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Aim: To examine the clinical and radiographic appearance of teeth with immature apices that were treated by single step procedure using mineral trioxide aggregate (MTA)., Summary: Creation of a physiological hard tissue barrier with calcium hydroxide in a nonvital tooth although quite predictable has certain limitations, such as the very long duration of the treatment spread over multiple visits and increased risk of root fracture. Plugging the root canal end with MTA has been advocated as an alternative treatment modality for open apices. The technique has been proven to be successful in many recently reported cases. The cases reported here present the successful treatment of two traumatized maxillary central incisors with open apices and periapical lesions using MTA. In this case report, MTA has been used to create a hard tissue barrier after disinfection of the root canal.

Background: More than 200 different operations have been described for the treatment of recurrent anterior dislocation of shoulder. The Modified Boytchev procedure employs rerouting of the detached tip of coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis) deep to subscapularis and reattaches to its anatomical location. We conducted a study on evaluation of long-term effect of modified Boytchev procedure and to compare our results with other studies published in literature., Materials and Methods: Since June 2002, modified Boytchev procedure was performed on 48 patients, who presented with recurrent anterior dislocation. 45 were men and 3 were women and were in the age group of 18-40 years (mean 27.83±4.95 years). Forty patients were affected on the dominant side and rest on the non-dominant side. The mean number of dislocations in these patients was 18.22±12.08. The mean followup period was 58.13±19.06 months (range 18-96 months). The patients were evaluated by visual analogue score, modified American Shoulder and Elbow Surgeon's Score (ASES), and Single Assessment Numeric Evaluation (SANE) score at the last followup., Results: All the patients regained almost preoperative range of forward flexion at the last followup. In the preoperative period the mean external rotation deficit at 0° and at 90° of abduction was 13.22°±5.16° and 18.06°±6.50°, respectively. At the last followup, the mean external rotation deficit at 0° and at 90° of abduction was 8.06°±2.47° and 8.95°±2.07°, respectively. This improvement in external rotation deficit was statistically significant (P<.05). Preoperative scores were compared with the most recent followup scores for all variables with use of a paired t test. All patients had significant improvement in visual analogue score, modified American Shoulder and Elbow Surgeon's Score (ASES), and Single Assessment Numeric Evaluation (SANE) score at the last followup. Four of the patients developed superficial infection which got resolved after treating with antibiotics, and two of the patients developed transient musculocutaneous nerve paresis. There was no radiological evidence of loosening and migration of coracoid screw or any glenohumeral arthritis on subsequent followup of skiagrams in any of our patients., Conclusion: Modified Boytchev procedure is an efficacious and technically simple procedure to treat recurrent anterior dislocation of shoulder.

Displaced midclavicular fractures resulting in malunion with shortening and rotational deformity does not remodel in adults and incidence of non-union in displaced midshaft clavicular fractures is between 10-15% especially in those with an initial shortening of >20 mm.We have treated 10 patients of displaced middle-third clavicle fracture by open reduction and internal fixation with plate and screws and found it to be very effective in respect to rehabilitation, union and cosmesis.

Twenty-five patients with dorsolumbar spinal injury was treated by pedicular screw fixation along with direct or indirect decompression within 1 1/2 years period. Eighteen patients with incomplete neurodeficit had some amount of neurological recovery in terms of ASIA impairment scale but no neurological recovery was seen in 6 patients with complete neurological injury. Mean correction of kyphotic angle was 11.76 degrees. Mean postoperative increase in anterior vertebral body height was 43%. Complications like bed sore, superficial wound infections and peroperative dural tear were seen but all of which were treated successfully. Neurological deterioration after operation, screw pull out and implant failure were seen in none. This study indicates that short segment pedicular screw fixation is a safe and effective method for treatment of unstable spinal injury.

Sixty-two femoral shaft fractures in 60 patients treated by elastic intramedullary nailing with mean age of the patients being 9.2 years (range 5 years to 12 years) and average follow-up of 15 months (range 7 months to 60 months) are evaluated. Twenty-eight fractures were fixed with titanium elastic nail while 34 fractures were fixed with Enders nail. There were 40 midshaft fractures, 18 proximal femoral and 4 were fractures of distal third. Fracture patterns were transverse in 35, short oblique in 14 cases and 13 were spiral fractures. Mean age of union in this series was 17 weeks (range 12 weeks to 28 weeks). Ten cases had complications, 5 had nail tip irritation, 3 varus or valgus malalignment and 2 had delayed union. In this series, we did not have any non-union, refracture, limb length discrepancy or any major infection. The result demonstrates 100% union rate irrespective of the age, weight and height of the patient. Regardless of the site of fracture and their pattern, it united every time with elastic nail fixation. We did not find and mismatch in the results of fractures stabilised with titanium elastic nail with that of elastic stainless steel nail.

