96 [O]; 0.93 [L]) and evening pain (r= 0.96 [O], 0.90 [L]).

Correlations between ecological and recalled measures were stronger for recall over the last 7 days than for recall over the last 28 days in osteoarthritis patients (r= 0.78, r= 0.63), but were similar for both recall periods in low back pain patients (r= 0.70, r= 0.72).

Correlations between assessments for the last 7 and 28 days were stronger for ecological (r= 0.88 [O], 0.91 [L]) than for clinical (r= 0.77 [O]; 0.86 [L]) assessments.

After adjustment for

current pain intensity, correlations remained significant click here for ecological assessments, but not for clinical assessments.

Recalled pain assessments were more accurate when made after 24 hours (r= 0.71 [O]; 0.70 [L]) than when Tubastatin A chemical structure made after 48 hours (r= 0.63 [O]; 0.61 [L]).

Conclusions. For both low back pain and osteoarthritis, overall daily pain recall is a reliable measurement correlated with daily ecological measurements, whereas a rapid decrease in recall occurs after 48 hours. The most reliable period for pain recall was 7 days, but the results obtained were influenced by current pain.”
“Objectives. Epidemiological

studies in patients with type 1 and type 2 diabetes show that hyperglycemia is associated with the development of long-term microvascular complications, including painful diabetic neuropathy (PDN). However, as the prevalence of type 2 diabetes in humans far exceeds that of type 1, the present study selleck chemicals llc was undertaken as a 22-week longitudinal investigation commencing at 7 weeks of age, to assess the utility of the Zucker diabetic fatty (ZDF) rat model of type 2 diabetes for the study of PDN.

Design. Behavioral methods were used to characterize temporal changes in hindpaw sensitivity as well as morphine potency

in these animals. The effect of long-term diabetes on mu-opioid receptor function and mRNA expression levels in the spinal cord was also assessed.

Results. Diabetes developed spontaneously in ZDF rats with marked hyperglycemia (blood glucose levels >= 15 mM) evident by 11 weeks of age, which was maintained until study completion at 29 weeks. In ZDF rats, there was progressive development of mechanical allodynia in the hindpaws such that it was fully developed by 6 months of age. Concurrently, there was temporal loss of opioid sensitivity in these animals such that marked morphine hyposensitivity was evident at 6 months. In the spinal cord, basal G-protein function was significantly impaired at 29 weeks of age, resulting in apparently reduced agonist-stimulated mu-opioid receptor function compared with the prediabetic state.

Conclusions. Together, our findings suggest that impaired basal G-protein activity underpins morphine hyposensitivity in PDN.

Clinical Relevance. Clinical management of diabetic neuropathic pain has been challenging. This study provides a mechanistic explanation regarding the effectiveness, or lack thereof, of opioid analgesia in the treatment of diabetic neuropathic pain.

009) We concluded that the TSER polymorphism appears not to be a risk factor for susceptibility to acute lymphoblastic leukemia

in the Kashmir population.”
“Supra-vesical diversion or ureteric reconstruction is indicated for fistulae from the bladder or ureter, urinary incontinence, painful frequency and for end-stage renal failure due to obstructive uropathy. In a palliative setting, conservative measures, such as an indwelling catheter or ureteric stents, AZD1208 concentration should be tried first. Open or laparoscopic surgery should be considered if these measures fail. For a patient who is leaking urine or has a very painful bladder, such surgery may well be justified, even very close to the end of life, as the symptoms are so unpleasant. When FaraA the problem is of end-stage renal failure that may be symptomless,

the decision is more difficult; the patient may only gain a few months of life with no change in symptoms in return for the major surgery. The options available include cutaneous diversion either by ureterostomy or conduit and reconstruction either by re-implanting a ureter into the bladder or transuretero-ureterostomy. A laparoscopic approach may be possible in many cases. (C) 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.”
“The antioxidant capacities of cranberry juice and three extracts isolated from frozen cranberries containing anthocyanins, water-soluble and apolar phenolic compounds, were evaluated at pH 2.5 and 7, respectively. VX-770 mw The free radical-scavenging (FRS) and the lipid peroxidation inhibition (LPI) activities of each samples, and extracts, were studied using the N,N-diethyl-p-phenylenediamine (DPD) decoloration test and the thiobarbituric acid reactive substances (TBARS) assay, respectively. The cranberry phenols displayed good free radical-scavenging properties, but were less efficient at inhibiting the peroxidation of lipids. Of all the samples tested, the water-soluble phenolic compounds

