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Favorable Results (favorable + result)
Selected AbstractsLongitudinal study of a health education program for Japanese women in menopauseNURSING & HEALTH SCIENCES, Issue 2 2009Masumi Ueda phd Abstract In this longitudinal intervention study, a 6 week health education program consisting of lectures and exercises was implemented for 39 Japanese menopausal women. The effects of the program were assessed by measuring their exercise participation, climacteric symptoms, and quality of life immediately before, 6 weeks after, and 1 year after the program. The Simplified Menopausal Index was used to assess the climacteric symptoms and the Medical Outcomes Study 36-Item Short-Form Health (SF-36) Survey was used to assess the quality of life. Significant improvements were observed in the subscale score for general health perception and the summary score for the physical component summary in the SF-36 Survey. Favorable results also were found for women without a previous exercise habit before the program but who participated in regular exercise 1 year after the program. No improvements were observed in the climacteric symptoms. We concluded that our program was effective for menopausal women in spite of the intervention period being relatively short. [source] Palatal adhesion: The treatment of unilateral palatal paralysis after high vagus nerve injuryHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2002James L. Netterville MD Abstract Background Resection of skull base tumors commonly necessitates intraoperative sacrifice of lower cranial nerves at the level of the jugular foramen. Sequelae of unilateral vagus nerve loss include ipsilateral laryngeal paralysis, ipsilateral palatal and pharyngeal paralysis, and velopharyngeal incompetence (VPI) marked by hypernasal speech and nasopharyngeal reflux of liquids during swallowing. Methods Palatal adhesion (PA), a procedure whereby the unilaterally paralyzed palate is attached to the posterior pharyngeal wall, decreases the size of the velopharyngeal port and minimizes the symptoms. This study assessed the outcome of PA in 31 patients with VPI secondary to proximal vagus nerve injury. Results PA decreased postoperative nasality in 96% of patients. Nasopharyngeal reflux was significantly improved in 83%. Three patients (11%) had minor wound breakdown postoperatively, all of which healed completely with conservative management. Conclusion PA offers a favorable result with minimal concomitant morbidity and is recommended for patients with VPI secondary to unilateral proximal vagus nerve paralysis. © 2002 Wiley Periodicals, Inc. Head Neck 24: 721,730, 2002 [source] Randomized trial of three different regimens for 24 weeks for re-treatment of chronic hepatitis C patients who failed to respond to interferon-, monotherapy in TaiwanLIVER INTERNATIONAL, Issue 6 2004Wan-Long Chuang Abstract: With the favorable result of interferon (IFN),ribavirin combination therapy for 24 weeks among naive Taiwanese chronic hepatitis C (CHC) patients, the optimal regimens of re-treatment for CHC patients who failed initial IFN monotherapy is not well-established. The study evaluated the effectiveness of re-treatment for 24 weeks with 3 different regimens and predictors for sustained virological response (SVR). Methods: Total 120 Taiwanese CHC patients (81 males, 70 relapsers, mean age: 48.6 years) who failed initial IFN monotherapy were enrolled. They were assigned randomly (with a ratio of 1:1:2) to receive one of the three regimens for re-treatment for 24 weeks; group A: IFN 6 million units (MU) monotherapy (N=30), group B: combination therapy with ribavirin and IFN 3 MU (N=30) or group C: combination therapy with ribavirin and IFN 6 MU (N=60). The intention-to-treat rate of sustained virological response (SVR) was 38.3%. The SVR rate in group C (53.3%) was significantly higher than group A (16.7%, P<0.005) and group B (30%, P<0.05). Drop-out rates were similar between the three groups. Patients achieving SVR had significant improvement histologically. Hepatitis C virus (HCV) genotype non-1b infection, lower pretreatment HCV RNA levels, combined with ribavirin and with higher IFN dose, and relapsers were independent predictors for SVR. Conclusion: We concluded that more than one-third Taiwanese CHC patients achieved SVR after 24 weeks re-treatment and combination therapy, especially with higher dose of IFN, yielded higher efficacy. [source] Treatment of Melasma Using Variable Square Pulse Er: YAG Laser ResurfacingDERMATOLOGIC SURGERY, Issue 3 2009RUNGSIMA WANITPHAKDEEDECHA MD BACKGROUND Treatment of melasma remains a challenge. Laser treatments