PURPOSE: Tracheal intubation in a hemorrhagic airway is a difficult procedure because the visibility can be obscured by blood or vomitus. Several devices and methods have been developed to overcome such obstacles, but they are not available at all practical sites. Therefore, this study was conducted to assess the time and success rate of tracheal intubation according to the type of suction tip used in a hemorrhagic airway manikin model. METHODS: This study was a randomized crossover manikin simulation study. We recruited 18 emergency physicians to perform intubation with suction using a Yankauer suction tip and a polyvinyl chloride (PVC) catheter suction tip in a hemorrhagic airway manikin model. We then measured the time and success rate of intubation for each suction tip. RESULTS: The mean intubation time using the Yankauer suction tip was 42.3 seconds, and the mean intubation time using the PVC catheter suction tip was 91.1 seconds (p < 0.001). Two cases of esophageal intubation occurred when the PVC catheter suction tip was used (success rate, 88.9%). In contrast, there was no esophageal intubation when the Yankauer suction tip was used (success rate, 100%) (p=0.217). CONCLUSION: Intubation of a hemorrhagic airway manikin model can be performed in a shorter time when a Yankauer suction tip is used than when a PVC catheter suction tip is used.
Catheters ; Emergencies ; Hemorrhage ; Intubation ; Manikins ; Polyvinyl Chloride ; Polyvinyls ; Suction

BACKGROUND: There have been a lot of methods that prevent catatrophic airway fires during laser surgery, but none of them can protect endotracheal tube cuff exposed directly to laser beam. This study was performed to know the preventive effect of viscous lidocaine-filled cuffs on laser-induced combustion, and to know how long we can maintain positive pressure ventilation if laser beam broke out cuff perforation. METHODS: Transparent acrylic trachea attached to artificaial lung was intubated with 8.0 ID polyvinylchloride endotracheal tube. Cuff was filled with 8ml of saline or saline and viscous lidocaine mixture with 2:1 or 4:1 ratio. Positive pressure ventilation with air in tidal volume of 500 ml was begun. The laser output was set to 10 watt/sec in the continuous mode with beam diameter of 1 mm. Laser beam was directed perpendicularly at the part of the cuff protruding between endotracheal tube shaft and acrylic trachea, and laser emission was continued until the cuff was perforated or combusted. RESULTS: There was no case of laser-induced fires. After the perforation of cuff, the tidal volume was slowly decreased in 2:1 mixture of saline and viscous lidocaine filled cuff compared to others (P<0.05). CONCLUSION: 2:1 mixture of saline and viscous lidocaine may be used as an efficient inflating material of endotracheal tube cuffs on laser airway surgery.
Fires* ; Laser Therapy ; Lidocaine ; Lung ; Polyvinyl Chloride* ; Polyvinyls* ; Positive-Pressure Respiration ; Tidal Volume* ; Trachea

BACKGROUND: Double-lumen endobronchial tube (DLT) malposition and displacement can occur easily by blind intubation or moving a patient into the lateral position. We compared a silicon DLT (Silbroncho(R)) with a polyvinyl chloride tube (Broncho-Cath(R)) to determine whether Silbroncho(R) can reduce the incidence of DLT malposition and displacement during anesthesia for one lung ventilation in right-side thoracic surgery. METHODS: Thirty nine patients requiring right lung deflation were randomly assigned to one of two groups. Eighteen patients received a Broncho-Cath(R) DLT and 21 patients received a Silbroncho(R) in the left mainstem bronchus. After blind intubation, we checked the incidence of right DLT intubation and tracheobronchial injury by fiberoptic bronchoscopy (FOB). After correcting DLTs for exact position and moving patients into the lateral position, we assessed the incidence of DLT displacement and changes of peak inspiratory pressure according to this position change during one lung ventilation. RESULTS: The incidence of right DLT intubation and tracheobronchial injury were not significantly different (P > 0.05) in the two groups (16.7% vs 0%, 38.9% vs 14.3%, Broncho-Cath(R) vs Silbroncho(R), respectively). After position change, the incidence of DLT displacement in the Silbroncho(R) group (4.8%) was lower (P < 0.05) than in the Broncho-Cath(R) group (44.8%). No significant difference was found between the two groups in terms of peak inspiratory pressure (P > 0.05). CONCLUSIONS: Our results suggest that Silbroncho(R) can reduce the incidence of DLT displacement because of the small-sized bronchial cuff, which is located more distally than the Broncho-Cath(R) cuff. We conclude that Silbroncho(R) is superior to Broncho- Cath(R) for one lung ventilation during thoracic surgery.
Anesthesia ; Bronchi ; Bronchoscopy ; Humans ; Incidence ; Intubation ; Lung ; One-Lung Ventilation ; Polyvinyl Chloride* ; Polyvinyls* ; Silicones* ; Thoracic Surgery*

