The impact of tertiary Gleason pattern 5 in the grade group system on recurrence following radical prostatectomy in patients with prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 44-44
Author(s):  
Masashi Kato ◽  
Toyonori Tsuzuki ◽  
Ryo Ishida ◽  
Tohru Kimura ◽  
Osamu Kamihira ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Grade Group ◽  
Group System ◽  
Gleason Pattern ◽  
Group 4 ◽  
Significant Difference ◽  
Psa Progression ◽  
Group 3 ◽  
Group 2

44 Background: The current ISUP/WHO grade group system classified the Gleason grade into five groups. Although presence of tertiary Gleason pattern 5 (tG5) reported to be related with unfavorable tumor characteristic, only a few data is available about influences on the grade group system of tG5 so far. In this study, we evaluated the effect of tG5 on recurrence following radical prostatectomy in patients with prostate cancer. Methods: We retrospectively evaluated 1,020 patients with prostate cancer who underwent radical prostatectomy without neoadjuvant therapy at the hospitals that the authors were affiliated with between 2005 and 2013. After excluding the patients with missing data or slides, 1000 patients were enrolled in this study. All prostatectomy specimen slides were reviewed by a single genitourinary pathologist according to ISUP 2014. Recurrence following radical prostatectomy was defined according to European Association of Urology guidelines. The endpoint was defined as an increase in PSA level. Results: Patient median age was 67 years (range 49–77 years). The median serum PSA was 6.9 ng/mL (range 0.4–82 ng/mL). The median follow-up period was 69 months (range 0.7–134 months). All the patients showed Group1:163 cases (16.3%), Group2: 436 (43.6%), Group 2 with tG5: 54 (5.4%), Group 3:121 (12.1%), Group 3 with tG5: 89 (8.9%), Group 4: 39 (3.9%), and Group 5: 98 (9.8%). PSA progression-free survival was significantly different among the five groups (Group1-5) (p = 0.0001). As concerning tG5, it showed significant difference between Group 2 and Group 2 with tG5 by using log rank test (p < 0.0001). Similarly, there was significant difference between Group 3 and Group 3 with tG5 (p = 0.001). On the other hand, there was no difference between Group 2 with tG5 and Group 3 (p = 0.916), and in the same way, no difference between Group 3 with tG5 and Group 4 (p = 0.854). Conclusions: The Presence of tG5 on the grade group system increase PSA progression following radical prostatectomy in patients with prostate cancer. Especially, Group 2 and 3 showed upgrade by presence of tG5. Integrating tG5 into the grade group system will improve the accuracy of patient outcome predictions.

The impact of intraductal carcinoma of the prostate on the grade group system.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 34-34
Author(s):  
Masashi Kato ◽  
Akiyuki Yamamoto ◽  
Ryo Ishida ◽  
Tohru Kimura ◽  
Tomoyasu Sano ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Surgical Margin ◽  
Grade Group ◽  
Group System ◽  
Carcinoma Of The Prostate ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2

