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The repeated puncture of vessels with a conventional syringe needle causes frequent pain and fear in patients and particularly increases the risk of infections. An indwelling needle implanted in veins for a long time can avoid repeated punctures. However, blood coagulation during implantation and bleeding after the withdrawal of the needle are still key problems. Herein, we present a novel strategy to engineer a smart indwelling needle with on-demand switchable anticoagulation and hemostatic activities by modifying the outer surface and the inner surface of the indwelling needle with a coagulant catechol-functionalized chitosan coating and anticoagulant magnetic FeNP–dopamine-conjugated heparin (FeNP–HepDA), respectively. The smart indwelling needle is implanted into a rabbit's ear vein. Remarkably, under a magnetic field, the FeNP–HepDA-coated cannula inner wall maintains excellent anticoagulation activity, ensuing the patency of the needle due to the firm fixation of FeNP–HepDA. Upon removing the magnetic field, FeNP–HepDA can be shed. Under this condition, the cannular inner surface loses anticoagulation activity and when the needle is extracted from the vein, the hemostatic CHCS coating on the external surface serves to prevent bleeding. The strategy reported in this study opens up an avenue for designing biomaterials and biodevices exhibiting the coexistence of anticoagulation and coagulation.

Background: Ganglion is one lesion that is frequently seen in minor surgical practice. Treatment of dorsal wrist ganglia begins from basic reassurance to advanced endoscopic excision. Many a time’s treatment not often necessary, but patients seek consultation asking for some form of definitive treatment. Recurrence is frequently seen with cyst aspiration/injection or after surgical excision. Recurrence is the common problem, whatever is the treatment modality. Materials and Methods: In this study we evaluate results of 30 dorsal wrist ganglia treated by the transfixation technique using a syringe needle. Results: Out of 30 cases included in this study 28 were completely cured of the symptoms giving a success rate of 93.33%, One patient (3.33%) had recurrence at 4 months and was painful and he had to undergo excision, One patient (3.33%) had recurrence at the end of 6 months. Discussion: Compared to various other modalities this method is cost-effective, time consumption is less, low invasion, recurrence rate is low, and can be performed under local anaesthesia, and does not require any complicated instrument and an easy-to-master technique.

Tissue puncture is an effective means in the diagnosis and treatment of diseases, providing important information for clinical doctors. Yet, haemorrhage is still a main and unavoidable complication, which can cause serious outcomes, especially in patients with abnormal coagulation function. Herein, we present a facile yet effective strategy to prepare haemostatic needles by coating the syringe needles surface with alginate-CaCl2-based hydrogel with carefully optimized mechanical and chemical properties, which can effectively prevent bleeding following tissue puncture. The needle with haemostatic coating exhibits complete prevention of blood loss following vessel and viscera puncture in the normal animal as well as in animal models with hemorrhagic diathesis. The syringe needle with haemostatic coating in this work holds enormous potentials for clinical applications, including sampling and injection.

Background Warts, or verrucae, are benign epithelial profilerations of skin and mucosa caused by infection with HPV and poses a challenge to treat. Objective To compare between single and microneedling-assisted multipuncture techniques of intralesional application in treatment of plantar warts. Methods The study included 60 Patients who were divided into two groups (A&B). Each group consisted of (30) patients. Group (A) subjects received intralesional bleomycin with a single injection using syringe needle. For Group (B) subjects, we combined microneedling with topical spraying of bleomycin (MN + Bleo) and followed by occlusion for 2 hours. Results The results revealed complete clearance of warts in 21 patients in group (A) (70%) whom were treated by intralesional (IL) bleomycin vs 25 patients (83.3%) in group (B) whom were treated by spraying of bleomycin following microneedling. Side effects other than pain, erythema, and transient induration were relatively infrequent, and no nail changes or Raynaud's phenomenon was observed in both groups. Conclusion We established a good safety and efficacy profile for bleomycin in plantar wart treatment and we demonstrated that microneedling followed by bleomycin spraying had a higher clearance and proved less painful as opposed to bleomycin injection.

The accelerator-based syringe needle-type proton-induced X-ray source, which was proposed by the authors in 2013 as an alternative for prostate cancer brachytherapy, has an essential issue in that its dose distribution is affected by many factors, such as the structure of the needle and incident proton beam conditions. In this paper, as a method of evaluating dose distribution, we propose a Geant4 simulation to study the effect of the incident proton beam condition on the spectrum and distribution of X-ray emission, using experimentally measured proton beam emittance as input data. The results showed that the effect of beam misalignment was significant and confirmed the effectiveness of this method. It is expected that improving this method will clarify the other factors that affect X-ray distribution, so that finally, we can optimize such factors in designing a special dose distribution for the irradiation of tumors of arbitrary size and shape in the tissue. Copyright © 2017 John Wiley & Sons, Ltd.

