Early pregnancy wastage: relationship between chorionic vascularization and embryonic development

The chorionic villous vascularization of 40 patients with first trimester spontaneous abortion was compared with that of 10 patients undergoing legal abortion (control group). The spontaneous abortion group was subdivided into a group with intrauterine embryonic death (n = 20) and a group with blighted ova (n = 20). Villous vascularization appeared unaffected after prolonged postmortem intrauterine retention. The incidence of vascularized villi was 89% in the control group, 26% in the group with embryonic death, and 9% in the group with blighted ova. In addition, the vascular density of vascularized villi was three to four times higher in the control group than in the two spontaneous abortion groups. The present study provides evidence that, in case of embryonic death and blighted ova, chorionic villous vascularization is deficient.     

Influence of thermal expansion mismatch and fatigue loading on phase changes in porcelain veneered Y-TZP zirconia discs

There is a rapidly growing interest for the use of Y-TZP zirconia as core material in veneered all-ceramic prostheses. It was hypothesized that a mismatch in coefficient of thermal expansion between the veneering porcelain and the Y-TZP zirconia core of these prostheses causes transformation of the tetragonal to the monoclinic structure in Y-TZP zirconia at the interface boundary when exposed to fatigue loading, resulting in fracture at the interface boundary. Y-TZP zirconia discs were veneered with three porcelains differing in coefficient of thermal expansion. Finite element analysis was used to investigate the stress distribution in the bi-layered discs because of the mismatch in thermal expansion. Two of these three groups were fatigued with the veneering ceramic in tension. X-ray diffraction was used to measure the intensity of monoclinic and tetragonal zirconia phase present at the zirconia core surface after sintering, airborne abrasion, veneering, and fatigue loading. It was found that the sintered tetragonal structure was converted to monoclinic up to a depth of 27 mum after airborne abrasion, and reversed back to tetragonal after porcelain veneering with porcelain. Fatigue loading of veneered discs did not, even with the highest possible thermal mismatch stress, cause any conversion from tetragonal to monoclinic phase.     

The initial hormone receptor/HER2 subtype is the main determinator of subtype discordance in advanced breast cancer: a study of the SONABRE registry

Breast Cancer Research and Treatment - The hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) are the main parameters in guiding systemic treatment choices in breast cancer,...     

The implementation of CDK 4/6 inhibitors and its impact on treatment choices in HR+/HER2− advanced breast cancer patients: A study of the Dutch SONABRE Registry

In August 2017, cyclin-dependent kinase 4/6 (CDK4/6) inhibitors combined with endocrine therapy have been reimbursed in the Netherlands for patients with hormone receptor positive (HR+), HER2 negative (HER2?) advanced breast cancer (ABC). This study evaluates the implementation of CDK4/6 inhibitors and changes in treatment choices in the Netherlands. All patients diagnosed with HR+/HER2? ABC in 2009 to 2018 in seven hospitals were selected from the Southeast Netherlands Advanced Breast cancer (SONABRE) registry. The 2-year cumulative use of CDK4/6 inhibitors since reimbursement date (August 2017) was assessed using competing-risk methodology in two cohorts. The first cohort included patients with ABC diagnosis between August 2017 and December 2018. The second cohort included patients with ABC diagnosis between 2009 and August 2017, and still alive on August 1, 2017. In addition, treatment choices in the first three lines of therapy in calendar years 2009 to 2018 were evaluated for the total study population. Among patients diagnosed since August 2017 (n = 214), 50% (95% confidence interval [CI] = 43-57) received CDK4/6 inhibitors within 2 years beyond diagnosis. Of eligible patients diagnosed before August 2017 (n = 417), 31% (95% CI = 27-36) received CDK4/6 inhibitors within 2 years following reimbursement. Another 20% of both cohorts are still CDK4/6 inhibitor naïve and on first-line therapy. The use of chemotherapy decreased in first two lines of therapy between 2009 and 2018 (first-line: 29%-13%; second-line: 26%-19%). The implementation rate of CDK4/6 inhibitors since reimbursement is currently 50% within 2 years beyond diagnosis and is expected to increase further. The implementation of targeted therapy decreased the use of chemotherapy as first-line therapy.     

The influence of porcelain layer thickness on the final shade of ceramic restorations

STATEMENT OF PROBLEM: Ceramic restorations should be made of porcelain layers of different opacity, shade, and thickness in order to provide a natural appearance. By means of CAD/CAM layering technology such as CICERO, it is feasible to produce all-ceramic crowns with porcelain layers of predetermined thickness. However, it is not yet known whether changes in thickness of these porcelain layers within the clinically available space can perceivably influence the overall shade of the restoration. PURPOSE: The purpose of this study was to determine, quantitatively, the effect of different thickness ratios of opaque porcelain (OP) and translucent porcelain (TP) layers on the overall shade of all-ceramic specimens. MATERIAL AND METHODS: The CIELAB values of 5 assembled specimens, each consisting of 2 or 3 discs (CORE 0.70 mm/OP--0, 0.25, 0.50, 0.75, or 1.00 mm/TP 1.00, 0.75, 0.50, 0.25, or 0 mm) were determined with a spectrophotometer for the Vita shades A1, A2, and A3. Distilled water was used to attain optical contact between the layers. Black or white backgrounds were used to assess the influence of the background on the final shade. Color differences (DeltaE) between layered specimens were determined. Correlation between the thickness ratio and the L*, a*, and b* values was calculated by 2-tailed Spearman correlation analysis. RESULTS: The results indicated that small changes in OP/TP thickness ratio can perceivably influence the final shade of the layered specimens (DeltaE>1). Redness a* and yellowness b* increased with the thickness of OP for all shades. Redness a* (P<.01 for all shades) correlated more strongly with thickness than yellowness b* (P<.01 for A1 and A3; P<.05 for A2). The lightness (L*) was shade dependent. The correlation (r) between OP/TP thickness and L* was 0.975 (P<.01) for shade A1, 0.700 (not statistically significant) for shade A2, and 0.900 (P<.05) for shade A3. CONCLUSION: Small changes in thickness and shade of opaque and translucent porcelain layers can influence the final shade of the layered porcelain specimen.