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Sample records for arthritis long-term results

  1. Antibiotic treatment and long term prognosis of reactive arthritis

    PubMed Central

    Laasila, K; Laasonen, L; Leirisalo-Repo, M

    2003-01-01

    Objective: To evaluate whether a three month course of lymecycline has an effect on the long term prognosis of reactive arthritis (ReA). Methods: In 1987–88 a double-blind controlled study with three month course of lymecycline/placebo was conducted. 17 of 23 patients treated at the outpatient department of Helsinki University Central Hospital volunteered to take part in a follow up study, where a physical examination were performed, and erythrocyte sedimentation rate, C reactive protein, rheumatoid factor, and radiographs of the lumbosacral spine and sacroiliac joints and of symptomatic peripheral joints were examined. Results: 16/17 (94%) patients reported some kind of back pain and 10/17 (59%) peripheral joint symptoms during the follow up. Two patients had unilateral grade 1 sacroiliitis, one patient grade 4 sacroiliitis, and one patient bilateral grade 2 sacroiliitis. In one patient the disease had progressed to ankylosing spondylitis (AS), and in another to chronic spondyloarthropathy. In addition, two patients had small erosions in radiocarpal joints. No statistically significant differences were found between placebo and lymecycline groups in the development of chronic arthritis, sacroiliitis, or AS. Conclusion: The results of the initial study showed that long term treatment with lymecycline in patients with acute ReA decreased the duration of arthritis in those with Chlamydia trachomatis triggered ReA, but not in other patients with ReA. Ten years after the acute arthritis one patient had developed AS, and three had radiological sacroiliitis, three patients had radiological changes at peripheral joints. Long term lymecycline treatment did not change the natural history of the disease. PMID:12810429

  2. The long-term outcome of uncemented Low Contact Stress total knee replacement in patients with rheumatoid arthritis: results at a mean of 22 years.

    PubMed

    Abram, S G F; Nicol, F; Hullin, M G; Spencer, S J

    2013-11-01

    We reviewed the long-term clinical and radiological results of 63 uncemented Low Contact Stress (LCS) total knee replacements (TKRs) in 47 patients with rheumatoid arthritis. The mean age of the patients at the time of surgery was 69 years (53 to 81). At a mean follow-up of 22 years (20 to 25), 12 patients were alive (17 TKRs), 27 had died (36 TKRs), and eight (ten TKRs) were lost to follow-up. Revision was necessary in seven patients (seven TKRs, 11.1%) at a mean of 12.1 years (0 to 19) after surgery. In the surviving ten patients who had not undergone revision (15 TKRs), the mean Oxford knee score was 30.2 (16 to 41) at a mean follow-up of 19.5 years (15 to 24.7) and mean active flexion was 105° (90° to 150°). The survival rate was 88.9% at 20 years (56 of 63) and the Kaplan-Meier survival estimate, without revision, was 80.2% (95% confidence interval 37 to 100) at 25 years.

  3. Long-term efficacy and safety of certolizumab pegol in Japanese rheumatoid arthritis patients with an inadequate response to methotrexate: 52-week results from an open-label extension of the J-RAPID study

    PubMed Central

    Tanaka, Yoshiya; Yamamoto, Kazuhiko; Takeuchi, Tsutomu; Yamanaka, Hisashi; Ishiguro, Naoki; Eguchi, Katsumi; Watanabe, Akira; Origasa, Hideki; Shoji, Toshiharu; Miyasaka, Nobuyuki; Koike, Takao

    2014-01-01

    Abstract Objectives. To evaluate the long-term efficacy and safety of certolizumab pegol (CZP) plus methotrexate treatment and to assess the efficacy of two CZP maintenance dosing schedules in Japanese rheumatoid arthritis (RA) patients with an inadequate response to methotrexate. Methods. J-RAPID double-blind patients were entered into an open-label extension (OLE) study. Patients withdrawn due to lack of efficacy at 16 weeks and double-blind completers without a week-24 American College of Rheumatology (ACR) 20 response received CZP 200 mg every other week (Q2W) plus methotrexate. Double-blind completers with week-24 ACR20 responses were randomized to CZP 200 mg Q2W plus methotrexate or CZP 400 mg every 4 weeks plus methotrexate. Results. The ACR20/ACR50/ACR70 response rates of double-blind completers (n = 204) were 89.7%/67.2%/36.3% at OLE entry and 95.6%/84.8%/58.3% at 52 weeks, respectively. Other clinical, functional and radiographic outcomes were sustained with long-term CZP plus methotrexate. Long-term treatment with CZP was well-tolerated with no new unexpected adverse events observed. The efficacy and safety of CZP treatment were similar between the two dosing schedules. Conclusions. Continued CZP administration with methotrexate maintained efficacy over 52 weeks and was well-tolerated for Japanese RA patients. No obvious differences in clinical efficacy and safety were observed between the two dosing schedules, giving flexibility in maintenance administration schedules. PMID:24593170

  4. [Childhood liver transplantation. Long-term results].

    PubMed

    Jara, Paloma; Hierro, Loreto

    2010-05-01

    Liver transplantation allows long-term survival (10 years or more) in 75% of children receiving transplants before 2000. The risk of mortality after the first year is 4-10% in the next 10-20 years. Chronic rejection affects 6%. The need for late retransplantation is 3-5%. However, the follow-up of these patients involves the management of diverse problems in the graft (immunological, biliary, vascular) and others related to the use of immunosuppressants (renal dysfunction, lymphoproliferative syndrome). The transition from pediatric to adult care generates special needs. Adolescence and young adulthood are associated with a lack of compliance. Adult specialists should be aware of the special features of the original diagnosis and the surgical techniques used in childhood transplantation. Final quality of life is good overall but is lower than that in healthy young persons.

  5. Systematic review: Evidence for Predictive Validity of Remission on Long Term Outcome in Rheumatoid Arthritis

    PubMed Central

    van Tuyl, Lilian HD; Felson, Prof David T; Wells, Prof George; Smolen, Prof Josef; Zhang, Dr Bin; Boers, Prof Maarten

    2010-01-01

    Objective Remission is rapidly becoming a key endpoint in rheumatoid arthritis clinical trials, but its definition is not satisfactory. Although it is generally believed that achieving a state of remission will lead to better structural outcome, this has not been studied systematically. As a part of an undertaking to redefine remission, the current review describes the relationship between remission and long term structural outcome. Methods A systematic literature search of PubMed, Embase.com, and the Cochrane Library intersected three groups of terms: rheumatoid arthritis, remission and long term outcome. The search identified 1138 records, of which 14 were relevant to the research question. Results All the studies included in this review showed a relationship between remission and long term structural damage or disability. Patients that achieved a state remission, defined in various ways, showed less deterioration of function and radiographic progression compared to patients who did not reach a state of remission. Conclusion Patients who achieve a state of remission are less likely to show deterioration of function and radiographic progression compared to patients that do not reach a state of remission. PMID:20191498

  6. [Long-term results of invaginated ileotransversoanastomosis].

    PubMed

    Nishanov, F N; Batirov, A K; Abdullazhanov, B R; Nishanov, M F

    2011-01-01

    The authors make an analysis of surgical treatment of 24 patients with right hemicolectomy and the formation of ileotransversoanastomosis. Depending on the method of the formation of interintestinal anastomosis the patients were divided into 2 groups: in the first group of 8 (33.3%) patients the ileotransversoanastomosis was formed by a traditional method using double row seams; in the second group of 16 (66.7%) the ileotransversoanastomosis was formed using a modified method of invagination using a single row seams. The authors based on the investigation performed make a conclusion that the results of right hemicolectomy depend on the method of forming the interintestinal anastomosis, the formation of ileotransversoanastomosis by a "classical" variant is fraught by the development of reflux enteritis. The authors propose a technique of formation of ileotransversoanastomosis by the method of invagination using a 1 row seam, performing the function of the valve, prevents regurgitation of the intestinal contents and is a measure of prophylactics of reflux-enteritis.

  7. Long-term clinical outcomes of patients with rheumatoid arthritis and concomitant coronary artery disease

    PubMed Central

    Spartera, Marco; Godino, Cosmo; Baldissera, Elena; Campochiaro, Corrado; La Spina, Ketty; Aiello, Patrizia; Salerno, Anna; Cera, Michela; Magni, Valeria; Jabbour, Richard J; Dagna, Lorenzo; Tresoldi, Moreno; Cappelletti, Alberto; Alfieri, Ottavio; Colombo, Antonio; Sabbadini, Maria Grazia; Margonato, Alberto

    2017-01-01

    Background: Rheumatoid arthritis (RA) is associated with high morbidity and mortality predominately due to increased cardiovascular risk. Few reports are available regarding the management of coronary artery disease (CAD) in RA patients and the long-term clinical outcomes after coronary revascularization. Methods and results: All consecutive patients with RA were identified by retrospective review at a rheumatology tertiary center in Milan, Italy between 2001 and 2013. RA patients affected by significant CAD (RA-CAD+) were prospectively followed for major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary revascularization (RA-PCI), coronary artery bypass grafting (RA-CABG) or medical therapy (RA-MT). Among 936 patients with RA, the presence of clinically significant CAD was found in 5.6% (53 patients, RA-CAD+). Of these, 32 patients (60%) underwent PCI (RA-PCI), 10 patients (19%) underwent CABG (RA-CABG) and 11 patients (21%) treated with MT (RA-MT). After a mean follow-up of 9±7 years, the rate of MACCE was 56% in RA-PCI patients, 50% in RA-CABG and 27% in RA-MT patients (P=0.184). The high MACCE rate was mainly driven by repeat coronary revascularization (47%) in the RA-PCI group and high rate of strokes (30%) in RA-CABG patients. Conclusion: In patients with rheumatoid arthritis and concomitant coronary artery disease (RA-CAD+), we observed at long-term follow-up a high MACCE rate, predominantly in those who underwent coronary revascularization PMID:28337386

  8. Long-term results after robotically assisted coronary bypass surgery

    PubMed Central

    Ramahi, Jehad; Hasan, Faisal; Edris, Ahmad; Bartel, Thomas; Nair, Ravi; Tuzcu, Murat; Suri, Rakesh; Mihaljevic, Tomislav

    2016-01-01

    Background Robotically-assisted coronary bypass grafting (CABG) was introduced in 1998 and dedicated centers have continuously applied and developed this minimally invasive method of coronary bypass surgery. While short-term results are relatively well published, data on long-term outcome are limited. In this literature review, we assessed the outcomes after robotic CABG following the first postoperative year. Methods We searched PubMed for articles containing the terms “robotic” or “robotically assisted” and “coronary bypass”. A total of 11 papers contained long-term results. We specifically investigated survival, graft patency, freedom from angina and re-intervention, as well as freedom from major adverse cardiac and cerebrovascular events (MACCE). Results Five-year survival after robotic CABG was consistently consistently greater than 90% and graft patency between 3 and 5 years was reported to be above 90%. Fifteen percent to 26% of patients re-experienced angina at 3 to 5 years postoperatively. Long-term freedom from re-intervention reached the range and the 5-year freedom from MACCE rate was approximately 75%. Conclusions According to data in the literature, long-term results after CABG carried out with the assistance of a surgical robot appear to be in line with results achieved after conventional CABG. PMID:27942487

  9. Long term functional results from major limb replantations.

    PubMed

    Laing, T A; Cassell, O; O'Donovan, D; Eadie, P

    2012-07-01

    Replantation is now firmly established as a viable treatment option in traumatic limb amputation, yet there are few long-term studies describing the functional outcome of these cases. The purpose of the present study was to evaluate long-term results in a population of such patients to determine overall success and patient satisfaction. Since 1981, twenty macro-replants involving nineteen patients have been performed in our unit. All patients were reviewed by means of case note analysis, patient questionnaire, and follow-up clinical evaluation for functional outcome using the Tamai scoring system. Acute limb salvage was successful in 18/20 (90%) cases. One patient is still undergoing secondary reconstructive surgery and was unable to be assessed for final outcome leaving 17 replanted limbs that underwent full functional assessment. Overall functional results were good in 7/17 (41%) limbs, fair in 7/17 (41%) and poor in 3/17 (18%). The majority of patients (12/17) claimed to be highly or well satisfied with their outcome and eleven have returned to work since their injury. The current study of major limb replantation demonstrates favorable or acceptable long term functional outcomes in the majority of cases. High patient satisfaction rates even where results were poor emphasise the positive psychological impact of successful replantation.

  10. Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease

    PubMed Central

    Burmester, Gerd R; Panaccione, Remo; Gordon, Kenneth B; McIlraith, Melissa J; Lacerda, Ana P M

    2013-01-01

    Background As long-term treatment with antitumour necrosis factor (TNF) drugs becomes accepted practice, the risk assessment requires an understanding of anti-TNF long-term safety. Registry safety data in rheumatoid arthritis (RA) are available, but these patients may not be monitored as closely as patients in a clinical trial. Cross-indication safety reviews of available anti-TNF agents are limited. Objective To analyse the long-term safety of adalimumab treatment. Methods This analysis included 23 458 patients exposed to adalimumab in 71 global clinical trials in RA, juvenile idiopathic arthritis, ankylosing spondylitis (AS), psoriatic arthritis, psoriasis (Ps) and Crohn's disease (CD). Events per 100 patient-years were calculated using events reported after the first dose through 70 days after the last dose. Standardised incidence rates for malignancies were calculated using a National Cancer Institute database. Standardised death rates were calculated using WHO data. Results The most frequently reported serious adverse events across indications were infections with greatest incidence in RA and CD trials. Overall malignancy rates for adalimumab-treated patients were as expected for the general population; the incidence of lymphoma was increased in patients with RA, but within the range expected in RA without anti-TNF therapy; non-melanoma skin cancer incidence was raised in RA, Ps and CD. In all indications, death rates were lower than, or equivalent to, those expected in the general population. Conclusions Analysis of adverse events of interest through nearly 12 years of adalimumab exposure in clinical trials across indications demonstrated individual differences in rates by disease populations, no new safety signals and a safety profile consistent with known information about the anti-TNF class. PMID:22562972

  11. Review of long-term results of stereotactic psychosurgery.

    PubMed

    Kim, Moon-Chan; Lee, Tae-Kyu; Choi, Chang-Rak

    2002-09-01

    Stereotactic psychosurgery is an effective method for treating some medically intractable psychiatric illnesses. However, it is unfamiliar and the long-term clinical results have not been reported in Asia. The long-term results of psychosurgery are evaluated and the neuroanatomical basis is discussed. Twenty-one patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses since 1993. All were referred from psychiatrists for these disorders. Two patients showed aggressive behavior, 12 had obsessive-compulsive disorder (OCD), and seven had depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were performed for aggressive behavior, limbic leucotomy was performed for OCD, and subcaudate tractotomy with or without cingulotomy was performed for depression with anxiety. OCD was evaluated with the Yale-Brown Obsessive Compulsive Scale (YBOCS), the visual analogue scale, the Clinical Global Impression Scale, and the Overt Aggression Scale (OAS). The Mini-Mental State Examination and the Wechsler Adult Intelligence Scale-Revised were used for the evaluation of aggressive behavior. The 17-item Hamilton Depression Rating Scale (HAMD) was used for evaluation of depression. Ventriculography was used in the first seven patients and magnetic resonance imaging-guided stereotaxy was used in the recent 14 cases for localization of the target. The lesions were made with a radiofrequency lesion generator. OAS scores in the two patients with aggressive behavior during follow up declined from 8 to 2 with clinical improvement. All 12 patients with OCD returned to their previous life and showed the mean YBOCS scores decreased from 34 to 3. Ten patients with OCD could be followed up (mean 45 months). All patients returned to their previous social life. In seven patients with depression with anxiety, HAMD scores declined from 28.5 to 16.5. There was no operative mortality and no significant morbidity except for one case of mild

  12. Percutaneous Treatment in Iliac Artery Occlusion: Long-Term Results

    SciTech Connect

    Gandini, Roberto; Fabiano, Sebastiano; Chiocchi, Marcello; Chiappa, Roberto Simonetti, Giovanni

    2008-11-15

    We evaluated the long-term results of recanalization with primary stenting for patients with long and complex iliac artery occlusions. This was a retrospective nonrandomised study. Between 1995 and 1999, 138 patients underwent recanalization of an occluded iliac artery with subsequent stenting. Patency results were calculated using Kaplan-Meier analysis. The mean length of follow-up was 108 months. Variables affecting primary stent patency such as patient age; stent type and diameter; lesion site, shape, and length; Society of Cardiovascular and Interventional Radiology classification; total runoff score; Fontaine classification; and cardiovascular risk factors were analysed using Breslow test. These variables were then evaluated for their relation to stent patency using Cox proportional hazards test. Technical success was 99%. Primary patency rates were 90% (SE .024), 85% (SE .029), 80% (SE .034), and 68% (SE .052) at 3, 5, 7, and 10 years, respectively. Lesion site (p = 0.022) and stent diameter (p = 0.028) were shown to have a statistically significant influence on primary stent patency. Long-term results of iliac recanalization and stent placement were excellent, without major complications, even in highly complex vascular obstructions. A primary endovascular approach appears to be justified in the majority of patients as a less invasive alternative treatment to surgery. In any case, a first-line interventional approach should be considered in elderly patients or in patients with severe comorbidities.

  13. Radiofrequency volumetric inferior turbinate reduction: long-term clinical results.

    PubMed

    De Corso, E; Bastanza, G; Di Donfrancesco, V; Guidi, M L; Morelli Sbarra, G; Passali, G C; Poscia, A; de Waure, C; Paludetti, G; Galli, J

    2016-06-01

    The aim of our study was to assess long-term results of radiofrequency volumetric tissue reduction of inferior turbinates (RVTR). We performed a prospective long-term longitudinal evaluation of 305 patients affected by rhinitis (114 allergic and 191 non-allergic) who were unresponsive to medical treatment and underwent RVTR (January 2004 - December 2010). Subjects were followed for a mean period of 39.70 ± 19.41 months (range 24-60). Patients completed the NOSE-scale questionnaire pre- and post-operatively after 1 month and yearly for 5-years. Recurrence was assumed if the post-operative total NOSE score increased by at least 75% during follow-up and the patient restarted medical treatments. Estimation of relapse over time was performed by Kaplan-Meyer analyses. We documented overall good satisfaction of patients regarding the procedure, with a good rate of pain control and a low rate of complications. Post-operatively there was a significant improvement in nasal stuffiness, nasal obstruction and mouth breathing (p < 0.05). We observed a worsening trend for symptoms after 36 months with progressive increasing rate of recurrences that were significantly higher in allergic than non-allergic patients (p < 0.05). We also observed a slight worsening trend of global satisfaction of patients. Our study confirms the minor discomfort and low risk of side effects of RVTR. Our data showed good efficacy of the procedure in the majority of patients for at least 36 months after surgery, and in fact in this time period the cumulative probability to remain relapse-free was up to 0.8. In the following 2 years, we observed a worse temporal trend in term of recurrence rate, and in particular in allergic patients with a significant difference vs non-allergic individuals (p < 0.05).

  14. [Psoriasis arthritis--long-term treatment of two patients with leflunomide].

    PubMed

    Schmitt, Jochen; Wozel, Gottfried

    2004-09-01

    The prodrug leflunomide is an immunomodulatory agent whose M1 metabolite inhibits the proliferation of T- and B-lymphocytes. The efficacy of leflunomide in rheumatoid arthritis suggests it may be useful psoriasis arthritis. Two patients with psoriasis arthritis in whom NSAIDs, glucocorticosteroids, sulfasalazine, cyclosporine and methotrexate were not as effective as expected were treated with leflunomide for 18 and 27 months. At regular visits examination of the joints (according to the ACR criteria) and the skin (PASI), the visual analogue scale for pain, and the quality of life (HAQ) were assessed. In both patients progression of the joint disease was arrested, pain reduced and quality of life improved. The cutaneous findings did not change, even though topical therapy was continued. Leflunomide is a long-term treatment option for patients with predominantly joint disease. In case of insufficient response, combination with other anti-inflammatory drugs, e.g. methotrexate, is possible. As leflunomide has little effect on psoriatic skin lesions, additional topical therapy is necessary.

  15. SULFURIC ACID REMOVAL PROCESS EVALUATION: LONG-TERM RESULTS

    SciTech Connect

    Gary M. Blythe; Richard McMillan

    2002-07-03

    longer-term (approximately 25-day) full-scale tests on two different units. The longer-term tests were conducted to confirm the effectiveness of the sorbents tested over extended operation on two different boilers, and to determine balance-of-plant impacts. The first long-term test was conducted on FirstEnergy's BMP, Unit 3, and the second test was conducted on AEP's Gavin Plant, Unit 1. The Gavin Plant testing provided an opportunity to evaluate the effects of sorbent injected into the furnace on SO{sub 3} formed across an operating SCR reactor. This report presents the results from those long-term tests. The tests determined the effectiveness of injecting commercially available magnesium hydroxide slurry (Gavin Plant) and byproduct magnesium hydroxide slurry (both Gavin Plant and BMP) for sulfuric acid control. The results show that injecting either slurry could achieve up to 70 to 75% overall sulfuric acid removal. At BMP, this overall removal was limited by the need to maintain acceptable electrostatic precipitator (ESP) particulate control performance. At Gavin Plant, the overall sulfuric acid removal was limited because the furnace injected sorbent was less effective at removing SO{sub 3} formed across the SCR system installed on the unit for NOX control than at removing SO{sub 3} formed in the furnace. The long-term tests also determined balance-of-plant impacts from slurry injection during the two tests. These include impacts on boiler back-end temperatures and pressure drops, SCR catalyst properties, ESP performance, removal of other flue gas species, and flue gas opacity. For the most part the balance-of-plant impacts were neutral to positive, although adverse effects on ESP performance became an issue during the BMP test.

  16. Reconstruction of old radical cavities and long-term results.

    PubMed

    Magliulo, Giuseppe; D'Amico, Raffaello; Fusconi, Massimo

    2004-06-01

    Various techniques and materials have been proposed to deal with the problems that concern radical cavities, such as recurrence of the inflammatory process, the need for regular medication, and social inconvenience (eg, inability to practice water sports, working in an adverse enviroment). This article provides a detailed report of the results of revalidation of old radical cavities using hydroxyapatite granules as a filling. The material was incorporated with fibrin adhesive to fill the mastoid cavity and was covered with a sheet of bone pate sealant. Twenty-eight patients with chronic discharging old radical cavities were selected for this study (mean follow-up 11.4 years; range 10-14 years). At the 6-month follow-up, grafting was successful in 25 patients, whereas the functional outcomes showed an air-bone gap below 30 dB in 18 patients. No postoperative sensorineural hearing loss was observed. The long-term follow-up demonstrated a slight worsening of the initial findings; four other patients had reperforation of the tympanic membrane, and hearing deteriorated in five patients to above 30 dB air-bone gap. These results could be a consequence of an alteration in the function of the eustachian tube and of the severity of the preoperative pathologic processes.

  17. Long-term results of endobronchial brachytherapy: A curative treatment?

    SciTech Connect

    Hennequin, Christophe . E-mail: christophe.hennequin@sls.ap-hop-paris.fr; Bleichner, Olivier; Tredaniel, Jean; Quero, Laurent; Sergent, Guillaume; Zalcman, Gerard; Maylin, Claude

    2007-02-01

    Purpose: To evaluate outcomes after high-dose-rate endobronchial brachytherapy (HDR-EBBT) for limited lung carcinoma. Methods: A total of 106 patients with endobronchial lung cancer and not eligible for surgery or external beam radiotherapy, without nodal or visceral metastases, were treated with HDR-EBBT. They had developed disease relapse after surgery (n = 43) or external beam radiotherapy (n = 27) or had early lung cancer with respiratory insufficiency (n = 36). Treatment consisted of six fractions of 5 or 7 Gy, usually delivered 1 cm from the source. Results: The complete histologic response rate, evaluated at 3 months after HDR-EBBT, was 59.4%. At 3 and 5 years, the local control, overall survival, and cause-specific survival rates were 60.3% and 51.6%, 47.4 and 24%, and 67.9 and 48.5%, respectively. Factors significantly associated with local failure were high tumor volume (tumor length >2 cm, bronchial obstruction >25%, tumor visibility on CT scan) and previous endoscopic treatment. Cause-specific survival, but not overall survival, was significantly associated with local control, probably because of the high rate of deaths not related to lung cancer. Five deaths were attributed to the HDR-EBBT procedure (two from fatal hemoptysis and three from bronchial necrosis). Conclusion: High-dose-rate-EBBT achieved a long-term cause-specific survival rate of 50% of the patients with localized endobronchial carcinoma and could be considered curative.