Background: Thorough cleaning of the pulp space is a challenging task. The mechanical instrumentation alone is usually not sufficient to completely debride the canals, and therefore, it requires the chemical action of irrigants also to disinfect the difficult to reach areas. Aim: The purpose of this study was to determine apical extrusion and assess irrigant penetration through cone-beam computed tomography (CBCT) for EndoActivator (EA) and XP Endo Finisher (XP). Materials and Methods: Sixty single-rooted mandibular premolars with oval-shaped canals were equally divided into three groups after instrumentation, based on the final irrigation: Group-1 syringe needle (30G Max-I-probe), Group-2 EA, and Group-3 XP. After the final irrigation, the weight of the extruded sodium hypochlorite was calculated. The prepared canals were then irrigated with a radiopaque contrast medium, which was activated according to the group of the sample (Group-1, 2, or 3). The volume of irrigant filled in the canal, especially in the apical third was determined through special tools in CBCT imaging. Statistics: One-way ANOVA test was used to compare the different groups. Results and Conclusion: Significantly more apical extrusion was seen in XP (P < 0.001). Both XP and EA have shown complete penetration of irrigant in the canal (100%).

Purpose: The aim of this retrospective study is to describe our initial experience by using new simplified mattress sutures with syringe needle for congenital diaphragmatic hernia (CDH) in neonates when no posterolateral rim of diaphragm exists. Methods: A retrospective review of the new simplified technique in 15 cases from February 2015 to February 2018 at a single institution was performed. In the procedure, two to three primary suture sites were taken from the relative intercostal region of the body surface. Two 2-0 nonabsorbable sutures around the rib were inserted between the anterior rim of the defect and the relative rib through a syringe needle. Knot tying was made extracorporally and the knots were under the skin of intercostals space. Results: Among the patients, 9 were male and 6 were female. The age was 10 minutes-1 day when admitted, 10 were term newborns, and 5 were premature. The mean operative time was 37.5 minutes (range, 25-60 minutes) for each CDH repair. No cases required conversion to open surgery, blood loss was minimal. The mean follow-up duration was 18.5 months (range 3-27 months), with no deaths, and no single case of recurrence. Conclusion: We have found this simple technique to be a useful adjunct in the thoracoscopic management of selected cases with CDH. It has the advantages of reduced operative time, simplicity, and feasibility and has the value of clinical popularization.

Introduction The purposes of this study were to measure the chest wall thicknesses (CWTs) at second intercostal space (ICS) mid-clavicular line (MCL) and fifth ICS MAL directly, and compare the actual success rates of needle thoracostomies (NTs) by inserting a 5-cm-long syringe needle. Predictive values of weight, body mass index (BMI) and CWT were also analyzed. Materials and Methods This study included 199 measurements of 50 adult fresh cadavers from both hemithoraces. Five-centimeter-long syringe needles were inserted and secured. Penetration into the pleural cavity was assessed, and CWTs at 4 locations were measured. Achieved power of this study for the primary aim of CWT comparison from 2 nd and 5 th ICSs was .94. Results Overall mean CWTs at 2 nd ICS MCL and 5 th ICS MAL were measured as 2.46 ± 0.78 and 2.89 ± 1.09, respectively, and 5 th ICS MAL was found to be statistically thicker ( P = .002). The success rate of NT at 2 nd ICS MCL was 87% (95% CI, 80-94), and that at 5 th ICS MAL was 78% (95% CI, 70-86; P = .3570). Only 6 (17.1%) of 35 failed NTs had a CWT greater than 5-cm. Needle thoracostomy has failed in 29 (14.9%) of 194 locations, despite a CWT less than 5-cm. Below a weight of 72 kg, BMI of 23 kg/m 2 , or CWT of 2.4 cm, all NTs were successful. Discussion and Conclusions In this report, we present the largest cadaver-based cohort to date to the best of our knowledge, and we observed a statistically nonsignificant 9% more NT success rate at 2 nd ICS at a power of 88% and statistically significant more success rate in males at 5 th ICS was (47.7%). We also observed thinner CWTs and higher success rates than previous imaging-based studies. A BMI of 23 kg/m 2 or less and weight of 72 kg or less seem to accurately rule-out NT failure in cadavers, and they seem to be better predictors at the bedside.

This study determines if detachable syringe-needle combinations redesigned to reduce their dead space volume may substantially reduce the burden of exposure to infectious HIV among people who inject drugs. Two novel, low dead space (LDS) syringe-needle designs-one added a piston to the plunger (LDS syringe) and the other added a filler to the needle (LDS needle) to reduce their dead space-were compared to standard detachable needle-syringe combinations and to syringes with fixed needles. LDS and standard syringes attached to LDS and standard needles of 23-, 25-, and 27-gauge size were contaminated with HIV-infected blood in the laboratory. The proportion of syringe-needle combinations containing infectious HIV was analyzed after syringes were (1) stored up to 7 days at 22°C or (2) rinsed with water. Detachable syringes attached to 25-gauge needles yielded comparable proportions of syringes with infectious HIV, whether the needle was standard or LDS. Among needles of greater diameter (23 gauge), LDS needles tended to reduce recoverable HIV to a greater extent than standard needles. Syringes with fixed needles showed superior results to LDS syringes attached to needles of equivalent diameter and were less likely to get clogged by blood. Detachable LDS syringe-needle designs must be recommended with caution since they still pose potential risk for HIV transmission. Distribution of LDS syringes and needles must be accompanied by recommendations and instructions for their proper rinsing and disinfection in order to reduce viral burden and chances of needle clogging.

