Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer

Background: Locally advanced breast cancer (LABC) is still common in developing countries. The association between neoadjuvant chemotherapy (NC) and oncoplastic surgery (OS) might provide an oncological treatment with satisfactory aesthetic results.Purpose: The goal was to demonstrate if oncoplastic surgical techniques can be utilized to treat LABC which was submitted to neoadjuvant chemotherapy.Methods: This prospective clinical trial included breast cancer patients, clinical stage III, who underwent established NC regimen. All patients underwent preoperative planning to control the tumor size and to define the surgical technique. A detailed analysis of the pathological specimen was performed.Results: 50 patients were assessed and surgically treated. Tumor size ranged from 3.0 to 14.0 cm (median 6.5 cm). Pathologic response was rated as stable, progressive, partial response, and complete response in 10%, 8%, 80% and 2% of the cases, respectively. Seventeen (34%) patients were submitted to OS. No patient had positive margins. Skin involvement was presented in 36% of pathologic specimen.Conclusions: Oncoplastic surgical techniques for selected patients decrease the rates of radical surgery despite large tumors. (www.clinicaltrials.gov, NCT00820690). (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Cold Renal Ischemia: Comparison of Efficacy Between Two Techniques of Cooling, in a Swine Model

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A comparison of profilometer and AutoCAD software techniques in evaluation of implant angulation in vitro

Purpose: The aim of this study was to compare 2 different methods of assessment of implants at different inclinations (90 degrees and 65 degrees)-with a profilometer and AutoCAD software. Materials and Methods: Impressions (n = 5) of a metal matrix containing 2 implants, 1 at 90 degrees to the surface and 1 at 65 degrees to the surface, were obtained with square impression copings joined together with dental floss splinting covered with autopolymerizing acrylic resin, an open custom tray, and vinyl polysiloxane impression material. Measurement of the angles (in degrees) of the implant analogs were assessed by the same blinded operator with a profilometer and through analysis of digitized images by AutoCAD software. For each implant analog, 3 readings were performed with each method. The results were subjected to a nonparametric Kruskal-Wallis test, with P <= .05 considered significant. Results: For implants perpendicular to the horizontal surface of the specimen (90 degrees), there were no significant differences between the mean measurements obtained with the profilometer (90.04 degrees) and AutoCAD (89.95 degrees; P=.9142). In the analyses of the angled implants at 65 degrees in relation to the horizontal surface of the specimen, significant differences were observed (P=.0472) between the mean readings with the profilometer (65.73 degrees) and AutoCAD (66.25 degrees). Conclusions: The degrees of accuracy of implant angulation recording vary among the techniques available and may vary depending on the angle of the implant. Further investigation is needed to determine the best test conditions and the best measuring technique for determination of the angle of the implant in vitro.

Effect of different repair techniques on the accuracy of repositioning the fractured denture base

Objective:This study investigated the efficacy of different techniques for the union of fragments of a denture before repair and on the accuracy of the reposition.Materials and methods:For this study, 20 maxillary dentures made with Lucitone 550 heat-cured resin were used. Points were determined with a scanner on the cusp of the teeth, as a measurement of the segments. After digitisation, each model was exported to the AUTOCAD R 14 program and two-dimensional measurements of the distances between the marked points were made. After the initial analysis, the dentures were fractured into two segments using an impact test machine. For the repair, maxillary dentures were divided into two groups; in the first, the repair was carried out using Kerr's sticky wax and in the second group, Super Bonder was used to join the fragments, with subsequent inclusion of DENTSPLY((R)) Repair Material resin. After the repair, the points of the maxillary dentures were measured again. The numerical values obtained were tabulated to compare the measurements before fracture and after the repair. For statistical analysis, analysis of variance was employed, using a single factor and double factor, followed by the Tukey test with a reliability of 95%.Results:The results demonstrated a statistically significant difference between the materials used to join the dentures for repair, where the dentures were joined with sticky wax presented a larger variation in the distances between the points.Conclusion:The variation in distances between the points is influenced by the agent of repair.

Accuracy of Impression Techniques for Impants. Part 2-Comparison of Splinting Techniques

Purpose: The aim of this study was to compare splinting techniques for impression copings of osseointegrated implants with different angulations.Materials and Methods: Replicas (N = 24) of a metal matrix (control) containing two implants at 90 degrees and 65 degrees in relation to the horizontal surface were obtained by using four impression techniques: Technique 1 (T1), direct technique with square copings without union in open trays; Technique 2 (T2), square copings splinted with dental floss and autopolymerizing acrylic resin; Technique 3 (T3), square copings splinted with dental floss and autopolymerizing acrylic resin, sectioned and splinted again with autopolymerizing acrylic resin; Technique 4 (T4), square copings splinted with prefabricated acrylic resin bar. The impression material was polyether. The replicas were individually scanned to capture the images, which were assessed in a graphic computation program. The program allowed the angulation between the bases of the replicas and the reading screws to be measured. The images of the replicas were compared with the matrix image (control), and the differences in angulations from the control image were calculated. The analysis of variance and the Tukey test for comparisons (p < 0.05) were used for statistical analysis.Results: All groups showed significant differences in the implant angulations in comparison with the control group (p < 0.05). Group T1 showed the highest difference (1.019 degrees) followed by groups T2 (0.747 degrees), T3 (0.516 degrees), and T4 (0.325 degrees), which showed the lowest angular alteration compared to the control group. There were significant differences between inclined and straight implants in all the groups, except in group T4.Conclusions: Based on the results, the splinting of pick-up impression copings is indicated for osseointegrated implant impressions. The square copings splinted with a prefabricated acrylic resin bar presented the best results among the pick-up impression techniques evaluated in this study.