  18. Long term results of PDR brachytherapy for lip cancer

    PubMed Central

    Karlsson, Leif; Hardell, Lennart; Persliden, Jan

    2011-01-01

    Purpose To evaluate the long time outcome with regard to local tumour control and side effects of a pulsed dose rate (PDR) monobrachytherapy of primary or recurrent cancer of the lip. Material and methods Between 1995 and 2007 we treated 43 patients with primary or recurrent clinical T1-T3N0 lip cancers. There were 22 T1 patients (51%), 16 T2 (37%) and 5 T3 cases (12%). A median dose of 60 (55-66) Gy was given, depending on the tumour volume. The PDR treatment was delivered with 0.83 Gy/pulse every second hour for 5.5-6.5 days. The patients were followed for a median of 55 (1-158) months. Results The 2-, 5- and 10-year rates of actuarial local control were 97.6%, 94.5% and 94.5%, overall survival 88.0%, 58.9% and 39.1%, disease free survival 92.7%, 86.4% and 86.4% respectively. The regional control rate was 93%. One patient (2%) developed distant metastases. A dosimetrical analysis showed a mean treated volume of 14.9 (3.0-56.2) cm3. Long-term side effects were mild and the cosmetic outcome excellent, except for 1 case (2%) of soft tissue necrosis and 1 case (2%) of osteoradionecrosis. Conclusions Local outcome is excellent and similar to other published studies of continuous low dose rate (cLDR) brachytherapy. PMID:27895671

  19. Long-term results of the Sauvé-Kapandji procedure in the rheumatoid wrist.

    PubMed

    Papp, Miklós; Papp, Levente; Lenkei, Balázs; Károlyi, Zoltán

    2013-12-01

    This retrospective long-term study evaluates the clinical and radiological results of the Sauvé-Kapandji procedure in rheumatoid wrists. Fourteen patients with rheumatoid arthritis who had undergone a Sauvé-Kapandji procedure were examined 10 to 16.5 years after surgery. Range of motion and grip strength were measured. The patients' complaints related with instability of the ulnar stump, the residual pain in the wrist, and the function of the operated hand were assessed. The review also included a radiological examination. Pain was found to have decreased and the gripping strength of the hand to have increased in all the patients. The range of wrist rotation was significantly improved. On radiographs, there were no signs of increased ulnar translation of the carpus. We noted no instance of subluxation or dislocation of the ulnar stump. In this long-term evaluation, the Sauvé-Kapandji procedure was found to provide long-term improvement of the function of the wrist-hand complex, by eliminating the distal radio-ulnar joint which is a major source of pain in the rheumatoid wrist.

  20. Aortic Annulus Enlargement: Early and Long-Terms Results

    PubMed Central

    Dumani, Selman; Likaj, Ermal; Dibra, Laureta; Beca, Vera; Kuci, Saimir; Refatllari, Ali

    2017-01-01

    AIM: Patient-prosthesis mismatch (PPM) is a common occurrence in aortic valve surgery. Even the discussions about the impact of this phenomenon on the results of aortic valve surgery, the management of this problem remain one of the main topics in this kind of surgery. One of the ways of a solution is aortic annulus enlargement. The main topic of this study is to evaluate the early and longterm results of this technique in our country. METHODS: During the period January 2010 –January 2015, 641 patients performed aortic valve surgery. In ten patients we performed aortic annulus enlargement according to Manouguian technique to avoid severe patient-prothesis mismatch. Operative mortality and perioperative complications (low cardiac output, pulmonary complications, etc..) were considered the indicators of the early results. Survival, clinical presentation according to NYHA, quality of life were the indicators to evaluate long-term results. Preoperative and postoperative echocardiographic data were also used to evaluate our results. We collected the data from hospital registrations and periodical clinical visit and echographic examination after hospital discharge. RESULTS: In our group, 6 of 10 patients were diagnosed with stenotic aortic valve, two patients had aortic valve regurgitation and two mixed valve pathology. Four patients had concomitant cardiac surgery procedure, mitral or CABG. In all cases, aortic valve pathology was the primary diagnose. In the preoperative echocardiographic examination mean transvalvular gradient was 54.3 ± 6.42. We had no death during early or late postoperative period. Only one patient had pulmonary complications and long time of respiratory assistance because of his pulmonary pathology. The same patient had low cardiac output and wound infection. Early after surgery mean transprostethic gradient was 16.2 ± 3.44 and late postoperative was 15.9 ± 4.3. No patient had the severe patient-prothesis mismatch. Mean follow-up was 49 ± 20

  1. Results of a Survey of Long-Term Archiving Implementations

    NASA Astrophysics Data System (ADS)

    Gurman, Joseph B.; Spencer, Jennifer L.

    2015-04-01

    NASA’s Heliophysics Data Management Policy calls for discipline-specific “final archives,” which will be responsible for the long-term archiving and service of Heliophysics mission data. Long-term archival functions, such as periodic revalidation of the data and migration to newer storage media when appropriate, have never been part of the Solar Data Analysis Center core capabilities. We also recognize that the largest space solar physics data set, the SDO AIA and HMI data at the Stanford Joint Science and Operations Center (JSOC), will eventually need preservation and long-term access, as will the potentially much larger data archive of DKIST observations. We have carried out a study of data archiving best practices in other disciplines and organizations, including NASA’s Space Physics Data Facility (SPDF), the National Institute of Standards and Technology (NIST), and private industry, and report on the lessons learned and possible cost models. We seek input from the broader solar physics community on the relative value of various levels of preservation effort.

  2. Long Term Corrosion/Degradation Test Six Year Results

    SciTech Connect

    M. K. Adler Flitton; C. W. Bishop; M. E. Delwiche; T. S. Yoder

    2004-09-01

    The Subsurface Disposal Area (SDA) of the Radioactive Waste Management Complex (RWMC) located at the Idaho National Engineering and Environmental Laboratory (INEEL) contains neutron-activated metals from non-fuel, nuclear reactor core components. The Long-Term Corrosion/Degradation (LTCD) Test is designed to obtain site-specific corrosion rates to support efforts to more accurately estimate the transfer of activated elements to the environment. The test is using two proven, industry-standard methods—direct corrosion testing using metal coupons, and monitored corrosion testing using electrical/resistance probes—to determine corrosion rates for various metal alloys generally representing the metals of interest buried at the SDA, including Type 304L stainless steel, Type 316L stainless steel, Inconel 718, Beryllium S200F, Aluminum 6061, Zircaloy-4, low-carbon steel, and Ferralium 255. In the direct testing, metal coupons are retrieved for corrosion evaluation after having been buried in SDA backfill soil and exposed to natural SDA environmental conditions for times ranging from one year to as many as 32 years, depending on research needs and funding availability. In the monitored testing, electrical/resistance probes buried in SDA backfill soil will provide corrosion data for the duration of the test or until the probes fail. This report provides an update describing the current status of the test and documents results to date. Data from the one-year and three-year results are also included, for comparison and evaluation of trends. In the six-year results, most metals being tested showed extremely low measurable rates of general corrosion. For Type 304L stainless steel, Type 316L stainless steel, Inconel 718, and Ferralium 255, corrosion rates fell in the range of “no reportable” to 0.0002 mils per year (MPY). Corrosion rates for Zircaloy-4 ranged from no measurable corrosion to 0.0001 MPY. These rates are two orders of magnitude lower than those specified in

  3. Long-Term Results of Surgery for Temporal Bone Paraganglioma

    PubMed Central

    Gjuric, Mislav; Seidinger, Lynda; Wigand, Malte Erik

    1996-01-01

    The only way to resolve the dispute about the effectiveness of surgery versus radiation therapy for glomus tympanicum and jugulare tumors is adequate long-term studies. In a retrospective study with an average follow-up period of 15 years (range 11 to 23 years) we reassessed 11 patients with glomus tympanicum tumors and 11 patients with glomus jugulare tumors. Ten of 11 patients with glomus tympanicum tumor were tumor-free after surgery. A temporary facial palsy and an external meatal wall defect were the only surgical complications. The air-bone gap postoperatively closed to within 10 dB in three patients, to within 20 dB in six patients, and to more than 30 dB in one patient. Nine of 10 patients with glomus jugulare tumor receiving complete resection were tumor-free. Less than half the patients experienced new-onset cranial nerve function loss, and all made satisfactory recovery, eliminating the need for tracheostomy or gastrostomy. In two patients, the hearing could be preserved on the preoperative level, but the majority already presented with deafness. In the long-term, surgery remains a treatment of choice for glomus tympanicum tumors. It is also an extremely effective treatment with low morbidity for glomus jugulare tumors, including those with intracranial extension. PMID:17170971

  4. Long-term results of aggressive weight reduction treatment.

    PubMed

    Svacina, S; Haas, T; Nedĕlníková, K; Sonka, J; Sucharda, P; Fried, M; Pesková, M

    1998-01-01

    We have checked weight changes in 11 patients eight years after 2-weeks in-patient weight reduction treatment and weight changes of another group of 11 patients three years after gastric banding. Using multiple linear regression we've looked for factors which could influence the aforementioned weight changes. For weight reduction regimens we confirmed only the following connection: BMI reduction in 8 years = 12.256 - 2.827 x BMI reduction in 2 weeks. For gastric banding it was: BMI reduction in 3 years = -7.880 + 2.383 x BMI reduction in 6 months. We therefore conclude that the long term effects of reduction regimens is not influenced by any hormonal or metabolic characteristics of the patient, but can be predicted by the early weight loss of the patient. Patients who lose too much during the reduction regimen will find it more difficult to keep the weight down, whereas patients who lose weight rapidly after gastric banding have the best long term prognosis.

  5. Supravalvular aortic stenosis. Long-term results of surgical treatment.

    PubMed

    van Son, J A; Danielson, G K; Puga, F J; Schaff, H V; Rastogi, A; Edwards, W D; Feldt, R H

    1994-01-01

    To determine long-term outcome after operation for supravalvular aortic stenosis, we reviewed the case histories of 80 patients who had repair of the localized form (group A) (n = 67) or diffuse form (group B) (n = 13) from 1956 to 1992, including 31 patients with the Williams-Beuren syndrome. Ages ranged from 7 months to 54 years (mean = 12.6 years). Forty-six patients had one or more associated cardiovascular anomalies; the most common was aortic valve stenosis (33.8%). Eighteen patients had 22 previous cardiovascular operations, and 28 patients had one or more additional anomalies repaired during their initial procedure at our institution. In group A, the aortic root was enlarged with a teardrop-shaped patch (n = 61) or a pantaloon-shaped patch (n = 6). In group B, patch enlargement of the aorta was confined to the root (n = 4) or extended into the ascending aorta or aortic arch (n = 7); one patient had a graft placed between the ascending and descending thoracic aorta and one patient had a left ventricular-aortic conduit. There were no deaths in group A; two patients in group B in whom patch enlargement was confined to the aortic root died during the operation (2.5%). Follow-up extended to 33.4 years (mean = 14.2 years); there were five late deaths in group A and one in group B. Survival excluding operative mortality was 94% at 10 years and 91% at 20 years. All patients were in functional class I or II. There was no significant difference between patients with a teardrop-shaped or pantaloon-shaped patch in terms of late gradient, survival, or aortic insufficiency. By Cox multivariate model, the only independent predictor of late death for all patients was associated aortic valve disease (p = 0.02), which was also a risk factor for late reoperation (p = 0.02). In group B, overall survival was better in patients who received an extended patch versus aortic root patch only (p = 0.02). We reached the following conclusions: (1) Associated aortic valve disease was

  6. Irradiated homologous cartilage grafts. Long-term results

    SciTech Connect

    Welling, D.B.; Maves, M.D.; Schuller, D.E.; Bardach, J.

    1988-03-01

    The use of irradiated homologous cartilage for the restoration of facial contour defects remains a controversial issue in reconstructive surgery. Both favorable and unfavorable reports can be found in the literature. Some basic research concerning the rate and mechanism of resorption has been completed but has failed to resolve the issue of the usefulness of this material in day-to-day practice. One frequently cited reference concerning the use of irradiated homologous cartilage in reconstructive surgery was coauthored by two of the present investigators ten years ago. In an effort to place this study in a long-term perspective, we examined 42 of the original 107 patients who formed the initial population base. Sixty-two of the original 145 irradiated homologous cartilage grafts have been followed up for an average of nine years, with an average resorption rate of approximately 75%. Eighteen of 24 grafts followed up from 11 to 16 years completely resorbed. In spite of complete graft resorption, some patients have maintained satisfactory facial contour with fibrous tissue replacement of the cartilage.

  7. Medulloblastoma in childhood: long-term results of treatment

    SciTech Connect

    Broadbent, V.A.; Barnes, N.D.; Wheeler, T.K.

    1981-07-01

    Thirty-one children under the age of 15 years with verified medulloblastoma were treated at Addenbrookes Hospital from 1940 to 1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom eight were examined. All these patients showed some residual problems, but five were leading active lives and had only minor physical disability. There was evidence of disturbance in growth, with shortening of the spine in relation to the limbs, in all the children. The height centile was lower than expected from parental height in four and one was severely dwarfed. Growth hormone secretion in response to exercise was, however, normal in five of six patients tested. Three children also showed failure of growth of the jaw sufficiently severe to be a cosmetic problem. Frank mental retardation was present in three children. A raised resting TSH level was found in two children, one of whom had a multinodular goiter. Of the three children with severe problems, two had been treated when under two years of age. Long-term follow-up of children who survive medulloblastoma is clearly necessary and consideration should perhaps be given to revision of current treatment regimes in very young children.

  8. Long term results in refractory tennis elbow using autologous blood.

    PubMed

    Gani, Naseem Ul; Khan, Hayat Ahmad; Kamal, Younis; Farooq, Munir; Jeelani, Hina; Shah, Adil Bashir

    2014-10-27

    Tennis elbow (TE) is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years). Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of <0.05 was taken as significant. The patients (76 females and 44 males) were evaluated after procedure. The mean age group was 40.67±8.21. The mean follow up was 5.7±1.72 (range 3 to 9 years). The mean pain score and Nirschl stage before the procedure was 3.3±0.9 and 6.2±0.82 respectively. At final follow up the pain score and Nirschl were 1.1±0.9 and 1.5±0.91 respectively. Autologous blood injection was found to be one of the modalities for treatment of TE. Being cheap, available and easy method of treatment, it should be considered as a treatment modality before opting for the surgery. Universal guidelines for the management of tennis elbow should be made as there is lot of controversy regarding the treatment.

  9. Long Term Results in Refractory Tennis Elbow Using Autologous Blood

    PubMed Central

    Gani, Naseem ul; Khan, Hayat Ahmad; Kamal, Younis; Farooq, Munir; Jeelani, Hina; Shah, Adil Bashir

    2014-01-01

    Tennis elbow (TE) is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years). Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of <0.05 was taken as significant. The patients (76 females and 44 males) were evaluated after procedure. The mean age group was 40.67±8.21. The mean follow up was 5.7±1.72 (range 3 to 9 years). The mean pain score and Nirschl stage before the procedure was 3.3±0.9 and 6.2±0.82 respectively. At final follow up the pain score and Nirschl were 1.1±0.9 and 1.5±0.91 respectively. Autologous blood injection was found to be one of the modalities for treatment of TE. Being cheap, available and easy method of treatment, it should be considered as a treatment modality before opting for the surgery. Universal guidelines for the management of tennis elbow should be made as there is lot of controversy regarding the treatment. PMID:25568727

  10. Aquatic exercise in older Korean women with arthritis: identifying barriers to and facilitators of long-term adherence.

    PubMed

    Kang, Hyun Sook; Ferrans, Carol Estwing; Kim, Mi Ja; Kim, Jong Im; Lee, Eun-Ok

    2007-07-01

    The purpose of this study was to identify factors influencing long-term adherence to aquatic exercise in older women with arthritis. Participants (n = 72) completed an educational program on aquatic exercise and underwent follow up for 6 months. At follow-up, women who continued aquatic exercise (adherence group, n = 25) had significantly higher scores than women in the nonadherence group (n = 47) in exercise self-efficacy (p < 0.0001) and group cohesion based on social aspects (p = 0.009). Both groups reported experiencing similar barriers to exercise (rho = 0.78). The findings provide insights for the development of strategies to promote long-term adherence to this type of aquatic exercise. Specifically, the findings encourage the fostering of exercise self-efficacy and social group cohesion during participation in educational programs to increase long-term exercise adherence.

  11. Brachytherapy in Lip Carcinoma: Long-Term Results

    SciTech Connect

    Guibert, Mireille; David, Isabelle; Vergez, Sebastien; Rives, Michel; Filleron, Thomas; Bonnet, Jacques; Delannes, Martine

    2011-12-01

    Purpose: The aim of this study was to evaluate the effectiveness of low-dose-rate brachytherapy for local control and relapse-free survival in squamous cell and basal cell carcinomas of the lips. We compared two groups: one with tumors on the skin and the other with tumors on the lip. Patients and methods: All patients had been treated at Claudius Regaud Cancer Centre from 1990 to 2008 for squamous cell or basal cell carcinoma. Low-dose-rate brachytherapy was performed with iridium 192 wires according to the Paris system rules. On average, the dose delivered was 65 Gy. Results: 172 consecutive patients were included in our study; 69 had skin carcinoma (squamous cell or basal cell), and 92 had squamous cell mucosal carcinoma. The average follow-up time was 5.4 years. In the skin cancer group, there were five local recurrences and one lymph node recurrence. In the mucosal cancer group, there were ten local recurrences and five lymph node recurrences. The 8-year relapse-free survival for the entire population was 80%. The 8-year relapse-free survival was 85% for skin carcinoma 75% for mucosal carcinoma, with no significant difference between groups. The functional results were satisfactory for 99% of patients, and the cosmetic results were satisfactory for 92%. Maximal toxicity observed was Grade 2. Conclusions: Low-dose-rate brachytherapy can be used to treat lip carcinomas at Stages T1 and T2 as the only treatment with excellent results for local control and relapse-free survival. The benefits of brachytherapy are also cosmetic and functional, with 91% of patients having no side effects.

  12. Rotationplasty in skeletally immature patients. Long-term followup results.

    PubMed

    Hanlon, M; Krajbich, J I

    1999-01-01

    Twenty-one skeletally immature patients with a Grade IIB osteosarcoma about the knee were treated with a modified Van Nes rotationplasty. Fourteen patients were followed up for 4 to 10.5 years (mean followup, 8 years). Functional assessment using Enneking's method showed all had good or excellent results. No patient thought that the reconstruction affected their ability to achieve recreational, sporting, or career goals. The reconstruction is durable and is not associated with an increase in late complications.

  13. Plasma skin resurfacing: personal experience and long-term results.

    PubMed

    Bentkover, Stuart H

    2012-05-01

    This article presents a comprehensive clinical approach to plasma resurfacing for skin regeneration. Plasma technology, preoperative protocols, resurfacing technique, postoperative care, clinical outcomes, evidence-based results, and appropriate candidates for this procedure are discussed. Specific penetration depth and specific laser energy measurements are provided. Nitrogen plasma skin regeneration is a skin-resurfacing technique that offers excellent improvement of mild to moderate skin wrinkles and overall skin rejuvenation. It also provides excellent improvement in uniformity of skin color and texture in patients with hyperpigmentation with Fitzpatrick skin types 1 through 4.

  14. Short and long term measures of anxiety exhibit opposite results.

    PubMed

    Fonio, Ehud; Benjamini, Yoav; Golani, Ilan

    2012-01-01

    Animal models of human diseases of the central nervous system, generalized anxiety disorder included, are essential for the study of the brain-behavior interface and obligatory for drug development; yet, these models fail to yield new insights and efficacious drugs. By increasing testing duration hundredfold and arena size tenfold, and comparing the behavior of the common animal model to that of wild mice, we raise concerns that chronic anxiety might have been measured at the wrong time, for the wrong duration, and in the wrong animal. Furthermore, the mice start the experimental session with a short period of transient adaptation to the novel environment (habituation period) and a long period reflecting the respective trait of the mice. Using common measures of anxiety reveals that mice exhibit opposite results during these periods suggesting that chronic anxiety should be measured during the post-habituation period. We recommend tools for measuring the transient period, and provide suggestions for characterizing the post habituation period.

  15. Automatic lighting controls demonstration: Long-term results

    SciTech Connect

    Rubinstein, F. )

    1991-10-18

    An advanced electronically ballasted lighting control system was installed in a portion of an office building to measure the energy and demand savings. The lighting control system used an integrated lighting control scenario that included daylight following, lumen depreciation correction, and scheduling. The system reduced lighting energy on weekdays by 62% and 51% in the north and south daylit zones, respectively, compared to a reference zone that did not have controls. During the summer, over 75% energy savings were achieved on weekdays in the north daylit zone. Even in the south interior zone, which benefitted lime from daylight, correction strategies and adjustment of the aisleway lights to a low level resulted in energy use of only half that of the reference zone. Although, in general, the savings varied over the year due to changing daylight conditions, the energy reduction achieved with controls could be fit using a simple analytical model. Significant savings also occurred during core operating hours when it is more expensive to supply and use energy. Compared to the usage in the reference zone, energy reductions of 49%, 44%, and 62% were measured in the south daylight, south interior, and north daylight zones, respectively, during core operating hours throughout the year. Lighting energy usage on weekends decreased dramatically in the zones with controls, with the usage in the north daylit zone only 10% that of the reference zone. A simple survey developed to assess occupant response to the lighting control system showed that the occupants were satisfied with the light levels provided.

  16. Long-term results after 110 tracheal resections

    PubMed Central

    Friedel, Godehard; Kyriss, Thomas; Leitenberger, Andrea; Toomes, Heikki

    2003-01-01

    Objective: Among the many therapeutic options for treating tracheal stenosis (e.g. bouginage, laser resection and stenting), segmental resection and reconstruction with end-to-end anastomosis is the method of choice. We verified this in an analysis of clinical material. Patients and methods: We retrospectively evaluated 110 tracheal sleeve resections performed between 1985 and 2001. Data before and after resection were analyzed, and the patients were interviewed. Results: The aetiology of stenosis was mainly postintubation injury (n = 92) (83.6%), followed by goiter with malacia (n = 8) (7.3%) and tumor (n = 6) (5.5%). There were a few other causes (n = 3) (2.7%). 48 patients (43.6%) had undergone prior conservative or surgical treatment other than sleeve resection. A cervical approach was used in 93 (84.6%), a cervicomediastinal in 15 (13.6%), and a transthoracic in two. Healing of anastomosis was uncomplicated in 101 patients (91.8%). Major and minor complications occurred in 29 patients (26.4); there were 4 dehiscences (3.6%), 3 restenoses (2.7%), 2 suture line granulations (1.8%) and 4 vocal cord dysfunctions (3.6%). The 30-day mortality rate was 0.9%. 77 patients were interviewed after surgery (median 80.1 months); 93.5% (n = 72) were satisfied with the surgical treatment. Conclusions: Resection and reconstruction offer the best treatment for tracheal stenosis. Lethal complications were due to severe comorbidity. Many patients today still undergo unsuccessful conservative treatment before being referred to surgery. PMID:19675708

  17. Coronary Artery Calcification Is Related to Inflammation in Rheumatoid Arthritis: A Long-Term Follow-Up Study

    PubMed Central

    Meedt, Thomas; Jonsson, Fredrik; Henein, Michael Y.

    2016-01-01

    Objective. A long-term follow-up of patients with rheumatoid arthritis (RA) to evaluate factors related to coronary artery calcification (CAC). Methods. All 22 eligible patients (4 males/18 females, mean age 65 years, and RA-duration 30–36 years) from the original (baseline; n = 39) study of atherosclerosis were included. Inflammation, cardiovascular risk factors, and biomarkers were measured at baseline. At follow-up 13 years later, CAC was assessed by computed tomography (CT) and the grade of inflammation was measured. Multivariate analysis of differences between patients with low (0–10) and high CAC (>10) was done by orthogonal projection to latent structures (OPLS). Results. Ten patients had CAC 0–10 and 12 had >10 (range 18–1700). Patients with high CAC had significantly higher ESR (24.3 versus 9.9 mm/h) and swollen joint count (2 versus 0). The OPLS models discriminated between patients having high or low CAC. With only baseline variables, the sensitivity was 73% and the specificity 82%. The model that also included inflammatory variables from follow-up had a sensitivity of 89% and a specificity of 85%. Exclusion of baseline intima media thickness and plaque from the latter model modestly reduced the accuracy (sensitivity 80% and specificity 83%). Conclusions. CAC is related to inflammation in patients with RA. PMID:27648442

  18. Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome.

    PubMed

    Gendi, N S; Axon, J M; Carr, A J; Pile, K D; Burge, P D; Mowat, A G

    1997-11-01

    We carried out a survival analysis of elbow synovectomy (ES) and excision of the radial head (RHE) performed on 171 rheumatoid elbows. The failure criteria were revision surgery (performed or desired) and/or the presence of significant or severe pain. The cumulative survival was 81% at one year which thereafter decreased by an average of 2.6% per year. The strongest predictor for success was a low preoperative range of supination-pronation when corresponding survival curves were compared. A low range of flexion-extension also predicted failure. Combining both factors gave better prediction (failure: 6.3% v 67%), but a long duration of elbow symptoms before surgery predicted failure (72%, p = 0.04). At review, there was a mean gain of 50 degrees in supination-pronation and 11 degrees in flexion-extension; both correlated with success. Failure correlated with recurrence of synovitis, elbow instability, ulnar neuropathy, poor general mobility and poor upper-limb function. The last was independently affected by the severity of RA in the ipsilateral shoulder. Our findings show that although the short-term result of ES and RHE in rheumatoid arthritis is good, the long-term outcome is poor except in a subgroup with more than 50% limitation of forearm rotation.

