Retention systems used in maxillofacial prostheses: A review.

Defects in the face area caused by trauma, accident, tumor or congenital defects are treated with special facial prostheses. Besides esthetics, the most common problem with these prostheses is the retention of prostheses. In the present article review, the methods used for the retention of prostheses from past to present were researched, and the advantages of adhesives and implants, which are the most commonly used current methods, were evaluated. Current techniques, new materials, treatment options, and implementation procedures are described. The success of maxillofacial prostheses in meeting the expectations of patients and dentist doctors is increasing day by day with the development of adhesive material science, the emergence of technical knowledge, and the development of implant technology. Increasing the retention provides both ease of use and acceptance by the patient. Therefore, the chosen method for retention has great importance in the long-term prognosis of the prosthesis.

Successful capecitabine desensitization for a delayed-type hypersensitivity reaction

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An investigations on the molecular structure, FT-IR, FT-Raman and NMR spectra of 1-(p-tolylsulfonyl) pyrrole by theoretical and experimental approach.

Fourier-Transform-Infrared, Fourier-Transform-Raman and Nuclear Magnetic Rezonans spectra of 1-(p-tolylsulfonyl) pyrrole molecule have been recorded. In the powder form, vibrational spectra of 1-(p-tolylsulfonyl) pyrrol molecule were investigated in the region 4000-400 cm(-1) and 3500-50 cm(-1), respectively. The conformational analysis, geometrical structure, molecular electrostatic potential map, HOMO-LUMO and vibrational spectroscopic properties of the isolated 1-(p-tolylsulfonyl) pyrrole molecule have also been carried out at the Molecular Mechanic and Density Functional Theory approaches. Density Functional Theory results have been associated with Scaled Quantum Mechanics Force Field for fitting between the theoretical and the experimental frequencies.

Synthesis, characterization and theoretical studies of 5-(benzylthio)-1-cylopentyl-1H-tetrazole.

In this study, 5-(benzylthio)-1-cylopentyl-1H-tetrazole (5B1C1HT) have been synthesized. Boiling points of the obtained compound have been determined and it has been characterized by FT-IR, (1)H NMR, (13)C-APT and LC-MS spectroscopy techniques. The FT-IR, (1)H NMR and (13)C-APT spectral measurements of the 5B1C1HT compound and complete assignment of the vibrational bands observed in spectra has been discussed. The spectra were interpreted with the aid of normal coordinate analysis following full structure optimization and force field calculations based on Density Functional Theory (DFT) at 6-311++G(**), cc-pVDZ and cc-pVTZ basis sets. The optimized geometry with 6-311++G(**) basis sets were used to determine the total energy distribution, harmonic vibrational frequencies, IR intensities.

Modified DCF (mDCF) regimen seems to be as effective as original DCF in advanced gastric cancer (AGC)

PURPOSE: The aim of this retrospective study (from January 2007 to December 2011) was to investigate the efficacy and tolerability of mDCF schedule for chemotherapy-naïve AGC patients. PATIENTS: Patients (n = 54) with locally inoperable or distant metastasis and performance status of 0-2 were eligible. The triplet combination chemotherapy consisting of docetaxel 60 mg/m(2) on day 1, cisplatin 60 mg/m(2) on day 1, and 5-fluorouracil 600 mg/m(2) for 5 days of continuous infusion were administered every 21 days, up to nine cycles. Prophylactic G-CSF was not allowed. RESULTS: In all, 36 (67 %) patients were male and 18 (33 %) were female; median age was 59 years. The majority of patients (n = 46, 85 %) had metastatic disease and 8 (15 %) of them had locally advanced disease. Liver metastasis and peritonitis carcinomatosa were found in 20 (43 %) and 18 (39 %) of the 46 cases, respectively. The median cycle of chemotherapy was 6. In assessing 50 patients for response evaluation, one had complete response. Partial response was achieved in 27 (54 %) patients. Seventeen patients (34 %) had stable disease and 5 (10 %) had progressive disease, while 4 % (n = 2) and 11 % (n = 6) of the patients developed severe (grade 3-4) neutropenia and anemia, respectively. During the median follow-up time (6.9 months, range 0.4-24), 28 (52 %) patients died. The overall and progression-free survival were 10.7 [95 % CI 8.9-12.4] and 6.8 [95 % CI 5.8-7.8] months, respectively. CONCLUSIONS: Although this was not a prospective comparative study, the mDCF regimen seems to be as effective as the original DCF in AGC with acceptable and manageable side effects (AU)

Modified DCF (mDCF) regimen seems to be as effective as original DCF in advanced gastric cancer (AGC).

