Test (NHPT). Elbow extension was measured using a goniometer. Biceps brachii, brachialis, pronator teres and pectoralis major muscles were injected with 22 units kg(-1) BoNT-A (Dysport, Ipsen). After injection, the treated arm was fixed with a plaster cast and progressively lengthened over 14 days. The cast was maintained for 30 days. Assessments of elbow extension, MRC, Mallet Scale and NHPT were made at baseline, 3, 6 and 12 months. RESULTS: After BoNT-A injection, children had significant improvement of active elbow extension (15.5 degrees +/- 17.1 at 12 months after injection, compared with 42.0 degrees +/- 10.4 at baseline; p < 0.001). NPHT scores improved significantly over the 12 months (51.1 +/- 21.8 seconds compared with 56.7 +/- 19.3 seconds at baseline, p < 0.01). MRC and Mallet scale scores of the paretic muscles were unchanged. CONCLUSION: The children showed a reduction in muscular contracture and improvements of the arm position and elbow extension. The data support the use of BoNT-A and plaster casting as an adjunct to physical therapy, in the treatment of children with mild UBPP.

Adolescent↗
PubMed2004

Occupational asthma after exposure to plaster casts containing methylene diphenyl diisocyanate.

BACKGROUND: The case of a 34-year-old female nurse is presented. She worked in an accident and emergency department in a district general hospital, with methylene diphenyl diisocyanate (MDI)-containing synthetic plaster casts. She worked with MDI on a daily basis for 4 years. She was out of the department for 1 year and on her return developed cough, wheeze and dyspnoea within 5 min of exposure to MDI- containing synthetic casts. METHOD: A bronchial provocation test was performed and confirmed an early asthmatic response. RESULTS: There was a 39% decrease in the forced expiratory volume in 1 s 15 min after exposure, which required the administration of a bronchodilator on two occasions. The patient has subsequently avoided MDI-containing synthetic plaster casts and has experienced no further respiratory symptoms. CONCLUSION: This case illustrates that respiratory sensitization can occur as a result of exposure to MDI-containing synthetic casts and highlights the need for vigilance when health care workers are using isocyanate-containing synthetic casts.

Adult↗
PubMed1993

Effect of total contact cast immobilization on subtalar and talocrural joint motion in patients with diabetes mellitus.

BACKGROUND AND PURPOSE: The purpose of this study was to determine the effect of total contact casting (TCC) on dorsiflexion at the talocrural joint (TCJ) and motion (inversion/eversion) at the subtalar joint (STJ). SUBJECTS: Thirty-seven patients (29 men, 8 women), ranging in age from 32 to 79 years (mean = 54, SD = 11), with diabetes mellitus and a unilateral plantar ulceration participated in the study. METHODS: The subjects were measured with a goniometer for dorsiflexion and STJ range of motion (ROM). The ROMs for each subject's casted and noncasted legs were compared before and after treatment with TCC for neuropathic plantar ulcers by use of a 2 x 2 repeated-measures analysis of variance design. RESULTS: Mean time of immobilization in TCC (healing time) was 42 days (SD = 43, range = 8-119). The results indicated (1) ROM was unchanged at the STJ, but dorsiflexion decreased slightly (1 degree) on both the casted and noncasted sides following the last cast removal, and (2) ROM was less on the ulcerated side prior to casting compared with the nonulcerated side. CONCLUSION AND DISCUSSION: We believe the beneficial effects (healing of wounds) outweigh the minimal detrimental effects (decreased dorsiflexion) of treatment with TCC.

Adult↗
PubMed1995

Serial casting of the lower extremity to correct contractures during the acute phase of burn care.

Severe contractures that develop early following a burn may not improve with splinting and exercise treatment. An alternative treatment is serial casting, which has been used to promote increased range of motion, to facilitate patient compliance with positioning, and to prevent the patient from scratching the burned area. This case report describes the use of serial casting for resolution of ankle plantar-flexion contractures that occurred in the acute phase of burn injury. The child described in this case report sustained a 49% total body surface area scald burn and developed contractures within 1 week after injury. The contractures, which were not corrected with thermoplastic splints, improved with casting from 45 degrees of plantar flexion to neutral dorsiflexion over 2 months with biweekly cast changes. The patient had multiple skin grafts and progressed in functional activities. Serial casting is a conservative and effective modality in correcting contractures resulting from burns. Further documentation of the efficacy of this treatment approach is necessary to support its use in burn care throughout various stages of healing.

Acute Disease↗
PubMedDate not supplied

Serial casting as a technique to correct burn scar contractures. A case report.

Serial casting is a fast, relatively simple, and inexpensive way to effectively correct burn scar contractures. Plaster casts provide circumferential pressure and a prolonged stretch to contracted tissue and cannot be removed by the patient. When casts are applied well and padded appropriately, there is little risk of pressure areas, since the casts are conforming and do not slip distally. Serial casting may be a successful alternative when low-force dynamic splinting cannot be sized small enough for a child, or when patient compliance is unreliable. A case study of a 2-year-old male patient with severe plantar-flexion contractures of the ankles is presented.