show limited efficacy, with a high rate of recurrence and side effects. Recently, variable-pulsed erbium:yttrium aluminum garnet (Er:YAG) lasers have shown favorable results in skin resurfacing, with minimal downtime and adverse effects. OBJECTIVE To determine the efficacy and side effects of variable square pulsed (VSP) Er:YAG laser resurfacing for treatment of epidermal type melasma. METHODS Twenty Thai women with epidermal-type melasma were treated with two passes of VSP Er:YAG laser resurfacing using a 7-mm spot size, pulse duration of 300 ,s, and a fluence of 0.4 J/cm2. Two treatments were given 1 month apart. Visual analog scale (VAS), Melasma Area and Severity Index (MASI) score and melanin index (MI) were measured at baseline and 1, 2, and 4 months after treatment. RESULTS There was a significant improvement in VAS from baseline at 1-, 2-, and 4-month follow-up visits (p<.001). Significant improvement in MASI score at the 2-month visit from baseline (p=.004) was also observed. The average MI measured using melanin reflectance spectrometry measurements corresponded to MASI score rating. CONCLUSIONS VSP Er:YAG laser resurfacing effectively but temporarily improved epidermal-type melasma. Recurrence was observed after the treatment was discontinued. [source] Treatment of Pigmented Hypertrophic Scars with the 585 nm Pulsed Dye Laser and the 532 nm Frequency-Doubled Nd:YAG Laser in the Q-Switched and Variable Pulse Modes: A Comparative StudyDERMATOLOGIC SURGERY, Issue 8 2002Leyda Elizabeth Bowes MD background. Pigmented hypertrophic scars are a difficult condition to treat. They may result from traumatic injuries or from surgical and cosmetic procedures. The 585 nm flashlamp-pumped pulsed dye laser (FLPDL) has been used to treat this condition, with significant improvement of varying degrees. It remains to be determined whether other laser modalities may have a similar or even greater success in the treatment of pigmented hypertrophic scars. objective. To determine the efficacy of the 532 nm frequency-doubled Nd:YAG laser in the treatment of pigmented hypertrophic scars as compared to the 585 nm FLPDL. methods. Six patients with pigmented hypertrophic scars and skin phototypes II,IV were chosen. A scar was selected for treatment in each patient and divided into four equal 2 cm segments. Three segments were each treated with a different laser modality and one was left untreated to serve as the control. A 585 nm FLPDL was used with an energy of 3.5 J, a pulse duration of 450 ,sec, and a 10 mm spot size. A 532 nm Q-switched frequency-doubled Nd:YAG laser was set to an energy of 2.8 J, a 10-nsec pulse, and a 3 mm spot size. The same 532 nm laser was set to the variable pulse mode to treat a 2 cm scar segment, with an energy of 9.5 J, a 10-msec pulse, and a 4 mm spot size. An average of 3.3 treatments were performed on each scar segment, at intervals of 4,6 weeks and long-term follow-up at 22 weeks. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. A SigmaStat t -test was used to determine the statistical significance of the values obtained. results. Treatment of pigmented hypertrophic scars with the 532 nm Q-switched Nd:YAG laser led to a significant improvement of 38% in the VGH scores when compared to baseline (P = .005). The 585 nm FLPDL also had a favorable effect on the scars, with an average improvement of 36.1% in the VGH scores. There was no significant difference noted between the outcome of treatment with either of these two lasers. Treatment with the 532 nm variable pulse Nd:YAG laser led to a 19% improvement in the VGH scores of scars, which did not differ significantly from the 16.1% improvement observed in control scars on the last follow-up visit. No side effects or complications from treatment were noted or reported during the course of the study. At the conclusion of the study, five of six patients chose the segment treated with the 532 nm Q-switched Nd:YAG laser as the best segment overall. conclusion. The 532 nm Q-switched Nd:YAG laser and the 585 nm FLPDL offer comparable favorable results in the treatment of pigmented hypertrophic scars. The 532 nm Q-switched Nd:YAG laser may be preferred by patients particularly distressed by the dark color of their scars. [source] Topical ascorbic acid on photoaged skin.EXPERIMENTAL DERMATOLOGY, Issue 3 2003Clinical, topographical, ultrastructural evaluation: double-blind study vs. placebo Abstract:, Vitamin C is known for its antioxidant potential and activity in the collagen biosynthetic pathway. Photoprotective properties of topically applied vitamin C have also been demonstrated, placing this molecule as a potential candidate for use in the