PURPOSE: The aim of this retrospective study (from January 2007 to December 2011) was to investigate the efficacy and tolerability of mDCF schedule for chemotherapy-naïve AGC patients. PATIENTS: Patients (n = 54) with locally inoperable or distant metastasis and performance status of 0-2 were eligible. The triplet combination chemotherapy consisting of docetaxel 60 mg/m(2) on day 1, cisplatin 60 mg/m(2) on day 1, and 5-fluorouracil 600 mg/m(2) for 5 days of continuous infusion were administered every 21 days, up to nine cycles. Prophylactic G-CSF was not allowed. RESULTS: In all, 36 (67 %) patients were male and 18 (33 %) were female; median age was 59 years. The majority of patients (n = 46, 85 %) had metastatic disease and 8 (15 %) of them had locally advanced disease. Liver metastasis and peritonitis carcinomatosa were found in 20 (43 %) and 18 (39 %) of the 46 cases, respectively. The median cycle of chemotherapy was 6. In assessing 50 patients for response evaluation, one had complete response. Partial response was achieved in 27 (54 %) patients. Seventeen patients (34 %) had stable disease and 5 (10 %) had progressive disease, while 4 % (n = 2) and 11 % (n = 6) of the patients developed severe (grade 3-4) neutropenia and anemia, respectively. During the median follow-up time (6.9 months, range 0.4-24), 28 (52 %) patients died. The overall and progression-free survival were 10.7 [95 % CI 8.9-12.4] and 6.8 [95 % CI 5.8-7.8] months, respectively. CONCLUSIONS: Although this was not a prospective comparative study, the mDCF regimen seems to be as effective as the original DCF in AGC with acceptable and manageable side effects.

Mammaglobin and maspin transcripts in blood may reflect disease progression and the effect of therapy in breast cancer.

Detection of residual tumor cells in the circulation can provide prognostic as well as therapeutic information and help in identifying patients at high risk for developing metastases. Maspin and mammaglobin are two molecules that are specifically associated with breast cancer. We looked for mammaglobin and maspin transcripts in the peripheral blood of patients with breast cancer and evaluated their utility as a marker of the response to therapy. Maspin and mammaglobin transcripts were analyzed in 85 breast-cancer patients by nested RT-PCR, prior to and after treatment. Before therapy, 10 patients were found positive for mammaglobin and 20 patients were positive for maspin. In four patients, both transcripts were detected. Immediately following treatment, only one patient was still positive for mammaglobin while maspin transcripts persisted in three patients. Disease progression was observed mainly in patients in whom maspin transcripts were not detectable. Molecular detection of circulating tumor cells during therapy based on analysis for mammaglobin and maspin transcripts is an easy and practical method that can be applied to follow-up patients. We suggest that detection of mammaglobin mRNA is useful to determine the effect of therapy while maspin transcripts may indicate more aggressive disease.

Effect of oral administration of kefir on serum proinflammatory cytokines on 5-FU induced oral mucositis in patients with colorectal cancer.

In order to investigate the effect of kefir consumption on mucositis induced by 5-FU based chemotherapy (CT), we monitored the systemic immune response by measurement of the serum proinflammatory cytokine levels and we evaluated the anti-microbial effect of kefir with an agar diffusion method. Forty patients with colorectal cancer were included in this randomized prospective study. On the first 5 days of each CT cycle, the study group received oral lavage with kefir and then swallowed 250 ml of kefir while control group received oral lavage with 0.09% NaCl twice a day. Before and after every cycle of CT, the oral mucosa was assessed. Serum proinflammatory cytokine levels were evaluated before the initiation and after the third and the sixth cycle. Kefir was administered in 99 out of 205 courses. Mucositis developed in 27.3% of the courses given with kefir administration and in 21.7% of the courses given with 0.9% NaCl oral rinses. The difference between the two groups was not statistically significant (p > 0.05). When we compared the serum proinflammatory cytokine levels of the two groups at the baseline and following the third and the sixth cycles, we again found no statistically significant difference (p > 0.05). Kefir consumption at the mentioned doses made no statistically significant effect on serum proinflammatory cytokine levels and on the incidence of mucositis development in cancer patients. Under in vitro conditions, kefir inhibits only Staphylococcus epidermidis.

