Accuracy of Orthodontic Indirect Bracket Bonding by CAD/CAM Transfer Tray

Introduction: Indirect bonding is a technique in which orthodontic attachments are transferred from dental casts (working models) and bonded onto dentition using a transfer tray. Indirect bonding is a preferred technique for many orthodontists as it is less time consuming compared to direct bonding. Evolution in technology allowed forming transfer trays digitally by the integration of computer-aided design and computer-aided manufacturing (CAD/CAM). This study was conducted to measure transfer accuracy of CAD/CAM indirect three dimensional printed bonding trays. Materials and methods: 140 teeth (all upper and lower incisors, canines and premolars) in 7 patients were bonded by vacuum-formed transfer tray formed on 3 dimensional (3D) printed models with resin brackets. Intra oral scanner was used initially to obtain stereolithographic file for virtual brackets positioning and another scan was taken after brackets bonding.   Superimposition of virtual STL files and post bonding STL files was done by Geomagic Qualify software to measure linear and angular deviation of brackets positions. Results: One sample t-test was performed to determine whether the mean transfer error was statistically within the selected acceptable limits of 0.5 mm for linear measurements. P-values of less than 0.05 indicated differences within the limits of 0.5 mm for linear measurements. All brackets were transferred within the accepted deviation limits Conclusions: CAD/CAM designed and printed transfer trays had high transfer accuracy in linear measurements in all teeth.

Signet ring cell component predicts the response to neoadjuvant chemoradiotherapy in rectal cancer. Long interim results of a single institution experience

There are limited studies evaluating the correlation between the presence of signet ring carcinoma and tumor response to neoadjuvant therapy in the rectum. Hereby, we aimed to report for the first time our experience from Upper Egypt through assessing the predictive role of signet ring cell component (SRCC) in the response to preoperative chemoradiotherapy (PCRT) and the impact of histological types (SRCC versus other types) on survival. This retrospective study analysed the medical records of 195 patients with locally advanced rectal cancer treated from 2011, to 2018. Patients were divided into two groups according to histological types: SRCC group and non SRCC group. All patients received PCRT followed by surgery. SRCC group was associated with significant higher rate of complete clinical response (cCR) and pathologic complete response (pCR) (83.3% and 88.9% respectively) as compared to non SRCC group (9.0% and 10.2% respectively); P<0.0001. Fifteen cases (93.8%) who were diagnosed by magnetic resonance tumor regression grade (mrTRG) and diffusion weighted imaging (DWI) as cCR after PCRT, also achieved pCR, in contrast to 88.9% of cases without SRCC. Signet ring histology was the only predictor of pCR in multivariate analysis (P=0.027). There was no statistically significant difference between both histological groups as regard to survival. SRCC is an important predictor of pCR and assessing their response to PCRT using mrTRG and DWI showed high sensitivity for the detection of cCR, making them good candidates for watch-and-wait approach. Histological types did not significantly affect the survival outcome.

Using miR-125b in the Prediction of Aromatase Inhibitors Resistance in Metastatic Breast Cancer

Background: Several studies investigated the miRNAs in cancer trying to assess the prognosis or to predict the response to certain treatment .One of these miRNAs are miR 125b , it was suggested by previous results as a good marker for prediction of aromatase inhibitors (AI) response. So, this study was conducted to assess the value using miRNA125b as a predictive factor to AI response. Patients and Methods: A total of 90 patients of postmenopausal HR+ve metastatic breast cancer who attended to medical oncology department outpatient’s clinic in SECI, Assiut university Egypt, from May 2017 to September 2018. Patients presented with metastasis at diagnosis as well as patients who relapsed only after 3 years of adjuvant hormonal treatment with SERM were included. All patients received AI as first line treatment for metastatic, miRNA 125b was isolated from peripheral blood samples and measured by using (q PCR).The response of patients was assessed by RECIST criteria and correlated with its expression levels. Results: Expression of the miR125-b was significantly higher in patients than control p= 0.000. However, no significant difference in its expression between those with single of multiple metastases or even between the site of metastases. We didn’t find also any significant difference in response p=0.648 and survival either PFS p=0.406 or OS p=0.384 between those patients with high expression vs. low expression. Conclusion: Our results suggest that miR125b could be used as a diagnostic marker as it is significantly increased in patients than control. However, we don’t recommend using miR125b as a marker to predict the AI resistance as further studies with large sample size are needed to confirm these results.

Double-blind randomized controlled trial of letrozole versus clomiphene citrate in subfertile women with polycystic ovarian syndrome

STUDY QUESTION

Would letrozole as a primary ovulation induction agent generate better pregnancy rates than clomiphene citrate (CC) in subfertile women with anovulatory polycystic ovarian syndrome (PCOS)?