34 Background: The 2014 International Society of Urological Pathology (ISUP) and WHO 2016 classifications proposed a new grade group system for prostate cancer. Intraductal carcinoma of the prostate (IDC-P) is newly recognized on them and is reported to be strongly associated with high-grade and high-volume invasive prostate cancer. Although the presence of the IDC-P influences biochemical failure in radical prostatectomy patients, no data are available regarding the significance of IDC-P in integrating to the classification grade group system. The aim of this study is to enhance the utility of grade group system integrating into the presence of IDC-P. Methods: We retrospectively evaluated 1019 patients with prostate cancer who underwent radical prostatectomy without neoadjuvant or adjuvant therapy at the hospitals that the authors were affiliated with between 2005 and 2013. Data on age, PSA level at diagnosis, clinical T stage (cT), pathological T stage (pT), presence of Gleason pattern 5 (GP5), presence of IDC-P, and surgical margin status were analyzed to predict PSA recurrence after prostatectomy. Results: The median patient age was 67 (range, 45–80) years. The median initial PSA was 6.8 ng/ml (range, 0.4–82 ng/ml). The median follow-up period was 82 (range, 0.7–148) months. IDC-P was detected in 157 patients (15.4%). Among these patients, IDC-P positive rate increased correlated with upgrading. The grade group were as follows: Group 1 without IDC-P, 16.0% (n=163); Group 2 without IDC-P, 46.1% (n=470); Group 3 without IDC-P, 15.7% (n=160); Group 4 without IDC-P, 2.6% (n=27); and Group 5 without IDC-P, 4.1% (n=42); Group 2 with IDC-P, 2.9% (n=29); Group 345 with IDC-P, 12.6% [n=128; Group 3 (n=60); Group 4 (n=13); Group 5 (n=55)] Group 3, 4, and 5 with IDC-P showed a significantly worse prognosis than any other groups without IDC-P and Group 2 with IDC-P (p<.0001). In a multivariate analysis, integrating IDC-P into ISUP Grade, PSA level at diagnosis, and surgical margin status significantly predicted the prognosis (P < .0001). Conclusions: Integrating the presence of IDC-P into the grade group system will improve the accuracy of patients’ outcome prediction.

The impact of Gleason pattern 4 ratio on recurrence following radical prostatectomy in Japanese patients with prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 114-114
Author(s):  
Masashi Kato
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Japanese Patients ◽  
Gleason Grade ◽  
Gleason Pattern ◽  
Significant Difference ◽  
Psa Progression ◽  
The Impact

114 Background: The 2014 International Society of Urological Pathology (ISUP) classified the Gleason grade into five groups and the Gleason score (GS) 7 was divided into groups 2 (GS3+4) and 3 (GS4+3). The ISUP recommended recording the Gleason pattern (GP) 4 ratio. However, no data are available on Japanese patients, and no studies have reported any difference between GS3+3 and a part of GS3+4. In this study, we evaluated the effect of the GP 4 ratio on recurrence following radical prostatectomy in Japanese patients with prostate cancer and revealed the equivalent between GS3+3 and part of GS3+4. Methods: We retrospectively evaluated 1,000 patients with prostate cancer who underwent radical prostatectomy at the author’s affiliated hospitals between 2005 and 2013. All prostatectomy specimen slides were reviewed by a single genitourinary pathologist according to ISUP 2014. Recurrence following radical prostatectomy was defined according to American Urological Association guidelines. The endpoint was defined as an increase in prostate-specific antigen (PSA) level. Results: Median patient age was 67 years (range, 42–77 years). Median serum PSA level was 6.8 ng/mL (range, 0.4–82 ng/mL). Median follow-up period was 59 months (range, 0.2–134 months). PSA progression was observed in 13.9% of pT2, 39.5% of pT3a, and 59.5% of pT3b. There were 164 group 1 cases (GS6), 484 group 2 (GS3+4), 212 group 3 (GS4+3), 39 group 4 (GS8), and 95 group 5 (GS9–10) cases. PSA progression-free survival was significantly different among the five groups (log rank; P = 0.0001). A significant difference was observed among the four groups with regard to the proportion by which the GP4 ratio increased (P = 0.0001) when groups 2 and 3 were divided by the GP4 ratio ( < 20%, 236 cases; 20–50%, 240 cases; 51–80%, 188 cases; and 81–100%, 17 cases). On the other hand, no difference was detected between GS3+3 and GS3+4 (GS4 < 20%) (P = 0.481). Conclusions: An increase in the GP4 ratio was correlated with PSA progression following radical prostatectomy in Japanese patients with prostate cancer. In addition, no difference was observed between GS3+3 and GS3+4 (GP4 < 20%), and GS3+4 (GP4 < 20%) patients may be an indication for active surveillance.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Prognostic impact of different Gleason patterns within grade group 4 prostate cancer in radical prostatectomy specimens

