Margins: a status report from the Annual Meeting of the American Society of Breast Surgeons.

PubMed

Harness, Jay K; Giuliano, Armando E; Pockaj, Barbara A; Downs-Kelly, Erinn

2014-10-01

Since the emergence of breast conserving surgery (BCS) as an alternative to mastectomy in the 1980's, there has been little consensus on what constitutes acceptable margins for cases of invasive breast cancer, how best to evaluate margins in the operating room, or an understanding of the challenging process of margin assessment by pathologists. The program committee for the 15th Annual Meeting of The American Society of Breast Surgeons organized a plenary session to discuss the latest thinking and guidelines for these important issues. The SSO/ASTRO Consensus Guideline on Margins for BCS was an important focus of discussion. The SSO/ASTRO consensus panelists concluded that "no ink on tumor" is an adequate surgical margin for BCS in patients with invasive breast cancers. Intraoperative strategies to decrease the incidence of positive margins include intraoperative localization techniques (wire-localization, ultrasound, radioactive seed) and intraoperative margin assessments with specimen radiography, imprint cytology, and frozen section. Studies also demonstrate the positive effect of shave margins with or without intraoperative margin assessment. The College of American Pathologists protocols for breast specimen margin evaluation consider multiple variables that can impact the proper assessment of margins. These variables include: tissue fixation time, specimen orientation, cold ischemia time, leaking ink, specimen pancaking and others that surgeons need to be aware of. Determining when "enough is enough" should not only be the application of guidelines and national standards, but also a multidisciplinary discussion between breast cancer specialists for what is right for the individual patient's unique circumstances.

Internal adaptation, marginal accuracy and microleakage of a pressable versus a machinable ceramic laminate veneers.

PubMed

Aboushelib, Moustafa Nabil; Elmahy, Waleed AbdelMeguid; Ghazy, Mohammed Hamed

2012-08-01

The aim of this study was to evaluate the internal adaptation and marginal properties of ceramic laminate veneers fabricated using pressable and machinable CAD/CAM techniques. 40 ceramic laminate veneers were fabricated by either milling ceramic blocks using a CAD/CAM system (group 1 n=20) or press-on veneering using lost wax technique (group 2 n=20). The veneers were acid etched using hydrofluoric acid, silanated, and cemented on their corresponding prepared teeth. All specimens were stored under water (37 °C) for 60 days, then received thermocycling (15,000 cycles between 5 and 55 °C and dwell time of 90 s) followed by cyclic loading (100,000 cycles between 50 and 100 N) before immersion in basic fuchsine dye for 24 h. Half of the specimens in each group were sectioned in labio-lingual direction and the rest were horizontally sectioned using precision cutting machine (n=10). Dye penetration, internal cement film thickness, and vertical and horizontal marginal gaps at the incisal and cervical regions were measured (α=0.05). Pressable ceramic veneers demonstrated significantly lower (F=8.916, P<0.005) vertical and horizontal marginal gaps at the cervical and incisal margins and lower cement film thickness (F=50.921, P<0.001) compared to machinable ceramic veneers. The inferior marginal properties of machinable ceramic veneers were associated with significantly higher microleakage values. Pressable ceramic laminate veneers produced higher marginal adaptation, homogenous and thinner cement film thickness, and improved resistance to microleakage compared to machinable ceramic veneers. The manufacturing process influences internal and marginal fit of ceramic veneers. Therefore, dentist and laboratory technicians should choose a manufacturing process with careful consideration. Copyright © 2012 Elsevier Ltd. All rights reserved.

Detection of breast surgical margins with optical coherence tomography imaging: a concept evaluation study.

PubMed

Savastru, Dan; Chang, Ernest W; Miclos, Sorin; Pitman, Martha B; Patel, Ankit; Iftimia, Nicusor

2014-05-01

This study aimed to evaluate the concept of using high-resolution optical coherence tomography (OCT) imaging to rapidly assess surgical specimens and determine if cancer positive margins were left behind in the surgical bed. A mouse model of breast cancer was used in this study. Surgical specimens from 30 animals were investigated with OCT and automated interpretation of the OCT images was performed and tested against histopathology findings. Specimens from 10 animals were used to build a training set of OCT images, while the remaining 20 specimens were used for a validation set of images. The validation study showed that automated interpretation of OCT images can differentiate tissue types and detect cancer positive margins with at least 81% sensitivity and 89% specificity. The findings of this pilot study suggest that OCT imaging of surgical specimens and automated interpretation of OCT data may enable in the future real-time feedback to the surgeon about margin status in patients with breast cancer, and potentially with other types of cancers. Currently, such feedback is not provided and if positive margins are left behind, patients have to undergo another surgical procedure. Therefore, this approach can have a potentially high impact on breast surgery outcome.

Effect of protective coating on microhardness of a new glass ionomer cement: Nanofilled coating versus unfilled resin.

PubMed

Faraji, Foad; Heshmat, Haleh; Banava, Sepideh

2017-01-01

EQUIA TM is a new gastrointestinal (GI) system with high compressive strength, surface microhardness (MH), and fluoride release potential. This in vitro study aimed to assess the effect of aging and type of protective coating on the MH of EQUIA TM GI cement. A total of 30 disc-shaped specimens measuring 9 mm in diameter and 2 mm in thickness were fabricated of EQUIA TM GI and divided into three groups of G-Coat nanofilled coating (a), no coating (b) and margin bond (c). The Vickers MH value of specimens was measured before (baseline) and at 3 and 6 months after water storage. Data were analyzed using repeated measures ANOVA. Group B had significantly higher MH than the other two groups at baseline. Both G-Coat and margin bond increased the surface MH of GI at 3 and 6 months. The MH values of G-Coat and margin bond groups did not significantly increase or decrease between 3 and 6 months. The increase in MH was greater in the G-Coat compared to the margin bond group in the long-term. Clinically, margin bond may be a suitable alternative when G-Coat is not available.

Significance of post-resection tissue shrinkage on surgical margins of oral squamous cell carcinoma.

PubMed

El-Fol, Hossam Abdelkader; Noman, Samer Abduljabar; Beheiri, Mohamed Galal; Khalil, Abdalla M; Kamel, Mahmoud Mohamed

2015-05-01

Resecting oral squamous cell carcinoma (SCC) with an appropriate margin of uninvolved tissue is critical in preventing local recurrence and in making decisions regarding postoperative radiation therapy. This task can be difficult due to the discrepancy between margins measured intraoperatively and those measured microscopically by the pathologist after specimen processing. A total of 61 patients underwent resective surgery with curative intent for primary oral SCC were included in this study. All patients underwent resection of the tumor with a measured 1-cm margin. Specimens were then submitted for processing and reviewing, and histopathologic margins were measured. The closest histopathologic margin was compared with the in situ margin (1 cm) to determine the percentage discrepancy. The mean discrepancy between the in situ margins and the histopathological margins of all close and positive margins were 47.6% for the buccal mucosa (with a P value corresponding to 0.05 equaling 2.1), which is statistically significant, 4.8% for the floor of mouth, 9.5% for the mandibular alveolus, 4.8% for the retromolar trigon, and 33.3% for the tongue. There is a significant difference among resection margins based on tumor anatomical location. Margins shrinkage after resection and processing should be considered at the time of the initial resection. Tumors located in the buccal mucosa show significantly greater discrepancies than tumors at other sites. These findings suggest that it is critical to consider the oral site when outlining margins to ensure adequacy of resection. Buccal SCC is an aggressive disease, and should be considered as an aggressive subsite within the oral cavity, requiring a radical and aggressive resective approach. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Ichthyofauna of two streams (silted and reference) in the Upper Paraná river basin, Southeastern Brazil.

PubMed

Casatti, L

2004-11-01

In this study the fish assemblages of the silted Aguas Claras stream (AC) was compared with that of a reference, the São Carlos stream (SC), so as to identify potential fish indicators of integrity or degradation. Both streams, located about 5 km from one another, are part of the Upper Paraná river basin, Brazil, and present similar physiographical features. Twenty-one species were collected in AC (1,271 specimens) and 18 in SC (940 specimens). In AC, dominant species e.g., Corydoras aeneus (sandy pools), Serrapinnus notomelas, and Pyrrhulina australis (warm marginal shallow pools) were those favored by new microhabitats linked to siltation and removal of the riparian vegetation. Changes in the composition of the marginal vegetation resulted in dominance of species such as Hisonotus francirochai (marginal grasses). In SC the dominant species was Phalloceros caudimacultus, abundant in marginal shallow pools, and Trichomycterus diabolus. and Hypostomus nigromaculatus, exclusively riffle-dwelling species, which were absent in AC. Fish assemblage monitoring is recommended for use in riparian management programs in order to evaluate negative instream sedimentation effects.

Operative outcomes of conventional specimen radiography versus in-operating room specimen radiography in radioactive seed-localized segmental mastectomies.

PubMed

Rhee, Daniel; Pockaj, Barbara; Wasif, Nabil; Stucky, Chee-Chee; Pizzitola, Victor; Giurescu, Marina; Patel, Bhavika; McCarthy, Janice; Gray, Richard

2018-01-01

In-operating room specimen radiography (ORSR) has not been studied among women undergoing radioactive seed localization (RSL) for breast cancer surgery and had the potential to decrease operative time and perhaps improve intraoperative margin management. One hundred consecutive RSL segmental mastectomies among 98 patients using ORSR were compared to 100 consecutive segmental mastectomies among 98 patients utilizing conventional radiography (CSR) prior to the initiation of ORSR from December 2013 to January 2015 after radioactive seed localization. Final pathologic margins were considered to be 10 mm for all cases of no residual disease after biopsy or neoadjuvant therapy, but such patients were excluded from analyses involving tumor size. All patients' specimens were subjected to intraoperative pathologic consultation in addition to ORSR or CSR. The median age of the cohort was 65 years (range 36-97), and the median tumor size was 1 cm. There were no differences between the ORSR and CSR groups in age, tumor size, percentage of cases with only DCIS, and percentage of cases with microcalcifications. The ORSR group had a statistically significant lower BMI. Mean operative time from cut-to-close was not significantly different (ORSR 77 min, SD 24.8 vs CSR 76 min, SD 24.8, p = 0.75). There was no statistical difference in mean closest final pathologic margin (4.99 mm, SD 3.3 vs 4.88 mm, SD 3.5, p = 0.9). The percentage undergoing intraoperative margin re-excision (ORSR 40%, CR 47%, p = 0.31) and the mean total number of margins excised intraoperatively (ORSR 0.9, CR 1.0 p = 0.65) were similar. The rate of any margin <2 mm was 14% vs 12% for ORSR and CR, respectively (p = 0.64). The mean specimen volume for ORSR was 76cm3 (SD 101.8) vs 90cm3 (SD 61.2) for CSR; this difference was not statistically significant (p = 0.25). The mean ratio of segmental mastectomy volume to maximum tumor diameter was less for ORSR (82.7cm2 vs 139.4cm2, p = 0.014). ORSR for RSL breast surgery, in the setting of routine intraoperative pathology consultation, does not significantly impact operative time, the rate or number of additional intraoperative margins excised, the number of reoperations for margins, or the width of final pathological margins. ORSR was associated with a decrease in the volume of segmental mastectomies relative to the tumor diameter. Copyright © 2017 Elsevier Inc. All rights reserved.

Multiscale nonlinear microscopy and widefield white light imaging enables rapid histological imaging of surgical specimen margins

PubMed Central

Giacomelli, Michael G.; Yoshitake, Tadayuki; Cahill, Lucas C.; Vardeh, Hilde; Quintana, Liza M.; Faulkner-Jones, Beverly E.; Brooker, Jeff; Connolly, James L.; Fujimoto, James G.

2018-01-01

The ability to histologically assess surgical specimens in real-time is a long-standing challenge in cancer surgery, including applications such as breast conserving therapy (BCT). Up to 40% of women treated with BCT for breast cancer require a repeat surgery due to postoperative histological findings of close or positive surgical margins using conventional formalin fixed paraffin embedded histology. Imaging technologies such as nonlinear microscopy (NLM), combined with exogenous fluorophores can rapidly provide virtual H&E imaging of surgical specimens without requiring microtome sectioning, facilitating intraoperative assessment of margin status. However, the large volume of typical surgical excisions combined with the need for rapid assessment, make comprehensive cellular resolution margin assessment during surgery challenging. To address this limitation, we developed a multiscale, real-time microscope with variable magnification NLM and real-time, co-registered position display using a widefield white light imaging system. Margin assessment can be performed rapidly under operator guidance to image specific regions of interest located using widefield imaging. Using simulated surgical margins dissected from human breast excisions, we demonstrate that multi-centimeter margins can be comprehensively imaged at cellular resolution, enabling intraoperative margin assessment. These methods are consistent with pathology assessment performed using frozen section analysis (FSA), however NLM enables faster and more comprehensive assessment of surgical specimens because imaging can be performed without freezing and cryo-sectioning. Therefore, NLM methods have the potential to be applied to a wide range of intra-operative applications. PMID:29761001

Effects of different abutment material and surgical insertion torque on the marginal adaptation of an internal conical interface: an in vitro study.

PubMed

Farronato, Davide; Pieroni, Stefano; Mangano, Francesco Guido; Briguglio, Francesco; Re, Dino

2014-10-01

To evaluate the marginal adaptation at implant-abutment connection of an implant featuring a conical (45° taper) internal hexagonal abutment with a connection depth of 2.5mm, comparing the performance of two identical abutments of different material (titanium grade-4 and Co-Cr-alloy). Twenty implants (3.75 mm×15 mm) were connected to non-matching abutments (5.5 mm×10 mm) of two different materials (titanium grade-4: n=10; Co-Cr-alloy: n=10). The specimens were separately embedded in epoxylite resin, inside copper cylinders, and submerged without covering the most coronal portion (5 mm) of the fixture. Five specimens per group were stressed simulating a surgical 100 Ncm insertion torque, while the others had no torque simulation. All specimens were subjected to a non-axial static load (100 N) in a universal testing machine, under an angle of 30° with respect to the implant axis. Once 100 N load was reached, low shrinkage self-curing resin was injected inside the cylinders, and load was maintained until complete resin polymerization. Specimens were cut and analyzed with optical and scanning-electron-microscope (SEM) to evaluate the marginal adaptation at the implant-abutment connection. Statistical analysis was performed using one-way ANOVA (p=0.02). None of the 20 samples failed. The implant-abutment connection was able to guarantee a good optical seal; SEM analysis confirmed the absence of microgaps. Within the limits of this study (small sample size, limited time) the marginal adaptation of the implant-abutment connection was not affected by the abutment material nor by the application of surgical insertion torque. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Applicability of a Conservative Margin Approach for Assessing NDE Flaw Detectability

NASA Technical Reports Server (NTRS)

Koshti, ajay M.

2007-01-01

Nondestructive Evaluation (NDE) procedures are required to detect flaws in structures with a high percentage detectability and high confidence. Conventional Probability of Detection (POD) methods are statistical in nature and require detection data from a relatively large number of flaw specimens. In many circumstances, due to the high cost and long lead time, it is impractical to build the large set of flaw specimens that is required by the conventional POD methodology. Therefore, in such situations it is desirable to have a flaw detectability estimation approach that allows for a reduced number of flaw specimens but provides a high degree of confidence in establishing the flaw detectability size. This paper presents an alternative approach called the conservative margin approach (CMA). To investigate the applicability of the CMA approach, flaw detectability sizes determined by the CMA and POD approaches have been compared on actual datasets. The results of these comparisons are presented and the applicability of the CMA approach is discussed.

Marginal adaptation of four inlay casting waxes on stone, titanium, and zirconia dies.

PubMed

Michalakis, Konstantinos X; Kapsampeli, Vassiliki; Kitsou, Aikaterini; Kirmanidou, Yvone; Fotiou, Anna; Pissiotis, Argirios L; Calvani, Pasquale Lino; Hirayama, Hiroshi; Kudara, Yukio

2014-07-01

Different inlay casting waxes do not produce copings with satisfactory marginal accuracy when used on different die materials. The purpose of this study was to evaluate the marginal accuracy of 4 inlay casting waxes on stone dies and titanium and zirconia abutments and to correlate the findings with the degree of wetting between the die specimens and the inlay casting waxes. The inlay casting waxes tested were Starwax (Dentaurum), Unterziehwachs (Bredent), SU Esthetic wax (Schuler), and Sculpturing wax (Renfert). The marginal opening of the waxes was measured with a stereomicroscope on high-strength stone dies and on titanium and zirconia abutments. Photographic images were obtained, and the mean marginal opening for each specimen was calculated. A total of 1440 measurements were made. Wetting between die materials and waxes was determined after fabricating stone, titanium, and zirconia rectangular specimens. A calibrated pipette was used to place a drop of molten wax onto each specimen. The contact angle was calculated with software after an image of each specimen had been made with a digital camera. Collected data were subjected to a 2-way analysis of variance (α=.05). Any association between marginal accuracy and wetting of different materials was found by using the Pearson correlation. The wax factor had a statistically significant effect both on the marginal discrepancy (F=158.31, P<.001) and contact angle values (F=68.09, P<.001). A statistically significant effect of the die material factor both on the marginal adaptation (F=503.47, P<.001) and contact angle values (F=585.02, P<.001) was detected. A significant correlation between the marginal accuracy and the contact angle values (Pearson=0.881, P=.01) was also found. Stone dies provided wax copings with the best marginal integrity, followed by titanium and zirconia abutments. Unterziehwachs (Bredent), wax produced the best marginal adaptation on different die materials. A significant correlation was found between the marginal accuracy and the contact angle values. As the contact angle value became smaller, the marginal accuracy improved. All combinations of waxes and stone and titanium dies presented a high wettability. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Radioactive Seed Localization or Wire-guided Localization of Nonpalpable Invasive and In Situ Breast Cancer: A Randomized, Multicenter, Open-label Trial.

PubMed

Langhans, Linnea; Tvedskov, Tove F; Klausen, Thomas L; Jensen, Maj-Britt; Talman, Maj-Lis; Vejborg, Ilse; Benian, Cemil; Roslind, Anne; Hermansen, Jonas; Oturai, Peter S; Bentzon, Niels; Kroman, Niels

2017-07-01

To compare the rate of positive resection margins between radioactive seed localization (RSL) and wire-guided localization (WGL) after breast conserving surgery (BCS). WGL is the current standard for localization of nonpalpable breast lesions in BCS, but there are several difficulties related to the method. From January 1, 2014 to February 4, 2016, patients with nonpalpable invasive breast cancer or DCIS visible on ultrasound were enrolled in this randomized, multicenter, open-label clinical trial, and randomly assigned to RSL or WGL. The primary outcome was margin status after BCS. Secondary outcomes were duration of the surgical procedure, weight of surgical specimen, and patients' pain perception. Analyses were performed by intention-to-treat (ITT) and per protocol. Out of 444 eligible patients, 413 lesions representing 409 patients were randomized; 207 to RSL and 206 to WGL. Twenty-three did not meet inclusion criteria, chose to withdraw, or had a change in surgical management and were excluded. The remaining 390 lesions constituted the ITT population. Here, resection margins were positive in 23 cases (11.8%) in the RSL group compared with 26 cases (13.3%) in the WGL group (P = 0.65). The per-protocol analysis revealed no difference in margin status (P = 0.62). There were no significant differences in the duration of the surgical procedure (P = 0.12), weight of the surgical specimen (P = 0.54) or the patients' pain perception (P = 0.28). RSL offers a major logistic advantage, as localization can be done several days before surgery without any increase in positive resection margins compared with WGL.

Effect of protective coating on microhardness of a new glass ionomer cement: Nanofilled coating versus unfilled resin

PubMed Central

Faraji, Foad; Heshmat, Haleh; Banava, Sepideh

2017-01-01

Background and Objectives: EQUIATM is a new gastrointestinal (GI) system with high compressive strength, surface microhardness (MH), and fluoride release potential. This in vitro study aimed to assess the effect of aging and type of protective coating on the MH of EQUIATM GI cement. Materials and Methods: A total of 30 disc-shaped specimens measuring 9 mm in diameter and 2 mm in thickness were fabricated of EQUIATM GI and divided into three groups of G-Coat nanofilled coating (a), no coating (b) and margin bond (c). The Vickers MH value of specimens was measured before (baseline) and at 3 and 6 months after water storage. Data were analyzed using repeated measures ANOVA. Results: Group B had significantly higher MH than the other two groups at baseline. Both G-Coat and margin bond increased the surface MH of GI at 3 and 6 months. The MH values of G-Coat and margin bond groups did not significantly increase or decrease between 3 and 6 months. Conclusion: The increase in MH was greater in the G-Coat compared to the margin bond group in the long-term. Clinically, margin bond may be a suitable alternative when G-Coat is not available. PMID:29259364

Evaluation of marginal fit of single implant-supported metal-ceramic crowns prepared by using presintered metal blocks.

PubMed

Pasali, Baris; Sarac, Duygu; Kaleli, Necati; Sarac, Yakup Sinasi

2018-02-01

Recently, presintered metal blocks for nonprecious and precious metal implant-supported restorations have gained popularity in computer-aided design and computer-aided manufacturing (CAD-CAM) systems. However, few studies have evaluated the marginal discrepancy of implant-supported restorations made with these new alloy systems. The purpose of this in vitro study was to compare the milling-sintering method with the lost-wax and milling methods in terms of the marginal fit of implant-supported metal-ceramic restorations. Thirty implant abutments screwed to implant analogs were embedded into acrylic resin to investigate marginal fit and then divided according to fabrication methods into the following 3 groups (n=10): lost-wax (LW; control group), milling (M), and milling-sintering (MS). Porcelain material was applied to all specimens after completion of the fabrication process. Subsequently, all specimens were cemented to implant abutments for the measurement of marginal discrepancies. Twelve marginal discrepancy measurements were recorded on each implant abutment by using a stereomicroscope. The arithmetic mean of these 12 measurements was considered the mean marginal discrepancy value of each abutment. Data were statistically analyzed by using 1-way ANOVA and Tukey honest significant difference tests (α=.05). The lowest mean marginal discrepancy values (81 ±2 μm) were observed in the M group, which was significantly different (P<.001) from the other methods. The highest mean marginal discrepancy values (99 ±2 μm) were observed in the MS group. The results revealed that restorations prepared by the milling-sintering method provided clinically acceptable results (<120 μm); however, this new technique was not found to be as precise as the milling method in terms of marginal fit. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Assessment of breast pathologies using nonlinear microscopy

PubMed Central

Tao, Yuankai K.; Shen, Dejun; Sheikine, Yuri; Ahsen, Osman O.; Wang, Helen H.; Schmolze, Daniel B.; Johnson, Nicole B.; Brooker, Jeffrey S.; Cable, Alex E.; Connolly, James L.; Fujimoto, James G.

2014-01-01

Rapid intraoperative assessment of breast excision specimens is clinically important because up to 40% of patients undergoing breast-conserving cancer surgery require reexcision for positive or close margins. We demonstrate nonlinear microscopy (NLM) for the assessment of benign and malignant breast pathologies in fresh surgical specimens. A total of 179 specimens from 50 patients was imaged with NLM using rapid extrinsic nuclear staining with acridine orange and intrinsic second harmonic contrast generation from collagen. Imaging was performed on fresh, intact specimens without the need for fixation, embedding, and sectioning required for conventional histopathology. A visualization method to aid pathological interpretation is presented that maps NLM contrast from two-photon fluorescence and second harmonic signals to features closely resembling histopathology using hematoxylin and eosin staining. Mosaicking is used to overcome trade-offs between resolution and field of view, enabling imaging of subcellular features over square-centimeter specimens. After NLM examination, specimens were processed for standard paraffin-embedded histology using a protocol that coregistered histological sections to NLM images for paired assessment. Blinded NLM reading by three pathologists achieved 95.4% sensitivity and 93.3% specificity, compared with paraffin-embedded histology, for identifying invasive cancer and ductal carcinoma in situ versus benign breast tissue. Interobserver agreement was κ = 0.88 for NLM and κ = 0.89 for histology. These results show that NLM achieves high diagnostic accuracy, can be rapidly performed on unfixed specimens, and is a promising method for intraoperative margin assessment. PMID:25313045

Micro-CT evaluation of the marginal fit of CAD/CAM all ceramic crowns

NASA Astrophysics Data System (ADS)

Brenes, Christian

Objectives: Evaluate the marginal fit of CAD/CAM all ceramic crowns made from lithium disilicate and zirconia using two different fabrication protocols (model and model-less). METHODS: Forty anterior all ceramic restorations (20 lithium disilicate, 20 zirconia) were fabricated using a CEREC Bluecam scanner. Two different fabrication methods were used: a full digital approach and a printed model. Completed crowns were cemented and marginal gap was evaluated using Micro-CT. Each specimen was analyzed in sagittal and trans-axial orientations, allowing a 360° evaluation of the vertical and horizontal fit. RESULTS: Vertical measurements in the lingual, distal and mesial views had and estimated marginal gap from 101.9 to 133.9 microns for E-max crowns and 126.4 to 165.4 microns for zirconia. No significant differences were found between model and model-less techniques. CONCLUSION: Lithium disilicate restorations exhibited a more accurate and consistent marginal adaptation when compared to zirconia crowns. No statistically significant differences were observed when comparing model or model-less approaches.

Histologic processing and reporting of cutaneous pigmented lesions: recommendations based on a survey of 94 dermatopathologists.

PubMed

Kolman, Olga; Hoang, Mai P; Piris, Adriano; Mihm, Martin C; Duncan, Lyn M

2010-10-01

Standard operating procedures for laboratory processing and reporting of margins of cutaneous pigmented lesions do not exist. We conducted a survey of 94 dermatopathologists to evaluate these practices. We sought to: (1) identify dominant practices among dermatopathologists; (2) determine the impact of the procedure, intent to excise, and histologic diagnosis on the process of margin evaluation; and (3) propose guidelines based on these findings. The survey consisted of 44 questions focused on the impact of procedure (punch, shave, or ellipse), intent (excision or biopsy), and histologic diagnosis (common nevus, congenital nevus, atypical nevus, melanoma) on processing and margin reporting. For ellipses, or specimens indicated as excisions, the majority practice (76%-98%) was to ink the specimens. Although more than 90% of observers report the margins on all melanomas and atypical nevi, fewer than 50% of respondents report margins on all nonatypical nevi. The study consists of a survey sample of dermatopathologists and does not represent the practices of those who did not respond to the survey. Based on the results of this survey we have arrived at the following recommendations: (1) ink all specimens that are ellipses or designated as excisions; (2) tips should be evaluated separately if the specimen is an ellipse; (3) obtain levels in cases with tumor in the tip but not at ink if the specimen is an ellipse or excision and the diagnosis is atypical nevus or melanoma; and (4) report margins on all atypical nevi and melanomas. Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

MRI Evaluation of Resection Margins in Bone Tumour Surgery

PubMed Central

Traore, Sidi Yaya; Lecouvet, Frédéric; Galant, Christine

2014-01-01

In 12 patients operated on for bone sarcoma resection, a postoperative magnetic resonance imaging of the resection specimens was obtained in order to assess the surgical margins. Margins were classified according to MRI in R0, R1, and R2 by three independent observers: a radiologist and two orthopaedic surgeons. Final margin evaluation (R0, R1, and R2) was assessed by a confirmed pathologist. Agreement for margin evaluation between the pathologist and the radiologist was perfect (κ = 1). Agreement between the pathologist and an experienced orthopaedic surgeon was very good while it was fair between the pathologist and a junior orthopaedic surgeon. MRI should be considered as a tool to give quick information about the adequacy of margins and to help the pathologist to focus on doubtful areas and to spare time in specimen analysis. But it may not replace the pathological evaluation that gives additional information about tumor necrosis. This study shows that MRI extemporaneous analysis of a resection specimen may be efficient in bone tumor oncologic surgery, if made by an experienced radiologist with perfect agreement with the pathologist. PMID:24976785

Marginal Gap Formation in Approximal "Bulk Fill" Resin Composite Restorations After Artificial Ageing.

PubMed

Peutzfeldt, A; Mühlebach, S; Lussi, A; Flury, S

The aim of this in vitro study was to investigate the marginal gap formation of a packable "regular" resin composite (Filtek Supreme XTE [3M ESPE]) and two flowable "bulk fill" resin composites (Filtek Bulk Fill [3M ESPE] and SDR [DENTSPLY DeTrey]) along the approximal margins of Class II restorations. In each of 39 extracted human molars (n=13 per resin composite), mesial and distal Class II cavities were prepared, placing the gingival margins below the cemento-enamel junction. The cavities were restored with the adhesive system OptiBond FL (Kerr) and one of the three resin composites. After restoration, each molar was cut in half in the oro-vestibular direction between the two restorations, resulting in two specimens per molar. Polyvinylsiloxane impressions were taken and "baseline" replicas were produced. The specimens were then divided into two groups: At the beginning of each month over the course of six months' tap water storage (37°C), one specimen per molar was subjected to mechanical toothbrushing, whereas the other was subjected to thermocycling. After artificial ageing, "final" replicas were produced. Baseline and final replicas were examined under the scanning electron microscope (SEM), and the SEM micrographs were used to determine the percentage of marginal gap formation in enamel or dentin. Paramarginal gaps were registered. The percentages of marginal gap formation were statistically analyzed with a nonparametric analysis of variance followed by Wilcoxon-Mann-Whitney tests and Wilcoxon signed rank tests, and all p-values were corrected with the Bonferroni-Holm adjustment for multiple testing (significance level: α=0.05). Paramarginal gaps were analyzed descriptively. In enamel, significantly lower marginal gap formation was found for Filtek Supreme XTE compared to Filtek Bulk Fill ( p=0.0052) and SDR ( p=0.0289), with no significant difference between Filtek Bulk Fill and SDR ( p=0.4072). In dentin, significantly lower marginal gap formation was found for SDR compared to Filtek Supreme XTE ( p<0.0001) and Filtek Bulk Fill ( p=0.0015), with no significant difference between Filtek Supreme XTE and Filtek Bulk Fill ( p=0.4919). Marginal gap formation in dentin was significantly lower than in enamel ( p<0.0001). The percentage of restorations with paramarginal gaps varied between 0% and 85%, and for all three resin composites the percentages were markedly higher after artificial ageing. The results from this study suggest that in terms of marginal gap formation in enamel, packable resin composites may be superior to flowable "bulk fill" resin composites, while in dentin some flowable "bulk fill" resin composites may be superior to packable ones.

Margins in Skin Excision Biopsies: Principles and Guidelines

PubMed Central

Ranjan, Richa; Singh, Lavleen; Arava, Sudheer K; Singh, Manoj Kumar

2014-01-01

Skin biopsies are usually undertaken to confirm a clinical diagnosis, to remove a lesion, and to determine the adequacy of excised tissue margin. A surgical margin is technically defined as the “edge” of the tissue removed. The term is especially pertinent when the tissue excised is suspected of being involved by a malignant process. One of the most important predictive and prognostic factors of a malignant lesion is whether the margins of the resected specimen are involved by the tumor or not. The purpose of this review is to provide an insight into grossing of a skin biopsy specimen with emphasis on techniques and reporting of excision biopsy margins. PMID:25484385

Role of imprint/exfoliative cytology in ulcerated skin neoplasms.

PubMed

Ramakrishnaiah, Vishnu Prasad Nelamangala; Babu, Ravindra; Pai, Dinker; Verma, Surendra Kumar

2013-12-01

Imprint cytology is a method of studying cells by taking an imprint from the cut surface of a wedge biopsy specimen or from the resected margins of a surgical specimen. It is rapid, simple and fairly accurate. Exfoliative cytology is an offshoot from the imprint cytology where in cells obtained from the surface of ulcers, either by scrape or brush, are analyzed for the presence of malignant cells. We undertook this study to see the role of imprint/exfoliative cytology in the diagnosis of ulcerated skin neoplasm and to check the adequacy of resected margins intra-operatively. This was a prospective investigative study conducted from September 2003 to July 2005. All patients presenting to surgical clinic with ulcerated skin and soft tissue tumours were included in the study. A wedge biopsy obtained from the ulcer and imprint smears were taken from the cut surface. Exfoliative cytology was analyzed from the surface smears. Wedge biopsy specimen was sent for histopathological (HPE) examination. The cytology and HPE were analyzed by a separate pathologist. Imprint cytology was also used to check the adequacy of resected margins in case of wide excision. This was compared with final HPE. Total of 107 patients was included in the present study and 474 imprint smears were done, with an average of 4.43 slides per lesion. Out of 59 wide excision samples, 132 imprint smears were prepared for assessing resected margins accounting for an average of 2.24 slides per each excised lesion. On combining imprint cytology with exfoliative cytology the overall sensitivity, specificity and positive predictive value were 90.38 %, 100 % and 90.38 % respectively. Only one out of 59 cases had a positive resected margin which was not picked by imprint cytology. Imprint cytology can be used for rapid and accurate diagnosis of various skin malignancies. It can also be used to check the adequacy of the resected margin intraoperatively.

Comparative assessment of marginal accuracy of grade II titanium and Ni–Cr alloy before and after ceramic firing: An in vitro study

PubMed Central

Patil, Abhijit; Singh, Kishan; Sahoo, Sukant; Suvarna, Suraj; Kumar, Prince; Singh, Anupam

2013-01-01

Objective: The aims of the study are to assess the marginal accuracy of base metal and titanium alloy casting and to evaluate the effect of repeated ceramic firing on the marginal accuracy of base metal and titanium alloy castings. Materials and Methods: Twenty metal copings were fabricated with each casting material. Specimens were divided into 4 groups of 10 each representing base metal alloys castings without (Group A) and with metal shoulder margin (Group B), titanium castings without (Group C) and with metal shoulder margin (Group D). The measurement of fit of the metal copings was carried out before the ceramic firing at four different points and the same was followed after porcelain build-up. Results: Significant difference was found when Ni–Cr alloy samples were compared with Grade II titanium samples both before and after ceramic firings. The titanium castings with metal shoulder margin showed highest microgap among all the materials tested. Conclusions: Based on the results that were found and within the limitations of the study design, it can be concluded that there is marginal discrepancy in the copings made from Ni–Cr and Grade II titanium. This marginal discrepancy increased after ceramic firing cycles for both Ni–Cr and Grade II titanium. The comparative statistical analysis for copings with metal-collar showed maximum discrepancy for Group D. The comparative statistical analysis for copings without metal-collar showed maximum discrepancy for Group C. PMID:24926205

Spectrally encoded confocal microscopy (SECM) for rapid assessment of breast excision specimens (Conference Presentation)

NASA Astrophysics Data System (ADS)

Brachtel, Elena F.; Johnson, Nicole B.; Huck, Amelia E.; Rice-Stitt, Travis L.; Vangel, Mark G.; Smith, Barbara L.; Tearney, Guillermo J.; Kang, DongKyun

2016-03-01

Unacceptably large percentage (20-40%) of breast cancer lumpectomy patients are required to undergo multiple surgeries when positive margins are found upon post-operative histologic assessment. If the margin status can be determined during surgery, surgeon can resect additional tissues to achieve tumor-free margin, which will reduce the need for additional surgeries. Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technology that has a potential to image the entire surgical margin within a short procedural time. Previously, SECM was shown to rapidly image a large area (10 mm by 10 mm) of human esophageal tissue within a short procedural time (15 seconds). When used in lumpectomy, SECM will be able to image the entire margin surface of ~30 cm2 in around 7.5 minutes. SECM images will then be used to determine margin status intra-operatively. In this paper, we present results from a study of testing accuracy of SECM for diagnosing malignant breast tissues. We have imaged freshly-excised breast specimens (N=46) with SECM. SECM images clearly visualized histomorphologic features associated with normal/benign and malignant breast tissues in a similar manner to histologic images. Diagnostic accuracy was tested by comparing SECM diagnoses made by three junior pathologists with corresponding histologic diagnoses made by a senior pathologist. SECM sensitivity and specificity were high, 0.91 and 0.93, respectively. Intra-observer agreement and inter-observer agreement were also high, 0.87 and 0.84, respectively. Results from this study showed that SECM has a potential to accurately determine margin status during breast cancer lumpectomy.

Influence of Different Ceramic Systems on Marginal Misfit.

PubMed

Vargas, S P; Neves, A C C; Vitti, R; Amaral, M; Henrique, M N; Silva-Concílio, L R

2017-09-01

the aim of this study was to evaluate the marginal misfit at the interface between a ceramic coping and its abutment. Twenty-four specimens were made with solid abutments. The specimens were divided into 3 groups according to the ceramic system (n = 8): Lava (zirconia), IPS e.max Press (lithium disilicate), and IPS Empress Esthetic (leucite). All copings were cemented with resin luting agent (RelyX U200) and the marginal misfit were evaluated at 3 different times: initial, after cementation, and after mechanical cycling using a linear measuring microscope (Measuring Microscope STM-Olympus) at a magnification of 40x. All specimens were subjected to mechanical cycling (1 million cycles) by an universal testing machine (Instron 8800). The results were statistically analyzed using Analysis of Variance and Student's t-test (α = 0.05). all groups showed an increase in the marginal misfit after cementation. The lithium disilicate group demonstrated the lowest interacial gap values at each evaluation (p = 0.001). The zirconia and leucite groups showed similar interfacial gap values (initial, p = 0.244; and post cementation, p = 0.751). the cementation increase the marginal misfit, but the mechanical cycling did not influence the marginal misfit of the ceramics systems evaluated. Copyright© 2017 Dennis Barber Ltd.

[Microleakage of various cementing agents for casting ceramics].

PubMed

Weng, Wei-min; Zhang, Xiu-yin; Zhang, Fu-qiang

2009-12-01

To observe and compare the microleakage of different composite resin cement systems for IPS Empress 2 ceramics base. Sixteen healthy non-carious human molars were selected in the study. Class V ceramic inlay was prepared by IPS Empress 2 ceramics. The samples were divided into two groups, eight in each group. RelyX Unicem and Variolink 2 were used for bonding respectively in 2 groups. All specimens were stored in water at 37 degrees centigrade for 24 hours, then the specimens were subjected to 500 thermocycles ranging from 5 degrees centigrade to 55 degrees centigrade. Eight specimens in each group were evaluated by dye penetration. The microleakage was examined with light microscope. Statistical analysis was performed with SPSS11.0 software package. Enamel margins exhibited lower leakage than dentin margins by using two cementing agents for casting ceramics (P<0.05). The depth of dye for Variolink 2 and RelyX Unicem at enamel and dentin was not significantly different (P>0.05). The microleakage of Variolink 2 and RelyX Unicem for IPS Empress 2 ceramics base has similar sealing abilities.

Automated detection of breast cancer in resected specimens with fluorescence lifetime imaging

NASA Astrophysics Data System (ADS)

Phipps, Jennifer E.; Gorpas, Dimitris; Unger, Jakob; Darrow, Morgan; Bold, Richard J.; Marcu, Laura

2018-01-01

Re-excision rates for breast cancer lumpectomy procedures are currently nearly 25% due to surgeons relying on inaccurate or incomplete methods of evaluating specimen margins. The objective of this study was to determine if cancer could be automatically detected in breast specimens from mastectomy and lumpectomy procedures by a classification algorithm that incorporated parameters derived from fluorescence lifetime imaging (FLIm). This study generated a database of co-registered histologic sections and FLIm data from breast cancer specimens (N  =  20) and a support vector machine (SVM) classification algorithm able to automatically detect cancerous, fibrous, and adipose breast tissue. Classification accuracies were greater than 97% for automated detection of cancerous, fibrous, and adipose tissue from breast cancer specimens. The classification worked equally well for specimens scanned by hand or with a mechanical stage, demonstrating that the system could be used during surgery or on excised specimens. The ability of this technique to simply discriminate between cancerous and normal breast tissue, in particular to distinguish fibrous breast tissue from tumor, which is notoriously challenging for optical techniques, leads to the conclusion that FLIm has great potential to assess breast cancer margins. Identification of positive margins before waiting for complete histologic analysis could significantly reduce breast cancer re-excision rates.

Refining the 'cucumber' technique for laryngeal biopsy.

PubMed

Robertson, S; Cooper, L; McPhaden, A; MacKenzie, K

2011-06-01

To refine the case selection process for the 'cucumber' mounting system for laryngeal biopsies. We conducted a retrospective audit of cucumber technique specimens taken between January 2002 and December 2008. We analysed the clinical indications for biopsy and the pathological diagnosis, for each specimen, in order to inform our case selection process. The cucumber technique was used for 125 laryngeal specimens. 60 specimens were taken for diagnostic sampling, 46 were taken during endoscopic laser resection, and 19 for overtly benign pathology. The cucumber technique was most useful for the interpretation of margins in endoscopic laser resection specimens. The cucumber technique is most useful for endoscopic resection cases in which tumour, dysplasia or suspicious lesions have been excised. Detailed information on resection margins is invaluable during multidisciplinary team discussions on patient management. Detailed photography of mounted specimens enables both laryngologist and pathologist to orientate and interpret specimens accurately.

Comparative Evaluation of Conventional and Accelerated Castings on Marginal Fit and Surface Roughness.

PubMed

Jadhav, Vivek Dattatray; Motwani, Bhagwan K; Shinde, Jitendra; Adhapure, Prasad

2017-01-01

The aim of this study was to evaluate the marginal fit and surface roughness of complete cast crowns made by a conventional and an accelerated casting technique. This study was divided into three parts. In Part I, the marginal fit of full metal crowns made by both casting techniques in the vertical direction was checked, in Part II, the fit of sectional metal crowns in the horizontal direction made by both casting techniques was checked, and in Part III, the surface roughness of disc-shaped metal plate specimens made by both casting techniques was checked. A conventional technique was compared with an accelerated technique. In Part I of the study, the marginal fit of the full metal crowns as well as in Part II, the horizontal fit of sectional metal crowns made by both casting techniques was determined, and in Part III, the surface roughness of castings made with the same techniques was compared. The results of the t -test and independent sample test do not indicate statistically significant differences in the marginal discrepancy detected between the two casting techniques. For the marginal discrepancy and surface roughness, crowns fabricated with the accelerated technique were significantly different from those fabricated with the conventional technique. Accelerated casting technique showed quite satisfactory results, but the conventional technique was superior in terms of marginal fit and surface roughness.

Marginal adaptation, fracture load and macroscopic failure mode of adhesively luted PMMA-based CAD/CAM inlays.

PubMed

Ender, Andreas; Bienz, Stefan; Mörmann, Werner; Mehl, Albert; Attin, Thomas; Stawarczyk, Bogna

2016-02-01

To evaluate marginal adaptation, fracture load and failure types of CAD/CAM polymeric inlays. Standardized prepared human molars (48) were divided into four groups (n=12): (A) PCG (positive control group); adhesively luted glass-ceramic inlays, (B) TRX; CAD/CAM polymeric inlays luted using a self-adhesive resin cement, (C) TAC; CAD/CAM polymeric inlays luted using a conventional resin cement, and (D) NCG (negative control group); direct-filled resin-based composite restorations. All specimens were subjected to a chewing simulator. Before and after chewing fatigue, marginal adaptation was assessed at two interfaces: (1) between dental hard tissues and luting cement and (2) between luting cement and restoration. Thereafter, the specimens were loaded and the fracture loads, as well as the failure types, were determined. The data were analysed using three- and one-way ANOVA with post hoc Scheffé test, two sample Student's t-test (p<0.05). Before and after chewing fatigue, marginal adaptation for interface 1 showed significantly better results for TRX and PCG than for TAC (p=0.001-0.02) and NCG (p=0.001-0.047). For interface 2, marginal adaptation for TAC was significantly inferior to TRX (p<0.001) and PCG (p<0.001). Chewing fatigue had a negative impact on the marginal adaptation of TAC and NCG. No significant differences in fracture load were found between all tested groups. Self-adhesive luted polymeric CAD/CAM inlays showed similar marginal adaptation and fracture load values compared to adhesively luted glass-ceramic inlays. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Comparative analysis of whole mount processing and systematic sampling of radical prostatectomy specimens: pathological outcomes and risk of biochemical recurrence.

PubMed

Salem, Shady; Chang, Sam S; Clark, Peter E; Davis, Rodney; Herrell, S Duke; Kordan, Yakup; Wills, Marcia L; Shappell, Scott B; Baumgartner, Roxelyn; Phillips, Sharon; Smith, Joseph A; Cookson, Michael S; Barocas, Daniel A

2010-10-01

Whole mount processing is more resource intensive than routine systematic sampling of radical retropubic prostatectomy specimens. We compared whole mount and systematic sampling for detecting pathological outcomes, and compared the prognostic value of pathological findings across pathological methods. We included men (608 whole mount and 525 systematic sampling samples) with no prior treatment who underwent radical retropubic prostatectomy at Vanderbilt University Medical Center between January 2000 and June 2008. We used univariate and multivariate analysis to compare the pathological outcome detection rate between pathological methods. Kaplan-Meier curves and the log rank test were used to compare the prognostic value of pathological findings across pathological methods. There were no significant differences between the whole mount and the systematic sampling groups in detecting extraprostatic extension (25% vs 30%), positive surgical margins (31% vs 31%), pathological Gleason score less than 7 (49% vs 43%), 7 (39% vs 43%) or greater than 7 (12% vs 13%), seminal vesicle invasion (8% vs 10%) or lymph node involvement (3% vs 5%). Tumor volume was higher in the systematic sampling group and whole mount detected more multiple surgical margins (each p <0.01). There were no significant differences in the likelihood of biochemical recurrence between the pathological methods when patients were stratified by pathological outcome. Except for estimated tumor volume and multiple margins whole mount and systematic sampling yield similar pathological information. Each method stratifies patients into comparable risk groups for biochemical recurrence. Thus, while whole mount is more resource intensive, it does not appear to result in improved detection of clinically important pathological outcomes or prognostication. Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Determination of safety margins for whole blood concentrations of alcohol and nineteen drugs in driving under the influence cases.

PubMed

Kristoffersen, Lena; Strand, Dag Helge; Liane, Veronica Horpestad; Vindenes, Vigdis; Tvete, Ingunn Fride; Aldrin, Magne

2016-02-01

Legislative limits for driving under the influence of 20 non-alcohol drugs were introduced in Norway in February 2012. Per se limits corresponding to blood alcohol concentrations (BAC) of 0.2g/kg were established for 20 psychoactive drugs, and limits for graded sanctions corresponding to BACs of 0.5 and 1.2g/kg were determined for 13 of these drugs. This new legislation made it possible for the courts to make sentences based on the analytical results, similar to the situation for alcohol. To ensure that the reported concentration is as least as high as the true concentration, with a 99% safety level, safety margins had to be calculated for each of the substances. Diazepam, tetrahydrocannabinol (THC) and alcohol were used as model substances to establish a new model for estimating the safety margins. The model was compared with a previous used model established several years ago, by a similar yet much simpler model, and they were found to be in agreement. The measurement uncertainties depend on the standard batch used, the work list and the measurements' replicate. A Bayesian modelling approach was used to determine the parameters in the model, using a dataset of 4700 diazepam positive specimens and 5400 THC positive specimens. Different safety margins were considered for low and high concentration levels of diazepam (≤2μM (0.6mg/L) and >2μM) and THC (≤0.01μM (0.003mg/L) and >0.01μM). The safety margins were for diazepam 19.5% (≤2μM) and 34% (>2μM), for THC 19.5% (≤0.01μM) and 24.9% (>0.01μM). Concentration dependent safety margins for BAC were based on a dataset of 29500 alcohol positive specimens, and were in the range 10.4% (0.1g/kg) to 4.0% (4.0g/kg) at a 99% safety level. A simplified approach was used to establish safety margins for the compounds amphetamine, MDMA, methamphetamine, alprazolam, phenazepam, flunitrazepam, clonazepam, nitrazepam, oxazepam, buprenorphine, GHB, methadone, ketamine, cocaine, morphine, zolpidem and zopiclone. The safety margins for these drugs were in the range 34-41%. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Marginal adaptation of newer root canal sealers to dentin: A SEM study.

PubMed

Polineni, Swapnika; Bolla, Nagesh; Mandava, Pragna; Vemuri, Sayesh; Mallela, Madhusudana; Gandham, Vijaya Madhuri

2016-01-01

This in vitro study evaluated and compared the marginal adaptation of three newer root canal sealers to root dentin. Thirty freshly extracted human single-rooted teeth with completely formed apices were taken. Teeth were decoronated, and root canals were instrumented. The specimens were randomly divided into three groups (n = 10) based upon the sealer used. Group 1 - teeth were obturated with epoxy resin sealer (MM-Seal). Group 2 - teeth were obturated with mineral trioxide aggregate (MTA) based sealer (MTA Fillapex), Group 3 - teeth were obturated with bioceramic sealer (EndoSequence BC sealer). Later samples were vertically sectioned using hard tissue microtome and marginal adaptation of sealers to root dentin was evaluated under coronal and apical halves using scanning electron microscopy (SEM) and marginal gap values were recorded. The data were statistically analyzed by two-way ANOVA and Tukey's multiple post hoc test. The highest marginal gap was seen in Group 2 (apical-16680.00 nm, coronal-10796 nm) and the lowest marginal gap was observed in Group 1 (apical-599.42 nm, coronal-522.72 nm). Coronal halves showed superior adaptation compared to apical halves in all the groups under SEM. Within the limitations of this study epoxy resin-based MM-Seal showed good marginal adaptation than other materials tested.

Direct comparison between confocal and multiphoton microscopy for rapid histopathological evaluation of unfixed human breast tissue.

PubMed

Yoshitake, Tadayuki; Giacomelli, Michael G; Cahill, Lucas C; Schmolze, Daniel B; Vardeh, Hilde; Faulkner-Jones, Beverly E; Connolly, James L; Fujimoto, James G

2016-12-01

Rapid histopathological examination of surgical specimen margins using fluorescence microscopy during breast conservation therapy has the potential to reduce the rate of positive margins on postoperative histopathology and the need for repeat surgeries. To assess the suitability of imaging modalities, we perform a direct comparison between confocal fluorescence microscopy and multiphoton microscopy for imaging unfixed tissue and compare to paraffin-embedded histology. An imaging protocol including dual channel detection of two contrast agents to implement virtual hematoxylin and eosin images is introduced that provides high quality imaging under both one and two photon excitation. Corresponding images of unfixed human breast tissue show that both confocal and multiphoton microscopy can reproduce the appearance of conventional histology without the need for physical sectioning. We further compare normal breast tissue and invasive cancer specimens imaged at multiple magnifications, and assess the effects of photobleaching for both modalities using the staining protocol. The results demonstrate that confocal fluorescence microscopy is a promising and cost-effective alternative to multiphoton microscopy for rapid histopathological evaluation of ex vivo breast tissue.

Direct comparison between confocal and multiphoton microscopy for rapid histopathological evaluation of unfixed human breast tissue

PubMed Central

Yoshitake, Tadayuki; Giacomelli, Michael G.; Cahill, Lucas C.; Schmolze, Daniel B.; Vardeh, Hilde; Faulkner-Jones, Beverly E.; Connolly, James L.; Fujimoto, James G.

2016-01-01

Abstract. Rapid histopathological examination of surgical specimen margins using fluorescence microscopy during breast conservation therapy has the potential to reduce the rate of positive margins on postoperative histopathology and the need for repeat surgeries. To assess the suitability of imaging modalities, we perform a direct comparison between confocal fluorescence microscopy and multiphoton microscopy for imaging unfixed tissue and compare to paraffin-embedded histology. An imaging protocol including dual channel detection of two contrast agents to implement virtual hematoxylin and eosin images is introduced that provides high quality imaging under both one and two photon excitation. Corresponding images of unfixed human breast tissue show that both confocal and multiphoton microscopy can reproduce the appearance of conventional histology without the need for physical sectioning. We further compare normal breast tissue and invasive cancer specimens imaged at multiple magnifications, and assess the effects of photobleaching for both modalities using the staining protocol. The results demonstrate that confocal fluorescence microscopy is a promising and cost-effective alternative to multiphoton microscopy for rapid histopathological evaluation of ex vivo breast tissue. PMID:28032121

Direct comparison between confocal and multiphoton microscopy for rapid histopathological evaluation of unfixed human breast tissue

NASA Astrophysics Data System (ADS)

Yoshitake, Tadayuki; Giacomelli, Michael G.; Cahill, Lucas C.; Schmolze, Daniel B.; Vardeh, Hilde; Faulkner-Jones, Beverly E.; Connolly, James L.; Fujimoto, James G.

2016-12-01

Rapid histopathological examination of surgical specimen margins using fluorescence microscopy during breast conservation therapy has the potential to reduce the rate of positive margins on postoperative histopathology and the need for repeat surgeries. To assess the suitability of imaging modalities, we perform a direct comparison between confocal fluorescence microscopy and multiphoton microscopy for imaging unfixed tissue and compare to paraffin-embedded histology. An imaging protocol including dual channel detection of two contrast agents to implement virtual hematoxylin and eosin images is introduced that provides high quality imaging under both one and two photon excitation. Corresponding images of unfixed human breast tissue show that both confocal and multiphoton microscopy can reproduce the appearance of conventional histology without the need for physical sectioning. We further compare normal breast tissue and invasive cancer specimens imaged at multiple magnifications, and assess the effects of photobleaching for both modalities using the staining protocol. The results demonstrate that confocal fluorescence microscopy is a promising and cost-effective alternative to multiphoton microscopy for rapid histopathological evaluation of ex vivo breast tissue.

Effects of different types of temporary cements on the tensile strength and marginal adaptation of crowns on implants.

PubMed

Akashia, Ana Eliza; Francischone, Carlos Eduardo; Tokutsune, Edson; da Silva, Walter

2002-01-01

The aim of this study was to evaluate the influence of four different types of temporary cements, Tempbond (Kerr), Tempbond NE (Kerr), Improv (Sterioss), and Dycal (Dentsply/Caulk), on the marginal adaptation and tensile strength of prosthetic specimens cemented on replicas of CeraOne abutments. Four test groups were formed: Group 1 (G-1), Tempbond (Kerr); Group 2 (G-2), Tempbond NE (Kerr); Group 3 (G-3), Improv (Sterioss); Group 4 (G-4), Dycal (Dentsply/Caulk). For the specimens, gold cylinders (DCB 160, Nobel Biocare) adapted to stainless steel replicas of CeraOne abutments (Nobel Biocare) were utilized. The replicas on a stainless steel base were made in a special machine for implant components. The cement thicknesses for each luting agent were measured using a Measurement Comparative Microscope (Mitutoyo). The readings obtained before cementation were used as the controls (G-0). Following each group's cementation, the specimens were submitted to tensile strength tests with a Universal Testing Machine (Kratus). The results of the marginal adaptation test as reflected by cement thicknesses were: G-0 = 11.7 microm, G-1 = 35.7 microm (+/- 8.8), G-2 = 41.7 microm (+/- 9.0), G-3 = 32.6 microm (+/- 9.7) and G-4 = 38.2 microm (+/- 6.7). The tensile strength tests yielded the following values: G-1 = 58.5 N (+/- 14.8), G-2 = 51 N (+/- 8.2), G-3 = 61.8 N (+/- 17.1) and G-4 = 71.8 N (+/- 9.3). The four temporary cements tested all provided similar marginal adaptation. G-4 (Dycal) showed a higher tensile strength than G-2 (Tempbond NE).

Limited Utility of Polymerase Chain Reaction in Induced Sputum Specimens for Determining the Causes of Childhood Pneumonia in Resource-Poor Settings: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study

PubMed Central

Seidenberg, Phil; Park, Daniel E.; Mwananyanda, Lawrence; Fu, Wei; Shi, Qiyuan; Baggett, Henry C.; Brooks, W. Abdullah; Feikin, Daniel R.; Howie, Stephen R.C.; Knoll, Maria Deloria; Kotloff, Karen L.; Levine, Orin S.; Madhi, Shabir A.; O’Brien, Katherine L.; Scott, J. Anthony G.; Antonio, Martin; Awori, Juliet O.; Baillie, Vicky L.; DeLuca, Andrea N.; Driscoll, Amanda J.; Higdon, Melissa M.; Hossain, Lokman; Jahan, Yasmin; Karron, Ruth A.; Kazungu, Sidi; Li, Mengying; Moore, David P.; Morpeth, Susan C.; Ofordile, Ogochukwu; Prosperi, Christine; Sangwichian, Ornuma; Sawatwong, Pongpun; Sylla, Mamadou; Tapia, Milagritos D.; Zeger, Scott L.; Murdoch, David R.; Hammitt, Laura L.; O., K. L.; L., O. S.; K., M. D.; F., D. R.; D., A. N.; D., A. J.; Fancourt, Nicholas; F., W.; H., L. L.; H., M. M.; Wangeci Kagucia, E.; K., R. A.; L., M.; P., D. E.; P., C.; Wu, Zhenke; Z., S. L.; Watson, Nora L.; Crawley, Jane; M., D. R.; W. A., B.; Endtz, Hubert P.; Khalequ, Zaman; Goswami, Doli; H., L.; J., Y.; Ashraf, Hasan; H., S. R. C.; Ebruke, Bernard E.; A., M.; McLellan, Jessica; Machuka, Eunice; Shamsul, Arifin; Zaman, Syed M. A.; Mackenzie, Grant; S., J. A. G.; A., J. O.; M., S. C.; Kamau, Alice; K., S.; Ominde, Micah Silaba; K., K. L.; T., M. D.; Sow, Samba O.; S., M.; Tamboura, Boubou; Onwuchekwa, Uma; Kourouma, Nana; Toure, Aliou; M., S. A.; M., D. P.; Adrian, Peter V.; B., V. L.; Kuwanda, Locadiah; Mudau, Azwifarwi; Groome, Michelle J.; Mahomed, Nasreen; B., H. C.; Thamthitiwat, Somsak; Maloney, Susan A.; Bunthi, Charatdao; Rhodes, Julia; S., P.; Akarasewi, Pasakorn; T., D. M.; M., L.; Chipeta, James; S., P.; Mwansa, James; wa Somwe, Somwe; Kwenda, Geoffrey; Anderson, Trevor P.; Mitchell, Joanne

2017-01-01

Abstract Background. Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from children hospitalized with severe or very severe pneumonia. Methods. Among children aged 1–59 months, we compared organism detection by multiplex PCR in IS and nasopharyngeal/oropharyngeal (NP/OP) specimens. To assess whether organism presence or density in IS specimens was associated with chest radiographic evidence of pneumonia (radiographic pneumonia), we compared prevalence and density in IS specimens from children with radiographic pneumonia and children with suspected pneumonia but without chest radiographic changes or clinical or laboratory findings suggestive of pneumonia (nonpneumonia group). Results. Among 4232 cases with World Health Organization–defined severe or very severe pneumonia, we identified 1935 (45.7%) with radiographic pneumonia and 573 (13.5%) with nonpneumonia. The organism detection yield was marginally improved with IS specimens (96.2% vs 92.4% for NP/OP specimens for all viruses combined [P = .41]; 96.9% vs 93.3% for all bacteria combined [P = .01]). After accounting for presence in NP/OP specimens, no organism was detected more frequently in the IS specimens from the radiographic pneumonia compared with the nonpneumonia cases. Among high-quality IS specimens, there were no statistically significant differences in organism density, except with cytomegalovirus, for which there was a higher quantity in the IS specimens from cases with radiographic pneumonia compared with the nonpneumonia cases (median cycle threshold value, 27.9 vs 28.5, respectively; P = .01). Conclusions. Using advanced molecular methods with IS specimens provided little additional diagnostic information beyond that obtained with NP/OP swab specimens. PMID:28575363

Limited Utility of Polymerase Chain Reaction in Induced Sputum Specimens for Determining the Causes of Childhood Pneumonia in Resource-Poor Settings: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study.

PubMed

Thea, Donald M; Seidenberg, Phil; Park, Daniel E; Mwananyanda, Lawrence; Fu, Wei; Shi, Qiyuan; Baggett, Henry C; Brooks, W Abdullah; Feikin, Daniel R; Howie, Stephen R C; Knoll, Maria Deloria; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; O'Brien, Katherine L; Scott, J Anthony G; Antonio, Martin; Awori, Juliet O; Baillie, Vicky L; DeLuca, Andrea N; Driscoll, Amanda J; Higdon, Melissa M; Hossain, Lokman; Jahan, Yasmin; Karron, Ruth A; Kazungu, Sidi; Li, Mengying; Moore, David P; Morpeth, Susan C; Ofordile, Ogochukwu; Prosperi, Christine; Sangwichian, Ornuma; Sawatwong, Pongpun; Sylla, Mamadou; Tapia, Milagritos D; Zeger, Scott L; Murdoch, David R; Hammitt, Laura L

2017-06-15

Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from children hospitalized with severe or very severe pneumonia. Among children aged 1-59 months, we compared organism detection by multiplex PCR in IS and nasopharyngeal/oropharyngeal (NP/OP) specimens. To assess whether organism presence or density in IS specimens was associated with chest radiographic evidence of pneumonia (radiographic pneumonia), we compared prevalence and density in IS specimens from children with radiographic pneumonia and children with suspected pneumonia but without chest radiographic changes or clinical or laboratory findings suggestive of pneumonia (nonpneumonia group). Among 4232 cases with World Health Organization-defined severe or very severe pneumonia, we identified 1935 (45.7%) with radiographic pneumonia and 573 (13.5%) with nonpneumonia. The organism detection yield was marginally improved with IS specimens (96.2% vs 92.4% for NP/OP specimens for all viruses combined [P = .41]; 96.9% vs 93.3% for all bacteria combined [P = .01]). After accounting for presence in NP/OP specimens, no organism was detected more frequently in the IS specimens from the radiographic pneumonia compared with the nonpneumonia cases. Among high-quality IS specimens, there were no statistically significant differences in organism density, except with cytomegalovirus, for which there was a higher quantity in the IS specimens from cases with radiographic pneumonia compared with the nonpneumonia cases (median cycle threshold value, 27.9 vs 28.5, respectively; P = .01). Using advanced molecular methods with IS specimens provided little additional diagnostic information beyond that obtained with NP/OP swab specimens. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Breast cancer margin delineation with fluorescence lifetime imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Phipps, Jennifer E.; Gorpas, Dimitris; Darrow, Morgan; Unger, Jakob; Bold, Richard; Marcu, Laura

2017-02-01

The current standard of care for early stages of breast cancer is breast-conserving surgery (BCS). BCS involves a lumpectomy procedure, during which the tumor is removed with a rim of normal tissue-if cancer cells found in that rim of tissue, it is called a positive margin and means part of the tumor remains in the breast. Currently there is no method to determine if cancer cells exist at the margins of lumpectomy specimens aside from time-intensive histology methods that result in reoperations in up to 38% of cases. We used fluorescence lifetime imaging (FLIm) to measure time-resolved autofluorescence from N=13 ex vivo human breast cancer specimens (N=10 patients undergoing lumpectomy or mastectomy) and compared our results to histology. Tumor (both invasive and ductal carcinoma in situ), fibrous tissue, fat and fat necrosis have unique fluorescence signatures. For instance, between 500-580 nm, fluorescence lifetime of tumor was shortest (4.7 +/- 0.4 ns) compared to fibrous tissue (5.5 +/- 0.7 ns) and fat (7.0 +/- 0.1 ns), P<0.05 (ANOVA). These differences are due to the biochemical properties of lipid, nicotineamide adenine dinucleotide (NADH) and collagen fibers in the fat, tumor and fibrous tissue, respectively. Additionally, the FLIm data is augmented to video of the breast tissue with image processing algorithms that track a blue (450 nm) aiming beam used in parallel with the 355 nm excitation beam. This allows for accurate histologic co-registration and in the future will allow for three-dimensional lumpectomy surfaces to be imaged for cancer margin delineation.

Real-time assessment of breast surgical margins with fluorescence-guided microscopy (Conference Presentation)

NASA Astrophysics Data System (ADS)

Iftimia, Nicusor V.; Park, Jesung; Maguluri, Gopi N.; Krishnamurthy, Savitri

2017-02-01

A novel multimodal optical imaging approach for real-time assessment of surgical margins on breast cancer lumpectomy specimens is presented. Our approach is to target cancer cells using an optically silent peptide substrate containing two (NIR) fluorochromes, internally quenched, which are cleaved by highly expressed breast cancer enzymes, like urokinase-type plasminogen activator (uPA). Thus this agent becomes highly fluorescent only on the cancer area when the specimen is excited by a NIR laser beam. A fluorescence imager is used to highlight cancer-suspect margins on the surgical specimen, while high-resolution optical coherence tomography (OCT) imaging is used to visualize tissue morphology on the highlighted areas and confirm or rule out cancer presence. This technology will hopefully increase the success rate of cancer surgeries, reduce the risk of cancer recurrence and significantly reduce US healthcare costs.

[The influence of the different polishing methods on the marginal sealing property of the computer aided design and computer aided manufacture zirconium dioxide full crown].

PubMed

Zhou, Jianying; Deng, Jiupeng; Li, Jinyuan; Wang, Jide; Shen, Baolian

2016-05-01

To evaluate the influence of different polishing methods on marginal microleakage of zirconium dioxide full crown. Thirty extracted premolars were selected and randomly divided into three groups, A, B and C, with 10 in each group. Group A was prepared with MANI TF-13 bur completely without the treatment of shoulder. The shoulder of group B was polished with MANI TR13-EF bur after the preparation using MANI TF-13. The shoulder of group C was polished with the dental pneumatic ultrasonic hand-piece of KaVo SONICflex after the preparation using MANI TF-13 bur. Five specimens after preparation were selected in each group. Fifteen CAD/CAM zirconium dioxide full crowns have been made. The crowns were bonded using PULPDENT resin cement, and the root canals were sealed using nail polish, and apical foramen were closed using flow resin. The test-pieces have been immersed in a 3% solution of methylene blue for 24 h. The condition of shoulder marginal microleakage was observed using light stereomicroscopy and evaluated in classification index. The remaining specimens in each group were used for roughness test and scanning electron microscope(SEM) experiment. The marginal microleakage situations of specimens in three groups was analyzed by SPSS 17.0. The enamel surface of different polishing methods was observed using SEM. The specimens in group C demonstrated the least marginal microleakage, and those in group B showed an intermediate level of marginal microleakage, and those in group A characterized the most serious marginal microleakage (total, χ2=44.610, P<0.01; among the different groups, P<0.05). The roughness experiment showed that specimens in group C achieve the smoothest results ([0.27±0.03] μm). Preparation shoulder polished using the dental pneumatic ultrasonic hand-piece demonstrated the best result under the SEM among the three groups. The anti-microleakage effectiveness of dental pneumatic ultrasonic hand-piece in shoulder refinement is better than ordinary shoulder treatment.

Comparative Evaluation of Conventional and Accelerated Castings on Marginal Fit and Surface Roughness

PubMed Central

Jadhav, Vivek Dattatray; Motwani, Bhagwan K.; Shinde, Jitendra; Adhapure, Prasad

2017-01-01

Aims: The aim of this study was to evaluate the marginal fit and surface roughness of complete cast crowns made by a conventional and an accelerated casting technique. Settings and Design: This study was divided into three parts. In Part I, the marginal fit of full metal crowns made by both casting techniques in the vertical direction was checked, in Part II, the fit of sectional metal crowns in the horizontal direction made by both casting techniques was checked, and in Part III, the surface roughness of disc-shaped metal plate specimens made by both casting techniques was checked. Materials and Methods: A conventional technique was compared with an accelerated technique. In Part I of the study, the marginal fit of the full metal crowns as well as in Part II, the horizontal fit of sectional metal crowns made by both casting techniques was determined, and in Part III, the surface roughness of castings made with the same techniques was compared. Statistical Analysis Used: The results of the t-test and independent sample test do not indicate statistically significant differences in the marginal discrepancy detected between the two casting techniques. Results: For the marginal discrepancy and surface roughness, crowns fabricated with the accelerated technique were significantly different from those fabricated with the conventional technique. Conclusions: Accelerated casting technique showed quite satisfactory results, but the conventional technique was superior in terms of marginal fit and surface roughness. PMID:29042726

Tumor margin detection using optical biopsy techniques

NASA Astrophysics Data System (ADS)

Zhou, Yan; Liu, Cheng-hui; Li, Jiyou; Li, Zhongwu; Zhou, Lixin; Chen, Ke; Pu, Yang; He, Yong; Zhu, Ke; Li, Qingbo; Alfano, Robert R.

2014-03-01

The aim of this study is to use the Resonance Raman (RR) and fluorescence spectroscopic technique for tumor margin detection with high accuracy based on native molecular fingerprints of breast and gastrointestinal (GI) tissues. This tumor margins detection method utilizes advantages of RR spectroscopic technique in situ and in real-time to diagnose tumor changes providing powerful tools for clinical guiding intraoperative margin assessments and postoperative treatments. The tumor margin detection procedures by RR spectroscopy were taken by scanning lesion from center or around tumor region in ex-vivo to find the changes in cancerous tissues with the rim of normal tissues using the native molecular fingerprints. The specimens used to analyze tumor margins include breast and GI carcinoma and normal tissues. The sharp margin of the tumor was found by the changes of RR spectral peaks within 2 mm distance. The result was verified using fluorescence spectra with 300 nm, 320 nm and 340 nm excitation, in a typical specimen of gastric cancerous tissue within a positive margin in comparison with normal gastric tissues. This study demonstrates the potential of RR and fluorescence spectroscopy as new approaches with labeling free to determine the intraoperative margin assessment.

Comparative analysis of intraoral radiographs with variation of tube angulation to detect insufficient crown margins.

PubMed

Sailer, Benjamin F; Geibel, Margrit-Ann

2013-01-01

Variations in angulation of the x-ray tube affect the appearance of insufficient approximal crown margins on intraoral radiographs. This study examines the impact of such angular variation on the assessment of digital radiographs using three different X-ray tubes--Heliodent DS (Sirona), Gendex Expert DC (KaVo Dental) and Focus (KaVo Dental)--as well as the Gendex Visualix eHD CCD sensor (KaVo Dental). The test specimens, crowned teeth 46 from two mandibles provided by the Institute of Anatomy and Cell Biology, were examined with each tube. The results indicate great differences in the angles indicative of insufficient crown margins on X-ray images. Because of beam divergence and the crown marginal gap, the length and width of which frequently varies, it is difficult to infer any optimum angle from the data. This leads to the conclusion that at present, it is not possible to establish ideal angles for visualization of insufficient approximal crown margins.

Rapid virtual H&E histology of breast tissue specimens using a compact fluorescence nonlinear microscope

PubMed Central

Cahill, Lucas C.; Giacomelli, Michael G.; Yoshitake, Tadayuki; Vardeh, Hilde; Faulkner-Jones, Beverly E.; Connolly, James L.; Sun, Chi-Kuang; Fujimoto, James G.

2017-01-01

Up to 40% of patients undergoing breast conserving surgery for breast cancer require repeat surgeries due to close to or positive margins. The lengthy processing required for evaluating surgical margins by standard paraffin embedded histology precludes its use during surgery and therefore, technologies for rapid evaluation of surgical pathology could improve the treatment of breast cancer by reducing the number of surgeries required. We demonstrate real-time histological evaluation of breast cancer surgical specimens by staining specimens with acridine orange (AO) and sulforhodamine 101 (SR101) analogously to hematoxylin and eosin (H&E) and then imaging the specimens with fluorescence nonlinear microscopy (NLM) using a compact femtosecond fiber laser. A video-rate computational light absorption model was used to produce realistic virtual H&E images of tissue in real time and in three dimensions. NLM imaging could be performed to depths of 100 µm below the tissue surface, which is important since many surgical specimens require subsurface evaluation due to artifacts on the tissue surface from electrocautery, surgical ink or debris from specimen handling. We validate this method by expert review of NLM images compared to formalin fixed, paraffin embedded (FFPE) H&E histology. Diagnostically important features such as normal terminal ductal lobular units, fibrous and adipose stromal parenchyma, inflammation, invasive carcinoma, and in-situ lobular and ductal carcinoma were present in NLM images associated with pathologies identified on standard FFPE H&E histology. We demonstrate that AO and SR101 were extracted to undetectable levels after FFPE processing and fluorescence in situ hybridization (FISH) HER2 amplification status was unaffected by the NLM imaging protocol. This method potentially enables cost-effective, real-time histological guidance of surgical resections. PMID:29131161

In vitro marginal fit of three all-ceramic crown systems.

PubMed

Yeo, In-Sung; Yang, Jae-Ho; Lee, Jai-Bong

2003-11-01

Studies on marginal discrepancies of single restorations using various systems and materials have resulted in statistical inferences that are ambiguous because of small sample sizes and limited numbers of measurements per specimen. The purpose of this study was to compare the marginal adaptation of single anterior restorations made using different systems. The in vitro marginal discrepancies of 3 different all-ceramic crown systems (Celay In-Ceram, conventional In-Ceram, and IPS Empress 2 layering technique), and a control group of metal ceramic restorations were evaluated and compared by measuring the gap dimension between the crowns and the prepared tooth at the marginal opening. The crowns were made for 1 extracted maxillary central incisor prepared with a 1-mm shoulder margin and 6-degree tapered walls by milling. Thirty crowns per system were fabricated. Crown measurements were recorded with an optical microscope, with an accuracy of +/-0.1 microm, at 50 points spaced approximately 400 microm along the circumferential margin. The criterion of 120 microm was used as the maximum clinically acceptable marginal gap. Mean gap dimensions and standard deviations were calculated for marginal opening. The data were analyzed with a 1-way analysis of variance (alpha=.05). Mean gap dimensions and standard deviations at the marginal opening for the incisor crowns were 87 +/- 34 microm for control, 83 +/- 33 microm for Celay In-Ceram, 112 +/- 55 microm for conventional In-Ceram, and 46 +/- 16 microm for the IPS Empress 2 layering technique. Significant differences were found among the crown groups (P<.05). Compared with the control group, the IPS Empress 2 group had significantly smaller marginal discrepancies (P<.05), and the conventional In-Ceram group exhibited significantly greater marginal discrepancies (P<.05). There was no significant difference between the Celay In-Ceram and the control group. Within the limitations of this study, the marginal discrepancies were all within the clinically acceptable standard set at 120 microm. However, the IPS Empress 2 system showed the smallest and most homogeneous gap dimension, whereas the conventional In-Ceram system presented the largest and more variable gap dimension compared with the metal ceramic (control) restoration.

Elastic scattering spectroscopy findings in formalin-fixed oral squamous cell carcinoma specimens

NASA Astrophysics Data System (ADS)

Swinson, B.; Elmaaytah, M.; Jerjes, W.; Hopper, C.

2005-11-01

Oral squamous cell carcinoma (OSCC) has been shown to spread locally and infiltrate adjacent bone or via the lymphatic system to the cervical lymph nodes. This usually necessitates a surgical neck dissection and either a local or segmental resection for bone clearance. While histopathology remains the gold standard for tissue diagnosis, several new diagnostic techniques are being developed that rely on physical and biochemical changes that mirror or precede malignant changes within tissue. The aim of this study was to compare findings of Elastic Scattering Spectroscopy (ESS) with histopathology on formalin-fixed specimens of both neck lymph node dissections and de-calcified archival bone from patients with OSCC. We wished to see if this technique could be used as an adjunct or alternative to histopathology in defining cervical nodal involvement and if it could be used to identify bone resection margins positive for tumour. 130 lymph nodes were examined from 13 patients. The nodes were formalin-fixed, bivalved and examined by ESS. The intensity of the spectrum at 4 points was considered for comparison; at 360nm, 450nm, 630nm and 690nm. 341 spectra were taken from the mandibular specimens of 21 patients, of which 231 spectra were taken from histologically positive sites and the rest were normal. The nodes and bone specimens were then routinely processed with haematoxylin and eosin-stained sections, examined histopathologically, and the results compared. Using Linear Discriminant Analysis (LDA) as a statistical method, a sensitivity of 98% and a specificity of 68% was obtained for the neck nodes and a sensitivity of 87% and a specificity of 80% for the bone margins.

Coded aperture coherent scatter spectral imaging for assessment of breast cancers: an ex-vivo demonstration

NASA Astrophysics Data System (ADS)

Spencer, James R.; Carter, Joshua E.; Leung, Crystal K.; McCall, Shannon J.; Greenberg, Joel A.; Kapadia, Anuj J.

2017-03-01

A Coded Aperture Coherent Scatter Spectral Imaging (CACSSI) system was developed in our group to differentiate cancer and healthy tissue in the breast. The utility of the experimental system was previously demonstrated using anthropomorphic breast phantoms and breast biopsy specimens. Here we demonstrate CACSSI utility in identifying tumor margins in real time using breast lumpectomy specimens. Fresh lumpectomy specimens were obtained from Surgical Pathology with the suspected cancerous area designated on the specimen. The specimens were scanned using CACSSI to obtain spectral scatter signatures at multiple locations within the tumor and surrounding tissue. The spectral reconstructions were matched with literature form-factors to classify the tissue as cancerous or non-cancerous. The findings were then compared against pathology reports to confirm the presence and location of the tumor. The system was found to be capable of consistently differentiating cancerous and healthy regions in the breast with spatial resolution of 5 mm. Tissue classification results from the scanned specimens could be correlated with pathology results. We now aim to develop CACSSI as a clinical imaging tool to aid breast cancer assessment and other diagnostic purposes.

Photoacoustic microscopy enables multilayered histological imaging of human breast cancer without staining

NASA Astrophysics Data System (ADS)

Wong, Terence T. W.; Zhang, Ruiying; Hai, Pengfei; Aft, Rebecca L.; Novack, Deborah V.; Wang, Lihong V.

2018-02-01

In 2016, an estimated 250,000 new cases of invasive and non-invasive breast cancer were diagnosed in US women. About 60-75% of these cases were treated with breast conserving surgery (BCS) as the initial therapy. To reduce the local recurrence rate, the goal of BCS is to excise the tumor with a rim of normal surrounding tissue, so that no cancer cells remain at the cut margin, while preserving as much normal breast tissue as possible. Therefore, patients with remaining cancer cells at the cut margin commonly require a second surgical procedure to obtain clear margins. Different approaches have been used to decrease the positive margin rate to avoid re-excision. However, these techniques are variously ineffective in reducing the re-operative rate, difficult to master by surgeons, or time-consuming for large specimens. Thus, 20-60% of patients undergoing BCS still require second surgeries due to positive surgical margins. The ideal tool for margin assessment would provide the same information as histological analysis, without the need for processing specimens. To achieve this goal, we have developed and refined label-free photoacoustic microscopy (PAM) for breast specimens. Exploiting the intrinsic optical contrast of tissue, ultraviolet (UV) laser illumination can highlight cell nuclei, thus providing the same contrast as hematoxylin labeling used in conventional histology and measuring features related to the histological landscape without the need for labels. We demonstrate that our UV-PAM system can provide label-free, high-resolution, and histology-like imaging of fixed, unprocessed breast tissue.

Differentiated intraepithelial neoplasia of the vulva.

PubMed

Mulvany, Nicholas J; Allen, David G

2008-01-01

We present the clinical and pathological findings of 6 women with intraepithelial neoplasia of differentiated or simplex type (DVIN). The mean age was 68 years (range 55-82). One lesion was still in situ, whereas 5 were associated with squamous carcinoma, 4 of well-differentiated keratinizing type and 1 of poorly differentiated spindle-cell type. The invasive depth of the squamous carcinomas ranged from 0.6 to 8 mm and the surgical margins of all of the resection specimens were uninvolved by neoplastic cells. In contrast, DVIN involved the surgical margins in 5 specimens while the remaining specimen had normal surgical margins. In all 6 vulvar specimens, DVIN showed intense immunoreactivity for Ki-67 in the basal and parabasal cells while only 4 specimens showed reactivity for p53. In 5 surgical specimens with DVIN the number of CD1a cells was increased but little if any immunoreactivity could be found amongst the corresponding invasive neoplastic cells. Four squamous carcinomas also showed diffuse p53 reactivity. There was little difference in the pattern of Ki-67 expression between DVIN and squamous carcinoma. For a number of reasons, DVIN present diagnostic difficulty and considerable interobserver variation also exists. Our study suggests that Ki-67 and p16 are useful for distinguishing DVIN and classical VIN 3, whereas p53 and CD1a are useful for distinguishing DVIN and invasive squamous carcinoma. Furthermore, p53 appears to have higher specificity than sensitivity for distinguishing DVIN from normal squamous epithelium.

Comparative evaluation of marginal leakage of provisional crowns cemented with different temporary luting cements: In vitro study.

PubMed

Arora, Sheen Juneja; Arora, Aman; Upadhyaya, Viram; Jain, Shilpi

2016-01-01

As, the longevity of provisional restorations is related to, a perfect adaptation and a strong, long-term union between restoration and teeth structures, therefore, evaluation of marginal leakage of provisional restorative materials luted with cements using the standardized procedures is essential. To compare the marginal leakage of the provisional crowns fabricated from Autopolymerizing acrylic resin crowns and bisphenol A-glycidyl dimethacrylate (BIS-GMA) resin crowns. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin crowns and BIS-GMA resin crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin (SC-10) crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from BIS-GMA resin crowns (Protemp 4) cemented with different temporary luting cements. Freshly extracted 60 maxillary premolars of approximately similar dimensions were mounted in dental plaster. Tooth reduction with shoulder margin was planned to use a customized handpiece-holding jig. Provisional crowns were prepared using the wax pattern fabricated from computer aided designing/computer aided manufacturing milling machine following the tooth preparation. Sixty provisional crowns were made, thirty each of SC-10 and Protemp 4 and were then cemented with three different luting cements. Specimens were thermocycled, submerged in a 2% methylene blue solution, then sectioned and observed under a stereomicroscope for the evaluation of marginal microleakage. A five-level scale was used to score dye penetration in the tooth/cement interface and the results of this study was analyzed using the Chi-square test, Mann-Whitney U-test, Kruskal-Wallis H-test and the results were statistically significant P < 0.05 the power of study - 80%. Marginal leakage was significant in both provisional crowns cemented with three different luting cements along the axial walls of teeth (P < 0.05) confidence interval - 95%. The temporary cements with eugenol showed more microleakage than those without eugenol. SC-10 crowns showed more microleakage compared to Protemp 4 crowns. SC-10 crowns cemented with Kalzinol showed maximum microleakage and Protemp 4 crowns cemented with HY bond showed least microleakage.

Microleakage of adhesive restorative materials.

PubMed

Gladys, S; Van Meerbeek, B; Lambrechts, P; Vanherle, G

2001-06-01

To compare the marginal sealing ability of two conventional and one polyacid-modified resin-based composite, and two conventional and three resin-modified glass-ionomers in conventional cylindrical box cavities following a silver-staining microleakage evaluation method. In 80 freshly extracted and caries-free human third molars, three standardized cylindrical butt-joint cavities were prepared: the first cavity in coronal enamel, the second at the cemento-enamel junction (CEJ) and the third completely in root cementum. A control group of 10 additional teeth was chosen. After the cavities were restored randomly using the eight restorative materials tested, the specimens were first stored in distilled water at 37 degrees C for 7 days and then thermocycled (500 cycles). Thereafter, the specimens were centrifuged for 10 min in plastic bottles containing 50 wt% silver nitrate aqueous solution. The degree of microleakage was recorded at four different depths along the restoration margins using an optical stereomicroscope equipped with a measuring gauge. None of the tested systems prevented microleakage completely, but the extent of leakage decreased towards the bottom of the restorations. The resin-modified glass-ionomers performed better than the conventional resin-based composites and conventional glass-ionomers. Distinct leakage patterns were recorded among all materials investigated. Complete marginal sealing could still not be reached with the new adhesive restorative materials.

The Setting Time of Polyether Impression Materials after Contact with Conventional and Experimental Gingival Margin Displacement Agents.

PubMed

Nowakowska, Danuta; Raszewski, Zbigniew; Ziętek, Marek; Saczko, Jolanta; Kulbacka, Julita; Więckiewicz, Włodzimierz

2018-02-01

The compatibility of chemical gingival margin displacement agents with polyether impression materials has not been determined. The aim of this study was to evaluate the setting time of polyether impression elastomers after contact with conventional and experimental gingival displacement agents. The study compared the setting time of two polyether impression materials: medium body (Impregum Penta Soft) and light body (Impregum Garant L DuoSoft) after contact with 10 gingival displacement agents, including 5 conventional astringents (10%, 20%, and 25% aluminum chloride, 25% aluminum sulfate, and 15.5% ferric sulfate) and 5 experimental adrenergics (0.1% and 0.01% HCl-epinephrine, 0.05% HCl-tetrahydrozoline, 0.05% HCl-oxymetazoline, and 10% HCl-phenylephrine). As many as 120 specimens (60 light body and 60 medium body) were mixed with 20 μl of each of 10 gingival displacement agents, and the time to achieve maximum viscosity was measured with a viscometer. The setting times of these specimens were compared with the control group of 12 specimens, which were polymerized without contact with the displacement agents. The experiments were performed in two environments: 23°C and 37°C (± 0.1°C). Individual and average polymerization time compatibility indices (PTCI) were calculated. Data were analyzed by 2-way ANOVA (α = 0.05). The evaluated chemical displacement agents from both groups changed the setting time of light- and medium-body PE. The negative individual PTCI values achieved astringent (20% aluminum chloride) with two PE in both temperature environments. The average PTCI values of the experimental displacement agents at laboratory and intraoral temperatures were significantly higher than the conventional agents. The present findings suggest that experimental retraction agents can be recommended clinically as gingival margin displacement agents with minimal effects on the setting time of medium- and light-body polyether impression materials; however, direct contact of chemical displacement agents and polyether impression materials can be avoided. © 2016 by the American College of Prosthodontists.

Microleakage of Glass Ionomer-based Provisional Cement in CAD/CAM-Fabricated Interim Crowns: An in vitro Study.

PubMed

Farah, Ra'fat I; Al-Harethi, Naji

2016-10-01

The aim of this study was to compare in vitro the marginal microleakage of glass ionomer-based provisional cement with resin-based provisional cement and zinc oxide non-eugenol (ZONE) provisional cement in computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated interim restorations. Fifteen intact human premolars were prepared in a standardized manner for complete coverage of crown restorations. Interim crowns for the prepared teeth were then fabricated using CAD/CAM, and the specimens were randomized into three groups of provisional cementing agents (n = 5 each): Glass ionomer-based provisional cement (GC Fuji TEMP LT™), bisphenol-A-glycidyldimethacrylate (Bis-GMA)/ triethylene glycol dimethacrylate (TEGDMA) resin-based cement (UltraTemp® REZ), and ZONE cement (TempBond NE). After 24 hours of storage in distilled water at 37°C, the specimens were thermocycled and then stored again for 24 hours in distilled water at room temperature. Next, the specimens were placed in freshly prepared 2% aqueous methylene blue dye for 24 hours and then embedded in autopolymerizing acrylic resin blocks and sectioned in buccolingual and mesiodistal directions to assess dye penetration using a stereomicroscope. The results were statistically analyzed using a nonparametric Kruskal-Wallis test. Dunn's post hoc test with a Bonferroni correction test was used to compute multiple pairwise comparisons that identified differences among groups; the level of significance was set at p < 0.05. All groups exhibited marginal microleakage; the Bis-GMA/TEGDMA resin-based provisional cement demonstrated the lowest microleakage scores, which were statistically different from those of the glass ionomer-based provisional cement and the ZONE cement. The provisional cementing agents exhibited different sealing abilities. The Bis-GMA/TEGDMA resin-based provisional cement exhibited the most effective favorable sealing properties against dye penetration compared with the glass ionomer-based provisional cement and conventional ZONE cement. Newly introduced glass ionomer-based provisional cement proved to be inferior to resin-based provisional cement as far as marginal microleakage is concerned.

High resolution microendoscopy with structured illumination and Lugol's iodine staining for evaluation of breast cancer architecture

NASA Astrophysics Data System (ADS)

Dobbs, Jessica; Kyrish, Matthew; Krishnamurthy, Savitri; Grant, Benjamin; Kuerer, Henry; Yang, Wei; Tkaczyk, Tomasz; Richards-Kortum, Rebecca

2016-03-01

Intraoperative margin assessment to evaluate resected tissue margins for neoplastic tissue is performed to prevent reoperations following breast-conserving surgery. High resolution microendoscopy (HRME) can rapidly acquire images of fresh tissue specimens, but is limited by low image contrast in tissues with high optical scattering. In this study we evaluated two techniques to reduce out-of-focus light: HRME image acquisition with structured illumination (SI-HRME) and topical application of Lugol's Iodine. Fresh breast tissue specimens from 19 patients were stained with proflavine alone or Lugol's Iodine and proflavine. Images of tissue specimens were acquired using a confocal microscope and an HRME system with and without structured illumination. Images were evaluated based on visual and quantitative assessment of image contrast. The highest mean contrast was measured in confocal images stained with proflavine. Contrast was significantly lower in HRME images stained with proflavine; however, incorporation of structured illumination significantly increased contrast in HRME images to levels comparable to that in confocal images. The addition of Lugol's Iodine did not increase mean contrast significantly for HRME or SI-HRME images. These findings suggest that structured illumination could potentially be used to increase contrast in HRME images of breast tissue for rapid image acquisition.

Discordance between location of positive cores in biopsy and location of positive surgical margin following radical prostatectomy.

PubMed

Kim, Ji Won; Park, Hyoung Keun; Kim, Hyeong Gon; Ham, Dong Yeub; Paick, Sung Hyun; Lho, Yong Soo; Choi, Woo Suk

2015-10-01

We compared location of positive cores in biopsy and location of positive surgical margin (PSM) following radical prostatectomy. This retrospective analysis included patients who were diagnosed as prostate cancer by standard 12-core transrectal ultrasonography guided prostate biopsy, and who have PSM after radical prostatectomy. After exclusion of number of biopsy cores <12, and lack of biopsy location data, 46 patients with PSM were identified. Locations of PSM in pathologic specimen were reported as 6 difference sites (apex, base and lateral in both sides). Discordance of biopsy result and PSM was defined when no positive cores in biopsy was identified at the location of PSM. Most common location of PSM were right apex (n=21) and left apex (n=15). Multiple PSM was reported in 21 specimens (45.7%). In 32 specimens (69.6%) with PSM, one or more concordant positive biopsy cores were identified, but 14 specimens (28%) had no concordant biopsy cores at PSM location. When discordant rate was separated by locations of PSM, right apex PSM had highest rate of discordant (38%). The discordant group had significantly lower prostate volume and lower number of positive cores in biopsy than concordant group. This study showed that one fourth of PSM occurred at location where tumor was not detected at biopsy and that apex PSM had highest rate of discordant. Careful dissection to avoid PSM should be performed in every location, including where tumor was not identified in biopsy.

In vitro analysis of the marginal adaptation and discrepancy of stainless steel crowns

PubMed Central

Mulder, Riaan; Medhat, Rasha; Mohamed, Nadia

2018-01-01

Abstract Aim: The purpose of the study was to assess the marginal adaptation and discrepancy of SSC’s. Differences in adaptation and discrepancy between the four surfaces (mesial, lingual, distal, and buccal) were evaluated. Methods: The placement of stainless steel crowns were completed on a phantom head in accordance with the clinical technique. The ideal tooth preparation was made and this ‘master tooth’ duplicated to achieve a sample size of 15. The stainless steel crowns were placed, trimmed, and cemented as per the clinical technique. The cemented stainless crowns were analyzed under 100× stereomicroscope magnification. The marginal adaptation and discrepancy of each specimen was measured every 2 µm. Results: All the specimens showed marginal adaptation and discrepancy. The lingual margin had a significantly better adaptation (p < .0001) over the other surfaces. The buccal surface was the only surface that had an appropriate supra-CEJ level with a significance of p < .0001. Conclusion: The marginal discrepancies occur during the trimming procedure and assessment of the gingival approximation of the SSC margin. The inspection of stainless steel crown adaptation and discrepancy is an essential clinical step. PMID:29536024

THE INFLUENCE OF SCREW TYPE, ALLOY AND CYLINDER POSITION ON THE MARGINAL FIT OF IMPLANT FRAMEWORKS BEFORE AND AFTER LASER WELDING

PubMed Central

Castilio, Daniela; Pedreira, Ana Paula Ribeiro do Vale; Rossetti, Paulo Henrique Orlato; Rossetti, Leylha Maria Nunes; Bonachela, Wellington Cardoso

2006-01-01

Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. Objectives: To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. Methods: After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected prosthetic components. Five specimens were one-piece cast in titanium and five in cobalt-chromium alloy. On each specimen, tests were conducted with hexagonal titanium and slotted gold screws separately, performing a total of thirty tested screws. Measurements at the interfaces were performed using an optical microscope with 5 μm accuracy. After sectioning, specimens were laser welded and new measurements were obtained. Data were submitted to a four-way ANOVA and Tukey's multiple comparisons test (α =0.05). Results: Slotted and hexagonal screws did not present significant differences regarding to the fit of cylinders cast in titanium, either in one-piece casting framework or after laser welding. When slotted and hexagonal screws were tested on the cobalt-chromium specimens, statistically significant differences were found for the one-piece casting condition, with the slotted screws presenting better fit (24.13μm) than the hexagonal screws (27.93 μm). Besides, no statistically significant differences were found after laser welding. Conclusions: 1) The use of different metal alloys do exert influence on the marginal fit, 2) The slotted and hexagonal screws play the exclusive role of fixing the prosthesis, and did not improve the fit of cylinders, and 3) cylinder position did not affect marginal fit values. PMID:19089035

The influence of screw type, alloy and cylinder position on the marginal fit of implant frameworks before and after laser welding.

PubMed

Castilio, Daniela; Pedreira, Ana Paula Ribeiro do Vale; Rossetti, Paulo Henrique Orlato; Rossetti, Leylha Maria Nunes; Bonachela, Wellington Cardoso

2006-04-01

Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected prosthetic components. Five specimens were one-piece cast in titanium and five in cobalt-chromium alloy. On each specimen, tests were conducted with hexagonal titanium and slotted gold screws separately, performing a total of thirty tested screws. Measurements at the interfaces were performed using an optical microscope with 5mm accuracy. After sectioning, specimens were laser welded and new measurements were obtained. Data were submitted to a four-way ANOVA and Tukey's multiple comparisons test (alpha=0.05). Slotted and hexagonal screws did not present significant differences regarding to the fit of cylinders cast in titanium, either in one-piece casting framework or after laser welding. When slotted and hexagonal screws were tested on the cobalt-chromium specimens, statistically significant differences were found for the one-piece casting condition, with the slotted screws presenting better fit (24.13 microm) than the hexagonal screws (27.93 microm). Besides, no statistically significant differences were found after laser welding. 1) The use of different metal alloys do exert influence on the marginal fit, 2) The slotted and hexagonal screws play the exclusive role of fixing the prosthesis, and did not improve the fit of cylinders, and 3) cylinder position did not affect marginal fit values.

Tumor margin assessment of surgical tissue specimen of cancer patients using label-free hyperspectral imaging

NASA Astrophysics Data System (ADS)

Fei, Baowei; Lu, Guolan; Wang, Xu; Zhang, Hongzheng; Little, James V.; Magliocca, Kelly R.; Chen, Amy Y.