SUMMARY ANSWER

Participants receiving letrozole as a primary treatment achieved a significantly (P = 0.022) higher clinical pregnancy rate per patient (61.2%) compared to CC (43.0%).

WHAT IS KNOWN ALREADY

According to a recent Cochrane systematic review (2014), letrozole appears to improve live-birth (LB) and pregnancy rates in anovulatory women with PCOS, compared to CC. However, the review concluded that the quality of evidence was low due to poor reporting of study methods and possible publication bias.

STUDY DESIGN, SIZE, DURATION

This double-blind randomized controlled trial (RCT) included 159 participants between April 2007 and June 2014. Subjects were randomly allocated to either CC (n = 79) or letrozole (n = 80) in a 1:1 ratio. Both drugs were encapsulated to look identical. Randomization was performed in mixed blocks and stratified by patients’ BMI (<30 and 30–35 kg/m²).

PARTICIPANTS/MATERIALS, SETTING, METHODS

The trial included subfertile women diagnosed with PCOS. Treatment started with one tablet (CC 50 mg, letrozole 2.5 mg) increasing to two in non-responders and continuing until pregnancy or for up to six ovulatory cycles. Non-responders were crossed over to the other treatment after a 6-week break. Cycles were initially monitored with ultrasound follicle tracking then mid-luteal serum progesterone measurement in subsequent cycles.

MAIN RESULTS AND THE ROLE OF CHANCE

Amongst the 159 participants included in the intention-to-treat analysis, four women conceived before treatment and six were lost-to-follow-up. The remaining 149 participants (74 on CC and 75 on letrozole) completed at least the first treatment. Women receiving letrozole achieved a significantly (P = 0.022; absolute difference [95% confidence interval] 18% [3–33%]) higher pregnancy rate (61.%) than those on CC (43%). The median number of treatment cycles received until pregnancy was significantly (log rank P = 0.038) smaller with letrozole (4[3–5] cycles) compared to CC (6[4–7] cycles). LB rates were not statistically (P = 0.089) different between the two groups, although there was a trend towards higher rates on letrozole (48.8%) compared to CC (35.4%). After the crossover, pregnancy and LB rates on letrozole (n = 45; 28.9 and 24.4%, respectively) were not statistically (P = 0.539 and P = 0.601) different from CC (n = 31; 22.6 and 19.4%).

LIMITATIONS, REASONS FOR CAUTION

One possible limitation of this trial may be the exclusion of PCOS women with BMI > 35 kg/m², which would limit the applicability of the results in this subgroup of PCOS. However, this group of women are generally excluded from treatment in the majority of fertility centres, especially in Europe, due to the associated challenges and risks.

WIDER IMPLICATIONS OF THE FINDINGS

The results of this trial are consistent with the recent Cochrane systematic review. However, with its robust design, the current RCT provides more valid and compelling evidence for the superiority of letrozole over CC as a primary ovulation induction agent in PCOS women with 40% increase in pregnancy rates and with a shorter time-to-pregnancy. Furthermore, the participants in this RCT are a good representation of subfertile PCOS population receiving fertility treatment in Europe and worldwide. The results are therefore globally generalizable for clinical practice.

STUDY FUNDING/COMPETING INTEREST(S)

This RCT was mainly funded by the R&D Funding Scheme of Derby Hospitals NHS Foundation Trust. The study also received funds from School of Medicine, University of Nottingham. The Trust R&D department was involved in the development of the protocol and the running of the trial. The trial was sponsored and monitored by the University of Nottingham. The authors have no conflicts of interest.

TRIAL REGISTRATION NUMBER

www.Clinicaltrials.gov: NCT00478504.

TRIAL REGISTRATION DATE

Registration was verified on 23/05/2007.

DATE OF FIRST PATIENT'S ENROLMENT

25/04/2007.

Diagnostic Utility of Twist1, Ki-67, and E-Cadherin in Diagnosing Molar Gestations and Hydropic Abortions

OBJECTIVES

This study aims to assess whether the expression of Twist1, Ki-67, and E-cadherin can guide the differential diagnosis of complete hydatidiform mole (CHM), partial hydatidiform mole (PHM), and hydropic abortion (HA).

METHODS

Differential expression of Twist1, Ki-67, and E-cadherin was analyzed in gestational products from 55 cases of CHM, PHM, and HA using immunohistochemistry. Prior to analysis, the studied cases were confirmed for their diagnosis by flow cytometric assessment of DNA ploidy and p57 immunostaining.