Objective: This study describes the research regarding injuries by surgical tools and the precautions to be undertaken in the event of such an injury. The study was conducted at the Ministry of Health of the Republic of Turkey, Istanbul (Fatih) Institution of Public Hospitals Province of Istanbul Association of Public Hospitals General Secretary, Istanbul Research and Education Hospital. The study aims to enhance professional safety programs in this regard.Methods: From March to April 2014, 200 nurses from different clinics were personally met. These volunteers answered 19 questions from the data collection form. The survey responses were analyzed. Proportional data was statistically analyzed using a chi-square test.Results: It was determined that 59% of volunteers (118 volunteers) experienced injuries from contaminated surgical or medical tools, and in 54% of these cases (64 volunteers), the injury occurred while putting the cap on a syringe needle. Only 6% (7 volunteers) of those injured by surgical or medical tools were reported. Moreover, 91% of volunteers (182 volunteers) answered that they had been vaccinated against hepatitis B. To prevent such injuries, 36% of volunteers recommended that workers should be given periodic and in-depth educational programs.Conclusion: We conclude that majority of nurses are vaccinated against hepatitis B. Moreover, although there are a high number of injury cases, a very small number of these cases are reported. In light of the information obtained in this study, it is probable that the use of safe medical tools and periodic educational programs that teach precautionary measures can reduce the number of injuries.

Background Pharmacists’ role in harm reduction is expanding in many states, yet there are limited data on pharmacists’ willingness to participate in harm reduction activities. This study assessed community pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange. Methods In 2015, all Kentucky pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community pharmacist respondents. Ordinal logistic regression estimated the impact of community pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing). Results Of 4699 practicing Kentucky pharmacists, 1282 pharmacists responded (response rate = 27.3%); the majority (n = 827) were community pharmacists. Community pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community pharmacists who agreed that pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket pharmacists (n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community pharmacists (n = 342, 41.4% of community pharmacies). Independent pharmacists reported different barriers (workflow) than their chain/supermarket pharmacist colleagues (concerns of clientele). Conclusions Kentucky community pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted. Electronic supplementary material The online version of this article (10.1186/s12954-018-0211-4) contains supplementary material, which is available to authorized users.

BACKGROUND Needle-stick injuries accounts for a great proportion of all medical accidents in developing and undeveloped countries. The main cause of needle-stick accident injuries is the medical personnel's ``recovering'' the needle action after injection. OBJECTIVE This study applies an electronic technique to the needling instrument for the purpose of automatically detaching the needle. The proposed method can effectively avoid needle-stick accident injury when ``recovering'' the needle. METHODS The syringe needle auto-detaching device includes an abutment on which there is a turntable mechanism composed of a pedestal, a turn-table and a driving unit. A photo interrupter on the pedestal detects the rotational angle of the turntable and controls the stepping motor through a control circuit. An optical sensor is located on the upper end of the sensing mechanism. When the syringe is inserted into the syringe plughole the exposed portion of the needle will be detected by the optical sensor. After the syringe is placed into the plughole, its needle will be detected by the sensor. At this time the needle will be detached from the syringe and automatically fall down into the needle collection box. RESULTS The syringe needle auto-detaching device was fatigue tested for an extensive period of time (A group: 1000 times/day for 3 ml, B group: 1000 times/day for 5 ml, C group: 1000 times/day for 3 ml and 5 ml staggered, D group: 1000 times/day for 3 ml and 5 ml randomized). The needle and syringe detachment rates were 100% in all test groups. CONCLUSIONS The syringe needle auto-detaching device developed in this study, in that the clinician performs only one step to dispose a needle. Six syringe needle sets can be managed sequence second by second. The proposed device without all of the risk factors of the traditional syringe needle detachment device.

The purpose of this ex vivo study was to evaluate the efficacy of three different irrigation techniques, ProRinse® syringe needle, ProUltra® PiezoFlow TM , and EndoActivator®, in cleaning the canals and isthmuses of human mandibular molars using a software program ImageJ. Materials and Methods : A custom-made metal cube was used to create a sealed canal system. Eighty extracted mandibular molars were randomly divided into four equal groups. Teeth were mounted; sectioned at 2, 4, and 6 mm; and reassembled into the metal cube. Chemo-mechanical preparation was done for all teeth. The teeth were divided into four groups for final debridement: Group 1 (control group) received only needle irrigation, group 2 used the ProRinse® syringe needle with 5% NaOCl irrigation within a 1-mm working length, group 3 used ProUltra® PiezoFlow TM ultrasonic agitation for 30 seconds, and group 4 used the EndoActivator® system to agitate for 30 seconds. All groups received a final irrigation with 5% NaOCl in each canal. Specimens were evaluated by digital image capture with a stereomicroscope. Statistical analysis was completed using an ANOVA test and Tukey's test. Results: The results showed no statistically significant difference in canal or isthmus cleanliness between the four groups. However, there was a statistically significant difference (P < 0.05) in isthmus cleanliness in group 4 at the 4-mm level. Conclusions: EndoActivator® produced a good result in isthmus cleaning at the 4-mm level.

