ES Group Research Articles

Comparison of Fit Accuracy between Procera® Custom Abutments and Three Implant Systems

Although increase of misfit has been reported when associating implant and abutment from different manufacturers, Procera custom abutment has been universally used in clinical practice. The purpose of this investigation was to compare the vertical gap of zirconia Procera® abutment associated with implants from the same manufacturer (Procera manufacturer) and two other implant systems. Twenty-four zirconia Procera abutments were produced using computer-assisted design and manufacture and paired with (a) eight MK III, RP 4.1 × 10 mm implants (Nobel Biocare™, Göteborg, Sweden) - GNB group (Nobel Biocare group); (b) eight Try on, 4.1 × 10 mm implants (Sistema de Implantes, São Paulo, Brazil) - ES group (SIN experimental group) ; and (c) eight Master screw, 4.1 × 10 mm implants (Conexão® Sistema de Prótese, São Paulo, Brazil) - EC group (Conexão experimental group). A comparison of the vertical misfit at the implant-abutment interface was taken at six measuring sites on each sample using scanning electron microscopy with a magnification of 408×. One-way analysis of variance was used to test for differences, and Tukey's test was used for pair-wise comparison of groups (α = 0.05). Significant differences relative to average misfit were found when Procera abutments were associated with other implant manufacturers. The ES group and EC group did not differ significantly, but both demonstrated significantly larger average misfit than the GNB group (p = .001). The average misfit was 5.7 µm ± 0.39, 9.53 µm ± 0.52, and 10.62 µm ± 2.16, respectively, for groups GNB, ES, and EC. The association of Procera zirconia abutment with other implant systems different from its manufacturer demonstrated significant alteration of vertical misfit at implant-abutment interface.

Large-diameter balloon sphincteroplasty for removal of bile duct stones： a prospective and randomized study from two endoscopy centers

Objective To investigate the efficiency and safety of endoscopic large balloon dilation following small sphincterotomy （ESBD） for treatment of common bile duct （CBD） stones, and to prospectively compare it with traditional sphincterotomy （ES）. Methods Patients with single or multiple calculi in extra-hepatic bile ducts and with the diameter of CBD larger than 13 mm, were randomized into 2 groups to receive maximal sphincterotomy （ES group）, or partial sphincterotomy plus sphincteroplasty with 15mm-balloon （ESBD group）, respectively, followed by conventional stones removal and/or lithotripsy. The success rate of stone clearance, operation time and related complications were observed. Results A total of 86 patients were enrolled in 2 endoscopy centers, with 2 excluded because of papillary pre-cut in 1 and non-compliance with the protocol in the other, and were randomly divided into groups ES and ESBD, with 42 patients in each. The clinical characteristics, including average diameter of CBD, size and quantity of calculi, and incidences of peri-ampullary diverticulum, of patients in both groups were all similar. Stones clearance with single session in 2 groups were 88% and 93%, respectively （P =0. 531 ）. The operation time were （25.76 ± 12. 74） min and （26. 38 ± 12. 86） min （ P = 0. 825 ）. The rate of mechanical lithotripsy was 36% and 25%, respectively （P=0. 363）. Complications occurred in 5 cases in ES group （3 mild, 2 medium）, and 2 mild complications occurred in ESBD group （no statistical difference）. No death happened in any group.Conclusion ESBD is an effective method for clearance of extra-hepatic bile duct stones with the similar safety, compared with traditional sphincterotomy. It could be an optimal alternative for those with large stones or difficult sphincterotomy. Key words: Common bile duct stone; Sphincterotomy, endoscopic; Balloon dilatation

Withdrawn: Comparison of Fit Accuracy between Procera Custom Abutments and Three Implant Systems

