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PubMed2006

Use of the ligaSure vessel sealing system in laparoscopic adrenalectomy.

Laparoscopic adrenalectomy is the operation of choice for benign adrenal lesions. During laparoscopic surgery, vessels are usually ligated with diathermy, ligaclips, staplers or ultrasonic coagulators. Use of the electrothermal bipolar vessel sealer (LigaSure; Valleylab, Boulder, CO, USA) has recently been described in a variety of procedures, not including adrenalectomy. This article is a retrospective study of 28 patients undergoing laparoscopic adrenalectomy within the University of Sydney Endocrine Surgical Unit at the Royal North Shore Hospital using the LigaSure vessel sealing system. Between July 2004 and August 2005, 28 consecutive patients underwent laparoscopic adrenalectomy using the LigaSure vessel sealing system to divide feeding adrenal vessels as well as the adrenal vein. There were no bleeding complications. The LigaSure vessel sealing system can be safely used to secure haemostasis, including division of the adrenal vein, in laparoscopic adrenalectomy.

Adrenalectomy↗

PubMed2004

Tracheal sealing characteristics of pediatric cuffed tracheal tubes.

BACKGROUND: The aim of the study was to compare sealing characteristics of the new Microcuff pediatric tracheal tube featuring a high volume-low pressure (HVLP) cuff with ultrathin membrane with three conventional pediatric cuffed tracheal tubes. METHODS: After obtaining approval of the local ethical committee, 80 children aged 2-4 years were tracheally intubated with the following tubes (i.d. 4.0 mm) in random order: Microcuff P-HVLP, Mallinckrodt Hi-Contour P, Rüschelit Super Safety Clear, and Sheridan CF. Cuff pressure to prevent air leakage at standardized ventilator setting (PIP 20 cm H2O/PEEP 5 cm H2O/RR 20 min(-1)) was assessed within 5 min after intubation by auscultation of audible sounds at the mouth. Cuff pressures required with each group were compared with Kruskall-Wallis test (P < 0.05). Values are median and range. RESULTS: No significant differences in patient characteristics were found between the four groups. The Microcuff tube required significantly lower sealing pressures [11 cm H2O (6-26)] compared with the other tracheal tube brands [Mallinckrodt: 36 cm H2O (18-48); Rüschelit: 21 cm H2O (8-46); Sheridan: 26 cm H2O (18-60), (P < 0.0001)]. CONCLUSION: This preliminary investigation suggests that the new Microcuff pediatric tracheal tube with ultrathin high volume-low pressure cuff membrane allows effective tracheal sealing at very low cuff pressures. This represents a benefit for children with regard to their lower mucosal perfusion pressures compared with adult patients.

Auscultation↗

PubMed1995

Sealing of a fabric vascular prosthesis with autologous adipose tissue: a preliminary report of its clinical application.

A new method of sealing fabric vascular prostheses with autologous adipose tissue was clinically applied as an alternative to preclotting with fresh blood. Thirty-six patients with peripheral arterial occlusive disease were implanted with highly porous fabric prostheses. The prostheses were prepared by sealing the fabric pores with autologous adipose tissue that had been chopped up into small pieces and enmeshed in the fabric by forceful injection of the tissue suspension through a syringe. There was no complication related to the sealed graft such as graft bleeding after implantation. In-hospital mortality occurred in 4 patients: 1 case each of pneumonia, pulmonary infarction, sepsis, and acute myocardial infarction. During the period of 274 +/- 190 days, 3 prostheses were found to be occluded. All the other grafts were patent. The overall patency rate was 91.4%. Postoperative angiography revealed neither intimal thickening at the anastomotic sites nor irregularity of the prosthetic surface. The method proved safe and useful for implantation of smaller caliber artificial grafts.

Adipose Tissue↗

PubMed1978

Follow-up study of sealing and filling with composite resins in the prevention of occlusal caries.

