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At least 1,279 records · Page 71Linked to original sources
PubMed1999

[Perioperative use of peripherally inserted central catheter for parenteral nutrition in patients with abdominal malignancy].

OBJECTIVE: To evaluate the use of peripherally inserted central catheter(PICC) in perioperative patients with abdominal malignancies for parenteral nutrition. METHODS: PICC was performed in 33 patients while subclavicular vein insertion in 30 patients for comparison in order to analyse prospectively the advantages and disadvanges of PICC. RESULTS: There was no difference in the rate of success of catheter placement and infection between PICC and the "subclavicular" insertion (P > 0.05), but PICC had significantly longer indwelling time than that of the "subclavicular" insertion (P < 0.05). There were less risks associated with PICC insertions, but the flow rate of was lower(p < 0.05). CONCLUSIONS: PICC can be widely used on account of its longer indwelling time, easy and safe insertion.

Abdominal Neoplasms↗
PubMed2002

[Use of peripherally inserted multilumen catheters as an alternative to central venous access].

BACKGROUND: In the last decade alternatives to central venous lines in critically ill children have been developed. Multilumen catheters have classically been used through central venous access but there are no reports on their use as peripherally inserted central lines. PATIENTS AND METHODS: We performed a retrospective study of patients admitted to the pediatric intensive care unit in the previous 3 years who underwent catheterization with peripherally inserted central venous lines. The catheters were four French, double-lumen and 30-cm long. RESULTS: Twenty-two catheters were used in 22 children (mean age: 8.3 years; range 1.7-13.8). The catheters remained in place for a mean of 7.2 days. Ninety percent of the catheters were placed in antecubital veins. The catheters were used to administer antibiotics (59 %), other drugs (81 %), total parenteral nutrition (50 %) and blood (9 %). Central venous pressure monitoring was performed in eight patients. Complications were found in five patients (22 %): three cases of phlebitis, one catheter occlusion and one infection at the site of insertion. No significant differences were found in the complication rate between peripherally inserted catheters and 298 central venous catheters inserted in our unit in the same time period. CONCLUSIONS: Peripherally inserted multilumen catheters may be an alternative in the management of critically-ill pediatric patients.

Adolescent↗
PubMed2002

Uterine rupture with the use of PGE2 vaginal inserts for labor induction in women with previous cesarean sections.

OBJECTIVE: To analyze the rate of uterine rupture in women with previous cesarean sections undergoing a trial of labor in which a prostaglandin E2 (PGE2) vaginal insert was used. STUDY DESIGN: The study was based on a computerized search and review of pharmacy records, medical records and the pertinent literature. Pharmacy records were correlated with the medical records of all women undergoing a trial of labor after cesarean section over a 33-month period. RESULTS: Between January 1998 and September 2000, 13,544 patients delivered. Of these cases, 790 were vaginal trials of labor after previous cesarean section. A PGE2 vaginal insert was used in 58 of the patients. A total of 6 of these 58 patients (10.3%) experienced uterine rupture. This compares to a rupture rate of 1.1% (8/732) in deliveries not using PGE2 vaginal inserts. CONCLUSION: The risk of uterine rupture was significantly increased in patients undergoing a trial of labor after previous cesarean section when a PGE2 vaginal insert was used. Physicians need to be aware that using a PGE2 vaginal inserts for cervical ripening and/or induction of labor in women with a previous cesarean section might increase the risk of uterine rupture above the standard risk for vaginal birth after cesarean (VBAC) candidates. We recommend that all VBAC patients using a PGE2 vaginal insert be closely monitored for evidence of uterine rupture.

Administration, Intravaginal↗
PubMed1982

Management of amenorrhea due to contraceptive injectables by temporary IUD insertion.