ABSTRACTBackground: Although increase of misfit has been reported when associating implant and abutment from different manufacturers, Procera® (Nobel Biocare™, Göteborg, Sweden) custom abutment has been universally used in clinical practice.Purpose: The purpose of this investigation was to compare the vertical gap of zirconia Procera abutment associated with implants from the same manufacturer (Nobel Biocare) and two other implant systems.Materials and Methods: Twenty‐four zirconia Procera abutments were produced using computer‐assisted design and manufacture (CAD/CAM) and paired with (1) eight MK Iii RP 4.1 × 10 mm implants (Nobel Biocare) – GNB group; (2) eight Try on, 4.1 × 10 mm implants (Sistema de Implantes, São Paulo, Brazil) – ES group; and (3) eight Master screw, 4.1 × 10 mm implants (Conexão Sistema de Prótese, São Paulo, Brazil) – EC group. A comparison of the vertical misfit at the implant‐abutment interface was taken at six measuring sites on each sample using scanning electron microscopy with a magnification of 408×. One‐way analysis of variance was used to test for differences, and Tukey's test was used for pairwise comparison of groups (α = 0.05).Results: Significant differences relative to average misfit were found when Procera abutments were associated with other implant manufacturers. The ES group and EC group did not differ significantly, but both demonstrated significantly larger average misfit than the GNB group (p = .001). The average misfit was 5.7 µm ± 0.39, 9.53 µm ± 0.52 and 10.62 µm ± 2.16, respectively, for groups GNB, ES, and EC.Conclusion: The association of Procera zirconia abutment with other implant systems different from its manufacturer demonstrated significant alteration of vertical misfit at implant‐abutment interface.

Effect of the oral administration of Ephedra Sinica extract on suppression of body weight gains

Ephedra Sinica (Ma-hwang, ES) is a medicinal extract used in Oriental Medicine. ES is used clinically to release exterior symptoms, disperse cold, control wheezing, promote urination and reduce edema. Historically, ES have suppressive effect on body weight gains. Using diet-induced obesity C57BL/6 mouse model, anti-obesity effect and cytotoxicity of the longterm oral administration of these herbal extracts were investigated. Herbal extract treated groups were arrested in weight increment only when they were lodged together. Such effects were abolished when they kept individually. ES fed mice behaved very rudely and violently. On the basis of histological studies of liver tissues and also in vitro cytotoxicity tests of the liver and kidney cell lines, no significant toxicity was found by 14 weeks of ES treatments. However, we found significant changes in gene expression profile between ES treated group and SA treated group by micro-array analysis. In case of ES group, up-regulated genes were 113 and down-regulated were 120. Some of lipid metabolism related genes also significantly changed in both treatment groups. In conclusion, ES had effects on increasing the basal metabolic rate by stimulating the sympathetic nervous systems.

The Learning Curve for Robotic Thyroidectomy: A Multicenter Study

The learning curve for robotic thyroidectomy with central compartment node dissection (CCND) has not been established. We examined the effect of experience of robotic thyroidectomy on a range of perioperative parameters in order to determine the learning curve. The learner surgeon outcomes were compared with those of an experienced surgeon. We conducted a prospective, controlled, multicenter study involving four endocrine surgeons at three academic centers. Patients underwent robotic total or subtotal thyroidectomy with CCND between September 2008 and October 2009. One surgeon was experienced in the technique (experienced surgeon, ES), while the other three surgeons had endoscopic thyroid surgery experience but no experience performing the robotic procedure (nonrobotic thyroid surgery experienced surgeon, NS). Outcome measures were demographic data, operative time, blood loss, hospital stay, pathologic results, and postoperative complications. A total of 644 total or subtotal robotic thyroidectomies with CCND were performed: 377 (58.7%) by NSs and 267 (41.5%) by the ES. Mean operative time was longer and the complication rate was higher for the NS patient group compared with the ES patient group (P < 0.001 for each). The operative times and complications rates for the NS group were similar to those of the ES group once the NSs had performed 50 cases for total thyroidectomies or 40 cases for subtotal thyroidectomies. The learning curve duration for robotic thyroidectomy with CCND using gasless transaxillary approach for experienced endoscopic thyroidectomy surgeons was 50 cases for total thyroidectomy and 40 cases for subtotal thyroidectomy.