RESULTS

Twist1 expression can distinguish CHM from PHM and HA with 100% sensitivity, 100%, specificity, 100% positive predictive value (PPV), and 100% negative predictive value (NPV). Furthermore, combined Ki-67 and E-cadherin expression could differentiate PHM and HA with 100% sensitivity, 93.3% specificity, 92.3% PPV, and 100% NPV.

CONCLUSIONS

Twist1 expression is a highly reliable marker for the diagnosis of CHM, where combined Ki-67 and E-cadherin immunoreactivity can distinguish PHM from nonmolar pregnancies.

Vascular lesions of the internal auditory canal

We report here two cases of vascular tumors arising within the internal auditory canal, both of which presented with cerebellopontine angle symptoms and simulated acoustic neurinomas. The first case was an arteriovenous malformation that caused moderate sensorineural hearing loss, tinnitus, vertigo with lateropulsion, facial weakness, and trigeminal hypoesthesia on the same side. The second case was a venous angioma, to our knowledge the first ever reported in this location, which presented with sudden complete deafness and progressive hemifacial spasm. The latter subsided completely after successful total extirpation of this unique tumor. The literature on these extremely rare lesions is also reviewed.

The Golden Potato Cyst Nematode Globodera rostochiensis Pathotype Ro1 in the Saint-Amable Regulated Area in Quebec, Canada

The golden potato cyst nematode, Globodera rostochiensis (Wollenweber, 1923) Behren, is an economically important parasite of potato (Solanum tuberosum L. subsp. tuberosum) and is recognized as a quarantine pest internationally (2). This pest attacks potato plants and causes stunting of the haulm and the root system, leaf yellowing, and tuber yield losses (2). The pathotype scheme proposed by Kort et al. distinguishes five pathotypes (Ro1, Ro2, Ro3, Ro4, and Ro5) of G. rostochiensis using differential Solanum clones (1). Several resistance genes and quantitative trait loci (QTL) that have been identified in wild Solanum species confer resistance to different G. rostochiensis pathotypes and have been introgressed into commercial potato cultivars (2). Determining G. rostochiensis pathotype(s) is essential to implement efficient management strategies, which include using resistant potato varieties. G. rostochiensis was discovered in the municipality of Saint-Amable, Quebec (QC), Canada in 2006 (3) and was subsequently characterized (4). In this study, cysts were collected from 11 representative infested fields and confirmed to be G. rostochiensis (3). The pathotypes of these nematodes were assessed on seven differential clones (S. tuberosum subsp. tuberosum cv. Desiree, S. tuberosum × S. andigena cv. Maris Piper, S. kurtzianum hybrid 60.21.19, S. vernei hybrid 62.33.3, S. vernei hybrid 58.1642/4, S. vernei hybrid 65.346/19, and S. multidissectum hybrid P55/7) in 2007 and 2009. Briefly, in each 1-liter plastic pot containing 907 g (2 lbs) of soil (3:1 loam/grit v v-1), a single differential Solanum clone was planted and 15 cysts from 1 of 11 fields were inoculated. Five replicates were set up for each Solanum-nematode combination and the pots were arranged in a completely randomized design in a greenhouse at 22°C with a 16-h light period per day. Nine weeks after inoculation, cysts were extracted from each pot and counted. Reproduction factor (Rf) for each replicate was calculated (Rf = Pf/Pi; Pf is the final cyst number and Pi is the initial cyst number added to each pot). Rf values were used to categorize the differential clones into two groups, "susceptible" leading to increase in nematode numbers (Rf > 1) and "resistant" resulting in decrease in nematode numbers (Rf ≤ 1) (1). Our results in 2007 and 2009 were consistent and the pathotype of the nematodes collected from all the fields were identified as Ro1. To our knowledge, this is the first time that the pathotype of G. rostochiensis in the Saint-Amable regulated area was identified. Accordingly, potato cultivars carrying genes or QTL resistant to G. rostochiensis pathotype Ro1 can be used to reduce the nematode numbers in infested fields in the Saint-Amable area, QC. References: (1) J. Kort et al. Nematologica 23:333, 1977. (2) R. J. Marks and B. B. Brodie. Potato Cyst Nematodes: Biology, Distribution, and Control. 1st ed. CAB International, Wallingford, 1998. (3) F. Sun et al. Plant Dis. 91:908, 2007. (4) Q. Yu et al. Can. J. Plant Pathol. 32:264, 2010.