Amenorrhea is a common side effect of injectable contraceptive. Lippes loops were inserted in 22 amenorrheic women who continued injectable contraception, and in 6 cases with prolonged postinjectable amenorrhea. The occurrence and rhythm of subsequent bleeding was recorded. IUD insertion induced bleeding in most cases of continued injectable users but it was usually irregular and unpredictable. It was regular in 6 subjects only while the IUD was in situ. After the removal of the IUD, the majority regained the state of amenorrhea within 3 months. Temporary IUD insertion had a positive impact on continuation (a mean additional rate of 18 months of use) among subjects who had wished to terminate the method because of amenorrhea. This procedure of temporary IUD insertion may serve to provide these women with an alternative contractive approach. In the postinjectable amenorrhea group, temporary IUD insertion induced bleeding during IUD application as well as after its removal, which was more predictable than that in the continued users. IUD insertion may facilitate return of regular menses and resumption of fertility in amenorrheic women who stop injectable contraception.

Age Factors↗
PubMed1975

[Genetic counseling in cases of chromosome insertions].

The principles of the estimation of the risk of repeated birth of malformed child and spontaneous abortion in families of balanced carriers of insertions are presented. A risk for a carrier is formed from two parts: a risk for a carrier of reciprocal translocation and a risk for a carrier of insertion of the came length as inseried segment. The first component of the risk is a constant, the latter one is a variable. It depends on the length of the inserted segment, the type of its inclusion (direct or inverted) and sites of break points. An estimation of the risk in hypothetical insertion 46, XX, inv ins (4; 2) (q24; q22q34) is described as a model. The same method of counselling may be used for the families with triple translocations t(a-, b-, c+) with "insertion" of fragment of chromosome "a" between the parts of "b" and "c" chromosomes. A tentative empirical mean value of repeated birth of malformed child and spontaneous abortion in families with insertions is 29% and 45% for the female carrier, and about 37% and 25% for the male carrier.

Abortion, Spontaneous↗
PubMed2003

[Anomalous insertion of the pectoralis minor muscle: ultrasound findings].

PURPOSE: With anomalous insertion of the pectoralis minor muscle, its distal fibers pass over the coracoid process instead of inserting on it, following sometimes a trajectory very similar to that of the coracohumeral ligament. The aim of this prospective study was to evaluate the frequency of detection of this anomalous insertion by ultrasonography. MATERIALS AND METHODS: Ultrasound demonstrated the abnormal insertion of the pectoralis minor muscle by directly visualizing its fibers slipping over the coracoid process during external and internal rotation of the humerus. Three hundred and three individuals underwent ultrasound of the shoulders (64,7% female, mean age of 45 years), for a total of six hundred and six shoulders; 30% (183/606) were symptomatic. RESULTS: An abnormal insertion was demonstrated in 9,57% of the examined shoulders (58/606), with a statistically significant predominance on the left side (12,2%) compared to the right side (6,9%), and of women (12,2%) compared to men (4,7%). CONCLUSION: Ultrasound demonstrated an abnormal insertion of the pectoralis minor muscle in 9,57% of 606 examined shoulders. There was a female and left side predominance and no significant correlation with symptoms.

Female↗
PubMed1992

Membrane insertion of the mannitol permease of Escherichia coli occurs under conditions of impaired SecA function.

The membrane insertion of the mannitol permease (MtlA protein) of Escherichia coli, a polytopic cytoplasmic membrane protein possessing an uncleaved amphiphilic signal sequence, was studied using a cell-free protein synthesis system. The MtlA protein synthesized in the presence of inside-out cytoplasmic membrane vesicles was shown to insert into the membranes based on the following criteria: (a) co-sedimentation of the majority of the MtlA protein with the vesicles; (b) selective extraction of the membrane-associated MtlA by doxycholate but not by urea treatment; and (c) protease resistance of a defined MtlA fragment observed exclusively in the presence of membranes. Post-translational addition of membrane vesicles allowed membrane association of MtlA but did not allow efficient integration. In cell-free systems having reduced levels of the export factors SecA and SecB and exhibiting defective translocation of preOmpA and preLamB, insertion of the in vitro synthesized MtlA apparently occurred normally. In contrast, when membranes from the secY24ts mutant or trypsin-treated membranes were used, insertion of MtlA was reduced. In vivo experiments monitoring the permease activity of MtlA in the secA and secY mutants supported the conclusions of the in vitro results. Thus, the insertion of MtlA is essentially SecA- and SecB-independent but may be dependent on SecY and/or an as yet unidentified membrane protein. The requirements for the insertion of the mannitol permease are therefore clearly different from those for the translocation of most proteins having a cleavable hydrophobic signal sequence.