Dental practice can produce and spread some infetious diseases from patients to dentist, dental assistant, and dental labors. One possible method for preventing these cross-contamination is to immerse dental impression in chemical disinfectants. So far many investigators studied on the dimensional changes of dental impressions and on the surface qualities of stone casts made from impression following immersion in disinfectants. This study was proposed to evaluate some popular impression/disinfectant combination from the point of dimensional stability. Impression was taken from dental arch-shaped metal model. Irreversible hydrocolloid and 3 elastomers(polyvinyl siloxane, polysulfide, polyether) were immersed in 3 disinfectants (2% glutaraldehyde, 1% povidone-iodine, 0.5% sodium hypochlorite) for 10 minutes and measured both cross-arch and anterior-posterior distance under stereo microscope to evaluate dimensional change. The results obtained were as follows: 1. Dimensional changes of irreversible hydrocolloid impression was statistically different in crossarch and anterior-posterior distance when immersed in 2% glutaraldehyde solution and in anterior-posterior distance when immersed in 0.5% sodium hypochlorite solution from control group(p<0.05). 2. Dimensional changes of polyvinyl siloxane and polysulfide impression were not statistically different from control group (p>0.05). 3. Dimensional changes of polyether impression was statistically different in cross-arch distance when immersed in 0.5% sodium hypochlorite solution and in anterior-posterior distance when immersed in 1% povidone-iodine solution from control group (p<0.05). 4. In all cases, dimensional changes were less than 0.1% from the original dimension and concluded clinically acceptable
Colloids ; Dental Assistants ; Dentists ; Disinfectants ; Disinfection* ; Glutaral ; Humans ; Immersion* ; Polyvinyls ; Povidone-Iodine ; Research Personnel ; Siloxanes ; Sodium ; Sodium Hypochlorite