  19. Adalimumab long-term safety: infections, vaccination response and pregnancy outcomes in patients with rheumatoid arthritis

    PubMed Central

    Burmester, Gerd R; Landewé, Robert; Genovese, Mark C; Friedman, Alan W; Pfeifer, Nathan D; Varothai, Nupun A; Lacerda, Ana P

    2017-01-01

    Background Adalimumab has been used in patients with moderately to severely active rheumatoid arthritis (RA) for over 10 years and has a well-established safety profile across multiple indications. Objective To update adverse events (AEs) of special interest from global adalimumab clinical trials in patients with RA. Methods This analysis includes 15 132 patients exposed to adalimumab in global RA clinical trials. AEs of interest included overall infections, laboratory abnormalities and AEs associated with influenza vaccination. Pregnancy outcome data were collected from the Adalimumab Pregnancy Registry. Results Serious infections and tuberculosis occurred at a rate of 4.7 and 0.3 events/100 patient-years, respectively. Two patients experienced hepatitis B reactivation. No significant laboratory abnormalities were reported with adalimumab-plus-methotrexate compared with placebo-plus-methotrexate. Influenza-related AEs occurred in 5% of vaccinated patients compared with 14% of patients not vaccinated during the study. Relative risk of major birth defects and spontaneous abortions in adalimumab-exposed women were similar between that of unexposed women with RA and healthy women. Conclusions This analysis confirms and expands the known safety profile of adalimumab and reports no additional safety risk of laboratory abnormalities, hepatitis B reactivation and pregnancy outcomes, including spontaneous abortions and birth defects. The benefits of influenza vaccination are reinforced. Trial registration numbers NCT00195663, NCT00195702, NCT00448383, NCT00049751, NCT00234845, NCT00650390, NCT00235859, NCT00647920, NCT00649545, NCT00647491, NCT00649922, NCT00538902, NCT00420927, NCT00870467, NCT00650156, NCT00647270, NCT01185288, NCT01185301. PMID:27338778

  20. Long-term followup of rheumatoid arthritis patients treated with total lymphoid irradiation

    SciTech Connect

    Tanay, A.; Field, E.H.; Hoppe, R.T.; Strober, S.

    1987-01-01

    Total lymphoid irradiation was administered to 32 patients with intractable rheumatoid arthritis. Twenty-four patients showed at least a 25% improvement in 3 of 4 disease activity parameters, which persisted during the followup period of up to 48 months. Eight of the 32 patients required adjunctive immunosuppressive drug therapy to maintain improvement. Four patients died after total lymphoid irradiation; the causes of death were acute myocardial infarction (1 patient), pulmonary embolism (1 patient), and rheumatoid lung disease complicated by respiratory infection (2 patients). After therapy, patients exhibited a prolonged reduction in the number and function of circulating T helper cells.

  1. Hydroxychloroquine-induced agranulocytosis in a patient with long-term rheumatoid arthritis

    PubMed Central

    Sames, Edward; Paterson, Heather; Li, Charles

    2016-01-01

    Agranulocytosis is a rare and little-known side effect of hydroxychloroquine use. This report describes the case of a 71-year-old woman with poorly controlled rheumatoid arthritis who developed agranulocytosis after several months of hydroxychloroquine therapy. She had been on several different disease-modifying antirheumatic drugs, including methotrexate and leflunomide, for her rheumatoid arthritis. Treatment became complicated following a diagnosis of leflunomide-induced pulmonary fibrosis that was discovered after an intensive care unit (ICU) admission for severe Pseudomonas pneumonia. All treatment was stopped apart from steroids and hydroxychloroquine. Because of persistent disabling symptoms, rituximab infusions were given, which improved the disease control. A second admission occurred after a routine blood test revealed agranulocytosis. Hydroxychloroquine was stopped, and after 24 h, she was discharged home. Blood counts returned to normal within 2 weeks of hydroxychloroquine cessation; hence, after the review of investigations, a diagnosis of hydroxychloroquine-induced agranulocytosis was made. This report considers current literature on hydroxychloroquine-induced agranulocytosis and explores the potential causes for this occurrence. PMID:27708979

  2. Hydroxychloroquine-induced agranulocytosis in a patient with long-term rheumatoid arthritis.

    PubMed

    Sames, Edward; Paterson, Heather; Li, Charles

    2016-06-01

    Agranulocytosis is a rare and little-known side effect of hydroxychloroquine use. This report describes the case of a 71-year-old woman with poorly controlled rheumatoid arthritis who developed agranulocytosis after several months of hydroxychloroquine therapy. She had been on several different disease-modifying antirheumatic drugs, including methotrexate and leflunomide, for her rheumatoid arthritis. Treatment became complicated following a diagnosis of leflunomide-induced pulmonary fibrosis that was discovered after an intensive care unit (ICU) admission for severe Pseudomonas pneumonia. All treatment was stopped apart from steroids and hydroxychloroquine. Because of persistent disabling symptoms, rituximab infusions were given, which improved the disease control. A second admission occurred after a routine blood test revealed agranulocytosis. Hydroxychloroquine was stopped, and after 24 h, she was discharged home. Blood counts returned to normal within 2 weeks of hydroxychloroquine cessation; hence, after the review of investigations, a diagnosis of hydroxychloroquine-induced agranulocytosis was made. This report considers current literature on hydroxychloroquine-induced agranulocytosis and explores the potential causes for this occurrence.

  3. Use of autogenic and allogenic malleus in tympanic membrane to footplate assembly - long-term results.

    PubMed

    Mahadevaiah, A; Parikh, Bhavin

    2009-03-01

    The objective of this study was to assess the functional performance and long-term stability of autogenic and allogenic malleus used for ossiculoplasty as tympanic membrane to footplate assembly. A retrospective study of 119 patients who underwent such ossiculoplasty in closed cavity mastoidectomy from 1989-2004 was carried out. There was no extrusion in any of our cases. Serviceable hearing (<20 dB air bone gap closure) was achieved in 24 out of 37 (65%) over long-term follow up of more than 1 year (mean and median for follow up being 37.4 and 30 months respectively). Thus malleus ossicle graft give acceptable long-term hearing results in one of the most difficult ossiculoplasty situations (absence of stapes suprastructure and malleus) with virtually no extrusion problems.

  4. Dose refinements in long-term therapy of rheumatoid arthritis with antimalarials.

    PubMed

    Mackenzie, A H

    1983-07-18

    No eye disease was detected in over 900 rheumatoid arthritis patients treated with less than 4.0 mg/kg per day of chloroquine or less than 6.5 mg/kg per day of hydroxychloroquine for a mean of about seven years. I therefore consider these dosage rates safe, since they are below the threshold of retinal toxicity. This is based on more than 6,000 patient-years of drug exposure. That dosage threshold for retinopathy appears to be 5.1 mg/kg per day for chloroquine and 7.8 mg/kg per day for hydroxychloroquine according to my studies with these compounds. The daily dosage rate, rather than total drug accumulation, seems to determine the development of eye disease. To prevent overdosage, dosing should be calculated not on the actual weight of the patient but on ideal (lean) body weight. Furthermore, the patient's renal and liver function should also be taken into account to avoid overdosage. Since exposure to light amplifies the risk of retinopathy in patients treated with antimalarials, dark sunglasses are recommended for patients spending much time in sunlight.

  5. Surgical treatment of lower limb ischemia in diabetic patients – long-term results

    PubMed Central

    Inan, Bekir; Ugurlucan, Murat; Aydin, Cemalettin; Teker, Melike Elif

    2013-01-01

    Introduction Lower limb ischemia may cause nonhealing ulcers, infection, amputation and even mortality in diabetic patients. In this study, we review our data of ischemic lower limb revascularization procedures in diabetic patients and present the early, mid- and long-term results. Material and methods From March 2004 to September 2008, 83 patients with lower limb ischemia in Fontaine class III and IV underwent distal arterial bypass procedures. Saphenous vein grafts were used for below-knee arterial bypasses in all patients. In 16 (19%) patients femoropopliteal bypasses were performed with PTFE grafts. Short-term and long-term surgical results were evaluated. Results Ulcer recovery was determined in 36% of patients. Graft patency was 95% and 1 death (1%) occurred in short-term follow-up. In long-term follow-up the total effectiveness rate was 74%. Graft patency was 79% and 6 deaths (7%) occurred during the follow-up. Conclusions Lower limb ischemia is a serious event in patients with diabetes mellitus. The consequences may include increased mortality and morbidity in this particular patient population. However, distal arterial revascularizations are considerably effective procedures to avoid amputation, to eliminate symptoms, to promote ulcer recovery and to help the patient participate in social life with acceptable short, mid- and long-term follow-up results. PMID:24482653

  6. Comparable long-term results for porcine and pericardial prostheses after isolated aortic valve replacement

    PubMed Central

    Andreas, Martin; Wallner, Stephanie; Ruetzler, Kurt; Wiedemann, Dominik; Ehrlich, Marek; Heinze, Georg; Binder, Thomas; Moritz, Anton; Hiesmayr, Michael J.; Kocher, Alfred; Laufer, Guenther

    2015-01-01

    OBJECTIVES Outcome of aortic valve replacement may be influenced by the choice of bioprosthesis. Pericardial heart valves are described to have a favourable haemodynamic profile compared with porcine valves, although the clinical notability of this finding is still controversially debated. Herein, we compared the long-term results of two commonly implanted bioprosthesis at a single centre. METHODS All consecutive patients undergoing isolated aortic valve replacement with either a Carpentier-Edwards Magna pericardial prosthesis or a Medtronic Mosaic porcine prosthesis between 2002 and 2008 were analysed regarding preoperative characteristics, short- and long-term survival, valve-related complications and echocardiographic findings. RESULTS The Medtronic Mosaic was implanted in 163 patients and the Carpentier-Edwards Magna in 295 patients. The sizes of implanted valves were 22.4 ± 1.5 mm for the Mosaic and 21.8 ± 1.8 mm for the Magna (P = 0.001). The long-term survival rate was 76 and 56% after 5 and 10 years for the Medtronic Mosaic, which was comparable with the Carpentier-Edwards Magna (77 and 57%; P = 0.92). Overall long-term survival was comparable with an age- and sex-matched Austrian general population for both groups. Valve-related adverse events were similar between groups. The postoperative mean transvalvular gradient was significantly increased in the Mosaic group (24 ± 9 mmHg vs 17 ± 7 mmHg; P < 0.001). CONCLUSIONS Both types of aortic bioprostheses offer excellent results after isolated aortic valve replacement. Despite relevant differences in gradients, long-term survival was comparable with the expected normal survival for both bioprostheses. Patients with a porcine heart valve had a higher postoperative transvalvular gradient. PMID:25527170

  7. Individual specialists in a generalist population: results from a long-term stable isotope series

    PubMed Central

    Vander Zanden, Hannah B.; Bjorndal, Karen A.; Reich, Kimberly J.; Bolten, Alan B.

    2010-01-01

    Individual variation in resource use has often been ignored in ecological studies, but closer examination of individual patterns through time may reveal significant intrapopulation differences. Adult loggerhead sea turtles (Caretta caretta) are generalist carnivores with a wide geographical range, resulting in a broad isotopic niche. We microsampled scute, a persistent and continuously growing tissue, to examine long-term variation in resource use (up to 12 years) in 15 nesting loggerhead turtles. Using stable isotopes of nitrogen and carbon, we examined the resource use patterns (integration of diet, habitat and geographical location) and demonstrate that individual loggerheads are long-term specialists within a generalist population. We present our results in the context of a conceptual model comparing isotopic niches in specialist and generalist populations. Individual consistency may have important ecological, evolutionary and conservation consequences, such as the reduction of intraspecific competition. PMID:20335202

  8. Long-Term Results of Bariatric Restrictive Procedures: A Prospective Study

    PubMed Central

    Wiryasaputra, Dorothee C.; van Dielen, Francois M. H.; van Gemert, Wim G.; Greve, Jan Willem M.

    2010-01-01

    Laparoscopic adjustable gastric banding (LAGB) and vertical-banded gastroplasty (VBG) are surgical treatment modalities for morbid obesity. This prospective study describes the long-term results of LAGB and VBG. One hundred patients were included in the study. Fifty patients underwent LAGB and 50 patients, open VBG. Study parameters were weight loss, changes in obesity-related comorbidities, long-term complications, re-operations including conversions to other bariatric procedures and laboratory parameters including vitamin status. From 91 patients (91%), data were obtained with a mean follow-up duration of 84 months (7 years). Weight loss [percent excess weight loss (EWL)] was significantly more after VBG compared with LAGB, 66% versus 54%, respectively. All comorbidities significantly decreased in both groups. Long-term complications after VBG were mainly staple line disruption (54%) and incisional hernia (27%). After LAGB, the most frequent complications were pouch dilatation (21%) and anterior slippage (17%). Major re-operations after VBG were performed in 60% of patients. All re-operations following were conversions to Roux-en-Y gastric bypass (RYGB). In the LAGB group, 33% of patients had a refixation or replacement of the band, and 11% underwent conversion to another bariatric procedure. There were no significant differences in weight loss between patients with or without re-interventions. No vitamin deficiencies were present after 7 years, although supplement usage was inconsistent. This long-term follow-up study confirms the high occurrence of late complications after restrictive bariatric surgery. The failure rate of 65% after VBG is too high, and this procedure is not performed anymore in our institution. The re-operation rate after LAGB is decreasing as a result of new techniques and materials. Results of the re-operations are good with sustained weight loss and reduction in comorbidities. However, in order to achieve these results, a durable and

  9. Cecal Ligation and Puncture Results in Long-Term Central Nervous System Myeloid Inflammation

    PubMed Central

    Singer, Benjamin H.; Newstead, Michael W.; Zeng, Xianying; Cooke, Christopher L.; Thompson, Robert C.; Singer, Kanakadurga; Ghantasala, Ramya; Parent, Jack M.; Murphy, Geoffrey G.; Iwashyna, Theodore J.; Standiford, Theodore J.

    2016-01-01

    Survivors of sepsis often experience long-term cognitive and functional decline. Previous studies utilizing lipopolysaccharide injection and cecal ligation and puncture in rodent models of sepsis have demonstrated changes in depressive-like behavior and learning and memory after sepsis, as well as evidence of myeloid inflammation and cytokine expression in the brain, but the long-term course of neuroinflammation after sepsis remains unclear. Here, we utilize cecal ligation and puncture with greater than 80% survival as a model of sepsis. We found that sepsis survivor mice demonstrate deficits in extinction of conditioned fear, but no acquisition of fear conditioning, nearly two months after sepsis. These cognitive changes occur in the absence of neuronal loss or changes in synaptic density in the hippocampus. Sepsis also resulted in infiltration of monocytes and neutrophils into the CNS at least two weeks after sepsis in a CCR2 independent manner. Cellular inflammation is accompanied by long-term expression of pro-inflammatory cytokine and chemokine genes, including TNFα and CCR2 ligands, in whole brain homogenates. Gene expression analysis of microglia revealed that while microglia do express anti-microbial genes and damage-associated molecular pattern molecules of the S100A family of genes at least 2 weeks after sepsis, they do not express the cytokines observed in whole brain homogenates. Our results indicate that in a naturalistic model of infection, sepsis results in long-term neuroinflammation, and that this sustained inflammation is likely due to interactions among multiple cell types, including resident microglia and peripherally derived myeloid cells. PMID:26862765

  10. Bronchial Artery Embolization for Hemoptysis Due to Benign Diseases: Immediate and Long-Term Results

    SciTech Connect

    Kato, Akira; Kudo, Sho; Matsumoto, Koichi; Fukahori, Tetsuhiro; Shimizu, Toshihisa; Uchino, Akira; Hayashi, Shinichiro

    2000-09-15

    Purpose: To clarify the immediate effect and long-term results of bronchial artery embolization (BAE) for hemoptysis due to benign diseases and the factors influencing the outcomes.Methods: One hundred and one patients (aged 34-89 years) received bronchial artery embolization with polyvinyl alcohol particles and gelatin sponge for massive or continuing moderate hemoptysis caused by benign pulmonary diseases and resistant to medical treatment.Results: After BAE, bleeding stopped in 94 patients (94%). The immediate effect was unfavorable in cases where feeder vessels were overlooked or the embolization of the intercostal arteries was insufficient. Long-term cumulative hemoptysis non recurrence rates after the initial embolization were 77.7% for 1 year and 62.5% for 5 years. In bronchitis (n 9) and active tuberculosis (n = 4) groups, an excellent (100%) 5-year cumulative non recurrence rate was obtained. The rate was lower in groups with pneumonia/abscess/pyothorax (n = 8) or with pulmonary aspergillosis (n = 9) (53.3%, 1-year cumulative non recurrence). There were higher incidences of early recurrence among patients with massive hemorrhage or more marked vascularity and systemic artery-pulmonary artery shunt in angiography: however, these trends were not statistically significant. Conclusions: BAE can yield long-term benefit in patients with hemoptysis due to benign diseases. Technical problems in the procedure had an impact on the short-term effect. The degree of hemorrhage or the severity of angiographical findings were not significant factors affecting the outcome. The most significant factor affecting long-term results was whether the inflammation caused by the underlying disease was medically well controlled.

  11. Long Term Results of Anterior Corpectomy and Fusion for Cervical Spondylotic Myelopathy

    PubMed Central

    Chen, Huajiang; Liu, Yang; Liang, Lei; Yuan, Wen

    2012-01-01

    Background Results showed good clinical outcomes of anterior corpectomy and fusion (ACCF) for patients with cervical spondylotic myelopathy (CSM) during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and radiographic outcomes, find out the factors that may affect the long term clinical outcome and evaluate the incidence of adjacent segment disease (ASD). Methods This is a retrospective study of 145 consecutive CSM patients on ACCF treatment with a minimum follow-up of 5 years. Clinical data were collected from medical and operative records. Patients were evaluated by using the Japanese Orthopedic Association (JOA) scoring system preoperatively and during the follow-up. X-rays results of cervical spine were obtained from all patients. Correlations between the long term clinical outcome and various factors were also analyzed. Findings Ninety-three males and fifty-two females completed the follow-up. The mean age at operation was 51.0 years, and the mean follow-up period was 102.1 months. Both postoperative sagittal segmental alignment (SSA) and the sagittal alignment of the whole cervical spine (SACS) increased significantly in terms of cervical lordosis. The mean increase of JOA was 3.8±1.3 postoperatively, and the overall recovery rate was 62.5%. Logistic regression analysis showed that preoperative duration of symptoms >12 months, high-intensity signal in spinal cord and preoperative JOA score ≤9 were important predictors of the fair recovery rate (≤50%). Repeated surgery due to ASD was performed in 7 (4.8%) cases. Conclusions ACCF with anterior plate fixation is a reliable and effective method for treating CSM in terms of JOA score and the recovery rate. The correction of cervical alignment and the repeated surgery rate for ASD are also considered to be satisfactory. PMID:22514669

  12. Long-term results of arterial switch repair of transposition of the great vessels.

    PubMed

    Blume, Elizabeth D.; Wernovsky, Gil

    1998-01-01

    The arterial switch operation has become the preferred surgical procedure for transposition of the great arteries worldwide. The low operative mortality at "low-risk" institutions has been well documented. The advantages of the arterial switch compared with atrial-level repairs include a lower incidence of arrhythmias and the likelihood of normal systemic ventricular function over the long term. However, the long-term sequelae of this operation must be continually evaluated, including the fate of the supravalvular pulmonary and aortic anastomoses, growth of the aortic root, competency of the neoaortic valve, patency of the coronary arteries, effects on the conduction system, and adequacy of ventricular function. These anatomic results, as well as the neurodevelopmental outcomes of these patients, are summarized in this review. Copyright 1998 by W.B. Saunders Company

  13. Long-term suppression of experimental arthritis following intramuscular administration of a pseudotyped AAV2/1-TNFR:Fc Vector.

    PubMed

    Sandalon, Ziv; Bruckheimer, Elizabeth M; Lustig, Kurt H; Burstein, Haim

    2007-02-01

    We previously reported that administration of an adeno-associated virus 2 (AAV2) vector encoding a rat tumor necrosis factor (TNF) receptor-immunoglobulin Fc (TNFR:Fc) fusion gene to rats with streptococcal cell wall-induced arthritis resulted in suppression of joint inflammation and cartilage and bone destruction, as well as expression of joint proinflammatory cytokines. In this study, we used an alternate rat model of arthritis to compare the serum levels and duration of TNFR:Fc protein expression following intramuscular administration of pseudotyped AAV-TNFR:Fc vectors based on serotypes 1, 2, and 5. All three pseudotyped AAV-TNFR:Fc vectors led to sustained expression of serum TNFR:Fc protein for at least one year. Serum TNFR:Fc protein levels in rats administered intramuscularly with AAV2/1-TNFR:Fc vector were up to 100- and 10-fold higher than in rats administered the AAV2-TNFR:Fc or AAV2/5-TNFR:Fc vectors, respectively. A single intramuscular administration of AAV2/1-TNFR:Fc vector at vector doses ranging from 10(10) to 10(12) DNase-resistant particles (DRP) per animal, resulted in complete and long-term suppression of recurrent joint inflammation for at least 150 days. Our results establish a proof of concept for administration of an AAV2/1-TNFR:Fc vector to the muscle to achieve long-term, sustained and therapeutically relevant levels of TNFR:Fc protein to treat chronic systemic inflammatory joint diseases.

  14. A meta-analysis of apremilast on psoriatic arthritis long-term assessment of clinical efficacy (PALACE).

    PubMed

    Qu, Xiaoyu; Zhang, Sixi; Tao, Lina; Song, Yanqing

    2016-06-01

    The aim of this article was to assess the efficacy and safety of apremilast in treatment of psoriatic arthritis (PsA) with meta-analysis method. We included four randomized clinical trials identified from MEDLINE, EMBASE, Cochrane Library, "ISRCTN Register" and "ClinicalTrials.gov" which compared apremilast with placebo. The meta-analysis was performed by the software of Review Manager, version 5.2. Apremilast was associated with significantly higher proportion of patients who achieved ACR20 at week 16 (in apremilast 20 mg subgroup, odds ratio [OR]= 2.04, 95% confidence interval [Cl] 1.58-2.63, P<0.00001; in apremilast 30 mg subgroup, OR=2.53, 95%Cl 1.96-3.25, P<0.00001) and significantly higher scores of Health Assessment Questionnaire-Disability Index (in apremilast 20 mg subgroup, WMD=-0.11, 95%Cl -0.16~-0.06, P<0.0001; in apremilast 30 mg subgroup, WMD=-0.16, 95%Cl -0.21~-0.11, P<0.00001). Apremilast was as safe as placebo in terms of serious adverse events (AEs). The AEs occurred in participants with apremilast were mild and well tolerated during treatment. Apremilast can be used in treatment of PsA with lower costs, oral availability and well tolerated. But the long-term benefit and safety of apremilast should be further investigated.

  15. Long term results of fast pathway ablation in atrioventricular nodal reentry tachycardia using a modified technique.

    PubMed Central

    Mehta, D.; Gomes, J. A.

    1995-01-01

    OBJECTIVE--To assess immediate and long term success of "fast" pathway catheter ablation with graded use of radiofrequency energy in patients with classic atrioventricular nodal reentrant tachycardia (AVNRT) and evaluate clinical, procedure related, and electrophysiological features affecting long term results. DESIGN--31 consecutive patients with classic AVNRT at electrophysiological study, who were candidates for radiofrequency ablation. Patients were followed for an average of 24 months after ablation. SETTING--All studies and ablations were performed in an electrophysiological laboratory under fluoroscopic guidance using standard electrophysiological techniques. INTERVENTION--Radiofrequency application was performed at the site of proximal His bundle electrogram with A:V ratio of > 1. It was started at 10 W with increment of 5 W to a maximum of 25 W at 60 s. With the onset of junctional rhythm, atrial pacing was begun in order to monitor the PR interval. Application was terminated prematurely with a non-conducted P wave, continued prolongation of the PR interval beyond 50% of the baseline, or a threefold rise in impedance. RESULTS--Successful ablation was possible in 30/31 patients (97%) with an average of seven applications (range 1-10). It was associated with significant prolongation of PR interval (P < 0.001) and AV Wenckebach cycle length (P = 0.01). Ventriculo-atrial conduction was abolished in 24/30 patients (82%) with successful ablation. Two patients developed transient complete heart block (3 and 12 min) and one persistent right branch block. Four patients had late recurrence. Presence of ventriculo-atrial block was the only electrophysiological index predictive of long term success (P = 0.01). CONCLUSIONS--Graded use of radiofrequency energy and atrial pacing to monitor PR interval decreases the risk of atrioventricular block in patients undergoing fast pathway ablation for AVNRT. Ventriculo-atrial block is predictive of long term success and should

  16. Long-term results in direct carotid-cavernous fistulas after treatment with detachable balloons.

    PubMed

    Lewis, A I; Tomsick, T A; Tew, J M; Lawless, M A

    1996-03-01

    Transarterial embolization of direct carotid-cavernous fistulas (CCFs) using detachable balloons is the best initial option for occlusion of the fistula and preservation of the internal carotid artery. However, the long-term safety and efficacy of this treatment is unknown. The authors reviewed the long-term outcome of 87 patients with 88 direct CCFs occluded by detachable balloons. Clinical follow up was obtained in 48 (83%) of 58 patients treated with latex balloons (mean follow-up period 10 years, range 5.9-15.5 years) and 28 (97%) of 29 patients treated with silicone balloons (mean follow-up period 4 years, range 1-6.6 years). Two patients were treated with both balloon types. There were no late recurrent symptoms of cranial bruit, proptosis, chemosis, or arterialized conjunctiva in patients treated with either latex or silicone balloons. Diplopia improved in all patients; however, five patients required shortening of the lateral rectus muscle. Delayed ischemia occurred in three patients: one patient had a transient ischemic episode 5 years after treatment with latex balloons and two patients (85 and 90 years old) who had ruptured spontaneous intracavernous aneurysms suffered cerebral infarctions 6 weeks and 4 months, respectively, after treatment with silicone balloons. There were five deaths in the series unrelated to balloon treatment. These results show that after transarterial embolization of direct CCFs using either silicone or latex detachable balloons, the long-term risks are low for fistula recurrence, symptomatic foreign body reaction, symptomatic pseudoaneurysm formation, and cerebral ischemia.

  17. Long-term sustained-released in situ gels of a water-insoluble drug amphotericin B for mycotic arthritis intra-articular administration: preparation, in vitro and in vivo evaluation.

