[Evaluation of absorbent sheet to prevent anticancer drugs contamination spread in urine].

OBJECTIVES: Medically, anticancer drugs contamination leading to human exposure has become an issue. The urine of patients receiving chemotherapy contains anticancer drugs. If urine containing anticancer drugs is excreted, the anticancer drugs are scattered around the toilet bowl, then adhere to slipper soles and spread. Therefore, we developed an absorbent sheet containing activated carbon that absorbs anticancer drugs and prevents anticancer drug contamination spread. In this article, we report the data on the sheet performance evaluation. METHODS: In artificial urine solutions, 100 µL (20 drops) of cyclophosphamide (CPA; 2,000 µg/mL), methotrexate (MTX; 6,000 µg/mL), and paclitaxel (PTX; 200 µg/mL) were dropped onto the stainless plate of two commercially available medical sheets (Pitapa SheetⓇ; control product 1 and Absocare sheetⓇ; control product 2) and a newly developed sheet (HD Safe Sheet-Neo, test product). Polyvinyl chloride (PVC) slippers were placed on the sheets for 30 s, and anticancer drugs that adhered to the slippers were quantified. We compared the drug quantities that were transferred to the slippers from different sheets. RESULTS: An average of 31.5%, 38.7%, and 50.5% of each of the dropped anticancer agents (CPA, MTX, and PTX, respectively) adhered to the slipper sole. Compared to that of the control product 2, the average adhesion of CPA and MTX was significantly reduced in the test product containing activated charcoal (224 vs 2 µg, p < .050 and 2,235 vs 19 µg, p < .050). Contrastingly, there was no significant difference in the PTX mean adherence (35 vs 13 µg). CONCLUSION: Activated carbon adsorbs anticancer drugs in urine. The test product containing activated charcoal reduced the amount of scattered anticancer drugs that adhered to the slippers. The results suggest that the activated carbon sheet may prevent anticancer drugs contamination spread in urine.

Development and evaluation of adsorption sheet (HD safe sheet-U) using active carbon for the purpose of the preventing the contamination diffusion of urinary excreted anticancer drug.

BACKGROUND: Certain amount of anticancer drugs is excreted in the urine of patients receiving anticancer drugs, and urinary scattering including anticancer drugs at excretion has become a route of anticancer drug contamination. Therefore, we developed an active carbon sheet (HD safe sheet-U) that prevented diffusion by adsorbing anticancer drugs including that excreted in urine. The present study conducted a performance evaluation of this sheet. METHODS: The adsorption performance of active carbon to anticancer drug in the urine was evaluated by determining concentration changes in the active carbon suspension (5 mg/mL) of 14 kinds of anticancer drugs (cyclophosphamide, ifosfamide, carboplatin, cisplatin, methotrexate, 5-fluorouracil, cytarabine, gemcitabine, doxorubicin, epirubicin, paclitaxel, docetaxel, etoposide, and irinotecan) diluted with artificial urine. Adhesion of the anticancer drug dropping on the sheet to a slipper sole was evaluated because urine including anticancer drugs is scattered on the floor, which can spread by adhering to shoe soles of patients and healthcare workers. The performance of the active carbon sheet was compared with two other types of medical adsorption sheets used as control sheets. Anticancer drugs diluted with artificial urine (1 mL) were dropped on the active carbon sheet and the two control sheets. The sheets were trod with slippers made by polyvinyl chloride. The adhered anticancer drug was wiped off and its quantity was determined. RESULTS: A remarkable decrease in anticancer drug concentrations, except for cisplatin, was detected by mixture of active carbon in the artificial urine (0-79.6%). The quantity of anticancer drug adhesion to slipper soles from the active carbon sheet was significantly lower compared with that observed for the two control sheets for eight kinds of anticancer drugs (cyclophosphamide, ifosfamide, carboplatin, methotrexate, cytarabine, gemcitabine, doxorubicin, and docetaxel). There was no adhesion in cyclophosphamide and docetaxel. Furthermore, the quantities of adhesion in cytarabine, gemcitabine, doxorubicin, paclitaxel, and irinotecan were lower than determination limit. CONCLUSION: Active carbon might be effective in adsorbing urinary anticancer drugs. The active carbon sheet adsorbed urinary excreted anticancer drugs, and use of such sheets might prevent diffusion of contamination due to urinary excreted anticancer drugs.

