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PubMed1987

Lindau plaster cast insert--contribution concerning the primarily closed, unpadded plaster cast.

An inflatable synthetic insert made of ethylene vinyl acetate is presented which prevents posttraumatic air supply and innervation disturbances caused by compression when applying a primarily closed, unpadded plaster cast. The insert, consisting of thin ethylene vinyl acetate, is flexible enough to adapt itself without difficulties to any portion of an extremity. The foil insert is manufactured in different lengths, so that it can be applied both for the upper and the lower extremities. A reliable fixation of the fractured extremity can be guaranteed for weeks and months by the possibility of modifying the interior pressure of the insert within the primarily unpadded, closed plaster cast. Possible contact eczemas resulting from intolerability of synthetic foils are safely avoided by putting a cellulose or Vienna cotton strip between skin and foil insert.

Casts, Surgical↗
PubMed1985

Effect of preferential insertion of LDL receptors near coated pits.

Recent experiments suggest that low density lipoprotein (LDL) receptors on human fibroblasts are not inserted into the plasma membrane uniformly, as earlier experiments indicated, but are inserted into specialized regions, called plaques, where coated pits form. If the consequent reduction in the time required for LDL receptors to diffuse to coated pits were significant, this could alter conclusions drawn from previous calculations based on the assumption that LDL receptors are inserted uniformly. In particular, the conclusion could be wrong that diffusion of LDL receptors to coated pits is the rate limiting step in the interaction of cell surface LDL receptors with coated pits. Here we calculate the extent of the reduction in mean travel time of an LDL receptor to a coated pit, as a function of the plaque radius. We find that only if LDL receptor insertion is limited to a very small portion of the plasma membrane near coated pit sites is there a substantial decrease in the average time it would take an LDL receptor to diffuse to a coated pit. In order for preferential insertion of LDL receptors into plaques to cut the mean receptor travel time in half, plaques would have to take up no more than 10% of the cell surface area; to reduce the travel time by a factor of 10, plaques would have to cover only 2% of the cell surface, approximately twice the area covered by coated pits at 37 degrees C.

Animals↗
PubMed1993

Patient response to laryngeal mask insertion after induction of anaesthesia with propofol or thiopentone.

The response to insertion of the laryngeal mask airway (LMA) following either propofol 2.5 mg.kg-1 or thiopentone 5 mg.kg-1 was assessed in two groups of patients. The purpose of the study was to ascertain which of these two induction agents provided the better conditions for insertion of the LMA. Anaesthesia was induced by propofol in 35 patients and by thiopentone in 37. Following induction, ventilation was assisted for two minutes using 50% oxygen and nitrous oxide and 2% isoflurane, before insertion of the LMA. The presence of gagging, coughing, laryngospasm and movement was noted and graded. Thiopentone was associated with an adverse response in 76% of patients, compared with propofol in 26% (P < 0.01). Gagging, laryngospasm and head movement were more common using thiopentone (P < 0.01, P < 0.05 and P < 0.05 respectively) and in 11% (P < 0.05) of the thiopentone group insertion of the LMA was impossible due to inadequate relaxation. We conclude that, using these doses, propofol is superior to thiopentone as an induction agent for insertion of the laryngeal mask airway.

Adult↗
PubMed2000

Oral clonidine premedication reduces propofol requirement for laryngeal mask airway insertion.