    PubMed

    Shan-Bin, Guo; Yue, Tian; Ling-Yan, Jian

    2015-04-01

    Amphotericin B (AMB) was often used in intra-articular injection administration for fungal arthritis, because it could often bring a satisfactory therapeutic efficacy and a minimum systemic toxic side effect. However, because of the multiple operations and the frequent injections, the compliance of the patients was bad. Therefore, to develop a long-term sustained-released preparation of AMB for mycotic arthritis intra-articular administration is of great significance. The purpose of present study was to develop a long-term sustained-released in situ gel of a water-insoluble drug AMB for mycotic arthritis intra-articular administration. Based on the evaluations of the in vitro properties of the formulations, the formulation containing 10% (w/w) ethanol, 15% (w/w) PG, 0.75% (w/w) HA, 5% (w/w) purified soybean oil, 0.03% (w/w) α-tocopherol, 15% (w/w) water and 55% (w/w) glyceryl monooleate was selected as a suitable intra-articular injectable in situ gel drug delivery system for water-insoluble drug AMB. Furthermore, the results of the in vivo study on rabbits showed that the selected formulation was a safe and effective long-term sustained-released intra-articular injectable AMB preparation. Therefore, the presented in situ AMB gel could reduce the frequency of the administration in the AMB treatment of fungal arthritis, and then would get a good patient compliance.

  18. Acute abscess with fistula: long-term results justify drainage and fistulotomy.

    PubMed

    Benjelloun, E B; Jarrar, A; El Rhazi, K; Souiki, T; Ousadden, A; Ait Taleb, K

    2013-09-01

    Conventional treatment of anal abscess by a simple drainage continues to be routine in many centers despite retrospective and randomized data showing that primary fistulotomy at the time of abscess drainage is safe and efficient. The purpose of this study is to report the long-term results of fistulotomy in the treatment of anal abscesses. This is a prospective nonrandomized study of 165 consecutive patients treated for anal abscess in University Hospital Hassan II, Fez, Morocco, between January 2005 and December 2010. Altogether 102 patients were eligible to be included in the study. Among them, 52 were treated by a simple drainage and 50 by drainage with fistulotomy. The results were analyzed in terms of recurrence and incontinence after a median follow-up of 3.2 years (range 2-6 years). The groups were comparable in terms of age, gender distribution, type and size of abscess. The recurrence rate after surgery was significantly higher in the group treated by drainage alone (88 %) compared to other group treated by drainage and fistulotomy (4, 8 %) (p < 0.0001). However, there was a tendency to a higher risk of fecal incontinence in the fistulotomy group (5 % vs 1 %), although this difference was not significant (p = 0.27). In the group treated by drainage and fistulotomy, high fistula tract patients are more prone to develop incontinence and recurrence, mainly within the first year. A long-term follow-up seems not to influence the results of fistulotomy group. These findings confirm that fistulotomy is an efficient and safe treatment of anal abscess with good long-term results. An exception is a high fistula, where fistulotomy may be associated with a risk of recurrence and incontinence.

  19. Long-term Results of Endovascular Stent Graft Placement of Ureteroarterial Fistula

    SciTech Connect

    Okada, Takuya Yamaguchi, Masato; Muradi, Akhmadu Nomura, Yoshikatsu; Uotani, Kensuke; Idoguchi, Koji; Miyamoto, Naokazu Kawasaki, Ryota; Taniguchi, Takanori; Okita, Yutaka; Sugimoto, Koji

    2013-08-01

    PurposeTo evaluate the safety, efficacy, and long-term results of endovascular stent graft placement for ureteroarterial fistula (UAF).MethodsWe retrospectively analyzed stent graft placement for UAF performed at our institution from 2004 to 2012. Fistula location was assessed by contrast-enhanced computed tomography (CT) and angiography, and freedom from hematuria recurrence and mortality rates were estimated.ResultsStent graft placement for 11 UAFs was performed (4 men, mean age 72.8 {+-} 11.6 years). Some risk factors were present, including long-term ureteral stenting in 10 (91 %), pelvic surgery in 8 (73 %), and pelvic radiation in 5 (45 %). Contrast-enhanced CT and/or angiography revealed fistula or encasement of the artery in 6 cases (55 %). In the remaining 5 (45 %), angiography revealed no abnormality, and the suspected fistula site was at the crossing area between urinary tract and artery. All procedures were successful. However, one patient died of urosepsis 37 days after the procedure. At a mean follow-up of 548 (range 35-1,386) days, 4 patients (36 %) had recurrent hematuria, and two of them underwent additional treatment with secondary stent graft placement and surgical reconstruction. The hematuria recurrence-free rates at 1 and 2 years were 76.2 and 40.6 %, respectively. The freedom from UAF-related and overall mortality rates at 2 years were 85.7 and 54.9 %, respectively.ConclusionEndovascular stent graft placement for UAF is a safe and effective method to manage acute events. However, the hematuria recurrence rate remains high. A further study of long-term results in larger number of patients is necessary.

  20. Urothelial-based reconstructive surgery for upper- and mid-ureteral defects: Long-term results

    PubMed Central

    Rosenzweig, Barak; Mor, Yoram; Erlich, Tomer; Laufer, Menachem; Winkler, Harry; Kaver, Issac; Ramon, Jacob; Dotan, Zohar A.

    2016-01-01

    Introduction: Ureteral strictures can result in obstructive nephropathy and renal function deterioration. Surgical management of ureteral defects, especially in the proximal- and mid-ureter, is particularly challenging. Our purpose was to analyze the long-term outcomes of urothelial-based reconstructive surgery for upper- and mid-ureteral defects. Methods: We conducted a retrospective analysis of a single tertiary centre’s database, including 149 patients treated for ureteral defects between 2001 and 2011. Thirty-one patients (21%) underwent complex urothelial-based surgical repairs for upper- and mid-ureter defects. Patients’ median age was 61 years. The mean length of the ureteral strictures was 2.5 cm, located in upper-, mid-ureter, or in between in 19 (61%), 10 (32%), and two (6%) patients, respectively. All patients were treated with a primary urothelial-based repair. Median followup time was 26 months. The primary outcome of the study was the long-term preservation of renal function and lack of clinical obstruction. The secondary endpoint of the study was the assessment of the intra- and postoperative complication rates. Results: Most of the lesions were benign (22, 71%), while nine strictures (29%) were malignant. Seven patients (23%) suffered from postoperative complications, five of which were infectious. The median pre- and postoperative calculated glomerular filtration rates were 66 ml/min/1.72m2 and 64ml/min/1.72m2, respectively. Success rate was 84%, defined as lack of need for re-operation or kidney drainage at the last followup. Conclusions: Upper- and mid-ureteral defects present a complex pathology necessitating experienced reconstructive surgical skills. Our data suggest good long-term results for primary urothelial-based reconstructions for these pathologies. PMID:27695582

  1. [Long-term results of treating children with kidney and ureteral stones with extracorporeal lithotripsy].

    PubMed

    Dzeranov, N K; Pugachev, A G; Romanov, G V

    2002-01-01

    Long-term outcomes of urolithiasis treatment with extracorporeal lithotripsy (ECLT) have been analysed for 132 children using, as the basic criterion, data of dynamic nephroscintigraphy. The results of ECLT were considered regarding characteristics of the concrement, inflammatory process, parameters of the shock wave. It was found that low-energy restruction regimens in minimal number of impulses per session and adequate intervals between them prevent irreversible changes in renal parenchyma in response to focused shock waves. Monitoring and adequate treatment late after ECLT lead to recovery of renal function if obstructive complications and stone formation are found early and if the course of the inflammation is controlled.

  2. Closure of gastrointestinal defects with Ovesco clip: long-term results and clinical implications

    PubMed Central

    Donatelli, Gianfranco; Cereatti, Fabrizio; Dhumane, Parag; Vergeau, Bertrand Marie; Tuszynski, Thierry; Marie, Christian; Dumont, Jean-Loup; Meduri, Bruno

    2016-01-01

    Background: The Over-The-Scope Clip (OTSC®, Ovesco Endoscopy GmbH, Tübingen, Germany) is an innovative clipping device that provides a strong tissue grasp and compression without provoking ischemia or laceration. In this retrospective study we evaluated immediate and long-term success rates of OTSC deployment in various pathologies of the gastrointestinal (GI) tract. Methods: A total of 45 patients (35 female, 10 male) with an average age of 56 years old (range, 24–90 years) were treated with an OTSC for GI defects resulting from a diagnostic or interventional endoscopic procedure (acute setting group) or for fistula following abdominal surgery (chronic setting group). All procedures were performed with CO2 insufflation. Results: From January 2012 to December 2015 a total of 51 OTSCs were delivered in 45 patients for different kinds of GI defects. Technical success was always achieved in the acute setting group with an excellent clip adherence and a clinical long-term success rate of 100% (15/15). Meanwhile, considering the chronic setting group, technical success was achieved in 50% of patients with a long-term clinical success of 37% (11/30); two minor complications occurred. A total of three patients died due to causes not directly related to clip deployment. Overall clinical success rate was achieved in 58% cases (26/45 patients). A mean follow-up period of 17 months was accomplished (range, 1–36 months). Conclusion: OTSC deployment is an effective and minimally-invasive procedure for GI defects in acute settings. It avoids emergency surgical repair and it allows, in most cases, completion of the primary endoscopic procedure. OTSC should be incorporated as an essential technique of today’s modern endoscopic armamentarium in the management of GI defects in acute settings. OTSCs were less effective in cases of chronic defects. PMID:27582884

  3. Long-Term Results of Targeted Intraoperative Radiotherapy (Targit) Boost During Breast-Conserving Surgery

    SciTech Connect

    Vaidya, Jayant S.; Baum, Michael; Tobias, Jeffrey S.; Wenz, Frederik; Massarut, Samuele; Keshtgar, Mohammed; Hilaris, Basil; Saunders, Christobel; Williams, Norman R.; Brew-Graves, Chris; Corica, Tammy; Roncadin, Mario; Kraus-Tiefenbacher, Uta; Suetterlin, Marc; Bulsara, Max; Joseph, David

    2011-11-15

    Purpose: We have previously shown that delivering targeted radiotherapy to the tumour bed intraoperatively is feasible and desirable. In this study, we report on the feasibility, safety, and long-term efficacy of TARGeted Intraoperative radioTherapy (Targit), using the Intrabeam system. Methods and Materials: A total of 300 cancers in 299 unselected patients underwent breast-conserving surgery and Targit as a boost to the tumor bed. After lumpectomy, a single dose of 20 Gy was delivered intraoperatively. Postoperative external beam whole-breast radiotherapy excluded the usual boost. We also performed a novel individualized case control (ICC) analysis that computed the expected recurrences for the cohort by estimating the risk of recurrence for each patient using their characteristics and follow-up period. Results: The treatment was well tolerated. The median follow up was 60.5 months (range, 10-122 months). Eight patients have had ipsilateral recurrence: 5-year Kaplan Meier estimate for ipsilateral recurrence is 1.73% (SE 0.77), which compares well with that seen in the boosted patients in the European Organization for Research and Treatment of Cancer study (4.3%) and the UK STAndardisation of breast RadioTherapy study (2.8%). In a novel ICC analysis of 242 of the patients, we estimated that there should be 11.4 recurrences; in this group, only 6 recurrences were observed. Conclusions: Lumpectomy and Targit boost combined with external beam radiotherapy results in a low local recurrence rate in a standard risk patient population. Accurate localization and the immediacy of the treatment that has a favorable effect on tumour microenvironment may contribute to this effect. These long-term data establish the long-term safety and efficacy of the Targit technique and generate the hypothesis that Targit boost might be superior to an external beam boost in its efficacy and justifies a randomized trial.

  4. Long term results of mechanical prostheses for treatment of active infective endocarditis

    PubMed Central

    Guerra, J; Tornos, M; Permanyer-Miralda, G; Almirante, B; Murtra, M; Soler-Soler, J

    2001-01-01

    OBJECTIVE—To analyse the long term results of mechanical prostheses for treating active infective endocarditis.
DESIGN—Prospective cohort study of a consecutive series of patients diagnosed with infective endocarditis and operated on in the active phase of the infection for insertion of a mechanical prosthesis.
SETTING—Tertiary referral centre in a metropolitan area.
RESULTS—Between 1975 and 1997, 637 cases of infective endocarditis were diagnosed in the centre. Of these, 436 were left sided (with overall mortality of 20.3%). Surgical treatment in the active phase of the infection was needed in 141 patients (72% native, 28% prosthetic infective endocarditis). Mechanical prostheses were used in 131 patients. Operative mortality was 30.5% (40 patients). Ninety one survivors were followed up prospectively for (mean (SD)) 5.4 (4.5) years. Thirteen patients developed prosthetic valve dysfunction. Nine patients suffered reinfection: four of these (4%) were early and five were late. The median time from surgery for late reinfection was 1.4 years. During follow up, 12 patients died. Excluding operative mortality, actuarial survival was 86.6% at five years and 83.7% at 10 years; actuarial survival free from death, reoperation, and reinfection was 73.1% at five years and 59.8% at 10 years.
CONCLUSIONS—In patients surviving acute infective endocarditis and receiving mechanical prostheses, the rate of early reinfection compares well with reported results of homografts. In addition, prosthesis dysfunction rate is low and long term survival is good. These data should prove useful for comparison with long term studies, when available, using other types of valve surgery in active infective endocarditis.


Keywords: infective endocarditis; surgery; mechanical prosthesis PMID:11410564

  5. Long Term Results of Innovative Procedure in Surgical Management of Chronic Lymphedema

    PubMed Central

    Mousavi, Seyed R.

    2016-01-01

    Background: Lymphedema is the result of impaired lymphatic drainage by the affected organ. This abnormality can be primary or secondary. Different operative approaches have been introduced to treat chronic lymphedema. Materials and Methods: This retrospective study included 816 patients who were diagnosed with chronic lower extremity lymphedema and did not respond to non-operative management for at least six months. Data was collected over 25 years, between March 1987 and March 2013. Doppler ultrasonography of the deep venous system was routinely undertaken in all patients to confirm patency. The patients underwent surgery and their progress was followed for at least one year postoperatively. Results: All patients were operated by the suggested technique and long term fallow-up which is a modified form of the Homan’s technique. The outcome was excellent, and 89.2% of patients were free of complication and 2% had poor results. The most common complication was wound seroma and wound infection. Conclusion: The long term results and considering the difficulties associated with the treatment of chronic lymphedema and the variety of surgical options, our method achieved excellent results, and may be proposed for the standard operative procedure for treating intractable forms of this disease. PMID:27990192

  6. Long-Term Results of Reconstruction for Treatment of a Flexible Cavovarus Foot in Charcot-Marie-Tooth Disease

    PubMed Central

    Ward, Christina M.; Dolan, Lori A.; Bennett, D. Lee; Morcuende, Jose A.; Cooper, Reginald R.

    2008-01-01

    Background: Cavovarus foot deformity is common in patients with Charcot-Marie-Tooth disease. Multiple surgical reconstructive procedures have been described, but few authors have reported long-term results. The purpose of this study was to evaluate the long-term results of an algorithmic approach to reconstruction for the treatment of a cavovarus foot in these patients. Methods: We evaluated twenty-five consecutive patients with Charcot-Marie-Tooth disease and cavovarus foot deformity (forty-one feet) who had undergone, between 1970 and 1994, a reconstruction consisting of dorsiflexion osteotomy of the first metatarsal, transfer of the peroneus longus to the peroneus brevis, plantar fascia release, transfer of the extensor hallucis longus to the neck of the first metatarsal, and in selected cases transfer of the tibialis anterior tendon to the lateral cuneiform. Each patient completed standardized outcome questionnaires (the Short Form-36 [SF-36] and Foot Function Index [FFI]). Radiographs were evaluated to assess alignment and degenerative arthritis, and gait analysis was performed. The mean age at the time of follow-up was 41.5 years, and the mean duration of follow-up was 26.1 years. Results: Correction of the cavus deformity was well maintained, although most patients had some recurrence of hindfoot varus as seen on radiographic examination. The patients had a lower mean SF-36 physical component score than age-matched norms, and the women had a lower mean SF-36 physical component score than the men, although this difference was not significant. Smokers had lower mean SF-36 scores and significantly higher mean FFI pain, disability, and activity limitation subscores (p < 0.0001). Seven patients (eight feet) underwent a total of eleven subsequent foot or ankle operations, but no patient required a triple arthrodesis. Moderate-to-severe osteoarthritis was observed in eleven feet. With the numbers studied, the age at surgery, age at the time of follow-up, and body

  7. Long-term results of surgical release of de Quervain’s stenosing tenosynovitis

    PubMed Central

    Scheller, Alexander; Schuh, Ralph; Hönle, Wolfgang

    2008-01-01

    The management of de Quervain’s disease (DD) is nonoperative in the first instance, but surgery should be considered if conservative measures fail. We present the long-term results of operative treatment of DD. From July 1988 to July 1998, 94 consecutive patients with DD were treated operatively by a single surgeon. There were 80 women and 14 men. Average age at the time of operation was 47.4 years (range 22–76). The right wrist was involved in 43 cases, the left in 51 cases. All operations were done under tourniquet control with local infiltration anaesthesia using a longitudinal incision and partial resection of the extensor ligament. There were six perioperative complications, including one superficial wound infection, one delayed wound healing, and four transient lesions of the radial nerve. A successful outcome was achieved in all cases with negative Finkelstein’s test. Simple decompression of both tendons and partial resection of the extensor ligament with a maximum of 3 mm can be recommended in operative treatment of DD with excellent long-term results. PMID:18956185

  8. Long-term clinical results and MRI changes after tendon ball arthroplasty for advanced Kienbock's disease.

    PubMed

    Mariconda, M; Soscia, E; Sirignano, C; Smeraglia, F; Soldati, A; Balato, G

    2013-06-01

    The purpose of this study was to assess the long-term clinical results and morphological changes after tendon ball arthroplasty for advanced Kienböck's disease. Twenty-six patients were reviewed, with a mean follow-up interval of 125 months (range 50-226). At follow-up, mean score on the Disabilities of the Arm, Shoulder, and Hand questionnaire was 7.7 and mean visual analogue scale score for pain was 1. Mean carpal height ratio was significantly reduced with respect to the pre-operative value. On magnetic resonance imaging scans, cartilage damage, synovitis, and erosive or oedematous changes in the bones were detected in most patients. Calcification in the defect filled by the tendon ball was seen in all patients. Narrowing of the radioscaphoid joint and the presence of intercarpal synovitis were negatively associated with clinical outcome. Tendon ball arthroplasty in advanced Kienböck's disease results in long-term satisfactory clinical outcomes, despite widespread changes in the bones and joints within the wrist.

  9. Neoadjuvant radiochemotherapy for locally advanced gastric cancer: Long-term results of a phase I trial

    SciTech Connect

    Allal, Abdelkarim S. . E-mail: abdelkarim.allal@hcuge.ch; Zwahlen, Daniel; Bruendler, Marie-Anne; Peyer, Raymond de; Morel, Philippe; Huber, Olivier; Roth, Arnaud D.

    2005-12-01

    Purpose: To assess the long-term results of radiation therapy (RT) when added preoperatively to systemic chemotherapy in patients with locally advanced gastric cancer. Methods and Materials: Patients presenting with T3-4 or N+ gastric cancer received two cycles of cisplatin 100 mg/m{sup 2} d1, 5FU 800 mg/m{sup 2} d1-4, and Leucovorin 60 mg twice daily d1-4; one cycle before and one concomitantly with hyperfractionated RT (median dose, 38.4; range, 31.2-45.6 Gy). All patients underwent a total or subtotal gastrectomy with D2 lymph node resection. Results: Nineteen patients were accrued and 18 completed the neoadjuvant therapeutic program. All patients were subsequently operated and no fatality occurred. At a mean follow-up of 8 years for the surviving patients, no severe late toxicity was observed. The 5-year locoregional control, disease-free, and overall survival were of 85%, 41%, and 35%, respectively. The peritoneum was the most frequent site of relapse. Among long terms survivors, no severe (Radiation Therapy Oncology Group Grade 3-4) late complication was reported. Conclusions: The present neoadjuvant treatment does not seem to increase the operative risk, nor the late side effects. The encouraging locoregional control rate suggests that the neoadjuvant approach should be considered for future trials in locally advanced gastric cancer. Also, the frequency of peritoneal recurrence stresses the need for a more efficient systemic or intraperitoneal treatment.

  10. [Immediate and long-term results of surgical treatment of patients for traumatic mandibular fracture].

    PubMed

    Kopchak, A V

    2014-01-01

    The analysis of immediate and long-term results of the surgical treatment of 286 patients, operated for traumatic mandibular fractures in the Department of Oral and Maxillofacial Surgery, National O. O. Bogomolets Medical University. In 67% of patients the anatomical shape of the bone was adequately restored. The presence of residual displacements in other cases was determined by the fracture type and localization, the technical complexity of the surgical intervention, lack of fixation rigidity under certain functional load conditions. In long terms of observation the infection and inflammatory complications were observed in 13.4% of patients, delayed unition and non-unition of bone fragments occurred--in 4.7%, arthosis with persistent dysfunction of the temporomandibular joint--in 6.7%, fibrous ankylosis--in 1.3%. Secondary displacement of fragments was observed in 23.5% of patients due to insufficient stiffness and reliaability of the bone-fixatorsystem. The non-precise reposition of fragments and secondary displacements in the early and late postoperative period were the main cause of occlusal disturbances of various severities, noted in 28% of operated patients, limitation of mouth opening (10%), TMJ disorders and changes in masticatory stereotype (33%), the sensation of pain and discomfort in tough food chewing (35%). A statistical analysis of the effectiveness of different osteosynthesis methods depending on the type and localization of the fracture was carried out and recommendations for usage of fixation devices in clinical practice were given.

  11. [Long-term health effects of air pollution: results of the European project ESCAPE].

    PubMed

    Stafoggia, Massimo; Cesaroni, Giulia; Galassi, Claudia; Badaloni, Chiara; Forastiere, Francesco

    2014-12-01

    Air pollution has been recently classified among the top ten risk factors for mortality worldwide. The evidence on the long-term effects of air pollutants is mounting, mostly from multi-centre American studies or longitudinal studies conducted in single European cohorts. Recently, the EU-funded project ESCAPE (European Study of Cohorts for Air Pollution Effects) involved more than 30 cohort studies with the aim of producing pooled estimates of the long-term health effects of ambient air pollution at European level. The project developed a standardized and flexible methodology to estimate chronic exposure to several air pollutants, applied such estimates to existing cohorts in Europe, and analyzed the exposure-response relationships with different health endpoints, including adverse pregnancy outcomes, respiratory diseases among children, cardio-respiratory diseases among adults, cause-specific mortality and lung cancer incidence. One of the most important results has been the detection of relevant health effects of particulate matter at concentrations below the current air quality limit values in Europe.

  12. Visual Internal Urethrotomy for Adult Male Urethral Stricture Has Poor Long-Term Results

    PubMed Central

    Al Taweel, Waleed; Seyam, Raouf

    2015-01-01

    Objective. To determine the long-term stricture-free rate after visual internal urethrotomy following initial and follow-up urethrotomies. Methods. The records of all male patients who underwent direct visual internal urethrotomy for urethral stricture disease in our hospital between July 2004 and May 2012 were reviewed. The Kaplan-Meier method was used to analyze stricture-free probability after the first, second, third, fourth, and fifth urethrotomies. Results. A total of 301 patients were included. The overall stricture-free rate at the 36-month follow-up was 8.3% with a median time to recurrence of 10 months (95% CI of 9.5 to 10.5, range: 2–36). The stricture-free rate after one urethrotomy was 12.1% with a median time to recurrence of eight months (95% CI of 7.1–8.9). After the second urethrotomy, the stricture-free rate was 7.9% with a median time to recurrence of 10 months (95% CI of 9.3 to 10.6). After the third to fifth procedures, the stricture-free rate was 0%. There was no significant difference in the stricture-free rate between single and multiple procedures. Conclusion. The long-term stricture-free rate of visual internal urethrotomy is modest even after a single procedure. PMID:26494995

  13. Long-term result of posterolateral fusion of the lumbar spine using the Tadpole system

    PubMed Central

    2014-01-01

    Background Failure of pedicle screw fixation is often seen in patients with severe osteoporosis. We developed new lumbar spinal instrumentation (Tadpole system) for elderly patients who have osteoporotic bone and poor general health status. The objective of this study was to document the long-term clinical outcomes after Tadpole system fixation, the rate of spinal fusion, the incidence of adjacent segment degeneration, the rate of instrumentation failure, and the overall complications. Methods Sixty patients who underwent posterolateral spinal fusion using the Tadpole system, in whom a radiograph of the lumbar spine was taken at more than 5 years after operation, were involved in this study. The improvement rate of the Japanese Orthopaedic Association (JOA) score, rate of spinal fusion, presence or absence of adjacent segment degeneration, rate of instrumentation failure, and postoperative complications of each patient were assessed at 5 years postoperatively. Results The mean JOA score improvement was 72.5%, and the posterolateral spinal fusion rate was 93.3% (56 of 60 patients) at the last follow-up. Adjacent segment degeneration occurred in only two patients who showed decreased intervertebral disc height, and instrumentation failure (hook deviation) was observed in one patient. No other complications were observed in any patients. Conclusion Tadpole system fixation shows favorable long-term clinical outcomes. PMID:24886530

  14. Long-term carcinologic results of advanced esthesioneuroblastoma: a systematic review.

    PubMed

    De Bonnecaze, Guillaume; Lepage, B; Rimmer, J; Al Hawat, A; Vairel, B; Serrano, E; Chaput, B; Vergez, S

    2016-01-01

    Surgical resection followed by radiotherapy can be considered like the optimal treatment modality for limited esthesioneuroblastoma. However, therapeutic management of locally advanced tumors remains a challenge. The aim of our study was to access and compare the oncologic results of the different treatment modalities in advanced esthesioneuroblastoma. We performed a systematic review using the Medline, and Cochrane database in accordance with PRISMA criteria and included all the cases of advanced esthesioneuroblastoma published between 2000 and 2013. We also retrospectively included 15 patients with an advanced esthesioneuroblastoma managed at our tertiary care medical center. Long-term survival rates defined as the time from diagnosis or randomization to the date of death or last follow-up were evaluated for each treatment with Kaplan-Meier survival curve analyses. 283 patients have been included. The mean follow-up was 78 months. Five-year highest survival rates were obtained in patients treated by surgery associated with radiotherapy. Ten-year highest survival rates were obtained in patients treated by the association of surgery, radiotherapy and chemotherapy (p = 0.0008). Within the surgical group, 5-year highest survival rates were obtained in patients treated by endoscopic resection (p = 0.003). Surgical resection combined with radiotherapy offers the gold standard of care. Adjuvant chemotherapy seems to improve the long-term survival in patients with locally advanced esthesioneuroblastoma. Endoscopic resection in advanced tumors should be discussed on a case-by-case basis.