showed the greatest free radical-scavenging (68.2 mmol TE/mg phenol) and antioxidant (13.4 mmol TE phenol) activities. The polarity of the phenols, the pH of the medium and the juice process had a great influence on the antioxidant activities. The phenols isolated from cranberries with an aqueous solvent have greater antioxidant properties than those extracted with an organic solvent mixture. The antioxidant activity of the cranberry samples adjusted at pH 2.5 was greater than those adjusted at pH 7. Compared to the cranberry extracts, the juice exhibited a much lower antioxidant activity, especially when compared with the extract containing water-soluble compounds which the extraction conditions were similar to those used to obtain the juice. (C) 2011 Elsevier Ltd. All rights reserved.

For HDDR powder at a DR Fedratinib purchase time greater than 14 min, changing the magnetic field by up to 1.0 kOe produced no observable wall motion. It follows that the high coercivity of HDDR powder is due

to domain wall pinning at the grain boundaries. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3339816]“
“The present work aims to study the interactive effect of drought stress and high vapour pressure deficit (VPD) on leaf gas exchange, and especially on mesophyll conductance to CO2 (g(m)), in two woody species of great agronomical importance in the Mediterranean basin: Vitis vinifera L. cv. Tempranillo and Olea europaea L. cv. Manzanilla. Plants were grown in specially designed outdoor chambers with ambient and below ambient VPD, under both well-irrigated and drought conditions. g(m) was estimated by the variable J method from simultaneous measurements of gas exchange SB203580 and fluorescence. In both species, the response to soil water deficit was larger in g(s) than in g(m), and more important than the response to VPD. Olea europaea was apparently more sensitive

to VPD, so that plants growing in more humid chambers showed higher g(s) and g(m). In V. vinifera, in contrast, soil water deficit dominated the response of g(s) and g(m). Consequently, changes in g(m)/g(s) were more related to VPD in O. europaea and to soil water deficit in V. vinifera. Most of the limitations of photosynthesis were diffusional and especially due to stomatal closure. No biochemical

limitation was detected. The results showed that structural parameters played an important role in determining g(m) during the acclimation process. Although the relationship between leaf mass per unit area (M-A) with learn more g(m) was scattered, it imposed a limitation to the maximum g(m) achievable, with higher values of M-A in O. europaea at lower g(m) values. M-A decreased under water stress in O. europaea but it increased in V. vinifera. This resulted in a negative relationship between M-A and the CO2 draw-down between substomatal cavities and chloroplasts in O. europaea, while being positive in V. vinifera.”
“The purpose of this analysis was to investigate whether the recommended daily dosage of 1-2 mg/kg robenacoxib provides consistent exposure when administered to dogs with chronic osteoarthritis (OA), and the need for dose adjustment in special patient populations.

Data from three prospective, multi-center field studies in 208 OA dogs were analyzed using non-linear mixed effects modeling. A model based assessment was performed with stepwise inclusion and exclusion of population characteristics to explain between-subject variability, and assess the according necessity for dose adjustment.

Only the influence of bodyweight on both apparent clearance and volume were found to be significant (p < 0.01). No significant influence of sex, age and breed, or kidney and liver variables was identified in this representative sample of OA dogs.

3 months.

Fifty-six patients had

cranial surgery, four patients underwent a spinal operation. Surgical cranial approaches included supratentorial procedures in 45 patients and posterior cranial fossa exploration in 11.

At 7-days follow-up, a CSF leak was reported in one patient after excision of a vestibular YM155 ic50 schwannoma and in another with a thoracic vertebral body fracture and spinal cord transaction. Neither needed reoperation. A subgaleal fluid collection in two patients who had been treated for a supratentorial lesion resolved after tapping. The transparency of the implant was beneficial to inspect the underlying surgical area at the end of the procedure in one patient in whom a hematoma formed after secondary to oozing glioblastoma removal.

Of the 56 patients who reached the 3-month follow-up, none had a CSF leak, meningitis, wound infection or fistulaeNo duroplasty failure was observed.