PURPOSE: To determine the effect of oral clonidine premedication on propofol requirement (ED(50)) for the insertion of the laryngeal mask airway (LMA) in healthy patients undergoing abdominal hysterectomy. METHODS: After ethics committee approval and informed consent, 41 patients were randomly assigned to receive 5 microg x kg(-1) clonidine po premedication 90 min before entering the operating room (n = 22), or no clonidine (n = 19). To alleviate pain associated with iv propofol, 3 ml lidocaine 2%iv were administered. General anesthesia was induced, 30 sec later, with propofol at a rate of 100 mg x min(-1) (600 ml x hr(-1)) iv. The dose of propofol at which insertion of the LMA was attempted was predetermined by modification of Dixon's up-and-down method with an initial dose of 2.5 mg x kg(-1) and 0.25 mg x kg(-1) as the step size. An LMA was inserted, without muscle relaxants or other adjuvants 90 sec after completion of the propofol injection, by an anesthesiologist blinded to the treatment of the patient. RESULTS: The ED(50) of propofol for LMA insertion in clonidine-treated patients (2.0 +/- 0.2 mg x kg(-1), 1.8-2.3 mg x kg(-1) [95% confidence interval]), was less than that in patients without clonidine (2.5 +/- 0.1 mg x kg(-1), 2.4-2.6 mg x kg(-1), P < 0.01). CONCLUSION: Oral clonidine premedication reduces propofol requirement for LMA insertion.

Administration, Oral↗
PubMed2006

Suction catheter guided insertion of the ProSeal laryngeal mask airway is superior to the digital technique.

PURPOSE: We tested the hypothesis that digital insertion of the ProSeal laryngeal mask airway (ProSeal LMA) is more successful when using a suction catheter (SC) as a guide. METHODS: Two hundred and forty-three patients (ASA physical status I-III; aged 18-84 yr) were randomly allocated for the digital or SC-guided technique. The digital technique was performed according to the manufacturer's instructions. The SC technique involved priming the drain tube with the SC so that it protruded by 15 cm, blindly inserting the SC into the pharynx to a depth of 15 cm, followed by the digital technique. Failed insertion was defined by any of the following criteria: 1) failed passage into the pharynx; 2) malposition; and 3) ineffective ventilation. Any airway trauma, and visible or occult blood was noted. Sore throat, dysphonia and dysphagia were assessed 16 to 24 hr postoperatively. RESULTS: Fewer insertion attempts were required with the SC-guided technique (P = 0.02), but first attempt and overall success were similar. The time taken to provide an effective airway was shorter for the SC-guided technique (36 +/- 24 sec vs 44 +/- 28 sec, P = 0.02). A lateral approach was required less frequently with the SC-guided technique (0% vs 4%, P = 0.0004). There were no adverse events. Mouth trauma was more frequent with the digital technique (P = 0.04), but overall trauma was similar. There were no differences in the frequency of visible or occult blood. There were no differences in postoperative airway morbidity. CONCLUSIONS: The SC-guided technique is more frequently successful than the digital technique and is associated with less mouth trauma during insertion of the ProSeal LMA. We suggest that the SC technique may be a useful alternative when the digital technique fails.

Adolescent↗
PubMed1999

An untranslated insertion variant in the uncoupling protein 2 gene is not related to body mass index and changes in body weight during a 26-year follow-up in Danish Caucasian men.

AIMS: Associations between a 45 bp 3'untranslated insertion polymorphism in the uncoupling protein 2 (UCP2) gene and both body mass index (BMI) and sleeping metabolic rate have previously been reported. We investigated the impact of this polymorphism on BMI and long-term body weight changes. METHODS: The allelic frequency of the UCP2 insertion variant was determined in a cohort of 744 obese Danish Caucasian men who had a BMI of at least 31 kg/m2 at the draft-board examinations and a randomly selected control cohort consisting of 872 draftees. Follow-up measurements of BMI were done on average 26 years after the draft-board examinations. RESULTS: The prevalence of the insertion allele was 30.4% (95% confidence interval: 28.0-32.8%) among the obese and 29.6% (27.4-31.8%) in the control group (p = 0.6). In a lean group selected as the 354 subjects with a BMI less than 25 kg/m2 at 46 years of age from the control group, the frequency of insertion allele was 29.0% (27.2-30.8%) (p = 0.5 compared with the obese cohort). The BMI at the ages of 20 and 46 years did not differ between genotypes either in the obese or the control group. Similarly, the changes in BMI/year between examinations at 20 and 46 years of age did not differ between genotypes in either group. CONCLUSION/INTERPRETATION: In a large group of Danish Caucasian men we found no association between a 3'untranslated insertion polymorphism in the UCP2 gene and obesity. Neither did we identify a relation between this variant and BMI changes during adult age.