Operative treatment modalities for calcaneal fracture are still controversial. The outcome of intra-articular calcaneal fracture is mainly influenced by the soft tissue and the subtalar joint. Percutaneous method of internal fixation has been attempted to avoid the problems. Patients with displaced intra-articular calcaneal fracture types IIA, IIB and IIC were treated by initial distraction of subtalar joint, restoration the of subtalar joint, reduction of lateral expansion and finally fixation with screws percutaneously. Twenty-two patients with 26 calcaneal fractures were included. After a mean follow-up of 2 1/2 years and with American Orthopaedic Foot and Ankle Society hind foot score 82 points out of 100. Percutaneous fixation of calcaneum fracture is good alternative method in types IIA, IIB and IIC and selective type III fractures.

Context: India has a high incidence of head and neck squamous cell carcinoma (HNSCC) mostly presenting in advanced stage. In the majority of inoperable patients a combination of chemotherapy and radiotherapy (CRT) is considered as the treatment of choice. Adding induction chemotherapy (ICT) before CRT has shown to decrease systemic relapse. Incorporation of taxanes to the cisplatin and 5-FU-based ICT has shown increase in response rates., Aims: To evaluate the efficacy and toxicity of triple drug-based ICT followed by CCRT in locally advanced, inoperable HNSCC in the Indian context., Settings and Design: Prospective, non-controlled, observational study, a single-institute experience., Materials and Methods: Consecutive, locally advanced inoperable HNSCC patients were put on sequential therapy consisting of docetaxel, 5-FU and cisplatin for three cycles followed by concurrent weekly cisplatin and radiotherapy for responding or stable disease patients., Results: Forty-four patients were enrolled with male,female ratio of 33/44(75%) and 11/44(25%). Hypopharynx 16/44(36.36%) was the most common site followed by oral cavity 12/44(27.27%) and oropharynx 12/44(27.27%); 38/44(86.36%) patients could complete the planned treatment. Seven patients required dose reduction in ICT. As per the RECIST criteria, 16 patients had Complete Response (CR) and 15 had partial response (PR), 10 had stable disease (SD) and three had progressive disease (PD) after ICT. Thirty-eight patients received concomitant chemo radiotherapy (CCRT); 28/44 (66.63%) patients achieved CR, 10/44 (22.72 %) had PR. The main toxicity was mucositis 18/44 (40.90%) secondary to ICT. Grade III and IV hematological toxicity was seen in 16/44(36.36%), of which 6/44 (13.63%) had febrile neutropenia., Conclusions: Triple drug-based sequential therapy is tolerable in our context. In this trial from a single institute the results are very encouraging.

The small ubiquitin-like modifier (SUMO) can undergo self-modification to form polymeric chains that have been implicated in cellular processes such as meiosis, genome maintenance and stress response. Investigations into the biological role of polymeric chains have been hampered by the absence of a protocol for the purification of proteins linked to SUMO chains. In this paper, we describe a rapid affinity purification procedure for the isolation of endogenous polySUMO-modified species that generates highly purified material suitable for individual protein studies and proteomic analysis. We use this approach to identify more than 300 putative polySUMO conjugates from cultured eukaryotic cells.

Purpose: Nuclear factor kappa B (NF-κB), a transcriptional factor that has been shown to be constitutively active in cervical cancer, is part of an important pathway leading to treatment resistance in many tumor types. The purpose of our study was to determine whether expression of NF-κB in pretreatment specimens and specimens taken shortly after treatment initiation correlated with outcome in cervical cancer patients treated with definitive chemoradiation., Methods and Materials: Eighteen patients with locally advanced cervical cancer were enrolled in a study in which cervical biopsy specimens were obtained before radiation therapy and 48 h after treatment initiation. Matched biopsy specimens from 16 of these patients were available and evaluated for the nuclear expression of NF-κB protein by immunohistochemical staining., Results: After a median follow-up of 43 months, there were 9 total treatment failures. Nuclear staining for NF-κB was positive in 3 of 16 pretreatment biopsy specimens (19%) and 5 of 16 postradiation biopsy specimens (31%). Pretreatment expression of NF-κB nuclear staining correlated with increased rates of local-regional failure (100% vs. 23%, p = 0.01), distant failure (100% vs. 38%, p = 0.055), disease-specific mortality (100% vs. 31%, p = 0.03), and overall mortality (100% vs. 38%, p = 0.055)., Conclusions: Our data suggest that pretreatment nuclear expression of NF-κB may be associated with a poor outcome for cervical cancer patients treated with chemoradiation. Although these data require validation in a larger group of patients, the results support the continued study of the relationship between NF-κB and outcome in patients treated for carcinoma of the cervix., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Purpose: The feeding value and nutritional adequacy of two cereal fodder, viz. sorghum (Sorghum vulgare) and maize (Zea mays), were evaluated in spotted deer (Axis axis) and compared with that in sheep in two consecutive feeding trials of 35 days each., Methods: Four spotted deer (2 years of age, 68.3 kg average body weight) and six sheep (1.5 years of age, 18.0 kg average body weight) were fed on the above two fodder types as sole feed. Nutrient digestibility and evaluations were made through two digestion studies that ended with each feeding period., Result: Both sorghum and maize fodder provided 11% CP and 4.4 kcal DE per gram of TDN in the two species studied. A lower intake of DM (40.6 vs 47.5 g/kg(0.75)) and other nutrients was observed in deer during maize feeding period. It was similar but lower in sheep compared to deer. The digestibility of nutrients from both fodder types was higher in deer (66-77%) than sheep (45-62%). Numerically, most of the nutrients from sorghum fodder were better digested than maize except CP and EE. Maize fodder provided a higher percentage of NDF (70.85% vs 67.90%) and ADF (37.22% vs 30.74%) with a digestibility depression of about two units in deer and three to five units in sheep. Deer and sheep lost body weight during both the sorghum (2.0 and 0.7 kg) and the maize (2.5 and 0.4 kg) feeding periods., Conclusion: Although the nutritive value of cereal fodder seemed optimum, a lower voluntary feed intake in both deer and sheep contributed to inadequate nutrient intake compared to standard recommendation.