In order to develop questionnaire estimating vinyl chloride monomer(VCM) exposure levels, to reset selection criteria for detailed tests, to measure current VCM exposure levels, to evaluate the mutagenic effects of VCM exposures and to develop multiphasic screening method of PVC- or VCM-handling workers, VCM concentrations of work environments were measured and tentative self-administrative questionnaire, physical examination, sister chromatid exchange(SCE) test and some clinical chemical test were applied to 195 men who had been handling VCM or PVC(Exposed Group) and 37, in the same factories without exposure to VCM or in polyethylene- or polypropylene-related factories(Control Group). Mean VCM concentrations of work environments were 0.268+/-0.183 ppm under PVC synthesis processes, 0.160+/-0.200 ppm under VCM synthesis process, 0.076+/-0.111 ppm under PVC pipe producing processes, 0.090+/-0.108 ppm under PVC wall paper, sheet, or film producing processes, 0.071+/-0.051 ppm under PVC floor producing processes, 0.243+/-0.250 ppm under PVC sash producing processes, and 0.020+/-0.031 ppm under triming process. VCM levels of work environments under manual resin mixing processes (0.209+/-0.168 ppm)were higher than those of the others (0.209+/-0.168 ppm) (p-value<0.05). There was no VCM-related symptoms, the positive response rates of which were higher in the Exposed Group. Overall abnormal rate in clinical chemistry test of the Exposed Group was higher than that of the Control Group, but due to extermely low exposure level of exposure group and to small sample size of the Control Group, no statistical significance was found(p-value>0.05). SCE frequencies of the Exposed Group were significantly higher than those of Contorl Group(p-value<0.05) and those of test-abnormal persons were higher than those of test-normal persons. SCE frequencies linearly increased with not only current but also cumulative VCM exposure levels(p-value<0.05). These results suggest that adverse health effect may ensue from VCM exposure to as low as 1 ppm. But SCE frequencies had no statistically significant correlation with drinking amounts, smoking amoutns, or radiation dose equivalents. Questionnaire was revised by referring to these results and formula estimating cumulative VCM exposure levels based on occupational history in questionnaire were made. In addition, were presented methods evaluating work environments and multiphasic screening test for PVC workers.
Chromatids ; Clinical Chemistry Tests ; Drinking ; Humans ; Male ; Multiphasic Screening* ; Patient Selection ; Physical Examination ; Polyvinyl Chloride* ; Polyvinyls* ; Questionnaires ; Sample Size ; Siblings ; Sister Chromatid Exchange ; Smoke ; Smoking ; Vinyl Chloride*

BACKGROUND: Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery. METHODS: One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (>10 mm) of DLT was compared between the groups. RESULTS: DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (p = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (p = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, p = 0.906). CONCLUSION: Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.
Adult ; Bronchi ; Bronchoscopy ; Humans ; Incidence ; Intubation, Intratracheal ; Lung ; One-Lung Ventilation ; Polyvinyl Chloride ; Polyvinyls ; Posture ; Silicon ; Silicones ; Supine Position ; Thoracic Surgery ; Thoracic Surgical Procedures

PURPOSE: The purpose of this study was to compare the accuracy of the implant master cast according to the type (pick-up, transfer) and the length (long, short) of the impression copings. MATERIALS AND METHODS: The metal master cast was fabricated with three internal connection type implant analogs (Osstem GS III analog), embedded parallel and with 10degrees of mesial angulation to the center analog. Four types of impression coping were prepared with different combinations of types (transfer, pick-up) and lengths (long, short) of the coping. The impressions were made using vinyl polysiloxane (one step, heavy + light body) with an individual tray, and 10 impressions were made for each group. Eventually, 40 experimental casts were produced. Then, the difference in the distance between the master cast and the experimental cast were measured, and the error rate was determined. The analysis of variance was performed using the SPSS (v 12.0) program (alpha = .05), and the statistical significance was set at P < .05. RESULTS: The ANOVA showed that the pick-up type impression coping exhibited a significantly lower error rate than the transfer type. However, no significant difference was observed with respect to the length of the impression coping. Additionally, no significant difference was observed between the parallel and mesial angulated groups. CONCLUSION: Within the limitations of this study, the pick-up type impression coping exhibited a more accurate implant master cast than the transfer type in parallel group. The accuracy of the implant master cast did not differ for different lengths of impression coping of at least 11 mm. Additionally, the accuracy of the implant cast was not different for the parallel and 10degrees mesial angulated groups.
Light ; Polyvinyls ; Siloxanes