Mortality of Pratylenchus penetrans by Volatile Fatty Acids from Liquid Hog Manure

As part of our research program assessing the use of liquid hog manure (LHM) to control root-lesion nematodes, Pratylenchus penetrans, a series of acute toxicity tests was conducted to: (i) examine if non-ionized forms of volatile fatty acids (VFA) are responsible for the mortality of P. penetrans exposed to LHM under acidic conditions, (ii) determine if Caenorhabditis elegans can be a surrogate for P. penetrans in screening tests by comparing their sensitivities to VFA, (iii) characterize the nematicidal effect of individual VFA in LHM to P. penetrans, and (iv) determine whether individual VFA in LHM interact in their toxicity to P. penetrans. LHM was significantly (P Collapse

Key Words

• bioassay
• caenorhabditis elegans
• lhm
• liquid hog manure
• lsm
• liquid swine manure
• management
• nematode
• potato
• pratylenchus penetrans
• root-lesion nematode
• vfa
• volatile fatty acids

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Affiliation(s)

A Mahran Departments of Soil Science, Plant Science, and Environment and Geography, University of Manitoba, Winnipeg, MB Canada R3T 2N2. Canada Research Chair in Applied Soil Ecology, University of Manitoba, Winnipeg, MB Canada R3T 2N2
M Tenuta
M L Hanson
F Daayf

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Poor semen quality from patients with malignancies does not rule out sperm banking

Cancer therapy can further impair the already poor semen quality in cancer patients. This study evaluated the prefreeze and postthaw semen quality before treatment of patients with malignancies to examine the rationale for sperm banking for these men. Records of nine patients with different malignant tumors, who had been referred for sperm cryopreservation between 1982 and 1997, were reviewed and the results were compared with those of 50 normal healthy donors. Patients did not differ from donors in age, ejaculate volume, or duration of sexual abstinence. The total motile sperm count (median and interquartile range) was significantly different between patients and donors for prefreeze specimens (P = 0.026) and postthaw specimens (P = 0.008). Also, the percent motility was significantly lower in the patients as compared with the donors in prefreeze (P = 0.035) and postthaw specimens (P = 0.005). The percentage change in motility after thawing was also larger for patient samples (-54% versus -47%, P = 0.39). Other sperm motion characteristics did not significantly differ between the two groups except for postthaw curvilinear velocity (P = 0.01). This study concludes that fresh and frozen thawed semen from patients with malignant tumors is poor in quality but is still adequate for assisted reproductive techniques. As cancer therapy may further impair semen quality, patients should be offered the chance to bank sperm before undergoing cancer therapy.

The effects of cryopreservation on semen from men with sarcoma or carcinoma

PURPOSE

This study evaluated prefreeze and postthaw semen quality before treatment in patients with different types of sarcomas and carcinomas to determine whether cryopreservation would be of value for these patients.

METHODS

Semen specimens were obtained from 50 normal donors and from 21 patients with carcinoma and from 14 patients with sarcoma. The specimens were cryopreserved by a standard freezing procedure using TEST-Yolk buffer. Prefreeze and postthaw sperm motion characteristics were measured.

RESULTS

Prefreeze total motile sperm count was significantly higher in donors (median: 129.6 x 10(6)/ml) than in men with carcinoma (46.9 x 10(6)/ml, P < .001) or sarcoma (66.3 10(6)/ml, P = .04). The percent motility and percent linearity were significantly lower in patients with carcinoma. In postthaw specimens, total motile sperm count, curvilinear velocity, and linearity were significantly lower in patients with carcinoma.

CONCLUSIONS

The two patient groups in this study had poor semen quality when compared with healthy donors both before and after cryopreservation. Sarcoma patients had better semen quality than carcinoma patients. As cancer therapy in these men could significantly impair their reproductive potential, these men should be advised to preserve their semen before starting treatment.

Surgery of petroclival meningiomas: report of 24 cases

Twenty-four patients with petroclival meningiomas were operated upon at the neurosurgical clinic of the City Hospital of Hannover between 1978 and 1987. Seventeen were women and seven men; the mean age was 45 years. Symptoms were usually present for more than 2 years before the diagnosis was made. The most common symptom was disturbance of gait; the most common preoperative sign was cranial nerve deficit, mainly of the 7th and 8th nerves. Preoperative neuroradiological evaluation included computed tomography and four-vessel cerebral angiography. Fifteen patients (62%) had a tumor larger than 2.5 cm in its major diameter. The surgical approaches used were the retromastoid, pterional, subtemporal, and combined retromastoid-subtemporal. We developed a modification of the retromastoid-subtemporal approach with preservation of the transverse sinus and used this in the last 2 patients. There was no postoperative death; 11 patients (46%) suffered postoperative complications, mainly in the form of cranial nerve deficits, often reversible. "Total" tumor removal was achieved in 17 patients (71%). Twenty patients (83%) were independent at the time of discharge from the hospital. With accurate neuroradiological evaluation, careful choice of the surgical approach, and sound application of microsurgical techniques, petroclival meningiomas may be "totally" and safely resected in a significant number of patients.