Reticular basement membrane fragmentation and potential epithelial mesenchymal transition is exaggerated in the airways of smokers with chronic obstructive pulmonary disease

In COPD, the airways are chronically inflamed, and we have now observed fragmentation of the reticular basement membrane (Rbm). This appears to be a hallmark of the process known as epithelial mesenchymal transition (EMT), in which epithelial cells migrate through the Rbm and differentiate into fibroblasts. The aim of this study was to confirm the extent and relevance of Rbm fragmentation in smokers and patients with COPD, and to undertake a preliminary analysis of some classical markers of EMT. Endobronchial biopsies from current smokers (CS; n = 17) and ex-smokers with COPD (ES; n = 15), smokers with normal lung function (NS; n = 16) and never-smoking control subjects (NC; n = 15) were stained for the EMT markers, S100A4, vimentin, epidermal growth factor receptor and matrix metalloproteinase-9. Compared with NC, there was significant Rbm fragmentation in the CS, ES and NS groups, which was positively associated with smoking history in subjects with COPD. Staining for basal epithelial S100A4, epithelial epidermal growth factor receptor and matrix metalloproteinase-9 in cells within Rbm clefts, and for S100A4 in Rbm cells, was increased in the CS, NS and ES groups compared with the NC group. There was also increased Rbm cell S100A4 staining in the CS group compared with the ES and NS groups. Basal epithelial cell staining for S100A4 was inversely correlated with airflow limitation. Double staining for both S100A4 and vimentin further strengthened the likelihood that these changes represented active EMT. This is the first detailed description of fragmentation and cellularity of the Rbm in smokers, which were most marked in subjects with COPD. The data are consistent with active EMT in these subjects.

Quantitative EEG in Patients With Alcohol‐Related Seizures

To investigate whether quantitative electroencephalography (QEEG) recorded within a few days after a generalized seizure can improve the discrimination between alcohol-related seizures (ARSs), seizures in epilepsy and other seizures. In addition, we wanted to evaluate the influence of various external factors on QEEG, e.g., drug use, time from seizure occurrence, and alcohol intake. An ARS was defined by (i) scores ≥8 in the Alcohol Use Disorders Identification Test (AUDIT) and (ii) no history of epilepsy. Twenty-two ARS patients, 21 epileptic patients with seizures (ES), 30 AUDIT-negative patients with seizures (OS), and 37 well-controlled epileptic outpatients (EPO) were included. EEG from 79 sciatica patients (SC) served as an additional control group. EEG was recorded in relaxed wakefulness with eyes closed. Spectral analysis of ongoing resting EEG activity was performed. For the main analysis, spectral band amplitudes were averaged across 14 electrodes. Major quantitative EEG abnormalities were mainly seen in the ES group. AUDIT score correlated negatively with QEEG band amplitudes in patients with seizures unrelated to alcohol, but not in the ARS group. Recent alcohol intake correlated negatively with delta and theta amplitude. We could not confirm that beta activity is increased in ARS subjects. A QEEG with slightly reduced alpha amplitude supports a clinical diagnosis of ARS. An abnormally slow QEEG profile and asymmetry in the temporal regions indicates ES. QEEG predicted the clinical diagnosis better than standard EEG.

Endostatin gene therapy enhances the efficacy of IL-2 in suppressing metastatic renal cell carcinoma in mice.