In one patient who underwent reoperation after 40 days, histopathological findings revealed the replacement of the implant by ingrowth from the original dura.

Tissudura is simple, efficacious and safe to use. The use of fibrin glue reduces suturing and facilitates the implantation of the collagen biomatrix. Its transparency SNX-5422 solubility dmso makes it unique and beneficial in inspection of the underlying area of operation. The lack of adverse reaction indicates that this graft may be used as an option in the repair of dural

defects.”
“Purpose: To verify iliolumbar ligament (ILL) location, to evaluate magnetic resonance (MR) imaging morphologic features for detecting lumbosacral transitional vertebrae (TVs) (LSTVs), and to determine whether transitional situations are associated with anomalous vertebral numbering.

Materials and Methods: Investigational review board approval was obtained

for this HIPAA-compliant retrospective study. A review of 147 subjects was performed by using spine radiography as the reference standard to determine total and segmental vertebral count and transitional Z-DEVD-FMK mouse anatomy. Thoracolumbar TVs (TLTVs) and LSTVs were identified. The lumbosacral intervertebral disk angle (LSIVDA), defined as the angle between the endplates, was measured, S1-2 disk morphology was rated according to the classification by O’Driscoll et al, and the ILL level was determined from MR images. Statistical analysis was performed by using x 2 tests for dichotomous and ordinal variables and the t test for continuous variables.

Results: An anomalous total number of vertebrae were present in 12 (8.2%) of 147 subjects. The ILL was identified in 126 (85.7%) of 147 subjects and was present at L5 in 122 (96.8%) subjects; the remaining four (3.2%) subjects had an anomalous total number of vertebrae. A complete S1-2 intervertebral disk was associated with LSTVs (P = .004); however, LSIVDA was not (P = .2). TLTVs were present in six (4.1%) and LSTVs were present in 22 (15.0%) of 147 subjects.

The test is most accurate in predicting spontaneous preterm birth within 7 days of testing in women with twin pregnancies and threatened preterm labor.”
“Objective: To evaluate the outcomes of younger (<60 yr) and older (>= 60 yr) patients implanted with the Vibrant Soundbridge (VSB). The aim was to AZD1480 nmr determine if there were differences between groups.

Method: A retrospective study was used to evaluate all patients who were implanted and fit with a VSB during 2008 and 2009 at the Department of Otorhinolaryngology-Head and Neck Surgery, Medical University Innsbruck. Differences in audiologic, medical, and surgical outcomes between younger and older patients were evaluated.

Results: No patients had major complications

during or after the surgical procedure. All patients had a good hearing benefit as supported by improvements

in hearing thresholds from the preoperative to the postoperative condition in the sound field. There were differences between groups in speech understanding postoperatively; however, the differences were not statistically significant.

Conclusion: All patients had, independent of age, good audiologic benefit from VSB use. Based on the low risk of medical or surgical complications, the easy use of the hearing implant, audiologic improvements, GF120918 supplier and potential social benefits, we think that the VSB should be regularly offered to adults with hearing loss, whether they are young or old.”
“Objectives: We investigated relation of preoperative renal scar to incidence of postoperative metabolic acidosis following ileocystoplasty in patients with neurogenic bladder.

Patients: Thirty patients with neurogenic bladder, who underwent ileocystoplasty, were enrolled in the present study. Median age at ileocystoplasty was 13.9 years and median follow-up period after ileocystoplasty was 8.2 years. Metabolic acidosis was defined based

on the outlined criteria: base excess (BE) is less than 0 mmol l (-1). Preoperative examination revealed that no apparent renal insufficiency was identified in blood analysis, although preoperative Tc-99m-DMSA scintigraphy GSK1838705A clinical trial indicated abnormalities such as renal scar in 14 patients (47%). Incidence of postoperative metabolic acidosis was compared between patients with and without preoperative renal scar, which may reflect some extent of renal tubular damage.

Results: Postoperative metabolic acidosis was identified in 13 patients (43%). Incidence of postoperative metabolic acidosis was significantly higher in patients with renal scar (11/14, 79%) compared with patients without renal scar (2/16, 13%; P<0.01). Particularly, all eight patients who had bilateral renal scars showed metabolic acidosis postoperatively. Compared with patients without preoperative renal scar, pH (P<0.05) and BE (P<0.01) were significantly lower postoperatively in patients with preoperative renal scar. However, there was no significant difference in PCO2.