2017-02-01

We are developing label-free hyperspectral imaging (HSI) for tumor margin assessment. HSI data, hypercube (x,y,λ), consists of a series of high-resolution images of the same field of view that are acquired at different wavelengths. Every pixel on the HSI image has an optical spectrum. We developed preprocessing and classification methods for HSI data. We used spectral features from HSI data for the classification of cancer and benign tissue. We collected surgical tissue specimens from 16 human patients who underwent head and neck (H&N) cancer surgery. We acquired both HSI, autofluorescence images, and fluorescence images with 2-NBDG and proflavine from the specimens. Digitized histologic slides were examined by an H&N pathologist. The hyperspectral imaging and classification method was able to distinguish between cancer and normal tissue from oral cavity with an average accuracy of 90+/-8%, sensitivity of 89+/-9%, and specificity of 91+/-6%. For tissue specimens from the thyroid, the method achieved an average accuracy of 94+/-6%, sensitivity of 94+/-6%, and specificity of 95+/-6%. Hyperspectral imaging outperformed autofluorescence imaging or fluorescence imaging with vital dye (2-NBDG or proflavine). This study suggests that label-free hyperspectral imaging has great potential for tumor margin assessment in surgical tissue specimens of H&N cancer patients. Further development of the hyperspectral imaging technology is warranted for its application in image-guided surgery.

Evaluation of margins in head and neck squamous cell carcinoma from the surgeon's perspective.

PubMed

Baumeister, Philipp; Baumüller, Konstantin; Harréus, Ulrich; Reiter, Maximilian; Welz, Christian

2018-05-01

The surgeon's evaluation of resection status based on frozen section analysis during operation and pathological examination of resected specimens often differ. For this study, we recapitulated the surgeon's perspective during an operation, accordingly classified the evaluation of margins by the surgeon, and analyzed its impact on the outcome compared with the pathological results. This was a retrospective analysis. As data sources, paper-based and digital patient files, as well as the Munich Cancer Registry database were used. Three hundred ninety-six cases were included in this analysis. Only the evaluation of margins by the surgeon influenced local control, and the pathological results influenced disease-free survival (DFS). Surprisingly, margins of >5 mm of normal tissue to cancer growth led to local control and overall survival (OS) significantly worse than 1 to 5-mm resections. The evaluation of margins by the surgeon is of significant importance for local control and OS. It is largely based on frozen section analysis, which, therefore, should be used whenever possible. © 2018 Wiley Periodicals, Inc.

Technical Considerations for Red Marking Ink Use When Interpreting Specimen Radiographs: Case Report.

PubMed

Brice, Matthew E; Gossweiler, Marisa; Bennett, Larry

2017-03-01

Artifacts are universal across all imaging modalities, varying in their conspicuity and significance. In this report three patients with pathology-proven breast cancer who had densities masquerading as microcalcifications at the resection margins of the lumpectomy specimens, but had negative microscopic margins, will be discussed. It was determined that these pseudocalcifications were the result of ink precipitates from a commonly utilized tissue marking dye. This artifact was further evaluated and reproduced by utilizing a boneless chicken breast as a phantom. © RSNA, 2016.

Automated margin analysis of contemporary adhesive systems in vitro: evaluation of discriminatory variables.

PubMed

Heintze, Siegward D; Forjanic, Monika; Roulet, François-Jean

2007-08-01

Using an optical sensor, to automatically evaluate the marginal seal of restorations placed with 21 adhesive systems of all four adhesive categories in cylindrical cavities of bovine dentin applying different outcome variables, and to evaluate their discriminatory power. Twenty-one adhesive systems were evaluated: three 3-step etch-and-rinse systems, three 2-step etch-and-rinse systems, five 2-step self-etching systems, and ten 1-step self-etching systems. All adhesives were applied in cylindrical cavities in bovine dentin together with Tetric Ceram (n=8). In the control group, no adhesive system was used. After 24 h of storage in water at 37 degrees C, the surface was polished with 4000-grit SiC paper, and epoxy resin replicas were produced. An optical sensor (FRT MicroProf) created 100 profiles of the restoration margin, and an algorithm detected gaps and calculated their depths and widths. The following evaluation criteria were used: percentage of specimens without gaps, the percentage of gap-free profiles in relation to all profiles per specimen, mean gap width, mean gap depth, largest gap, modified marginal integrity index MI. The statistical analysis was carried out on log-transformed data for all variables with ANOVA and post-hoc Tukey's test for multiple comparisons. The correlation between the variables was tested with regression analysis, and the pooled data accordingto the four adhesive categories were compared by applying the Mann-Whitney nonparametric test (p < 0.05). For all the variables that characterized the marginal adaptation, there was a great variation from material to material. In general, the etch-and-rinse adhesive systems demonstrated the best marginal adaptation, followed by the 2-step self-etching and the 1-step self-etching adhesives; the latter showed the highest variability in test results between materials and within the same material. The only exception to this rule was Xeno IV, which showed a marginal adaptation that was comparable to that of the best 3-step etch-and-rinse systems. Except for the variables "largest gap" and "mean gap depth", all the other variables had a similar ability to discriminate between materials. Pooled data according to the four adhesive categories revealed statistically significant differences between the one-step self-etching systems and the other three systems as well as between two-step self-etching and three-step etch-and-rinse systems. With one exception, the one-step self-etching systems yielded the poorest marginal adaptation results and the highest variability between materials and within the same material. Except for the variable "largest gap", the percentage of continuous margin, mean gap width, mean gap depth, and the marginal integrity index MI were closely related to one another and showed--with the exception of "mean gap depth"--similar discriminatory power.

Anatomic comparison of traditional and enucleation partial nephrectomy specimens.

PubMed

Calaway, Adam C; Gondim, Dibson D; Flack, Chandra K; Jacob, Joseph M; Idrees, Muhammad T; Boris, Ronald S

2017-05-01

To compare pseudocapsule (PC) properties of clear cell renal cell carcinoma tumors removed via both traditional partial nephrectomy (PNx) and enucleative techniques as well as quantify the difference in volume of normal renal parenchyma removed between groups. A retrospective review of clear cell PNx specimens between 2011 and 2014 was performed. All patients undergoing tumor enucleation (TE) were included. A single pathologist reviewed the pathological specimens. This cohort was compared with a previously collected clear cell traditional PNx database. A total of 47 clear cell partial nephrectomies were reviewed (34 PNx and 13 TE). Invasion of tumor completely through the PC and positive surgical margins were seen in 2 (5.8%) and 1 (7.7%) of traditional and TE specimens, respectively (P = 0.82). PC mean (0.63 vs. 0.52mm), maximum (1.39 vs. 1.65mm), and minimum thickness (0.27 vs. 0.19mm) were similar between cohorts (P = 0.29, P = 0.36, and P = 0.44). Gross specimen volume varied considerably between the 2 groups (35.6 vs. 17.9cm 3 , P≤0.05) although tumor volume did not (12 vs. 14.2cm 3 , P = 0.64). The renal tumor consisted of only 37% of the total volume of the traditional PNx specimens compared to 80% of the volume in TEs (P<0.01). Four TE specimens (31%) were "true" TEs (no additional parenchyma identified outside of the PC). PC properties appear independent of surgical technique. True TEs are uncommon. Regardless, there is considerable volume discrepancy of normal renal parenchymal removed between enucleative and nonenucleative PNx groups. Copyright © 2017 Elsevier Inc. All rights reserved.

The Effect of Sintering Time on the Marginal Fit of Zirconia Copings.

PubMed

Khaledi, Amir Ali Reza; Vojdani, Mahroo; Farzin, Mitra; Pirouzi, Sudabeh; Orandi, Sepideh

2018-01-03

This study analyzed the effect of different sintering times on the marginal adaptation of zirconia ceramic copings. Thirty copings of pre-sintered 3Y-TZP blanks were milled and subsequently sintered in a special furnace for three different durations (n = 10 per group). The sintering time was 1 hour, 15 minutes for IPS e.max ZirCAD, 4 hours 20 minutes for Speed ZrO 2, and 7 hours 20 minutes for the conventional ZrO 2 group. The marginal gaps of specimens were measured at 18 spots on the master die by employing a digital microscope. One-way ANOVA test compared the mean differences among the 3 groups (α = 0.05). The mean values for the marginal gap of the IPS e.max ZirCAD, Speed ZrO 2 , and conventional ZrO 2 groups were 41.06 ± 14.03, 43.03 ± 11.67, and 39.88 ± 15.23 μm, respectively. There was no statistically significant difference among the groups regarding the marginal gap. Different sintering times did not alter the marginal fit of the zirconia copings. The mean values of the marginal gap were within the clinically acceptable level for all three groups. © 2018 by the American College of Prosthodontists.

Whole specimen intraoperative frozen section analysis. Experience with 1082 basal cell carcinomas.

PubMed

Kedilioglu, Muhammed A; Bos, Paul G; De Jong, Kim; Noordzij, Niels A; Kibbelaar, Robby E; Lapid, Oren; Mouës, Chantal M

2018-01-01

Basal cell carcinomas (BCCs) excised leaving positive tumour margins, are at a higher risk of recurrence. Accordingly, complete tumour removal with preservation of healthy tissue, aiming for low recurrence rates, is the main goal in treating BCCs. The present study aimed to identify the reliability of the Whole Specimen Intraoperative Frozen Section Analysis (WIFSA) technique by comparing intraoperative WIFSA and postoperative Formalin-Fixed Paraffin-Embedded section analysis (FFPE) results in 1082 basal cell carcinomas and by assessing the recurrence rates during a follow-up period up to 10 years. A single-centre retrospective cohort of all patients with BCC of the face receiving surgical excision with the WIFSA method between January 2007 and December 2013 was evaluated. We compared the intraoperative frozen section results with postoperative FFPE in order to assess accuracy of the WIFSA. Recurrence rates were assessed among all BCCs with a tumour-free margin at final excision that had a minimum follow-up of 6 months. A total of 996 patients with 1082 BCCs were treated with the WIFSA. Overall agreement of WIFSA with conventional postoperative FFPE was 98·8%, sensitivity and specificity being 99·0% and 98·7% respectively. We excluded 23 BCCs that still had positive tumour margins at the end of the procedure and another 67 for the analysis of recurrence rate because follow-up was shorter than 6 months. A total of 992 BCCs with a tumour-free margin at final excision had a mean follow-up of 5·6 years (mean 67 ± 27·7 months (range 6-117 months)). The total recurrence rate was 2·1% (21 out of 992 BCCs). The recurrence rate among the primary tumours was 1·6% (13 out of 828 cases) and 4·9% among the recurring tumours (8 out of 164 cases). This study indicates that, in patients with primary or recurring BCCs, WIFSA provides a high accuracy for intraoperative specimen analysis and has a low recurrence rate after a mean follow-up of 5·6 years. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Outcomes of multiple wire localization for larger breast cancers: when can mastectomy be avoided?

PubMed

Kirstein, Laurie J; Rafferty, Elizabeth; Specht, Michelle C; Moore, Richard H; Taghian, Alphonse G; Hughes, Kevin S; Gadd, Michele A; Smith, Barbara L

2008-09-01

Mastectomy is often recommended when mammography shows a breast cancer with extensive calcifications. We wished to determine whether the use of multiple localizing wires to guide lumpectomy in this setting was associated with increased rates of breast conservation. We also wanted to identify factors that predicted a poor chance of successful lumpectomy, to avoid multiple lumpectomy attempts in a patient who would ultimately require mastectomy. Records of 153 women with breast cancer who underwent lumpectomy for larger lesions that required multiple wire localization and 196 controls who required only single wire localization were reviewed retrospectively. The number of localizing wires, specimen volume, largest specimen dimension, number of surgical procedures, and rates of breast conservation were scored. Seventy-seven percent of patients requiring multiple wire localization had successful breast conservation, compared with 90% of those needing only single wire localization. Only 28% of multiple wire patients required more than 1 excision to achieve clear margins, compared with 36% of single wire patients (p < 0.01). Breast conservation is possible in the great majority of breast cancer patients whose mammographic lesions require multiple localizing wires for excision. The use of multiple wires can decrease the number of procedures required to obtain clear lumpectomy margins.

Osteology of a new specimen of Macrocnemus aff. M. fuyuanensis (Archosauromorpha, Protorosauria) from the Middle Triassic of Europe: potential implications for species recognition and paleogeography of tanystropheid protorosaurs

NASA Astrophysics Data System (ADS)

Jaquier, Vivien P.; Fraser, Nicholas C.; Furrer, Heinz; Scheyer, Torsten M.

2017-11-01

Over the past two decades, a wealth of marine and terrestrial reptiles, including protorosaurian archosauromorphs, has been described from Triassic shales and limestone layers in southern China. Recovered from the eastern margin of the Tethys Ocean, these forms often show remarkable similarities to taxa that were previously known and described from Europe, i.e., the western Tethyan margin. One protorosaurian that is known from the western and the eastern Tethyan province is the genus Macrocnemus, with currently three recognized species: 1) M. bassanii from the Middle Triassic Besano Formation and Meride Limestone (late Anisian – early Ladinian), UNESCO World Heritage Site Monte San Giorgio, Ticino, Switzerland; 2) M. obristi from the Prosanto Formation (early Ladinian) of the Ducan area, Grisons, Switzerland; and 3) M. fuyuanensis from the Falang Formation (Ladinian), Yunnan Province, southern China. Recently a new specimen, PIMUZ T 1559, from the upper Besano Formation at Meride, Ticino, Switzerland, was prepared, revealing a disarticulated skeleton which includes most of the cranium and lower jaw, pre-caudal vertebral column and ribs, the forelimbs, and girdle elements. Unambiguously assignable to the genus Macrocnemus, it evinces particularly gracile elongated cervical ribs, as well as a humerus/radius ratio that is comparable only to that of M. fuyuanensis from southern China. Based on this feature we tentatively recognize the new specimen as M. aff. fuyuanensis from Europe. The position and exquisite preservation of the clavicle and interclavicle in this specimen allows a revision of the shoulder girdle of Macrocnemus when articulated, which also has implications for closely related protorosaurian taxa, such as the long-necked Tanystropheus. Furthermore, differences in the shape and morphology of the interclavicle including pointed wing-like lateral processes and a short, fusiform caudal process represent rare discrete characters that allow separation of the specimens of M. bassanii from the new specimen of M. aff. fuyuanensis.

Intraoperative ultrasound control of surgical margins during partial nephrectomy.

PubMed

Alharbi, Feras M; Chahwan, Charles K; Le Gal, Sophie G; Guleryuz, Kerem M; Tillou, Xavier P; Doerfler, Arnaud P

2016-01-01

To evaluate a simple and fast technique to ensure negative surgical margins on partial nephrectomies, while correlating margin statuses with the final pathology report. This study was conducted for patients undergoing partial nephrectomy (PN) with T1-T2 renal tumors from January 2010 to the end of December 2015. Before tumor removal, intraoperative ultrasound (US) localization was performed. After tumor removal and before performing hemostasis of the kidney, the specimens were placed in a saline solution and a US was performed to evaluate if the tumor's capsule were intact, and then compared to the final pathology results. In 177 PN(s) (147 open procedures and 30 laparoscopic procedures) were performed on 147 patients. Arterial clamping was done for 32 patients and the mean warm ischemia time was 19 ± 6 min. The mean US examination time was 41 ± 7 s. The US analysis of surgical margins was negative in 172 cases, positive in four, and in only one case it was not possible to conclude. The final pathology results revealed one false positive surgical margin and one false negative surgical margin, while all other margins were in concert with US results. The mean tumor size was 3.53 ± 1.43 cm, and the mean surgical margin was 2.8 ± 1.5 mm. The intraoperative US control of resection margins in PN is a simple, efficient, and effective method for ensuring negative surgical margins with a small increase in warm ischemia time and can be conducted by the operating urologist.

Fit of single tooth zirconia copings: comparison between various manufacturing processes.

PubMed

Grenade, Charlotte; Mainjot, Amélie; Vanheusden, Alain

2011-04-01

Various CAD/CAM processes are commercially available to manufacture zirconia copings. Comparative data on their performance in terms of fit are needed. The purpose of this in vitro study was to compare the internal and marginal fit of single tooth zirconia copings manufactured with a CAD/CAM process (Procera; Nobel Biocare) and a mechanized manufacturing process (Ceramill; Amann Girrbach). Abutments (n=20) prepared in vivo for ceramic crowns served as a template for manufacturing both Procera and Ceramill zirconia copings. Copings were manufactured and cemented (Clearfil Esthetic Cement; Kuraray) on epoxy replicas of stone cast abutments. Specimens were sectioned. Nine measurements were performed for each coping. Over- and under-extended margins were evaluated. Comparisons between the 2 processes were performed with a generalized linear mixed model (α=.05). Internal gap values between Procera and Ceramill groups were not significantly different (P=.13). The mean marginal gap (SD) for Procera copings (51(50) μm) was significantly smaller than for Ceramill (81(66) μm) (P<.005). The percentages of over- and under-extended margins were 43% and 57% for Procera respectively, and 71% and 29% for Ceramill. Within the limitations of this in vitro study, the marginal fit of Procera copings was significantly better than that of Ceramill copings. Furthermore, Procera copings showed a smaller percentage of over-extended margins than did Ceramill copings. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Response of Damaged and Undamaged Tailored Extension-Shear-Coupled Composite Panels

NASA Technical Reports Server (NTRS)

Baker, Donald J.

2008-01-01

The results of an analytical and experimental investigation of the response of composite I-stiffener panels with extension-shear coupling are presented. This tailored concept, when used in the panel cover skins of a tiltrotor aircraft wing has the potential for increasing the aeroelastic stability margins and improving the aircraft productivity. The extension-shear coupling is achieved by using unbalanced plus or minus 45 deg. plies in the skin. Experimental and STAGS analysis results are compared for eight I-stiffener panel specimens. The results indicate that the tailored concept would be feasible to use in the wing skin of a tiltrotor aircraft. Evaluation of specimens impacted at an energy level of 500 in.-lbs indicate a minimal loss in stiffness and less than 30 percent loss in strength. Evaluation of specimens with severed center stiffener and adjacent skin indicated a strength loss in excess of 60 percent.

Comparative evaluation of marginal leakage of provisional crowns cemented with different temporary luting cements: In vitro study

PubMed Central

Arora, Sheen Juneja; Arora, Aman; Upadhyaya, Viram; Jain, Shilpi

2016-01-01

Background or Statement of Problem: As, the longevity of provisional restorations is related to, a perfect adaptation and a strong, long-term union between restoration and teeth structures, therefore, evaluation of marginal leakage of provisional restorative materials luted with cements using the standardized procedures is essential. Aims and Objectives: To compare the marginal leakage of the provisional crowns fabricated from Autopolymerizing acrylic resin crowns and bisphenol A-glycidyl dimethacrylate (BIS-GMA) resin crowns. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin crowns and BIS-GMA resin crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin (SC-10) crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from BIS-GMA resin crowns (Protemp 4) cemented with different temporary luting cements. Methodology: Freshly extracted 60 maxillary premolars of approximately similar dimensions were mounted in dental plaster. Tooth reduction with shoulder margin was planned to use a customized handpiece-holding jig. Provisional crowns were prepared using the wax pattern fabricated from computer aided designing/computer aided manufacturing milling machine following the tooth preparation. Sixty provisional crowns were made, thirty each of SC-10 and Protemp 4 and were then cemented with three different luting cements. Specimens were thermocycled, submerged in a 2% methylene blue solution, then sectioned and observed under a stereomicroscope for the evaluation of marginal microleakage. A five-level scale was used to score dye penetration in the tooth/cement interface and the results of this study was analyzed using the Chi-square test, Mann–Whitney U-test, Kruskal–Wallis H-test and the results were statistically significant P < 0.05 the power of study - 80%. Results: Marginal leakage was significant in both provisional crowns cemented with three different luting cements along the axial walls of teeth (P < 0.05) confidence interval - 95%. Conclusion: The temporary cements with eugenol showed more microleakage than those without eugenol. SC-10 crowns showed more microleakage compared to Protemp 4 crowns. SC-10 crowns cemented with Kalzinol showed maximum microleakage and Protemp 4 crowns cemented with HY bond showed least microleakage. PMID:27134427

Incidental Prostate Adenocarcinoma in Cystoprostatectomy Specimens: Partial Versus Complete Prostate Sampling.

PubMed

Filter, Emily R; Gabril, Manal Y; Gomez, Jose A; Wang, Peter Z T; Chin, Joseph L; Izawa, Jonathan; Moussa, Madeleine

2017-08-01

The rate of incidental prostate adenocarcinoma (PCa) detection in radical cystoprostatectomy (RCP) varies widely, ranging from 15% to 54%. Such variability may be explained by institutional differences in prostate grossing protocols. Either partial or complete submission of the prostate gland in RCP may result in detection of clinically insignificant or significant incidental PCa. The aim of the study was to compare the clinical significance of PCa in RCP specimens in partial versus complete sampling. Seventy-two out of 158 RCP cases showed incidental PCa. The pathologic features, including Gleason score, margin status, extraprostatic extension (EPE), seminal vesicle invasion (SVI), PCa stage, and tumor volume, were assessed. The 72 cases were divided into partial (n = 21, 29.1%) and complete sampling (n = 51, 70.8%) groups. EPE was detected in 13/72 (18.1%) with 11/13 (84.6%) cases in the complete group. Positive margins were present in 11/72 (15.3%) with 9/11 (81.8%) in the complete group. SVI was detected in 4/72 (5.6%) with 3/4 (75.0%) in the complete group. Overall, 4/72 (5.6%) had a Gleason score >7, all of which were in the complete group. Our data suggest that complete sampling of the prostate may be the ideal approach to grossing RCP specimens, allowing for greater detection of clinically significant incidental PCa.

Real-time confocal laser endomicroscopic evaluation of primary liver cancer based on human liver autofluorescence.

PubMed

Maki, Harufumi; Kawaguchi, Yoshikuni; Arita, Junichi; Akamatsu, Nobuhisa; Kaneko, Junichi; Sakamoto, Yoshihiro; Hasegawa, Kiyoshi; Harihara, Yasushi; Kokudo, Norihiro

2017-02-01

Confocal laser endomicroscopy (CLE) is available for real-time microscopic examination. This study aims to evaluate the usefulness of intraoperative CLE examination as a modality to evaluate surgical margins in surgery for primary liver cancer. A probe-based CLE system (Cellvizio 100, Mauna Kea Technologies, Paris, France) was used. The subjects comprised seven specimens obtained from six patients with primary liver cancer in November 2015. The probe was manually attached to the surfaces of specimens, and images were collected without external fluorophores. CLE images were compared with hematoxylin and eosin-stained slides. Fluorescence intensity (FI) values of the CLE images were assessed using luminance-analyzing software. CLE examination visualized non-cancerous regions in the background liver as regular structures with high fluorescence because of human liver autofluorescence. Conversely, hepatocellular carcinoma and intrahepatic cholangiocarcinoma were depicted as irregular structures with low fluorescence. The median FI values of the non-cancerous regions and the cancerous regions were 104 (79.8-156) and 74.9 (60.6-106), respectively, and were significantly different (P = 0.031). The probe-based CLE enables real-time differentiation of cancerous regions from non-cancerous tissues in surgical specimens because of human liver autofluorescence. CLE can be used to confirm negative surgical margins in the operating room. J. Surg. Oncol. 2017;115:151-157. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Comparison of microleakage of three acid-base luting cements versus one resin-bonded cement for Class V direct composite inlays.

PubMed

Piemjai, Morakot; Miyasaka, Kumiko; Iwasaki, Yasuhiko; Nakabayashi, Nobuo

2002-12-01

Demineralized dentin beneath set cement may adversely affect microleakage under fixed restorations. Microleakage of direct composite inlays cemented with acid-base cements and a methyl methacrylate resin cement were evaluated to determine their effect on the integrity of the underlying hybridized dentin. Sixty Class V box preparations (3 mm x 3 mm x 1.5 mm) were precisely prepared in previously frozen bovine teeth with one margin in enamel and another margin in dentin. Direct composite inlays (EPIC-TMPT) for each preparation were divided into 4 groups of 15 specimens each and cemented with 3 acid-base cements (control group): Elite, Ketac-Cem, Hy-Bond Carbo-Cem, and 1 adhesive resin cement: C&B Metabond. All specimens were stored in distilled water for 24 hours at 37 degrees C before immersion in 0.5% basic fuchsin for 24 hours. The dye penetration was measured on the sectioned specimens at the tooth-cement interface of enamel and cementum margins and recorded with graded criteria under light microscopy (Olympus Vanox-T) at original magnification x 50, 100, and 200. A Kruskal-Wallis and the Mann-Whitney test at P<.05 were used to analyze leakage score. All cementum margins of the 3 acid-base cements tested demonstrated significantly higher leakage scores than cementum margins for inlays cemented with the resin cement tested(P<.01). No leakage along the tooth-cement interface was found for inlays retained with the adhesive resin cement. Within the limitations of this study, the 3 acid-base cements tested exhibited greater microleakage at the cementum margins than did the adhesive resin cement that was tested.

Label-free reflectance hyperspectral imaging for tumor margin assessment: a pilot study on surgical specimens of cancer patients

NASA Astrophysics Data System (ADS)

Fei, Baowei; Lu, Guolan; Wang, Xu; Zhang, Hongzheng; Little, James V.; Patel, Mihir R.; Griffith, Christopher C.; El-Diery, Mark W.; Chen, Amy Y.

2017-08-01

A label-free, hyperspectral imaging (HSI) approach has been proposed for tumor margin assessment. HSI data, i.e., hypercube (x,y,λ), consist of a series of high-resolution images of the same field of view that are acquired at different wavelengths. Every pixel on an HSI image has an optical spectrum. In this pilot clinical study, a pipeline of a machine-learning-based quantification method for HSI data was implemented and evaluated in patient specimens. Spectral features from HSI data were used for the classification of cancer and normal tissue. Surgical tissue specimens were collected from 16 human patients who underwent head and neck (H&N) cancer surgery. HSI, autofluorescence images, and fluorescence images with 2-deoxy-2-[(7-nitro-2,1,3-benzoxadiazol-4-yl)amino]-D-glucose (2-NBDG) and proflavine were acquired from each specimen. Digitized histologic slides were examined by an H&N pathologist. The HSI and classification method were able to distinguish between cancer and normal tissue from the oral cavity with an average accuracy of 90%±8%, sensitivity of 89%±9%, and specificity of 91%±6%. For tissue specimens from the thyroid, the method achieved an average accuracy of 94%±6%, sensitivity of 94%±6%, and specificity of 95%±6%. HSI outperformed autofluorescence imaging or fluorescence imaging with vital dye (2-NBDG or proflavine). This study demonstrated the feasibility of label-free, HSI for tumor margin assessment in surgical tissue specimens of H&N cancer patients. Further development of the HSI technology is warranted for its application in image-guided surgery.

Evaluation of marginal and internal adaptation of hybrid and nanoceramic systems with microcomputed tomography: An in vitro study.

PubMed

Yildirim, Güler; Uzun, Ismail H; Keles, Ali

2017-08-01

The accuracy of recently introduced chairside computer-aided design and computer-aided manufacturing (CAD-CAM) blocks is not well established, and marginal integrity and internal adaptation are not known. The purpose of this in vitro study was to evaluate the marginal and internal adaptation of hybrid and nanoceramics using microcomputed tomography (μ-CT). The marginal and internal adaptation of 3 polymer-infiltrated ceramic-network (PICN) materials (Vita Enamic [VE]; Lava Ultimate [LU]; Vita Suprinity [VS]) were compared with lithium disilicate (IPS e.max.CAD, IPS). Ninety-six specimens (48 dies and 48 crowns) were prepared (n=12 each group) using a chairside CAD-CAM system. The restorations were scanned with μ-CT, with 160 measurements made for each crown, and used in 2-dimensional (2D) analysis. The marginal adaptation of marginal discrepancy (MD), absolute marginal discrepancy (AMD), internal adaptation of shoulder area (SA), axial space (AS), and occlusal space (OS) were compared using appropriate statistical analysis methods (α=.05). Cement volumes were compared using 3D analysis. The IPS blocks showed higher MD (130 μm), AMD (156 μm), SA (111 μm) (P<.05), AS (52 μm), and OS (192 μm) than the other blocks (P<.01). The adaptation values of VS were significantly lower than those of the IPS block (P<.05). The adaption values of the LU and VE blocks were significantly lower than those of others (P<.01) but were statistically similar to one another (P>.05). IPS had the largest cement space at 18 mm 3 (P<.01). The marginal and internal adaptation values were within a clinically acceptable range for all 3 hybrids and nanoceramics tested. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Effect of Heat Treatment on the Physical Properties of Provisional Crowns during Polymerization: An in Vitro Study

PubMed Central

Mei, May L.; So, Sam Y. C.; Li, Hao; Chu, Chun-Hung

2015-01-01

This study concerned the effect of heat treatment during setting on the physical properties of four resin-based provisional restorative materials: Duralay (polymethyl methacrylate), Trim II (polyethyl methacrylate), Luxatemp (bis-acrylic composite), and Protemp 4 (bis-acrylic composite). Specimens were prepared at 23, 37, or 60 °C for evaluation of flexural strength, surface roughness, color change and marginal discrepancy. Flexural strength was determined by a three-point bending test. Surface profile was studied using atomic force microscopy. Color change was evaluated by comparing the color of the materials before and after placement in coffee. A travelling microscope helped prepare standardized crowns for assessment of marginal discrepancy. Flexural strength of all tested materials cured at 23 °C or 37 °C did not significantly change. The surface roughness and marginal discrepancy of the materials increased at 60 °C curing temperature. Marginal discrepancies, color stability, and other physical properties of materials cured at 23 °C or 37 °C did not significantly change. Flexural strength of certain provisional materials cured at 60 °C increased, but there was also an increase in surface roughness and marginal discrepancy. PMID:28788031

Tunnel restorations using glass ionomer or glass cermet: in vitro marginal ridge fracture and microleakage.

PubMed

Shetty, R; Munshi, A K

1996-01-01

The purpose of this in vitro study was to compare the marginal ridge fracture resistance and microleakage following restorations of partial tunnel preparations using glass ionomer and glass cermet cements. Sixty eight sound premolars were selected for this study and were divided randomly into six groups. A standardized partial tunnel preparation was done on all the teeth except specimens belonging to Group I. The partial tunnel preparations of Groups III & V were restored with glass ionomer and that of Groups IV & VI were restored with glass cermet. The teeth belonging to Groups I, II, III & IV were subjected to marginal ridge fracture resistance testing. The teeth of Groups V & VI were tested for microleakage after immersing them in 5% methylene blue solution for 4 hours. The results indicated that the teeth restored with glass cermet were marginally better than that with glass ionomer in terms of marginal ridge fracture resistance. Both the materials failed to reinforce the marginal ridge to the level of an intact tooth. The microleakage which occurred around both the materials were statistically insignificant, but on comparison glass ionomer showed better results. Hence, glass ionomer is preferred as a restorative material for partial tunnel preparations because of additional inherent advantages like superior esthetics and fluoride leachability.

Gigapixel surface imaging of radical prostatectomy specimens for comprehensive detection of cancer-positive surgical margins using structured illumination microscopy

PubMed Central

Wang, Mei; Tulman, David B.; Sholl, Andrew B.; Kimbrell, Hillary Z.; Mandava, Sree H.; Elfer, Katherine N.; Luethy, Samuel; Maddox, Michael M.; Lai, Weil; Lee, Benjamin R.; Brown, J. Quincy

2016-01-01

Achieving cancer-free surgical margins in oncologic surgery is critical to reduce the need for additional adjuvant treatments and minimize tumor recurrence; however, there is a delicate balance between completeness of tumor removal and preservation of adjacent tissues critical for normal post-operative function. We sought to establish the feasibility of video-rate structured illumination microscopy (VR-SIM) of the intact removed tumor surface as a practical and non-destructive alternative to intra-operative frozen section pathology, using prostate cancer as an initial target. We present the first images of the intact human prostate surface obtained with pathologically-relevant contrast and subcellular detail, obtained in 24 radical prostatectomy specimens immediately after excision. We demonstrate that it is feasible to routinely image the full prostate circumference, generating gigapixel panorama images of the surface that are readily interpreted by pathologists. VR-SIM confirmed detection of positive surgical margins in 3 out of 4 prostates with pathology-confirmed adenocarcinoma at the circumferential surgical margin, and furthermore detected extensive residual cancer at the circumferential margin in a case post-operatively classified by histopathology as having negative surgical margins. Our results suggest that the increased surface coverage of VR-SIM could also provide added value for detection and characterization of positive surgical margins over traditional histopathology. PMID:27257084

Intraoperative Evaluation of Breast Tumor Margins with Optical Coherence Tomography

PubMed Central

Nguyen, Freddy T.; Zysk, Adam M.; Chaney, Eric J.; Kotynek, Jan G.; Oliphant, Uretz J.; Bellafiore, Frank J.; Rowland, Kendrith M.; Johnson, Patricia A.; Boppart, Stephen A.

2009-01-01

As breast cancer screening rates increase, smaller and more numerous lesions are being identified earlier, leading to more breast-conserving surgical procedures. Achieving a clean surgical margin represents a technical challenge with important clinical implications. Optical coherence tomography (OCT) is introduced as an intraoperative high-resolution imaging technique that assesses surgical breast tumor margins by providing real-time microscopic images up to 2 mm beneath the tissue surface. In a study of 37 patients split between training and study groups, OCT images covering 1 cm2 regions were acquired from surgical margins of lumpectomy specimens, registered with ink, and correlated with corresponding histological sections. A 17 patient training set used to establish standard imaging protocols and OCT evaluation criteria demonstrated that areas of higher scattering tissue with a heterogeneous pattern were indicative of tumor cells and tumor tissue, in contrast to lower scattering adipocytes found in normal breast tissue. The remaining 20 patients were enrolled into the feasibility study. Of these lumpectomy specimens, 11 were identified with a positive or close surgical margin and 9 were identified with a negative margin under OCT. Based on histological findings, 9 true positives, 9 true negatives, 2 false positives, and 0 false negatives were found, yielding a sensitivity of 100% and specificity of 82%. These results demonstrate the potential of OCT as a real-time method for intraoperative margin assessment in breast conserving surgeries. PMID:19910294

Indication and method of frozen section in vaginal radical trachelectomy.

PubMed

Chênevert, Jacinthe; Têtu, Bernard; Plante, Marie; Roy, Michel; Renaud, Marie-Claude; Grégoire, Jean; Grondin, Katherine; Dubé, Valérie

2009-09-01

Vaginal radical trachelectomy (VRT) is a fertility-sparing surgical technique used as an alternative to radical hysterectomy in early stage cervical carcinoma. With the advent of VRT, preoperative evaluation of the surgical margin has become imperative, because if the tumor is found within 5 mm of the endocervical margin, additional surgical resection is required. In a study published earlier from our center, we came to the conclusion that a frozen section should be conducted only when a cancerous lesion is grossly visible, and that it could be omitted in normal-looking specimens or VRT with nonspecific lesions. Since then, 53 VRT have been performed in our center, and frozen sections were conducted according to these recommendations. Fifteen VRT were grossly normal, 24 had a nonspecific lesion and 14 showed a grossly visible lesion. Final margins were satisfactory on all 15 grossly normal specimens. Of the 24 VRT with nonspecific lesions, 2 cases for which no frozen section was performed had unsatisfactory final margins (<5 mm). Of the 14 VRT with grossly visible lesions, 3 cases were inadequately evaluated by frozen section due to sampling errors, which led to unsatisfactory final margin assessment. These results confirm that a frozen section can be omitted on normal looking VRT specimens, but contrary to results published earlier, we recommend that a frozen section be performed on all VRT with nonspecific lesions. As for VRT with a grossly visible lesion, frozen section evaluation is still warranted, and we recommend increasing the sampling to improve the adequacy of frozen sections.

Marginal Accuracy and Internal Fit of 3-D Printing Laser-Sintered Co-Cr Alloy Copings.

PubMed

Kim, Myung-Joo; Choi, Yun-Jung; Kim, Seong-Kyun; Heo, Seong-Joo; Koak, Jai-Young

2017-01-23

Laser sintered technology has been introduced for clinical use and can be utilized more widely, accompanied by the digitalization of dentistry and the development of direct oral scanning devices. This study was performed with the aim of comparing the marginal accuracy and internal fit of Co-Cr alloy copings fabricated by casting, CAD/CAM (Computer-aided design/Computer-assisted manufacture) milled, and 3-D laser sintered techniques. A total of 36 Co-Cr alloy crown-copings were fabricated from an implant abutment. The marginal and internal fit were evaluated by measuring the weight of the silicone material, the vertical marginal discrepancy using a microscope, and the internal gap in the sectioned specimens. The data were statistically analyzed by One-way ANOVA (analysis of variance), a Scheffe's test, and Pearson's correlation at the significance level of p = 0.05, using statistics software. The silicone weight was significantly low in the casting group. The 3-D laser sintered group showed the highest vertical discrepancy, and marginal-, occlusal-, and average- internal gaps ( p < 0.05). The CAD/CAM milled group revealed a significantly high axial internal gap. There are moderate correlations between the vertical marginal discrepancy and the internal gap variables ( r = 0.654), except for the silicone weight. In this study, the 3-D laser sintered group achieved clinically acceptable marginal accuracy and internal fit.

Marginal Accuracy and Internal Fit of 3-D Printing Laser-Sintered Co-Cr Alloy Copings

PubMed Central

Kim, Myung-Joo; Choi, Yun-Jung; Kim, Seong-Kyun; Heo, Seong-Joo; Koak, Jai-Young

2017-01-01

Laser sintered technology has been introduced for clinical use and can be utilized more widely, accompanied by the digitalization of dentistry and the development of direct oral scanning devices. This study was performed with the aim of comparing the marginal accuracy and internal fit of Co-Cr alloy copings fabricated by casting, CAD/CAM (Computer-aided design/Computer-assisted manufacture) milled, and 3-D laser sintered techniques. A total of 36 Co-Cr alloy crown-copings were fabricated from an implant abutment. The marginal and internal fit were evaluated by measuring the weight of the silicone material, the vertical marginal discrepancy using a microscope, and the internal gap in the sectioned specimens. The data were statistically analyzed by One-way ANOVA (analysis of variance), a Scheffe’s test, and Pearson’s correlation at the significance level of p = 0.05, using statistics software. The silicone weight was significantly low in the casting group. The 3-D laser sintered group showed the highest vertical discrepancy, and marginal-, occlusal-, and average- internal gaps (p < 0.05). The CAD/CAM milled group revealed a significantly high axial internal gap. There are moderate correlations between the vertical marginal discrepancy and the internal gap variables (r = 0.654), except for the silicone weight. In this study, the 3-D laser sintered group achieved clinically acceptable marginal accuracy and internal fit. PMID:28772451

The specialty of the treating physician affects the likelihood of tumor-free resection margins for basal cell carcinoma: results from a multi-institutional retrospective study.

PubMed

Fleischer, A B; Feldman, S R; Barlow, J O; Zheng, B; Hahn, H B; Chuang, T Y; Draft, K S; Golitz, L E; Wu, E; Katz, A S; Maize, J C; Knapp, T; Leshin, B

2001-02-01

Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Surgical experience and physician specialty may affect the outcome quality of surgical excision of BCC. We performed a multicenter retrospective study of BCC excisions submitted to the respective Departments of Pathology at 4 major university medical centers. Our outcome measure was presence of histologic evidence of tumor present in surgical margins of excision specimens (incomplete excision). Clinician experience was defined as the number of excisions that a clinician performed during the study interval. The analytic sample pool included 1459 tumors that met all inclusion and exclusion criteria. Analyses included univariate and multivariate techniques involving the entire sample and separate subsample analyses that excluded 2 outlying dermatologists. Tumor was present at the surgical margins in 243 (16.6%) of 1459 specimens. A patient's sex, age, and tumor size were not significantly related to the presence of tumor in the surgical margin. Physician experience did not demonstrate a significant difference either in the entire sample (P <.09) or in the subsample analysis (P >.30). Tumors of the head and neck were more likely to be incompletely excised than truncal tumors in all the analyses (P <.03). Compared with dermatologists, otolaryngologists (P <.02) and plastic surgeons (P <.008) were more likely to incompletely excise tumors; however, subsample analysis for plastic surgeons found only a trend toward significance (P <.10). Dermatologists and general surgeons did not differ in the likelihood of performing an incomplete excision (P >.4). The physician specialty may affect the quality of care in the surgical management of BCC.

Effect of resin coating as a means of preventing marginal leakage beneath full cast crowns.

PubMed

Kosaka, Satomi; Kajihara, Hirotada; Kurashige, Hisanori; Tanaka, Takuo

2005-03-01

The purpose of this study was to evaluate the effectiveness of resin coating as a means of preventing marginal leakage beneath full cast crowns which were emplaced using different cements. Standard full cast crown preparation was made on 64 extracted premolars. These samples were then divided into four groups, with half of each group coated with dentin coating material after preparation. Crowns were cemented onto the teeth using zinc cement, Fuji I, Vitremer, or C&B Metabond. The samples were thermal-cycled for 10,000 cycles. They were then immersed in erythrosine solution, sectioned, and observed under a microscope. Microleakage analyses were performed using a 0-4 point system. The data were statistically analyzed. There were significant differences between the coated specimens and the uncoated specimens using Fuji I and Vitremer. The results showed that a resin coating could decrease the amount of marginal leakage when applied with these two cements.

Combined reflectance confocal microscopy-optical coherence tomography for delineation of basal cell carcinoma margins: an ex vivo study

NASA Astrophysics Data System (ADS)

Iftimia, Nicusor; Peterson, Gary; Chang, Ernest W.; Maguluri, Gopi; Fox, William; Rajadhyaksha, Milind

2016-01-01

We present a combined reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) approach, integrated within a single optical layout, for diagnosis of basal cell carcinomas (BCCs) and delineation of margins. While RCM imaging detects BCC presence (diagnoses) and its lateral spreading (margins) with measured resolution of ˜1 μm, OCT imaging delineates BCC depth spreading (margins) with resolution of ˜7 μm. When delineating margins in 20 specimens of superficial and nodular BCCs, depth could be reliably determined down to ˜600 μm, and agreement with histology was within about ±50 μm.

Biomechanical comparison of suture anchor versus margin convergence plus suture anchor for rotator cuff repair.

PubMed

Chen, Shi-yi; Malcarney, Hilary L; Murrell, George A C

2009-02-01

To evaluate results of margin convergence versus suture anchors in rotator cuff repair, and to determine which method is mechanically superior. Eighteen kangaroo shoulders were randomly divided into three groups (n = 6). A full thickness tendon defect 1.0 cm × 1.5 cm in size was created in the supraspinatus tendon at humeral insertion, simulating a massive rotator cuff tear. Three different techniques were employed for rotator cuff repair: (i) Mitek GII suture anchor alone (Group 1); (ii) margin convergence alone (Group 2); and (iii) margin convergence plus Mitek GII suture anchor (Group 3). Combined loads were applied to each specimen. After completion of cyclic loading, the construct was loaded to failure. ANOVA and LSD (Least Significant Difference) multiple comparisons of the means were applied to results. Cyclic load testing showed progressive gap formation in each repaired specimen with increasing cycles. Group 1 reached 50% failure at an average of 34 cycles, Group 2 at 75 cycles and Group 3 at 73 cycles. There were significant difference between Groups 1 and 2, and Groups 1 and 3 (P ≤ 0.001). After 100 loading cycles, the average gap size was 6.8 mm, 6.1 mm and 4.7 mm in Groups 1, 2 and 3, respectively. There was a significant difference between Groups 1 and 3 (P ≤ 0.015). All specimens eventually reached failure. Rotator cuff repairs with margin convergence +/- suture anchor were far stronger than suture anchor alone, both in gap formation and ultimate failure load. However, progressive gap formation with cyclic loading seems inevitable after cuff repair, which may facilitate clinical understanding of the phenomena of re-tear or residual defect. © 2009 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

Spectrally Encoded Confocal Microscopy (SECM) for Diagnosing of Breast Cancer in Excision and Margin Specimens

PubMed Central

Brachtel, Elena F.; Johnson, Nicole B.; Huck, Amelia E.; Rice-Stitt, Travis L.; Vangel, Mark G.; Smith, Barbara L.; Tearney, Guillermo J.; Kang, Dongkyun

2016-01-01

A large percentage of breast cancer patients treated with breast conserving surgery need to undergo multiple surgeries due to positive margins found during post-operative margin assessment. Carcinomas could be removed completely during the initial surgery and additional surgery avoided if positive margins can be determined intra-operatively. Spectrally-encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technology that has a potential to rapidly image the entire surgical margin at sub-cellular resolution and accurately determine margin status intra-operatively. In this paper, in order to test feasibility of using SECM for intra-operative margin assessment, we have evaluated the diagnostic accuracy of SECM for detecting various types of breast cancers. Forty-six surgically-removed breast specimens were imaged with a SECM system. Side-by-side comparison between SECM and histologic images showed that SECM images can visualize key histomorphologic patterns of normal/benign and malignant breast tissues. Small (500 µm × 500 µm) spatially-registered SECM and histologic images (n=124 for each) were diagnosed independently by three pathologists with expertise in breast pathology. Diagnostic accuracy of SECM for determining malignant tissues was high, average sensitivity of 0.91, specificity of 0.93, positive predictive value of 0.95, and negative predictive value of 0.87. Intra-observer agreement and inter-observer agreement for SECM were also high, 0.87 and 0.84, respectively. Results from this study suggest that SECM may be developed into an intra-operative margin assessment tool for guiding breast cancer excisions. PMID:26779830

Utilisation of Waste Marble Dust as Fine Aggregate in Concrete

NASA Astrophysics Data System (ADS)

Vigneshpandian, G. V.; Aparna Shruthi, E.; Venkatasubramanian, C.; Muthu, D.

2017-07-01

Concrete is the important construction material and it is used in the construction industry due to its high compressive strength and its durability. Now a day’s various studies have been conducted to make concrete with waste material with the intention of reducing cost and unavailability of conventional materials. This paper investigates the strength properties of concrete specimens cast using waste marble dust as replacement of fine aggregate. The marble pieces are finely crushed to powdered and the gradation is compared with conventional fine aggregate. Concrete specimen were cast using wmd in the laboratory with different proportion (25%, 50% and 100%) by weight of cement and from the studies it reveals that addition of waste marble dust as a replacement of fine aggregate marginally improves compressive, tensile and flexural strength in concrete.

Effect of three surface sealants on marginal sealing of Class V composite resin restorations.

PubMed

Ramos, R P; Chimello, D T; Chinelatti, M A; Dibb, R G; Mondelli, J

2000-01-01

This study evaluated in vitro the effectiveness of three different surface sealants (Fortify, Protect-it! and Optiguard) on the marginal sealing of Class V light-activated composite resin restorations (Prodigy). For this purpose, 20 sound noncarious human premolars extracted within a six-month period were selected. Class V cavities with the occlusal margin in enamel and cervical margin in cementum were prepared in both buccal and lingual surfaces. The teeth, randomly assigned in four groups with 10 cavities in each group, were restored with composite resin after applying an adhesive system (Optibond FL). After the finishing and polishing procedures, the restorations were covered with a specific surface sealant, except for the control samples, which were not sealed. After placing restorations, the specimens were thermocycled and immersed in a 50% silver nitrate solution (tracer agent) for eight hours, sectioned longitudinally and analyzed for leakage using an optical microscope in a blind study with three examiners. The marginal microleakage was evaluated at the occlusal and cervical interfaces and compared among the four groups using the Kruskall-Wallis and the Wilcoxon Tests. There was better sealing at the occlusal margin, and in this region, there were no statistically significant differences among the materials (p > 0.05). In the cervical region, Fortify and Protect-it! showed improved results over the Control Group, and Optiguard showed similar results to the Control Group (without sealing).

Does the distance between tumor and margin in radical prostatectomy specimens correlate with prognosis: relation to tumor location.

PubMed

Paluru, Swetha; Epstein, Jonathan I

2016-10-01

The posterior half of the prostate has a smooth well-defined edge unlike anteriorly. Often, tumor extends close to the posterior margin, where it is controversial whether pathologists should measure the distance between the tumor and the margin. There are no published data regarding the significance of a close margin factoring in the anatomical location within the radical prostatectomy (RP). We identified 158 RPs with 39 anterior-predominant carcinomas and 119 cases with posterior-predominant cancer. Distances between the tumor and inked margin were measured with an ocular micrometer. Eighty-seven cases had no progression with a minimum 6-year follow-up (median, 8; range, 6-9). Eighteen cases had progression with a median time to progression of 2 years with all men progressing within 6 years after RP. There was no statistically significant difference in the risk of progression relative to distance of tumor to the posterior margin (P=.09). The mean distance of tumor to the anterior margin for the cases that progressed was 0.6 mm (median, 0.5 mm; range, 0.05-1.18) compared to 1.9 mm (median, 1.1; range, 0.02-4) for the cases that did not progress (P=.02). Of 7 cases with anterior-predominant tumors that progressed, 5 had tumor located less than 1 mm from the anterior margin. In conclusion, if cancer is present less than 1 mm from the anterior margin, there is an increased tendency to recur, and this finding should be included in pathology reports. However, close margins posteriorly are not clinically significant and should not be reported. Copyright © 2016 Elsevier Inc. All rights reserved.

Self-etching aspects of a three-step etch-and-rinse adhesive.

PubMed

Bahillo, Jose; Roig, Miguel; Bortolotto, Tissiana; Krejci, Ivo

2013-11-01

The purpose of this study is to assess the marginal adaptation of cavities restored with a three-step etch-and-rinse adhesive, OptiBond FL (OFL) under different application protocols. Twenty-four class V cavities were prepared with half of the margins located in enamel and half in dentin. Cavities were restored with OFL and a microhybrid resin composite (Clearfil AP-X). Three groups (n = 8) that differed in the etching technique were tested with thermomechanical loading, and specimens were subjected to quantitative marginal analysis before and after loading. Micromorphology of etching patters on enamel and dentin were observed with SEM. Data was evaluated with Kruskal-Wallis and Bonferroni post hoc test. Significantly lower percent CM (46.9 ± 19.5) were found after loading on enamel in group 3 compared to group 1 (96.5 ± 5.1) and group 2 (93.1 ± 8.1). However, no significant differences (p = 0.30) were observed on dentin margins. Etching enamel with phosphoric acid but avoiding etching dentin before the application of OFL, optimal marginal adaptation could be obtained, evidencing a self-etching primer effect. A reliable adhesive interface was attained with the application of the three-step etch-and-rinse OFL adhesive with a selective enamel etching, representing an advantage on restoring deep cavities.

Comparison of marginal adaptation of mineral trioxide aggregate, glass ionomer cement and intermediate restorative material as root-end filling materials, using scanning electron microscope: An in vitro study

PubMed Central

Gundam, Sirisha; Patil, Jayaprakash; Venigalla, Bhuvan Shome; Yadanaparti, Sravanthi; Maddu, Radhika; Gurram, Sindhura Reddy

2014-01-01

Aim: The present study compares the marginal adaption of Mineral Trioxide Aggregate (MTA), Glass Ionomer Cement (GIC) and Intermediate Restorative Material (IRM) as root-end filling materials in extracted human teeth using Scanning Electron Microscope (SEM). Materials and Methods: Thirty single rooted human teeth were obturated with Gutta-percha after cleaning and shaping. Apical 3 mm of roots were resected and retrofilled with MTA, GIC and IRM. One millimeter transverse section of the retrofilled area was used to study the marginal adaptation of the restorative material with the dentin. Mounted specimens were examined using SEM at approximately 15 Kv and 10-6 Torr under high vacuum condition. At 2000 X magnification, the gap size at the material-tooth interface was recorded at 2 points in microns. Statistical Analysis: One way ANOVA Analysis of the data from the experimental group was carried out with gap size as the dependent variable, and material as independent variable. Results: The lowest mean value of gap size was recorded in MTA group (0.722 ± 0.438 μm) and the largest mean gap in GIC group (1.778 ± 0.697 μm). Conclusion: MTA showed least gap size when compared to IRM and GIC suggesting a better marginal adaptation. PMID:25506146

Method and device for intraoperative imaging of lumpectomy specimens to provide feedback to breast surgeon for prompt re-excision during the same procedure

NASA Astrophysics Data System (ADS)

Krol, Andrzej; Hemingway, Susan; Kort, Kara; de la Rosa, Gustavo; Adhikary, Ravi; Masrani, Deepa; Feiglin, David; O'Connell, Avice; Nagarajan, Mahesh; Yang, Chien-Chun; Wismüller, Axel

2014-03-01

Breast conserving therapy (BCT) of breast cancer is now widely accepted due to improved cosmetic outcome and improved patients' quality of life. One of the critical issues in performing breast-conserving surgery is trying to achieve microscopically clear surgical margins while maintaining excellent cosmesis. Unfortunately, unacceptably close or positive surgical margins occur in at least 20-25% of all patients undergoing BCT requiring repeat surgical excision days or weeks later, as permanent histopathology routinely takes days to complete. Our aim is to develop a better method for intraoperative imaging of non-palpable breast malignancies excised by wire or needle localization. Providing non-deformed three dimensional imaging of the excised breast tissue should allow more accurate assessment of tumor margins and consequently allow further excision at the time of initial surgery thus limiting the enormous financial and emotional burden of additional surgery. We have designed and constructed a device that allows preservation of the excised breast tissue in its natural anatomic position relative to the breast as it is imaged to assess adequate excision. We performed initial tests with needle-guided lumpectomy specimens using micro-CT and digital breast tomosynthesis (DBT). Our device consists of a plastic sphere inside a cylindrical holder. The surgeon inserts a freshly excised piece of breast tissue into the sphere and matches its anatomic orientation with the fiducial markers on the sphere. A custom-shaped foam is placed inside the sphere to prevent specimen deformation due to gravity. DBT followed by micro-CT images of the specimen were obtained. We confirmed that our device preserved spatial orientation of the excised breast tissue and that the location error was lower than 10mm and 10 degrees. The initial obtained results indicate that breast lesions containing microcalcifications allow a good 3D imaging of margins providing immediate intraoperative feedback for further excision as needed at the initial operation.

Influence of Cavity Margin Design and Restorative Material on Marginal Quality and Seal of Extended Class II Resin Composite Restorations In Vitro.

PubMed

Soliman, Sebastian; Preidl, Reinhard; Karl, Sabine; Hofmann, Norbert; Krastl, Gabriel; Klaiber, Bernd

2016-01-01

To investigate the influence of three cavity designs on the marginal seal of large Class II cavities restored with low-shrinkage resin composite limited to the enamel. One hundred twenty (120) intact human molars were randomly divided into 12 groups, with three different cavity designs: 1. undermined enamel, 2. box-shaped, and 3. proximal bevel. The teeth were restored with 1. an extra-low shrinkage (ELS) composite free of diluent monomers, 2. microhybrid composite (Herculite XRV), 3. nanohybrid composite (Filtek Supreme XTE), and 4. silorane-based composite (Filtek Silorane). After artificial aging by thermocycling and storage in physiological saline, epoxy resin replicas were prepared. To determine the integrity of the restorations' approximal margins, two methods were sequentially employed: 1. replicas were made of the 120 specimens and examined using SEM, and 2. the same 120 specimens were immersed in AgNO3 solution, and the dye penetration depth was observed with a light microscope. Statistical analysis was performed using the Kruskal-Wallis and the Dunn-Bonferroni tests. After bevel preparation, SEM observations showed that restorations did not exhibit a higher percentage of continuous margin (SEM-analysis; p>0.05), but more leakage was found than with the other cavity designs (p<0.05). The lowest percentage of continuous margin was observed in ELS restorations (p<0.05). More fractured margins were observed in the undermined enamel cavity design groups (p<0.05). Bevel preparation failed to improve margin quality in large Class II composite restorations and is no longer recommended. However, undermined enamel should be removed to prevent enamel fractures.

Number of fragments, margin status and thermal artifacts of conized specimens from LLETZ surgery to treat cervical intraepithelial neoplasia.

PubMed

Bittencourt, Dulcimary Dias; Zanine, Rita Maira; Sebastião, Ana Martins; Taha, Nabiha Saadi; Speck, Neila Góis; Ribalta, Julisa Chamorro Lascasas

2012-01-01

Large loop excision of the transformation zone (LLETZ) is a nontraumatic cut and coagulation method with several advantages, but it induces thermal artifacts in the cut region. The aim here was to assess the correlations of age, number of fragments, lesion grade and degree of thermal artifacts with margin quality in conized specimens from LLETZ for cervical intraepithelial neoplasia (CIN). Cross-sectional study at Universidade Federal de São Paulo (Unifesp). The records and histopathology findings of 118 women who underwent LLETZ between 1999 and 2007 were reviewed. Age, number of fragments, lesion grade, degree of thermal artifacts and margin quality were assessed. The patients' mean age was 27.14 years; 63.6% had been diagnosed with CIN II and 36.4% with CIN III. The lesion was removed as a single fragment in 79.6% of the cases. The margins were free from intraepithelial neoplasia in 85.6% and compromised in the endocervical margin in 6.8%. Fragment damage due to artifacts occurred in 2.5%. Severe artifacts occurred in 22.8%. Women aged 30 years or over presented more cases of CIN III (P < 0.0004). Neoplastic compromising of surgical margins and severe artifacts occurred more often in cases in which two or more fragments were removed, and in patients aged 30 years or over. CIN III in women aged 30 or over, when removed in two or more fragments during LLETZ, presented a greater number of compromised margins and greater severity of thermal artifacts.

Effects of an erbium, chromium: yttrium, scandium, gallium, garnet laser on mucocutanous soft tissues.

PubMed

Rizoiu, I M; Eversole, L R; Kimmel, A I

1996-10-01

Lasers are effective tools for soft tissue surgery. The erbium, chromium: yttrium, scandium, gallium, garnet laser is a new system that incorporates an air-water spray. This study evaluates the cutting margins of this laser and compares healing with laser and conventional scalpel and punch biopsy-induced wounds. New Zealand white rabbits were divided into serial sacrifice groups; the tissues were grossly and microscopically analyzed after laser and convential steel surgical wounding. Wound margins were found to show minimal edge coagulation artifact and were 20 to 40 mm in width. Laser wounds showed minimal to no hemorrhage and re-epithelialization and collagenization were found to occur by day 7 in both laser and conventional groups. The new laser system is an effective soft tissue surgical device; wound healing is comparable to that associated with surgical steel wounds. The minimal edge artifact observed with this laser system should allow for the procurement of diagnostic biopsy specimens.

Is the apical soft tissue margin a better predictor of biochemical recurrence than the surgical specimen?

PubMed

Godoy, Guilherme; Tareen, Basir U; Lepor, Herbert

2011-01-01

To identify predictors of apical surgical margin (ASM) and apical soft tissue margin (ASTM), determine if the ASTM is a better predictor of biochemical recurrence (BR) than the ASM, and ascertain the impact of apical biopsies on BR rates. One thousand three hundred eight consecutive men underwent open radical retropubic prostatectomy (RP) between October 2000 and December 2006. Circumferential biopsies of the ASTM were obtained intraoperatively and submitted for frozen section analysis. Logistic regression models were utilized to identify the factors associated with the presence of positive ASMs and ASTMs. The estimated 5-year risk of BR was calculated by the Kaplan-Meier method. Overall, 43 (3.3%) and 86 (6.6%) of cases exhibited positive ASM and ASTM, respectively. ASM was significantly associated with higher mean serum prostate-specific antigen levels, presence of perineural invasion, and greater volume of tumor in the biopsy specimen. None of these factors were observed to be associated with the presence of cancer in the ASTMs. In the multivariate analysis, only the presence of perineural invasion was a significant independent predictor of ASMs. The estimated 5-year BR rates in the positive ASMs only, ASTMs only, and both positive ASMs and ASTMs groups were 48.6%, 4.7%, and 38.8%, respectively. A positive ASM was associated with a significantly greater risk of BR compared with a positive ASTM. The very low estimated risk of BR at 5 years in cases with ASTM suggests that performing the ASTM biopsies may increase the cure rates achieved with RP. Copyright © 2011 Elsevier Inc. All rights reserved.

The impact of use of an intraoperative margin assessment device on re-excision rates.

PubMed

Sebastian, Molly; Akbari, Stephanie; Anglin, Beth; Lin, Erin H; Police, Alice M

2015-01-01

Historically there has been a high rate of surgical interventions to obtain clear margins for breast cancer patients undergoing breast conserving local therapy. An intraoperative margin assessment tool (MarginProbe) has been approved for use in the US since 2013. This study is the first compilation of data from routine use of the device, to assess the impact of device utilization on re-excision rates. We present a retrospective, observational, review from groups of consecutive patients, before and after the implementation of intraoperative use of the device during lumpectomy procedures. Lesions were localized by standard methods. The intraoperative margin assessment device was used on all circumferential margins of the main specimen, but not on any additional shavings. A positive reading by the device led to an additional shaving of the corresponding cavity location. Specimens were also, when feasible, imaged intra-operatively by X-ray, and additional shavings were taken if needed based on clinical assessment. For each surgeon, historical re-excision rates were established based on a consecutive set of patients from a time period proximal to initiation of use of the device. From March 2013 to April 2014 the device was routinely used by 4 surgeons in 3 centers. In total, 165 cases lumpectomy cases were performed. Positive margins resulted in additional re-excision procedures in 9.7% (16/165) of the cases. The corresponding historical set from 2012 and 2013 consisted of 186 Lumpectomy cases, in which additional re-excision procedures were performed in 25.8% (48/186) of the cases. The reduction in the rate of re-excision procedures was significant 62% (P < 0.0001). Use of an intraoperative margin assessment device contributes to achieving clear margins and reducing re-excision procedures. As in some cases positive margins were found on shavings, future studies of interest may include an analysis of the effect of using the device on the shavings intra-operatively.

Description and Phylogeny of Urostyla grandis wiackowskii subsp. nov. (Ciliophora, Hypotricha) from an Estuarine Mangrove in Brazil.

PubMed

Paiva, Thiago da Silva; Shao, Chen; Fernandes, Noemi Mendes; Borges, Bárbara do Nascimento; da Silva-Neto, Inácio Domingos

2016-01-01

Interphase specimens, aspects of physiological reorganization and divisional morphogenesis were investigated in a strain of a hypotrichous ciliate highly similar to Urostyla grandis Ehrenberg, (type species of Urostyla), collected from a mangrove area in the estuary of the Paraíba do Sul river (Rio de Janeiro, Brazil). The results revealed that albeit interphase specimens match with the known morphologic variability in U. grandis, morphogenetic processes have conspicuous differences. Parental adoral zone is entirely renewed during morphogenesis, and marginal cirri exhibit a unique combination of developmental modes, in which left marginal rows originate from multiple anlagen arising from innermost left marginal cirral row, whereas right marginal ciliature originates from individual within-row anlagen. Based on such characteristics, a new subspecies, namely U. grandis wiackowskii subsp. nov. is proposed, and consequently, U. grandis grandis Ehrenberg, stat. nov. is established. Bayesian and maximum-likelihood analyses of the 18S rDNA unambiguously placed U. grandis wiackowskii as adelphotaxon of a cluster formed by other U. grandis sequences. The implications of such findings to the systematics of Urostyla are discussed. © 2015 The Author(s) Journal of Eukaryotic Microbiology © 2015 International Society of Protistologists.

Robotic lateral oropharyngectomy following diagnostic tonsillectomy is oncologically safe in patients with high risk human papillomavirus related squamous cell cancer.

PubMed

Siddiq, Somiah; Cartlidge, David; Stephen, Sarah; Sathasivam, Hans P; Fox, Hannah; O'Hara, James; Meikle, David; Iqbal, Muhammad Shahid; Kelly, Charles G; Robinson, Max; Paleri, Vinidh

2018-05-12

Diagnostic tonsillectomy is rarely an oncologic operation owing to close or positive margins. The standard of care is for further treatment to the primary site, typically with adjuvant radiotherapy. 14 patients with close or positive margins following a diagnostic tonsillectomy underwent transoral robotic surgery (TORS) and lateral oropharyngectomy; five patients with the longest follow-up had their excision specimens examined with a step serial sectioning technique (SSS). Conventional histopathological examination of the TORS resection specimens did not demonstrate residual carcinoma in 13 patients, confirmed by examination using SSS in 5 patients. There were no post-operative complications or long-term functional deficit. Seven patients received surgery alone with 100% overall and disease specific survival, respectively (median follow-up 27.5 months; range 5.2-50.4). This prospective study suggests that TORS lateral oropharyngectomy alone is an oncologically safe treatment when close or positive margins are identified on diagnostic tonsillectomy in HPV-positive SCC.

Marginal Fit Comparison of CAD/CAM Crowns Milled from Two Different Materials.

PubMed

Azarbal, Atousa; Azarbal, Mohsen; Engelmeier, Robert L; Kunkel, Thomas C

2018-06-01

To evaluate the marginal fit of CAD/CAM copings milled from hybrid ceramic (Vita Enamic) blocks and lithium disilicate (IPS e.max CAD) blocks, and to evaluate the effect of crystallization firing on the marginal fit of lithium disilicate copings. A standardized metal die with a 1-mm-wide shoulder finish line was imaged using the CEREC AC Bluecam. The coping was designed using CEREC 3 software. The design was used to fabricate 15 lithium disilicate and 15 hybrid ceramic copings. Design and milling were accomplished by one operator. The copings were seated on the metal die using a pressure clamp with a uniform pressure of 5.5 lbs. A Macroview Microscope (14×) was used for direct viewing of the marginal gap. Four areas were imaged on each coping (buccal, distal, lingual, mesial). Image analysis software was used to measure the marginal gaps in μm at 15 randomly selected points on each of the four surfaces. A total of 60 measurements were made per specimen. For lithium disilicate copings the measurements for marginal gap were made before and after crystallization firing. Data were analyzed using paired t-test and Kruskal-Wallis test. The overall mean difference in marginal gap between the hybrid ceramic and crystallized lithium disilicate copings was statistically significant (p < 0.01). Greater mean marginal gaps were measured for crystallized lithium disilicate copings. The overall mean difference in marginal gap before and after firing (precrystallized and crystallized lithium disilicate copings) showed an average of 62 μm increase in marginal gap after firing. This difference was also significant (p < 0.01). A significant difference exists in the marginal gap discrepancy when comparing hybrid ceramic and lithium disilicate CAD/CAM crowns. Also crystallization firing can result in a significant increase in the marginal gap of lithium disilicate CAD/CAM crowns. © 2017 by the American College of Prosthodontists.

Updated evidence-based clinical practice guidelines for the diagnosis and management of melanoma: definitive excision margins for primary cutaneous melanoma.

PubMed

Sladden, Michael J; Nieweg, Omgo E; Howle, Julie; Coventry, Brendon J; Thompson, John F

2018-02-19

Definitive management of primary cutaneous melanoma consists of surgical excision of the melanoma with the aim of curing the patient. The melanoma is widely excised together with a safety margin of surrounding skin and subcutaneous tissue, after the diagnosis and Breslow thickness have been established by histological assessment of the initial excision biopsy specimen. Sentinel lymph node biopsy should be discussed for melanomas ≥ 1 mm thickness (≥ 0.8 mm if other high risk features) in which case lymphoscintigraphy must be performed before wider excision of the primary melanoma site. The 2008 evidence-based clinical practice guidelines for the management of melanoma (http://www.cancer.org.au/content/pdf/HealthProfessionals/ClinicalGuidelines/ClinicalPracticeGuidelines-ManagementofMelanoma.pdf) are currently being revised and updated in a staged process by a multidisciplinary working party established by Cancer Council Australia. The guidelines for definitive excision margins for primary melanomas have been revised as part of this process. Main recommendations: The recommendations for definitive wide local excision of primary cutaneous melanoma are: melanoma in situ: 5-10 mm margins invasive melanoma (pT1) ≤ 1.0 mm thick: 1 cm margins invasive melanoma (pT2) 1.01-2.00 mm thick: 1-2 cm margins invasive melanoma (pT3) 2.01-4.00 mm thick: 1-2 cm margins invasive melanoma (pT4) > 4.0 mm thick: 2 cm margins Changes in management as a result of the guideline: Based on currently available evidence, excision margins for invasive melanoma have been left unchanged compared with the 2008 guidelines. However, melanoma in situ should be excised with 5-10 mm margins, with the aim of achieving complete histological clearance. Minimum clearances from all margins should be assessed and stated. Consideration should be given to further excision if necessary; positive or close histological margins are unacceptable.

Preclinical evaluation of nuclear morphometry and tissue topology for breast carcinoma detection and margin assessment

PubMed Central

Nyirenda, Ndeke; Farkas, Daniel L.

2010-01-01

Prevention and early detection of breast cancer are the major prophylactic measures taken to reduce the breast cancer related mortality and morbidity. Clinical management of breast cancer largely relies on the efficacy of the breast-conserving surgeries and the subsequent radiation therapy. A key problem that limits the success of these surgeries is the lack of accurate, real-time knowledge about the positive tumor margins in the surgically excised tumors in the operating room. This leads to tumor recurrence and, hence, the need for repeated surgeries. Current intraoperative techniques such as frozen section pathology or touch imprint cytology severely suffer from poor sampling and non-optimal detection sensitivity. Even though histopathology analysis can provide information on positive tumor margins post-operatively (~2–3 days), this information is of no immediate utility in the operating rooms. In this article, we propose a novel image analysis method for tumor margin assessment based on nuclear morphometry and tissue topology and demonstrate its high sensitivity/specificity in preclinical animal model of breast carcinoma. The method relies on imaging nuclear-specific fluorescence in the excised surgical specimen and on extracting nuclear morphometric parameters (size, number, and area fraction) from the spatial distribution of the observed fluorescence in the tissue. We also report the utility of tissue topology in tumor margin assessment by measuring the fractal dimension in the same set of images. By a systematic analysis of multiple breast tissues specimens, we show here that the proposed method is not only accurate (~97% sensitivity and 96% specificity) in thin sections, but also in three-dimensional (3D) thick tissues that mimic the realistic lumpectomy specimens. Our data clearly precludes the utility of nuclear size as a reliable diagnostic criterion for tumor margin assessment. On the other hand, nuclear area fraction addresses this issue very effectively since it is a combination of both nuclear size and count in any given region of the analyzed image, and thus yields high sensitivity and specificity (~97%) in tumor detection. This is further substantiated by an independent parameter, fractal dimension, based on the tissue topology. Although the basic definition of cancer as an uncontrolled cell growth entails a high nuclear density in tumor regions, a simple but systematic exploration of nuclear distribution in thick tissues by nuclear morphometry and tissue topology as performed in this study has never been carried out, to the best of our knowledge. We discuss the practical aspects of implementing this imaging approach in automated tissue sampling scenario where the accuracy of tumor margin assessment can be significantly increased by scanning the entire surgical specimen rather than sampling only a few sections as in current histopathology analysis. PMID:20446030

Corrosion behavior and microhardness of three amalgams.

PubMed

Patsurakos, A; Moberg, L E

1988-08-01

The marginal microhardness of three different types of amalgam was tested after 2 months' immersion in an aqueous solution of NaCl (85 mM) and phosphates (Na2HPO4 100 mM and NaH2PO4 100 mM). Amalgams immersed in distilled water were used as controls. The microhardness tests were conducted at a distance of 50 micron from the margins and at the bulk of each specimen. The solutions were analyzed for Sn, Cu, Zn, Ag, and Hg by means of atomic absorption spectrophotometry (AAS). A statistically significant reduction in the marginal microhardness after immersion in the test solution was found for the conventional and the high-Cu single composition amalgam but not for the high-Cu blended amalgam. SEM-examination of cross-sections of the amalgams revealed small areas of subsurface grain boundary corrosion, no deeper than 10 micron for all the amalgams. The SEM-examination of the specimens and AAS analysis of the solutions indicated that the reduction in marginal microhardness was attributed mainly to corrosion of the Cu-rich phases for the high-Cu single composition amalgam and to corrosion of the gamma 2 phase for the conventional amalgam. The phosphates reduced the corrosion of the amalgams in the presence of NaCl. It is concluded that the marginal strength of dental amalgams in a corrosive environment is largely dependent upon their corrosion resistance.

Margins in breast conserving surgery: The financial cost & potential savings associated with the new margin guidelines.

PubMed

Singer, Lauren; Brown, Eric; Lanni, Thomas

2016-08-01

In this study, we compare the indications for re-excision, the findings of additional tumor in the re-excision specimen as they relate to margin status, and costs associated with re-excision based on recent new consensus statements. A retrospective analysis was performed on 462 patients with invasive breast carcinoma who underwent at least one lumpectomy between January 2011 and December 2013. Postoperative data was analyzed based on where additional disease was found, as it relates to the margin status of the initial lumpectomy and the additional direct costs associated with additional procedures. Of the 462 patients sampled, 149 underwent a re-excision surgery (32.2%). Four patients underwent mastectomy as their second operation. In the 40 patients with additional disease found on re-excision, 36 (90.0%) of them had a positive margin on their initial lumpectomy. None of the four mastectomy patients had residual disease. The mean cost of the initial lumpectomy for all 462 patients was $2118.01 plus an additional $1801.92 for those who underwent re-excision. A positive margin was most predictive of finding residual tumor on re-excision as would be expected. Using old criteria only 0.07% (4/61) of patients who had undergone re-excision with a 'clear' margin, had additional tumor found, at a total cost of $106,354.11. Thus, the new consensus guidelines will lead to less overall cost, at no clinical risk to patients while reducing a patient's surgical risk and essentially eliminating delays in adjuvant care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Histopathological Validation of the Surface-Intermediate-Base Margin Score for Standardized Reporting of Resection Technique during Nephron Sparing Surgery.

PubMed

Minervini, Andrea; Campi, Riccardo; Kutikov, Alexander; Montagnani, Ilaria; Sessa, Francesco; Serni, Sergio; Raspollini, Maria Rosaria; Carini, Marco

2015-10-01

The surface-intermediate-base margin score is a novel standardized reporting system of resection techniques during nephron sparing surgery. We validated the surgeon assessed surface-intermediate-base score with microscopic histopathological assessment of partial nephrectomy specimens. Between June and August 2014 data were prospectively collected from 40 consecutive patients undergoing nephron sparing surgery. The surface-intermediate-base score was assigned to all cases. The score specific areas were color coded with tissue margin ink and sectioned for histological evaluation of healthy renal margin thickness. Maximum, minimum and mean thickness of healthy renal margin for each score specific area grade (surface [S] = 0, S = 1 ; intermediate [I] or base [B] = 0, I or B = 1, I or B = 2) was reported. The Mann-Whitney U and Kruskal-Wallis tests were used to compare the thickness of healthy renal margin in S = 0 vs 1 and I or B = 0 vs 1 vs 2 grades, respectively. Maximum, minimum and mean thickness of healthy renal margin was significantly different among score specific area grades S = 0 vs 1, and I or B = 0 vs 1, 0 vs 2 and 1 vs 2 (p <0.001). The main limitations of the study are the low number of the I or B = 1 and I or B = 2 samples and the assumption that each microscopic slide reflects the entire score specific area for histological analysis. The surface-intermediate-base scoring method can be readily harnessed in real-world clinical practice and accurately mirrors histopathological analysis for quantification and reporting of healthy renal margin thickness removed during tumor excision. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Harnessing the Power of Light to See and Treat Breast Cancer

DTIC Science & Technology

2014-10-01

effect of novel therapeutic agents in vivo. 15. SUBJECT TERMS optical spectroscopy, imaging , fiber-optic, molecular, screening, breast cancer 16...therapeutic agents in vivo. a. Original Statement of Work for 5 Years Aim 1: Optical imaging of margin morphology on breast lumpectomy specimens: To...evaluate the role of wide-field imaging (coverage) and high-resolution interrogation (localization) of breast margin morphology to guide surgical

Quantification of Collagen Ultrastructure after Penetrating Keratoplasty – Implications for Corneal Biomechanics

PubMed Central

Gardner, Steven J.; Kamma-Lorger, Christina S.; Hayes, Sally; Nielsen, Kim; Hjortdal, Jesper; Sorensen, Thomas; Terrill, Nicholas J.; Meek, Keith M.

2013-01-01

Purpose To quantify long-term changes in stromal collagen ultrastructure following penetrating keratoplasty (PK), and evaluate their possible implications for corneal biomechanics. Methods A pair of 16 mm post-mortem corneo-scleral buttons was obtained from a patient receiving bilateral penetrating keratoplasty 12 (left)/28 (right) years previously. Small-angle x-ray scattering quantified collagen fibril spacing, diameter and spatial order at 0.5 mm or 0.25 mm intervals along linear scans across the graft margin. Corresponding control data was collected from two corneo-scleral buttons with no history of refractive surgery. Wide-angle x-ray scattering quantified collagen fibril orientation at 0.25 mm (horizontal)×0.25 mm (vertical) intervals across both PK specimens. Quantification of orientation changes in the graft margin were verified by equivalent analysis of data from a 13 year post-operative right PK specimen obtained from a second patient in a previous study, and comparison made with new and published data from normal corneas. Results Marked changes to normal fibril alignment, in favour of tangentially oriented collagen, were observed around the entire graft margin in all PK specimens. The total number of meridional fibrils in the wound margin was observed to decrease by up to 40%, with the number of tangentially oriented fibrils increasing by up to 46%. As a result, in some locations the number of fibrils aligned parallel to the wound outnumbered those spanning it by up to five times. Localised increases in fibril spacing and diameter, with an accompanying reduction in matrix order, were also evident. Conclusions Abnormal collagen fibril size and spatial order within the PK graft margin are indicative of incomplete stromal wound remodelling and the long term persistence of fibrotic scar tissue. Lasting changes in collagen fibril orientation in and around PK wounds may alter corneal biomechanics and compromise the integrity of the graft-host interface in the long term. PMID:23861866

A microcomputed tomography evaluation of the marginal fit of cobalt-chromium alloy copings fabricated by new manufacturing techniques and alloy systems.

PubMed

Kim, Eun-Ha; Lee, Du-Hyeong; Kwon, Sung-Min; Kwon, Tae-Yub

2017-03-01

Although new digital manufacturing techniques are attracting interest in dentistry, few studies have comprehensively investigated the marginal fit of fixed dental prostheses fabricated with such techniques. The purpose of this in vitro microcomputed tomography (μCT) study was to evaluate the marginal fit of cobalt-chromium (Co-Cr) alloy copings fabricated by casting and 3 different computer-aided design and computer-aided manufacturing (CAD-CAM)-based processing techniques and alloy systems. Single Co-Cr metal crowns were fabricated using 4 different manufacturing techniques: casting (control), milling, selective laser melting, and milling/sintering. Two different commercial alloy systems were used for each fabrication technique (a total of 8 groups; n=10 for each group). The marginal discrepancy and absolute marginal discrepancy of the crowns were determined with μCT. For each specimen, the values were determined from 4 different regions (sagittal buccal, sagittal lingual, coronal mesial, and coronal distal) by using imaging software and recorded as the average of the 4 readings. For each parameter, the results were statistically compared with 2-way analysis of variance and appropriate post hoc analysis (using Tukey or Student t test) (α=.05). The milling and selective laser melting groups showed significantly larger marginal discrepancies than the control groups (70.4 ±12.0 and 65.3 ±10.1 μm, respectively; P<.001), whereas the milling/sintering groups exhibited significantly smaller values than the controls (P=.004). The milling groups showed significantly larger absolute marginal discrepancy than the control groups (137.4 ±29.0 and 139.2 ±18.9 μm, respectively; P<.05). In the selective laser melting and milling/sintering groups, the absolute marginal discrepancy values were material-specific (P<.05). Nonetheless, the milling/sintering groups yielded statistically comparable (P=.935) or smaller (P<.001) absolute marginal discrepancies to the control groups. The findings of this in vitro μCT study showed that the marginal fit values of the Co-Cr alloy greatly depended on the fabrication methods and, occasionally, the alloy systems. Fixed dental prostheses produced by using the milling/sintering technique can be considered clinically acceptable in terms of marginal fit. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The influence of FRCs reinforcement on marginal adaptation of CAD/CAM composite resin endocrowns after simulated fatigue loading.

PubMed

Rocca, Giovanni Tommaso; Saratti, Carlo Massimo; Poncet, Antoine; Feilzer, Albert J; Krejci, Ivo

2016-05-01

To evaluate the marginal adaptation of endodontically treated molars restored with CAD/CAM composite resin endocrowns either with or without reinforcement by fibre reinforced composites (FRCs), used in different configurations. 32 human endodontically treated molars were cut 2 mm over the CEJ. Two interproximal boxes were created with the margins located 1 mm below the CEJ (distal box) and 1 mm over the CEJ (mesial box). All specimens were divided in four groups (n = 8). The pulp chamber was filled with: group 1 (control), hybrid resin composite (G-aenial Posterior, GC); group 2, as group 1 but covered by 3 meshes of E-glass fibres (EverStick NET, Stick Tech); group 3, FRC resin (EverX Posterior, GC); group 4, as group 3 but covered by 3 meshes of E-glass fibres. The crowns of all teeth were restored with CAD/CAM composite resin endocrowns (LAVA Ultimate, 3M). All specimens were thermo-mechanically loaded in a computer-controlled chewing machine (600,000 cycles, 1.6 Hz, 49 N and simultaneously 1500 thermo-cycles, 60 s, 5-55 °C). Marginal analysis before and after the loading was carried out on epoxy replicas by SEM at 200× magnification. For all the groups, the percentage values of perfect marginal adaptation after loading were always significantly lower than before loading (p < 0.05). The marginal adaptation before and after loading was not significantly different between the experimental groups (p > 0.05). Within the limitations of this in vitro study, the use of FRCs to reinforce the pulp chamber of devitalized molars restored with CAD/CAM composite resin restorations did not significantly influenced their marginal quality.

Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer: Long-term oncologic outcome between mesocolic and non-mesocolic planes of surgery.

PubMed

Siani, L M; Pulica, C

2015-12-01

To analyze our experience in translating the concept of total mesorectal excision to "no-touch" complete removal of an intact mesocolonic envelope (complete mesocolic excision), along with central vascular ligation and apical node dissection, in the surgical treatment of right-sided colonic cancers, comparing "mesocolic" to less radical "non-mesocolic" planes of surgery in respect to quality of the surgical specimen and long-term oncologic outcome. A total of 115 patients with right-sided colonic cancers were retrospectively enrolled from 2008 to 2013 and operated on following the intent of minimally invasive complete mesocolic excision with central vascular ligation. Morbidity and mortality were 22.6% and 1.7%, respectively. Mesocolic, intramesocolic, and muscularis propria planes of resection were achieved in 65.2%, 21.7%, and 13% of cases, respectively, with significant impact for mesenteric plane of surgery on R0 resection rate (97.3%), circumferential resection margin <1 mm (2.6%), and consequent survival advantage (82.6% at 5 years) when compared to muscularis propria plane of surgery, with R0 resection rate and overall survival falling to 72% and 60%, respectively, and with circumferential resection margin <1 mm raising to 33.3%, all being statistically significant. Stratifying patients for stage of disease, laparoscopic complete mesocolic excision with central vascular ligation significantly impacted survival in patients with stage II, IIIA/B, and in a subgroup of IIIC patients with negative apical nodes. In our experience, minimally invasive complete mesocolic excision with central vascular ligation allows for both safety and higher quality of surgical specimens when compared to less radical intramesocolic or muscularis propria planes of "standard" surgery, significantly impacting loco-regional control and thus overall survival. © The Finnish Surgical Society 2014.

Assessment of margins in resection specimens for head and neck malignancies.

PubMed

Janjua, Omer Sefvan; Ahmed, Waseem; Qureshi, Sana Mehmood; Khan, Tariq Sarfaraz; Ahmed, Ashfaq; Alamgir, Wajiha

2013-04-01

To determine the relative frequency of clear, close and involved margins in resection specimens for head and neck malignancies. An observational study. The Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi and the Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from January 2008 to December 2010. Tumour registers and computer data bases in the department of Histopathology of Armed Forces Institute of Pathology, Rawalpindi, were analyzed for the cases of malignancies involving head and neck region that were sent for histopathological analysis after resection in the last three years. Histopathology reports were obtained. The data regarding age, gender, site, type of malignancy and margin status (clear, close or involved) was recorded on specially designed proformas for the study and later on analyzed by using SPSS version 17.0. Results were expressed. A total of 319 cases were registered in the study duration. The age of the patients ranged from 22-90 years (mean 59.5 + 14.1 years). Male to female ratio was 1.53:1. One hundred and thirty six (42.6%) were squamous cell carcinoma (SCC), 163 were basal cell carcinomas (BCC, 51.0%); the rest included 18 salivary gland malignancies (5.7%) and one carcino-sarcoma (0.31%) and chondrosarcoma each. All margins were found clear in 137 patients (42.9%); involved in 168 cases (52.7%) and close in 14 cases (4.4%). Margin clearance could not be achieved in more than 50% cases, this can lead to poor prognosis. Hence, methods should be adopted to improve the margin clearance in various head and neck malignancies.

Risk factors for positive resection margins of breast cancer tumorectomy specimen following breast-conserving surgery.

PubMed

Heiss, Niko; Rousson, Valentin; Ifticene-Treboux, Assia; Lehr, Hans-Anton; Delaloye, Jean-François

2017-12-09

Background The aim of the study was to identify risk factors for positive surgical margins in breast-conserving surgery for breast cancer and to evaluate the influence of surgical experience in obtaining complete resection. Methods All lumpectomies for invasive breast carcinoma and ductal carcinoma in situ (DCIS) between April 2008 and March 2010 were selected from the database of a single institution. Re-excision rates for positive margins as well as patient and histopathologic tumor characteristics were analyzed. Surgical experience was staged by pairs made of Resident plus Specialist or Consultant. Two periods were defined. During period A, the majority of operations were performed by Residents under supervision of Specialist or Consultant. During period B, only palpable tumors were operated by Residents. Results The global re-excision rate was 27% (50 of 183 patients). The presence of DCIS increased the risk for positive margins: 60% (nine of 15 patients) in the case of sole DCIS compared to 26% (41 of 160 patients) for invasive cancer (p = 0.005) and 35% (42 of 120 patients) in the case of peritumoral DCIS compared to 11% (seven of 62 patients) in the case of sole invasive cancer (p = 0.001). Re-excision rate decreased from 36% (23 of 64 patients) during period A to 23% (27 of 119 patients) during period B (p = 0.055). There was no significant difference between the surgical pairs. Conclusion In our study, DCIS was the only risk factor for positive surgical margins. Breast-conserving surgery for non-palpable tumors should be performed by Specialists, however, palpable tumors can be safely operated by Residents under supervision.

Magnetic resonance imaging-guided navigation with a thermoplastic shell for breast-conserving surgery.

PubMed

Abe, M; Kiryu, T; Sonoda, K; Kashiki, Y

2011-11-01

The aim of this study was to evaluate the accuracy of a magnetic resonance imaging (MRI) marking technique with a drape-type thermoplastic shell for planning breast-conserving surgery (BCS). A prospective review was performed on 35 consecutive patients who underwent MRI in the supine position and used the specified MRI marking technique. Eleven cases underwent pre-operative chemotherapy and 24 cases did not. After immobilizing the breast mound with a drape-type thermoplastic shell, patients underwent MRI, and the location of the lesion was marked on the shell. Resection lines were dyed blue by indigo carmine, which was pushed through the pores of the shell. Specimens obtained during BCS were sliced into 5-mm contiguous sections, and the margin was assessed for each specimen. Cancer foci less than 5 mm from the margin were classified as positive. Of 35 patients, 33 were included in the analysis; 2 were excluded due to a lack of effect of pre-operative chemotherapy. Of these 33 patients, 25 (75.8%) had negative margins and 7 (21.2%) had positive margins. Our MRI marking technique may be useful for evaluating the extent of tumors that were determined by MRI alone. Long-term outcomes of this technique should be evaluated further. Copyright © 2011 Elsevier Ltd. All rights reserved.

The relation between knee flexion angle and anterior cruciate ligament femoral tunnel characteristics: a cadaveric study comparing a standard and a far anteromedial portal.

PubMed

Alavekios, Damon; Peterson, Alexander; Patton, John; McGarry, Michelle H; Lee, Thay Q

2014-11-01

The purpose of this study was to compare the anterior cruciate ligament (ACL) femoral tunnel characteristics between 2 common arthroscopic portals used for ACL reconstruction, a standard anteromedial portal and a far anteromedial portal. Seven cadaveric knees were used. A 1.25-mm Kirschner wire was drilled through the center of the ACL femoral footprint and through the distal femur from the standard anteromedial and far anteromedial portals at knee flexion angles of 100°, 120°, and 140°. No formal tunnels were drilled. Each tunnel exit point was marked with a colored pin. After all tunnels were created, the specimens were digitized with a MicroScribe device (Revware, Raleigh, NC) to measure the tunnel length; distance to the posterior femoral cortical wall (posterior cortical margin); and tunnel orientation in the sagittal, coronal, and axial planes. The standard anteromedial portal resulted in a longer tunnel length, a less horizontal tunnel in the coronal plane, and a greater posterior cortical margin compared with the far anteromedial portal at all knee flexion angles. For both portal locations, the tunnel length and posterior cortical margin increased, and the tunnel position became more horizontal in the coronal plane, more anterior in the sagittal plane, and less horizontal in the transverse plane as knee flexion increased. Portal position affects femoral tunnel characteristics, with results favoring the more laterally positioned standard anteromedial portal at all flexion angles. Increasing the knee flexion angle leads to a longer femoral tunnel length and posterior femoral cortical margin with either portal position. Understanding how portal positioning and knee flexion angle affect femoral tunnel orientation and characteristics may lead to improved surgical outcomes after ACL reconstruction. Published by Elsevier Inc.

Marginal discrepancy dimensions of single unit metal crowns fabricated by using CAD-CAM-milled acrylate resin polymer blocks or a conventional waxing technique.

PubMed

Lalande, David; Hodd, Jeffrey A; Brousseau, John S; Ramos, Van; Dunham, Daniel; Rueggeberg, Frederick

2017-10-14

Because crowns with open margins are a well-known problem and can lead to complications, it is important to assess the accuracy of margins resulting from the use of a new technique. Currently, data regarding the marginal fit of computer-aided design and computer-aided manufacturing (CAD-CAM) technology to fabricate a complete gold crown (CGC) from a castable acrylate resin polymer block are lacking. The purpose of this in vitro study was to compare marginal discrepancy widths of CGCs fabricated by using either conventional hand waxing or acrylate resin polymer blocks generated by using CAD-CAM technology. A plastic model of a first mandibular molar was prepared by using a 1-mm, rounded chamfer margin on the entire circumference of the tooth. The master die was duplicated 30 times, and 15 wax patterns were fabricated by using a manual waxing technique, and 15 were fabricated by using CAD-CAM technology. All patterns were invested and cast, and resulting CGCs were cemented on their respective die by using resin-modified glass ionomer cement. The specimens were then embedded in acrylic resin and sectioned buccolingually. The buccal and lingual marginal discrepancies of each sectioned portion were measured by using microscopy at ×50 magnification. Data were subjected to repeated measures 2-way ANOVA, by using the Tukey post hoc pairwise comparison test (α=.05). The factor of "technique" had no significant influence on marginal discrepancy measurement (P=.431), but a significant effect of "margin location" (P=.019) was noted. The confounding combination of factors was found to be significantly lower marginal discrepancy dimensions of the lingual margin discrepancy than on the buccal side by using CAD-CAM technology. The marginal discrepancy of CAD-CAM acrylate resin crowns was not significantly different from those made with a conventional manual method; however, lingual margin discrepancies present from CAD-CAM-prepared crowns were significantly less than those measured on the respective buccal surface. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Experimental evaluation of outer planets probe thermal insulation concepts

NASA Technical Reports Server (NTRS)

Grote, M. G.; Mezines, S. A.

1976-01-01

An experimental program was conducted to evaluate various thermal insulation concepts for use in the Outer Planets Probe (OPP) during entry and descent into the atmospheres of Jupiter, Saturn, and Uranus. Phenolic fiberglass honeycomb specimens representative of the OPP structure were packed and tested with various fillers: Thermal conductivity measurements were made over a temperature range of 300 K to 483 K and pressures from vacuum up to 10 atmospheres in helium and nitrogen gas environments. The conductivity results could not be fully explained so new test specimens were designed with improved venting characteristics, and tested to determine the validity of the original data. All of the conductivity data showed results that were substantially higher than expected. The original test data in helium were lower than the data from the redesigned specimens, probably due to inadequate venting of nitrogen gas from the original specimens. The thermal conductivity test results show only a marginal improvement in probe thermal protection performance for a filled honeycomb core compared to an unfilled core. In addition, flatwise tension tests showed a severe bond strength degradation due to the inclusion of either the powder or foam fillers. In view of these results, it is recommended that the baseline OPP design utilize an unfilled core.

Determination of safe margin in the surgical pathologic specimens of non-small cell carcinoma of the lung.

PubMed

Feizi, Iraj; Sokouti, Mohsen; Golzari, Samad E J; Gojazede, Morteza; Farahnak, Mohammad Reza; Hashemzadeh, Shahriar; Rahimi-Rad, Mohammad Hossein

2013-01-01

Local recurrences of the tumor at the surgical margin are serious problems in pulmonary resections for lung cancer. The aim of this study is to determine the involved margins and safe distances of the resection sites from tumor for prevention of local recurrences. In this prospective study, 66 patients operated for non-small cell lung carcinoma (NSCLC) from Jan 2006 to Sep 2008 were evaluated. After performing pulmonary resections, multiple biopsies were taken up from 5 mm (A), 10 mm (B), 15 mm (C), and 20 mm (D) distance from tumor. The specimens were studied histopathologically. From a total of66 patients with NSCLC admitted to our referral hospital, 25 (38%) had adenocarcinoma, 18 (27.3%) squamous cell carcinoma, 5 (7.5%) large cell carcinoma, 4 (6%) bronchoalveolar cell carcinoma, 4 (6%) adenoid cystic carcinoma, 3 (4.6%) malignant carcinoid tumor and 7 (10.6%) had metastasis. The most common symptoms were dyspnea and cough. Histopathologically tumor positive margins were found in 84.8% (A), 10.6% (B), 4.5% (C), and 0% (D). There was a significant statistically difference between tumor involvement at distances 5 mm (A) versus 10-20 mm (B-D) (P <0.001). A 20 mm distance from the gross tumor is considered as a safe surgical margin in any type of malignant pulmonary resections for prevention of local surgical recurrences if there was no pathologic examination before surgery.

Early development of the circumferential axonal pathway in mouse and chick spinal cord.