We investigated whether the administration of IL-2 combined with endostatin gene therapy was able to produce additive or even synergistic immunomodulatory activity in a mouse model of metastatic renal carcinoma. Renca cells were injected into the tail vein of BALB/c mice. After 24 h, the animals were randomly divided into four groups (5 mice/group). One group of mice was the control, the second group received treatment with 100,000 UI of Recombinant IL-2 (Proleukin, Chiron) twice a day, 1 day per week during 2 weeks (IL-2), the third group received treatment with a subcutaneous inoculation of 3.6 x 10(6) endostatin-producing cells, and the fourth group received both therapies (IL-2 + ES). Mice were treated for 2 weeks. In the survival studies, 10 mice/group daily, mice were monitored daily until they died. The presence of metastases led to a twofold increase in endostatin levels. Subcutaneous inoculation of NIH/3T3-LendSN cells resulted in a 2.75 and 2.78-fold increase in endostatin levels in the ES and IL-2 + ES group, respectively. At the end of the study, there was a significant decrease in lung wet weight, lung nodules area, and microvascular area (MVA) in all treated groups compared with the control group (P < 0.001). The significant difference in lung wet weight and lung nodules area between groups IL-2 and IL-2 + ES revealed a synergistic antitumor effect of the combined treatment (P < 0.05). The IL-2 + ES therapy Kaplan-Meier survival curves showed that the probability of survival was significantly higher for mice treated with the combined therapy (log-rank test, P = 0.0028). Conjugated therapy caused an increase in the infiltration of CD4, CD8 and CD49b lymphocytes. An increase in the amount of CD8 cells (P < 0.01) was observed when animals received both ES and IL-2, suggesting an additive effect of ES over IL-2 treatment. A synergistic effect of ES on the infiltration of CD4 (P < 0.001) and CD49b cells (P < 0.01) was also observed over the effect of IL-2. Here, we show that ES led to an increase in CD4 T helper cells as well as cytotoxic lymphocytes, such as NK cells and CD8 cells, within tumors of IL-2 treated mice. This means that ES plays a role in supporting the actions of T cells.

Cardiac Vagal Modulation with Combined Endurance and Strength Training: Use of pNN Time Domain Statistics

Cardiac vagal modulation can be quantified from heart rate variability (HRV) using time and frequency domain measures, including pNN50 and high frequency (HF) power. The use of pNN thresholds lower than the traditional 50 ms may provide more information about cardiac vagal modulation, and be useful in detecting changes in parasympathetic activity induced by endurance training. Due to the specific effects of endurance and strength training, information is limited about the effects of combining these two training modes on cardiac autonomic function. PURPOSE: To examine the effects of combined endurance and strength training on cardiac vagal modulation in short (< 15 min) recordings of RR intervals. METHODS: 93 healthy men (mean age = 55 yr, SD = 7 yr) completed a 21 week progressive training period consisting one of the following: two endurance (E, n=23), two strength (S, n=25), two endurance and two strength (ES, n=29) training sessions per week, or no systematic training (control group, n=16). RR intervals were recorded during 10 min supine rest, and probability distributions for pNN10, 20, 30, 40, and 50 were calculated. HF domain power was computed using Fourier spectral methods. RESULTS: At baseline, for low pNN50 (< 5 %) or low HF power (< 250 ms2), pNN10 ranged widely from approximately 15 to 70 %. These results indicate that pNN10 describes different characteristics of short-term RR interval dynamics than traditional pNN50 or HF power among healthy middle-aged men. After training, significant changes (p < 0.05 between groups) were only observed in the ES group in pNN10 [from 59 (18) % to 63 (20) %, p = 0.023] and pNN20 [from 34 (20) % to 39 (23) %, p = 0.043]. Other training groups did not show significant changes after the 21 week training period. No significant changes were seen in HF power. CONCLUSION: pNN time domain statistics with thresholds lower than the conventional 50 ms may be sensitive in detecting training-induced changes in short term recordings of HRV. Based on the increases in pNN10 and pNN20, combining endurance and strength training may be especially beneficial for enhancing cardiac autonomic function in middle-aged men, even though endurance or strength training alone did not lead to significant changes in these measures in very short-term recordings. Supported by Ministry of Education, Finland.

