Comparison Between Bioactive Fluoride Modified and Bioinert Anodically Oxidized Implant Surfaces in Early Bone Response Using Rabbit Tibia Model

PURPOSE:: The aim of this study was to investigate whether bioactive surfaces were more favorable to bone than bioinert surfaces by evaluating bone responses around two commercial dental implants.MATERIALS AND METHODS:: Bioactive fluoride-modified implants (Osseospeed) were compared with bioinert oxidized implants (TiUnite). Field emission scanning electron microscopy, energy dispersive spectroscopy, and confocal laser scanning microscopy analyzed the implant surface characteristics. Five New Zealand white rabbits were used to evaluate the bone response. Each rabbit received two implants: a fluoride-modified implant in one tibia and an oxidized implant in the other. Drilling was performed bicortically, and a gap defect was created in the upper cortexonly. Bone-to-implant contact and bone area were measured on the histological specimens 2 weeks after implant insertion.RESULTS:: No significant differences were found in surface roughness (P > 0.05). The gap defects were almost filled with new bone within a period of 2 weeks. The histomorphometry revealed no significant differences in bone-to-implant contact and bone area (P > 0.05).CONCLUSIONS:: Within the limitation of this study, the bioactive fluoride-modified surface may show no superiority to the bioinert anodized surface in early bone response.OAIID:oai:osos.snu.ac.kr:snu2012-01/102/2008003883/1SEQ:1PERF_CD:SNU2012-01EVAL_ITEM_CD:102USER_ID:2008003883ADJUST_YN:NEMP_ID:A078517DEPT_CD:861CITE_RATE:1.05FILENAME:Implant Dent 201204 21(2) 124-8.pdfDEPT_NM:치의학과EMAIL:[email protected]_YN:YCONFIRM:

Clinical characteristics and prognosis of Korean patients with hepatocellular carcinoma with respect to etiology

Background/Aim The profile of patients with hepatocellular carcinoma (HCC) has changed globally; the role of etiology in predicting prognosis of HCC patients remains unclear. We aimed to analyze the characteristics and prognosis of Korean patients with HCC according to disease etiology. Methods This retrospective observational study included patients diagnosed with HCC between 2010 and 2014 in a single center in Korea. Patients with HCC aged <19 years old, had coinfection with other viral hepatitis, had missing follow-up data, were Barcelona Clinic Liver Cancer stage D, or died before 1 month were excluded. Results A total of 1,595 patients with HCC were analyzed; they were classified into the hepatitis B virus (HBV) group (1,183 [74.2%]), hepatitis C virus (HCV) group (146 [9.2%]), and non-B non-C (NBNC) group (266 [16.7%]). The median overall survival of all patients was 74 months. The survival rates at 1, 3, and 5 years were 78.8%, 62.0% and 54.9% in the HBV group; 86.0%, 64.0%, and 48.6% in the HCV group; and 78.4%, 56.5%, and 45.9% in the NBNC group, respectively. NBNC-HCC has a poorer prognosis than other causes of HCC. Survival was significantly longer in the HBV group with early-stage HCC than in the NBNC group. Furthermore, survival was shorter in patients with early-stage HCC and diabetes mellitus (DM) than in those without DM. Conclusions The etiology of HCC affected clinical characteristics and prognosis to some extent. NBNC-HCC patients showed shorter overall survival than viral-related HCC patients. Additionally, the presence of DM is an additional important prognostic factor in patients with early-stage HCC

Current consensus and guidelines of contrast enhanced ultrasound for the characterization of focal liver lesions

The application of ultrasound contrast agents (UCAs) is considered essential when evaluating focal liver lesions (FLLs) using ultrasonography (US). Microbubble UCAs are easy to use and robust; their use poses no risk of nephrotoxicity and requires no ionizing radiation. The unique features of contrast enhanced US (CEUS) are not only noninvasiveness but also real-time assessing of liver perfusion throughout the vascular phases. The later feature has led to dramatic improvement in the diagnostic accuracy of US for detection and characterization of FLLs as well as the guidance to therapeutic procedures and evaluation of response to treatment. This article describes the current consensus and guidelines for the use of UCAs for the FLLs that are commonly encountered in US. After a brief description of the bases of different CEUS techniques, contrast-enhancement patterns of different types of benign and malignant FLLs and other clinical applications are described and discussed on the basis of our experience and the literature data