Ankle Joint↗
PubMedDate not supplied

The benefits of plaster casting for lower-extremity burns after grafting in children.

Plaster casts are frequently used for immobilization of extremities after grafting in our burn center. A retrospective study was undertaken to evaluate the efficacy of this technique versus posterior splinting in children with burns below the knee. Thirty-six of 165 patients who required skin grafts from October 1986 to October 1989 received skin grafts to the lower extremity below the knee. Twenty patients (56%) were casted and 16 (44%) were not. Various parameters were analyzed in order to compare the casted versus noncasted groups. Several statistical techniques were used to compare the two groups. The casted group had younger children, more rapid wound closure, fewer therapy treatments, and more complete graft take. When sheet and meshed grafts were compared, the same variables were significantly improved for only the group that received meshed grafts. The use of plaster casting after skin grafting is a cost-effective method of improving patient care.

Burns↗
PubMedDate not supplied

Waterproof casts for immobilization of children's fractures and sprains.

This study was designed to determine the efficacy of waterproof cast-lining materials in children with short-arm, long-arm, and short-leg casts. Eligible patients had healing fractures 2 weeks after reduction, stable fractures requiring no reduction, or sprains. A total of 165 waterproof-lined casts were applied and 124 children and parents completed a survey (76.9%) upon cast removal. Results revealed 79% very satisfied, 21% satisfied, and 0% dissatisfied. There were 16 (12.9%) minor skin integrity issues. Waterproof casts in stable fractures and sprains allow acceptable immobilization with no significant associated unusual risk and allow children to resume their usual recreational water activities and hygiene regimen without risk of adverse results.

Adolescent↗
PubMedDate not supplied

Forty degree angled coronal CT scanning of scaphoid fractures through plaster and fiberglass casts.

A method for obtaining coronal CT scans angled 40 degrees to the longitudinal axis of the wrist, parallel to the long axis of the scaphoid, is described. Its potential for evaluating scaphoid fractures is assessed in 10 patients with healing or clinically suspected fractures. Overlapping 3 mm thick angled coronal CT scans were obtained for each patient both in and out of cast. The CT images were compared to plain films and tomography. Comparisons were also made of CT images obtained through fiberglass and plaster casts. All fractures apparent by plain films and tomography were apparent by CT; one case suspected of fracture on initial plain films showed no evidence of fracture on CT and subsequent clinical course and plain films. Osseous union of healing fractures was more reliably assessed on CT than on plain films and plain film tomography. There was no degradation of CT images by either fiberglass or plaster casts; fiberglass casts allowed easy planning of tomographic slices from scout films. We conclude that direct 40 degree angled coronal CT examination of the scaphoid is a quick reliable method to detect scaphoid fractures and to assess their healing without the need of cast removal.

Carpal Bones↗
PubMed1976

Cast bracing for femoral shaft fractures.

The femoral cast-brace offers a new method of treatment for femoral shaft fractures. The cast-brace is especially well suited to fractures below the isthmus, although it can be used to treat those more proximal by giving special attention to detail. The method allows early knee motion without prolonged bed rest. Patients who should not be operated on for any medical reason or whose fracture is not amenable to surgery may be treated with the cast-brace. A series of patients with simple and complicated problems that have been treated with the cast-brace is presented. Comparisons between femoral cast-bracing, intramedullary nailing, and traction treatment are made.

Adolescent↗
PubMed2007

Gap index: a good predictor of failure of plaster cast in distal third radius fractures.

The aim of this study was to assess the usefulness of the cast index and an indigenously developed gap index as measures of poor moulding of plaster. Twenty cases of re-manipulation of distal third radius fractures in children excluding growth plate injuries were compared with a control of 80 patients. A significant difference (<0.001) was observed in the cast index and the gap index of both the groups. The gap index was more sensitive than the cast index in predicting failure. At a level of cast index of more than 0.8 the relative risk of failure is 6.8 as compared with 35 when the sum of the gap index is more than 0.15. The gap index is a better predictor of failure than the cast index. A quick assessment of these indices is a good practice before accepting any plaster following a manipulation of distal radial fractures.

Casts, Surgical↗
PubMed1982

Early ambulation with localizer cast following posterior spinal fusion without internal fixation.

One hundred fourteen patients have been treated with posterior spinal fusion with no internal fixation, followed by early ambulation in localizer casts. The group included 114 patients (104 girls and 10 boys) with an average age of 14.5 years at the time of surgery. All patients underwent preoperative Cotrel traction. Localizer casts were fitted during the first postoperative week, and ambulation was begun as soon as supine films in the cast showed acceptable correction. Six months postfusion the localizer casts were removed and replaced with underarm casts, which were maintained for an additional 4 months. We have found this treatment to be quite effective in patients with single curves, with an average curve correction of 44 degrees. Results in patients with double structural curves have been less encouraging, and it would seem that such patients are best treated with internal fixation.