3' Untranslated Regions↗
PubMed2007

Histological changes and apoptosis of cartilage layer in human anterior cruciate ligament tibial insertion after rupture.

The purpose of this study is to investigate the histological changes and apoptosis of cartilaginous layers in human anterior cruciate ligament (ACL) tibial insertion at different time periods after rupture. By using a core reamer, 35 tibial insertions of ruptured ACLs were obtained during primary ACL reconstructions (number of days after injury: 19-206 days). A histological examination was performed and a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) staining assay was carried out to detect apoptosis. The average thickness of the cartilage layer, the glycosaminoglycan-stained area and the number of chondrocytes per millimeter decreased with time. The percentage average of TUNEL-positive chondrocytes was 42.0 +/- 16.2. The histological degenerative changes of the cartilage layer in the ruptured ACL tibial insertion progressed with time, especially in the first 2 months. Moreover, chondrocyte apoptosis continued from 19 to 206 days after rupture. The results may help elucidate the etiology of the histological changes of the insertion, and may help in devising optimal treatment protocols for ACL injuries if apoptosis is controlled. Moreover, we consider that using a surviving ligament and minimizing a debridement of ACL remnant during ACL reconstruction may be important for ACL reconstruction to maintain cartilage layers in ACL insertions.

Adolescent↗
PubMed2000

A new positioning device for precise femoral insertion of the anterior cruciate ligament autograft.

Optimal anatomical replacement of anterior cruciate ligament (ACL) is essential for achieving knee stability. Several methods for localizing a correct center of femoral insertion of the ACL graft and identifying a center of the femoral tunnel have been proposed, including free-hand drilling with "eyeballing," the use of tensiometers or isometers, fluoroscopic or radioscopic control, and aiming devices. We present a new positioning device for precise femoral insertion of the ACL autograft based on preoperative radiographic measurements (quadrant method) for locating the femoral ACL insertion. The aim was to find the best placement in the individual knee considering the wide variations among individuals and to decrease the likelihood of the surgeon making a mistake in localizing the optimal position of femoral insertion of the ACL. In comparison to other positioning procedures this method provides an exact preoperative planning of femoral insertion of the ACL and eliminates numerous sources of errors.

Adolescent↗
PubMed1999

A 59 amino acid insertion increases Ca(2+) sensitivity of rbslo1, a Ca2+ -activated K(+) channel in renal epithelia.

We previously cloned a MaxiK channel alpha-subunit isoform, rbslo1, from rabbit kidney with an amino acid sequence highly homologous to mslo but with a 59 amino acid insertion between S8 and S9 (Morita et al., 1997. Am. J. Physiol. 273:F615-F624). rbslo1 activation properties differed substantially from mslo with much greater Ca2+ sensitivity, half-activation potential of -49 mV in 1 micron m Ca2+. We now report single-channel analysis of rbslo1 and delA, a construct produced by removal of the 59 amino acid insertion at site A. delA is identical to mslo from upstream of S1 to downstream of S10 with the exception of 8 amino acids. Slope of the steady-state Boltzmann voltage activation curve was 8.1 mV per e-fold change in probability of opening for both rbslo1 and delA. The apparent [Ca2+](i) properties in delA were more like mslo but the voltage-activation properties remained distinctly rbslo1. Ca2+ affinity decreased and transmembrane voltage effects on apparent Ca2+ affinity increased in delA. The differences between rbslo1 and other cloned channels appear to be localized at insertion site A with both the insertion sequence and amino acid substitutions near site A being important. The steeper activation slope makes the channel more responsive to small changes in transmembrane voltage while the insertion sequence makes the channel functional at physiological low levels of [Ca2+](i).