“
“This review focuses on recent findings in pathobiology of osteoarthritis (OA). The progress in this field will be illustrated based on three questions; 1. What factors maintain or alter the articular chondrocyte phenotype?

2. What is the role of inflammation in OA? 3. Is there a role for aging-related genes in OA? Recent findings make it more and more obvious that OA is not a single tissue disease, but that development and progression of OA is the resulted of an integrated complex of local and buy LXH254 systemic factors that contribute to the pathobiology of this widespread disease. (C) 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.”
“Purpose of review

Angiogenesis is the formation of new capillaries from pre-existing vessels, whereas vasculogenesis is de-novo capillary formation from endothelial precursor cells (EPCs). Current understanding of the role of angiogenesis and vasculogenesis in rheumatoid arthritis (RA) and possibilities of therapeutic intervention should be summarized.

Recent findings

There have been many recent studies on the role of the hypoxia and hypoxia-inducible factor (HIF)-vascular endothelial growth factor (VEGF)-angiopoietin axis in angiogenesis associated with RA. The role of additional growth

factors, chemokines, cytokines, matrix components selleck kinase inhibitor and adhesion molecules has been further characterized. Macrophage migration inhibitory factor (MIF) may link inflammation, angiogenesis and atherosclerosis. Junctional adhesion molecules (JAMs) and focal adhesion kinases (FAKs) have recently been implicated in inflammatory angiogenesis. Novel information regarding the role of serum amyloid A (SAA) and sphingosine kinase has become available. Most of these angiogenic factors have recently been targeted using various techniques and arthritis models. Whereas angiogenesis is abundant in RA, there is defective EPC function and vasculogenesis leading to atherosclerosis and vascular disease in arthritis.

Treatment with EPCs already under investigation PLX3397 inhibitor in vascular diseases may also be attempted in RA.

Summary

Targeting angiogenesis and restoration of vasculogenesis may be beneficial for the therapy and outcome of RA.”
“Purpose: Biomarkers provide useful diagnostic information by detecting cartilage degradation in osteoarthritis (OA), reflecting disease-relevant biological activity and predicting the course of disease progression. They also serve as surrogate endpoints in the drug discovery process. The aim of this narrative review was to focus on OA biomarker-related papers published between the osteoarthritis research society international (OARSI) 2011 meeting in San Diego and the OARS! 2012 meeting in Barcelona.

04). The groups

did not establish a significant difference between patients’ sex, patient’s weight or weight of the remaining gland. Patient’s age, preoperative serum TSH level, ratio of the remaining thyroid gland weight to patient’s weight is the main factors of hypothyroidism after hemithyroidectomy. A risk scoring system was created to predict hypothyroidism after hemithyroidectomy before the operation.”
“AimsThis study performs the first cost-effectiveness analysis (CEA) of Recovery Management Checkups (RMC) for adults with chronic substance use disorders.

DesignCost-effectiveness analysis of a randomized clinical trial of RMC. Participants were assigned randomly to a control condition of outcome monitoring (OM-only) or the experimental Ilomastat Proteases inhibitor condition OM-plus-RMC, with quarterly follow-up for 4 years.

SettingParticipants were recruited from the largest central intake unit for substance abuse treatment in Chicago, Illinois, USA.

ParticipantsA total of 446 participants who were 38 years old on average, 54% male, and predominantly African American (85%).

MeasurementsData on the quarterly cost per participant come from a previous study of OM and RMC intervention costs. Effectiveness is measured as the number of days DMXAA inhibitor of abstinence and number of substance use-related problems.

FindingsOver the 4-year trial, OM-plus-RMC cost on average $2184 more than OM-only (P<0.01). Participants in OM-plus-RMC

averaged 1026 days abstinent and had 89 substance use-related problems. OM-only averaged 932 days abstinent and reported 126 substance use-related problems.

Mean differences for both effectiveness measures were statistically significant (P<0.01). The incremental cost-effectiveness ratio for OM-plus-RMC was $23.38 per day abstinent and $59.51 per reduced substance-related problem. When additional https://www.selleckchem.com/Wnt.html costs to society were factored into the analysis, OM-plus-RMC was less costly and more effective than OM-only.

