57 resultados para heating stage
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Bisegmentectomy 7-8 is feasible even in the absence of a large inferior right hepatic vein. To our knowledge, this operation has never been performed by laparoscopy. This study was designed to present video of pure laparoscopic bisegmentectomy 7-8 and bisegmentectomy 2-3 in one-stage operation for bilateral liver metastasis. A 67-year-old man with metachronous bilobar colorectal liver metastasis was referred for surgical treatment after neoadjuvant chemotherapy. CT scan disclosed two liver metastases: one located between segments 7 and 8 and another one in segment 2. At liver examination, another metastasis was found on segment 3. We decided to perform a bisegmentectomy 7-8 along with bisegmentectomy 2-3 in a single procedure. The operation began with mobilization of the right liver with complete dissection of retrohepatic vena cava. Inferior right hepatic vein was absent. Right hepatic vein was dissected and encircled. Upper part of right liver, containing segment 7 and 8, was marked with cautery. Selective hemi-Pringle maneuver was performed and right hepatic vein was divided with stapler. At this point, liver rotation to the left allowed direct view and access to the superior aspect of the right liver. Liver transection was accomplished with harmonic scalpel and endoscopic stapling device. Bisegmentectomy 2-3 was performed using the intrahepatic Glissonian approach. The specimens were extracted through a suprapubic incision. Liver raw surfaces were reviewed for bleeding and bile leaks. Operative time was 240 minutes with no need for transfusion. Recovery was uneventful. Patient was discharged on the fifth postoperative day. Patient is well with no evidence of disease 14 months after liver resection. Tumor markers are within normal range. Bisegmentectomy 7-8 may increase resectability rate in patients with bilateral lesions. This operation can be performed safely by laparoscopy. Preservation of segments 5 and 6 permitted simultaneous resection of segments 2 and 3 with adequate liver remnant.
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The use of adjuvant chemotherapy following resection for all patients with stage III colon cancer is now part of the standard of care around the world. Recent trials have led to changes in the standard regimens, which now include the use of oxaliplatin (Eloxatin) for most patients with stage III colon cancer. The addition of oxaliplatin has resulted in a 23% reduction in the risk of recurrence compared with fluorouracil/leucovorin alone, with a small but statistically significant survival benefit. Unfortunately, no adequately powered trial has determined whether adjuvant chemotherapy is beneficial for stage II patients, and its use is much more controversial. Most investigators agree that adjuvant chemotherapy has some activity against stage H disease. However, its impact on progression-free and overall survival remains highly controversial. Despite the lack of data, there is growing acceptance of an informal classification system, which stratifies stage II patients by risk on the basis of clinical data, as a guide for deciding whether to use adjuvant therapy. The only phase III clinical trial for stage H patients currently ongoing in the United States uses molecular classification as the basis for patient randomization.
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Chronic renal failure (CRF) leads in the majority of instances to end-stage renal disease (ESRD) requiring renal replacement therapy. Age, gender, genetics, race, hypertension, and smoking among others are factors associated with ESRD. Our interest was to evaluate the possible associations of class I and II HLA antigens with ESRD renal disease independent of other factors, among patients with CRF, having various diagnoses in the Brazilian population of the Sao Paulo state. So 21 HLA-A, 31 HLA-B, and 13 HLA-DR were detected in 105 patients who were compared with 160 healthy controls of both sexes who were not related to the patients evaluated until 2005. We calculated allelic frequencies, haplotypes frequencies, etiological fractions (EF), preventive fractions, and relative risks (RR). We compared demographic data of patients and controls. The antigens positively associated with ESRD were: HLA-A78 (RR = 30.31 and EF = 0.96) and HLA-DR11 (RR = 18.87 and EF = 0.65). The antigens HLAB14 (RR = 29.90 and EF = 0.75) was present at a significantly lower frequency among patients compared with controls. In contrast, no haplotype frequency showed statically significant associations. Further molecular studies may clarify types and subtypes of alleles involved with ESRD progression.
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BACKGROUND AND OBJECTIVE: To compare the results of preoperative Nd:YAG laser anterior capsulotomy versus two-stage continuous curvilinear capsulorhexis (CCC) in phacoemulsification of eyes with white intumescent cataracts and liquefied cortex. PATIENTS AND METHODS: Twenty-three eyes with white intumescent cataract were consecutively randomized for phacoemulsification with preoperative Nd:YAG laser anterior capsulotomy (group 1, n = 11) or two-stage CCC (group 2, n = 12) procedures. Intraoperative findings and postoperative outcomes were compared using the nonparametric tests. RESULTS: Postoperative Visual acuity, mean surgical time, mean effective phacoemulsification time, and frequency of complications were not significantly different between the two groups (P > .05). Two cases in each group were converted to the extracapsular technique. Excluding these four patients, surgical time was shorter In group 1 (P = .017). CONCLUSION: Preoperative Nd:YAG laser anterior capsulotomy is a safe technique in decompressing the capsular bag before phacoemulsification of white intumescent cataracts with liquefied cortex.