A diluted composite resin (Concise diluted with Concise Enamel Bond) was used for fissure sealing and filling in 896 permanent first molars of 281 children, initially 5--7 years of age. Ordinary fissure sealing was used for fissures with no apparent caries, while a filling method was used after an explorative drilling with a small round bur (Ash No. 1/2) in fissures with incipient caries. On the basis of clinical evaluation every 6 months, the frequency of total retention of the composite material after different observation periods was calculated using the life table method. The rate of success in the fissure sealing group was 94.8% after 6 months, falling to 75.2% after 30 months. The corresponding data for the filled teeth were 92.6 % and 83.5%. It would seem that diluted composite resin is well suited for the prevention of caries in pits and fissures.

Child↗

PubMed1977

Hardness testing of some fissure-sealing materials.

The mechanical properties of fissure-sealing materials are of significant importance for their durability, i.e. their wear resistance. One of the methods of evaluating a material's resistance to attrition is to apply a hardness test. In the present investigation, the surface hardness of some fissure-sealing materials was tested. Sealants made from diluted composite materials and with inclusion of inorganic filler particles appeared to have a considerable higher surface hardness than the other sealing materials tested.

Composite Resins↗

PubMed2004

Cytotoxicity and sealing properties of four classes of endodontic sealers evaluated by succinic dehydrogenase activity and confocal laser scanning microscopy.

The objectives of this study were to evaluate the cytotoxicity and sealing properties of four classes of endodontic sealers (PCS/Kerr, RoekoSeal/Roeko, TopSeal/Dentsply, and EndoREZ/Ultradent). For cytotoxicity testing (MTT method), the materials were either placed immediately in contact with cultured cells or 24 h after setting, then evaluated at three subsequent time points (24 h, 48 h, or 1 wk). For the leakage study, extracted human roots were obturated with acrylic cones and sealers and immersed for 48 h into rhodamine-labeled lipopolysaccharide. The roots were then observed under a confocal laser scanning microscope to estimate (semiquantitatively) the presence of the rhodamine-lipopolysaccharide (LPS) inside the canal. The results showed that cytotoxicity generally increased with time, and that most materials pose significant cytotoxic risks, particularly in the freshly mixed condition. Further, all materials showed significant leakage although there was large variation among teeth. Overall, the silicon-based material (Roeko Seal) was less cytotoxic and more effective in sealing root canals against LPS leakage than other materials.

Analysis of Variance↗

PubMed1995

Evaluation of sealing ability, pH and flow rate of three calcium hydroxide-based sealers.

Three endodontic sealers containing calcium hydroxide (Sealapex, Sealer 26 and Apexit) and a zinc oxide-eugenol cement (Grossman's sealer) were examined for sealing ability, release of hydroxyl ions and flow rate. Dye penetration test was used to assess the sealing ability of the endodontic sealers. The pH test was accomplished to evaluate the release of hydroxyl ions from sealers and the pH readings were done at intervals of 30 min, 60 min and 7 days. In the flow test the sealers were placed between two glass slabs and a weight of 500 g was placed on the top of the glass. The diameters of the formed discs were recorded. The results revealed no statistically significant difference between apical seal provided by the four sealers. All of the calcium hydroxide based sealers alkalinized the surrounding medium. Sealer 26 cement presented significantly superior flow rate when compared with the other cements. These findings indicated that endodontic sealers containing calcium hydroxide presented satisfactory physicochemical properties when compared with a zinc oxide-eugenol sealer commonly used in endodontics.

Analysis of Variance↗

PubMed1995

Sealing ability of potential retrograde root filling materials.

