The osteogenic effects of mineral trioxide aggregate and modified mineral trioxide aggregate on normal human osteoblast cells in vitro

Thesis (MSD)--Boston University, Goldman School of Dental Medicine, 2008 (Dept. of Restorative Sciences/Biomaterials).Includes bibliographical references: leaves 110-123.The aim of this study was to investigate, on normal human osteoblast cells, the osteogenic effects of a synthetic Mineral Trioxide Aggregate (SMTA), SMTA+20% silicon, SMTA+40% silicon, SMTA+20% bioactive inorganic element (BIE) and SMTA+40% BIE. The materials were mixed and incubated 24 hours prior to testing in 24 wells plates. Osteoblasts were obtained from culturing bone chips from eight healthy patients, then seeded at a density of 1.5×10[5] cells on each well. Cells grown alone on the wells served as a control. Crystal violet dye was used to measure cell attachment efficiency and proliferation rate at 16h, 12 and 20 days. SEM examination was done at 12 days, using the SMTA and SMTA-Silicon 40% samples, with and without cells. Osteocalcin levels were measured by immunoradiometric assay at 12 and 20 days. The data were statistically analyzed with an analysis of variance (ANOVA) and post-hoc testing compared means by treatment group. The overall proliferation results showed that both the SMTA-BIE40% and the SMTA-Si40% groups had a higher cell attachment efficiency compared to the SMTA and the control groups (P[less than]0.05). The control group had a higher level of osteocalcin than the SMTA-BIE20%, SMTA-Si20% and SMTA-Si40% (p[less than]0.05). There was no significant difference in osteocalcin levels between the control group and the SMTA and SMTA-BIE40% groups. The SEM examination showed cell attachment on both SMTA and SMTA-Si40% samples. As a conclusion, modified MTA with addition of 40% BIE could promote the proliferation of normal human osteoblast cells in vitro. Supported by BU Department of Biomaterials

Impact of microsatellite status in early-onset colonic cancer

Background The molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status. Methods Anonymized data from an international collaboration were analysed. Criteria for inclusion were patients younger than 50 years diagnosed with stage I-III colonic cancer that was surgically resected. Clinicopathological features, microsatellite status, and disease-specific outcomes were evaluated. Results A total of 650 patients fulfilled the criteria for inclusion. Microsatellite instability (MSI) was identified in 170 (26.2 per cent), whereas 480 had microsatellite-stable (MSS) tumours (relative risk of MSI 2.5 compared with older patients). MSI was associated with a family history of colorectal cancer and lesions in the proximal colon. The proportions with pathological node-positive disease (45.9 versus 45.6 per cent; P = 1.000) and tumour budding (20.3 versus 20.5 per cent; P = 1.000) were similar in the two groups. Patients with MSI tumours were more likely to have BRAF (22.5 versus 6.9 per cent; P < 0.001) and KRAS (40.0 versus 24.2 per cent; P = 0.006) mutations, and a hereditary cancer syndrome (30.0 versus 5.0 per cent; P < 0.001; relative risk 6). Five-year disease-free survival rates in the MSI group were 95.0, 92.0, and 80.0 per cent for patients with stage I, II, and III tumours, compared with 88.0, 88.0, and 65.0 per cent in the MSS group (P = 0.753, P = 0.487, and P = 0.105 respectively). Conclusion Patients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers. Data on 650 patients aged less than 50 years diagnosed with stage I-III colonic cancer and undergoing surgery with curative intent were collected, and the impact of microsatellite instability (MSI) on clinicopathological features and disease-specific outcomes was assessed. Patients with early-onset disease had a high risk of MSI and defined genetic conditions. Those with MSI tumours had more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (&lt;50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, &lt;50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

Le développement touristique de l'Alpe-d'Huez

Barussaud Marie. Le développement touristique de l'Alpe-d'Huez . In: Revue de géographie alpine, tome 49, n°2, 1961. pp. 275-292

How can we improve our practices in obstetric anal sphincter injury prevention, diagnosis, and management of symptomatic women?

International audienceObstetric anal sphincter injury (OASI) is strongly associated with a major negative impact on women’s health. Due to the consequences of an undiagnosed and therefore unrepaired OASI, it is essential to prevent or at least diagnose OASI at childbirth. We need to promote training of professionals to improve OASI screening at childbirth. High-risk situations such as operative delivery must be identified and preventive strategies such as the choice of a less traumatic instrument (vacuum) and mediolateral episiotomy should be considered. For a woman with OASI and/or symptoms, postnatal consultation with a specialist on pelvic floor disorders is essential to correctly orient her toward an adequate care pathway and to eventually identify occult or underestimated OASI. More data are required on therapeutic approaches for symptomatic women, primarily including physical therapy, sacral neuromodulation, delayed sphincter repair and palliative devices

To Drain or Not to Drain Infraperitoneal Anastomosis After Rectal Excision for Cancer

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Sacral neuromodulation with the interstim tm system for faecal incontinence: results from a prospective french multicentre observational study

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Sacral neuromodulation with the interstim tm system for faecal incontinence: results from a prospective french multicentre observational study

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