Medical simulation plays a critical role in the training of surgical and medical residents. Training simulators give residents an environment to practice a wide variety of procedures where they can learn and make mistakes without harming a living patient [1]. In recent years, much research has been conducted on applying haptic or force feedback technology to surgical simulators in order to create more effective training devices [2]. Simulators such as the LapSim (laparoscopic simulator) and the PalpSim (palpitation needle insertion simulator) have both utilized haptic feedback arms to provide the physical sensation of performing surgical procedures to the user [3, 4]. The haptic simulator shown in Fig. 1 is currently in development. This virtual reality haptic robotic simulator for central venous catheterization (CVC) utilizes a haptic feedback arm to provide the feeling of a syringe being inserted into neck tissue [5]. Currently, there is little experimental data relating needle force to depth. To determine the forces necessary to program into the haptic robotic device, a force sensing syringe was developed and cadaver experiments were performed. This paper presents the development of a syringe which can accurately measure needle insertion force and the proceeding experiments conducted using this device on a fresh frozen cadaver. The results of these cadaver needle insertions are characterized into force profiles for needle insertion force that are implemented into the haptic based CVC simulator.

İnal-Aslan G, Ötgün İ, Güney LH, Hiçsönmez A. Foreign body punctured the spleen: An incidental diagnosis. Turk J Pediatr 2017; 59: 97-99. A foreign body can enter the body via penetration through the skin. In the presented case, a broken syringe needle was found and removed from the splenic parenchyma. In order to prevent such iatrogenic injuries, which could have fatal consequences, the hospital staff must give particular care in the handling of sharp FBs.

Staff manipulating radiopharmaceuticals in radiopharmacies and nuclear medicine departments can receive significant radiation doses to the tips of their fingers. However, dosemeters for monitoring the fingers are frequently attached to a ring worn at the base of the finger and the doses recorded are significantly lower. Therefore a correction factor is required to estimate the dose to the finger tip from that recorded by a ring dosemeter. A survey of practices in UK nuclear medicine departments has been undertaken via a questionnaire, results of studies in the literature reporting ratios of doses to the tip and base of the finger reviewed, and patterns of finger exposure studied using an electronic dosemeter. The survey indicates that UK staff use vial and syringe shields for the majority of manipulations. Ratios between doses to the tip and base of the index finger reported in the literature vary between 2 and 6. Higher ratios appear to be associated with poor protection practices including not using syringe shields and use of a finger to support a syringe needle. Staff are recommended to wear dosemeters on the palmar side of the index finger of each hand. Dosemeters worn at the finger tips are ideal, but doses to the tips can be estimated from ring dosemeters worn on the index fingers, and factors that can be used for this are proposed. For staff who always use vial and syringe shields and never touch the syringe needle or vial a factor of 3 is appropriate. For staff who mostly use syringe shields and may occasionally support a needle during an injection, a factor of 4 can be used, while for others a factor of 6 should be applied.

The aim of the study was to evaluate the knowledge, attitude, and practices of dental surgeons in the city of Karachi providing treatment to pediatric patients. A cross-sectional study was conducted to evaluate the knowledge, attitude, and practices of dental surgeons in the city of Karachi providing treatment to pediatric patients. A cluster-sampling technique was used and 200 dental surgeons from six different dental institutions were selected. A self-constructed questionnaire was distributed to the dental surgeons that comprised 20 closed-ended questions. The data was entered and analyzed for frequency and percentages by using Statistical Package for the Social Sciences (SPSS) version 19. The results showed that 76 (38%) dental surgeons took the responsibility of managing pediatric patient when given; 68 (34%) dental surgeons allowed the parents in the clinic; 111 (55.5%) dental surgeons are of the view that colorful and fun environment in dental clinic make the child at ease; 59 (29.5%) always demonstrate the dental procedure to the child to eradicate imaginary fears; 94 (47.0%) dental surgeons preferred the child to be treated in general anesthesia (GA) to avoid difficult behavior of the child; 135 (67.5%) dental surgeons did not show syringe needle or any instrument to the child. All the members of dental profession must be aware of patient perceptions, preferences, and fear to meet patient's needs. Dental studies should include guidelines and techniques to train the upcoming dentists for excellent practice in pediatric dentistry. How to cite this article Wali A, Siddiqui TM, Khan R, Batool K. Knowledge, Attitude, and Practices of Dental Surgeons in managing Child Patients. Int J Clin Pediatr Dent 2016;9(4):372-378.

Needlestick and sharp injuries are important problems for nursing students as they increase the risk of spread of infection. The aims of this study were to investigate the prevalence of needlestick and sharps injuries (NSI) of work-related in Turkish nursing students, A questionnaire-based methodology adapted from other international investigations was conducted among 285 nursing students in Turkey in 2007, and analysed needlestick and sharps events as a percentage of all students and as a proportion of all cases. A total of 33.0% students reported a NSI. By causative item, 43.6% of students had been injured by a glass item, 39.4% by a normal injector syringe needle. Regarding prior usage, 79.5% of all injuring items were unused, 17.8% had been used on a patient. The NSI occurred in the medical clinic (33%). This study has shown that NSI occur among Turkish nursing students at reasonably high rates when compared internationally. We recommend that student nurses require targeted education for injection practices, and information about the existence of formalized reporting mechanisms.