Amino Acid Sequence↗
PubMed1999

Transhepatic insertion of vascular dialysis catheters in children: a safe, life-prolonging procedure.

INTRODUCTION: Central venous catheters (CVC) have been inserted percutaneously since 1989. This technique has been adapted for transhepatic insertion of large-bore catheters in children with occluded central veins. MATERIALS AND METHODS: Three children aged 5, 11, and 12 years required hemodialysis or plasmaphoresis for treatment of life-threatening conditions. All central veins were occluded, thus transhepatic insertion of a large-bore catheter was necessary. All children underwent successful placement using a combination of ultrasound guidance and fluoroscopy. No complications occurred. DISCUSSION: Transhepatic insertion of large-bore catheters can be performed safely in children. Catheter removal should be accompanied by track embolization to prevent exsanguinating hemorrhage. CONCLUSION: Transhepatic insertion of dialysis catheters is a safe alternative in children with occluded central veins.

Ammonia↗
PubMed2006

Percutaneous insertion of Zilver stent in malignant biliary obstruction.

BACKGROUND: We evaluated the clinical efficacy and technical feasibility of the percutaneously inserted self-expandable nitinol stent (Zilver stent) for palliation of malignant biliary obstruction. METHODS: Seventeen patients with malignant tumors involving the intra- or extrahepatic bile duct who presented with obstructive jaundice underwent percutaneous insertion of a self-expandable nitinol stent. We retrospectively reviewed the hospital records of patients and evaluated the technical feasibility on stent placement, complications, patient survival, and duration of stent patency. RESULTS: Percutaneous biliary stenting with 27 Zilver stents was performed in 17 patients with malignant biliary obstruction. Technical success was 95%. Malposition of the stent was encountered in one patient. Minor technical problems were encountered in two patients: the introducer tip was broken during stent insertion, so endoscopic removal was done. Mean follow-up period for the 17 patients was 182 days (range 29-485 days): nine patients died of progressive disease at a mean follow-up of 151 days (range 61-371days) after stent insertion and eight patients remained alive at the final follow-up of 216 days (range 29-485 days). The median survival period for all patients was 277 days. The stent occlusion rate was 26% and the mean patency period was 280 days. In five patients, seven stents were obstructed by tumor ingrowth and overgrowth. Stent patency rates were 100%, 100%, 75%, 61%, and 41% at 1, 2, 3, 6, and 12 months, respectively. A late complication, erosive bleeding of the hepatic artery by the stent, developed in one patient. CONCLUSION: Percutaneous biliary stenting using the nitinol stent is technically feasible and safe and clinically efficacious treatment for malignant biliary obstruction, even with a minor technical problem during stent insertion.

Aged↗
PubMed1999

An exceptional group-I intron-like insertion in the SSU rDNA of lichen mycobionts.

An exceptional group-I intron-like insertion at position 940 of the nuclear small subunit rDNA is found in lichen mycobionts of the families Parmeliaceae and Lecanoraceae. This shared insertion site is exceptional as it follows a G. Although several features of the self-splicing Tetrahymena intron are missing, the conserved structure of the presumed core region indicates that the new intron-like insertion, which is missing in mature transcripts, is not part of a silenced ribosomal repeat. It is unlikely that the new insertion is horizontally transferred from the adjacent position 943. A phylogenetic analysis indicates congruence with lichen phylogeny and suggests that the insertion has been vertically inherited.

Base Sequence↗
PubMed2005

Evolutionary implications of multiple SINE insertions in an intronic region from diverse mammals.

