Chemical analysis and performance evaluation of ClearCorrect® aligners as received and after intraoral use: Implications for durability, aesthetics, and patient safety.

Background: Orthodontic treatment with transparent aligners is popular with patients. Any alteration of the plastic material, as subjected to the oral environment, could influence the treatment's durability, the aligner's aesthetic appearance, and the patient's safety.

Purpose: This study concerns the physicochemical properties of ClearCorrect® aligners before and after intraoral use, focusing on transparency, surface topography, leachable, polymer glass transition temperature, and viscoelastic properties.

Right-Sided Heart Failure and the Liver.

Currently, there are 6.2 million people with heart failure (HF) in the United States with 1 million new HF cases being diagnosed annually. Twenty to 30% of patients with acute heart failure also have liver dysfunction.

Thionolactone as a Resin Additive to Prepare (Bio)degradable 3D Objects via VAT Photopolymerization.

Three-dimensional (3D) printing and especially VAT photopolymerization leads to cross-linked materials with high thermal, chemical, and mechanical stability. Nevertheless, these properties are incompatible with requirements of degradability and re/upcyclability. We show here that thionolactone and in particular dibenzo[c,e]-oxepane-5-thione (DOT) can be used as an additive (2 wt %) to acrylate-based resins to introduce weak bonds into the network via a radical ring-opening polymerization process.

Cardiac Radiofrequency Ablation: A Clinical Update for Nurses.

The field of electrophysiology (EP) has rapidly evolved from a focus on diagnostic procedures to an emphasis on interventions. Many cardiac arrhythmias traditionally treated with antiarrhythmic agents, cardioversion, or cardiac surgery are now routinely cured with cardiac ablation. To optimally manage the care of cardiac ablation patients, it is essential that nurses have an understanding of the EP procedures and related nursing implications.

Saphenous laser ablation at 1470 nm targets the vein wall, not blood.

The 2 primary objectives of this study were to investigate whether the 1470-nm wavelength can close a saphenous vein painlessly and determine safety, efficacy, and side effects of the 1470-nm laser. In all, 26 limbs were treated in the Dominican Republic, with a radially-emitting fiber at low energy ranging from 20 J/cm to 30 J/cm. Perivenous anesthesia was used selectively.

Atypical mycobacterial infection of the periocular region after periocular and facial surgery.

Purpose: To delineate the clinicopathologic features of patients who have atypical mycobacterial infections of the periorbital region after periocular and facial surgery and to define the sequelae after treatment and their management.

Methods: A case series of patients from 7 practices of ophthalmic plastic and reconstructive surgeons was analyzed retrospectively.

Results: Thirteen patients had infection in the following clinical settings: 8 patients had infections after blepharoplasty, 2 patients had infections that involved the anophthalmic socket, 1 patient had orbital cellulitis after orbital fracture repair with an alloplastic implant, and 2 patients had infections involving the lacrimal system, one after silicone tube insertion and the other after dacryocystorhinostomy with silicone tube intubation.

Oral and topical antibiotic therapy of complete, primary acquired nasolacrimal duct obstruction in adults.

Purpose: To determine whether patients with complete, acquired nasolacrimal duct obstruction may be treated with broad spectrum oral antibiotics and office lacrimal irrigation.

Methods: In a retrospective review, patients with complete, primary acquired nasolacrimal duct obstruction (NLDO) were divided by predominant symptoms and signs into two main groups: (a) those with tearing and/or mucous discharge and (b) those with previous acute dacryocystitis and/or lacrimal sac mucocele. All patients received a therapeutic trial of oral and topical antibiotics followed by lacrimal irrigation.

Long-term enhancement of botulinum toxin injections by upper-eyelid surgery in 14 patients with facial dyskinesias.

Objectives: To determine the effects of upper-eyelid surgery (limited myectomy, blepharoplasty, and levator aponeurotic advancement) on patients who demonstrated a suboptimal response or residual heaviness of the upper eyelids after botulinum toxin eyelid injections for facial dyskinesia.

Design: Retrospective study.

Subjects: Charts of 358 patients with a diagnosis of benign essential blepharospasm, Meige syndrome (with eyelid involvement), and hemifacial spasm were reviewed.

Correlation of orbital computed tomographic findings with office probing and irrigation in 17 patients after successful and failed dacryocystorhinostomy.