A metallic obstruction in the canal orifice of a maxillary right canine could not be bypassed during endodontic treatment. Aids such as ultrasonics and retrieval kits were not available for the removal of the obstruction. Therefore, a novel approach using a disposable syringe needle was employed. A 22-gauge needle was inserted into the orifice and turned in an arc with a gentle apical pressure and alternate rocking motion around the obstruction. This procedure was repeated few times to cut dentin and successfully dislodge and remove the obstruction using the sharp beveled tip of the needle. This case report demonstrates that, in the absence of other aids, the use of a disposable syringe needle is a simple, economical, and yet an effective technique for conservative removal of dentin and to dislodge and remove an obstruction from the root canal. However, its effectiveness depends on case selection and straight-line accessibility to the obstruction.

Background Controversy exists concerning the need for aspiration before injection with hyaluronic acid (HA) fillers. Objective The authors undertook a study of HA products to determine if blood could be aspirated back into a syringe of HA when the needle has been primed or filled with HA. Methods and materials Two studies were set up to determine if or when blood could be withdrawn from a heparinized fresh tube of blood into the HA syringe. Two different techniques were tested; one using a slow-pull retraction of the plunger and up to a 5-second waiting time before release versus a rapid pullback and quick release. Results Review of these data demonstrates that the usual clinical method, which involves quick withdrawal and instant release of the syringe plunger does not allow for sufficient removal of the filler found intraluminal in the needle and may give rise to false negative results in vitro and likely in vivo with the exception being the Galderma/Medicis products. Conclusion In summary, withdrawal of the syringe plunger with no visible blood in the syringe does not eliminate the possibility of intravascular placement of the syringe needle.

Sample introduction into GC is an important but also demanding part of the gas chromatographic analysis. It is a critical step for quantitative analysis (easily the most important source of deviations) and should produce short initial bands not affecting the separation efficiency of the system. Liquid samples may be introduced by classical vaporizing, programmed temperature vaporizing (PTV), or on-column injection, with each of these offering a choice of methods. The evaporation of the solvent and the transfer of the sample into the column are unique for each technique and rules must be respected to achieve adequate performance. The broad choice provides many options, but also shows that each technique has limitations. Knowledge about the processes also provides access to special techniques, such as the selective desorption of sample components from high boiling matrices or the introduction of large volumes (up to 1 ml).

BACKGROUND: The next clinical frontier in the therapeutics of ischemic heart disease may involve the development and delivery of specific molecules and cells into the myocardium. The aim of the present study was to evaluate the efficiency and safety of the MyoStar injection catheter (Biosense-Webster Inc.) that has recently been developed to deliver molecules and cells to the myocardium. The 8 Fr (110 cm length) catheter comprises a navigation sensor with a 27 gauge needle at the distal tip. METHODS: Mouse myogenic cells (C2) were delivered to a tissue culture dish through different modalities: a standard laboratory pipette, a syringe needle (27 gauge) and the injection catheter. The cells were counted and monitored for growth and differentiation in the tissue culture immediately after delivery and two, three and six days later. Cells that were injected through a regular syringe needle or through the injection catheter demonstrated the same capacity to proliferate in tissue culture up to six days. RESULTS: The behavior of the cells in culture (fusion) was identical for the cells delivered to the tissue culture by a pipette or by the injection catheter. CONCLUSION: The results of the present study indicate that delivery of cells through the MyoStar injection catheter is a method with no significant loss or adverse effects to the cells along the path of the catheter. The catheter, which possesses both injection and navigation capabilities, can be used to deliver cell therapy to patients with ischemic heart disease.

The authors evaluated accidental exposures to blood and body fluids reported to a hotline or to health officials at four dental teaching clinics. The authors used a standard questionnaire to solicit and record data regarding each exposure. During a 63-month period, 428 parenteral exposures to blood or body fluids were documented. Dental students and dental assistants had the highest rates of exposure. Syringe needle injuries were the most common type of exposure, while giving injections, cleaning instruments after procedures and drilling were the activities most frequently associated with exposures.

In nowadays' medical care, needle-stick injury accounts for a great proportion in all of the accidents. For example when doctors and nurses do the acts of medical treatment, or when relevant personnel dispose of the medical wastes, it is a high probability that they are injured by the used syringe needle. Because there is a serious potential fatal crisis in the accidents of needle-stick injury, for example, the diseases infected by blood such as hepatitis, AIDS, syphilis, etc. may infect the relevant doctors and nurses through the used syringe needle, it indeed causes a great damage. The statistical analysis also indicates that the main cause of the accident of needle-stick injury is the medical personnel's chronic action of "recovering" the needle after injection. Such carelessness of this action may cause accidents. The paper aims at applying the electronic technique to the needling instrument for the purpose of detaching the needle automatically, i.e. an action that can detach the used needles from the syringe and then collect respectively. Thus, it can effectively avoid the accident of needle-stick injury or even the case of serious infection when "recovering" the needle.