An analysis of the nuclear beta-fibrinogen intron 7 locus from 30 taxa representing 12 placental orders of mammals reveals the enriched occurrences of short interspersed element (SINE) insertion events. Mammalian-wide interspersed repeats (MIRs) are present at orthologous sites of all examined species except those in the order Rodentia. The higher substitution rate in mouse and a rare MIR deletion from rat account for the absence of MIR in the rodents. A minimum of five lineage-specific SINE sequences are also found to have independently inserted into this intron in Carnivora, Artiodactyla and Lagomorpha. In the case of Carnivora, the unique amplification pattern of order-specific CAN SINE provides important evidence for the "pan-carnivore" hypothesis of this repeat element and reveals that the CAN SINE family may still be active today. Particularly interesting is the finding that all identified lineage-specific SINE elements show a strong tendency to insert within or in very close proximity to the preexisting MIRs for their efficient integrations, suggesting that the MIR element is a hot spot for successive insertions of other SINEs. The unexpected MIR excision as a result of a random deletion in the rat intron locus and the non-random site targeting detected by this study indicate that SINEs actually have a greater insertional flexibility and regional specificity than had previously been recognized. Implications for SINE sequence evolution upon and following integration, as well as the fascinating interactions between retroposons and the host genomes are discussed.

Animals↗
PubMed2005

An insertion mutation of the bovine Fii gene is responsible for factor XI deficiency in Japanese black cattle.

Factor XI deficiency in Japanese black cattle is an hereditary mild bleeding disorder with an autosomal recessive mode of inheritance. To characterize the molecular lesion causing factor XI deficiency in cattle, we isolated an entire coding region of the bovine F11 gene, which comprises 15 exons and 14 introns, and determined its nucleotide sequences. Comparison of the nucleotide sequences of the F11 gene between affected and unaffected animals revealed an insertion of 15 nucleotides in exon 9 of the affected animals. The insertion results in a substitution of one amino acid with six amino acids in a highly conserved amino acid sequence in the fourth apple domain of factor XI protein. Genotyping of the F11 gene in 109 Japanese black cattle revealed that the insertion clearly corresponded to the factor XI activities of the animals. We therefore concluded that the insertion of 15 nucleotides in the F11 gene is the causative mutation for factor XI deficiency in Japanese black cattle. Genotyping of the F11gene by detecting the insertion will be an effective DNA-based diagnostic system to prevent incidence of the disease.

Amino Acid Sequence↗
PubMed1997

The mouse Clc1/myotonia gene: ETn insertion, a variable AATC repeat, and PCR diagnosis of alleles.

Myotonias are muscle diseases in which the function of the muscular chloride channel ClC-1 is impaired. Null alleles of the corresponding Clc1 gene on mouse chromosome (Chr) 6 provide animal models for human myotonias. It was shown that the allele adr (Clc1adr) is due to an insertion of an ETn type transposon that is transcribed and leads to multiple splicing events; the allele mto (Clc1adr-mto) involves a stop codon near the N-terminus. We have determined the genomic organization of the mouse Clc1 gene and the sequence requirements for the transposon insertion in the Clc1adr allele. The mouse Clc1 gene is composed of 23 exons, ranging from 39 to 372 bp, and spans approximately 23 kb of genomic DNA. The exon/intron organization is highly homologous to that of the human CLCN1 gene; the homology of the coding sequence is 97% to rat and 89% to human. In the adr allele the ETn transposon is inserted into intron 12, the largest intron. Whereas the 5' and 3' LTR sequences of the ETn transposon are homologous to those reported for other insertional mutations of the mouse, no consensus motif for an insertion target site could be defined. On the basis of flanking sequences, we provide duplex PCR diagnoses for the adr, adr-mto, and wild-type alleles of Clc1. Close to the 3' end of intron 12, a tetranucleotide repeat (AATC)n was found that is polymorphic between mouse species Mus musculus, M. molossinus, M. castaneus, and M. spretus, and can thus be used for chromosomal mapping studies.

Alleles↗
PubMed2004

[Tolerance of a new calcium-alginate-insert for controlled medication therapy of the eye].