Purpose: To investigate the role of orbital computed tomography (CT) in the evaluation of patients after dacryocystorhinostomy (DCR).

Methods: Computed tomography scans of patients who underwent both successful and failed DCR were examined to determine the relationship of the soft-tissue changes to the surgical ostium, and the findings were correlated with postoperative results of office probing and irrigation.

Results: After a successful DCR (n = 7), a patent fistulous tract was confirmed by office probing and irrigation.

CT of soft tissue injury and orbital fractures.

Complex orbital rim and fractures of the internal orbital skeleton (orbital walls) are best analyzed by high-resolution axial CT. Optic canal fractures are optimally visualized with thin 1-mm section high-resolution CT scanning. Spiral CT may be used in the acutely injured patient because of its rapid scan technique.

Modified levator aponeurotic advancement with delayed postoperative office revision.

The results of a "modified" levator aponeurotic advancement were reviewed to determine the appropriate indications and optimum timing for office revision after blepharoptosis repair. The levator advancement was modified as follows: 1) elimination of epinephrine from the local anesthetic so as not to stimulate the Müller muscle, 2) use of a 6-0 silk rather than a monofilament nonabsorbable suture to secure the advanced levator to avoid possible cheese-wiring and late recurrence, and 3) excision of a strip of preseptal orbicularis muscle just above the tarsal border to create surgically apposed "raw" surfaces for a firm attachment of the "advanced" levator. Office adjustments were delayed for at least 8 days after surgery and were performed as late as 14 days after surgery.

Drug-associated facial dyskinesias--a study of 238 patients.

Unlabelled: The purpose of this study was to determine whether antidepressant, antimania, antipsychotic, antihistamine, or antiparkinsonian drugs are associated with eyelid and facial dyskinesias; whether discontinuing such drugs results in improvement in the facial dyskinesias; and whether response to botulinum toxin treatment is influenced by such medications.

Methods: A retrospective review was performed on a population of 238 patients with presumed benign essential blepharospasm and Meige syndrome. Types of drugs taken before the development of disease and clinical response to botulinum toxin injections were studied.

The role of proliferating cell nuclear antigen (PCNA) in predicting biologic behavior of lymphoid infiltrates of the orbit and ocular adnexae.

The authors performed a retrospective clinicopathologic review of lymphoid tumors of the orbit and ocular adnexa. In addition, we used an immunohistologic marker for proliferating cell nuclear antigen (PCNA), an intranuclear protein with greatest expression in actively proliferating (dividing) cells, to determine whether levels of PCNA can be correlated with the presence or future development of systemic lymphoma. To the authors' knowledge, the present study represents the first in which PCNA indices, i.

Effectiveness of homologous cadaveric fascia lata and role of suture fixation to tarsus in frontalis suspension.

The results of frontalis suspension (double rhomboid technique with preserved homologous cadaver fascia) were compared in two surgical groups: 1) patients in whom the fascia was sutured to the tarsus and 2) patients in whom the fascia was not sutured to the tarsus. The study was performed to determine the optimum surgical technique and to determine whether preserved cadaver fascia is a suitable suspensory material. All data retrospectively reviewed included 1) predisposing cause of severe blepharoptosis, 2) results in the two groups of patients, suture fixation and nonsuture fixation, and 3) surgical complications.

Adenoid squamous carcinoma of the conjunctiva--a clinicopathological study of 14 cases.

Aims: In order to determine the clinicopathological features and optimum management of a series of patients with adenoid squamous cell carcinoma of the conjunctiva, all cases of squamous cell carcinoma (SCC) of the conjunctiva and cornea on file in the registry of the ophthalmic pathology at the Armed Forces Institute of Pathology were reviewed.

Methods: On histopathological examination, a predominant adenoid or pseudoglandular pattern due to islands of neoplastic squamous or epidermoid cells surrounded by acantholytic cells was necessary for inclusion in the study. Histochemical and transmission electron microscopic studies (TEM) were performed.

Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis.

Complications occurred in six patients after gold weights were implanted into the upper eyelid tissues for fifth and seventh nerve palsies. These complications included implant infection without extrusion (in one patient); entropion with trichiasis and presumed inflammatory reaction to the gold weight material (in one patient); upper eyelid distortion and poor eyelid contour with corneal ulceration and scarring (in one patient); significant residual lagophthalmos with exposure keratitis (in one patient); and blepharoptosis obscuring the pupillary access (in two patients). Resolution of the complications required 1.

