Facial soft tissue undergoes significant deterioration over time, with the most dramatic changes between the ages of 30 and 60 in the temporal, infraorbital, and lateral and medial cheek areas. Soft tissue augmentation and volume correction in these areas may be an effective strategy for facial rejuvenation.
BACKGROUND.Immunocytochemical staining (ICC) is often limited by the lack of cell blocks that contain diagnostic cells or by the unavailability of smear materials.The cell-transfer technique, in which original smear material is divided into several pieces and then transferred to multiple slides, can facilitate multiple ICC on limited materials. However the reliability of the staining results has not been systematically evaluated. METHODS. RESULTS.One hundred pieces of transferred materials were immunostained, of which 5 (5%) were lost during the staining procedure. Of the remaining 95 pieces, 92 (97%) showed staining results that agreed with those of the previous ICC, whereas 3 (3%) showed results that disagreed. The original ICC in the latter three specimens was performed on cell block sections and showed focally positive synaptophysin staining in a sample with a neuroendocrine tumor, focally positive CK5/6 staining in a pleural effusion sample with mesothelioma, and positive TTF-1 staining in a lymph node sample with metastatic lung carcinoma. Their corresponding ICC of cell-transferred materials showed negative results. An increase in background staining was observed in 1 of the 95 tissue pieces, but no false-positive results were observed.
Similar outcomes have been reported for obese and nonobese patients after primary total hip arthroplasty (THA), indicating obesity is not a contraindication to total hip arthroplasty. However, obese patients may develop implant failure and require revision THA. We compared the outcomes of revision THA in a matched cohort of obese and nonobese patients. Patients were stratified into two groups according to BMI (body mass index, kg/m2): Group 1 included 31 obese patients (BMI > 35), and Group 2 included 62 nonobese patients (BMI < 30) matched on age, gender, and type of revision procedure. Obese patients had increased total operating room time, a higher rate of discharge to a skilled nursing facility, and a higher dislocation rate (p < 0.05). Seven patients in the obese group underwent revision surgery, six of whom underwent additional reoperations to treat recurrent postoperative dislocation. Obese patients should be counseled about the increased risk of dislocation that can occur after revision THA.
Purpose To evaluate whether pretreatment combined endorectal magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI) findings are predictive of outcome in patients who undergo external beam radiotherapy for prostate cancer. Methods and Materials We retrospectively identified 67 men with biopsy-proven prostate cancer who underwent combined endorectal MRI and MRSI at our institution between January 1998 and October 2003 before whole-pelvis external beam radiotherapy. A single reader recorded tumor presence, stage, and metabolic abnormality at combined MRI and MRSI. Kaplan-Meier survival and Cox univariate and multivariate analyses explored the relationship between clinical and imaging variables and outcome, using biochemical or metastatic failure as endpoints. Results After a mean follow-up of 44 months (range, 3–96), 6 patients developed both metastatic and biochemical failure, with an additional 13 patients developing biochemical failure alone. Multivariate Cox analysis demonstrated that the only independent predictor of biochemical failure was the volume of malignant metabolism on MRSI (hazard ratio [HR] 1.63, 95% confidence interval [CI] 1.29–2.06; p < 0.0001). The two independent predictors of metastatic failure were MRI tumor size (HR 1.34, 95% CI 1.03–1.73; p = 0.028) and the finding of seminal vesicle invasion on MRI (HR 28.05, 95% CI 3.96–198.67; p = 0.0008). Conclusions In multivariate analysis, MRI and MRSI findings before EBRT in patients with prostate cancer are more accurate independent predictors of outcome than clinical variables, and in particular, the findings of seminal vesicle invasion and extensive tumor predict a worse prognosis.
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