The sealing ability of two potential retrograde root filling materials, a light-cured glass ionomer cement (Vitrebond) and a reinforced zinc oxide-eugenol cement (Kalzinol) was compared with that of amalgam using three methods of assessment: bacterial leakage, confocal microscopy and Indian ink leakage. the root canals of 80 extracted human single-rooted teeth were prepared. All the teeth were apicected, retrograde cavities were prepared and then divided into four equal groups of 20 teeth. The teeth were sterilised by autoclaving and the retrograde cavities filled with the test materials. In the control group, retrograde cavities in 10 teeth were left unfilled while cavities in another 10 teeth were sealed with cyanoacrylate cement. The teeth were first subjected to a bacterial leakage test using Enterococcus faecalis as a leakage marker. After which, the adaptation of the retrograde root fillings was assessed using a confocal optical microscope. Finally, the teeth were processed for the Indian ink leakage test. Bacterial leakage occurred in more teeth filled with amalgam compared with both Vitrebond and Kalzinol (P<0.001), between which there were no differences. With confocal microscopy, the size of the marginal gap was largest with amalgam and smallest with Vitrebond; all differences were statistically significant (<0.001). Finally, there was more Indian ink penetration with amalgam compared with both Vitrebond and Kalzinol (P<0.001) but there were no differences between Vitrebond and Kalzinol. Although there were individual differences within samples, overall, the three methods of assessment produced similar results. The sealing ability of Vitrebond and Kalzinol was similar and both materials were better than amalgam.

Carbon↗

PubMed1991

Ultraconservative sealed restorations: three-year results.

The overall objective of this clinical study was to determine the feasibility of using a sealed composite restoration to arrest caries without the removal of the carious lesion and without the traditional cavity preparation. The minimal tooth preparation (a bevel in enamel) usually did not require any anesthetic injection and conserved tooth structure. These ultraconservative sealed composite restorations placed over caries (CompS/C) have been compared with ultraconservative sealed amalgam restorations (AGS) and with the traditional outline form (unsealed) amalgam restorations (AGU). This clinical study has shown that: (1) caries can be arrested by the CompS/C restoration for a period of three years; (2) the marginal integrity of the AGS restorations showed a definite trend toward improvement as compared to the AGU restorations; and (3) complete sealant retention over posterior restorations was similar in both the CompS/C and the AGS groups during the first two years; however, at Year 3 complete sealant retention was 16 percent higher in the CompS/C than in the AGS group.

Adolescent↗

PubMed2004

[Isolation of Listeria monocytogenes from a patient with sealed ruptured thoracoabdominal aortic aneurysm].

We are reporting a case of sealed rupture of thoracoabdominal aortic aneurysm associated with the isolation of Listeria monocytogenes. The patient was a 75-year-old man with previous history of hypertension that had not required medication for the 3 years prior to hospital admission. He was admitted due to chest pain, but he was afebrile. There were no clinical findings indicating infection, although CRP was slightly elevated. During his clinical course, a sealed rupture of a thoracoabdominal aortic aneurysm was found and replaced with an artificial artery. After surgery, he was treated for 2 weeks with sultamicillin. He was discharged from hospital on the 43rd postoperative day. No bacteria were observed after microscopic examination of gram stained samples from the thrombus that was present in the sealed rupture of the aneurysm. However, a L. monocytogenes strain isolated from the thrombus only after enrichment culturing by HK medium at 37 degrees C for 4 days. By histopathology, there was a slight cellular infiltration of lymphocytes and neutrophils at the aperture of the aneurysm. Although L. monocytogenes strains possess major pathogenic genes, such as prfA, hlyA, plcA, plcB, mpl, inlA, inlB and actA that can be identified by PCR, none of the evidence indicated that this case was a mycotic aortic aneurysm due to L. monocytogenes.

Aged↗

PubMed2004

Geographic variation and acoustic structure of the underwater vocalization of harbor seal (Phoca vitulina) in Norway, Sweden and Scotland.

The male harbor seal (Phoca vitulina) produces broadband nonharmonic vocalizations underwater during the breeding season. In total, 120 vocalizations from six colonies were analyzed to provide a description of the acoustic structure and for the presence of geographic variation. The complex harbor seal vocalizations may be described by how the frequency bandwidth varies over time. An algorithm that identifies the boundaries between noise and signal from digital spectrograms was developed in order to extract a frequency bandwidth contour. The contours were used as inputs for multivariate analysis. The vocalizations' sound types (e.g., pulsed sound, whistle, and broadband nonharmonic sound) were determined by comparing the vocalizations' spectrographic representations with sound waves produced by known sound sources. Comparison between colonies revealed differences in the frequency contours, as well as some geographical variation in use of sound types. The vocal differences may reflect a limited exchange of individuals between the six colonies due to long distances and strong site fidelity. Geographically different vocal repertoires have potential for identifying discrete breeding colonies of harbor seals, but more information is needed on the nature and extent of early movements of young, the degree of learning, and the stability of the vocal repertoire. A characteristic feature of many vocalizations in this study was the presence of tonal-like introductory phrases that fit into the categories pulsed sound and whistles. The functions of these phrases are unknown but may be important in distance perception and localization of the sound source. The potential behavioral consequences of the observed variability may be indicative of adaptations to different environmental properties influencing determination of distance and direction and plausible different male mating tactics.

