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PubMedDate not supplied

Age and body mass index may increase the chance of failure in sentinel lymph node biopsy for women with breast cancer.

Age and body mass index (BMI) have been shown to correlate with an increased incidence of failure in identifying a sentinel lymph node (SLN). Mapping senior, overweight adults is common; therefore, the relationship of patient age and BMI on SLN biopsy success is essential. This study examines the mapping failures as they relate to age and BMI. From April 1994 to May 1999, patients underwent an injection of radiocolloid (450 mci) and blue dye (5 cc) prior to SLN biopsy. SLN biopsy failure was defined as lymph nodes being unidentifiable by blue dye or having an in vivo node radiocolloid count of less than 3:1 over background count. BMI was measured as (weight in pounds)(703)/(height in inches)(2); 1,356 patients were attempted for SLN mapping, and 54 failed (3.98%). The radioactive node count was inversely proportional to age ( p < 0.0001). The radioactive node count decreased by a mean of 34 counts per node with each additional year ( p < 0.001). The estimated odds ratios for success were 0.945 for age and 0.946 for BMI. Therefore, every increase of 1 year of age or one unit of BMI decreased the odds of success by approximately 5%. The mean BMI was 29.54 in failed patients and was 26.42 in successful mapping patients ( p = 0.042). Surgeons should be aware that node counts will decrease with increasing age and that increased age and BMI are potential risk factors for SLN mapping failure. However, increased age and/or BMI alone do not appear to be contraindications for SLN biopsy in older or overweight patients.

Adult↗
PubMedDate not supplied

Influence of dentin conditioning and contamination on the marginal integrity of sandwich Class II restorations.

This study investigated the influence of dentin conditioning and contamination on the marginal adaptation of Class II sandwich restorations. Large butt-joint MOD cavities with cervical margins located 1 mm below the CEJ were cut into 72 extracted human molars. Nine groups were filled using a total-bond technique with Z100 or a sandwich technique with either Vitremer or F2000 in combination with Z100. For all three material combinations three different pretreatments were compared: total etch, selective etch and dentin contamination with saliva and blood prior to primer/adhesive application. After water storage for 21 days and thermocycling (2000x, 5-55 degrees C) replicas were produced for quantitative marginal analysis in the SEM. Teeth were immersed in 0.5% basic fuchsin for 24 hours and dried. Percent dye penetration over the total marginal length was analyzed in three layers using a sequential grinding technique. Statistical analysis was performed using a two-way ANOVA. Post-hoc analyses were carried out with univariate Mann-Whitney-U-tests adjusting for multiple comparisons by a sequentially rejective test procedure (Bonferroni-Holm) at p < 0.05. Both F2000 and Vitremer sandwich restorations showed better marginal adaptation than Z100 total-bond restorations with all pretreatments. Acid etching of the dentin significantly influenced the marginal adaptation of Z100 total-bond restorations and Vitremer sandwich restorations. All types of restorations showed considerable microleakage. On contaminated dentin, sandwich restorations showed better marginal integrity than total-bond restorations. Marginal adaptation did not correspond with microleakage in all groups. In conclusion, F2000/Z100 and Vitremer/Z100 sandwich restorations show better marginal adaptation than Z100 total-bond restorations in large Class II cavities with cervical margins in dentin. Microleakage cannot predictably be prevented with the sandwich technique. Sandwich restorations seem to be less sensitive to contamination with saliva and blood.

Acid Etching, Dental↗
PubMed1994

Lymphatic mapping and sentinel lymphadenectomy for breast cancer.