Discrimination of Nonalcoholic Steatohepatitis Using Transient Elastography in Patients with Nonalcoholic Fatty Liver Disease

<div><p>Background/aims</p><p>The accuracy of noninvasive markers to discriminate nonalcoholic steatohepatitis (NASH) is unsatisfactory. We investigated whether transient elastography (TE) could discriminate patients with NASH from those with nonalcoholic fatty liver disease (NAFLD).</p><p>Methods</p><p>The patients suspected of NAFLD who underwent liver biopsy and concomitant TE were recruited from five tertiary centers between November 2011 and December 2013.</p><p>Results</p><p>The study population (n = 183) exhibited a mean age of 40.6 years and male predominance (n = 111, 60.7%). Of the study participants, 89 (48.6%) had non-NASH and 94 (51.4%) had NASH. The controlled attenuation parameter (CAP) and liver stiffness (LS) were significantly correlated with the degrees of steatosis (r = 0.656, <i>P</i><0.001) and fibrosis (r = 0.714, <i>P</i><0.001), respectively. The optimal cut-off values for steatosis were 247 dB/m for S1, 280 dB/m for S2, and 300 dB/m for S3. Based on the independent predictors derived from multivariate analysis [<i>P</i> = 0.044, odds ratio (OR) 4.133, 95% confidence interval (CI) 1.037–16.470 for <u><i>C</i></u>AP>250 dB/m; <i>P</i> = 0.013, OR 3.399, 95% CI 1.295–8.291 for <u><i>L</i></u>S>7.0 kPa; and <i>P</i><0.001, OR 7.557, 95% CI 2.997–19.059 for <u><i>A</i></u>lanine aminotransferase>60 IU/L], we developed a novel CLA model for discriminating patients with NASH. The CLA model showed good discriminatory capability, with an area under the receiver operating characteristic curve (AUROC) of 0.812 (95% CI 0.724–0.880). To assess discriminatory power, the AUROCs, as determined by the bootstrap method, remained largely unchanged between iterations, with an average value of 0.833 (95% CI 0.740–0.893).</p><p>Conclusion</p><p>This novel TE-based CLA model showed acceptable accuracy in discriminating NASH from simple steatosis. However, further studies are required for external validation.</p></div

The Influence of Histologic Inflammation on the Improvement of Liver Stiffness Values Over 1 and 3 Years

Background: Transient elastography is now an indispensable tool for estimating liver fibrosis. Although many clinical factors other than fibrosis itself are known to affect liver stiffness (LS) values, it is still not yet clear what factors are related to improving LS values. The aim of this study was to find out how baseline histologic inflammation influences LS values and how much this inflammation affects improvement in LS values over time, regardless of actual fibrosis content. Methods: This retrospective study included 678 consecutive patients who underwent liver biopsy and sequential LS assessment from 2006 to 2015 at six tertiary hospitals in Korea. Linear regression analysis was used to evaluate how improvement of LS value can be associated with other factors besides fibrosis content. Results: Basal LS values increased with increasing inflammation in the same fibrosis stage. Degree of inflammation influenced the baseline LS value in a proportional manner (beta coefficient (BE), 6.476; 95% confidence interval (CI), 2.24&ndash;10.72; p = 0.003). Moreover, histologic inflammation affected the change in LS value significantly. Higher inflammation grade at baseline was a significant predictor for an improvement in LS value, regardless of the fibrosis stage (BE, &minus;8.581; 95% CI, &minus;15.715&ndash;&minus;1.447; p = 0.019). In a subgroup analysis of patients who received repeated liver biopsies, the results showed a similar tendency. Conclusions: The LS value is affected by the degree of inflammation even at a low ALT level. Furthermore, baseline histologic inflammation has a significant impact on the improvement of LS values over time. Therefore, baseline inflammation should be taken into consideration when interpreting an improvement in LS value

Diagnostic performance of LS for assessing liver fibrosis in patients with NAFLD

<p>Diagnostic performance of LS for assessing liver fibrosis in patients with NAFLD</p

The distribution of LS and CAP values according to histologic fibrosis and steatosis grade.

<p>The bar lines mean the range of each grade of steatosis and fibrosis. LS, liver stiffness; CAP, controlled attenuation parameter.</p