prevention and treatment of skin ageing. A topically applied cream containing 5% vitamin C and its excipient were tested on healthy female volunteers presenting with photoaged skin on their low-neck and arms in view to evaluate efficacy and safety of such treatment. A double-blind, randomized trial was performed over a 6-month period, comparing the action of the vitamin C cream vs. excipient on photoaged skin. Clinical assessments included evaluation at the beginning and after 3 and 6 months of daily treatment. They were performed by the investigator and compared with the volunteer self assessment. Skin relief parameters were determined on silicone rubber replicas performed at the same time-points. Cutaneous biopsies were obtained at the end of the trial and investigated using immunohistochemistry and electron microscopy. Clinical examination by a dermatologist as well as self-assessment by the volunteers disclosed a significant improvement, in terms of the ,global score', on the vitamin C-treated side compared with the control. A highly significant increase in the density of skin microrelief and a decrease of the deep furrows were demonstrated. Ultrastructural evidence of the elastic tissue repair was also obtained and well corroborated the favorable results of the clinical and skin surface examinations. Topical application of 5% vitamin C cream was an effective and well-tolerated treatment. It led to a clinically apparent improvement of the photodamaged skin and induced modifications of skin relief and ultrastructure, suggesting a positive influence of topical vitamin C on parameters characteristic for sun-induced skin ageing. [source] Long-term results of endoureterotomy using a holmium laserINTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2007Hastuki Hibi Abstract: The long-term results of endoureterotomy using a holmium laser in cases of benign ureteral stricture, uretero-pelvic junction obstruction (UPJ-O) and ureteroenteric stricture were evaluated. Twenty procedures were carried out in 18 patients. Strictures were incised with a holmium laser using a fiber passed through the ureteroscope. Sixteen of the 20 procedures (80%) were successful at average follow-up of 60.5 months (range, 46,74). Stricture recurred in four cases. All failures occurred within 18 months. Although stricture length was not correlated with recurrence, all failures, with the exception of a single UPJ-O, involved middle ureteral strictures. Endoureterotomy using a holmium laser affords favorable results with respect to long-term patency. This procedure is recommended as a satisfactory therapeutic option for the initial management of patients presenting with ureteral stricture. [source] Clinical features of testicular tumors in childrenINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2004SATORU KANTO Abstract Aim:, Testicular tumors are not common pediatric solid tumors, especially in Asian children. There have been few reviews of cases in Japan to date. We present the clinical features of 14 pediatric testicular tumor patients. Methods:, Clinical features of 14 testicular tumor patients, such as chief complaints, age at diagnosis, pathology, stages, treatments and prognosis, were examined from medical records. Two patients had their semen tested at adolescence. Results:, Of the 14 prepubescent patients, 12 (85.7%) patients were diagnosed before 3 years of age. Ten cases (71.4%) were diagnosed as yolk sac tumors, three (21.4%) as mature teratomas and one case as an epidermoid cyst. Nine cases (90.0%) among the 10 cases of yolk sac tumor were diagnosed as stage I and one case was stage IV. One stage I yolk sac tumor patient developed lung metastasis later. Eventually, two yolk sac tumor patients died, despite chemotherapy. While all the cases with a diagnosis before 2 years of age survived, 67% (2/3) of cases with a diagnosis after the age of 2 died of tumors. Semen analysis in two patients showed normospermia. Conclusion:, In the present study, the most common testicular tumors were yolk sac tumors and the patients diagnosed before 2 years of age showed favorable results. Age could be a relapse risk factor in yolk sac tumors. Guidelines for handling testicular tumors in children is not yet well established in Japan. An organized system seems necessary to gather and accumulate the results of the cases in Japan in order to develop better guidelines for treatment. [source] Treatment of Dogs with Lymphoma Using a 12-Week, Maintenance-Free Combination Chemotherapy ProtocolJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2006D. Simon Background: Treatment of lymphoma in dogs by long-term chemotherapy has favorable