  15. [Long-term (33 years) result of revascularization of subtotally amputated upper arm].

    PubMed

    Kaczmarzyk, Janusz; Kocieba, Ryszard; Jabłecki, Jerzy

    2008-01-01

    Replantations and revascularizations on the level of the arm are performed in the smallest number. The achieved functional results are poor. The paper presents a result achieved in a patient who sustained an avulsion amputation of an upper arm in the year 1974. The first long-term control was made 11 years after the revascularization of the limb which rated the result as III acc. to Chen's score system. The patient was steadily highly motivated for hand rehabilitation process. The second control performed 33 years after the accident proved the increase of sensibility, muscle strength as well as the range of movements. The result was up-graded as II (good). No degenerative changes in hand bones of mutilated hand were found.

  16. Long-term results of children diagnosed with idiopathic nephrotic syndrome; single center experience

    PubMed Central

    Hacıhamdioğlu, Duygu Övünç; Kalman, Süleyman; Gök, Faysal

    2015-01-01

    Aim: The aim of this study was to determine the long-term results of children followed up with a diagnosis of nephrotic syndrome in a single center. Materials and Method: The medical data of 33 patients aged between 6 months and 10 years who were diagnosed with idiopathic nephrotic syndrome in our center between January 2000 and December 2012 and followed up for a period of 2–12 years were reviewed (Gulhane Military Medical Academy Ethics committee, 07.11.2012/10). Results: The mean age of disease onset was 3.2±2.04 years (range: 0.5–10 years) and the mean follow-up period was 6±3.4 years (range: 2–12 years). Thirteen (39.4%) of the study group (or the patients) were female and 20 (60.6%) were male. Twenty seven (1.8%) of the patients were sensitive to steroid and 6 (18.1%) were resistant to steroid. Four (12.1%) of the steroid-resistant patients had steroid-dependent nephrotic syndrome, 5 (15.2%) had frequently relapsing nephrotic syndrome and 18 (54.5%) had rarely relapsing nephrotic syndrome. Histopathological diagnoses of six patients who underwent biopsy because of resistance to steroid were as follows: focal segmental glomerulosclerosis (n=3), C1q nephropathy (n=1), diffuse mesangial proliferation (n=1) and membraneous nephropathy (n=1). Fifteen (45.5%) patients entered into full remission and 2 (6%) patients developed chronic renal failure. Treatment complications including decreased bone mineral density in three patients (9%), short stature in 2 patients (6%) and cataract in 2 patients (6%) developed. Conclusions: Children with nephrotic syndrome carry a risk in terms of short stature, osteoporosis, cataract and renal failure in the long-term follow-up. It was observed that our rates of response to steroid were similar to the literature and the most common histopathological diagnosis was focal segmental glomerulosclerosis in our patients who underwent biopsy because of resistance to steroid. It was thought that multi-center studies should be

  17. Aortic valve replacement in the elderly. Risk factors and long-term results.

    PubMed Central

    Tseng, E E; Lee, C A; Cameron, D E; Stuart, R S; Greene, P S; Sussman, M S; Watkins, L; Gardner, T J; Baumgartner, W A

    1997-01-01

    OBJECTIVE: The current study was undertaken to determine long-term results of aortic valve replacement (AVR) in the elderly, to ascertain predictors of poor outcome, and to assess quality of life. SUMMARY BACKGROUND DATA: Aortic valve replacement is the procedure of choice for elderly patients with aortic valve disease. The number of patients aged 70 and older requiring AVR continues to increase. However, controversy exists as to whether surgery devoted to this subset reflect a cost-effective approach to attaining a meaningful quality of life. METHODS: This study reviews data on 247 patients aged 70 to 89 years who underwent isolated AVR between 1980 and 1995; there were 126 men (51%) and 121 women (49%). Follow-up was 97% complete (239/247 patients) for a total of 974.9 patient-years. Mean age was 76.2 +/- 4.8 years. Operative mortality and actuarial survival were determined. Patient age, gender, symptoms, associated diseases, prior conditions, New York Health Association class congestive heart failure, native valve disease, prosthetic valve type, preoperative catheterization data, and early postoperative conditions were analyzed as possible predictors of outcome. Functional recovery was evaluated using the SF-36 quality assessment tool. RESULTS: Operative mortality was 6.1% (15/247). Multivariate logistic regression showed that poor left ventricular function and preoperative pacemaker insertion were independent predictors of early mortality. After surgery, infection was predictive of early mortality. Overall actuarial survival at 1, 5, and 10 years was 89.5 +/- 2% (198 patients at risk), 69.3 +/- 3.4% (89 patients at risk), and 41.2 +/- 6% (13 patients at risk), respectively. Cox proportional hazards model showed that chronic obstructive pulmonary disease and urgency of operation were independent predictors of poor long-term survival. Postoperative renal failure also was predictive of poor outcome. Using the SF-36 quality assessment tool, elderly patients who

  18. Long-term safety and efficacy of biosimilar infliximab among patients with inflammatory arthritis switched from reference product

    PubMed Central

    Abdalla, Abuelmagd; Byrne, Niamh; Conway, Richard; Walsh, Thomas; Mannion, Geraldine; Hanly, Michael; O’Sullivan, Miriam; Curran, Ann Maria; Carey, John J

    2017-01-01

    Purpose To evaluate the efficacy and safety of the biosimilar infliximab in adult patients with inflammatory arthritis switched from reference product in our center. Patients and methods In April 2014, patients attending our rheumatology service for infliximab infusions were switched from reference product to the biosimilar infliximab following consent and hospital approval. Results Around 34 patients with inflammatory arthritis were switched from reference product to biosimilar infliximab in 2014: 50% female, mean age 55 years (standard deviation=12.9), mean disease duration 14.79 years (9.7), median duration on infliximab 57 months, and two-thirds on oral disease-modifying antirheumatic drugs. There was no difference in efficacy or safety in the first 6 months of therapy. By the end of 2015, the mean follow-up on biosimilar infliximab was 15.8 (standard deviation=6.3) months. Our results showed no significant difference in Health Assessment Questionnaire score, patient global assessment of disease activity, number of disease flares, or the medication dose between the originator and the biosimilar infliximab. However, reported pain and C-reactive protein values were significantly higher during the longer follow-up period (p=0.043, 0.001 respectively). There was no significant difference in the number of adverse events or infusion reactions during follow-up periods. Only five (14.7%) patients discontinued the biosimilar infliximab. Conclusion Our patients experienced similar efficacy and safety for managing their arthritis with the biosimilar infliximab as the reference product infliximab, but at a much lower cost. PMID:28331376

  19. Results from the long-term interaction and modeling of SRL-131 glass with aqueous solutions

    SciTech Connect

    Strachan, D.M.; Pederson, L.R.; Lokken, R.O.

    1985-11-01

    Leaching studies on SRL-131 simulated defense waste glass have been carried out for a duration of two years. This glass contained nonradioactive elements and depleted uranium to simulate the waste content. The leachants used in this study were deionized water, a sodium bicarbonate/silicic acid solution (silicate water), a synthetic groundwater, and a high ionic strength K-Mg-Na-Cl brine. Two temperatures were used: 40/sup 0/C and 90/sup 0/C. The long-term results were in fair agreement with modeling calculations performed using the PHREEQE geochemical code. The leachability of SRL-131 glass from results up to two years followed the trend: deionized water > silicate water > synthetic groundwater > salt brine at 40/sup 0/C and deionized water approx. = synthetic groundwater > silicate water > salt brine at 90/sup 0/C. Solid state analyses are reported along with an Appendix containing a complete data set.

  20. Leksell Gamma Knife treatment for pilocytic astrocytomas: long-term results.

    PubMed

    Simonova, Gabriela; Kozubikova, Petra; Liscak, Roman; Novotny, Josef

    2016-07-01

    OBJECTIVE The purpose of this study was to evaluate long-term treatment results, radiation-related toxicity, and prognostic factors for the progression-free survival (PFS) of patients with pilocytic astrocytomas treated by means of stereotactic radiosurgery with a Leksell Gamma Knife. METHODS A total of 25 patients with pilocytic astrocytomas underwent Gamma Knife surgery during the period 1992-2002. The median target volume was 2700 mm(3) (range 205-25,000 mm(3)). The 18 patients treated with 5 daily fractions received a median minimum target dose of 25 Gy. Doses for the 2 patients treated with 10 fractions over 5 days (2 fractions delivered on the same day at least 6 hours apart) were 23 and 28 Gy. For the 5 patients treated with a single fraction, the minimum target dose ranged from 13 to 20 Gy (median 16 Gy). RESULTS Complete regression occurred in 10 patients (40%) and partial regression in 10 patients (40%). The 10-year overall survival rate was 96% and the 10-year PFS rate was 80%. Target volume appeared to be a significant prognostic factor for PFS (p = 0.037). Temporary Grade 3 toxicity appeared in 2 patients (8%), and these patients were treated with corticosteroids for 2 months. Permanent Grade 4 toxicity appeared in 2 patients (8%) and was associated with neurocognitive dysfunction. In these 2 individuals, the neurocognitive dysfunction was also felt to be in part the result of the additional therapeutic interventions (4 in one case and 6 in the other) required to achieve durable control of their tumors. CONCLUSIONS Radiosurgery represents an alternative treatment modality for small residual or recurrent volumes of pilocytic astrocytomas and provides long-term local control. Target volume appears to be the most important factor affecting PFS.

  1. Evaluation of long-term quality of life after reoperative coronary artery surgery: preliminary results

    PubMed Central

    Noyez, L.; Schultz, A.; van der Heide, S.M.; van Eck, F.M.; Brouwer, R.M.H.J.

    2003-01-01

    Objective The risks of reoperative coronary artery bypass surgery (RECABG) still exceed those of a primary revascularisation and late results are not very favourable either. The subject of the present study is an evaluation of the long-term quality of life after RECABG. Methods We studied the outcome of 541 patients who underwent a RECABG from January 1987 to December 1998. The endpoint of the study was December 2002, or the patient's death. Quality of life, using the EuroQol registration, was evaluated. Results Hospital mortality was 6.7%. Follow-up was 95.6% complete, mean 7.7 years. There were 177 late deaths. The cumulative survival rates were 83.8, 76.9, and 60.6%, and cardiac survival rates were 84.8, 78.5, and 66.5%, at the one-year, five-year and ten-year follow-up, respectively. For 255 patients (89%), NYHA and EuroQol information was complete. In total 23% of the patients were in NYHA class I, 51% in class II, 21% in class III and 5% were in class IV. In the EuroQol registration, 54% of the patients declared they had no mobility problems, 85% no problems with self-care, and 65% no problems with usual activities. However, 60% suffered from moderate pain or discomfort, and 33% from anxiety or depression. On the visual analogue scale (mean 63.5), 13% of the patients scored >90, 68% between 50 and 90, and 19% of the patients <50. Conclusion The long-term results of cumulative survival and cardiac survival, and NYHA class in our patient population who underwent RECABG are comparable with other studies. Quality of life is acceptable regarding the high risk of a RECABG. PMID:25696170

  2. Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results

    SciTech Connect

    Olivatto, Luis O.; Cabral, Vania; Rosa, Arthur; Bezerra, Marcos; Santarem, Erick; Fassizoli, Ana; Castro, Leonaldson; Simoes, Jose Humberto; Small, Isabele A.; Ferreira, Carlos Gil

    2011-02-01

    Purpose: To evaluate the long-term efficacy of concurrent radiotherapy with mitomycin-C (MMC)-based or cisplatin (CP)-based combinations in a cohort of patients with locally advanced anal canal carcinoma. Methods and Materials: Between 1988 and 2000, 179 patients with locally advanced anal canal carcinoma were treated at the Instituto Nacional de Cancer with two cycles of chemotherapy during Weeks 1 and 5 of radiotherapy. 5-Fluorouracil (750 mg/m{sup 2} 120-hour infusion or 1,000 mg/m{sup 2} 96-hour infusion) plus CP (100 mg/m{sup 2}) on the first day of each cycle or MMC (10-15 mg/m{sup 2}) on the first day of Cycle 1 was administered concurrent with radiotherapy (total dose, 55-59.4 Gy). Of the 179 patients, 60% were included from a randomized trial initiated at the Instituto Nacional de Cancer in 1991 that compared concurrent chemoradiotherapy with MMC vs. CP. Results: The median follow-up for the whole chemoradiotherapy group was 83 months. The median patient age was 58 years, 57% had Stage T3-T4 tumors, and 35% had N-positive disease. The 5-year cumulative colostomy rate was not significantly different between the CP group (22%) and MMC group (29%; p = .28). The actuarial 10-year overall survival and disease-free survival rate for the CP group was 54% and 49% and for the MMC group was 52% and 53%, respectively (p = .32 and p = .92, respectively). On multivariate analysis, male gender (p = .042) and advanced Stage T3-T4 disease (p <.0001) were statistically significant for worse disease-free survival. Stage T3-T4 (p = .039) and N+ (p = .039) disease remained independently significant for overall survival. Conclusion: Long-term follow-up has confirmed the good results of chemoradiotherapy with CP plus 5-fluorouracil, which seem to provide results equivalent to those with MMC plus 5-fluorouracil.

  3. Long-term results after muscle-rib flap transfer for reconstruction of composite limb defects.

    PubMed

    Georgescu, Alexandru V; Ignatiadis, Ioannis; Ileana, Matei; Irina, Capota; Filip, Ardelean; Olariu, Radu

    2011-03-01

    The authors present the long-term results in a series of 44 cases with post-traumatic bone defects solved with muscle-rib flaps, between March 1997 and December 2007. In these cases, we performed 21 serratus anterior-rib flaps (SA-R), 10 latissimus dorsi-rib flaps (LD-R), and 13 LD-SA-R. The flaps were used in upper limb in 18 cases and in lower limb in 26 cases. With an overall immediate success rate of 95.4% (42 of 44 cases) and a primary bone union rate of 97.7% (43 of 44 cases), and despite the few partisans of this method, we consider that this procedure still remains very usefully for small and medium bone defects accompanied by large soft tissue defects.

  4. INTEGRAL long-term monitoring results on persistently bright NS LMXBs

    NASA Astrophysics Data System (ADS)

    Savolainen, P.; Hannikainen, D. C.; Paizis, A.; Farinelli, R.; Kuulkers, E.; Vilhu, O.

    2010-07-01

    We present long-term spectral and timing results from an INTEGRAL monitoring program of persistently bright neutron star Low-Mass X-ray Binaries, i.e. the three bright Atoll sources GX 3+1, GX 9+1 and GX 9+9, and the Z sources GX 5-1, GX 17+2, GX 340+0 and GX 349+2. From the available observing periods between 2003 and 2009, each lasting ~2 months, we have selected a few sample periods for each source, and analyzed all JEM-X and IBIS/ISGRI data with offsets <4 degrees. We seek an explanation for the dichotomy between the hard X-ray tails or lack thereof in the (otherwise very similar) X-ray spectra of Z sources and bright Atolls, respectively.

  5. Subtotal parathyroidectomy for primary hyperparathyroidism. Long-term results in 292 patients

    SciTech Connect

    Paloyan, E.; Lawrence, A.M.; Oslapas, R.; Shah, K.H.; Ernst, K.; Hofmann, C.

    1983-04-01

    Subtotal parathyroidectomy was performed in a consecutive series of 292 patients with primary hyperparathyroidism. We evaluated the long-term postoperative results during a period of 16 years. Patients ranged in age from 14 to 83 years and included 176 women and 116 men. Of these, 16% had a history of exposure to radiation in childhood or adolescence, while thyroid disease requiring some form of thyroidectomy coexisted in 91 (31%) of the patients. Histologic information on three or more parathyroid glands was obtained in 73% of the cases. We considered 285 patients (97.6%) cured after their first operation. The remaining seven patients (2.4%) had persistent hyperparathyroidism. However, five were cured after a sternum-splitting mediastinal exploration and one after a second neck exploration. The seventh remains hypercalcemic despite a subsequent mediastinal exploration. Temporary postoperative hypoparathyroidism occurred in 10% of our cases and permanent hypoparathyroidism in 1%. There have been no instances of recurrent hyperparathyroidism.

  6. Long Term Results of Liner Polyethylene Cementation Technique in Revision for Peri-acetabular Osteolysis.

    PubMed

    Rivkin, Gurion; Kandel, Leonid; Qutteineh, Bilal; Liebergall, Meir; Mattan, Yoav

    2015-06-01

    Patients with peri-acetabular osteolysis around a well fixed cementless acetabular component may be treated with liner exchange. When the locking mechanism is unreliable or unavailable, cementing the liner into the fixed acetabular component is a feasible option. The purpose of this study was to evaluate the clinical and radiographic long term results of this technique. Forty hip revisions with liner cementation in 37 patients were performed. The minimum follow up was 10 years. Modified Harris Hip Score and recent x rays were reviewed. Four hips were re-revised. Two patients were diagnosed with exacerbation of osteolysis but refused revision. Dislocation rate was relatively high (16%). Liner cementation technique in revision hip surgery is useful in patients with a well fixed metal backed acetabular component.

  7. Long Term Seismic Observation in Mariana by OBSs : Results of the DD inversion

    NASA Astrophysics Data System (ADS)

    Shiobara, H.; Sugioka, H.; Mochizuki, K.; Oki, S.; Kanazawa, T.; Fukao, Y.; Suyehiro, K.

    2004-12-01

    In order to obtain the deep arc structural image of Mariana, a large-scale seismic observation by using 58 long-term ocean bottom seismometers (LTOBS) had been performed from June 2003 until April 2004, which is a part of the MARGINS program funded by the NSF. Prior to this observation, a pilot long-term seismic array observation was conducted in the same area by using 10 LTOBSs from Oct. 2001 until Feb. 2003. By using seven LTOBS's data, those are about 11 months long, hypocenter determination was performed at first and more than 3000 local events were found, although the PDE list contains only 59. A 1D velocity structure based on the iasp91 model was used, and a systematic shift of epicenters between the PDE list and this study was seen. To investigate the detail of hypocenter distribution and the 3D velocity structure, the DD inversion (tomoDD: Zhang and Thurber, 2003) was applied for this data set with a 1D structure initial model except for the crust, which has been surveyed by using a dense airgun-OBS system (Takahashi et al., 2003). The result of relocated hypocenters shows double seismic zones until about 200km depth and a lined focuses along the current ridge axis in the back-arc basin, and the result of the tomographic inversion shows a image of subducting slab and a low-Vs region below the Pagan island erupted in 1981 at 80km depth. The mantle structure beneath the back-arc basin was not clearly resolved due to the inadequate source-receiver coverage, which is cleared in the recent experiment.

  8. Safety of long-term use of linezolid: results of an open-label study

    PubMed Central

    Vazquez, Jose A; Arnold, Anthony C; Swanson, Robert N; Biswas, Pinaki; Bassetti, Matteo

    2016-01-01

    Objective The objective of this study was to assess the long-term safety of linezolid in patients with chronic infections requiring treatment for ≥6 weeks. Enhanced monitoring for optic neuropathy was included to characterize the early development of this side effect and to identify ophthalmologic tests that might be valuable in early detection of this event. Methods This was a multicenter, open-label, pilot study of patients aged ≥18 years on long-term linezolid therapy. Matched control patients were included for baseline assessment comparison. Patients were assessed at study entry, monthly while on treatment, at the end of treatment, and 30 days following the last dose. Aggregate ocular safety data were reviewed. Response to treatment was reported. Results The study was terminated owing to slow enrollment. Twenty-four patients received linezolid; nine patients were included as matched controls. Linezolid was prescribed for a median of 80.5 days (range, 50–254 days). In patients with a reported clinical outcome, the majority were considered improved or cured. Common treatment-related adverse events (AEs) included anemia, peripheral neuropathy, polyneuropathy, vomiting, and asthenia, and were consistent with the known safety profile. Most AEs resolved or stabilized with discontinuation of treatment. Results of ophthalmologic tests in the one case adjudicated as probable linezolid-associated optic neuropathy revealed abnormal color vision, characteristic changes in the optic disk, and central scotomas in each eye. Conclusion In our small population, linezolid was generally well tolerated and AEs were consistent with the known safety profile. Extensive ophthalmologic testing of all 24 linezolid-treated patients identified one case adjudicated as probable, linezolid-associated optic neuropathy. PMID:27621644

  9. Long-term performance of landfill covers - results of lysimeter test fields in Bavaria (Germany).

    PubMed

    Henken-Mellies, Wolf-Ulrich; Schweizer, Andreas

    2011-01-01

    A comprehensive study was conducted to examine the performance and possible changes in the effectiveness of landfill surface covers. Three different profiles of mineral landfill caps were examined. The results of precipitation and flow measurements show distinct seasonal differences which are typical for middle-European climatic conditions. In the case of the simple landfill cap design consisting of a thick layer of loamy sand, approximately 100-200 L m(-2) of annual seepage into the landfill body occurs during winter season. The three-layer systems of the two other test fields performed much better. Most of the water which percolated through the top soil profile drained sideways in the drainage layer. Only 1-3% of precipitation percolated through the sealing layer. The long-term effectiveness of the mineral sealing layer depended on the ability of the top soil layer to protect it from critical loss of soil water/critical increase of suction. In dry summers there was even a loss in soil water content at the base of the 2.0 m thick soil cover. The results of this study demonstrate the importance of the long-term aspect when assessing the effectiveness of landfill covers: The hydraulic conductivity at the time of construction gives only an initial (minimum) value. The hydraulic conductivity of the compacted clay layer or of the geosynthetic clay liner may increase substantially, if there is no long-lasting protection against desiccation (by a thick soil cover or by a geomembrane). This has to be taken into account in landfill cover design.

  10. Long-term social isolation in the adulthood results in CA1 shrinkage and cognitive impairment.

    PubMed

    Pereda-Pérez, Inmaculada; Popović, Natalija; Otalora, Beatriz Baño; Popović, Miroljub; Madrid, Juan Antonio; Rol, Maria Angeles; Venero, César

    2013-11-01

    Social isolation in adulthood is a psychosocial stressor that can result in endocrinological and behavioral alterations in different species. In rodents, controversial results have been obtained in fear conditioning after social isolation at adulthood, while neural substrates underlying these differences are largely unknown. Neural cell adhesion molecule (NCAM) and its polysialylated form (PSA-NCAM) are prominent modulators of synaptic plasticity underlying memory processes in many tasks, including fear conditioning. In this study, we used adult female Octodon degus to investigate the effects of long-term social isolation on contextual and cued fear conditioning, and the possible modulation of the synaptic levels of NCAM and PSA-NCAM in the hippocampus. After 6½ months of social isolation, adult female degus showed a normal auditory-cued fear memory, but a deficit in contextual fear memory, a hippocampal dependent task. Subsequently, we observed reduced hippocampal synaptic levels of PSA-NCAM in isolated compared to grouped-housed female degus. No significant differences were found between experimental groups in hippocampal levels of the three main isoforms of NCAM (NCAM180, NCAM140 and NCAM120). Interestingly, social isolation reduced the volume of the hippocampal CA1 subfield, without affecting the volume of the CA3 subregion or the total hippocampus. Moreover, attenuated body weight gain and reduced number of granulocytes were detected in isolated animals. Our findings indicate for the first time, that long-term social isolation of adult female animals induces a specific shrinkage of CA1 and a decrease in synaptic levels of PSA-NCAM in the hippocampus. These effects may be related to the deficit in contextual fear memory observed in isolated female degus.