Variations in the dental anatomy are found in all teeth. Understanding root canal morphology is one of the most important steps in successful root canal treatment. Thus, during the diagnosis and treatment phases of maxillary molars, a clinician must be aware that anatomical variations exist. The purpose of this study is to present a clinical case of a maxillary first molar having three mesiobuccal canals with separate orifices. This unusual morphology was confirmed by spiral computed tomography (SCT). This article discusses the variations in canal morphology and the role of SCT in successfully diagnosing and negotiating them.

Introduction: The aim of this retrospective study was to determine the prevalence of three-rooted mandibular permanent first molars among the Indian population by using periapical radiographs., Methods: Five hundred eighty-six patients (320 females and 266 males) were selected, with at least 1 mandibular first molar. A total of 1054 periapical radiographs of mandibular first molars, comprising 526 right side and 528 left side, were included. The radiographs were taken at 30-degree mesial angulation and were evaluated by using the magnifying lens. The incidence, gender, and symmetry of three-rooted mandibular first molars were recorded and analyzed by using the chi(2) test., Results: The prevalence of three-rooted mandibular first molars was 5.97% for all patients and 4.55% for all teeth, respectively. The incidence of bilateral symmetrical distribution was 37.14%. The incidence was 6.88% for female patients and 4.89% for male patients (chi(2) = 1.02, P > .05) and 4.94% for the right side and 4.17% for the left side, respectively (chi(2) = 0.36, P > .05). No statistically significant differences were found between female and male patients and between the right-side and left-side occurrences., Conclusions: Clinicians should be aware of the high racial prevalence of this unusual root morphology in mandibular first molars among the Indian population before and during the root canal treatment of three-rooted mandibular first molars., (Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

A major anatomical variant of the two-rooted mandibular first molar is a tooth with an additional distolingual third root: The radix entomolaris (RE). It is essential to anticipate and find all roots and canals during root canal treatment. Proper angulations and interpretation of radiographs help to identify pulp chamber and root anatomy. If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment.

We analyzed the records of 44 patients with moyamoya disease evaluated and treated at our Institute from 1998 until 2007. Out of 44 patients, 18 (41%) were in the paediatric age group and 26 (59%) were adults. Presentation was ischemic in 14 (32%) and hemorrhagic in 30 patients (68%). Revascularization was performed in 11 patients (five patients with ischemic presentation and six with hemorrhagic presentation): nine patients underwent indirect revascularization procedures only and two patients underwent indirect revascularization procedures and a combined superficial temporal artery-middle cerebral artery bypass. Thirty-six patients (81.8%) were available for follow-up. Out of 11 patients who underwent revascularization procedures, none had further hemorrhagic or ischemic episodes. Out of the 19 conservatively managed patients who were followed-up, seven (36.8%) developed new episodes of ischemia (n=2) or hemorrhage (n=5). In-hospital mortality was 6.8% (three patients), all of whom were in the hemorrhagic presentation group., ((c) 2009 Elsevier Ltd. All rights reserved.)

Forty weaned male guinea pigs (Cavia porcellus) of 152.6 +/- 7.96 g mean body weight were divided into four equal groups and fed a common basal diet comprised of 25% ground cowpea (Vigna unguiculata) hay, 30% ground maize (Zea mays) grain, 22% ground gram (Cicer arietinum) grain, 9.5% deoiled rice (Oryza sativa) bran, 6% soybean (Glycine max) meal, 6% fish meal, 1.5% mineral mixture (without Se), and ascorbic acid at 200 mg/kg to meet their nutrient requirements along with 0, 0.1, 0.2, and 0.3 ppm of organic selenium (Se) in groups I, II, III, and IV, respectively. Experimental feeding lasted for a period of 10 weeks, during which, daily feed intake and weekly body weights were recorded. Intake and digestibility of dry matter, organic matter, ether extract, crude fiber, and nitrogen-free extract as well as uptake of calcium and phosphorus were similar (P > 0.05) among the four groups. Feed:gain ratio was also similar (P > 0.05) in the four groups. However, digestibility of crude protein was significantly (P < 0.001) higher in group II supplemented with 0.1 ppm organic Se as compared to other three group. Intake and absorption of Se was significantly (P < 0.001) higher in all the Se supplemented groups as compared to control group. Average daily gain (ADG) was significantly (P < 0.05) higher in group II (3.16 g/day) and III (3.38 g/day) as compared to group I (2.88 g/day). However, ADG in group IV (supplemented 0.3 ppm organic Se) was significantly (P < 0.05) lower (2.83 g/day) than group II and III, but comparable (P > 0.05) to group I. Findings of the present experiment suggests that Se requirements of guinea pigs are > or =0.2 ppm, as supplementation of 0.1 ppm organic Se in the diet (having 0.1 ppm Se) not only enhanced their growth rate but also improved the protein utilization.