results. However, the efficacy of short-term, maintenance-free treatment protocols on remission and survival times in dogs has not been determined. Hypothesis: That treatment using a 12-week chemotherapy protocol would be associated with satisfactory treatment outcome in dogs with lymphoma. Animals: 77 dogs with histologically or cytologically confirmed diagnosis of lymphoma. Methods: Prospective clinical trial in which dogs were treated with a 12-week chemotherapy protocol consisting of L-asparaginase, vincristine, cyclophosphamide, doxorubicin, and prednisolone. Results: Complete remission rate was 76.3%. Multivariate logistic regression analysis revealed that clinical substage (P= .006) and immunophenotype (P= .003) had a significant influence on the likelihood of a dog achieving complete remission. Median duration of first complete remission was 243 days (range 19,1, 191 days). The 6-month, 1-year, and 2-year remission rates were 68%, 28%, and 16%, respectively. In the multivariate analysis of patient variables, immunophenotype (P= .022) revealed a significant influence on first remission duration. Toxicosis was mild with the exception of 1 treatment-associated death. Conclusions and Clinical Importance: In this group of dogs the 12-week maintenance-free chemotherapy protocol was well tolerated and had satisfactory results. [source] The thoracodorsal vascular tree-based combined fascial flapsMICROSURGERY, Issue 2 2009Meisei Takeishi M.D. In this study, combined fascial flaps pedicled on the thoracodorsal artery and vein were raised and used for thin coverage of dorsal surfaces of the fingers and the dorsum of hand and foot with favorable results. The combined fascial flaps consist of the serratus anterior fascia and the axillary fascia at the entrance of the latissimus dorsi. These flaps were used for reconstruction of the hand, fingers, or foot in nine patients. Reconstruction was performed for burn or burn scar contracture, after resection of malignant tumors, posttraumatic skin defects, and chronic regional pain syndrome. The sites of reconstruction were dorsal surfaces of fingers, dorsum of hand, wrist and palm, forearm, lower leg, and foot. The flaps were used in various configurations including two independent fascial flaps, two-lobed fascial flap with separate feeding vessels, and composite fascial and thoracodorsal artery perforator flap. The fascial and skin flaps survived in all nine patients, with favorable results both functionally and esthetically. Good coverage of soft tissue defects and good recovery of range of motion in resurfaced joints were achieved. There were no complications. The scars at the sites of harvest were not noticeable. The advantage of this method is that not only a single flap but flaps of a variety of configurations can be harvested for different purposes. The thoracodorsal vascular tree-based combined fascial flaps are useful for the reconstruction of soft tissue defects in the extremities. © 2008 Wiley-Liss, Inc. Microsurgery, 2009. [source] Complications of Bryan cervical disc replacementORTHOPAEDIC SURGERY, Issue 2 2010Jun-ming Cao MD The primary goals of cervical disc replacement are to avoid fusion in the affected segment, maintain the mobility and function of the involved cervical segments, allow patients to quickly return to routine activities and reduce or eliminate adjacent-segment disease. A large number of patients have already undergone, and more and more patients will in the future undergo, cervical disc replacement. The cervical device which best preserves movement, and has therefore been the device of choice, has been the Bryan cervical disc. Although a safe surgical technique has been demonstrated and favorable results of using the Bryan disc reported, some complications have also accompanied this arthroplasty. Complications of Bryan cervical disc replacement include those related to the operative approach and decompression process, loosening and failure of the device, postoperative kyphosis, heterotopic ossification, and loss of movement due to spontaneous fusion. In order to avoid these complications, strict patient selection criteria and a meticulous knowledge of anatomy are necessary. [source] Palivizumab efficacy in preterm infants with gestational age ,30 weeks without bronchopulmonary dysplasiaPEDIATRIC PULMONOLOGY, Issue 3 2007Marianne Grimaldi MD Abstract The present study was designed to determine the efficacy of administration of palivizumab to preterm infants with gestational age (GA) ,30 weeks without bronchopulmonary dysplasia (BPD). All patients born with GA ,30 weeks without BPD on Day 28 and hospitalized for RSV bronchiolitis in Burgundy (12 