2021 ◽  
Vol 79 ◽  
pp. S1548-S1549
Author(s):  
K. Mori ◽  
V. Sharma ◽  
E.M. Comperat ◽  
E. Laukhtina ◽  
V.M. Schuettfort ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prognostic Impact ◽  
Grade Group ◽  
Group 4

scholarly journals Microleakage beneath Ceramic and Metal Brackets Bonded with a Conventional and an Antibacterial Adhesive System

2006 ◽  
Vol 76 (6) ◽  
pp. 1028-1034 ◽  
Author(s):  
Neslihan Arhun ◽  
Ayca Arman ◽  
Sevi Burçak Çehreli ◽  
Serdar Arıkan ◽  
Erdem Karabulut ◽  
...  
Keyword(s):  
Adhesive System ◽  
White Spot Lesions ◽  
Adhesive Interface ◽  
Group 4 ◽  
Significant Difference ◽  
Ceramic Brackets ◽  
Group 3 ◽  
Group 2 ◽  
Ceramic Bracket ◽  
Nail Varnish

Abstract Objective: To assess microleakage of a tooth-adhesive-bracket complex when metal or ceramic brackets were bonded with a conventional and an antibacterial self-etching adhesive. Materials and Methods: Forty freshly extracted human premolars were randomly assigned to four equal groups and received the following treatments: group 1 = Transbond XT + metal bracket, group 2 = Transbond XT + ceramic bracket, group 3 = Clearfil Protect Bond + ceramic bracket, and group 4 = Clearfil Protect Bond + metal bracket. After photopolymerization, the teeth were kept in distilled water for 1 month and thereafter subjected to thermal cycling (500 cycles). Specimens were further sealed with nail varnish, stained with 0.5% basic fuchsin for 24 hours, sectioned and examined under a stereomicroscope, and scored for marginal microleakage for the adhesive-tooth and bracket-adhesive interfaces from incisal and gingival margins. Statistical analysis was accomplished by Kruskal-Wallis test and Mann-Whitney U-test with Bonferroni correction. Results: All groups demonstrated microleakage between the adhesive-enamel and bracket-adhesive interfaces. A significant difference was observed among all groups (P &lt; .05) for the microleakage between the bracket-adhesive interface. Metal brackets exhibited significantly more microleakage than did ceramic brackets between the bracket-adhesive interface with either of the adhesives. Clearfil Protect Bond exhibited results similar to Transbond XT. Clearfil Protect Bond may be a choice of adhesive in bracket bonding because of its antibacterial activity and similar microleakage results with the orthodontic adhesive. Conclusions: Metal brackets cause more leakage between an adhesive-bracket interface, which may lead to lower clinical shear bond strength and white-spot lesions.

scholarly journals Comparative evaluation of postoperative pain intensity after single-visit and multiple-visit retreatment cases: a prospective randomized clinical trial

2018 ◽  
Vol 21 (1) ◽  
pp. 26 ◽  
Author(s):  
Hatice Miray Uyan ◽  
Keziban Olcay ◽  
Mutlu Özcan
Keyword(s):  
Postoperative Pain ◽  
Repeated Measures ◽  
Control Group ◽  
Periapical Lesions ◽  
Single Visit ◽  
Group 4 ◽  
Multiple Visit ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