Root Canal Area Increase Promoted by the EndoSequence and ProTaper Systems: Comparison by Computed Tomography

Introduction The aim of this study was to compare the increase of the root canal area after instrumentation with EndoSequence or ProTaper rotary systems. Methods Twenty-two mesial root canals from mandibular molars were instrumented. Teeth were mounted on a base, numbered, and divided into 2 groups; teeth from 1–11 (PT group) were instrumented by using the ProTaper system, and teeth from 12–22 (ES group) were instrumented by using the EndoSequence system. Cone beam computed tomography was performed on all teeth before and after instrumentation. Measurements at 3, 5, and 7 mm as well as differences in instrument performance were statistically compared by the Student t test at 5% significance level. Results Both systems increased significantly the root canal area ( P < .05) at all levels. Comparison between the rotary systems showed significantly greater increase ( P < .05) for EndoSequence at 3 mm, with no statistically significant difference ( P < .05) at the other levels. Conclusions Both rotary systems increased significantly the root canal area.

Peripheral Arterial Atherosclerosis in Patients with Extracranial, not Intracranial, Arterial Stenosis

It is not known whether stroke patients with intracranial stenosis often have lower extremity atherosclerosis. The aim of our study was to elucidate this issue. Consecutive stroke patients who had cerebral angiography were prospectively enrolled in this study. Cerebral artery and lower extremity artery stenoses were evaluated simultaneously using conventional angiography. To investigate sub-clinical arteriosclerosis, duplex ultrasonography was performed to assess the maximal intima media thickness (IMT) of the common carotid artery (CCA) and the femoral artery, and the ankle brachial pressure index (ABI) was determined. The patients were classified into three groups based on the cerebral angiographic findings: 1) IS group, with a > or = 50% stenosis of the intracranial artery; 2) ES group, with a > or = 50% of the extracranial carotid artery; 3) NS group, with no stenosis. We compared the IMT of the CCA and the femoral artery, as well as the ABI, among the three groups. A total of 81 patients (mean age 63 +/- 13 years old; 61 males) were enrolled. The prevalence of hypertension was greatest in the ES group. The maximal IMT of the femoral artery was highest in the ES group (ES group, 2.1 +/- 1.0 mm; IS group, 1.5 +/- 0.7 mm; NS group, 1.7 +/- 0.9 mm; p=0.043). The ES group had the lowest ABI (ES group, 1.00 +/- 0.24; IS group, 1.11 +/- 0.17; NS group, 1.13 +/- 0.15, p=0.031). The presence of sub-clinical atherosclerosis of the lower extremity arteries differed between patients with intracranial and extracranial stenosis. The mechanism of atherosclerosis may differ between intracranial and extracranial internal carotid artery.

Hybrid-Training Method Increases Muscle Strength and Mass in the Forearm without Adverse Effect of Hand Function in Healthy Male Subjects

Conventional neuromuscular electrical stimulation (NMES) results in surface muscle contraction but high electrical stimulation intensity is required to activate the deep muscles. Therefore, NMES is not useful for training at complicated sites such as the forearm. To make NMES more effective we developed a hybrid training method (HYB), consisting of electrically stimulated antagonists to resist agonist muscle contractions. The purpose of this study was to compare the effects of HYB on the forearm as compared with NMES alone, and to determine whether HYB had any adverse effects on complex hand movements. Thirty subjects were randomly distributed into three groups: a HYB program group, an isometric electrical stimulation group (ES), and a control group (CN). Subjects trained 3 times a week for 6 weeks. Each session consisted of 10 sets of 10 reciprocal 2-sec wrist flexions and extensions separated by 1-min rest intervals. Wrist flexion/extension torques, grip strengths (GS), forearm flexor/extensor cross sectional areas (CSA), and hand dexterity (Purdue Pegboard (PEG) test, finger tapping (Tapping) test were measured. The HYB group demonstrated statistically significant increases in wrist extension torques (22.8%, p<0.01), forearm flexor CSA (9.6%, p<0.01), and in forearm extensor CSA (5.1%, p<0.05) at the end of training. There was no increase in torque or CSA in the ES or CN groups. Hand dexterity showed no significant differences in any of the three groups. HYB had no adverse effect on hand function and was more effective in forearm training than NMES alone.

