New material for orthopedic implants: Electrochemical study of nickel free P558 stainless steel in minimum essential medium

Nickel, a component of stainless steels (SS) applied in orthopedic implants may cause allergic processes in human tissues P558 nickel free SS was studied to verify its viability as a substitute for stainless steel containing nickel Its performance is compared to ISO 5832-9 and F138 most used nowadays grades in implants fabrications, in minimum essential medium. MEM, at 37 degrees C. Potentiodynamic polarization curves, electrochemical impedance spectroscopy (EIS), scanning electron microscopy (SEM) and ""in vitro"" cytotoxicity were used as techniques. From the electrochemical point of view P558 SS is comparable to ISO 5832-9 SS in MEM It remains passivated until the transpassivation potential, above which generalized corrosion occurs F138 presents pitting corrosion at 370 mV/SCE. The cytotoxicity results showed that P558. ISO 5832-9 and F138 do not present cytotoxic character Therefore, these results suggest that P558 SS can be applied in orthopedic implants (C) 2010 Elsevier BV All rights reserved

Neoadjuvant interstitial high-dose-rate (HDR) brachytherapy combined with systemic chemotherapy in patients with breast cancer

BACKGROUND AND PURPOSE: This is the first study investigating neoadjuvant interstitial high-dose-rate (HDR) brachytherapy combined with chemotherapy in patients with breast cancer. The goal was to evaluate the type of surgical treatment, histopathologic response, side effects, local control, and survival. PATIENTS AND METHODS: 53 patients, who could not be treated with breast-conserving surgery due to initial tumor size (36/53) or due to an unfavorable breast-tumor ratio (17/53), were analyzed retrospectively. All but one were in an intermediate/high-risk group (St. Gallen criteria). The patients received a neoadjuvant protocol consisting of systemic chemotherapy combined with fractionated HDR brachytherapy (2 x 5 Gy/day, total dose 30 Gy). In cases, where breast-conserving surgery was performed, patients received additional external-beam radiotherapy (EBRT, 1.8 Gy/day, total dose 50.4 Gy). In patients, who underwent mastectomy but showed an initial tumor size of T3/T4 and/or more than three infiltrated lymph nodes, EBRT was also performed. RESULTS: In 30/53 patients (56.6%) breast-conserving surgery could be performed. The overall histopathologic response rate was 96.2% with a complete remission in 28.3% of patients. 49/53 patients were evaluable for follow-up. After a median of 58 months (45-72 months), one patient showed a mild fibrosis of the breast tissue, three patients had mild to moderate lymphatic edema of the arm. 6/49 (12.2%) patients died of distant metastases, 4/49 (8.2%) were alive with disease, and 39/49 (79.6%) were free from disease. Local recurrence was observed in only one case (2%) 40 months after primary therapy. After mastectomy, this patient is currently free from disease. CONCLUSION: The combination of interstitial HDR brachytherapy and chemotherapy is a well-tolerated and effective neoadjuvant treatment in patients with breast cancer. Compared to EBRT, treatment time is short. Postoperative EBRT of the whole breast -- if necessary -- is still possible after neoadjuvant brachytherapy. Even though the number of patients does not permit definite conclusions, the results are promising regarding survival and the very low rate of local recurrences.