  11. Long term treatment with abatacept or tocilizumab does not increase Epstein-Barr virus load in patients with rheumatoid arthritis - A three years retrospective study

    PubMed Central

    Balandraud, Nathalie; Texier, Gaetan; Massy, Emmanuel; Muis-Pistor, Olivier; Martin, Marielle; Auger, Isabelle; Guzian, Marie-Caroline; Guis, Sandrine; Pham, Thao; Roudier, Jean

    2017-01-01

    Background Epstein-Barr Virus (EBV) is a widely disseminated lymphotropic herpes virus implicated in benign and malignant disorders. In transplant patients, immunosuppressive drugs (cyclosporine) diminish control of EBV replication, potentially leading to lymphoproliferative disorders (LPD). Rheumatoid arthritis (RA) patients have impaired control of EBV infection and have EBV load ten times higher than controls. As post transplant patients, patients with RA have increased risk of developing lymphomas. Immunosuppressive drugs used to treat RA (conventional disease modifying drugs cDMARDs or biologics bDMARDs) could enhance the risk of developing LPD in RA patients. We have previously shown that long term treatment with Methotrexate and/or TNF alpha antagonists does not increase EBV load in RA. Our objective was to monitor the Epstein-Barr Virus load in RA patients treated with Abatacept (CTLA4 Ig), a T cell coactivation inhibitor, and Tocilizumab, an anti IL6 receptor antibody. Methods EBV load in the peripheral blood mononuclear cells (PBMCs) of 55 patients under Abatacept (in 34% associated with Methotrexate) and 35 patients under Tocilizumab (in 37% associated with Methotrexate) was monitored for durations ranging from 6 months to 3 years by real time PCR. The influences of treatment duration and disease activity score 28 (DAS28) index on EBV load were analyzed. Results Abatacept did not significantly modify EBV load over time. Tocilizumab significantly diminished EBV load over time. No patient (of 90) developed EBV associated lymphoma. Conclusion Long term treatment with Abatacept or Tocilizumab does not increase EBV load in the PBMNCs of patients with RA. PMID:28199343

  12. Long-term study of the impact of methotrexate on serum cytokines and lymphocyte subsets in patients with active rheumatoid arthritis: correlation with pharmacokinetic measures

    PubMed Central

    Kremer, Joel M; Lawrence, David A; Hamilton, Robert; McInnes, Iain B

    2016-01-01

    Objective To describe changes in immune parameters observed during long-term methotrexate (MTX) therapy in patients with active rheumatoid arthritis (RA) and explore correlations with simultaneously measured MTX pharmacokinetic (PKC) parameters. Design Prospective, open-label, long-term mechanism of action study. Setting University clinic. Methods MTX was initiated at a single weekly oral dose of 7.5 mg and dose adjusted for efficacy and toxicity for the duration of the study. Standard measures of disease activity were performed at baseline and every 6–36 months. Serum cytokine measurements in blood together with lymphocyte surface immunophenotypes and stimulated peripheral blood mononuclear cell (PBMC) cytokine production were assessed at each clinical evaluation. Results Cytokine concentrations exhibited multiple significant correlations with disease activity measures over time. The strongest correlations observed were for interleukin (IL)-6 (r=0.45, p<0.0001 for swollen joints and r=0.32, p=0.002 for tender joints) and IL-8 (r=0.25, p=0.01 for swollen joints). Significant decreases from baseline were observed in serum IL-1B, IL-6 and IL-8 concentrations. The most significant changes were observed for IL-6 (p<0.001). Significant increases from baseline were observed in IL-2 release from PBMCs ex vivo (p<0.01). In parallel, multiple statistically significant correlations were observed between MTX PKC measures and immune parameters. The change in swollen joint count correlated inversely with the change in area under the curve (AUC) for MTX (r=−0.63, p=0.007). Conclusions MTX therapy of patients with RA is accompanied by a variety of changes in serum cytokine expression, which in turn correlate strongly with clinical disease activity and MTX pharmacokinetics (PKCs). These data strongly support the notion that MTX mediates profound and functionally relevant effects on the immunological hierarchy in the RA lesion. PMID:27335660

  13. Long-Term Results for Trigeminal Schwannomas Treated With Gamma Knife Surgery

    SciTech Connect

    Hasegawa, Toshinori Kato, Takenori; Iizuka, Hiroshi; Kida, Yoshihisa

    2013-12-01

    Purpose: Surgical resection is considered the desirable curative treatment for trigeminal schwannomas. However, complete resection without any complications remains challenging. During the last several decades, stereotactic radiosurgery (SRS) has emerged as a minimally invasive treatment modality. Information regarding long-term outcomes of SRS for patients harboring trigeminal schwannomas is limited because of the rarity of this tumor. The aim of this study was to evaluate long-term tumor control and functional outcomes in patients harboring trigeminal schwannomas treated with SRS, specifically with gamma knife surgery (GKS). Methods and Materials: Fifty-three patients harboring trigeminal schwannomas treated with GKS were evaluated. Of these, 2 patients (4%) had partial irradiation of the tumor, and 34 patients (64%) underwent GKS as the initial treatment. The median tumor volume was 6.0 cm{sup 3}. The median maximum and marginal doses were 28 Gy and 14 Gy, respectively. Results: The median follow-up period was 98 months. On the last follow-up image, 7 patients (13%) had tumor enlargement, including the 2 patients who had partial treatment. Excluding the 2 patients who had partial treatment, the actuarial 5- and 10-year progression-free survival (PFS) rates were 90% and 82%, respectively. Patients with tumors compressing the brainstem with deviation of the fourth ventricle had significantly lower PFS rates. If those patients with tumors compressing the brainstem with deviation of the fourth ventricle are excluded, the actuarial 5- and 10-year PFS rates increased to 95% and 90%, respectively. Ten percent of patients had worsened facial numbness or pain in spite of no tumor progression, indicating adverse radiation effect. Conclusions: GKS can be an acceptable alternative to surgical resection in patients with trigeminal schwannomas. However, large tumors that compress the brainstem with deviation of the fourth ventricle should be surgically removed first and then

  14. Brock transventricular pulmonary valvotomy in patients with pulmonary stenosis: long-term results.

    PubMed

    Vogel, M; Eger, R; Klinner, W; Bühlmeyer, K

    1990-10-01

    As no long-term results of a blind opening up of the pulmonary valve either by balloon valvoplasty or closed Brock valvotomy have been published, we examined the outcome of 12 patients with valvar pulmonary stenosis 17 +/- 5 (11-22) years after surgery. The Brock valvotomy had been carried out at a mean age of 3 +/- 2.8 (0.2-8.5) years. The mean pressure gradient across the right ventricular outflow tract had been 116 +/- 45 (75-97) mmHg at the catheter study or 106 +/- 43 (40-160) mmHg as measured intraoperatively. The right ventricular pressure after the Brock procedure was measured in the operating room in five patients as 46 +/- 15 (30-60) mmHg. Seven patients had been recatheterized at a mean age of 9.5 +/- 2 (7-12.7) years; at that time the gradient across the pulmonary valve had been 20 +/- 14 (10-37) mmHg. At a mean age of 21.7 +/- 3 (15-26) years these and five further patients were reexamined by echo Doppler. This time the pressure gradient across the pulmonary valve was 13 +/- 6 (7-20) mmHg. Moderate pulmonary incompetence was present in four and mild incompetence in eight patients; two had mild tricuspid insufficiency. All except one patient, who had suffered a cerebrovascular accident before surgery, were in NYHA functional class 1 and pursuing a profession. From these data we conclude that the blind opening-up of the pulmonary valve achieves excellent long-term palliation.

  15. Residents' reactions to long-term sonic boom exposure: Preliminary results

    NASA Technical Reports Server (NTRS)

    Fields, James M.; Moulton, Carey; Baumgartner, Robert M.; Thomas, Jeff

    1994-01-01

    This presentation is about residents' reactions to sonic booms in a long-term sonic boom exposure environment. Although two phases of the data collection have been completed, the analysis of the data has only begun. The results are thus preliminary. The list of four authors reflects the complex multi-disciplinary character of any field study such as this one. Carey Moulton is responsible for Wyle Laboratories' acoustical data collection effort. Robert Baumgartner and Jeff Thomas of HBRS, a social science research firm, are responsible for social survey field work and data processing. The study is supported by the NASA Langley Research Center. The study has several objectives. The preliminary data addresses two of the primary objectives. The first objective is to describe the reactions to sonic booms of people who are living where sonic booms are a routine, recurring feature of the acoustical environment. The second objective is to compare these residents' reactions to the reactions of residents who hear conventional aircraft noise around airports. Here is an overview of the presentation. This study will first be placed in the context of previous community survey research on sonic booms. Next the noise measurement program will be briefly described and part of a social survey interview will be presented. Finally data will be presented on the residents' reactions and these reactions will be compared with reactions to conventional aircraft. Twelve community studies of residents' reactions to sonic booms were conducted in the United States and Europe in the 1960's and early 1970's. None of the 12 studies combined three essential ingredients that are found in the present study. Residents' long-term responses are related to a measured noise environment. Sonic booms are a permanent feature of the residential environment. The respondents' do not live on a military base. The present study is important because it provides the first dose/response relationship for sonic booms

  16. Long-Term Treatment by Vitamin B1 and Reduction of Serum Proinflammatory Cytokines, Hyperalgesia, and Paw Edema in Adjuvant-Induced Arthritis

    PubMed Central

    Zaringhalam, Jalal; Akbari, Akhtar; Zali, Alireza; Manaheji, Homa; Nazemian, Vida; Shadnoush, Mahdi; Ezzatpanah, Somayeh

    2016-01-01

    Introduction: Immune system is involved in the etiology and pathophysiology of inflammation and vitamins are important sources of substances inducing nonspecific immunomodulatory effects. Given the proinflammatory role of cytokines in the inflammation and pain induction, this study aimed to assess the effects of long-term administration of vitamin B1 on the proinflammatory cytokines, edema, and hyperalgesia during the acute and chronic phases of adjuvant-induced arthritis. Methods: On the first day of study, inflammation was induced by intraplantar injection of complete Freund's adjuvant (CFA) in the hindpaws of rats. Vitamin B1 at doses of 100, 150, and 200 mg/kg was administrated intraperitoneally during 21 days of the study. Antinociceptive and anti-inflammatory effects of vitamin B1 were also compared to indomethacin (5 mg/kg). Inflammatory symptoms such as thermal hyperalgesia and paw edema were measured by radiant heat and plethysmometer, respectively. Serum TNF-α and IL-1β levels were checked by rat standard enzyme-linked immune sorbent assay (ELISA) specific kits. Results: The results indicated that vitamin B1(150 and 200 mg/kg) attenuated the paw edema, thermal hyperalgesia, and serum levels of TNF-α and IL-1β during both phases of CFA-induced inflammation in a dose-dependent manner. Effective dose of vitamin B1(150 mg/kg) reduced inflammatory symptoms and serum levels of TNF-α and IL-1β compare to indomethacin during the chronic phase of inflammation. Conclusion: Anti-inflammatory and antihyperalgesic effects of vitamin B1 during CFA-induced arthritis, more specifically after chronic vitamin B1 administration, suggest its therapeutic property for inflammation. PMID:27872694

  17. Combined treatment of achalasia - botulinum toxin injection followed by pneumatic dilatation: long-term results.

    PubMed

    Kroupa, R; Hep, A; Dolina, J; Valek, V; Matyasova, Z; Prokesova, J; Mrazova, J; Sedmik, J; Novotny, I

    2010-02-01

    Injection of botulinum toxin (BT) and pneumatic dilatation are available methods in nonsurgical treatment of achalasia. Authors anticipate beneficial effect of prior BT injection on the success of pneumatic dilatation and duration of its effect. There are no long-term data available to assess efficacy of combined treatment. From 1998 to 2007, 51 consecutive patients (20 men and 31 women, age 24-83) with achalasia were included and prospectively followed up. Each patient received injection of 200 IU of BT into the lower esophageal sphincter (LES) during endoscopy and 8 days later pneumatic dilatation (PD) under X-ray control was performed. The follow-up was established every 3 months first year and then annually. The efficacy was evaluated by a questionnaire concerning patient's symptoms and manometry. Results were compared with 40 historical controls (16 men and 24 women, age 26-80) treated by PD alone using the same method and follow-up. Fifty-one patients underwent combined treatment. Four patients failed in follow-up and were not included for analysis. The mean duration of follow-up was 48 months with range 12-96 months. Thirty-four of forty-seven (72%) patients were satisfied with results with none or very rare and mild troubles at the time of the last visit. Forty-one patients were followed up more than 2 years. Effect of therapy lasted in 75% (31/41) of them. In 17 patients, more than 5 years after treatment, effect lasted in 12 (70%). Mean tonus of LES before therapy was 29 mm Hg (10-80), 3 months after therapy decreased to 14 mmHg (5-26). The cumulative 5 years remission rate (+/-95% CI) in combined treated patients 69% +/- 8% was higher than in controls 50% +/- 9%; however it, was not statistically significant (P= 0.07). In control group 1, case of perforation (2.5%) occurred. Eight patients (17%) with relapse of dysphagia were referred to laparoscopic Heller myotomy with no surgical complication. The main adverse effect was heartburn that appeared in 17

  18. The free vascularized fibular epiphyseal transfer: long-term results of wrist reconstruction in young patients.

    PubMed

    Papadopulos, Nikolaos A; Weigand, Christian; Kovacs, Laszlo; Biemer, Edgar

    2009-01-01

    To date, the dominant blood supply to the head of the fibula and to the growth plate is known to be the anterior tibial artery. The peroneal artery had been used before, among other donor pedicles, for microvascular transfers of this epiphyseal region. This study presents the long-term results of this now obsolete pedicle and compares them to other reports in the literature. Follow-up was performed in 1996 and in 2003 with six patients who underwent wrist reconstruction in the 1980s. Procedures were performed following one resection of a malignant synovialoma, two traumatic hand amputations, and three radial aplasias. Evaluation was performed with functional and radiographic examinations. Three cases that were examined in 2003 are presented in detail. The study shows that if growth plates are closed at the time of procedure or the transplanted fibula is long enough to ensure anastomotic flow between metaphyseal and epiphyseal vessels, results are good. If any of these two conditions is not fulfilled, vascular supply to the epiphysis is insufficient. Long bone deviation or bone necrosis will result. These results confirm clinically current knowledge about the epiphyseal and metaphyseal blood supply to the fibula.

  19. Early and Long-Term Results of Subclavian Angioplasty in Aortoarteritis (Takayasu Disease): Comparison with Atherosclerosis

    SciTech Connect

    Tyagi, Sanjay; Verma, Puneet K.; Gambhir, Daljeet S.; Kaul, Upkar A.; Saha, Renuka; Arora, Ramesh

    1998-05-15

    Purpose: To compare the early andlong-term outcomes of subclavian artery angioplasty in patients with aortoarteritis and atherosclerosis. Methods: Sixty-one subclavian artery angioplasties were performed in 55 consecutive patients with aortoarteritis (n= 32) and atherosclerosis (n= 23) between 1986 and 1995. An arch aortogram followed by a selective subclavian artery angiogram was done to profile the site and extent of the lesion, its relation to the vertebral artery, and the distal circulation. Percutaneous transluminal angioplasty (PTA) was performed via the femoral route for 56 stenotic lesions and 5 total occlusions. Results: PTA was successful in 52 (92.8%) stenotic lesions and 3 (60%) total occlusions. Three patients (5.4%) had complications, that could be effectively managed nonsurgically. Compared with atherosclerosis, patients with aortoarteritis were younger (27.4 {+-} 9.3 years vs 54.5 {+-} 10.5 years; p < 0.001), more often female (75% vs 17.4%; p < 0.001), gangrene was uncommon (0% vs 17.4%; p < 0.05), and diffuse involvement was seen more often (43.8% vs 4.4%; p < 0.001). The luminal diameter stenoses were similar before PTA (88.6 {+-} 9.7% vs 89.0 {+-} 9.1%; p= NS). Higher balloon inflation pressure was required to dilate the lesions of aortoarteritis (9.9 {+-} 4.6 ATM vs 5.5 {+-} 1.0 ATM; p < 0.001). This group had more residual stenosis (15.5 {+-} 12.4% vs 8.3 {+-} 9.4%; p < 0.05) after PTA. There were no neurological sequelae, even in PTA of prevertebral lesions. On 3-120 months (mean 43.3 {+-} 28.9 months) follow-up of 40 patients, restenosis was more often observed in patients with aortoarteritis, particularly in those with diffuse arterial narrowing. These lesions could be effectively redilated. Clinical symptoms showed marked improvement after successful angioplasty. Conclusion: Subclavian PTA is safe and can be performed as effectively in aortoarteritis as in atherosclerosis, with good long-term results. Long-term follow-up shows that it

  20. Long-Term Follow-Up Results of Delayed Fixation of Femoral Neck Fractures in Adults

    PubMed Central

    Elmi, Asghar; Tabrizi, Ali; Rouhani, Alireza; Mirzatolouei, Fardin

    2013-01-01

    Background Femoral neck fractures are urgent injuries that require precise reduction and stable fixation. In some cases, however, early treatment is not possible. Objectives The present study aimed to evaluate long-term results of delayed fixation of femoral neck fractures using cannulated screws. Patients and Methods This retrospective descriptive-analytical study was conducted on 26 patients with femoral neck fractures. The patients were treated through a closed reduction and fixation method using cannulated screws. Patients were followed up for at least five years and the rate of complications was determined. Results In this study, 26 patients with mean age of 34.3 years were assessed. Average time interval from injury to surgery was 46.4 ± 12.2 hours; 18 patients (69%) were operated on with more than 36 hours of delay. Incidence of AVN and nonunion was reported in 10 (38.4%) and 3 (11.5%) patients, respectively. Conclusions Time plays an important role in treatment results of femoral neck fractures. To treat the fractures, closed reduction and fixation using cannulated screws may still be the best option. PMID:24350142

  1. Legeais BioKpro III keratoprosthesis implantation: long term results in seven patients

    PubMed Central

    Hollick, E J; Watson, S L; Dart, J K G; Luthert, P J; Allan, B D S

    2006-01-01

    Aims The long term results of the Legeais BioKpro III keratoprosthesis are presented for seven patients with severe corneal scarring. Methods The study took place at Moorfields Eye Hospital, London. Patients had either end stage ocular surface disease or corneal opacification after multiple failed graft surgery, with the potential for significant visual improvement. After insertion the device was covered with a conjunctival flap or buccal mucous membrane graft, which was later opened to expose the optic. The outcome measures were vision, complications, and retention of the device. Results The BioKpro III was inserted into seven patients with severe corneal scarring: ocular cicatricial pemphigoid, measles keratitis, thermal injury, Stevens‐Johnson syndrome, aniridia, chemical injury, and congenital rubella. The follow up was 18–48 months. The keratoprosthesis failed in six, because of extrusion occurring 2–28 months postoperatively. Retroprosthetic membranes occurred in three patients, and endophthalmitis in one. Vision improved from hand movements to 6/12 in the only patient who retained the KPro; however he was troubled by mucus accumulation on the optic. Conclusions The one success has been in a patient with thermal burns. The remaining results have been poor, with the KPro extruding in six of the seven patients. PMID:16929061

  2. Long-Term Results After Intraoperative Radiation Therapy for Gastric Cancer

    SciTech Connect

    Drognitz, Oliver Henne, Karl; Weissenberger, Christian; Bruggmoser, Gregor; Goebel, Heike; Hopt, Ulrich Theodor; Frommhold, Herrmann; Ruf, Guenther

    2008-03-01

    Purpose: We retrospectively analyzed the impact of intraoperative radiation therapy (IORT) on long-term survival in patients with resectable gastric cancer. Methods and Materials: From 1991 to 2001, a total of 84 patients with gastric neoplasms underwent gastectomy or subtotal resection with IORT (23 Gy, 6-15 MeV; IORT-positive [IORT{sup +}] group). Patients with a history of additional neoadjuvant chemotherapy, histologically confirmed R1 or R2 resection, or reoperation with curative intention after local recurrence were excluded from further analysis. The remaining 61 patients were retrospectively matched with 61 patients without IORT (IORT-negative [IORT{sup -}] group) for Union Internationale Contre le Cancer (UICC) stage, patient age, histologic grading, extent of surgery, and level of lymph node dissection. Subgroups included postoperative UICC Stages I (n = 31), II (n = 11), III (n = 14), and IV (n = 5). Results: Mean follow-up was 4.8 years in the IORT{sup +} group and 5.0 years in the IORT{sup -} group. The overall 5-year patient survival rate was 58% in the IORT{sup +} group vs. 59% in the IORT{sup -} group (p = 0.99). Subgroup analysis showed no impact of IORT on 5-year patient survival for those with UICC Stages I/II (76% vs. 80%; p = 0.87) and III/IV (21% vs. 14%, IORT{sup +} vs. IORT{sup -} group; p = 0.30). Perioperative mortality rates were 4.9% and 4.9% in the IORT{sup +} vs. IORT{sup -} group. Total surgical complications were more common in the IORT{sup +} than IORT{sup -} group (44.3% vs. 19.7%; p < 0.05). The locoregional tumor recurrence rate was 9.8% in the IORT{sup +} group. Conclusions: Use of IORT was associated with low locoregional tumor recurrence, but had no benefit on long-term survival while significantly increasing surgical morbidity in patients with curable gastric cancer.

  3. Williams-Beuren syndrome. Long-term results of surgical treatments in six patients.

    PubMed

    Actis Dato, G M; La Torre, M; Caimmi, P; Actis Dato, A; Centofanti, P; Ottino, G M; Di Summa, M

    1997-04-01

    some responsibility. We conclude that surgery for the correction of supravalvular aortic stenosis in Williams-Beuren syndrome is mandatory and both the procedures with patch techniques provide excellent long-term results of gradients and aortic valve competence. Moreover the patients after the operation can have a normal activity with a satisfactory style and expectation of life.

  4. Maquet III procedure: what remains after initial complications - long-term results

    PubMed Central

    2013-01-01

    Background Maquet III procedure, unloved due to its complications (2% to 59%), has been progressively abandoned. At long-term follow-up, what happens to patients with complications that exceeded the initial ones (Acta Orthop Scand 60:20, 1989)? We retrospectively studied patients who were submitted to Maquet III procedure, by functional and radiologic long-term outcomes, in order to determine if this surgery has or has not fulfilled its initially proposed objectives. From 1970 to 1991, 116 patients benefit from the Maquet III procedure. From this, we were able to review in 2011, 23 patients (25 knees) who went through a single Maquet III procedure. Of these patients, 52% were males. Age at surgery was 39.7 ± 11.4, with a postoperative follow-up of 27.2 ± 3.1 years. Methods A questionnaire has been prepared for collecting data, and it has been supplemented by clinical records. We evaluated the preoperative complaints, postoperative complications, and range of motion during the recovery time, as well as the postoperative pain-absence period. All patients underwent an objective assessment using the visual analog scale (VAS) at rest and activity, and the Kujala patellofemoral scoring system. A radiological assessment was also made in order to evaluate the arthrosis degree. The bicondylo-patellar angle described by Delgado-Martins (Arch Orthop Traumat Surg 96:303–304, 1980) was used to measure patellar tilt, and the Caton-Deschamps index to calculate the patellar height. Results Only one knee had benefited from a total knee arthroplasty (20 years after the Maquet III procedure). Preoperative complains were mainly anterior knee pain, crepitus, and patellar instability. Nowadays, 10 patients (40%) still are pain free. Others had an average period without pain of 19.1 ± 6.1 years. VAS at rest was 1.7 ± 0.7 and in activity 4.4 ± 3.0. KPS was 61.9 ± 22.3 points. X-ray shows that 40% had a Kellgren-Lawrence grade of 1 at the patellofemoral joint. Conclusion Maquet

  5. Long-Term Results From the Contura Multilumen Balloon Breast Brachytherapy Catheter Phase 4 Registry Trial

    SciTech Connect

    Cuttino, Laurie W.; Arthur, Douglas W.; Vicini, Frank; Julian, Thomas; Mukhopadhyay, Nitai

    2014-12-01

    Purpose: To describe the long-term outcomes from a completed, multi-institutional phase 4 registry trial using the Contura multilumen balloon (CMLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer. Methods and Materials: Three hundred forty-two evaluable patients were enrolled by 23 institutions between January 2008 and February 2011. All patients received 34 Gy in 10 fractions, delivered twice daily. Rigorous target coverage and normal tissue dose constraints were observed. Results: The median follow-up time was 36 months (range, 1-54 months). For the entire patient cohort of 342 patients, 10 patients experienced an ipsilateral breast tumor recurrence (IBTR). Eight of these IBTR were classified as true recurrences/marginal miss (TRMM), and 2 were elsewhere failures (EF). Local recurrence-free survival was 97.8% at 3 years. For the entire cohort, 88% of patients had good to excellent overall cosmesis. The overall incidence of infection was 8.5%. Symptomatic seroma was reported in only 4.4% of patients. A separate analysis was performed to determine whether improved outcomes would be observed for patients treated at high-volume centers with extensive brachytherapy experience. Three IBTR were observed in this cohort, only 1 of which was classified as a TRMM. Local recurrence-free survival at high-volume centers was 98.1% at 3 years. Overall cosmetic outcome and toxicity were superior in patients treated at high-volume centers. In these patients, 95% had good to excellent overall cosmesis. Infection was observed in only 2.9% of patients, and symptomatic seroma was reported in only 1.9%. Conclusion: Use of the CMLB for APBI delivery is associated with acceptable long-term local control and toxicity. Local recurrence-free survival was 97.8% at 3 years. Significant (grade 3) toxicity was uncommon, and no grade 4 toxicity was observed. Treatment at high-volume centers was associated

  6. Long-term results of definitive radiotherapy for stage I esophageal cancer

    SciTech Connect

    Sai, Heitetsu . E-mail: hsai@kuhp.kyoto-u.ac.jp; Mitsumori, Michihide; Araki, Norio; Mizowaki, Takashi; Nagata, Yasushi; Nishimura, Yasumasa; Hiraoka, Masahiro

    2005-08-01

    Purpose: To analyze retrospectively the long-term results of external beam radiotherapy (RT) with or without intraluminal brachytherapy (ILBT) for patients with Stage I esophageal cancer. Methods and Materials: A total of 34 patients with esophageal squamous cell carcinoma, clinically diagnosed as having Stage I disease, were treated with definitive RT, with or without ILBT. The median age was 69 years. Seven patients were treated with external beam RT alone (median, 64 Gy), and 27 were treated with external beam RT (median, 52 Gy) plus ILBT (8-12 Gy in two to three fractions). Results: The 5-year overall survival, local relapse-free survival, and cause-specific survival rate was 58.9%, 68.4%, and 80.0%, respectively, with a median follow-up of 61 months. Of 9 patients with local recurrence after initial therapy, 7 were successfully treated, and the 5-year cumulative rate of esophagectomy was 19.6%. The 2-year local relapse-free rate for patients with and without ILBT was 79.1% and 53.6%, respectively. Conclusion: Although local recurrence was frequent within 2 years, the disease-specific survival rate was high owing to effective salvage therapy. Definitive RT is a reasonable treatment option for highly comorbid and elderly patients with Stage I esophageal cancer. The role of ILBT needs to be clarified.