Fifteen adult crossbred cattle bulls, 18-22 months old (mean body weight 286.33 + 9.43) were divided into 3 groups following RBD design and were fed sugarcane tops (SCT) supplemented with some agro-industrial byproducts and concentrate feeds to determine nitrogen, Ca and P in crossbred cattle bull. For this purpose, crossbred cattle bulls were fed for 30 days ad lib SCT supplemented with Wheat bran (WB), Lentil chuni (LC) and WB + LC (50:50) in Group I, II, and III respectively. The balance values were 15.28 + 2.70, 26.85 + 4.35 and 18.00 + 3.17 for nitrogen, 11.77 + 1.34, 12.94 + 2.96 and 15.38 + 1.15 for calcium, 11.74 + 0.64, 11.26 + 1.58 and 11.69 + 0.79 for phosphorus in group I, II and III, respectively. There were no significant differences among the experimental groups in Ca and P balance values but balance of nitrogen was significantly (P < 0.05) higher in group II as compared to group I and III. It may indicated that the rumen fermentation was more appropriate in group III where animals were fed 50% lentil chuni and 50% wheat bran (supplementation of both protein and energy).

Expert landmark correspondences are widely reported for evaluating deformable image registration (DIR) spatial accuracy. In this report, we present a framework for objective evaluation of DIR spatial accuracy using large sets of expert-determined landmark point pairs. Large samples (>1100) of pulmonary landmark point pairs were manually generated for five cases. Estimates of inter- and intra-observer variation were determined from repeated registration. Comparative evaluation of DIR spatial accuracy was performed for two algorithms, a gradient-based optical flow algorithm and a landmark-based moving least-squares algorithm. The uncertainty of spatial error estimates was found to be inversely proportional to the square root of the number of landmark point pairs and directly proportional to the standard deviation of the spatial errors. Using the statistical properties of this data, we performed sample size calculations to estimate the average spatial accuracy of each algorithm with 95% confidence intervals within a 0.5 mm range. For the optical flow and moving least-squares algorithms, the required sample sizes were 1050 and 36, respectively. Comparative evaluation based on fewer than the required validation landmarks results in misrepresentation of the relative spatial accuracy. This study demonstrates that landmark pairs can be used to assess DIR spatial accuracy within a narrow uncertainty range.

Purpose: To determine the differences in dosimetric coverage of the Level III axillary node target as a function of the superior tangential/supraclavicular match line in breast cancer patients undergoing with tangential breast and supraclavicular fossa radiotherapy., Methods and Materials: The data from 20 consecutive breast cancer patients who were treated with breast conservation surgery and Level I and II axillary dissection followed by radiotherapy to the undissected Level III axilla/supraclavicular fossa were retrospectively analyzed. The nodal volumes were delineated from the computed tomography simulation data set. Three composite treatment plans were generated for each patient according to the placement of the match line., Results: Coverage of the contoured Level III/axillary apex varied significantly with respect to the ipsilateral clavicular head, depending on the placement of the superior tangential/supraclavicular match line. The mean volume of the Level III/axillary apex covered by the 90% isodose line (45 Gy) was 100% for caudal placement of the match line, significantly greater than the 92% for intermediate placement (bisecting the clavicular head; p = 0.001) and the 68% for cranial placement with respect to the clavicular head (p < 0.001)., Conclusion: Placement of the superior tangential/supraclavicular match line caudal to the clavicular head results in statistically improved dosimetric coverage of the Level III axilla/axillary apex in breast cancer patients undergoing tangential/supraclavicular radiotherapy.

Object: The object of the present study was 3-fold: 1) to study regional cerebral perfusion before and after endoscopic third ventriculostomy (ETV) in patients with obstructive hydrocephalus by using (99m)Tc ethyl cysteinate dimer SPECT: 2) to study any correlation between clinically successful third ventriculostomy and CSF flow across the third ventriculostomy; and 3) to determine any changes in hormone profile following ETV., Methods: The authors prospectively studied 15 patients with aqueductal stenosis who underwent ETV during the last 2 years. All the patients underwent pre- and postoperative MR imaging, brain (99m)Tc ethyl cysteinate dimer SPECT, and hormone profile studies., Results: Eight patients were infants. The mean follow-up duration was 17.6 months. Thirteen patients (86.7%) exhibited clinical improvement after surgery. In all patients with clinical improvement the studies documented CSF flow through the ventriculostomy site. Clinical progress could be correlated with SPECT changes in 14 cases (93.3%). In the 13 clinically successful cases, 12 were substantiated by improvement on SPECT scans, whereas in the 2 failed cases, SPECT images revealed no improvement of perfusion defects. Hormone analysis conducted in 14 patients revealed hyperprolactinemia in 8, low triiodothyronine values in 2 patients, and hypocortisolemia in 1, which was reversed after ETV., Conclusions: Clinical improvement is not well correlated with a decrease in ventricular size following ETV. Brain SPECT is a valuable tool for the follow-up of patients with hydrocephalus after ETV, particularly in cases in which MR imaging findings are not clear. There are subtle hormonal changes in patients with hydrocephalus that may improve following ETV.