PURPOSE To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements. METHODS The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT. RESULTS The average thickness of gluteal SCF was 15.92+/-4.08 mm in males and 24.90+/-5.47 mm in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients. CONCLUSION The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.

Introduction Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Methods This article presents an overview of the irrigant agitation methods currently available and their debridement efficacy. Results Technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms of irrigant transfer, soft tissue debridement, and, depending on treatment philosophy, removal of smear layers. These devices might be divided into the manual and machine-assisted agitation systems. Overall, they appear to have resulted in improved canal cleanliness when compared with conventional syringe needle irrigation. Despite the plethora of in vitro studies, no well-controlled study is available. This raises imperative concerns on the need for studies that could more effectively evaluate specific irrigation methods by using standardized debris or biofilm models. In addition, no evidence-based study is available to date that attempts to correlate the clinical efficacy of these devices with improved treatment outcomes. Thus, the question of whether these devices are really necessary remains unresolved. There also appears to be the need to refocus from a practice management perspective on how these devices are perceived by clinicians in terms of their practicality and ease of use. Conclusions Understanding these fundamental issues is crucial for clinical scientists to improve the design and user-friendliness of future generations of irrigant agitation systems and for manufacturers' contentions that these systems play a pivotal role in contemporary endodontics.

In Asia, especially in China, women think a dimple is an important part of a beautiful smiling face. The dimple can make them more confident. Unfortunately, not all women have dimples. Hence, with the development of the Chinese economy, there is an increasing demand among Chinese women for the creation of dimples. Most women hope the impairment of the operation will be slight and the period of recovery short so they can go to work as quickly as possible. Some of them want to have dimples only when they smile. The authors have used a new simple technique to form 56 dimples for 36 women. During the operation, they use a syringe needle to guide a monofilament nylon suture through the dermis and the active facial muscles (usually the buccinator). A sling is formed between the skin and the buccinator muscle. The knot is tied, and the dimple is created. After the operation, patients have been satisfied with the shape of the dimples. Furthermore, hematoma and infection never occurred. As a result, on the basis of their experience, the authors conclude that this technique is simple and easy to duplicate. Moreover, this technique has many benefits. For example, with this procedure, it is easy to adjust the bulk of dimples by adjusting the tension of the knot and the amount of dermis tissue the injection needle sutures. Because no tissue is resected, there is mild postoperative swelling. Consequently, patients can return to work or other activities 2 days after the operation.

To compare two different laparotomy methods for modeling rabbit VX2 hepatocarcinoma.Thirty New Zealand rabbits were randomly divided into two groups: A and B. Group A was assigned a traditional laparotomy method (embedding tumor fragments directly into the liver with tweezers). Group B was subjected to an improved laparotomy method (injection of tumor fragments into the liver through a 15 G syringe needle). The operation time, incision length, incision infection rate, and mortality rate were compared between the two groups after laparotomy. Magnetic resonance imaging (MRI) was performed to evaluate tumor formation rates and the characteristics of the tumors 2 wk after laparotomy.The mean operation times for the two groups (Group A vs Group B) were 23.2 ± 3.4 min vs 17.5 ± 2.9 min (P0.05); the incision length was 3.3 ± 0.5 cm vs 2.4 ± 0.6 cm (P0.05); and the mortality rate after 2 wk was 26.7% vs 0% (P0.05); all of these outcomes were significantly different between the two groups. The incision infection rates in the two groups were 6.7% vs 0% (P0.05), which were not significantly different. MRI performed after 2 weeks showed that the tumor formation rates in the two groups were 90.9% vs 93.3% (P0.05). These rates were not significantly different between the two groups. The celiac implantation rate and abdominal wall metastasis rate in the two groups were 36.4% vs 13.3% (P0.05) and 27.2% vs 6.7% (P0.05), respectively, which were significantly different between the two groups.The tumor formation rates were not significantly different between the two methods for modeling rabbit VX2 hepatocarcinoma. However, the improved method is recommended because it has certain advantages.

Although needlestick and sharps injuries (NSI) represent a major hazard in nursing practice, most studies rely on officially reported data and none have yet been undertaken in tropical environments. Therefore, we conducted a cross-sectional NSI survey targeting all nurses within a tropical Australian hospital, regardless of whether they had experienced an NSI or not. Our overall response rate was 76.7%. A total of 39 nurses reported 43 NSI events in the previous 12 months. The most common causative device was a normal syringe needle, followed by insulin syringe needles, i.v. needles or kits and blood collection needles. Half of the nurses' NSI events occurred beside the patient's bed: drawing up medication was the most common reason. Nurses working in the maternity/neonatal wards were only 0.3 times as likely to have experienced an NSI as their counterparts in the medical or surgical wards. Overall, our study has shown that NSI events represent an important workplace issue for tropical Australian nurses. Their actual rate might also be higher than official reports suggest.

