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1.
Pituitary ; 23(6): 721-732, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32740679

RESUMO

PURPOSE: Granular cell tumors (GCT) are highly vascularized and adherent to adjacent structures, and so, complete resection represents a challenge. Adjuvant therapy decisions for residual GCTs currently relies on individual clinician decisions due to a paucity of systematic literature data. We present a comprehensive analysis about the impact of adjuvant therapy in reported cases of patients with incomplete GCT resection. METHODS: One database (PubMed) and crossed references were queried for GCT with incomplete resection or biopsy from 1962 to 2020. Literature review was performed according to the PRISMA guidelines. Also, two patients with residual GCT from our institutions are added to the analysis. Data regarding clinical presentation, surgical approach, use of adjuvant therapy, Ki-67 labeling, and follow up assessments were extracted and analyzed from selected publications. RESULTS: Thirty-three studies met the predetermined inclusion criteria and 53 patients were selected (including our two reported cases). The median of age was 49 [IQR, 39-60 years], with a slight male predominance (1.2:1). Among the surgical procedures, seven (13%) were biopsies alone. Adjuvant therapy was used in 18 patients (radiotherapy, 94.5%; chemotherapy, 5.5%) but there is no statistical correlation with adjuvant therapy and the progression of the remnant tumor (p = 0.33). Our institutions' patients did not receive adjuvant therapy and did not show tumor progression on MRI. CONCLUSION: Our systematic literature review suggests there is a limited role for chemo and/or radiotherapy in the management of incomplete GCT resection. It may be reasonable recommending close clinical follow up in patients with incomplete resection.


Assuntos
Tumor de Células Granulares/cirurgia , Neoplasias Hipofisárias/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PubMed
2.
World Neurosurg ; 138: 485-490, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32229304

RESUMO

BACKGROUND: Craniocervical junction chordoma treated with surgery and Proton Beam Therapy evolved with Osteonecrosis and CSF leak. As the vascularization of the head was compromised, we harvested an Anterolateral thigh musculofascial flap to seal the leak. CASE DESCRIPTION: A 56-year-old man presented with a history of chronic headaches and dysarthria with tongue deviation to the right. Magnetic resonance imaging showed a lesion at the craniocervical junction with imaging characteristics compatible with chordoma. Endoscopic endonasal resection was followed by proton beam therapy. Recurrence of the chordoma was subsequently resected via far lateral approach again followed by proton beam therapy accumulating a total dose of 75 Gy. Unfortunately, this led to osteoradionecrosis of the skull base resulting in a cerebrospinal fluid (CSF) leak more than 1 year after treatment. After multiple failed attempts to seal the defect using local vascularized tissue and free fat grafts, the defect was reconstructed with a vastus lateralis free tissue transfer. Six weeks later, the flap had mucosalized, the patient was pain free, and there was no evidence of a CSF leak. CONCLUSIONS: In select cases, vascularized free flaps offer a superior reconstruction for osteoradionecrosis because radiotherapy often compromises the blood supply of local tissues.


Assuntos
Fossa Craniana Posterior/cirurgia , Osteorradionecrose/cirurgia , Terapia com Prótons/efeitos adversos , Vazamento de Líquido Cefalorraquidiano/cirurgia , Vértebras Cervicais/cirurgia , Cordoma/complicações , Cordoma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Complicações Pós-Operatórias/cirurgia , Procedimentos de Cirurgia Plástica , Neoplasias da Coluna Vertebral/radioterapia , Neoplasias da Coluna Vertebral/cirurgia , Resultado do Tratamento
3.
RPG, Rev. Pós-Grad ; 17(1): 7-12, jan.-mar. 2010. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-855251

RESUMO

Este estudo teve o objetivo de avaliar a influência da contaminação salivar sobre a resistência de união (RU) em dentina de um sistema adesivo autocondicionante de dois passos. Sessenta dentes bovinos foram incluídos e lixados para exposição de dentina superficial, onde foi preparado smear layer padronizado. Seis grupos (n=10) foram divididos de acordo com os fatorers de variação: momento da contaminação [antes do sistema adesivo (G2 e G3); após aplicação do primer (G4); e após a aplicação do bond (G5 e G6)] e tratamento do contaminante [secagem (G2, G4 e G5) ou lavagem (G3 e G6)]. No grupo controle (G1), não houve contaminação. O sistema adesivo Clearfil SE Bond (SE) foi utilizado de acordo com as recomendações do fabricante. A contaminação foi efetuada com saliva aplicada sobre a área de dentina exposta, sendo o contaminante lavado por 10 segundos com jato de água ou secado por 10 segundos com jato de ar. A resina composta (Filtek Z-250, 3M ESPE) foi utilizada para montar os corpos-de-prova, que foram tracionados após 24 horas de estocagem em água a 37ºC. Os resultados obtidos (em MPa) foram avaliados por meio do teste ANOVA e comparados através do intervalo de confiança. Os resultados obtidos [G1-24,27(±2,82); G2-18,71(±5,51); G3-19,90(±4,56); G4-17,54(±6,24); G5-5,95 (±4,58); G6-6,91(±0,03)] demonstraram que a saliva influencia significativamente na RU, mas não os tratamentos do contaminante, e há influência estatisticamente significativa quanto ao momento em que ocorreu a contaminação.