OBJECTIVE: The authors report the feasibility and accuracy of intraoperative lymphatic mapping with sentinel lymphadenectomy in patients with breast cancer. SUMMARY BACKGROUND DATA: Axillary lymph node dissection (ALND) for breast cancer generally is accepted for its staging and prognostic value, but the extent of dissection remains controversial. Blind lymph node sampling or level I dissection may miss some nodal metastases, but ALND may result in lymphedema. In melanoma, intraoperative lymph node mapping with sentinel lymphadenectomy is an effective and minimally invasive alternative to ALND for identifying nodes containing metastases. METHODS: One hundred seventy-four mapping procedures were performed using a vital dye injected at the primary breast cancer site. Axillary lymphatics were identified and followed to the first ("sentinel") node, which was selectively excised before ALND. RESULTS: Sentinel nodes were identified in 114 of 174 (65.5%) procedures and accurately predicted axillary nodal status in 109 of 114 (95.6%) cases. There was a definite learning curve, and all false-negative sentinel nodes occurred in the first part of the study; sentinel nodes identified in the last 87 procedures were 100% predictive. In 16 of 42 (38.0%) clinically negative/pathologically positive axillae, the sentinel node was the only tumor-involved lymph node identified. The anatomic location of the sentinel node was examined in the 54 most recent procedures; ten cases had only level II nodal metastases that could have been missed by sampling or low (level I) axillary dissection. CONCLUSIONS: This experience indicates that intraoperative lymphatic mapping can accurately identify the sentinel node--i.e., the axillary lymph node most likely to contain breast cancer metastases--in some patients. The technique could enhance staging accuracy and, with further refinements and experience, might alter the role of ALND.

Adult↗
PubMed1999

Toxicity and metabolism of malachite green and leucomalachite green during short-term feeding to Fischer 344 rats and B6C3F1 mice.

Malachite green, an N-methylated diaminotriphenylmethane dye, has been widely used as an antifungal agent in commercial fish hatcheries. Malachite green is reduced to and persists as leucomalachite green in the tissues of fish. Female and male B6C3F1 mice and Fischer 344 rats were fed up to 1200 ppm malachite green or 1160 ppm leucomalachite green for 28 days to determine the toxicity and metabolism of the dyes. Apoptosis in the transitional epithelium of the urinary bladder occurred in all mice fed the highest dose of leucomalachite green. This was not observed with malachite green. Hepatocyte vacuolization was present in rats administered malachite green or leucomalachite green. Rats given leucomalachite green also had apoptotic thyroid follicular epithelial cells. Decreased T4 and increased TSH levels were observed in male rats given leucomalachite green. A comparison of adverse effects suggests that exposure of rats or mice to leucomalachite green causes a greater number of and more severe changes than exposure to malachite green. N-Demethylated and N-oxidized malachite green and leucomalachite green metabolites, including primary arylamines, were detected by high performance liquid chromatography/mass spectrometry in the livers of treated rats. 32P-Postlabeling analyses indicated a single adduct or co-eluting adducts in the liver DNA. These data suggest that malachite green and leucomalachite green are metabolized to primary and secondary arylamines in the tissues of rodents and that these derivatives, following subsequent activation, may be responsible for the adverse effects associated with exposure to malachite green.

Aniline Compounds↗
PubMedDate not supplied

Localization of the sentinel lymph node in breast cancer by combined lymphoscintigraphy, blue dye and intraoperative gamma probe.

Axillary lymph node status represents the most important prognostic factor in patients with operable breast cancer. A severe limitation of this technique is the relatively high rate of false negative sentinel lymph nodes (>5%). We studied 284 patients suffering from breast cancer; 264 had T1 tumors (16 T1a, 37 T1b and 211 T1c), while 20 had T2 tumors. All patients underwent lymphoscintigraphy 18-h before surgery. At surgery, 0.5 mL of patent blue violet was injected subdermally, and the sentinel lymph node (SN) was searched by gamma probe and by the dye method. The surgically isolated SN was processed for intraoperative and delayed examinations. The SN was successfully identified by the combined radioisotopic procedure and patent blue dye technique in 278/284 cases (97.9%). Analysis of the predictive value of the SN in relation to the status of the axillary lymph nodes was limited to 191 patients undergoing standard axillary dissection irrespective of the SN status. Overall, 63/191 (33%) identified SNs were metastatic, the SN alone being involved in 37/63 (58.7%) patients; a positive axillary status with negative SN was found in 10/73 (13.7%) patients with metastatic involvement. In T1a-T1b patients the SN turned out to be metastatic in 9/53 patients (17.0%). In 7/9 patients the SN was the only site of metastasis, while in 2/9 patients other axillary lymph nodes were found to be metastatic in addition to the SN. None of the 44 patients in whom the SN proved to be non-metastatic showed any metastatic involvement of other axillary lymph nodes. Our results demonstrate a good predictive value of SN biopsy in patients with breast cancer; the predictive value was excellent in those subjects with nodules smaller than 1 cm.

