Torsion and linear accuracy in intraoral scans obtained with different scanning principles

PurposeFew investigations have examined the production of single restorations using intraoral scanners (IOS). Data on full-arch scans are rare, and data regarding torsion within the entire arch are very sparsely reported. Therefore, the aim of this study was to examine the deviations of torsion and linear distances in full-arch scans of three IOS based on different scanning principles.MethodsA cobalt-chrome-molybdenum alloy master model (CCMM) with four hemispheres was fabricated by laser sintering. The CCMM was digitized using a laboratory scanner (ATOS-Core/GOM) and scanned with three IOS (Omnicam/Sirona(OC); True Definition/3M(TD); TriosII/Cara-Version/Kulzer(TR)). All scan data were exported in a standard STL-file format and were analyzed with GOM Inspect software (V7.5/GOM). Torsion between the right and left side of the arch and linear accuracy (trueness and precision) were evaluated. After normality was confirmed, all data were subjected to parametric statistical analyses.ResultsThe torsion ranged from 0.07 ± 0.03°(OC) to 0.29 ± 0.14°(TD). Pairwise comparisons showed significant differences between the OC and TD scanners and between the TR and TD scanners. The linear distances ranged from 6 ± 5 μm(OC) to 298 ± 317 μm(TD). Significant differences were observed among all investigated IOS (p = 0.05).ConclusionsAlthough the highest torsion was observed for the TD scanner, it is still not clear whether the differences between the IOS are related to the scanning principle or to the scanning algorithm. Due to the high clinical relevance of full-arch restorations, future studies should consider torsion. Regarding linear accuracy, no general difference related to the scanning principles of the IOSs was observed.     

Proteases and their inhibitors as prognostic factors for high-grade serous ovarian cancer

Ovarian carcinoma is one of the most lethal malignancies, but only very few prognostic biomarkers are known. The degradome, comprising proteases, protease non-proteolytic homologues and inhibitors, have been involved in the prognosis of many cancer types, including ovarian carcinoma. The prognostic significance of the whole degradome family has not been specifically studied in high-grade serous ovarian cancer. A targeted DNA microarray known as the CLIP-CHIP microarray was used to identify potential prognostic factors in ten high-grade serous ovarian cancer women who had early recurrence (<1.6 years) or late/no recurrence after first line surgery and chemotherapy. In women with early recurrence, we identified seven upregulated genes (TMPRSS4, MASP1/3, SPC18, PSMB1, IGFBP2, CFI – encoding Complement Factor I – and MMP9) and one down-regulated gene (ADAM-10). Using immunohistochemistry, we evaluated the prognostic effect of these 8 candidate genes in an independent cohort of 112 high-grade serous ovarian cancer women. Outcomes were progression, defined according to CA-125 criteria, and death. Multivariate Cox proportional hazard regression models were done to estimate the associations between each protein and each outcome. High ADAM-10 expression (intensity of 2–3) was associated with a lower risk of progression (adjusted hazard ratio (HR): 0.51; 95% confidence interval (CI): 0.29-0.87). High complement factor I expression (intensity 2–3) was associated with a higher risk of progression (adjusted HR: 2.30, 95% CI: 1.17–4.53) and death (adjusted HR: 3.42; 95% CI: 1.72–6.79). Overall, we identified the prognostic value of two proteases, ADAM-10 and complement factor I, for high-grade serous ovarian cancer which could have clinical significance.     

Hiperplasia endotelial papilar intravascular (tumor Masson) de localización ginecológica

Intravascular papillary endothelial hyperplasia or Masson's tumour is a non-neoplastic vascular lesion of reactive character. It is a rare diagnosis, clinically non-specific and with diverse locations. It is essential to take it into consideration and make a differential diagnosis with malignant vascular tumours such as angiosarcoma. Pathological study is fundamental for diagnosis. Treatment consists of complete resection of the tumour, including sufficiently wide margins to avoid recurrence.The case reported is an exceptional event, because of the pelvic location of the Masson's tumour that was diagnosed as part of the surgical staging of an ovarian cancer.     