Effect of Flasking and Polymerization Techniques on Tooth Movement in Complete Denture Processing

Purpose: The purpose of this study was to compare the artificial tooth positional changes following the flasking and polymerization of complete dentures by a combination of two flasking methods and two polymerization techniques using computer graphic measurements.Materials and Methods: Four groups of waxed complete dentures (n = 10) were invested and polymerized using the following techniques: (1) adding a second investment layer of gypsum and conventional water bath polymerization (Control), (2) adding a second investment layer of gypsum and polymerization with microwave energy (Gyp-micro), (3) adding a second investment layer of silicone (Zetalabor) and conventional polymerization (Silwater), and (4) adding a second investment layer of silicone and polymerization with microwave energy (Silmicro). For each specimen, six segments of interdental distances (A to F) were measured to determine the artificial tooth positions in the waxed and polymerized stages using software program AutoCad R14. The mean values of the changes were statistically compared by univariate ANOVA with Tukey post-hoc test at 5% significance.Results: There were no significant differences among the four groups, except for segment D of the Silmicro group (-0.004 +/- 0.032 cm) in relation to the Gypwater group (0.044 +/- 0.031 cm) (p < 0.05), which presented, repectively, expansion and shrinkage after polymerization.Conclusions: Within the limitations of this study, it was concluded that although the differences were not statistically significant, the use of a silicone investment layer when flasking complete dentures resulted in the least positional changes of the artificial teeth regardless of the polymerization technique.

Evaluation of the color stability of two techniques for reproducing artificial irides after microwave polymerization

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Color alteration in teeth subjected to different bleaching techniques

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Accuracy of impression and pouring techniques for an implant-supported prosthesis

Purpose: The purpose of this in vitro study was to compare the dimensional accuracy of a stone index and of 3 impression techniques (tapered impression copings, squared impression copings, and squared impression copings splinted with acrylic resin) associated with 3 pouring techniques (conventional, pouring using latex tubes fitted onto analogs, and pouring after joining the analogs with acrylic resin) for implant-supported prostheses. Materials and Methods: A mandibular brass cast with 4 stainless steel implant-abutment analogs, a framework, and 2 aluminum custom trays were fabricated. Polyether impression material was used for all impressions. Ten groups were formed (a control group and 9 test groups formed by combining each pouring technique and impression technique). Five casts were made per group for a total of 50 casts and 200 gap values (1 gap value for each implant-abutment analog). Results: The mean gap value with the index technique was 27.07 mu m. With the conventional pouring technique, the mean gap values were 116.97 mu m for the tapered group, 5784 mu m for the squared group, and 73.17 mu m for the squared splinted group. With pouring using latex tubes, the mean gap values were 65.69 mu m for the tapered group, 38.03 mu m for the squared group, and 82.47 mu m for the squared splinted group. With pouring after joining the analogs with acrylic resin, the mean gap values were 141.12 jum for the tapered group, 74.19 mu m for the squared group, and 104.67 mu m for the squared splinted group. No significant difference was detected among Index, squarellatex techniques, and master cast (P > .05). Conclusions: The most accurate impression technique utilized squared copings. The most accurate pouring technique for making the impression with tapered or squared copings utilized latex tubes. The pouring did not influence the accuracy of the stone casts when using splinted squared impression copings. Either the index technique or the use of squared coping combined with the latex-tube pouring technique are preferred methods for making implant-supported fixed restorations with dimensional accuracy.

Composite surfaces after finishing and polishing techniques

Purpose: To evaluate the effect of finishing and polishing techniques on surface roughness of resin-based composites (RBCs). Materials and Methods: Forty specimens of each material were cured under Mylar strips and immersed in artificial saliva for 1 wk. Samples were tested with a profilometer to obtain baseline average surface roughness (Ra). Specimens of both RBCs were then finished and polished according to four techniques: (1) Sof-Lex disks; (2) Sof-Lex disks followed by Prisma Gloss; (3) Enhance points; (4) Enhance points followed by Prisma Gloss application. New readings of the roughness pattern were carried out and the difference of post-polishing and baseline values were analyzed. Results: ANOVA test (alpha= 0.05) did not show differences between materials (P= 0.9393) nor interaction effects (P= 0.3094), but significant difference among the finishing/polishing techniques were detected (P= 0.0157). Tukey's test showed that the smoothest surface was obtained when the specimens were treated by Sof-Lex followed by Prosma Gloss polishing paste; and the worst results were obtained after using Enhance points alone.