PubMed

Holley, J A

1982-03-10

The early development of the circumferential axonal pathway in the brachial and lumbar spinal cord of mouse and chick embryos was studied by scanning and transmission electron microscopy. The cellular processes which comprise this pathway grow in the transverse plane and along the lateral margin of the marginal zone (i.e., circumferentially oriented), as typified by the early embryonic commissural axons. The first formative event observed was in the ventrolateral margin of the primitive spinal cord ventricular zone. Cellular processes were found near the external limiting membrane that appeared to grow a variable distance either dorsally or ventrally. Later in development, presumptive motor column neurons migrated into the ventrolateral region, distal to these early circumferentially oriented processes. Concurrently, other circumferentially oriented perikarya and processes appeared along the dorsolateral margin. Due to their aligned sites of origin and parallel growth, the circumferential processes formed a more or less continuous line or pathway, which in about 10% of the scanned specimens could be followed along the entire lateral margin of the embryonic spinal cord. Several specimens later in development had two sets of aligned circumferential processes in the ventral region. Large numbers of circumferential axons were then found to follow the preformed pathway by fasciculation, after the primitive motor column had become established. Since the earliest circumferential processes appeared to differentiate into axons and were found nearly 24 hours prior to growth of most circumferential axons, their role in guidance as pioneering axons was suggested.

Decision-making in the colposcopy clinic--a critical analysis.

PubMed

Bornstein, J; Yaakov, Z; Pascal, B; Faktor, J; Baram, A; Zarfati, D; Abramovici, H

1999-08-01

To consider the omission of several diagnostic steps from the management of patients with high-grade squamous intraepithelial lesion (SIL) by analyzing the role of each step on the choice of treatment. Each diagnostic procedure was correlated to the treatment and outcome in 87 women with high-grade SIL. Treatments considered were large loop excision of the transformation zone (LLETZ) cold knife conization, and CO2 laser vaporization. Unsatisfactory colposcopy (P< or =0.01) and positive endocervical curettage (ECC) specimen (P< or =0.01) were essential for choice of treatment. CIN2 diagnoses of the preoperative cervical biopsy were rediagnosed as CIN3 based on the surgical specimen in 57% of the cases. The margins of 33 and 23% of surgical specimens removed by LLETZ or knife conization, respectively, displayed CIN involvement. Forty and 47% of these patients, respectively, later developed recurrent CIN. Omission of colposcopy and ECC could have resulted in sub-optimal treatment in many cases. Excision by LLETZ or knife conization is recommended for cases of CIN2 and CIN3. Follow up is imperative for patients with involvement of the margins.

A novel approach emphasising intra-operative superficial margin enhancement of head-neck tumours with narrow-band imaging in transoral robotic surgery.

PubMed

Vicini, C; Montevecchi, F; D'Agostino, G; DE Vito, A; Meccariello, G

2015-06-01

The primary goal of surgical oncology is to obtain a tumour resection with disease-free margins. Transoral robotic surgery (TORS) for surgical treatment of head-neck cancer is commensurate with standard treatments. However, the likelihood of positive margins after TORS is up to 20.2% in a recent US survey. The aim of this study is to evaluate the efficacy and the feasibility of narrow-band imaging (NBI) during TORS in order to improve the ability to achieve disease-free margins during tumour excision. The present study was conducted at the ENT, Head- Neck Surgery and Oral Surgery Unit, Department of Special Surgery, Morgagni Pierantoni Hospital, Azienda USL Romagna. From March 2008 to January 2015, 333 TORS were carried out for malignant and benign diseases. For the present study, we retrospectively evaluated 58 biopsy-proven squamous cell carcinoma patients who underwent TORS procedures. Patients were divided into 2 groups: (1) 32 who underwent TORS and intra-operative NBI evaluation (NBI-TORS); (2) 21 who underwent TORS with standard intra-operative white-light imaging (WLITORS). Frozen section analysis of margins on surgical specimens showed a higher rate of negative superficial lateral margins in the NBI-TORS group compared with the WLI-TORS group (87.9% vs. 57.9%, respectively, p = 0.02). The sensitivity and specificity of intra-operative use of NBI, respectively, were 72.5% and 66.7% with a negative predictive value of 87.9%. Tumour margin enhancement provided by NBI associated with magnification and 3-dimensional view of the surgical field might increase the capability to achieve an oncologically-safe resection in challenging anatomical areas where minimal curative resection is strongly recommended for function preservation.

Microleakage of class V resin composite restorations after bur, air-abrasion or Er:YAG laser preparation.

PubMed

Corona, S A; Borsatto, M; Dibb, R G; Ramos, R P; Brugnera, A; Pécora, J D

2001-01-01

This in vitro study compared the microleakage of Class V resin composite restorations placed in cavities prepared with a high-speed dental bur, air-abrasion or Er:YAG laser. Twenty sound extracted human third molars were selected and randomly assigned to four equal Groups (n=10): Group I, cavities were cut by dental drill at high-speed; Group II, aluminum oxide air-abrasion was used for cavity preparation, and in Groups III and IV, cavities were prepared by Er:YAG laser. Following cavity preparation, Groups I and II were acid-etched, Group III was treated only by Er:YAG laser and Group IV was conditioned by Er:YAG laser followed by acid-etching. Cavities were restored (Single Bond + Z-100) and the teeth stored for seven days in distilled water. Then, the restorations were polished and the specimens thermocycled, immersed in a 0.2% Rhodamine solution, sectioned and analyzed for leakage at the occlusal (enamel) and cervical (dentin/cementum) interfaces using an optical microscope connected to a video camera. The images were digitized and software was utilized for microleakage assessment. Upon analyzing the results, statistically significant differences (p<0.01) between the occlusal and cervical regions for all groups was observed, and, as a rule, there was better marginal sealing at the enamel margins. The highest degree of infiltration was observed for cavities prepared and treated exclusively by Er:YAG (Group III). The other experimental groups showed statistical similarities in the amount of marginal leakage at the enamel margins. However, at the cervical margins, there was a significant difference (p<0.05) between Group I and the remaining groups. None of the techniques completely eliminated marginal microleakage at the dentin/ cementum margins.

In vitro evaluation of reverse torque value of abutment screw and marginal opening in a screw- and cement-retained implant fixed partial denture design.

PubMed

Kim, Seok-Gyu; Park, Jae-Uk; Jeong, Jae-Heon; Bae, Chang; Bae, Tae-Soo; Chee, Winston

2009-01-01

The purpose of this study was to evaluate the clinical efficacy of implant prostheses retained by screws and cement (SCPs) by examining the reverse torque values (RTVs) of the abutment screws and the marginal openings of the implant prostheses. Two implants (3.8 x 13 mm; Camlog Biotechnologies) were embedded in an acrylic resin block 5 mm apart. Eighteen copies of this resin specimen were fabricated and randomly divided into two groups. Two-unit implant prostheses with two different designs-purely cement-retained implant prostheses (group 1) and SCPs (group 2)-were made out of type IV gold alloy and placed on the implants. After tightening to about 30 Ncm, the preloading RTVs of the abutment screws were measured. After retightening the abutment screws or cementing the prostheses, followed by cyclic loading, the postloading RTVs of the abutment screws were examined. Also, the marginal openings of the prostheses in the two groups were measured under a stereomicroscope. These measurements were compared statistically. The postloading RTVs and their differences from the preloading RTVs of the abutment screws demonstrated no significant differences between groups (P > .05). Group 2 prostheses showed significantly smaller marginal openings than group 1 prostheses (P < .05). The forces generated when torquing the abutment screw of the SCP did not cause more loosening of the abutment screws than the purely cement-retained implant prosthesis. The SCP showed better marginal adaptation of the cement-retained part than the purely cement-retained implant prosthesis, possibly as a result of the screw-retained abutment seating the restoration. Within the limitations of this in vitro test, the SCP showed no significant difference in RTV of the abutment screw and a smaller marginal gap compared to a purely cement-retained implant prosthesis.

Magnetic resonance imaging (MRI)-based indication for neoadjuvant treatment of rectal carcinoma and the surrogate endpoint CRM status.

PubMed

Strassburg, Joachim; Junginger, Theo; Trinh, Trong; Püttcher, Olaf; Oberholzer, Katja; Heald, Richard J; Hermanek, Paul

2008-11-01

Is it possible to reduce the frequency of neoadjuvant therapy for rectal carcinoma and nevertheless achieve a rate of more than 90% circumferential resection margin (CRM)-negative resection specimens by a novel concept of magnetic resonance imaging (MRI)-based therapy planning? One hundred eighty-one patients from Berlin and Mainz, Germany, with primary rectal carcinoma, without distant metastasis, underwent radical surgery with curative intention. Surgical procedures applied were anterior resection with total mesorectal excision (TME) or partial mesorectal excision (PME; PME for tumours of the upper rectum) or abdominoperineal excision with TME. With MRI selection of the highest-risk cases, neoadjuvant therapy was given to only 62 of 181 (34.3%). The rate of CRM-negative resection specimens on histology was 170 of 181 (93.9%) for all patients, and in Berlin, only 1 of 93 (1%) specimens was CRM-positive. Patients selected for primary surgery had CRM-negative specimens on histology in 114 of 119 (95.8%). Those selected for neoadjuvant therapy had a lower rate of clear margin: 56 of 62 (90%). By applying a MRI-based indication, the frequency of neoadjuvant treatment with its acute and late adverse effects can be reduced to 30-35% without reduction of pathologically CRM-negative resection specimens and, thus, without the danger of worsening the oncological long-term results. This concept should be confirmed in prospective multicentre observation studies with quality assurance of MRI, surgery and pathology.

Structured pathology reporting improves the macroscopic assessment of rectal tumour resection specimens.

PubMed

King, Simon; Dimech, Margaret; Johnstone, Susan

2016-06-01

We examined whether introduction of a structured macroscopic reporting template for rectal tumour resection specimens improved the completeness and efficiency in collecting key macroscopic data elements. Fifty free text (narrative) macroscopic reports retrieved from 2012 to 2014 were compared with 50 structured macroscopic reports from 2013 to 2015, all of which were generated at John Hunter Hospital, Newcastle, NSW. The six standard macroscopic data elements examined in this study were reported in all 50 anatomical pathology reports using a structured macroscopic reporting dictation template. Free text reports demonstrated significantly impaired data collection when recording intactness of mesorectum (p<0.001), relationship to anterior peritoneal reflection (p=0.028) and distance of tumour to the non-peritonealised circumferential margin (p<0.001). The number of words used was also significantly (p<0.001) reduced using pre-formatted structured reports compared to free text reports. The introduction of a structured reporting dictation template improves data collection and may reduce the subsequent administrative burden when macroscopically evaluating rectal resections. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

Harnessing the Power of Light to See and Treat Breast Cancer

DTIC Science & Technology

2012-10-01

informed approach to study tumor biology and assay the effect of novel therapeutic agents in vivo. 15. SUBJECT TERMS optical spectroscopy, imaging , fiber...Statement of Work for 5 Years Aim 1: Optical imaging of margin morphology on breast lumpectomy specimens: To evaluate the role of wide-field imaging ...assessment of the tumor margin post-operatively (Timeframe: year 1-5). 1a. Development of one optical spectral imaging system that integrates sensing

Warm prestress effects in fracture-margin assessment of PWR-RPVs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shum, D.K.M.

This paper examines various issues that would impact the incorporation of warm prestress (WPS) effects in the fracture-margin assessment of reactor pressure vessels (RPVs). By way of an example problem, possible beneficial effects of including type-I WPS in the assessment of an RPV subjected to a small break loss of coolant accident are described. In addition, the need to consider possible loss of constraint effects when interpreting available small specimen WPS-enhanced fracture toughness data is demonstrated through two- and three-dimensional local crack-lip field analyses of a compact tension specimen. Finally, a hybrid correlative-predictive model of WPS base on J-Q theorymore » and the Ritchie-Knott-Rice model is applied to a small scale yielding boundary layer formulation to investigate near crack-tip fields under varying degrees of loading and unloading.« less

Flexible scintillator autoradiography for tumor margin inspection using 18F-FDG

NASA Astrophysics Data System (ADS)

Vyas, K. N.; Grootendorst, M.; Mertzanidou, T.; Macholl, S.; Stoyanov, D.; Arridge, S. R.; Tuch, D. S.

2018-03-01

Autoradiography potentially offers high molecular sensitivity and spatial resolution for tumor margin estimation. However, conventional autoradiography requires sectioning the sample which is destructive and labor-intensive. Here we describe a novel autoradiography technique that uses a flexible ultra-thin scintillator which conforms to the sample surface. Imaging with the flexible scintillator enables direct, high-resolution and high-sensitivity imaging of beta particle emissions from targeted radiotracers. The technique has the potential to identify positive tumor margins in fresh unsectioned samples during surgery, eliminating the processing time demands of conventional autoradiography. We demonstrate the feasibility of the flexible autoradiography approach to directly image the beta emissions from radiopharmaceuticals using lab experiments and GEANT-4 simulations to determine i) the specificity for 18F compared to 99mTc-labeled tracers ii) the sensitivity to detect signal from various depths within the tissue. We found that an image resolution of 1.5 mm was achievable with a scattering background and we estimate a minimum detectable activity concentration of 0.9 kBq/ml for 18F. We show that the flexible autoradiography approach has high potential as a technique for molecular imaging of tumor margins using 18F-FDG in a tumor xenograft mouse model imaged with a radiation-shielded EMCCD camera. Due to the advantage of conforming to the specimen, the flexible scintillator showed significantly better image quality in terms of tumor signal to whole-body background noise compared to rigid and optimally thick CaF2:Eu and BC400. The sensitivity of the technique means it is suitable for clinical translation.

Role of TiF4 in Microleakage of Silorane and Methacrylate-based Composite Resins in Class V Cavities.

PubMed

Koohpeima, Fatemeh; Sharafeddin, Farahnaz; Jowkar, Zahra; Ahmadzadeh, Samaneh; Mokhtari, Mohammad Javad; Azarian, Babak

2016-03-01

This study investigated the effect of TiF4 solution pretreat-ment on microleakage of silorane and nanofilled methacrylate-based composites in class V cavities. Forty-eight intact premolar teeth were randomly allocated to four groups of 12 teeth. Restorative techniques after standard class V tooth preparations were as follows: Group 1, Filtek P90 composite; group 2, Filtek Z350 XT; group 3, TiF4 solution pretreatment and Filtek P90 composite; group 4, TiF4 solution pretreatment and Filtek Z350 XT. After storing the specimens in distilled water at 37°C for 24 hours and followed by immersion of the specimens in a 0.5% basic-fuchsin solution for 24 hours, they were sectioned buccolingually to obtain four surfaces for each specimen for analysis of microleakage using a stereomicroscope. Data analysis was performed using Kruskal-Wallis test to compare the four groups and the Mann-Whitney test for paired comparisons with Statistical Package for the Social Sciences (SPSS) version 17 software. At the enamel margins, microleakage score of the Filtek Z350 XT group was lower than those of the Filtek P90 with and without the application of the TiF4 (p = 0.009 and p = 0.031 respectively). At the dentin margins, groups 3 and 4 (TiF4+Filtek P90 and TiF4+Filtek z350 XT respectively) showed significantly lower microleakage than group 1 (Filtek P90). However, there was no significant difference between other groups (p > 0.05). At the enamel margins, microleakage score of the silorane-based composite was more than that of the nanofilled composite. No significant differences were observed between the other groups. At the dentin margins, for the silorane-based composite restorations, TiF4 solution pretreatment resulted in significantly lower microleakage. However, the similar result was not observed for Filtek Z350 XT. Also, no significant difference was observed between microleakage scores of Filtek P90 and Filtek Z350 XT with or without TiF4 pretreatment. In spite of better mechanical and physical properties of modern composites than earlier methacrylate-based composites, polymerization shrinkage has been remaining as one of the main shortcomings of them. Different methods, such as using new low shrinkage resin composites and different dentin pretreatments, have been suggested to overcome this problem. This study evaluated the effect of TiF4 as pretreatment on microleakage of class V tooth preparations restored with a nanocomposite and a silorane-based resin composite.

Effectiveness of an infiltrant on sealing of composite restoration margins with/without artificial caries.

PubMed

Tulunoglu, Ozlem; Tulunoglu, Ibrahim Fevzi; Antonson, Sibel A; Campillo-Funollet, Marc; Antonson, Donald; Munoz-Viveros, Carlos

2014-11-01

The aim of this in vitro study was to evaluate the effectiveness of a resin infiltrant (ICON) on marginal sealing ability of class II resin restorations with/without-caries. Forty-eight noncarious human pre-molar teeth were embedded and MO and DO preparations of standard dimensions were prepared. The left side of dentin margins of the cavities were left nonbonded (UB) while the right side were bonded using total etch-bonding agent and all restored with a Nanohybrid composite. The teeth were thermocycled and half of the specimens in the UB and B groups were subjected to an artificial caries process. ICON was applied to caries and noncaries subgroups following the manufacturer's directions. Impressions were made at each step: after the restorations were completed, thermocycling, artificial caries procedures, and infiltrant application and the silicone tag lengths were measured with a stereomicroscope. The specimens were immersed in 0.5% basic fuchsine at 37° C for 24 hours, sectioned and microleakage was evaluated with a stereomicroscope. Selected samples and their replicas were assessed for marginal quality under a stereomicroscope and SEM. Statistical evaluation of the data were made using Kruskal-Wallis, Mann-Whitney U and Wilcoxon Sign Rank tests. While bonding application did not create a meaningful difference, the thermocycling and artificial caries significantly increased the gap length and microleakage (p < 0.05). ICON application was decreased the microleakage, created gap-free margins and closed the gaps which were previously occurred at the same cavities (p < 0.05). A resin infiltrant (ICON) application decreased the microleakage, created gap-free margins and closed the gaps, which previously occurred at the same cavities. Approximal application of resin infiltrant may increase the success of the class II composite restorations also reduced the risk of needing more complex restoration therapy.

Positive margins prediction in breast cancer conservative surgery: Assessment of a preoperative web-based nomogram.

PubMed

Alves-Ribeiro, Lídia; Osório, Fernando; Amendoeira, Isabel; Fougo, José Luís

2016-08-01

Margin status of the surgical specimen has been shown to be a prognostic and risk factor for local recurrence in breast cancer surgery. It has been studied as a topic of intervention to diminish reoperation rates and reduce the probability of local recurrence in breast conservative surgery (BCS). This study aims to validate the Dutch BreastConservation! nomogram, created by Pleijhus et al., which predicts preoperative probability of positive margins in BCS. Patients with diagnosis of breast cancer stages cT1-2, who underwent BCS at the Breast Center of São João University Hospital (BC-CHSJ) in 2013-2014, were included. Association and correlation were evaluated for clinical, radiological, pathological and surgical variables. Multivariable logistic regression and ROC curves were used to assess nomogram parameters and discrimination. In our series of 253 patients, no associations were found between margin status and other studied variables (such as age or family history of breast cancer), except for weight (p-value = 0.045) and volume (p-value = 0.012) of the surgical specimen. Regarding the nomogram, a statistically significant association was shown between cN1 status and positive margins (p-value = 0.014). No differences were registered between the scores of patients with positive versus negative margins. Discrimination analysis showed an AUC of 0.474 for the basic and 0.508 for the expanded models. We cannot assume its external validation or its applicability to our cohort. Further studies are needed to determine the validity of this nomogram and achieve a broader view of currently available tools. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fatigue Behavior of Inconel 718 TIG Welds

NASA Astrophysics Data System (ADS)

Alexopoulos, Nikolaos D.; Argyriou, Nikolaos; Stergiou, Vasillis; Kourkoulis, Stavros K.

2014-08-01

Mechanical behavior of reference and TIG-welded Inconel 718 specimens was examined in the present work. Tensile, constant amplitude fatigue, and fracture toughness tests were performed in ambient temperature for both, reference and welded specimens. Microstructure revealed the presence of coarse and fine-grained heat-affected zones. It has been shown that without any post-weld heat treatment, welded specimens maintained their tensile strength properties while their ductility decreased by more than 40%. It was found that the welded specimens had lower fatigue life and this decrease was a function of the applied fatigue maximum stress. A 30% fatigue life decrease was noticed in the high cycle fatigue regime for the welded specimens while this decrease exceeded 50% in the low cycle fatigue regime. Cyclic stress-strain curves showed that Inconel 718 experiences a short period of hardening followed by softening for all fatigue lives. Cyclic fatigue response of welded specimens' exhibited cyclically stable behavior. Finally, a marginal decrease was noticed in the Mode I fracture toughness of the welded specimens.

Partial nephrectomy for renal tumors: lack of correlation between margin status and local recurrence.

PubMed

Antic, Tatjana; Taxy, Jerome B

2015-05-01

To evaluate the relationship between a positive resection margin in partial nephrectomy (PN) and local recurrence. From January 2005 through December 2012, there were 473 PNs in 466 patients at the University of Chicago. A positive margin was defined as tumor extending to the inked specimen edge, either the parenchymal interface or the peripheral fibroadipose tissue. A local recurrence was defined as an ipsilateral tumor of identical histologic type. Renal cell carcinoma (RCC) accounted for 406 tumors: 243 clear cell RCCs (CRCCs), 77 papillary RCCs (PRCCs), and 47 chromophobe RCCs (CHRCCs). Sixty-one RCCs had positive margins: 43 CRCCs, six PRCCs, nine CHRCCs, and three miscellaneous cell types. Of the 61 positive margins, four CRCCs (all originally multifocal) had a local recurrence, two of which occurred in the same patient. One translocation RCC also recurred. Six cases with negative resection margins had a recurrence. A literature review of 3,803 cases, including our study, shows positive margins in 173, of which 13 recurred; however, 39 with negative margins also recurred. A positive margin in PN seldom correlates with a local recurrence. However, protection from recurrence is not ensured by a negative margin. Copyright© by the American Society for Clinical Pathology.

Optical characterization of lesions and identification of surgical margins in pancreatic metastasis from renal cell carcinoma by using two-photon excited fluorescence microscopy

NASA Astrophysics Data System (ADS)

Chen, Jing; Hong, Zhipeng; Chen, Hong; Chen, Youting; Xu, Yahao; Zhu, Xiaoqin; Zhuo, Shuangmu; Shi, Zheng; Chen, Jianxin

2014-11-01

Two-photon excited fluorescence (TPEF) microscopy has become a powerful instrument for imaging unstained tissue samples in biomedical research. The purpose of this study was to determine whether TPEF imaging of histological sections without hematoxylin-eosin (H-E) stain can be used to characterize lesions and identify surgical margins in pancreatic metastasis from renal cell carcinoma (RCC). The specimens of a pancreatic metastasis from RCC, as well as a primary RCC from a patient, were examined by TPEF microscopy and compared with their corresponding H-E stained histopathological results. The results showed that high-resolution TPEF imaging of unstained histological sections of pancreatic metastasis from RCC can reveal that the typical morphology of the tissue and cells in cancer tissues is different from the normal pancreas. It also clearly presented histopathological features of the collagenous capsule, which is an important boundary symbol to identify normal and cancerous tissue and to instruct surgical operation. It indicated the feasibility of using TPEF microscopy to make an optical diagnosis of lesions and identify the surgical margins in pancreatic metastasis from RCC.

Assessment of Surgical Learning Curves in Transoral Robotic Surgery for Squamous Cell Carcinoma of the Oropharynx

PubMed Central

Albergotti, William G.; Gooding, William E.; Kubik, Mark W.; Geltzeiler, Mathew; Kim, Seungwon; Duvvuri, Umamaheswar; Ferris, Robert L.

2017-01-01

IMPORTANCE Transoral robotic surgery (TORS) is increasingly employed as a treatment option for squamous cell carcinoma of the oropharynx (OPSCC). Measures of surgical learning curves are needed particularly as clinical trials using this technology continue to evolve. OBJECTIVE To assess learning curves for the oncologic TORS surgeon and to identify the number of cases needed to identify the learning phase. DESIGN, SETTING, AND PARTICIPANTS A retrospective review of all patients who underwent TORS for OPSCC at the University of Pittsburgh Medical Center between March 2010 and March 2016. Cases were excluded for involvement of a subsite outside of the oropharynx, for nonmalignant abnormality or nonsquamous histology, unknown primary, no tumor in the main specimen, free flap reconstruction, and for an inability to define margin status. EXPOSURES Transoral robotic surgery for OPSCC. MAIN OUTCOMES AND MEASURES Primary learning measures defined by the authors include the initial and final margin status and time to resection of main surgical specimen. A cumulative sum learning curve was developed for each surgeon for each of the study variables. The inflection point of each surgeon’s curve was considered to be the point signaling the completion of the learning phase. RESULTS There were 382 transoral robotic procedures identified. Of 382 cases, 160 met our inclusion criteria: 68 for surgeon A, 37 for surgeon B, and 55 for surgeon C. Of the 160 included patients, 125 were men and 35 were women. The mean (SD) age of participants was 59.4 (9.5) years. Mean (SD) time to resection including robot set-up was 79 (36) minutes. The inflection points for the final margin status learning curves were 27 cases (surgeon A) and 25 cases (surgeon C). There was no inflection point for surgeon B for final margin status. Inflection points for mean time to resection were: 39 cases (surgeon A), 30 cases (surgeon B), and 27 cases (surgeon C). CONCLUSIONS AND RELEVANCE Using metrics of positive margin rate and time to resection of the main surgical specimen, the learning curve for TORS for OPSCC is surgeon-specific. Inflection points for most learning curves peak between 20 and 30 cases. PMID:28196200

In Vivo and Ex Vivo Confocal Microscopy for Dermatologic and Mohs Surgeons.

PubMed

Longo, Caterina; Ragazzi, Moira; Rajadhyaksha, Milind; Nehal, Kishwer; Bennassar, Antoni; Pellacani, Giovanni; Malvehy Guilera, Josep

2016-10-01

Confocal microscopy is a modern imaging device that has been extensively applied in skin oncology. More specifically, for tumor margin assessment, it has been used in two modalities: reflectance mode (in vivo on skin patient) and fluorescence mode (on freshly excised specimen). Although in vivo reflectance confocal microscopy is an add-on tool for lentigo maligna mapping, fluorescence confocal microscopy is far superior for basal cell carcinoma and squamous cell carcinoma margin assessment in the Mohs setting. This article provides a comprehensive overview of the use of confocal microscopy for skin cancer margin evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

Pathology report assessment of incidental gallbladder carcinoma diagnosed from cholecystectomy specimens: results of a French multicentre survey.

PubMed

Chatelain, Denis; Fuks, David; Farges, Olivier; Attencourt, Christophe; Pruvot, François René; Regimbeau, Jean-Marc

2013-12-01

To assess the accuracy of pathology reports on gallbladder specimens from patients operated on for incidental gallbladder carcinoma. Demographic data, details on pathological reports including gross and microscopic features section were recorded in 100 selected patients with incidental gallbladder carcinoma diagnosed from 2004 to 2007. Pathology reports had a conventional format in 93% of cases, without any standardization. Turnaround time ranged from 1 to 35 days. Frozen sections were performed in 20% of cases. The reports failed to give information on prognostic histological factors: exact tumour site (missing in 55% of cases), depth of tumour infiltration within the gallbladder wall (missing in 10%), surgical margins (missing in 40% for the cystic duct margin), tumour differentiation (missing in 28%), vascular invasion (missing in 52%) and perineural invasion (missing in 51%). Lymph node status could be assessed in 44% of cases. Distances between the tumour and the cystic duct and circumferential margins were not specified in 68% and 84% of cases. Only 29% of the reports clearly stated the pTNM stage in the conclusion section. The pT stage with margin status and tumour site was only mentioned in 30% of the reports. Pathology reports on gallbladder carcinoma from participating centres frequently lacked important information on key prognostic histological factors. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Feasibility demonstration of frequency domain terahertz imaging in breast cancer margin determination

NASA Astrophysics Data System (ADS)

Yngvesson, Sigfrid K.; St. Peter, Benjamin; Siqueira, Paul; Kelly, Patrick; Glick, Stephen; Karellas, Andrew; Khan, Ashraf

2012-03-01

In breast conservation surgery, surgeons attempt to remove malignant tissue along with a surrounding margin of healthy tissue. Subsequent pathological analysis determines if those margins are clear of malignant tissue, a process that typically requires at least one day. Only then can it be determined whether a follow-up surgery is necessary. This possibility of re-excision is undesirable in terms of reducing patient morbidity, emotional stress and healthcare. It has been shown that terahertz (THz) images of breast specimens can accurately differentiate between breast carcinoma, normal fibroglandular tissue, and adipose tissue. That study employed the Time-Domain Spectroscopy (TDS) technique. We are instead developing a new technique, Frequency-Domain Terahertz Imaging (FDTI). In this joint project between UMass/Amherst and UMass Medical School/Worcester (UMMS), we are investigating the feasibility of the FDTI technique for THz reflection imaging of breast cancer margins. Our system, which produces mechanically scanned images of size 2cm x 2cm, uses a THz gas laser. The system is calibrated with mixtures of water and ethanol and reflection coefficients as low as 1% have been measured. Images from phantoms and specimens cut from breast cancer lumpectomies at UMMS will be presented. Finally, there will be a discussion of a possible transition of this FDTI setup to a compact and inexpensive CMOS THz camera for use in the operating room.

Encrustation of inarticulate brachiopods on scaphitid ammonites and inoceramid bivalves from the Upper Cretaceous U. S. Western Interior

NASA Astrophysics Data System (ADS)

Landman, Neil H.; Slattery, Joshua S.; Harries, Peter J.

2016-12-01

The inarticulate brachiopod Discinisca is a rare faunal element in the Upper Cretaceous of the U.S. Western Interior. We report two occurrences of encrustation of Discinisca on a scaphitid ammonite (scaphite) and several inoceramids from the lower Maastrichtian Baculites baculus/Endocostea typica Biozones of the Pierre Shale at two localities. Six specimens of Discinisca are present on a single specimen of Hoploscaphites crassus from east-central Montana. They occur along the furrow at the mature apertural margin. Because the brachiopods are restricted to the margin and do not occur on the rest of the shell, it is likely that they encrusted the ammonite during its lifetime. If so, this implies that the soft body of the scaphite did not cover the outside surface of the aperture, leaving this area vulnerable to epizoan attachment. A total of 13 specimens of Discinisca are also present on four specimens of Cataceramus? barabini from east-central Wyoming. The brachiopods occur in crevices on the outside of the shells and may have encrusted the inoceramids after their death as the shells began to break down and delaminate, resulting from the decomposition of the organic matrix holding them together. Based on the faunal assemblages at both localities, the presence of Discinisca may indicate environments with either low oxygen levels and/or few predators or competitors.

Human Papillomavirus Genotyping After Denaturation of Specimens for Hybrid Capture 2 Testing: Feasibility Study for the HPV Persistence and Progression Cohort†

PubMed Central

LaMere, Brandon J.; Kornegay, Janet; Fetterman, Barbara; Sadorra, Mark; Shieh, Jen; Castle, Philip E.

2009-01-01

Human papillomavirus (HPV) genotyping could be clinically useful, depending on the results of large, prospective studies like the HPV Persistence and Progression cohort. The cohort is based on genotyping and follow-up of Hybrid Capture-positive women at Kaiser Permanente, Northern California. HPV DNA testing by Hybrid Capture 2 requires denaturation with alkali, possibly damaging the DNA for optimal PCR-based genotyping. A feasibility study was conducted on paired aliquots of anonymized specimens from 100 women with low-grade intraepithelial lesion cytology. Test aliquots were left in denaturant for 10 or 18 hours at 4°C and then neutralized; comparison aliquots were not denatured but diluted to match the timing, temperature, concentration and salt conditions of the treated specimens. The masked aliquots were tested using a commercialized PCR-based assay that detects of 37 HPV genotypes. There was no overall effect of treatment on test positivity or number of types. HPV16 was marginally more likely to be detected in untreated versus treated aliquots (P = 0.09) but HPV45 was marginally more likely to be detected in treated than untreated aliquots (P = 0.07), suggesting that these differences represented chance (intra-test variability). It can be concluded that residual Hybrid Capture-positive specimens can be accurately genotyped by PCR after Hybrid Capture 2 processing. PMID:17673302

Deep and superficial infrapatellar bursae: cadaveric investigation of regional anatomy using magnetic resonance after ultrasound-guided bursography.

PubMed

Viegas, Flavio C; Aguiar, Rodrigo O C; Gasparetto, Emerson; Marchiori, Edson; Trudell, Debbie J; Haghighi, Parviz; Resnick, Donald

2007-01-01

To demonstrate the anatomy of the deep and superficial infrapatellar bursae using magnetic resonance (MR) imaging and anatomic correlation in cadavers. MR imaging of the infrapatellar bursae of nine cadaveric knees was performed after ultrasound-guided bursography. The images were compared with those seen on anatomic sectioning. Histologic analysis was obtained in two specimens. The deep infrapatellar bursa (DIB) was visualized in all specimens (n=9) and the superficial infrapatellar bursa (SIB) in five specimens (55%). The mean dimensions of the DIB in the craniocaudal, mediolateral, and anteroposterior planes were respectively 25, 28.7, and 6 mm, and for SIB 19.5, 21.2 and 2.2 mm. A fat apron dividing the DIB was depicted in eight knees (89%). Lateral extension of the DIB beyond the patellar tendon was observed in 100% of cases. Cadaveric analysis depicted a thin septum in the SIB in four of five cases (80%). The DIB is generally present and extends beyond the lateral margin of the patellar tendon. A fat apron partially separating this structure is usual. The SIB is not an unusual finding and may have a septum separating its compartments.

Comparison of intracorporeal single-stapled and double-stapled anastomosis in laparoscopic low anterior resection for rectal cancer: a case-control study.

PubMed

Kim, Hye Jin; Choi, Gyu-Seog; Park, Jun Seok; Park, Soo Yeun

2013-01-01

Recently, a single-stapled technique (SST) was performed instead of the conventional double-stapled technique (DST) in laparoscopic low anterior resection for anastomosis, by placement of intracorporeal purse-string sutures on the distal rectum with transanal specimen extraction. This study aimed to compare the short-term outcomes between the two anastomotic techniques. Between July 2007 and April 2010, 60 patients underwent SST by laparoscopic or robotic procedure. These patients were matched 1:2 by age, gender, date of surgery, and tumor stage with 120 patients who underwent conventional DST in laparoscopic low anterior resection. The robotic-assisted operative approach was used more frequently in the SST group than in the DST group (61.7 % vs. 3.3 %, p < 0.001). The mean operative time was 203.9 (range, 120-400) min for the SST group and 167.6 (range, 90-300) min for the DST group (p < 0.001). For specimen removal, the transanal approach was used in the SST group, while the transabdominal approach was used for the DST group. The pain score (visual analogue scale) of the SST group was lower (4.5 vs. 5.6, p < 0.001), although postoperative recovery was similar. Pathological examination revealed that the distal resection margin was significantly longer in the SST group (3.1 vs. 2.5 cm, p = 0.018). Postoperative morbidity including anastomotic leakage was similar in both groups. SST yielded equivalent short-term outcomes when compared to conventional DST and provided the advantages of minimal access and a longer distal resection margin. Therefore, SST in lower anterior resection may be a useful alternative to conventional DST.

The lid wiper and muco-cutaneous junction anatomy of the human eyelid margins: an in vivo confocal and histological study

PubMed Central

Knop, Erich; Knop, Nadja; Zhivov, Andrey; Kraak, Robert; Korb, Donald R; Blackie, Caroline; Greiner, Jack V; Guthoff, Rudolf

2011-01-01

The inner border of the eyelid margin is critically important for ocular surface integrity because it guarantees the thin spread of the tear film. Its exact morphology in the human is still insufficiently known. The histology in serial sections of upper and lower lid margins in whole-mount specimens from 10 human body donors was compared to in vivo confocal microscopy of eight eyes with a Heidelberg retina-tomograph (HRT II) and attached Rostock cornea module. Behind the posterior margin of the Meibomian orifices, the cornified epidermis stopped abruptly and was replaced by a continuous layer of para-keratinized (pk) cells followed by discontinuous pk cells. The pk cells covered the muco-cutaneous junction (MCJ), the surface of which corresponded to the line of Marx (0.2–0.3 mm wide). Then a stratified epithelium with a conjunctival structure of cuboidal cells, some pk cells, and goblet cells formed an epithelial elevation of typically about 100 μm initial thickness (lid wiper). This continued for 0.3–1.5 mm and formed a slope. The MCJ and lid wiper extended all along the lid margin from nasal to temporal positions in the upper and lower lids. Details of the epithelium and connective tissue were also detectable using the Rostock cornea module. The human inner lid border has distinct zones. Due to its location and morphology, the epithelial lip of the lid wiper appears a suitable structure to spread the tear film and is distinct from the MCJ/line of Marx. Better knowledge of the lid margin appears important for understanding dry eye disease and its morphology can be analysed clinically by in vivo confocal microscopy. PMID:21413985

PubMed Central

VICINI, C.; MONTEVECCHI, F.; D'AGOSTINO, G.; DE VITO, A.

2015-01-01

SUMMARY The primary goal of surgical oncology is to obtain a tumour resection with disease-free margins. Transoral robotic surgery (TORS) for surgical treatment of head-neck cancer is commensurate with standard treatments. However, the likelihood of positive margins after TORS is up to 20.2% in a recent US survey. The aim of this study is to evaluate the efficacy and the feasibility of narrow-band imaging (NBI) during TORS in order to improve the ability to achieve disease-free margins during tumour excision. The present study was conducted at the ENT, Head- Neck Surgery and Oral Surgery Unit, Department of Special Surgery, Morgagni Pierantoni Hospital, Azienda USL Romagna. From March 2008 to January 2015, 333 TORS were carried out for malignant and benign diseases. For the present study, we retrospectively evaluated 58 biopsy-proven squamous cell carcinoma patients who underwent TORS procedures. Patients were divided into 2 groups: (1) 32 who underwent TORS and intra-operative NBI evaluation (NBI-TORS); (2) 21 who underwent TORS with standard intra-operative white-light imaging (WLITORS). Frozen section analysis of margins on surgical specimens showed a higher rate of negative superficial lateral margins in the NBI-TORS group compared with the WLI-TORS group (87.9% vs. 57.9%, respectively, p = 0.02). The sensitivity and specificity of intra-operative use of NBI, respectively, were 72.5% and 66.7% with a negative predictive value of 87.9%. Tumour margin enhancement provided by NBI associated with magnification and 3-dimensional view of the surgical field might increase the capability to achieve an oncologically-safe resection in challenging anatomical areas where minimal curative resection is strongly recommended for function preservation. PMID:26246659

Color stability and marginal integrity of interim crowns: An in vitro study

PubMed Central

Elagra, Marwa I.; Rayyan, Mohammad R.; Alhomaidhi, Maisam M.; Alanaziy, Areej A.; Alnefaie, Mona O.

2017-01-01

Objective: Many commercial dental materials are used to fabricate interim restorations. This study aimed to compare the color stability and the marginal integrity of four different interim crown materials. Materials and Methods: An ivorine right maxillary central incisor was prepared for a full coverage all-ceramic restoration. A total of 36 specimens in the form of crowns were fabricated on the master die using four different materials (n = 9); Polymethyl methacrylate (PMMA) resin (TrimPLUS), PMMA computer-aided design, and computer-aided manufacturing (CAD-CAM) blocks (Ceramill TEMP), cold cure bis-acryl resin (Success CD), and bis-acryl resin dual-cure composite (TempSpan). Color change ΔE for each sample was calculated by measuring its color as Commission Internationale de l’Eclairage L* a* b* with a spectrophotometer before and after immersing in a concentrated tea solution for 7 days. Marginal gap was measured at four reference points using stereomicroscope at ×40. One-way ANOVA and the Tukey multiple comparisons test were used to determine any statistically significant difference between the four groups, (α = 0.05). Results: Success CD showed significantly the greatest color change (7.7) among all the tested materials, while no significant difference was found between the other three materials. TempSpan showed significantly the highest marginal gap formation (430.15 μm), while no significant difference was found between the three other materials. Conclusions: Bis-acryl resin composite materials demonstrated clinically noticeable change in color while PMMA materials demonstrated superior color stability. Dual cure interim materials exhibited significantly higher marginal discrepancy in comparison to PMMA and cold cure bis-acrylic resin materials. CAD-CAM PMMA material exhibited the best color stability and marginal integrity. PMID:28932142

Identifying viscoelastic parameters of tissue specimens using Hertz contact mechanics

NASA Astrophysics Data System (ADS)

Namiri, Nikan K.; Maccabi, Ashkan; Bajwa, Neha; Badran, Karam W.; St. John, Maie A.; Taylor, Zachary D.; Grundfest, Warren S.; Saddik, George N.

2018-02-01

The unique viscoelastic properties of tissues throughout the human body can be utilized in a variety of clinical applications. Palpation techniques, for instance, enable surgeons to distinguish malignancies in tissue composition during surgical procedures. Additionally, imaging devices have begun utilizing the viscoelastic properties of tissue to delineate tumor margins. Vibroacoustography (VA), a non-invasive, high resolution imaging modality, has the ability to detect sub-millimeter differences in tissue composition. VA images tissue using a low frequency acoustic radiation force, which perturbs the target and causes an acoustic response that is dependent on the target's viscoelastic properties. Given the unique properties specific to human and animal tissues, there are far-reaching clinical applications of VA. To date, however, a comprehensive model that relates viscoelasticity to VA tissue response has yet to be developed. Utilizing tissue-mimicking phantoms (TMPs) and fresh ex vivo tissues, a mechanical stress relaxation model was developed to compare the viscoelastic properties of known and unknown specimens. This approach was conducted using the Hertz theory of contact mechanics. Fresh hepatic tissue was obtained from porcine subjects (n=10), while gelatin and agar TMPs (n=12) were fabricated from organic extracts. Each specimen's elastic modulus (E), long term shear modulus (η), and time constant (τ) were found to be unique. Additionally, each specimen's stress relaxation profiles were analyzed using Weichert-Maxwell viscoelastic modeling, and retained high precision (R2>0.9) among all samples.

Pathologic findings of Whipple pancreaticoduodenectomy: a 5-year review on 51 cases at Taleghani general hospital.

PubMed

Foroughi, Forough; Mohsenifar, Zhaleh; Ahmadvand, Alireza; Zare, Khandan

2012-01-01

The aim of this study was to comprehensively analyze histopathologic parameters of Whipple pancreaticoduodenectomy specimens at Taleghani general hospital pathology department. The Whipple procedure is performed for variety of tumors involving the head of the pancreas, ampulla of Vater, common bile duct, or duodenum. Records of all cases of Whipple pancreaticoduodenectomy between 2007 and 2011were retrospectively reviewed and pathological details of diagnosis and staging were extracted. A total of 51 patients underwent Whipple procedure during a 5-year period, including 37 males and 14 females. The average age was 57 years (18-82 years). The most frequent presenting symptoms were jaundice and weight loss. Forty-four patients (86.3%) had malignant and 7 (13.7%) had benign lesions. Among malignant lesions, 27 (61.4%) were ampullary carcinomas, 12 (27.3%) were pancreatic carcinomas and 5 (11.4%) were cholangiocarcinomas. The pathological stage of most of the tumors was T3 (50%); followed by T2 (29.5%), and T1 (15.9%); only 4.5% were T4. Mean tumor size was 2.8 cm (0.2-7 cm). Duodenal and common bile duct margins were tumor-free in most cases (95.5 %). The pancreatic margin was free in 81.8% of patients; this margin had not been evaluated in 5 patients. Nearly 38.6% of all tumors showed vascular invasion while 68.2% showed perineural invasion. The average number of dissected lymph nodes was 4 (range 1-15); although in 25% of specimens, no lymph nodes had been found. Twelve specimens (35.3%) had lymph node metastases. The present study demonstrates that most of our patients are diagnosed with malignancy, at advanced stage, and further research is needed to develop practical methods for earlier diagnosis. The fact that 25% of specimens had no lymph nodes needs more consideration.

Composite Replacement of Amalgam Restoration Versus Freshly Cut Dentin: An In Vitro Microleakage Comparison.

PubMed

Redwan, H; Bardwell, D N; Ali, A; Finkelman, M; Khayat, S; Weber, H-P

2016-01-01

The aim of this study was to evaluate the microleakage of the composite restorations when bonded to tooth structure previously restored with amalgam material compared with that of freshly cut dentin. Thirty intact, extracted intact human molars were mounted in autopolymerizing acrylic resin. Class II box preparations were prepared on the occluso-proximal surfaces of each tooth (4-mm bucco-lingual width and 2-mm mesio-distal depth) with the gingival cavosurface margin 1 mm above the CEJ. Each cavity was then restored using high copper amalgam restoration (Disperalloy, Dentsply) and then thermocycled for 10,000 thermal cycles. Twenty-five of the amalgam restorations were then carefully removed and replaced with Filtek Supreme Ultra Universal (3M ESPE); the remaining five were used for scanning electron microscopy and energy dispersive x-ray spectroscopy analysis. A preparation of the same dimensions was performed on the opposite surface of the tooth and restored with composite resin and thermocycled for 5000 thermal cycles. Twenty samples were randomly selected for dye penetration testing using silver nitrate staining to detect the microleakage. The specimens were analyzed with a stereomicroscope at a magnification of 20×. All of the measurements were done in micrometers; two readings were taken for each cavity at the occlusal and proximal margins. Two measurements were taken using a 0-3 scale and the percentage measurements. Corrosion products were not detected in either group (fresh cut dentin and teeth previously restored with amalgam). No statistically significant difference was found between the microleakage of the two groups using a 0-3 scale at the occlusal margins (McNemar test, p=0.727) or proximal margins (Wilcoxon signed-rank test, p=0.174). No significance difference was found between the two groups using the percentage measurements and a Wilcoxon signed-rank test at either the occlusal (p=0.675) or proximal (p=0.513) margins. However, marginal microleakage was statistically significant between the proximal and occlusal margins (p<0.001). Within the limitations of this in vitro study, no significant difference was found between the microleakage of nondiscolored dentin in teeth that were previously restored with amalgam compared with freshly cut dentin. However, marginal microleakage in the proximal surface was higher than that in the occlusal surface.

[Histological classification: evaluation of resection specimens of EMR/ESD--response evaluation after neoadjuvant therapy].

PubMed

Munding, J; Ziebarth, W; Belyaev, O; Uhl, W; Tannapfel, A

2013-12-01

The surveillance of patients with Barrett mucosa in the distal oesophagus leads to an increase of patients diagnosed with early cancer of the oesophagogastric junction and stomach with only superficial infiltration. Comparable to Asian countries where screening of patients at risk is recommended due to the high incidence of gastric cancer, endoscopic resection of early cancer in the stomach and distal oesophagus is increasing. In spite of the special endoscopic techniques--there are several requirements for the resected specimen which ensure its exact pathohistological evaluation. This is necessary to detect the exact depth of infiltration and the resection margins. To provide an exact pathohistological diagnosis is important for further therapeutic implications and prognosis. Advanced carcinomas of the oesophagus and stomach need multimodal treatment with radiation and chemotherapy. This has a special impact on the tumour which leads to pathohistological detectable changes as estimated in the so-called regression grading. Georg Thieme Verlag KG Stuttgart · New York.

Specific and Nonspecific B-Cell Function in the Small Intestines of Patients with Whipple's Disease ▿

PubMed Central

Geelhaar, Anika; Moos, Verena; Schinnerling, Katina; Allers, Kristina; Loddenkemper, Christoph; Fenollar, Florence; LaScola, Bernard; Raoult, Didier; Schneider, Thomas

2010-01-01

Whipple's disease is a chronic multisystemic infection caused by Tropheryma whipplei that is characterized by arthritis, weight loss, and diarrhea. The immunological defects in the duodenal mucosa, the site of major replication of the agent underlying the pathogenesis of Whipple's disease, are poorly understood. Mucosal immunoglobulins are essential for the defense against intestinal pathogens; therefore, we analyzed the B-cell response in duodenal specimens and sera of Whipple's disease patients. Whereas systemic immunoglobulin production was affected only marginally, duodenal biopsy specimens of Whipple's disease patients contained reduced numbers of immunoglobulin-positive plasma cells and secreted less immunoglobulin compared to healthy controls but showed a weak secretory IgA response toward T. whipplei. This T. whipplei-specific intestinal immune response was not observed in controls. Thus, we were able to demonstrate that general mucosal immunoglobulin production in Whipple's disease patients is impaired. However, this deficiency does not completely abolish T. whipplei-specific secretory IgA production that nonetheless does not protect from chronic infection. PMID:20696822

The effect of various veneering techniques on the marginal fit of zirconia copings.

PubMed

Torabi, Kianoosh; Vojdani, Mahroo; Giti, Rashin; Taghva, Masumeh; Pardis, Soheil

2015-06-01

This study aimed to evaluate the fit of zirconia ceramics before and after veneering, using 3 different veneering processes (layering, press-over, and CAD-on techniques). Thirty standardized zirconia CAD/CAM frameworks were constructed and divided into three groups of 10 each. The first group was veneered using the traditional layering technique. Press-over and CAD-on techniques were used to veneer second and third groups. The marginal gap of specimens was measured before and after veneering process at 18 sites on the master die using a digital microscope. Paired t-test was used to evaluate mean marginal gap changes. One-way ANOVA and post hoc tests were also employed for comparison among 3 groups (α=.05). Marginal gap of 3 groups was increased after porcelain veneering. The mean marginal gap values after veneering in the layering group (63.06 µm) was higher than press-over (50.64 µm) and CAD-on (51.50 µm) veneered groups (P<.001). Three veneering methods altered the marginal fit of zirconia copings. Conventional layering technique increased the marginal gap of zirconia framework more than pressing and CAD-on techniques. All ceramic crowns made through three different veneering methods revealed clinically acceptable marginal fit.

Effect of specific surface area of MWCNTS on surface roughness and delamination in drilling Epoxy/Glass Fabric Composite

NASA Astrophysics Data System (ADS)

Ponnuvel, S.; Ananth, M. Prem

2018-03-01

In this study the effect of specific surface area of the MWCNTs on the drilled hole qualities was investigated. Epoxy araldite LY556 with hardener HY951 and E-glass coarse plain weave fabric are used for the fabrication of reference material (specimen A). Multi-WalledCarbon Nanotubes (MWCNTs) with diameters <8 nm and 20–30 nm are used for the fabrication of study materials, namely specimen B and specimen C respectively. In specimen B the epoxy resin was filled with MWCNTs having a specific surface area >500 m2 g‑1. MWCNTs in specimen C had a specific surface area >110 m2 g‑1. Drilling experiments were conducted on all the three specimens. Two dimensional delamination factor and the surface roughness of the inner wall of the drilled holes were investigated using Grey Relational Analysis (GRA) and Analysis of variance (ANOVA). Two dimensional delamination factor showed better performance from specimen B and specimen C in comparison with specimen A suggesting improvement in the bonding between epoxy and the glass fiber in the presence of MWCNTs. Similar observations were made for surface roughness of the inner wall of the drilled holes at 1250 rpm. Whereas the presence of MWCNTs (Specimen B and specimen C) produced poor surface finish at 500 rpm in comparison with specimen A. Variations in the hole quality characteristics between specimen B and specimen C was marginal with better observations in specimen C.

Image Guided Focal Therapy for Magnetic Resonance Imaging Visible Prostate Cancer: Defining a 3-Dimensional Treatment Margin Based on Magnetic Resonance Imaging Histology Co-Registration Analysis.

PubMed

Le Nobin, Julien; Rosenkrantz, Andrew B; Villers, Arnauld; Orczyk, Clément; Deng, Fang-Ming; Melamed, Jonathan; Mikheev, Artem; Rusinek, Henry; Taneja, Samir S

2015-08-01

We compared prostate tumor boundaries on magnetic resonance imaging and radical prostatectomy histological assessment using detailed software assisted co-registration to define an optimal treatment margin for achieving complete tumor destruction during image guided focal ablation. Included in study were 33 patients who underwent 3 Tesla magnetic resonance imaging before radical prostatectomy. A radiologist traced lesion borders on magnetic resonance imaging and assigned a suspicion score of 2 to 5. Three-dimensional reconstructions were created from high resolution digitalized slides of radical prostatectomy specimens and co-registered to imaging using advanced software. Tumors were compared between histology and imaging by the Hausdorff distance and stratified by the magnetic resonance imaging suspicion score, Gleason score and lesion diameter. Cylindrical volume estimates of treatment effects were used to define the optimal treatment margin. Three-dimensional software based registration with magnetic resonance imaging was done in 46 histologically confirmed cancers. Imaging underestimated tumor size with a maximal discrepancy between imaging and histological boundaries for a given tumor of an average ± SD of 1.99 ± 3.1 mm, representing 18.5% of the diameter on imaging. Boundary underestimation was larger for lesions with an imaging suspicion score 4 or greater (mean 3.49 ± 2.1 mm, p <0.001) and a Gleason score of 7 or greater (mean 2.48 ± 2.8 mm, p = 0.035). A simulated cylindrical treatment volume based on the imaging boundary missed an average 14.8% of tumor volume compared to that based on the histological boundary. A simulated treatment volume based on a 9 mm treatment margin achieved complete histological tumor destruction in 100% of patients. Magnetic resonance imaging underestimates histologically determined tumor boundaries, especially for lesions with a high imaging suspicion score and a high Gleason score. A 9 mm treatment margin around a lesion visible on magnetic resonance imaging would consistently ensure treatment of the entire histological tumor volume during focal ablative therapy. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Identification of Cytological Features Distinguishing Mucosa-Associated Lymphoid Tissue Lymphoma from Reactive Lymphoid Proliferation Using Thyroid Liquid-Based Cytology

PubMed Central

Suzuki, Ayana; Hirokawa, Mitsuyoshi; Ito, Aki; Takada, Nami; Higuchi, Miyoko; Hayashi, Toshitetsu; Kuma, Seiji; Miyauchi, Akira

2018-01-01

Objective To identify cytological differences between mucosa-associated lymphoid tissue lymphoma (MALT-L) and nonneoplastic lymphocytes using thyroid liquid-based cytology (LBC). Study Design We observed LBC and conventional specimens from 35 MALT-L cases, 3 diffuse large B-cell cell lymphoma (DLBCL) cases, and 44 prominent nonneoplastic lymphocytic infiltration cases. Results In MALT-L cases, the incidence of lymphoglandular bodies in the LBC specimens was lower than that in the conventional specimens (p < 0.001). Moreover, the nuclear sizes in LBC specimens were larger than those in conventional specimens. In 62.9% of the MALT-L and all DLBCL specimens, large nuclei were present in > 10% of the lymphoid cells in LBC specimens. Two cases with prominent nonneoplastic lymphocytic infiltration also exhibited these findings. In LBC specimens, swollen naked nuclei with less punctate chromatin patterns and thin nuclear margins were observed in 92.1% of lymphoma and 20.5% of prominent nonneoplastic lymphocytic infiltration. Elongated nuclei were significantly more apparent in thyroid lymphoma than in prominent nonneoplastic lymphocytic infiltration (p < 0.001), with a significantly higher incidence in LBC specimens than in conventional specimens (p < 0.001). Conclusions Lymphoglandular bodies are not reliable markers for lymphoma diagnosis using LBC specimens. Large, swollen naked, and elongated nuclei are useful in distinguishing thyroid lymphoma from nonneoplastic lymphocytes in LBC specimens. PMID:29597203

The Effect of Antibiotic Exposure and Specimen Volume on the Detection of Bacterial Pathogens in Children With Pneumonia.

PubMed

Driscoll, Amanda J; Deloria Knoll, Maria; Hammitt, Laura L; Baggett, Henry C; Brooks, W Abdullah; Feikin, Daniel R; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; O'Brien, Katherine L; Scott, J Anthony G; Thea, Donald M; Howie, Stephen R C; Adrian, Peter V; Ahmed, Dilruba; DeLuca, Andrea N; Ebruke, Bernard E; Gitahi, Caroline; Higdon, Melissa M; Kaewpan, Anek; Karani, Angela; Karron, Ruth A; Mazumder, Razib; McLellan, Jessica; Moore, David P; Mwananyanda, Lawrence; Park, Daniel E; Prosperi, Christine; Rhodes, Julia; Saifullah, Md; Seidenberg, Phil; Sow, Samba O; Tamboura, Boubou; Zeger, Scott L; Murdoch, David R

2017-06-15

Antibiotic exposure and specimen volume are known to affect pathogen detection by culture. Here we assess their effects on bacterial pathogen detection by both culture and polymerase chain reaction (PCR) in children. PERCH (Pneumonia Etiology Research for Child Health) is a case-control study of pneumonia in children aged 1-59 months investigating pathogens in blood, nasopharyngeal/oropharyngeal (NP/OP) swabs, and induced sputum by culture and PCR. Antibiotic exposure was ascertained by serum bioassay, and for cases, by a record of antibiotic treatment prior to specimen collection. Inoculated blood culture bottles were weighed to estimate volume. Antibiotic exposure ranged by specimen type from 43.5% to 81.7% in 4223 cases and was detected in 2.3% of 4863 controls. Antibiotics were associated with a 45% reduction in blood culture yield and approximately 20% reduction in yield from induced sputum culture. Reduction in yield of Streptococcus pneumoniae from NP culture was approximately 30% in cases and approximately 32% in controls. Several bacteria had significant but marginal reductions (by 5%-7%) in detection by PCR in NP/OP swabs from both cases and controls, with the exception of S. pneumoniae in exposed controls, which was detected 25% less frequently compared to nonexposed controls. Bacterial detection in induced sputum by PCR decreased 7% for exposed compared to nonexposed cases. For every additional 1 mL of blood culture specimen collected, microbial yield increased 0.51% (95% confidence interval, 0.47%-0.54%), from 2% when volume was ≤1 mL to approximately 6% for ≥3 mL. Antibiotic exposure and blood culture volume affect detection of bacterial pathogens in children with pneumonia and should be accounted for in studies of etiology and in clinical management. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Case-controlled clinical and histopathological study of conjunctivochalasis.

PubMed

Francis, I C; Chan, D G; Kim, P; Wilcsek, G; Filipic, M; Yong, J; Coroneo, M T

2005-03-01

Conjunctivochalasis, a secondary cause of the watery eye, is frequently seen in the older age group as an elevation of the bulbar conjunctiva lying along the lateral or central lower lid margin. A prospective, interventional, case-controlled clinical and histopathological study was conducted. The relevant features of 18 patients (29 eyes) who had their conjunctivochalasis resected as part of the surgical management of their watery eye syndrome were examined. In the control group, tissue was obtained from an age matched series of 24 normal subjects undergoing routine cataract surgery. 24 controls (24 specimens) and 18 patients (29 specimens) had conjunctival strip biopsies, taken from the usual lid margin level bulbar conjunctiva in line with the inferior limbus (controls), and the clinically apparent conjunctivochalasis (patients). These were submitted for histological study. 23 of 24 control sections demonstrated normal conjunctival variation. Four of 29 patient specimens demonstrated a chronic non-granulomatous conjunctivitis, while three eyes of the patient group (two patients) demonstrated features of elastosis. Of the four patients who had the inflammatory infiltrates, three had functional nasolacrimal duct obstructions (FNLDOs) and one had a primary acquired nasolacrimal duct obstruction (PANDO). Of the two patients who had elastosis, one had an FNLDO and the other had normal lacrimal drainage and was Jones 1 positive. Six of 18 patients--that is, seven of 29 specimens of conjunctivochalasis demonstrated signs of elastosis or of chronic non-granulomatous inflammation. Clinically, patients had a spectrum of aetiologies of their watery eye syndrome.

The effect of porcelain firing and type of finish line on the marginal fit of zirconia copings.

PubMed

Vojdani, Mahroo; Safari, Anahita; Mohaghegh, Mina; Pardis, Soheil; Mahdavi, Farideh

2015-06-01

Although all-ceramic restorations are broadly used, there is a lack of information concerning how their fit is affected by fabrication procedure and marginal configuration. The purpose of this study was to evaluate the marginal fit of zirconia CAD/CAM ceramic crowns before and after porcelain firing. The influence of finish line configuration on the marginal fit was also evaluated. Twenty standardized zirconia CAD/CAM copings were fabricated for chamfer and shoulder finish line designs (n=10). The marginal fit of specimens was measured on 18 points, marked on the master metal die by using a digital microscope. After the crowns were finalized by porcelain veneering, the measurements of marginal fit were performed again. The means and standard deviations were calculated and data were analyzed using student's t-test and paired t-test (α=0.05). There were significant differences between marginal fit of chamfer and shoulder finish line groups before and after porcelain firing (p= 0.014 and p= 0.000, respectively). The marginal gap of copings with shoulder finish line was significantly smaller than those with chamfer configuration (p= 0.000), but there were no significant differences between the two marginal designs, after porcelain firing (p= 0.341). Porcelain veneering was found to have a statistically significant influence on the marginal fit of zirconia CAD/CAM crowns. Both margin configurations showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.

Prospective Analysis of Surgical Bone Margins After Partial Foot Amputation in Diabetic Patients Admitted With Moderate to Severe Foot Infections.

PubMed

Schmidt, Brian M; McHugh, Jonathan B; Patel, Rajiv M; Wrobel, James S

2018-04-01

Osteomyelitis is common in diabetic foot infections and medical management can lead to poor outcomes. Surgical management involves sending histopathologic and microbiologic specimens which guides future intervention. We examined the effect of obtainment of surgical margins in patients undergoing forefoot amputations to identify patient characteristics associated with outcomes. Secondary aims included evaluating interobserver reliability of histopathologic data at both the distal-to and proximal-to surgical bone margin. Data were prospectively collected on 72 individuals and was pooled for analysis. Standardized method to retrieve intraoperative bone margins was established. A univariate analysis was performed. Negative outcomes, including major lower extremity amputation, wound dehiscence, reulceration, reamputation, or death were recorded. Viable proximal margins were obtained in 63 out of 72 cases (87.5%). Strong interobserver reliability of histopathology was recorded. Univariate analysis demonstrated preoperative platelets, albumin, probe-to-bone testing, absolute toe pressures, smaller wound surface area were associated with obtaining viable margins. Residual osteomyelitis resulted in readmission 2.6 times more often and more postoperative complications. Certain patients were significantly different in the viable margin group versus dirty margin group. High interobserver reliability was demonstrated. Obtainment of viable margins resulted in reduced rates of readmission and negative outcomes. Prognostic, Level I: Prospective.

Validation of full-field optical coherence tomography in distinguishing malignant and benign tissue in resected pancreatic cancer specimens

PubMed Central

Fariña-Sarasqueta, Arantza; de Haan, Lorraine M.; Eggermont, Jeroen; Bonsing, Bert A.; Morreau, Hans; Lelieveldt, Boudewijn P. F.; van de Velde, Cornelis J. H.; Vahrmeijer, Alexander L.; Dijkstra, Jouke

2017-01-01

Background Pancreatic cancer is the fourth leading cause of cancer-related mortality in the United States. The minority of patients can undergo curative-intended surgical therapy due to progressive disease stage at time of diagnosis. Nonetheless, tumor involvement of surgical margins is seen in up to 70% of resections, being a strong negative prognostic factor. Real-time intraoperative imaging modalities may aid surgeons to obtain tumor-free resection margins. Full-field optical coherence tomography (FF-OCT) is a promising diagnostic tool using high-resolution white-light interference microscopy without tissue processing. Therefore, we composed an atlas of FF-OCT images of malignant and benign pancreatic tissue, and investigated the accuracy with which the pathologists could distinguish these. Materials and methods One hundred FF-OCT images were collected from specimens of 29 patients who underwent pancreatic resection for various indications between 2014 and 2016. One experienced gastrointestinal pathologist and one pathologist in training scored independently the FF-OCT images as malignant or benign blinded to the final pathology conclusion. Results were compared to those obtained with standard hematoxylin and eosin (H&E) slides. Results Overall, combined test characteristics of both pathologists showed a sensitivity of 72%, specificity of 74%, positive predictive value of 69%, negative predictive value of 79% and an overall accuracy of 73%. In the subset of pancreatic ductal adenocarcinoma patients, 97% of the FF-OCT images (n = 35) were interpreted as tumor by at least one pathologist. Moreover, normal pancreatic tissue was recognised in all cases by at least one pathologist. However, atrophy and fibrosis, serous cystadenoma and neuroendocrine tumors were more often wrongly scored, in 63%, 100% and 25% respectively. Conclusion FF-OCT could distinguish normal pancreatic tissue from pathologic pancreatic tissue in both processed as non-processed specimens using architectural features. The accuracy in pancreatic ductal adenocarcinoma is promising and warrants further evaluation using improved assessment criteria. PMID:28414765

Prospective multicenter registration study of colorectal cancer: significant variations in radicality and oncosurgical quality-Swiss Group for Clinical Cancer Research Protocol SAKK 40/00.

PubMed

Maurer, Christoph A; Dietrich, Daniel; Schilling, Martin K; Metzger, Urs; Laffer, Urban; Buchmann, Peter; Lerf, Bruno; Villiger, Peter; Melcher, Gian; Klaiber, Christian; Bilat, Christian; Brauchli, Peter; Terracciano, Luigi; Kessler, Katharina

2017-01-01

This study aimed to investigate in a multicenter cohort study the radicality of colorectal cancer resections, to assess the oncosurgical quality of colorectal specimens, and to compare the performance between centers. One German and nine Swiss hospitals agreed to prospectively register all patients with primary colorectal cancer resected between September 2001 and June 2005. The median number of eligible patients with one primary tumor included per center was 95 (range 12-204). The following variations of median values or percentages between centers were found: length of bowel specimen 20-39 cm (25.8 cm), maximum height of mesocolon 6.5-12.5 cm (9.0 cm), number of examined lymph nodes 9-24 (16), distance to nearer bowel resection margin in colon cancer 4.8-12 cm (7 cm), and in rectal cancer 2-3 cm (2.5 cm), central ligation of major artery 40-97 % (71 %), blood loss 200-500 ml (300 ml), need for perioperative blood transfusion 5-40 % (19 %), tumor opened during mobilization 0-11 % (5 %), T4-tumors not en-bloc resected 0-33 % (4 %), inadvertent perforation of mesocolon/mesorectum 0-8 % (4 %), no-touch isolation technique 36-86 % (67 %), abdominoperineal resection for rectal cancer 0-30 % (17 %), rectal cancer specimen with circumferential margin ≤1 mm 0-19 % (10 %), in-hospital mortality 0-6 % (2 %), anastomotic leak or intra-abdominal abscess 0-17 % (7 %), re-operation 0-17 % (8 %). In colorectal cancer, surgery considerable variations between different centers were found with regard to radicality and oncosurgical quality, suggesting a potential for targeted improvement of surgical technique.

A comparison of microscopic ink characteristics of 35 commercially available surgical margin inks.

PubMed

Milovancev, Milan; Löhr, Christiane V; Bildfell, Robert J; Gelberg, Howard B; Heidel, Jerry R; Valentine, Beth A

2013-11-01

To compare microscopic characteristics of commercially available surgical margin inks used for surgical pathology specimens. Prospective in vitro study. Thirty-five different surgical margin inks (black, blue, green, orange, red, violet, and yellow from 5 different manufacturers). Inks were applied to uniform, single-source, canine cadaveric full-thickness ventral abdominal tissue blocks. Tissue blocks and ink manufacturers were randomly paired and each color was applied to a length of the cut tissue margin. After drying, tissues were fixed in formalin, and 3 radial slices were obtained from each color section and processed for routine histologic evaluation, yielding 105 randomly numbered slides with each manufacturer's color represented in triplicate. Slides were evaluated by 5 blinded, board-certified veterinary anatomic pathologists using a standardized scoring scheme. Statistical analyses were performed to evaluate for ink manufacturer effects on scores, correlation among different subjective variables, and pathologist agreement. Black and blue had the most consistently high scores whereas red and violet had the most consistently low overall scores, across all manufacturers. All colors tested, except yellow, had statistically significant differences in overall scores among individual manufacturers. Overall score was significantly correlated to all other subjective microscopic scores evaluated. The average Spearman correlation coefficient among the 10 pairwise pathologists overall ink scores was 0.60. There are statistically significant differences in microscopic ink characteristics among manufacturers, with a notable degree of inter-pathologist agreement. © Copyright 2013 by The American College of Veterinary Surgeons.

Complete embedding and close step-sectioning of radical prostatectomy specimens both increase detection of extra-prostatic extension, and correlate with increased disease-free survival by stage of prostate cancer patients.

PubMed

Desai, A; Wu, H; Sun, L; Sesterhenn, I A; Mostofi, F K; McLeod, D; Amling, C; Kusuda, L; Lance, R; Herring, J; Foley, J; Baldwin, D; Bishoff, J T; Soderdahl, D; Moul, J W

2002-01-01

The objectives of this work were to evaluate the efficacy of controlled close step-sectioned and whole-mounted radical prostatectomy specimen processing in prediction of clinical outcome as compared to the traditional processing techniques. Two-hundred and forty nine radical prostatectomy (RP) specimens were whole-mounted and close step-sectioned at caliper-measured 2.2-2.3 mm intervals. A group of 682 radical prostatectomy specimens were partially sampled as control. The RPs were performed during 1993-1999 with a mean follow-up of 29.3 months, pretreatment PSA of 0.1-40, and biopsy Gleason sums of 5-8. Disease-free survival based on biochemical or clinical recurrence and secondary intervention were computed using a Kaplan-Meier analysis. There were no significant differences in age at diagnosis, age at surgery, PSA at diagnosis, or biopsy Gleason between the two groups (P<0.05). Compared with the non-close step-sectioned group, the close step-sectioned group showed higher detection rates of extra-prostatic extension (215 (34.1%) vs, 128 (55.4%), P<0.01), and seminal vesicle invasion (50 (7.6%) vs 35 (14.7%), P<0.01). The close step-sectioned group correlated with greater 3-y disease-free survival in organ-confined (P<0.01) and specimen-confined (P<0.01) cases, over the non-uniform group. The close step-sectioned group showed significantly higher disease-free survival for cases with seminal vesicle invasion (P=0.046). No significant difference in disease-free survival was found for the positive margin group (P=0.39) between the close step-sectioned and non-uniform groups. The close step-sectioned technique correlates with increased disease-free survival rates for organ and specimen confined cases, possibly due to higher detection rates of extra-prostatic extension and seminal vesicle invasion. Close step-sectioning provides better assurance of organ-confined disease, resulting in enhanced prediction of outcome by pathological (TNM) stage.

Carbon dioxide laser fiber for the excision of oral leukoplakia.

PubMed

Chee, Michael; Sasaki, Clarence

2013-09-01

We compared the efficacies of cold knife excision and carbon dioxide (CO2) laser fiber excision of oral cavity leukoplakia. Between August 2009 and June 2011,45 patients who underwent excision of oral cavity leukoplakia were assessed for operative time, use of bipolar cautery, blood loss, and number of intraoperative margins needed. Patients were assigned randomly to either a cold knife group (23 procedures) or a CO2 laser fiber group (24 procedures) at the time of the procedure. The times of excision were similar in the CO2 laser fiber group (1.64 min/cm2) and the cold knife group (1.70 min/cm2). There were large differences between the CO2 laser fiber group and the cold knife group in the categories of bipolar cautery uses per square centimeter (0.34 uses versus 3.32 uses) and blood loss (0.19 g/cm2 versus 2.55 g/cm2). The average number of margins needed to clear a specimen by frozen section was 1.21 for the CO2 laser fiber group and 1.83 for the cold knife group. The CO2 laser fiber did not show an advantage in operative time. The CO2 laser fiber did show better outcomes in the areas of blood loss, bipolar cautery use, and intraoperative margins needed.

Hall versus conventional stainless steel crown techniques: in vitro investigation of marginal fit and microleakage using three different luting agents.

PubMed

Erdemci, Zeynep Yalçınkaya; Cehreli, S Burçak; Tirali, R Ebru

2014-01-01

This study's purpose was to investigate microleakage and marginal discrepancies in stainless steel crowns (SSCs) placed using conventional and Hall techniques and cemented with three different luting agents. Seventy-eight human primary maxillary second molars were randomly assigned to two groups (N=39), and SSCs were applied either with the Hall or conventional technique. These two groups were further subgrouped according to the material used for crown cementation (N=13 per group). Two specimens in each group were processed for scanning electron microscopy investigation. The extent of microleakage and marginal fit was quantified in millimeters on digitally photographed sections using image analysis software. The data were compared with a two-way independent and a two-way mixed analysis of variance (P=.05). The scores in the Hall group were significantly worse than those in the conventional technique group (P<.05). In both groups, resin cement displayed the lowest extent of microleakage, followed by glass ionomer and polycarboxylate cements (P<.05). Stainless steel crowns applied using the Hall technique displayed higher microleakage scores than those applied using the conventional technique, regardless of the cementation material. When the interaction of the material and technique was assessed, resin cement presented as the best choice for minimizing microleakage in both techniques.

Aspects of the distribution, population structure and reproduction of the gastropod Tibia delicatula (Nevill, 1881) inhabiting the oxygen minimum zone of the Oman and Pakistan continental margins

NASA Astrophysics Data System (ADS)

Ramirez-Llodra, Eva; Olabarria, Celia

2005-11-01

The present study describes some aspects of the distribution and biology of Tibia delicatula (Nevill), a gastropod belonging to the family Strombidae. This species has been found in large numbers in the upper oxygen minimum zone (OMZ) of the Oman margin, and has also been collected from the OMZ of the Pakistan margin. The highest abundance of adult specimens in the Oman OMZ was found between 300 and 450 m. Numbers dropped rapidly below 450 m, to zero below 500 m depth. Similarly dense populations were not observed in the Pakistan OMZ. Multiple regression with oxygen concentration and depth indicates that depth (and its related variables) is the main factor explaining the variation in abundance of T. delicatula. The populations from the Oman and Pakistan OMZs were dominated by juveniles. This suggests a unimodal size structure with evidence of a marked recruitment event. Basic reproductive aspects were analysed. All specimens had a penis and sperm groove. The gonad wall consisted of reticular tissue that might be used for nutrient storage or as an irrigation system. Only vitellogenic oocytes were present. The large oocyte sizes observed (200-300 μm) suggest a lecithotrophic larval development.

Pterygodermatites (Paucipectines) baiomydis n. sp. (Nematoda: Rictulariidae), a parasite of Baiomys taylori (Cricetidae)

PubMed Central

Lynggaard, Christina; García-Prieto, Luis; Guzmán-Cornejo, Carmen; Osorio-Sarabia, David

2014-01-01

Pterygodermatites (Paucipectines) baiomydis n. sp., an intestinal parasite of the northern pygmy mouse, Baiomys taylori (Cricetidae), collected in La Yerbabuena, Colima, Mexico, is described herein. Specimens were studied using light and scanning electronic microscopy. This is the 19th species of the subgenus Paucipectines described worldwide and the fourth collected in Mexico. It is differentiated from the remaining species in the subgenus by having 25 perioral denticles, arranged in a triangle (seven on each lateroventral margin, and eleven on the dorsal margin), and 10 pairs of caudal papillae. PMID:25375029

PFC2D simulation of thermally induced cracks in concrete specimens

NASA Astrophysics Data System (ADS)

Liu, Xinghong; Chang, Xiaolin; Zhou, Wei; Li, Shuirong

2013-06-01

The appearance of cracks exposed to severe environmental conditions can be critical for concrete structures. The research is to validate Particle Flow Code(PFC2D) method in the context of concrete thermally-induced cracking simulations. First, concrete was discreted as meso-level units of aggregate, cement mortar and the interfaces between them. Parallel bonded-particle model in PFC2D was adapted to describe the constitutive relation of the cementing material. Then, the concrete mechanics meso-parameters were obtained through several groups of biaxial tests, in order to make the numerical results comply with the law of the indoor test. The concrete thermal meso-parameters were determined by compared with the parameters in the empirical formula through the simulations imposing a constant heat flow to the left margin of concrete specimens. At last, a case of 1000mm×500mm concrete specimen model was analyzed. It simulated the formation and development process of the thermally-induced cracks under the cold waves of different durations and temperature decline. Good agreements in fracture morphology and process were observed between the simulations, previous studies and laboratory data. The temperature decline limits during cold waves were obtained when its tensile strength was given as 3MPa. And it showed the feasibility of using PFC2D to simulate concrete thermally-induced cracking.

No-Touch Radiofrequency Ablation: A Comparison of Switching Bipolar and Switching Monopolar Ablation in Ex Vivo Bovine Liver

PubMed Central

Chang, Won; Lee, Sang Min; Han, Joon Koo

2017-01-01

Objective To evaluate the feasibility, efficiency, and safety of no-touch switching bipolar (SB) and switching monopolar (SM) radiofrequency ablation (RFA) using ex vivo bovine livers. Materials and Methods A pork loin cube was inserted as a tumor mimicker in the bovine liver block; RFA was performed using the no-touch technique in the SM (group A1; 10 minutes, n = 10, group A2; 15 minutes, n = 10) and SB (group B; 10 minutes, n = 10) modes. The groups were compared based on the creation of confluent necrosis with sufficient safety margins, the dimensions, and distance between the electrode and ablation zone margin (DEM). To evaluate safety, small bowel loops were placed above the liver surface and 30 additional ablations were performed in the same groups. Results Confluent necroses with sufficient safety margins were created in all specimens. SM RFA created significantly larger volumes of ablation compared to SB RFA (all p < 0.001). The DEM of group B was significantly lower than those of groups A1 and A2 (all p < 0.001). Although thermal injury to the small bowel was noted in 90%, 100%, and 30% of the cases in groups A1, A2, and B, respectively, full depth injury was noted only in 60% of group A2 cases. Conclusion The no-touch RFA technique is feasible in both the SB and SM modes; however, SB RFA appears to be more advantageous compared to SM RFA in the creation of an ablation zone while avoiding the unnecessary creation of an adjacent parenchymal ablation zone or adjacent small bowel injuries. PMID:28246508

Intraoperative narrow band imaging better delineates superficial resection margins during transoral laser microsurgery for early glottic cancer.

PubMed

Garofolo, Sabrina; Piazza, Cesare; Del Bon, Francesca; Mangili, Stefano; Guastini, Luca; Mora, Francesco; Nicolai, Piero; Peretti, Giorgio

2015-04-01

The high rate of positive margins after transoral laser microsurgery (TLM) remains a matter of debate. This study investigates the effect of intraoperative narrow band imaging (NBI) examination on the incidence of positive superficial surgical margins in early glottic cancer treated by TLM. Between January 2012 and October 2013, 82 patients affected by Tis-T1a glottic cancer were treated with TLM by type I or II cordectomies. Intraoperative NBI evaluation was performed using 0-degree and 70-degree rigid telescopes. Surgical specimens were oriented by marking the superior edge with black ink and sent to a dedicated pathologist. Comparison between the rate of positive superficial margins in the present cohort and in a matched historical control group treated in the same way without intraoperative NBI was calculated by chi-square test. At histopathological examination, all surgical margins were negative in 70 patients, whereas 7 had positive deep margins, 2 close, and 3 positive superficial margins. The rate of positive superficial margins was thus 3.6% in the present group and 23.7% in the control cohort (P<.001). Routine use of intraoperative NBI increases the accuracy of neoplastic superficial spreading evaluation during TLM for early glottic cancer. © The Author(s) 2014.

The effect of various veneering techniques on the marginal fit of zirconia copings

PubMed Central

Torabi, Kianoosh; Vojdani, Mahroo; Giti, Rashin; Pardis, Soheil

2015-01-01

PURPOSE This study aimed to evaluate the fit of zirconia ceramics before and after veneering, using 3 different veneering processes (layering, press-over, and CAD-on techniques). MATERIALS AND METHODS Thirty standardized zirconia CAD/CAM frameworks were constructed and divided into three groups of 10 each. The first group was veneered using the traditional layering technique. Press-over and CAD-on techniques were used to veneer second and third groups. The marginal gap of specimens was measured before and after veneering process at 18 sites on the master die using a digital microscope. Paired t-test was used to evaluate mean marginal gap changes. One-way ANOVA and post hoc tests were also employed for comparison among 3 groups (α=.05). RESULTS Marginal gap of 3 groups was increased after porcelain veneering. The mean marginal gap values after veneering in the layering group (63.06 µm) was higher than press-over (50.64 µm) and CAD-on (51.50 µm) veneered groups (P<.001). CONCLUSION Three veneering methods altered the marginal fit of zirconia copings. Conventional layering technique increased the marginal gap of zirconia framework more than pressing and CAD-on techniques. All ceramic crowns made through three different veneering methods revealed clinically acceptable marginal fit. PMID:26140175

Two new species of Litobothrium Dailey, 1969 (Cestoda: Litobothriidea) from thresher sharks in the Gulf of California, Mexico, with redescriptions of two species in the genus.

PubMed

Olson, P D; Caira, J N

2001-03-01

As part of a survey of the metazoan parasites of elasmobranchs of the Gulf of California, Mexico, the spiral intestines of 10 pelagic thresher sharks Alopias pelagicus and one bigeye thresher shark A. superciliosus were examined for tapeworms. Eight of the A. pelagicus specimens examined were found to host Litobothrium amplifica and L. daileyi. Both tapeworm species are redescribed based on examination of this new material with light and scanning electron microscopy, and the ranges of most of the measurements for these species are expanded; scanning electron micrographs and detailed illustrations and measurements of their segment anatomy are presented for the first time. An argument is made that the identification of the original host specimens of these species was in error and that A. pelagicus is likely to be the correct original host. In addition, L. nickoli n. sp., a third species in the genus hosted by A. pelagicus, was found in three of the 10 individual hosts examined. This species differs from all six known Litobothrium species in the form of the pseudosegments of the scolex, the anterior two being essentially non-cruciform, while the latter three are distinctly cruciform. All other species possess either no non-cruciform or at most one non-cruciform segment anteriorly. The single specimen of A. superciliosus examined was found to host the new species, L. janovyi. This species differs from L. coniformis, L. gracile and L. amsichensis in its possession of four rather than three, three and five cruciform pseudosegments, respectively. It lacks the modificiations of the fourth pseudosegment seen in L. amplifica and lacks the anterior non-cruciform fifth pseudosegment found in L. daileyi. It most closely resembles L. alopias but differs among other features in its greater total length, greater number of segments and longer mature segments. SEM of the four species collected from the Gulf of California as well as material of L. amsichensis from the goblin shark Mitsukurina owstoni that hosted the type-specimens of this species show that all surfaces of the body of all five species bear a dense covering of long filiform microtriches. L. amplifica bears a single row of large spine-like structures throughout most of the posterior margins of the first and second cruciform pseudosegment only. L. daileyi possesses one to two rows of overlapping spine-like structures on the posterior margins of the first four pseudosegments with the exception of the medial projections. The fifth pseudosegment lacks these structures. L. janovyi n. sp. bears spine-like structures on the lateral margins of only the third and fourth pseudosegments. L. nickoli n. sp. bears spine-like structures throughout the posterior margins of the first and second pseudosegments, and throughout the posterior margins of the third and fourth pseudosegments with the exception of the medial projections; the fifth pseudosegment lacks these structures. L. amsichensis bears no structures that could be considered to be spine-like on any of its pseuosegments, but possesses a border of densely arranged larger microtriches on the posterior margin of all five pseudosegments. A key to the species is included.

Whipple Resection: Concordance Between Frozen Section And Permanent Section Diagnosis Of Surgical Margins.

PubMed

Bilal, Muhammad; Tariq, Hina; Mamoon, Nadira

2018-01-01

Margin assessment is done in Whipple procedures which are usually performed to resect tumours of head of pancreas and ampullary/periampullary region. Aims and objective of the study are to determine the concordance between frozen sections (FS) and permanent sections (PS) of surgical margins in Whipple resections. It is a retrospective study, from January 2008 to January 2015 (07 years). It includes the specimen with malignancy in final report and for which FS of pancreatic and/or CBD margin(s) were requested. Data was retrieved from Laboratory information system (LIS) database. Of the 41 bile duct margins in cases of ampullary tumours, 03 were positive on FS as well as PS, 35 were negative on FS as well as on PS. Results showed 100% sensitivity, 92.1% specificity, 50% PPV and 100% NPV. Results of 36 pancreatic margins in cases of ampullary showed 100% sensitivity, 97.1% specificity, 50% PPV and 100% NPV. In pancreatic carcinoma cases, none of CBD margins were reported as positive on FS, 02 margins reported as negative were found positive on PS, while 17 were negative on FS as well as PS. Results showed 100% specificity and 89.5% NPV. Of the 27 pancreatic margins tested in pancreatic tumours 100% sensitivity, 94.1% specificity, 88.9% PPV and 100% NPV was found. Factors such as absent prior tissue diagnosis and/or inflammatory processes make margin diagnosis difficult. However, a high concordance was observed between our FS and PS diagnosis.

The Effect of Porcelain Firing and Type of Finish Line on the Marginal Fit of Zirconia Copings

PubMed Central

Vojdani, Mahroo; Safari, Anahita; Mohaghegh, Mina; Pardis, Soheil; Mahdavi, Farideh

2015-01-01

Statement of the Problem Although all-ceramic restorations are broadly used, there is a lack of information concerning how their fit is affected by fabrication procedure and marginal configuration. Purpose The purpose of this study was to evaluate the marginal fit of zirconia CAD/CAM ceramic crowns before and after porcelain firing. The influence of finish line configuration on the marginal fit was also evaluated. Materials and Method Twenty standardized zirconia CAD/CAM copings were fabricated for chamfer and shoulder finish line designs (n=10). The marginal fit of specimens was measured on 18 points, marked on the master metal die by using a digital microscope. After the crowns were finalized by porcelain veneering, the measurements of marginal fit were performed again. The means and standard deviations were calculated and data were analyzed using student’s t-test and paired t-test (α=0.05). Results There were significant differences between marginal fit of chamfer and shoulder finish line groups before and after porcelain firing (p= 0.014 and p= 0.000, respectively). The marginal gap of copings with shoulder finish line was significantly smaller than those with chamfer configuration (p= 0.000), but there were no significant differences between the two marginal designs, after porcelain firing (p= 0.341). Conclusion Porcelain veneering was found to have a statistically significant influence on the marginal fit of zirconia CAD/CAM crowns. Both margin configurations showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy. PMID:26046107

Skin cancer margin analysis within minutes with full-field OCT (Conference Presentation)

NASA Astrophysics Data System (ADS)

Dalimier, Eugénie; Ogrich, Lauren; Morales, Diego; Cusack, Carrie Ann; Abdelmalek, Mark; Boccara, Claude; Durkin, John

2017-02-01

Non-melanoma skin cancer (NMSC) is the most common cancer. Treatment consists of surgical removal of the skin cancer. Traditional excision involves the removal of the visible skin cancer with a significant margin of normal skin. On cosmetically sensitive areas, Mohs micrographic tissue is the standard of care. Mohs uses intraoperative microscopic margin assessment which minimizes the surgical defect and can help reduce the recurrence rate by a factor of 3. The current Mohs technique relies on frozen section tissue slide preparation which significantly lengthens operative time and requires on-site trained histotechnicians. Full-Field Optical Coherence Tomography (FFOCT) is a novel optical imaging technique which provides a quick and efficient method to visualize cancerous areas in minutes, without any preparation or destruction of the tissue. This study aimed to evaluate the potential of FFOCT for the analysis of skin cancer margins during Mohs surgery. Over 150 images of Mohs specimens were acquired intraoperatively with FFOCT before frozen section analysis. The imaging procedure took less than 5 minutes for each specimen. No artifacts on histological preparation were found arising from FFOCT manipulation; however frozen section artifact was readily seen on FFOCT. An atlas was established with FFOCT images and corresponding histological slides to reveal FFOCT reading criteria of normal and cancerous structures. Blind analysis showed high concordance between FFOCT and histology. FFOCT can potentially reduce recurrence rates while maintaining short surgery times, optimize clinical workflow, and decrease healthcare costs. For the patient, this translates into smaller infection risk, decreased stress, and better comfort.

Electrical impedance map (EIM) for margin assessment during robot-assisted laparoscopic prostatectomy (RALP) using a microendoscopic probe

NASA Astrophysics Data System (ADS)

Mahara, Aditya; Khan, Shadab; Schned, Alan R.; Hyams, Elias S.; Halter, Ryan J.

2015-03-01

Positive surgical margins (PSMs) found following prostate cancer surgery are a significant risk factor for post-operative disease recurrence. Noxious adjuvant radiation and chemical-based therapies are typically offered to men with PSMs. Unfortunately, no real-time intraoperative technology is currently available to guide surgeons to regions of suspicion during the initial prostatectomy where immediate surgical excisions could be used to reduce the chance of PSMs. A microendoscopic electrical impedance sensing probe was developed with the intention of providing real-time feedback regarding margin status to surgeons during robot-assisted laparoscopic prostatectomy (RALP) procedures. A radially configured 17-electrode microendoscopic probe was designed, constructed, and initially evaluated through use of gelatin-based phantoms and an ex vivo human prostate specimen. Impedance measurements are recorded at 10 frequencies (10 kHz - 100 kHz) using a high-speed FPGA-based electrical impedance tomography (EIT) system. Tetrapolar impedances are recorded from a number of different electrode configurations strategically chosen to sense tissue in a pre-defined sector underlying the probe face. A circular electrical impedance map (EIM) with several color-coded pie-shaped sectors is created to represent the impedance values of the probed tissue. Gelatin phantom experiments show an obvious distinction in the impedance maps between high and low impedance regions. Similarly, the EIM generated from the ex vivo prostate case shows distinguishing features between cancerous and benign regions. Based on successful development of this probe and these promising initial results, EIMs of additional prostate specimens are being collected to further evaluate this approach for intraoperative surgical margin assessment during RALP procedures.

Microleakage in Class V Composite Restorations after Desensitizing Surface Treatment with Er:YAG and CO2 Lasers.

PubMed

Mozaffari, Hamid Reza; Ehteshami, Alireza; Zallaghi, Farshad; Chiniforush, Nasim; Moradi, Zohreh

2016-12-30

Aims: Glutaraldehyde, CO 2 and Er:YAG lasers can be used for treatment of dentin hypersensitivity. However, their application may have adverse effects on the clinical service of restorations. This study aimed to assess the microleakage in composite restorations following surface treatment with Glutaraldehyde desensitizer, CO 2 and Er:YAG laser irradiation for treatment of dentin hypersensitivity. Materials and methods: This experimental study was conducted on 60 extracted sound human teeth. Class V cavities were prepared measuring 3×3 mm using a diamond bur. Specimens were randomly divided into 4 groups of 15. Group one:no surface treatment, Group two:applying Glutaraldehyde desensitizer, Groups of three and four were irradiated with CO 2 and Er:YAG lasers, respectively. Surfaces were restored with bonding agent (Single Bond 2, 3M, USA) and Z250 composite (3M, USA). Specimens were thermocycled and immersed in 1% methylene blue solution for 24 hours. Microleakage scores were assessed under a stereomicroscope at ×20 magnification. Data were analyzed using SPSS and the Kruskal Wallis test (P=0.05). Results: There was no significant difference between microleakage of groups in enamel margins (P=0.694). The difference in microleakage at the dentin margin was significant between groups (P=0.018). Conclusions: Application of Glutaraldehyde-desensitizer and CO 2 laser irradiation of surfaces prior to composite restoration do not increase microleakage at the enamel or dentin margins but tooth surface treatment with Er:YAG laser significantly increased the microleakage at the dentin margins.

Influence of polyurethane resin dies on the fit and adaptation of full veneer crowns.

PubMed

Lillywhite, Graeme R R; Vohra, Fahim

2015-01-01

Polyurethane resin is a possible alternative to type IV dental stone for fabrication of indirect restorations however its dimensional accuracy is questionable. The aim was to investigate the dimensional accuracy of silica filled polyurethane resin die material by evaluating the marginal fit and adaptation of indirect gold castings. Experimental, in vitro study. Totally 40 copper plated replicas of a nickel chrome master die analogous to a veneer gold crown preparation were made and impressions recorded using polyvinylsiloxane material. Twenty impressions were poured in type IV dental stone (control group (Vel-mix, Kerr, UK) and the remaining (n = 20) in silica filled polyurethane die material (test group) (Alpha Die MF, CA, USA). Gold castings were fabricated for each die using standardized techniques. The castings were seated on their respective copper plated dies, embedded in resin and sectioned. The specimens were analyzed by measuring marginal opening and the area beneath the casting at a ×63 magnification and using image analysis software. Data were analyzed using a Student's t-test. No significant difference was observed between the experimental groups (P > 0.05). The mean marginal opening for type IV, dental stone and polyurethane resin, was 57 ± 22.6 μm and 63.47 ± 27.1 μm, respectively. Stone displayed a smaller area beneath the casting (31581 ± 16297 μm 2 ) as compared to polyurethane resin (35003 ± 23039 μm 2 ). The fit and adaptation of indirect gold castings made on polyurethane and type IV dental stone dies were comparable.

Comparing the Marginal Adaptation of Cold Ceramic and Mineral Trioxide Aggregate by Means of Scanning Electron Microscope: An In vitro Study.

PubMed

Mokhtari, Fatemeh; Modaresi, Jalil; Javadi, Gholamreza; Davoudi, Amin; Badrian, Hamid

2015-09-01

Long-term success of endodontic surgeries is often influenced by the type of root-end filling material (RFM). The aim of present study was to compare the marginal adaptation of two different RFM, cold ceramic (CC) and mineral trioxide aggregate (MTA), using scanning electron microscope (SEM). About 20 extracted human single-rooted teeth were collected and stored into sodium hypochlorite 5.25%. The teeth were decronated from the cemento-enamel junction to prepare 16 mm roots. The working length was measured, and 1/3 coronal of the canal was prepared by Gates-Glidden drills. Apical flaring was followed by K file size # 40-70 based on step back technique. After filling of the canals, 3 mm above the apex was cut at 90° to the long axis. Furthermore, 3 mm of the filling was removed from the apical part using the ultrasonic device. All of the prepared specimens were divided into two groups and were retro filled by MTA and CC. The roots were cut horizontally from 1 mm above the apical part, and dentin-filling material interface was observed by SEM. Finally, the collected data were analyzed by Mann-Whitney test and using SPSS software version 18 at a significant level of 0.05. The mean interfacial adaptation was higher in CC group. However, no significant differences were observed by statistical test (P = 0.35). Both CC and MTA had similar marginal adaptation as RFM however in vivo studies are recommended for better determination.

Raman spectroscopy reveals biophysical markers in skin cancer surgical margins

NASA Astrophysics Data System (ADS)

Feng, Xu; Moy, Austin J.; Nguyen, Hieu T. M.; Zhang, Yao; Fox, Matthew C.; Sebastian, Katherine R.; Reichenberg, Jason S.; Markey, Mia K.; Tunnell, James W.

2018-02-01

The recurrence rate of nonmelanoma skin cancer is highly related to the residual tumor after surgery. Although tissueconserving surgery, such as Mohs surgery, is a standard method for the treatment of nonmelanoma skin cancer, they are limited by lengthy and costly frozen-section histopathology. Raman spectroscopy (RS) is proving to be an objective, sensitive, and non-destructive tool for detecting skin cancer. Previous studies demonstrated the high sensitivity of RS in detecting tumor margins of basal cell carcinoma (BCC). However, those studies rely on statistical classification models and do not elucidate the skin biophysical composition. As a result, we aim to discover the biophysical differences between BCC and primary normal skin structures (including epidermis, dermis, hair follicle, sebaceous gland and fat). We obtained freshly resected ex vivo skin samples from fresh resection specimens from 14 patients undergoing Mohs surgery. Raman images were acquired from regions containing one or more structures using a custom built 830nm confocal Raman microscope. The spectra were grouped using K-means clustering analysis and annotated as either BCC or each of the five normal structures by comparing with the histopathology image of the serial section. The spectral data were then fit by a previously established biophysical model with eight primary skin constituents. Our results show that BCC has significant differences in the fit coefficients of nucleus, collagen, triolein, keratin and elastin compared with normal structures. Our study reveals RS has the potential to detect biophysical changes in resection margins, and supports the development of diagnostic algorithms for future intraoperative implementation of RS during Mohs surgery.