Eighteen male lambs (8-9 months of age, 25.00 +/- 0.90 kg body weight) were divided into three groups of six animals in each and fed a total mixed ration (TMR) containing concentrate mixture (30% maize grain, 27% soybean meal, 40% wheat bran, 2% mineral mixture, and 1% common salt) and wheat straw in 65:35 ratio and supplemented with selenium (Se) as sodium selenite at 0 (T1, control), 0.15 (T2), and 0.30 ppm (T3) levels. Experimental feeding was done for a period of 90 days including a 6-day metabolism trial. To assess the growth performance, lambs were weighed every 15 days throughout the experimental period. All the lambs were intramuscularly inoculated with a single dose (2 ml) of haemorrhagic septicaemia oil adjuvant vaccine on 0 day to evaluate the humoral immune response. Blood samples were collected on 0 day and thereafter at 30 days interval. Results revealed that supplementation of Se both at 0.15 and 0.30 ppm levels had no significant (P > 0.05) effect on intake and digestibility of dry matter, organic matter, crude protein (CP), ether extract, neutral detergent fiber, acid detergent fiber, and hemicellulose; balances of calcium and phosphorus; and level and intake of digestible CP and total digestible nutrients. Se supplementation also had no significant (P > 0.05) effect on the levels of serum total cholesterol, total protein, albumin, globulin, albumin/globulin ratio, tri-iodothyronine (T(3)), thyroxine (T(4)), and T(4)/T(3) ratio; and serum glutamate oxaloacetate transaminase and serum glutamate pyruvate transaminase enzyme activity in the lambs. However, there was a significant (P < 0.05) increase in the plasma Se levels, red blood cell glutathione peroxidase enzyme activity, and humoral immune response in both the Se-supplemented groups. Feed (TMR) required per kilogram gain was less by 11.1% and 16.5% in groups T2 and T3, respectively, as compared to control (T1) group. Average daily gain was highest (108.5 g) in group T3, followed by group T2 (98.2 g), and lowest (89.06 g) in the control group (T1). These results indicated that supplementation of 0.15 and 0.3 ppm Se in the diet (having 0.19 ppm Se) of lambs significantly improves their immune response and antioxidant status.

Twenty male buffalo calves (8-9 months, 112.1 +/- 7.69 kg) were divided into four groups of five animals in each and fed diets without (T1) or supplemented with 0.3 ppm selenium (Se) (T2), 0.3 ppm Se + 10 ppm copper (Cu) (T3), and 10 ppm Cu (T4) for 120 days during which blood samples were collected on day 0, 40, 80, and 120. Concentrations of glucose, total protein, urea, uric acid, and creatinine were similar in all the four groups, but the level of globulin was significantly (P < 0.01) increased in groups T2 and T3, leading to reduced levels of albumin and A:G ratio (P < 0.01) in these groups. The level of different serum enzymes viz. lactate dehydrogenase (LDH), alkaline phosphatase (ALP), glutamate pyruvate transaminase (SGPT), and glutamate oxaloacetate transaminase (SGOT) and hormones viz. T3, T4, testosterone and insulin and T4:T3 ratio were similar (P > 0.05) among the four groups. It was deduced that supplementation of 0.3 ppm Se and/or 10.0 ppm of Cu had no effect on blood metabolic profile in buffalo calves, except for an increased globulin level, indicating improved immunity status of these animals.

Because conventional dental impression methods often are imprecise and subject to guesswork, and because these methods often are uncomfortable for the patient and expensive for the practitioner, the Cadent iTero system was created to help reduce or eliminate those negative aspects of dental impressions. The system's enhanced visualization and real-time analytical tools enable clinicians to adjust measurements before completing the intraoral digital scanning of dental patients. And because the iTero technology lends itself for use with all restorative procedures and materials via a network of dental laboratory partners, implantologists as well as other dentists interested in quality production of restorations can lower costs while assuring precise and patient-pleasing results.