<p><strong>Objective:</strong> This study was designed to evaluate postoperative pain after endodontic retreatment. <strong>Material and Methods:</strong> Asymptomatic, multi-rooted molar &amp; premolar teeth requiring retreatment with 2–5 mm periapical lesions were included. Seventy-eight teeth were randomly placed in four groups (n=20): single-visit (control, group 1), Ledermix (group 2), metronidazole, ciprofloxacin, minocycline mixture (group 3), calcium hydroxide (group 4). The postoperative pain was recorded using a VAS at 6, 12, 24, and 48 h after retreatment. Statistical evaluation was performed using Two-Way Repeated Measures ANOVA and Tukey test. <strong>Results:</strong> Mild pain occurred in 67.5%, moderate in 30%, and flare-ups in 2.5%, and there was a significant difference between the groups (p&lt;0.01). Significantly lower postoperative pain was observed in TAP and CaOH<sub>2 </sub>groups(p&lt;0.05). In the 6, 12, and 24 h intervals, there was a significant difference in the pain levels (p&lt;0.05). <strong>Conclusion:</strong> TAP and CaOH<sub>2</sub> are effective for reducing postoperative pain after retreatment.</p><p><strong>Keywords</strong></p><p>Intracanal medicaments; Multiple-visit; Postoperative pain; Retreatment; Single-visit.</p>

In vivosilymarin’s antioxidant and anti-apoptotic effects on photodynamic therapy’s responsiveness

2017 ◽  
Vol 21 (03) ◽  
pp. 189-197 ◽  
Author(s):  
Vlad Dionisie ◽  
Simona Clichici ◽  
Rodica M. Ion ◽  
Oana O. Danila ◽  
Remus Moldovan ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Reactive Oxygen Species Generation ◽  
Group 4 ◽  
Significant Difference ◽  
Anti Oxidant ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Apoptotic Effects ◽  
Oxidant Effect

Several studies have shown that some anti-oxidant natural compounds in combination with photodynamic therapy (PDT) can enhance the effectiveness of treatment. The aim of this study is to evaluate the effect of silymarin (SIL) in combination with 5,10,15,20-tetra-sulphonato-phenyl-porphyrin (TSPP) based photodynamic therapy, on experimental tumors. 30 Wistar rats with Walker carcinosarcoma, were divided into 6 groups: group 0 (control) — control, untreated group; group 1 (TSPP) — one dose of TSPP; group 2 (SIL) — silymarin; group 3 (PDT) — TSPP and irradiation 24 h after; group 4 (SIL[Formula: see text]PDT) — silymarin, TSPP and irradiation 24 h after; group 5 (SIL[Formula: see text]IR) and group 6 (IR) — irradiation and in addition, group 5 received SIL. Silymarin administered before photodynamic therapy decreased the lipid peroxidation ([Formula: see text] < 0.05) and modulated the antioxidant defense in tumor treated with PDT and silymarin suggesting that silymarin administration along with photodynamic therapy has an anti-oxidant effect. The caspase — 8 level and -3 activity increased in PDT and PDT [Formula: see text] SIL groups compared to the control; between the two groups there was a significant difference in term of apoptosis in favor to PDT. In conclusion, silymarin administration inhibited the reactive oxygen species generation and reduced the tumoral cells’ apoptosis, suggesting that natural compound administered before photodynamic therapy did not improve the therapy’s effect.

Efficacy of Double Manual Cleaning Versus Automated Cleaning for Removal of Biofilm of Hinged Surgical Instruments

2020 ◽  
Vol 41 (S1) ◽  
pp. s518-s519
Author(s):  
Dayane Costa ◽  
Roel Castillo ◽  
Lillian Kelly Lopes ◽  
Anaclara Tipple ◽  
Honghua Hu ◽  
...  
Keyword(s):  
Protein Level ◽  
Positive Control ◽  
Surgical Instruments ◽  
Microbial Load ◽  
Positive Control Group ◽  
Control Group ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