Bioactive glass fillers reduce bacterial penetration into marginal gaps for composite restorations

PubMed Central

Khvostenko, D.; Hilton, T. J.; Ferracane, J. L.; Mitchell, J. C.; Kruzic, J. J.

2015-01-01

Objectives Bioactive glass (BAG) is known to possess antimicrobial and remineralizing properties; however, the use of BAG as a filler for resin based composite restorations to slow recurrent caries has not been studied. Accordingly, the objective of this study was to investigate the effect of 15 wt% BAG additions to a resin composite on bacterial biofilms penetrating into marginal gaps of simulated tooth fillings in vitro during cyclic mechanical loading. Methods Human molars were machined into approximately 3 mm thick disks of dentin and 1.5–2 mm deep composite restorations were placed. A narrow 15–20 micrometer wide dentin-composite gap was allowed to form along half of the margin by not applying dental adhesive to that region. Two different 72 wt% filled composites were used, one with 15 wt% BAG filler (15BAG) and the balance silanated strontium glass and one filled with OX-50 and silanated strontium glass without BAG (0BAG – control). Samples of both groups had Streptococcus mutans biofilms grown on the surface and were tested inside a bioreactor for two weeks while subjected to periods of cyclic mechanical loading. After post-test biofilm viability was confirmed, each specimen was fixed in glutaraldehyde, gram positive stained, mounted in resin and cross-sectioned to reveal the gap profile. Depth of biofilm penetration for 0BAG and 15BAG was quantified as the fraction of gap depth. The data were compared using a Student’s t-test. Results The average depth of bacterial penetration into the marginal gap for the 15BAG samples was significantly smaller (~61%) in comparison to 0BAG, where 100% penetration was observed for all samples with the biofilm penetrating underneath of the restoration in some cases. Significance BAG containing resin dental composites reduce biofilm penetration into marginal gaps of simulated tooth restorations. This suggests BAG containing composites may have the potential to slow the development and propagation of secondary tooth decay at restoration margins. PMID:26621028

Influence of Hand Instrumentation and Ultrasonic Scaling on the Microleakage of various Cervical Restorations: An in vitro Study.

PubMed

Rohani, Bita; Barekatain, Mehrdad; Farhad, Shirin Z; Haghayegh, Navid

2017-06-01

In cervical lesions, various restorative materials can be inserted, which can be affected by the application of periodontal scalers. This study evaluated and compared the marginal seal of class V glass ionomer, composite resin, and amalgam restorations after subjecting them to hand instrumentation and ultrasonic scaling. In this experimental study, 30 sound human first premolars were selected. In each tooth, buccal and lingual cavities (4 mm mesiodistal width, 3 mm occlusogingival height, and 2 mm depth) were made. The teeth were randomly assigned to three groups of 10 teeth: (1) Glass ionomer group, (2) composite group, and (3) amalgam group. Teeth were subjected to thermocycling procedure for 1,000 cycles between 5 and 55°C water baths and a 1-minute dwell time. Then, each group was randomly subdivided: (1) Margins of 30 restorations were exposed to hand instrumentation procedures by applying 10 working strokes, (2) margins of 30 restorations were exposed to a periodontal tip mounted on a piezoelectric ultrasonic handpiece working at 25 kHz for 10 seconds. The specimens were serially sectioned mesiodistally. Each section was examined under a stereomicroscope. The extent of microleakage was ranked using a 0 to 4 scale at both occlusal and cervical margins of the restorations. Data were analyzed initially using the Kruskal-Wallis test, followed by multiple comparisons using the Mann-Whitney and Wilcoxon test. The type of restorative material had a significant influence on dye penetration, whether in the enamel margin or in the dentinal margin (p < 0.001). The microleakage of glass ionomer group was the highest. No statistical differences were found in dye penetration between scaling groups (hand instrumentation and ultrasonic scaling) (p > 0.05). Type of restorative material had a significant influence on microleakage. No statistical differences were found in dye penetration between scaling groups. The microleakage of glass ionomer restoration is greater than amalgam and composite restorations after subjecting them to hand instrumentation and ultrasonic scaling.

Comparative Evaluation of Marginal Adaptation and Fracture Strength of Different Ceramic Inlays Produced by CEREC Omnicam and Heat-Pressed Technique.

PubMed

Oz, F D; Bolay, S

2018-01-01

The aim of this in vitro study was to evaluate marginal adaptation and fracture strength of inlays produced by CEREC Omnicam using different types of blocs and heat-pressed technique. Methods: Seventy-five extracted human mandibular molars were divided randomly into 5 groups ( n =15). 60 molars in four groups received MOD inlay preparations. Experimental groups were CO: Intact teeth, EC: IPS e.max CAD and CEREC, LU: Lava Ultimate and CEREC, EL: IPS Empress CAD and CEREC, EP: IPS Empress Esthetic ingots and heat-pressed technique. Marginal gap measurements were taken with a stereomicroscope. Restorations were cemented with Variolink N and stored in distilled water at 37°C for 24 hours. All samples were subjected to thermocycling. The fracture strength of specimens was determined at a 0.5 mm/min crosshead speed until fracture. Fracture modes were determined. Statistical analyses were performed using one-way analysis of variance for fracture strength data and Kruskal-Wallis for marginal gap data ( p =0.05). The mean marginal gap size of EC, LU, EL, and EP were 33.54  µ m, 33.77  µ m, 34.23  µ m, and 85.34  µ m, respectively. EP had statistically higher values than other groups. The fracture strength values were significantly higher in the intact teeth group (3959,00 ± 1279,79 N) than those of restored groups EC (2408,00 ± 607,97 N), LU (2206,73 ± 675,16), EL (2573.27 ± 644,73) ve EP (2879,53 ± 897,30). Inlays fabricated using CEREC Omnicam demonstrated better marginal adaptation than inlays produced with heat-pressed technique, whereas fracture strength values of inlays fabricated with different type of blocks using CEREC Omnicam exhibited similarity to those fabricated with heat-pressed technique.

Comparative Evaluation of Marginal Adaptation and Fracture Strength of Different Ceramic Inlays Produced by CEREC Omnicam and Heat-Pressed Technique

PubMed Central

Bolay, S.

2018-01-01

Objective The aim of this in vitro study was to evaluate marginal adaptation and fracture strength of inlays produced by CEREC Omnicam using different types of blocs and heat-pressed technique. Methods: Seventy-five extracted human mandibular molars were divided randomly into 5 groups (n=15). 60 molars in four groups received MOD inlay preparations. Experimental groups were CO: Intact teeth, EC: IPS e.max CAD and CEREC, LU: Lava Ultimate and CEREC, EL: IPS Empress CAD and CEREC, EP: IPS Empress Esthetic ingots and heat-pressed technique. Marginal gap measurements were taken with a stereomicroscope. Restorations were cemented with Variolink N and stored in distilled water at 37°C for 24 hours. All samples were subjected to thermocycling. The fracture strength of specimens was determined at a 0.5 mm/min crosshead speed until fracture. Fracture modes were determined. Statistical analyses were performed using one-way analysis of variance for fracture strength data and Kruskal–Wallis for marginal gap data (p=0.05). Results The mean marginal gap size of EC, LU, EL, and EP were 33.54 µm, 33.77 µm, 34.23 µm, and 85.34 µm, respectively. EP had statistically higher values than other groups. The fracture strength values were significantly higher in the intact teeth group (3959,00 ± 1279,79 N) than those of restored groups EC (2408,00 ± 607,97 N), LU (2206,73 ± 675,16), EL (2573.27 ± 644,73) ve EP (2879,53 ± 897,30). Conclusion Inlays fabricated using CEREC Omnicam demonstrated better marginal adaptation than inlays produced with heat-pressed technique, whereas fracture strength values of inlays fabricated with different type of blocks using CEREC Omnicam exhibited similarity to those fabricated with heat-pressed technique. PMID:29853894

Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection.

PubMed

Park, Jun Chul; Park, Yehyun; Kim, Hyun Ki; Jo, Jeong-Hyeon; Park, Chan Hyuk; Kim, Eun Hye; Jung, Da Hyun; Chung, Hyunsoo; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan

2017-05-01

We evaluated probe-based confocal laser endomicroscopy (pCLE) in the margin delineation of early gastric cancer (EGC) for endoscopic submucosal dissection in comparison with white-light imaging with chromoendoscopy (CE). We conducted a prospective, randomized controlled study from November 2013 to October 2014 in a tertiary referral hospital. A total of 101 patients scheduled for endoscopic submucosal dissection due to differentiated EGC were randomized into pCLE and CE groups (pCLE 51, CE 50). Markings were made by electrocautery at the proximal and distal tumor margins, as determined by either pCLE or CE. The distance from the marking to the tumor margin was measured in the resected specimen histopathologically and was compared between the two groups by a linear mixed model. Among 104 lesions, 80 lesions with 149 markings (pCLE 68, CE 81) were analyzed after excluding undifferentiated EGCs (n = 8) and unidentifiable markings (n = 13). Although the complete resection rate showed no difference between the groups (94.6% vs 93.2%, P = 1.000), the median distance from the marking to the margin was shorter in the pCLE group (1.3 vs 1.8 mm, P = 0.525) and the proportion of the distance <1 mm was higher (43.9% vs 27.6%, P = 0.023) in the pCLE group. Finally, subgroup analysis with superficial flat lesions (18 lesions, 31 marking dots) showed a significantly decreased distance in the pCLE group (0.5 vs 3.1 mm, P = 0.007). Among EGCs with superficial flat morphology, in which the accurate evaluation of lateral extent is difficult with CE, pCLE would be useful for more precise margin delineation. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma.

PubMed

Jang, Jeon Yeob; Choi, Nayeon; Ko, Young-Hyeh; Chung, Man Ki; Son, Young-Ik; Baek, Chung-Hwan; Baek, Kwan-Hyuck; Jeong, Han-Sin

2017-06-01

The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers. We retrospectively analyzed the clinical data of 325 patients with surgically treated oral cavity squamous cell carcinomas to determine the effect of a close surgical margin (<5 mm) (cSM 5 ) on local recurrence. In addition, the depth of microscopic tumor infiltration was determined in 90 available surgical specimens. The cSM 5 was not related to the risk of local tumor recurrence in early-stage oral cancer, while it significantly increased the rate of local tumor recurrence in resectable advanced-stage oral cancers (hazard ratio 3.157, 95 % confidence interval 1.050-9.407, p = 0.041). Addition of postoperative adjuvant radiation to early-stage tumors with cSM 5 did not further reduce the local recurrence rate compared to surgery alone. The depth of microscopic tumor extension from the gross tumor border was significantly associated with primary tumor thickness (ρ = 0.390, p < 0.001) and tumor sizes (ρ = 0.308, p = 0.003), which was a median (range) of 0.84 (0.14-2.32) mm in T1, 1.06 (0.20-4.34) mm in T2, and 1.77 (0.13-4.70) mm in T3-4. The cSM 5 was a significant risk factor for local recurrence only in advanced oral cancers, but not in early-stage tumors, where microscopic tumor extension was not beyond 3 mm in T1 tumors. Thus, the extent of surgical safety margin can be redefined according to the primary tumor size.

Multicolour versus monocolour inking specimens after pancreaticoduodenectomy for periampullary cancer: A single centre prospective randomised clinical trial.

PubMed

Casadei, Riccardo; Ricci, Claudio; Taffurelli, Giovanni; Pacilio, Carlo Alberto; Santini, Donatella; Di Marco, Mariacristina; Minni, Francesco

2018-03-01

R status represents an important prognostic factors in periampullary cancers. Thus, it is useful to verify if it can be influenced by different techniques of margination. Single-centre, randomised clinical trial of patients affected by periampullary cancer who underwent pancreaticoduodenectomies which included two different types of margination: arm A (multicolour inking) and arm B (monocolour inking). The primary endpoint was the overall R1 resection rate and its difference between the two arms. The secondary endpoints were the R1 resection rate in each margin and its difference between the two arms, and the impact of margin status on survival. Fifty patients were randomised, 41 analysed: 22 in arm A, 19 arm B. The overall R1 status was 61%, without significant differences between the two arms. The margin most commonly involved was the superior mesenteric artery (SMA) (36.6%). A trend in favour of arm B was shown for the superior mesenteric artery margin (arm A = 22.7% versus arm B = 52.6%; P = 0.060). The anterior surface (P = 0.015), SMA (P = 0.047) and pancreatic remnant (P = 0.018) margins significantly influenced disease-free survival. The R status was not influenced by different techniques of margination using a standardised pathological protocol. The SMA margin seemed to be the most important margin for evaluating both R status and disease-free survival. Copyright © 2018. Published by Elsevier Ltd.

Microleakage and shear punch bond strength in class II primary molars cavities restored with low shrink silorane based versus methacrylate based composite using three different techniques.

PubMed

Fahmy, Amal Ezzeldin; Farrag, Nadia Moustafa

2010-01-01

This in vitro study aimed to evaluate the gingival microleakage in class II cavities in primary molars restored with a low shrink silorane resin composite (Filtek P90) or a nanohybride composite resin (Filtek supreme XT) using three different techniques, (total bonding, closed or open sandwich techniques) lined by nano-filled resin modified glass ionomer cement RMGIC (Ketac N100). Additionally, the shear punch bond strength between the two types of composite and KNIO0 was also examined. For microleakage test, two standardized class II slot cavities were prepared in proximal surfaces of 60 sound extracted primary molars which were divided into 2 groups of 30 each according to the type of composite. Each group was subdivided into 3 groups (n = 10) according to the restorative technique used. The restored teeth were examined for microleakage after immersion in 2% methylene blue dye using stereomicroscope at 20 X. Microleakage scores among the groups were compared using Kruskal Wallis test followed by pair wise Mann Whitney U test at P < or = 0.05. Thirty disc specimens were prepared for determining the shear punch bond strength between the two composite materials and the KN100. Specimens were divided into 5 groups (n = 6) according to the adhesive protocol. The differences in mean bond strength values in MPa between groups were statistically analyzed using ANOVA followed by pair wise Tukey Post hoc test at P < or = 0. 05. Mode of failure was also evaluated for all groups. Both the silorane resin and nano-composite resin showed superior marginal seal with the total bonding technique compared to closed and open sandwich techniques. The recorded mean shear punch bond strength values showed no statistical significant difference between the two resin composites without or with their adhesive bonding systems when bonded to the nano-ionomer. All specimens showed cohesive mode of failures except for silorane resin with Adper Easy Bond Self Etch Adhesive (AEBSEA) which showed adhesive mode of failure. The best marginal seal was obtained with the total bonding technique using both resin composites. The shear punch bond strength between KN100 and the two composite materials was not affected by either of the used adhesive bonding agent.

Holographic evaluation of the marginal fits of complete crowns loaded at the central fossa

NASA Astrophysics Data System (ADS)

Chen, Terry Y.; Chang, Guan L.; Wu, Shih H.

1995-05-01

In dentistry, a defect of cementation on the margins of crowns accumulates bacterial plaque easily. This can result in recurrent caries and periodontal disease. In this paper holographic interferometry was applied to evaluate the effect of masticatory force on various complete crowns. Four complete molar crowns made from different materials (Au alloy, Pd-Ag alloy, Ni-Cr alloy, and porcelain fused to metal) were tested. The out-of-plane displacements of the crown specimens were measured by the method of multiple observations. The displacements measured range from 6 to 10 micrometers under normal load (25 N). However, the marginal openings of all four crowns were estimated to be less than 0.2 micrometers . In addition the defect of the crown was examined.

Two new species of the genus Haplotropis Saussure, 1888 (Orthoptera, Acridoidea, Pamphagidae) from China.

PubMed

Ye, Bao-Hua; Yin, Zhan; Li, Xin-Jiang

2016-06-30

Two new species of the genus Haplotropis Saussure, 1888 from China are described in this paper. The new species Haplotropis xiai sp. nov. is similar to Haplotropis brunneriana Saussure, 1888, but differs from latter by frontal ridge of male widened at median ocellus; tegmina narrower, cover 2/5 tympanum; cercus of male apical half part gently tapering; lower margin of epiphallus with high projection in the middle; anterior margin of pronotum in female with distinct acute angular in middle; length of subgenital plate shorter than width in female. The Haplotropis zhuoluensis sp. nov. is similar to Haplotropis xiai sp. nov., but differs from latter by anterior margin of pronotum reaching hind margin of eyes; length of temina is 1.6 times in male and 1.3 times in female of width; length of interspace shorter than narrowest in mesosternum of male; ancorae of epiphallus oblique inward distinctly, lower margin with high projection in the middle; length of subgenital plate longer than width in female. Type specimens are deposited in the College of Life Sciences, Hebei University, Baoding, China.

Fretting wear behaviors of a dual-cooled nuclear fuel rod under a simulated rod vibration

NASA Astrophysics Data System (ADS)

Lee, Young-Ho; Kim, Hyung-Kyu; Kang, Heung-Seok; Yoon, Kyung-Ho; Kim, Jae-Yong; Lee, Kang-Hee

2012-06-01

Recently, a dual-cooled fuel (i.e., annular fuel) that is compatible with current operating PWR plants has been proposed in order to realize both a considerable amount of power uprating and an increase of safety margins. As the design concept should be compatible with current operating PWR plants, however, it shows a narrow gap between the fuel rods when compared with current solid nuclear fuel arrays and needs to modify the spacer grid shapes and their positions. In this study, fretting wear tests have been performed to evaluate the wear resistance of a dual-cooled fuel by using a proposed spring and dimple of spacer grids that have a cantilever type and hemispherical shape, respectively. As a result, the wear volume of the spring specimen gradually increases as the contact condition is changed from a certain gap, just contact to positive force. However, in the dimple specimen, just contact condition shows a large wear volume. In addition, a circular rod motion at upper region of contact surface is gradually increased and its diametric size depends on the wear depth increase. Based on the test results, the fretting wear resistance of the proposed spring and dimple is analyzed by comparing the wear measurement results and rod motion in detail.

Flexural behavior of reinforced concrete beam with polymer coated pumice

NASA Astrophysics Data System (ADS)

Nainggolan, Christin Remayanti; Wijatmiko, Indradi; Wibowo, Ari

2017-09-01

Sustainable development has become an important issue due to the increasing consideration of preserving the nature. Many alternative for coarse aggregate replacement have been investigated ranging from natural and fabricated aggregates. In this study, natural aggregate pumice was investigated since it offers lower density that give paramount benefit in reducing total building weight and hence reducing the earthquake excitation effect and optimizing the structural dimension. However, the characteristic of porous surfaces of pumice causes excessive water absorption during concrete mixing process. Therefore, to reduce the additional water, the pumice aggregates were coated with polymer. The tested specimens consisted of normal concrete beams (NCB), uncoated pumice aggregate concrete beam (UPA) and polymer coated pumice aggregate concrete beam (PCP). The objective of the research was to obtain the effect of coating on the pumice aggregate to the flexural behavior of concrete beams. The lateral load-displacement behavior, ductility and collapse mechanism were studied. The results showed that there were only marginal drop on the load-carrying capacity of the pumice aggregate beam compared to those of normal beam. Additionally, the ductility coefficient of specimens UPA and PCP decreased of 11,97% and 14,03% respectively compared to NCB, and the ultimate load capacity decreased less than 1%. Overall, the pumice aggregate showed good characteristic for replacing normal coarse aggregate.

Marginal and Internal Gap of Handmade, Milled and 3D Printed Additive Manufactured Patterns for Pressed Lithium Disilicate Onlay Restorations.

PubMed

Revilla-León, M; Olea-Vielba, M; Esteso-Saiz, A; Martínez-Klemm, I; Özcan, M

2018-03-01

On a pressed lithium disilicate restoration, the building up of a wax pattern of the future restoration is a necessary step on the fabrication process. Conventionally, a wax pattern can be produced by handmade or milled procedures; however, the development of additive manufacturing technologies allows a new fabrication method. The present study measured the marginal and internal gap of handmade, milled and additive manufactured patterns for an onlay restoration. A preparation of an onlay restoration was made on an extracted mandibular tooth. A definitive cast was fabricated from a conventional silicone impression of the prepared tooth. Three groups were established: handmade (HM), milled (ML) and additive manufactured (AM); 4 specimens per group were obtained. The marginal and internal gap of each pattern was measured on the extracted molar through a computed tomography test. Sixty measurements were done to measure the marginal gap and another 60 measurements were calculated to analyze the internal gap on each pattern on the prepared tooth. A total of 1.440 measurements were completed. Mann-Whitney and Turkey statistical tests were used for pairwise comparison. The mean of the marginal and internal gap was of 67.56 ± 6.08 μm and 80.62 ± 3.26 μm for the HM group, 85.28 ± 2.17 μm and 96 ± 1.97 μm for the ML group and 86.49 ± 1.74 μm and 91.86 ± 2.88 μm for the AM group, respectively. The HM group presented significantly lower marginal (p=0.029) and internal (p=0.029) gap compared to the ML and AM groups. There was no statistical significant difference (p=0.486) on the marginal gap between the ML and the AM groups, but the AM group, showed significantly (p=0.029) smaller internal gap than the ML group. All the groups presented less than 100 μm marginal and internal gap, which is a considered clinically acceptable. The three fabrication processes are viable option for manufacturing patterns for lithium disilicate onlay restorations, but the best marginal and internal fit was still obtained by the conventional handmade procedures. Copyright© 2018 Dennis Barber Ltd.

[Pathoanatomical preparation and reporting for dysplasias and cancers of the cervix uteri: cervical biopsy, conization, radical hysterectomy and exenteration].

PubMed

Horn, L-C; Einenkel, J; Höckel, M; Kölbl, H; Kommoss, F; Lax, S F; Reich, O; Riethdorf, L; Schmidt, D

2007-07-01

A careful macroscopic description with selection of representative tissue for histological examination is required for quality assurance, for assessing prognostic factors and for answering legal questions in (pre)cancerous lesions of the cervix uteri. Exact and standardized gross inspection and preparation are decisive for the quality of the histopathological statement. The extent of cervical carcinomas should be given in three dimensions, including the relative depth of invasion into the cervical wall. The report should include size, type (according to the WHO classification) and grading of the tumor, the presence of lymphatic as well as blood vessel invasion and perineural involvement. The statement for resection margins should include the vaginal, parametrial, rectal and vesical directions. It is also mandatory to document the number of lymph nodes with metastatic disease in relation to the total number of nodes investigated. The staging should follow the TNM system. In the handling of conisation specimens, it is important to appropriately document localization, horizontal expansion, depth of invasion including microinvasion of any dysplastic or malignant lesions. Clockwise dissection of the conisation specimen, total submission, and step sections are recommended. The preparation of exenteration specimens is a highly skilled job: the exact tumor dimension should be given in its relation to all resected organs and structures with special focus on resection margins.

Clinical outcome of dedifferentiated liposarcoma in the extremities: A retrospective case series of 7 patients.

PubMed

Kito, Munehisa; Yoshimura, Yasuo; Isobe, Ken'ichi; Aoki, Kaoru; Suzuki, Shuichiro; Tanaka, Atsushi; Okamoto, Masanori; Sano, Kenji; Kato, Hiroyuki

2016-09-01

Wide resection is the generally recommended surgical treatment for dedifferentiated liposarcoma (DDLPS) in the extremities. However, it may be appropriate to distinguish the surgical margin of low-grade atypical lipomatous tumor (ALT)/well-differentiated liposarcoma (WDLPS) area from the high-grade dedifferentiated area, because the low- and high-grade areas can be clearly separated, both radiologically and histologically. This study re-evaluated the details of surgical margin of DDLPS in the extremities, and aimed to investigate the optimal surgical margin and the usefulness of adjuvant therapy for DDLPS in the extremities. Seven patients diagnosed with DDLPS in the extremities and treated between 1995 and 2013 were analyzed. The use of adjuvant therapy before and after surgery was assessed, and the surgical margins for the ALT/WDLPS and dedifferentiated areas were re-evaluated by using the specimens resected at surgery. Subsequently, the recurrence rates, metastatic rates, and oncological outcomes were examined. Four and three patients had wide (adequate wide margin, n = 3; inadequate wide margin, n = 1) and marginal margins for the dedifferentiated area, respectively, while three and four patients had wide (adequate wide margin, n = 2; inadequate wide margin, n = 1) and marginal margins for the ALT/WDLPS area, respectively. Postoperative radiotherapy was performed in three patients with an inadequate wide margin or a marginal margin for the dedifferentiated area. No patient had local recurrence. Distant metastases occurred in two patients. These patients died of their disease. The other five patients were disease-free. The ALT/WDLPS and dedifferentiated areas in the tumor margin may be better to be considered separately in determining the appropriate resection extent for DDLPS in the extremities. Postoperative radiotherapy may provide good local control for cases with a narrow surgical margin. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Feasibility and accuracy of computational robot-assisted partial nephrectomy planning by virtual partial nephrectomy analysis.

PubMed

Isotani, Shuji; Shimoyama, Hirofumi; Yokota, Isao; China, Toshiyuki; Hisasue, Shin-ichi; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Ukimura, Osamu; Horie, Shigeo

2015-05-01

To evaluate the feasibility and accuracy of virtual partial nephrectomy analysis, including a color-coded three-dimensional virtual surgical planning and a quantitative functional analysis, in predicting the surgical outcomes of robot-assisted partial nephrectomy. Between 2012 and 2014, 20 patients underwent virtual partial nephrectomy analysis before undergoing robot-assisted partial nephrectomy. Virtual partial nephrectomy analysis was carried out with the following steps: (i) evaluation of the arterial branch for selective clamping by showing the vascular-supplied area; (ii) simulation of the optimal surgical margin in precise segmented three-dimensional model for prediction of collecting system opening; and (iii) detailed volumetric analyses and estimates of postoperative renal function based on volumetric change. At operation, the surgeon identified the targeted artery and determined the surgical margin according to the virtual partial nephrectomy analysis. The surgical outcomes between the virtual partial nephrectomy analysis and the actual robot-assisted partial nephrectomy were compared. All 20 patients had negative cancer surgical margins and no urological complications. The tumor-specific renal arterial supply areas were shown in color-coded three-dimensional model visualization in all cases. The prediction value of collecting system opening was 85.7% for sensitivity and 100% for specificity. The predicted renal resection volume was significantly correlated with actual resected specimen volume (r(2) = 0.745, P < 0.001). The predicted estimated glomerular filtration rate was significantly correlated with actual postoperative estimated glomerular filtration rate (r(2) = 0.736, P < 0.001). Virtual partial nephrectomy analysis is able to provide the identification of tumor-specific renal arterial supply, prediction of collecting system opening and prediction of postoperative renal function. This technique might allow urologists to compare various arterial clamping methods and resection margins with surgical outcomes in a non-invasive manner. © 2015 The Japanese Urological Association.

Active contour configuration model for estimating the posterior ablative margin in image fusion of real-time ultrasound and 3D ultrasound or magnetic resonance images for radiofrequency ablation: an experimental study.

PubMed

Lee, Junkyo; Lee, Min Woo; Choi, Dongil; Cha, Dong Ik; Lee, Sunyoung; Kang, Tae Wook; Yang, Jehoon; Jo, Jaemoon; Bang, Won-Chul; Kim, Jongsik; Shin, Dongkuk

2017-12-21

The purpose of this study was to evaluate the accuracy of an active contour model for estimating the posterior ablative margin in images obtained by the fusion of real-time ultrasonography (US) and 3-dimensional (3D) US or magnetic resonance (MR) images of an experimental tumor model for radiofrequency ablation. Chickpeas (n=12) and bovine rump meat (n=12) were used as an experimental tumor model. Grayscale 3D US and T1-weighted MR images were pre-acquired for use as reference datasets. US and MR/3D US fusion was performed for one group (n=4), and US and 3D US fusion only (n=8) was performed for the other group. Half of the models in each group were completely ablated, while the other half were incompletely ablated. Hyperechoic ablation areas were extracted using an active contour model from real-time US images, and the posterior margin of the ablation zone was estimated from the anterior margin. After the experiments, the ablated pieces of bovine rump meat were cut along the electrode path and the cut planes were photographed. The US images with the estimated posterior margin were compared with the photographs and post-ablation MR images. The extracted contours of the ablation zones from 12 US fusion videos and post-ablation MR images were also matched. In the four models fused under real-time US with MR/3D US, compression from the transducer and the insertion of an electrode resulted in misregistration between the real-time US and MR images, making the estimation of the ablation zones less accurate than was achieved through fusion between real-time US and 3D US. Eight of the 12 post-ablation 3D US images were graded as good when compared with the sectioned specimens, and 10 of the 12 were graded as good in a comparison with nicotinamide adenine dinucleotide staining and histopathologic results. Estimating the posterior ablative margin using an active contour model is a feasible way of predicting the ablation area, and US/3D US fusion was more accurate than US/MR fusion.

3D and 2D marginal fit of pressed and CAD/CAM lithium disilicate crowns made from digital and conventional impressions.

PubMed

Anadioti, Evanthia; Aquilino, Steven A; Gratton, David G; Holloway, Julie A; Denry, Isabelle; Thomas, Geb W; Qian, Fang

2014-12-01

This in vitro study evaluated the 3D and 2D marginal fit of pressed and computer-aided-designed/computer-aided-manufactured (CAD/CAM) all-ceramic crowns made from digital and conventional impressions. A dentoform tooth (#30) was prepared for an all-ceramic crown (master die). Thirty type IV definitive casts were made from 30 polyvinyl siloxane (PVS) impressions. Thirty resin models were produced from thirty Lava Chairside Oral Scanner impressions. Thirty crowns were pressed in lithium disilicate (IPS e.max Press; 15/impression technique). Thirty crowns were milled from lithium disilicate blocks (IPS e.max CAD; 15/impression technique) using the E4D scanner and milling engine. The master die and the intaglio of the crowns were digitized using a 3D laser coordinate measurement machine with accuracy of ±0.00898 mm. For each specimen a separate data set was created for the Qualify 2012 software. The digital master die and the digital intaglio of each crown were merged using best-fitting alignment. An area above the margin with 0.75 mm occlusal-gingival width circumferentially was defined. The 3D marginal fit of each specimen was an average of all 3D gap values on that area. For the 2D measurements, the marginal gap was measured at two standardized points (on the margin and at 0.75 mm above the margin), from standardized facial-lingual and mesial-distal digitized sections. One-way ANOVA with post hoc Tukey's honestly significant difference and two-way ANOVA tests were used, separately, for statistical analysis of the 3D and 2D marginal data (alpha = 0.05). One-way ANOVA revealed that both 3D and 2D mean marginal gap for group A: PVS impression/IPS e.max Press (0.048 mm ± 0.009 and 0.040 mm ± 0.009) were significantly smaller than those obtained from the other three groups (p < 0.0001), while no significant differences were found among groups B: PVS impression/IPS e.max CAD (0.088 mm ± 0.024 and 0.076 mm ± 0.023), C: digital impression/IPS e.max Press (0.089 mm ± 0.020 and 0.075 mm ± 0.015) and D: digital impression/IPS e.max CAD (0.084 mm ± 0.021 and 0.074 mm ± 0.026). The results of two-way ANOVA revealed a significant interaction between impression techniques and crown fabrication methods for both 3D and 2D measurements. The combination of PVS impression method and press fabrication technique produced the most accurate 3D and 2D marginal fits. © 2014 by the American College of Prosthodontists.

Laser conization for the treatment of cervical intraepithelial neoplasia: the experience of the Colposcopy and Laser Surgery Unit, Department of Obstetrics and Gynecology, Conegliano Hospital

NASA Astrophysics Data System (ADS)

Fantin, Gian P.; Grasso, Alessandra; Tasinazzo, Raffaella; Bortolozzi, Giorgio

1998-01-01

From November 1990 to December 1995 eighty patients were treated with laser conization. They were high grade CIN extending to the endocervical canal and/or with purely ectocervical lesions and patients with low grade endocervical CIN persisting more than one year or cyto- histological discrepancy. Before surgery all the patients had colposcopy, cytology and guided cervical biopsies. Seventy-six out of eighty underwent local anaesthesia and in three cases a general anaesthetic was required although one case was treated without any anaesthesia. Complementary vaporization of the cone bed was performed in every single case. All specimens were judged fully evaluable by the pathologist. The accuracy of the preconization histology as evaluated in 79 patients. Exact agreement or a one degree discrepancy between punch biopsies and cone specimens was found in 96.25%. We did not find any unexpected invasive carcinoma. The apex of the specimen was free of disease in 93.75% of cases. A high grade lesion on the endocervical margin was found in 4 out of 5 cases with an apex involvement. Stenosis of the external cervical os occurred in 7 cases, 3 of which were symptomatic. In our experience laser conization is an effective and safe treatment of CIN with the results comparable to the literature.

From Lucy to Kadanuumuu: balanced analyses of Australopithecus afarensis assemblages confirm only moderate skeletal dimorphism.

PubMed

Reno, Philip L; Lovejoy, C Owen

2015-01-01

Sexual dimorphism in body size is often used as a correlate of social and reproductive behavior in Australopithecus afarensis. In addition to a number of isolated specimens, the sample for this species includes two small associated skeletons (A.L. 288-1 or "Lucy" and A.L. 128/129) and a geologically contemporaneous death assemblage of several larger individuals (A.L. 333). These have driven both perceptions and quantitative analyses concluding that Au. afarensis was markedly dimorphic. The Template Method enables simultaneous evaluation of multiple skeletal sites, thereby greatly expanding sample size, and reveals that A. afarensis dimorphism was similar to that of modern humans. A new very large partial skeleton (KSD-VP-1/1 or "Kadanuumuu") can now also be used, like Lucy, as a template specimen. In addition, the recently developed Geometric Mean Method has been used to argue that Au. afarensis was equally or even more dimorphic than gorillas. However, in its previous application Lucy and A.L. 128/129 accounted for 10 of 11 estimates of female size. Here we directly compare the two methods and demonstrate that including multiple measurements from the same partial skeleton that falls at the margin of the species size range dramatically inflates dimorphism estimates. Prevention of the dominance of a single specimen's contribution to calculations of multiple dimorphism estimates confirms that Au. afarensis was only moderately dimorphic.

An Evaluation of the Gap Sizes of 3-Unit Fixed Dental Prostheses Milled from Sintering Metal Blocks.

PubMed

Jung, Jae-Kwan

2017-01-01

This study assessed the clinical acceptability of sintering metal-fabricated 3-unit fixed dental prostheses (FDPs) based on gap sizes. Ten specimens were prepared on research models by milling sintering metal blocks or by the lost-wax technique (LWC group). Gap sizes were assessed at 12 points per abutment (premolar and molar), 24 points per specimen (480 points in a total in 20 specimens). The measured points were categorized as marginal, axial wall, and occlusal for assessment in a silicone replica. The silicone replica was cut through the mesiodistal and buccolingual center. The four sections were magnified at 160x, and the thickness of the light body silicone was measured to determine the gap size, and gap size means were compared. For the premolar part, the mean (standard deviation) gap size was nonsignificantly ( p = 0.139) smaller in the SMB group (68.6 ± 35.6  μ m) than in the LWC group (69.6 ± 16.9  μ m). The mean molar gap was nonsignificantly smaller ( p = 0.852) in the LWC (73.9 ± 25.6  μ m) than in the SMB (78.1 ± 37.4  μ m) group. The gap sizes were similar between the two groups. Because the gap sizes were within the previously proposed clinically accepted limit, FDPs prepared by sintered metal block milling are clinically acceptable.

An Evaluation of the Gap Sizes of 3-Unit Fixed Dental Prostheses Milled from Sintering Metal Blocks

PubMed Central

2017-01-01

This study assessed the clinical acceptability of sintering metal-fabricated 3-unit fixed dental prostheses (FDPs) based on gap sizes. Ten specimens were prepared on research models by milling sintering metal blocks or by the lost-wax technique (LWC group). Gap sizes were assessed at 12 points per abutment (premolar and molar), 24 points per specimen (480 points in a total in 20 specimens). The measured points were categorized as marginal, axial wall, and occlusal for assessment in a silicone replica. The silicone replica was cut through the mesiodistal and buccolingual center. The four sections were magnified at 160x, and the thickness of the light body silicone was measured to determine the gap size, and gap size means were compared. For the premolar part, the mean (standard deviation) gap size was nonsignificantly (p = 0.139) smaller in the SMB group (68.6 ± 35.6 μm) than in the LWC group (69.6 ± 16.9 μm). The mean molar gap was nonsignificantly smaller (p = 0.852) in the LWC (73.9 ± 25.6 μm) than in the SMB (78.1 ± 37.4 μm) group. The gap sizes were similar between the two groups. Because the gap sizes were within the previously proposed clinically accepted limit, FDPs prepared by sintered metal block milling are clinically acceptable. PMID:28246605

Osteology of Galeamopus pabsti sp. nov. (Sauropoda: Diplodocidae), with implications for neurocentral closure timing, and the cervico-dorsal transition in diplodocids

PubMed Central

Mateus, Octávio

2017-01-01

Diplodocids are among the best known sauropod dinosaurs. Numerous specimens of currently 15 accepted species belonging to ten genera have been reported from the Late Jurassic to Early Cretaceous of North and South America, Europe, and Africa. The highest diversity is known from the Upper Jurassic Morrison Formation of the western United States: a recent review recognized 12 valid, named species, and possibly three additional, yet unnamed ones. One of these is herein described in detail and referred to the genus Galeamopus. The holotype specimen of Galeamopus pabsti sp. nov., SMA 0011, is represented by material from all body parts but the tail, and was found at the Howe-Scott Quarry in the northern Bighorn Basin in Wyoming, USA. Autapomorphic features of the new species include a horizontal canal on the maxilla that connects the posterior margin of the preantorbital and the ventral margin of the antorbital fenestrae, a vertical midline groove marking the sagittal nuchal crest, the presence of a large foramen connecting the postzygapophyseal centrodiapophyseal fossa and the spinopostzygapophyseal fossa of mid- and posterior cervical vertebrae, a very robust humerus, a laterally placed, rugose tubercle on the concave proximal portion of the anterior surface of the humerus, a relatively stout radius, the absence of a distinct ambiens process on the pubis, and a distinctly concave posteroventral margin of the ascending process of the astragalus. In addition to the holotype specimen SMA 0011, the skull USNM 2673 can also be referred to Galeamopus pabsti. Histology shows that the type specimen SMA 0011 is sexually mature, although neurocentral closure was not completed at the time of death. Because SMA 0011 has highly pneumatized cervical vertebrae, the development of the lamination appears a more important indicator for individual age than neurocentral fusion patterns. SMA 0011 is one of very few sauropod specimens that preserves the cervico-dorsal transition in both vertebrae and ribs. The association of ribs with their respective vertebrae shows that the transition between cervical and dorsal vertebrae is significantly different in Galeamopus pabsti than in Diplodocus carnegii or Apatosaurus louisae, being represented by a considerable shortening of the centra from the last cervical to the first dorsal vertebra. Diplodocids show a surprisingly high diversity in the Morrison Formation. This can possibly be explained by a combination of geographical and temporal segregation, and niche partitioning. PMID:28480132

Marginal and Internal Discrepancies of Posterior Zirconia-Based Crowns Fabricated with Three Different CAD/CAM Systems Versus Metal-Ceramic.

PubMed

Ortega, Rocio; Gonzalo, Esther; Gomez-Polo, Miguel; Suárez, María J

2015-01-01

The aim of this study was to analyze the marginal and internal fit of metalceramic and zirconia-based crowns. Forty standardized steel specimens were prepared to receive posterior crowns and randomly divided into four groups (n = 10): (1) metal-ceramic, (2) NobelProcera Zirconia, (3) Lava Zirconia, and (4) VITA In-Ceram YZ. All crowns were cemented with glass-ionomer agent and sectioned buccolingually. A scanning electron microscope was used for measurements. Kruskal-Wallis and Wilcoxon signed rank test (α = .05) statistical analyses were conducted. Significant differences (P < .0001) in marginal discrepancies were observed between metal-ceramic and zirconia groups. No differences were found for the axial wall fit (P = .057). Significant differences were shown among the groups in discrepancies at the occlusal cusp (P = .0012) and at the fossa (P = .0062). No differences were observed between surfaces. All zirconia groups showed better values of marginal discrepancies than the metal-ceramic group. Procera Zirconia showed the lowest gaps.

New species of the giant deep-sea isopod genus Bathynomus (Crustacea, Isopoda, Cirolanidae) from Hainan Island, South China Sea.

PubMed

Kou, Qi; Chen, Jun; Li, Xinzheng; He, Lisheng; Wang, Yong

2017-07-01

Several specimens of the giant deep-sea isopod genus Bathynomus were collected by a deep-sea lander at a depth of 898 m near Hainan Island in the northern South China Sea. After careful examination, this material and the specimens collected from the Gulf of Aden, north-western Indian Ocean, previously reported as Bathynomus sp., were identified to be the same as a new species to the genus. Bathynomus jamesi sp. nov. can be distinguished from the congeners by: the distal margin of pleotelson with 11 or 13 short straight spines and central spine not bifid; uropodal endopod and exopod with distolateral corner slightly pronounced; clypeus with lateral margins concave; and antennal flagellum extending when extended posteriorly reaches the pereonite 3. In addition, Bathynomus jamesi sp. nov. is also supported by molecular analyses based on mitochondrial COI and 16S rRNA gene sequences. The distribution range of the new species includes the western Pacific and north-western Indian Ocean. © 2017 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Urothelial carcinoma involving the distal penis.

PubMed

Dason, Shawn; Sheikh, Adeel; Wang, Jing Gennie; Tauqir, Syeda; Davies, Timothy O; Shayegan, Bobby

2012-04-01

Urothelial carcinoma (UC) rarely metastasizes to the penis and skin. We report the case of a 73-year-old man with UC metastases to the corpus spongiosum and dermis of the distal penis. We also review the clinicopathologic characteristics and management options for UC metastasizing to the penis. The patient presented with priapism and edema of the genital region. This follows a 5-year history of urothelial carcinoma in situ that progressed to invasive cancer despite intravesical immunotherapy. Seventeen months prior to presentation, the patient underwent a radical cystectomy with adjuvant chemotherapy. The cystectomy specimen demonstrated a pT4a N2 M0 G3 UC and margins were positive for carcinoma in situ. Follow-up had been negative for recurrence until his presentation with priapism. Incisional biopsy of the glans revealed UC and radical penectomy was performed with negative margins. The penile specimen demonstrated extensive involvement of the corpus spongiosum by UC with lymphovascular invasion and subepidermal involvement. Three months after penectomy, the patient presented with inguinal nodal recurrence. Palliative radiotherapy was administered and the patient passed away eight months after surgery.

Comparison of Macroscopic Pathology Measurements With Magnetic Resonance Imaging and Assessment of Microscopic Pathology Extension for Colorectal Liver Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mendez Romero, Alejandra, E-mail: a.mendezromero@erasmusmc.nl; Verheij, Joanne; Dwarkasing, Roy S.

2012-01-01

Purpose: To compare pathology macroscopic tumor dimensions with magnetic resonance imaging (MRI) measurements and to establish the microscopic tumor extension of colorectal liver metastases. Methods and Materials: In a prospective pilot study we included patients with colorectal liver metastases planned for surgery and eligible for MRI. A liver MRI was performed within 48 hours before surgery. Directly after surgery, an MRI of the specimen was acquired to measure the degree of tumor shrinkage. The specimen was fixed in formalin for 48 hours, and another MRI was performed to assess the specimen/tumor shrinkage. All MRI sequences were imported into our radiotherapymore » treatment planning system, where the tumor and the specimen were delineated. For the macroscopic pathology analyses, photographs of the sliced specimens were used to delineate and reconstruct the tumor and the specimen volumes. Microscopic pathology analyses were conducted to assess the infiltration depth of tumor cell nests. Results: Between February 2009 and January 2010 we included 13 patients for analysis with 21 colorectal liver metastases. Specimen and tumor shrinkage after resection and fixation was negligible. The best tumor volume correlations between MRI and pathology were found for T1-weighted (w) echo gradient sequence (r{sub s} = 0.99, slope = 1.06), and the T2-w fast spin echo (FSE) single-shot sequence (r{sub s} = 0.99, slope = 1.08), followed by the T2-w FSE fat saturation sequence (r{sub s} = 0.99, slope = 1.23), and the T1-w gadolinium-enhanced sequence (r{sub s} = 0.98, slope = 1.24). We observed 39 tumor cell nests beyond the tumor border in 12 metastases. Microscopic extension was found between 0.2 and 10 mm from the main tumor, with 90% of the cases within 6 mm. Conclusions: MRI tumor dimensions showed a good agreement with the macroscopic pathology suggesting that MRI can be used for accurate tumor delineation. However, microscopic extensions found beyond the tumor border indicate that caution is needed in selecting appropriate tumor margins.« less

Two imaging techniques for 3D quantification of pre-cementation space for CAD/CAM crowns.

PubMed

Rungruanganunt, Patchanee; Kelly, J Robert; Adams, Douglas J

2010-12-01

Internal three-dimensional (3D) "fit" of prostheses to prepared teeth is likely more important clinically than "fit" judged only at the level of the margin (i.e. marginal "opening"). This work evaluates two techniques for quantitatively defining 3D "fit", both using pre-cementation space impressions: X-ray microcomputed tomography (micro-CT) and quantitative optical analysis. Both techniques are of interest for comparison of CAD/CAM system capabilities and for documenting "fit" as part of clinical studies. Pre-cementation space impressions were taken of a single zirconia coping on its die using a low viscosity poly(vinyl siloxane) impression material. Calibration specimens of this material were fabricated between the measuring platens of a micrometre. Both calibration curves and pre-cementation space impression data sets were obtained by examination using micro-CT and quantitative optical analysis. Regression analysis was used to compare calibration curves with calibration sets. Micro-CT calibration data showed tighter 95% confidence intervals and was able to measure over a wider thickness range than for the optical technique. Regions of interest (e.g., lingual, cervical) were more easily analysed with optical image analysis and this technique was more suitable for extremely thin impression walls (<10-15μm). Specimen preparation is easier for micro-CT and segmentation parameters appeared to capture dimensions accurately. Both micro-CT and the optical method can be used to quantify the thickness of pre-cementation space impressions. Each has advantages and limitations but either technique has the potential for use as part of clinical studies or CAD/CAM protocol optimization. Copyright © 2010 Elsevier Ltd. All rights reserved.

Minimally invasive anterior pelvic internal fixation: An anatomic study comparing Pelvic Bridge to INFIX.

PubMed

Reichel, Lee M; MacCormick, Lauren M; Dugarte, Anthony J; Rizkala, Amir R; Graves, Sara C; Cole, Peter A

2018-02-01

Anterior external fixation for pelvic ring fractures has shown to effectively improve stability and reduce mortality. However, these fixators can be associated with substantial morbidity such as pin tract infection, premature loss of fixation, and decreased quality of life in patients. Recently, two new methods of subcutaneous anterior pelvic internal fixation have been developed; the INFIX and the Pelvic Bridge. These methods have the purported advantages of lower wound complications, less surgical site pain, and improved quality of life. We sought to investigate the measured distances to critical anatomic structures, as well as the qualitative and topographic differences notable during implantation of both devices in the same cadaveric specimen. The Pelvic Bridge and INFIX were implanted in eleven fresh cadavers. Distances were then measured to: the superficial inguinal ring, round ligament, spermatic cord, lateral femoral cutaneous nerve (LFCN), femoral nerve, femoral artery, and femoral vein. Observations regarding implantation and topography were also recorded. The INFIX had greater measured distances from all structures except for the LFCN, in which its proximity placed this structure at risk. Neither device appears to put other critical structures at risk in the supine position. Significant implantation and topographic differences exist between the devices. The INFIX application lacked "safety margins" concerning the LFCN in 10/11 (90.9%) specimens, while Pelvic Bridge placement lacked "safety margins" with regard to the right superficial ring (1/11, 9%) and the right spermatic cord (1/11, 9%). Both the Pelvic Bridge and INFIX lie at safe distances from most critical pelvic structures in the supine position, though INFIX application places the LFCN at risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

Frozen section analysis of margins for head and neck tumor resections: reduction of sampling errors with a third histologic level.

PubMed

Olson, Stephen M; Hussaini, Mohammad; Lewis, James S

2011-05-01

Frozen section analysis is an essential tool for assessing margins intra-operatively to assure complete resection. Many institutions evaluate surgical defect edge tissue provided by the surgeon after the main lesion has been removed. With the increasing use of transoral laser microsurgery, this method is becoming even more prevalent. We sought to evaluate error rates at our large academic institution and to see if sampling errors could be reduced by the simple method change of taking an additional third section on these specimens. All head and neck tumor resection cases from January 2005 through August 2008 with margins evaluated by frozen section were identified by database search. These cases were analyzed by cutting two levels during frozen section and a third permanent section later. All resection cases from August 2008 through July 2009 were identified as well. These were analyzed by cutting three levels during frozen section (the third a 'much deeper' level) and a fourth permanent section later. Error rates for both of these periods were determined. Errors were separated into sampling and interpretation types. There were 4976 total frozen section specimens from 848 patients. The overall error rate was 2.4% for all frozen sections where just two levels were evaluated and was 2.5% when three levels were evaluated (P=0.67). The sampling error rate was 1.6% for two-level sectioning and 1.2% for three-level sectioning (P=0.42). However, when considering only the frozen section cases where tumor was ultimately identified (either at the time of frozen section or on permanent sections) the sampling error rate for two-level sectioning was 15.3 versus 7.4% for three-level sectioning. This difference was statistically significant (P=0.006). Cutting a single additional 'deeper' level at the time of frozen section identifies more tumor-bearing specimens and may reduce the number of sampling errors.

Aggressive resection at the infiltrative margins of glioblastoma facilitated by intraoperative fluorescein guidance.

PubMed

Neira, Justin A; Ung, Timothy H; Sims, Jennifer S; Malone, Hani R; Chow, Daniel S; Samanamud, Jorge L; Zanazzi, George J; Guo, Xiaotao; Bowden, Stephen G; Zhao, Binsheng; Sheth, Sameer A; McKhann, Guy M; Sisti, Michael B; Canoll, Peter; D'Amico, Randy S; Bruce, Jeffrey N

2017-07-01

OBJECTIVE Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma (GBM). Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue, facilitating safe maximal resection of GBM. In this study, the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing (CE) regions, where this relationship has been established, and into the non-CE (NCE), diffusely infiltrated margins. METHODS Thirty-two patients received fluorescein sodium (3 mg/kg) intravenously prior to resection. Fluorescence was intraoperatively visualized using a Zeiss Pentero surgical microscope equipped with a YELLOW 560 filter. Stereotactically localized biopsy specimens were acquired from CE and NCE regions based on preoperative MRI in conjunction with neuronavigation. The fluorescence intensity of these specimens was subjectively classified in real time with subsequent quantitative image analysis, histopathological evaluation of localized biopsy specimens, and radiological volumetric assessment of the extent of resection. RESULTS Bright fluorescence was observed in all GBMs and localized to the CE regions and portions of the NCE margins of the tumors, thus serving as a visual guide during resection. Gross-total resection (GTR) was achieved in 84% of the patients with an average resected volume of 95%, and this rate was higher among patients for whom GTR was the surgical goal (GTR achieved in 93.1% of patients, average resected volume of 99.7%). Intraoperative fluorescein staining correlated with histopathological alteration in both CE and NCE regions, with positive predictive values by subjective fluorescence evaluation greater than 96% in NCE regions. CONCLUSIONS Intraoperative administration of fluorescein provides an easily visualized marker for glioma pathology in both CE and NCE regions of GBM. These findings support the use of fluorescein as a microsurgical adjunct for guiding GBM resection to facilitate safe maximal removal.

Microleakage of Posterior Composite Restorations with Fiber Inserts Using two Adhesives after ging

PubMed Central

Sharafeddin, F; Yousefi, H; Modiri, Sh; Tondari, A; Safaee Jahromi, SR

2013-01-01

Statement of Problem: Microleakage is one of the most frequent problems associated with resin composites, especially at the gingival margin of posterior restorations. Insertion of fibers in composite restorations can reduce the total amount of composite and help to decrease the shrinkage. Purpose: The aim of this study was to evaluate the effect of polyethylene fiber inserts on gingival microleakage of class II composite restorations using two different adhesive systems. Materials and Method: In this experimental study, class II cavities were prepared on 60 premolars. The gingival floor was located 1.0 mm below the CEJ. Dimension of each cavity were 3 mm buccolingually and 1.5 mm in axial depth. The specimens were divided into 4 groups according to the adhesive type and fiber insert (n=4). Single bond and Clearfill SE bond and Filtek p60 were used to restore the cavities. In groups without fiber inserts composite was adapted onto cavities using layering technique. For cavities with fiber inserts, 3 mm piece of fiber insert was placed onto the composite increment and cured. The specimens were stored in distilled water at 37oC for 6 months. All specimens were subjected to 3000 thermo-cycling. The tooth surfaces except for 1 mm around the restoration margins covered with two layers of nail varnish .The teeth were immersed in 2% Basic Fuchsin for 24 hours, then rinsed and sectioned mesiodistally. The microleakage was determined under a stereomicroscope (40X). Data were statistically analyzed by Kruskal-wallis and Mann-Whitney U tests (p< 0.05). Results: The Kruskal-Wallis test revealed no significant differences in mean microleakage scores among all groups (p= 0.281). Conclusion: Use of polyethylene fiber inserts and etch-and-rinse and self-etch adhesives had no effect on microleakage in class II resin composite restorations with gingival margins below the CEJ after 6- month water storage. PMID:24724129

Design and control of six degree-of-freedom active vibration isolation table.

PubMed

Hong, Jinpyo; Park, Kyihwan

2010-03-01

A six-axis active vibration isolation system (AVIS) is designed by using the direct driven guide and ball contact mechanisms in order to have no cross-coupling between actuators. The point contact configuration gives an advantage of having an easy assembly of eight voice coil actuators to an upper and a base plate. A voice coil actuator is used since it can provide a large displacement and sufficient bandwidth required for vibration control. The AVIS is controlled considering the effect of flexible vibration mode in the upper plate and velocity sensor dynamics. A loop shaping technique and phase margin condition are applied to design a vibration controller. The performances of the AVIS are investigated in the frequency domain and finally validated by comparing with the passive isolation system. The scanning profiles of the specimen are compared together by using the atomic force microscope. The robustness of the AVIS is verified by showing the impulse response.

Design and control of six degree-of-freedom active vibration isolation table

NASA Astrophysics Data System (ADS)

Hong, Jinpyo; Park, Kyihwan

2010-03-01

A six-axis active vibration isolation system (AVIS) is designed by using the direct driven guide and ball contact mechanisms in order to have no cross-coupling between actuators. The point contact configuration gives an advantage of having an easy assembly of eight voice coil actuators to an upper and a base plate. A voice coil actuator is used since it can provide a large displacement and sufficient bandwidth required for vibration control. The AVIS is controlled considering the effect of flexible vibration mode in the upper plate and velocity sensor dynamics. A loop shaping technique and phase margin condition are applied to design a vibration controller. The performances of the AVIS are investigated in the frequency domain and finally validated by comparing with the passive isolation system. The scanning profiles of the specimen are compared together by using the atomic force microscope. The robustness of the AVIS is verified by showing the impulse response.

Planktonic benthonic foraminiferal ratios: Modern patterns and Tertiary applicability

USGS Publications Warehouse

Gibson, T.G.

1989-01-01

The abundance of planktonic specimens in foraminiferal assemblages was determined in numerous bottom samples from inner neritic to deep oceanic depths along the Atlantic margin of the northeastern United States. The results augment previous studies in other areas that have shown a general increase in percentage of planktonic specimens in total foraminiferal bottom assemblages as water depth increases. The patterns found in this area of complex shelf bathymetry and hydrography illustrate the influence on the planktonic-benthonic percentages of water depth, distance from shore, different water mass properties and downslope movement of tests in high energy areas. The patterns found in the 661 samples from the Atlantic margin were compared with results from 795 stations in the Gulf of Mexico, Pacific Ocean and Red Sea. The relative abundance of planktonic specimens and water depth correlates positively in all open oceanic areas even though taxonomic composition and diversity of the faunas from different areas is variable. The variation of planktonic percentages in bottom samples within most depth intervals is large so that a precise depth determination cannot be made for any given value. However, an approximate upper depth limit for given percentages can be estimated for open ocean environments. A decrease in planktonic percentages is seen in the lower salinity and higher turbidity coastal waters of the Gulf of Maine. Planktonic percentages intermediate between the lower values in the less saline coastal waters and the higher values in the normal open oceanic conditions occur in the transitional area between the Gulf of Maine and the open marine Atlantic Ocean to the east. Similarly lowered values in another area of restricted oceanic circulation occur in the high salinity, clear, but nutrient-poor waters of the Gulf of Aqaba off the Red Sea. A comparison of the similarity of modern planktonic percentage values to those found in earlier Tertiary assemblages was made to confirm the usefulness of this measure in the fossil record. In some stratigraphic sections in upper Paleocene and lower Eocene strata of the eastern Gulf Coastal Plain, water depths inferred from trends and values of planktonic percentages consistently match paleobathymetry constructed from physical stratigraphic characteristics and paleogeographic relationships. ?? 1989.

Pattern of Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jobsen, Jan, E-mail: j.jobsen@mst.nl; Palen, Job van der; Department of Research Methodology, Measurement, and Data Analysis, Faculty of Behavioral Science, University of Twente, Enschede

Purpose: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up. Methods and Materials: We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event. Results: The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjectsmore » by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors. Conclusions: We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, much higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors.« less

Influence of artificial aging in marginal adaptation of mixed class V cavities.

PubMed

Tonetto, Mateus Rodrigues; Bandéca, Matheus Coelho; Barud, Hélida Gomes de Oliveira; Pinto, Shelon Cristina Souza; Lima, Darlon Martins; Borges, Alvaro Henrique; de Campos, Edson Alves; de Andrade, Marcelo Ferrarezi

2013-03-01

The aim of this study was to investigate whether the artificial aging by thermal cycling had influenced the marginal adaptation of class V restorations with/without chlorhexidine application in the bond process. Twelve intact human third molars were used. Class V cavity preparations were performed on the buccal surface and the teeth received 35% phosphoric acid-etching procedure (Ultradent Products Inc., South Jordan, Utah, USA). Subsequently, the samples were divided in two groups: Untreated acid-etched dentin and chlorhexidine application as an adjunct in the bond process. The adhesive Single Bond 2 (3M ESPE, St. Paul, MN, USA) was used after 2% chlorhexidine application, and the restorations were performed with Filtek™ Z350 XT (3M ESPE) composite resin. The specimens were submitted to artificial aging by thermal cycling with 3,000 cycles. Analyzes were performed on scanning electron microscopy using replicas of marginal adaptation in percentage of continuous margin before and after the artificial aging. The data were analyzed by paired test and the results showed statistically significant differences in the percentage of continuous margin with/without chlorhexidine treatment before and after thermal cycling. This study concluded that the artificial aging by thermal cycling influenced the marginal adaptation of mixed class V composite restorations.

Optical assessment of tumor resection margins in the breast

PubMed Central

Brown, J. Quincy; Bydlon, Torre M.; Richards, Lisa M.; Yu, Bing; Kennedy, Stephanie A.; Geradts, Joseph; Wilke, Lee G.; Junker, Marlee; Gallagher, Jennifer; Barry, William; Ramanujam, Nimmi

2011-01-01

Breast conserving surgery, in which the breast tumor and surrounding normal tissue are removed, is the primary mode of treatment for invasive and in situ carcinomas of the breast, conditions that affect nearly 200,000 women annually. Of these nearly 200,000 patients who undergo this surgical procedure, between 20–70% of them may undergo additional surgeries to remove tumor that was left behind in the first surgery, due to the lack of intra-operative tools which can detect whether the boundaries of the excised specimens are free from residual cancer. Optical techniques have many attractive attributes which may make them useful tools for intra-operative assessment of breast tumor resection margins. In this manuscript, we discuss clinical design criteria for intra-operative breast tumor margin assessment, and review optical techniques appied to this problem. In addition, we report on the development and clinical testing of quantitative diffuse reflectance imaging (Q-DRI) as a potential solution to this clinical need. Q-DRI is a spectral imaging tool which has been applied to 56 resection margins in 48 patients at Duke University Medical Center. Clear sources of contrast between cancerous and cancer-free resection margins were identified with the device, and resulted in an overall accuracy of 75% in detecting positive margins. PMID:21544237

Hydrostatic pulpal pressure effect upon microleakage.

PubMed

Roberts, Howard W; Pashley, David H

2012-02-01

To evaluate if hydrostatic pulpal pressure plays a role in reducing microleakage. Uniform Class 5 preparations were accomplished on human molars with one margin on root dentin. Prepared teeth were randomly placed in one of three groups: (1) Hydrostatic pressure simulation at 20 cm pulpal pressure; (2) Hydrostatic pressure simulation but no pressure applied (positive control); and (3) Conventional microleakage method. Specimens were subjected to 24 hours methylene blue dye, sectioned, and microleakage assessed as a function of microleakage length versus entire preparation wall length using a traveling microscope. Hydrostatic pressure specimens demonstrated less gingival wall microleakage than the control groups while no difference was found between occlusal preparation walls.

Influence of different restorative techniques on marginal seal of class II composite restorations

PubMed Central

RODRIGUES JUNIOR, Sinval Adalberto; PIN, Lúcio Fernando da Silva; MACHADO, Giovanna; DELLA BONA, Álvaro; DEMARCO, Flávio Fernando

2010-01-01

Objective To evaluate the gingival marginal seal in class II composite restorations using different restorative techniques. Material and Methods Class II box cavities were prepared in both proximal faces of 32 sound human third molars with gingival margins located in either enamel or dentin/cementum. Restorations were performed as follows: G1 (control): composite, conventional light curing technique; G2: composite, soft-start technique; G3: amalgam/composite association (amalcomp); and G4: resin-modified glass ionomer cement/ composite, open sandwich technique. The restored specimens were thermocycled. Epoxy resin replicas were made and coated for scanning electron microscopy examination. For microleakage evaluation, teeth were coated with nail polish and immersed in dye solution. Teeth were cut in 3 slices and dye penetration was recorded (mm), digitized and analyzed with Image Tool software. Microleakage data were analyzed statistically by non-parametric Kruskal-Wallis and Mann-Whitney tests. Results Leakage in enamel was lower than in dentin (p<0.001). G2 exhibited the lowest leakage values (p<0.05) in enamel margins, with no differences between the other groups. In dentin margins, groups G1 and G2 had similar behavior and both showed less leakage (p<0.05) than groups G3 and G4. SEM micrographs revealed different marginal adaptation patterns for the different techniques and for the different substrates. Conclusion The soft-start technique showed no leakage in enamel margins and produced similar values to those of the conventional (control) technique for dentin margins. PMID:20379680

Tumor response and negative distal resection margins of rectal cancer after hyperthermochemoradiation therapy.

PubMed

Tsutsumi, Soichi; Tabe, Yuichi; Fujii, Takaaki; Yamaguchi, Satoru; Suto, Toshinaga; Yajima, Reina; Morita, Hiroki; Kato, Toshihide; Shioya, Mariko; Saito, Jun-Ichi; Asao, Takayuki; Nakano, Takashi; Kuwano, Hiroyuki

2011-11-01

The safety of regional hyperthermia has been tested in locally advanced rectal cancer. The aim of this study was to assess the effects of shorter distal margins on local control and survival in rectal cancer patients who were treated with preoperative hyperthermochemoradiation therapy (HCRT) and underwent rectal resection by using the total mesorectal excision (TME) method. Ninety-three patients with rectal adenocarcinoma who received neoadjuvant HCRT (total radiation: 50 Gy) were included in this study. Surgery was performed 8 weeks after HCRT, and each resected specimen was evaluated histologically. Length of distal surgical margins, status of circumferential margins, pathological response, and tumor node metastasis stage were examined for their effects on recurrence and survival. Fifty-eight (62.4%) patients had tumor regression, and 20 (21.5%) had a pathological complete response. Distal margin length ranged from 1 to 55 mm (median, 21 mm) and did not correlate with local recurrence (p=0.57) or survival (p=0.75) by univariate analysis. Kaplan-Meier estimates of recurrence-free survival and local recurrence for the <10 mm versus ≥10 mm groups were not significantly different. Positive circumferential margins and failure of tumors to respond were unfavorable factors in survival. Distal resection margins that are shorter than 10 mm but are not positive appear to be equivalent to longer margins in patients who undergo HCRT followed by rectal resection with TME. To improve the down-staging rate, additional studies are needed.

Reconstruction of the PETM onset from single specimen analyses of foraminiferal stable isotopes at Medford, NJ

NASA Astrophysics Data System (ADS)

Makarova, M.; Miller, K. G.; Wright, J. D.

2017-12-01

The Paleocene-Eocene transition ( 56 Ma) is marked by a global temperature increase of 4-8°C and the carbon isotope excursion (CIE) found ubiquitously in marine and terrestrial realms. However, the mechanisms of warming and overall changes in the ocean-atmosphere system during the Paleocene-Eocene thermal maximum (PETM) are uncertain. The timing of the PETM onset has been debated suggested by various studies between years to thousands of years and therefore is of particular interest to ascertain the trigger mechanism. One way to resolve this is to study thick cores on the continental margins that have higher sedimentation rates and thus resolution. Stratigraphically more complete in regard to the CIE onset marine PETM sections are found along the U.S. mid-Atlantic margin, New Jersey coastal plain (35-40°N paleolatitude). We present new carbon and oxygen isotopic data of planktonic and benthic foraminifera from the Medford 3A core, drilled on the New Jersey coastal plain in Summer 2016. Medford is the most proximal among the New Jersey coastal plain sites. The Medford 3A core has recovered 4 ft (1.2 m) of the Marlboro Formation, unit that contains the CIE "core" with low stable δ13C values and CIE recovery in other New Jersey cores. The top of the Marlboro Formation is truncated at Medford 3A, but the base is conformable with the underlaying Vincentown Formation. The sharp δ13C decrease appears within the Vincentown/Marlboro transitional lithological interval 1.5 ft (0.5 m) thick allowing a detailed study of the PETM onset. The Medford 3A core recovered sufficient well-preserved foraminifera to establish isotopic changes across the PETM onset. We measure δ13C and δ18O in single specimens of surface dwellers (Morozovella, Acarinina), thermocline dwellers (Subbotina), and benthic foraminifera (Anomalinoides, Cibicidoides) at high resolution to understand the nature of the PETM onset. We compliment previously published single specimen isotopic records from the deepest water Bass River core, NJ with newly generated lithologic and single specimen isotopic data at most proximal Medford. This allows high resolution reconstruction of the PETM onset at marginal depositional settings along the New Jersey paleoshelf: from 25 m at Medford to over 100 m at Bass River.

Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic, peracetic, and etidronic acids with different concentrations.

PubMed

Ulusoy, Özgür İlke; Zeyrek, Salev; Çelik, Bülent

2017-07-01

The purpose of this study was to investigate the effects of different irrigation solutions on the smear layer removal and marginal adaptation of a resin-based sealer to root canal dentine. A total of 152 instrumented roots were irrigated with the following irrigants: 9,18% etidronic acid (HEBP), 0.5, 1,2% peracetic acid (PAA), 17% ethylenediaminetetraacetic acid (EDTA), saline. The amount of smear layer was evaluated using scanning electron microscope (SEM) in seventy root samples. Eighty-two roots were filled with AH Plus and gutta-percha. Slices obtained from apical third of each specimen were viewed with SEM to assess marginal adaptation. Use of 9% and 18% HEBP resulted in more efficient smear layer removal in the apical third than the other chelators (p < 0.05). Higher smear layer scores in the coronal and middle thirds were obtained from 0.5%, 1% PAA groups. Regarding marginal adaptation, 18% HEBP group showed the lowest gap size values (p < 0.05), and better marginal adaptation. Etidronic acid is a promising candidate for final irrigation of root canals. © 2017 Wiley Periodicals, Inc.

The effects of the Er:YAG laser on trabecular bone micro-architecture: Comparison with conventional dental drilling by micro-computed tomographic and histological techniques

PubMed Central

Zeitouni, Jihad; Clough, Bret; Zeitouni, Suzanne; Saleem, Mohammed; Al Aisami, Kenan; Gregory, Carl

2017-01-01

Background: The use of lasers has become increasingly common in the field of medicine and dentistry, and there is a growing need for a deeper understanding of the procedure and its effects on tissue. The aim of this study was to compare the erbium-doped yttrium aluminium garnet (Er:YAG) laser and conventional drilling techniques, by observing the effects on trabecular bone microarchitecture and the extent of thermal and mechanical damage. Methods: Ovine femoral heads were employed to mimic maxillofacial trabecular bone, and cylindrical osteotomies were generated to mimic implant bed preparation. Various laser parameters were tested, as well as a conventional dental drilling technique. The specimens were then subjected to micro-computed tomographic (μCT) histomorphometic analysis and histology. Results: Herein, we demonstrate that mCT measurements of trabecular porosity provide quantitative evidence that laser-mediated cutting preserves the trabecular architecture and reduces thermal and mechanical damage at the margins of the cut. We confirmed these observations with histological studies. In contrast with laser-mediated cutting, conventional drilling resulted in trabecular collapse, reduction of porosity at the margin of the cut and histological signs of thermal damage. Conclusions: This study has demonstrated, for the first time, that mCT and quantification of porosity at the margin of the cut provides a quantitative insight into damage caused by bone cutting techniques. We further show that with laser-mediated cutting, the marrow remains exposed to the margins of the cut, facilitating cellular infiltration and likely accelerating healing. However, with drilling, trabecular collapse and thermal damage is likely to delay healing by restricting the passage of cells to the site of injury and causing localized cell death. PMID:29416849

Risk factor assessment of endoscopically removed malignant colorectal polyps.

PubMed

Netzer, P; Forster, C; Biral, R; Ruchti, C; Neuweiler, J; Stauffer, E; Schönegg, R; Maurer, C; Hüsler, J; Halter, F; Schmassmann, A

1998-11-01

Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. To determine the significance of histological findings of patients with malignant polyps. Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67 months). Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16 (42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems sufficient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk.

Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications.

PubMed

Scaperrotta, Gianfranco; Ferranti, Claudio; Capalbo, Emanuela; Paolini, Biagio; Marchesini, Monica; Suman, Laura; Folini, Cristina; Mariani, Luigi; Panizza, Pietro

2016-01-01

To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤ 1 cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients. This is a retrospective study of 105 patients undergone to stereotactic breast biopsy with the BLES. It excises a single specimen containing the whole mammographic target, allowing better histological assessment due to preserved architecture. Our case series consists of 41 carcinomas (39%) and 64 benign lesions (61%). Cancer involved the specimen margins in 20/41 cases (48.8%) or was close to them (≤ 1 mm) in 14 cases (34.1%); margins were disease-free in only 7 DCIS (17.1%). At subsequent excision of 39/41 malignant cases, underestimation occurred for 5/32 DCIS (15.6%), residual disease was found in 15/39 cancers (38.5%) and no cancer in 19/39 cases (48.7%). For DCIS cases, no residual disease occurred for 66.7% G1-G2 cases and for 35.3% G3 cases (P=0.1556) as well as in 83.3%, 40.0% and 43.8% cases respectively for negative, close and positive BLES margins (P=0.2576). The BLES is a good option for removal of small clusters of breast microcalcifications, giving better histological interpretation, lower underestimation rates and possibly reducing the need of subsequent surgical excision in selected patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Nitrates (V) in drinking water as factor of a health risk for people in Podlaskie Voivodship].

PubMed

Szczerbiński, Robert; Karczewski, Jan; Fiłon, Joanna

2006-01-01

The aim of this article was to evaluate of a health danger and to estimate the risk due to the presence of nitrates (V) in drinking water used by people in Podlaskie Voivodship. For research I used water specimens taken in 14 poviats (smaller administration districts) in Podlaskie Voivodship as part of drinking water quality monitoring in the years 2001-2003. Evaluation of danger of nitrates (V) taken in with drinking water by the population of Podlaskie Voivodship was carried out by comparing ADI (Acceptable Daily Intake) with value of EDI (Evaluated Daily Intake) and TMDI (Theoretical Maximum Daily Intake) Risk was estimated by calculating safety margin between ADI and EDI. On the basis of the obtained results it was stated that on the territory of Podlaskie Voivodship 1.79% of urban population and 4.86% of rural population, was taking in nitrates (V) with water supplied by waterworks in doses below the safety margin. Nitrates (V) from drinking water in doses below the safety margin were taken in by population of 10 poviats, with the highest percentage of the population noted in the poviats of: Grajewo (10.97%), Augustów (10.77%) and Sejny (10.43%). Among the urban population the highest percentage noted in the Poviat of Augustów (9.46%), and among the rural population--in the Poviat of Grajewo (22.46%). The highest percentage of the population (69.97%) in Podlaskie Voivodship consumed nitrates (V) with drinking water supplied by waterworks in the range of the safety margin from 1 to 10, including 78.86% of urban population and 53.3% of rural population. It seems useful to continue the environmental research on the exposure of Podlaskie Voivodship inhabitants to nitrates by correlating the risk expressed by the safety margin with cancer epidemiology.

Influence of melting and casting methods and finish line design on the marginal discrepancy of nickel-chromium-titanium alloy crowns.

PubMed

Cogolludo, Pablo G; Suarez, María J; Peláez, Jesús; Lozano, José F L

2010-01-01

The aim of this study was to analyze the influence of melting and casting procedures and the cervical finish line design on the marginal fit of nickel-chromium-titanium alloy crowns. Sixty standardized specimens were prepared to receive metal-ceramic crowns and were divided into two groups according to the cervical finish line: chamfer or rounded shoulder. Three melting and casting procedures were analyzed: (1) induction-centrifuge (IC), (2) gas oxygen torch-centrifuge (TC), and (3) induction-vacuum/pressure (IP). The marginal fit was measured with an image analysis system. Significant differences (P =.005) were observed among the groups, with TC showing the lowest discrepancies (45.87 μm). No significant differences were observed between the two finish lines. The accuracy of fit achieved for the groups analyzed may be regarded as within the range of clinical acceptance.

Ciliate protists from Cabiúnas Lagoon (Restinga de Jurubatiba, Macaé, Rio de Janeiro) with emphasis on water quality indicator Species and description of Oxytricha marcili sp. n.

PubMed

Paiva, T S; Silva-Neto, I D

2004-08-01

We found 34 species of ciliate protists in the samples collected by the margins of Cabiúnas Lagoon during 2001. The ciliates were cultivated in the laboratory, where they were examined in vivo and identified through silver impregnation techniques. A new species, Oxytricha marcili (Ciliophora, Oxytrichidae), was found and characterized as follows: in vivo length about 60-80 microm x 30-40 microm wide; on average 22 adoral membranelles; 18 left marginal cirri; 18 right marginal cirri; and 3 small caudal cirri. All specimens analyzed presented 7 frontal cirri (3 anterior + 4 posterior), 1 buccal cirrus, 4 ventral cirri (3 postoral + 1 pre-transverse), and 5 transverse cirri. Among the species found, some are considered as water quality indicators ranging from alpha-mesosaprobity to polysaprobity and isosaprobity.

Influence of preservative and mounting media on the size and shape of monogenean sclerites.

PubMed

Fankoua, Severin-Oscar; Bitja Nyom, Arnold R; Bahanak, Dieu Ne Dort; Bilong Bilong, Charles F; Pariselle, Antoine

2017-08-01

Based on Cichlidogyrus sp. (Monogenea, Ancyrocephalidae) specimens from Hemichromis sp. hosts, we tested the influence of different methods to fix/preserve samples/specimens [frozen material, alcohol or formalin preserved, museum process for fish preservation (fixed in formalin and preserved in alcohol)] and different media used to mount the slides [tap water, glycerin ammonium picrate (GAP), Hoyer's one (HM)] on the size/shape of sclerotized parts of monogenean specimens. The results show that the use of HM significantly increases the size of haptoral sclerites [marginal hooks I, II, IV, V, and VI; dorsal bar length, width, distance between auricles and auricle length, ventral bar length and width], and changes their shape [angle opening between shaft and guard (outer and inner roots) in both ventral and dorsal anchors, ventral bar much wider, dorsal one less curved]. This influence seems to be reduced when specimens/samples are fixed in formalin. The systematics of Monogenea being based on the size and shape of their sclerotized parts, to prevent misidentifications or description of invalid new species, we recommend the use of GAP as mounting medium; Hoyer's one should be restricted to monogenean specimens fixed for a long time which are more shrunken.

Evaluation of Margins of Safety in Brazed Joints

NASA Technical Reports Server (NTRS)

Flom, Yury; Wang, Len; Powell, Mollie M.; Soffa, Matthew A.; Rommel, Monica L.

2009-01-01

One of the essential steps in assuring reliable performance of high cost critical brazed structures is the assessment of the Margin of Safety (MS) of the brazed joints. In many cases the experimental determination of the failure loads by destructive testing of the brazed assembly is not practical and cost prohibitive. In such cases the evaluation of the MS is performed analytically by comparing the maximum design loads with the allowable ones and incorporating various safety or knock down factors imposed by the customer. Unfortunately, an industry standard methodology for the design and analysis of brazed joints has not been developed. This paper provides an example of an approach that was used to analyze an AlBeMet 162 (38%Be-62%Al) structure brazed with the AWS BAlSi-4 (Al-12%Si) filler metal. A practical and conservative interaction equation combining shear and tensile allowables was developed and validated to evaluate an acceptable (safe) combination of tensile and shear stresses acting in the brazed joint. These allowables are obtained from testing of standard tensile and lap shear brazed specimens. The proposed equation enables the assessment of the load carrying capability of complex brazed joints subjected to multi-axial loading.

Analysis of incomplete excisions of basal-cell carcinomas after breadloaf microscopy compared with 3D-microscopy: a prospective randomized and blinded study.

PubMed

Boehringer, Alexandra; Adam, Patrick; Schnabl, Saskia; Häfner, Hans-Martin; Breuninger, Helmut

2015-08-01

Basal-cell carcinomas may show irregular, asymmetric subclinical growth. This study analyzed the efficacy of 'breadloaf' microscopy (serial sectioning) and three-dimensional (3D) microscopy in detecting positive tumor margins. Two hundred eighty-three (283) tumors (51.2%) were put into the breadloaf microscopy group; 270 tumors (48.8%) into the 3D microscopy group. The position of any detected tumor outgrowths was identified in clock face fashion. The time required for cutting and embedding the specimens and the examination of the microscopic slides was measured. Patient/tumor characteristics and surgical margins did not differ significantly. Tumor outgrowths at the excision margin were found in 62 of 283 cases (21.9%) in the breadloaf microscopy group and in 115 of 270 cases (42.6%) in the 3D microscopy group, constituting a highly significant difference (p < 0.001). This difference held true with incomplete excision of fibrosing (infiltrative/sclerosing/morpheaform) tumors [32.9% in the breadloaf microscopy group and 57.5% in the 3D microscopy group (p = 0.003)] and also with solid (nodular) tumors [16.1 and 34.2%, respectively (p < 0.001)]. The mean overall examination time required showed no important difference. In summary, for detection of tumor outgrowths, 3D microscopy has almost twice the sensitivity of breadloaf microscopy, particularly in the situation of aggressive/infiltrative carcinomas. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Ontogeny and Molecular Phylogeny of Apoamphisiella vernalis Reveal Unclear Separation between Genera Apoamphisiella and Paraurostyla (Protozoa, Ciliophora, Hypotricha)

PubMed Central

Fernandes, Noemi Mendes; Schlegel, Martin; Paiva, Thiago da Silva

2016-01-01

Morphology and divisional morphogenesis of the hypotrich ciliate Apoamphisiella vernalis are investigated based on two populations from Brazil. Typical specimens of A. vernalis replicates its ventral ciliature from six fronto-ventral-transverse (FVT) anlagen independently formed for proter and opisthe, plus one or more short anlagen located between IV and V, which form surplus transverse cirri. Dorsal morphogenesis occurs as in typical oxytrichid dorsomarginalians, viz., with formation of three anlagen and fragmentation of the rightmost one. Dorsomarginal kineties are formed near anterior end of right marginal cirral row anlagen. Various anomalous specimens exhibiting more than two long ventral rows were found, which are explained by increasing the number of FVT anlagen and/or the number of cirri produced by anlagen. Comparative ontogeny and phylogenetic analyses based on the 18S rDNA reveal that Apoamphisiella vernalis is closely affine to North American and European strains of the Paraurostyla weissei complex. Their reduced genetic distances and conspicuous morphological variability show that both genera can overlap, which implies the necessity of re-evaluating the contextual relevance of some morphological characters commonly used for genus-level separation within hypotrich taxa. PMID:27196427

Experimental characterization of shape memory alloy actuator cables

NASA Astrophysics Data System (ADS)

Biggs, Daniel B.; Shaw, John A.

2016-04-01

Wire rope (or cables) are a fundamental structural element in many engineering applications. Recently, there has been growing interest in stranding NiTi wires into cables to scale up the adaptive properties of NiTi tension elements and to make use of the desirable properties of wire rope. Exploratory experiments were performed to study the actuation behavior of two NiTi shape memory alloy cables and straight monofilament wire of the same material. The specimens were held under various dead loads ranging from 50 MPa to 400 MPa and thermally cycled 25 times from 140°C to 5°C at a rate of 12°C/min. Performance metrics of actuation stroke, residual strain, and work output were measured and compared between specimen types. The 7x7 cable exhibited similar actuation to the single straight wire, but with slightly longer stroke and marginally more shakedown, while maintaining equivalent specific work output. This leads to the conclusion that the 7x7 cable effectively scaled up the adaptive properties the straight wire. Under loads below 150 MPa, the 1x27 cable had up to double the actuation stroke and work output, but exhibited larger shakedown and poorer performance when loaded higher.

Sampling of radical prostatectomy specimens. How much is adequate?

PubMed

Cohen, M B; Soloway, M S; Murphy, W M

1994-03-01

Prostate glands from 52 patients with clinical stage B carcinoma were examined using two sampling techniques. After fixation and conization of the apical portions, each gland was serially sectioned with sections mounted whole on oversized glass slides and examined for pathologic features of prognostic importance. A second examination was subsequently conducted on the same tissue using only alternate sections. No differences in tumor type, grade, Gleason score, multiplicity, or capsular penetration were detected in 75% of cases. The discrepancies that did occur were most often minor variations in multiplicity and Gleason score. Of the 20 glands with capsular penetration observed with the serial sectioning method, 17 (85%) were detected using alternate sectioning. The surgical margin was involved in two of the three invasive foci that would have been missed. Although the topography is better displayed, the authors' examinations indicated no significant advantage to whole mount sections compared with sections mounted on standard-sized glass slides. Considering the most effective use of resources, as well as the current modalities available for patient monitoring, the results support the use of an alternate sectioning method for pathologic examination of specimens removed for clinically localized prostate cancer.

[Impact of Gleason score on biochemical recurrence free survival after radical prostatectomy with positive surgical margins].

PubMed

Roux, V; Eyraud, R; Brureau, L; Gourtaud, G; Senechal, C; Fofana, M; Blanchet, P

Research of predictive factors of biochemical recurrence to guide the establishment of an adjuvant treatment after radical prostatectomy for cancer with positive surgical margins. A retrospective cohort of 1577 afro-caribbean patients undergoing radical prostatectomy operated between 1st January 2000 and 1st July 2013 was analyzed. In this cohort, 406 patients had positive surgical margin, we excluded 11 patients who received adjuvant therapy (radiotherapy, hormonotherapy, radio-hormonotherapy) and 2 patients for whom histological analysis of the surgical specimen was for a pT4 pathological stage. After a descriptive analysis, we used a Cox model to look for predictors of survival without biochemical recurrence then, depending on the significant variables, we separated our population into six groups: stage pT2 with Gleason score≤3+4 (group 1), stage pT2 with a score of Gleason≥4+3 (group 2), stage pT3a with a Gleason core≤3+4 (group 3), pT3a stage with a score of Gleason≥4+3 (group 4), stage pT3b with a Gleason score≤3+4 (group 5) and stage pT3b Gleason≥with a score of 4+3 (group 6) and compared survival without biochemical recurrence using a log rank test. After radical prostatectomy with surgical margins with an anatomopathological stage≤pT3b, a Gleason score≥4+3 had a pejorative survival without biochemical recurrence than pathological stage (P<0.001). In multivariate analysis, predictors of survival without biochemical recurrence after radical prostatectomy with positive surgical margins were the majority Gleason postoperative (P<0.0001), pathological stage (P=0.049) adjusted preoperative PSA (P=0.826), with the body mass index (BMI) (P=0.59) and tumor volume (P=0.95). A high postoperatively Gleason score (≥4+3) has a better predictive value of biochemical recurrence than pathological stage pT2 or pT3 at the patients having been treated for prostate cancer by radical prostatectomy with positive surgical margins. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Comparison of marginal fit of cemented zirconia copings manufactured after digital impression with lava™ C.O.S and conventional impression technique.

PubMed

Dauti, Rinet; Cvikl, Barbara; Franz, Alexander; Schwarze, Uwe Yacine; Lilaj, Bledar; Rybaczek, Tina; Moritz, Andreas

2016-12-08

Evaluation of the marginal fit of cemented zirconia copings manufactured after digital impression with Lava™ Chairside Oral Scanner in comparison to that of zirconia copings manufactured after conventional impressions with polyvinyl siloxane. A prepared typodont tooth #36, was replicated 40 times with a vinyl silicone and precise model resin. The dies were randomly divided into two groups according to the impression taking technique. Digital impressions with Lava™ C.O.S. and conventional impressions were taken according to the group. Subsequently zirconia copings were manufactured and cemented on their respective dies with zinc oxide phosphate cement. After embedding in resin, mesio-distal section of each coping was performed with a diamond saw in order to obtain two slices. One half of the specimen was used for evaluation with an optical microscope (OM) and the other half for evaluation with a scanning electron microscope (SEM). Marginal gap (MG) and absolute marginal discrepancy (AMD) were measured mesial and distal on each slice. No significant difference of the marginal parameters between the digital and the conventional group was found. The mean values for MG in the digital group were 96.28 μm (+/-43.21 μm) measured with the OM and 99.26 μm (+/-48.73 μm) measured with the SEM, respectively. AMD mean values were 191.54 μm (+/-85.42 μm) measured with the optical microscope and 211.6 μm (+/-96.55 μm) with the SEM. For the conventional group the mean MG values were 94.84 μm (+/-50.77 μm) measured with the OM and 83.37 μm (+/-44.38 μm) measured with the SEM, respectively. AMD mean values were 158.60 μm (+/-69.14 μm) for the OM and 152.72 μm (+/-72.36) for the SEM. Copings manufactured after digital impression with Lava™ C.O.S. show comparable marginal parameters with the copings manufactured after conventional impression with polyvinyl syloxane. The mean MG values of both groups fit in the clinically acceptable range.

A Quantitative Exposure Planning Tool for Surgical Approaches to the Sacroiliac Joint.

PubMed

Phelps, Kevin D; Ming, Bryan W; Fox, Wade E; Bellamy, Nelly; Sims, Stephen H; Karunakar, Madhav A; Hsu, Joseph R

2016-06-01

To aid in surgical planning by quantifying and comparing the osseous exposure between the anterior and posterior approaches to the sacroiliac joint. Anterior and posterior approaches were performed on 12 sacroiliac joints in 6 fresh-frozen torsos. Visual and palpable access to relevant surgical landmarks was recorded. Calibrated digital photographs were taken of each approach and analyzed using Image J. The average surface areas of exposed bone were 44 and 33 cm for the anterior and posterior approaches, respectively. The anterior iliolumbar ligament footprint could be visualized in all anterior approaches, whereas the posterior aspect could be visualized in all but one posterior approach. The anterior approach provided visual and palpable access to the anterior superior edge of the sacroiliac joint in all specimens, the posterior superior edge in 75% of specimens, and the inferior margin in 25% and 50% of specimens, respectively. The inferior sacroiliac joint was easily visualized and palpated in all posterior approaches, although access to the anterior and posterior superior edges was more limited. The anterior S1 neuroforamen was not visualized with either approach and was more consistently palpated when going posterior (33% vs. 92%). Both anterior and posterior approaches can be used for open reduction of pure sacroiliac dislocations, each with specific areas for assessing reduction. In light of current plate dimensions, fractures more than 2.5 cm lateral to the anterior iliolumbar ligament footprint are amenable to anterior plate fixation, whereas those more medial may be better addressed through a posterior approach.

Ceramic inlays and partial ceramic crowns: influence of remaining cusp wall thickness on the marginal integrity and enamel crack formation in vitro.

PubMed

Krifka, Stephanie; Anthofer, Thomas; Fritzsch, Marcus; Hiller, Karl-Anton; Schmalz, Gottfried; Federlin, Marianne

2009-01-01

No information is currently available about what the critical cavity wall thickness is and its influence upon 1) the marginal integrity of ceramic inlays (CI) and partial ceramic crowns (PCC) and 2) the crack formation of dental tissues. This in vitro study of CI and PCC tested the effects of different remaining cusp wall thicknesses on marginal integrity and enamel crack formation. CI (n = 25) and PCC (n = 26) preparations were performed in extracted human molars. Functional cusps of CI and PCC were adjusted to a 2.5 mm thickness; for PCC, the functional cusps were reduced to a thickness of 2.0 mm. Non-functional cusps were adjusted to wall thicknesses of 1) 1.0 mm and 2) 2.0 mm. Ceramic restorations (Vita Mark II, Cerec3 System) were fabricated and adhesively luted to the cavities with Excite/Variolink II. The specimens were exposed to thermocycling and central mechanical loading (TCML: 5000 x 5 degrees C-55 degrees C; 30 seconds/cycle; 500000 x 72.5N, 1.6Hz). Marginal integrity was assessed by evaluating a) dye penetration (fuchsin) on multiple sections after TCML and by using b) quantitative margin analysis in the scanning electron microscope (SEM) before and after TCML. Ceramic- and tooth-luting agent interfaces (LA) were evaluated separately. Enamel cracks were documented under a reflective light microscope. The data were statistically analyzed with the Mann Whitney U-test (alpha = 0.05) and the Error Rates Method (ERM). Crack formation was analyzed with the Chi-Square-test (alpha = 0.05) and ERM. In general, the remaining cusp wall thickness, interface, cavity design and TCML had no statistically significant influence on marginal integrity for both CI and PCC (ERM). Single pairwise comparisons showed that the CI and PCC of Group 2 had a tendency towards less microleakage along the dentin/LA interface than Group 1. Cavity design and location had no statistically significant influence on crack formation, but the specimens with 1.0 mm of remaining wall thickness had statistically significantly more crack formation after TCML than the group with 2.0 mm of remaining cusp wall thickness for CI. The remaining cusp wall thickness of non-functional cusps of adhesively bonded restorations (especially for CI) should have a thickness of at least 2.0 mm to avoid cracks and marginal deficiency at the dentin/LA interface.

Histologic processing artifacts and inter-pathologist variation in measurement of inked margins of canine mast cell tumors.

PubMed

Kiser, Patti K; Löhr, Christiane V; Meritet, Danielle; Spagnoli, Sean T; Milovancev, Milan; Russell, Duncan S

2018-05-01

Although quantitative assessment of margins is recommended for describing excision of cutaneous malignancies, there is poor understanding of limitations associated with this technique. We described and quantified histologic artifacts in inked margins and determined the association between artifacts and variance in histologic tumor-free margin (HTFM) measurements based on a novel grading scheme applied to 50 sections of normal canine skin and 56 radial margins taken from 15 different canine mast cell tumors (MCTs). Three broad categories of artifact were 1) tissue deformation at inked edges, 2) ink-associated artifacts, and 3) sectioning-associated artifacts. The most common artifacts in MCT margins were ink-associated artifacts, specifically ink absent from an edge (mean prevalence: 50%) and inappropriate ink coloring (mean: 45%). The prevalence of other artifacts in MCT skin was 4-50%. In MCT margins, frequency-adjusted kappa statistics found fair or better inter-rater reliability for 9 of 10 artifacts; intra-rater reliability was moderate or better in 9 of 10 artifacts. Digital HTFM measurements by 5 blinded pathologists had a median standard deviation (SD) of 1.9 mm (interquartile range: 0.8-3.6 mm; range: 0-6.2 mm). Intraclass correlation coefficients demonstrated good inter-pathologist reliability in HTFM measurement (κ = 0.81). Spearman rank correlation coefficients found negligible correlation between artifacts and HTFM SDs ( r ≤ 0.3). These data confirm that although histologic artifacts commonly occur in inked margin specimens, artifacts are not meaningfully associated with variation in HTFM measurements. Investigators can use the grading scheme presented herein to identify artifacts associated with tissue processing.

Arrangement of the orbicularis oris muscle in different types of cleft lips.

PubMed

Wijayaweera, C J; Amaratunga, N A; Angunawela, P

2000-05-01

A thorough knowledge of the anatomy of the labial region, especially the arrangement of the muscle fibers, is essential for the success of primary repair of the cleft lip. Pared lateral and medial edges from 20 unilateral incomplete cleft lips and 25 unilateral complete cleft lips were obtained during primary surgery. Three specimens of normal lips were taken from unclaimed infant cadavers as the controls. They were prepared for routine histological studies and were examined to study the direction of muscle fibers. Intrinsic and extrinsic bundles were identified in both lateral and medial sides of specimens of both cleft types. The intrinsic bundle was not displaced but was interrupted by the cleft. The extrinsic bundle in the lateral side of both cleft types ran upward along the lateral cleft margin, whereas in the medial side it ran horizontally to terminate close to the medial cleft margin. The extrinsic bundle is the retractor, which is associated with facial expression, whereas the intrinsic bundle is the constrictor of the mouth. Because there are two functional components in the orbicularis oris muscle, identifying and repairing them separately will enable each of them to accomplish their distinctive functions.

Conjunctival lymphoma arising from reactive lymphoid hyperplasia.

