Trial of duplication procedure for complete dentures by CAD/CAM

summary The purpose of this study was to duplicate the shapes of complete dentures by using a computer-aided design/manufacturing (CAD/CAM) system. The shapes of the complete dentures of an edentulous patient were measured using a non-contact type shape measurement system and morphological data at the interval of 0.25 mm were obtained in the X-axis and Y-axis directions. Measurement was performed from the occlusal surface and mucosal surface sides. Based on the three-dimensional morphological data, cutter paths for cutting were generated. For cutting, the three-step method consisting of rough cutting, finish cutting, and partial finish cutting was used and for duplicating the dentures the modelling wax was cut using a computerized numerical control (CNC) processor and ball-end mills with diameters of 6 mm and I mm. The method for the controlling of three axes (X, Y, and Z) of CNC machine was used, and cutting was performed only from two directions. Although further improvements are needed in the measurement and cutting in acute slope areas, the duplication of complete dentures appears to be possible using the CAD/CAM system.     

Application of a three-dimensional reconstruction method to analysis of the residual ridge

summary The purpose of this study was to develop a new method of analysing the shape of the residual ridge. The line of the residual ridge crest was regarded as the reference for artificial tooth arrangement and a method of determining it was evaluated. The shape of a plaster model was measured with a contact-type shape measurement system. The measurement data in each frontal section were interpolated by cubic splines. The points corresponding to the residual ridge crest were calculated and superimposed onto the image of the plaster model on a monitor screen of an image processor. Using these points and the image of the plaster model, the line of the residual ridge crest was marked on the plaster model. It was concluded that this method could be used to determine the line of the residual ridge crest on a plaster model.     

Usefulness of tonsil forceps in radical retropubic prostatectomy

The presence of positive surgical margins after radical retropubic prostatectomy (RRP) for prostate cancer leads to an increased risk of progression and reduces disease free survival. A positive surgical margin at the apex is more frequent and is associated with worse clinical prognosis compared to other locations. The urethra usually enters the prostate slightly anterior and proximal to the prostatic apex. After dividing the dorsal vessels and separating neurovascular bundles (NVB) from the prostatic urethral junction using scissors, the operator dissects around the urethra just below the apex to avoid incision into the apex and injury of the NVB and sphincter mechanism. We use tonsil forceps instead of a right-angle clamp to make this important operative step more approachable. Its special curved shape with an angle of 105 degrees and short tip should make it much easier to isolate the urethra just below the apex from the surrounding tissue.     

Multi-modal treatment of primarily using continuous subcutaneous interferon-α injection in combination with surgery and/or radiotherapy

PURPOSE: Thirty-nine renal cell carcinoma patients with bony metastasis were intensively treated, primarily with immunotherapy using natural type interferon-alpha (IFN-alpha) continuous subcutaneous injection in combination with surgical resection and radiation therapy. Long-term survival was achieved, including three patients with complete response. The results of this study are presented. METHODS: The mode of administration of IFN-alpha was as follows: natural-type IFN-alpha (25,000,000 IU) was dissolved in 60 mL of distilled water and administered via continuous subcutaneous injection (0.5 mL/h) as 'one course of the treatment'. Two courses of IFN-alpha therapy were given 2 weeks preoperatively, while 13 courses of IFN-alpha therapy were given postoperatively (one course per week). Thus, 15 courses of IFN-alpha therapy were administered during the trial period. Thereafter, IFN-alpha therapy was repeated either every week or every other week depending on the condition of the patient. Additionally, blood levels of IFN-alpha were monitored for four patients following initiation of IFN-alpha continuous subcutaneous injection therapy. RESULTS: Immediately after injection of IFN-alpha, blood levels of IFN-alpha started to rise, reaching 40.5 IU/mL on average at 24 h after initiation of IFN-alpha therapy. Thereafter, blood levels of IFN-alpha remained high and measurable blood levels of IFN-alpha were maintained for up to 24 h after completion of IFN-alpha injection. As a whole, IFN-alpha was detectable for 6-8 days and Cmax (maximum blood concentration of IFN) was 167 IU/mL. Thirty-nine patients with bony metastases were treated as follows: IFN mono-therapy (19 patients), IFN and radiation therapy (15 patients) and IFN and surgical resection of bony metastases (five patients). Fourteen patients survived and the details of these 14 patients are as follows: complete response in three cases, partial response in two, no change in six and progressive disease in three. Twenty-five patients died of renal cell carcinoma. The overall 5-year survival rate was 35.0%. CONCLUSIONS: These findings indicate that IFN-alpha continuous subcutaneous injection therapy is a useful modality for renal cell carcinoma patients with bony metastasis if administered in combination of radical nephrectomy and radiation therapy.     