Purpose: Postmastectomy radiotherapy (PMRT) improves locoregional control (LRC) in patients with high-risk features after mastectomy. Young age continues to evolve as a potentially important risk factor. The objective of this study was to assess the benefits of PMRT in patients <35 years old treated with doxorubicin-based neoadjuvant chemotherapy for Stage II-III breast cancer., Patients and Methods: We retrospectively analyzed 107 consecutive breast cancer patients <35 years old with Stage IIA-IIIC disease treated at our institution with doxorubicin-based neoadjuvant chemotherapy and mastectomy, with or without PMRT. The treatment groups were compared in terms of LRC and overall survival., Results: Despite more advanced disease stages, the patients who received PMRT (n = 80) had greater rates of LRC (5-year rate, 88% vs. 63%, p = 0.001) and better overall survival (5-year rate, 67% vs. 48%, p = 0.03) than patients who did not receive PMRT (n = 27)., Conclusion: Among breast cancer patients <35 years old at diagnosis, the use of PMRT after doxorubicin-based neoadjuvant chemotherapy and mastectomy led to a statistically greater rate of LRC and overall survival compared with patients without PMRT. The benefit seen for PMRT in young patients provides valuable data to better tailor adjuvant, age-specific treatment decisions after mastectomy.

Objective: Descending cervical mediastinitis can occur as a complication of oropharyhgeal and cervical space that spread to the mediastinum vis cervical space. Descending mediastinitis represent a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce high morality associated with the disease. Surgical management and a particularly optimal form of mediastinal drainage remain controversial., Method: From 1998-2004, eighteen patients were treated in our institution. Surgical treatment consisted more than 2 times. Cervical drainage associated with drainage of the mediastinum through a thoracic approach in 11 patients with pleural drainage in 8 patients., Result: The outcome was favorable in eleven patients who had mediastinum drained through thoracotomy. One patient who was not drained died with tracheo-oesophageal fistula. Main culprit neck space is pre and para tracheal space which lead to anterior, superior and posterior mediastinal collection in our series. The tracheostomy is of immense help not only in opening cervical space collections and also to secure a partially compromised airway.

DEXIS intraoral radiography provides clarity of image, a software interface that is intuitive and easy to use, and a flexibility that allows it to network reliably with a practice's existing computer systems. For oral implantology in particular, which is highly dependent on the proper preoperative treatment planning and appropriate radiographic evaluation of the edentulous ridge, modem imaging techniques such as those provided by DEXIS are facilitating the trend toward the nonspecialist place-ment of implants. DEXIS can be used effectively to assess the quantity and quality of the bone present and to visualize the location and relationships between critical internal anatomic structures for implant placement. The company's patented PerfectSize intraoral sensor replaces traditional intraoral X-ray film, providing images that are particularly useful as adjuncts to implant planning and placement.

Though no single, specific occlusal pattern has been developed that is ideal for oral implantology, research suggests some general criteria for deciding on a particular occlusal pattern that will help reduce cuspal interferences and lessen horizontal or lateral forces on the fixtures. Anticipated occlusal and chewing forces need to be taken under consideration for any implant-supported prosthesis. In addition, opposing dentition, as well as potential parafunctional mandibular movements, should be noted. Tekscan's T-Scan Occlusal Analysis System can help clinicians meet the needs of their patients for reliable measurements of occlusal biting forces. The T-Scan III System is Tekscan's most recent attempt to help dental clinicians obtain consistent and useful occlusal data for the placement, analysis, and repair of dental implants.

Early in the development of implant technology, conventional dental imaging techniques were limited for evaluating the patient for implant surgery. During the treatment-planning phase, the recipient bed is routinely assessed by visual examination and palpation, as well as by periapical and panoramic radiology. These two imaging modalities provide a two-dimensional image of the mesiodistal and occlusoapical dimensions of the edentulous regions where the implants might be placed. When adequate occlusoapical bone height is available for endosteal implants, the buccolingual width and angulation of the available bone are the most important criteria for implant selection and success. However, neither buccolingual width nor angulation can be visualized on most traditional radiographs. Although clinical examination and traditional radiographs may be adequate for patients with wide residual ridges that exhibit sufficient bone crestal to the mandibular nerve and maxillary sinus, these methods do not allow for the precise measurement of the buccolingual dimension of the bone or assessment of the location of unanticipated undercuts. Because of these concerns, it is necessary to view the recipient site in a plane through the arch of the maxilla or mandible in the region of the proposed implants. Implant surgeons soon recognized that, for the optimum placement of implants, cross-sectional views of the maxilla and mandible are the ideal means for providing necessary preoperative information. For complex cases where multiple implants are required or where anatomical measurements are crucial, but also increasingly for more routine cases, more and more clinicians are recommending CT scan imaging procedure such as that offered by TeraRecon's Dental CBCT system. Because of its ability to reconstruct a fully three-dimensional model of the maxilla and mandible, CBCT provides a highly sophisticated format for precisely defining the jaw structure and locating critical anatomic structures. CBCT scans, in conjunction with software that renders immediate treatment plans using the most real and accurate information, provide the most precise radiographic modality currently available for the evaluation of patients for oral implants.