Adult↗
PubMed1986

Coomassie brilliant blue G-250 dye-binding technique for determination of autolytic protein breakdown in Euglena gracilis and comparison to other methods of autolysis measurement.

The Coomassie brilliant blue G-250 dye-binding technique of M. M. Bradford (1976, Anal. Biochem. 72, 248-254) for protein quantification has been used to measure autolytic protein breakdown in cell-free extracts of Euglena gracilis. Specific autolysis rates were calculated from the difference between initial and actual absorbances at different incubation times of Coomassie brilliant blue-stained protein. They were found to depend linearly on time and initial protein concentration. Calibration against another method of protein determination is necessary due to different color yields with various protein mixtures. The high sensitivity and reproducibility of this method permit determination of specific autolysis rates below 0.1% mg-1 h-1 over a pH range between 3 and 8, without protein precipitation or pH adjustment, and in the presence of high amounts of amino acids and/or small peptides. Results obtained by this method are comparable to those of other autolysis measurements and to proteolytic activity determination by azocaseinolysis. Proteolytic autolysis has been observed in both the soluble and the particulate fractions of E. gracilis cell-free extracts, but displays different pH optima and specific activities in these fractions, as is also the case for azocaseinolysis. The method described is easy to perform, inexpensive, time saving, and should be applicable to other biological systems as well.

Animals↗
PubMedDate not supplied

Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling.

PURPOSE: To report the use of the dye brilliant blue G (BBG) for staining of the internal limiting membrane (ILM) during macular hole (MH) and epiretinal membrane (ERM) surgery. METHODS: This study was designed as an interventional, noncomparative, prospective, clinical case series. Twenty eyes from 20 consecutive patients with MH or ERM underwent BBG-assisted ILM and ERM removal. In MH cases, a posterior vitreous detachment was created, followed by the injection of 0.25 mg/mL BBG solution into the vitreous cavity and immediate washout of the BBG. This technique improved visualization of the ILM, enabling peeling and surgery to be performed successfully. However, in ERM cases, staining of the ERM could not be confirmed at this concentration. Finally, the ILM including the ERM was removed in all cases. Preoperative and postoperative ophthalmic examinations were performed. RESULTS: Postoperatively, 17 patients (85%) had visual acuity improved by at least 2 Snellen lines. No adverse effects were observed postoperatively during the observation period (mean follow-up +/- SD, 7.3 +/- 1.0 months). CONCLUSIONS: BBG selectively stains the ILM. This technique can facilitate the management of MH and ERM surgery without any adverse effects, as was shown in this short-term study.

Adult↗
PubMed1990

Eight-month longitudinal study of urinary excretion of albumin and tubular proteins in diabetic subjects.

To evaluate the importance of tubular proteinuria in diabetic nephropathy, we studied the serial changes of micro-albuminuria, microproteinuria and protein patterns by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) in 38 diabetic patients over 8 months. There was a significant correlation between the amount of micro-albuminuria measured by radio-immunoassay and the amount of microproteinuria quantitated by the Coomassie brilliant blue dye binding method (r = 0.976; p less than 0.0001). Micro-albuminuria of 50 mg/day was equivalent to microproteinuria of 190 mg/day. Among the 38 diabetic patients, 26 had micro-albuminuria above 50 mg/day, while 12 had micro-albuminuria below this level. There was a significant correlation between the amount of microproteinuria and haemoglobin A1, showing that the quantity of microproteinuria was affected by metabolic control. Diabetic patients with micro-albuminuria of above 50 mg/day have a significantly higher diastolic blood pressure than those below this level. Among the diabetic patients with micro-albuminuria of less than 50 mg/day, the amount of micro-albuminuria and microproteinuria remained constant, whereas progressive increases in micro-albuminuria and microproteinuria were observed among the 12 diabetic subjects with micro-albuminuria above 50 mg/day. These support the prognostic importance of this quantity of micro-albuminuria. The protein patterns as revealed by SDS-PAGE with Coomassie blue staining show a significant loss of low-molecular-weight proteins in 7 patients, which may therefore suggest tubular damage. The loss of tubular proteins persisted over a period of 8 months in all 7 subjects, and the amount gradually increased over this period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Bacteriological follow-up of pulmonary tuberculosis treatment: a study with a simple colorimetric assay.