Clinical impact of tamsulosin on generic and symptom-specific quality of life for benign prostatic hyperplasia patients: Using international prostate symptom score and Rand Medical Outcomes Study 36-item Health Survey

AIM: To examine the efficiency of alpha1-blocker treatment on disease-specific and generic quality of life (QOL) in men with clinically diagnosed benign prostatic hyperplasia (BPH), the improvement of QOL scores with International prostate symptom score (I-PSS) and Rand Medical Outcomes Study 36-item Health Survey (SF-36) was prospectively analyzed. METHODS: A total of 68 newly diagnosed patients with symptomatic BPH that satisfied all inclusion and none of the exclusion criteria were prospectively recruited. All patients received 0.2 mg/day of tamsulosin for 12 weeks. All patients underwent pretreatment documentation of lower urinary tract symptoms (LUTS) and assessment of symptom-specific QOL. Symptoms and general health-related QOL (HRQOL) were assessed using the I-PSS and SF-36, respectively. Also, other objective variables, such as prostate volume, maximal urinary flow and postvoid residual urine volume, were evaluated. RESULTS: After 12 weeks, decrease in I-PSS was 27% compared with baseline (from 16.4 +/- 7.18 to 11.9 +/- 7.56). All questionnaires in the I-PSS showed improvement after tamsulosin treatment and the I-PSS QOL score was improved from 4.51 +/- 1.14 to 3.17 +/- 1.38 (P < 0.0001) at 12 weeks after tamsulosin administration. In intragroup comparisons of HRQOL scores with age-gender adjusted SF-36 Japanese national norms, three SF-36 subscales (bodily pain, BP; social function, SF; and mental health, MH) were worse in the BPH group aged over 70 years, while younger BPH groups aged <70 had better mean SF-36 physical function (PF) scores compared with age-gender adjusted Japanese national norms. In the BPH group with a prostatic volume > or =20 mL, three mean SF-36 scales (BP, SF and MH) were significantly improved after tamsulosin treatment. It is noteworthy that these SF-36 subscales were identical to those observed to worsen in the older BPH group compared to Japanese national norms. CONCLUSIONS: Treatment with tamsulosin for symptomatic BPH patients is associated with significant improvement in the generic HRQOL, in addition to disease-specific QOL and symptoms, at 3 months after drug administration. In particularly, for generic HRQOL with SF-36, tamsulosin treatment can efficiently improve three mean SF-36 subscales (BP, SF and MH) that are decreased in older BPH patients.     

Intestinal brush-border transport of the oral cephalosporin antibiotic,cefdinir, mediated by dipeptide and monocarboxylic acid transport systems in rabbits

Abstract— Intestinal absorption of the orally active cephalosporin, cefdinir, was investigated using brush-border membrane vesicles prepared from rabbit small intestine. The initial uptake of cefdinir was pH-dependent, with increased uptake at acidic pH, and was not influenced by either sodium gradient or membrane potential difference. Cefdinir uptake was saturable with an apparent Michaelis constant of 8·1 Mm . Initial uptake of cefdinir was inhibited by dipeptides (glycyl-l -proline and glycylsarcosine), β-lactam antibiotics (cephradine, cefixime and penicillin V), and monocarboxylic acids (acetic acid and l -lactic acid), whereas the uptake of cephradine and cefixime was not inhibited by monocarboxylic acids. Cefdinir significantly inhibited the initial uptake of cephradine, cefixime and [³H]acetic acid. From these results, it was suggested that cefdinir was transported across brush-border membranes by both dipeptide and monocarboxylic acid carriers.