PubMed

Fukuhara, Junichi; Kase, Satoru; Noda, Mika; Ishijima, Kan; Yamamoto, Teppei; Ishida, Susumu

2012-09-18

Extra nodal marginal zone B-cell lymphoma (EMZL) of the conjunctiva typically arises in the marginal zone of mucosa-associated lymphoid tissue. The pathogenesis of conjunctival EMZL remains unknown. We describe an unusual case of EMZL arising from reactive lymphoid hyperplasia (RLH) of the conjunctiva. A 35-year-old woman had fleshy salmon-pink conjunctival tumors in both eyes, oculus uterque (OU). Specimens from conjunctival tumors in the right eye, oculus dexter (OD), revealed a collection of small lymphoid cells in the stroma. Immunohistochemically, immunoglobulin (Ig) light chain restriction was not detected. In contrast, diffuse atypical lymphoid cell infiltration was noted in the left eye, oculus sinister (OS), and positive for CD20, a marker for B cells OS. The tumors were histologically diagnosed as RLH OD, and EMZL OS. PCR analysis detected IgH gene rearrangement in the joining region (JH) region OU. After 11 months, a re-biopsy specimen demonstrated EMZL based on compatible pathological and genetic findings OD, arising from RLH. This case suggests that even if the diagnosis of the conjunctival lymphoproliferative lesions is histologically benign, confirmation of the B-cell clonality by checking IgH gene rearrangement should be useful to predict the incidence of malignancy.

Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

PubMed

Kohorst, Philipp; Junghanns, Janet; Dittmer, Marc P; Borchers, Lothar; Stiesch, Meike

2011-08-01

The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 μm (CerconCAM) and 58 μm (Compartis), vertical discrepancies ranged between 63 μm (CerconCAD/CAM) and 162 μm (CerconCAM), and absolute marginal discrepancies ranged between 94 μm (CerconCAD/CAM) and 181 μm (CerconCAM). The marginal gap varied between 72 μm (CerconCAD/CAM) and 112 μm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs.

Significance of lobular intraepithelial neoplasia at margins of breast conservation specimens: a report of 38 cases and literature review

PubMed Central

2010-01-01

Background Presence of lobular intraepithelial neoplasia (LIN) is not routinely reported as part of margin assessment in breast conservation therapy (BCT) as in ductal carcinoma in situ (DCIS). With new emerging evidence of LIN as possible precursor lesion, the hypothesis is that LIN at the margin may increase the risk of local recurrence with BCT. The aim is to determine whether there is an increase incidence of recurrence when LIN is found at surgical margins on BCT. Methods We retrospectively reviewed a total of 1,334 BCT at a single institution in a 10 year period. Inclusion criteria are positive margin with LIN from primary BCT containing invasive and/or in situ carcinoma with comparison to the negative control group who had similar diseases with negative margin for LIN. Results We identified 38 cases (2.8%) with LIN either lobular carcinoma in situ/atypical lobular hyperplasia (LCIS/ALH) at a margin on initial BCT with 36% recurrence rate. Of the 38 cases: 5 (13%) were lost to follow-up, 12 (32%) had no further procedures performed and 21 (55%) had re-excision. Out of 21 patients who had re-excisions, 12 (57%) had residual invasive carcinoma or DCIS, three (14%) had pleomorphic LCIS and 4 (19%) showed residual classic type LCIS. 71% had significant residual disease (local recurrence) and 29% had no residual disease. A negative control group consisted of 38 cases. We found two patients with bone or brain metastasis and one local recurrence. Clinical follow up periods range from 1 to 109 months. Conclusions LIN found at a margin on BCT showed a significant recurrent ipsilateral disease. Our study supports the view that LIN seen at the margin may play a role in recurrence. PMID:20727142

Combination Effect of Hemostatic and Disinfecting Agents on Micro-leakage of Restorations Bonded with Different Bonding Systems

PubMed Central

H, Farhadpour; F, Sharafeddin; Sc, Akbarian; B, Azarian

2016-01-01

Statement of Problem: Hemostatic agents may affect the micro-leakage of different adhesive systems. Also, chlorhexidine has shown positive effects on micro-leakage. However, their interaction effect has not been reported yet. Objectives: To evaluate the effect of contamination with a hemostatic agent on micro-leakage of total- and self-etching adhesive systems and the effect of chlorhexidine application after the removal of the hemostatic agent. Materials and Methods: Standardized Class V cavity was prepared on each of the sixty caries free premolars at the cemento-enamel junction, with the occlusal margin located in enamel and the gingival margin in dentin. Then, the specimens were randomly divided into 6 groups (n = 10) according to hemostatic agent (H) contamination, chlorhexidine (CHX) application, and the type of adhesive systems (Adper Single Bond and Clearfil SE Bond) used. After filling the cavities with resin composite, the root apices were sealed with utility wax. Furthermore, all the surfaces, except for the restorations and 1mm from the margins, were covered with two layers of nail varnish. The teeth were immersed in a 0.5% basic fuschin dye for 24 hours, rinsed, blot-dried and sectioned longitudinally through the center of the restorations bucco- lingualy. The sections were examined using a stereomicroscope and the extension of dye penetration was analyzed according to a non-parametric scale from 0 to 3. Statistical analysis was performed using Kruskal-Wallis test and Mann-Whitney U-test. Results: While ASB group showed no micro-leakage in enamel, none of the groups showed complete elimination of micro-leakage from the dentin. Regarding micro-leakage at enamel, and dentin margins, there was no significant difference between groups 1 and 2, 1 and 3, and 2 and 3 (p > 0.05). A significantly lower micro-leakage at the enamel and dentin margins was observed in group 3, compared to group 6. No significant difference was observed between groups 4 and 5 in enamel (p = 0.35) and dentin (p = 0.34). Group 6 showed significantly higher micro-leakage, compared to group 4 and 5 (p < 0.05). Conclusions: Hemostatic agent contamination had no significant effect on micro-leakage of total- and self-etching adhesive systems. Application of chlorhexidine after the removal of hemostatic agent increased micro-leakage in self-etching adhesives but did not affect when total-etching was used. PMID:28959756

Effect of Resin Bonded Luting Agents Influencing Marginal Discrepancy in All Ceramic Complete Veneer Crowns.

PubMed

Ganapathy, Dhanraj; Sathyamoorthy, Anusha; Ranganathan, Hemalatha; Murthykumar, Karthikeyan

2016-12-01

Marginal discrepancy severely affects the long term success of All ceramic complete veneer crowns. The precise role of resin luting agents influencing this phenomenon needs to be explored further. To estimate and compare the marginal discrepancy in CAD/CAM processed All ceramic complete veneer crowns prior and following luting with resin bonded luting agents. Extracted human maxillary first premolars were randomly allocated into four groups of 27 samples each Viz., Group I-Resin Modified Glass Ionomer Cement (GIC) (RelyX), Group II-Bis-GMA based dual cure resin cement (Variolink II), Group III-PMMA based resin cement (Superbond), Group IV- Urethane Dimethacrylate resin cement (Calibra). Following tooth preparation, CAD/CAM All ceramic complete veneer crowns were fabricated and sectioned and marginal discrepancy was evaluated using a scanning electron microscope (TESCAN, Magnification power-1,00,000x) prior and after luting with the experimental resin cements. The vertical and horizontal discrepancy before and after cementation with Group I [270.08±103.10μm, 165.3±53.00μm and 270.86±102.70μm, 166.62±54.96μm respectively]; Group II [254.21±79.20μm, 117.75±24.29μm and 234.81±79μm, 116.89±18.22μm respectively]; Group III [272.47±86.25μm, 142.08±50.83μm and 251.82±62.69μm, 136.07±44.95μm respectively]; Group IV were [260.28±64.81μm, 116.98±17.71μm and 233.08±69.44μm, 116.58±21.13μm respectively]. ANOVA inferred a statistically significant difference between the four test specimen with regards to vertical and horizontal marginal discrepancy after cementation (F=9.092, p<0.001), (F=10.97, p<0.001). Tukey HSD Post-hoc test observed significant differences in vertical and horizontal marginal discrepancies between the resin modified glass ionomer and resin cements (p<0.05). Resin cements exhibited a greater reduction in the marginal discrepancy than the resin modified glass ionomer following luting in All ceramic complete veneer crowns. Hence resin cements are more preferable to GIC for luting All ceramic complete veneer crowns.

Effect of Resin Bonded Luting Agents Influencing Marginal Discrepancy in All Ceramic Complete Veneer Crowns

PubMed Central

Sathyamoorthy, Anusha; Ranganathan, Hemalatha; Murthykumar, Karthikeyan

2016-01-01

Introduction Marginal discrepancy severely affects the long term success of All ceramic complete veneer crowns. The precise role of resin luting agents influencing this phenomenon needs to be explored further. Aim To estimate and compare the marginal discrepancy in CAD/CAM processed All ceramic complete veneer crowns prior and following luting with resin bonded luting agents. Materials and Methods Extracted human maxillary first premolars were randomly allocated into four groups of 27 samples each Viz., Group I-Resin Modified Glass Ionomer Cement (GIC) (RelyX), Group II-Bis-GMA based dual cure resin cement (Variolink II), Group III-PMMA based resin cement (Superbond), Group IV- Urethane Dimethacrylate resin cement (Calibra). Following tooth preparation, CAD/CAM All ceramic complete veneer crowns were fabricated and sectioned and marginal discrepancy was evaluated using a scanning electron microscope (TESCAN, Magnification power-1,00,000x) prior and after luting with the experimental resin cements. Results The vertical and horizontal discrepancy before and after cementation with Group I [270.08±103.10μm, 165.3±53.00μm and 270.86±102.70μm, 166.62±54.96μm respectively]; Group II [254.21±79.20μm, 117.75±24.29μm and 234.81±79μm, 116.89±18.22μm respectively]; Group III [272.47±86.25μm, 142.08±50.83μm and 251.82±62.69μm, 136.07±44.95μm respectively]; Group IV were [260.28±64.81μm, 116.98±17.71μm and 233.08±69.44μm, 116.58±21.13μm respectively]. ANOVA inferred a statistically significant difference between the four test specimen with regards to vertical and horizontal marginal discrepancy after cementation (F=9.092, p<0.001), (F=10.97, p<0.001). Tukey HSD Post-hoc test observed significant differences in vertical and horizontal marginal discrepancies between the resin modified glass ionomer and resin cements (p<0.05). Conclusion Resin cements exhibited a greater reduction in the marginal discrepancy than the resin modified glass ionomer following luting in All ceramic complete veneer crowns. Hence resin cements are more preferable to GIC for luting All ceramic complete veneer crowns. PMID:28209008

Effect of casting atmosphere on the marginal deficiency and misfit of Ni-Cr alloys with and without beryllium.

PubMed

da Silva, Leandro J; Leal, Monica B; Valente, Mariana L C; de Castro, Denise T; Pagnano, Valéria O; Dos Reis, Andréa C; Bezzon, Osvaldo L

2017-07-01

The marginal adaptation of prosthetic crowns is still a significant clinical problem. The purpose of this in vitro study was to evaluate the marginal deficiency and misfit of Ni-Cr alloys with and without beryllium under different casting conditions. Four casting conditions were selected: flame-torch, induction/argon, induction/vacuum, and induction/air; and 2 alloys were used, Ni-Cr-Be and Ni-Cr. For each group, 10 metal specimens were prepared. Silicone indirect impressions and analysis of the degree of rounding were used to evaluate the marginal deficiencies of metal copings, and a standardized device for the setting pressure associated with optical microscopy was used to analyze the marginal misfit. Results were evaluated with 2-way ANOVA (α=.05), followed by the Tukey honest significant difference post hoc test, and the Pearson correlation test (α=.05). Alloy (P<.001) and casting technique (P<.001) were shown to affect marginal deficiencies. The Ni-Cr cast using the torch technique showed the highest marginal deficiency, and the Ni-Cr-Be cast in a controlled argon atmosphere showed the lowest (P<.001). Alloy (P=.472) and casting techniques (P=.206) did not affect the marginal misfit, but significant differences were found in the interaction (P=.001); the lowest misfit was achieved using the Ni-Cr-Be, and the highest misfit occurred with the molten Ni-Cr, using the cast torch technique. No correlation was found between deficiency and marginal misfit (r=.04, P=.69). The interactions demonstrated that the alloy containing beryllium that was cast in an argon atmosphere led to reduced marginal deficiency. Improved marginal adaptation can be achieved for the same alloy by using the torch technique. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Involved LEEP excision margins as predictor of residual/recurrent disease in HIV-positive and HIV-negative women in a low-resource setting.

PubMed

van Bogaert, Louis-Jacques

2015-04-01

To describe the accuracy of the diagnosis of involved excision margins after loop electrosurgical excision procedure (LEEP) in a low-resource setting. Cross-sectional study of 176 LEEPs indicated for a cytological report of high-grade squamous intraepithelial lesion (HGSIL). A total of 72 HIV-positive and 104 HIV-negative women with cervical intraepithelial neoplasia (CIN) ≥ 2 on their LEEP histology report with involved excision margins were enrolled in the study. All patients underwent either a repeat LEEP or a hysterectomy. The specimens were evaluated for residual/recurrent CIN ≥ 2 or less. Persistent/recurrent CIN ≥ 2 was diagnosed in 139 (79.4%) instances and microinvasive squamous cell carcinoma in 6 (3.4%). Thirty (17.2%) showed CIN1. The persistence/recurrence rate was 72.2% and 88.5% in HIV-positive and HIV-negative women, respectively (χ2 = 7.5, p = 0.006). In > 80% the diagnosis of involved excision margins was confirmed, a positive predictive value of 82.4%. In the absence of more accurate follow-up methods such as HPV testing or co-testing with cytology, a correct diagnosis of margin status, especially when involved, is an important guide to further management and follow-up.

Microleakage in conservative cavities varying the preparation method and surface treatment

PubMed Central

ATOUI, Juliana Abdallah; CHINELATTI, Michelle Alexandra; PALMA-DIBB, Regina Guenka; CORONA, Silmara Aparecida Milori

2010-01-01

Objective To assess microleakage in conservative class V cavities prepared with aluminum-oxide air abrasion or turbine and restored with self-etching or etch-and-rinse adhesive systems. Material and Methods Forty premolars were randomly assigned to 4 groups (I and II: air abrasion; III and IV: turbine) and class V cavities were prepared on the buccal surfaces. Conditioning approaches were: groups I/III - 37% phosphoric acid; groups II/IV -self-priming etchant (Tyrian-SPe). Cavities were restored with One Step Plus/Filtek Z250. After finishing, specimens were thermocycled, immersed in 50% silver nitrate, and serially sectioned. Microleakage at the occlusal and cervical interfaces was measured in mm and calculated by a software. Data were subjected to ANOVA and Tukey’s test (α=0.05). Results Forty premolars were randomly assigned to 4 groups (I and II: air abrasion; III and IV: turbine) and class V cavities were prepared on the buccal surfaces. Conditioning approaches were: groups I/III - 37% phosphoric acid; groups II/IV -self-priming etchant (Tyrian-SPe). Cavities were restored with One Step Plus/Filtek Z250. After finishing, specimens were thermocycled, immersed in 50% silver nitrate, and serially sectioned. Microleakage at the occlusal and cervical interfaces was measured in mm and calculated by a software. Data were subjected to ANOVA and Tukey’s test (α=0.05). Conclusion Marginal seal of cavities prepared with aluminum-oxide air abrasion was different from that of conventionally prepared cavities, and the etch-and-rinse system promoted higher marginal seal at both enamel and dentin margins. PMID:20835580

Novel Totally Laparoscopic Endolumenal Rectal Resection With Transanal Natural Orifice Specimen Extraction (NOSE) Without Rectal Stump Opening: A Modification of Our Recently Published Clean Surgical Technique in a Porcine Model.

PubMed

Kvasha, Anton; Hadary, Amram; Biswas, Seema; Szvalb, Sergio; Willenz, Udi; Waksman, Igor

2015-06-01

Our group has recently described a novel technique for clean endolumenal bowel resection, in which abdominal and transanal approaches were used. In the current study, 2 modifications of this procedure were tested for feasibility in a porcine model. A laparoscopic approach to the peritoneal cavity was employed in rectal mobilization; this was followed by a transanal rectorectal intussusception and pull-through (IPT). IPT was established in a stepwise fashion. First, the proximal margin of resection was attached to the shaft of the anvil of an end-to-end circular stapler with a ligature around the rectum. Second, this complex was pulled transanally to produce IPT. Once IPT was established, a second ligature was placed around the rectum approximating the proximal and distal resection margins. This was followed by a purse string suture through 2 bowel walls, encircling the shaft of the anvil just proximal to the ligatures. The specimen was resected and extracted by making a full-thickness incision through the 2 bowel walls distal to the previously placed purse string suture and ligatures. The anastomosis was achieved by applying the stapler. The technique was found to be feasible. Peritoneal samples, collected after transanal specimen extraction, did not demonstrate bacterial growth. Although, this is a novel and evolving procedure, its minimally invasive nature, as well as aseptic bowel manipulation during endolumenal rectal resection, has the potential to limit the complications associated with abdominal wall incision and surgical site infection. © The Author(s) 2014.

Lateral Intercondylar Ridge: Is it a reliable landmark for femoral ACL insertion?: An anatomical study.

PubMed

Bhattacharyya, Rahul; Ker, Andrew; Fogg, Quentin; Spencer, Simon J; Joseph, Jibu

2018-02-01

Incorrect femoral tunnel placement is the most common cause of graft failure during Anterior Cruciate Ligament (ACL) Reconstruction. A reliable landmark can minimize errors. To identify whether the Lateral Intercondylar Ridge (LIR) is a consistent anatomical structure and define its relationship with the femoral ACL insertion. Phase 1: we studied 23 femoral dry bone specimens macroscopically. Using a digital microscribe, the medial surface of the lateral femoral condyle was reconstructed (3D) to evaluate whether there was an identifiable bony ridge. Phase 2: 7 cadaveric specimens with intact soft tissues were dissected to identify the femoral ACL insertion. A 3D reconstruction of the femoral ACL insertion and the surface allowed us to define the relationship between the LIR and the ACL insertion. All specimens had a defined LIR on the medial surface of the lateral femoral condyle. The ridge was consistently located just anterior to the femoral ACL insertion. The ACL footprint was present in the depression between the ridge and the Inferior Articular Cartilage Margin (IACM). The mean distance from the midpoint of the IACM to the LIR was 10.1 mm. This is the first study to use the microscribe to digitally reconstruct the medial surface of the lateral femoral condyle. It shows that the LIR is a consistent anatomical structure that defines the anterior margin of the femoral ACL insertion, which guides femoral tunnel placement. Our findings support the ruler technique, which is a commonly used method for anatomic single bundle ACL reconstruction. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Redescription of the Indo-West Pacific cardinalfishes (Perciformes: Apogonidae) Rhabdamia spilota Allen Kuiter 1994 and R. gracilis (Bleeker 1856).

PubMed

Yoshida, Tomohiro; Motomura, Hiroyuki

2018-01-31

Rhabdamia spilota Allen Kuiter 1994 (Apogonidae), a poorly known cardinalfish previously known only from the Philippines, Indonesia and the Red Sea, is redescribed on the basis of 70 specimens (20.9-61.2 mm standard length) (including types), from the Indo-West Pacific (Red Sea, Andaman Sea, Japan, South China Sea, the Philippines, Indonesia, New Caledonia, and Australia). Because most reports of the similar species R. gracilis (Bleeker 1856), following its original description, were based on misidentifications, R. gracilis is also redescribed (based on 98 Indo-West Pacific specimens from Seychelles, Maldives, Andaman Sea, Japan, Malaysia, Indonesia, New Caledonia, and Australia, 27.9-59.3 mm standard length); a lectotype is designated for it. Rhabdamia spilota differs from R. gracilis in having 27-33 (mode 30-31) developed gill rakers [vs. 22-27 (mode 24) in the latter], 27-33 (30) gill rakers including rudiments [vs. 23-27 (24-25)], a black stripe from the jaw tips to the anterior margin of the orbit (vs. black pigments only at snout and tip of lower jaw), 3-6 reddish brown to blackish blotches on the opercle and anterior of body (vs. blotches absent), and indistinct black pigment restricted to caudal fin outer margins (vs. pigment scattered over entire fin). Rhabdamia gracilis exhibits sexual dichromatism, female specimens larger than 41.3 mm SL having one or two black stripes on the lateral surface of the body; the stripes are absent in males and smaller females. No evidence of sexual dichromatism was found in R. spilota.

A comparative study of accuracy of linear measurements using cone beam and multi-slice computed tomographies for evaluation of mandibular canal location in dry mandibles.

PubMed

Naser, Asieh Zamani; Mehr, Bahar Behdad

2013-01-01

Cross- sectional tomograms have been used for optimal pre-operative planning of dental implant placement. The aim of the present study was to assess the accuracy of Cone Beam Computed Tomography (CBCT) measurements of specific distances around the mandibular canal by comparing them to those obtained from Multi-Slice Computed Tomography (MSCT) images. Ten hemi-mandible specimens were examined using CBCT and MSCT. Before imaging, wires were placed at 7 locations between the anterior margin of the third molar and the anterior margin of the second premolar as reference points. Following distances were measured by two observers on each cross-sectional CBCT and MSCT image: Mandibular Width (W), Length (L), Upper Distance (UD), Lower Distance (LD), Buccal Distance (BD), and Lingual Distance (LID). The obtained data were evaluated using SPSS software, applying paired t-test and intra-class correlation coefficient (ICC). There was a significant difference between the values obtained by MSCT and CBCT measurement for all areas such as H, W, UD, LD, BD, and LID, (P < 0.001), with a difference less than 1 mm. The ICC for all distances by both techniques, measured by a single observer with a one week interval and between 2 observers was 99% and 98%, respectively. Comparing the obtained data of both techniques indicates that the difference between two techniques is 2.17% relative to MSCT. The results of this study showed that there is significant difference between measurements obtained by CBCT and MSCT. However, the difference is not clinically significant.

Effect of Laparoscopic-Assisted Resection vs Open Resection of Stage II or III Rectal Cancer on Pathologic Outcomes

PubMed Central

Fleshman, James; Branda, Megan; Sargent, Daniel J.; Boller, Anne Marie; George, Virgilio; Abbas, Maher; Peters, Walter R.; Maun, Dipen; Chang, George; Herline, Alan; Fichera, Alessandro; Mutch, Matthew; Wexner, Steven; Whiteford, Mark; Marks, John; Birnbaum, Elisa; Margolin, David; Larson, David; Marcello, Peter; Posner, Mitchell; Read, Thomas; Monson, John; Wren, Sherry M.; Pisters, Peter W. T.; Nelson, Heidi

2016-01-01

IMPORTANCE Evidence about the efficacy of laparoscopic resection of rectal cancer is incomplete, particularly for patients with more advanced-stage disease. OBJECTIVE To determine whether laparoscopic resection is noninferior to open resection, as determined by gross pathologic and histologic evaluation of the resected proctectomy specimen. DESIGN, SETTING, AND PARTICIPANTS A multicenter, balanced, noninferiority, randomized trial enrolled patients between October 2008 and September 2013. The trial was conducted by credentialed surgeons from 35 institutions in the United States and Canada. A total of 486 patients with clinical stage II or III rectal cancer within 12 cm of the anal verge were randomized after completion of neoadjuvant therapy to laparoscopic or open resection. INTERVENTIONS Standard laparoscopic and open approaches were performed by the credentialed surgeons. MAIN OUTCOMES AND MEASURES The primary outcome assessing efficacy was a composite of circumferential radial margin greater than 1 mm, distal margin without tumor, and completeness of total mesorectal excision. A 6%noninferiority margin was chosen according to clinical relevance estimation. RESULTS Two hundred forty patients with laparoscopic resection and 222 with open resection were evaluable for analysis of the 486 enrolled. Successful resection occurred in 81.7%of laparoscopic resection cases (95%CI, 76.8%–86.6%) and 86.9%of open resection cases (95%CI, 82.5%–91.4%) and did not support noninferiority (difference, −5.3%; 1-sided 95%CI, −10.8%to ∞; P for noninferiority = .41). Patients underwent low anterior resection (76.7%) or abdominoperineal resection (23.3%). Conversion to open resection occurred in 11.3%of patients. Operative time was significantly longer for laparoscopic resection (mean, 266.2 vs 220.6 minutes; mean difference, 45.5 minutes; 95%CI, 27.7–63.4; P < .001). Length of stay (7.3 vs 7.0 days; mean difference, 0.3 days; 95%CI, −0.6 to 1.1), readmission within 30 days (3.3%vs 4.1%; difference, −0.7%; 95%CI, −4.2%to 2.7%), and severe complications (22.5%vs 22.1%; difference, 0.4%; 95%CI, −4.2%to 2.7%) did not differ significantly. Quality of the total mesorectal excision specimen in 462 operated and analyzed surgeries was complete (77%) and nearly complete (16.5%) in 93.5%of the cases. Negative circumferential radial margin was observed in 90% of the overall group (87.9% laparoscopic resection and 92.3%open resection; P = .11). Distal margin result was negative in more than 98%of patients irrespective of type of surgery (P = .91). CONCLUSIONS AND RELEVANCE Among patients with stage II or III rectal cancer, the use of laparoscopic resection compared with open resection failed to meet the criterion for noninferiority for pathologic outcomes. Pending clinical oncologic outcomes, the findings do not support the use of laparoscopic resection in these patients. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00726622 PMID:26441179

Characterizing T-cell response in low-grade and high-grade vulval intraepithelial neoplasia, study of CD3, CD4 and CD8 expressions.

PubMed

Gul, Nahid; Ganesan, Raji; Luesley, David M

2004-07-01

The objective of our study was to compare immunocyte infiltrates in vulval epithelium from low-grade and high-grade vulval intraepithelial neoplasia (VIN) lesions to determine if difference in T-cell presence reflected the grade of VIN. Thirty-six vulval specimens were obtained from 24 patients who had previously undergone vulval biopsies for VIN, 14 high-grade diseases (VIN 3 with or without HPV) and 14 low-grade diseases (VIN 1 and VIN 2 with or without HPV). Eight samples of normal vulval tissue were selected from the excision margins of resected vulval biopsies. The lymphocyte surface markers included CD3 (Pan T-cell marker), CD4 (T helper cells), and CD8 (T cytotoxic cells). Each tissue section was visualized under high power magnification and cells were counted in 10 random areas at the dermo-epidermal junction. A significantly higher number of total mean T lymphocytes were detected in VIN specimens compared to normal vulval tissue (P = 0.002). In low-grade VIN, there were significantly more CD8 cells than CD4 when compared to high-grade VIN. This difference in CD4/CD8 ratio was significant (P = 0.001). This study suggests that increased CD8 response in VIN is a feature of low-grade disease and we speculate that this may be a protective mechanism. In high-grade disease, both CD4 cells and CD8 cells are equally present with preservation of normal CD4/CD8 ratio.

Two new species and a new phyllobothriid cestode genus from sharks of the genus Negaprion Whitley (Carcharhiniformes).

PubMed

Ruhnke, T R; Workman, R E

2013-05-01

Alexandercestus n. g. (Cestoda: Tetraphyllidea) is erected for two cestode species found parasitising the two known species of lemon sharks (Carcharhiniformes: Negaprion spp.). This new genus differs from all other phyllobothriid genera except for Hemipristicola Cutmore, Theiss, Bennett & Cribb, 2011, Marsupiobothrium Yamaguti, 1952, Nandocestus Reyda, 2008, Orectolobicestus Ruhnke, Caira & Carpenter 2006, Orygmatobothrium Diesing, 1863, Paraorygmatobothrium Ruhnke, 1994 and Phyllobothrium van Beneden, 1849 in possessing uniloculate bothridia with an apical sucker and neck scutes. Alexandercestus differs from Orectolobicestus and Nandocestus in lacking marginal loculi on the bothridia, from Paraorygmatobothrium in possessing uninterrupted vitelline follicles at the level of the ovary and from Phyllobothrium in being euapolytic as opposed to anapolytic and in lacking posteriorly bifid bothridia. The new genus lacks the central accessory bothridial organ seen in specimens of Orygmatobothrium, and lacks the central bothridial accessory sucker of specimens of Marsupiobothrium. Alexandercestus spp. compare most favourably with specimens of Hemipristicola, especially with respect to aspects of proglottid morphology, but differ in possessing aristate gladiate spinitriches rather than serrate gladiate spinitriches on the proximal bothridial surface. In addition, the bothridia of Alexandercestus spp. are comparatively more fleshy and foliose than those in specimens of Hemipristicola. Two new species of Alexandercestus n. g. are described, Alexandercestus gibsoni n. sp. from Negaprion acutidens, collected from off northern Australia and the Marshall Islands, and Alexandercestus manteri n. sp. from N. brevirostris, collected off the islands of Bimini and the Florida Keys. The two new species differ in total length and vitelline follicle distribution. Bayesian inference and parsimony analysis of the D1-D3 region of the large nuclear ribosomal DNA of 17 published and seven novel sequences placed A. gibsoni as the sister taxon to a clade containing Hemipristicola gunterae Cutmore, Theiss, Bennett & Cribb, 2011 and species of Paraorygmatobothrium. This result supports the erection of Alexandercestus as a genus separate from Hemipristicola and Paraorygmatobothrium. At the present time, species of Alexandercestus are known only from hosts of the carcharhinid genus Negaprion Whitley; examination of extensive survey data suggests this may be the extent of the host distribution of this genus.

Development and validation of a periarticular injection technique of the sacroiliac joint in horses.

PubMed

Engeli, E; Haussler, K K; Erb, H N

2004-05-01

Sacroiliac joint osteoarthritis has been recognised as a significant cause of poor performance in competition and racehorses. Reliable diagnostic tools are currently lacking. The diagnosis has been based typically on exclusion of other possible causes of poor performance, back pain and hindlimb lameness. To develop a safe, reliable and minimally invasive periarticular or intra-articular injection technique of potential use for diagnosis and therapy of sacroiliac joint disease in horses. Twenty-six horses were used to develop and assess a medial approach to the sacroiliac joint with a 15 gauge, 25 cm long spinal needle. In Part I, the cadaveric study, the spinal needle was introduced cranial to the contralateral tuber sacrale and advanced along the medial aspect of the ipsilateral iliac wing until the dorsal surface of the sacrum was encountered. One ml methylene blue (MB) was injected in both sacroiliac joint regions of the sacropelvic specimens. The location of MB-stained tissues relative to the sacroiliac joints was recorded after dissection and disarticulation of the sacroiliac joint. In Part II, the in vivo study, 18 horses were used to validate the in vivo application of the sacroiliac joint injection technique. Horses were restrained in stocks and sedated in preparation for needle placement. One ml MB was injected bilaterally prior to euthanasia. Stained tissues were identified and recorded at necropsy. Successful joint injections were characterised as having MB located intra-articularly or < or = 2 cm periarticularly from the sacroiliac joint margin and localised to the middle or caudal third of the sacroiliac joint. Intra-articular MB was not observed in any specimen. However, MB-stained tissue was identified periarticularly in all injection sites (n = 48). Based on the predetermined success criteria, 96% of the methylene blue depots were located at the middle or caudal third of the sacroiliac joint. Dye-stained tissue was located < or = 2 cm from the sacroiliac joint margins in 88% of the specimens. Median distance of the MB from the sacroiliac joint margins was 1.0 cm (range 0.2-3.8 cm). The overall success rate considering both location and distance of the MB-stained tissue relative to sacroiliac joint margins was 83% (40 of 48 joints). The injection technique provides a reliable, easy to perform and consistent access to the medial periarticular aspect of the sacroiliac joint. The described injection technique has the potential for both diagnostic and therapeutic applications in the medical management of equine sacroiliac joint disease. Further investigation is necessary to evaluate clinical efficacy and potential adverse effects.

Evaluation of the sealing capability of implants to titanium and zirconia abutments against Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum under different screw torque values.

PubMed

Smith, Nicole A; Turkyilmaz, Ilser

2014-09-01

When evaluating long-term implant success, clinicians have always been concerned with the gap at the implant-abutment junction, where bacteria can accumulate and cause marginal bone loss. However, little information regarding bacterial leakage at the implant-abutment junction, or microgap, is available. The purpose of this study was to evaluate sealing at 2 different implant-abutment interfaces under different screw torque values. Twenty sterile zirconia abutments and 20 sterile titanium abutments were screwed into 40 sterile implants and placed in test tubes. The ability of a bacterial mixture of Prevotella intermedia, Porphyromonas gingivalis, and Fusobacterium nucleatum to leak through an implant-titanium abutment seal under 20 and 35 Ncm torque values and an implant-zirconia abutment seal under 20 and 35 Ncm torque values was evaluated daily until leakage was noted. Once a unit demonstrated leakage, a specimen was plated. After 4 days, the number of colonies on each plate was counted with an electronic colony counter. Plating was used to verify whether or not bacterial leakage occurred and when leakage first occurred. The implant-abutment units were removed and rinsed with phosphate buffered saline solution and evaluated with a stereomicroscope. The marginal gap between the implant and the abutment was measured and correlated with the amount of bacterial leakage. The data were analyzed with ANOVA. Bacterial leakage was noted in all specimens, regardless of material or screw torque value. With titanium abutments, changing the screw torque value from 20 to 35 Ncm did not significantly affect the amount of bacterial leakage. However, with zirconia abutments, changing the screw torque value from 20 to 35 Ncm was statistically significant (P<.017). Overall, the marginal gap noted was larger at the zirconia-abutment interface (5.25 ±1.99 μm) than the titanium-abutment interface (12.38 ±3.73 μm), irrespective of the screw torque value. Stereomicroscopy revealed a nonuniform marginal gap in all specimens. The results of this study showed that, over time, bacteria will leak through the implant-abutment microgap at the implant-abutment interface. Implants with a titanium abutment demonstrate a smaller microgap than implants with a zirconia abutment. Tightening the zirconia abutment screw from 20 to 35 Ncm decreases the size of the microgap, which suggests a more intimate fit between the implant and the abutment. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Influence of oscillating and rotary cutting instruments with electric and turbine handpieces on tooth preparation surfaces.

PubMed

Geminiani, Alessandro; Abdel-Azim, Tamer; Ercoli, Carlo; Feng, Changyong; Meirelles, Luiz; Massironi, Domenico

2014-07-01

Rotary and nonrotary cutting instruments are used to produce specific characteristics on the axial and marginal surfaces of teeth being prepared for fixed restorations. Oscillating instruments have been suggested for tooth preparation, but no comparative surface roughness data are available. To compare the surface roughness of simulated tooth preparations produced by oscillating instruments versus rotary cutting instruments with turbine and electric handpieces. Different grit rotary cutting instruments were used to prepare Macor specimens (n=36) with 2 handpieces. The surface roughness obtained with rotary cutting instruments was compared with that produced by oscillating cutting instruments. The instruments used were as follows: coarse, then fine-grit rotary cutting instruments with a turbine (group CFT) or an electric handpiece (group CFE); coarse, then medium-grit rotary cutting instruments with a turbine (group CMT) or an electric handpiece (group CME); coarse-grit rotary cutting instruments with a turbine handpiece and oscillating instruments at a low-power (group CSL) or high-power setting (group CSH). A custom testing apparatus was used to test all instruments. The average roughness was measured for each specimen with a 3-dimensional optical surface profiler and compared with 1-way ANOVA and the Tukey honestly significant difference post hoc test for multiple comparisons (α=.05). Oscillating cutting instruments produced surface roughness values similar to those produced by similar grit rotary cutting instruments with a turbine handpiece. The electric handpiece produced smoother surfaces than the turbine regardless of rotary cutting instrument grit. Rotary cutting instruments with electric handpieces produced the smoothest surface, whereas the same instruments used with a turbine and oscillating instruments achieved similar surface roughness. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Feasibility of using an inversion-recovery ultrashort echo time (UTE) sequence for quantification of glenoid bone loss.

PubMed

Ma, Ya-Jun; West, Justin; Nazaran, Amin; Cheng, Xin; Hoenecke, Heinz; Du, Jiang; Chang, Eric Y

2018-02-02

To utilize the 3D inversion recovery prepared ultrashort echo time with cones readout (IR-UTE-Cones) MRI technique for direct imaging of lamellar bone with comparison to the gold standard of computed tomography (CT). CT and MRI was performed on 11 shoulder specimens and three patients. Five specimens had imaging performed before and after glenoid fracture (osteotomy). 2D and 3D volume-rendered CT images were reconstructed and conventional T1-weighted and 3D IR-UTE-Cones MRI techniques were performed. Glenoid widths and defects were independently measured by two readers using the circle method. Measurements were compared with those made from 3D CT datasets. Paired-sample Student's t tests and intraclass correlation coefficients were performed. In addition, 2D CT and 3D IR-UTE-Cones MRI datasets were linearly registered, digitally overlaid, and compared in consensus by these two readers. Compared with the reference standard (3D CT), glenoid bone diameter measurements made on 2D CT and 3D IR-UTE-Cones were not significantly different for either reader, whereas T1-weighted images underestimated the diameter (mean difference of 0.18 cm, p = 0.003 and 0.16 cm, p = 0.022 for readers 1 and 2, respectively). However, mean margin of error for measuring glenoid bone loss was small for all modalities (range, 1.46-3.92%). All measured ICCs were near perfect. Digitally registered 2D CT and 3D IR-UTE-Cones MRI datasets yielded essentially perfect congruity between the two modalities. The 3D IR-UTE-Cones MRI technique selectively visualizes lamellar bone, produces similar contrast to 2D CT imaging, and compares favorably to measurements made using 2D and 3D CT.

Factors That Influence Surgical Margin State in Patients Undergoing Cold Knife Conization - A Single Center Experience.

PubMed

Aluloski, Igor; Tanturovski, Mile; Petrusevska, Gordana; Jovanovic, Rubens; Kostadinova-Kunovska, Slavica

2017-12-01

To evaluate the factors that influence the surgical margin state in patients undergoing cold knife conization at the University Clinic of Gynecology and Obstetrics in Skopje, Republic of Macedonia Materials and methods: We have retrospectively analyzed the medical records of all patients that underwent a cold knife conization at our Clinic in 2015. We cross-referenced the surgical margin state with the histopathological diagnosis (LSIL, HSIL or micro-invasive/invasive cancer), menopausal status of the patients, number of pregnancies, surgeon experience, operating time and cone depth. The data was analyzed with the Chi square test, Fisher's exact test for categorical data and Student's T test for continuous data and univariate and multivariate logistical regressions were performed. A total of 246 medical records have neen analyzed, out of which 29 (11.79%) patients had LSIL, 194 (78.86%) had HSIL and 23 (9.34%) patients suffered micro-invasive/invasive cervical cancer. The surgical margins were positive in 78 (31.7%) of the patients. The average age of the patients was 41.13 and 35 (14.23%) of the patients were menopausal. The multivariate logistic regression identified preoperative forceps biopsy of micro-invasive SCC, HSIL or higher cone specimen histology and shorter cone depth as independent predictors of surgical margin involvement in patients undergoing cold knife conization. In the current study, we have found no association between the inherent characteristics of the patient and the surgeon and the surgical margin state after a CKC. The most important predictors for positive margins were the severity of the lesion and the cone depth.

Metabolic syndrome and low high-density lipoprotein cholesterol are associated with adverse pathological features in patients with prostate cancer treated by radical prostatectomy.

PubMed

Lebdai, Souhil; Mathieu, Romain; Leger, Julie; Haillot, Olivier; Vincendeau, Sébastien; Rioux-Leclercq, Nathalie; Fournier, Georges; Perrouin-Verbe, Marie-Aimée; Doucet, Laurent; Azzouzi, Abdel Rahmene; Rigaud, Jérome; Renaudin, Karine; Charles, Thomas; Bruyere, Franck; Fromont, Gaelle

2018-02-01

Previous studies have suggested a link between metabolic syndrome (MetS) and prostate cancer (PCa). In the present study, we aimed to assess the association between MetS and markers of PCa aggressiveness on radical prostatectomy (RP). All patients consecutively treated for PCa by RP in 6 academic institutions between August 2013 and July 2016 were included. MetS was defined as at least 3 of 5 components (obesity, elevated blood pressure, diabetes, low high-density lipoprotein (HDL)-cholesterol, and hypertriglyceridemia). Demographic, biological, and clinical parameters were prospectively collected, including: age, biopsy results, preoperative serum prostate-specific antigen, surgical procedure, and pathological data of RP specimen. Locally advanced disease was defined as a pT-stage ≥3. International Society of Urological Pathology (ISUP) groups were used for pathological grading. Qualitative and quantitative variables were compared using chi-square and Wilcoxon tests; logistic regression analyses assessed the association of MetS and its components with pathological data. Statistical significance was defined as a P<0.05. Among 567 men, 249 (44%) had MetS. In a multivariate model including preoperative prostate-specific antigen, biopsy ISUP-score, clinical T-stage, age, and ethnicity: we found that MetS was an independent risk factor for positive margins, and ISUP group ≥4 on the RP specimen (odds ratio [OR] = 1.5; 95% CI: 1.1-2.3; P = 0.035; OR = 2.0; 95% CI: 1.1-4.0; P = 0.044, respectively). In addition, low HDL-cholesterol level was associated with locally advanced PCa (OR = 1.6; 95% CI: 1.1-2.4; P = 0.024). Risks of adverse pathological features increased with the number of MetS components: having ≥ 4 MetS components was significantly associated with higher risk of ISUP group ≥ 4 and higher risk of positive margins (OR = 1.9; 95% CI: 1.1-3.3; P = 0.017; OR = 1.8; 95% CI: 1.1-2.8; P = 0.007, respectively). MetS was an independent predictive factor for higher ISUP group and positive margins at RP. Low HDL-cholesterol alone, and having 4 and more MetS components were also associated with higher risk of adverse pathological features. Copyright © 2018. Published by Elsevier Inc.

Left phrenic nerve anatomy relative to the coronary venous system: Implications for phrenic nerve stimulation during cardiac resynchronization therapy.

PubMed

Spencer, Julianne H; Goff, Ryan P; Iaizzo, Paul A

2015-07-01

The objective of this study was to quantitatively characterize anatomy of the human phrenic nerve in relation to the coronary venous system, to reduce undesired phrenic nerve stimulation during left-sided lead implantations. We obtained CT scans while injecting contrast into coronary veins of 15 perfusion-fixed human heart-lung blocs. A radiopaque wire was glued to the phrenic nerve under CT, then we created three-dimensional models of anatomy and measured anatomical parameters. The left phrenic nerve typically coursed over the basal region of the anterior interventricular vein, mid region of left marginal veins, and apical region of inferior and middle cardiac veins. There was large variation associated with the average angle between nerve and veins. Average angle across all coronary sinus tributaries was fairly consistent (101.3°-111.1°). The phrenic nerve coursed closest to the middle cardiac vein and left marginal veins. The phrenic nerve overlapped a left marginal vein in >50% of specimens. © 2015 Wiley Periodicals, Inc.

Radioguided localisation of impalpable breast lesions using 99m-Technetium macroaggregated albumin: Lessons learnt during introduction of a new technique to guide preoperative localisation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Landman, Joanne; Kulawansa, Sagarika; McCarthy, Michael

2015-03-15

Preoperative wire-guided localisation (WGL) of impalpable breast lesions is widely used but can be technically difficult. Risks include wire migration, inaccurate placement, and inadequate surgical margins. Research shows that radioguided occult lesion localisation (ROLL) is quicker, easier, and can improve surgical and cosmetic outcomes. An audited introduction of ROLL was conducted to validate the technique as a feasible alternative to WGL. Fifty patients with single impalpable lesions and biopsy proven malignancy or indeterminate histology underwent WGL followed by intralesional radiopharmaceutical injection of 99m-Technetium macroaggregated albumin. Postprocedural mammography was performed to demonstrate wire position, and scintigraphy to evaluate radiopharmaceutical migration. Lymphoscintigraphymore » and intraoperative sentinel node biopsy were performed if indicated, followed by lesion localisation and excision using a gamma probe. Specimen imaging was performed, with immediate reexcision for visibly inadequate margins. Accurate localisation was achieved in 86% of patients with ROLL compared to 72% with WGL. All lesions were successfully removed, with clear margins in 71.8% of malignant lesions. Reexcision and intraoperative sentinel node localisation rates were equivalent to preaudit figures for WGL. ROLL was easy to perform and problems were infrequent. Inaccurate radiopharmaceutical placement necessitating WGL occurred in four patients. Minor radiopharmaceutical migration was common, but precluded using ROLL in only two cases. ROLL is effective, simple, inexpensive, and easily learnt; however, preoperative confirmation of correct radiopharmaceutical placement using mammography and the gamma probe is important to help ensure successful lesion removal. Insertion of a backup hookwire is recommended during the initial introduction of ROLL.« less

A novel device for endoscopic submucosal dissection, the Fork knife

PubMed Central

Kim, Hyun Gun; Cho, Joo Young; Bok, Gene Hyun; Cho, Won Young; Kim, Wan Jung; Hong, Su Jin; Ko, Bong Min; Kim, Jin Oh; Lee, Joon Seong; Lee, Moon Sung; Shim, Chan Sup

2008-01-01

AIM: To introduce and evaluate the efficacy and technical aspects of endoscopic submucosal dissection (ESD) using a novel device, the Fork knife. METHODS: From March 2004 to April 2008, ESD was performed on 265 gastric lesions using a Fork knife (Endo FS®) (group A) and on 72 gastric lesions using a Flexknife (group B) at a single tertiary referral center. We retrospectively compared the endoscopic characteristics of the tumors, pathological findings, and sizes of the resected specimens. We also compared the en bloc resection rate, complete resection rate, complications, and procedure time between the two groups. RESULTS: The mean size of the resected specimens was 4.27 ± 1.26 cm in group A and 4.29 ± 1.48 cm in group B. The en bloc resection rate was 95.8% (254/265 lesions) in group A and 93.1% (67/72) in group B. Complete ESD without tumor cell invasion of the resected margin was obtained in 81.1% (215/265) of group A and in 73.6% (53/72) of group B. The perforation rate was 0.8% (2/265) in group A and 1.4% (1/72) in group B. The mean procedure time was 59.63 ± 56.12 min in group A and 76.65 ± 70.75 min in group B (P < 0.05). CONCLUSION: The Fork knife (Endo FS®) is useful for clinical practice and has the advantage of reducing the procedure time. PMID:19034979

A new genus and species of Planopinae (Xenarthra: Tardigrada) from the Miocene of Santa Cruz Province, Argentina.

PubMed

Carlini, Alfredo A; Brandoni, Diego; Dal Molin, Carlos N

2013-01-01

Prepoplanops boleadorensis, a new genus and species of Planopinae (Xenarthra, Tardigrada), is described herein. The new taxon is based on a nearly complete specimen recovered from the Cerro Boleadoras Formation (Miocene, Rio Zeballos Group), in northwestern Santa Cruz Province, Argentina. The shape and length of the predentary region of the skull and the length of the diastema of Prepoplanops boleadorensis differ from those present in the species of Planops. The posterolateral opening of the mandibular canal and the position of the posterior margin of the mandibular symphysis differ from those of species of Prepotherium. In addition, Prepoplanops boleadorensis differs from Planops martini in the size of the humeral tuberosities, the development of the deltoid crest, the position of the distal margin of the humeral trochlea, the shape and position of the olecranon, the development of the femoral epicondyles, and the shape of the medial margins of the patellar trochlea and medial condyle. On the other hand, it differs from Prepotherium potens in the shape of the medial margin of the medial condyle. The recognition of Prepoplanops boleadorensis increases the diversity of Planopinae for the Miocene of Patagonia, Argentina.

To Evaluate Effect of Airborne Particle Abrasion using Different Abrasives Particles and Compare Two Commercial Available Zirconia on Flexural Strength on Heat Treatment.

PubMed

Prasad, Hari A; Pasha, Naveed; Hilal, Mohammed; Amarnath, G S; Kundapur, Vinaya; Anand, M; Singh, Sumeet

2017-06-01

The popularity of ceramic restorations can be attributed to its life-like appearance, durability and biocompatibility and therefore ceramic restorations have been widely used for anterior and posterior teeth. Ceramic restorations have esthetic and biocompatible advantages but low fracture resistance. Since it has high flexural strength and fracture resistance, yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) is the dental material most commonly used for the core of ceramic crowns and fixed dental prosthesis. In spite of improved mechanical properties, acceptable marginal adaptation and biocompatibility the whitish opacity of zirconia is an obvious esthetic disadvantage. The zirconia framework is often veneered with conventional feldspathic porcelain to achieve a natural appearance. However it is difficult to achieve sufficient bond strength between zirconia and the veneering material. Achieving sufficient bond strength between the veneering ceramic and the zirconia core is a major challenge in the long term clinical success of veneered zirconia restorations. The main objective of this study is to evaluate the effect of different surface treatments on the fracture strength of the two commercially available Zirconia namely Ceramill and ZR-White (AMANNGIRRBACH and UPCERA) respectively. Two commercially available pre-sinteredyttrium stabilized Zirconia blanks (ZR-White and Ceramill) from AMANNGIRRBACH and UPCERA respectively are used to produce the disc shaped specimens of size (15.2 ± 0.03 mm in diameter and 1.2 ± 0.03 mm thick) from each Zirconia blank. All disc shaped specimens are heated at 1200°C in a furnace for 2 hours to form homogenous tetragonal ZrO 2 . The dimensions of the specimens are measured with a digital caliper (aerospace). The thickness and diameter of each specimen are calculated as the means of 3 measurements made at random sites. 80 discs from each Zirconia blank are divided into ten groups of 8 specimens each. Heat treatment after airborne-particle abrasion using 50 µm Al 2 O 3 particles and 50 µm silica coated Al 2 O 3 are applied to the upper and lower surfaces of the specimens. Each specimen is held under a pressure of 30 psi for 15 seconds at a direction perpendicular to the surface and at a distance of 30mm with an airborne particle abrasion device for the specimens in the airborne particle abraded groups. Heat treatments were performed at a starting temperature of 500°C, heating rate of 100°c/ min, ending at a temperature of 1000°C and 15 minutes holding time without vacuum for the specimens in the group 4, 5, 9 and 10. Airborne-particle abrasion mimicking the preparation for cementation was applied to the lower surfaces with 50 µm alumina and silica coated alumina particles for the specimens in the groups 6, 7, 8, 9 and 10. The specimens were cleaned for 15 minutes in an ultrasonic bath containing distilled water. To determine the fracture strength, a disc of 10 mm diameter was used to place 3 hardened steel balls of 3 mm diameter separated each other by 120 degrees (described in the ISO standard 6872 for dental ceramics). Each specimen was centrally placed on this disc. The lower surface mimicking the internal surface of zirconia was the tension side, facing the supporting device testing, while the upper surface mimicking the external surface of the zirconia core was loaded with a flat punch (1 mm in diameter). A universal testing machine was used to perform the test at a cross head speed of 1mm/min. The failure stress was calculated with the equation listed in ISO 6872. The results were then statistically analyzed. A post hoc test was used for pair wise comparisons. The mean fracture strength of commercially available Zirconia Ceramill (AMANNGIRBACH) showed a significant higher value compared to the ZR-White (UPCERA) Zirconia ( P <0.001), Airborne abrasion treatment to the specimens showed a significant difference between the abraded groups and the control group ( P <0.001); further AMANNGIRRBACH specimens gave a higher value compare to the UPCERA specimens. The study also revealed that the heat treatment of the specimens gave significant value ( P <0.001) compared to the control group, but heat treatment following the air abrasion reduces the fracture strength of the sample than the air abraded group. Within the limitation of this study, it is concluded that, the in vitro fracture strength of Zirconia specimens treated with an airborne abrasion both on the veneering surface (50 µm silica coated Al2O3) and the cementing surface (50 µm Al 2 O 3 ) was significantly higher than the heat treated and the control group. Airborne particle abrasion followed by the heat treatment reduces the fracture strength of the specimen than that ofthe group treated only by the air abrasives. The fracture strength of a commercially available Ceramill (AMANNGIRRBACH) is greater than that of a Zirconia from ZR-White (UPCERA) variety.

To Evaluate Effect of Airborne Particle Abrasion using Different Abrasives Particles and Compare Two Commercial Available Zirconia on Flexural Strength on Heat Treatment

PubMed Central

Prasad, Hari A.; Pasha, Naveed; Hilal, Mohammed; Amarnath, G. S.; Kundapur, Vinaya; Anand, M; Singh, Sumeet

2017-01-01

Background and objective: The popularity of ceramic restorations can be attributed to its life-like appearance, durability and biocompatibility and therefore ceramic restorations have been widely used for anterior and posterior teeth. Ceramic restorations have esthetic and biocompatible advantages but low fracture resistance. Since it has high flexural strength and fracture resistance, yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) is the dental material most commonly used for the core of ceramic crowns and fixed dental prosthesis. In spite of improved mechanical properties, acceptable marginal adaptation and biocompatibility the whitish opacity of zirconia is an obvious esthetic disadvantage. The zirconia framework is often veneered with conventional feldspathic porcelain to achieve a natural appearance. However it is difficult to achieve sufficient bond strength between zirconia and the veneering material. Achieving sufficient bond strength between the veneering ceramic and the zirconia core is a major challenge in the long term clinical success of veneered zirconia restorations. The main objective of this study is to evaluate the effect of different surface treatments on the fracture strength of the two commercially available Zirconia namely Ceramill and ZR-White (AMANNGIRRBACH and UPCERA) respectively. Method: Two commercially available pre-sinteredyttrium stabilized Zirconia blanks (ZR-White and Ceramill) from AMANNGIRRBACH and UPCERA respectively are used to produce the disc shaped specimens of size (15.2 ± 0.03 mm in diameter and 1.2 ± 0.03 mm thick) from each Zirconia blank. All disc shaped specimens are heated at 1200°C in a furnace for 2 hours to form homogenous tetragonal ZrO2. The dimensions of the specimens are measured with a digital caliper (aerospace). The thickness and diameter of each specimen are calculated as the means of 3 measurements made at random sites. 80 discs from each Zirconia blank are divided into ten groups of 8 specimens each. Heat treatment after airborne-particle abrasion using 50 µm Al2O3 particles and 50 µm silica coated Al2O3 are applied to the upper and lower surfaces of the specimens. Each specimen is held under a pressure of 30 psi for 15 seconds at a direction perpendicular to the surface and at a distance of 30mm with an airborne particle abrasion device for the specimens in the airborne particle abraded groups. Heat treatments were performed at a starting temperature of 500°C, heating rate of 100°c/ min, ending at a temperature of 1000°C and 15 minutes holding time without vacuum for the specimens in the group 4, 5, 9 and 10. Airborne-particle abrasion mimicking the preparation for cementation was applied to the lower surfaces with 50 µm alumina and silica coated alumina particles for the specimens in the groups 6, 7, 8, 9 and 10. The specimens were cleaned for 15 minutes in an ultrasonic bath containing distilled water. To determine the fracture strength, a disc of 10 mm diameter was used to place 3 hardened steel balls of 3 mm diameter separated each other by 120 degrees (described in the ISO standard 6872 for dental ceramics). Each specimen was centrally placed on this disc. The lower surface mimicking the internal surface of zirconia was the tension side, facing the supporting device testing, while the upper surface mimicking the external surface of the zirconia core was loaded with a flat punch (1 mm in diameter). A universal testing machine was used to perform the test at a cross head speed of 1mm/min. The failure stress was calculated with the equation listed in ISO 6872. The results were then statistically analyzed. A post hoc test was used for pair wise comparisons. Result: The mean fracture strength of commercially available Zirconia Ceramill (AMANNGIRBACH) showed a significant higher value compared to the ZR-White (UPCERA) Zirconia (P<0.001), Airborne abrasion treatment to the specimens showed a significant difference between the abraded groups and the control group (P<0.001); further AMANNGIRRBACH specimens gave a higher value compare to the UPCERA specimens. The study also revealed that the heat treatment of the specimens gave significant value (P<0.001) compared to the control group, but heat treatment following the air abrasion reduces the fracture strength of the sample than the air abraded group. Conclusion: Within the limitation of this study, it is concluded that, the in vitro fracture strength of Zirconia specimens treated with an airborne abrasion both on the veneering surface (50 µm silica coated Al2O3) and the cementing surface (50 µm Al2O3) was significantly higher than the heat treated and the control group. Airborne particle abrasion followed by the heat treatment reduces the fracture strength of the specimen than that ofthe group treated only by the air abrasives. The fracture strength of a commercially available Ceramill (AMANNGIRRBACH) is greater than that of a Zirconia from ZR-White (UPCERA) variety. PMID:28824346

Ablative performance of uncoated silicone-modified and shuttle baseline reinforced carbon composites

NASA Technical Reports Server (NTRS)

Dicus, D. L.; Hopko, R. N.; Brown, R. D.

1976-01-01

The relative ablative performance of uncoated silicone-modified reinforced carbon composite (RCC) and uncoated shuttle baseline RCC substrates was investigated. The test specimens were 13 plies (5.3 to 5.8 millimeters) thick and had a 25-millimeter-diameter test face. Prior to arc tunnel testing, all specimens were subjected to a heat treatment simulating the RCC coating process. During arc tunnel testing, the specimens were exposed to cold wall heating rates of 178 to 529 kilowatts/sq m and stagnation pressures ranging from 0.015 to 0.046 atmosphere at Mach 4.6 in air, with and without preheating in nitrogen. The results show that the ablative performance of uncoated silicone-modified RCC substrates is significantly superior to that of uncoated shuttle baseline RCC substrates over the range of heating conditions used. These results indicate that the silicone-modified RCC substrate would yield a substantially greater safety margin in the event of complete coating loss on the shuttle orbiter.

Notes on Mesocapromys sanfelipensis (Rodentia: Capromyidae) from Cuba.

PubMed

LÓpez, Lazaro W viÑola; Garrido, Orlando H; BermÚdez, Alberto

2018-04-16

The San Felipe Hutia, Mesocapromys sanfelipensis, is one of the most endangered species of rodents in the world, and little is known about its ecology, evolution, and ancient distribution. At present, this hutia has been found only in its type locality, Cayo Juan Garcia, a cay in the southwest Cuban insular platform. Here we report for the first time a well preserved fossil skull referred to this species, collected in Cueva del Indio, Mayabeque province, western Cuba. This specimen shows that the modern population of M. sanfelipensis is a marginal relic of its former distribution, a consequence of climatic, eustatic, and neotectonic changes in the last 8 ka years. Also, we reevaluate the cranial characters and measurements that correspond to M. sanfelipensis and found that two of the eight specimens referred to this species and deposited at the Instituto de Ecologia y Sistematica belong to Mesocapromys auritus. Finally, we include six unpublished photos of specimens of M. sanfelipensis captured in 1970 during two expeditions to Cayo Juan Garcia.

In situ fossil seedlings of a Metasequoia-like taxodiaceous conifer from Paleocene river floodplain deposits of central Alberta, Canada.

PubMed

Falder, A B; Stockey, R A; Rothwell, G W

1999-06-01

Fossil seeds and seedlings of a Metasequoia-like taxodiaceous conifer occur in Paleocene deposits at the Munce's Hill and Gao Mine localities of central Alberta, Canada. Compression/impression specimens are preserved in upright growth positions among seedlings of the cercidiphyllaceous dicot Joffrea speirsii Crane & Stockey. There are a large number of seeds, a few of which were buried while germinating and show a radicle or short primary root. More than 500 Metasequoia-like seedlings have been identified that have two linear cotyledons with parallel margins and rounded tips. Three specimens have been found that display three cotyledons. Slightly older seedlings show decussate pairs of leaves attached to the stem distal to the cotyledons. Still older seedlings have axillary branches that show varying sizes and numbers of opposite leaves arranged in a single plane distal to the opposite pairs. These specimens reveal that both Joffrea and this extinct taxodiaceous conifer were early colonizers of North American floodplain communities at the beginning of the Tertiary.

The effect of short fiber composite base on microleakage and load-bearing capacity of posterior restorations

PubMed Central

Garoushi, Sufyan K.; Hatem, Marwa; Lassila, Lippo V. J.; Vallittu, Pekka K.

2015-01-01

Abstract Objectives: To determine the marginal microleakage of Class II restorations made with different composite base materials and the static load-bearing capacity of direct composite onlay restorations. Methods: Class II cavities were prepared in 40 extracted molars. They were divided into five groups (n = 8/group) depending on composite base material used (everX Posterior, SDR, Tetric EvoFlow). After Class II restorations were completed, specimens were sectioned mid-sagitally. For each group, sectioned restorations were immersed in dye. Specimens were viewed under a stereo-microscope and the percentage of cavity leakage was calculated. Ten groups of onlay restorations were fabricated (n = 8/group); groups were made with composite base materials (everX Posterior, SDR, Tetric EvoFlow, Gradia Direct LoFlo) and covered by 1 mm layer of conventional (Tetric N-Ceram) or bulk fill (Tetric EvoCeram Bulk Fill) composites. Groups made only from conventional, bulk fill and short fiber composites were used as control. Specimens were statically loaded until fracture. Data were analyzed using ANOVA (p = 0.05). Results: Microleakage of restorations made of plain conventional composite or short fiber composite base material showed statistically (p < 0.05) lower values compared to other groups. ANOVA revealed that onlay restorations made from short fiber-reinforced composite (FRC) as base or plain restoration had statistically significant higher load-bearing capacity (1593 N) (p < 0.05) than other restorations. Conclusion: Restorations combining base of short FRC and surface layer of conventional composite displayed promising performance related to microleakage and load-bearing capacity. PMID:28642894

Effects of Topical Emu Oil on Burn Wounds in the Skin of Balb/c Mice

PubMed Central

Afshar, Mohammad; Ghaderi, Reza; Zardast, Mahmoud; Delshad, Parvin

2016-01-01

The goal of this study was to determine the effect of topical Emu oil on the healing of burn wounds and hair follicle restoration in superficial II-degree burns in the skin of Balb/c mice. Thirty-two male Balb/c mice with burns on the back of the neck were divided into two groups: The Emu oil group received topical Emu oil twice daily, whereas the control was left untreated. Skin biopsies were obtained on days 4, 7, 10, and 14 of the experiment. Then the specimens were viewed with Olympus SZX research microscope. The Emu oil treated burns were found to heal more slowly and inflammation lasted longer in this group. The number of hair follicles in the margins of the wounds increased through time in the Emu oil group compared to the control group. Also, the hair follicles in the Emu oil group were in several layers and seemed to be more active and mature. Moreover, Emu oil had a positive effect on fibrogenesis and synthesis of collagen. The findings indicate that although Emu oil delays the healing process, it has a positive effect on wound healing and it increases the number of hair follicles in the margins of the wound. PMID:27069472

Does Ferrule Effect Affect Implant-Abutment Stability?

PubMed

Mohajerfar, Maryam; Beyabanaki, Elaheh; Geramy, Allahyar; Siadat, Hakimeh; Alikhasi, Marzieh

2016-12-01

This study investigated the influence of placing implant-supported crowns on the torque loss of the abutment screw before and after loading. Twenty implant-abutment assemblies were randomly assigned to two groups. The first group was consisted of abutments with abutment-level finishing line (abutment-level), and in the second group the crown margin was placed on the implant shoulder (implant-level). Initial torque loss was recorded for all specimens. After 500000 cyclic load of 75 N and frequency of 2 Hz, post loading torque loss was recorded. Finite element model of each group was also modeled and screw energy, and stress were analyzed and compared between two groups. ANOVA for repeated measurements showed that the torque loss did not change significantly after cyclic loading (P=0.73). Crown margin also had no significant effect on the torque loss (P=0.56). However, the energy and stress of screw in abutment-level model (4.49 mJ and 22.74 MPa) was higher than implant-level model (3.52 mJ and 20.81 MPa). Although embracing the implant with crown produced less stress and energy in the abutment-implant screw, it did not have any significant influence on the torque loss of the screw. Copyright© 2016 Dennis Barber Ltd

Adenoid cystic carcinoma of the right main bronchus showing squamous differentiation and mimicking mucoepidermoid carcinoma: a case report.

PubMed

Tajima, Shogo; Koda, Kenji

2015-01-01

Complete dissection of tracheobronchial adenoid cystic carcinoma (TACC) by surgery alone is sometimes difficult and has a greater propensity than tracheobronchial mucoepidermoid carcinoma (TMEC) for its surgical margin to become positive. In addition, TACC is more likely to present distant metastases than TMEC. Considering these facts, TACC and TMEC should be differentiated based on histopathological examination of biopsy specimens. Herein, we present a case of 54-year-old woman with a tumor in the right main bronchus, whose biopsy specimen was difficult to diagnose as TACC or TMEC. The specimen from the rounded protrusion of the tumor showed squamous differentiation, along with the presence of glandular and basaloid cells, making morphological examination alone ineffective in rendering a definite diagnosis. Thus, the addition of immunohistochemical analysis, αSMA and CD43 expression in basaloid cells and c-kit expression in glandular cells, was useful for accurately diagnosing TACC in this case. The squamous component was considered to be neoplastic because of its increased expression of cyclin D1 and overexpression of p16. The surgically resected specimen contained typical morphology of ACC, and the diagnosis of TACC was definitely confirmed.

3D Printing of 316L Stainless Steel and Its Effect on Microstructure and Mechanical Properties

NASA Astrophysics Data System (ADS)

Rawn, Penn

Laser powder bed fusion or 3D printing is a potential candidate for net shape forming and manufacturing complex shapes. Understanding of how various parameters affect build quality is necessary. Specimens were made from 316L stainless steel at 0°, 30°, 60°, and 90° angles measured from the build plate. Three tensile and four fatigue specimens at each angle were produced. Fracture morphology investigation was performed to determine the fracture mode of specimens at each build angle. Microstructural analysis was performed on one of each orientation. The average grain size of the samples was marginally influenced by the build angle orientation. Tensile yield strength was the highest for 0° and decreased in the order of 60°, 30°, and 90° angles; all had higher yield strength than wrought. Unlike with the tensile results, the 60° had the highest fatigue strength followed by the 0°, then the 30°, and the 90° build angle had the lowest fatigue strength. Tensile specimens all failed predominantly by ductile fracture, with a few locations of brittle fracture suspected to be caused by delamination. Fatigue fracture always initiated at void space.

Optimizing signal output: effects of viscoelasticity and difference frequency on vibroacoustic radiation of tissue-mimicking phantoms

NASA Astrophysics Data System (ADS)

Namiri, Nikan K.; Maccabi, Ashkan; Bajwa, Neha; Badran, Karam W.; Taylor, Zachary D.; St. John, Maie A.; Grundfest, Warren S.; Saddik, George N.

2018-02-01

Vibroacoustography (VA) is an imaging technology that utilizes the acoustic response of tissues to a localized, low frequency radiation force to generate a spatially resolved, high contrast image. Previous studies have demonstrated the utility of VA for tissue identification and margin delineation in cancer tissues. However, the relationship between specimen viscoelasticity and vibroacoustic emission remains to be fully quantified. This work utilizes the effects of variable acoustic wave profiles on unique tissue-mimicking phantoms (TMPs) to maximize VA signal power according to tissue mechanical properties, particularly elasticity. A micro-indentation method was utilized to provide measurements of the elastic modulus for each biological replica. An inverse relationship was found between elastic modulus (E) and VA signal amplitude among homogeneous TMPs. Additionally, the difference frequency (Δf ) required to reach maximum VA signal correlated with specimen elastic modulus. Peak signal diminished with increasing Δf among the polyvinyl alcohol specimen, suggesting an inefficient vibroacoustic response by the specimen beyond a threshold of resonant Δf. Comparison of these measurements may provide additional information to improve tissue modeling, system characterization, as well as insights into the unique tissue composition of tumors in head and neck cancer patients.

Light-sheet microscopy for slide-free non-destructive pathology of large clinical specimens

PubMed Central

Glaser, Adam K.; Reder, Nicholas P.; Chen, Ye; McCarty, Erin F.; Yin, Chengbo; Wei, Linpeng; Wang, Yu; True, Lawrence D.; Liu, Jonathan T.C.

2017-01-01

For the 1.7 million patients per year in the U.S. who receive a new cancer diagnosis, treatment decisions are largely made after a histopathology exam. Unfortunately, the gold standard of slide-based microscopic pathology suffers from high inter-observer variability and limited prognostic value due to sampling limitations and the inability to visualize tissue structures and molecular targets in their native 3D context. Here, we show that an open-top light-sheet microscope optimized for non-destructive slide-free pathology of clinical specimens enables the rapid imaging of intact tissues at high resolution over large 2D and 3D fields of view, with the same level of detail as traditional pathology. We demonstrate the utility of this technology for various applications: wide-area surface microscopy to triage surgical specimens (with ~200 μm surface irregularities), rapid intraoperative assessment of tumour-margin surfaces (12.5 sec/cm2), and volumetric assessment of optically cleared core–needle biopsies (1 mm in diameter, 2 cm in length). Light-sheet microscopy can be a versatile tool for both rapid surface microscopy and deep volumetric microscopy of human specimens. PMID:29750130

Normalization of urinary pteridines by urine specific gravity for early cancer detection.

PubMed

Burton, Casey; Shi, Honglan; Ma, Yinfa

2014-08-05

Urinary biomarkers, such as pteridines, require normalization with respect to an individual's hydration status and time since last urination. Conventional creatinine-based corrections are affected by a multitude of patient factors whereas urine specific gravity (USG) is a bulk specimen property that may better resist those same factors. We examined the performance of traditional creatinine adjustments relative to USG to six urinary pteridines in aggressive and benign breast cancers. 6-Biopterin, neopterin, pterin, 6-hydroxymethylpterin, isoxanthopterin, xanthopterin, and creatinine were analyzed in 50 urine specimens with a previously developed liquid chromatography-tandem mass spectrometry technique. Creatinine and USG performance were evaluated with non-parametric Mann-Whitney hypothesis testing. USG and creatinine were moderately correlated (r=0.857) with deviations occurring in dilute and concentrated specimens. In 48 aggressive and benign breast cancers, normalization by USG significantly outperformed creatinine adjustments which marginally outperformed uncorrected pteridines in predicting pathological status. In addition, isoxanthopterin and xanthopterin were significantly higher in pathological specimens when normalized by USG. USG, as a bulk property, can provide better performance over creatinine-based normalizations for urinary pteridines in cancer detection applications. Copyright © 2014 Elsevier B.V. All rights reserved.

Effect of different monomer-based composites and acid etching pre-treatment of enamel on the microleakage using self-etch adhesives systems.

PubMed

Catelan, Anderson; Giorgi, Maria Cecília Caldas; Soares, Giulliana Panfiglio; Lima, Debora Alves Nunes Leite; Marchi, Giselle Maria; Aguiar, Flávio Henrique Baggio

2014-11-01

To evaluate quantitatively the marginal microleakage of restorations carried out with self-etching adhesives with or without prior phosphoric enamel acid etching of silorane or methacrylate resin-based composite restorations subjected to thermal cycling. Forty cavities were prepared at the proximal surface of bovine incisors and randomly divided according to the etching of the enamel and restorative system used. The groups were restored with methacrylate [Adper SE Plus adhesive (3M ESPE) + Filtek Z250 (3M ESPE)] or silorane [Filtek LS adhesive (3M ESPE) + Filtek LS composite (3M ESPE)] restorative systems, light-cured using a LED unit (Bluephase 16i, Vivadent). After restorative procedure and thermocycling (1000 cycles), the specimens were immersed in methylene blue for 2 h. The specimens were triturated and the powder was used for analysis in an absorbance spectrophotometer. Data were statistically analyzed by 2-way ANOVA (alpha = 0.05). No statistical difference between the restorative materials tested with or without previous acid etching of enamel in Class II marginal microleakage was observed (p > 0.05). The use of acid etching prior to self-etching adhesives did not interfere on the microleakage of methacrylate- or silorane-based restorations.

The effect of endodontic materials on the optical density of dyes used in marginal leakage studies.

PubMed

Kubo, Claudio Hideki; Valera, Marcia Carneiro; Gomes, Ana Paula Martins; Mancini, Maria Nadir Gasparoto; Camargo, Carlos Henrique Ribeiro

2008-01-01

The aim of this study was to determine the effect of the exposure of different endodontic materials to different dye solutions by evaluating the optical density of the dye solutions. Seventy-five plastic tubes were filled with one of the following materials: AH Plus, Sealapex, Portland cement, MTA (Angelus and Pro Root) and fifteen control plastic tubes were not. Each specimen of material and control was immersed in a container with 1 ml of each dye solution. A 0.1 ml-dye solution aliquote was removed before immersion and after 12, 24, 48 and 72 hours of each specimen immersion to record its optical density (OD) in a spectrophotometer. Statistical analysis was performed with ANOVA and Tukey tests (5%). No significant difference was found among any of the solution OD values for AH Plus cement. Portland cement promoted different OD values after 12 hours of immersion. MTA-Angelus cement presented different OD values only for 2% rhodamine B and the MTA-Pro Root cement presented different OD values in all 2% rhodamine B samples. Sealapex cement promoted a reduction in the India Ink OD values. Dye evaluation through OD seems to be an interesting method to select the best dye solution to use in a given marginal leakage study.

Bythaelurus vivaldii, a new deep-water catshark (Carcharhiniformes, Scyliorhinidae) from the northwestern Indian Ocean off Somalia.

PubMed

Weigmann, Simon; Kaschner, Carina Julia

2017-05-08

A new very small deep-water catshark, Bythaelurus vivaldii, is described based on two female specimens caught off Somalia in the northwestern Indian Ocean during the German 'Valdivia' expedition in 1899. It is morphologically closest to the recently described B. bachi, which is the only other Bythaelurus species in the western Indian Ocean that shares a stout body of large specimens and the presence of oral papillae. It further resembles B. vivaldii in the broad mouth and broad posterior head, but differs in the presence of composite oral papillae and a higher diversity in dermal denticle morphology. Additionally, the new species differs from all congeners in the western Indian Ocean in a larger pre-second dorsal fin length, a longer head, a larger interdorsal space, a larger intergill length, a longer pectoral-fin posterior margin, a shorter caudal fin, an intermediate caudal fin preventral margin, and a larger internarial width. Furthermore, the second dorsal fin of the new species is smaller than in its congeners in the western Indian Ocean except for B. lutarius, which is easily distinguished by the slender body and virtual absence of oral papillae, as well as the aforementioned further characters. An updated key to all valid species of Bythaelurus is provided.

Evaluation of the ablation margin of hepatocellular carcinoma using CEUS-CT/MR image fusion in a phantom model and in patients.

PubMed

Li, Kai; Su, Zhongzhen; Xu, Erjiao; Huang, Qiannan; Zeng, Qingjing; Zheng, Rongqin

2017-01-19

To assess the accuracy of contrast-enhanced ultrasound (CEUS)-CT/MR image fusion in evaluating the radiofrequency ablative margin (AM) of hepatocellular carcinoma (HCC) based on a custom-made phantom model and in HCC patients. Twenty-four phantoms were randomly divided into a complete ablation group (n = 6) and an incomplete ablation group (n = 18). After radiofrequency ablation (RFA), the AM was evaluated using ultrasound (US)-CT image fusion, and the results were compared with the AM results that were directly measured in a gross specimen. CEUS-CT/MR image fusion and CT-CT / MR-MR image fusion were used to evaluate the AM in 37 tumors from 33 HCC patients who underwent RFA. The sensitivity, specificity, and accuracy of US-CT image fusion for evaluating AM in the phantom model were 93.8, 85.7 and 91.3%, respectively. The maximal thicknesses of the residual AM were 3.5 ± 2.0 mm and 3.2 ± 2.0 mm in the US-CT image fusion and gross specimen, respectively. No significant difference was observed between the US-CT image fusion and direct measurements of the AM of HCC. In the clinical study, the success rate of the AM evaluation was 100% for both CEUS-CT/MR and CT-CT/MR-MR, and the duration was 8.5 ± 2.8 min (range: 4-12 min) and 13.5 ± 4.5 min (range: 8-16 min) for CEUS-CT/MR and CT-CT/MR-MR, respectively. The sensitivity, specificity, and accuracy of CEUS-CT/MR imaging for evaluating the AM were 100.0, 80.0, and 90.0%, respectively. A phantom model composed of carrageenan gel and additives was suitable for the evaluation of HCC AM. CEUS-CT/MR image fusion can be used to evaluate HCC AM with high accuracy.

Comparative study of the marginal microleakage of six cements in fixed provisional crowns.

PubMed

Baldissara, P; Comin, G; Martone, F; Scotti, R

1998-10-01

In many situations, provisional restorations require a long-term permanence in the oral cavity. During this period, the abutments need the best possible biologic and mechanical protection. In this way, the vitality of the pulp and the integrity of mineralized tissues can be preserved. The luting cement used to fix interim restorations should have good mechanical properties, low solubility, and good adhesion to resist bacterial and molecular penetration. However, because of its provisional nature, the prosthesis should be easy to remove from the abutments. These contrasting requirements may lead to a compromise in cement behavior, particularly in its mechanical properties. This in vitro study evaluated the marginal microleakage of 4 provisional cements, a cavity base compound and a zinc-phosphate luting cement in provisional acrylic resin crowns fixed on extracted human teeth. Thirty acrylic resin crowns were made and fitted on intact human premolars with the 6 cements. All restorations were applied in a standardized manner by means of an axial load of 10 kg. Specimens were thermocycled then submerged in a 5% basic fuchsin solution, then sectioned and observed under a light stereomicroscope. A 5-level scale was used to score dye penetration in the tooth/cement interface. A high dye penetration in the tooth/cement interface was present in all 4 provisional cements. Microleakage existed in specimens where zinc-phosphate and cavity base compounds were used; however, it was lower than the other materials. A significant difference (P < .05) was found between zinc-phosphate and one eugenol-free cement and between cavity base and the same eugenol-free cement. All materials tested demonstrated different degrees of microleakage. Zinc-phosphate and cavity base compound cements had the best sealing properties. This latter, even if conceived as a cavity base, may be considered a good provisional cement as far as microleakage is concerned.

The association between metabolic syndrome and prostate cancer: Effect on its aggressiveness and progression.

PubMed

Sanchís-Bonet, A; Ortiz-Vico, F; Morales-Palacios, N; Sánchez-Chapado, M

2015-04-01

To evaluate the impact of metabolic syndrome and its individual components on prostate biopsy findings, the radical prostatectomy specimen and on biochemical recurrence. An observational study was conducted of 1319 men who underwent prostate biopsy between January 2007 and December 2011. The impact on the biopsy findings, the radical prostatectomy specimen and biochemical recurrence was evaluated using logistic regression and Cox regression. Of the 1319 patients, 275 (21%) had metabolic syndrome, and 517 prostate cancers were diagnosed. A greater percentage of metabolic syndrome was found among patients with prostate cancer than among patients without prostate cancer (25% vs. 18%; P=.002). Poorer results were found in the radical prostatectomy specimens (Gleason score ≥ 7, P<.001; stage ≥ T2c, P<.001; positive surgical margins, P<.001), and there was a greater percentage of biochemical recurrence in patients with metabolic syndrome than in those without metabolic syndrome (24% vs. 13%; P=.003). Metabolic syndrome behaved as an independent predictive factor of finding a Gleason score ≥ 7 for the specimen, as well as for finding a specimen stage ≥ T2c. Metabolic syndrome was also able to independently predict a greater rate of biochemical recurrence (OR: 3.6, P<.001; OR: 3.2, P=.03; HR: 1.7; respectively). Metabolic syndrome is associated with poorer findings in the radical prostatectomy specimens and is an independent prognostic factor of biochemical recurrence. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Marginal adaptation of mineral trioxide aggregate (MTA) compared with amalgam as a root-end filling material: a low-vacuum (LV) versus high-vacuum (HV) SEM study.

PubMed

Shipper, G; Grossman, E S; Botha, A J; Cleaton-Jones, P E

2004-05-01

To compare the marginal adaptation of mineral trioxide aggregate (MTA) or amalgam root-end fillings in extracted teeth under low-vacuum (LV) versus high-vacuum (HV) scanning electron microscope (SEM) viewing conditions. Root-end fillings were placed in 20 extracted single-rooted maxillary teeth. Ten root ends were filled with MTA and the other 10 root ends were filled with amalgam. Two 1 mm thick transverse sections of each root-end filling were cut 0.50 mm (top) and 1.50 mm (bottom) from the apex. Gap size was recorded at eight fixed points along the dentine-filling material interface on each section when uncoated wet (LV wet (LVW)) and dry under LV (0.3 Torr) in a JEOL JSM-5800 SEM and backscatter emission (LV dry uncoated (LVDU)). The sections were then air-dried, gold-coated and gap size was recorded once again at the fixed points under HV (10(-6) Torr; HV dry coated (HVDC)). Specimen cracking, and the size and extent of the crack were noted. Gap sizes at fixed points were smallest under LVW and largest under HVDC SEM conditions. Gaps were smallest in MTA root-end fillings. A General Linear Models Analysis, with gap size as the dependent variable, showed significant effects for extent of crack in dentine, material and viewing condition (P = 0.0001). This study showed that MTA produced a superior marginal adaptation to amalgam, and that LVW conditions showed the lowest gap size. Gap size was influenced by the method of SEM viewing. If only HV SEM viewing conditions are used for MTA and amalgam root-end fillings, a correction factor of 3.5 and 2.2, respectively, may be used to enable relative comparisons of gap size to LVW conditions.

Comparative analysis of different joining techniques to improve the passive fit of cobalt-chromium superstructures.

PubMed

Barbi, Francisco C L; Camarini, Edevaldo T; Silva, Rafael S; Endo, Eliana H; Pereira, Jefferson R

2012-12-01

The influence of different joining techniques on passive fit at the interface structure/abutment of cobalt-chromium (Co-Cr) superstructures has not yet been clearly established. The purpose of this study was to compare 3 different techniques of joining Co-Cr superstructures by measuring the resulting marginal misfit in a simulated prosthetic assembly. A specially designed metal model was used for casting, sectioning, joining, and measuring marginal misfit. Forty-five cast bar-type superstructures were fabricated in a Co-Cr alloy and randomly assigned by drawing lots to 3 groups (n=15) according to the joining method used: conventional gas-torch brazing (G-TB), laser welding (LW), and tungsten inert gas welding (TIG). Joined specimens were assembled onto abutment analogs in the metal model with the 1-screw method. The resulting marginal misfit was measured with scanning electron microscopy (SEM) at 3 different points: distal (D), central (C), and mesial (M) along the buccal aspect of both abutments: A (tightened) and B (without screw). The Levene test was used to evaluate variance homogeneity and then the Welsch ANOVA for heteroscedastic data (α=.05). Significant differences were found on abutment A between groups G-TB and LW (P=.013) measured mesially and between groups G-TB and TIG (P=.037) measured centrally. On abutment B, significant differences were found between groups G-TB and LW (P<.001) and groups LW and TIG (P<.001) measured mesially; groups G-TB and TIG (P=.007) measured distally; and groups G-TB and TIG (P=.001) and LW and TIG (P=.007) measured centrally. The method used for joining Co-Cr prosthetic structures had an influence on the level of resulting passive fit. Structures joined by the tungsten inert gas method produced better mean results than did the brazing or laser method. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Risk factor assessment of endoscopically removed malignant colorectal polyps

PubMed Central

Netzer, P; Forster, C; Biral, R; Ruchti, C; Neuweiler, J; Stauffer, E; Schonegg, R; Maurer, C; Husler, J; Halter, F; Schmassmann, A

1998-01-01

Background—Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. 
Aims—To determine the significance of histological findings of patients with malignant polyps. 
Methods—Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67months). 
Results—Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16(42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. 
Conclusion—As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems sufficient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk. 

 Keywords: malignant polyps; colon cancer; colonoscopy; polypectomy; histology PMID:9824349

More Accurate Definition of Clinical Target Volume Based on the Measurement of Microscopic Extensions of the Primary Tumor Toward the Uterus Body in International Federation of Gynecology and Obstetrics Ib-IIa Squamous Cell Carcinoma of the Cervix

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xie, Wen-Jia; Wu, Xiao; Xue, Ren-Liang

Purpose: To more accurately define clinical target volume for cervical cancer radiation treatment planning by evaluating tumor microscopic extension toward the uterus body (METU) in International Federation of Gynecology and Obstetrics stage Ib-IIa squamous cell carcinoma of the cervix (SCCC). Patients and Methods: In this multicenter study, surgical resection specimens from 318 cases of stage Ib-IIa SCCC that underwent radical hysterectomy were included. Patients who had undergone preoperative chemotherapy, radiation, or both were excluded from this study. Microscopic extension of primary tumor toward the uterus body was measured. The association between other pathologic factors and METU was analyzed. Results: Microscopicmore » extension toward the uterus body was not common, with only 12.3% of patients (39 of 318) demonstrating METU. The mean (±SD) distance of METU was 0.32 ± 1.079 mm (range, 0-10 mm). Lymphovascular space invasion was associated with METU distance and occurrence rate. A margin of 5 mm added to gross tumor would adequately cover 99.4% and 99% of the METU in the whole group and in patients with lymphovascular space invasion, respectively. Conclusion: According to our analysis of 318 SCCC specimens for METU, using a 5-mm gross tumor volume to clinical target volume margin in the direction of the uterus should be adequate for International Federation of Gynecology and Obstetrics stage Ib-IIa SCCC. Considering the discrepancy between imaging and pathologic methods in determining gross tumor volume extent, we recommend a safer 10-mm margin in the uterine direction as the standard for clinical practice when using MRI for contouring tumor volume.« less

Fracture resistance and marginal discrepancy of porcelain laminate veneers influenced by preparation design and restorative material in vitro.

PubMed

Lin, Tai-Min; Liu, Perng-Ru; Ramp, Lance C; Essig, Milton E; Givan, Daniel A; Pan, Yu-Hwa

2012-03-01

The purpose of this investigation is to evaluate marginal discrepancy and fracture resistance of two veneering materials using two preparation designs. Two veneer preparation designs (full and traditional) were restored with leucite-reinforced ceramic (ProCAD, Ivoclar Vivadent, Amherst, NY) milled by CAD/CAM (Cerec 3D milling system, Serona Dental Systems), and conventional sintered feldspathic porcelain (Noritake Super Porcelain EX3, Noritake Dental Supply Co). Forty-eight specimens were analysed with a sample size of n=12 per group. The thickness of each veneer was measured on four specific surfaces. Marginal discrepancy was evaluated with a replica technique and cross-sectional view using a digital microscope. The fracture resistance of veneers cemented on standardised composite resin dies was evaluated using a universal testing machine. Results were analysed with ANOVA, Tukey-Kramer post hoc testing, and linear regression. The results of this investigation revealed no correlation between the thickness and marginal discrepancy of the veneers. The full preparation design with ProCAD and the traditional preparation design with feldspathic porcelain manifested smaller gap. Fracture resistance was decreased for the full preparation design with feldspathic porcelain. In terms of marginal discrepancy and fracture resistance, the most favourable combination was a traditional veneer preparation design with conventional sintered feldspathic porcelain. For the full veneer preparation, a stronger ceramic material such as ProCAD is suggested. Published by Elsevier Ltd.

Gallbladder Cancer: expert consensus statement

PubMed Central

Aloia, Thomas A; Járufe, Nicolas; Javle, Milind; Maithel, Shishir K; Roa, Juan C; Adsay, Volkan; Coimbra, Felipe J F; Jarnagin, William R

2015-01-01

An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists was convened on 15 January 2014 to review current evidence on the management of gallbladder carcinoma in order to establish practice guidelines. In summary, within high incidence areas, the assessment of routine gallbladder specimens should include the microscopic evaluation of a minimum of three sections and the cystic duct margin; specimens with dysplasia or proven cancer should be extensively sampled. Provided the patient is medically fit for surgery, data support the resection of all gallbladder polyps of >1.0 cm in diameter and those with imaging evidence of vascular stalks. The minimum staging evaluation of patients with suspected or proven gallbladder cancer includes contrasted cross-sectional imaging and diagnostic laparoscopy. Adequate lymphadenectomy includes assessment of any suspicious regional nodes, evaluation of the aortocaval nodal basin, and a goal recovery of at least six nodes. Patients with confirmed metastases to N2 nodal stations do not benefit from radical resection and should receive systemic and/or palliative treatments. Primary resection of patients with early T-stage (T1b–2) disease should include en bloc resection of adjacent liver parenchyma. Patients with T1b, T2 or T3 disease that is incidentally identified in a cholecystectomy specimen should undergo re-resection unless this is contraindicated by advanced disease or poor performance status. Re-resection should include complete portal lymphadenectomy and bile duct resection only when needed to achieve a negative margin (R0) resection. Patients with preoperatively staged T3 or T4 N1 disease should be considered for clinical trials of neoadjuvant chemotherapy. Following R0 resection of T2–4 disease in N1 gallbladder cancer, patients should be considered for adjuvant systemic chemotherapy and/or chemoradiotherapy. PMID:26172135

Gallbladder cancer: expert consensus statement.

PubMed

Aloia, Thomas A; Járufe, Nicolas; Javle, Milind; Maithel, Shishir K; Roa, Juan C; Adsay, Volkan; Coimbra, Felipe J F; Jarnagin, William R

2015-08-01

An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists was convened on 15 January 2014 to review current evidence on the management of gallbladder carcinoma in order to establish practice guidelines. In summary, within high incidence areas, the assessment of routine gallbladder specimens should include the microscopic evaluation of a minimum of three sections and the cystic duct margin; specimens with dysplasia or proven cancer should be extensively sampled. Provided the patient is medically fit for surgery, data support the resection of all gallbladder polyps of >1.0 cm in diameter and those with imaging evidence of vascular stalks. The minimum staging evaluation of patients with suspected or proven gallbladder cancer includes contrasted cross-sectional imaging and diagnostic laparoscopy. Adequate lymphadenectomy includes assessment of any suspicious regional nodes, evaluation of the aortocaval nodal basin, and a goal recovery of at least six nodes. Patients with confirmed metastases to N2 nodal stations do not benefit from radical resection and should receive systemic and/or palliative treatments. Primary resection of patients with early T-stage (T1b-2) disease should include en bloc resection of adjacent liver parenchyma. Patients with T1b, T2 or T3 disease that is incidentally identified in a cholecystectomy specimen should undergo re-resection unless this is contraindicated by advanced disease or poor performance status. Re-resection should include complete portal lymphadenectomy and bile duct resection only when needed to achieve a negative margin (R0) resection. Patients with preoperatively staged T3 or T4 N1 disease should be considered for clinical trials of neoadjuvant chemotherapy. Following R0 resection of T2-4 disease in N1 gallbladder cancer, patients should be considered for adjuvant systemic chemotherapy and/or chemoradiotherapy. © 2015 International Hepato-Pancreato-Biliary Association.

Real-time, intraoperative detection of residual breast cancer in lumpectomy cavity walls using a novel cathepsin-activated fluorescent imaging system.

PubMed

Smith, Barbara L; Gadd, Michele A; Lanahan, Conor R; Rai, Upahvan; Tang, Rong; Rice-Stitt, Travis; Merrill, Andrea L; Strasfeld, David B; Ferrer, Jorge M; Brachtel, Elena F; Specht, Michelle C

2018-06-09

Obtaining tumor-free surgical margins is critical to prevent recurrence in breast-conserving surgery but it remains challenging. We assessed the LUM Imaging System for real-time, intraoperative detection of residual tumor. Lumpectomy cavity walls and excised specimens of breast cancer lumpectomy patients were assessed with the LUM Imaging System (Lumicell, Inc., Wellesley MA) with and without intravenous LUM015, a cathepsin-activatable fluorescent agent. Fluorescence at potential sites of residual tumor was evaluated with a sterile hand-held probe, displayed on a monitor and correlated with histopathology. Background autofluorescence was assessed in excised specimens from 9 patients who did not receive LUM015. In vivo lumpectomy cavities and excised specimens were then imaged in 15 women undergoing breast cancer surgery who received no LUM015, 0.5, or 1 mg/kg LUM015 (5 women per dose). Among these, 11 patients had invasive carcinoma with ductal carcinoma in situ (DCIS) and 4 had only DCIS. Image acquisition took 1 s for each 2.6-cm-diameter surface. No significant background normal breast fluorescence was identified. Elevated fluorescent signal was seen from invasive cancers and DCIS. Mean tumor-to-normal signal ratios were 4.70 ± 1.23 at 0.5 mg/kg and 4.22 ± 0.9 at 1.0 mg/kg (p = 0.54). Tumor was distinguished from normal tissue in pre-and postmenopausal women and readings were not affected by breast density. Some benign tissues produced fluorescent signal with LUM015. The LUM Imaging System allows rapid identification of residual tumor in the lumpectomy cavity of breast cancer patients and may reduce rates of positive margins.

Effect of Low-Temperature Sensitization on the Corrosion Behavior of AISI Type 304L SS Weld Metal in Simulated Groundwater

NASA Astrophysics Data System (ADS)

Suresh, Girija; Nandakumar, T.; Viswanath, A.

2018-04-01

The manuscript presents the investigations carried out on the effect of low-temperature sensitization (LTS) of 304L SS weld metal on its corrosion behavior in simulated groundwater, for its application as a canister material for long-term storage of nuclear vitrified high-level waste in geological repositories. AISI type 304L SS weld pad was fabricated by multipass gas tungsten arc welding process using 308L SS filler wire. The as-welded specimens were subsequently subjected to carbide nucleation and further to LTS at 500 °C for 11 days to simulate a temperature of 300 °C for 100-year life of the canister in geological repositories. Delta ferrite (δ-ferrite) content of the 304L SS weld metal substantially decreased on carbide nucleation treatment and further only a marginal decrease occurred on LTS treatment. The microstructure of the as-welded consisted of δ-ferrite as a minor phase distributed in austenite matrix. The δ-ferrite appeared fragmented in the carbide-nucleated and LTS-treated weld metal. The degree of sensitization measured by double-loop electrochemical potentokinetic reactivation method indicated an increase in carbide nucleation treatment when compared to the as-welded specimens, and further increase occurred on LTS treatment. Potentiodynamic anodic polarization investigations in simulated groundwater indicated a substantial decrease in the localized corrosion resistance of the carbide-nucleated and LTS 304L SS weld metals, when compared to the as-welded specimens. Post-experimental micrographs indicated pitting as the primary mode of attack in the as-welded, while pitting and intergranular corrosion (IGC) occurred in the carbide-nucleated weld metal. LTS-treated weld metal predominantly underwent IGC attack. The decrease in the localized corrosion resistance of the weld metal after LTS treatment was found to have a direct correlation with the degree of sensitization and the weld microstructure. The results are detailed in the manuscript.

Effect of Low-Temperature Sensitization on the Corrosion Behavior of AISI Type 304L SS Weld Metal in Simulated Groundwater

NASA Astrophysics Data System (ADS)

Suresh, Girija; Nandakumar, T.; Viswanath, A.

2018-05-01

The manuscript presents the investigations carried out on the effect of low-temperature sensitization (LTS) of 304L SS weld metal on its corrosion behavior in simulated groundwater, for its application as a canister material for long-term storage of nuclear vitrified high-level waste in geological repositories. AISI type 304L SS weld pad was fabricated by multipass gas tungsten arc welding process using 308L SS filler wire. The as-welded specimens were subsequently subjected to carbide nucleation and further to LTS at 500 °C for 11 days to simulate a temperature of 300 °C for 100-year life of the canister in geological repositories. Delta ferrite ( δ-ferrite) content of the 304L SS weld metal substantially decreased on carbide nucleation treatment and further only a marginal decrease occurred on LTS treatment. The microstructure of the as-welded consisted of δ-ferrite as a minor phase distributed in austenite matrix. The δ-ferrite appeared fragmented in the carbide-nucleated and LTS-treated weld metal. The degree of sensitization measured by double-loop electrochemical potentokinetic reactivation method indicated an increase in carbide nucleation treatment when compared to the as-welded specimens, and further increase occurred on LTS treatment. Potentiodynamic anodic polarization investigations in simulated groundwater indicated a substantial decrease in the localized corrosion resistance of the carbide-nucleated and LTS 304L SS weld metals, when compared to the as-welded specimens. Post-experimental micrographs indicated pitting as the primary mode of attack in the as-welded, while pitting and intergranular corrosion (IGC) occurred in the carbide-nucleated weld metal. LTS-treated weld metal predominantly underwent IGC attack. The decrease in the localized corrosion resistance of the weld metal after LTS treatment was found to have a direct correlation with the degree of sensitization and the weld microstructure. The results are detailed in the manuscript.

Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis

PubMed Central

Ranganathan, Hemalatha; Ganapathy, Dhanraj M.; Jain, Ashish R.

2017-01-01

Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups. PMID:28839415

Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis.

PubMed

Ranganathan, Hemalatha; Ganapathy, Dhanraj M; Jain, Ashish R

2017-01-01

Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. This was an experimental, single-blinded, in vitro trial. Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

Comparison of marginal accuracy of castings fabricated by conventional casting technique and accelerated casting technique: an in vitro study.

PubMed

Reddy, S Srikanth; Revathi, Kakkirala; Reddy, S Kranthikumar

2013-01-01

Conventional casting technique is time consuming when compared to accelerated casting technique. In this study, marginal accuracy of castings fabricated using accelerated and conventional casting technique was compared. 20 wax patterns were fabricated and the marginal discrepancy between the die and patterns were measured using Optical stereomicroscope. Ten wax patterns were used for Conventional casting and the rest for Accelerated casting. A Nickel-Chromium alloy was used for the casting. The castings were measured for marginal discrepancies and compared. Castings fabricated using Conventional casting technique showed less vertical marginal discrepancy than the castings fabricated by Accelerated casting technique. The values were statistically highly significant. Conventional casting technique produced better marginal accuracy when compared to Accelerated casting. The vertical marginal discrepancy produced by the Accelerated casting technique was well within the maximum clinical tolerance limits. Accelerated casting technique can be used to save lab time to fabricate clinical crowns with acceptable vertical marginal discrepancy.

Marginal and internal fit of curved anterior CAD/CAM-milled zirconia fixed dental prostheses: an in-vitro study.

PubMed

Büchi, Dominik L; Ebler, Sabine; Hämmerle, Christoph H F; Sailer, Irena

2014-01-01

To test whether or not different types of CAD/CAM systems, processing zirconia in the densely and in the pre-sintered stage, lead to differences in the accuracy of 4-unit anterior fixed dental prosthesis (FDP) frameworks, and to evaluate the efficiency. 40 curved anterior 4-unit FDP frameworks were manufactured with four different CAD/CAM systems: DCS Precident (DCS) (control group), Cercon (DeguDent) (test group 1), Cerec InLab (Sirona) (test group 2), Kavo Everest (Kavo) (test group 3). The DCS System was chosen as the control group because the zirconia frameworks are processed in its densely sintered stage and there is no shrinkage of the zirconia during the manufacturing process. The initial fit of the frameworks was checked and adjusted to a subjectively similar level of accuracy by one dental technician, and the time taken for this was recorded. After cementation, the frameworks were embedded into resin and the abutment teeth were cut in mesiodistal and orobuccal directions in four specimens. The thickness of the cement gap was measured at 50× (internal adaptation) and 200× (marginal adaptation) magnification. The measurement of the accuracy was performed at four sites. Site 1: marginal adaptation, the marginal opening at the point of closest perpendicular approximation between the die and framework margin. Site 2: Internal adaptation at the chamfer. Site 3: Internal adaptation at the axial wall. Site 4: Internal adaptation in the occlusal area. The data were analyzed descriptively using the ANOVA and Bonferroni/ Dunn tests. The mean marginal adaptation (site 1) of the control group was 107 ± 26 μm; test group 1, 140 ± 26 μm; test group 2, 104 ± 40 μm; and test group 3, 95 ± 31 μm. Test group 1 showed a tendency to exhibit larger marginal gaps than the other groups, however, this difference was only significant when test groups 1 and 3 were compared (P = .0022; Bonferroni/Dunn test). Significantly more time was needed for the adjustment of the frameworks of test group 1 compared to the other test groups and the control group (21.1 min vs 3.8 min) (P < .0001; Bonferroni/Dunn test). For the adjustment of the frameworks of test groups 2 and 3, the same time was needed as for the frameworks of the control group. No differences of the framework accuracy resulting from the different CAM and CAD/CAM procedures were found; however, only after adjustment of the fit by an experienced dental technician. Hence, the influence of a manual correction of the fit was crucial, and the efforts differed for the tested systems. The CAM system led to lower initial accuracy of the frameworks than the CAD/CAM systems, which may be crucial for the dental laboratory. The stage of the zirconia materials used for the different CAD/CAM procedures, ie presintered or densely sintered, exhibited no influence.

Effect of Preparation Depth on the Marginal and Internal Adaptation of Computer-aided Design/Computer-assisted Manufacture Endocrowns.

PubMed

Gaintantzopoulou, M D; El-Damanhoury, H M

The aim of the study was to evaluate the effect of preparation depth and intraradicular extension on the marginal and internal adaptation of computer-aided design/computer-assisted manufacture (CAD/CAM) endocrown restorations. Standardized preparations were made in resin endodontic tooth models (Nissin Dental), with an intracoronal preparation depth of 2 mm (group H2), with extra 1- (group H3) or 2-mm (group H4) intraradicular extensions in the root canals (n=12). Vita Enamic polymer-infiltrated ceramic-network material endocrowns were fabricated using the CEREC AC CAD/CAM system and were seated on the prepared teeth. Specimens were evaluated by microtomography. Horizontal and vertical tomographic sections were recorded and reconstructed by using the CTSkan software (TView v1.1, Skyscan).The surface/void volume (S/V) in the region of interest was calculated. Marginal gap (MG), absolute marginal discrepancy (MD), and internal marginal gap were measured at various measuring locations and calculated in microscale (μm). Marginal and internal discrepancy data (μm) were analyzed with nonparametric Kruskal-Wallis analysis of variance by ranks with Dunn's post hoc, whereas S/V data were analyzed by one-way analysis of variance and Bonferroni multiple comparisons (α=0.05). Significant differences were found in MG, MD, and internal gap width values between the groups, with H2 showing the lowest values from all groups. S/V calculations presented significant differences between H2 and the other two groups (H3 and H4) tested, with H2 again showing the lowest values. Increasing the intraradicular extension of endocrown restorations increased the marginal and internal gap of endocrown restorations.

Surgical margin-negative endoscopic mucosal resection with simple three-clipping technique: a randomized prospective study (with video).

PubMed

Mori, Hirohito; Kobara, Hideki; Nishiyama, Noriko; Fujihara, Shintaro; Kobayashi, Nobuya; Ayaki, Maki; Masaki, Tsutomu

2016-11-01

Although endoscopic mucosal resection is an established colorectal polyp treatment, local recurrence occurs in 13 % of cases due to inadequate snaring. We evaluated whether pre-clipping to the muscularis propria resulted in resected specimens with negative surgical margins without thermal denaturation. Of 245 polyps from 114 patients with colorectal polyps under 20 mm, we included 188 polyps from 81 patients. We randomly allocated polyps to the conventional injection group (CG) (97 polyps) or the pre-clipping injection group (PG) (91 polyps). The PG received three-point pre-clipping to ensure ample gripping to the muscle layer on the oral and both sides of the tumor with 4 mL local injection. Endoscopic ultrasonography was performed to measure the resulting bulge. Outcomes included the number of instances of thermal denaturation of the horizontal/vertical margin (HMX/VMX) or positive horizontal/vertical margins (HM+/VM+), the shortest distance from tumor margins to resected edges, and the maximum bulge distances from tumor surface to the muscularis propria. The numbers of HMX and HM+ in the CG and PG were 27 and 6, and 9 and 2 (P = 0.001), and VMX and VM+ were 8 and 5, and 0 and 0 (P = 0.057). The shortest distance from tumor margin to resected edge [median (range), mm] in polyps in the CG and PG was 0.6 (0-2.7) and 4.7 (2.1-8.9) (P = 0.018). The maximum bulge distances were 4.6 (3.0-8.0) and 11.0 (6.8-17.0) (P = 0.005). Pre-clipping enabled surgical margin-negative resection without thermal denaturation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, Brandon T., E-mail: Brandon.Nguyen@act.gov.au; Canberra Hospital, Radiation Oncology Department, Garran, ACT; Deb, Siddhartha

Purpose: To determine an appropriate clinical target volume for partial breast radiation therapy (PBRT) based on the spatial distribution of residual invasive and in situ carcinoma after wide local excision (WLE) for early breast cancer or ductal carcinoma in situ (DCIS). Methods and Materials: We performed a prospective pathologic study of women potentially eligible for PBRT who had re-excision and/or completion mastectomy after WLE for early breast cancer or DCIS. A pathologic assessment protocol was used to determine the maximum radial extension (MRE) of residual carcinoma from the margin of the initial surgical cavity. Women were stratified by the closestmore » initial radial margin width: negative (>1 mm), close (>0 mm and {<=}1 mm), or involved. Results: The study population was composed of 133 women with a median age of 59 years (range, 27-82 years) and the following stage groups: 0 (13.5%), I (40.6%), II (38.3%), and III (7.5%). The histologic subtypes of the primary tumor were invasive ductal carcinoma (74.4%), invasive lobular carcinoma (12.0%), and DCIS alone (13.5%). Residual carcinoma was present in the re-excision and completion mastectomy specimens in 55.4%, 14.3%, and 7.2% of women with an involved, close, and negative margin, respectively. In the 77 women with a noninvolved radial margin, the MRE of residual disease, if present, was {<=}10 mm in 97.4% (95% confidence interval 91.6-99.5) of cases. Larger MRE measurements were significantly associated with an involved margin (P<.001), tumor size >30 mm (P=.03), premenopausal status (P=.03), and negative progesterone receptor status (P=.05). Conclusions: A clinical target volume margin of 10 mm would encompass microscopic residual disease in >90% of women potentially eligible for PBRT after WLE with noninvolved resection margins.« less

[NOTES ASSISTED ENDOLUMENAL RECTAL RESECTION AND SPECIMEN EXTRACTION WITHOUT RECTAL STUMP OPENING - OUR EXPERIENCE WITH THIS NOVEL TECHNIQUE IN A PORCINE MODEL].

PubMed

Kvasha, Anton; Rosenthal, Eyal; Khalifa, Muhammad; Waksman, Igor

2017-05-01

Laparoscopic surgery has long been used for colon and rectal resection, and the laparoscopic-assisted approach has prevailed in surgical practice. While this technique includes the fashioning of an intra-corporeal anastomosis, it still requires an abdominal incision for specimen extraction. Elimination of the abdominal incision and its potential complications has been the motivation for the development of natural orifice specimen extraction (NOSE) techniques. Many of these techniques make use of an open rectal stump, which poses as a potential for intra-abdominal contamination. Our group has recently described a novel, NOTES assisted, clean, endoluminal rectal resection utilizing transabdominal and transanal approaches. In this paper we report the combined experience of two study groups: an open approach to the abdominal cavity and a laparoscopic approach to the peritoneal cavity. Ten female pigs were used for this research; 5 in a group using an open approach and 5 using a laparoscopic approach for the abdominal part of the procedure. During the procedure, the rectum was mobilized. An end-to-end circular stapler was used to create a recto-rectal intussusception and pull-through (IPT). The specimen was resected and extracted by making a full thickness incision through 2 bowel walls. The stapler was applied, and a recto-rectal anastomosis created. This was allowed to retract into the abdomen. Peritoneal fluid was sampled for bacteria, the pigs were sacrificed immediately after the experiment and necropsy was performed. All 10 pigs underwent an endoluminal rectal resection utilizing the trans-anal IPT technique. The proximal and distal resection margins remained approximated over the shaft of the anvil after bowel resection in all 10 subjects. A 2- to 4-mm resection margin, distal to the ligatures was accomplished consistently in all 10 subjects. No aerobic or anaerobic bacterial growth was observed in any of the peritoneal fluid samples. Our research demonstrated the feasibility of the described technique in both open and laparoscopic approaches to a clean endoluminal bowel resection and trans-anal specimen extraction without rectal stump opening. The fact that no bacterial growth was found in any of the peritoneal samples supports the initial classification of this novel technique as clean, as opposed to clean contaminated, which classifies all other techniques in use to date.

Leucon parasiphonatus, a new species (Crustacea: Cumacea: Leuconidae) from Antarctic waters

NASA Astrophysics Data System (ADS)

Mühlenhardt-Siegel, U.

1994-03-01

Six specimens of Leucon parasiphonatus n. sp. were collected at depths ranging from 15 to 424 m in the vicinity of King George Island (South Shetland Islands, Antarctica) and the south eastern Weddell Sea. Leucon parasiphonatus belongs to the subgenus Leucon and differs from the other already known antarctic and Subantarctic species of the genus, in the absence of a serrated dorsomedian line and in the presence of a long pseudorostrum with several fine setae at its tip, surrounding the very long branchial siphon. The surface of the carapace is granulated; the carapace displays no teeth except for a few at its antero-lateral margin and at its ventral margin. The species most similar to Leucon parasiphonatus is Leucon siphonatus, reported from Mediterranean and North Atlantic waters.

Prognostic value of the new Grade Groups in Prostate Cancer: a multi-institutional European validation study.

PubMed

Mathieu, R; Moschini, M; Beyer, B; Gust, K M; Seisen, T; Briganti, A; Karakiewicz, P; Seitz, C; Salomon, L; de la Taille, A; Rouprêt, M; Graefen, M; Shariat, S F

2017-06-01

We aimed to assess the prognostic relevance of the new Grade Groups in Prostate Cancer (PCa) within a large cohort of European men treated with radical prostatectomy (RP). Data from 27 122 patients treated with RP at seven European centers were analyzed. We investigated the prognostic performance of the new Grade Groups (based on Gleason score 3+3, 3+4, 4+3, 8 and 9-10) on biopsy and RP specimen, adjusted for established clinical and pathological characteristics. Multivariable Cox proportional hazards regression models assessed the association of new Grade Groups with biochemical recurrence (BCR). Prognostic accuracies of the models were assessed using Harrell's C-index. Median follow-up was 29 months (interquartile range, 13-54). The 4-year estimated BCR-free survival (bRFS) for biopsy Grade Groups 1-5 were 91.3, 81.6, 69.8, 60.3 and 44.4%, respectively. The 4-year estimated bRFS for RP Grade Groups 1-5 were 96.1%, 86.7%, 67.0%, 63.1% and 41.0%, respectively. Compared with Grade Group 1, all other Grade Groups based both on biopsy and RP specimen were independently associated with a lower bRFS (all P<0.01). Adjusted pairwise comparisons revealed statistically differences between all Grade Groups, except for group 3 and 4 on RP specimen (P=0.10). The discriminations of the multivariable base prognostic models based on the current three-tier and the new five-tier systems were not clinically different (0.3 and 0.9% increase in discrimination for clinical and pathological model). We validated the independent prognostic value of the new Grade Groups on biopsy and RP specimen from European PCa men. However, it does not improve the accuracies of prognostic models by a clinically significant margin. Nevertheless, this new classification may help physicians and patients estimate disease aggressiveness with a user-friendly, clinically relevant and reproducible method.

Reconstructing Holocene seasonal hydrographic variability in the eastern North Atlantic using bivalve shells from St Kilda, Scotland

NASA Astrophysics Data System (ADS)

Alexandroff, Stella; Scourse, James; Butler, Paul; Schöne, Bernd; Reimer, Paula

2017-04-01

Bivalve shells like Arctica islandica and Glycymeris glycymeris can be used as highly resolved archives of past marine climate and long-term biomonitors. The annual growth patterns of the shell reflect the environment the animals live in and by cross-matching these growth patterns it is possible to construct multi-centennial, annually resolved chronologies that form a temporal template for isotope sampling. The aim of this study is to detect a signal of Atlantic hydrographic variability in Scottish Shelf Seas that is as far as possible uncontaminated by other influences. In May 2014, we collected dead valves and young live specimens of G. glycymeris from St Kilda, Outer Hebrides, Scotland, and in April 2016, live specimens of A. islandica were collected at the same location. This area is of particular interest as it is close to the Scottish shelf margin, has negligible freshwater input, and is thought to represent open-ocean North Atlantic signals well. We here present two floating chronologies, each spanning >180 years, built from dead-collected G. glycymeris shells from St Kilda. All the shells in these chronologies were assigned radiocarbon ages between 3700-3300 cal yr BP. By combining the radiocarbon dates and the chronological data derived from cross-matching annual bands in the shells, one of the floating chronologies could be further constrained to 3750-3500 cal yr BP (95% range). Sub-annual δ18O data from the floating chronologies and from the modern specimens show a strong seasonal signal and multi-year trends. We calibrate the δ18O results from the modern specimens with instrumental data, which enables us (subject to the assumption that there has been no change in δ18Owater) to compare mean and seasonal seawater temperatures between the present day and the fourth millennium BP.

Comparison of Reconstructive Outcomes in Breast Cancer Patients With Preexisting Subpectoral Implants: Implant-Sparing Mastectomy With Delayed Implant Exchange Versus Immediate Tissue Expander Reconstruction.

PubMed

Parabkaharan, Sangeetha; Melody, Megan; Trotta, Rose; Lleshi, Amina; Sun, Weihong; Smith, Paul D; Khakpour, Nazanin; Dayicioglu, Deniz

2016-06-01

Women who have undergone prior augmentation mammoplasty represent a unique subset of breast cancer patients with several options available for breast reconstruction. We performed a single institution review of surgical outcomes of breast reconstruction performed in patients with breast cancer with prior history of subpectoral breast augmentation. Institutional review board-approved retrospective review was conducted among patients with previously mentioned criteria treated at our institution between 2000 and 2014. Reconstructions were grouped into 2 categories as follows: (1) removal of preexisting subpectoral implant during mastectomy with immediate tissue expander placement and (2) implant-sparing mastectomy followed by delayed exchange to a larger implant. We reviewed demographics, tumor features, and reconstruction outcomes of these groups. Fifty-three patients had preexisting subpectoral implants. Of the 63 breast reconstructions performed, 18 (28.6%) had immediate tissue expander placed and 45 (71.4%) had implant-sparing mastectomy followed by delayed implant exchange. The groups were comparable based on age, body mass index, cancer type, tumor grade, TNM stage at presentation, and hormonal receptor status. No significant difference was noted between tumor margins or subsequent recurrence, mastectomy specimen weight, removed implant volume, volume of implant placed during reconstruction, or time from mastectomy to final implant placement. Rates of complications were significantly higher in the tissue expander group compared to the implant-sparing mastectomy group 7 (38.9%) versus 4 (8.9%) (P = 0.005). Implant-sparing mastectomy with delayed implant exchange in patients with preexisting subpectoral implants is safe and has fewer complications compared to tissue expander placement. There was no difference noted in the final volume of implant placed, time interval for final implant placement, or tumor margins.

A new polystomatid (Monogenea, Polystomatidae) from the mouth of the North American freshwater turtle Pseudemys nelsoni

PubMed Central

Du Preez, Louis H.; Van Rooyen, Michelle

2015-01-01

Abstract Based on material collected from Pseudemys nelsoni (Reptilia: Chelonia: Emydidae) during a parasite survey of the herpetofauna around Gainesville, Florida, USA, Polystomoides nelsoni sp. n. is described as a new polystome species. This parasite was found in the oral and pharyngeal region of the host. In a sample of nine Pseudemys nelsoni, three specimens were found to release polystome eggs. One turtle was euthanized and dissected and found to be infected in the oral region with 19 specimens belonging to an as-yet-unknown Polystomoides. This is only the fifth Polystomoides recorded from the Nearctic realm. This species is distinguished from known species by a combination of characteristics including marginal hooklet morphology, body length and haptor dimensions. PMID:26798243

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shum, D.K.M.

This paper examines various issues that would impact the incorporation of warm prestress (WPS) effects in the fracture-margin assessment of reactor pressure vessels (RPVs). By way of an example problem, possible beneficial effects of including type-I WPS in the assessment of an RPV subjected to a small break loss of coolant accident are described. In addition, the need to consider possible loss of constraint effects when interpreting available small specimen WPS-enhanced fracture toughness data is demonstrated through two- and three-dimensional local crack-lip field analyses of a compact tension specimen. Finally, a hybrid correlative-predictive model of WPS base on J-Q theorymore » and the Ritchie-Knott-Rice model is applied to a small scale yielding boundary layer formulation to investigate near crack-tip fields under varying degrees of loading and unloading.« less

Surgical treatments for esophageal cancers

PubMed Central

Allum, William H.; Bonavina, Luigi; Cassivi, Stephen D.; Cuesta, Miguel A.; Dong, Zhao Ming; Felix, Valter Nilton; Figueredo, Edgar; Gatenby, Piers A.C.; Haverkamp, Leonie; Ibraev, Maksat A.; Krasna, Mark J.; Lambert, René; Langer, Rupert; Lewis, Michael P.N.; Nason, Katie S.; Parry, Kevin; Preston, Shaun R.; Ruurda, Jelle P.; Schaheen, Lara W.; Tatum, Roger P.; Turkin, Igor N.; van der Horst, Sylvia; van der Peet, Donald L.; van der Sluis, Peter C.; van Hillegersberg, Richard; Wormald, Justin C.R.; Wu, Peter C.; Zonderhuis, Barbara M.

2015-01-01

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy. PMID:25266029

Effect of two prophylaxis methods on marginal gap of Cl Vresin-modified glass-ionomer restorations.

PubMed

Kimyai, Soodabeh; Pournaghi-Azar, Fatemeh; Daneshpooy, Mehdi; Abed Kahnamoii, Mehdi; Davoodi, Farnaz

2016-01-01

Background. This study evaluated the effect of two prophylaxis techniques on the marginal gap of CI V resin-modified glass-ionomer restorations. Methods. Standard Cl V cavities were prepared on the buccal surfaces of 48 sound bovine mandibular incisors in this in vitro study. After restoration of the cavities with GC Fuji II LC resin-modified glass-ionomer, the samples were randomly assigned to 3 groups of 16. In group 1, the prophylactic procedures were carried out with rubber cup and pumice powder and in group 2 with air-powder polishing device (APD). In group 3 (control), the samples did not undergo any prophylactic procedures. Then the marginal gaps were measured. Two-way ANOVA was used to compare marginal gaps at the occlusal and gingival margins between the groups. Post hoc Tukey test was used for two-by-two comparisons. Statistical significance was set at P < 0.05. Results. There were significant differences in the means of marginal gaps in terms of prophylactic techniques (P < 0.001), with significantly larger marginal gaps in the APD group compared to the pumice and rubber cup group, which in turn exhibited significantly larger marginal gaps compared to the control group (P < 0.0005). In addition, the means of marginal gaps were significant in terms of the margin type (P < 0.001), with significantly larger gaps at gingival margins compared to the occlusal margins (P < 0.0005). Conclusion. The prophylactic techniques used in this study had a negative effect on the marginal gaps of Cl V resin-modified glass-ionomer restorations.

Optical contrast agents to visualize molecular expression in breast cancer

NASA Astrophysics Data System (ADS)

Langsner, Robert James

Breast cancer is the second leading cause of death of women in the United States. Improvements in screening technology have increased the breast cancer incidence rate, as smaller lesions are being detected. Due to the small size of lesions, patients can choose to receive breast conservation therapy (BCT) rather than a modified radical mastectomy. Even though the breast retains cosmesis after BCT, there is an increased risk of the patient having residual microscopic disease, known as positive margins. Patients with positive margins receive increased radiation and have an increased chance of second surgery. Pathology with hematoxylin and eosin (H&E) remains the gold standard for diagnosing margin status in patients. Intraoperative pathology has been shown to reduce the rate of positive margins in BCT. However, a minority of surgery centers have intraoperative pathology centers, limiting the number of patients that receive this standard of care. The expression profiles of surface receptors such as ErbB2 (HER2-positive) and epidermal growth factor receptor (EGFR) provide information about the aggressiveness of a particular tumor. Recent research has shown that there was elevated EGFR expression in patients with a local recurrence even though the biopsies were assessed to be disease free using standard H&E. If the physicians had known the molecular expression of these biopsies, a different treatment regimen or excision of more tissue might have prevented the recurrence. This thesis investigates targeted molecular contrast agents that enhance the visualization of molecular markers such as glucose transporters (GLUTs) and growth factor receptors in tissue specimens. First, application of 2-NBDG, a fluorescent deoxyglucose, enhances signal in cancerous tissue with a 20-minute incubation. Then, antibody functionalized silica-gold nanoshells enhance the visualization of ErbB2 overexpression in specimens with a 5-minute incubation. To image these contrast agents in cancerous tissue, a portable, inexpensive device was developed as a tool to help physicians visualize expression of surface markers. The system visualizes absorbance from nanoshell aggregates and fluorescence in the visible and near-infrared light spectrum. This study represents the first step in the development of an intraoperative optical imaging device to enhance the visualization of molecular markers overexpressed in cancerous cells.

Multiple Head and Neck Tumors Frequently Originate from a Single Preneoplastic Lesion

PubMed Central

Tabor, Maarten P.; Brakenhoff, Ruud H.; Ruijter-Schippers, Henrique J.; van der Wal, Jacqueline E.; Snow, Gordon B.; Leemans, C. René; Braakhuis, Boudewijn J. M.

2002-01-01

The development of second primary tumors has a negative impact on the prognosis of head and neck squamous cell carcinoma. Previously, we detected genetically altered and tumor-related mucosal lesions in the resection margins in 25% of unselected head and neck squamous cell carcinoma patients (Tabor MP, Brakenhoff RH, van Houten VMM, Kummer JA, Snel MHJ, Snijders PJF, Snow GB, Leemans CR, Braakhuis BJM: Persistence of genetically altered fields in head and neck cancer patients: biological and clinical implications. Clin Cancer Res 2001, 7: 1523–1532). The aim of this study was to determine whether first and second primary tumors are clonally related and originate from a single genetically altered field. From 10 patients we analyzed the first tumor of the oral cavity or oropharynx, the >3-cm remote second primary tumor, and the mucosa from the tumor-free margins from both resection specimens. We compared TP53 mutations and loss of heterozygosity profiles using 19 microsatellite markers at chromosomes 3p, 9p, 13q, and 17p. In all patients, genetically altered mucosal lesions were detected in at least one resection margin from both first and second primary tumor. Evidence for a common clonal origin of the first tumor, second primary tumor, and the intervening mucosa was found for at least 6 of 10 patients. Our results indicate that a proportion of multiple primary tumors have developed within a single preneoplastic field. Based on different etiology and clinical consequences, we propose that independent second primary tumors should be distinguished from second field tumors, that arise from the same genetically altered field the first tumor has developed from. PMID:12213734

Accuracy of ringless casting and accelerated wax-elimination technique: a comparative in vitro study.

PubMed

Prasad, Rahul; Al-Keraif, Abdulaziz Abdullah; Kathuria, Nidhi; Gandhi, P V; Bhide, S V

2014-02-01

The purpose of this study was to determine whether the ringless casting and accelerated wax-elimination techniques can be combined to offer a cost-effective, clinically acceptable, and time-saving alternative for fabricating single unit castings in fixed prosthodontics. Sixty standardized wax copings were fabricated on a type IV stone replica of a stainless steel die. The wax patterns were divided into four groups. The first group was cast using the ringless investment technique and conventional wax-elimination method; the second group was cast using the ringless investment technique and accelerated wax-elimination method; the third group was cast using the conventional metal ring investment technique and conventional wax-elimination method; the fourth group was cast using the metal ring investment technique and accelerated wax-elimination method. The vertical marginal gap was measured at four sites per specimen, using a digital optical microscope at 100× magnification. The results were analyzed using two-way ANOVA to determine statistical significance. The vertical marginal gaps of castings fabricated using the ringless technique (76.98 ± 7.59 μm) were significantly less (p < 0.05) than those castings fabricated using the conventional metal ring technique (138.44 ± 28.59 μm); however, the vertical marginal gaps of the conventional (102.63 ± 36.12 μm) and accelerated wax-elimination (112.79 ± 38.34 μm) castings were not statistically significant (p > 0.05). The ringless investment technique can produce castings with higher accuracy and can be favorably combined with the accelerated wax-elimination method as a vital alternative to the time-consuming conventional technique of casting restorations in fixed prosthodontics. © 2013 by the American College of Prosthodontists.

Adaptation of adhesive post and cores to dentin after in vitro occlusal loading: evaluation of post material influence.

PubMed

Dietschi, Dider; Ardu, Stefano; Rossier-Gerber, Anne; Krejci, Ivo

2006-12-01

Fatigue resistance of post and cores is critical to the long term behavior of restored nonvital teeth. The purpose of this in vitro trial was to evaluate the influence of the post material's physical properties on the adaptation of adhesive post and core restorations after cyclic mechanical loading. Composite post and cores were made on endodontically treated deciduous bovine teeth using 3 anisotropic posts (made of carbon, quartz, or quartz-and-carbon fibers) and 3 isotropic posts (zirconium, stainless steel, titanium). Specimens were submitted to 3 successive loading phases--250,000 cycles at 50 N, 250,000 at 75 N, and 500,000 at 100 N--at a rate of 1.5 Hz. Restoration adaptation was evaluated under SEM, before and during loading (margins) and after test completion (margins and internal interfaces). Six additional samples were fabricated for the characterization of interface micromorphology using confocal microscopy. Mechanical loading increased the proportion of marginal gaps in all groups; carbon fiber posts presented the lowest final gap proportion (7.11%) compared to other stiffer metal-ceramic or softer fiber posts (11.0% to 19.1%). For internal adaptation, proportions of debonding between dentin and core or cement varied from 21.69% (carbon post) to 47.37% (stainless steel post). Debonding at the post-cement interface occurred only with isotropic materials. Confocal microscopy observation revealed that gaps were generally associated with an incomplete hybrid layer and reduced resin tags. Regardless of their rigidity, metal and ceramic isotropic posts proved less effective than fiber posts at stabilizing the post and core structure in the absence of the ferrule effect, due to the development of more interfacial defects with either composite or dentin.

An In Vivo Evaluation of the Fit of Zirconium-Oxide Based, Ceramic Single Crowns with Vertical and Horizontal Finish Line Preparations.

PubMed

Vigolo, Paolo; Mutinelli, Sabrina; Biscaro, Leonello; Stellini, Edoardo

2015-12-01

Different types of tooth preparations influence the marginal precision of zirconium-oxide based ceramic single crowns. In this in vivo study, the marginal fits of zirconium-oxide based ceramic single crowns with vertical and horizontal finish lines were compared. Forty-six teeth were chosen in eight patients indicated for extraction for implant placement. CAD/CAM technology was used for the production of 46 zirconium-oxide-based ceramic single crowns: 23 teeth were prepared with vertical finishing lines, 23 with horizontal finishing lines. One operator accomplished all clinical procedures. The zirconia crowns were cemented with glass ionomer cement. The teeth were extracted 1 month later. Marginal gaps along vertical planes were measured for each crown, using a total of four landmarks for each tooth by means of a microscope at 50× magnification. On conclusion of microscopic assessment, ESEM evaluation was completed on all specimens. The comparison of the gap between the two types of preparation was performed with a nonparametric test (two-sample Wilcoxon rank-sum test) with a level of significance fixed at p < 0.05. All data were analyzed with STATA12. In the group with horizontal finish line preparations, the median value of the gap was 35.45 μm (Iqr, 0.33); for the vertical finish line group, the median value of the gap was 35.44 μm (Iqr, 0.40). The difference between the two groups was not statistically significant (two-sample Wilcoxon rank-sum test, p = 0.0872). Within the limitations of this study, the gaps of the zirconium-oxide-based ceramic CAD/CAM crowns with vertical and horizontal finish line preparations were not different. © 2015 by the American College of Prosthodontists.

Two new species of Sternaspis Otto, 1821 (Polychaeta: Sternaspidae) from China seas.

PubMed

Wu, Xuwen; Salazar-Vallejo, Sergio I; Xu, Kuidong

2015-12-03

Two species of Sternaspidae, Sternaspis chinensis sp. nov. and S. liui sp. nov., are described based on historic material and recently collected specimens in the sea areas of China. Sternaspis chinensis is abundantly distributed from the Bohai Sea southwards to the East China Sea. It has been frequently misidentified as the nominally cosmopolitan species S. scutata (Ranzani, 1817) in China since the 1950s. However, S. chinensis differs from the latter by possessing concentric bands on the shield (vs. absent) and crenulated posterior margin reaching or slightly expanded beyond the posterolateral corners (vs. posterior margin smooth and markedly expanded beyond the posterolateral corners). Sternaspis chinensis most resembles the NE Pacific species S. affinis Stimpson, 1864, but differs distinctly by its markedly concentric bands decorated from margin to center (vs. mainly restricted in the marginal area). Sternaspis liui is characterized within the genus by its slightly soft shield with firmly adhered sediment particles, which gives it a superficial resemblance to species of Caulleryaspis Sendall & Salazar-Vallejo, 2013. However, the shields of the latter are remarkably soft and poorly developed, without ribs and concentric lines, while in Sternaspis liui both the ribs and concentric lines are well defined. Variations of both species with remarks on juvenile shield development are provided.

Comparison of Conventional Methods and Laser-Assisted Rapid Prototyping for Manufacturing Fixed Dental Prostheses: An In Vitro Study.

PubMed

Pompa, Giorgio; Di Carlo, Stefano; De Angelis, Francesca; Cristalli, Maria Paola; Annibali, Susanna

2015-01-01

This study assessed whether there are differences in marginal fit between laser-fusion and conventional techniques to produce fixed dental prostheses (FDPs). A master steel die with 2 abutments was produced to receive a posterior 4-unit FDPs and single copings. These experimental models were divided into three groups (n = 20/group) manufactured: group 1, Ni-Cr alloy, with a lost-wax casting technique; group 2, Co-Cr alloy, with selective laser melting (SLM); and group 3, yttria-tetragonal zirconia polycrystal (Y-TZP), with a milling system. All specimens were cut along the longitudinal axis and their adaptation was measured at the marginal and shoulder areas on the right and left sides of each abutment. Measurements were made using a stereomicroscope (×60 magnification) and a scanning electron microscope (×800 magnification). The data were analyzed using one-way analysis of variance and the Bonferroni post hoc test, with a significance cutoff of 5%. Significant differences (P < 0.05) were observed between group 3 and the other groups. The marginal opening was smallest with Co-Cr alloy substructures, while the shoulder opening was smallest with Ni-Cr alloy substructures. Within the limitations of this study, the marginal fit of an FDP is better with rapid prototyping (RP) via SLM than conventional manufacturing systems.

Radiation therapy and surgery for fibrosarcoma in 33 cats.

PubMed

Cronin, K; Page, R L; Spodnick, G; Dodge, R; Hardie, E N; Price, G S; Ruslander, D; Thrall, D E

1998-01-01

Thirty-three cats with histologically confirmed fibrosarcomas were treated with radiation therapy followed by surgery. The median (95% confidence interval) disease free interval and overall survival were 398 (261,924) and 600 (lower limit 515) days, respectively. There were 19 treatment failures; 11 cats had only local recurrence, 4 cats developed metastatic disease, 3 cats had local recurrence followed by metastasis, and 1 cat developed simultaneous local and distant disease. Twelve cats are alive and disease free. Two cats died without evidence of treatment failure. The presence of tumor cells at the margin of resected tissue after radiation was the only variable which influenced treatment success. The median (95% confidence interval) disease free interval in 5 cats with tumor cells at the margin of the resected specimen was 112 (94,150) days versus 700 (lower limit 328) days for 26 cats with negative tumor margins, p < 0.0001. We did not identify a relationship between tumor volume, number of prior tumor excisions, concomitant use of chemotherapy or various descriptors of the radiation therapy technique and disease free interval.

Redefining the Positive Margin in Pancreatic Cancer: Impact on Patterns of Failure, Long-Term Survival and Adjuvant Therapy.

PubMed

Osipov, Arsen; Nissen, Nicholas; Rutgers, Joanne; Dhall, Deepti; Naziri, Jason; Chopra, Shefali; Li, Quanlin; Hendifar, Andrew Eugene; Tuli, Richard

2017-11-01

There is debate regarding the definition and clinical significance of margin clearance in pancreatic ductal adenocarcinoma (PDA). A comprehensive archival analysis of surgical resection margins was performed to determine the effect on locoregional recurrence and survival, and the impact of adjuvant therapy in PDA. We identified 105 patients with resected PDA. Pancreatic, anterior, bile duct, and posterior surgical resection margins (PM; posterior surface, uncinate and vascular groove) were identified. Three pathologists reviewed all archival surgical specimens and recategorized each margin as tumor at ink/transected, <0.5, 0.5-1, >1-2, or >2 mm from the inked surface. The impact of these and other clinical variables was assessed on local control, disease-free survival (DFS), and overall survival (OS). Among all margins, PM clearance up to 2 mm was prognostic of DFS (p = 0.01) and OS (p = 0.01). Dichotomizing the PM at 2 mm revealed it to be an independent predictor of local recurrence-free survival [hazard ratio HR] 0.20, 95% confidence interval [CI] 0.048-0.881, p = 0.033), DFS (HR 0.46, 95% CI 0.22-0.96, p = 0.03), and OS (HR 0.31, 95% CI 0.14-0.74, p = 0.008). A margin status of >2 mm was also prognostic of OS in patients who received adjuvant chemotherapy (HR 0.31, 95% CI 0.11-0.89, p = 0.03), however this difference was mitigated in patients receiving adjuvant chemoradiotherapy (HR 0.40, 95% CI 0.10-1.58, p = 0.19). These data highlight the clinical significance of the PM and the lack of significance of other resection margins. Clearance in excess of 2 mm should be considered to improve long-term clinical outcomes. The use of adjuvant radiotherapy should be strongly considered in patients with PMs <2 mm.

The Effect of Temperature on Compressive and Tensile Strengths of Commonly Used Luting Cements: An In Vitro Study

PubMed Central

Patil, Suneel G; Sajjan, MC Suresh; Patil, Rekha

2015-01-01

Background: The luting cements must withstand masticatory and parafunctional stresses in the warm and wet oral environment. Mouth temperature and the temperature of the ingested foods may induce thermal variation and plastic deformation within the cements and might affect the strength properties. The objectives of this study were to evaluate the effect of temperature on the compressive and diametral tensile strengths of two polycarboxylate, a conventional glass ionomer and a resin modified glass ionomer luting cements and, to compare the compressive strength and the diametral tensile strength of the selected luting cements at varying temperatures. Materials and Methods: In this study, standardized specimens were prepared. The temperature of the specimens was regulated prior to testing them using a universal testing machine at a crosshead speed of 1 mm/min. Six specimens each were tested at 23°C, 37°C and 50°C for both the compressive and diametral tensile strengths, for all the luting cements. Results: All the luting cements showed a marginal reduction in their compressive and diametral tensile strengths at raised temperatures. Fuji Plus was strongest in compression, followed by Fuji I > Poly F > Liv Carbo. Fuji Plus had the highest diametral tensile strength values, followed by Poly F = Fuji I = Liv Carbo, at all temperatures. Conclusion: An increase in the temperature caused no significant reduction in the compressive and diametral tensile strengths of the cements evaluated. The compressive strength of the luting cements differed significantly from one another at all temperatures. The diametral tensile strength of resin modified glass ionomers differed considerably from the other cements, whereas there was no significant difference between the other cements, at all the temperatures. PMID:25859100

The effect of temperature on compressive and tensile strengths of commonly used luting cements: an in vitro study.

PubMed

Patil, Suneel G; Sajjan, Mc Suresh; Patil, Rekha

2015-02-01

The luting cements must withstand masticatory and parafunctional stresses in the warm and wet oral environment. Mouth temperature and the temperature of the ingested foods may induce thermal variation and plastic deformation within the cements and might affect the strength properties. The objectives of this study were to evaluate the effect of temperature on the compressive and diametral tensile strengths of two polycarboxylate, a conventional glass ionomer and a resin modified glass ionomer luting cements and, to compare the compressive strength and the diametral tensile strength of the selected luting cements at varying temperatures. In this study, standardized specimens were prepared. The temperature of the specimens was regulated prior to testing them using a universal testing machine at a crosshead speed of 1 mm/min. Six specimens each were tested at 23°C, 37°C and 50°C for both the compressive and diametral tensile strengths, for all the luting cements. All the luting cements showed a marginal reduction in their compressive and diametral tensile strengths at raised temperatures. Fuji Plus was strongest in compression, followed by Fuji I > Poly F > Liv Carbo. Fuji Plus had the highest diametral tensile strength values, followed by Poly F = Fuji I = Liv Carbo, at all temperatures. An increase in the temperature caused no significant reduction in the compressive and diametral tensile strengths of the cements evaluated. The compressive strength of the luting cements differed significantly from one another at all temperatures. The diametral tensile strength of resin modified glass ionomers differed considerably from the other cements, whereas there was no significant difference between the other cements, at all the temperatures.

Extracting laboratory test information from biomedical text

PubMed Central

Kang, Yanna Shen; Kayaalp, Mehmet

2013-01-01

Background: No previous study reported the efficacy of current natural language processing (NLP) methods for extracting laboratory test information from narrative documents. This study investigates the pathology informatics question of how accurately such information can be extracted from text with the current tools and techniques, especially machine learning and symbolic NLP methods. The study data came from a text corpus maintained by the U.S. Food and Drug Administration, containing a rich set of information on laboratory tests and test devices. Methods: The authors developed a symbolic information extraction (SIE) system to extract device and test specific information about four types of laboratory test entities: Specimens, analytes, units of measures and detection limits. They compared the performance of SIE and three prominent machine learning based NLP systems, LingPipe, GATE and BANNER, each implementing a distinct supervised machine learning method, hidden Markov models, support vector machines and conditional random fields, respectively. Results: Machine learning systems recognized laboratory test entities with moderately high recall, but low precision rates. Their recall rates were relatively higher when the number of distinct entity values (e.g., the spectrum of specimens) was very limited or when lexical morphology of the entity was distinctive (as in units of measures), yet SIE outperformed them with statistically significant margins on extracting specimen, analyte and detection limit information in both precision and F-measure. Its high recall performance was statistically significant on analyte information extraction. Conclusions: Despite its shortcomings against machine learning methods, a well-tailored symbolic system may better discern relevancy among a pile of information of the same type and may outperform a machine learning system by tapping into lexically non-local contextual information such as the document structure. PMID:24083058

Detection of Distinct Changes in Gene-expression Profiles in Specimens of Tumors and Transition Zones of Tenascin-positive/-negative Head and Neck Squamous Cell Carcinoma.

PubMed

Zivicova, Veronika; Gal, Peter; Mifkova, Alzbeta; Novak, Stepan; Kaltner, Herbert; Kolar, Michal; Strnad, Hynek; Sachova, Jana; Hradilova, Miluse; Chovanec, Martin; Gabius, Hans-Joachim; Smetana, Karel; Fik, Zdenek

2018-03-01

Having previously initiated genome-wide expression profiling in head and neck squamous cell carcinoma (HNSCC) for regions of the tumor, the margin of surgical resecate (MSR) and normal mucosa (NM), we here proceed with respective analysis of cases after stratification according to the expression status of tenascin (Ten). Tissue specimens of each anatomical site were analyzed by immunofluorescent detection of Ten, fibronectin (Fn) and galectin-1 (Gal-1) as well as by microarrays. Histopathological examination demonstrated that Ten + Fn + Gal-1 + co-expression occurs more frequently in samples of HNSCC (55%) than in NM (9%; p<0.01). Contrary, the Ten - Fn + Gal-1 - (45%) and Ten - Fn - Gal-1 - (39%) status occurred with significantly (p<0.01) higher frequency than in HNSCC (3% and 4%, respectively). In MSRs, different immunophenotypes were distributed rather equally (Ten + Fn + Gal-1 + =24%; Ten - Fn + Gal-1 - =36%; Ten - Fn - Gal-1 - =33%), differing to the results in tumors (p<0.05). Absence/presence of Ten was used for stratification of patients into cohorts without a difference in prognosis, to comparatively examine gene-activity signatures. Microarray analysis revealed i) expression of several tumor progression-associated genes in Ten + HNSCC tumors and ii) a strong up-regulation of gene expression assigned to lipid metabolism in MSRs of Ten - tumors, while NM profiles remained similar. The presented data reveal marked and specific changes in tumors and MSR specimens of HNSCC without a separation based on prognosis. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

A comparative study on the bond strength of porcelain to the millingable Pd-Ag alloy

PubMed Central

Hong, Jun-Tae

2014-01-01

PURPOSE The porcelain fused to gold has been widely used as a restoration both with the natural esthetics of the porcelain and durability and marginal fit of metal casting. However, recently, due to the continuous rise in the price of gold, an interest towards materials to replace gold alloy is getting higher. This study compared the bond strength of porcelain to millingable palladium-silver (Pd-Ag) alloy, with that of 3 conventionally used metal-ceramic alloys. MATERIALS AND METHODS Four types of metal-ceramic alloys, castable nonprecious nickel-chrome alloy, castable precious metal alloys containing 83% and 32% of gold, and millingable Pd-Ag alloy were used to make metal specimens (n=40). And porcelain was applied on the center area of metal specimen. Three-point bending test was performed with universal testing machine. The bond strength data were analyzed with a one-way ANOVA and post hoc Scheffe's tests (α=.05). RESULTS The 3-point bending test showed the strongest (40.42 ± 5.72 MPa) metal-ceramic bond in the nonprecious Ni-Cr alloy, followed by millingable Pd-Ag alloy (37.71 ± 2.46 MPa), precious metal alloy containing 83% of gold (35.89 ± 1.93 MPa), and precious metal alloy containing 32% of gold (34.59 ± 2.63 MPa). Nonprecious Ni-Cr alloy and precious metal alloy containing 32% of gold showed significant difference (P<.05). CONCLUSION The type of metal-ceramic alloys affects the bond strength of porcelain. Every metal-ceramic alloy used in this study showed clinically applicable bond strength with porcelain (25 MPa). PMID:25352959

Accuracy of line probe assays for the diagnosis of pulmonary and multidrug-resistant tuberculosis: a systematic review and meta-analysis

PubMed Central

Cudahy, Patrick G.T; Schumacher, Samuel G.; Steingart, Karen R.; Pai, Madhukar; Denkinger, Claudia M.

2017-01-01

Only 25% of multidrug-resistant tuberculosis (MDR-TB) cases are currently diagnosed. Line probe assays (LPAs) enable rapid drug-susceptibility testing for rifampicin (RIF) and isoniazid (INH) resistance and Mycobacterium tuberculosis detection. Genotype MTBDRplusV1 was WHO-endorsed in 2008 but newer LPAs have since been developed. This systematic review evaluated three LPAs: Hain Genotype MTBDRplusV1, MTBDRplusV2 and Nipro NTM+MDRTB. Study quality was assessed with QUADAS-2. Bivariate random-effects meta-analyses were performed for direct and indirect testing. Results for RIF and INH resistance were compared to phenotypic and composite (incorporating sequencing) reference standards. M. tuberculosis detection results were compared to culture. 74 unique studies were included. For RIF resistance (21 225 samples), pooled sensitivity and specificity (with 95% confidence intervals) were 96.7% (95.6–97.5%) and 98.8% (98.2–99.2%). For INH resistance (20 954 samples), pooled sensitivity and specificity were 90.2% (88.2–91.9%) and 99.2% (98.7–99.5%). Results were similar for direct and indirect testing and across LPAs. Using a composite reference standard, specificity increased marginally. For M. tuberculosis detection (3451 samples), pooled sensitivity was 94% (89.4–99.4%) for smear-positive specimens and 44% (20.2–71.7%) for smear-negative specimens. In patients with pulmonary TB, LPAs have high sensitivity and specificity for RIF resistance and high specificity and good sensitivity for INH resistance. This meta-analysis provides evidence for policy and practice. PMID:28100546

Imaging-Assisted Large-Format Breast Pathology: Program Rationale and Development in a Nonprofit Health System in the United States

PubMed Central

Tucker, F. Lee

2012-01-01

Modern breast imaging, including magnetic resonance imaging, provides an increasingly clear depiction of breast cancer extent, often with suboptimal pathologic confirmation. Pathologic findings guide management decisions, and small increments in reported tumor characteristics may rationalize significant changes in therapy and staging. Pathologic techniques to grossly examine resected breast tissue have changed little during this era of improved breast imaging and still rely primarily on the techniques of gross inspection and specimen palpation. Only limited imaging information is typically conveyed to pathologists, typically in the form of wire-localization images from breast-conserving procedures. Conventional techniques of specimen dissection and section submission destroy the three-dimensional integrity of the breast anatomy and tumor distribution. These traditional methods of breast specimen examination impose unnecessary limitations on correlation with imaging studies, measurement of cancer extent, multifocality, and margin distance. Improvements in pathologic diagnosis, reporting, and correlation of breast cancer characteristics can be achieved by integrating breast imagers into the specimen examination process and the use of large-format sections which preserve local anatomy. This paper describes the successful creation of a large-format pathology program to routinely serve all patients in a busy interdisciplinary breast center associated with a community-based nonprofit health system in the United States. PMID:23316372

TTX-Bearing Planocerid Flatworm (Platyhelminthes: Acotylea) in the Ryukyu Islands, Japan

PubMed Central

Ueda, Hiroyuki; Itoi, Shiro; Sugita, Haruo

2018-01-01

Polyclad flatworms comprise a highly diverse and cosmopolitan group of marine turbellarians. Although some species of the genera Planocera and Stylochoplana are known to be tetrodotoxin (TTX)-bearing, there are few new reports. In this study, planocerid-like flatworm specimens were found in the sea bottom off the waters around the Ryukyu Islands, Japan. The bodies were translucent with brown reticulate mottle, contained two conical tentacles with eye spots clustered at the base, and had a slightly frilled-body margin. Each specimen was subjected to TTX extraction followed by liquid chromatography with tandem mass spectrometry analysis. Mass chromatograms were found to be identical to those of the TTX standards. The TTX amounts in the two flatworm specimens were calculated to be 468 and 3634 μg. Their external morphology was found to be identical to that of Planocera heda. Phylogenetic analysis based on the sequences of the 28S rRNA gene and cytochrome-c oxidase subunit I gene also showed that both specimens clustered with the flatworms of the genus Planocera (Planocera multitentaculata and Planocera reticulata). This fact suggests that there might be other Planocera species that also possess highly concentrated TTX, contributing to the toxification of TTX-bearing organisms, including fish. PMID:29351203

Influence of different cusp coverage methods for the extension of ceramic inlays on marginal integrity and enamel crack formation in vitro.

PubMed

Krifka, Stephanie; Stangl, Martin; Wiesbauer, Sarah; Hiller, Karl-Anton; Schmalz, Gottfried; Federlin, Marianne

2009-09-01

No information is available to date about cusp design of thin (1.0 mm) non-functional cusps and its influence upon (1) marginal integrity of ceramic inlays (CI) and partial ceramic crowns (PCC) and (2) crack formation of dental tissues. The aim of this in vitro study was to investigate the effect of cusp coverage of thin non-functional cusps on marginal integrity and enamel crack formation. CI and PCC preparations were performed on extracted human molars. Non-functional cusps were adjusted to 1.0-mm wall thickness and 1.0-mm wall thickness with horizontal reduction of about 2.0 mm. Ceramic restorations (Vita Mark II, Cerec3 System) were adhesively luted with Excite/Variolink II. The specimens were exposed to thermocycling and central mechanical loading. Marginal integrity was assessed by evaluating dye penetration after thermal cycling and mechanical loading. Enamel cracks were documented under a reflective-light microscope. The data were statistically analysed with the Mann-Whitney U test, the Fishers exact test (alpha = 0.05) and the error rates method. PCC with horizontal reduction of non-functional cusps showed statistically significant less microleakage than PCC without such a cusp coverage. Preparation designs with horizontal reduction of non-functional cusps showed a tendency to less enamel crack formation than preparation designs without cusp coverage. Thin non-functional cusp walls of adhesively bonded restorations should be completely covered or reduced to avoid enamel cracks and marginal deficiency.

Reliability of skin biopsies in determining accurate tumor margins: a retrospective study after Mohs micrographic surgery.

PubMed

Koslosky, Cynthia Lynn; El Tal, Abdel Kader; Workman, Benjamin; Tamim, Hani; Durance, Michelle Christine; Mehregan, David Ali

2014-09-01

Skin biopsy reports of basal cell carcinoma and squamous cell carcinoma are often accompanied by comments on the margins. A physician's management can be influenced by such reports, particularly when the margins are reported as clear and no further interventions are pursued. To retrospectively review pathology margins on Mohs micrographic surgery (MMS) cases performed at a University Center and to compare biopsy margins with the Mohs margins found on the first stage. Data collection of 1,000 cases of Mohs surgery was obtained regarding margins on skin biopsy and compared with margins on the first stage of MMS. Overall, of the biopsies that showed only deep margin involvement, a lateral margin was seen on 32% of the first stages of MMS. Conversely, of the biopsies that showed only lateral margin involvement, a deep margin was seen on 14% of the first stages of MMS. Of the biopsies that showed clear margins, a margin was seen in 30% of the cases on the first stage of MMS. Skin biopsies processed through the "bread-loafing" technique are not reliable in detecting accurate margins, and therefore, a biopsy report should not include margin involvement within it.

Fossil human remains from Bolomor Cave (Valencia, Spain).

PubMed

Arsuaga, Juan Luis; Fernández Peris, Josep; Gracia-Téllez, Ana; Quam, Rolf; Carretero, José Miguel; Barciela González, Virginia; Blasco, Ruth; Cuartero, Felipe; Sañudo, Pablo

2012-05-01

Systematic excavations carried out since 1989 at Bolomor Cave have led to the recovery of four Pleistocene human fossil remains, consisting of a fibular fragment, two isolated teeth, and a nearly complete adult parietal bone. All of these specimens date to the late Middle and early Late Pleistocene (MIS 7-5e). The fibular fragment shows thick cortical bone, an archaic feature found in non-modern (i.e. non-Homo sapiens) members of the genus Homo. Among the dental remains, the lack of a midtrigonid crest in the M(1) represents a departure from the morphology reported for the majority of Neandertal specimens, while the large dimensions and pronounced shoveling of the marginal ridges in the C(1) are similar to other European Middle and late Pleistocene fossils. The parietal bone is very thick, with dimensions that generally fall above Neandertal fossils and resemble more closely the Middle Pleistocene Atapuerca (SH) adult specimens. Based on the presence of archaic features, all the fossils from Bolomor are attributed to the Neandertal evolutionary lineage. Copyright © 2012 Elsevier Ltd. All rights reserved.

Malignant Change in an Epidermal Cyst Over Gluteal Region

PubMed Central

Kshirsagar, Ashok Y; Sulhyan, Sanjitsingh R; Deshpande, Shradha; Jagtap, SV

2011-01-01

A 72-year-old male presented with a large ulceroproliferative lesion over left gluteal region. After histopathological confirmation of squamous cell carcinoma, the lesion was excised with wide margins. Further histopathological study of the excised specimen revealed the growth arising from an epidermal cyst. Malignant change is a rare, but wellknown complication occurring in an epidermal cyst. The mainstay of treatment consists of wide excision of cancerous lesion with primary reconstruction of the defect. PMID:21572684

A new species of wedgefish Rhynchobatus cooki (Rhinopristiformes, Rhinidae) from the Indo-West Pacific.

PubMed

Last, Peter R; Kyne, Peter M; Compagno, Leonard J V

2016-07-20

A new dwarf wedgefish, Rhynchobatus cooki sp. nov. is described from a single female from a Jakarta fish market (Indonesia) and 11 specimens collected at Jurong fish market (Singapore). First collected in 1934, the broader ichthyological community have been aware of this distinctive but little known ray since the late 1990's. Rhynchobatus cooki is the smallest of the wedgefishes (to 81 cm TL) and has the lowest vertebral count (fewer than 107 centra). It is also distinguishable from its congeners based on its long, hastate snout, very strongly undulate anterior pectoral-fin margin, coloration and aspects of its squamation. The dorsal coloration is mainly dark and distinctively marked with white blotches, spots and streaks, and has a dark cruciate marking on the interorbit and a prominent white border around the body margin. Unlike most other wedgefish species, the snout tip lacks dark blotches and there is no black pectoral-fin marking. It shares well-developed rostral spines with a much larger Atlantic species (Rhynchobatus luebberti), but these spines are confined to the snout tip (rather than being more numerous and extending in paired rows along the rostral ridges nearly to the eyes). No additional specimens have been observed since 1996, despite an increased recent effort to survey the chondrichthyan fauna of South-East Asia and collect biological data for species, raising concerns over its conservation status.

Re-appraisal of the Magma-rich versus Magma-poor Paradigm at Rifted Margins: consequences for breakup processes

NASA Astrophysics Data System (ADS)

Tugend, J.; Gillard, M.; Manatschal, G.; Nirrengarten, M.; Harkin, C. J.; Epin, M. E.; Sauter, D.; Autin, J.; Kusznir, N. J.; McDermott, K.

2017-12-01

Rifted margins are often classified based on their magmatic budget only. Magma-rich margins are commonly considered to have excess decompression melting at lithospheric breakup compared with steady state seafloor spreading while magma-poor margins have suppressed melting. New observations derived from high quality geophysical data sets and drill-hole data have revealed the diversity of rifted margin architecture and variable distribution of magmatism. Recent studies suggest, however, that rifted margins have more complex and polyphase tectono-magmatic evolutions than previously assumed and cannot be characterized based on the observed volume of magma alone. We compare the magmatic budget related to lithospheric breakup along two high-resolution long-offset deep reflection seismic profiles across the SE-Indian (magma-poor) and Uruguayan (magma-rich) rifted margins. Resolving the volume of magmatic additions is difficult. Interpretations are non-unique and several of them appear plausible for each case involving variable magmatic volumes and mechanisms to achieve lithospheric breakup. A supposedly 'magma-poor' rifted margin (SE-India) may show a 'magma-rich' lithospheric breakup whereas a 'magma-rich' rifted margin (Uruguay) does not necessarily show excess magmatism at lithospheric breakup compared with steady-state seafloor spreading. This questions the paradigm that rifted margins can be subdivided in either magma-poor or magma-rich margins. The Uruguayan and other magma-rich rifted margins appear characterized by an early onset of decompression melting relative to crustal breakup. For the converse, where the onset of decompression melting is late compared with the timing of crustal breakup, mantle exhumation can occur (e.g. SE-India). Our work highlights the difficulty in determining a magmatic budget at rifted margins based on seismic reflection data alone, showing the limitations of margin classification based solely on magmatic volumes. The timing of decompression melting onset and melting rates (magmatic processes) relative to crustal thinning (tectonic processes) appear equally, if not more important, than the magmatic budget for unravelling the evolution of rifted margins.

SurePath Specimens Versus ThinPrep Specimen Types on the COBAS 4800 Platform: High-Risk HPV Status and Cytology Correlation in an Ethnically Diverse Bronx Population.

PubMed

Naeem, R C; Goldstein, D Y; Einstein, Mark H; Ramos Rivera, G; Schlesinger, K; Khader, S N; Suhrland, M; Fox, A S

2017-08-01

To compare the cytologic preparations of 130 cervical specimens (from women of various ethnicities at high risk for human papillomavirus [HPV] infection) using the SurePath (SP) collection system with specimens gathered using the ThinPrep (TP) system, as processed on the Cobas 4800 analyzer, to determine which collection method more accurately identifies HPV infection. In our prospective study, specimens were collected from 130 women of various ethnicities residing in or near Bronx County, NY. The SP-collected specimen was first processed for cytologic findings; if clinical HPV testing was requested on that specimen, it was tested using Hybrid Capture II (HC2) methodology. We tested the remnant SP-collected cell concentrate using the Cobas analyzer. Then, the TP-collected and SP-collected specimens were tested in the same run on that analyzer, and the results were compared. We also compared the results with the concurrent cytologic findings. The results were concordant for overall HR-HPV status in 93.8% of cases. Also, a statistically significant lower cycle threshold value was observed with Cobas testing of specimen concentrates tested via the BD SurePath Pap Test (P = .001), suggesting higher sensitivity compared with specimens tested via the ThinPrep Pap Test. Cobas 4800 HPV testing of SP-collected specimen concentrates yields comparable results to TP-collected specimen concentrates. Based on the limited data that we derived, SP collection may be a more favorable methodology than TP collection for HPV testing of individuals at high risk in our ethnically diverse, urban patient population. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

New records and description of two new species of carideans shrimps from Bahía Santa María-La Reforma lagoon, Gulf of California, Mexico (Crustacea, Caridea, Alpheidae and Processidae)

PubMed Central

Salgado-Barragán, José; Ayón-Parente, Manuel; Zamora-Tavares, Pilar

2017-01-01

Abstract Two new species of the family Alpheidae: Alpheus margaritae sp. n. and Leptalpheus melendezensis sp. n. are described from Santa María-La Reforma, coastal lagoon, SE Gulf of California. Alpheus margaritae sp. n. is closely related to A. antepaenultimus and A. mazatlanicus from the Eastern Pacific and to A. chacei from the Western Atlantic, but can be differentiated from these by a combination of characters, especially the morphology of the scaphocerite and the first pereopods. Leptalpheus melendezensis sp. n. resembles L. mexicanus but can be easily differentiated because L. melendezensis sp. n. has the anterior margin of the carapace broadly rounded and has only one spine on the mesial margin of ischium in the major cheliped, versus an acute rostrum and an unarmed major cheliped. Additionally, a phylogenetic analysis was used to explore the relationships of these two new taxa. These results show that Alpheus margaritae sp. n. and Leptalpheus melendezensis sp. n. are indeed related to the species against which we are comparing them, and demonstrate that they can be considered as different species. Additional specimens of Leptalpheus cf. mexicanus, Ambidexter panamensis and A. swifti are recorded for the first time in the Santa María-La Reforma coastal lagoon. PMID:28769664

[Laparoscopic radical cystectomy with enteric urinary diversion. Alternative to open cystectomy?].

PubMed

Lucan, M; Iacob, G; Lucan, V; Măgurean, O; Elec, F; Burghelea, C; Bărbos, A

2005-01-01

Radical cystectomy is the standard therapy for invasive bladder cancer, with best oncological results compared to any other therapeutic alternative. Even if laparoscopic radical cystectomy (LRC) is a well established surgical procedure, performing the urinary diversion completely intracorporeal, is still a challenge due to technical difficulties and associated complications. The aim of our study is to present the first series of LRC with ureterosigmoidostomy. Since May 2004 were performed 7 LRC (5 males and 2 females) (Gr. A). All cases were T2N0 clinical stage. These patients were compared with a retrospective group of 50 patients who underwent open procedure (Gr. B) in term of: operative time, blood loss, analgesic requirements, and hospital stay. LRC has a longer operative time but with statistically significant lower blood loss, less analgesia, and shorter hospital stay. The resection margins of the surgical specimens were tumor free at pathologic examination. Long-term follow-up is pending. On short-term, the results of laparoscopic radical cystectomy are encouraging. When significant experience in laparoscopic surgery is lacking, surgeons should exercise caution with completely intracorporeal urinary diversion.

Regulatory T-cell cytokines in patients with nonsegmental vitiligo.

PubMed

Kidir, Mehtap; Karabulut, Ayse A; Ercin, Mustafa E; Atasoy, Pınar

2017-05-01

In the etiopathogenesis of vitiligo, the role of suppressor cytokines, such as transforming growth factor-β (TGF-β) and interleukin-10 (IL-10), associated with regulatory T-cells (Treg) is not completely known. In this study, the role of Treg-cell functions in the skin of patients with nonsegmental vitiligo was investigated. Lesional and nonlesional skin samples from 30 adult volunteers ranging in age from 18 to 36 years with nonsegmental vitiligo were compared with normal skin area excision specimens of 30 benign melanocytic nevus cases as controls. All samples were evaluated staining for forkhead box P3 (Foxp3), TGF-β, and IL-10 using the standardized streptavidin-biotin immunoperoxidase immunohistochemistry method. Foxp3 expression was lower in lesional vitiligo skin specimens compared to controls; it was also lower in lesional vitiligo specimens than nonlesional vitiligo specimens. IL-10 levels were lower in lesional vitiligo specimens compared to the controls, whereas IL-10 expression was significantly lower in lesional specimens compared with nonlesional specimens. TGF-β expression was higher in both lesional and nonlesional skin specimens of patients with vitiligo compared to controls. TGF-β expression was lower in lesional skin specimens than nonlesional skin specimens. In addition, there was no significant correlation between Foxp3 expression with TGF-β and IL-10 expressions in lesional skin specimens in the vitiligo group. In this study, results supporting the contribution of Treg cells and IL-10 deficiency to the autoimmune process were obtained. Therefore, future studies are necessary to demonstrate the definitive role of Treg-cell functions in the etiopathogenesis of vitiligo. © 2017 The International Society of Dermatology.

Comparative evaluation of traditional and self-priming hydrophilic resin

PubMed Central

Singla, Ruchi; Bogra, Poonam; Singal, Bhawana

2012-01-01

Background: The purpose of this study was to compare the microleakage of traditional composite (Charisma/Gluma Comfort Bond) and self-priming resin (Embrace Wetbond). Materials and Methods: Standardized Class V cavities partly in enamel and cementum were prepared in 20 extracted human premolars. Teeth were divided into two groups. Group 1 was restored with Charisma/Gluma Comfort Bond and Group 2 with Embrace Wetbond. The specimens were stored in distilled water at room temperature for 24 h and then subjected to 200 thermocycles at 5°C and 55°C with a 1 min dwell time. After thermocycling teeth were immersed in a 0.2% solution of methylene blue dye for 24 h. Teeth were sectioned vertically approximately midway through the facial and lingual surfaces using a diamond saw blade. Microleakage was evaluated at enamel and cementum surfaces using 10 × stereomicroscope. The statistical analysis was performed using Wilcoxon signed-rank test. Results: Wetbond showed less microleakage at occlusal and gingival margins as compared with Charisma/Gluma Comfort Bond and the results were statistically significant (P < 0.05). Conclusion: Class V cavities restored with Embrace Wetbond with fewer steps and fewer materials offers greater protection against microleakage at the tooth restorative interface. PMID:22876008

From Lucy to Kadanuumuu: balanced analyses of Australopithecus afarensis assemblages confirm only moderate skeletal dimorphism

PubMed Central

Lovejoy, C. Owen

2015-01-01

Sexual dimorphism in body size is often used as a correlate of social and reproductive behavior in Australopithecus afarensis. In addition to a number of isolated specimens, the sample for this species includes two small associated skeletons (A.L. 288-1 or “Lucy” and A.L. 128/129) and a geologically contemporaneous death assemblage of several larger individuals (A.L. 333). These have driven both perceptions and quantitative analyses concluding that Au. afarensis was markedly dimorphic. The Template Method enables simultaneous evaluation of multiple skeletal sites, thereby greatly expanding sample size, and reveals that A. afarensis dimorphism was similar to that of modern humans. A new very large partial skeleton (KSD-VP-1/1 or “Kadanuumuu”) can now also be used, like Lucy, as a template specimen. In addition, the recently developed Geometric Mean Method has been used to argue that Au. afarensis was equally or even more dimorphic than gorillas. However, in its previous application Lucy and A.L. 128/129 accounted for 10 of 11 estimates of female size. Here we directly compare the two methods and demonstrate that including multiple measurements from the same partial skeleton that falls at the margin of the species size range dramatically inflates dimorphism estimates. Prevention of the dominance of a single specimen’s contribution to calculations of multiple dimorphism estimates confirms that Au. afarensis was only moderately dimorphic. PMID:25945314

Influence of ultrasound or halogen light on microleakage and hardness of enamel adjacent to glass ionomer cement.

PubMed

Guglielmi, Camila Almeida Brandão; Mohana, Anice; Hesse, Daniela; Lenzi, Tathiane Larissa; Bonini, Gabriela Cunha; Raggio, Daniela Prócida

2012-03-01

The use of external sources of energy may accelerate the setting rate of glass ionomer cements (GICs) allowing better initial mechanical properties. To investigate the influence of ultrasound and halogen light on the microleakage and hardness of enamel adjacent to GIC restorations, after artificial caries challenge. Cavities were prepared in 60 primary canines, restored with GIC, and randomly distributed into three groups: control group (CG), light group (LG) - irradiation with a halogen light-curing unit for 60s, and ultrasonic group (UG) - application of ultrasonic scaler device for 15s. All specimens were then submitted to a cariogenic challenge in a pH cycling model. Half of sample in each group were immersed in methylene blue for 4h and sectioned for dye penetration analysis. The remaining specimens were submitted to Knoop cross-sectional microhardness assessments, and mineral changes were calculated for adjacent enamel. Data were compared using Kruskal-Wallis test and two-way ANOVA with 5% significance. Higher dye penetration was observed for the UG (P<0.01). No significant mineral changes were observed between groups (P=0.844). The use of halogen light-curing unit does not seem to interfere with the properties of GICs, whereas the use of ultrasound can affect its marginal sealing. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

Performance Enhancement Using Selective Reinforcement for Metallic Single- and Multi-Pin Loaded Holes

NASA Technical Reports Server (NTRS)

Farley, Gary L.; Seshadri, Banavara R.

2005-01-01

An analysis based investigation of aluminum with metal matrix composite selectively reinforced single- and multi-hole specimens was performed and their results compared with results from geometrically comparable non-reinforced specimens. All reinforced specimens exhibited a significant increase in performance. Performance increase of up to 170 percent was achieved. Specimen failure modes were consistent with results from reinforced polymeric matrix composite specimens. Localized reinforcement application (circular) proved as effective as a broader area (strip) reinforcement. Also, selective reinforcement is an excellent method of increasing the performance of multi-hole specimens.

Microcracking of Materials for Space

NASA Technical Reports Server (NTRS)

Brown, Timothy L.

1998-01-01

The effect of thermal-cycling-induced microcracking in fiber-reinforced polymer matrix composites is studied. Specific attention is focused on microcrack density as a function of the number of thermal cycles, and the effect of microcracking on the dimensional stability of composite materials. Changes in laminate coefficient of thermal expansion (CTE) and laminate stiffness are of primary concern. Included in the study are materials containing four different Thornel fiber types: a PAN-based T50 fiber and three pitch-based fibers, P55, P75, and P120. The fiber stiffnesses range from 55 Msi to 120 Msi. The fiber CTE's range from -0.50 x 1O(exp -6)/degrees F to -0.80 x 10(exp -6)/degrees F. Also included are three matrix types: Fiberite's 934 epoxy, Amoco's ERL1962 toughened epoxy, and YLA's RS3 cyanate ester. The lamination sequences of the materials considered include a cross-ply configuration, [0/90](sub 2s), and two quasi-isotropic configurations, [0/+45/-45/90](sub s), and [0/+45/90/-45](sub s). The layer thickness of the materials range from a nominal 0.001 in. to 0.005 in. In addition to the variety of materials considered, three different thermal cycling temperature ranges are considered. These temperature ranges are +/-250 degrees F, +/-l5O degrees F, and +/-50 degrees F. The combination of these material and geometric parameters and temperature ranges, combined with thermal cycling to thousands of cycles, makes this one of the most comprehensive studies of thermal-cycling-induced microcracking to date. Experimental comparisons are presented by examining the effect of layer thickness, fiber type, matrix type, and thermal cycling temperature range on microcracking and its influence on the laminates. Results regarding layer thickness effects indicate that thin-layer laminates microcrack more severely than identical laminates with thick layers. For some specimens in this study, the number of microcracks in thin-layer specimens exceeds that in thick-layer specimens by more than a factor of two. Despite the higher number of microcracks in the thin-layer specimens, small changes in CTE after thousands of cycles indicate that the thin-layer specimens are relatively unaffected by the presence of these cracks compared to the thick-layer specimens. Results regarding fiber type indicate that the number of microcracks and the change in CTE after thousands of cycles in the specimens containing PAN-based fibers are less than in the specimens containing comparable stiffness pitch-based fibers. Results for specimens containing the different pitch-based fibers indicate that after thousands of cycles, the number of microcracks in the specimens does not depend on the modulus or CTE of the fiber. The change in laminate CTE does, however, depend highly on the stiffness and CTE of the fiber. Fibers with higher stiffness and more negative CTE exhibit the lowest change in laminate CTE as a result of thermal cycling. The overall CTE of these specimens is, however, more negative as a result of the more negative CTE of the fiber. Results regarding matrix type based on the +/-250 degree F temperature range indicate that the RS3 cyanate ester resin system exhibits the greatest resistance to microcracking and the least change in CTE, particularly for cycles numbering 3000 and less. Extrapolations to higher numbers of cycles indicate, however, that the margin of increased performance is expected to decrease with additional thermal cycling. Results regarding thermal cycling temperature range depend on the matrix type considered and the layer thickness of the specimens. For the ERL1962 resin system, microcrack saturation is expected to occur in all specimens, regardless of the temperature range to which the specimens are exposed. By contrast, the RS3 resin system demonstrates a threshold effect such that cycled to less severe temperature ranges, microcracking does not occur. For the RS3 specimens with 0.005 in. layer thickness, no microcracking or changes in CTE are observed in specimens cycled between +/-150 degree F or +/- 50 degree F. For the RS3 specimens with 0.002 in. layer thickness, no microcracking or changes in CTE are observed in specimens cycled between +/-50 degree F. Results regarding laminate stiffness indicate negligible change in laminate stiffness due to thermal cycling for the materials and geometries considered in this investigation. The study includes X-ray examination of the specimens, showing that cracks observed at the edge of the specimens penetrate the entire width of the specimen. Glass transition temperatures of the specimens are measured, showing that resin chemistry is not altered as a result of thermal cycling. Results are also presented based on a one-dimensional shear lag analysis developed in the literature. The analysis requires material property information that is difficult to obtain experimentally. Using limited data from the present investigation, material properties associated with the analysis are modified to obtain reasonable agreement with measured microcrack densities. Based on these derived material properties, the analysis generally overpredicts the change in laminate CTE. Predicted changes in laminate stiffness show reasonable correlation with experimentally measured values.

Positive Margins by Oropharyngeal Subsite in Transoral Robotic Surgery for T1/T2 Squamous Cell Carcinoma.

PubMed

Persky, Michael J; Albergotti, William G; Rath, Tanya J; Kubik, Mark W; Abberbock, Shira; Geltzeiler, Mathew; Kim, Seungwon; Duvvuri, Umamaheswar; Ferris, Robert L

2018-04-01

Objective To compare positive margin rates between the 2 most common subsites of oropharyngeal transoral robotic surgery (TORS), the base of tongue (BOT) and the tonsil, as well as identify preoperative imaging characteristics that predispose toward positive margins. Study Design Case series with chart review. Setting Tertiary care referral center. Subjects and Methods We compared the final and intraoperative positive margin rate between TORS resections for tonsil and BOT oropharyngeal squamous cell carcinoma (OPSCC), as well as the effect of margins on treatment. A blinded neuroradiologist examined the preoperative imaging of BOT tumors to measure their dimensions and patterns of spread and provided a prediction of final margin results. Results Between January 2010 and May 2016, a total of 254 patients underwent TORS for OPSCC. A total of 140 patients who underwent TORS for T1/T2 OPSCC met inclusion criteria. A final positive margin is significantly more likely for BOT tumors than tonsil tumors (19.6% vs 4.5%, respectively, P = .004) and likewise for intraoperative margins of BOT and tonsil tumors (35.3% vs 12.4%, respectively; P = .002). A positive final margin is 10 times more likely to receive chemoradiation compared to a negative margin, controlling for extracapsular spread and nodal status (odds ratio, 9.6; 95% confidence interval, 1.6-59.6; P = .02). Preoperative imaging characteristics and subjective radiologic examination of BOT tumors did not correlate with final margin status. Conclusion Positive margins are significantly more likely during TORS BOT resections compared to tonsil resections. More research is needed to help surgeons predict which T1/T2 tumors will be difficult to completely extirpate.

Interleukins in gingival crevicular fluid in patients with definitive full-coverage restorations.

PubMed

Chang, Kai-Chiao J; Wheater, Michelle A; Cabanilla Jacobs, Levyee; Litonjua, Luis A

2014-04-01

The objective of this study was to determine interleukin (IL)-1α and IL-8 levels in the gingival crevicular fluid (GCF) of patients with different levels of crown margin placements. Samples of GCF were obtained from 12 study participants with definitive full-coverage restorations with supragingival or equigingival crown margin placements. The periodontal status of the volunteers ranged from healthy to generalized severe periodontitis. Pocket depth and bleeding on probing were assessed at the clinical examination, and interleukin concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Analysis of variance (ANOVA) was used to statistically compare interleukin concentrations between the control, supragingival, and equigingival GCF samples. Compared to controls (60.4 ± 8.9 pg/mL), the average IL-1α concentration in the GCF samples surrounding the supragingival margins was 53.8 ± 9.7 pg/mL and was 110.5 ± 23.3 pg/mL in the equigingival margins. Compared to controls (59.0 ± 14.1 pg/mL), the average IL-8 concentration in the supragingival margins was 46.9 ± 9.7 pg/mL and was 131.4 ± 27.5 pg/mL in the equigingival margins. The trend of higher levels of interleukins in GCF corresponding to equigingival margins was consistent, as was the trend of lower concentrations in supragingival margins compared to the controls; however, statistical significance was not achieved because of the wide biological variation within and between patients. In conclusion, differences in GCF IL-1α and IL-8 concentrations were observed when comparing fixed crown restorations with equigingival and supragingival margins. Gingival inflammation may be dependent on the periodontal condition in addition to restoration or margin placement.

Comparison of histologic margin status in low-grade cutaneous and subcutaneous canine mast cell tumours examined by radial and tangential sections.

PubMed

Dores, C B; Milovancev, M; Russell, D S

2018-03-01

Radial sections are widely used to estimate adequacy of excision in canine cutaneous mast cell tumours (MCTs); however, this sectioning technique estimates only a small fraction of total margin circumference. This study aimed to compare histologic margin status in grade II/low grade MCTs sectioned using both radial and tangential sectioning techniques. A total of 43 circumferential margins were evaluated from 21 different tumours. Margins were first sectioned radially, followed by tangential sections. Tissues were examined by routine histopathology. Tangential margin status differed in 10 of 43 (23.3%) margins compared with their initial status on radial section. Of 39 margins, 9 (23.1%) categorized as histologic tumour-free margin (HTFM) >0 mm were positive on tangential sectioning. Tangential sections detected a significantly higher proportion of positive margins relative to radial sections (exact 2-tailed P-value = .0215). The HTFM was significantly longer in negative tangential margins than positive tangential margins (mean 10.1 vs 3.2 mm; P = .0008). A receiver operating characteristic curve comparing HTFM and tangentially negative margins found an area under the curve of 0.83 (95% confidence interval: 0.71-0.96). Although correct classification peaked at the sixth cut-point of HTFM ≥1 mm, radial sections still incorrectly classified 50% of margins as lacking tumour cells. Radial sections had 100% specificity for predicting negative tangential margins at a cut-point of 10.9 mm. These data indicate that for low grade MCTs, HTFMs >0 mm should not be considered completely excised, particularly when HTFM is <10.9 mm. This will inform future studies that use HTFM and overall excisional status as dependent variables in multivariable prognostic models. © 2017 John Wiley & Sons Ltd.

Diode laser (808 nm) applied to oral soft tissue lesions: a retrospective study to assess histopathological diagnosis and evaluate physical damage.

PubMed

Angiero, Francesca; Parma, Luisa; Crippa, Rolando; Benedicenti, Stefano

2012-03-01

The diode laser is today widely used in oral pathology to excise lesions; however, some controversy surrounds laser surgery, specifically the accuracy of pathological diagnosis and the control over thermal tissue damage. This study aimed to establish if physical damage induced by the diode laser could affect the histopathological diagnosis and to evaluate the damage caused to the resection margins. Between 2005 and 2010, at S. Gerardo Hospital, Milan, 608 cases of soft tissue lesions localized in the oral cavity (cheek, gingiva, buccal mucosa, tongue, and lips) were examined. Specimens were excised with an 808-nm diode laser, output 1.6-2.7 W, in continuous-wave mode with fibers of 320 μm. Specimens were fixed in 10% buffered formalin solution and examined separately under an optical microscope by two pathologists. In all of the specimens, changes to the epithelium, connective tissue and blood vessels, shape of incision damage, and overall width of modified tissues were evaluated. The data for specimens larger than 3 mm excised with the diode laser were not significant in terms of stromal changes or vascular stasis, while epithelial and stromal changes were significantly more frequent in specimens with a mean size below 3 mm; the diagnosis was not achievable in 46.15%. Our data show that the diode laser is a valid therapeutic instrument for excising oral lesions larger than 3 mm in diameter, but induces serious thermal effects in small lesions (mean size below 3 mm). However, from a clinical standpoint, it is suggested necessary that the specimens taken have in vivo a diameter of at least 5 mm in order to have a reliable reading of the histological sample.

Perinatal Specimens of Saurolophus angustirostris (Dinosauria: Hadrosauridae), from the Upper Cretaceous of Mongolia.

PubMed

Dewaele, Leonard; Tsogtbaatar, Khishigjav; Barsbold, Rinchen; Garcia, Géraldine; Stein, Koen; Escuillié, François; Godefroit, Pascal

2015-01-01

The Late Cretaceous Nemegt Formation, Gobi Desert, Mongolia has already yielded abundant and complete skeletons of the hadrosaur Saurolophus angustirostris, from half-grown to adult individuals. Herein we describe perinatal specimens of Saurolophus angustirostris, associated with fragmentary eggshell fragments. The skull length of these babies is around 5% that of the largest known S. angustirostris specimens, so these specimens document the earliest development stages of this giant hadrosaur and bridge a large hiatus in our knowledge of the ontogeny of S. angustirostris. The studied specimens are likely part of a nest originally located on a riverbank point bar. The perinatal specimens were buried by sediment carried by the river current presumably during the wet summer season. Perinatal bones already displayed diagnostic characters for Saurolophus angustirostris, including premaxillae with a strongly reflected oral margin and upturned premaxillary body in lateral aspect. The absence of a supracranial crest and unfused halves of the cervical neural arches characterize the earliest stages in the ontogeny of S. angustirostris. The eggshell fragments associated with the perinatal individuals can be referred to the Spheroolithus oogenus and closely resemble those found in older formations (e.g. Barun Goyot Fm in Mongolia) or associated with more basal hadrosauroids (Bactrosaurus-Gilmoreosaurus in the Iren Dabasu Fm, Inner Mongolia, China). This observation suggests that the egg microstructure was similar in basal hadrosauroids and more advanced saurolophines. One of the authors (FE) is employed by the commercial organization Eldonia. Eldonia provided support in the form of a salary for FE, but did not have any additional role or influence in the study design, data collection and analysis, decision to publish, or preparation of the manuscript and it does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.

Fatigue and Fracture-Toughness Characterization of SAW and SMA A537 Class I Ship-Steel Weldments.

DTIC Science & Technology

1981-12-01

Charpy criterion and proposed NDT-DT criterion of Rolfe . Recommendations are made and further research is suggested to help clarify the assessment of...acceptable performance at -60aF. Likewise, at -60OF the NDT and DT data for these weldments marginally exceed the criteria proposed by Rolfe when the...exceed the CVN values equivalent to the 5/8 DT values required by Rolfe . The 5/8-inch dynamic-tear specimen is not recommended as a quality-control test

Dehydroepiandrosterone Derivatives as Potent Antiandrogens with Marginal Agonist Activity

DTIC Science & Technology

2015-05-01

according to eppin tigen level of I0.2 ng/ml. hed by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2011.02.027 E U RO P E AN URO L OG Y 5 9...control), as indicated. Endocrine-Related Cancer (2011) 18 451–464 www.endocrinology-journals.orgradical cystectomy specimens with high-grade uro - thelial...is primarily derived from the uro - genital sinus during embryogenesis, which in males also gives rise to the prostate, similar mechanisms of AR

The paleogeographic significance of Aquilapollenites occurrence in Pakistan

NASA Astrophysics Data System (ADS)

Khan, Asrar M.; Srivastava, Satish K.

2006-12-01

The occurrence of the genus Aquilapollenites in Upper Cretaceous and Neogene sediments of northwestern Pakistan is reported here. Aquilapollenites amplus, Aquilapollenites reductus, and Aquilapollenites sp. occur in the Maastrichtian palynomorph assemblage from an outcrop sample of the Mir Ali section, northern Waziristan. Aquilapollenites medeis in the Neogene Murgha Faqir Zai Formation of the Pishin Basin, Balochistan, is considered a reworked Cretaceous specimen. The Upper Cretaceous sediments of the Asian plate on the Tethys margin are considered to be the source of Aquilapollenites spp. in these samples.

Influence of Material Selection on the Marginal Accuracy of CAD/CAM-Fabricated Metal- and All-Ceramic Single Crown Copings

PubMed Central

Schneider, Lea; Rinke, Sven

2018-01-01

This study evaluated the marginal accuracy of CAD/CAM-fabricated crown copings from four different materials within the same processing route. Twenty stone replicas of a metallic master die (prepared upper premolar) were scanned and divided into two groups. Group 1 (n = 10) was used for a pilot test to determine the design parameters for best marginal accuracy. Group 2 (n = 10) was used to fabricate 10 specimens from the following materials with one identical CAD/CAM system (GAMMA 202, Wissner GmbH, Goettingen, Germany): A = commercially pure (cp) titanium, B = cobalt-chromium alloy, C = yttria-stabilized zirconia (YSZ), and D = leucite-reinforced glass-ceramics. Copings from group 2 were evaluated for the mean marginal gap size (MeanMG) and average maximum marginal gap size (AMaxMG) with a light microscope in the “as-machined” state. The effect of the material on the marginal accuracy was analyzed by multiple pairwise comparisons (Mann–Whitney, U-test, α = 0.05, adjusted by Bonferroni-Holmes method). MeanMG values were as follows: A: 46.92 ± 23.12 μm, B: 48.37 ± 29.72 μm, C: 68.25 ± 28.54 μm, and D: 58.73 ± 21.15 μm. The differences in the MeanMG values proved to be significant for groups A/C (p = 0.0024), A/D (p = 0.008), and B/C (p = 0.0332). AMaxMG values (A: 91.54 ± 23.39 μm, B: 96.86 ± 24.19 μm, C: 120.66 ± 32.75 μm, and D: 100.22 ± 10.83 μm) revealed no significant differences. The material had a significant impact on the marginal accuracy of CAD/CAM-fabricated copings. PMID:29765979

Lock-in thermography, penetrant inspection, and scanning electron microscopy for quantitative evaluation of open micro-cracks at the tooth-restoration interface

NASA Astrophysics Data System (ADS)

Streza, M.; Hodisan, I.; Prejmerean, C.; Boue, C.; Tessier, Gilles

2015-03-01

The evaluation of a dental restoration in a non-invasive way is of paramount importance in clinical practice. The aim of this study was to assess the minimum detectable open crack at the cavity-restorative material interface by the lock-in thermography technique, at laser intensities which are safe for living teeth. For the analysis of the interface, 18 box-type class V standardized cavities were prepared on the facial and oral surfaces of each tooth, with coronal margins in enamel and apical margins in dentine. The preparations were restored with the Giomer Beautifil (Shofu) in combination with three different adhesive systems. Three specimens were randomly selected from each experimental group and each slice has been analysed by visible, infrared (IR), and scanning electron microscopy (SEM). Lock-in thermography showed the most promising results in detecting both marginal and internal defects. The proposed procedure leads to a diagnosis of micro-leakages having openings of 1 µm, which is close to the diffraction limit of the IR camera. Clinical use of a thermographic camera in assessing the marginal integrity of a restoration becomes possible. The method overcomes some drawbacks of standard SEM or dye penetration testing. The results support the use of an IR camera in dentistry, for the diagnosis of micro-gaps at bio-interfaces.

Environmental and ammonoid faunal changes related to Albian Bay of Biscay opening: Insights from the northern margin of the Basque-Cantabrian Basin

NASA Astrophysics Data System (ADS)

Agirrezabala, Luis M.; López-Horgue, Mikel A.

2017-12-01

The opening and ocean floor spreading of the Bay of Biscay began in the earliest Albian. The integrative study of the Albian sedimentary record and its ammonoid fauna (around 250 specimens) from the northern margin of the Basque-Cantabrian Basin indicates that environmental changes, occurred as a consequence of the Bay of Biscay opening, triggered significant ammonoid bioevents. Main bioevents are diversity changes in the ammonoid associations, occurrence of large forms (diameter up to 0.45 m) and the incursion of elements from other basins. Time-correlation of faulting pulses with ammonoid bioevents indicates that transtensive tectonics was ultimately the major control on the marine environmental conditions such as depth, sea bottom physiography, seaways, sedimentary systems and sea-water chemistry. The pulsating faulting during the Albian led to the increment of the subsidence rate, the deepening and widening of the margin and the progressive increase in the oceanic circulation between the margin and the nascent Bay of Biscay and North Atlantic. In addition, Albian synsedimentary faults constituted conduits for ascending magmas and hydrocarbon-rich hydrothermal fluids, which expelled to the seafloor, causing changes in the sediments, the sea-water chemistry (fertilization) and biota. The integration of sedimentological and palaeontological data has given the basis for a conceptual model of the ammonoid habitats.

Comparison of Conventional Methods and Laser-Assisted Rapid Prototyping for Manufacturing Fixed Dental Prostheses: An In Vitro Study

PubMed Central

Pompa, Giorgio; Di Carlo, Stefano; De Angelis, Francesca; Cristalli, Maria Paola; Annibali, Susanna

2015-01-01

This study assessed whether there are differences in marginal fit between laser-fusion and conventional techniques to produce fixed dental prostheses (FDPs). A master steel die with 2 abutments was produced to receive a posterior 4-unit FDPs and single copings. These experimental models were divided into three groups (n = 20/group) manufactured: group 1, Ni-Cr alloy, with a lost-wax casting technique; group 2, Co-Cr alloy, with selective laser melting (SLM); and group 3, yttria-tetragonal zirconia polycrystal (Y-TZP), with a milling system. All specimens were cut along the longitudinal axis and their adaptation was measured at the marginal and shoulder areas on the right and left sides of each abutment. Measurements were made using a stereomicroscope (×60 magnification) and a scanning electron microscope (×800 magnification). The data were analyzed using one-way analysis of variance and the Bonferroni post hoc test, with a significance cutoff of 5%. Significant differences (P < 0.05) were observed between group 3 and the other groups. The marginal opening was smallest with Co-Cr alloy substructures, while the shoulder opening was smallest with Ni-Cr alloy substructures. Within the limitations of this study, the marginal fit of an FDP is better with rapid prototyping (RP) via SLM than conventional manufacturing systems. PMID:26576419

Drawings for an exacting author: illustrations from Giovanni Antonio Scopoli's "Deliciae florae et faunae insubricae".

PubMed

Siviero, Monica; Violani, Carlo

2006-01-01

Giovanni Antonio Scopoli (1723-1788) was one of the most versatile naturalists in eighteenth-century Italy. In 1785, Scopoli conceived the ambitious publication, "Deliciae florae et faunae insubricae". Appearing in installments, this included descriptions and illustrations of plants, animals and minerals found in northern Italy. Unfortunately, Scopoli's sudden death halted publication of the "Deliciae" after its third installment. Recently, a corpus of 98 paintings, in the gouache style, were discovered in the Biblioteca Universitaria of Pavia. These gouaches appear to be the basis for plates planned in future installments of the "Deliciae". Marginal notes in Scopoli's handwriting are included. Because Scopoli's plant and animal specimens have been destroyed or dispersed, these drawings are crucial for reconstructing his scientific opus. Combined with other documents, Scopoli's marginal notes also reveal his exacting standards. He criticized the way his artists had poorly rendered the scientific details of the paintings.

New technique of transanal proctectomy with completely robotic total mesorrectal excision for rectal cancer.

PubMed

Gómez Ruiz, Marcos; Palazuelos, Carlos Manuel; Martín Parra, José Ignacio; Alonso Martín, Joaquín; Cagigas Fernández, Carmen; del Castillo Diego, Julio; Gómez Fleitas, Manuel

2014-05-01

Anterior resection with total mesorectal excision is the standard method of rectal cancer resection. However, this procedure remains technically difficult in mid and low rectal cancer. A robotic transanal proctectomy with total mesorectal excision and laparoscopic assistance is reported in a 57 year old male with BMI 32 kg/m2 and rectal adenocarcinoma T2N1M0 at 5 cm from the dentate line. Operating time was 420 min. Postoperative hospital stay was 6 days and no complications were observed. Pathological report showed a 33 cm specimen with ypT2N0 adenocarcinoma at 2 cm from the distal margin, complete TME and non affected circumferential resection margin. Robotic technology might reduce some technical difficulties associated with TEM/TEO or SILS platforms in transanal total mesorectal excision. Further clinical trials will be necessary to assess this technique. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Indocyanine Green Fluorescence Navigation Thoracoscopic Metastasectomy for Pulmonary Metastasis of Hepatocellular Carcinoma.

PubMed

Kawakita, Naoya; Takizawa, Hiromitsu; Kondo, Kazuya; Sakiyama, Shoji; Tangoku, Akira

2016-12-20

Indocyanine green can selectively accumulate in primary hepatocellular carcinoma (HCC) and extrahepatic metastases. We report a patient who underwent resection of pulmonary metastasis of HCC using a thoracoscopic near-infrared imaging system and fluorescent navigation surgery. A 66-year-old man with suspicion of pulmonary metastasis of HCC was referred to our hospital. Indocyanine green was injected intravenously at a dose of 0.5 mg/kg body weight, 20 h before thoracoscopic surgery. An endoscopic indocyanine green near-infrared fluorescence imaging system showed clear blue fluorescence, indicating pulmonary metastasis of HCC in a lingular segment. We performed wide wedge resection using the fluorescence image for navigation to confirm the surgical margins. The specimen was histologically confirmed as a pulmonary metastasis of HCC. In conclusion, thoracoscopic indocyanine green near-infrared fluorescence imaging for pulmonary metastases of HCC is useful in identifying tumor locations and ensuring resection margins.

In-vitro examination of the positive inotropic effect of caffeine and taurine, the two most frequent active ingredients of energy drinks.