The viability of Mycobacterium tuberculosis (MTB) in serial sputum specimens from persistently smear positive patients was evaluated. The assay was based on oxidation-reduction of Alamar Blue and Malachite Green dyes that change their color in response to MTB growth. A total of 280 sputum specimens from 40 persistently smear positive TB patients and 40 sputa from non-tuberculosis patients were digested, decontaminated and examined microscopically. To check the MTB viability, the sediments from decontaminated samples were inoculated into three culture media: Lowenstein-Jensen (LJ) slants, Alamar Blue and Malachite Green culture tubes. We found that out of 280 smear positive specimens, the LJ culture was positive in 124 (44%). The numbers of correctly identified S+/C+ cases by Alamar Blue and Malachite Green were 118 (95%) and 116 (93%), respectively. The mean time required for reporting the positive signal in Alamar Blue culture tubes was 9 versus 11 days by Malachite Green culture tubes. In the standard LJ culture media the average detection time was 27 days (P < 0.05). The sensitivity of LJ was 99%, Alamar Blue 95% and Malachite Green 93%. The specificity was 100%, 92% and 93%, respectively. The oxidation-reduction method is rapid, sensitive and inexpensive in monitoring the treatment response of patients with pulmonary TB. Thus, using this method can be of paramount importance, particularly in resource-constrained areas.

Antitubercular Agents↗
PubMed2002

Combined MR lymphangiography and MR imaging-guided needle localization of sentinel lymph nodes using Gadomer-17.

OBJECTIVE: The goals of our study were to determine the technical feasibility of dynamic MR lymphangiography for detecting sentinel lymph nodes using Gadomer-17 contrast material to compare these results to the clinically standardized blue dye contrast agent, and to show MR imaging-guided needle localization marking of the sentinel nodes. MATERIALS AND METHODS: Six anesthetized swine underwent MR imaging before and for 1 hr after interstitial injection of Gadomer-17 in the posterior tongue and intradermally in the stifle (knee). Using MR imaging guidance, we percutaneously placed a histology needle into the sentinel node or nodes. A standardized intraoperative sentinel node detection procedure was then performed using isosulfan blue contrast agent. Sentinel nodes identified on the MR images were compared with and matched to those identified by biopsy needle localization and the isosulfan blue contrast agent. RESULTS. Interstitial and intradermal injection of Gadomer-17 resulted in a lasting, increased MR signal in the regional lymph nodes. Seven sentinel nodes were identified in both the neck and the groin, with one pig showing two sentinel nodes in the neck and another showing two sentinel nodes in the groin. In all cases, the isosulfan blue contrast agent agreed with the location of the sentinel node determined by Gadomer-17 and marked with the needle. CONCLUSION: In this large animal model, dynamic MR angiography of sentinel lymph nodes is technically feasible using a contrast agent (Gadomer-17) and can be easily combined with MR imaging-guided needle localization.

Animals↗
PubMed2000

Feasibility of sentinel lymph node biopsy and lymphatic mapping in nodular thyroid neoplasms.

Although the prognostic significance of occult lymph node metastases in thyroid cancer remains controversial, identifying these patients may help direct therapy. The purpose of this study was to determine the feasibility and safety of sentinel lymph node biopsy (SLNBx) in thyroid nodular disease. Patients undergoing thyroid resection, with no evidence of clinical lymphadenopathy, were enrolled. The nodule was injected with isosulfan blue vital dye. Blue-stained lymphatic channels were traced within the central compartment to the SLN, which was excised. A total of 40 patients underwent SLNBx; lymphatics were seen in 31 patients, and SLNs were found in 26. In 11 patients the lymphatic vessels were traced through the central compartment into the lateral or mediastinal compartments, although a central SLN was retrieved in only 6. Of the 18 patients with benign neoplasms, 14 had benign SLNs, and no SLN was found in 4. A thyroid lymphoma patient had a true positive SLN. In the 12 patients with papillary thyroid cancer (PTC), 6 had true positive SLNs, and 2 had a true negative SLN. In one patient with metastatic PTC, the parathyroid stained blue. Another patient with PTC had lateral lymphatic channels, but no SLN was found. There were two false negatives, proven by a node dissection in one and lateral uptake on (131)I scanning in the other. There were no postoperative complications. SLNBx for thyroid disease is feasible and safe. Potential staining of the parathyroids makes their identification before injection mandatory. The variable lymphatic drainage patterns and the two false-negative nodes indicate that further investigation is required before the procedure can be recommended for patients with thyroid disease.