  7. Microbial Community Transplant Results in Increased and Long-Term Oxalate Degradation

    PubMed Central

    Miller, Aaron W.; Oakeson, Kelly F.; Dale, Colin; Dearing, M. Denise

    2016-01-01

    Gut microbes are essential for the degradation of dietary oxalate, and this function may play a role in decreasing the incidence of kidney stones. However, many oxalate-degrading bacteria are susceptible to antibiotics and the use of oxalate-degrading probiotics has only led to an ephemeral reduction in urinary oxalate. The objective of the current study was to determine the efficacy of using whole-community microbial transplants from a wild mammalian herbivore, Neotoma albigula, to increase oxalate degradation over the long term in the laboratory rat, Rattus norvegicus. We quantified the change in total oxalate degradation in lab rats immediately after microbial transplants and at 2- and 9-month intervals following microbial transplants. Additionally, we tracked the fecal microbiota of the lab rats, with and without microbial transplants, using high-throughput Illumina sequencing of a hyper-variable region of the 16S rRNA gene. Microbial transplants resulted in a significant increase in oxalate degradation, an effect that persisted 9 months after the initial transplants. Functional persistence was corroborated by the transfer, and persistence of a group of bacteria previously correlated with oxalate consumption in N. albigula, including an anaerobic bacterium from the genus Oxalobacter known for its ability to use oxalate as a sole carbon source. The results of this study indicate that whole-community microbial transplants are an effective means for the persistent colonization of oxalate-degrading bacteria in the mammalian gut. PMID:27312892

  8. Recent results of comparative radiobiological experiments with short and long term expositions of Arabidopsis seed embryos

    NASA Astrophysics Data System (ADS)

    Zimmermann, M. W.; Gartenbach, K. E.; Kranz, A. R.; Baican, B.; Schopper, E.; Heilmann, C.; Reitz, G.

    1996-01-01

    Comparison of experimental data obtained from short (SDEF) and long duration exposure flights (LDEF) recently led to results, which will contribute for the estimation of genetic risk for long and/or repeated stay of man in space. Under orbital conditions biological stress and damage are induced in test subjects by cosmic radiation, especially the high energetic, densely ionizing component of heavy ions. Plant seeds were successful model systems for a biotest in studying the physiological damages and mutagenic effects caused by ionizing radiation in particular stem cells. In this article we present an overview of our space experiments with Arabidopis thaliana seeds. We present first results of investigations on certain damage endpoints (seed germination, plant survival, mutation frequencies), caused by cosmic ionizing radiation in dry dormant plant seeds ofArabidopsis thaliana after different short term (e.g. IML-1 and D-2) and long term (e.g. EURECA and LDEF-1) space exposures. Total dose effects of heavy ions and the other components of the mixed radiation field on damage endpoints and survival after space exposure and gamma-ray pre-irradiation were obtained. A new method of total dose spectrometry by neutron activation has been applied.

  9. Long-term results of allograft composite total hip prostheses for tumors.

    PubMed

    Langlais, F; Lambotte, J C; Collin, P; Thomazeau, H

    2003-09-01

    The functional results of standard reconstruction prostheses are impaired by instability because of poor muscular reinsertion, especially of the gluteal muscles. In 21 patients, composite hip prostheses including proximal femoral allografts were used after primary malignant tumor resection. Ten reconstructions used combined bone-tendon allografts that allowed reinsertion of the gluteal muscles to the allograft tendons. None of the 21 patients had dislocation or infection. Ten patients died within 2 years of surgery without complications requiring reoperations. The mean followup in the 11 other patients was 10 years. Eight patients had reoperation: four for loosening (two at 3 years, two at 11 and 12 years), and four had autologous graftings for nonunion of the trochanter or of the distal graft-bone interface. Evaluation of function in the 11 patients with follow-ups ranging from 4 to 15 years showed an average Musculoskeletal Tumor Society score of 77%. Satisfactory strength of the abductor muscles was achieved by reinsertion of the trochanter or by suture of the patients gluteal muscles with the combined tendon-bone allograft. At long-term, radiologically, the bony allograft showed no change in five patients, very mild resorption in five, and severe resorption in one. Stem fixation was excellent in 10 patients and fair in one. Comparison between the functional results of reconstruction prostheses versus composite prostheses showed a significant improvement with the composite prosthesis. In the authors' institution, at 10 years, the mechanical survival of composite prostheses was 81%, as compared with only 65% for reconstruction prostheses.

  10. Tracer experiment results during the Long-Term Flow Test of the Fenton Hill reservoir

    SciTech Connect

    Rodrigues, N.E.V.; Robinson, B.A.; Counce, D.A.

    1993-02-01

    Three chemical tracer experiments and one extended injection of fluid low in concentration of dissolved species have been carried out during the Long Term Flow Test (LTFT) of the Fenton Hill Hot Dry Rock (HDR) reservoir. The tracer tests,results illustrate the dynamic nature of the flow system, with more fluid traveling through longer residence time paths as heat is extracted. The total fracture volumes calculated from these tests allow us to determine the fate of unrecovered injection fluid, examine the pressure-dependence of fracture volume, and, through a comparison to the hydraulic performance, postulate a model for the nature of the pressure drops through the system. The Fresh Water Flush (FWF) test showed that while no dissolved specie behavior is truly conservative (no sources or sinks), several breakthrough curves are well explained with a pore fluid displacement model. Other dissolved components are clearly influenced by dissolution or precipitation reactions. Finally, the transient response of the chemistry during the FWF to an increase in production well pressure showed that some fractures connected to the production well preferentially open when pressure is raised.

  11. New advanced surface modification technique: titanium oxide ceramic surface implants: long-term clinical results

    NASA Astrophysics Data System (ADS)

    Szabo, Gyorgy; Kovacs, Lajos; Barabas, Jozsef; Nemeth, Zsolt; Maironna, Carlo

    2001-11-01

    The purpose of this paper is to discuss the background to advanced surface modification technologies and to present a new technique, involving the formation of a titanium oxide ceramic coating, with relatively long-term results of its clinical utilization. Three general techniques are used to modify surfaces: the addition or removal of material and the change of material already present. Surface properties can also be changed without the addition or removal of material, through the laser or electron beam thermal treatment. The new technique outlined in this paper relates to the production of a corrosion-resistant 2000-2500 A thick, ceramic oxide layer with a coherent crystalline structure on the surface of titanium implants. The layer is grown electrochemically from the bulk of the metal and is modified by heat treatment. Such oxide ceramic-coated implants have a number of advantageous properties relative to implants covered with various other coatings: a higher external hardness, a greater force of adherence between the titanium and the oxide ceramic coating, a virtually perfect insulation between the organism and the metal (no possibility of metal allergy), etc. The coated implants were subjected to various physical, chemical, electronmicroscopic, etc. tests for a qualitative characterization. Finally, these implants (plates, screws for maxillofacial osteosynthesis and dental root implants) were applied in surgical practice for a period of 10 years. Tests and the experience acquired demonstrated the good properties of the titanium oxide ceramic-coated implants.

  12. PTA and Stenting of Benign Venous Stenoses in the Pelvis: Long-Term Results

    SciTech Connect

    Wohlgemuth, Walter A.; Weber, Hermann; Loeprecht, Henning; Tietze, Wolfram; Bohndorf, Klaus

    2000-01-15

    Purpose: To provide follow-up data on endovascular intervention for venous stenoses in the pelvis.Methods: Between 1985 and 1995, 35 patients presented with 42 stenoses of the pelvic veins after operative thrombectomy and creation of an arteriovenous fistula, combined with intraoperative venous angioscopy. All patients underwent angioplasty and, if unsuccessful, percutaneous insertion of an endovascular stent (n = 7).Results: Angioplasty with and without endovascular stenting was technically successful in 34 of 35 patients (97%). Average length of the stenoses was 20.6 mm (range 10-90 mm), average diameter before dilation 4.1 mm (range 2-6 mm), and average diameter after dilation 10.1 mm (range 5-18 mm). Intraoperative angioscopy showed pathologic findings (intimal laceration or residual thrombotic material) in 14 patients. After an average follow-up period of 4.13 years, 24 (69%) patients had patent veins. The difference in the primary patency rate between patients with angioscopically abnormal veins (6 of 14 patients, corresponding to a patency rate of 43%) and patients with angioscopically normal veins after thrombectomy (18 of 21 patients, corresponding to a patency rate of 86%) was statistically significant (p < 0.01, log rank test).Conclusions: Percutaneous transluminal angioplasty and/or stenting are good treatment modalities for pelvic vein stenosis following surgical thrombectomy. Angioscopically abnormal veins have a poorer long-term patency, regardless of the type of intervention.

  13. 2015 Long-Term Hydrologic Monitoring Program Sampling and Analysis Results Report for Project Rulison, Co

    SciTech Connect

    Findlay, Rick; Kautsky, Mark

    2015-12-01

    The U.S. Department of Energy (DOE) Office of Legacy Management conducted annual sampling at the Rulison, Colorado, Site for the Long-Term Hydrologic Monitoring Program (LTHMP) on May 20–22 and 27, 2015. Several of the land owners were not available to allow access to their respective properties, which created the need for several sample collection trips. This report documents the analytical results of the Rulison monitoring event and includes the trip report and the data validation package (Appendix A). The groundwater and surface water monitoring were shipped to the GEL Group Inc. laboratories for analysis. All requested analyses were successfully completed. Samples were analyzed for gamma-emitting radionuclides by high- resolution gamma spectrometry. Tritium was analyzed using two methods, the conventional tritium method, which has a detection limit on the order of 400 picocuries per liter (pCi/L), and the enriched method (for selected samples), which has a detection limit on the order of 3 pCi/L.

  14. 2015 Long-Term Hydrologic Monitoring Program Sampling and Analysis Results at Rio Blanco, Colorado

    SciTech Connect

    Findlay, Rick; Kautsky, Mark

    2015-12-01

    The U.S. Department of Energy (DOE) Office of Legacy Management conducted annual sampling at the Rio Blanco, Colorado, Site for the Long-Term Hydrologic Monitoring Program (LTHMP) on May 20–21, 2015. This report documents the analytical results of the Rio Blanco annual monitoring event, the trip report, and the data validation package. The groundwater and surface water monitoring samples were shipped to the GEL Group Inc. laboratories for conventional analysis of tritium and analysis of gamma-emitting radionuclides by high-resolution gamma spectrometry. A subset of water samples collected from wells near the Rio Blanco site was also sent to GEL Group Inc. for enriched tritium analysis. All requested analyses were successfully completed. Samples were collected from a total of four onsite wells, including two that are privately owned. Samples were also collected from two additional private wells at nearby locations and from nine surface water locations. Samples were analyzed for gamma-emitting radionuclides by high-resolution gamma spectrometry, and they were analyzed for tritium using the conventional method with a detection limit on the order of 400 picocuries per liter (pCi/L). Four locations (one well and three surface locations) were analyzed using the enriched tritium method, which has a detection limit on the order of 3 pCi/L. The enriched locations included the well at the Brennan Windmill and surface locations at CER-1, CER-4, and Fawn Creek 500 feet upstream.

  15. Endovascular Therapy of Ruptured Abdominal Aortic Aneurysm: Mid- and Long-Term Results

    SciTech Connect

    Kubin, Klaus Sodeck, Gottfried H.; Teufelsbauer, H.; Nowatschka, Bernd; Kretschmer, Georg; Lammer, Johannes; Schoder, Maria

    2008-05-15

    As an alternative to open aneurysm repair, emergency endovascular aortic repair (EVAR) has emerged as a promising technique for ruptured abdominal aortic aneurysm (rAAA) within the last decade. The aim of this retrospective study is to present early and late outcomes of patients treated with EVAR for rAAA. Twenty-two patients (5 women, 17 men; mean age, 74 years) underwent EVAR for rAAA between November 2000 and April 2006. Diagnostic multislice computed tomography angiography was performed prior to stent-graft repair to evaluate anatomical characteristics and for follow-up examinations. Periprocedural patient characteristics and technical settings were evaluated. Mortality rates, hospital stay, and early and late complications, within a mean follow-up time of 744 {+-} 480 days, were also assessed. Eight of 22 patients were hemodynamically unstable at admission. Stent-graft insertion was successful in all patients. The total early complication rate was 54%, resulting in a 30-day mortality rate of 23%. The median intensive care unit stay was 2 days (range, 2-48 days), and the median hospital stay was 16 days (range, 9-210 days). During the follow-up period, three patients suffered from stent-graft-related complications. The overall mortality rate in our study group was 36%. EVAR is an acceptable, minimally invasive treatment option in patients with acute rAAA, independent of the patient's general condition. Short- and long-term outcomes are definitely comparable to those with open surgical repair procedures.

  16. Adalimumab effectiveness for the treatment of ankylosing spondylitis is maintained for up to 2 years: long-term results from the ATLAS trial

    PubMed Central

    van der Heijde, D; Schiff, M H; Sieper, J; Kivitz, A J; Wong, R L; Kupper, H; Dijkmans, B A C; Mease, P J; Davis, J C

    2009-01-01

    Objective: To determine the long-term effect of adalimumab on patients with ankylosing spondylitis (AS) who participated in the Adalimumab Trial Evaluating Long-Term Efficacy and Safety in AS (ATLAS), a randomised, double-blind, placebo controlled, 24-week trial. Methods: Patients received adalimumab 40 mg every other week (eow) or placebo for 24 weeks in ATLAS. At week 24, patients were switched to open-label adalimumab 40 mg eow. Efficacy measures included 20% improvement in the Assessment in SpondyloArthritis International Society (ASAS) criteria (ASAS20), ASAS40 and ASAS partial remission responses and changes in individual components of the ASAS20 response evaluations, for example, Bath AS Functional Index (BASFI) and Bath AS Disease Activity Index (BASDAI). Two-year interim data were analysed based on the total duration of adalimumab exposure, irrespective of the treatment randomisation group. Results: At 2 years, 255 (82.0%) of the original 311 ATLAS patients continued receiving adalimumab treatment. Improvements in ASAS responses observed in ATLAS were sustained during long-term treatment; 64.5% (200/310) were ASAS20 responders, 50.6% (157/310) were ASAS40 responders and 33.5% (104/310) had maintained ASAS-defined partial remission. Changes in individual ASAS response components were sustained or improved during long-term adalimumab treatment. From ATLAS baseline to 2 years of adalimumab exposure, respectively, BASDAI improved from 6.3 (SD 1.7) to 2.4 (SD 2.3) and BASFI improved from 5.2 (SD 2.4) to 2.9 (SD 2.5). Adalimumab was well tolerated. No cases of tuberculosis, congestive heart failure, lupus-like symptoms, or demyelinating disease were reported. Conclusions: Adalimumab reduced the signs and symptoms of AS and induced partial remission for up to 2 years. The long-term safety profile was similar to the short-term safety profile. Trial registration information: NCT00085644 PMID:18701556

  17. Results from long-term dissolution tests using oxidized spent fuel

    SciTech Connect

    Wilson, C.N.

    1990-11-01

    Two semi-static dissolution tests using oxidized PWR spent fuel specimens are being conducted under ambient hot cell conditions in Nevada Test Site J-13 well water and unsealed fused silica vessels. The test specimens were oxidized at 250{degree}C in air to bulk oxygen-to-metal (O/M) values of 2.21 and 2.33. Following an initial 191-day test cycle, the specimens were restarted in fresh J-13 water for a second long-term test cycle. Results through the first 40 months of Cycle 2 are compared with results from similar tests at 25{degree}C and 85{degree}C using unoxidized spent fuel specimens. Increased concentrations of U, Am, Cm and NP were measured in 0.4-{mu}m filtered samples from the oxidized fuel tests compared to the unoxidized fuel tested at 25{degree}C; Pu concentrations were not affected by the fuel oxidation state. Most of the Am and Cm, and a portion of the Pu, measured in 0.4-{mu}m filtered samples was removed by 2-nm filtration. Fission product release results were normalized to specimen inventories and reported as fractional release. No attempt was made to normalize the data to surface area. Initial {sup 99}Tc release was greatly increased, and prolonged increases in the fractional release rates of {sup 99}Tc and {sup 129}I occurred as a result of fuel oxidation. Fractional release rates for {sup 137}Cs and {sup 90}Sr from oxidized fuel eventually decreased to levels similar to those observed with unoxidized fuel after equivalent testing times, suggesting that matrix dissolution rates normalized to fuel mass were not increased as a result of oxidation. 6 refs., 3 figs., 2 tabs.

  18. Long-term results after posterior fixation of thoraco-lumbar burst fractures.

    PubMed

    Andress, H-J; Braun, H; Helmberger, T; Schürmann, M; Hertlein, H; Hartl, W H

    2002-05-01

    Current concepts of treating thoraco-lumbar burst-compression injuries are based on posterior transpedicular fixation techniques which are angular stable. However, the long-term results of this approach are controversial due to inconsistent reports and due to a paucity of data on late outcome. In the present study we analyzed 50 patients retrospectively who had an unstable burst-compression injury at T 11-L 2 (type A 3 according to Magerl) without a neurological deficit. All fractures were stabilized by an internal fixator either with or without transpedicular spongiosa grafting. Patients were treated between 1991 and 1997. Follow-up times ranged from 36 to 103 months. Follow-up examinations collected occupational, subjective and clinical data (activity score, Hannover spine score) and included radiographic measurements. The latter were used to calculate the sagittal index (SI) which measures deformities of the fractured vertebral body, and the sagittal plane kyphosis (SPK) which additionally describes an eventual destruction of the affected intervertebral disc. Compared with the preinjury status, the percentage of subjects who were able to do physical labor was reduced by half at follow-up, and four times as many patients had a permanent disability. Correspondingly, activity scores and Hannover spine scores declined significantly. After the initial surgical correction SI remained stable until follow-up, whereas SPK decreased again towards pre-operative values indicating a progressive deformity of the intervertebral disc space. Clinical results did not correlate with radiographic results, and neither the time until follow-up nor the type of fracture n or the use of transpedicular bone grafting affected clinical or radiographic results significantly.

  19. Reduced Requirements for Long-Term Institutional Care: Results of a Retrospective Study.

    ERIC Educational Resources Information Center

    Gurewitsch, Eleanor Chestnut

    1984-01-01

    Conducted a retrospective study of 102 Swiss seniors to determine nonmedical factors affecting substantial care days required prior to death. Protected senior housing and an independent and helpful personality seemed to contribute significantly to compression of morbidity and to reduced need for long-term institutional care. (JAC)

  20. Long-term results of radiotherapy for periarthritis of the shoulder: a retrospective evaluation

    PubMed Central

    Niewald, Marcus; Fleckenstein, Jochen; Naumann, Susanne; Ruebe, Christian

    2007-01-01

    Background To evaluate retrospectively the results of radiotherapy for periarthritis of the shoulder Methods In 1983–2004, 141 patients were treated, all had attended at least one follow-up examination. 19% had had pain for several weeks, 66% for months and 14% for years. Shoulder motility was impaired in 137/140 patients. Nearly all patients had taken oral analgesics, 81% had undergone physiotherapy, five patients had been operated on, and six had been irradiated. Radiotherapy was applied using regular anterior-posterior opposing portals and Co-60 gamma rays or 4 MV photons. 89% of the patients received a total dose of 6 Gy (dose/fraction of 1 Gy twice weekly, the others had total doses ranging from 4 to 8 Gy. The patients and the referring doctors were given written questionnaires in order to obtain long-term results. The mean duration of follow-up was 6.9 years [0–20 years]. Results During the first follow-up examination at the end of radiotherapy 56% of the patients reported pain relief and improvement of motility. After in median 4.5 months the values were 69 and 89%, after 3.9 years 73% and 73%, respectively. There were virtually no side effects. In the questionnaires, 69% of the patients reported pain relief directly after radiotherapy, 31% up to 12 weeks after radiotherapy. 56% of the patients stated that pain relief had lasted for "years", in further 12% at least for "months". Conclusion Low-dose radiotherapy for periarthropathy of the shoulder was highly effective and yielded long-lasting improvement of pain and motility without side effects. PMID:17868446

  1. [Kienböck's disease: an actual summary with long-term results of the therapeutic options].

    PubMed

    Kaszap, B; Daecke, W

    2010-06-01

    Only a few diseases are treated by such a wide spectrum of therapeutic options as avascular necrosis of the lunate bone. The ultimate aim of all these very different biomechanical concepts is to avoid carpal collapse and wrist osteoarthritis. To be able to assess the efficiency of the separate operative methods, a crucial analysis of the present long-term publications is needed. We have reviewed 20 long-term studies (mean follow-up interval >10 years) to evaluate the different therapeutic options. The main results of these publications have been collected here. Decompression osteotomies can provide in the long term a ROM of 80-87%, a pain-free state in 20-67%, a progression in 20-50% and osteoarthritis in 25-73% of the cases. In contrast, revascularisation procedures can provide in the long term a ROM of 68-81%, pain-free state in 35-72%, progression in 11-100% and osteoarthritis in 32-100%. Salvage procedures can be applied at a later stage of the disease; they can provide in the long term a ROM of 61-78%, pain-free state in 38-50%, and osteoarthritis in 24-48% of the cases. Based on the listed long-term studies, it was demonstrated that a differentiated therapy should be based on the anatomic conditions and stage of the disease. Due to the restricted comparability of the studies, the formulation of a common therapy algorithm was not possible.

  2. Differences in chemical composition of soil organic carbon resulting from long-term fertilization strategies.

    PubMed

    Li, Zengqiang; Zhao, Bingzi; Wang, Qingyun; Cao, Xiaoyan; Zhang, Jiabao

    2015-01-01

    Chemical composition of soil organic carbon (SOC) is central to soil fertility. We hypothesize that change in SOC content resulting from various long-term fertilization strategies accompanies the shift in SOC chemical structure. This study examined the effect of fertilization strategies along with the time of fertilizer application on the SOC composition by 13C nuclear magnetic resonance (NMR) spectroscopy. The soils (Aquic Inceptisol) subjected to seven fertilizer treatments were collected in 1989, 1999 and 2009, representing 0, 10 and 20 years of fertilization, respectively. The seven fertilizer treatments were (1-3) balanced fertilization with application of nitrogen (N), phosphorus (P) and potassium (K) including organic compost (OM), half organic compost plus half chemical fertilizer (1/2OM), and pure chemical NPK fertilizer (NPK); (4-6) unbalanced chemical fertilization without application of one of the major elements including NP fertilizer (NP), PK fertilizer (PK), and NK fertilizer (NK); and (7) an unamended control (CK). The SOC content in the balanced fertilization treatments were 2.3-52.6% and 9.4-64.6% higher than in the unbalanced fertilization/CK treatments in 1999 and 2009, respectively, indicating significant differences in SOC content with time of fertilizer application between the two treatment groups. There was a significantly greater proportion of O-alkyl C and a lower proportion of aromatic C in the balanced fertilization than in unbalanced fertilization/CK treatments in 1999, but not in 2009, because their proportions in the former treatments approached the latter in 2009. Principal component analysis further showed that the C functional groups from various fertilization strategies tended to become compositionally similar with time. The results suggest that a shift in SOC chemical composition may be firstly dominated by fertilization strategies, followed by fertilization duration.

  3. Long-term surgical results of supplementary motor area epilepsy surgery.

    PubMed

    Alonso-Vanegas, Mario A; San-Juan, Daniel; Buentello García, Ricardo M; Castillo-Montoya, Carlos; Sentíes-Madrid, Horacio; Mascher, Erika Brust; Bialik, Paul Shkurovick; Trenado, Carlos

    2017-02-03

    OBJECTIVE Supplementary motor area (SMA) epilepsy is a well-known clinical condition; however, long-term surgical outcome reports are scarce and correspond to small series or isolated case reports. The aim of this study is to present the surgical results of SMA epilepsy patients treated at 2 reference centers in Mexico City. METHODS For this retrospective descriptive study (1999-2014), 52 patients underwent lesionectomy and/or corticectomy of the SMA that was guided by electrocorticography (ECoG). The clinical, neurophysiological, neuroimaging, and pathological findings are described. The Engel scale was used to classify surgical outcome. Descriptive statistics, Student t-test, and Friedman, Kruskal-Wallis, and chi-square tests were used. RESULTS Of these 52 patients, the mean age at epilepsy onset was 26.3 years, and the mean preoperative seizure frequency was 14 seizures per month. Etiologies included low-grade tumors in 28 (53.8%) patients, cortical dysplasia in 17 (32.7%) patients, and cavernomas in 7 (13.5%) patients. At a mean follow-up of 5.7 years (range 1-10 years), 32 patients (61%) were classified as Engel Class I, 16 patients (31%) were classified as Engel Class II, and 4 (8%) patients were classified as Engel Class III. Overall seizure reduction was significant (p = 0.001). The absence of early postsurgical seizures and lesional etiology were associated with the outcome of Engel Class I (p = 0.05). Twenty-six (50%) patients had complications in the immediate postoperative period, all of which resolved completely with no residual neurological deficits. CONCLUSIONS Surgery for SMA epilepsy guided by ECoG using a multidisciplinary and multimodality approach is a safe, feasible procedure that shows good seizure control, moderate morbidity, and no mortality.