PURPOSE: This study was designed to determine the embolic effect of PVA particles of various sizes on the cerebral artery of a cat and to determine the appropriate particle size for embolization. MATERIALS AND METHODS: A total of 21 cats were divided into three groups according to the PVA particle size injected: group I(n=7), embolized with 45-150 micrometer PVA; group II(n=7), with 150-250 micrometer PVA; and group III(n=7), with 350-500 micrometer PVA. PVA particles were slowly injected into the left common carotid artery of each cat, and T2-weighted coronal MR images were obtained 24 hours after injection. During histologic examination of brain sections we analyzed the size, number of occluded vessels, and the ischemic changes caused by the particles. RESULTS: On T2 weighted images, areas of high signal intensity (infarction) were observed in four of the seven cats (57%) in group Iand in two of the seven (29%) in group II. High signal intensity was not found in group III. The mean percentage of areas of high signal intensity was 11.86 +/-1 . 37 % in group Iand 5.18 +/-1 . 77% in group II( P <0.05). During histologic examination, occlusion of the distal branches of the anterior cerebral (ACA) and/or the middle cerebral arteries(MCA) by PVA particles was observed in all seven cats (100%) in group I, and in four of the seven cats (57%) in group II. No group IIIcat showed occlusion of the distal branches of the ACA and/or MCA. The mean caliber of occluded vessels was 175 micrometer in Group Iand 258 micrometer in Group II. The mean number of occluded vessels seen on all slide sections was 14 in Group I and 5 in Group II. CONCLUSION: Small PVA particles had a greater cerebral embolic effect than did those which were medium or large. For the induction of embolic infarction in cat brain, PVA particles 45-150 micrometer in size are appropriate.
Animals ; Brain ; Carotid Artery, Common ; Cats* ; Cerebral Arteries* ; Infarction ; Particle Size* ; Polyvinyl Alcohol* ; Polyvinyls*

PURPOSE: This study was designed to determine the embolic effect of PVA particles of various sizes on the cerebral artery of a cat and to determine the appropriate particle size for embolization. MATERIALS AND METHODS: A total of 21 cats were divided into three groups according to the PVA particle size injected: group I(n=7), embolized with 45-150 micrometer PVA; group II(n=7), with 150-250 micrometer PVA; and group III(n=7), with 350-500 micrometer PVA. PVA particles were slowly injected into the left common carotid artery of each cat, and T2-weighted coronal MR images were obtained 24 hours after injection. During histologic examination of brain sections we analyzed the size, number of occluded vessels, and the ischemic changes caused by the particles. RESULTS: On T2 weighted images, areas of high signal intensity (infarction) were observed in four of the seven cats (57%) in group Iand in two of the seven (29%) in group II. High signal intensity was not found in group III. The mean percentage of areas of high signal intensity was 11.86 +/-1 . 37 % in group Iand 5.18 +/-1 . 77% in group II( P <0.05). During histologic examination, occlusion of the distal branches of the anterior cerebral (ACA) and/or the middle cerebral arteries(MCA) by PVA particles was observed in all seven cats (100%) in group I, and in four of the seven cats (57%) in group II. No group IIIcat showed occlusion of the distal branches of the ACA and/or MCA. The mean caliber of occluded vessels was 175 micrometer in Group Iand 258 micrometer in Group II. The mean number of occluded vessels seen on all slide sections was 14 in Group I and 5 in Group II. CONCLUSION: Small PVA particles had a greater cerebral embolic effect than did those which were medium or large. For the induction of embolic infarction in cat brain, PVA particles 45-150 micrometer in size are appropriate.
Animals ; Brain ; Carotid Artery, Common ; Cats* ; Cerebral Arteries* ; Infarction ; Particle Size* ; Polyvinyl Alcohol* ; Polyvinyls*

Coronary artery perforation is a rare and serious complication in coronary angioplasty. Some patients complicated by coronary perforation may develop cardiac tamponade, which is generally due to massive hemorrhage in the pericardial space between the epicardium and the pericardium. We report a case of coronary artery perforation producing impending tamponade, which was successfully treated by transcatheter embolization of distal circumflex artery using polyvinyl alcohol.
Angioplasty ; Arteries* ; Cardiac Tamponade ; Coronary Vessels ; Hemorrhage ; Humans ; Pericardium ; Polyvinyl Alcohol* ; Polyvinyls*