Adult↗
PubMed1990

A multipurpose solid-phase method for protein determination with Coomassie brilliant blue G-250.

The multipurpose method for protein determination (MMPD) is based in the Coomassie brilliant blue G-250 binding to immobilized and washed proteins in paper filter disks, and the A600 measurement of the eluted protein-dye complexes. The analysis requires 5-microliters samples, put in 7-mm paper filter disks, which can be stored for up to 2 weeks, without sensible changes in their protein content. The A600 is a logarithmic function of the log of bovine serum albumin quantity, between 2.5 and 250 micrograms with two linear segments used as standard curves: one between 2.5 to 20 micrograms and the other between 20 and 80 micrograms. Results with the MMPD were quantitatively comparable with those obtained with the method of Lowry et al., and those reported by other workers, assaying the following material: (i) bovine serum albumin, in doubly distilled water or in presence of several substances that interfere with the current methods; and (ii) total homogenates and their respective trichloroacetic acid-insoluble extracts, which were obtained from several phenol-rich vegetal specimens and complex animal products. The MMPD is proposed as an alternative for protein determination for its versatility and reliability, in both vegetal or animal products, especially when the analysis with traditional methods is made difficult by the presence of natural or added interfering substances and the sample volume is too small to discard them, or when the material must be stored for relatively long periods of time, prior to its processing.

Animals↗
PubMed2006

RT-PCR and immunohistochemical evaluation of sentinel lymph nodes after in vivo mapping with Patent Blue V in colon cancer patients.

OBJECTIVE: Lymph node status is the most important predictive factor in the treatment of colorectal cancer. As sentinel lymph node (SLN) biopsy might upstage stage II colon cancer, it could have therapeutic consequences in the future. We investigated the feasibility of in vivo SLN detection with Patent Blue V dye and evaluated nodal microstaging and ultrastaging using cytokeratin immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR). MATERIAL AND METHODS: In 30 consecutive patients operated on for colon cancer, subserosal injection with Patent Blue dye was used for SLN detection in four different hospitals under the supervision of one regional coordinator. In searching for occult micrometastases, each SLN was examined at three levels. In tumor-negative SLNs at routine hematoxylin-eosin (H&E) examination (pN0) we performed CK8/CK18 immunohistochemistry (IHC) and RT-PCR for carcinoembryonic antigen (CEA). RESULTS: The procedure was successful in 29 out of 30 patients (97%). The SLN was negative in 18 patients detected by H&E and IHC. In 16 patients the non-SLN was also negative, leading to a negative predictive value of 89% and an accuracy of 93%. Upstaging occurred in 10 patients (33%) - 7 by IHC and 3 by RT-PCR. Aberrant lymphatic drainage was seen in 3 patients (10%). CONCLUSIONS: The SLN concept in colon carcinoma using Patent Blue V is feasible and accurate. It leads to upstaging of nodal status in 33% of patients when IHC and PCR techniques are combined. Therefore, the clinical value of SLN should be the subject of further studies.

Aged↗
PubMed1997

Localizing the sentinel node in cutaneous melanoma: gamma probe detection versus blue dye.