Adenosine Triphosphatases↗
PubMed2003

[Polymorphism of six Alu-insertions in residents of Morocco: comparative study in Arab and Berber populations and residents of Casablanca].

Alu elements are the largest family of short tandem interspersed elements (SINEs) in human who have arisen to a copy number with an excess of 500,000 copies per haploid human genome and mobilize through an RNAse polymerase III derived transcript in a process termed "retroposition." Several features make Alu insertions a powerful tool used in population genetic studies: the polymorphic nature of many Alu insertions, the stability of an Alu insertion event and, furthermore, the ancestral state of an Alu insertion is known to be the absence (complete and exact) of the Alu element at a particular locus and the presence of an Alu insertion at the site that forward mutational change. Here we report on the distribution of six polymorphic Alu insertions in a general Moroccan population and in the Arab and Berber populations from Morocco and their relationships with other populations previously studied. Our results show that there is a small difference between Arabs and Berbers and that the Arab population was closer to African populations than Berber population which is closest to Europeans.

Alu Elements↗
PubMed1992

Clinical evaluation of percutaneous insertion and long-term usage of a new cuffed polyurethane catheter for central venous access.

A new, long-term venous access catheter was evaluated in clinical practice and the insertion time, complication rate and prospective follow-up recorded. Fifty novel polyurethane catheters (Cuff-Cath) were inserted in 48 patients, for cytotoxic chemotherapy in 36, long-term total parenteral nutrition in five and miscellaneous indications in seven. All catheters were inserted by a percutaneous technique under local anaesthesia. The mean insertion time was 18 min. There were three insertion complications; failure to cannulate, pneumothorax and malposition. Seven catheters required removal (sepsis in five, subclavian vein thrombosis in two) and one catheter fell out. Total catheter days to date has been 6607 (mean 132, range 18-831 days). Eleven catheters are still in use a mean of 154 days (range 38-490 days) after insertion. Furthermore, a new technique has been described which prevents inadvertent displacement. This new catheter combines the mechanical advantages of polyurethane, together with those of a Dacron cuff. Early results suggest that this catheter may be a useful alternative to silicone catheters of the Hickman/Broviac type for long-term central venous access.

Antineoplastic Agents↗
PubMed1992

Transduction of circular membrane ruffling by the platelet-derived growth factor beta-receptor is dependent on its kinase insert.

The platelet-derived growth factor (PDGF) alpha- and beta-receptors both mediate a mitogenic response, but only the beta-receptor mediates circular actin reorganization and chemotaxis. The tyrosine kinase domains of the receptors contain noncatalytic inserts of about 100 residues. In order to determine the role of these domains in the differential signaling of the two receptors, we constructed chimeric PDGF receptors and expressed the constructs in porcine aortic endothelial cells. The chimeric receptors were similar to the wild-type receptors in their ability to induce mitogenicity in response to ligand. Examination of receptor-associated substrates by in vitro kinase assays revealed that phosphoproteins of 72 and 110 kilodaltons were associated with the kinase insert of the alpha-receptor, whereas a phosphoprotein of 130 kilodaltons was associated with the kinase insert of the beta-receptor. Actin reorganization in the form of circular membrane ruffling was seen after ligand stimulation of the beta-receptor and the alpha-receptor containing the beta-receptor kinase insert but not after stimulation of the alpha-receptor or the beta-receptor containing the alpha-receptor kinase insert. These data indicate that the PDGF beta-receptor kinase insert has an essential function in the signal transduction pathway leading to circular membrane ruffling.

Actins↗
PubMed1980

Transascending aortic intraaortic balloon insertion with delayed sternal closure: A retrospective analysis.

