\u201cA randomised factorial trial of sequential doxorubicin and CMF vs CMF and chemotherapy alone vs chemotherapy followed by goserelin plus tamoxifen as adjuvant treatment of node-positive breast cancer\u201d

The sequential doxorubicin \u2192 CMF (CMF = cyclophosphamide, methotrexate, fluorouracil) regimen has never been compared to CMF in a randomised trial. The role of adding goserelin and tamoxifen after chemotherapy is unclear. In all, 466 premenopausal node-positive patients were randomised to: (a) CMF 7 6 cycles (CMF); (b) doxorubicin 7 4 cycles followed by CMF 7 6 cycles (A \u2192 CMF); (c) CMF 7 6 cycles followed by goserelin plus tamoxifen 7 2 years (CMF \u2192 GT); and (d) doxorubicin 7 4 cycles followed by CMF 7 6 cycles followed by goserelin plus tamoxifen 7 2 years (A \u2192 CMF \u2192 GT). The study used a 2 7 2 factorial experimental design to assess: (1) the effect of the chemotherapy regimens (CMF vs A 7 CMF or arms a + c vs b + d) and (2) the effect of adding GT after chemotherapy (arms a + b vs c + d). At a median follow-up of 72 months, A \u2192 CMF as compared to CMF significantly improved disease-free survival (DFS) with a multivariate hazard ratio (HR) = 0.740 (95% confidence interval (CI): 0.556-0.986; P = 0.040) and produced a nonsignificant improvement of overall survival (OS) (HR = 0.764; 95% CI: 0.489-1.193). The addition of GT after chemotherapy significantly improved DFS (HR = 0.74; 95% CI: 0.555-0.987; P = 0.040), with a nonsignificant improvement of OS (HR = 0.84; 95% CI: 0.54-1.32). A \u2192 CMF is superior to CMF. Adding GT after chemotherapy is beneficial for premenopausal node-positive patients. \ua9 2005 Cancer Research UK

Evaluation of factors influencing resonance frequency analysis values, at insertion surgery, of implants placed in sinus-augmented and nongrafted sites

BACKGROUND: The immediate loading technique requires a high primary stability. Resonance frequency analysis (RFA) has been proposed to assess this stability with a quantitative method. PURPOSE: The aim of the present study was to evaluate if a good primary stability could be achieved in sites that had undergone a sinus augmentation procedure and also to evaluate the importance of different clinical factors in the determination of resonance frequency values at implant insertion. MATERIALS AND METHODS: In 14 patients, 80 implants were inserted. Sixty-three implants were inserted in a site previously treated with a sinus augmentation procedure, while 17 implants were inserted in healed or postextraction sites. For each implant, diameter, length, bone density, insertion torque, RFA value, and percentage of implant fixed to a nongrafted bone were recorded. RESULTS: Grafted sites showed high RFA values. A statistically significant positive correlation was found between resonance frequency values and implant diameter (p=0.007), implant length (p=0.02), diameter of the last bur used (p=0.01). No statistically significant correlation between RFA values and all the other variables considered was found. CONCLUSIONS: Sites treated with sinus augmentation procedures can offer good primary stability after 6 months of healing. The length and diameter of the implants, together with the geometry of the implant used, are important to obtain high RFA values

Failure after closed traction of an unerupted maxillary permanent canine: Diagnosis and treatment planning

This report describes the treatment of a 13-year-old girl with unerupted maxillary permanent canines. It illustrates how recognizing an unexpected problem influenced the decision-making process. Despite 6 months of closed- eruption traction, the left canine had not erupted. However, the neighboring teeth were intruded, suggesting a diagnosis of canine ankylosis. When the site was surgically reopened, the wire chain used for the orthodontic traction appeared to be osseointegrated. It was renewed, and traction was applied for another 16 months, and the tooth was successfully brought into the arch. Bone tissue passing through the chain might have prevented forced eruption. In young patients with unerupted maxillary permanent canines, failure of closed traction can be attributed to ankylosis, and this accounts for tooth extraction as the treatment of choice. However, this clinical report suggests that additional measures might be warranted before the definitive diagnosis of ankylosis can be made and the tooth extracted

Gingival recession and toothbrushing in an Italian School of Dentistry: A pilot study

The aim of this pilot study was to evaluate the prevalence of gingival recession at buccal tooth surfaces in a student population of Bologna University Dental School. A total of 55 subjects, attending the 1st and 5th year of the course were examined. The clinical examination involved assessment of plaque, calculus, width of keratinized gingiva, buccal probing depth and buccal gingival recession. Information about toothbrushing behavior was collected in an interview. The multiple regression analysis showed that level of education (p=0.002), toothbrushing technique (p=0.013) and toothbrushing frequency (p=0.016) are significant contributors to gingival recession. Notwithstanding the limits of a preliminary study, a higher prevalence of buccal recession is observed in the final year students, which have also a significantly lower % of buccal surfaces with calculus (p=0.014). In addition, it clearly appears that there is the necessity to investigate other factors connected with toothbrushing (pressure, time, toothpaste quantity) in order to provide an oral hygiene education without undesired effects. © Munksgaard, 1999

Role of reactive oxygen species as signal molecules in the pre-commitment phase of adult stem cells.

This mini-review summarizes evidence, provided by our group, relevant to the understanding of how redox signalling may control the fate of adult hematopoietic stem/progenitor cells (HSPCs). In particular it is shown that bone marrow-derived human HSPC are endowed with a composite panel of constitutively active NADPH-oxidases (NOXs) comprising the cell membrane-localized catalytic subunits of the NOX1, NOX2 and NOX4 isoforms. It is proposed that the coordinated activity of the NOX isoforms in HSPCs function as environmental oxygen sensor and generate low level of ROS, which likely serve as second messengers. The pro-oxidant setting, entering into play when HSPCs leave the hypoxic bone marrow niche, would enable them to be more responsive to proliferative/differentiative stimuli. Moreover it is suggested that enhanced ROS elicit mitochondrial "differentiation" in a pre-commitment phase needed to match the bioenergetic request in the oncoming proliferation/differentiation process