BACKGROUND: Sentinel node (SN) biopsy can be used to select patients with melanoma for therapeutic lymphadenectomy. We investigated the value of two methods to locate the SN: patent blue dye (PBD) and gamma probe detection of 99mTc-nanocolloid. METHODS: One hundred ten patients with cutaneous melanoma were studied. Lymphoscintigraphy with 99mTc-nanocolloid was performed to determine the position of the SN. Before operation, PBD was injected at the same site as the radiopharmaceutical. When a blue node was identified intraoperatively, its radioactivity level was measured with the probe. In the absence of blue coloration, the probe was used to trace the SN. RESULTS: Scintigrams visualized a total of 219 SNs in 141 basins. Eight SNs were not explored. One SN was not found. The remaining 210 and 27 additional intraoperatively identified SNs were excised. From the total of 237 removed SNs, 200 (84%) were found using PBD only. All 37 nodes that were not found with the PBD were localized with the probe so that the probe combined with PBD identified 99.5% of all SNs. In 23 patients the SN contained tumor. In three patients the SN was false-negative for metastasis. CONCLUSION: The gamma probe together with PBD can identify more SNs (99.5%) than lymphatic mapping with PBD alone (84%).

Adolescent↗
PubMed1992

Quantifying proliferation of cultured human and rabbit airway smooth muscle cells in response to serum and platelet-derived growth factor.

Development of suitable methods for the quantification of the proliferative response of airway smooth muscle (ASM) cells in culture will assist the investigation of the cellular mechanisms underlying the hyperplasia and hypertrophy of ASM as seen in asthmatic airways. In this study, two rapid and simple colorimetric assays have been modified to enable the growth of human bronchial and rabbit tracheal smooth muscle in culture to be assessed. One method depends upon the reduction by living cells of the tetrazolium salt MTT to form a blue formazan product, whereas the other relies on rapid binding of the dye Coomassie brilliant blue to protein at acidic pH. Experiments demonstrated the validity of both assays in quantifying the proliferative response of cultured human and rabbit ASM cells. The increase in optical density observed for each assay correlated directly, throughout the duration of culture, with the increase in cell number determined by hemocytometry in human and rabbit ASM cells proliferating in response to fetal calf serum (1.25 to 10%). This relationship held also for rabbit tracheal ASM cells proliferating in response to the heterodimer of platelet-derived growth factor (1 to 50 ng/ml). Application of these methods to adherent proliferating cultures of human and rabbit ASM cells demonstrated their adaptability to the generation of growth curves in response to serum and to a defined growth factor. These methods allow both total cellular protein and proliferation to be estimated in human and rabbit ASM cells in culture, using assays that are rapid, reproducible, inexpensive, and easy to perform while negating the use of radioisotopes. It is intended that these additional methods should be useful in delineating some of the mechanisms that might contribute to the proliferative response of these cells--particularly since there has been a resurgence in interest in culturing smooth muscle cells derived from the airways.

Animals↗
PubMed2006

Ex vivo sentinel lymph node mapping in colon cancer: improving the accuracy of pathologic staging?

BACKGROUND: A subset of patients with colon cancer staged by conventional methods have occult micrometastases and do not receive adjuvant chemotherapy. Sentinel lymph node (SLN) mapping and staining by immunohistochemistry is a technique that may identify such occult micrometastases, thereby upstaging patients with positive findings. The purpose of this study was to determine whether ex vivo SLN mapping in colon cancer could be applied successfully to patients at our institution. METHODS: Seventeen patients with intraperitoneal colon tumors undergoing resection were studied prospectively. SLNs were identified as the first blue stained node(s) after ex vivo peritumoral injection of isosulfan blue dye. Additional lymph nodes were harvested and processed in accordance with standard pathologic evaluation for colon cancer. All nodes were examined after routine hematoxylin and eosin (H&E) staining. SLNs that were negative on H&E were analyzed further by multilevel sectioning and immunohistochemistry staining using anticytokeratin monoclonal antibody. RESULTS: Of the 17 study patients, SLNs were identified in 16 (94%) cases. The SLN was the only positive node in 3 patients. An identified SLN was positive (by H&E) in all patients with associated positive non-SLN nodes. The average number of nodes retrieved per patient was 16 (range, 4-54). Overall, SLNs accurately reflected the status of the entire lymph node basin in 16 (94%) patients. Two (12%) patients with negative nodes by H&E potentially were upstaged after further SLN analysis. The negative predictive value for SLN mapping was 89%. CONCLUSIONS: The ex vivo technique of SLN mapping for colon cancer is feasible. In the current study, SLN results were concordant with non-SLNs in the majority of patients. Furthermore, this technique may have upstaged 2 (12%) patients. Whether this ultimately will affect overall survival has yet to be determined.