Concluiu-se que a presença do contaminante reduz a resistência de união do sistema autocondicionate em dentina, sendo que o momento mais crítico para ocorrer a contaminação é após a aplicação do bond. Nenhum dos tratamentos da saliva realizados foi capaz de recuperar a resistência de união


Assuntos
Animais , Bovinos , Poluição Ambiental , Dentina , Adesivos Dentinários , Saliva , Análise de Variância , Esmalte Dentário , Materiais Dentários , Estética Dentária
4.
Braz. j. oral sci ; 9(2): 98-103, Apr.-June 2010. ilus, tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: lil-578073

RESUMO

Aim: To evaluate the influence of saliva contamination on the short- and long-term bond strength of a self-etch adhesive system. Methods: One hundred and twelve non-carious human molars were randomly divided according to: substrate (enamel/dentin); presence of saliva [none (control- C), before primer (BP), after primer (AP) and after bonding agent (AB)]; treatment of the contamination [none (1), rinsing + drying (2), drying (3) and primer re-application (4)] and specimen storage (24 h or 6 months). A self-etch adhesive system was applied to the dental surfaces followed by incremental insertions of composite resin. After storage in water at 37oC, the specimens were perpendicularly cut into beams for microtensile bond strength testing. Data in MPa were compared by A NOVA followed by Tukey’s test (p< 0.05). Micrographs were obtained by low vacuum scanning electron microscopy. Results: Control groups (G1 and G8) presented higher bond strength than all other groups. The factors presence of saliva, treatments of the contaminant and specimen storage showed no statistically significant results for the two dental substrates. Contaminants could be detected by LV-SEM. Six-month storage did not affect bond strength. Conclusions: The presence of saliva during the application of the self-etch system was deleterious to the bond to enamel and dentin, irrespective of the operative step in which the contamination occurred.


Assuntos
Humanos , Adesivos Dentinários/química , Colagem Dentária , Saliva/microbiologia , Resistência à Tração , Análise de Variância , Teste de Materiais , Microscopia Eletrônica de Varredura , Fatores de Tempo
5.
Rev. odonto ciênc ; 24(4): 410-413, Oct.-Dec. 2009. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-873971

RESUMO

Purpose: The aim of this study was to investigate the effect of saliva contamination on bond strength of an etch-and-rinse system to dentin. Methods: Fifty bovine incisors were embedded in acrylic resin and divided into 5 groups: G1 (control) - application of the adhesive system (Adper Single Bond 2 - 3M-ESPE); G2 - saliva contamination after acid etching of dentin, rinsing and drying; G3 - saliva contamination after acid etching of dentin and drying; G4 - saliva contamination after adhesive application, rinsing and drying; G5 - saliva contamination after adhesive application and drying. Contamination was performed by using 4 µL of simulated human saliva for 20 s. The adhesive system was applied according to the manufacturer's instructions; a composite resin was built as an inverted cone and was tested after 24 h at a cross-head speed of 0.5 mm/min. Results: When saliva contamination occurred after the adhesive photo-polymerization, bond strength was significantly reduced. The adhesive strength (MPa) mean values were: G1 = 18.1(±4.7) a; G2 = 20.5(±5.7) a; G3 = 17.3(±3.4) a; G4 = 12.6(±4.0) b; G5 = 9.8(±2.1) b (means followed by distinct letters are statistically different, P < 0.05). Conclusion: Saliva contamination negatively influenced bond strength of an etch-and-rinse adhesive, especially after the final polymerization of the adhesive system; in this condition, treatments were not efficient to recover adhesion.


