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A new nasal mask for nocturnal home ventilation in chronic neuromuscular disorders.

A new nasal mask for nocturnal, intermittent positive pressure ventilation was used by patients with symptomatic sleep hypoventilation due to chronic neuromuscular disorders. The custom-fabricated mask is cast in visible light curing acrylic from a plaster model. Air is delivered through plastic tubes cast in the mask. The treatment was introduced through close cooperation between a physiotherapist and a technician. Evaluation was performed after 4-34 months' regular use. The mask was well tolerated. All patients reported comfortable sleep and symptom relief. The effectiveness was confirmed by whole-night measurements of oxygen saturation and end-tidal carbon dioxide.

Adult↗

Plaster-associated Bacillus cereus wound infection. A case report.

Plaster of Paris and nonsterile cast padding have previously been implicated in wound infections. The observation of three pin site infections with Bacillus cereus following pin placement and plaster fixation of an open forearm fracture led to an epidemiologic investigation. Two hundred sixty-one bacterial cultures were taken from materials in the Steinmann pin application and plaster fixation procedures. B. cereus with a similar antibiogram and biotype as was identified in the pin site cultures was recovered from three of the 22 (14%) plaster-impregnated gauze rolls and six of seven (81%) tapwater samples. The Bacillus sp contamination rate of plaster when dry or wetted with sterile water or tapwater was 58%, 25% and 40% respectively. All cultures of plaster samples were negative after steam or gas sterilization. These results suggest that the patient may have acquired the infection from the plaster-impregnated gauze wetted in tapwater. In this case, the Steinmann pins may have facilitated infection by guiding the plaster-associated bacteria to the pin insertion site. The use of gas sterilized plaster materials should be considered in certain circumstances.

Adult↗

Mounting casts on a new plasterless plane line articulator.

A technique of mounting casts on a plane line articulator without the aid of plaster or artificial stone has been described. The advantages of this technique are: The dimensional change errors inherent in a plaster or dental stone mounting are avoided. Casts may be routinely mounted and articulated in less than 3 minutes. Casts may be removed and returned to their original position with precise reliability. The disadvantages include the lack of an adjustable horizontal condylar guidance and the lack of an anterior guide pin or anterior guidance. Further studies should be directed toward determining the accuracy of remounting casts on the instrument.

Dental Articulators↗

Improvement in the properties of gypsum casts by polymer impregnation.

It is known that porous solids such as Portland cement, concrete, and ceramic tile bodies can be strengthened by polymer impregnation. The solid material is infiltrated with a liquid monomer, which is then polymerized in situ. In the present investigation, it has been found that this process is effective for strengthening gypsum casts prepared from ordinary laboratory plaster. Impregnation with poly(methyl methacrylate) confers marked improvements in tensile and compressive strength and abrasion resistance. The process would be particularly applicable to the preservation of study casts for record purposes.

Calcium↗

[Study on precision during articulator handling].

Using several brands of articulators, the precision involved in the manipulation of them was examined. First of all, the extent of three-dimensional displacement caused in the upper frame was examined when the 'Inclination of sagittal condyle path' (I.S.C.P.) and the 'Inclination of sagittal incisal path' (I.S.I.P.) of articulators were adjusted. Secondly, the displacement was measured, which is caused as it was loaded statically to the center of the upper frame. Thirdly, the vertical displacement of the upper frame and cast were measured when the cast is mounted by the plaster. Following results were obtained. The various displacement occurred between the upper and lower frame during articulator handling. After all, the rigidity or the precision of articulators should be taken into consideration, and the I.S.C.P. should be adjusted to 30 degrees and the I.S.I.P. to 0 degrees as the upper cast was mounted. However, the error due to three-dimensional displacement was found, which was caused by these adjustments after mounting casts. When casts are mounted with high or low ratio of water and powder, the expansion was smaller in the case of high ratio, so the ratio should be taken into consideration. Accordingly, I planned out the 'Remounting Method' which is able to use the articulator in high precision.

Dental Articulators↗

Technique for fabrication of an "instant total-contact cast" for treatment of neuropathic diabetic foot ulcers.

Addressing pressure reduction in the treatment of diabetic foot wounds is a critical component of therapy. The total-contact cast has proven to be the gold standard of treatment because of its ability to reduce pressure and facilitate patient adherence to the off-loading regimen. Removable cast walkers have proven to be as effective as total-contact casts in pressure reduction, but this has not translated into equivalent time to healing. A simple technique to convert the removable cast walker into a device that is not as easily detached from the lower extremity, thereby encouraging the use of this device over a 24-hour period, is presented in this article. The procedure involves wrapping the cast walker with cohesive bandage or plaster of Paris. In the authors' opinion, this technique addresses many of the disadvantages of the total-contact cast, resulting in an adequate compromise in this aspect of care.

Bandages↗

Slipper cast management of emergency foot problems.

Foot conditions are frequently seen in the emergency department. In many cases, although weight bearing is painful, it is not precluded, per se. When a soft dressing does not provide sufficient support, a below knee walking cast may be applied. We present an alternative dressing that may be of benefit in selected foot injuries. The dressing is fashioned with cast padding, foam sheeting and plaster. It is designed and molded to fit like a slipper. The plaster slipper has distinct advantages in that it is comfortable, lighter for the patient, and avoids the problem of ankle stiffness. We believe that this option is underused in the emergency setting.

Ankle↗