Intraaortic balloon pumping (IABP) is an established therapeutic adjunct in the treatment of postcardiotomy/infarction low cardiac output states. Although the common femoral or iliac arteries are the preferred sites for balloon insertion, severe arterial occlusive disease may preclude entry by these methods. To circumvent this problem, alternative methods of insertion utilizing transthoracic approaches have evolved. In our institution, direct (transaortic) IABP insertion, combined with delayed sternal closure to avoid cardiac compression and possible tamponade, was performed in 28 adult postcardiotomy patients (mean age 60.4 +/- 3 years). The severity of generalized atherosclerosis was reflected in an overall survival rate of 28.6%. Retrospective analyses of the clinical courses of these patients revealed that the transaortic approach allowed utilization of larger and more effective balloons. Successful insertion of 30 and 40 ml balloons was accomplished in 27 of 28 (96%) of these patients, and one patient with a hypoplastic aorta required a 20 ml balloon. There were no complications directly attributable to this alternative site of balloon insertion, and tamponade was avoided. Delayed sternal closure was accomplished within 48 to 96 hours. We concluded that when severe peripheral vascular occlusive disease prevents insertion of intraaortic balloons via the femoral or iliac arteries in patients with low cardiac output, the alternative transaortic approach is indicated. Combined with delayed sternal closure in patients with postcardiotomy dilatation, additional benefits accrue.

Journal Article↗
PubMed1992

Nodule DNA in the (GA)37.(CT)37 insert in superhelical plasmids.

Di- or trivalent metal ions stabilize a supercoil-dependent transition in pGA37, which contains the (GA)37.(CT)37 insert, at neutral and basic pH. The structure formed is different from the well known protonated triplexes (H-DNA) adopted at low pH by polypurine.polypyrimidine (Pur.Pyr) inserts in plasmids. DNA samples must be preincubated in the presence of multivalent ions at 50 degrees C for the new transition to occur. At neutral pH in the presence of Co hexamine, both strands of the insert have modification maxima situated at one-third of the distance from both ends. We propose the formation of a new structure called nodule DNA which consists of both Pyr.Pur.Pyr and Pur.Pur.Pyr triplexes and does not contain continuous single-stranded regions. At basic pH (greater than 8.5) in the presence of magnesium ions, the modification pattern corresponds to Pur.Pur.Pyr triplex formation in the whole insert. At neutral pH in the presence of magnesium, both nodule DNA and the Pur.Pur.Pyr triplex can be formed in the insert. We also observed a magnesium-dependent transition at neutral pH in the other Pur.Pyr insert containing plasmids. These data demonstrate that Pur.Pyr sequences can adopt several non-B conformations at close to in vivo conditions.

Base Sequence↗
PubMed2004

Routine insertion of permanent peritoneal dialysis catheters in the nephrology ward. The sliding percutaneous technique.

AIM: A prerequisite to the technical success of peritoneal dialysis in its different modifications is a safe, reliable, correctly positioned, and functioning peritoneal catheter. The ideal method for insertion of permanent catheters (PC) remains debatable. The most commonly used technique is an open surgical approach, by minilaparatomy. Others have proposed a blind approach, using either a trocar method or a modified Seldinger technique or an insertion by means of peritoneoscopy. METHODS: We describe our 5-year experience (May 1997 - June 2002) with 68 percutaneous PC insertions in 63 consecutive patients. A modified technique of percutaneous PC insertion was used that here we call sliding percutaneous technique (SPT): 1) a midline incision is made 4 cm below the umbilicus; the peritoneum is punctured using a straight plastic catheter with a stylet. The catheter is pushed caudally towards the left iliac fossa; 2) a straight stiff 90 cm stylet is inserted through the temporary catheter, which is subsequently removed. The stylet has 2 tips, a blunt proximal one, which is pushed through the catheter into the iliac fossa, and the distal one; 3) having the stylet in situ, a double-cuffed curled-end PC is mounted at the distal tip of the stylet starting from the curl; then, the PC is gently slid down along the stylet as a train does along the rail-way. PC failure was defined as mechanical dysfunction, persistent dialysate leak and persistent peritonitis, or exit site/tunnel infection requiring PC removal. Furthermore, PC failure was defined as early, if occurring in the first 30 days after PC placement, or late, if occurring more than 30 days post-operation. Life-table estimates of PC survival were determined by Kaplan-Meier analysis. RESULTS: Early complications: in the 1st month on dialysis, obstruction to dialysate flow was the commonest cause leading to PC failure. The early actuarial survival (AS) was 90%. Late complications: peritonitis was the commonest cause of PC failure. The late AS, i.e. excluding the catheter failures occurring in the 1st month post-operation, was 82% at 3 years. Global AS, i.e. including both early and late PC failures, was excellent (74% at 3 years). CONCLUSIONS: Even though this study is retrospective and does not compare percutaneous with surgical PC placement techniques, it allows us to state that percutaneous PC insertion is a well-tolerated, rapidly performed, side-room procedure that gives excellent results, above all when using SPT.