Comparison of Interscalene brachial plexus blockade by eliciting multiple point paresthesia and electrical nerve stimulation techniques: a prospective, randomized trial

Background: Despite worldwide use of regional blocks, interscalene block has failed to gain widespread acceptance in routine anesthesia practice owing to a higher risk of failure and untoward events. We intend to review its clinical applicability and compare the blockade features using two different techniques.Methods: We evaluated 110 patients of ASA physical status I-III at two centers over 2 years, receiving interscalene brachial plexus block and compared the blockade features of two techniques viz. eliciting paresthesia on multiple points and injecting local anesthetic (group MP, n=55) or injecting total dose of local anesthetic with needle immobilized on a single point after confirming muscular twitches using electrical stimulation at current amplitude of 0.3-0.6 mV (group ES, n=55).Results: Complete success, inadequate block and complete failure of block was observed in [92.7%; 5.45%; 0.9%] cases in MP group and [87.2%; 9%; 1.8%] cases in ES group respectively. The procedural time and time for readiness to surgery was 13±3.5min and 11.4±4.0min in MP group; 6.2±3.0 min and 15±5.6min in ES group p(<0.05). The number of needle pricks and passes was [2.1(1-3); 12 (9-21)] in MP group and [1.2(1-2); 7(5-12)] in ES group (p<0.01). Post-operative neurological dysfunction occurred in 4 cases MP/ES group: 3/1Conclusion: We conclude that either of the techniques is associated with minimal risk of complications and recommend their use in interscalene block depending on choice and experience of attending anesthesiologist.

Differences in self-reported depressive symptoms between patients with epileptic and psychogenic nonepileptic seizures

Depression is a multidimensional condition encompassing affective, physiological, and cognitive symptoms. Although depression's high comorbidity with both epileptic and psychogenic nonepileptic seizures (ES and PNES) has been established, few studies have addressed whether the types of depressive symptoms experienced differ by seizure type (ES and PNES). This study compared the self-reported depressive symptomatology of patients ( n = 60 ES and 59 PNES) who underwent video-EEG monitoring and completed self-reported objective measures of psychopathology (PAI and BDI-II). Differences in depressive symptoms were also compared by gender and among several subgroups with ES. Results revealed the PNES group, particularly PNES females, endorsed a significantly higher level of physiological symptoms of depression as measured by the PAI DEP-P subscale than the ES group; the BDI-II did not differ between groups. These findings have potential clinical implications for the identification and management of depressive symptoms among these patient groups.

Study of rAAV-TK-IRES-ES gene therapy of bladder cancer in vivo

Objective To study the therapeutically effect of rAAV-TIE model in vivo. Meth-ods Cell suspensions of T24 cells were injected into the subcutaneously of right scapular region of nude mice. The nude mice were raised under SPF condition and the xenograft tumor growth was ob-served. Bearing tumor nude mice were randomly divided into 5 groups: rAAV-MCS group, rAAV-Tk group, rAAV-ES group, rAAV-TIE group and control group. Four weeks later of treatment, the nude mice were sacrificed. The xenografts tumors were fixed for HE staining. The liver tissue and ne-phridial tissue were also fixed for HE stain. The blood sample and endostatin concentration was as-sayed by ELISA. Results After 3 weeks of injected with T24 cells on nude mice, 25 showed visible tumor on the injected location. The rate of tumor formation was 93%. After 9 days injected by rAAV-ES, rAAV-TK, rAAV-TIE, the tumor volume were: rAAV-ES group(0.75±0.08)cm3 , rAAV-TK group(0.71±0.11)cm3 , rAAV-TIE group(0.52±0.09)cm3 , rAAV-MCS group(1.27±0.13)cm3 and control group (1.24±0.17)cm3. The microvessel density in the different groups were as follow-ings: rAAV-ES group(18.72±2.53)/HP, rAAV-TK group(21.74±4.62)/HP, rAAV-TIE group (12.73±1.78)/HP, rAAV-MCS group(52.38±6.46)/HP and control group(49.94±7.17)/HP. The endostatin concentration in the diffcrent groups were as followings: rAAV ES group(38.52 6.53)μg/L and rAAV-TIE group(40.33±7.48)μg/L. HE staining confirmed the tumor. The liver tissue and kidncy tissue of each group had no obviously cell degeneration or necrosis. Conclusion The rAAV-TIE could inhibit tumor induced angiogenesis and suppress both the initiation and the subse-quent growth of human bladder cancer in nude mice model. Key words: Bladder neoplasms; Adeno-associatcd virus; Suicide gcne; Endostatin