Acoustics↗

PubMed1970

Bronchograms and tracheograms of seals under pressure.

Radiograms of the upper portion of the respiratory system were obtained at pressures up to 31.6 atmospheres absolute in the Weddell seal, Leptonychotes weddelli, and the northern elephant seal, Mirounga angustirostris. The trachea was considerably compressed but not fully collapsed at the highest pressures. No measurable change in the size of the bronchioles and smaller bronchi was observed. Measurements of total lung volume obtained simultaneously showed that the seals consistently dived with a small volume.

Animals↗

PubMed2006

Progression of sealed initial bovine enamel lesions under demineralizing conditions in vitro.

The use of sealants for the infiltration of proximal enamel lesions could be a promising alternative to the common strategies of remineralization and operative treatment. The aim of the present study was to compare the progression of sealed initial enamel lesions after exposure to a demineralizing solution in vitro. In each of 54 bovine enamel specimens three subsurface lesions were created. Two of the lesions were etched with phosphoric acid and sealed with either a fissure sealant or with various adhesives (1-5) for 15 s or 30 s, respectively, whereas one lesion remained as the untreated control. Subsequently, half of each specimen was covered with nail varnish (baseline) and the other half was reexposed to a demineralizing solution for 14 days (experimental). The specimens were cut perpendicularly to the surface, infiltrated with a low-viscosity fluorescent resin and observed with a confocal laser scanning microscope (CLSM). For lesions sealed with the fissure sealant and adhesives 1-3, the progression of lesion depth (0-31 microm) was significantly decreased (p<0.01; paired t test) compared with the untreated control (57 microm). For the fissure sealant and adhesives 1 and 3 extended penetration times (30 s) resulted in significantly reduced lesion progression compared to 15 s. It can be concluded that filling of the pores in initial enamel lesions with the fissure sealant and adhesives 1-3 can inhibit further demineralization in vitro.

Acrylates↗

PubMed2006

Efficacy of sealing proximal early active lesions: an 18-month clinical study evaluated by conventional and subtraction radiography.

This study assessed the efficacy of sealing proximal lesions on adult patients using a split-mouth design. Eighty-two 15- to 39-year-olds from the Dental Faculties in Copenhagen and Bogotá participated, each having 2 or more proximal lesions in the following radiographic stages: (1) lesion restricted to the outer half of enamel; (2) lesion from the inner half of enamel including the enamel dentine junction, and (3) lesion restricted to the outer third of dentine. Standardized geometrically aligned baseline and follow-up radiographs were obtained. One randomly selected lesion (test) in each patient was sealed with 1 of 2 resins. The patients were instructed to floss all the proximal lesions 3 times per week. The baseline to 18 months difference in caries lesion progression status was assessed using 3 methods: (1) radiographs were independently assessed visually; (2) radiographs were read in pairs, and (3) using subtraction radiography of digitized images. A total of 72 subjects finished the study (12.2% dropout). The compliance concerning flossing was poor (15%). For the repeated examinations kappa was 0.84 for the visual examination, 0.44 for the paired readings and 0.84 for the subtraction examination. Two test lesions and 1 control lesion were restored. For the independent radiograph assessment method 10 and 26% progressed in the test and control group, respectively (p > 0.05); with the paired radiograph method the corresponding data were 22% in the test and 47% in the control groups (p < 0.01). By subtraction radiography 44% of the test group and 84% of the control were judged to have progressed (p < 0.001). The sealing technique was superior to instructing patients to floss, and subtraction radiography appeared to be the most sensitive method for assessing lesion progression.