Dacryocystectomy: surgical indications and results in 25 patients.

The main indication for dacryocystectomy (DCT) is excision of lacrimal sac tumors. DCT may be considered less invasive than dacryocystorhinostomy (DCR) because lacrimal bone and nasal mucosa are not violated. To determine other indications for DCT, we performed a retrospective review of all patients who underwent DCT from the Oculoplastics Division, Department of Ophthalmology, UMD-New Jersey Medical School from July 1983 through July 1994.

Modified corncrib (inverted T) procedure with Quickert suture for repair of involutional entropion.

Purpose: The purpose of the study was to determine long-term results of involutional entropion repair by a modified corncrib (inverted T) procedure with a Quickert suture.

Methods: A retrospective review of consecutive patients with involutional entropion who underwent repair by a modified corncrib procedure from January 1986 to July 1994 was performed. A full-thickness basedown triangle (corncrib) excised at the lateral limbus corrects horizontal laxity and everts the eyelid margin.

The role of proliferating cell nuclear antigen (PCNA) in differentiating idiopathic orbital inflammatory disease and lymphoid proliferations.

The purpose of the present study was to determine whether proliferating cell nuclear antigen (PCNA), an immunohistochemical marker for a nuclear protein abundant in actively proliferating (dividing) cells, is useful as an aid in differentiating idiopathic orbital inflammatory syndrome (IOIS) from lymphoproliferative lesions (LLs). Records of all patients with IOIS and LLs were studied retrospectively. Tissue biopsy specimens from four patients with IOIS and nine patients with LLs were examined.

Treatment selections of 239 patients with blepharospasm and Meige syndrome over 11 years.

Background: A retrospective review of 239 patients with benign essential blepharospasm and Meige syndrome was performed in order to determine patients' long term treatment preferences.

Methods: Of 239 patients evaluated, 228 received local injections of botulinum toxin, type A, into the eyelid and facial musculature over 11 years.

Results: Of 228 patients, 202 (72.

Acute dacryocystitis: an unusual cause of life-threatening orbital intraconal abscess with frozen globe.

An 84-year-old woman developed a markedly proptotic right eye with external ophthalmoplegia and displacement of the globe into the superotemporal orbit. She had minimal pain and no history of the usual predisposing causes of orbital cellulitis. Vision was unaffected.

Use of a modified monocanalicular silicone stent in 33 eyelids.

Background And Objective: To determine (1) whether a modified monocanalicular silicone stent fixated to the peripunctal tissues by a 6-0 polypropylene suture is a practical alternative to bicanalicular intubation for canalicular reconstruction, and (2) whether this technique is superior to previously described methods of monocanalicular intubation.

Patients And Methods: The charts of patients from the Oculoplastics Division of the Ophthalmology Department at the UMDNJ Medical School who had undergone insertion of a modified canalicular stent were retrospectively reviewed from April 1, 1991, to April 1, 1995.

Results: The technique was used successfully in 33 eyelids (32 patients) for the following conditions: (1) unicanalicular (17 eyelids) and bicanalicular lacerations (1 eyelid), (2) reconstruction of a single canaliculus after eyelid tumor resection (5 eyelids), (3) after canaliculotomy for canaliculitis refractory to medical treatment (3 eyelids), and (4) after punctal plasty for congenital punctal agenesis and after a three-snip procedure for acquired punctal stenosis (6 eyelids).

Medial canthoplasty for optimum support of the lower eyelid in 14 patients.

Background And Objectives: Medial canthoplasty surgically fuses the upper and lower lids medial to the puncta. The authors modified the procedure by inserting a temporary lacrimal stent in order to avoid kinking and scar contracture of the canaliculi.

Patients And Methods: A medial canthoplasty successfully corrected lower eyelid laxity in 14 patients with the following conditions: (1) exposure and/or neurotrophic keratitis with medial ectropion and/or retraction of the lower eyelid (11 patients), and (2) inability to retain a prosthesis because of lower eyelid ectropion and contracture of the inferior conjunctival fornix (3 anophthalmic patients).