Treatment of Distal Radius Fractures with a Wrist-Bridging External Fixation: The Value of Alternating Electric Current Stimulation

The radiological and functional outcomes of two groups of comminuted intraarticular fractures of the distal radius that were treated with wrist-bridging external fixation, with or without an alternating electric current stimulation (EF + ES or EF group, respectively), were compared. The radial length, radial inclination and palmar tilt were measured on radiographs taken immediately after removal of wrist external fixator and also after bone union had occurred. Furthermore, active range of motion was compared at the final consultation. Bridging callus was observed earlier postoperatively in the EF + ES group than in the EF group. The radial length and palmar tilt were significantly larger, and the loss of radial length and radial inclination significantly smaller, in the EF + ES group. We believe that callus maturation is enhanced by alternating electric current stimulation, which enables the early removal of external fixator.

A prospective randomized trial comparing completion technique of fissures for lobectomy: Stapler versus precision dissection and sealant

Alveolar air leaks are common after pulmonary resection, often prolonging hospitalization and increasing surgical morbidity and costs. Air leakages result from lung tissue traumatized by the dissection of fissures. This randomized and controlled trial evaluates 2 different surgical techniques for the completion of interlobar fissures during pulmonary lobectomy to establish which is superior in preventing air leakage. There were 20 patients in each of the 2 groups: Electrocautery was used for precision dissection and collagen patches were coated with human fibrinogen and thrombin (TachoSil, Nycomed, Vienna, Austria) for aerostasis in the electrocautery and sealant group (ES), and the approved routine surgical procedure with staplers was used in the stapler group (ST). Statistically significant reductions of air leakage were found in the ES group in the overall incidence of air leaks (50% vs 95%, P = .0001), duration of air leaks (1.7 days vs 4.5 days, P = .003), and procedure costs (425 euros vs 630.5 euros, P = .0001). There were no complications related to the use of the patches, and a significantly lower incidence of dead pleural space was observed in the ES group (5% vs 40%, P = .020). The use of electrocautery dissection and collagen patches coated with human fibrinogen and thrombin (TachoSil, Nycomed, Vienna, Austria) for aerostasis to complete interlobar fissures seems to be safe and effective in reducing alveolar air leaks and procedure costs. Although this pilot study showed advantages in terms of hospitalization and cost benefits, further multicentric studies are required to clarify that these differences are statistically significant.

Exposure to risk information and women's interest in direct to consumer testing for BRCA 1 and 2 mutations