Purpose The aim of this study was to evaluate our technique of nonincisional (threading) levator plication operation in cases of mild to moderate blepharoptosis. Setting Ophthalmology Department, Suez Canal University Hospital, Ismailia, Egypt. Design This study was interventional in design. Patients and methods We perform nylon threading 7/0 through the skin using a guiding syringe needle gauge no. 21 and the superior levator palpebral muscle and Mόller's muscle are tucked in by sutures guided to the tarsus surface; then, threads are tightened till the lid margin is elevated to the correct level, and the thread is knotted and inserted under the skin and orbicularis muscle. A total of 21 eyelids of 18 patients were subjected to this procedure. Results A total of 18 patients (12 male and six female, mean age 40 years) were studied. Nineteen eyelids were normally corrected or within 0.5 mm of normal, yielding a success rate of 90.5%. One (4.8%) patient was elevated within 1 mm of normal, and it was accepted. One (4.8%) eyelid was undercorrected and it wasn't accepted. An excellent lid contour was noted in all cases, except one, in whom a slight irregularity of the lid margin was observed, which was corrected spontaneously within 1 month. Conclusion The nonincisional (threading) levator plication technique is a safe and effective surgery for the treatment of mild to moderate blepharoptosis. It has a high success rate and good cosmetic outcome.

In an effort to bring the AIDS epidemic under control among the highest risk population of injecting drug users, Syringe/ Needle Exchange Programs are being considered, developed and implemented. This paper looks at some of the programs in the United States in various stages of development. Also discussed will be the medical, social and political issues surrounding Needle Exchange Programs.

Publisher Summary This chapter provides an overview of the experiment conducted on the local bubble size distribution in stirred vessels using phase doppler anemometry. The local bubble size distribution in gassed stirred tanks equipped with two different types of impellers, a Rushton turbine and a pitched blade impeller, was investigated by using phase Doppler anemometry (PDA). The accuracy of the PDA-system was checked on single bubbles of defined size that were produced at the tip of a syringe needle. The deviation of the mean diameter measured by the PDA-system from the actual size was less than 7%. The PDA-system was thereafter applied to analyze gas–liquid flows in stirred reactors. From the measurements the mean diameter d32 according to Sauter was calculated and it was found that the mean diameter varies locally between 0.65 mm and 1.5 mm for both types of impellers. The flow fields produced by the impellers have a considerable impact on the distribution of the mean diameter. Larger bubble sizes were detected in the ring vortices present in the large scale flow fields, with a significant increase occurring in the lower ring vortex produced by the Rushton turbine. In addition, break-up of bubbles in the discharge flow of the impellers was observed, but this does not necessarily lead to a drop in the mean diameter. Larger bubble sizes are also present more frequently in the discharge flow than in other regions so that other mechanisms have also to be taken into account, such as the low pressure region associated with the presence of trailing vortices and the recirculation of primary bubbles introduced to this region.

Since the beginning of the HIV/AIDS epidemic, syringe-exchange programs have been established in a number of developed countries and have proven effective in reducing the transmission of HIV. Very few similar programs have been established in developing countries. This study reports on the feasibility of establishing a syringe-exchange program in Vietnam. Process data collected since the beginning of the program indicate the feasibility of establishing such a program as well as highlight a number of important issues. These issues are: 1) Acceptability of the program in the community which has been achieved through workshops with key community people including the local police; 2) training and recruitment of ex-user outreach workers; 3) the distribution of clean syringes and needles through outreach services rather than at established exchange sites; 4) the establishment of appropriate methods for the collection of used injection equipment. Further research is needed to examine the efficacy of the program in reducing risks and acceptability of the program in the larger society.

In asia dimple is an important part of a beautiful smiling face .In our technique, we use a syringe needle to guide a monofilament nylon suture through the dermis and the active facial muscles (usually the buccinator). A sling is formed between the skin and the buccinator muscle. The knot is tied, and the dimple is created. After the operation, patients have been satisfied with the shape of the dimples. This technique is simple and easy to duplicate. Moreover, this technique has many benefits. For example, with this procedure, it is easy to adjust the bulk of dimples by adjusting the tension of the knot and the amount of dermis tissue the injection needle sutures. Because no tissue is resected, there is mild postoperative swelling.

A teaching method was developed to improve the ability of dental students to understand and perform their first inferior alveolar nerve block. Lectures, demonstrations, and laboratory sessions were utilized to provide correlation of anatomical and clinical information. The use of cadavers for injection demonstration and practice was an integral part of this teaching approach. Cadavers were dissected so that the oral cavity remained intact. Laterally the skin and masseter muscle were reflected, and the superior portion of the ramus of the mandible was removed. This procedure permitted exposure of the medial pterygoid muscle and the inferior alveolar and lingual nerves and, therefore, permitted observation of a syringe needle during the practice of inferior alveolar nerve blocks. In addition, the supraorbital, infraorbital, and mental nerves were exposed. This combined anatomical-clinical experience provided reinforcement of the relevance of anatomy in clinical practice, provided instruction and practice sessions before the first patient injection, and aided in relieving some of the anxiety often associated with the initial injection. © 1995 WiIey-Liss, Inc.