Purpose: To compile and review data on radiation proctopathy in the treatment of prostate cancer with respect to epidemiology, clinical manifestations, pathogenesis, risk factors, and treatment., Methods: Medical literature databases including PubMed and Medline were screened for pertinent reports, and critically analyzed for relevance in the scope of our purpose., Results: Rectal toxicity as a complication of radiotherapy has received attention over the past decade, especially with the advent of dose-escalation in prostate cancer treatment. A number of clinical criteria help to define acute and chronic radiation proctopathy, but lack of a unified grading scale makes comparing studies difficult. A variety of risk factors, related to either radiation delivery or patient, are the subject of intense study. Also, a variety of treatment options, including medical therapy, endoscopic treatments, and surgery have shown varied results, but a lack of large randomized trials evaluating their efficacy prevents forming concrete recommendations., Conclusion: Radiation proctopathy should be an important consideration for the clinician in the treatment of prostate cancer especially with dose escalation. With further study of possible risk factors, the advent of a standardized grading scale, and more randomized trials to evaluate treatments, patients and physicians will be better armed to make appropriate management decisions.

Useful in a variety of oral surgery procedures, piezosurgery has therapeutic features that include a micrometric cut (precise and secure action to limit tissue damage, especially to osteocytes), a selective cut (affecting mineralized tissues, but not surrounding soft tissues), and a clear surgical site (the result of the cavitation effect created by an irrigation/cooling solution and oscillating tip). Because the instrument's tip vibrates at different ultrasonic frequencies, since hard and soft tissues are cut at different frequencies, a "selective cut" enables the clinician to cut hard tissues while sparing fine anatomical structures (e.g., schneiderian membrane, nerve tissue). An oscillating tip drives the cooling-irrigation fluid, making it possible to obtain effective cooling as well as higher visibility (via cavitation effect) compared to conventional surgical instruments (rotating burs and oscillating saws), even in deep spaces. As a result, implantology surgical techniques such as bone harvesting (chips and blocks), crestal bone splitting, and sinus floor elevation can be performed with greater ease and safety.

Forty weaned male guinea pigs of 208.20 +/- 6.62 g mean body weight were divided into 4 groups of 10 animals in a randomized block design. All of the guinea pigs were fed a basal diet [25% ground maize hay, 30% ground maize grain, 22% ground chickpea (Cicer arietinum L.), 9.5% deoiled rice bran, 6% soybean meal, 6% fish meal, 1.45% mineral supplement (without Zn) and 0.05% ascorbic acid] and available green fodder. Group I served as the control (no Zn supplementation), whereas 20 ppm Zn was added in the diet in groups II, III, and IV either as zinc sulfate (ZnSO(4)), zinc amino acid complex (ZAAC), and ZnSO4 + ZAAC in equal parts, respectively. Experimental feeding lasted for 70 d, including a 3-d digestibility trial. Blood was collected through cardiac puncture from four animals in each group at d 0 and subsequently at the end of experimental feeding. After 40 d of experimental feeding, four animals from each group were injected with 0.4 mL of Brucella abortus cotton strain-19 vaccine to assess the humoral immune response of the animals. After 10 wk of study, four animals from each group were sacrificed to study the concentration of Zn, Cu, Co, Fe, and Mn in the liver, pancreas and spleen. Results revealed no significant difference in the feed intake, body weight gain, and digestibility of the nutrients, except for crude protein (CP) digestibility, which was significantly (p < 0.05) lower in group IV. Although concentrations of serum glucose, Ca, and P and the albumin:globulin (A:G) ratio were similar in the different groups, the total protein, albumin, and serum alkaline phosphatase activity were higher in all of the Zn-supplemented groups on d 70. The serum Zn levels at the end of experimental feeding were significantly higher in groups II and III, whereas serum Mn levels were found to be significantly (p < 0.05) higher in groups III and IV. The organ weights (as percentage of body weights) did not show any differences among the treatment groups. Although the Mn concentration was significantly (p < 0.05) higher in the pancreas, the Cu concentration was significantly (p < 0.05) reduced in the spleen in all of the Zn-supplemented groups. The humoral immune response (antibody titer values) on d 14 of vaccination was significantly (p < 0.05) higher in all of the Zn-supplemented groups. It was concluded that the 20-ppm level of Zn in the diet might be adequate for growth and nutrient utilization in guinea pigs, but supplementation of 20-ppm zinc significantly improved the immune response and impact was more prominent with the ZAAC (organic source) compared to ZnSO(4) (inorganic source).

The phytochromes are a family of red/far-red light absorbing photoreceptors that control plant developmental and metabolic processes in response to changes in the light environment. We report here the overexpression of Arabidopsis thaliana PHYTOCHROME A (PHYA) gene in a commercially important indica rice variety (Oryza sativa L. Pusa Basmati-1). The expression of the transgene was driven by the light-regulated and tissue-specific rice rbcS promoter. Several independent homozygous sixth generation (T(5)) transgenic lines were characterized and shown to accumulate relatively high levels of PHYA protein in the light. Under both far-red and red light, PHYA-overexpressing lines showed inhibition of the coleoptile extension in comparison to non-transgenic seedlings. Furthermore, compared with non-transgenic rice plants, mature transgenic plants showed significant reduction in plant height, internode length and internode diameter (including differences in cell size and number), and produced an increased number of panicles per plant. Under greenhouse conditions, rice grain yield was 6-21% higher in three PHYA-overexpressing lines than in non-transgenic plants. These results demonstrate the potential of manipulating light signal-transduction pathways to minimize the problems of lodging in basmati/aromatic rice and to enhance grain productivity.