hospitals) from December 1 to April 30 of the next year were included in this prospective observational study during five successive RSV seasons (1999,2000, 2000,2001, 2001,2002, 2002,2003, and 2003,2004). Palivizumab was given to premature infants with a gestational age ,30 weeks without BPD in the 2002,2003 and 2003,2004 periods only. In the cohort of premature infants with GA ,30 weeks without BPD, the respiratory syncytial virus (RSV) bronchiolitis hospitalization rate was reduced significantly (P,<,0.01) in the two seasons with palivizumab prophylaxis (2002,2003: 0% and 2003,2004: 2%) versus the three previous RSV seasons (1999,2000: 14.3%; 2000,2001: 16.7%; 2001,2002: 10.2%). The number needed to treat to prevent one hospitalization for RSV bronchiolitis was 6 (95%CI: 4,11). Such favorable results have not been always found in the few available postmarketing epidemiological studies on hospitalization rate after palivizumab prophylaxis. Differences in health care organization could explain those discrepancies. Pediatr Pulmonol. 2007; 42:189,192. © 2007 Wiley-Liss, Inc. [source] Hyperbaric oxygen therapy for hepatic artery thrombosis following liver transplantation: Current conceptsPEDIATRIC TRANSPLANTATION, Issue 2 2006Ian Grover Abstract:, This article presents the case of an infant who underwent an orthotopic liver transplant and then developed hepatic artery thrombosis that was detected on routine post-operative right upper quadrant ultrasound. Alteplase (TPA) failed to open the artery, so the child received systemic heparin and hyperbaric oxygen (HBO) therapy. After six HBO treatments, the hepatic artery had recanalized and his liver function tests had returned to normal or near normal. There were no complications to the HBO therapy, and 1 yr after the transplant, the child's liver is functioning well. The present study discusses the beneficial effects of HBO therapy and the proposed mechanisms for its favorable results. In our patient, systemic heparin and HBO therapy prevented liver failure and need for retransplantation. [source] Replication of sub-micron features using amorphous thermoplasticsPOLYMER ENGINEERING & SCIENCE, Issue 7 2002Kari mönkkönen A comprehensive experimental study was carried out to replicate sub-micron features using the injection molding technique. For the experiments, five different plastic materials were selected according to their flow properties. The materials were polycarbonate (PC), styrene-butadiene block copolymer (SBS), impact modified poly(methyl methacrylate), methyl methacrylate-acrylonitrile-butadiene-styrene polymer (MABS), and cyclic olefin copolymer (COC). Nanofeatures down to 200-nm line width and with aspect ratios (aspect ratio = depth/width) of 1:1 could be replicated. In all selected materials, the greatest differences between the materials emerged when the aspect ratio increased to 2:1. The most favorable results were obtained with the use of high flow polycarbonate as the molding material. The best replication results were achieved when melt and mold temperatures were higher than normal values. [source] Eversion Thrombectomy for Portal Vein Thrombosis During Liver TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2002Jérôme Dumortier Portal vein thrombosis (PVT) has been seen as an obstacle to orthotopic liver transplantation (OLT), but recent data suggest that favorable results may be achieved in this group of patients. The aim of this study was to analyze the incidence, management, and survival of patients with PVT undergoing primary OLT with thrombectomy. Between October 1990 and August 2000, 468 liver transplantations were performed in our center and portal vein thrombosis was present in 38 patients (8.1%). Preoperative diagnosis, extension, intraoperative management, postoperative recurrence of portal vein thrombosis, and 1-year actuarial survival rates were retrospectively studied. Preoperative diagnosis was made in 17 cases (44.7%). In all patients, portal flow was restored after portal vein thrombectomy, followed by usual end-to-end portal anastomosis. All patients received preventive low-weight heparin from day 2 to hospital discharge, and then aspirin. Rethrombosis was observed in one patient with extended splanchnic thrombus. The 1-year actuarial patient survival rate was 83.7%, and did not significantly differ from the patients without portal vein thrombosis (86.7%). Our results suggest that portal vein thrombosis is often partial and thus difficult to diagnose preoperatively; it can be managed successfully during surgery by thrombectomy, except when there is complete splanchnic veins thrombosis; and it did not affect 1-year