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Ipomoea cameo Jacq. ssp. fistulosa (Mart. Ex Choisy; Convolvulaceae; I. cameo) possesses a toxic component: an indolizidine alkaloid swainsonine (SW) that has immunomodulatory effects due to its inhibition of glycoprotein metabolism. It is also known that SW is excreted into both the amniotic fluid and milk of female rats exposed to I. cameo. Thus, the aim of this study was to determine whether SW exposure, either in utero or from the milk of dams treated with I. cornea, modulates offspring immune function into adulthood. In addition, adult (70 days old) and juvenile rats (21 days old) were exposed to I. cameo in order to evaluate several other immune parameters: lymphoid organs relative weight and cellularity, humoral and cellular immune responses. Offspring exposed to I. cornea during lactation developed rheumatoid arthritis (RA) in adulthood after an immunogenic challenge. In addition, both adult and juvenile rats exposed to I. cameo showed discrepancies in several immune parameters, but did not exhibit any decrease in humoral immune response, which was enhanced at both ages. These findings indicate that SW modulates immune function in adult rats exposed to SW during lactation and in juvenile and adult rats exposed to SW as juveniles and adults, respectively.
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Objectives: The aim was to verify the concordance of CT evaluation among four radiologists (two oral and maxillofacial and two medical radiologists) at the TN (tumour/node) stage and in the follow-up of oral cavity and oropharyngeal cancer patients. The study also compared differences between clinical and CT examinations in determining the TN stage. Methods: The following clinical and tomographic findings of 15 non-treated oral cavity and oropharyngeal cancer patients were compared: tumour size, bone invasion and lymph node metastases. In another 15 patients, who had previously been treated, a clinical and tomographic analysis comparison for the presence of tumoural recurrence, post-therapeutic changes in muscles and lymph node metastases was performed. The concordances of tomographic evaluation between the radiologists were analysed using the kappa index. Results: Significant agreement was verified between all radiologists for the T stage, but not for the N stage. In the group of treated patients, CT disclosed post-therapeutic changes in muscles, tumour recurrence and lymph node metastases, but no concordance for the detection of lymph node metastases was found between radiologists. In the first group, for all radiologists, no concordance was demonstrated between clinical and tomographic staging. CT was effective for delimitating advanced lesions and for detecting lymph node involvement in N0 stage patients. CT revealed two cases of bone invasion not clinically detected. Conclusions: Interprofessional relationships must be stimulated to improve diagnoses, and to promote a multidisciplinary approach to oral cavity and oropharyngeal cancer. Although CT was important in the diagnosis and follow-up of cancer patients, differences between medical and dental analyses should be acknowledged. Dentomaxillofacial Radiology (2010) 39, 140-148. doi: 10.1259/dmfr/69910245
Development of human minor salivary glands: expression of mucins according to stage of morphogenesis
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The formation of salivary glands entails the proliferation of epithelial cells from the stomatodeum into the underlying ectomesenchyme, culminating in a complex network of ducts and acinar bulbs. The extent to which mucins regulate this process is unknown, but they appear to mediate luminal space formation and maturation. Our aim was to examine mucin expression patterns during the morphogenesis of human salivary glands. Mucin expression - MUC1, 2, 3, 4, 5AC, 5B, 6, and 16 - was analyzed in specimens of developing human salivary glands, obtained from fetuses at 4-24 weeks` gestation, and fully developed salivary glands by immunohistochemistry. Expression patterns were analyzed qualitatively according to the development stage of the salivary glands. Mucins 1, 3, 4, 5B, and 16 were expressed during salivary gland development - being stronger in all ductal segments by the final phases of branching morphogenesis and in mature glands. Acinar cells were negative for most mucins, including MUC1 in mature salivary glands. Mucins 2, 5AC, and 6 were not expressed. Mucins MUC1, 3, 4, 5B, and 16 are expressed in developing human salivary glands and in mature glands, suggesting important roles in the maturation and maintenance of the ductal network.