PubMed

Chaban, R; Kornberger, A; Branski, N; Buschmann, K; Stumpf, N; Beiras-Fernandez, A; Vahl, C F

2017-08-10

Our study aimed to evaluate changes in the contractile behavior of human myocardium after exposure to caffeine and taurine, the main active ingredients of energy drinks (EDs), and to evaluate whether taurine exhibits any inotropic effect at all in the dosages commonly used in EDs. Myocardial tissue was removed from the right atrial appendages of patients undergoing cardiac surgery and prepared to obtain specimens measuring 4 mm in length. A total of 92 specimens were exposed to electrical impulses at a frequency of 75 bpm for at least 40 min to elicit their maximum contractile force before measuring the isometric contractile force (ICF) and duration of contraction (CD). Following this, each specimen was treated with either taurine (group 1, n = 29), or caffeine (group 2, n = 31) or both (group 3, n = 32). After exposure, ICF and CD measuring were repeated. Post-treatment values were compared with pre-treatments values and indicated as percentages. Exposure to taurine did not alter the contraction behavior of the specimens. Exposure to caffeine, in contrast, led to a significant increase in ICF (118 ± 03%, p < 0.01) und a marginal decrease in CD (95 ± 1.6%, p < 0.01). Exposure to a combination of caffeine and taurine also induced a statistically significant increase in ICF (124 ± 4%, p < 0.01) and a subtle reduction in CD (92 ± 1.4%, p < 0.01). The increase in ICF achieved by administration of caffeine was similar to that achieved by a combination of both caffeine and taurine (p = 0.2). The relative ICF levels achieved by administration of caffeine and a combination of taurine and caffeine, respectively, were both significantly higher (p < 0.01) than the ICF resulting from exposure to taurine only. While caffeine altered the contraction behavior of the specimen significantly in our in-vitro model, taurine did not exhibit a significant effect. Adding taurine to caffeine did not significantly enhance or reduce the effect of caffeine.

Marginal adaptation and CAD-CAM technology: A systematic review of restorative material and fabrication techniques.

PubMed

Papadiochou, Sofia; Pissiotis, Argirios L

2018-04-01

The comparative assessment of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and other fabrication techniques pertaining to marginal adaptation should be documented. Limited evidence exists on the effect of restorative material on the performance of a CAD-CAM system relative to marginal adaptation. The purpose of this systematic review was to investigate whether the marginal adaptation of CAD-CAM single crowns, fixed dental prostheses, and implant-retained fixed dental prostheses or their infrastructures differs from that obtained by other fabrication techniques using a similar restorative material and whether it depends on the type of restorative material. An electronic search of English-language literature published between January 1, 2000, and June 30, 2016, was conducted of the Medline/PubMed database. Of the 55 included comparative studies, 28 compared CAD-CAM technology with conventional fabrication techniques, 12 contrasted CAD-CAM technology and copy milling, 4 compared CAD-CAM milling with direct metal laser sintering (DMLS), and 22 investigated the performance of a CAD-CAM system regarding marginal adaptation in restorations/infrastructures produced with different restorative materials. Most of the CAD-CAM restorations/infrastructures were within the clinically acceptable marginal discrepancy (MD) range. The performance of a CAD-CAM system relative to marginal adaptation is influenced by the restorative material. Compared with CAD-CAM, most of the heat-pressed lithium disilicate crowns displayed equal or smaller MD values. Slip-casting crowns exhibited similar or better marginal accuracy than those fabricated with CAD-CAM. Cobalt-chromium and titanium implant infrastructures produced using a CAD-CAM system elicited smaller MD values than zirconia. The majority of cobalt-chromium restorations/infrastructures produced by DMLS displayed better marginal accuracy than those fabricated with the casting technique. Compared with copy milling, the majority of zirconia restorations/infrastructures produced by CAD-CAM milling exhibited better marginal adaptation. No clear conclusions can be drawn about the superiority of CAD-CAM milling over the casting technique and DMLS regarding marginal adaptation. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Cariostatic effect of fluoride-containing restorative materials associated with fluoride gels on root dentin

PubMed Central

BORGES, Fernanda Tavares; CAMPOS, Wagner Reis da Costa; MUNARI, Lais Sant'ana; MOREIRA, Allyson Nogueira; PAIVA, Saul Martins; MAGALHÃES, Claudia Silami

2010-01-01

Secondary caries is still the main cause of restoration replacement, especially on the root surface Objective This in vitro study evaluated the cariostatic effects of fluoride-containing restorative materials associated with fluoride gels, on root dentin. Materials and Methods A randomized complete block design was used to test the effects of the restorative systems, fluoride regimes and the interactions among them at different distances from restoration margins. Standardized cavities were prepared on 240 bovine root specimens and randomly assigned to 15 groups of treatments (n=16). Cavities were filled with the following restorative materials: Ketac-Fil (3M-ESPE); Vitremer (3M-ESPE); Dyract/Prime & Bond NT (Dentsply); Charisma/Gluma One Bond (Heraeus Kulzer) and the control, Z250/Single Bond (3M-ESPE). The specimens were subjected to a pH-cycling model designed to simulate highcaries activity. During the cycles, 1.23% acidulated phosphate fluoride, 2.0% neutral sodium fluoride or deionized/distilled water (control) was applied to the specimens for 4 min. The surface Knoop microhardness test was performed before (KHNi) and after (KHNf) the pH cycles at 100, 200 and 300 mm from the margins. Dentin microhardness loss was represented by the difference in initial and final values (KHNi - KHNf). Data were analyzed by Friedman's and Wilcoxon's tests, ANOVA and Tukey's test (α=5%). Results The interaction of restorative systems and topical treatments was not significant (p=0.102). Dentin microhardness loss was lowest closer to the restoration. Ketac-fil presented the highest cariostatic effect. Vitremer presented a moderate effect, while Dyract and Charisma did not differ from the control, Z250. The effects of neutral and acidulated fluoride gels were similar to each other and higher than the control. Conclusion Conventional and resin-modified glass ionomer cements as well as neutral and acidulated fluoride gels inhibit the progression of artificial caries adjacent to restorations. The associated effect of fluoride-containing restorative materials and gels could not be demonstrated. PMID:21085800

Occult invasive cervical cancer after simple hysterectomy: a multi-center retrospective study of 89 cases.

PubMed

Bai, Huimin; Cao, Dongyan; Yuan, Fang; Wang, Huilan; Chen, Jie; Wang, Yue; Shen, Keng; Zhang, Zhenyu

2016-07-20

Occult invasive cervical cancer (OICC) is sometimes incidentally found in surgical specimens after a simple hysterectomy (SH). This study was aimed at identifying a subset of patients with OICC who have a favorable prognosis. This patient group may not require adjuvant radiotherapy and other procedures. The medical records of women in whom OICC was detected after an inadvertent SH were retrospectively reviewed. The relevant data, including clinicopathological characteristics, treatment and clinical outcome were evaluated. The primary and secondary endpoints were overall survival (OS) and relapse-free survival (RFS), respectively. Eighty-nine patients who met the inclusion criteria were included for analysis, and the risk of OICC was found to be 1.9 %. Finding an invasive cancer in a hysterectomy specimen after a conization procedure that shows positive margins was the most common reason (41.6 %) for the performance of inadvertent SH. In the univariate analysis, a tumor width > 20 mm, deep stromal invasion, and lymph node metastasis (LNM) were adversely associated with relapse (P < 0.001, < 0.001, and = 0.001, respectively) and survival (P = 0.003, 0.004, and 0.027, respectively), although these parameters were not independently associated with patient prognoses in the multivariate analysis. In patients with a tumor width ≤ 20 mm and superficial stromal invasion in the observation subgroup, the 5-year RFS and 5-year OS were both 100 %, whereas they were 57.1 % and 66.7 %, respectively, in patients with a tumor size > 20 mm and deep stromal invasion in the radiotherapy or chemotherapy subgroup (P < 0.001, and = 0.008, respectively). Simple observation after a lymphadenectomy procedure may be feasible in OICC patients with a tumor width ≤ 20 mm, superficial stromal invasion, a negative section margin in hysterectomy specimens, and no LNM.

Calibration and analysis of a multimodal micro-CT and structured light imaging system for the evaluation of excised breast tissue

NASA Astrophysics Data System (ADS)

McClatchy, David M., III; Rizzo, Elizabeth J.; Meganck, Jeff; Kempner, Josh; Vicory, Jared; Wells, Wendy A.; Paulsen, Keith D.; Pogue, Brian W.

2017-12-01

A multimodal micro-computed tomography (CT) and multi-spectral structured light imaging (SLI) system is introduced and systematically analyzed to test its feasibility to aid in margin delineation during breast conserving surgery (BCS). Phantom analysis of the micro-CT yielded a signal-to-noise ratio of 34, a contrast of 1.64, and a minimum detectable resolution of 240 μm for a 1.2 min scan. The SLI system, spanning wavelengths 490 nm to 800 nm and spatial frequencies up to 1.37 mm-1 , was evaluated with aqueous tissue simulating phantoms having variations in particle size distribution, scatter density, and blood volume fraction. The reduced scattering coefficient, μs\\prime and phase function parameter, γ, were accurately recovered over all wavelengths independent of blood volume fractions from 0% to 4%, assuming a flat sample geometry perpendicular to the imaging plane. The resolution of the optical system was tested with a step phantom, from which the modulation transfer function was calculated yielding a maximum resolution of 3.78 cycles per mm. The three dimensional spatial co-registration between the CT and optical imaging space was tested and shown to be accurate within 0.7 mm. A freshly resected breast specimen, with lobular carcinoma, fibrocystic disease, and adipose, was imaged with the system. The micro-CT provided visualization of the tumor mass and its spiculations, and SLI yielded superficial quantification of light scattering parameters for the malignant and benign tissue types. These results appear to be the first demonstration of SLI combined with standard medical tomography for imaging excised tumor specimens. While further investigations are needed to determine and test the spectral, spatial, and CT features required to classify tissue, this study demonstrates the ability of multimodal CT/SLI to quantify, visualize, and spatially navigate breast tumor specimens, which could potentially aid in the assessment of tumor margin status during BCS.

Grit blasting and the marginal accuracy of two ceramic veneer systems--a pilot study.

PubMed

Lim, C; Ironside, J G

1997-04-01

Margins of ceramic restorations can be damaged during removal of investment materials with grit blasting and result in relatively large marginal discrepancies and excessive marginal discrepancies with greater exposure of cement to the oral environment. Subsequent dissolution of cement can encourage plaque retention, dental caries, and periodontal problems. This study compared marginal adaptation of ceramic veneers created by the refractory die technique (R), Dicor glass ceramic technique (D), and effects of grit blasting on their margins. Two groups of ceramic veneers were constructed for each system, one without grit blasting (R g and D g) and one with grit blasting (R+g and D+g). Statistical analyses revealed that grit blasting had a greater effect in reducing marginal accuracy for Dicor ceramic veneers compared with refractory die ceramic veneers.

Comparative evaluation of microleakage of nano-filled resin-modified glass ionomer: An in vitro study

PubMed Central

Eronat, Nesrin; Yilmaz, Emir; Kara, Nazan; Topaloglu, Ak Asli

2014-01-01

Objective: This in vitro study evaluated the microleakage of a nano-filled resin-modified glass ionomer and a high viscosity glass-ionomer restorations in class V cavities. Materials and Methods: Thirty-two class V cavities prepared on the buccal and lingual surfaces of 16 sound, third molar teeth were randomly assigned into two groups and restored by one of the glass ionomer material; Group A: A high viscosity (Ketac Molar, 3M ESPE) Group B: A nano-filled resin-modified (Ketac N100, 3M ESPE) glass ionomer. One clinician prepared all the cavities. The materials were used according to the manufacturers’ recommendations. The restored teeth were then stored in distilled water at 37°C for 24 h, thermocycled at 5-55°C for 1000 cycles. The specimens were immersed in aqueous solution of Indian ink dye for 48 h at room temperature. They were embedded in resin polyester and sectioned longitudinally in a buccolingual direction. Microleakage was assessed according to the depth of dye penetration along the restoration. The extent of dye penetration at the occlusal and gingival margins was assessed using a stereo microscope. Randomly selected samples from each group were prepared for scanning electron microscope evaluation. The data were statistically analyzed with Friedman and Wilcoxon signed ranks tests. Results: There were statistically significant differences between the microleakage scores of the two groups for both occlusal and gingival scores (P = 0.001). Occlusal and gingival scores for high viscosity glass ionomer (P = 0.024) and nanoionomer (P = 0.021) using Wilcoxon signed ranks tests showed statistically significant differences. High viscosity glass ionomer showed significantly less microleakage compared to the nano-filled resin-modified glass-ionomer (RMGIs) at occlusal margin (P = 0.001). No significant differences were found between the groups at gingival margin (P = 0.0317). Conclusion: Within the limitations of this in vitro study, nano-filled RMGIs restorations did not perform better than high viscosity glass ionomer in class V cavities in terms of microleakage assessment. PMID:25512723

Madeirasquilla tuerkayi, a new genus and species of mantis shrimps from Madeira Island, eastern Atlantic (Crustacea: Stomatopoda: Nannosquillidae).

PubMed

ĎuriŠ, ZdenĚk

2018-03-22

Madeirasquilla tuerkayi is described as a new genus and species of the nannosquillid mantis shrimps (Stomatopoda) based on a single specimen collected from Madeira, eastern Atlantic. That specimen is remarkable by a combination of the following morphological characters: rostral plate with three sharp anterior projections; antennal protopod with two mesial and one ventral papillae; cornea subglobular; raptorial claw dactylus with 11 or 12 teeth, and with acute proximal tooth on outer margin; pleonite 6 with strong posterolateral spine and two posteriorly directed sternal spines; telson bearing smooth shield-like dorsal prominence with acute median spine posteriorly; four pairs of fixed primary teeth posteriorly on the telson; outer primary spine of uropodal protopod longer than inner primary spine. The separate position of the new genus is supported also by molecular comparison. A key to the genera of the family Nannosquillidae is proposed.

Laparoscopic vs open total mesorectal excision for rectal cancer: an evaluation of the mesorectum's macroscopic quality.

PubMed

Breukink, S O; Grond, A J K; Pierie, J P E N; Hoff, C; Wiggers, T; Meijerink, W J H J

2005-03-01

Next to surgical margins, yield of lymph nodes, and length of bowel resected, macroscopic completeness of mesorectal excision may serve as another quality control of total mesorectal excision (TME). In this study, the macroscopic completeness of laparoscopic TME was evaluated. A series of 25 patients with rectal cancer were managed laparoscopically (LTME) and included in this study. The pathologic specimens of the LTME group were prospectively examined and matched with a historical group of resection specimens from patients who had undergone open TME (OTME). The two groups were matched for gender and type of resection (low anterior or abdominoperineal resection). Special care was given to the macroscopic judgment concerning the completeness of the mesorectum. A three-grade scoring system showed no differences between the LTME and OTME groups. The current study supports the hypothesis that oncologic resection using laparoscopic TME is feasible and adequate.

Aspidoras mephisto, new species: The first troglobitic Callichthyidae (Teleostei: Siluriformes) from South America

PubMed Central

Bichuette, Maria Elina

2017-01-01

Aspidoras mephisto n. sp. is described from the Anésio-Russão cave system, upper Tocantins River basin, Goiás, Brazil. The species can be readily distinguished from its congeners by troglomorphic features and also by presenting the following combination of features: infraorbital 1 generally with well-developed ventral laminar; or moderately developed; poorly-developed serrations on posterior margin of pectoral spine; nuchal plate not externally visible; dorsal fin, even in conspicuously colored specimens, with only dark brown or black chromatophores concentrated on rays, forming spots in some specimens; membranes hyaline; or sparse dark brown or black chromatophores on membranes, not forming any conspicuous pattern; and inner laminar expansion of infraorbital 1 moderately developed. Information about its habitat, ecology, behaviour and conservation status are provided and also a brief description of the juvenile stage. PMID:28248959

Physically-based landslide assessment for railway infrastructure

NASA Astrophysics Data System (ADS)

Heyerdahl, Håkon; Høydal, Øyvind

2017-04-01

A new high-speed railway line in Eastern Norway passes through areas with Quaternary soil deposits where stability of natural slopes poses considerable challenges. The ground typically consist of thick layers of marine clay deposits, overlain by 8-10 m of silt and sand. Both shallow landslides in the top layers of silt and sand and deep-seated failures in clay must be accounted for. In one section of the railway, the potential for performing stabilizing measures is limited due to existing cultural heritage on top of the slope. Hence, the stability of a steep top section of the slope needs to be evaluated. Assessment of the slope stability for rainfall-triggered slides relies on many parameters. An approach based only on empirical relations will not comply with the design criteria, which only allows deterministic safety margins. From a classic geotechnical approach, the slope would also normally be considered unsafe. However, considerable suction is assumed to exist in the silty and sandy deposits above ground-water level, which will improve the stability. The stabilizing effect however is highly dependent on rainfall, infiltration and soil moisture, and thereby varies continuously. An unsaturated geomechanical approach was taken to assess the slope stability. Soil moisture sensors were installed to monitor changes of in situ water content in the vadose zone. Retention curves for silt/sand specimens samples were measured by pressure plate tests. Some triaxial tests soil strength were performed to check the effect of suction on soil shear strength (performed as drained constant water content tests on compacted specimens). Based on the performed laboratory tests, the unsaturated response of the slope will be modelled numerically and compared with measured soil moisture in situ. Work is still on-going. Initial conditions after respectively dry and wet periods need to be coupled with selected rainfall intensities and duration to see the effect on slope stability. The aim of the work is to reach a result informing the client about the probability of a landslide in the slope, based on expected critical rainfall. A strictly deterministic criterion for minimum safety margin may need to be replaced by scenarios for probability and geometry of potential failures for given return periods and rainfall events.

Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of short-term outcomes.

PubMed

Serin, Kursat Rahmi; Gultekin, Fatma Ayca; Batman, Burçin; Ay, Serden; Kapran, Yersu; Saglam, Sezer; Asoglu, Oktar

2015-09-01

The aim of our study was to compare short-term outcomes of robotic and laparoscopic sphincter-saving total mesorectal excision (TME) in male patients with mid-low rectal cancer (RC) after neadjuvant chemoradiotherapy (NCRT). The study was conducted as a retrospective review of a prospectively maintained database, and we analyzed 14 robotic and 65 laparoscopic sphincter saving TME (R-TME and L-TME, respectively) performed by one surgeon between 2005 and 2013. Patient characteristics, perioperative recovery, postoperative complications and and pathology results were compared between the two groups. The patient characteristics did not differ significantly between the two groups. Median operating time was longer in the R-TME than in the L-TME group (182 min versus 140 min). Only two conversions occurred in the L-TME group. No difference was found between groups regarding perioperative recovery and postoperative complication rates. The median number of harvested lymph nodes was higher in the RTME than in the L-TME group (32 versus 23, p = 0.008). The median circumferential margin (CRM) was 10 mm in the R-TME group, 6.5 mm in the L-TME group (p = 0.047. The median distal resection margin (DRM) was 27.5 mm in the R-TME, 15 mm in the L-TME group (p = 0.014). Macroscopic grading of the specimen in the R-TME group was complete in all patients. In the L-TME group, grading was complete in 52 (80%) and incomplete in 13 (20%) cases (p = 0.109). R-TME is a safe and feasible procedure that facilitates performing of TME in male patients with mid-low RC after NCRT.

The fit of cobalt-chromium three-unit fixed dental prostheses fabricated with four different techniques: a comparative in vitro study.

PubMed

Örtorp, Anders; Jönsson, David; Mouhsen, Alaa; Vult von Steyern, Per

2011-04-01

This study sought to evaluate and compare the marginal and internal fit in vitro of three-unit FDPs in Co-Cr made using four fabrication techniques, and to conclude in which area the largest misfit is present. An epoxy resin master model was produced. The impression was first made with silicone, and master and working models were then produced. A total of 32 three-unit Co-Cr FDPs were fabricated with four different production techniques: conventional lost-wax method (LW), milled wax with lost-wax method (MW), milled Co-Cr (MC), and direct laser metal sintering (DLMS). Each of the four groups consisted of eight FDPs (test groups). The FDPs were cemented on their cast and standardised-sectioned. The cement film thickness of the marginal and internal gaps was measured in a stereomicroscope, digital photos were taken at 12× magnification and then analyzed using measurement software. Statistical analyses were performed with one-way ANOVA and Tukey's test. Best fit based on the means (SDs) in μm for all measurement points was in the DLMS group 84 (60) followed by MW 117 (89), LW 133 (89) and MC 166 (135). Significant differences were present between MC and DLMS (p<0.05). The regression analyses presented differences within the parameters: production technique, tooth size, position and measurement point (p < 0.05). Best fit was found in the DLMS group followed by MW, LW and MC. In all four groups, best fit in both abutments was along the axial walls and in the deepest part of the chamfer preparation. The greatest misfit was present occlusally in all specimens. Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Detection of early osteoarthritis in the centrodistal joints of Icelandic horses: Evaluation of radiography and low-field magnetic resonance imaging.

PubMed

Ley, C J; Björnsdóttir, S; Ekman, S; Boyde, A; Hansson, K

2016-01-01

Validated noninvasive detection methods for early osteoarthritis (OA) are required for OA prevention and early intervention treatment strategies. To evaluate radiography and low-field magnetic resonance imaging (MRI) for the detection of early stage OA osteochondral lesions in equine centrodistal joints using microscopy as the reference standard. Prospective imaging of live horses and imaging and microscopy of cadaver tarsal joints. Centrodistal (distal intertarsal) joints of 38 Icelandic research horses aged 27-29 months were radiographed. Horses were subjected to euthanasia approximately 2 months later and cadaver joints examined with low-field MRI. Osteochondral joint specimens were classified as negative or positive for OA using light microscopy histology or scanning electron microscopy. Radiographs and MRIs were evaluated for osteochondral lesions and results compared with microscopy. Forty-two joints were classified OA positive with microscopy. Associations were detected between microscopic OA and the radiography lesion categories; mineralisation front defect (P<0.0001), joint margin lesion (P<0.0001), central osteophyte (P = 0.03) and the low-field MRI lesion categories; mineralisation front defect (P = 0.01), joint margin lesion (P = 0.02) and articular cartilage lesion (P = 0.0003). The most frequent lesion category detected in microscopic OA positive joints was the mineralisation front defect in radiographs (28/42 OA positive joints, specificity 97%, sensitivity 67%). No significant differences were detected between the sensitivity and specificity of radiography and low-field MRI pooled lesion categories, but radiography was often superior when individual lesion categories were compared. Early stage centrodistal joint OA changes may be detected with radiography and low-field MRI. Detection of mineralisation front defects in radiographs may be a useful screening method for detection of early OA in centrodistal joints of young Icelandic horses. © 2015 EVJ Ltd.

Nitric oxide synthase 2 (NOS2) expression in histologically normal margins of oral squamous cell carcinoma.

PubMed

Morelatto, Rosana; Itoiz, María-Elina; Guiñazú, Natalia; Piccini, Daniel; Gea, Susana; López-de Blanc, Silvia

2014-05-01

The activity of Nitric Oxide Synthase 2 (NOS2) was found in oral squamous cell carcinomas (OSCC) but not in normal mucosa. Molecular changes associated to early carcinogenesis have been found in mucosa near carcinomas, which is considered a model to study field cancerization. The aim of the present study is to analyze NOS2 expression at the histologically normal margins of OSCC. Eleven biopsy specimens of OSCC containing histologically normal margins (HNM) were analyzed. Ten biopsies of normal oral mucosa were used as controls. The activity of NOS2 was determined by immunohistochemistry. Salivary nitrate and nitrite as well as tobacco and alcohol consumption were also analyzed. The Chi-squared test was applied. Six out of the eleven HNM from carcinoma samples showed positive NOS2 activity whereas all the control group samples yielded negative (p=0.005). No statistically significant association between enzyme expression and tobacco and/or alcohol consumption and salivary nitrate and nitrite was found. NOS2 expression would be an additional evidence of alterations that may occur in a state of field cancerization before the appearance of potentially malignant morphological changes.

Influence of an alloy addition on the physical and clinical behaviour of glass ionomer cement

NASA Astrophysics Data System (ADS)

Abour, Mohamed Abour Bashir

These in vitro studies compared the various properties of an experimental high powder liquid content glass ionomer cement (EXPT) with those of a metal addition GIC (Hi-Dense) and disperse phase amalgam (Dispersalloy). Bi-axial, four point flexural and compressive tests were used to evaluate strength. Six groups of ten specimens were constructed for each test for each material and allowed to set in an oven at 37°C for 60 minutes. Specimens were stored in distilled water at 37°C until testing at one day, one week, one, three, six months and year. It was found that the strength of Hi-Dense increased and then maintained over extended time, whereas the strength of EXPT showed a declined at 3 months. The bond strengths of the materials to both enamel and dentine were also evaluated. Ten groups of ten teeth, five for each surface for each glass ionomer materials, were prepared. Teeth were aligned leaving the enamel and dentine surfaces exposed. The mixed material was condensed into a cylinder placed on the appropriate surface. These specimens were also stored in distilled water at 37°C. It was found that Hi-Dense had a higher bond strength to enamel that increased with time. The bond strength to dentine was maintained over the test period. The erosion rate of the materials was evaluated using the lactic acid erosion test. Three groups of six specimens for each material were constructed and tested after one hour, one day and at six months. Each specimen was subjected to an impinging jet of lactic acid solution. The erosion rate was determined by weight loss and dimensional change. It was found that Hi-Dense had a high erosion resistance which was slightly better than the experimental material. The microleakage, around restorations prepared, using the glass ionomer materials, was evaluated after cyclical loading the restoration-tooth complex. It was found that there was less leakage around Hi-Dense than EXPT at both the cervical and occlusal margins. In a clinical comparative evaluation of Hi-Dense with a disperse phase alloy placed as Class I restoration, the indirect assessment showed that Hi-Dense showed greater wear at six months than the amalgam using Ivoclar method of model assessment of wear. These studies indicate that the incorporation of a metal addition in the glass ionomer may have brought about a slight improvement in some of the properties tested. However, the performance of the experimental material with similar high powder content but no metal addition indicates that the use of a high powder content may be the predominant cause for the possible improvement.

Microleakage of Four Dental Cements in Metal Ceramic Restorations With Open Margins.

PubMed

Eftekhar Ashtiani, Reza; Farzaneh, Babak; Azarsina, Mohadese; Aghdashi, Farzad; Dehghani, Nima; Afshari, Aisooda; Mahshid, Minu

2015-11-01

Fixed prosthodontics is a routine dental treatment and microleakage is a major cause of its failure. The aim of this study was to assess the marginal microleakage of four cements in metal ceramic restorations with adapted and open margins. Sixty sound human premolars were selected for this experimental study performed in Tehran, Iran and prepared for full-crown restorations. Wax patterns were formed leaving a 300 µm gap on one of the proximal margins. The crowns were cast and the samples were randomly divided into four groups based on the cement used. Copings were cemented using zinc phosphate cement (Fleck), Fuji Plus resin-modified glass ionomer, Panavia F2.0 resin cement, or G-Cem resin cement, according to the manufacturers' instructions. Samples were immersed in 2% methylene blue solution. After 24 hours, dye penetration was assessed under a stereomicroscope and analyzed using the respective software. Data were analyzed using ANOVA, paired t-tests, and Kruskal-Wallis, Wilcoxon, and Mann-Whitney tests. The least microleakage occurred in the Panavia F2.0 group (closed margin, 0.18 mm; open margin, 0.64 mm) and the maximum was observed in the Fleck group (closed margin, 1.92 mm; open margin, 3.32 mm). The Fleck group displayed significantly more microleakage compared to the Fuji Plus and Panavia F2.0 groups (P < 0.001) in both closed and open margins. In open margins, differences in microleakage between the Fuji Plus and G-Cem as well as between the G-Cem and Panavia F2.0 groups were significant (P < 0.001). In closed margins, only the G-Cem group displayed significantly more microleakage as compared to the Panavia F2.0 group (P < 0.05). Paired t-test results showed significantly more microleakage in open margins compared to closed margins, except in the Fuji Plus group (P = 0.539). Fuji Plus cement exhibited better sealing ability in closed and open margins compared to G-Cem and Fleck cements. When using G-Cem and Fleck cements for full metal ceramic restorations, clinicians should try to minimize marginal gaps in order to reduce restoration failure. In situations where there are doubts about perfect marginal adaptation, the use of Fuji Plus cement may be helpful.

Diffuse reflectance spectroscopy from 400-1600 nm to evaluate tumor resection margins during head and neck surgery (Conference Presentation)

NASA Astrophysics Data System (ADS)

Brouwer de Koning, Susan G.; Baltussen, E. J. M.; Karakullukcu, M. Baris; Smit, L.; van Veen, R. L. P.; Hendriks, Benno H. W.; Sterenborg, H. J. C. M.; Ruers, Theo J. M.

2017-02-01

This ex vivo study evaluates the feasibility of diffuse reflectance spectroscopy (DRS) for discriminating tumor from healthy oral tissue, with the aim to develop a technique that can be used to determine a complete excision of tumor through intraoperative margin assessment. DRS spectra were acquired on fresh surgical specimens from patients with an oral squamous cell carcinoma. The spectra represent a measure of diffuse light reflectance (wavelength range of 400-1600 nm), detected after illuminating tissue with a source fiber at 1.0 and 2.0 mm distances from a detection fiber. Spectra were obtained from 23 locations of tumor tissue and 16 locations of healthy muscle tissue. Biopsies were taken from all measured locations to facilitate an optimal correlation between spectra and pathological information. The area under the spectrum was used as a parameter to classify spectra of tumor and healthy tissue. Next, a receiver operating characteristics (ROC) analysis was performed to provide the area under the receiver operating curve (AUROC) as a measure for discriminative power. The area under the spectrum between 650 and 750 nm was used in the ROC analysis and provided AUROC values of 0.99 and 0.97, for distances of 1 mm and 2 mm between source and detector fiber, respectively. DRS can discriminate tumor from healthy oral tissue in an ex vivo setting. More specimens are needed to further evaluate this technique with component analyses and classification methods, prior to in vivo patient measurements.

Money well spent: a comparison of hospital operating margin for laparoscopic and open colectomies.

PubMed

Koopmann, M C; Harms, B A; Heise, C P

2007-10-01

Cost analysis after laparoscopic colectomy has been examined, although reports evaluating the effects of laparoscopy on hospital operating margin are lacking. We compared several cost/revenue measures, including hospital operating margin, between open and laparoscopic colectomies at an academic center. Our cost-accounting database was queried for laparoscopic partial (LPC) and total colectomies (LTC), and open partial (OPC) and total colectomies (OTC) to analyze net revenue, total costs, and total hospital operating margin over a 4-year period. Laparoscopic and open colectomy cases were compared, with mean operating margin as the primary outcome. From July, 2002 through May, 2006, 842 patients were included for analysis with 138 undergoing laparoscopic colectomy. Net revenue was higher in the LTC group compared with open (US dollars 30,300 vs US dollars 26,800 [P = .02]), and lower in the LPC group (US dollars 15,300 vs US dollars 21,300 open [P < .0001]). Total costs were reduced in both the LPC and LTC groups compared with open [US dollars 11,700 vs US dollars 17,600 [P < .0001] and US dollars 18,000 vs US dollars 19,400 [P = .0019], respectively). LPC resulted in a similar HOM (US dollars 3,602) compared with OPC (US dollars 3,647; P = .35). LTC resulted in a higher HOM (US dollars 12,300) compared with OTC (US dollars 7,400; P = .02). LTC generates a significantly higher hospital operating margin than an OTC, although the margins are similar for LPC and OPC.

Simultaneous detection of and differentiation between herpes simplex and varicella-zoster viruses with two fluorescent probes in the same test system.

PubMed

Brumback, B G; Farthing, P G; Castellino, S N

1993-12-01

Specimens from skin lesions were examined simultaneously for herpes simplex virus (HSV) and varicella-zoster virus (VZV) by direct specimen testing and shell vial culture in single-test systems. For direct testing, cells in a single specimen well were stained with a combination direct-indirect immunofluorescence stain by using two fluorescent tags. A total of 203 fresh specimens were tested in parallel. Of these, 100 specimens contained too few cells for the direct VZV comparison and 91 contained too few cells for the HSV comparison. After these specimens were eliminated, the sensitivities and specificities, respectively, of the dual direct test were 86.1 and 97.3% for HSV compared with single culture and 92.2 and 100% for VZV compared with single direct testing. Shell vial monolayers in the combined cultures were stained for both viruses by the same method. A total of 305 fresh specimens were cultured in parallel by dual- and single-culture methods. The sensitivities and specificities, respectively, of the combined culture compared with separate cultures were 100 and 98.4% for HSV and 87.9 and 99.2% for VZV. The combined methods gave a performance comparable to those of single tests, required less specimen volume, and were less costly to perform.

Assessing trace element diffusion models in fossil and sub-fossil bone

NASA Astrophysics Data System (ADS)

Suarez, C. A.; Kohn, M. J.

2012-12-01

Three different diffusion models have been proposed to explain trace element uptake during fossilization of bone: diffusion-adsorption (DA), diffusion-recrystallization (DR), and double-medium diffusion (DMD). Theoretically, differences in trace element profiles, particularly the rare earth elements (REE) and U, can discriminate among these possibilities. In this study, we tested which model best explains natural samples by analyzing trace element profiles in natural bone using laser-ablation inductively-coupled plasma mass spectrometry (LA-ICP-MS). Fossil bones ranging in age from a few ka to over 100 Ma were analyzed along traverses from the outer cortical edge to the inner marrow cavity margin. Forty major, minor and trace elements were analyzed, notably Ca, P, transition metals, Sr, Ba, REE, U, Th and Pb. Spatial and analytical resolutions were ~10 μm and ~100 ppb respectively. Many specimens show commonly observed exponential decreases in REE from the outer edge and marrow cavity, with relatively homogeneous U distributions. Yet, most significantly, specimens from American Falls (last interglacial) and Duck Point (last glacial maximum) show distinctive U plateaus adjacent to the outer and inner cortical bone margins. Whereas exponential profiles can be produced by different uptake processes, such plateaus are diagnostic of a DR mechanism. Our work is consistent with recent investigation of trace element diffusivities in modern fresh and deproteinated bone. These studies show similar diffusion rates for REE and U, so the profound disparity in U vs. REE profiles in most fossils cannot result solely from differences in volume diffusion within the context of DA and DMD. Rather, as a recrystallization front propagates into bone, the bone appears to encode changing soil water compositions with earlier vs. later compositions reflected in the bone margin vs. interior. Soil water U concentrations apparently remain nearly fixed during fossilization, whereas REE are rapidly stripped from the surrounding matrix, leading to nearly homogeneous U vs. steep REE profiles. However in our Pleistocene bones (American Falls and Duck Point), changes to U concentrations on the bone margin reveal more complex changes to boundary compositions, and eliminate both DA and DMD (alone) as the dominant mechanisms of trace element uptake. Our work reconciles disparate zoning patterns observed in fossil bone, and simplifies interpretations of soil or sediment water chemistry, but complicates U-series dating of fossils.

Scala tympani cochleostomy II: topography and histology.

PubMed

Adunka, Oliver F; Radeloff, Andreas; Gstoettner, Wolfgang K; Pillsbury, Harold C; Buchman, Craig A

2007-12-01

To assess intracochlear trauma using two different round window-related cochleostomy techniques in human temporal bones. Twenty-eight human temporal bones were included in this study. In 21 specimens, cochleostomies were initiated inferior to the round window (RW) annulus. In seven bones, cochleostomies were drilled anterior-inferior to the RW annulus. Limited cochlear implant electrode insertions were performed in 19 bones. In each specimen, promontory anatomy and cochleostomy drilling were photographically documented. Basal cochlear damage was assessed histologically and electrode insertion properties were documented in implanted bones. All implanted specimens showed clear scala tympani electrode placements regardless of cochleostomy technique. All 21 inferior cochleostomies were atraumatic. Anterior-inferior cochleostomies resulted in various degrees of intracochlear trauma in all seven bones. For atraumatic opening of the scala tympani using a cochleostomy approach, initiation of drilling should proceed from inferior to the round window annulus, with gradual progression toward the undersurface of the lumen. While cochleostomies initiated anterior-inferior to the round window annulus resulted in scala tympani opening, many of these bones displayed varying degrees of intracochlear trauma that may result in hearing loss. When intracochlear drilling is avoided, the anterior bony margin of the cochleostomy remains a significant intracochlear impediment to in-line electrode insertion.

Proliferative activity of denture-induced fibrous inflammatory hyperplasia analyzed by proliferating cell nuclear antigen labeling index.

PubMed

Coelho, C M; Zucoloto, S

1999-01-01

Denture-induced fibrous inflammatory hyperplasia (FIH) occurs around the borders of an ill-fitting denture. There has been no report in the literature concerning epithelial proliferative activity in FIH. The purpose of this study was to observe the labeling of proliferating cell nuclear antigen (PCNA) and evaluate its clinicopathologic results. The labeling index (LI) was assessed by using the PCNA, a nuclear protein synthesized mainly in the G1-S stages of the cell cycle that could be detected immunohistochemically by the monoclonal antibody PC10. The PCNA LI was assessed in FIH specimens, in clinically normal specimens 1 cm from the FIH margin (adjacent group), and in clinically normal specimens located at least 2 cm from the adjacent group; the last were considered the control group. The mean PCNA LI values in the basal, parabasal, and overall epithelial layers were similar in FIH and in the adjacent group and were significantly higher than in the control group. These data support the importance of the surgical treatment of FIH with wide excision (about 1 cm) since the clinically normal tissue around the lesion could be histologically altered.

What can be done when the cored specimen in a Frey procedure for chronic pancreatitis is reported as adenocarcinoma?

PubMed

Mahesh, S; Lekha, V; Manipadam, John Mathew; Venugopal, A; Ramesh, H

2016-11-01

The aim of this study is to analyze the outcomes of patients with chronic pancreatitis who underwent the Frey procedure and who had a histologic evidence of adenocarcinoma in the cored out specimen.The type of analysis is retrospective. Out of 523 patients who underwent Frey procedure for chronic pancreatitis, seven (five males and two females; age range 42 to 54 years) had histologically proven adenocarcinoma. In the first four cases, intraoperative frozen section was not done. The diagnosis was made on routine histopathology and only one out of four could undergo attempted curative therapy. In the remaining three cases, intraoperative frozen section confirmation was available, and curative resection performed. Only four out of seven had a clear-cut mass lesion: (a) cancer can occur in chronic pancreatitis in the absence of a mass lesion and (b) intraoperative frozen section of the cored specimen is crucial to exercising curative therapeutic options and must be performed routinely. If frozen section is reported as adenocarcinoma, a head resection with repeat frozen of the margins of resection is appropriate. If the adenocarcinoma is reported on regular histopathology after several days, then a total pancreatectomy may be more appropriate.

Fluorescence lifetime-based contrast enhancement of indocyanine green-labeled tumors

NASA Astrophysics Data System (ADS)

Kumar, Anand T. N.; Carp, Stefan A.; Yang, Jing; Ross, Alana; Medarova, Zdravka; Ran, Chongzhao

2017-04-01

Although the development of tumor-targeted fluorescent probes is a major area of investigation, it will be several years before these probes are realized for clinical use. Here, we report an approach that employs indocyanine-green (ICG), a clinically approved, nontargeted dye, in conjunction with fluorescence lifetime (FLT) detection to provide high accuracy for tumor-tissue identification in mouse models of subcutaneous human breast and brain tmors. The improved performance relies on the distinct FLTs of ICG within tumors versus tissue autofluorescence and is further aided by the well-known enhanced permeability and retention of ICG in tumors and the clearance of ICG from normal tissue several hours after intravenous injection. We demonstrate that FLT detection can provide more than 98% sensitivity and specificity, and a 10-fold reduction in error rates compared to intensity-based detection. Our studies suggest the significant potential of FLT-contrast for accurate tumor-tissue identification using ICG and other targeted probes under development, both for intraoperative imaging and for ex-vivo margin assessment of surgical specimens.

Steam Oxidation of FeCrAl and SiC in the Severe Accident Test Station (SATS)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pint, Bruce A.; Unocic, Kinga A.; Terrani, Kurt A.

2015-08-01

Numerous research projects are directed towards developing accident tolerant fuel (ATF) concepts that will enhance safety margins in light water reactors (LWR) during severe accident scenarios. In the U.S. program, the high temperature steam oxidation performance of ATF solutions has been evaluated in the Severe Accident Test Station (SATS) at Oak Ridge National Laboratory (ORNL) since 2012 [1-3] and this facility continues to support those efforts in the ATF community. Compared to the current UO2/Zr-based alloy fuel system, alternative cladding materials can offer slower oxidation kinetics and a smaller enthalpy of oxidation that can significantly reduce the rate of heatmore » and hydrogen generation in the core during a coolant-limited severe accident [4-5]. Thus, steam oxidation behavior is a key aspect of the evaluation of ATF concepts. This report summarizes recent work to measure steam oxidation kinetics of FeCrAl and SiC specimens in the SATS.« less

Biomechanical Effect of Margin Convergence Techniques: Quantitative Assessment of Supraspinatus Muscle Stiffness.

PubMed

Hatta, Taku; Giambini, Hugo; Zhao, Chunfeng; Sperling, John W; Steinmann, Scott P; Itoi, Eiji; An, Kai-Nan

2016-01-01

Although the margin convergence (MC) technique has been recognized as an option for rotator cuff repair, little is known about the biomechanical effect on repaired rotator cuff muscle, especially after supplemented footprint repair. The purpose of this study was to assess the passive stiffness changes of the supraspinatus (SSP) muscle after MC techniques using shear wave elastography (SWE). A 30 × 40-mm U-shaped rotator cuff tear was created in 8 cadaveric shoulders. Each specimen was repaired with 6 types of MC technique (1-, 2-, 3-suture MC with/without footprint repair, in a random order) at 30° glenohumeral abduction. Passive stiffness of four anatomical regions in the SSP muscle was measured based on an established SWE method. Data were obtained from the SSP muscle at 0° abduction under 8 different conditions: intact (before making a tear), torn, and postoperative conditions with 6 techniques. MC techniques using 1-, or 2-suture combined with footprint repair showed significantly higher stiffness values than the intact condition. Passive stiffness of the SSP muscle was highest after a 1-suture MC with footprint repair for all regions when compared among all repair procedures. There was no significant difference between the intact condition and a 3-suture MC with footprint repair. MC techniques with single stitch and subsequent footprint repair may have adverse effects on muscle properties and tensile loading on repair, increasing the risk of retear of repairs. Adding more MC stitches could reverse these adverse effects.

Comparative biogeochemistry-ecosystem-human interactions on dynamic continental margins

USGS Publications Warehouse

Levin, Lisa A.; Liu, Kon-Kee; Emeis, Kay-Christian; Breitburg, Denise L.; Cloern, James; Deutsch, Curtis; Giani, Michele; Goffart, Anne; Hofmann, Eileen E.; Lachkar, Zouhair; Limburg, Karin; Liu, Su-Mei; Montes, Enrique; Naqvi, Wajih; Ragueneau, Olivier; Rabouille, Christophe; Sarkar, Santosh Kumar; Swaney, Dennis P.; Wassman, Paul; Wishner, Karen F.

2014-01-01

The ocean’s continental margins face strong and rapid change, forced by a combination of direct human activity, anthropogenic CO2-induced climate change, and natural variability. Stimulated by discussions in Goa, India at the IMBER IMBIZO III, we (1) provide an overview of the drivers of biogeochemical variation and change on margins, (2) compare temporal trends in hydrographic and biogeochemical data across different margins (3) review ecosystem responses to these changes, (4) highlight the importance of margin time series for detecting and attributing change and (5) examine societal responses to changing margin biogeochemistry and ecosystems. We synthesize information over a wide range of margin settings in order to identify the commonalities and distinctions among continental margin ecosystems. Key drivers of biogeochemical variation include long-term climate cycles, CO2-induced warming, acidification, and deoxygenation, as well as sea level rise, eutrophication, hydrologic and water cycle alteration, changing land use, fishing, and species invasion. Ecosystem responses are complex and impact major margin services including primary production, fisheries production, nutrient cycling, shoreline protection, chemical buffering, and biodiversity. Despite regional differences, the societal consequences of these changes are unarguably large and mandate coherent actions to reduce, mitigate and adapt to multiple stressors on continental margins.

Comparative biogeochemistry-ecosystem-human interactions on dynamic continental margins

NASA Astrophysics Data System (ADS)

Levin, Lisa A.; Liu, Kon-Kee; Emeis, Kay-Christian; Breitburg, Denise L.; Cloern, James; Deutsch, Curtis; Giani, Michele; Goffart, Anne; Hofmann, Eileen E.; Lachkar, Zouhair; Limburg, Karin; Liu, Su-Mei; Montes, Enrique; Naqvi, Wajih; Ragueneau, Olivier; Rabouille, Christophe; Sarkar, Santosh Kumar; Swaney, Dennis P.; Wassman, Paul; Wishner, Karen F.

2015-01-01

The oceans' continental margins face strong and rapid change, forced by a combination of direct human activity, anthropogenic CO2-induced climate change, and natural variability. Stimulated by discussions in Goa, India at the IMBER IMBIZO III, we (1) provide an overview of the drivers of biogeochemical variation and change on margins, (2) compare temporal trends in hydrographic and biogeochemical data across different margins, (3) review ecosystem responses to these changes, (4) highlight the importance of margin time series for detecting and attributing change and (5) examine societal responses to changing margin biogeochemistry and ecosystems. We synthesize information over a wide range of margin settings in order to identify the commonalities and distinctions among continental margin ecosystems. Key drivers of biogeochemical variation include long-term climate cycles, CO2-induced warming, acidification, and deoxygenation, as well as sea level rise, eutrophication, hydrologic and water cycle alteration, changing land use, fishing, and species invasion. Ecosystem responses are complex and impact major margin services. These include primary production, fisheries production, nutrient cycling, shoreline protection, chemical buffering, and biodiversity. Despite regional differences, the societal consequences of these changes are unarguably large and mandate coherent actions to reduce, mitigate and adapt to multiple stressors on continental margins.

Cytomorphological identification of advanced pulmonary adenocarcinoma harboring KRAS mutation in lymph node fine-needle aspiration specimens: Comparative investigation of adenocarcinoma with KRAS and EGFR mutations.

PubMed

Song, Dae Hyun; Lee, Boram; Shin, Yooju; Choi, In Ho; Ha, Sang Yun; Lee, Jae Jun; Hong, Min Eui; Choi, Yoon-La; Han, Joungho; Um, Sang-Won

2015-07-01

Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) mutation in pulmonary adenocarcinoma is clinically important due to its association with resistance to EGFR inhibitors and poor prognosis. To our knowledge, there has not been a comparative study focusing on cytological nuclear features of pulmonary adenocarcinoma harboring KRAS mutation (KRAS-AD). Hence, we compared the cytomorphology of metastatic KRAS-AD and EGFR-positive adenocarcinoma (EGFR-AD) in aspiration specimens from lymph nodes. Forty lymph node aspiration specimens from forty KRAS-AD patients were collected at Samsung Medical Center (Seoul, Korea) from 2009 to 2013. As a control group, 40 EBUS-FNA lymph node specimens from 20 EGFR-AD patients were collected. EGFR-AD specimens were evaluated at Samsung Medical Center (Seoul, Korea) from 2012 to 2013. All 80 specimens were histologically confirmed to metastatic adenocarcinoma. Two pathologists performed a blinded review of all specimens. Compared with EGFR-AD, KRAS-AD exhibited more severe nuclear pleomorphism (P < 0.001), coarse chromatin (P = 0.001), cherry-red nucleoli (P < 0.001) and naked tumor cells (P = 0.002) with necrotic (P < 0.001) and neutrophilic (P = 0.008) background. Our study provides the first demonstration of cytomorphologic differentiation between metastatic KRAS-AD and metastatic EGFR-AD in lymph node aspiration specimens. © 2014 Wiley Periodicals, Inc.

Incidental Warthin Tumor on Pertechnetate Scintigraphy.

PubMed

Kulkarni, Mukta; Shetkar, Shubhangi; Joshi, Prathamesh; Kasaliwal, Sanket; Chaudhari, Shrikant

2016-09-01

A 30-year-old woman underwent Tc-pertechnetate scintigraphy for evaluation of thyrotoxicosis. The scintigraphy revealed hypervascular thyroid gland with markedly increased trapping function in both the lobes suggesting diagnosis of Graves disease. Incidentally, a hypervascular and pertechnetate avid focus was seen along the lateral margin of the right parotid gland. Pertechnetate avidity and site of uptake suggested possibility of Warthin tumor. Clinical examination and ultrasonography revealed a well-defined lesion in the superficial lobe of the right parotid gland favoring diagnosis of benign lesion. Postsurgery specimen confirmed diagnosis of Warthin tumor.

Through the looking glass: Basics and principles of reflectance confocal microscopy.

PubMed

Que, Syril Keena T; Fraga-Braghiroli, Naiara; Grant-Kels, Jane M; Rabinovitz, Harold S; Oliviero, Margaret; Scope, Alon

2015-08-01

Reflectance confocal microscopy (RCM) offers high-resolution, noninvasive skin imaging and can help avoid obtaining unnecessary biopsy specimens. It can also increase efficiency in the surgical setting by helping to delineate tumor margins. Diagnostic criteria and several RCM algorithms have been published for the differentiation of benign and malignant neoplasms. We provide an overview of the basic principles of RCM, characteristic RCM features of normal skin and cutaneous neoplasms, and the limitations and future directions of RCM. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The Purpose of Generating Fatigue Crack Growth Threshold Data

NASA Technical Reports Server (NTRS)

Forth, Scott

2006-01-01

Test data shows that different width and thickness C(T), M(T) and ESE(T) specimens generate different thresholds Structures designed for "infinite life" are being re-evaluated: a) Threshold changes from 6 to 3 ksi in(sup 1/2); b) Computational life changes from infinite to 4 missions. Multi-million dollar test programs required to substantiate operation. Using ASTM E647 as standard guidance to generate threshold data is not practical. A threshold test approach needs to be standardized that will provide positive margin for high cycle fatigue applications.

3D Pathology Volumetric Technique: A Method for Calculating Breast Tumour Volume from Whole-Mount Serial Section Images

PubMed Central

Clarke, G. M.; Murray, M.; Holloway, C. M. B.; Liu, K.; Zubovits, J. T.; Yaffe, M. J.

2012-01-01

Tumour size, most commonly measured by maximum linear extent, remains a strong predictor of survival in breast cancer. Tumour volume, proportional to the number of tumour cells, may be a more accurate surrogate for size. We describe a novel “3D pathology volumetric technique” for lumpectomies and compare it with 2D measurements. Volume renderings and total tumour volume are computed from digitized whole-mount serial sections using custom software tools. Results are presented for two lumpectomy specimens selected for tumour features which may challenge accurate measurement of tumour burden with conventional, sampling-based pathology: (1) an infiltrative pattern admixed with normal breast elements; (2) a localized invasive mass separated from the in situ component by benign tissue. Spatial relationships between key features (tumour foci, close or involved margins) are clearly visualized in volume renderings. Invasive tumour burden can be underestimated using conventional pathology, compared to the volumetric technique (infiltrative pattern: 30% underestimation; localized mass: 3% underestimation for invasive tumour, 44% for in situ component). Tumour volume approximated from 2D measurements (i.e., maximum linear extent), assuming elliptical geometry, was seen to overestimate volume compared to the 3D volumetric calculation (by a factor of 7x for the infiltrative pattern; 1.5x for the localized invasive mass). PMID:23320179

Assessment of Breast Specimens With or Without Calcifications in Diagnosing Malignant and Atypia for Mammographic Breast Microcalcifications Without Mass: A STARD-Compliant Diagnostic Accuracy Article.

PubMed

Cheung, Yun-Chung; Juan, Yu-Hsiang; Ueng, Shir-Hwa; Lo, Yung-Feng; Huang, Pei-Chin; Lin, Yu-Ching; Chen, Shin-Cheh

2015-10-01

Presence of microcalcifications within the specimens frequently signifies a successful attempt of stereotactic vacuum-assisted breast biopsy (VABB) in obtaining a pathologic diagnosis of the breast microcalcifications. In this study, the authors aimed to assess and compare the accuracy and consistency of calcified or noncalcified specimens obtained from same sites of sampling on isolated microcalcifications without mass in diagnosing high-risk and malignant lesions. To the best of our knowledge, an individual case-based prospective comparison has not been reported.With the approval from institutional review board of our hospital (Chang Gung Memorial Hospital), the authors retrospectively reviewed all clinical cases of stereotactic VABBs on isolated breast microcalcifications without mass from our database. The authors included those having either surgery performed or had clinical follow-up of at least 3 years for analysis. All the obtained specimens with or without calcification were identified using specimen radiographs and separately submitted for pathologic evaluation. The concordance of diagnosis was assessed for both atypia and malignant lesions.A total of 390 stereotactic VABB procedures (1206 calcified and 1456 noncalcified specimens) were collected and reviewed. The consistent rates between calcified and noncalcified specimens were low for atypia and malignant microcalcifications (44.44% in flat epithelial atypia, 46.51% in atypical ductal hyperplasia, 55.73% in ductal carcinoma in situ, and 71.42% in invasive ductal carcinoma). The discordance in VABB diagnoses indicated that 41.33% of malignant lesions would be misdiagnosed by noncalcified specimens. Furthermore, calcified specimens showed higher diagnostic accuracy of breast cancer as compared with the noncalcified specimens (91.54 % versus 69.49%, respectively). The evaluation of both noncalcified specimens and calcified specimens did not show improvement of diagnostic accuracy as compared with evaluating calcified specimens alone (91.54% versus 91.54%, respectively).The high prevalence of diagnostic discordance between the calcified and noncalcified specimens indicated the higher value of calcified specimens in diagnosing atypia and malignant microcalcifications. Noncalcified specimens did not provide additional diagnostic benefit from this study. The separation of calcified and noncalcified specimens may facilitate more focused interpretation from pathologists among the large number of specimens.

The anatomy and histology of the bicipital tunnel of the shoulder.

PubMed

Taylor, Samuel A; Fabricant, Peter D; Bansal, Manjula; Khair, M Michael; McLawhorn, Alexander; DiCarlo, Edward F; Shorey, Mary; O'Brien, Stephen J

2015-04-01

The bicipital tunnel is the extra-articular, fibro-osseous structure that encloses the long head of the biceps tendon. Twelve cadaveric shoulder specimens underwent in situ casting of the bicipital tunnel with methyl methacrylate cement to demonstrate structural competence (n = 6) and en bloc harvest with gross and histologic evaluation (n = 6). The percentage of empty tunnel was calculated histologically by subtracting the proportion of cross-sectional area of the long head of the biceps tendon from that of the bicipital tunnel for each zone. Cement casting demonstrated that the bicipital tunnel was a closed space. Zone 1 extended from the articular margin to the distal margin of the subscapularis tendon. Zone 2 extended from the distal margin of the subscapularis tendon to the proximal margin of the pectoralis major tendon. Zone 3 was the subpectoral region. Zones 1 and 2 were both enclosed by a dense connective tissue sheath and demonstrated the presence of synovium. Zone 3 had significantly greater percentage of empty tunnel than zones 1 and 2 did (P < .01). The bicipital tunnel is a closed space with 3 distinct zones. Zones 1 and 2 have similar features, including the presence of synovium, but differ from zone 3. A significant bottleneck occurs between zone 2 and zone 3, most likely at the proximal margin of the pectoralis major tendon. The bicipital tunnel is a closed space where space-occupying lesions may produce a bicipital tunnel syndrome. Careful consideration should be given to surgical techniques that decompress both zones 1 and 2 of the bicipital tunnel. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Effect of investment type and mold temperature on casting accuracy and titanium-ceramic bond.

PubMed

Leal, Mônica Barbosa; Pagnano, Valéria Oliveira; Bezzon, Osvaldo Luiz

2013-01-01

This study evaluated the casting accuracy of crown margins and metal-ceramic shear bond strength (SBS) of pure titanium injected into casting molds made using 2 investment types at 3 mold temperatures. Sixty crown (30-degree beveled finish line) and 60 cylinder (5mm diameter × 8mm high) patterns were divided into 6 groups (n=10), and cast using a phosphate-bonded investment (P) and a magnesium oxide-bonded investment (U), at 400°C (groups P400 and U400), 550°C (groups P550 and U550) and 700°C (groups P700 and U700) mold temperatures. Crown margins were recorded in impression material, the degree of marginal rounding was measured and margin length deficiencies (µm) were calculated. Titanium-ceramic specimens were prepared using Triceram ceramic (2mm high) and SBS was tested. Failure modes were assessed by optical microscopy. Data were subjected to two-way ANOVA and Tukey's HSD test (α=0.05). For casting accuracy, expressed by marginal deficiency (µm), investment U provided more accurate results (64 ± 11) than P (81 ± 23) (p<0.001). The increase in temperature resulted in different effects for the tested investments (p<0.001), as it provided better casting accuracy for U700 (55 ± 7) and worse for P700 (109 ± 18). Casting accuracy at 700°C (82 ± 31) was significantly different from 400°C (69 ± 9) and 550°C (68 ± 9) (p<0.05). For SBS, there was no significant differences among the groups for factors investment (p=0.062) and temperature (p=0.224), or for their interaction (p=0.149). Investment U provided better casting accuracy than investment P. The SBS was similar for all combinations of investments and temperatures.

A simulation study of spectral Čerenkov luminescence imaging for tumour margin estimation

NASA Astrophysics Data System (ADS)

Calvert, Nick; Helo, Yusef; Mertzanidou, Thomy; Tuch, David S.; Arridge, Simon R.; Stoyanov, Danail

2017-03-01

Breast cancer is the most common cancer in women in the world. Breast-conserving surgery (BCS) is a standard surgical treatment for breast cancer with the key objective of removing breast tissue, maintaining a negative surgical margin and providing a good cosmetic outcome. A positive surgical margin, meaning the presence of cancerous tissues on the surface of the breast specimen after surgery, is associated with local recurrence after therapy. In this study, we investigate a new imaging modality based on Cerenkov luminescence imaging (CLI) for the purpose of detecting positive surgical margins during BCS. We develop Monte Carlo (MC) simulations using the Geant4 nuclear physics simulation toolbox to study the spectrum of photons emitted given 18F-FDG and breast tissue properties. The resulting simulation spectra show that the CLI signal contains information that may be used to estimate whether the cancerous cells are at a depth of less than 1 mm or greater than 1 mm given appropriate imaging system design and sensitivity. The simulation spectra also show that when the source is located within 1 mm of the surface, the tissue parameters are not relevant to the model as the spectra do not vary significantly. At larger depths, however, the spectral information varies significantly with breast optical parameters, having implications for further studies and system design. While promising, further studies are needed to quantify the CLI response to more accurately incorporate tissue specific parameters and patient specific anatomical details.

Evaluating the Effect of Margin Consensus Guideline Publication on Operative Patterns and Financial Impact of Breast Cancer Operation.

PubMed

Bhutiani, Neal; Mercer, Megan K; Bachman, Katelynn C; Heidrich, Samantha R; Martin, Robert C G; Scoggins, Charles R; McMasters, Kelly M; Ajkay, Nicolás

2018-02-09

This study sought to evaluate re-excision rates, patient satisfaction with their breasts, and healthcare costs before and after publication of 2014 Society of Surgical Oncology/American Society of Radiation Oncology consensus guideline on margins for breast conserving operation with whole-breast irradiation for stage I and II breast cancer at an academic institution. Patients with stage I and II invasive carcinomas who underwent partial mastectomy were divided into 2 groups based on whether they were treated before (PRE) or after (POST) guideline publication in March 2014. Groups were compared with respect to re-excision rates, conversion to mastectomy, specimen volumes, mean cost per patient of surgical care, and prospectively collected patient post-procedure quality of life. A total of 237 patients who underwent partial mastectomy were examined (n = 126 in the PRE group and n = 111 in the POST group). Patients in the POST group were less likely to require re-excision (9% POST vs 37% PRE; p < 0.001) and were less likely to undergo conversion to mastectomy (5% POST vs 14% PRE; p = 0.02). After consensus guideline publication, mean operative cost per patient decreased ($4,874 POST vs $5,772 PRE; p < 0.001), and patients had improved breast quality of life scores (77 out of 100 POST vs 61 out of 100 PRE; p = 0.03). On multivariable analysis, publication of the consensus statement was an independent predictor of decreased re-excision rates (odds ratio 0.17; 95% CI 0.08 to 0.38; p < 0.001) and operative cost per patient (odds ratio 0.14; 95% CI 0.78 to 0.30; p < 0.001). Widespread implementation of the consensus guideline on margins for breast conserving operation will likely lead to the intended improvements in operative and financial outcomes, as well as patient satisfaction with breast conserving operation. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Tumor resection at the pelvis using three-dimensional planning and patient-specific instruments: a case series.

PubMed

Jentzsch, Thorsten; Vlachopoulos, Lazaros; Fürnstahl, Philipp; Müller, Daniel A; Fuchs, Bruno

2016-09-21

Sarcomas are associated with a relatively high local recurrence rate of around 30 % in the pelvis. Inadequate surgical margins are the most important reason. However, obtaining adequate margins is particularly difficult in this anatomically demanding region. Recently, three-dimensional (3-D) planning, printed models, and patient-specific instruments (PSI) with cutting blocks have been introduced to improve the precision during surgical tumor resection. This case series illustrates these modern 3-D tools in pelvic tumor surgery. The first consecutive patients with 3-D-planned tumor resection around the pelvis were included in this retrospective study at a University Hospital in 2015. Detailed information about the clinical presentation, imaging techniques, preoperative planning, intraoperative surgical procedures, and postoperative evaluation is provided for each case. The primary outcome was tumor-free resection margins as assessed by a postoperative computed tomography (CT) scan of the specimen. The secondary outcomes were precision of preoperative planning and complications. Four patients with pelvic sarcomas were included in this study. The mean follow-up was 7.8 (range, 6.0-9.0) months. The combined use of preoperative planning with 3-D techniques, 3-D-printed models, and PSI for osteotomies led to higher precision (maximal (max) error of 0.4 centimeters (cm)) than conventional 3-D planning and freehand osteotomies (max error of 2.8 cm). Tumor-free margins were obtained where measurable (n = 3; margins were not assessable in a patient with curettage). Two insufficiency fractures were noted postoperatively. Three-dimensional planning as well as the intraoperative use of 3-D-printed models and PSI are valuable for complex sarcoma resection at the pelvis. Three-dimensionally printed models of the patient anatomy may help visualization and precision. PSI with cutting blocks help perform very precise osteotomies for adequate resection margins.

Cyclic Strain Resistance, Stress Response, Fatigue Life, and Fracture Behavior of High Strength Low Alloy Steel 300 M

NASA Astrophysics Data System (ADS)

Manigandan, K.; Srivatsan, T. S.; Tammana, Deepthi; Poorgangi, Behrang; Vasudevan, Vijay K.

2014-05-01

The focus of this technical manuscript is a record of the specific role of microstructure and test specimen orientation on cyclic stress response, cyclic strain resistance, and cyclic stress versus strain response, deformation and fracture behavior of alloy steel 300 M. The cyclic strain amplitude-controlled fatigue properties of this ultra-high strength alloy steel revealed a linear trend for the variation of log elastic strain amplitude with log reversals-to-failure, and log plastic strain amplitude with log reversals-to-failure for both longitudinal and transverse orientations. Test specimens of the longitudinal orientation showed only a marginal improvement over the transverse orientation at equivalent values of plastic strain amplitude. Cyclic stress response revealed a combination of initial hardening for the first few cycles followed by gradual softening for a large portion of fatigue life before culminating in rapid softening prior to catastrophic failure by fracture. Fracture characteristics of test specimens of this alloy steel were different at both the macroscopic and fine microscopic levels over the entire range of cyclic strain amplitudes examined. Both macroscopic and fine microscopic observations revealed fracture to be a combination of both brittle and ductile mechanisms. The underlying mechanisms governing stress response, deformation characteristics, fatigue life, and final fracture behavior are presented and discussed in light of the competing and mutually interactive influences of test specimen orientation, intrinsic microstructural effects, deformation characteristics of the microstructural constituents, cyclic strain amplitude, and response stress.

New record of Japanese snake blenny Xiphasia matsubarai (Perciformes: Blenniidae) from South China Sea

NASA Astrophysics Data System (ADS)

Yi, Murong; Zhao, Chunxu; Su, Xin; Tao, Yajin; Yan, Yunrong

2017-11-01

Specimens belonging to the family Blenniidae were collected in a fishery resource investigation from the coastal waters of Xisha Islands and Hainan Island, South China Sea in 2016. Combining morphological results with sequence analysis, we identified one specimen as Xiphasia matsubarai Okada & Suzuki, 1952. This represents a new record in the South China Sea. In morphology, the specimen has the following traits: body elongated, eel-like or ribbon-like in shape; flanks medium flat; the head small bluntly rounded anteriorly and without a moustache; eyes is slightly smaller, on upper lateral position of head, which is about equal to 1/5 of the length of the head; body without scales, lateral line has been degraded; both sides of the upper and lower jaws with a canine; gill is opening at the top of the pectoral fin base, approximately equal to the length of eye diameter. Dorsal fin XI, 96; pectoral fin 10; anal fin II, 95. Head and body grey-brown, including 26 dark grey-brown bands; abdomen and lower operculum yellowish grey and colour lighter; and dorsal base long with dark grey. Origin of dorsal is located over the anterior margin of pupil; black blotch on dorsal fin between 8th and 10th dorsal spine; anal and caudal fins dark grey, pectoral and ventral fins pale yellow. Sequence analysis of cytochrome oxidase subunit I gene (COI) strongly supports the identity of the specimen as X. matsubarai.

Beyond Wires and Seeds: Reflector-guided Breast Lesion Localization and Excision.

PubMed

Mango, Victoria L; Wynn, Ralph T; Feldman, Sheldon; Friedlander, Lauren; Desperito, Elise; Patel, Sejal N; Gomberawalla, Ameer; Ha, Richard

2017-08-01

Purpose To evaluate outcomes of Savi Scout (Cianna Medical, Aliso Viejo, Calif) reflector-guided localization and excision of breast lesions by analyzing reflector placement, localization, and removal, along with target excision and rates of repeat excision (referred to as re-excision). Materials and Methods A single-institution retrospective review of 100 women who underwent breast lesion localization and excision by using the Savi Scout surgical guidance system from June 2015 to May 2016 was performed. By using image guidance 0-8 days before surgery, 123 nonradioactive, infrared-activated, electromagnetic wave reflectors were percutaneously inserted adjacent to or within 111 breast targets. Twenty patients had two or three reflectors placed for bracketing or for localizing multiple lesions, and when ipsilateral, they were placed as close as 2.6 cm apart. Target and reflector were localized intraoperatively by one of two breast surgeons who used a handpiece that emitted infrared light and electromagnetic waves. Radiographs of the specimen and pathologic analysis helped verify target and reflector removal. Target to reflector distance was measured on the mammogram and radiograph of the specimen, and reflector depth was measured on the mammogram. Pathologic analysis was reviewed. Re-excision rates and complications were recorded. By using statistics software, descriptive statistics were generated with 95% confidence intervals (CIs) calculated. Results By using sonographic (40 of 123; 32.5%; 95% CI: 24.9%, 41.2%) or mammographic (83 of 123; 67.5%; 95% CI: 58.8% 75.1%) guidance, 123 (100%; 95% CI: 96.4%, 100%) reflectors were placed. Mean mammographic target to reflector distance was 0.3 cm. All 123 (100%; 95% CI: 96.4%, 100%) targets and reflectors were excised. Pathologic analysis yielded 54 of 110 malignancies (49.1%; 95% CI: 39.9%, 58.3%; average, 1.0 cm; range, 0.1-5 cm), 32 high-risk lesions (29.1%; 95% CI: 21.4%, 38.2%), and 24 benign lesions (21.8%; 95% CI: 115.1%, 30.4%). Four of 54 malignant cases (7.4%; 95% CI: 2.4%, 18.1%) demonstrated margins positive for cancer that required re-excision. Five of 110 radiographs of the specimen (4.5%; 95% CI: 1.7%, 10.4%) demonstrated increased distance between the target and reflector distance of greater than 1.0 cm (range, 1.1-2.6 cm) compared with postprocedure mammogram the day of placement, three of five were associated with hematomas, two of five migrated without identifiable cause. No related postoperative complications were identified. Conclusion Savi Scout is an accurate, reliable method to localize and excise breast lesions with acceptable margin positivity and re-excision rates. Bracketing is possible with reflectors as close as 2.6 cm. Savi Scout overcomes many limitations of other localization methods, which warrants further study. © RSNA, 2017.

Comparison of the effects of friction varnish and electroforming on the retention of telescopic crowns.

PubMed

Özyemişci-Cebeci, Nuran; Yavuzyilmaz, Hüsnü

2013-06-01

Methods to improve the retention of telescopic crowns, including the application of friction varnish and electroforming, are available. However, information about their efficiency is limited. The purpose of this study was to compare the influence of 2 different friction varnishes and an electroforming method on the retention of telescopic crowns. Thirty inner and outer crowns were fabricated from cobalt-chromium-molybdenum alloy having lengths and cervical diameters of 6 mm, 2-degree tapers, and shoulder margins of 1 mm. Fifty-μm thick layers were removed from the internal surfaces of the outer crowns with a vertical machining center to simulate wear. The retentive forces of these specimens were measured with a testing machine. FGP friction varnish (FGP Friction-Fit-System), SD friction varnish (Servo-dental), and an electroforming method (GES\\Gold Electroforming System) were applied to the specimens. After the application of the 3 methods, retention values were measured, and the results analyzed with 1-way ANOVA, paired sample t test (α=.05). The increase in the retentive forces of all specimens was statistically significant (P<.01). The mean retentive forces increased from 3.6 N to 9.8 N for group FGP, 3.6 N to 4.6 N for group SD, and 3.7 N to 6.0 N for group EF. Group FGP was significantly different from group SD and group EF (P<.05), and no significant difference was observed between group SD and group EF. Mean standard deviation values of retentive forces for group FGP before, FGP after, SD before, SD after, EF before and EF after is 0.5, 2.7, 0.6, 1.3, 0.8, 2.3, respectively. Group FGP showed the maximum retention values. Group EF showed higher retention values than group SD. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Use of polymerase chain reaction for the detection of Chlamydia trachomatis in ocular and nasopharyngeal specimens from infants with conjunctivitis.

PubMed

Hammerschlag, M R; Roblin, P M; Gelling, M; Tsumura, N; Jule, J E; Kutlin, A

1997-03-01

Chlamydia trachomatis is the most common identifiable infectious cause of neonatal conjunctivitis. Nonculture tests including enzyme immunoassays and direct fluorescent antibody tests have been shown to perform well for the diagnosis of chlamydial conjunctivitis with sensitivities and specificities > or = 90%. However, the performance with respiratory specimens has been less than satisfactory. We compared a new, commercially available polymerase chain reaction (PCR) assay, Roche AMPLICOR (Roche Diagnostic Systems, Branchburg, NJ) with culture for the detection of C. trachomatis in conjunctival and nasopharyngeal specimens from infants with conjunctivitis. We also evaluated AMPLICOR for the detection of C. trachomatis in the urine of mothers of positive infants. Ocular and nasopharyngeal specimens from 75 infants with conjunctivitis were obtained for culture and PCR. AMPLICOR was equivalent to culture for eye specimens and more sensitive than culture for nasopharyngeal specimens. The sensitivity, specificity and positive and negative predictive values of PCR compared with culture for conjunctival specimens were 92.3, 100, 100 and 98.4%, respectively. The sensitivity, specificity and positive and negative predictive values for nasopharyngeal specimens were 100, 97.2, 60 and 100%, respectively. We also detected C. trachomatis by PCR in the urine of 12 mothers of culture positive infants. PCR performed comparably to culture for detection of C. trachomatis in conjunctival and nasopharyngeal specimens from infants with conjunctivitis.

High-strain rate tensile characterization of graphite platelet reinforced vinyl ester based nanocomposites using split-Hopkinson pressure bar

NASA Astrophysics Data System (ADS)

Pramanik, Brahmananda

The dynamic response of exfoliated graphite nanoplatelet (xGnP) reinforced and carboxyl terminated butadiene nitrile (CTBN) toughened vinyl ester based nanocomposites are characterized under both dynamic tensile and compressive loading. Dynamic direct tensile tests are performed applying the reverse impact Split Hopkinson Pressure Bar (SHPB) technique. The specimen geometry for tensile test is parametrically optimized by Finite Element Analysis (FEA) using ANSYS Mechanical APDLRTM. Uniform stress distribution within the specimen gage length has been verified using high-speed digital photography. The on-specimen strain gage installation is substituted by a non-contact Laser Occlusion Expansion Gage (LOEG) technique for infinitesimal dynamic tensile strain measurements. Due to very low transmitted pulse signal, an alternative approach based on incident pulse is applied for obtaining the stress-time history. Indirect tensile tests are also performed combining the conventional SHPB technique with Brazilian disk test method for evaluating cylindrical disk specimens. The cylindrical disk specimen is held snugly in between two concave end fixtures attached to the incident and transmission bars. Indirect tensile stress is estimated from the SHPB pulses, and diametrical transverse tensile strain is measured using LOEG. Failure diagnosis using high-speed digital photography validates the viability of utilizing this indirect test method for characterizing the tensile properties of the candidate vinyl ester based nanocomposite system. Also, quasi-static indirect tensile response agrees with previous investigations conducted using the traditional dog-bone specimen in quasi-static direct tensile tests. Investigation of both quasi-static and dynamic indirect tensile test responses show the strain rate effect on the tensile strength and energy absorbing capacity of the candidate materials. Finally, the conventional compressive SHPB tests are performed. It is observed that both strength and energy absorbing capacity of these candidate material systems are distinctively less under dynamic tension than under compressive loading. Nano-reinforcement appears to marginally improve these properties for pure vinyl ester under dynamic tension, although it is found to be detrimental under dynamic compression.

Perinatal Specimens of Saurolophus angustirostris (Dinosauria: Hadrosauridae), from the Upper Cretaceous of Mongolia

PubMed Central

Dewaele, Leonard; Tsogtbaatar, Khishigjav; Barsbold, Rinchen; Garcia, Géraldine; Stein, Koen; Escuillié, François; Godefroit, Pascal

2015-01-01

Background The Late Cretaceous Nemegt Formation, Gobi Desert, Mongolia has already yielded abundant and complete skeletons of the hadrosaur Saurolophus angustirostris, from half-grown to adult individuals. Methodology/Principal Findings Herein we describe perinatal specimens of Saurolophus angustirostris, associated with fragmentary eggshell fragments. The skull length of these babies is around 5% that of the largest known S. angustirostris specimens, so these specimens document the earliest development stages of this giant hadrosaur and bridge a large hiatus in our knowledge of the ontogeny of S. angustirostris. Conclusions/Significance The studied specimens are likely part of a nest originally located on a riverbank point bar. The perinatal specimens were buried by sediment carried by the river current presumably during the wet summer season. Perinatal bones already displayed diagnostic characters for Saurolophus angustirostris, including premaxillae with a strongly reflected oral margin and upturned premaxillary body in lateral aspect. The absence of a supracranial crest and unfused halves of the cervical neural arches characterize the earliest stages in the ontogeny of S. angustirostris. The eggshell fragments associated with the perinatal individuals can be referred to the Spheroolithus oogenus and closely resemble those found in older formations (e.g. Barun Goyot Fm in Mongolia) or associated with more basal hadrosauroids (Bactrosaurus-Gilmoreosaurus in the Iren Dabasu Fm, Inner Mongolia, China). This observation suggests that the egg microstructure was similar in basal hadrosauroids and more advanced saurolophines. Competing Interests One of the authors (FE) is employed by the commercial organization Eldonia. Eldonia provided support in the form of a salary for FE, but did not have any additional role or influence in the study design, data collection and analysis, decision to publish, or preparation of the manuscript and it does not alter the authors’ adherence to all the PLoS ONE policies on sharing data and materials. PMID:26466354

Comparison of marginal and internal adaptation of copings fabricated from three different fabrication techniques: An in vitro study.

PubMed

Arora, Aman; Yadav, Avneet; Upadhyaya, Viram; Jain, Prachi; Verma, Mrinalini

2018-01-01

The purpose of this study was to compare the marginal and internal adaptation of cobalt-chromium (Co-Cr) copings fabricated from conventional wax pattern, three-dimensional (3D)-printed resin pattern, and laser sintering technique. A total of thirty copings were made, out of which ten copings were made from 3D-printed resin pattern (Group A), ten from inlay wax pattern (Group B), and ten copings were obtained from direct metal laser sintering (DMLS) technique (Group C). All the thirty samples were seated on their respective dies and sectioned carefully using a laser jet cutter and were evaluated for marginal and internal gaps at the predetermined areas using a stereomicroscope. The values were then analyzed using one-way ANOVA test and post hoc Bonferroni test. One-way ANOVA showed lowest mean marginal discrepancy for DMLS and highest value for copings fabricated from inlay wax. The values for internal discrepancy were highest for DMLS (169.38) and lowest for 3D-printed resin pattern fabricated copings (133.87). Post hoc Bonferroni test for both marginal and internal discrepancies showed nonsignificant difference when Group A was compared to Group B ( P > 0.05) and significant when Group A was compared with Group C ( P < 0.05). Group B showed significant difference ( P < 0.05) when compared with Group C. Marginal and internal discrepancies of all the three casting techniques were within clinically acceptable values. Marginal fit of DMLS was superior as compared to other two techniques, whereas when internal fit was evaluated, conventional technique showed the best internal fit.

Comparative Evaluation of Marginal Accuracy of a Cast Fixed Partial Denture Compared to Soldered Fixed Partial Denture Made of Two Different Base Metal Alloys and Casting Techniques: An In vitro Study.

PubMed

Jei, J Brintha; Mohan, Jayashree

2014-03-01

The periodontal health of abutment teeth and the durability of fixed partial denture depends on the marginal adaptation of the prosthesis. Any discrepancy in the marginal area leads to dissolution of luting agent and plaque accumulation. This study was done with the aim of evaluating the accuracy of marginal fit of four unit crown and bridge made up of Ni-Cr and Cr-Co alloys under induction and centrifugal casting. They were compared to cast fixed partial denture (FPD) and soldered FPD. For the purpose of this study a metal model was fabricated. A total of 40 samples (4-unit crown and bridge) were prepared in which 20 Cr-Co samples and 20 Ni-Cr samples were fabricated. Within these 20 samples of each group 10 samples were prepared by induction casting technique and other 10 samples with centrifugal casting technique. The cast FPD samples obtained were seated on the model and the samples were then measured with travelling microscope having precision of 0.001 cm. Sectioning of samples was done between the two pontics and measurements were made, then the soldering was made with torch soldering unit. The marginal discrepancy of soldered samples was measured and all findings were statistically analysed. The results revealed minimal marginal discrepancy with Cr-Co samples when compared to Ni-Cr samples done under induction casting technique. When compared to cast FPD samples, the soldered group showed reduced marginal discrepancy.

Chronobiology of deep-water decapod crustaceans on continental margins.

PubMed

Aguzzi, Jacopo; Company, Joan B

2010-01-01

Species have evolved biological rhythms in behaviour and physiology with a 24-h periodicity in order to increase their fitness, anticipating the onset of unfavourable habitat conditions. In marine organisms inhabiting deep-water continental margins (i.e. the submerged outer edges of continents), day-night activity rhythms are often referred to in three ways: vertical water column migrations (i.e. pelagic), horizontal displacements within benthic boundary layer of the continental margin, along bathymetric gradients (i.e. nektobenthic), and endobenthic movements (i.e. rhythmic emergence from the substrate). Many studies have been conducted on crustacean decapods that migrate vertically in the water column, but much less information is available for other endobenthic and nektobenthic species. Also, the types of displacement and major life habits of most marine species are still largely unknown, especially in deep-water continental margins, where steep clines in habitat factors (i.e. light intensity and its spectral quality, sediment characteristics, and hydrography) take place. This is the result of technical difficulties in performing temporally scheduled sampling and laboratory testing on living specimens. According to this scenario, there are several major issues that still need extensive research in deep-water crustacean decapods. First, the regulation of their behaviour and physiology by a biological clock is almost unknown compared to data for coastal species that are easily accessible to direct observation and sampling. Second, biological rhythms may change at different life stages (i.e. size-related variations) or at different moments of the reproductive cycle (e.g. at egg-bearing) based on different intra- and interspecific interactions. Third, there is still a major lack of knowledge on the links that exist among the observed bathymetric distributions of species and selected autoecological traits that are controlled by their biological clock, such as the diel rhythm of behaviour. Species evolved in a photically variable environment where intra- and inter-specific interactions change along with the community structure over 24 h. Accordingly, the regulation of their biology through a biological clock may be the major evolutionary constraint that is responsible for their reported bathymetric distributions. In this review, our aim is to propose a series of innovative guidelines for a discussion of the modulation of behavioural rhythms of adult decapod crustaceans, focusing on the deep waters of the continental margin areas of the Mediterranean as a paradigm for other marine zones of the world. Copyright © 2010 Elsevier Ltd. All rights reserved.

The marginal fit of E.max Press and E.max CAD lithium disilicate restorations: A critical review.

PubMed

Mounajjed, Radek; M Layton, Danielle; Azar, Basel

2016-12-01

This critical review aimed to assess the vertical marginal gap that was present when E.max lithium disilicate-based restoration (Press and CAD) are fabricated in-vitro. Published articles reporting vertical marginal gap measurements of in-vitro restorations that had been fabricated from E.Max lithium disilicate were sought with an electronic search of MEDLINE (PubMed) and hand search of selected dental journals. The outcomes were reviewed qualitatively. The majority of studies that compared the marginal fit of E.max press and E.max CAD restorations, found that the E.max lithium disilicate restorations fabricated with the press technique had significantly smaller marginal gaps than those fabricated with CAD technique. This research indicates that E.max lithium disilicate restorations fabricated with the press technique have measurably smaller marginal gaps when compared with those fabricated with CAD techniques within in-vitro environments. The marginal gaps achieved by the restorations across all groups were within a clinically acceptable range.

Fluorescence Confocal Microscopy for Ex Vivo Diagnosis of Conjunctival Tumors: A Pilot Study.

PubMed

Iovieno, Alfonso; Longo, Caterina; De Luca, Mariacarla; Piana, Simonetta; Fontana, Luigi; Ragazzi, Moira

2016-08-01

To evaluate the potential use of fluorescence confocal microscopy (FCM) for ex vivo diagnosis and excision margin assessment of conjunctival neoplasms. Validity study. setting: Single institution. Consecutive patients with clinically suspicious conjunctival lesions. Conjunctival lesions were excised in toto using a standard "no-touch technique" by a single surgeon (A.I.). Collected specimens were examined with a commercially available laser scanning fluorescence confocal microscope after immersion in a 0.6 mM solution of acridine orange dye for 10-20 seconds. Specimens were subsequently processed with standard histologic analysis. FCM diagnosis of the nature and extension of conjunctival lesions. Sixteen consecutive patients were included in the study (11 male, 5 female; mean age 58.1 ± 26.1 years, range 10-90 years). The median time needed to process and analyze a sample with FCM was 15 minutes. Eleven of 16 lesions were identified by FCM as squamous (2 benign papillomas, 2 grade 2 conjunctival intraepithelial neoplasias, 7 in situ squamous carcinomas) and 5 as nonsquamous (1 pingueculum, 1 dermolipoma, 2 melanocytic nevi, 1 melanoma). In all cases FCM was able to detect horizontal and vertical extension of the lesion. All FCM findings were confirmed by corresponding subsequent histologic examination. FCM provides a fast ex vivo preliminary diagnosis of suspicious conjunctival lesions with good histologic details and margin assessment, and may represent a novel tool for intraoperative and postsurgical management of conjunctival tumors. This is the first study to investigate ex vivo FCM application in ophthalmology. Copyright © 2016 Elsevier Inc. All rights reserved.

Overcoming sampling depth variations in the analysis of broadband hyperspectral images of breast tissue (Conference Presentation)

NASA Astrophysics Data System (ADS)

Kho, Esther; de Boer, Lisanne L.; Van de Vijver, Koen K.; Sterenborg, Henricus J. C. M.; Ruers, Theo J. M.

2017-02-01

Worldwide, up to 40% of the breast conserving surgeries require additional operations due to positive resection margins. We propose to reduce this percentage by using hyperspectral imaging for resection margin assessment during surgery. Spectral hypercubes were collected from 26 freshly excised breast specimens with a pushbroom camera (900-1700nm). Computer simulations of the penetration depth in breast tissue suggest a strong variation in sampling depth ( 0.5-10 mm) over this wavelength range. This was confirmed with a breast tissue mimicking phantom study. Smaller penetration depths are observed in wavelength regions with high water and/or fat absorption. Consequently, tissue classification based on spectral analysis over the whole wavelength range becomes complicated. This is especially a problem in highly inhomogeneous human tissue. We developed a method, called derivative imaging, which allows accurate tissue analysis, without the impediment of dissimilar sampling volumes. A few assumptions were made based on previous research. First, the spectra acquired with our camera from breast tissue are mainly shaped by fat and water absorption. Second, tumor tissue contains less fat and more water than healthy tissue. Third, scattering slopes of different tissue types are assumed to be alike. In derivative imaging, the derivatives are calculated of wavelengths a few nanometers apart; ensuring similar penetration depths. The wavelength choice determines the accuracy of the method and the resolution. Preliminary results on 3 breast specimens indicate a classification accuracy of 93% when using wavelength regions characterized by water and fat absorption. The sampling depths at these regions are 1mm and 5mm.

A Prospective, Single Arm, Multi-site, Clinical Evaluation of a Nonradioactive Surgical Guidance Technology for the Location of Nonpalpable Breast Lesions during Excision.

PubMed

Cox, Charles E; Russell, Scott; Prowler, Vanessa; Carter, Ebonie; Beard, Abby; Mehindru, Ankur; Blumencranz, Peter; Allen, Kathleen; Portillo, Michael; Whitworth, Pat; Funk, Kristi; Barone, Julie; Norton, Denise; Schroeder, Jerome; Police, Alice; Lin, Erin; Combs, Freddie; Schnabel, Freya; Toth, Hildegard; Lee, Jiyon; Anglin, Beth; Nguyen, Minh; Canavan, Lynn; Laidley, Alison; Warden, Mary Jane; Prati, Ronald; King, Jeff; Shivers, Steven C

2016-10-01

This study was a multicenter evaluation of the SAVI SCOUT(®) breast localization and surgical guidance system using micro-impulse radar technology for the removal of nonpalpable breast lesions. The study was designed to validate the results of a recent 50-patient pilot study in a larger multi-institution trial. The primary endpoints were the rates of successful reflector placement, localization, and removal. This multicenter, prospective trial enrolled patients scheduled to have excisional biopsy or breast-conserving surgery of a nonpalpable breast lesion. From March to November 2015, 154 patients were consented and evaluated by 20 radiologists and 16 surgeons at 11 participating centers. Patients had SCOUT(®) reflectors placed up to 7 days before surgery, and placement was confirmed by mammography or ultrasonography. Implanted reflectors were detected by the SCOUT(®) handpiece and console. Presence of the reflector in the excised surgical specimen was confirmed radiographically, and specimens were sent for routine pathology. SCOUT(®) reflectors were successfully placed in 153 of 154 patients. In one case, the reflector was placed at a distance from the target that required a wire to be placed. All 154 lesions and reflectors were successfully removed during surgery. For 101 patients with a preoperative diagnosis of cancer, 86 (85.1 %) had clear margins, and 17 (16.8 %) patients required margin reexcision. SCOUT(®) provides a reliable and effective alternative method for the localization and surgical excision of nonpalpable breast lesions using no wires or radioactive materials, with excellent patient, radiologist, and surgeon acceptance.

Evaluation of the amount of excess cement around the margins of cement-retained dental implant restorations: the effect of the cement application method.

PubMed

Chee, Winston W L; Duncan, Jesse; Afshar, Manijeh; Moshaverinia, Alireza

2013-04-01

Complete removal of excess cement from subgingival margins after cementation of implant-supported restorations has been shown to be unpredictable. Remaining cement has been shown to be associated with periimplant inflammation and bleeding. The purpose of this study was to investigate and compare the amount of excess cement after cementation with 4 different methods of cement application for cement-retained implant-supported restorations. Ten implant replicas/abutments (3i) were embedded in acrylic resin blocks. Forty complete veneer crowns (CVCs) were fabricated by waxing onto the corresponding plastic waxing sleeves. The wax patterns were cast and the crowns were cemented to the implant replicas with either an interim (Temp Bond) or a definitive luting agent (FujiCEM). Four methods of cement application were used for cementation: Group IM-Cement applied on the internal marginal area of the crown only; Group AH-Cement applied on the apical half of the axial walls of the crown; Group AA-Cement applied to all axial walls of the interior surface of the crown, excluding the occlusal surface; and Group PI-Crown filled with cement then seated on a putty index formed to the internal configuration of the restoration (cementation device) (n=10). Cement on the external surfaces was removed before seating the restoration. Cement layers were applied on each crown, after which the crown was seated under constant load (80 N) for 10 minutes. The excess cement from each specimen was collected and measured. One operator performed all the procedures. Results for the groups were compared, with 1 and 2-way ANOVA and the Tukey multiple range test (α=.05). No significant difference in the amount of excess/used cement was observed between the 2 different types of cements (P=.1). Group PI showed the least amount of excess cement in comparison to other test groups (P=.031). No significant difference was found in the amount of excess cement among groups MI, AH, and AA. Group AA showed the highest amount of excess cement. The volume of cement used for group PI specimens was significantly higher than for those in the other groups (P=.001). With respect to the volume of cement loaded into the test crowns no statistically significant difference was observed among other test groups (groups IM, AH, and AA). Group MI used the least amount of cement, followed by group AH and AA. No correlation between the amount of used cement and the amount of excess cement was found in any of the tested groups. Within the limitations of this in vitro study, the least amount of excess cement was present when a cementation device was used to displace the excess cement before seating the crown on the abutment (Group PI). With this technique a uniform layer of the luting agent is distributed over the internal surface of the crown leaving minimal excess cement when the restoration is seated. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Nitric oxide synthase 2 (NOS2) expression in histologically normal margins of oral squamous cell carcinoma

PubMed Central

Itoiz, María E.; Guiñazú, Natalia; Piccini, Daniel; Gea, Susana; López-de Blanc, Silvia

2014-01-01

The activity of Nitric Oxide Synthase 2 (NOS2) was found in oral squamous cell carcinomas (OSCC) but not in normal mucosa. Molecular changes associated to early carcinogenesis have been found in mucosa near carcinomas, which is considered a model to study field cancerization. The aim of the present study is to analyze NOS2 expression at the histologically normal margins of OSCC. Study Design: Eleven biopsy specimens of OSCC containing histologically normal margins (HNM) were analyzed. Ten biopsies of normal oral mucosa were used as controls. The activity of NOS2 was determined by immunohistochemistry. Salivary nitrate and nitrite as well as tobacco and alcohol consumption were also analyzed. The Chi-squared test was applied. Results: Six out of the eleven HNM from carcinoma samples showed positive NOS2 activity whereas all the control group samples yielded negative (p=0.005). No statistically significant association between enzyme expression and tobacco and/or alcohol consumption and salivary nitrate and nitrite was found. Conclusions: NOS2 expression would be an additional evidence of alterations that may occur in a state of field cancerization before the appearance of potentially malignant morphological changes. Key words:Field cancerization, oral squamous cell carcinoma, Nitric Oxide Synthase 2 (NOS2), malignity markers. PMID:24316703

Effect of occlusal calculus utilized as a potential "biological sealant" in special needs patients with gastric feeding tubes: a qualitative in vitro contrast to pit and fissure sealant restorations.

PubMed

Owens, Barry M; Sharp, Harry K; Fourmy, Emily E; Phebus, Jeffrey G

2016-01-01

The aim of this case report and in vitro investigation was to evaluate the marginal microleakage of intact occlusal calculus of primary molars extracted from a special needs patient who received nutrition via a gastric feeding tube. An adolescent with a history of developmental disturbance presented for routine dental care in a hospital facility. Prophylaxis was performed, and 2 mandibular permanent molars were restored. Five primary molars were extracted due to mobility and delayed retention. Heavy deposits of intact calculus were present on the occlusal surfaces of the primary teeth. The extracted teeth were immersed in methylene blue dye solution, invested in acrylic resin, sectioned into blocks, and photographed at 20× and 40× magnification. Previously photographed calculus-free molars with pit and fissure sealants were reviewed and served as contrasting "restorations." The occlusal calculus on the primary teeth extracted from the patient absorbed the dye, while the comparison teeth containing pit and fissure sealants exhibited varying degrees of marginal dye penetration (microleakage). No marginal microleakage was noted in the calculus specimens, indicating that this substrate may serve as a "natural" occlusal surface sealant and that its removal from occlusal surfaces during routine oral prophylaxis may be unnecessary.

The Likely Sites of Nodal Metastasis Differs According to the Tumor Extent in Distal Bile Duct Cancer.

PubMed

Kato, Yuichiro; Takahashi, Shinichiro; Gotohda, Naoto; Konishi, Masaru

2016-09-01

In the revised Japanese and Worldwide TNM classification of distal bile duct cancer, the lymph node status is defined as N0 or N1 without reference to the tumor location or extent, according to the presence/absence of metastasis to the regional lymph nodes. Data of 94 patients with distal bile duct cancer who had undergone pancreaticoduodenectomy were reviewed retrospectively. In formalin-fixed specimens, we measured the longitudinal lengths from the papilla to the lower and upper margins of the tumor, in order to investigate the correlation of the tumor extent with the likely sites of nodal metastasis. The frequencies of metastasis to the posterior pancreaticoduodenal nodes (7.1 %) and superior mesenteric artery nodes (0.0 %) were significantly lower in the cases in which the length from the papilla to the lower margin of the tumor was ≥30 mm. The frequencies of nodal metastasis to the common hepatic artery nodes (0.0 %) and hepatoduodenal ligament nodes (6.7 %) were significantly lower in the cases in which the length from the papilla to the upper margin was <40 mm. The likely sites of nodal metastasis differ according to the extent of the tumor in cases of bile duct cancer.

Cipactlichthys scutatus, gen. nov., sp. nov. a New Halecomorph (Neopterygii, Holostei) from the Lower Cretaceous Tlayua Formation of Mexico

PubMed Central

Brito, Paulo M.; Alvarado-Ortega, Jesus

2013-01-01

Based on specimens from the Lower Cretaceous Tlayua Formation of Mexico, we describe a new genus and species of Halecomorphi, Cipactlichthys scutatus gen. et sp. nov, which exhibits several diagnostic characters such as the dermal bones and the scales with ganoin and highly ornamented by numerous tubercles and ridges; parietal slightly longer than wide with approximately the same length as the frontal; jaws extending far, below the posterior orbital margin, reaching the posterior third of the postorbital plate; maxilla with a convexly rounded posterior margin; pectoral fin margins slightly convex; first ray of pectoral fin very long, reaching the posterior edge of the pelvic fin; about 37 preural vertebrae and 7 Ural centra; a series of hypertrophied scales just posterior to the cleithrum; arrangement of flank scales with two rows of deep scales; a series of dorsal and ventral scutes forming the dorsal and ventral midline, between the dorsal and anal fins and the caudal fin. A phylogenetic analysis including two outgroups and eleven neopterygians confirmed the monophyly of the Holostei as well as the monophyly of the Halecomorphi, although this last clade is weakly supported. Cipactlichthys scutatus was hypothesised as the sister-group of the (Ionoscopiformes + Amiiformes). PMID:24023885

Combined multispectral spatial frequency domain imaging and computed tomography system for intraoperative breast tumor margin assessment

NASA Astrophysics Data System (ADS)

McClatchy, D. M.; Rizzo, E. J.; Krishnaswamy, V.; Kanick, S. C.; Wells, W. A.; Paulsen, K. D.; Pogue, B. W.