Adenoma, Villous↗
PubMed2000

Marginal integrity of large compomer Class II restorations with cervical margins in dentine.

OBJECTIVES: The aim of the present study was to investigate the marginal integrity of total-bond Dyract AP restorations in large Class II restorations with cervical margins in dentine. The efficacy of a new non-rinse conditioner and the effect of beveling the enamel margins were also studied. METHODS: Large MOD cavities with cervical margins located 1mm below the CEJ were prepared in 48 extracted human molars. Six groups (n=8) were filled using a total-bond technique with Spectrum TPH or Dyract AP or a sandwich technique with Dyract in combination with Spectrum TPH. For Dyract AP total-bond restorations, a new non-rinse conditioner was tested vs. a total-etch with 36% phosphoric acid in beveled and butt-joint cavities. After water storage for 21 days and thermocycling (2000x, 5-55 degrees C), replicas were produced for quantitative marginal analysis in the SEM. Afterwards, teeth were immersed in 0.5% basic fuchsin for 24h and dried. Percent dye penetration over the total margin length was analysed in three layers using a sequential grinding technique. Statistical analysis was performed with non-parametric tests and the Bonferroni correction for multiple comparisons at p<0.05. RESULTS: All restoration types showed microleakage. On cervical margins in dentine, Dyract AP restorations showed better marginal adaptation than Spectrum TPH total-bond restorations (marginal openings (MO), median 33.8 vs. 79.6%), but were inferior to Dyract/Spectrum TPH sandwich restorations (MO: 0. 0%). The non-rinse conditioner improved the marginal adaptation of Dyract AP restorations in dentine (MO: 4.7 vs. 38.4%, p=0.0206 for beveled cavities, 12.2 vs. 33.8%, p=0.0238, for butt-joint cavities) and yielded similar results in enamel margins provided that enamel margins were beveled. Beveling of enamel significantly reduced the occurrence of enamel microcracks. CONCLUSIONS: The use of a non-rinse conditioner in combination with Dyract AP may improve the marginal adaptation of Class II restorations compared to composite restorations. The sandwich technique with Dyract results in better marginal adaptation in cervical dentine compared to all other restorative techniques tested in this study. However, microleakage cannot predictably be prevented with the sandwich technique.

Acid Etching, Dental↗
PubMed2005

Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27.

PURPOSE: Experience with sentinel node biopsy (SNB) after neoadjuvant chemotherapy is limited. We examined the feasibility and accuracy of this procedure within a randomized trial in patients treated with neoadjuvant chemotherapy. PATIENTS AND METHODS: During the conduct of National Surgical Adjuvant Breast and Bowel Project trial B-27, several participating surgeons attempted SNB before the required axillary dissection in 428 patients. All underwent lymphatic mapping and an attempt to identify and remove a sentinel node. Lymphatic mapping was performed with radioactive colloid (14.7%), with lymphazurin blue dye alone (29.9%), or with both (54.7%). RESULTS: Success rate for the identification and removal of a sentinel node was 84.8%. Success rate increased significantly with the use of radioisotope (87.6% to 88.9%) versus with the use of lymphazurin alone (78.1%, P = .03). There were no significant differences in success rate according to clinical tumor size, clinical nodal status, age, or calendar year of random assignment. Of 343 patients who had SNB and axillary dissection, the sentinel nodes were positive in 125 patients and were the only positive nodes in 70 patients (56.0%). Of the 218 patients with negative sentinel nodes, nonsentinel nodes were positive in 15 (false-negative rate, 10.7%; 15 of 140 patients). There were no significant differences in false-negative rate according to clinical patient and tumor characteristics, method of lymphatic mapping, or breast tumor response to chemotherapy. CONCLUSION: These results are comparable to those obtained from multicenter studies evaluating SNB before systemic therapy and suggest that the sentinel node concept is applicable following neoadjuvant chemotherapy.

Adult↗