ConclusionsRecovery Management Checkups are a cost-effective and potentially cost-saving strategy for promoting abstinence and reducing substance use-related problems among chronic substance users.”
“Purpose of review

Male infertility impacts a substantial proportion of men and has serious implication for a man’s quality of life. Advances in reproductive technology may allow men to bypass urologic care in order to achieve their family planning goals. Recent data suggests that male reproductive failure may be a harbinger of future urologic diseases, including prostate cancer (CaP), thus emphasizing the importance of dedicated urologic evaluation and care for all male infertility patients.

Recent findings

We will review the epidemiologic data that explores an association between male reproductive health and CaP. We will review the potential biologic mechanisms that may underlie this association, and explore possible reasons for inconsistencies in study findings.

Patients presenting with preoperative sinusitis and sinuses ZD1839 Protein Tyrosine Kinase inhibitor with thick mucosa need to be informed of the increased risk. They require a close follow-up and prompt treatment in the event of signs and symptoms of sinusitis. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e1-e4)”
“FexPt(1-x) nanowire arrays embedded in porous alumina membranes with controlled diameters and high aspect ratios were fabricated by the pulse electrodeposition method in a novel bath with a simple composition. The composition of FexPt(1-x) nanowires can be highly controlled by the negative deposition

voltage and the pulse duration. A growth mode of alternating Fe and Pt composition within wires is observed for electrodeposition in different periods of pulse time. The space separation between the iron-rich layer and the platinum-rich layer contributes to the relatively low coercivity of FexPt(1-x) nanowire arrays with an atomic ratio of 1:1. (C) 2011 American Institute of Physics. [doi:10.1063/1.3537941]“
“Oral lichen planus (OLP) is a chronic mucosal disorder of unclear etiology.

The mainstay of therapy is topical use of steroids but other immuno-modulating therapies have also been tried. One such example is topical application of tacrolimus. Tacrolimus was in 2000 approved for treatment of atopic dermatitis, SN-38 DNA Damage inhibitor but in 2005 a boxed warning was included because of a potential risk of cancer development and for lack of long-term studies of the safety click here of the drug. The present study describes a patient who in 2003 was diagnosed with OLP and where treatment has included an intermittent use of tacrolimus. Five years after diagnosis, the patient developed a squamous cell carcinoma in the region where tacrolimus had been applied. The possible relationship between the use of tacrolimus and cancer development and rationale to include tacrolimus in OLP treatment is discussed. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e19-e25)”
“Predictors of quality of life can define potentially modifiable factors to increase favorable outcomes after

pediatric stroke. Quality of life was measured using the Centre for Health Promotion’s Quality of Life Profile (CHP-QOL) in 112 children surviving arterial ischemic stroke or cerebral sinovenous thrombosis at mean 3 years after stroke. Overall quality of life was poor in 17.8% children despite mean scores (3.52) in the “”adequate”" range. Quality of life related to school and play was most problematic and that related to physical and home environment was least problematic. Female gender, cerebral sinovenous thrombosis stroke, and older age at testing predicted reduced overall and domain-specific quality of life (P < .05), whereas neurological outcome and family socioeconomic status did not. Cognitive/behavioral deficit and low Verbal IQ adversely affected socialization and quality of life, especially among older children and females.

mutans cells and better at blocking bacterial adhesion to saliva-coated plastic surfaces compared with the anti-full-length P1 antiserum. In addition, adsorption of the anti-P1 antiserum with

P1(39-512) eliminated MAPK inhibitor its ability to block the adhesion of S. mutans cells to abiotic surfaces. The present results indicate that P1(39-512), expressed and purified from a recombinant B. subtilis strain, maintains important immunological features of the native protein and represents an additional tool for the development of anticaries vaccines.”
“Background: Advancements in emergency care and diagnostic methods have increased the number of children who survive atlanto-occipital PD0325901 manufacturer dislocation. We report our experience with one of the largest series of pediatric patients with atlanto-occipital dislocation.

