Patient-reported outcomes after surgery or radiotherapy for localised prostate cancer: a retrospective study.

INTRODUCTION: To compare the intermediate-term outcomes and patient-reported outcomes of robot-assisted laparoscopic prostatectomy (RALP) and radical external beam radiotherapy (RT) in Chinese patients with localised prostate cancer. METHODS: This was a retrospective study of patients with localised prostate cancer diagnosed between 2010 and 2011 and treated with either RALP or RT. Baseline patient and disease characteristics, post-treatment complications, and latest disease status were retrospectively collected from hospital records. For assessment of patient-reported outcomes, the Chinese version of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire was completed by the patients. RESULTS: Ninety three patients aged 58 to 84 years were recruited. Thirty patients were treated by RALP (32.3%), whereas 63 received RT (67.7%). The RALP group had significantly lower baseline prostate-specific antigen levels than the RT group (P<0.001). More patients who underwent RALP reported urinary incontinence (70.0% vs 3.2%, P<0.001), whereas more patients who underwent RT reported other voiding symptoms (87.3% vs 50.0%, P<0.001) and perirectal bleeding (36.5% vs 0%, P<0.001) during follow-up. Of the 85 patients who were still alive at the time of the study, 52 (61.2%) returned completed questionnaires. Patients who underwent RALP had poorer median (interquartile range) EPIC urinary summary scores than patients who underwent RT [81.5 (18.3) vs 88.9 (17.9), P=0.016]. Urinary function [75.9 (20.4) vs 93.6 (16.2), P<0.001] and incontinence [60.5 (31.8) vs 91.8 (14.5), P<0.001] were also significantly worse in the RALP group. The bowel and sexual domain scores were similar between the two groups. CONCLUSIONS: We found that RALP and RT were associated with different patterns of complications and patient-reported outcomes. Urinary incontinence was much more prevalent in the patients treated surgically. This may significantly affect patients' quality of life.

An improved dynamic model of tuning fork probe for scanning probe microscopy.

This paper presents a two coupled oscillators model to describe the dynamics of a tuning fork with a probe attached. The two coupled oscillators are unbalanced only in their effective masses and the damping ratios. By applying a frequency domain system identification approach in experimental investigation of various probe attachment cases, a good accuracy of the model is demonstrated. The effectiveness of the model is further demonstrated in quantitative analysis of the noise performance and the sensitivity of force sensing with a tuning fork probe. Compared with existing models, the proposed model can more accurately characterize the dynamics of a tuning fork probe.

The bitewing radiograph as an assessment tool in fixed prosthodontics.

Molar crown preparations, as described in the literature, have standard forms dictated by the demands of retention, resistance and the physical properties of materials. Standard designs may not be appropriate for all patients because of ethnic variations in tooth shape, pulp size and dentine thickness. Accurate data on these features could assist clinicians to minimize the risk of accidental pulpal injury. The aim of this study was to compare the first molar crown and pulp dimensions between Asian (Chinese, Korean, Malay) and other ethnic groups, using measurements from the bitewing radiographs of 121 subjects. Comparisons revealed the following significantly different features of Asian first molars: larger total pulp areas in uppers (P < 0.0005); shorter crowns (P < 0.0005); narrower upper teeth at the cervix (P < 0.0005); wider pulps at the cervix of lowers (P < 0.02); more bulbous crowns (P < 0.0005 for uppers; P < 0.01 for lowers), and finally significantly thinner dentine interproximally at the cervix (P=0.001 for uppers; P=0.011 for lowers). Preparations with wide shoulders could pose hazards to the pulps in Asian subjects. This study emphasizes the value of bitewing films in assessing crown and pulp size and shape before making crown preparations. The experienced practitioner may intuitively include tooth and pulp morphology in treatment planning, but this appears not to be taught or documented in textbooks.

Effects of sealers and liners on marginal leakage of amalgam and gallium alloy restorations.

In an in vitro study, the use of sealers and liners (Fuji varnish, Vitrabond, Vitremer, Paama 2, All-Bond 2, or Resinomer) significantly reduced the amount of marginal leakage around amalgam (Permite C or Lojic Plus) and gallium (Galloy) alloy restorations. This reduction in marginal leakage was produced by all sealers and liners tested, and there were no statistically significant differences between these materials. Unlined restorations of Permite C had significantly less marginal leakage than Galloy or Lojic Plus. Unlined Lojic Plus restorations had the greatest amount of marginal leakage. The experimental method used in the present study proved to be suitable for quantitative comparison of marginal leakage of different dental materials.

Effects of lining materials on shear bond strength of amalgam and gallium alloy restorations.

In this in vitro study, where alloys were condensed into unset paste lining materials, shear bond strengths were significantly greater than with the unlined controls. The use of varnish or Paama 2 linings did not significantly increase the shear bond strength of amalgam or gallium alloy restorations. The use of Vitrabond, Vitremer, or Resinomer liners significantly increased the shear bond strength compared to unlined restorations. Permite C restorations lined with Resinomer all showed cohesive failure within the mixed alloy/ liner. Of the unlined restorations, Permite C had significantly higher shear bond strength than Lojic Plus. The experimental method used in the present study proved to be suitable for quantitative comparison of the shear bond strength of different dental materials.

Blood levels of PAF are elevated during induction of immune complex mediated enteropathy in the rat.

Intravenous injection into rats of immune complexes (IC) prepared in 5 x antigen excess rapidly induces annular bands of vascular congestion and transmural haemorrhage producing a striped appearance of the small intestine. Indirect evidence suggested a major role for PAF in the induction of lesions. In the present study, we showed that blood and leukocyte levels of PAF were elevated in most rats injected 10 min earlier with sufficient IC to induce lesions of 3+ to 4+ intensity. There was no significant difference in the number of rats with elevated plasma levels of PAF. The possibility that changes in blood PAF levels might be mirrored at sites closer to the lesions was considered. The overall effect of PAF on the small intestine of the rats is to induce stasis of flow; the precise target of PAF in mediating this effect is unknown.

Inhibition of immune complex-induced enteropathy by three different platelet-activating factor receptor antagonists.

We previously showed that intravenous injection of rat anti-BSA-BSA complexes (IC) prepared in 5x antigen excess rapidly induced a striate pattern of serosal (to mucosal) hemorrhage and vascular congestion throughout the small intestine of the Sprague-Dawley rat. In this study, we tested the effect of three different platelet-activating factor (PAF) receptor antagonists on the development of lesions. L-652,731, a synthetic derivative of kadsurenone (at doses of 1.3-2.7 mg/kg), SRI 63-675, a substituted quinolinium compound (6.7-15 mg/kg), and WEB 2086, a thienotriazolodiazepine (5-25 mg/kg) were each capable of completely or partially inhibiting IC-induced enteropathy in the majority of animals tested. Pretreatment with WEB 2086 prevented IC-induced hemoconcentration but not neutropenia. The antagonists did not lower the level of blood complement nor interfere with the fall in complement induced by administration of IC. The ability of PAF receptor antagonists to completely or partially inhibit IC-induced small intestinal lesions suggests that endogenous PAF is a major mediator of IC-induced enteropathy.