Objectives: To evaluate the efficacy of double manual cleaning (DMC) with enzymatic followed by alkaline detergent for removing biofilm on hinged surgical instruments compared to automated cleaning by the washer-disinfector. Methods: Biofilm of Staphylococcus aureus (ATCC 25923) was formed in vitro on hemostatic forceps (Fig. 1). Biofilm-covered forceps were rinsed in distilled water and subjected to one of the following cleaning regimes (n = 5 forceps each): Group 1 forceps were soaked in sterile water for 5 minutes. Group 2-DMC forceps were soaked in enzymatic detergent, brushed 5 times on each face, rinsed with filtrated water (0.2 µm), soaked in alkaline detergent, brushed 5 times each face, rinsed with filtrated water (0.2 µm), and dried with sterile cloth. For group 3-DMC plus hinge inner brushing (n = 5), the forceps were soaked in detergents and brushed as in group 2, including hinge inner brushing (2-mm lumen brush) (Fig. 1). In group 4 (automated cleaning in a washer/disinfector), forceps were prewashed, washed once, washed again, rinsed, thermally rinsed, and dried. After the treatments, forceps were evaluated for microbial load (counting of colony-forming units), residual protein (BCA protein assay kit), and biofilm (scanning electron microscopy). Results: There was no statistically significant differences between the microbial load and protein level contaminating the forceps subjected to DMC (group 2) and the positive control group. The DMC with hinge inner brushing group (group 3) and the automated cleaning group (group 4) demonstrated a significantly reduced microbial load: reduction averages of 2.8 log 10 (P = .038) and 7.6 log10 (P ≤ .001), respectively. The protein level remaining on the forceps also significantly decreased: 2.563 μg (P = .016) and 1,453 μg (P = .001), respectively, compared to the positive control group. There was no statistically significant difference between DMC with hinge inner brushing and automated cleaning (groups 3 and 4) for all of the tests performed. None of the cleaning methods completely removed biofilm and/or soil from the forceps hinge internal region (Fig. 1). Conclusions: Automated cleaning had the best efficacy for removing biofilm. However, DMC with hinge inner brushing was an acceptable alternative cleaning method for sterilizing service units with only manual cleaning available, as is the case in most low- and middle-income countries. Neither automated nor any manual cleaning regimes were able to completely remove biofilm and soil from the forceps hinged area, and the amount of protein left after automated and DMC plus hinge brushing was higher than the recommended. Cleaning is the most important step for the reprocessing of reusable medical devices; thus, efforts must be undertaken to improve cleaning in different social and economic realities and scenarios.Funding: This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES.Disclosures: None

scholarly journals Effect of Different Finishing and Polishing Methods for Color Stability of the E-Max Dental Ceramics: In vitro Study

2021 ◽  
Vol 14 (4) ◽  
pp. 1508-1513
Author(s):  
Ibraheem F Alshiddi
Keyword(s):  
Surface Brightness ◽  
Color Stability ◽  
Color Measurement ◽  
Control Group ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In order to assess the influence of finishing and polishing on the surface brightness and color stability of the ceramic veneer, fifty specimens were fabricated with 10 mm diameter and 2 mm thickness using IPS E-Max Ceramic. After glazing, 10 specimens were untouched as control group, and the other 40 specimens were abraded using 125µm diamond bur to create surface roughness. Forty specimens were divided into four groups (n=10), in group 1: specimens were finished using diamond point, in group 2 specimens’ surface was polished with a polishing kit, Group 3: Each specimen surface was polished with the polishing kit as in protocol 2 and was polished a polishing past and group 4 Each specimen was glazed by heating at 621℃ for 3 minutes followed by a temperature increase of 83℃/min up to 918℃ for 30 seconds. Color measurement was performed using spectrophotometer. Color stability data were analyzed using two-way ANOVA and Tukey’s HSD test (α=0.05). For Ra values, paired-samples t-tests were used to analyze the data and compare groups. The change in L and E showed a significant difference among the study groups; (group 1, group 2, group 3 and group 4) with respect to three variables L, a and b. A significant difference was noted when compared each group with the control; however, only group 2 showed a significant difference from group 4; the remaining groups demonstrated similar findings for all three variables. The study displayed a significant impact of the finishing and polishing technique on the surface brightness and color stability of ceramic restoration. However, it was evident that combination of two or three polishing techniques which includes polish kit and glaze enhances the surface finish and adds color stability by alternating the yellow – blue axis (increase in b) and red- green axis (decrease in a).

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