Dear Editor, Of late with the use of Indian made Foley's catheters non deflation of Foley's catheter bulb has become a common problem. Standard text books describe various methods like (i) cut the valve of the balloon (ii) injecting liquid paraffin down the main drainage channel (iii) passing urethral catheter stylet down the balloon channel (iv) puncture of balloon with 19g spinal needle passed suprapubically, transvaginally or transrectally. However, in female patients, I have used a simpler and safer technique in over 20 cases in the last few years. The method is as follows: 1. Clean vulva with Savlon & saline 2. Place the patient in lithotomy position with thighs spread out. 3. With the left hand pull the Foleys catheter and keep it pulled with gentle traction. 4. With the gloved (right) hand, thin disposble syringe needle is passed along side the Foley's catheter per urethrally. Invariably the needle punctures the balloon and the fluid from balloon is seen coming out through the needle. The Foley's catheter comes out on its own with traction.

This paper presents a methodology for guiding a radiation of ArF excimer laser in a liquid surrounding and confining it to the spots that can be varied in dimension from submicron diameters to tens and hundreds of microns. The approach described here is to confine and guide the excimer laser with variable diameter tapered tubes, thus opening the possibility of applying this laser in vitro-retinal surgery using endo laser techniques. Presently because of a lack of methods to guide the 193 nm ArF radiation in liquid this laser is used exclusively in ophthalmology in topical applications such as in corneal sculpturing. The methodology presented in this paper resolves this problem in a unique way and with impressive results. Specifically, the authors show that with this syringe needle guided excimer laser it is possible to accurately remove retinal tissue without any detectable damage to surrounding cells. Applications of this new technology in retinal surgery are discussed.

A continuous near-field electrospinning (NFES) process has been developed to deposit solid nanofibers with orderly patterns over large areas. Before the onset of electrospinning, a bias voltage is applied to a semispherical shaped polymer droplet outside of a syringe needle, and a probe tip mechanically draws a single fiber from the droplet to initiate continuous NFES. Contrary to the conventional electrospinning process, we show that decreasing electrical field in continuous NFES results in smaller linewidth deposition, and nanofibers can be assembled into controlled complex patterns such as circular shapes and grid arrays on large and flat areas.

Local anesthesia as an aid in operative procedures involving the dentine and pulp of the maxillary incisors has been a failure in the hands of many dentists. This has resulted in the substitution of dental obtundants, pressure anesthesia, or pulp devitalization pastes in an attempt to perform painless operative procedures on these teeth. The reason so many dentists fail to obtain satisfactory anesthesia of the pulps of these teeth is due primarily to a misunderstanding of their innervation. Injections on the labial aspect of these teeth based upon the assumption that the incisors are innervated by the anterior superior alveolar nerves has nearly always resulted in incomplete anesthesia. The experience of the Detroit Department of Health Root Surgery Clinic in which over 2,000 vital pulps were extirpated painlessly from maxillary incisors using only the nasopalatine injection, together with a consideration of the embryologic development of the face and jaws and a series of anatomie dissections, has shown the definite relationship of the nasopalatine nerves to these teeth. Profound anesthesia of the pulps of the maxillary incisors may be readily obtained by inserting the syringe needle high into the incisive canals and depositing slowly 1 4 c.c. of anesthetic solution at this level. Contrary to popular belief, the incisive canal injection is not painful when properly administered. In fact, children report less discomfort during the injection and after anesthesia has dissipated than with the labial injections. The utilization of this injection as an aid in painful operative procedures involving the dentine or pulp of the maxillary incisors should result in the discontinuance of many of the unsatisfactory procedures now commonly practiced for this purpose.

Summary A method of preparing cervical scrape specimens for automatic analysis is described. A cell suspension is obtained by washing the spatula used to scrape the cervix in a balanced salt solution. Cell clumps are disaggregated by pumping the specimen to and fro through a hypodermic syringe needle, and the resulting suspension is centrifuged, fixed and pipetted onto a glass slide. Specimens are stained with haematoxylin and eosin.

A syringe-needle attachment unit was evaluated in a test designed to show whether or not it would be possible to attach needles to filled syringes with that unit and maintain sterility of the medication. Of 460 syringes filled and closed in a horizontal laminar flow unit, none was contaminated. Based on the moderate sample, it can be concluded that the unit will indeed permit closure of syringes without introduction of contamination.

SUMMARY This note describes how damaged Philips electron microscope specimen holders may be repaired simply and cheaply. The damaged part is replaced by a length of 18-gauge syringe needle which is silver-soldered into position. This simple and rapid repair caused no subsequent electrical distortion.

A polyantibiotic for the treatment of infected root canals was described by Grossman.' The polyantibiotic consists of a suspension of penicillin, bacitracin, streptomycin, and caprylate sodium in silicone fluid. A small amount of the suspension is ordinarily ejected from a syringe needle into the root canal. In narrow canals of posterior teeth, the suspension is introduced into the pulp chamber and pumped into the root canals with a suitable sterile instrument. An effort is made to limit the polyantibiotic to the confines of the canal. The polyantibiotic has been in use by dentists and in at least one dental school clinic for more than 15 years. Despite this long usage, there have been few accounts of sensitivity reaction. An explanation of this might be that the penicillin contained in the polyantibiotic, to elicit a systemic reaction, would have to reach the blood circulation via the apical foramen and be present in sufficient amount to cause a reaction. The purpose of this study was to determine whether penicillin was present in the blood after sealing the polyantibiotic in the root canal, since sensitivity is reported in 2 to 5 percent of the population.2A