XELOX followed by XELIRI or the reverse sequence in advanced colorectal cancer.

BACKGROUND: Capecitabine has demonstrated high efficacy as first-line treatment for metastatic colorectal cancer (mCRC). In this non-randomized pilot study, we investigated the efficacy and safety of sequentially administered XELOX and XELIRI regimens or the reverse sequence in patients with advanced colorectal cancer. PATIENTS AND METHODS: Entry criteria were histologically confirmed mCRC, ECOG performance status (PS) < or =2 and adequate bone marrow, renal and hepatic function. All patients consecutively received XELOX followed by XELIRI at disease progression or vice versa. RESULTS: In multivariate analysis, independent prognostic factors with worse overall survival were: lower PS (p = 0.0001), multiple metastatic sites (p = 0.016) and high tumor grade. Higher serum levels of alkaline phosphatase and worse ECOG PS were associated with a shorter progression-free survival. Grade 3/4 mucositis, nausea/vomiting, grade 3/4 alopecia and grade 3 diarrhea were more frequent with XELIRI, whereas major toxicity events with XELOX were grade 3 neutropenia, thrombocytopenia and grade 2/3 neurotoxicity. CONCLUSION: Capecitabine appears to be an acceptable alternative to continuous-infusion fluorouracil (FU)/leucovorin (LV) in combination therapy and offers an effective, but more convenient alternative to continuous infusion FU/LV in the first-line treatment of patients with mCRC.

Soluble interleukin-2 receptor and interleukin-10 levels in patients with chronic hepatitis B infection.

BACKGROUND/AIMS: In the current investigation, we evaluated patients with hepatitis B infection to determine whether serum soluble interleukin-2 receptor and interleukin-10 levels were changed and whether the degree of these changes in serum levels correlated with histologic severity of hepatitis related liver injury. METHODOLOGY: 25 patients diagnosed of chronic active B hepatitis, 25 asymptomatic hepatitis B carriers, 25 healthy people with antibody to hepatitis B surface antigen and 20 healthy people without any hepatitis marker positivity were included in the study. Serum interleukin-10 and soluble interleukin-2 receptor levels were measured. The association between liver pathology, HBV DNA, serum transaminase values and these parameters were researched. RESULTS: Serum soluble interleukin-2 receptor and interleukin-10 levels were significantly higher in chronic hepatitis cases and asymptomatic carriers than that of others (P < 0.01). Serum interleukin-10 levels correlated with histological activity index and HBV DNA values (r = 0.7, P < 0.01) but not with soluble interleukin-2 receptor levels and transaminase values. CONCLUSIONS: Our results support the observation that interleukin-10 and soluble interleukin-2 receptor may play an important role in the inappropriate regulation of immune response in patients with chronic hepatitis B virus infection and interleukin-10 may be responsible for chronicity.

A fatal acute subdural hematoma occurring after evacuation of "contralateral" chronic subdural hematoma.

Although chronic subdural hematomas (SDHs) are bilateral in about 20% of the cases, an acute SDH in one side associated with chronic SDH in "contralateral" side is an extremely rare and devastating condition. In this report, a case of "contralateral" acute SDH occurring after evacuation of chronic SDH in one side is presented. The clinical history, complaints, neurological and neuroradiological findings, and pathophysiological mechanisms of this uncommon entity are discussed and related literature is reviewed.

Giant schwannoma of the trigeminal nerve misdiagnosed as maxillary sinusitis. A case report.

A 24-year-old woman presented with left-sided ptosis, diplopia, sensory impairment on the left side of her face and diminished hearing in her left ear. The neurological findings were hypo-anesthesia in all three divisions of the trigeminal nerve, left-sided facial paralysis of the oculomotor and abducens nerves. Initially the condition was misdiagnosed as maxillary sinusitis and was treated with antibiotics. It seems that this presentation has not been previously described in commonly read English-language journals. In our case, the tumour was removed totally and the neuropathological diagnosis was schwannoma. The case report describes the presentation, investigations, management and outcome in this patient.