survival. [source] Cryopreservation of Fibroblasts Immobilized Within a Porous Scaffold: Effects of Preculture and Collagen Coating of Scaffold on Performance of Three-Dimensional CryopreservationARTIFICIAL ORGANS, Issue 7 2010Hirotoshi Miyoshi Abstract As a preliminary investigation to establish a cryopreservation method suited for bioartificial livers (BALs), three-dimensional (3-D) cryopreservation experiments with fibroblasts were performed, in which the cells were firstly seeded into a porous scaffold, and the scaffold containing the cells was then cryopreserved. After thawing, 65% of the initially applied cells were still attached to the scaffold, and this efficiency was significantly higher than that in the control experiments (39%), in which fibroblasts cryopreserved in a suspension were seeded into the scaffold. This higher efficiency was mainly caused by higher immobilization efficiency at the time of cell seeding (83%) than in the controls (54%). Collagen coating of the scaffold in the 3-D cryopreservation enhanced immobilization efficiency at the time of cell seeding, and 1-day precultures before the 3-D cryopreservation considerably improved cell growth after thawing. From these favorable results, this 3-D cryopreservation method may become useful for developing BALs. [source] The value of medical interventions for lung cancer in the elderly,CANCER, Issue 11 2007Results from SEER-CMHSF Abstract BACKGROUND. Lung cancer is the leading source of cancer mortality and spending. However, the value of spending on the treatment of lung cancer has not been conclusively demonstrated. The authors evaluated the value of medical care between 1983 and 1997 for nonsmall cell lung cancer in the elderly US population. METHODS. The authors used Surveillance, Epidemiology, and End Results (SEER) data to calculate life expectancy after diagnosis over the period 1983 to 1997. Direct costs for nonsmall cell lung cancer detection and treatment were determined by using Part A and Part B reimbursements from the Continuous Medicare History Sample File (CMHSF) data. The CMHSF and SEER data were linked to calculate lifetime treatment costs over the time period of interest. RESULTS. Life expectancy improved minimally, with an average increase of approximately 0.60 months. Total lifetime lung cancer spending rose by approximately $20,157 per patient in real, ie, adjusted for inflation, 2000 dollars from the early 1980s to the mid-1990s, for a cost-effectiveness ratio of $403,142 per life year (LY). The cost-effectiveness ratio was $143,614 for localized cancer, $145,861 for regional cancer, and $1,190,322 for metastatic cancer. CONCLUSIONS. The cost-effectiveness ratio for nonsmall cell lung cancer was higher than traditional thresholds used to define cost-effective care. The most favorable results were for persons diagnosed with early stage cancer. These results suggested caution when encouraging more intensive care for lung cancer patients without first considering the tradeoffs with the costs of this therapy and its potential effects on mortality and/or quality of life. Cancer 2007. © 2007 American Cancer Society. [source] Histopathologic grading of medulloblastomasCANCER, Issue 2 2002A Pediatric Oncology Group Study Abstract BACKGROUND Medulloblastomas are small cell embryonal tumors of the cerebellum found predominantly in children, only slightly more than half of whom survive. Predicting favorable outcome has been difficult, and improved stratification clearly is required to avoid both undertreatment and overtreatment. Patients currently are staged clinically, but no pathologic staging system is in use. Two rare subtypes at extreme ends of the histologic spectrum, i.e., medulloblastomas with extensive nodularity and large cell/anaplastic medulloblastomas, are associated with better and worse clinical outcomes, respectively. However, there is little data about correlations between histologic features and clinical outcome for most patients with medulloblastomas that fall between these histologic extremes of nodularity and anaplasia. Therefore, the authors evaluated the clinical effects of increasing anaplasia and nodularity in a large group of children with medulloblastomas, hypothesizing that increasing nodularity would predict better clinical outcomes and that increasing anaplasia would presage less favorable results. METHODS Medulloblastomas from 330 Pediatric Oncology Group patients were evaluated histologically with respect to extent of nodularity, presence of desmoplasia, grade of anaplasia, and extent of anaplasia. Pathologic and clinical data were then compared using Kaplan,Meier and log-rank analyses. RESULTS Increasing grade of