Aged↗
PubMed2005

Subgingival debridement with a teflon-coated sonic scaler insert in comparison to conventional instruments and assessment of substance removal on extracted teeth.

OBJECTIVE: Previous studies have shown that endotoxins are located on the periodontally diseased root cementum and not within it. To what extent a Teflon-tubed sonic scaler was capable of removing bacterial deposits in comparison to conventional scaling instruments, and the resulting root surface roughness and root surface topography, were recently assessed. The objective of the present study was to evaluate how much root cementum is removed with these instruments. METHODS AND MATERIALS: Eighty-two teeth were treated subgingivally on one approximal site either with a Teflon-coated sonic scaler insert (tSS), a Gracey curette, a conventional sonic scaler (SS), a piezoelectric ultrasonic scaler insert (US), or an oscillating Periotor insert (PT) before extraction. The untreated site served as control. The width and length of cementum removal were compared histomorphometrically. Nonparametric analyses were carried out for statistical comparison. RESULTS: The US, PT, and tSS inserts removed less substance than the curettes or SS inserts. The cementum removed was 40 microm for root surfaces treated with the curette or SS, 30 microm for those treated with US, 20 microm for PT, and 17 microm for tSS. CONCLUSION: The Teflon-coated sonic scaler inserts can be a reasonable choice for gentle maintenance treatment of compliant patients with good plaque control, and little or no subgingival deposits.

Adolescent↗
PubMed2004

[A 30-year history of the change in package insert for Japanese pharmaceutical medicines].

Package inserts are very important in the medical field. They are full of useful and fundamental information. We have edited two books, named 'Drugs in Japan - Ethical Drugs' and 'Drugs in Japan - Over-the-Counter Drugs' based on the review of package inserts provided for pharmaceutical medicine for more 30 years. We tried to analyze the change in package insert contents; in particular, information quality and quantity.The quality of the information provided in package inserts has improved year by year, with drastic improvements being seen three times. The information quantity has also increased in proportion to the improvement in quality. We created a graph based on package inserts, Warfarin; Eisai, chronologically. It shows that improvement in information quality is supported by the amount of text in the package insert.

Drug Labeling↗
PubMed2005

Peritoneal dialysis catheter insertion.

Peritoneal dialysis (PD) catheter insertion can be accomplished by any 1 of 3 techniques. These include dissective or surgical, the blind or modified Seldinger, and laparoscopic techniques. The dissective technique solely utilized by surgeons, places the catheter by mini-laparotomy under general anesthesia. In the blind or modified Seldinger technique a needle is inserted into the abdomen, a guide-wire placed, a tract dilated and the catheter is inserted through a split-sheath, all without visualization of the peritoneal cavity. Of the various laparoscopes, peritoneoscopic insertion uses a small optical peritoneoscope for direct inspection of the peritoneal cavity and identification of a suitable site for the intraperitoneal portion of the catheter. Hence, of the 3 techniques, only the latter allows for the direct visualization of the intraperitoneal structures. This technique can be easily used by nephrologists as well as surgeons. Peritoneoscopic placement varies from traditional laparoscopic techniques by using: a much smaller scope (2.2 mm diameter) and puncture size, only one peritoneal puncture site, a device to advance the cuff into the musculature, air in the peritoneum rather than CO2, and local anesthesia rather than general anesthesia. Prospective randomized and nonrandomized studies have shown that PD catheters peritoneoscopically placed by nephrologists have less incidence of complications (infection, exit site leak) and longer catheter survival rates than those inserted surgically. The current review focuses on the peritoneoscopic insertion of PD catheter and presents some of the complicating issues (bowel perforation, catheter migration, and prior abdominal surgery) related to this procedure.