Adolescent↗
PubMed1993

The effect of selective die spacer placement techniques on the seatability of castings.

It has been reported in the literature that impingement of the casting at the axial-occlusal line angle of the tooth preparation may be a major cause of incomplete seating following cementation. It has been suggested that an additional coat of spacer applied to these areas on the laboratory die before the fabrication of the casting may alleviate this discrepancy. This study evaluated the effect of three die spacer placement techniques on the seatability of cemented castings. Results showed no statistical difference in seating between castings made with conventional relief and those made with additional relief at the axial-occlusal line angles. Castings relieved exclusively at the axial-occlusal line angles exhibited significant post-cementation marginal openings.

Analysis of Variance↗
PubMedDate not supplied

An evaluation of six synthetic casting materials: strength of cylinders in bending.

Six fiberglass casting tapes were evaluated in bending, using an unstable fracture model. Cylindrical casts were constructed and evaluated in bending at 2, 3, and 24 hours after application. Scotchcast Plus (3M, St. Paul, MN), Vet Cast II (3M), and Zim-Flex (Zimmer, Warsaw, IN) were significantly stronger than other materials at 2 hours; however, by 24 hours, casts constructed from Delta-Lite (Johnson & Johnson Products, New Brunswick, NJ) were strongest. Delta-Lite Conformable casts were significantly weaker at all times.

Casts, Surgical↗
PubMed1992

Bond strength of porcelain on cast vs. wrought titanium.

The bond strength of porcelain fused to cast and wrought titanium surfaces was calculated from fracture loads in a 4-point bending test. Two different porcelain were applied (O'Hara and Duceratin). The surface of Ti-cast specimens was treated in two different ways to produce variations in the impurity level before porcelain veneering. Microhardness measurements as well as scanning electron microscopy with EDX analysis were conducted. The results showed no significant difference in bond strength between the two porcelains. Nor was any difference in bond capacity found between thoroughly blasted castings and wrought titanium. Significantly lower bond strengths were observed for lightly blasted specimens and for specimens treated with Gold bonding agent. Impurities in the surface region of the castings were found to be due to contact with the investment during solidification. This indicates that a thin surface layer (50-100 microns) of the casting should be removed before firing of the porcelain.

Aluminum Oxide↗
PubMedDate not supplied

Natural course of experimental choroidal neovascularization: three-dimensional study with corrosion cast and scanning electron microscope.

OBJECTIVES: The details of the morphological features of choroidal neovascularization (CNV) remain unclear. The purpose of this study was to establish a CNV rat model and study the natural course of CNV using vascular casts and a scanning electron microscope (SEM). METHODS: Focal laser photocoagulation (argon green 50 mW, 0.04 s, 200 microm) was applied to Brown Norway pigmented rats. Choroidal vascular casts were prepared 1 and 3 days, 1 and 2 weeks, and 1, 3 and 6 months after laser photocoagulation. The choroidal casts were examined with a SEM. RESULTS: One day after photocoagulation, corrosion casts and SEM revealed complete defects of the choriocapillaris at the laser shot sites. One week after photocoagulation, small vascular buds originating from the damaged choriocapillaris were observed. Two weeks after photocoagulation, newly formed CNV originating from an individual laser burn was observed. One to three months after photocoagulation, these new vessels were connected to each other to form CNV networks. Six months later, some thin and atrophic vessels were observed in the CNV network. CONCLUSIONS: We succeeded in making fine corrosion casts of CNV formed by photocoagulation in pigmented rats and in demonstrating the details of CNV formation and regression. It is hoped that the results of this study will contribute to the development of a drug therapy for CNV and to the interpretation of diagnostic imaging of CNV in humans.

Animals↗
PubMed2006

A cotton batting compression dressing and fiberglass cast used safely in the immediate postoperative period after hindfoot or ankle surgery.

BACKGROUND: Patients undergoing surgery on the foot and ankle who require immobilization are typically placed in splints or soft compression dressings after surgery to avoid complications associated with swelling. As swelling subsides, this temporary immobilization is removed and replaced with a short-leg cast, making an additional office visit necessary, which adds to the cost as well as patient discomfort. METHODS: We apply a cast in the operating room using a special padding technique to accommodate postoperative swelling. It is supportive enough that it does not need to be replaced shortly after surgery. This cast was applied to 38 patients having surgery on the hindfoot or ankle between March, 2003, and February, 2004. RESULTS: All patients tolerated the cast during the initial 2 weeks after surgery, and there were no complications. CONCLUSION: The purpose of this study was to describe the casting technique and document its safety for use immediately after surgery on the hindfoot and ankle.

Adolescent↗