2017-02-01

There is a dire clinical need for surgical margin guidance in breast conserving therapy (BCT). We present a multispectral spatial frequency domain imaging (SFDI) system, spanning the visible and near-infrared (NIR) wavelengths, combined with a shielded X-ray computed tomography (CT) system, designed for intraoperative breast tumor margin assessment. While the CT can provide a volumetric visualization of the tumor core and its spiculations, the co-registered SFDI can provide superficial and quantitative information about localized changes tissue morphology from light scattering parameters. These light scattering parameters include both model-based parameters of sub-diffusive light scattering related to the particle size scale distribution and also textural information of the high spatial frequency reflectance. Because the SFDI and CT components are rigidly fixed, a simple transformation can be used to simultaneously display the SFDI and CT data in the same coordinate system. This is achieved through the Visualization Toolkit (vtk) file format in the open-source Slicer medical imaging software package. In this manuscript, the instrumentation, data processing, and preliminary human specimen data will be presented. The ultimate goal of this work is to evaluate this technology in a prospective clinical trial, and the current limitations and engineering solutions to meet this goal will also be discussed.

SU-F-J-17: Patient Localization Using MRI-Guided Soft Tissue for Head-And-Neck Radiotherapy: Indication for Margin Reduction and Its Feasibility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qi, X; Yang, Y; Jack, N

Purpose: On-board MRI provides superior soft-tissue contrast, allowing patient alignment using tumor or nearby critical structures. This study aims to study H&N MRI-guided IGRT to analyze inter-fraction patient setup variations using soft-tissue targets and design appropriate CTV-to-PTV margin and clinical implication. Methods: 282 MR images for 10 H&N IMRT patients treated on a ViewRay system were retrospectively analyzed. Patients were immobilized using a thermoplastic mask on a customized headrest fitted in a radiofrequency coil and positioned to soft-tissue targets. The inter-fraction patient displacements were recorded to compute the PTV margins using the recipe: 2.5∑+0.7σ. New IMRT plans optimized on themore » revised PTVs were generated to evaluate the delivered dose distributions. An in-house dose deformation registration tool was used to assess the resulting dosimetric consequences when margin adaption is performed based on weekly MR images. The cumulative doses were compared to the reduced margin plans for targets and critical structures. Results: The inter-fraction displacements (and standard deviations), ∑ and σ were tabulated for MRI and compared to kVCBCT. The computed CTV-to-PTV margin was 3.5mm for soft-tissue based registration. There were minimal differences between the planned and delivered doses when comparing clinical and the PTV reduced margin plans: the paired t-tests yielded p=0.38 and 0.66 between the planned and delivered doses for the adapted margin plans for the maximum cord and mean parotid dose, respectively. Target V95 received comparable doses as planned for the reduced margin plans. Conclusion: The 0.35T MRI offers acceptable soft-tissue contrast and good spatial resolution for patient alignment and target visualization. Better tumor conspicuity from MRI allows soft-tissue based alignments with potentially improved accuracy, suggesting a benefit of margin reduction for H&N radiotherapy. The reduced margin plans (i.e., 2 mm) resulted in improved normal structure sparing and accurate dose delivery to achieve intended treatment goal under MR guidance.« less

Compression of laminated composite beams with initial damage

NASA Technical Reports Server (NTRS)

Breivik, Nicole L.; Gurdal, Zafer; Griffin, O. H., Jr.

1993-01-01

The effect of isolated damage modes on the compressive strength and failure characteristics of laminated composite test specimens were evaluated experimentally and numerically. In addition to specimens without initial damage, specimens with three types of initial damage were considered: (1) specimens with short delaminations distributed evenly through the specimen thickness, (2) specimens with few long delaminations, and (3) specimens with local fiber damage in the surface plies under the three-point bend contact point. It was found that specimens with short multiple delamination experienced the greatest reduction in compression strength compared to the undamaged specimens. Single delaminations far from the specimen surface had little effect on the final compression strength, and moderate strength reduction was observed for specimens with localized surface ply damage.

Two new species of the genus Sinopodisma Chang, 1940 (Orthoptra, Acridoidea, Catantopidae, Podisminae) from Taiwan, China.

PubMed

Ye, Bao-Hua; Shi, Jian-Ping; Yin, Zhan

2017-05-03

Two new species of the genus Sinopodisma Chang, 1940 from Taiwan, China are described in this paper. The new species Sinopodisma orchofemura sp. nov. is similar to Sinopodisma kodamae (Shiraki, 1910), but differs from latter in antennae length of joint 2.9 times width in the middle part, hind femur yellow, length of interspace of mesosternum larger than narrowest, tegmina almost reaching the hind margin of second abdominal tergum. The Sinopodisma hsinchuensis sp. nov. is similar to Sinopodisma orchofemura sp. nov., but differs from latter by vertical diameter of eyes 1.7 times horizontal diameter and 1.8 times subocular furrow; tegmina extending over the hind margin of first abdominal tergite slightly; the length of interspace of mesosternum equal to narrowest and subgenital plate longer than ovipositor valves ventral view. Type specimens are deposited in the National Museum of Natural Science, Taichung, Taiwan, China and the Institute of Entomology, Taiwan University, Taibei, Taiwan, China respectively.

Talonavicular joint arthroscopic portals: A cadaveric study of feasibility and safety.

PubMed

Xavier, Gabriel; Oliva, Xavier Martin; Rotinen, Mauri; Monzo, Mariano

2016-09-01

The objectives of the study were to evaluate the safety of hypothetical arthroscopic portals from talonavicular joint and to evaluate their reproducibility and enforceability. 19 cadaveric feet were marked and four arthroscopic portals were made (medial, dorsomedial, dorsolateral and lateral). The specimens were dissected in layers and the distances between neurovascular structures and the trocars were measured. Medial and dorsomedial portals were in average 8.3 and 8.7, respectively, to the saphenous vein and nerve. Dorsolateral portal was in average 8.1mm to the deep peroneal nerve and dorsalis pedis artery, and 9.1mm to the medial dorsal cutaneous branch of the superficial peroneal nerve. Lateral portal was in average 12.3mm to the intermediate dorsal cutaneous branch of the superficial peroneal nerve. Tested portals shown to have a good safety margin for the foot neurovascular deep dorsal structures and an acceptable safety margin for the superficial neurovascular structures. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

A comparative evaluation of the marginal accuracy of crowns fabricated from four commercially available provisional materials: An in vitro study

PubMed Central

Amin, Bhavya Mohandas; Aras, Meena Ajay; Chitre, Vidya

2015-01-01

Purpose: The purpose of this in vitro study was to evaluate and compare the primary marginal accuracy of four commercially available provisional materials (Protemp 4, Luxatemp Star, Visalys Temp and DPI tooth moulding powder and liquid) at 2 time intervals (10 and 30 min). Materials and Methods: A customized stainless steel master model containing two interchangeable dies was used for fabrication of provisional crowns. Forty crowns (n = 10) were fabricated, and each crown was evaluated under a stereomicroscope. Vertical marginal discrepancies were noted and compared at 10 min since the start of mixing and then at 30 min. Observations and Results: Protemp 4 showed the least vertical marginal discrepancy (71.59 μ), followed by Luxatemp Star (91.93 μ) at 10 min. DPI showed a marginal discrepancy of 95.94 μ while Visalys Temp crowns had vertical marginal discrepancy of 106.81 μ. There was a significant difference in the marginal discrepancy values of Protemp 4 and Visalys Temp. At 30 min, there was a significant difference between the marginal discrepancy of Protemp 4 crowns (83.11 μ) and Visalys Temp crowns (128.97 μ) and between Protemp 4 and DPI (118.88 μ). No significant differences were observed between Protemp 4 and Luxatemp Star. Conclusion: The vertical marginal discrepancy of temporary crowns fabricated from the four commercially available provisional materials ranged from 71 to 106 μ immediately after fabrication (at 10 min from the start of mix) to 83–128 μ (30 min from the start of mix). The time elapsed after mixing had a significant influence on the marginal accuracy of the crowns. PMID:26097348

Emerging aspects of oesophageal and gastro-oesophageal junction cancer histopathology – an update for the surgical oncologist

PubMed Central

Griffiths, Ewen A; Pritchard, Susan A; Mapstone, Nicholas P; Welch, Ian M

2006-01-01

Adenocarcinoma of the oesophagus and gastro-oesophageal junction are rapidly increasing in incidence and have a well described sequence of carcinogenesis: the Barrett's metaplasia-dysplasia-adenocarcinoma sequence. During recent years there have been changes in the knowledge surrounding disease progression, cancer management and histopathology specimen reporting. Tumours around the gastro-oesophageal junction (GOJ) pose several specific challenges. Numerous difficulties arise when the existing TNM staging systems for gastric and oesophageal cancers are applied to GOJ tumours. The issues facing the current TNM staging and GOJ tumour classification systems are reviewed in this article. Recent evidence regarding the importance of several histopathologically derived prognostic factors, such as circumferential resection margin status and lymph node metastases, have implications for specimen reporting. With the rising use of multimodal treatments for oesophageal cancer it is important that the response of the tumour to this therapy is carefully documented pathologically. In addition, several controversial and novel areas such as endoscopic mucosal resection, lymph node micrometastases and the sentinel node concept are being studied. We aim to review these aspects, with special relevance to oesophageal and gastro-oesophageal cancer specimen reporting, to update the surgical oncologist with an interest in upper gastrointestinal cancer. PMID:17118194

Coherent Raman Scattering Microscopy for Evaluation of Head and Neck Carcinoma.

PubMed

Hoesli, Rebecca C; Orringer, Daniel A; McHugh, Jonathan B; Spector, Matthew E

2017-09-01

Objective We aim to describe a novel, label-free, real-time imaging technique, coherent Raman scattering (CRS) microscopy, for histopathological evaluation of head and neck cancer. We evaluated the ability of CRS microscopy to delineate between tumor and nonneoplastic tissue in tissue samples from patients with head and neck cancer. Study Design Prospective case series. Setting Tertiary care medical center. Subjects and Methods Patients eligible were surgical candidates with biopsy-proven, previously untreated head and neck carcinoma and were consented preoperatively for participation in this study. Tissue was collected from 50 patients, and after confirmation of tumor and normal specimens by hematoxylin and eosin (H&E), there were 42 tumor samples and 42 normal adjacent controls. Results There were 42 confirmed carcinoma specimens on H&E, and CRS microscopy identified 37 as carcinoma. Of the 42 normal specimens, CRS microscopy identified 40 as normal. This resulted in a sensitivity of 88.1% and specificity of 95.2% in distinguishing between neoplastic and nonneoplastic images. Conclusion CRS microscopy is a unique label-free imaging technique that can provide rapid, high-resolution images and can accurately determine the presence of head and neck carcinoma. This holds potential for implementation into standard practice, allowing frozen margin evaluation even at institutions without a histopathology laboratory.

A new fish species of the subfamily Serraninae (Perciformes, Serranidae) from the Philippines.

PubMed

Williams, Jeffrey T; Carpenter, Kent E

2015-01-19

A new species of serranine fish is described from the Philippine Islands. A single specimen of a new species, Chelidoperca santosi, captured by fishermen working in Palawan waters was discovered in the public fish market in Iloilo City, Panay, Philippines. Two additional specimens of the new species, also from the Philippines, were subsequently discovered in the collections of the Museum Victoria, Australia. The new species is currently known only from the Philippines and is characterized by its distinctive coloration with a row of four small dark spots on the snout (two in front of each eye) and two dark spots on the chin (one on each side of the symphysis of the dentaries), a white anal fin with six large yellow spots separated by broad white interspaces and a narrow yellow distal border, caudal fin with narrow yellow bars and a yellowish distal margin and no dark spots, and a combination of meristic and morphological characters. 

Apparatus for electrophoresis separation

DOEpatents

Anderson, Norman L.

1978-01-01

An apparatus is disclosed for simultaneously performing electrophoresis separations on a plurality of slab gels containing samples of protein, protein subunits or nucleic acids. A reservoir of buffer solution is divided into three compartments by two parallel partitions having vertical slots spaced along their length. A sheet of flexible, electrically insulative material is attached to each partition and is provided with vertical slits aligned with the slots. Slab-gel holders are received within the slots with the flexible material folded outwardly as flaps from the slits to overlay portions of the holder surfaces and thereby act as electrical and liquid seals. An elongated, spaghetti-like gel containing a sample of specimen that was previously separated by isoelectric focusing techniques is vertically positioned along a marginal edge portion of the slab gel. On application of an electrical potential between the two outer chambers of buffer solution, a second dimensional electrophoresis separation in accordance with molecular weight occurs as the specimen molecules migrate across the slab gel.

Recharacterization of Rhinophis dorsimaculatus Deraniyagala, 1941 (Serpentes: Uropeltidae), including description of new material.

PubMed

Gower, David J; Wickramasinghe, L J Mendis

2016-08-29

The Sri Lankan uropeltid (shieldtail) snake Rhinophis dorsimaculatus Deraniyagala, 1941 was described originally from two specimens that were subsequently lost. The small amount of previously published data and lack of published colour photographs made this one of South Asia's most poorly known snake species, and this resulted in at least one instance of taxonomic misidentification. An additional 10 specimens from a historical collection from the vicinity of the type locality recently came to light. This material is reviewed and documented and the species recharacterized. An additional locality for the species is reported. The newly reported material helps to corroborate the taxonomic validity and distinctiveness of Rhinophis dorsimaculatus. The species is readily distinguished from congeners by having 227 or more ventral scales; a large, dorsally carinate rostral shield; posterior margins of paired anals that are largely separated by the posteriormost ventral scale; and a distinctive colour pattern with bilaterally asymmetrical dark blotches within a broad, pale middorsal stripe and regularly punctate flanks.

Comparison of two culture approaches, blind passage and dual observation, for detecting Chlamydia trachomatis in various prevalence populations.

PubMed Central

Zimmerman, S J; Moses, E; Sofat, N; Bartholomew, W R; Amsterdam, D

1992-01-01

Chlamydia trachomatis diagnosis in our laboratory consisted of dual inoculation of shell vials and detection of inclusions by using fluorescein-conjugated monoclonal antiserum; the second culture vial was conventionally used for blind passage when the first vial was negative. We compared the increase in positivity using blind passage with that of a strategy utilizing observation of two stained monolayers (dual observation) without blind passage, in an effort to reduce the reporting time and labor associated with the conventional approach. A total of 4,329 specimens were obtained from an obstetrics and gynecology (OB-GYN) clinic (2,563 specimens) and the sexually transmitted disease clinic (1,766 specimens). These specimens were used to compare the two strategies. Blind passage of 1,269 initially culture-negative specimens from the OB-GYN clinic resulted in an additional 6 positive chlamydial diagnoses. In comparison, a similar number of specimens (1,294) from the OB-GYN clinic collected subsequently to the first group were tested by dual observation. There were five additional positive findings. A similar evaluation of specimens from the sexually transmitted disease clinic was performed. Blind passage of 313 initially culture-negative specimens yielded 3 additional positive diagnoses, whereas dual observation of 1,435 similar specimens resulted in 9 positive diagnoses. On the basis of analysis of 4,332 specimens, sensitivity of dual observation is comparable to that of blind passage; labor, cost, and reporting time of dual observation are reduced in comparison to those of blind passage. PMID:1452664

A comparison of the marginal fit of In-Ceram, IPS Empress, and Procera crowns.

PubMed

Sulaiman, F; Chai, J; Jameson, L M; Wozniak, W T

1997-01-01

The in vitro marginal fit of three all-ceramic crown systems (In-Ceram, Procera, and IPS Empress) was compared. All crown systems were significantly different from each other at P = 0.05. In-Ceram exhibited the greatest marginal discrepancy (161 microns), followed by Procera (83 microns), and IPS Empress (63 microns). There were no significant differences among the various stages of the crown fabrication: core fabrication, porcelain veneering, and glazing. The facial and lingual margins exhibited significantly larger marginal discrepancies than the mesial and distal margins.

Methods of defining the non-inferiority margin in randomized, double-blind controlled trials: a systematic review.

PubMed

Althunian, Turki A; de Boer, Anthonius; Klungel, Olaf H; Insani, Widya N; Groenwold, Rolf H H

2017-03-07

There is no consensus on the preferred method for defining the non-inferiority margin in non-inferiority trials, and previous studies showed that the rationale for its choice is often not reported. This study investigated how the non-inferiority margin is defined in the published literature, and whether its reporting has changed over time. A systematic PubMed search was conducted for all published randomized, double-blind, non-inferiority trials from January 1, 1966, to February 6, 2015. The primary outcome was the number of margins that were defined by methods other than the historical evidence of the active comparator. This was evaluated for a time trend. We also assessed the under-reporting of the methods of defining the margin as a secondary outcome, and whether this changed over time. Both outcomes were analyzed using a Poisson log-linear model. Predictors for better reporting of the methods, and the use of the fixed-margin method (one of the historical evidence methods) were also analyzed using logistic regression. Two hundred seventy-three articles were included, which account for 273 non-inferiority margins. There was no statistically significant difference in the number of margins that were defined by other methods compared to those defined based on the historical evidence (ratio 2.17, 95% CI 0.86 to 5.82, p = 0.11), and this did not change over time. The number of margins for which methods were unreported was similar to those with reported methods (ratio 1.35, 95% CI 0.76 to 2.43, p = 0.31), with no change over time. The method of defining the margin was less often reported in journals with low-impact factors compared to journals with high-impact factors (OR 0.20; 95% CI 0.10 to 0.37, p < 0.0001). The publication of the FDA draft guidance in 2010 was associated with increased reporting of the fixed-margin method (after versus before 2010) (OR 3.54; 95% CI 1.12 to 13.35, p = 0.04). Non-inferiority margins are not commonly defined based on the historical evidence of the active comparator, and they are poorly reported. Authors, reviewers, and editors need to take notice of reporting this critical information to allow for better judgment of non-inferiority trials.

Explanted Diseased Livers – A Possible Source of Metabolic Competent Primary Human Hepatocytes

PubMed Central

Krech, Till; DeTemple, Daphne; Jäger, Mark D.; Lehner, Frank; Manns, Michael P.; Klempnauer, Jürgen; Borlak, Jürgen; Bektas, Hueseyin; Vondran, Florian W. R.

2014-01-01

Being an integral part of basic, translational and clinical research, the demand for primary human hepatocytes (PHH) is continuously growing while the availability of tissue resection material for the isolation of metabolically competent PHH remains limited. To overcome current shortcomings, this study evaluated the use of explanted diseased organs from liver transplantation patients as a potential source of PHH. Therefore, PHH were isolated from resected surgical specimens (Rx-group; n = 60) and explanted diseased livers obtained from graft recipients with low labMELD-score (Ex-group; n = 5). Using established protocols PHH were subsequently cultured for a period of 7 days. The viability and metabolic competence of cultured PHH was assessed by the following parameters: morphology and cell count (CyQuant assay), albumin synthesis, urea production, AST-leakage, and phase I and II metabolism. Both groups were compared in terms of cell yield and metabolic function, and results were correlated with clinical parameters of tissue donors. Notably, cellular yields and viabilities were comparable between the Rx- and Ex-group and were 5.3±0.5 and 2.9±0.7×106 cells/g liver tissue with 84.3±1.3 and 76.0±8.6% viability, respectively. Moreover, PHH isolated from the Rx- or Ex-group did not differ in regards to loss of cell number in culture, albumin synthesis, urea production, AST-leakage, and phase I and II metabolism (measured by the 7-ethoxycoumarin-O-deethylase and uracil-5′-diphosphate-glucuronyltransferase activity). Likewise, basal transcript expressions of the CYP monooxygenases 1A1, 2C8 and 3A4 were comparable as was their induction when treated with a cocktail that consisted of 3-methylcholantren, rifampicin and phenobarbital, with increased expression of CYP 1A1 and 3A4 mRNA while transcript expression of CYP 2C8 was only marginally changed. In conclusion, the use of explanted diseased livers obtained from recipients with low labMELD-score might represent a valuable source of metabolically competent PHH which are comparable in viability and function to cells obtained from specimens following partial liver resection. PMID:24999631

Marginal zone lymphoma-derived interfollicular diffuse large B-cell lymphoma harboring 20q12 chromosomal deletion and missense mutation of BIRC3 gene: a case report.

PubMed

Hatem, Joseph; Schrank-Hacker, April M; Watt, Christopher D; Morrissette, Jennifer J D; Rubin, Adam I; Kim, Ellen J; Nasta, Sunita D; Wasik, Mariusz A; Bogusz, Agata M

2016-12-19

Diffuse large B-cell lymphoma (DLBCL) typically leads to effacement of the nodal architecture by an infiltrate of malignant cells. Rarely (<1%), DLBCL can present with an interfollicular pattern (DLBCL-IF) preserving the lymphoid follicles. It has been postulated that DLBCL-IF is derived from marginal zone B cells and may represent a large-cell transformation of marginal zone lymphoma (MZL), however no direct evidence has been provided to date. Here we describe a rare case of a diagnostically challenging DLBCL-IF involving a lymph node in a patient with a prior history of lymphadenopathy for several years and MZL involving skin. A 53-year old man presented to our Dermatology Clinic due to a 1-year history of generalized itching, fatigue of 2-3 month's duration, nausea and mid back rash that was biopsied. PET (positron emission tomography)/CT (computed tomography) was performed and revealed inguinal, pelvic, retroperitoneal, axillary, and cervical lymphadenopathy. The patient was referred to surgery for excisional biopsy of a right inguinal lymph node. Diagnostic H&E stained slides and ancillary studies were reviewed for the lymph node and skin specimens. B-cell clonality by PCR and sequencing studies were performed on both specimens. We demonstrate that this patient's MZL and DLBCL-IF are clonally related, strongly suggesting that transformation of MZL to DLBCL had occurred. Furthermore, we identified a novel deletion of the long arm of chromosome 20 (del(20q12)) and a missense mutation in BIRC3 (Baculoviral IAP repeat-containing protein 3) in this patient's DLBCL that are absent from his MZL, suggesting that these genetic alterations contributed to the large cell transformation. To our knowledge, this is the first report providing molecular evidence for a previously suspected link between MZL and DLBCL-IF. In addition, we describe for the first time del(20q12) and a missense mutation in BIRC3 in DLBCL. Our findings also raise awareness of DLBCL-IF and discuss the diagnostic pitfalls of this rare entity.

CompareTests-R package

Cancer.gov

CompareTests is an R package to estimate agreement and diagnostic accuracy statistics for two diagnostic tests when one is conducted on only a subsample of specimens. A standard test is observed on all specimens.

Evaluation of the Abbott RealTime MTB and RealTime MTB INH/RIF Assays for Direct Detection of Mycobacterium tuberculosis Complex and Resistance Markers in Respiratory and Extrapulmonary Specimens.

PubMed

Hofmann-Thiel, Sabine; Molodtsov, Nikolay; Antonenka, Uladzimir; Hoffmann, Harald

2016-12-01

The Abbott RealTime MTB (RT MTB) assay is a new automated nucleic acid amplification test for the detection of Mycobacterium tuberculosis complex (MTBC) in clinical specimens. In combination with the RealTime MTB INH/RIF (RT MTB INH/RIF) resistance assay, which can be applied to RT MTB-positive specimens as an add-on assay, the tests also indicate the genetic markers of resistance to isoniazid (INH) and rifampin (RIF). We aimed to evaluate the diagnostic sensitivity and specificity of RT MTB using different types of respiratory and extrapulmonary specimens and to compare performance characteristics directly with those of the FluoroType MTB assay. The resistance results obtained by RT MTB INH/RIF were compared to those from the GenoType MTBDRplus and from phenotypic drug susceptibility testing. A total of 715 clinical specimens were analyzed. Compared to culture, the overall sensitivity of RT MTB was 92.1%; the sensitivity rates for smear-positive and smear-negative samples were 100% and 76.2%, respectively. The sensitivities of smear-negative specimens were almost identical for respiratory (76.3%) and extrapulmonary (76%) specimens. Specificity rates were 100% and 95.8% for culture-negative specimens and those that grew nontuberculous mycobacteria, respectively. RT MTB INH/RIF was applied to 233 RT MTB-positive samples and identified resistance markers in 7.7% of samples. Agreement with phenotypic and genotypic drug susceptibility testing was 99.5%. In conclusion, RT MTB and RT MTB INH/RIF allow for the rapid and accurate diagnosis of tuberculosis (TB) in different types of specimens and reliably indicate resistance markers. The strengths of this system are the comparably high sensitivity with paucibacillary specimens, its ability to detect INH and RIF resistance, and its high-throughput capacities. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Imaging of prostate cancer: a platform for 3D co-registration of in-vivo MRI ex-vivo MRI and pathology

NASA Astrophysics Data System (ADS)

Orczyk, Clément; Mikheev, Artem; Rosenkrantz, Andrew; Melamed, Jonathan; Taneja, Samir S.; Rusinek, Henry

2012-02-01

Objectives: Multi-parametric MRI is emerging as a promising method for prostate cancer diagnosis. prognosis and treatment planning. However, the localization of in-vivo detected lesions and pathologic sites of cancer remains a significant challenge. To overcome this limitation we have developed and tested a system for co-registration of in-vivo MRI, ex-vivo MRI and histology. Materials and Methods: Three men diagnosed with localized prostate cancer (ages 54-72, PSA levels 5.1-7.7 ng/ml) were prospectively enrolled in this study. All patients underwent 3T multi-parametric MRI that included T2W, DCEMRI, and DWI prior to robotic-assisted prostatectomy. Ex-vivo multi-parametric MRI was performed on fresh prostate specimen. Excised prostates were then sliced at regular intervals and photographed both before and after fixation. Slices were perpendicular to the main axis of the posterior capsule, i.e., along the direction of the rectal wall. Guided by the location of the urethra, 2D digital images were assembled into 3D models. Cancer foci, extra-capsular extensions and zonal margins were delineated by the pathologist and included in 3D histology data. A locally-developed software was applied to register in-vivo, ex-vivo and histology using an over-determined set of anatomical landmarks placed in anterior fibro-muscular stroma, central. transition and peripheral zones. The mean root square distance across corresponding control points was used to assess co-registration error. Results: Two specimens were pT3a and one pT2b (negative margin) at pathology. The software successfully fused invivo MRI. ex-vivo MRI fresh specimen and histology using appropriate (rigid and affine) transformation models with mean square error of 1.59 mm. Coregistration accuracy was confirmed by multi-modality viewing using operator-guided variable transparency. Conclusion: The method enables successful co-registration of pre-operative MRI, ex-vivo MRI and pathology and it provides initial evidence of feasibility of MRI-guided surgical planning.

The effect of mechanical load cycling and polishing time on microleakage of class V glass-ionomer and composite restorations: A scanning electron microscopy evaluation

PubMed Central

Mirzaie, Mansoreh; Yasini, Esmail; Kermanshah, Hamid; Omidi, Baharan Ranjbar

2014-01-01

Background: Microleakage is one of the challenging concerns in direct filling restorations. Understanding of its related factors is important in clinical practice. The aim of this study was scanning electron microscopy (SEM) evaluation of marginal integrity in three types of tooth-colored restorative materials in class V cavity preparations and the effect of load cycling and polishing time on the microleakage. Materials and Methods: In this in vitro experimental study, class V cavity preparations were prepared on the buccal and lingual surfaces of 60 bovine incisors. The specimens were divided into three groups each containing 20 teeth: group 1: Filtek Z350, Group 2: Fuji IX/G Coat Plus, Group 3: Fuji II LC/GC varnish. In each group, 2 subgroups (n = 20) were established based on finishing time (immediate or delayed by 24 h). All specimens were thermocycled (×2,000, 5-50°C). In each sub groups, half of the teeth were load cycled. Epoxy resin replicas of 24 specimens were evaluated under field emission-SEM and interfacial gaps were measured. All teeth were then immersed in 0.5% basic fuchsin dye for 24 h, sectioned and observed under stereomicroscope. Data were analyzed with Kruskal-Wallis’ test and Mann-Whitney U test and a comparison between incisal and cervical microleakage was made with Wilcoxon test. P < 0.05 was considered as significant. Results: Load cycling and filling material had a significant effect on microleakage, but polishing time did not. Cervical microleakage in Z350/load cycle/immediate polish and Fuji IX/load cycle/immediate or delayed polish and Fuji IX/no load cycle/immediate polish were significantly higher than incisal microleakage. Conclusion: It was concluded that the cervical sealing ability of Fuji IX under load cycling was better than Fuji II LC. Under load cycling and immediate polishing Z350 showed better marginal integrity than both Fuji II LC and Fuji IX. The immediate polishing didn’t cause a statistically significant increase in microleakage of evaluated tooth-colored class V restorations. PMID:24688568

The effect of mechanical load cycling and polishing time on microleakage of class V glass-ionomer and composite restorations: A scanning electron microscopy evaluation.

PubMed

Mirzaie, Mansoreh; Yasini, Esmail; Kermanshah, Hamid; Omidi, Baharan Ranjbar

2014-01-01

Microleakage is one of the challenging concerns in direct filling restorations. Understanding of its related factors is important in clinical practice. The aim of this study was scanning electron microscopy (SEM) evaluation of marginal integrity in three types of tooth-colored restorative materials in class V cavity preparations and the effect of load cycling and polishing time on the microleakage. In this in vitro experimental study, class V cavity preparations were prepared on the buccal and lingual surfaces of 60 bovine incisors. The specimens were divided into three groups each containing 20 teeth: group 1: Filtek Z350, Group 2: Fuji IX/G Coat Plus, Group 3: Fuji II LC/GC varnish. In each group, 2 subgroups (n = 20) were established based on finishing time (immediate or delayed by 24 h). All specimens were thermocycled (×2,000, 5-50°C). In each sub groups, half of the teeth were load cycled. Epoxy resin replicas of 24 specimens were evaluated under field emission-SEM and interfacial gaps were measured. All teeth were then immersed in 0.5% basic fuchsin dye for 24 h, sectioned and observed under stereomicroscope. Data were analyzed with Kruskal-Wallis' test and Mann-Whitney U test and a comparison between incisal and cervical microleakage was made with Wilcoxon test. P < 0.05 was considered as significant. Load cycling and filling material had a significant effect on microleakage, but polishing time did not. Cervical microleakage in Z350/load cycle/immediate polish and Fuji IX/load cycle/immediate or delayed polish and Fuji IX/no load cycle/immediate polish were significantly higher than incisal microleakage. It was concluded that the cervical sealing ability of Fuji IX under load cycling was better than Fuji II LC. Under load cycling and immediate polishing Z350 showed better marginal integrity than both Fuji II LC and Fuji IX. The immediate polishing didn't cause a statistically significant increase in microleakage of evaluated tooth-colored class V restorations.

Obstructive Thebesian valve: anatomical study and implications for invasive cardiologic procedures.

PubMed

Ghosh, Sanjib Kumar; Raheja, Shashi; Tuli, Anita

2014-03-01

Thebesian valve is the embryological remnant of the right sinoatrial valve, guarding the coronary sinus (CS) ostium. Advanced invasive and interventional cardiac diagnostic and management tools involve cannulation of the CS ostium. The presence of obstructive Thebesian valves has been reported to lead to unsuccessful cannulation of the CS. We studied the morphology of the Thebesian valve and CS ostium to assess the possible impact of these structures on invasive cardiological procedures. One hundred fifty randomly selected human cadaveric heart specimens fixed in 10% formalin were dissected in the customary routine manner. The Thebesian valves were classified according to their shape as semilunar/fenestrated/biconcave band like and according to their composition as membranous/fibromuscular/fibrous/muscular, and the extent to which the valve covered the CS ostium was also noted. An obstructive Thebesian valve that could interfere with the cannulation of the CS was defined as non-fenestrated (semilunar/biconcave band like) and non-membranous (fibromuscular/fibrous/muscular) valves covering >75% of the CS ostium. Thebesian valves were present in 118 (79%) heart specimens, of which 27 (18%) met the criteria of being obstructive. Semilunar was the most common type of Thebesian valve in terms of shape and was observed in 65 (65/118; 55%) hearts. This type was associated with the least mean craniocaudal (7.9±0.6 mm) and mean transverse (6.25±0.6 mm) diameters of the CS ostium. The mean craniocaudal diameter of the CS ostium (9.4±2.1 mm) was significantly larger (p=0.004) than the mean transverse diameter (7.15±1.5 mm) in specimens with Thebesian valves, and the cranial margin of the CS ostium was free from any attachment of the Thebesian valve in all the types observed (in terms of shape). Hence, attempts to direct the tip of the catheter toward the cranial margin of the CS ostium under direct vision may lead to successful cannulation of the same when conventional techniques have been unsuccessful because of the presence of an obstructive Thebesian valve.

Surgical quality of wedge resection affects overall survival in patients with early stage non-small cell lung cancer.

PubMed

Ajmani, Gaurav S; Wang, Chi-Hsiung; Kim, Ki Wan; Howington, John A; Krantz, Seth B

2018-07-01

Very few studies have examined the quality of wedge resection in patients with non-small cell lung cancer. Using the National Cancer Database, we evaluated whether the quality of wedge resection affects overall survival in patients with early disease and how these outcomes compare with those of patients who receive stereotactic radiation. We identified 14,328 patients with cT1 to T2, N0, M0 disease treated with wedge resection (n = 10,032) or stereotactic radiation (n = 4296) from 2005 to 2013 and developed a subsample of propensity-matched wedge and radiation patients. Wedge quality was grouped as high (negative margins, >5 nodes), average (negative margins, ≤5 nodes), and poor (positive margins). Overall survival was compared between patients who received wedge resection of different quality and those who received radiation, adjusting for demographic and clinical variables. Among patients who underwent wedge resection, 94.6% had negative margins, 44.3% had 0 nodes examined, 17.1% had >5 examined, and 3.0% were nodally upstaged; 16.7% received a high-quality wedge, which was associated with a lower risk of death compared with average-quality resection (adjusted hazard ratio [aHR], 0.74; 95% confidence interval [CI], 0.67-0.82). Compared with stereotactic radiation, wedge patients with negative margins had significantly reduced hazard of death (>5 nodes: aHR, 0.50; 95% CI, 0.43-0.58; ≤5 nodes: aHR, 0.65; 95% CI, 0.60-0.70). There was no significant survival difference between margin-positive wedge and radiation. Lymph nodes examined and margins obtained are important quality metrics in wedge resection. A high-quality wedge appears to confer a significant survival advantage over lower-quality wedge and stereotactic radiation. A margin-positive wedge appears to offer no benefit compared with radiation. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Computerized margin and texture analyses for differentiating bacterial pneumonia and invasive mucinous adenocarcinoma presenting as consolidation.

PubMed

Koo, Hyun Jung; Kim, Mi Young; Koo, Ja Hwan; Sung, Yu Sub; Jung, Jiwon; Kim, Sung-Han; Choi, Chang-Min; Kim, Hwa Jung

2017-01-01

Radiologists have used margin characteristics based on routine visual analysis; however, the attenuation changes at the margin of the lesion on CT images have not been quantitatively assessed. We established a CT-based margin analysis method by comparing a target lesion with normal lung attenuation, drawing a slope to represent the attenuation changes. This approach was applied to patients with invasive mucinous adenocarcinoma (n = 40) or bacterial pneumonia (n = 30). Correlations among multiple regions of interest (ROIs) were obtained using intraclass correlation coefficient (ICC) values. CT visual assessment, margin and texture parameters were compared for differentiating the two disease entities. The attenuation and margin parameters in multiple ROIs showed excellent ICC values. Attenuation slopes obtained at the margins revealed a difference between invasive mucinous adenocarcinoma and pneumonia (P<0.001), and mucinous adenocarcinoma produced a sharply declining attenuation slope. On multivariable logistic regression analysis, pneumonia had an ill-defined margin (odds ratio (OR), 4.84; 95% confidence interval (CI), 1.26-18.52; P = 0.02), ground-glass opacity (OR, 8.55; 95% CI, 2.09-34.95; P = 0.003), and gradually declining attenuation at the margin (OR, 12.63; 95% CI, 2.77-57.51, P = 0.001). CT-based margin analysis method has a potential to act as an imaging parameter for differentiating invasive mucinous adenocarcinoma and bacterial pneumonia.

The influence of micro-scale dimples and nano-sized grains on the fretting characteristics generated by laser pulses.

PubMed

Amanov, Auezhan; Watabe, Tsukasa; Sasaki, Shinya

2013-12-01

The tribological characteristics of micro-scale dimpled Cu-based alloy specimen generated using a laser surface texturing (LST) were assessed and compared with that of the untextured specimen. The objective of this study is to improve the tribological characteristics of internal combustion engine (ICE) bearings and bushings made of Cu-based alloy by generating micro-scale dimples using an LST. Fretting wear tests were performed by sliding a hardened SAE52100 steel ball against the untextured and LSTed specimens at a normal load of 5 N under oil-lubricated conditions. The friction force and relative movement between the specimens were measured simultaneously during the fretting tests. The test results showed that the LSTed specimens showed a reduction in friction coefficient and an enhancement in fretting wear resistance compared to that of the untextured specimen. The friction coefficient and fretting wear volume increased with increasing frequency for both untextured and LSTed specimens. The improved tribological properties of the LSTed specimen may be attributed to the micro-scale dimples, refined grain size and high lattice strain. In addition, a model for the nanocrystallization mechanism of the LSTed specimen was proposed.

Operational impact of using a vanadate oxidase method for direct bilirubin measurements at an academic medical center clinical laboratory.

PubMed

Dhungana, Neha; Morris, Cory; Krasowski, Matthew D

2017-08-01

The aim of this study was to compare the operational impact of using vanadate oxidase versus diazo direct bilirubin assays for an academic medical center patient population. Retrospective study was done over an approximately 3.5 year period. The main automated chemistry instrumentation was a Roche Diagnostics cobas 8000 line. The Roche Direct Bilirubin assay was compared to Diazyme Laboratories Direct Bilirubin Assay and Randox Laboratories Direct Bilirubin assay using manufacturer's guidelines for hemolysis index, lipemia index, and analytical measurement range (AMR). Retrospective data was analyzed for 47,333 serum/plasma specimens that had clinical orders for direct bilirubin. A total of 5943 specimens (12.6%) exceeded the hemolysis index limit for the Roche method compared to only 0.2% and 0.05% of specimens for the Diazyme and Randox methods, respectively. The impact was particularly large on patients less than 2 years old, for which 51.3% of specimens exceeded the hemolysis index for the Roche method. A total of 1671 specimens (3.5%) exceeded the lipemia index limit for the Roche method compared to less than 0.1% for the Randox method. Lastly, 988 (2.1%) of specimens had direct bilirubin concentrations exceeding the upper AMR limit of 10 mg/dL [171 µmol/L] for the Roche assay compared to less than 1% of specimens for the vanadate oxidase methods. Vanadate oxidase direct bilirubin methods offer advantages over diazo methods in terms of less interference by hemolysis and lipemia, as well as wider AMR. The advantages are particularly evident for neonatal and infant populations.

Comparing Microstructures and Tensile Properties of Intercritically Annealed and Quenched-Tempered 1.7Ni-1.5Cu-0.5Mo-0.2C Powder Metallurgy Steels

NASA Astrophysics Data System (ADS)

Güral, Ahmet; Başak, Hüdayim; Türkan, Mustafa

2018-01-01

The aim of this study was to compare the influence of intercritical quenching (IQ), step quenching (SQ) and quenching plus tempering (QT) heat treatments on the microstructure and tensile properties of 1.7Ni-1.5Cu-0.5Mo-0.2C pre-alloyed powder metallurgy (P/M) steels. In the microstructures of the IQ and SQ specimens partial martensite having Ni-rich phases formed up in the soft ferritic matrix. It was observed that unlike Mo, a Cu alloying element dissolved homogeneously in the specimens. The martensite volume fraction (MVF) in the SQ specimens was higher than that in the IQ specimens. It was found that macrohardness, yield and tensile strengths increased, whereas microhardness of ferrite and elongation decreased with increasing MVF. However, with this increase, microhardness values of martensite phases decreased in the IQ specimen, while they increased in SQ specimens. It was observed that the yield, tensile, and elongation values of the QT specimens were lower than those of all intercritically annealed specimens having the same hardness values.

A review of chevron-notched fracture specimens

NASA Technical Reports Server (NTRS)

Newman, J. C., Jr.

1984-01-01

The historical development of chevron notched fracture specimens is reviewed. Stress intensity factors and load line displacement solutions proposed for some of these specimens are compared. The original bend bar configurations up to the present day short rod and bar specimens are reviewed. The results of an analytical round robin that was conducted on chevron-notched specimens are presented. In the round robin, stress-intensity factors for either the chevron notched round rod or square bar specimens were calculated. The consensus stress intensity factor (compliance) solution for these specimens is assessed. The stress intensity factor solutions proposed for three and four point bend chevron notched specimens are reviewed.

A new species of the genus Xya Latreille, 1809 from China (Orthoptra, Tridctyloidea, Tridactylidae).

PubMed

Cao, Cheng-Quan; Shi, Jian-Ping; Yin, Zhan

2018-04-23

A new species of the genus Xya Latreille, 1809 from Sichuan, China is described in this paper. The new species Xya sichuanensis sp. nov. is similar to Xya japonica (Haan, 1844), but differs from latter by head with yellow stripe on both sides, vertex with two yellow stripes on the inner margin of eyes, pronotum with yellow stripe on both sides, tegmina with two small yellow spots, fore and mid legs black, with yellow spots and hind wing yellow. Type specimens are deposited in the College of Life Science, Leshan Normal University, Leshan 614004, China.

Two Flat-Backed Polydesmidan Millipedes from the Miocene Chiapas-Amber Lagerstätte, Mexico

PubMed Central

Riquelme, Francisco; Hernández-Patricio, Miguel; Martínez-Dávalos, Arnulfo; Rodríguez-Villafuerte, Mercedes; Montejo-Cruz, Maira; Alvarado-Ortega, Jesús; Ruvalcaba-Sil, José L.; Zúñiga-Mijangos, Luis

2014-01-01

Two species of fossil polydesmidan millipedes (Diplopoda: Polydesmida) embedded in amber are described from Miocene strata near Simojovel, in the Chiapas Highlands, Mexico. Maatidesmus paachtun gen. et sp. nov., placed into Chelodesmidae Cook, 1895, and Anbarrhacus adamantis gen. et sp. nov., assigned in the family Platyrhacidae Pocock, 1895. Morphological data from fossil specimens have been recovered using 3D X-ray micro-computed tomography and regular to infrared-reflected microscopy. Both fossil species are recognizable as new primarily but not exclusively, by collum margin modification and remarkable paranotal and metatergite dorsal sculpture. PMID:25162220

Two flat-backed polydesmidan millipedes from the Miocene Chiapas-amber Lagerstätte, Mexico.

PubMed

Riquelme, Francisco; Hernández-Patricio, Miguel; Martínez-Dávalos, Arnulfo; Rodríguez-Villafuerte, Mercedes; Montejo-Cruz, Maira; Alvarado-Ortega, Jesús; Ruvalcaba-Sil, José L; Zúñiga-Mijangos, Luis

2014-01-01

Two species of fossil polydesmidan millipedes (Diplopoda: Polydesmida) embedded in amber are described from Miocene strata near Simojovel, in the Chiapas Highlands, Mexico. Maatidesmus paachtun gen. et sp. nov., placed into Chelodesmidae Cook, 1895, and Anbarrhacus adamantis gen. et sp. nov., assigned in the family Platyrhacidae Pocock, 1895. Morphological data from fossil specimens have been recovered using 3D X-ray micro-computed tomography and regular to infrared-reflected microscopy. Both fossil species are recognizable as new primarily but not exclusively, by collum margin modification and remarkable paranotal and metatergite dorsal sculpture.

Head and Neck Sarcomas: The UCLA Experience

PubMed Central

Tajudeen, Bobby A.; Fuller, Jennifer; Lai, Chi; Grogan, Tristan; Elashoff, David; Abemayor, Elliot; St. John, Maie

2014-01-01

Purpose To profile the clinical presentation, subtype distribution, and treatment results of sarcomas of the head and neck at a single tertiary academic center over an 11-year period. Materials and Methods A retrospective review was performed by examining the records and reviewing the pathology of 186 patients with head and neck sarcomas treated at UCLA Medical Center from 2000 to 2011. Results The mean age of the study population was 49 +/− 22 years. 58% of the patients were male and 42% were female. Median duration of follow-up for the entire group was 18.5 months. The most common presenting symptom was a mass lesion in 59.9% of patients. The nasal cavity/sinus was the most common presenting site seen in 22% of patients. Solitary fibrous tumor/hemangiopericytoma was the most common subtype. 15% of patients had evidence of prior radiation exposure. 26.3% of tumors were greater than 5cm and 35.5% were high-grade. Margins were positive in 31.2% of patients. Lymph node metastasis was rare at 6.5%. Perineural invasion was identified in 6.5%. Among all subtypes, 5-yr recurrence-free survival and overall survival were 50% and 49%, respectively. Multivariate analysis demonstrated that grade and margin status were predictors of recurrence-free survival while grade and age affected overall survival. Conclusions Head and neck sarcomas are a rare entity frequently presenting as a mass lesion. In our series, lesions tended to be high-grade with a significant portion of surgical specimens having positive margins. Grade and margin status were the most important predictors of survival. PMID:24721744

Discrimination of benign and neoplastic mucosa with a high-resolution microendoscope (HRME) in head and neck cancer.

PubMed

Vila, Peter M; Park, Chan W; Pierce, Mark C; Goldstein, Gregg H; Levy, Lauren; Gurudutt, Vivek V; Polydorides, Alexandros D; Godbold, James H; Teng, Marita S; Genden, Eric M; Miles, Brett A; Anandasabapathy, Sharmila; Gillenwater, Ann M; Richards-Kortum, Rebecca; Sikora, Andrew G

2012-10-01

The efficacy of ablative surgery for head and neck squamous cell carcinoma (HNSCC) depends critically on obtaining negative margins. Although intraoperative "frozen section" analysis of margins is a valuable adjunct, it is expensive, time-consuming, and highly dependent on pathologist expertise. Optical imaging has potential to improve the accuracy of margins by identifying cancerous tissue in real time. Our goal was to determine the accuracy and inter-rater reliability of head and neck cancer specialists using high-resolution microendoscopic (HRME) images to discriminate between cancerous and benign mucosa. Thirty-eight patients diagnosed with head and neck squamous cell carcinoma (HNSCC) were enrolled in this single-center study. HRME was used to image each specimen after application of proflavine, with concurrent standard histopathologic analysis. Images were evaluated for quality control, and a training set containing representative images of benign and neoplastic tissue was assembled. After viewing training images, seven head and neck cancer specialists with no previous HRME experience reviewed 36 test images and were asked to classify each. The mean accuracy of all reviewers in correctly diagnosing neoplastic mucosa was 97% (95% confidence interval (CI), 94-99%). The mean sensitivity and specificity were 98% (97-100%) and 92% (87-98%), respectively. The Fleiss kappa statistic for inter-rater reliability was 0.84 (0.77-0.91). Medical professionals can be quickly trained to use HRME to discriminate between benign and neoplastic mucosa in the head and neck. With further development, the HRME shows promise as a method of real-time margin determination at the point of care.

Discrimination of Benign and Neoplastic Mucosa with a High-Resolution Microendoscope (HRME) in Head and Neck Cancer

PubMed Central

Vila, Peter M.; Park, Chan W.; Pierce, Mark C.; Goldstein, Gregg H.; Levy, Lauren; Gurudutt, Vivek V.; Polydorides, Alexandras D.; Godbold, James H.; Teng, Marita S.; Genden, Eric M.; Miles, Brett A.; Anandasabapathy, Sharmila; Gillenwater, Ann M.; Richards-Kortum, Rebecca; Sikora, Andrew G.

2012-01-01

Background The efficacy of ablative surgery for head and neck squamous cell carcinoma (HNSCC) depends critically on obtaining negative margins. While intraoperative "frozen section" analysis of margins is a valuable adjunct, it is expensive, time-consuming, and highly dependent on pathologist expertise. Optical imaging has potential to improve the accuracy of margins by identifying cancerous tissue in real time. Our aim was to determine the accuracy and inter-rater reliability of head and neck cancer specialists using high-resolution microendoscopic (HRME) images to discriminate between cancerous and benign mucosa. Methods Thirty-eight patients diagnosed with HNSCC were enrolled in this single-center study. HRME was used to image each specimen after application of proflavine, with concurrent standard histopathologic analysis. Images were evaluated for quality control, and a training set containing representative images of benign and neoplastic tissue was assembled. After viewing training images, seven head and neck cancer specialists with no prior HRME experience reviewed 37 test images and were asked to classify each. Results The mean accuracy of all reviewers in correctly diagnosing neoplastic mucosa was 97 percent (95% Cl = 94–99%). The mean sensitivity and specificity were 98 percent (97–100%) and 92 percent (87–98%), respectively. The Fleiss kappa statistic for inter-rater reliability was 0.84 (0.77–0.91). Conclusions Medical professionals can be quickly trained to use HRME to discriminate between benign and neoplastic mucosa in the head and neck. With further development, the HRME shows promise as a method of real-time margin determination at the point of care. PMID:22492225

Dried blood spot specimen quality and validation of a new pre-analytical processing method for qualitative HIV-1 PCR, KwaZulu-Natal, South Africa

PubMed Central

Parboosing, Raveen; Siyaca, Ntombizandile; Moodley, Pravikrishnen

2016-01-01

Background Poor quality dried blood spot (DBS) specimens are usually rejected by virology laboratories, affecting early infant diagnosis of HIV. The practice of combining two incompletely-filled DBS in one specimen preparation tube during pre-analytical specimen processing (i.e., the two-spot method) has been implemented to reduce the number of specimens being rejected for insufficient volume. Objectives This study analysed laboratory data to describe the quality of DBS specimens and the use of the two-spot method over a one-year period, then validated the two-spot method against the standard (one-spot) method. Methods Data on HIV-1 PCR test requests submitted in 2014 to the Department of Virology at Inkosi Albert Luthuli Central Hospital in KwaZulu-Natal province, South Africa were analysed to describe reasons for specimen rejection, as well as results of the two-spot method. The accuracy, lower limit of detection and precision of the two-spot method were assessed. Results Of the 88 481 specimens received, 3.7% were rejected for pre-analytical problems. Of those, 48.9% were rejected as a result of insufficient specimen volume. Two health facilities had significantly more specimen rejections than other facilities. The two-spot method prevented 10 504 specimen rejections. The Pearson correlation coefficient comparing the standard to the two-spot method was 0.997. Conclusions The two-spot method was comparable with the standard method of pre-analytical specimen processing. Two health facilities were identified for targeted retraining on specimen quality. The two-spot method of DBS specimen processing can be used as an adjunct to retraining, to reduce the number of specimens rejected and improve linkage to care. PMID:28879108

Dried blood spot specimen quality and validation of a new pre-analytical processing method for qualitative HIV-1 PCR, KwaZulu-Natal, South Africa.

PubMed

Govender, Kerusha; Parboosing, Raveen; Siyaca, Ntombizandile; Moodley, Pravikrishnen

2016-01-01

Poor quality dried blood spot (DBS) specimens are usually rejected by virology laboratories, affecting early infant diagnosis of HIV. The practice of combining two incompletely-filled DBS in one specimen preparation tube during pre-analytical specimen processing (i.e., the two-spot method) has been implemented to reduce the number of specimens being rejected for insufficient volume. This study analysed laboratory data to describe the quality of DBS specimens and the use of the two-spot method over a one-year period, then validated the two-spot method against the standard (one-spot) method. Data on HIV-1 PCR test requests submitted in 2014 to the Department of Virology at Inkosi Albert Luthuli Central Hospital in KwaZulu-Natal province, South Africa were analysed to describe reasons for specimen rejection, as well as results of the two-spot method. The accuracy, lower limit of detection and precision of the two-spot method were assessed. Of the 88 481 specimens received, 3.7% were rejected for pre-analytical problems. Of those, 48.9% were rejected as a result of insufficient specimen volume. Two health facilities had significantly more specimen rejections than other facilities. The two-spot method prevented 10 504 specimen rejections. The Pearson correlation coefficient comparing the standard to the two-spot method was 0.997. The two-spot method was comparable with the standard method of pre-analytical specimen processing. Two health facilities were identified for targeted retraining on specimen quality. The two-spot method of DBS specimen processing can be used as an adjunct to retraining, to reduce the number of specimens rejected and improve linkage to care.

Digital tomosynthesis rendering of joint margins for arthritis assessment

NASA Astrophysics Data System (ADS)

Duryea, Jeffrey W.; Neumann, Gesa; Yoshioka, Hiroshi; Dobbins, James T., III

2004-05-01

PURPOSE: Rheumatoid arthritis (RA) of the hand is a significant healthcare problem. Techniques to accurately quantity the structural changes from RA are crucial for the development and prescription of therapies. Analysis of radiographic joint space width (JSW) is widely used and has demonstrated promise. However, radiography presents a 2D view of the joint. In this study we performed tomosynthesis reconstructions of proximal interphalangeal (PIP), and metacarpophalangeal (MCP) joints to measure the 3D joint structure. METHODS: We performed a reader study using simulated radiographs of 12 MCP and 12 PIP joints from skeletal specimens imaged with micro-CT. The tomosynthesis technique provided images of reconstructed planes with 0.75 mm spacing, which were presented to 2 readers with a computer tool. The readers were instructed to delineate the joint surfaces on tomosynthetic slices where they could visualize the margins. We performed a quantitative analysis of 5 slices surrounding the central portion of each joint. Reader-determined JSW was compared to a gold standard. As a figure of merit we calculated the average root-mean square deviation (RMSD). RESULTS: RMSD was 0.22 mm for both joints. For the individual joints, RMSD was 0.18 mm (MCP), and 0.26 mm (PIP). The reduced performance for the smaller PIP joints suggests that a slice spacing less than 0.75 mm may be more appropriate. CONCLUSIONS: We have demonstrated the capability of limited 3D rendering of joint surfaces using digital tomosynthesis. This technique promises to provide an improved method to visualize the structural changes of RA.

Effect of different resin luting cements on the marginal fit of lithium disilicate pressed crowns.

PubMed

Mounajjed, Radek; Salinas, Thomas J; Ingr, Tomas; Azar, Basel

2017-11-15

The vertical marginal discrepancy of restorations can increase upon cementation, and poor marginal fit can lead to cement dissolution, marginal discoloration, microleakage, and secondary caries. The amount of increase is related to the type of luting cement used, but how lithium disilicate pressed crowns are affected by different resin cements is unclear. The purpose of this in vitro study was to compare the effect of using different resin luting cements on the vertical marginal discrepancy of lithium disilicate pressed crowns. A total of 18 intact extracted mandibular third molars were disinfected in a solution of 10% formalin for 7 days and were then prepared to receive a ceramic crown. Impressions were made with polyvinyl siloxane and lithium disilicate pressed crowns made and cemented with 1 of 3 resin luting cements. The marginal discrepancy was measured at 4 points on the finishing line of each tooth, with optical microscopy at ×200 magnification before and after cementation. Statistical analysis was done with the Kruskal-Wallis test to compare the median marginal increase among the 3 groups. The least amount of marginal increase after cementation was with Harvard PremiumFlow cement, with an average marginal increase of 42 ±11 μm. RelyX Ultimate cement increased the margins by an average 45 ±29 μm. The highest marginal increase was found in the Enamel Plus HRi preheated composite resin group (116 ±47 μm). The marginal increase of pressed crowns cemented with preheated composite resin (Enamel Plus HRi) exceeded the clinically acceptable range of marginal discrepancy. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Estimation of marginal abatement costs of CO2 in Chinese provinces under 2020 carbon emission rights allocation: 2005-2020.

PubMed

Duan, Fumei; Wang, Yong; Wang, Ying; Zhao, Han

2018-06-16

The calculation of marginal abatement costs of CO 2 plays a vital role in meeting China's 2020 emission reduction targets by providing reference for determining carbon tax and carbon trading pricing. However, most existing researches only used one method to discuss regional and industrial marginal abatement costs, and almost no studies predicted future marginal abatement costs from the perspective of CO 2 emission efficiency. To make up for the gaps, this paper first estimates marginal abatement costs of CO 2 in three major industries of 30 provinces in China from 2005 to 2015 based on three assumptions. Second, based on the principle of fairness and efficiency, China's 2020 emission reduction targets are decomposed by province. Based on the ZSG-C-DDF model, the marginal abatement costs of CO 2 in all provinces in China in 2020 are estimated and compared with the marginal abatement costs of 2005 to 2015. The results show that (1) from 2005 to 2015, marginal abatement costs of CO 2 in all provinces show a fluctuating upward trend; (2) compared with the marginal abatement costs of primary industry or tertiary industry, most provinces have lower marginal abatement costs for secondary industry; and (3) the average marginal abatement costs of CO 2 for China in 2020 are 2766.882 Yuan/tonne for the 40% carbon intensity reduction target and 3334.836 Yuan/tonne for the 45% target, showing that the higher the emission reduction target, the higher the marginal abatement costs of CO 2 . (4) Overall, the average marginal abatement costs of CO 2 in China by 2020 are higher than those in 2005-2015. The empirical analysis in this paper can provide multiple references for environmental policy makers.

Drug Resistance and R Factors in the Bowel Bacteria of London Patients before and after Admission to Hospital

PubMed Central

Datta, Naomi

1969-01-01

The content of drug-resistant coliform bacteria in faecal specimens collected before admission from patients awaiting non-urgent surgery were compared with specimens collected in hospital. Resistant strains of Escherichia coli were isolated from 52% of preadmission specimens and were present in large numbers in 28%. Tetracycline, sulphonamide, and streptomycin resistance were commonest: 60% of resistant strains carried transmissible R factors and multiple resistance was commoner than single. No characteristically resistant intestinal bacteria of any genera were found in hospital specimens as compared with those from outside. PMID:4976456

In Vitro Inhibition of Enamel Demineralisation by Fluoride-releasing Restorative Materials and Dental Adhesives.

PubMed

Dionysopoulos, Dimitrios; Koliniotou-Koumpia, Eugenia; Helvatzoglou-Antoniades, Maria; Kotsanos, Nikolaos

2016-01-01

To determine the ability of 5 contemporary fluoride-releasing restoratives and 3 fluoride-releasing adhesives to inhibit enamel demineralisation surrounding restorations, and the associations between inhibition and the levels of fluoride released from these materials. Five fluoride-releasing restoratives (Fuji IX GP, Ketac N100, Dyract Extra, Beautifil II and Wave) and 3 fluoride-releasing adhesives (Stae, Prime & Bond NT and Fluoro Bond II) were investigated. Eight disks of each material were prepared. Fluoride release was measured daily using a fluoride-ion-selective electrode for 15 days. Twenty-four cavities for each group were restored with a restorative and an adhesive. Specimens were subjected to thermal stress and stored for 30 days in saline solution. After a 15-day pH-cycling regimen, two 150-μm-thick sections were derived from each specimen. Enamel lesion depth was measured at 0, 100, and 200 μm from each restoration's margin via polarised light microscopy. Of the restoratives investigated, Fuji IX GP released the most fluoride. The fluoride-releasing restoratives tested exhibited shallower enamel lesions than did the control group at all distances tested (p < 0.05). Fuji IX GP yielded significantly lower enamel lesion depth than did the other experimental materials. The depths of enamel lesions did not differ significantly when comparing restoratives applied with a fluoride-releasing adhesive with those applied with a non-fluoride-releasing adhesive. The fluoride-releasing materials tested reduced enamel demineralisation but to different extents, depending on their levels of fluoride release. Fluoride-releasing adhesives did not influence enamel lesion formation.

Utility of bronchial lavage fluids for epithelial growth factor receptor mutation assay in lung cancer patients: Comparison between cell pellets, cell blocks and matching tissue specimens

PubMed Central

Asaka, Shiho; Yoshizawa, Akihiko; Nakata, Rie; Negishi, Tatsuya; Yamamoto, Hiroshi; Shiina, Takayuki; Shigeto, Shohei; Matsuda, Kazuyuki; Kobayashi, Yukihiro; Honda, Takayuki

2018-01-01

The detection of epidermal growth factor receptor (EGFR) mutations is necessary for the selection of suitable patients with non-small cell lung cancer (NSCLC) for treatment with EGFR tyrosine kinase inhibitors. Cytology specimens are known to be suitable for EGFR mutation detection, although tissue specimens should be prioritized; however, there are limited studies that examine the utility of bronchial lavage fluid (BLF) in mutation detection. The purpose of the present study was to investigate the utility of BLF specimens for the detection of EGFR mutations using a conventional quantitative EGFR polymerase chain reaction (PCR) assay. Initially, quantification cycle (Cq) values of cell pellets, cell-free supernatants and cell blocks obtained from three series of 1% EGFR mutation-positive lung cancer cell line samples were compared for mutation detection. In addition, PCR analysis of BLF specimens obtained from 77 consecutive NSCLC patients, detecting EGFR mutations was validated, and these results were compared with those for the corresponding formalin-fixed paraffin-embedded (FFPE) tissue specimens obtained by surgical resection or biopsy of 49 of these patients. The Cq values for mutation detection were significantly lower in the cell pellet group (average, 29.58) compared with the other groups, followed by those in cell-free supernatants (average, 34.15) and in cell blocks (average, 37.12) for all three series (P<0.05). Mutational status was successfully analyzed in 77 BLF specimens, and the results obtained were concordant with those of the 49 matching FFPE tissue specimens. Notably, EGFR mutations were even detected in 10 cytological specimens that contained insufficient tumor cells. EGFR mutation testing with BLF specimens is therefore a useful and reliable method, particularly when sufficient cancer cells are not obtained. PMID:29399190

The Degeneration of Meniscus Roots Is Accompanied by Fibrocartilage Formation, Which May Precede Meniscus Root Tears in Osteoarthritic Knees.

PubMed

Park, Do Young; Min, Byoung-Hyun; Choi, Byung Hyune; Kim, Young Jick; Kim, Mijin; Suh-Kim, Haeyoung; Kim, Joon Ho

2015-12-01

Fibrocartilage metaplasia in tendons and ligaments is an adaptation to compression as well as a pathological feature during degeneration. Medial meniscus posterior roots are unique ligaments that resist multidirectional forces, including compression. To characterize the degeneration of medial meniscus posterior root tears in osteoarthritic knees, with an emphasis on fibrocartilage and calcification. Cross-sectional study; Level of evidence, 3. Samples of medial meniscus posterior roots were harvested from cadaveric specimens and patients during knee replacement surgery and grouped as follows: normal reference, no tear, partial tear, and complete tear. Degeneration was analyzed with histology, immunohistochemistry, and real-time polymerase chain reaction. Uniaxial tensile tests were performed on specimens with and without fibrocartilage. Quantifiable data were statistically analyzed by the Kruskal-Wallis test with the Dunn comparison test. Thirty, 28, and 42 samples harvested from 99 patients were allocated into the no tear, partial tear, and complete tear groups, respectively. Mean modified Bonar tendinopathy scores for each group were 3.97, 9.31, and 14.15, respectively, showing a higher degree of degeneration associated with the extent of the tear (P < .05 for all groups). The characterization of root matrices revealed an increase in fibrocartilage according to the extent of the tear. Tear margins revealed fibrocartilage in 59.3% of partial tear samples and 76.2% of complete tear samples, with a distinctive cleavage-like shape. Root tears with a similar shape were induced within fibrocartilaginous areas during uniaxial tensile testing. Even in the no tear group, 56.7% of samples showed fibrocartilage in the anterior margin of the root, adjacent to the meniscus. An increased stained area of calcification and expression of the ectonucleotide pyrophosphatase/phosphodiesterase 1 gene were observed in the complete tear group compared with the no tear group (P < .0001 and P = .24, respectively). Fibrocartilage and calcification increased in medial meniscus posterior roots, associated with the degree of the tear. Both findings, which impair the ligament's resistance to tension, may play a pivotal role during the pathogenesis of degenerative meniscus root tears in osteoarthritic knees. Fibrocartilage and calcification may be useful as diagnostic markers as well as markers of degeneration, which may aid in determining the treatment modality in meniscus root tears. The presence of fibrocartilage in intact roots may suggest an impending tear in osteoarthritic knees. © 2015 The Author(s).

Species composition, larval habitats, seasonal occurrence and distribution of potential malaria vectors and associated species of Anopheles (Diptera: Culicidae) from the Republic of Korea

PubMed Central

2010-01-01

Background Larval mosquito habitats of potential malaria vectors and related species of Anopheles from three provinces (Gyeonggi, Gyeongsangbuk, Chungcheongbuk Provinces) of the Republic of Korea were surveyed in 2007. This study aimed to determine the species composition, seasonal occurrence and distributions of Anopheles mosquitoes. Satellite derived normalized difference vegetation index data (NDVI) was also used to study the seasonal abundance patterns of Anopheles mosquitoes. Methods Mosquito larvae from various habitats were collected using a standard larval dipper or a white plastic larval tray, placed in plastic bags, and were preserved in 100% ethyl alcohol for species identification by PCR and DNA sequencing. The habitats in the monthly larval surveys included artificial containers, ground depressions, irrigation ditches, drainage ditches, ground pools, ponds, rice paddies, stream margins, inlets and pools, swamps, and uncultivated fields. All field-collected specimens were identified to species, and relationships among habitats and locations based on species composition were determined using cluster statistical analysis. Results In about 10,000 specimens collected, eight species of Anopheles belonging to three groups were identified: Hyrcanus Group - Anopheles sinensis, Anopheles kleini, Anopheles belenrae, Anopheles pullus, Anopheles lesteri, Anopheles sineroides; Barbirostris Group - Anopheles koreicus; and Lindesayi Group - Anopheles lindesayi japonicus. Only An. sinensis was collected from all habitats groups, while An. kleini, An. pullus and An. sineroides were sampled from all, except artificial containers. The highest number of Anopheles larvae was found in the rice paddies (34.8%), followed by irrigation ditches (23.4%), ponds (17.0%), and stream margins, inlets and pools (12.0%). Anopheles sinensis was the dominant species, followed by An. kleini, An. pullus and An. sineroides. The monthly abundance data of the Anopheles species from three locations (Munsan, Jinbo and Hayang) were compared against NDVI and NDVI anomalies. Conclusion The species composition of Anopheles larvae varied in different habitats at various locations. Anopheles populations fluctuated with the seasonal dynamics of vegetation for 2007. Multi-year data of mosquito collections are required to provide a better characterization of the abundance of these insects from year to year, which can potentially provide predictive capability of their population density based on remotely sensed ecological measurements. PMID:20163728

Assessment of fresh breast tissue specimens with confocal strip-mosaicking microscopy in an emulated pathology setting (Conference Presentation)

NASA Astrophysics Data System (ADS)

Abeytunge, Sanjeewa; Larson, Bjorg A.; Peterson, Gary; Rajadhyaksha, Milind; Murray, Melissa

2017-02-01

Confocal microscopy is in clinical use to diagnose skin cancers in the United States and in Europe. Potentially, this technology may provide bed-side pathology in breast cancer surgery during tumor removal. Initial studies have described major findings of invasive breast cancers as seen on fluorescence confocal microscopy. In many of these studies the region of interest (ROI) used in the analysis was user-selected and small (typically 15 square-mm). Although these important findings open exploration into rapid pathology, further development and implementation in a surgical setting will require examination of large specimens in a blinded fashion that will address the needs of typical surgical settings. In post surgery pathology viewing, pathologists inspect the entire pathology section with a low (2X) magnification objective lens initially and then zoomed in to ROIs with higher magnification lenses (10X to 40X) magnifications to further investigate suspected regions. In this study we explore the possibility of implementation in a typical surgical setting with a new microscope, termed confocal strip-mosaicking microscope (CSM microscope), which images an area of 400 square-mm (2 cm x 2 cm) of tissue with cellular level resolution in 10 minutes. CSM images of 34 human breast tissue specimens from 18 patients were blindly analyzed by a board-certified pathologist and correlated with the corresponding standard fixed histopathology. Invasive tumors and benign tissue were clearly identified in CSM images. Thirty specimens were concordant for images-to-histopathology correlation while four were discordant. Preliminary results from on-going work to molecularly target tumor margin will also be presented.

Clinical and histologic evaluation of non-surgical periodontal therapy with enamel matrix derivative: a report of four cases.

PubMed

Mellonig, James T; Valderrama, Pilar; Gregory, Holly J; Cochran, David L

2009-09-01

Enamel matrix derivative (EMD) is a composite of proteins that was demonstrated histologically to work as an adjunct to periodontal regenerative surgical therapy. The purpose of this study was to evaluate the clinical and histologic effects of EMD as an adjunct to scaling and root planing. Four patients with severe chronic periodontitis and scheduled to receive complete dentures were accrued. Probing depth and clinical attachment levels were obtained. Unlimited time was allowed for hand and ultrasonic instrumentation. A notch was placed in the root >or=1 to 2 mm from the apical extent of root planing. EMD was inserted into the pocket, and a periodontal dressing was placed. Patients were seen every 2 weeks for plaque control. At 6 months post-treatment, soft tissue measurements were repeated, and the teeth were removed en bloc and prepared for histomorphologic analysis. Probing depth reduction and clinical attachment level gain were obtained in three-fourths of the specimens. Three of the four specimens analyzed histologically demonstrated new cementum, bone, periodontal ligament, and connective tissue attachment coronal to the notch. In one specimen, the gingival margin had receded below the notch. The results were unexpected and may represent an aberration. However, the substantial reduction in deep probing depths and clinical attachment level gain in three of four specimens, in addition to the histologic findings of new cementum, new bone, a new periodontal ligament, and a new connective tissue attachment, suggest that EMD may be useful as an adjunct to scaling and root planing in single-rooted teeth.

Patient safety in the clinical laboratory: a longitudinal analysis of specimen identification errors.

PubMed

Wagar, Elizabeth A; Tamashiro, Lorraine; Yasin, Bushra; Hilborne, Lee; Bruckner, David A

2006-11-01

Patient safety is an increasingly visible and important mission for clinical laboratories. Attention to improving processes related to patient identification and specimen labeling is being paid by accreditation and regulatory organizations because errors in these areas that jeopardize patient safety are common and avoidable through improvement in the total testing process. To assess patient identification and specimen labeling improvement after multiple implementation projects using longitudinal statistical tools. Specimen errors were categorized by a multidisciplinary health care team. Patient identification errors were grouped into 3 categories: (1) specimen/requisition mismatch, (2) unlabeled specimens, and (3) mislabeled specimens. Specimens with these types of identification errors were compared preimplementation and postimplementation for 3 patient safety projects: (1) reorganization of phlebotomy (4 months); (2) introduction of an electronic event reporting system (10 months); and (3) activation of an automated processing system (14 months) for a 24-month period, using trend analysis and Student t test statistics. Of 16,632 total specimen errors, mislabeled specimens, requisition mismatches, and unlabeled specimens represented 1.0%, 6.3%, and 4.6% of errors, respectively. Student t test showed a significant decrease in the most serious error, mislabeled specimens (P < .001) when compared to before implementation of the 3 patient safety projects. Trend analysis demonstrated decreases in all 3 error types for 26 months. Applying performance-improvement strategies that focus longitudinally on specimen labeling errors can significantly reduce errors, therefore improving patient safety. This is an important area in which laboratory professionals, working in interdisciplinary teams, can improve safety and outcomes of care.

Comparing vaccines: a systematic review of the use of the non-inferiority margin in vaccine trials.

PubMed

Donken, R; de Melker, H E; Rots, N Y; Berbers, G; Knol, M J

2015-03-17

Non-inferiority (NI) randomized controlled trials (RCTs) aim to demonstrate that a new treatment is no worse than a comparator that has already shown its efficacy over placebo within a pre-specified margin. However, clear guidelines on how the NI margin should be determined are lacking for vaccine trials. A difference (seroprevalence/risk) of 10% or a geometric mean titre/concentration (GMT) ratio of 1.5 or 2.0 in antibody levels is implicitly recommended for vaccine trials. We aimed to explore which NI margins were used in vaccine RCTs and how they were determined. A systematic search for NI vaccine RCTs yielded 177 eligible articles. Data were extracted from these articles using a standardized form and included general characteristics and characteristics specific for NI trials. Relations between the study characteristics and the NI margin used were explored. Among the 143 studies using an NI margin based on difference (n=136 on immunogenicity, n=2 on efficacy and n=5 on safety), 66% used a margin of 10%, 23% used margins lower than 10% (range 1-7.5%) and 11% used margins larger than 10% (range 11.5-25%). Of the 103 studies using a NI margin based on the GMT ratio, 50% used a margin of 0.67/1.5 and 49% used 0.5/2.0. As observed, 85% of the studies did not discuss the method of margin determination; and 19% of the studies lacked a confidence interval or p-value for non-inferiority. Most NI vaccine RCTs used an NI margin of 10% for difference or a GMT ratio of 1.5 or 2.0 without a clear rationale. Most articles presented enough information for the reader to make a judgement about the NI margin used and the conclusions. The reporting on the design, margins used and results of NI vaccine trials could be improved; more explicit guidelines may help to achieve this end. Copyright © 2015 Elsevier Ltd. All rights reserved.

The trophic and metabolic pathways of foraminifera in the Arabian Sea: evidence from cellular stable isotopes

NASA Astrophysics Data System (ADS)

Jeffreys, R. M.; Fisher, E. H.; Gooday, A. J.; Larkin, K. E.; Wolff, G. A.; Billett, D. S. M.

2014-12-01

The Arabian Sea is a region of elevated productivity with the highest globally recorded fluxes of particulate organic matter (POM) to the deep ocean, providing an abundant food source for fauna at the seafloor. However, benthic communities are also strongly influenced by an intense oxygen minimum zone (OMZ), which impinges on the continental slope at bathyal depths. We compared the trophic ecology of foraminifera on the Oman and Pakistan margins of the Arabian Sea (140-3185 m water depth). Organic carbon concentrations of surficial sediments were higher on the Oman margin (3.32 ± 1.4%) compared to the Pakistan margin (2.45 ± 1.1%) and sedimentary organic matter (SOM) quality estimated from the Hydrogen Index was also higher on the Oman margin (300-400 mg HC (mg TOC)-1) compared to the Pakistan margin (<250 mg HC (mg TOC)-1). δ13C and δ15N values of sediments were similar on both margins (-20 and 8‰, respectively). Stable isotope analysis (SIA) showed that foraminiferal cells had a wide range of δ13C values (-25.5 to -11.5‰), implying that they utilise multiple food sources; indeed δ13C values varied between depths, foraminiferal types and between the two margins. Foraminifera had broad ranges in δ15N values (-7.8 to 27.3‰). The enriched values suggest that some species may store nitrate to utilise in respiration; this was most notable on the Pakistan margin. Depleted foraminiferal δ15N values were identified on both margins, particularly the Oman margin, and may reflect feeding on chemosynthetic bacteria. We suggest that differences in productivity regimes between the two margins may be responsible for the differences observed in foraminiferal isotopic composition. In addition, at the time of sampling, whole jellyfish carcasses (Crambionella orsini) and a carpet of jelly detritus were observed across the Oman margin transect. Associated chemosynthetic bacteria may have provided an organic-rich food source for foraminifera at these sites. Our data suggest that foraminifera in OMZ settings can utilise a variety of food sources and metabolic pathways to meet their energetic demands.

Home-based versus clinic-based specimen collection in the management of Chlamydia trachomatis and Neisseria gonorrhoeae infections.

PubMed

Fajardo-Bernal, Luisa; Aponte-Gonzalez, Johanna; Vigil, Patrick; Angel-Müller, Edith; Rincon, Carlos; Gaitán, Hernando G; Low, Nicola

2015-09-29

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most frequent causes of bacterial sexually transmitted infections (STIs). Management strategies that reduce losses in the clinical pathway from infection to cure might improve STI control and reduce complications resulting from lack of, or inadequate, treatment. To assess the effectiveness and safety of home-based specimen collection as part of the management strategy for Chlamydia trachomatis and Neisseria gonorrhoeae infections compared with clinic-based specimen collection in sexually-active people. We searched the Cochrane Sexually Transmitted Infections Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS on 27 May 2015, together with the World Health Organization International Clinical Trials Registry (ICTRP) and ClinicalTrials.gov. We also handsearched conference proceedings, contacted trial authors and reviewed the reference lists of retrieved studies. Randomized controlled trials (RCTs) of home-based compared with clinic-based specimen collection in the management of C. trachomatis and N. gonorrhoeae infections. Three review authors independently assessed trials for inclusion, extracted data and assessed risk of bias. We contacted study authors for additional information. We resolved any disagreements through consensus. We used standard methodological procedures recommended by Cochrane. The primary outcome was index case management, defined as the number of participants tested, diagnosed and treated, if test positive. Ten trials involving 10,479 participants were included. There was inconclusive evidence of an effect on the proportion of participants with index case management (defined as individuals tested, diagnosed and treated for CT or NG, or both) in the group with home-based (45/778, 5.8%) compared with clinic-based (51/788, 6.5%) specimen collection (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.29; 3 trials, I² = 0%, 1566 participants, moderate quality). Harms of home-based specimen collection were not evaluated in any trial. All 10 trials compared the proportions of individuals tested. The results for the proportion of participants completing testing had high heterogeneity (I² = 100%) and were not pooled. We could not combine data from individual studies looking at the number of participants tested because the proportions varied widely across the studies, ranging from 30% to 96% in home group and 6% to 97% in clinic group (low-quality evidence). The number of participants with positive test was lower in the home-based specimen collection group (240/2074, 11.6%) compared with the clinic-based group (179/967, 18.5%) (RR 0.72, 95% CI 0.61 to 0.86; 9 trials, I² = 0%, 3041 participants, moderate quality). Home-based specimen collection could result in similar levels of index case management for CT or NG infection when compared with clinic-based specimen collection. Increases in the proportion of individuals tested as a result of home-based, compared with clinic-based, specimen collection are offset by a lower proportion of positive results. The harms of home-based specimen collection compared with clinic-based specimen collection have not been evaluated. Future RCTs to assess the effectiveness of home-based specimen collection should be designed to measure biological outcomes of STI case management, such as proportion of participants with negative tests for the relevant STI at follow-up.

Molecular Analysis of Sarcoidosis Granulomas Reveals Antimicrobial Targets

PubMed Central

Celada, Lindsay J.; Polosukhin, Vasiliy V.; Atkinson, James B.; Drake, Wonder P.

2016-01-01

Sarcoidosis is a granulomatous disease of unknown cause. Prior molecular and immunologic studies have confirmed the presence of mycobacterial virulence factors, such as catalase peroxidase and superoxide dismutase A, within sarcoidosis granulomas. Molecular analysis of granulomas can identify targets of known antibiotics classes. Currently, major antibiotics are directed against DNA synthesis, protein synthesis, and cell wall formation. We conducted molecular analysis of 40 sarcoidosis diagnostic specimens and compared them with 33 disease control specimens for the presence of mycobacterial genes that encode antibiotic targets. We assessed for genes involved in DNA synthesis (DNA gyrase A [gyrA] and DNA gyrase B), protein synthesis (RNA polymerase subunit β), cell wall synthesis (embCAB operon and enoyl reductase), and catalase peroxidase. Immunohistochemical analysis was conducted to investigate the locale of mycobacterial genes such as gyrA within 12 sarcoidosis specimens and 12 disease controls. Mycobacterial DNA was detected in 33 of 39 sarcoidosis specimens by quantitative real-time polymerase chain reaction compared with 2 of 30 disease control specimens (P < 0.001, two-tailed Fisher’s test). Twenty of 39 were positive for three or more mycobacterial genes, compared with 1 of 30 control specimens (P < 0.001, two-tailed Fisher’s test). Immunohistochemistry analysis localized mycobacterial gyrA nucleic acids to sites of granuloma formation in 9 of 12 sarcoidosis specimens compared with 1 of 12 disease controls (P < 0.01). Microbial genes encoding enzymes that can be targeted by currently available antimycobacterial antibiotics are present in sarcoidosis specimens and localize to sites of granulomatous inflammation. Use of antimicrobials directed against target enzymes may be an innovative treatment alternative. PMID:26807608

Influence of specimen dimensions on ductile-to-brittle transition temperature in Charpy impact test

NASA Astrophysics Data System (ADS)

Rzepa, S.; Bucki, T.; Konopík, P.; Džugan, J.; Rund, M.; Procházka, R.

2017-02-01

This paper discusses the correlation between specimen dimensions and transition temperature. Notch toughness properties of Standard Charpy-V specimens are compared to samples with lower width (7.5 mm, 5 mm, 2.5 mm) and sub-size Charpy specimens with cross section 3×4. In this study transition curves are correlated with lateral ductile part of fracture related ones for 5 considered geometries. Based on the results obtained, correlation procedure for transition temperature determination of full size specimens defined by fracture appearance of sub-sized specimens is proposed.

Method for accurate registration of tissue autofluorescence imaging data with corresponding histology: a means for enhanced tumor margin assessment

NASA Astrophysics Data System (ADS)

Unger, Jakob; Sun, Tianchen; Chen, Yi-Ling; Phipps, Jennifer E.; Bold, Richard J.; Darrow, Morgan A.; Ma, Kwan-Liu; Marcu, Laura

2018-01-01

An important step in establishing the diagnostic potential for emerging optical imaging techniques is accurate registration between imaging data and the corresponding tissue histopathology typically used as gold standard in clinical diagnostics. We present a method to precisely register data acquired with a point-scanning spectroscopic imaging technique from fresh surgical tissue specimen blocks with corresponding histological sections. Using a visible aiming beam to augment point-scanning multispectral time-resolved fluorescence spectroscopy on video images, we evaluate two different markers for the registration with histology: fiducial markers using a 405-nm CW laser and the tissue block's outer shape characteristics. We compare the registration performance with benchmark methods using either the fiducial markers or the outer shape characteristics alone to a hybrid method using both feature types. The hybrid method was found to perform best reaching an average error of 0.78±0.67 mm. This method provides a profound framework to validate diagnostical abilities of optical fiber-based techniques and furthermore enables the application of supervised machine learning techniques to automate tissue characterization.

Comparison of sampling methods for the detection of human rhinovirus RNA.

PubMed

Waris, Matti; Österback, Riikka; Lahti, Elina; Vuorinen, Tytti; Ruuskanen, Olli; Peltola, Ville

2013-09-01

Obtaining a nasal swab (NS) from a child for human rhinovirus (HRV) RNA detection is simple and well tolerated even for repeated sampling, but only few studies have compared them qualitatively and quantitatively with other sampling methods. Real-time PCR was used to study the stability of HRV genomes in swabs, and to compare different swabs and induced sputum specimens with nasopharyngeal aspirates (NPAs). Replicate swabs in a dry test tube were stored at room temperature or mailed to the laboratory before freezing, and compared to freshly frozen specimens. To compare sampling methods, paediatric patients had NPA, NS and throat swab collected. In paired sputum and NPA specimens, viral load was correlated to the amount of β-actin mRNA. Specimens were stable at room temperature for at least 4 days and survived mailing without loss of HRV detectability. As compared to NPA, NS had an equal diagnostic sensitivity, with no significant quantitative difference using flocked nylon swabs and a 2.2-fold drop in the average copy number using cotton swabs. The diagnostic sensitivity of cotton swab-collected throat specimens was 97%, with a 26-fold lower mean copy number. Sputum specimens had higher HRV RNA (2.3-fold) and β-actin mRNA (1.6-fold) copy numbers than NPAs, but there was a poor correlation between HRV RNA and β-actin mRNA. HRV remains well detectable by PCR in specimens mailed to the laboratory. The diagnostic efficacy of NPA can be obtained with NS, quantitative comparison and patient comfort favouring flocked nylon-tipped over cotton-tipped swabs. Copyright © 2013 Elsevier B.V. All rights reserved.

Stainless and Galvanized Steel, Hydrophobic Admixture and Flexible Polymer-Cement Coating Compared in Increasing Durability of Reinforced Concrete Structures

NASA Astrophysics Data System (ADS)

Tittarelli, Francesca; Giosuè, Chiara; Mobili, Alessandra

2017-08-01

The use of stainless or galvanized steel reinforcements, a hydrophobic admixture or a flexible polymer-cement coating were compared as methods to improve the corrosion resistance of sound or cracked reinforced concrete specimens exposed to chloride rich solutions. The results show that in full immersion condition, negligible corrosion rates were detected in all cracked specimens, except those treated with the flexible polymer-cement mortar as preventive method against corrosion and the hydrophobic concrete specimens. High corrosion rates were measured in all cracked specimens exposed to wet-dry cycles, except for those reinforced with stainless steel, those treated with the flexible polymer-cement coating as restorative method against reinforcement corrosion and for hydrophobic concrete specimens reinforced with galvanized steel reinforcements.

Rolling contact fatigue strengths of shot-peened and crack-healed ceramics

NASA Astrophysics Data System (ADS)

Takahashi, K.; Oki, T.

2018-06-01

The effects of shot-peening (SP) and crack-healing on the rolling contact fatigue (RCF) strengths of Al2O3/SiC composite ceramics were investigated. Non-shot-peened, shot- peened, and shot-peened + crack-healed specimens were prepared. SP was performed using ZrO2 beads. The shot-peened + crack-healed specimen was crack-healed after SP. X-ray diffraction clearly showed that SP induced a compressive residual stress up to 300 MPa at the specimen surfaces. Furthermore, the shot-peened + crack-healed specimen retained a compressive residual stress of 200 MPa. The apparent surface fracture toughness of the shot- peened specimens increased owing to the positive effects of the compressive residual stress. RCF tests were performed using a thrust load-bearing test device. The RCF lives of the shot- peened specimens did not improve compared to that of the non-shot-peened specimen, because the numerous SP-introduced surface cracks could act as crack initiation sites during the RCF tests. However, the RCF life of the shot-peened + crack-healed specimen did improve compared to those of non-shot-peened and shot-peened specimens, implying that combining SP and crack-healing was an effective strategy for improving the RCF lives of Al2O3/SiC composite ceramics.

Heavy section fracture toughness screening specimen

NASA Technical Reports Server (NTRS)

Shannon, J. L., Jr.; Donald, J. K.; Brown, W. F., Jr.

1976-01-01

Size requirements for a pin loaded double edge notch + crack tension specimen proposed for fracture toughness screening heavy section alloys were studied. Ranking of eight selected alloys based on the specimen's net strength was compared with that based on the valid plane strain fracture toughness separately determined. Performance of the specimen was judged on the basis of that comparison. The specimen's net strength was influenced by three critical specimen dimensions: distance between the crack plane and the loading hole, specimen width, and specimen thickness. Interaction between the stress fields of the crack and the loading holes reduced the net strength, but this effect disappeared as the separation reached a dimension equal to the specimen width. The effects of specimen width and thickness are interrelated and affect the net strength through their influence on the development of the crack tip plastic zone.

Retention Strength of PMMA/UDMA-Based Crowns Bonded to Dentin: Impact of Different Coupling Agents for Pretreatment

PubMed Central

Stawarczyk, Bogna; Teuss, Simona; Eichberger, Marlis; Roos, Malgorzata; Keul, Christine

2015-01-01

Computer aided design/computer aided manufacturing (CAD/CAM) polymers for long-term dental restorations benefit from enhanced mechanical properties. However, the quantification of their bonding properties on teeth is lacking. Therefore, the aim of this study was to determine the retention strength (RS) of differently pretreated new developed polymethylmethacrylate/urethanedimethacrylate-based CAD/CAM polymer bonded on dentin. In summary, 120 human caries-free molars were prepared, and polymeric crowns were milled and pretreated (n = 20): visio.link (VL), Scotchbond Universal (SU), Monobond Plus/Heliobond (MH), Margin Bond (MB), Margin Bond mixed with acetone (1:1) (MBA) or not pretreated (CG). Half of the specimens were cemented using Variolink II and the other half with RelyX Ultimate. Specimens were stored for 24 h in distilled water and thermal cycled (5000 ×, 5 °C/55 °C). The retention load was measured and failure types were defined. RS was calculated and analyzed using both two- and one-way ANOVA with a post-hoc Scheffé-test, unpaired t-test, Kaplan–Meier with Breslow–Gehan test and chi-squared test (p < 0.05). Crowns bonded using RelyX Ultimate showed higher RS than those bonded using Variolink II. The pretreatment showed no impact on the RS. However, survival analysis within Variolink II found an impact of pretreatment. The median RS for MH was the lowest and statistically different from MB, MBA and CG. For Variolink II MH had the poorest survival as the estimated cumulative failure function of the debonded crown increased very quickly with increasing TBS. Within the RelyX Ultimate groups, no significant differences were determined. The newly developed CAD/CAM polymer showed the highest bonding properties after cementation using RelyX Ultimate. PMID:28793651

Augmented Reality Robot-assisted Radical Prostatectomy: Preliminary Experience.

PubMed

Porpiglia, Francesco; Fiori, Cristian; Checcucci, Enrico; Amparore, Daniele; Bertolo, Riccardo

2018-05-01

To present our preliminary experience with augmented reality robot-assisted radical prostatectomy (AR-RARP). From June to August 2017, patients candidate to RARP were enrolled and underwent high-resolution multi-parametric magnetic resonance imaging (1-mm slices) according to dedicated protocol. The obtained three-dimensional (3D) reconstruction was integrated in the robotic console to perform AR-RARP. According to the staging at magnetic resonance imaging or reconstruction, in case of cT2 prostate cancer, intrafascial nerve sparing (NS) was performed: a mark was placed on the prostate capsule to indicate the virtual underlying intraprostatic lesion; in case of cT3, standard NS AR-RARP was scheduled with AR-guided biopsy at the level of suspected extracapsular extension (ECE). Prostate specimens were scanned to assess the 3D model concordance. Sixteen patients underwent intrafascial NS technique (cT2), whereas 14 underwent standard NS+ selective biopsy of suspected ECE (cT3). Final pathology confirmed clinical staging. Positive surgical margins' rate was 30% (no positive surgical margins in pT2). In patients whose intraprostatic lesions were marked, final pathology confirmed lesion location. In patients with suspected ECE, AR-guided selective biopsies confirmed the ECE location, with 11 of 14 biopsies (78%) positive for prostate cancer. Prostate specimens were scanned with finding of a good overlap. The mismatch between 3D reconstruction and scanning ranged from 1 to 5 mm. In 85% of the entire surface, the mismatch was <3 mm. In our preliminary experience, AR-RARP seems to be safe and effective. The accuracy of 3D reconstruction seemed to be promising. This technology has still limitations: the virtual models are manually oriented and rigid. Future collaborations with bioengineers will allow overcoming these limitations. Copyright © 2018 Elsevier Inc. All rights reserved.

Osteochondral lesions in distal tarsal joints of Icelandic horses reveal strong associations between hyaline and calcified cartilage abnormalities.

PubMed

Ley, C J; Ekman, S; Hansson, K; Björnsdóttir, S; Boyde, A

2014-03-25

Osteochondral lesions in the joints of the distal tarsal region of young Icelandic horses provide a natural model for the early stages of osteoarthritis (OA) in low-motion joints. We describe and characterise mineralised and non-mineralised osteochondral lesions in left distal tarsal region joint specimens from twenty-two 30 ±1 month-old Icelandic horses. Combinations of confocal scanning light microscopy, backscattered electron scanning electron microscopy (including, importantly, iodine staining) and three-dimensional microcomputed tomography were used on specimens obtained with guidance from clinical imaging. Lesion-types were described and classified into groups according to morphological features. Their locations in the hyaline articular cartilage (HAC), articular calcified cartilage (ACC), subchondral bone (SCB) and the joint margin tissues were identified and their frequency in the joints recorded. Associations and correlations between lesion-types were investigated for centrodistal joints only. In centrodistal joints the lesion-types HAC chondrocyte loss, HAC fibrillation, HAC central chondrocyte clusters, ACC arrest and ACC advance had significant associations and strong correlations. These lesion-types had moderate to high frequency in centrodistal joints but low frequencies in tarsometatarsal and talocalcaneal-centroquartal joints. Joint margin lesion-types had no significant associations with other lesion-types in the centrodistal joints but high frequency in both the centrodistal and tarsometatarsal joints. The frequency of SCB lesion-types in all joints was low. Hypermineralised infill phase lesion-types were detected. Our results emphasise close associations between HAC and ACC lesions in equine centrodistal joints and the importance of ACC lesions in the development of OA in low-motion compression-loaded equine joints.

Real-Time Intraoperative Detection of Breast Cancer using Near-infrared Fluorescence Imaging and Methylene Blue

PubMed Central

Tummers, Quirijn R.J.G.; Verbeek, Floris P.R.; Schaafsma, Boudewijn E.; Boonstra, Martin C.; van der Vorst, Joost R.; Liefers, Gerrit-Jan; van de Velde, Cornelis J.H.; Frangioni, John V.; Vahrmeijer, Alexander L.

2014-01-01

Background Despite recent developments in preoperative breast cancer imaging, intraoperative localization of tumor tissue can be challenging, resulting in tumor-positive resection margins during breast-conserving surgery. Based on certain physicochemical similarities between Technetium(99mTc)-sestamibi (MIBI), a SPECT radiodiagnostic with a sensitivity of 83–90% to detect breast cancer preoperatively, and the near-infrared (NIR) fluorophore Methylene Blue (MB), we hypothesized that MB might detect breast cancer intraoperatively using NIR fluorescence imaging. Methods Twenty-four patients with breast cancer, planned for surgical resection, were included. Patients were divided in 2 administration groups, which differed with respect to the timing of MB administration. N = 12 patients per group were administered 1.0 mg/kg MB intravenously either immediately or 3 h before surgery. The mini-FLARE imaging system was used to identify the NIR fluorescent signal during surgery and on post-resected specimens transferred to the pathology department. Results were confirmed by NIR fluorescence microscopy. Results 20/24 (83%) of breast tumors (carcinoma in N=21 and ductal carcinoma in situ in N=3) were identified in the resected specimen using NIR fluorescence imaging. Patients with non-detectable tumors were significantly older. No significant relation to receptor status or tumor grade was seen. Overall tumor-to-background ratio (TBR) was 2.4 ± 0.8. There was no significant difference between TBR and background signal between administration groups. In 2/4 patients with positive resection margins, breast cancer tissue identified in the wound bed during surgery would have changed surgical management. Histology confirmed the concordance of fluorescence signal and tumor tissue. Conclusions This feasibility study demonstrated an overall breast cancer identification rate using MB of 83%, with real-time intraoperative guidance having the potential to alter patient management. PMID:24862545