PURPOSE: For an effective pharmaceutical treatment it is necessary in some cases to maintain a constant drug level over a certain period. This cannot be achieved by conventional eye drop application. Therefore, a new insert basically consisting of alginates with a different hydroxyethylcellulose (HEC) content was developed. The aim of this study was to evaluate the tolerance of these inserts applied to the conjunctival cul de sac. METHODS: 24 healthy volunteers received the insert containing different concentrations of hydroxyethylcellulose (0%, 5%, 30%) for 1 up to 5 days. The eyes have been examined several times (including visual acuity, ocular surface morphology, break-up-time, Schirmer-Tear-Test). Subjective parameters were pain sensations or daily life disturbance. RESULTS: After an initial conjunctival hyperemia and a mild foreign body sensation, the insert was well tolerated. No variations concerning the tolerance between the different concentrations of hydroxyethylcellulose were observed. CONCLUSION: This study showed good tolerance of the new calcium-alginate-insert applied to the ocular surface for controlled drug release.

Alginates↗
PubMed2006

Conservative use of chest-tube insertion in children with pleural effusion.

The aim of this work was to evaluate the effect of a more conservative use of chest-tube insertion on the short-term and long-term outcome of pleural infection. Sixty-five patients with pleural infection, aged 1 month to 16 years were each treated according to one of the two protocols: classical management with chest-tube insertion (classical group, n = 33), or conservative use of chest-tube insertion (conservative group, n = 32), with drainage indicated only in the case of voluminous pleural effusion defined by a mediastinal shift and respiratory distress and/or an uncontrolled septic situation. The two groups were comparable with regard to age, baseline C-reactive protein (CRP) value and white blood cell counts, pleural thickness, identified bacteria, and antibiotic treatment. Chest-tube insertion was performed in 17 patients (52%) of the classical group compared to eight patients (25%) of the conservative group (P = 0.03). Duration of temperature above 39 degrees C was shorter in the conservative group (10 +/- 1 vs. 14 +/- 1 days, P = 0.01), as was the normalization of CRP (13 +/- 1 vs. 17 +/- 1 days, P = 0.03). Duration of hospitalization and intravenous (IV) antibiotherapy as well as the delay of chest-radiograph normalization was not significantly different between the two groups. A more conservative use of chest-tube insertion did not change short- and long-term outcome of the pleural infection in children. Drainage could be restricted to the most severely affected patients with pleural empyema causing a mediastinal shift and respiratory distress and/or presenting with an uncontrolled septic situation.

Adolescent↗
PubMed2003

Electrode insertion depth in cochlear implantees estimated during surgery, on plain film radiographs and with electrode function testing.

Three methods of determining electrode insertion depth in cochlear implantees are studied: intraoperative counting of inserted electrodes, plain film radiography using Stenvers projection and postoperative electrode function testing. In 16 cases the number of electrodes inserted in the cochlea were counted both by the surgeon at surgery and by two independent observers on plain film radiographs using Stenvers projections. The electrode function was tested postoperatively. The differences between the three methods in estimation of the number of intracochlear electrodes were analyzed with t-tests, and 95% confidence intervals (95% CI) of the mean differences were calculated. The mean difference between the radiograph observers was 0.25 electrode (95% CI, -0.69 to 1.19 electrodes.) The mean difference between radiography observations and the surgical counts was 0.60 electrode (95% CI, -0.71 to 1.91 electrodes.) The mean difference between surgical counting and electrode function testing was 0.40 electrode (95% CI, -0.66 to 1.46 electrodes.) The mean difference between radiograph observations and electrode function testing was 0.50 electrode (95% CI, -0.51 to 1.51 electrodes.) No significant differences existed between the three methods. Our findings showed similar results in estimating electrode array insertion depth with the three methods. Plain film radiography using Stenvers projection is satisfactory if imaging is indicated for determining the number of inserted electrodes.

Cochlea↗