anaplasia and extent of anaplasia were associated strongly with progressively worse clinical outcomes (P < 0.0001 for both). Significant anaplasia (moderate or severe) was identified in 24% of medulloblastoma specimens. Neither increasing degrees of nodularity nor desmoplasia were associated significantly with longer survival. CONCLUSIONS Moderate anaplasia and severe anaplasia were associated with aggressive clinical behavior in patients with medulloblastomas and were detected in a significant number of specimens (24%). Pathologic grading of medulloblastomas with respect to anaplasia may be of clinical utility. Cancer 2002;94:552,60. © 2002 American Cancer Society. [source] Bone formation at titanium porous oxide (TiUniteÔ) oral implants in type IV boneCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005Yi-Hao Huang Abstract Background: Several oral implant design advances have been suggested to overcome poor bone quality, an impediment for successful implant treatment. A novel titanium porous oxide (TPO) surface has been shown to offer favorable results in several settings. The objective of this study was to evaluate the local bone formation and osseointegration at TPO-modified implants in type IV bone. Method: Three TPO surface-modified implants (TiUniteÔ) were installed into the edentulated posterior maxilla in each of 8 Cynomolgus monkeys. The animals were injected with fluorescent bone labels at 2, 3, 4 and 16 weeks post-surgery and were euthanized at week 16 when block biopsies were collected for histologic analysis. Results: The predominant observation of the TPO implant surface was a thin layer of new bone covering most of the implant threads. Mean (±SE) bone,implant contact for the whole study group was 74.1±4.8%. There was a significant variability in bone,implant contact between animals (P=0.0003) and between sites of the same animal (P<0.0001). The variance in bone,implant contact was 30% larger among sites of the same animal than between different animals (187.5 vs. 144.8, respectively). There was a small but significant difference in bone density immediately outside, compared to within the threaded area of the implants (37.1±3.2% vs. 32.1±3.2%, P<0.0001). Bone density outside the implant threads was significantly correlated (,=0.682, P<0.0001) with the bone density within thethreaded area. Bone density within the threaded area was significantly correlated (,=0.493, P=0.0002) with bone,implant contact, whereas bone density outside the implant threads did not have a significant effect (,=0.232, P=0.1). Conclusions: The results suggest that the TPO surface possesses a considerable osteoconductive potential promoting a high level of implant osseointegration in type IV bone in the posterior maxilla. Résumé Différents nouveaux modèles d'implants ont été suggéréspour tenter de compenser la mauvaise qualité osseuse qui est un problème pour le traitement implantaire à succès. Une nouvelle surface en oxyde poreux de titane (TPO) a apporté des résultats favorables en différentes occasions. L'objectif de cette étude a été d'évaluer la formation osseuse locale et l'ostéoïntégration d'implants modifiés TPO dans de l'os de qualité type IV. Trois implants dont la surface était modifiée TPO (TiUniteTM) ont été insérés dans un maxillaire édenté postérieur de huit singes cynomolgus. Les animaux ont subi des injections de marqueurs osseux par flurorescence à deux, trois, quatre et seize semaines après la chirurgie et ont été euthanasiés à la semaine 16 quand des biopsies en bloc ont été prélevées pour l'analyse histologique. L'observation prédominante de la surface implantaire TPO était une fine couche de nouvel os couvrant la plupart des filetages implantaires. La moyenne ±SE du contact os-implant pour tout le groupe étudiéétait de 74±5%. Il y avait une variation significative dans le contact os-implant entre les animaux (P<0,0003) et entre les sites d'un même animal (P<0,0001). La variance du contact os-implant était 30% plus importante parmi les sites du même animal qu'entre différents animaux (respectivement 187 et 145). Il y avait une différence significative bien que faible dans la densité osseuse immédiatement á l'extérieur comparéà l'intérieur des zones à filetage des implants (37±3% vs 32±3%, P<0,0001). La densité osseuse en dehors des filetages implantaires était en corrélation significative (ß=0,682, P<0,0001) avec la densité osseuse à l'intérieur des zones de filetage. La densité osseuse à l'intérieur des zones de filetage était en corrélation significative (ß=0,493, P<0,0002) avec le contact os-implant, tandis que la densité osseuse en dehors des filetages implantaires n'avait pas d'effet significatif (ß=0,232, P=0,1). Ces résultats suggèrent que la surface TPO possède un potentiel ostéoconducteur considérable qui peut promouvoir une ostéoïntégration implantaire de haut niveau dans l'os de type IV dans la région maxillaire postérieure. Zusammenfassung Ziel: Um trotz schlechter Knochenqualität die Aussicht auf eine erfolgreiche implantologische Behandlung zu verbessern, wurden verschiedene Entwicklungen des Designs von Zahnimplantaten vorgeschlagen. Bei verschiedenen Gelegenheiten hat eine neue poröse Titanoxidoberfläche (TPO) scheinbar vorteilhafte Resultate gezeigt. Das Ziel dieser Studie war, die lokale Knochenbildung und die Osseointegration von Implantaten mit einer TPO-modifizierten Oberfläche im Typ IV Knochen zu untersuchen. Methode: In die zahnlosen posterioren Oberkiefern eines jeden von 8 Cynomolgus-Affen implantierte man drei Implantate mit einer TPO-modifizierten Oberfläche (TiUnite®). Den Tieren wurden 2, 3, 4 und 16 Wochen nach dem chirurgischen Eingriff fluoreszierende Knochenmarker injiziert und in der Wochen 16 wurden sie eingeschläfert und für die histologische Analyse Blockbiopsien entnommen. Resultate: Die wichtigste Beobachtung bei der TPO-Implantatoberfläche war eine dünne Schicht neuen Knochens, welche die meisten Schraubenwindungen des Implantates bedeckte. Der mittlere Knochen-Implantatkontakt (±SE) betrug in der ganzen Testgruppe 74.1±4.8%. Man fand eine signifikante Variabilität des Knochen-Implantatkontaktes unterhalb der Tiere (P=0.0003) und auch unterhalb der verschiedenen Impantate desselben Tieres (P<0.0001). Innerhalb der Implantate desselben Tieres war die Varianz des Knochen-Implantatkontaktes bis zu 30% grösser, als zwischen den verschiedenen Tieren (187.5 gegenüber 144.8). Man fand auch einen kleinen, aber signifikanten Unterschied der Knochendichte im Bereich direkt ausserhalb der Schraubenwindungen, verglichen mit dem inneren Bereich (37.1±3.2% gegenüber 32.1±3.2%, P<0.0001). Diese beiden Knochendichten waren aber signifikant miteinander korreliert (0.682, P<0.0001). Die Knochendichte innerhalb der Schraubenwindungen korrelierte signifikant mit dem Knochen-Implantat-Kontakt (ß=0.493, P=0.0002), währenddem die Knochendichte ausserhalb des Bereiches der Schraubenwindungen in dieser Beziehung keine signifikante Korrelation aufwies (ß=0.232, P=0.1). Zusammenfassung: Die Resultate lassen vermuten, dass die TPO-Oberfläche eine beachtliche osteokonduktive Fähigkeit hat, die im posterioren Oberkieferbereich mit Typ IV Knochen zu einer sehr guten Osseointegration führt. Resumen Antecedentes: Se han sugerido varios avances en los diseños de los implantes orales para superar una baja calidad de hueso, un impedimento para un tratamiento exitoso de implantes. Se ha presentado una nueva superficie de óxido de titanio poroso (TPO) que ofrece resultados favorables en diversas situaciones. El objetivo de este estudio fue evaluar la formación local de hueso y la osteointegración en implantes TPO modificados en hueso tipo IV. Método: Se instalaron tres implantes (TiUniteTM) con superficie modificada TPO en el maxilar posterior edéntulo en 8 monos Cynomolgus. Los animales fueron inyectados con marcadores óseos fluorescentes en la semana 2, 3, 4 y 16 tras la cirugía y se sacrificaron en la semana 16 recogiéndose biopsias en bloque para análisis histológicos. Resultados: La observación predominante de la superficie TPO del implante fue una fina capa de hueso nuevo cubriendo la mayor parte de las roscas. El contacto hueso-implante medio (±SE) para todo el grupo de estudio fue de 74.1±4.8%. Hubo una variabilidad significativa en el contacto hueso-implante entre animales (P=0.0003) y entre lugares del mismo animal (P<0.0001). La varianza en el contacto hueso-implante fue un 30% mayor entre lugares del mismo animal que entre los diferentes animales (187.5 vs. 144.8, respectivamente). Hubo una pequeña pero significativa diferencia en la densidad ósea inmediatamente por fuera comparada con el área roscada de los implantes (37.1±3.2% vs. 32.1±3.2%, P<0.0001). La densidad ósea por fuera de las roscas del implante se correlacionó significativamente (,=0.682, P<0.0001) con la densidad ósea entre las áreas de roscas. La densidad ósea entre las áreas de roscas se correlacionó significativamente (,=0.492, P<0.0002) con el contacto hueso implante, mientras que la densidad ósea por fuera de las roscas del implante no tuvo un efecto significativo (,=0.232, P=0.1). Conclusiones: Los resultados sugieren que la superficieTPOposee un considerable potencial osteoconductivo promoviendo un alto nivel de osteointegracióndel implante en hueso tipo IV en el maxilar posterior. [source] | ||||||||||||||||||||||