Systematic review of acceptability,cardiovascular, neurological,bone health and HRT outcomes following risk reducing surgery in BRCA carriers

Primary surgical prevention in the form of risk-reducing salpingo-oophorectomy (RRSO) is the most effective option and the gold standard for ovarian cancer (OC) risk-reduction, particularly given the absence of an effective national OC screening programme. However, premenopausal RRSO leads to premature surgical menopause with detrimental long-term health sequelae particularly in women who do not/are unable to take hormone replacement therapy (HRT). HRT uptake in women undergoing pre-menopausal oophorectomy appears low and is dependent on informed counselling, the safety of HRT and efficacy in mitigating the health sequelae of premature menopause. Acceptance of a central role for the fallopian tube in OC etiopathogenesis, coupled with the detrimental consequences of premature menopause, has led to the attractive proposal of early-salpingectomy with delayed oophorectomy as an alternative OC surgical prevention strategy in premenopausal women who have completed childbearing but decline or wish to delay RRSO. The successful implementation of risk reducing surgery for OC prevention depends on the acceptability of surgery to both, recipients (e.g. BRCA1/BRCA2 carriers) and intervention deliverers (healthcare professionals/researchers). Acceptability is also informed by an understanding of health outcomes following risk reducing surgery and the safety of HRT. It is therefore vital to understand the effects of surgery on important health outcomes such as cardiovascular health, neurological function and bone health. We present a comprehensive review of acceptability, the selected health outcomes mentioned above and HRT safety following risk reducing surgery.     

睾丸扭转和精索扭转的诊断与治疗(附68例报告)

目的:探讨睾丸和精索扭转的诊断与治疗方法,提高睾丸和精索扭转的治疗水平。方法:对68例睾丸和精索扭转的临床资料进行总结,68例平均年龄21岁,<20岁者占84%,左侧55例占80.8%.发病至确诊时间6h～30天,12h以上者占90.2%。结果:53例术前彩色多普勒血流动态显象(CDFI)应作为诊断疾病的常见与首选检查方法。诊断并经手术证实,符合率100%,经手术探查;41例行手术复位、固定,睾丸获救。27例行患侧睾丸切除术,所有病例均行对侧探察,固定。结论:阴囊X核素显象,B超对睾丸精索扭转早期诊断有帮助。早期诊断,及时治疗是提高疗效的关键。彩色多普勒血流动态显象应作为诊断该疾病的常见及首选检查方法,对睾丸精索一旦确诊或疑有精索扭转的患者应及早行紧急复位,以期挽救睾丸,同时行睾丸固定术也十分必要。对于确诊毫无保留价值的睾丸需行切除术。     

Pleural flap to prevent lobar torsion: a novel technique

Lobar torsion is reported as very rare but sometimes catastrophic complication if overlooked during the early postoperative period following a lobectomy, though it is totally preventable. In this novel technique, a piece of parietal pleural flap is harvested from the posterior wall of the chest using a hook diathermy while keeping its upper border as close to the apex as possible. Finally, distal end of the flap is secured to the upper edge of the lobe using a fine monofilament absorbable suture. This procedure not only protects the lobe from rotation but also maintains continuous expansion of the lung in the early postoperative period and may, therefore, be a good option to prevent such a serious complication in selected patients following a lobectomy.     

31例卵巢恶性畸胎瘤临床分析

本文报道了我院收治的卵巢恶性畸胎瘤３１例，随访中２例失访，随访率为９３．５３％。并讨论了卵巢恶性畸瘤的治疗方式为手术加联合化疗，对年轻的Ｉ期患者可行患侧单侧附件切除术，术后化疗极为重要。化疗方法采用ＶＡＣ或ＰＶＢ方案联合化疗，本文还 影响预后的重要因素为临床分期期和病理学特点．     

雌二醇周效贴片166例疗效观察

本研究观察国产雌二醇周效贴片（Ｅ２贴片）治疗因卵巢功能低落所致的主要临床表现的疗效，结合血ＦＳＨ、ＬＨ、Ｅ２测定，阴道脱落细胞成熟指数和部分病例的子宫内膜活检，对Ｅ２贴片的疗效进行了综合评价。结果显示，雌二醇周效贴片对卵巢功能低落所致的潮热、出汗、失眠、情绪波动，眩晕和阴道干涩等有显著疗效，且疗效随用药时间的延长而递增，在用药１４０天时总有效率分别达９８．９％，９２．０％、９１．４％、９０．０％和７８．０％，对ＬＨ、ＦＳＨ的释放有抑制作用；血清Ｅ２水平属轻度升高，但趋于平稳；部分病例子宫内膜组织学检查未见雌激素作用所致的内膜增殖效应。用药期间部分病例出现周期性阴道出血，这对年轻卵巢功能早哀者在生理和心理上均有治疗意义，但对更年期患者会造成不便和不安感。约２０％的病例贴片局部有轻微痒感，无其它不良反应。