The interdental gingiva,a visible guide for placement of mini‐implants

Authors – Chun YS, Lee SK, Wikesjö UME, Lim WH Objectives – To determine whether the tip of the interdental gingiva can serve as a visible guide for placement of mini‐implants. Setting and Sample population – Computer tomography (CT) images from 15 males and 15 females (mean age 27 years, range: 23–35 years) were used to evaluate the distance from the tip of the interdental gingiva to the alveolar crest from the central incisor to the 1st molar. The distance from a reference point to the tip of interdental gingiva was recorded from study models using a caliper. The distance between the reference point and the alveolar crest was recorded using CT and added to the model recordings thus providing the distance from the tip of interdental gingiva to the alveolar crest for the various interdental sites. Two‐way anova and Student–Newman–Keuls test for multiple comparisons were used for the statistical analysis. Results – There was no significant difference in the distance from the tip of interdental gingiva to the alveolar crest between maxilla and mandible. The distance between the tip of interdental gingiva and the alveolar crest at the central/lateral incisors was the shortest compared with that of other sites. There was also a statistically significant difference between the male and female groups except for the maxillary 2nd premolar/1st molar interradicular site. Conclusion – The tip of interdental gingiva appears a reasonable visual guide for the placement of mini‐implants for orthodontic anchorage.     

Limited Margins Using Modern Radiotherapy Techniques Does Not Increase Marginal Failure Rate of Glioblastoma

PURPOSE: We investigate the patterns of failure in the treatment of glioblastoma(GBM) based on clinical target volume(CTV) margin size,dose delivered to the site of initial failure,and the use of temozolomide and intensity-modulated radiotherapy(IMRT).METHODS: Between August 2000 and May 2010,161 patients with GBM were treated with radiotherapy with or without concurrent temozolomide.Patients were treated with CTV expansions that ranged from 5 to 20 mm using a shrinking field technique.Patterns of failure and time to progression and overall survival were compared based on CTV margin,use of temozolomide,and use of IMRT.Kaplan Meier analysis was used to estimate survival times,and χ test was used for comparison of cohorts.RESULTS: For patients treated with 5-,10-,and 15-to 20-mm CTV,79%,77%,and 86% experienced failures in the 60 Gy volume,respectively.Forty-eight percent,55%,and 66% of patients with 5-,10-,and 15-to 20-mm CTV experienced failures in the 46 Gy volume,respectively.There was no statistical difference between patients treated with 5-,10-,15-to 20-mm margins with regard to 60 Gy failure(P=0.76),46 Gy failure(P=0.51),or marginal failure(P=0.73).Eighty percent of patients receiving temozolomide experienced failures in the 60 Gy volume.There was no increased likelihood of marginal failures in patients receiving IMRT(P =0.97).CONCLUSIONS: Modern treatment techniques including use of concurrent temozolmide,limited CTV margin size,and IMRT have not greatly changed the patterns of failure of GBM.     

International validation of the Chinese University Prognostic Index for staging of hepatocellular carcinoma:a joint United Kingdom and Hong Kong study

The outcome of hepatocellular carcinoma （HCC） patients significantly differs between western and eastern population centers. Our group previously developed and validated the Chinese University Prognostic Index （CUPI） for the prognostication of HCC among the Asian HCC patient population. In the current study, we aimed to validate the CUPI using an international cohort of patients with HCC and to compare the CUPI to two widely used staging systems, the Barcelona Clinic Liver Cancer （BCLC） classification and the Cancer of the Liver Italian Program （CLIP）. To accomplish this goal, two cohorts of patients were enrolled in the United Kingdom （UK; n = 567; 2006-2011） and Hong Kong （HK; n = 517; 2007-2012）. The baseline clinical data were recorded. The performances of the CUPI, BCLC, and CLIP were compared in terms of a concordance index （C-index） and were evaluated in subgroups of patients according to treatment intent. The results revealed that the median follow-up durations of the UK and HK cohorts were 27.9 and 29.8 months, respectively. The median overall survival of the UK and HK cohorts were 22.9 and 8.6 months, respectively. The CUPI stratified the patients in both cohorts into three risk subgroups corresponding to distinct outcomes. The median overall survival of the CUPI low-, intermediate-, and high-risk subgroups were 3.15, 1.24, and 0.29 years, respectively, in the UK cohort and were 2.07, 0.32, and 0.10 years, respectively, in the HK cohort. For the patients who underwent curative treatment, the prognostic performance did not differ between the three staging systems, and all were suboptimal. For those who underwent palliative treatment, the CUPI displayed the highest C-index, indicating that this staging system was the most informative for both cohorts. In conclusion, the CUPI is applicable to both western and eastern HCC patient populations. The performances of the three staging systems differed according to treatment intent, and the CUPI was demonstrated to be optimal for those     