Long-term radiographic evaluation of risk factors related to implant treatment: suggestion for alternative statistical analysis of marginal bone loss.

OBJECTIVE: Secular change in marginal bone loss (MBL), which is the index adopted for implant success criteria, has often been used to evaluate risk factors. However, the need to revise these criteria has recently been indicated due to rapid developments in implant treatment. The purpose of this study was to evaluate risk factors by analyzing MBL with an alternative statistical method. MATERIAL AND METHODS: The analyses were performed on the outcomes of 366 patients with 1,902 implants during an average follow-up period of 84.8 months (with a maximum follow-up of 258 months). Instead of evaluating annual MBL, time was calculated as one of the explanatory variables because the correlation between MBL and time was small (correlation coefficient of 0.09010). Analysis of covariance (ANCOVA) was used for exploratory assessment of each factor, and multiple regression analysis was then utilized to identify risk factors. The multiple regression analysis was performed twice, once among all implants and another in which one implant per patient was randomly selected. RESULTS: As a result of multiple regression analysis, smoking habits showed a significant effect on MBL. Age, sex, diabetes mellitus, implant positions, guided bone regeneration, and sinus floor elevation did not affect MBL. IMZ® implants were associated with significantly higher MBL than were ANKYLOS® and SPI® implants. There was no significant difference between Straumann® and other implants. CONCLUSION: Our results showed that another statistical process, which eliminated the effect of time rather than comparing annual MBL, could be applied to evaluate MBL because the correlation between MBL and time was small.

Case presentation of two patients using diagonal platform-switched double implants for maxillary single-first-molar replacement as the alternative of a single-tooth implant.

A single-tooth implant restoration is generally performed for maxillary single-first-molar replacement. If the interdental space between the second premolar and the second molar is large enough, a double-implant placement can be performed to avoid creating mesiodistal cantilever and to distribute occlusal loading forces.If there is not adequate space for a double-implant placement to be performed mesiodistally along the crest of the alveolar ridge line, they should be placed along a diagonal line offset lingually to increase the space. This procedure has two primary advantages. First, greater stability is provided by a double-implant placement. Resistance to lateral forces (palatal-buccal) is much stronger than two implants placed along the alveolar crest ridge line. Residual palatal and buccal bone can provide support against occlusal forces, provided that there is adequate residual bone in these regions.If anatomical conditions are favorable, the placement of two diagonal implants in the palatal and buccal residual bones can be a rational procedure.We report on two typical patients. The progress of these patients was followed using computed tomography for 7 and 6 years, respectively.

Use of cephalometric analysis for implant placement in a patient with an edentulous maxilla with a severe Class III intermaxillary relationship.

A patient with a totally edentulous maxilla and a seVere Class III intermaxillary relationship in the anterior region was treated by implants. In the mandible, there were 10 teeth between the second premolars. The inclination and width of the maxillary anterior residual bone were measured on cephalometric X-ray film obtained before treatment. The results of cephalometric analysis did not support clockwise rotation of the mandible or lingual angling of the maxillary anterior teeth by use of prosthesis to improve the Class III relationship. Ten implants were simultaneously placed in the maxilla. Then, a maxillary temporary full bridge was seated after reduction of the crown lengths of the mandibular anterior teeth. An apically positioned flap operation was performed to eliminate periodontal pockets and to obtain clinically suitable crown lengths of the mandibular anterior teeth. A noncemented, screw-retained maxillary full bridge and a conventional mandibular full bridge were placed. Postoperative cephalometric analysis showed that the outcome was clinically acceptable. The patient has been satisfied for more than 5 years since placement of the implant prostheses.