Adolescent↗

PubMed1986

Elements in marginal seals at amalgam-tooth interfaces.

X-ray micro-analysis was used to determine the elemental composition of the tooth, amalgam, and base material of ten aged, amalgam-restored, posterior teeth after they had been fractured across the amalgam-tooth interface. Subsequently, replicas were used to remove marginal seal material from each interface for examination by x-ray micro-analysis. The results show that P and Sn were present in all marginal seal material analyzed. Ca, Cl, Cu, Fe, S, and Zn were present in the marginal seals of various numbers of specimens.

Dental Amalgam↗

PubMed1994

Structural evidence of a sealed tissue interface with a total-etch wet-bonding technique in vivo.

The resin-dentin interface of in vivo specimens restored with the All-Bond 2 system by use of a total-etch wet-bonding technique on vital deep human dentin was investigated by: (a) SEM examination of cryofractured specimens; (b) SEM examination of acid-rinsed, highly polished, embedded specimens; and (c) TEM examination of demineralized ultrathin sections. Ultrastructural features that were pertinent to the formation of an effective clinical seal were characterized. It is suggested that the establishment of an effective seal of the patent dentinal tubules following total etching is accomplished by: (1) the formation of an outer zone of a solid resin plug surrounded by a circumferential cuff of resin-impregnated dentin; and (2) the formation of an inner zone of a hollow resin sheath with resin globules along the internal walls of the tubules, closely adapting to the odontoblast process. The structural appearance and functional implications of these two zones were strikingly similar, with the sealing of exposed dentinal tubules in arrested carious lesions or cervical abfraction lesions. It appeared that there is a common denominator in physiologic isolation defense mechanisms and the total-etch, wet-bonding technique in the All-Bond 2 system in preserving the biological and morphological integrity of the pulpo-dentinal complex.

Acid Etching, Dental↗

PubMedDate not supplied

Arterial access site closure with a novel sealing device: Duett.

Management of arterial access sites following percutaneous endovascular procedures is associated with patient discomfort and local complications. A new vascular sealing device, comprised of a balloon delivery catheter and a flowable procoagulant consisting of thrombin and collagen, was tested. Immediately following catheterization 200 patients (age, 66.1 +/- 11.2 years) were treated with the sealing device (Duett). Of these 200 patients, 132 underwent diagnostic catheterization, 67 underwent percutaneous transluminal coronary angioplasty, and one underwent percutaneous transluminal angioplasty. The sheath sizes included 2-5 Fr, 166-6 Fr, 25-7 Fr and 7-8 Fr. All patients undergoing diagnostic procedures received at least 5,000 U of intravenous heparin during the procedure. The Duett was used successfully in 198/200 (99%) patients immediately following completion of the endovascular procedure. In two patients a device malfunction resulted in uncomplicated crossover to manual compression. The time to hemostasis ranged from 3 to 5 minutes. All patients were walking 2 to 5 hours following the procedure unless a complication had occurred. No patient experienced leg ischemia, required surgical repair of the arterial access site, or had an infection at the site. In three patients (1.5%), a pseudoaneurysm occurred and was successfully treated with ultrasound-guided compression and three patients received a blood transfusion. No late complications were observed following hospital discharge. This novel vascular sealing device successfully achieves rapid hemostasis and allows early ambulation following percutaneous endovascular procedures with a low incidence of complications.

Aged↗

PubMed2004

A proposed classification and scoring system for supraglottic sealing airways: a brief review.

We provide an approach to evaluating sealing supraglottic airways by using a classification based on a sealing mechanism. Three main sealing mechanisms are identified, thus defining three groups: cuffed perilaryngeal sealers, cuffed pharyngeal sealers, and uncuffed anatomically preshaped sealers. We provide a brief overview of supraglottic airways and present a scoring system that is relevant to particular requirements. Scoring airways for routine applications is the example provided.

Anesthesiology↗