Huge ossified crust-like subdural hematoma covering the hemisphere and causing acute signs of increased intracranial pressure.

We report the successful removal of an ossified crust-like chronic subdural hematoma (SDH) covering the hemisphere in a 16-year-old boy. In this article, the importance of the surgical approach is stressed, and the rarity of this condition in the neurosurgical literature is also outlined.

Factors affecting morbidity and mortality following surgical intervention in patients with intracranial meningioma.

BACKGROUND: Meningiomas usually grow slowly but they may cause recurrences despite surgical resection. The impact of clinical, neuroradiological and surgical characteristics on operative morbidity and mortality of patients operated on for intracranial meningioma was analysed. METHODS: A series of 450 patients operated on for intracranial meningiomas at the Department of Neurosurgery, Hacettepe University Hospital during the period 1964-1992 is reported. The surgical results were analysed with regard to intracranial site, extent of removal, histological type, and different time periods. Computed tomography (CT) and magnetic resonance imaging (MRI) facilitated the diagnosis and helped with the planning of treatment. RESULTS: Two hundred and ninety-two patients were examined with both CT and MRI. Overall mortality was 4% but showed a decline from 9% in the pre-CT era to 3% in the post-CT era and to 1% in the past 3 years. CONCLUSIONS: Operative mortality and recurrence rates are affected by the intracranial location of the tumour, histological type, and extent of tumour removal. Emphasis is also given to the importance of the introduction of the imaging techniques, and the microsurgical techniques with the Cavitron ultrasonic surgical aspirator (CUSA), laser, and/or bipolar coagulator which have further improved the operative mortality and recurrence rates.

Twenty-five years experience in the treatment of trigeminal neuralgia. Comparison of three different operative procedures in forty-nine patients.

A series of 49 patients with trigeminal neuralgia (TN) were treated by three different surgical procedures: (1) peripheral ablative procedures in 10 patients; (2) percutaneous rhizotomy in 17 patients and (3) intracranial rhizotomy (IR) in 22 patients. On the basis of surgical treatment, the concept that neurovascular compression is a mechanical factor in the aetiology of TN was supported in 14 to 18 patients who underwent posterior fossa exploration. The results support the conclusion that retromastoid craniectomy with IR is the procedure of choice for the majority of patients with TN.

Placement of mechanically detachable spiral coils in the endovascular treatment of intracranial aneurysms. Work in progress.

PURPOSE: To determine the usefulness of mechanically detachable spiral tungsten coils (MDSs) in the endovascular, endosaccular occlusion of intracranial aneurysms. MATERIALS AND METHODS: Anterior communicating artery aneurysms shown at angiography in two patients and a basilar tip aneurysm shown in one patient were treated with MDSs. RESULTS: In the basilar artery aneurysm, eight coils were delivered. Two additional coils were placed at 3 months because of filling of the residual aneurysm neck. Angiography at 1 year showed no recanalization. The smaller aneurysm in the anterior communicating artery was totally occluded by a single coil. Angiography at 6 months showed no recanalization. The other aneurysm was occluded by two coils, with a small amount of residual filling. A third coil was withdrawn before detachment. The patient had aspiration pneumonia and electrolyte imbalance, but he was in stable condition 3 weeks later and was discharged. CONCLUSION: The pliable, soft, retrievable MDS system provides instantaneous release of a spiral coil.

Giant intrasacral schwannoma forming a presacral mass: a report of an unusual cause of lumbosacral radiculopathy.

Schwannomas are extremely rare tumours deriving from cells within the neurilemma. The authors report a case of giant intrasacral schwannoma presenting in the presacral region. The tumour presented with a lumbosacral pain and it was removed totally by two-stage surgical intervention. When seen five years after the second surgical intervention, the patient was asymptomatic. The rarity of such cases prompted this report.

Syringohydromyelia as a complication of Goldenhar syndrome.

Goldenhar syndrome is a multifocal developmental disorder consisting of ocular, auricular and vertebral anomalies. A case of Goldenhar syndrome is presented with a previously undescribed association with syringohydromelia. The pertinent literature is reviewed and possible mechanisms of the pathogenesis of syringohydromyelia in this syndrome are discussed.