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The aim of this work was to determine the effect of temperature and heating rate on the densification of four leucite-based dental porcelains: two low-fusion (Dentsply Ceramco and Ivoclar) and two high-fusion commercial porcelains (Dentsply Ceramco). Porcelain powders were characterized by differential thermal analysis (DTA), X-ray diffraction (XRD), particle size distribution, helium picnometry, and by scanning electron microscopy. Test specimens were sintered from 600 to 1050 degrees C, with heating rates of 55 degrees C/min and 10 degrees C/min. The bulk density of the specimens was measured by the Archimedes method in water, and microstructures of fracture surfaces were analyzed by scanning electron microscopy (SEM). The results showed that densification of specimens increased with the increase in temperature. The increase in the heating rate had no effect on the densification of the porcelains studied. Both high-fusion materials and one of the low-fusing porcelains reached the maximum densification at a temperature that was 50 degrees C lower than that recommended by the manufactures. (C) 2011 Elsevier Ltd and Techna Group S.r.l. All rights reserved.
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Objectives. This study evaluated the effect of composite pre-polymerization temperature and energy density on the marginal adaptation (MA), degree of conversion (DC), flexural strength (FS), and polymer cross-linking (PCL) of a resin composite (Filtek Z350, 3M/ESPE). Methods. For MA, class V cavities (4mmx2mmx2mm) were prepared in 40 bovine incisors. The adhesive system Adper Single Bond 2 (3M/ESPE) was applied. Before being placed in the cavities, the resin composite was either kept at room-temperature (25 degrees C) or previously pre-heated to 68 degrees C in the Calset (TM) device (AdDent Inc., Danbury, CT, USA). The composite was then light polymerized for 20 or 40s at 600mW/cm(2) (12 or 24 J/cm(2), respectively). The percentage of gaps was analyzed by scanning electron microscopy, after sectioning the restorations and preparing epoxy resin replicas. DC (n = 3) was obtained by FT-Raman spectroscopy on irradiated and non-irradiated composite surfaces. FS (n = 10) was measured by the three-point-bending test. KHN (n = 6) was measured after 24h dry storage and again after immersion in 100% ethanol solution for 24 h, to calculate PCL density. Data were analyzed by appropriate statistical analyses. Results. The pre-heated composite showed better MA than the room-temperature groups. A higher number of gaps were observed in the room-temperature groups, irrespective of the energy density, mainly in the axial wall (p < 0.05). Composite pre-heating and energy density did not affect the DC, FS and PCL (p > 0.05). Significance. Pre-heating the composite prior to light polymerization similar in a clinical situation did not alter the mechanical properties and monomer conversion of the composite, but provided enhanced composite adaptation to cavity walls. (C) 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
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Purpose: Gaps between an abutment and a dental implant are unavoidable, and microleakage may occur, leading to problems such as malodor and peri-implantitis. The aim of the present in vitro study was to investigate leakage of Staphylococcus aureus through the implant/abutment interface by the method of bacterial culture, and to compare the leakage rates of two different types of implant-abutment connections. Materials and Methods: Twenty Morse taper implants with abutments were divided into two groups: group A, which were evaluated for microleakage into the inner part of the implants, and group B, which were evaluated for microleakage from the inner part of the implants. Twenty internal-hexagon implants with abutments were also divided into two groups: group C, which were evaluated for microleakage into the inner part of the implants, and group D, which were evaluated for microleakage from the inner part of the implants. For the evaluation of leakage from the implants, the assemblies had the inner parts inoculated with S aureus, and each assembly was incubated in sterile brain heart infusion broth for 1 week. For assessment of leakage into the implants, each assembly was submerged in 4 mL S aureus culture in tubes and incubated for 2 weeks. The microleakage of the two implant connections was compared. Results: Microbial leakage occurred in all groups, and there was no statistically significant difference between groups A and C or between groups B and D. Conclusions: In vitro, S aureus leakage through the implant/abutment interface occurred with both Morse taper and internal-hexagon implants. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:56-62
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Objectives: (1) To compare the anatomopathological variables and recurrence rates in patients with early-stage adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the uterine cervix; (2) to identify the independent risk factors for recurrence. Study design: This historical cohort study assessed 238 patients with carcinoma of the uterine cervix (113 and IIA), who underwent radical hysterectomy with pelvic lymph node dissection between 1980 and 1999. Comparison of category variables between the two histological types was carried out using the Pearson`s X-2 test or Fisher exact test. Disease-free survival rates for AC and SCC were calculated using the Kaplan-Meier method and the curves were compared using the log-rank test. The Cox proportional hazards model was used to identify the independent risk factors for recurrence. Results: There were 35 cases of AC (14.7%) and 203 of SCC (85.3%). AC presented lower histological grade than did SCC (grade 