Percentage of gutta-percha in mesial canals of mandibular molars obturated by lateral compaction or single cone techniques

The aim of this study was to compare the percentage of gutta-percha (PGP) in mesial root canals of mandibular molars obturated with LC (Lateral Compaction) or SC (Single Cone) ProTaper Universal System techniques at different levels of the root. Mesial root canals of 20 human permanent molars with similar anatomical characteristics were instrumented using the ProTaper Universal rotary system technique until the F2 instrument, with 20 canals filled by SC ProTaper Universal technique and 20 canals by the LC technique. The mesial roots were sectioned transversely to 3, 5, and 7 mm from the root apex. Digital images of specimens were obtained at MIC-D digital microscope in increases of 30 to 35X. The gutta-percha area was measured using ImageTool software. Data were analyzed using two-way ANOVA and Bonferroni test (a = 0.05). The SC technique provided greater PGP than the LC technique in the apical third (3 mm) (P < 0.001). In the other thirds (5 and 7 mm) there was no statistical difference between the two techniques regarding the PGP (P > 0.05). There was no statistically significant difference between thirds of the root canal for both techniques (P > 0.05). It was concluded that SC technique provided greater PGP than the LC technique in the apical third of mesial root canals of mandibular molars. There was no difference between the two techniques regarding the PGP in the cervical and middle thirds. Microsc. Res. Tech. 75:12291232, 2012. (C) 2012 Wiley Periodicals, Inc.

Identification of the shark species Rhizoprionodon lalandii and R-porosus (Elasmobranchii, Carcharhinidae) by multiplex PCR and PCR-RFLP techniques

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Crystal structure of human purine nucleoside phosphorylase at 2.3 angstrom resolution

Purine nucleoside phosphorylase (PNP) catalyzes the phosphorolysis of the N-ribosidic bonds of purine nucleosides and deoxynucleosides. In human, PNP is the only route for degradation of deoxyguanosine and genetic deficiency of this enzyme leads to profound T-cell mediated immunosuppression. PNP is therefore a target for inhibitor development aiming at T-cell immune response modulation and its low resolution structure has been used for drug design. Here we report the structure of human PNP solved to 2.3 Angstrom resolution using synchrotron radiation and cryocrystallographic techniques. This structure allowed a more precise analysis of the active site, generating a more reliable model for substrate binding. The higher resolution data allowed the identification of water molecules in the active site, which suggests binding partners for potential ligands. Furthermore, the present structure may be used in the new structure-based design of PNP inhibitors. (C) 2003 Published by Elsevier B.V.

Antiepileptic effect of acylpolyaminetoxin JSTX-3 on rat hippocampal CA1 neurons in vitro

The Joro spider toxin (JSTX-3), derived from Nephila clavata, has been found to block glutamate excitatory activity. Epilepsy has been studied in vitro, mostly on rat hippocampus, through brain slices techniques. The aim of this study is to verify the effect of the JSTX-3 on the epileptiform activity induced by magnesium-free medium in rat CA1 hippocampal neurons. Experiments were performed on hippocampus slices of control and pilocarpine-treated Wistar rats, prepared and maintained in vitro. Epileptiform activity was induced through omission of magnesium from the artificial cerebrospinal fluid (0-Mg2+ ACSF) superfusate and iontophoretic application of N-methyl-D-aspartate (NMDA). Intracellular recordings were obtained from CA] pyramidal neurons both of control and epileptic rats. Passive membrane properties were analyzed before and after perfusion with the 0-Mg2+ ACSF and the application of toxin JSTX-3. During the ictal-like activity, the toxin JSTX-3 was applied by pressure ejection, abolishing this activity. This effect was completely reversed during the washout period 2. when the slices were formerly perfused with artificial cerebrospinal fluid (ACSF) and again with 0-Mg2+ ACSF. Our results suggest that the toxin JSTX-3 is a potent blocker of induced epileptiform activity. (c) 2005 Elsevier B.V. All rights reserved.

Phosphate closes the solution structure of the 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) from Mycobacterium tuberculosis

The 5-enolpyruvylshikimate-3-phosphate synthase catalyses the sixth step of the shikimate pathway that is responsible for synthesizing aromatic compounds and is absent in mammals, which makes it a potential target for drugs development against microbial diseases. Here, we report the phosphate binding effects at the structure of the 5-enolpyruvyl shikimate-3-phosphate synthase from Mycobacterium tuberculosis. This enzyme is formed by two similar domains that close on each other induced by ligand binding, showing the occurrence of a large conformation change. We have monitored the phosphate binding effects using analytical ultracentrifugation, small angle X-ray scattering and, circular dichroism techniques. The low resolution results showed that the enzyme in the presence of phosphate clearly presented a more compact structure. Thermal-induced unfolding experiments followed by circular dichroism suggested that phosphate rigidified the enzyme. Summarizing, these data suggested that the phosphate itself is able to induce conformational change resulting in the closure movement in the M. tuberculosis 5-enolpyruvylshikimate-3-phosphate synthase. (c) 2006 Elsevier B.V. All rights reserved.