Methods: Patients ranging in age from newborn to sixteen years old who had a diagnosis of atlanto-occipital dislocation from 1991 through 2011 were identified. Inclusion criteria were complete radiographic and clinical records and duration of follow-up of at least six months. Basic patient characteristics,

mechanism of injury, associated injuries, neurological impairment, surgical treatment and type of implant used for fixation, complications, and clinical and radiographic outcomes were recorded.

Results: The fourteen patients who were included (seven male and seven female) had a mean age of 5.2 years at the time of injury. An automobile accident in which the victim was a passenger was the most common mechanism of injury. Twelve patients had associated injuries, with a brain injury in eleven

of them, and nearly half Akt inhibitors in clinical trials sustained a spinal cord injury. According to the Traynelis classification system, eight patients had a type-II (longitudinal) atlanto-occipital dislocation, five had a typed (anterior) dislocation, and one had a type-Ill (posterior) dislocation. All patients had posterior occipitocervical fusion with internal fixation. The mean duration of follow-up was 75.4 months. The most common postoperative complication was hydrocephalus, which occurred in four patients. Spinal fusion occurred in all patients by four to six months postoperatively. At the time of the most recent follow-up evaluation, half of the patients had neurological impairment.

Conclusions: More patients with atlanto-occipital dislocation now survive the initial trauma, although most have associated injuries and many have neurological impairment. Our preferred management is early occipitocervical fusion and stabilization. If there is neurological decline after spinal fixation, obstructive hydrocephalus should be suspected.”
“Background : Making the cytologic differentiation between benign and malignant effusions can be difficult.

We hypothesized that birth weight selleckchem and BMI may partly share a common genetic background.

Objective: The objective was to examine the associations of 12 established BMI variants in or near the NEGR1, SEC16B, TMEM18, ETV5, GNPDA2, BDNF, MTCH2, BCDIN3D, SH2B1, FTO, MC4R, and KCTD15 genes and their additive score with birth weight.

Design: A meta-analysis was conducted with the

use of 1) the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk, Hertfordshire, Fenland, and European Youth Heart Study cohorts (n(max) = 14,060); 2) data extracted from the Early Growth Genetics Consortium meta-analysis of 6 genome-wide association studies for birth weight (n(max) = 10,623); and 3) all published data (n(max) = 14,837).

Results: Only the MTCH2 and FTO loci showed a nominally significant association with birth weight. The BMI-increasing allele of the MTCH2 variant (rs10838738) was associated with a lower birth weight (beta +/- SE: 213 +/- 5 g/allele; P = 0.012; n = 23,680), and the BMI-increasing allele of the FTO variant (rs1121980) was associated with a higher birth weight

(beta +/- SE: 11 +/- 4 g/allele; P = 0.013; n = 28,219). These results were not significant after correction for multiple testing.

Conclusions: Obesity-susceptibility loci have Erastin in vitro a small or no effect on weight at birth. Some evidence of an association was found for the MTCH2 and FTO loci, ie, lower and higher birth weight, respectively. These findings may provide new insights into the underlying mechanisms by which these loci confer an increased risk of obesity. Am J Clin Nutr 2011;93:851-60.”
“Background: Utilizing laparoscopy for major surgeries such as hepatectomy Selleck PD98059 is a relatively new concept. Initially, benign pathologies dominated indications for resection. Our experience in an Australian setting with primarily malignant diagnoses is described.

Methods:

A review of patients’ profiles, pathology, surgery and outcome was performed on 35 patients between December 2005 and August 2008. Data were collected and analysed retrospectively from medical records on a pre-designed datasheet.

Results: Commonest indication for resection was colorectal metastasis (54%), 71% of all resections were for malignancy. Average operating time was 2 h 31 min (range 30 min-7 h, 15 min). Major morbidity consisted of one bile leak, two subphrenic abscesses and one pulmonary embolus. There were no deaths. Conversion to open was required in 20% and two patients required intra-operative blood transfusions. Average length of stay overall was 6.1 days (range 1-27), but as low as 2 days for some left lateral sectionectomies. Cessation of parenteral analgesia, return to normal diet and full mobility were achieved on average at 2.4, 2.3 and 2.8 days. Significant post-operative liver dysfunction was seen in two patients, which returned to normal by discharge. One patient died of disease progression 4 months after surgery. There were two involved margins in 35 patients (6%).