1: 68.6% versus 9.4%; p < 0.001), lower rate of lymphovascular space involvement (25.7% versus 53.7%; p = 0.002), lower rate of invasion into the middle or deep thirds of the uterine cervix (40.0% versus 80.8%; p < 0.001) and lower rate of lymph node metastasis (2.9% versus 16.3%; p = 0.036). Although the recurrence rate was lower for AC than for SCC (11.4% versus 15.8%), this difference was not statistically significant (p = 0.509). Multivariate analysis identified three independent risk factors for recurrence: presence of metastases in the pelvic lymph nodes, invasion of the deep third of the uterine cervix and absence of or slight inflammatory reaction in the cervix. When these variables were adjusted for the histological type and radiotherapy status, they remained in the model as independent risk factors. Conclusion: The AC group showed less aggressive histological behavior than did the SCC group, but no difference in the disease-free survival rates was noted. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
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The aim of this preliminary work was to present a novel method, suitable to investigate the glass cooling, from melt to solid state, based on a fast, non-usual and easy microwave method. The following glass system xBaO . (100-x)B(2)O(3) (x = 0% and 40%) was selected as an example for this study. The melt was poured inside a piece of waveguide and then, its cooling was monitored by the microwave signal as a function of time. The variations in the signal can provide valuable informations about some structural changes that take place during the cooling stages, such as relaxation processes. This method can be useful to investigate the cooling and heating of other materials, opening new possibilities for investigation of dielectric behavior of materials under high temperatures. (C) 2008 Elsevier Inc. All rights reserved.
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In this work, a new theoretical mechanism is presented in which equatorial Rossby and inertio-gravity wave modes may interact with each other through resonance with the diurnal cycle of tropical deep convection. We have adopted the two-layer incompressible equatorial primitive equations forced by a parametric heating that roughly represents deep convection activity in the tropical atmosphere. The heat source was parametrized in the simplest way according to the hypothesis that it is proportional to the lower-troposphere moisture convergence, with the background moisture state function mimicking the structure of the ITCZ. In this context, we have investigated the possibility of resonant interaction between equatorially trapped Rossby and inertio-gravity modes through the diurnal cycle of the background moisture state function. The reduced dynamics of a single resonant duo shows that when this diurnal variation is considered, a Rossby wave mode can undergo significant amplitude modulations when interacting with an inertio-gravity wave mode, which is not possible in the context of the resonant triad non-linear interaction. Therefore, the results suggest that the diurnal variation of the ITCZ can be a possible dynamical mechanism that leads the Rossby waves to be significantly affected by high frequency modes.
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We study segregation phenomena in 57 groups selected from the 2dF Percolation-Inferred Galaxy Groups (2PIGG) catalogue of galaxy groups. The sample corresponds to those systems located in areas of at least 80 per cent redshift coverage out to 10 times the radius of the groups. The dynamical state of the galaxy systems was determined after studying their velocity distributions. We have used the Anderson-Darling test to distinguish relaxed and non-relaxed systems. This analysis indicates that 84 per cent of groups have galaxy velocities consistent with the normal distribution, while 16 per cent of them have more complex underlying distributions. Properties of the member galaxies are investigated taking into account this classification. Our results indicate that galaxies in Gaussian groups are significantly more evolved than galaxies in non-relaxed systems out to distances of similar to 4R(200), presenting significantly redder (B - R) colours. We also find evidence that galaxies with M(R) <= -21.5 in Gaussian groups are closer to the condition of energy equipartition.
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Analysis of floristic similarity relationships between plant communities can detect patterns of species occurrence and also explain conditioning factors. Searching for such patterns, floristic similarity relationships among Atlantic Forest sites situated at Ibiuna Plateau, Sao Paulo state, Brazil, were analyzed by multivariate techniques. Twenty one forest fragments and six sites within a continuous Forest Reserve were included in the analyses. Floristic composition and structure of the tree community (minimum dbh 5 cm) were assessed using the point centered quarter method. Two methods were used for multivariate analysis: Detrended Correspondence Analysis (DCA) and Two-Way Indicator Species Analysis (TWINSPAN). Similarity relationships among the study areas were based on the successional stage of the community and also on spatial proximity. The more similar the successional stage of the communities, the higher the floristic similarity between them, especially if the communities are geographically close. A floristic gradient from north to south was observed, suggesting a transition between biomes, since northern indicator species are mostly heliophytes, occurring also in cerrado vegetation and seasonal semideciduous forest, while southern indicator species are mostly typical ombrophilous and climax species from typical dense evergreen Atlantic Forest.