6526 Background: Direct to consumer (DTC) access to cancer genetic testing has the potential to enhance cancer control efforts. However, it is not known if current DTC websites provide adequate risk information for informed medical decision-making. Methods: 767 women were randomly assigned to view a “mock” DTC commercial website (control condition: CC, n=257) or the same “mock” website that included information on the potential risks of obtaining genetic testing online (risk condition: RC). Risk information was framed in two different ways: basic risk information (BR, n=253) and risk information from expert sources (ES, n=257). Subjects then completed an online survey. The primary endpoints were intentions to get BRCA testing and attitudes about DTC BRCA testing. Results: Sample characteristics: mean age 37 (range 18–71), 79% white, 62% married, mean education 3 yrs. college. Women in the RC reported lower intentions to get BRCA testing than women in the CC (mean 2.78 vs. 3.07, p<0.05) and were more likely to report wanting to obtain testing in clinic rather than online (mean 5.11 vs. 4.83, p<0.05). Women in the RC had more negative attitudes about online BRCA testing than women in the CC (mean 23.76 vs. 25.18, p <0.001). Framing effects were seen: women in the ES group were more likely to report a preference for clinic based testing and had more negative attitudes about online testing than the BR group. Conclusions: Exposing women to information on the potential risks of online BRCA testing altered their intentions to get testing as well as their attitudes about testing. Additionally, some risk messages appear to be more effective in altering attitudes and intentions than other risk messages. Policy makers may want to consider both the content and framing of risk information on DTC commercial websites as they enact regulation aimed at optimizing informed decision-making in this rapidly growing industry. No significant financial relationships to disclose.

Investigation of epidermal growth factor containing liposome formulation effects on burn wound healing

It was aimed to develop liposome formulations containing epidermal growth factor (EGF) and to investigate the healing effects of these formulations on second-degree burn wounds in rats. Multilamellar type liposomes containing EGF were prepared by film formation method. In vitro releases of EGF from liposome formulations were determined using spectrofluorometer. Second-degree standard burn wounds were formed on rats and liposome formulations containing 10 microg/mL EGF (ELP group), EGF solution (ES group), liposome without containing EGF (LP group), and Silverdine ointment (SIL group) were applied daily. Untreated control groups [unburned (S) and untreated (Y) rats] were also evaluated. Biopsies were taken at the 3rd, 7th, and 14th day of the treatment from the wounds and histological observations were performed under transmission electron microscope. Bromodeoxyuridine (BrdU) staining technique was used for immunohistochemical analysis. After trichrome stainings, the thicknesses of the epidermis and the areas of the fibroblast nucleus were measured using a light microscope and Vision Screening Analysis Program. It was observed that the healing in the ELP group was the fastest among all groups (p < 0.05) at the 14th day of therapy. The healing effect in order from highest to lowest efficacy was found to be ELP>SIL>ES groups, respectively, at the 14th day. All results indicated that the EGF-liposome formulation is effective and can be used for the treatment of burn wounds.

Treatment of Titanium Dental Implants With Three Piezoelectric Ultrasonic Scalers: An In Vivo Study

Dental implants require regular maintenance. It is crucial that the instrument used for maintenance be able to remove plaque and calculus from the implant surface effectively and efficiently, while causing minimal damage to its circumference. Some ultrasonic scalers may be useful for implant maintenance; however, no clinical study has examined this. This study evaluated the treatment of titanium implants with three piezoelectric scalers in vivo. Fourteen patients underwent implant treatment in which plaque and calculus were removed from the abutment surfaces with ultrasonic scalers. The abutments were treated with scalers with carbon (VS; N = 7), plastic (PS; N = 7), or metallic (ES; N = 7) tips. The abutment surface characteristics were examined after instrumentation using scanning electron microscopy. The amount of plaque remaining and roughness were estimated using a modification of the remaining plaque and calculus score and the modified roughness score, respectively. In addition, the abutment surfaces were imaged with a laser profilometer and a laser scanning electron microscope (SEM). The remaining plaque and calculus scores did not differ significantly among the VS, PS, and ES groups. VS and PS produced a significantly smoother abutment surface than ES. The laser SEM three-dimensional images also demonstrated that VS and PS produced smooth abutment surfaces, whereas ES resulted in damaged surfaces. VS and PS produced clean, smooth abutment surfaces. Piezoelectric scalers with non-metal tips are suitable for use in dental implant maintenance.