Objetivo: Investigar o efeito da contaminação salivar na resistência de união de um adesivo condicione-e-lave em dentina. Metodologia: Cinquenta incisivos bovinos foram divididos em 5 grupos: G1 = (controle) aplicação do sistema adesivo (Adper Single Bond 2 - 3M-ESPE); G2 = contaminação com saliva após condicionamento ácido da dentina + lavagem e secagem; G3 = contaminação após o condicionamento ácido da dentina + secagem; G4 = contaminação com saliva após a aplicação do adesivo + lavagem e secagem; G5 = contaminação com saliva após a aplicação do adesivo + secagem. A contaminação foi realizada com 4 µL de saliva humana estimulada por 20 s. O sistema adesivo foi usado de acordo com as instruções do fabricante. A resina composta foi aplicada na forma de cone invertido, com o teste de tração realizado após24 h a 0,5 mm/min de velocidade. Resultados: As médias de resistência de união (em MPa): G1 = 18,1(±4,7) a; G2 = 20,5(±5,7) a; G3 = 17,3(±3,4) a; G4 = 12,6(±4,0) b; G5 = 9,8(±2,1) b, demonstrando que a resistência de união foi reduzida significativamente quando a contaminação salivar ocorreu após a fotopolimerização do adesivo. Conclusão: A contaminação influenciou negativamente a resistência de união do adesivo somente após a sua polimerização; nesta condição os tratamentos realizados não foram eficientes para recuperar a adesão.


Assuntos
Animais , Bovinos , Poluição Ambiental , Dentina , Adesivos Dentinários
6.
Am J Dent ; 21(2): 101-4, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18578177

RESUMO

PURPOSE: To evaluate the influence of cleaning procedures (pumice, anionic detergent and both procedures together) on the tensile bond strength of etch-and-rinse and self-etch adhesive systems to bovine enamel and dentin in vitro. METHODS: Eighty non-carious, bovine incisors were extracted, embedded in acrylic resin to obtain enamel/dentin specimens. Flat bonding surfaces were obtained by grinding. Groups were divided according to substrate (enamel or dentin), adhesive system [etch-and-rinse, Adper Single Bond 2 (SB) or self-etch, Clearfil Protect Bond (PB)]; and cleaning substances (pumice, anionic detergent and their combination). The teeth were randomly divided into 20 groups (n=8): G1--Enamel (E) + SB; G2--E + oil (O) + SB; G3--E + O + Pumice (P) + SB; G4--E + O + Tergentol (T) + SB; G5--E + O + P + T + SB; G6--E + PB; G7--E + O + PB; G8--E + O + P + PB; G9--E + O + T + PB; G10--E + O + P + T + PB; G11--Dentin (D) + SB; G12 D + SB + O; G13--D + SB + O + P; G14--D + SB + O + T;G15--D + SB + O + P + T; G16--D + PB; G17--D + O + PB +; G18--D + O + P + PB; G19--D + O + T + PB; G20--D + O + P + T + PB. Specimens were contaminated with handpiece oil for 5 seconds before bonding. Adhesive systems and resin composite were applied according to manufacturers' instructions. Specimens were tested in tension after 24 hours of immersion using a universal testing machine at a crosshead speed of 0.5 mm/minute. Bond strengths were analyzed with ANOVA. Failure sites were observed and recorded. RESULTS: Tensile bond strength in MPa were: G1 (23.6 +/- 0.9); G2 (17.3 +/- 2.2); G3 (20.9 +/- 0.9); G4 (20.6 +/- 0.5); G5 (18.7 +/- 2.3); G6 (23.0 +/- 1.0); G7 (21.5 +/- 2.4); G8 (19.9 +/- 1.3); G9 (22.1 +/- 1.2); G10 (19.1 +/- 1.2); G11 (18.8 +/- 1.3); G12 (15.7 +/- 2.1); G13 (17.8 +/- 3.3); G14 (15.3 +/- 2.9); G15 (15.6 +/- 1.9); G16 (14.7 +/- 2.3); G17 (5.5 +/- 0.9); G18 (19.3 +/- 1.8); G19 (15.6 +/- 1.6); G20 (20.3 +/- 3.9). Statistical analysis showed that the main factors substrate and cleaning were statistically significant, as well as the triple interaction between factors of variance. However, the factor adhesive system did not show statistical difference. Oil contamination reduced bond strengths, being less detrimental to enamel than to dentin. Etch-and-rinse (SB) and two-step self-etch (PB) systems had similar bond strengths in the presence of oil contamination. For etch-and-rinse (SB), the cleaning procedures were able to clean enamel, but dentin was better cleaned by pumice. When self-etch (PB) system was used on enamel, anionic detergent was the best cleaning substance, while on dentin the tested procedures were similarly efficient.


Assuntos
Colagem Dentária , Esmalte Dentário/ultraestrutura , Adesivos Dentinários/química , Dentina/ultraestrutura , Óleos Industriais , Condicionamento Ácido do Dente/métodos , Animais , Bis-Fenol A-Glicidil Metacrilato/química , Bovinos , Resinas Compostas/química , Materiais Dentários/química , Detergentes/química , Teste de Materiais , Distribuição Aleatória , Silicatos/química , Estresse Mecânico , Temperatura , Resistência à Tração , Fatores de Tempo , Água/química
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