To our knowledge, this study shows the first longitudinal results (range 12-30 months) of immediate loading of implant-support overdenture with ball attachment connection placed in the anterior mandible. Immediately after surgery, the overdenture was connected to the implants with 2-ball attachments. The housings were filled with Impregum (3M Espe AG; Seefeld, Germany) impression material to provide retention as well as reduce forces in the initial phase of loading. Of the 28 implants placed, only 1 failed; the 1 failed implant for total implants placed represents a success rate of 96.4%. The minimal bone loss (1 mm) in 2 sites represents a success rate of 92.8%.

Purpose: Molecular factors involved in apoptosis may affect breast cancer response to chemotherapy. Herein, we studied the nuclear factor kappaB (NF-kappaB)/bcl-2 pathway to determine whether or not activation of this antiapoptotic pathway was associated with a poor response of human breast cancer to anthracycline-based neoadjuvant chemotherapy., Experimental Design: We studied 82 human breast cancer samples from patients treated with neoadjuvant doxorubicin-based chemotherapy and studied whether or not nuclear location of the transcription factor NF-kappaB was associated with expression of bcl-2 and bax and whether or not expression of these proteins correlated with chemotherapy response. Protein expression was measured with immunohistochemical staining. A dedicated breast cancer pathologist who was unaware of the clinical outcome data dichotomized the slides as positive or negative based on the presence or absence of cytoplasmic staining for bcl-2 and bax or nuclear staining for NF-kappaB., Results: Sixty-one percent of the tumors were positive for bcl-2, 85% were positive for bax, and 16% were positive for NF-kappaB. All bcl-2-positive tumors were also bax positive (P < 0.0001) and all NF-kappaB-positive tumors were both bcl-2 positive (P = 0.001) and bax positive (P = 0.113). Eleven of the 82 patients (13%) had a pathologic complete response (pCR) to chemotherapy. Patients with positive staining tumors for any of the markers less commonly achieved a pCR to chemotherapy than those with negative tumor staining. The pCR rates were NF-kappaB positive 0% (0 of 13) versus NF-kappaB negative 13% (11 of 69; P = 0.130); bcl-2 positive 4% (2 of 49) versus bcl-2 negative 27% (9 of 33; P = 0.004); and bax positive 6% (4 of 69) versus bax negative 58% (7 of 12; P < 0.001)., Conclusion: We conclude that nuclear localization of NF-kappaB correlates with bcl-2 and bax expression and that the NF-kappaB/bcl-2 pathway may be associated with a poor response to neoadjuvant doxorubicin-based chemotherapy.

Background and Purpose: To evaluate the feasibility whether intensity-modulated radiotherapy (IMRT) can be used to reduce doses to normal lung than three-dimensional conformal radiotherapy (3 DCRT) in treating distal esophageal malignancies., Patients and Methods: Ten patient cases with cancer of the distal esophagus were selected for a retrospective treatment-planning study. IMRT plans using four, seven, and nine beams (4B, 7B, and 9B) were developed for each patient and compared with the 3 DCRT plan used clinically. IMRT and 3 DCRT plans were evaluated with respect to PTV coverage and dose-volumes to irradiated normal structures, with statistical comparison made between the two types of plans using the Wilcoxon matched-pair signed-rank test., Results: IMRT plans (4B, 7B, 9B) reduced total lung volume treated above 10 Gy (V(10)), 20 Gy (V(20)), mean lung dose (MLD), biological effective volume (V(eff)), and lung integral dose (P<0.05). The median absolute improvement with IMRT over 3DCRT was approximately 10% for V(10), 5% for V(20), and 2.5 Gy for MLD. IMRT improved the PTV heterogeneity (P<0.05), yet conformity was better with 7B-9B IMRT plans. No clinically meaningful differences were observed with respect to the irradiated volumes of spinal cord, heart, liver, or total body integral doses., Conclusions: Dose-volume of exposed normal lung can be reduced with IMRT, though clinical investigations are warranted to assess IMRT treatment outcome of esophagus cancers.

The treatment of cancer with chemotherapeutic agents and radiation has two major problems: time-dependent development of tumor resistance to therapy (chemoresistance and radioresistance) and nonspecific toxicity toward normal cells. Many plant-derived polyphenols have been studied intently for their potential chemopreventive properties and are pharmacologically safe. These compounds include genistein, curcumin, resveratrol, silymarin, caffeic acid phenethyl ester, flavopiridol, emodin, green tea polyphenols, piperine, oleandrin, ursolic acid, and betulinic acid. Recent research has suggested that these plant polyphenols might be used to sensitize tumor cells to chemotherapeutic agents and radiation therapy by inhibiting pathways that lead to treatment resistance. These agents have also been found to be protective from therapy-associated toxicities. How these polyphenols protect normal cells and sensitize tumor cells to treatment is discussed in this review., (Antioxid. Redox Signal. 7, 1630-1647.)