Catheterization↗
PubMed2005

Effect of insertion technique and adhesive system on microleakage of Class V resin composite restorations.

PURPOSE: To evaluate the effect of different insertion techniques and adhesive systems on microleakage of Class V composite resin restorations. MATERIALS AND METHODS: Forty-eight human molars were randomly assigned to four groups (n = 12). Standardized mixed Class V cavities (enamel and dentin margins) were prepared at the CEJ. A total-etch (Adper Scotchbond MultiPurpose) and a self-etching (iBond) adhesive system were evaluated using either an incremental or single-step (bulk) insertion technique. The preparations were restored with Esthet*X micromatrix hybrid composite. The teeth were thermocycled 1000 cycles, immersed in 1% methylene blue dye for 24 h, and invested in acrylic resin. The specimen blocks were then sectioned longitudinally, with dye penetration (microleakage) examined with a 20X binocular microscope. Enamel and dentin margins were scored separately for microleakage using an ordinal ranking system. Results were analyzed using non-parametric tests at a p < 0.05 level of significance. RESULTS: Significance was exhibited between the groups (adhesive material/insertion technique) at the coronal and apical margins. At the coronal margin, the total-etch adhesive/incremental insertion group exhibited significantly less leakage than the other groups, while at the apical margin, the total-etch adhesive/incremental insertion group showed significantly less leakage than the self-etching adhesive/bulk insertion group. Significantly less leakage was found at the coronal margins compared to the apical margins of the material/technique groups. CONCLUSION: The use of a total-etch adhesive system and incremental insertion of composite significantly reduced microleakage at the coronal and apical margins of Class V composite restorations.

Coloring Agents↗
PubMed2006

Histological comparison of fate of ligamentous insertion after reconstruction of anterior cruciate ligament: autograft vs allograft.

OBJECTIVE: To analyze the histological results and the biological remodeling of ligamentous insertion after the reconstruction of anterior cruciate ligament (ACL) with autograft or allograft tendon. METHODS: Extensor digitorum tendon was harvested from hind limb as graft material and transplanted to reconstruct the resected ACL in 12 mongrel dogs. Each free tendon end was secured by holding sutures and then the sutures were tied to the post screw at the femoral and tibial bony tunnel outlet after transplantation respectively. Autograft was randomly performed on one side of knee while allograft on the other side of knee. After transplantation, the histological analysis was undertaken at the 6th, 12th weeks and the 6th month using hematoxylin-eosin (HE) stain under light microscope. RESULTS: The insertion structure of normal ACL typically consisted of four layers, i.e., dense connective tissue, fibrocartilage, mineralized fibrocartilage and bone. There was a distinct regular tidemark line between fibrocartilage and mineralized fibrocartilage. At the 6th week postoperatively, loose connective tissue presented in the interspace between graft and bony tunnel wall in both autograft and allograft groups. At the 12th week postoperatively, the collagenous fibers between autograft and tunnel wall became well organized and the four layers of insertion with discontinuous tidemark line were demonstrated indistinctly in autograft group but not in allograft group. At the 6th month postoperatively, both of a clear and continuous tidemark line and distinct four layers could be seen in autograft group. In allograft group, only a waved discontinuous tidemark line was shown and either the anatomic morphology or the maturity of insertion was inferior to that of autograft group. CONCLUSIONS: At the 6th month postoperatively, although the ligament-cartilage insertion is primarily formed after ACL reconstruction with autograft or allograft tendon, the histological morphology and the maturation of insertion of autograft tendon are better than those of allograft group, which suggests that postoperative rehabilitation should be paid more attention and could be safer if little delayed during ACL reconstruction with allograft tendon.

Animals↗