Pancreatic diffusion‐weighted imaging (DWI): Comparison between mass‐forming focal pancreatitis (FP), pancreatic cancer (PC), and normal pancreas

Purpose

To compare diffusion‐weighted imaging (DWI) findings and the apparent diffusion coefficient (ADC) values of pancreatic cancer (PC), mass‐forming focal pancreatitis (FP), and the normal pancreas.

Materials and Methods

DWI (b = 0 and 600 seconds/mm²) findings of 14 patients with mass‐forming FP proven by histopathology and or clinical follow‐up, 10 patients with histopathologically‐proven PC, and 14 subjects with normal pancreatic exocrine function and normal imaging findings were retrospectively evaluated. ADC values of the masses, the remaining pancreas, and the normal pancreas were measured.

Results

On b = 600 seconds/mm² DWI, mass‐forming FP was visually indistinguishable from the remaining pancreas whereas PC was hyperintense relative to the remaining pancreas. The mean ADC value of PC (1.46 ± 0.18 mm²/second) was significantly lower than the remaining pancreas (2.11 ± 0.32 × 10^–3 mm²/second; P < 0.0001), mass‐forming FP (2.09 ± 0.18 × 10^–3 mm²/second; P < 0.0001), and pancreatic gland in the control group (1.78 ± 0.07 × 10^–3 mm²/second; P < 0.0005). There was no significant difference of ADC values between the mass‐forming focal pancreatitis and the remaining pancreas (2.03 ± 0.2 × 10^–3 mm²/second; P > 0.05).

Conclusion

Differences on DWI may help to differentiate PC, mass‐forming FP, and normal pancreas from each other. J. Magn. Reson. Imaging 2009;29:350–356. © 2009 Wiley‐Liss, Inc.     

Mouse models in liver cancer research： A review of current literature

Primary liver cancer remains one of the most lethal malignancies worldwide. Due to differences in prevalence of etiological factors the incidence of primary liver cancer varies among the world, with a peak in East-Asia. As this disease is still lethal in most of the cases, research has to be done to improve our understanding of the disease, offering insights for possible treatment options. For this purpose, animal models are widely used, especially mouse models. In this review, we describe the different types of mouse models used in liver cancer research, with emphasis on genetically engineered mice used in this field. We focus on hepatocellular carcinoma （HCC）, as this is by far the most common type of primary liver cancer, accounting for 70%-85% of cases.     

Orbital septal resection and the hanging curtain of fat

PURPOSE: To describe a technique of lower eyelid blepharoplasty and report observations on 274 consecutive surgeries. METHODS: Retrospective, noncomparative case series of lower eyelid blepharoplasty by 2 surgeons from January 2004 through January 2006. RESULTS: Two-hundred seventy-four eyelids of 137 patients underwent transcutaneous lower eyelid blepharoplasty for the treatment of steatoblepharon. There were 27 men and 110 women with an age range of 35 years to 85 years. Minimum length of follow-up was 6 months. Two-thirds of patients had simultaneous horizontal lower eyelid tightening. Four patients (3%) had surgical enhancement for retained lower eyelid fat. CONCLUSIONS: With appropriate patient selection, orbital septal excision is an effective aesthetic technique for lower eyelid blepharoplasty. It combines surgical simplicity with good cosmetic outcomes.     

苦楝化学成份的研究

从苦楝(Melia azedarach L.)果中分得苦楝新醇(Ⅰ),苦楝醇(Ⅱ)、苦楝酮(Ⅲ)、苦楝二醇(Ⅳ)、香草醛(Ⅴ)和香草酸(Ⅵ)。根据波谱(IR,MS,~1HNMR,~(13)CNMR)分析和理化常数测定,确定了它们的结构。其中苦楝新醇(Ⅰ)为新化合物,对菜青小虫有一定的拒食活性。