  4. Long-term results in 144 localized Ewing's sarcoma patients treated with combined therapy

    SciTech Connect

    Bacci, G.; Toni, A.; Avella, M.; Manfrini, M.; Sudanese, A.; Ciaroni, D.; Boriani, S.; Emiliani, E.; Campanacci, M.

    1989-04-15

    The results of 144 previously untreated cases of primary Ewing's sarcoma of bone are reported with a minimum follow-up of 5 years. This series was treated between 1972 and 1982 at Istituto Ortopedico Rizzoli with a combined therapy. The local control of the disease consisted of amputation (ten cases), resection followed by radiation therapy (35-45 Gy) (48 cases) and radiation therapy alone (40-60 Gy) (86 cases). Adjuvant chemotherapy, rigorously standardized, was performed according two different protocols: the first (85 cases treated in the period 1972-1978) consisted of vincristine (VCR) Adriamycin (doxorubicin) (ADM), and cyclophosphamide (EDX); the second (59 cases treated in the period 1979-1982) of VCR, ADM, EDX and dactinomycin (DACT). At a follow-up of 5 to 16 years (median, 9), 59 patients (41%) are continuously disease-free (CDF), 81 (56%) developed metastatic disease and/or local recurrence, and four (3%) had a second malignancy. Three factors seem to be correlated to prognosis: the site of the initial lesion (only 23% of the pelvic lesions are represented in the CDF group versus 46% of the other locations); the chemotherapy protocol (32% of the cases in the first protocol are CDF versus 54% in the second); the type of local treatment (60% of the patients treated with amputation or resection plus radiotherapy versus 28% of those treated with radiation therapy alone are CDF). A local recurrence was observed in 24% of the patients (8% in the group locally treated with surgery or surgery plus radiation therapy versus 36% in the group treated with radiation therapy alone). These data suggest that even though adjuvant chemotherapy can improve the long-term results in localized Ewing's sarcoma patients, this disease still represents, in a high percentage of cases, a lethal process whose final prognosis widely depends on the local control of the lesion.

  5. Self-contained self-rescuer long term field evaluation: combined eighth and ninth phase results

    SciTech Connect

    2006-10-15

    The National Institute for Occupational Safety and Health (NIOSH) National Personal Protective Technology Laboratory (NPPTL) and the Mine Safety and Health Administration (MSHA) conduct a Long Term Field Evaluation (LTFE) program to evaluate deployed self-contained self rescuers (SCSRs). The objective of the program is to evaluate how well SCSRs endure the underground coal mining environment with regard to both physical damage and aging when they are deployed in accordance with Federal regulations (30 CFR 75.1714). This report presents findings of the combined eighth and ninth phases of the LTFE. For these phases, over four hundred SCSRs were evaluated. The units tested include the CSE SR-100, Draeger Oxy K-Plus, MSA Life-saver 60, and the OCENCO EBA 6.5. The OCENCO 20 was evaluated only in Phase 9. Testing was performed between December 2000 and April 2004. Results of the evaluation indicate that all SCSRs experience some performance degradation due to the mining environment. Observed degradation varies from elevated levels of carbon dioxide, high breathing resistance, and reduced capacity. Mechanical degradation to the SCSR components included breathing hoses, chemical beds, outer cases and seals. The LTFE tests discussed in this report are different from tests performed for SCSR certification to the requirements of 42 Code of Federal Regulations, Part 84 (42 CFR, Part 84). LTFE tests reported here are conducted to an end point, oxygen depletion, to enable comparison of the duration of new and deployed SCSRs. The method for obtaining deployed SCSRs for this evaluation was not a random selection from the deployed population of SCSRs. Although the results of these tests are useful for observing performance of the tested SCSRs, they are not representative of all deployed SCSRs. 9 refs., 10 figs., 9 tabs., 3 apps.

  6. Long-Term Results of Percutaneous Bilioenteric Anastomotic Stricture Treatment in Liver-Transplanted Children

    SciTech Connect

    Moreira, Airton Mota Carnevale, Francisco Cesar; Tannuri, Uenis; Suzuki, Lisa; Gibelli, Nelson; Maksoud, Joao Gilberto; Cerri, Giovanni Guido

    2010-02-15

    The purpose of this study was to evaluate the mid- and long-term results of percutaneous transhepatic cholangiography (PTC) and biliary drainage in children with isolated bilioenteric anastomotic stenosis (BAS) after pediatric liver transplantation. Sixty-four children underwent PTC from March 1993 to May 2008. Nineteen cholangiograms were normal; 10 showed intrahepatic biliary stenosis and BAS, and 35 showed isolated BAS. Cadaveric grafts were used in 19 and living donor grafts in 16 patients. Four patients received a whole liver, and 31 patients received a left lobe or left lateral segment. Roux-en-Y hepaticojejunostomy was performed in all patients. Indication for PTC was based on clinical, laboratory, and histopathologic findings. In patients with isolated BAS, dilation and biliary catheter placement, with changes every 2 months, were performed. Patients were separated into 4 groups according to number of treatment sessions required. The drainage catheter was removed if cholangiogram showed no significant residual stenosis and normal biliary emptying time after a minimum of 6 months. The relationship between risk factors (recipient's weight <10 kg, previous exposure to Cytomegalovirus, donor-recipient sex and weight relations, autoimmune disease as indication for transplantion, previous Kasai's surgery, use of reduced liver grafts, chronic or acute rejection occurrence) and treatment was evaluated. Before PTC, fever was observed in 46%, biliary dilation in 23%, increased bilirubin in 57%, and increased gamma-glutamyltransferase (GGT) in 100% of patients. In the group with BAS, 24 of 35 (69%) patients had histopathologic findings of cholestasis as did 9 of 19 (47%) patients in the group with normal PTC. Of the 35 patients, 23 (65.7%) needed 1 (group I), 7 needed 2 (group II), 4 needed 3 (group III), and 1 needed 4 treatment sessions (group IV). The best results were observed after 1 treatment session, and the mean duration of catheter placement and replacement

  7. Chemoradiation and brachytherapy in biliary tract carcinoma: Long-term results

    SciTech Connect

    Deodato, Francesco . E-mail: fdeodato@rm.unicatt.it; Clemente, Gennaro; Mattiucci, Gian Carlo; Macchia, Gabriella; Costamagna, Guido; Giuliante, Felice; Smaniotto, Daniela; Luzi, Stefano; Valentini, Vincenzo; Mutignani, Massimiliano; Nuzzo, Gennaro; Cellini, Numa; Morganti, Alessio G.

    2006-02-01

    Purpose: To evaluate long-term effects of chemoradiation and intraluminal brachytherapy in terms of local control, disease-free survival, overall survival, and symptom relief in patients with unresectable or residual extrahepatic biliary carcinoma. Methods and Materials: Twenty-two patients with unresectable (17 patients) or residual (5 patients) nonmetastatic extrahepatic bile tumors received external beam radiation therapy (39.6-50.4 Gy) between 1991 and 1997. In 21 patients, 5-fluorouracil (96-h continuous infusion, Days 1-4, 1,000 mg/m{sup 2}/day) was administered. Twelve patients received a boost of intraluminal brachytherapy with {sup 192}Ir wires (30-50 Gy) 1 cm from the source axis. Results: During external beam radiotherapy, 10 patients (45.4%) developed Grade 1 to 2 gastrointestinal toxicity. In patients with unresectable tumor who could be evaluated, the clinical response was 28.6% (4 of 14). Two patients showed complete response. In all 22 patients, median durations of local control, disease-free survival, and overall survival were 44.5 months, 16.3 months, and 23.0 months, respectively. Two patients who received external beam radiation therapy and intraluminal brachytherapy developed late duodenal ulceration. In patients with unresectable tumors, median survival was 13.0 months and 22.0 months in those treated with and without brachytherapy, with 16.7% and no 5-year survival, respectively (p = 0.607). Overall 5-year survival was 18.0%: 40% and 11.7% in patients treated with partial resection and in those with unresectable tumor, respectively (p = 0.135). Conclusion: This study confirmed the role of concurrent chemoradiation in advanced biliary carcinoma; the role of intraluminal brachytherapy boost remains to be further analyzed in larger clinical trials.

  8. Long-term results following reconstruction of craniofacial defects with titanium micro-mesh systems.

    PubMed

    Kuttenberger, Johannes J.; Hardt, Nicolas

    2001-04-01

    Introduction: Reconstruction of craniofacial defects can be carried out with autogenous tissue (calvarium, rib, iliac crest), allogeneic implants (AAA-bone, lyophilized cartilage) or alloplastic material (methacrylate, hydroxyapatite, titanium implants and mesh systems). Selection of the implant material used for reconstruction is still controversial. Material and Methods: At the Department of Oral and Maxillofacial Surgery, Kantonsspital Luzern, 20 patients with defects in the craniofacial and/or orbito-ethmoidal region have been treated using titanium micro-mesh between 1991 and 1998. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh, have been used for bony reconstruction in non load-bearing areas. The defects were caused by acute trauma, osteomyelitis of the frontal bone and previous operations. The titanium micro-mesh was used with the following indications: (1) immediate reconstruction in the primary treatment of comminuted fractures with bone loss in non load-bearing areas, (2) treatment of contour irregularities (possibly in combination with bone or cartilage grafts). All patients were followed up clinically and radiographically at quarterly intervals for a year. Results: No wound infections, exposures or loss of the mesh have been observed. Long-term stability of the reconstructions was excellent. When walls of the paranasal sinuses were reconstructed complete repneumatisation took place. Conclusions: Advantages of this reconstructive technique are: (1) universal applicability (craniofacial, orbital, sinus defects, comminuted fractures); (2) stable 3-D reconstruction of complex anatomic structures were easily performed; (3) immediate availability with no donor site morbidity as bone or cartilage grafts were not necessary; (4) combination with bone or cartilage grafts is possible; and (5) very low susceptibility to infection. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

  9. Long-term result and patient reported outcome of wrist splint treatment for carpal tunnel syndrome.

    PubMed

    Povlsen, Bo; Bashir, Muhammad; Wong, Fabian

    2014-06-01

    Carpal tunnel syndrome (CTS) is the commonest peripheral neuropathy presenting to specialist hand and wrist clinics. This study investigated the long-term outcome of carpal tunnel syndrome treated with isolated night wrist splint and the factors determining the likelihood of success of this intervention. Seventy-five patients referred to a specialist hand clinic with CTS were given night wrist splint treatment for 3 months as per a previous study protocol. Fifty-two patients from this cohort did not wish to have surgery after wrist splint treatment and were followed for a further 33-month period. Baseline pain and numbness levels were recorded on a Visual Analogue Scale (VAS) using a questionnaire upon first presentation. A further questionnaire at 36 months reassessed pain and numbness levels, patients' satisfaction with the treatment, and whether they had subsequent surgical decompression. Of the patients who completed the follow-up questionnaire 33 months after their period of conservative management, 43% were successfully treated with splint treatment alone. There was no difference in the VAS for pain or numbness at the baseline and at 36 months between successful and failed treatment groups. Patients successfully treated with wrist splinting alone reported a higher level of satisfaction with their treatment compared to patients who failed wrist splint treatment or had surgical decompression. The results reinforce the previous recommendation on wrist splinting as a first-line treatment in the Primary Care setting. Referral to specialist hand and wrist clinics should be reserved for patients with symptoms refractory to this initial measure.

  10. [Fluorine osteosis caused by a very long-term niflumic acid treatment in 2 cases of rheumatoid arthritis].

    PubMed

    Prost, A; Boiteau, H L; Gaillard, F; Hamelin, J P; Carlier, N; Rossel-Renac, F

    1978-12-01

    An osteosclerosis opacifying the axial skeleton and affecting in particular all of the spine, was observed in two women aged 75 and 42 years who had been suffering from a rheumatoid arthritis developing between 15 and 26 years. It was traced to a chronic fluorine intoxication, stemming from the regular taking, for 10 years and 8 1/2 years, of a non cortisone, anti-inflammatory niflumic acid. This fluorine product has 3 atoms of fluor in its molecule (50.0 mg for a tablet of 250 mg). Its administration to control subjects proved the production of ionized fluor by way of the metabolism, and the accumulation of fluor in the organism. Rheumatoid polyarthritis and the prolonged corticotherapy (10 mg of prednisone per day for 21 years) cannot be dismissed as the origin of the severe demineralization of the limbs observed in the second patient, but the role of fluorine seems marked in the occurrence of this peripheral involvement with problems of mineralization and secondary hyperparathyroidisms. On the other hand, the absence of an intervertebral narrowing in the 2 patients, despite the very prolonged taking of cortisone (5 mg of prednisone per day for 15 years, for the 75-year-old patient) is perhaps a result of the fluorine.

  11. Recurrence rate after discontinuation of long-term mebendazole therapy in alveolar echinococcosis (preliminary results).

    PubMed

    Ammann, R W; Hirsbrunner, R; Cotting, J; Steiger, U; Jacquier, P; Eckert, J

    1990-11-01

    The recurrence rate was investigated in 19 patients with non-resectable alveolar echinococcosis after discontinuation of a long-term therapy with mebendazole (average treatment 4.3 years). A control group consisted of 14 patients who underwent radical surgery and finished a course of prophylactic postoperative mebendazole treatment of 2 years. In the controls, no recurrence was observed after a post-therapy period averaging 3.5 years. In contrast, recurrence occurred in 7/19 patients (37%) with non-resectable alveolar echinococcosis an average of 1.6 years after discontinuation of the long-term mebendazole therapy. The absence of clinically detectable recurrence in the remaining 12 patients seems to be due either to spontaneous inactivation of alveolar echinococcosis preceding chemotherapy or too short post-therapy surveillance. The patients with recurrence responded favorably to reintroduction of chemotherapy. The data indicate that mebendazole therapy is parasitostatic rather than parasiticidal.

  12. Long-Term Hydrologic Monitoring Program Sampling and Analysis Results for 2010

    SciTech Connect

    2011-01-10

    The U.S. Department of Energy (DOE) Office of Legacy Management conducted annual sampling at the Rulison, Colorado, Site for the Long-Term Hydrologic Monitoring Program (LTHMP) on May 10 and 11, 2010. The U.S. Environmental Protection Agency (EPA) Radiation and Indoor Environments National Laboratory in Las Vegas, Nevada, analyzed the samples. Samples were analyzed for gamma-emitting radionuclides by high-resolution gamma spectroscopy and for tritium using the conventional and enriched methods.

  13. Rio Blanco, Colorado, Long-Term Hydrologic Monitoring Program Sampling and Analysis Results for 2009

    SciTech Connect

    2009-12-21

    The U.S. Department of Energy (DOE) Office of Legacy Management conducted annual sampling at the Rio Blanco, Colorado, Site, for the Long-Term Hydrologic Monitoring Program (LTHMP) on May 13 and 14, 2009. Samples were analyzed by the U.S. Environmental Protection Agency (EPA) Radiation&Indoor Environments National Laboratory in Las Vegas, Nevada. Samples were analyzed for gamma-emitting radionuclides by high-resolution gamma spectroscopy and tritium using the conventional and enriched methods.

  14. Long-term results from an epiretinal prosthesis to restore sight to the blind

    PubMed Central

    Ho, Allen C.; Humayun, Mark S.; Dorn, Jessy D.; da Cruz, Lyndon; Dagnelie, Gislin; Handa, James; Barale, Pierre-Olivier; Sahel, José-Alain; Stanga, Paulo E.; Hafezi, Farhad; Safran, Avinoam B.; Salzmann, Joel; Santos, Arturo; Birch, David; Spencer, Rand; Cideciyan, Artur V.; de Juan, Eugene; Duncan, Jacque L.; Eliott, Dean; Fawzi, Amani; Olmos de Koo, Lisa C.; Brown, Gary C.; Haller, Julia A.; Regillo, Carl D.; Del Priore, Lucian V.; Arditi, Aries; Geruschat, Duane R.; Greenberg, Robert J.

    2015-01-01

    Purpose Retinitis Pigmentosa (RP) is a group of inherited retinal degenerations leading to blindness due to photoreceptor loss. A rare disease, it affects about 100,000 people in the United States. There is no cure and no approved medical therapy to slow or reverse RP. The purpose of this clinical trial was to evaluate the safety, reliability, and benefit of the Argus® II Retinal Prosthesis System (Second Sight Medical Products, Inc., Sylmar, CA) in restoring some visual function to subjects completely blind from RP. Herein, we report clinical trial results at 1 and 3 years post-implant. Design The study is a multicenter, single-arm, prospective clinical trial. Subjects There were 30 subjects in 10 centers in the U.S. and Europe. Subjects served as their own controls – i.e., implanted eye vs. fellow eye, and System ON vs. System OFF (native residual vision). Methods The Argus II System was implanted on and in a single eye (typically the worse-seeing eye) of blind subjects. Subjects wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina. Main Outcome Measures The primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by three computer-based, objective tests. Results Twenty-nine out of 30 subjects remained implanted with functioning Argus II Systems at 3 years post-implant. Eleven subjects experienced a total of 23 serious device- or surgery-related adverse events. All were treated with standard ophthalmic care. As a group, subjects performed significantly better with the System ON than OFF on all visual function tests and functional vision assessments. Conclusions The three-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind from RP. Earlier results from this trial were used to gain approval of the Argus II by the FDA

  15. Intermediate- to Long-Term Results of Combined Anterior Cruciate Ligament Reconstruction and Autologous Chondrocyte Implantation

    PubMed Central

    Pike, Andrew N.; Bryant, Tim; Ogura, Takahiro; Minas, Tom

    2017-01-01

    primary reconstructions. Conclusion: Challenging cases of ACL tears with large chondral defects treated with concurrent ACL reconstruction and ACI can lead to moderately improved pain and function at long-term follow-up. Factors associated with clinical failure are not clear. When combined with ACI, patients undergoing revision ACL reconstructions have worse function preoperatively compared with those undergoing primary reconstructions but have similar final outcomes. PMID:28321429

  16. Long-Term Results after Surgical Treatment of Ebstein's Anomaly: a 30-year Experience

    PubMed Central

    Kim, Min-Seok; Lim, Hong-Gook; Kim, Woong Han; Lee, Jeong Ryul

    2016-01-01

    Background and Objectives The aim of the study is to evaluate the long-term results after a surgical repair of Ebstein's anomaly. Subjects and Methods Forty-eight patients with Ebstein's anomaly who underwent open heart surgery between 1982 and 2013 were included. Median age at operation was 5.6 years (1 day-42.1 years). Forty-five patients (93.7%) demonstrated tricuspid valve (TV) regurgitation of less than moderate degree. When the patients were divided according to Carpentier's classification, types A, B, C, and D were 11, 21, 12, and 4 patients, respectively. Regarding the type of surgical treatment, bi-ventricular repair (n=38), one-and-a half ventricular repair (n=5), and single ventricle palliation (n=5) were performed. Of 38 patients who underwent a bi-ventricular repair, TV repairs were performed by Danielson's technique (n=20), Carpentier's technique (n=11), Cone repair (n=4), and TV annuloplasty (n=1). Two patients underwent TV replacement. Surgical treatment strategies were different according to Carpentier's types (p<0.001) and patient's age (p=0.022). Results There were 2 in-hospital mortalities (4.2%; 1 neonate and 1 infant) and 2 late mortalities during follow-up. Freedom from recurrent TV regurgitation rates at 5, 10, and 15 years were 88.6%, 66.3%, 52.7%, respectively. TV regurgitation recurrence did not differ according to surgical method (p=0.800). Survival rates at 5, 10, and 20 years were 95.8%, 95.8%, and 85.6%, respectively, and freedom from reoperation rates at 5, 10, and 15 years were 85.9%, 68.0%, and 55.8%, respectively. Conclusion Surgical treatment strategies were decided according to Carpentier's type and patient's age. Overall survival and freedom from reoperation rates at 10 years were 95.8% and 68.0%, respectively. Approximately 25% of patients required a second operation for TV during the follow-up. PMID:27721863

  17. Accuracy and stability of positioning in radiosurgery: Long term results of the Gamma Knife system

    SciTech Connect

    Heck, Bernhard; Jess-Hempen, Anja; Kreiner, Hans Juerg; Schoepgens, Hans; Mack, Andreas

    2007-04-15

    The primary aim of this investigation was to determine the long term overall accuracy of an irradiation position of Gamma Knife systems. The mechanical accuracy of the system as well as the overall accuracy of an irradiation position was examined by irradiating radiosensitive films. To measure the mechanical accuracy, the GafChromic registered film was fixed by a special tool at the unit center point (UCP). For overall accuracy the film was mounted inside a phantom at a target position given by a two-dimensional cross. Its position was determined by CT or MRI scans, a treatment was planned to hit this target by use of the standard planning software and the radiation was finally delivered. This procedure is named ''system test'' according to DIN 6875-1 and is equivalent to a treatment simulation. The used GafChromic registered films were evaluated by high resolution densitometric measurements. The Munich Gamma Knife UCP coincided within x;y;z: -0.014{+-}0.09 mm; 0.013{+-}0.09 mm; -0.002{+-}0.06 mm (mean{+-}SD) to the center of dose distribution. There was no trend in the measured data observed over more than ten years. All measured data were within a sphere of 0.2 mm radius. When basing the target definition in the system test on MRI scans, we obtained an overall accuracy of an irradiation position in the x direction of 0.21{+-}0.32 mm and in the y direction 0.15{+-}0.26 mm (mean{+-}SD). When a CT-based target definition was used, we measured distances in x direction 0.06{+-}0.09 mm and in y direction 0.04{+-}0.09 mm (mean{+-}SD), respectively. These results were compared with those obtained with a Gamma Knife equipped with an automatic positioning system (APS) by use of a different phantom. This phantom was found to be slightly less accurate due to its mechanical construction and the soft fixation into the frame. The phantom related position deviation was found to be about {+-}0.2 mm, and therefore the measured accuracy of the APS Gamma Knife was evidently less

  18. Long term results of surgical intervention for osteoarthritis of the trapeziometacarpal joint

    PubMed Central

    Kerkhoffs, G. M.M.J.; Rutten, S.; Marsman, A. J.W.; Marti, R. K.; Albers, G. H.R.

    2006-01-01

    Trapeziometacarpal osteoarthritis is a common entity, often bilateral and predominantly affecting postmenopausal women. In the case of failure of conservative treatment, surgery is a good option. The aim of this study was to compare three surgical procedures. 63 patients (74 thumbs) with osteoarthritis of the trapezio-metacarpal joint were surgically treated; 54 patients were seen for follow-up, 7 had died and 2 were lost to follow-up. The patients were stratified according to treatment; resection arthroplasty (the joint surface’s of the metacarpal and the trapezium are resected) (18 thumbs), trapeziectomy with tendon interposition (17 thumbs) or trapezio-metacarpal arthrodesis (28 thumbs). Baseline characteristics were comparable in the three groups for mean age at operation, Eaton classification, left right distribution and dominant hands operated. The average follow-up was 13 years for the resection group, 8 years for the trapeziectomy group and 9 years for the arthrodesis group. No statistically significant difference between the three groups was found for the visual analogue pain and satisfaction scale, pain frequency nor DASH score. Patients in the trapeziectomy group had significantly less pain compared to the arthrodesis group (p=0.025). Statistically, radial abduction was significantly better after trapeziectomy compared to resection arthroplasty (p<0.01) or arthrodesis (p=0.01). There was no difference among the three groups in grip and tip pinch strength nor in pain on palpation. None of the patients in the trapeziectomy group needed a re-operation, one patient in the resection arthroplasty group had a re-operation, and 22 patients in the arthrodesis group had one or more re-operations for hardware removal or because of a complication. This study shows that the resection arthroplasty has equally good long term results compared to trapeziectomy combined with tendon interposition or arthrodesis. Resection arthroplasty is performed through a single

  19. [Long-term results of treated bi- and trifurcations in periodontitis profunda].

    PubMed

    Mutschelknauss, R; Simon, B; Blair, W

    1991-05-01

    In 180 patients treated between 1971 and 1989 and subjected to regular follow-up checks, a total of 1111 molar teeth have been studied. 944 of them showed furcation involvement. Primarily 828 furcation involved teeth (87.7%) could be saved. The most frequently used method of treatment was flap surgery in primary treatment, and curettage in secondary treatment. Radectomy has gained ground in the past few years in the treatment of class III furcations. A treatment concept emphasizing the discriminating use of various treatment methods allows long-term preservation of molars with advanced furcation involvement.

  20. Long-term results with tracheoesophageal voice prosthesis: primary versus secondary TEP.

    PubMed

    Boscolo-Rizzo, Paolo; Zanetti, Federica; Carpené, Silvia; Da Mosto, Maria Cristina

    2008-01-01

    The aim of this study was to evaluate the influence of timing of tracheoesophageal puncture (TEP)with indwelling voice prosthesis insertion regarding long-term success rate and postoperative complication. We conducted a Retrospective clinical study at tertiary academic center. There were 75 patients with primary TEP (80.6%) and 18 with secondary TEP (19.3%). Long-term success rate was 81.7%, with 80.0% in primary TEP and 88.9% in secondary TEP. No significant difference in Harrison-Robillard-Schultz Rating Scale success assessment were observed between patients with primary and secondary TEP (P = .596). The use of postoperative radiotherapy did not significantly influence the success rate. The age of patients who were older or younger than 60 years significantly influence the success rate in primary TEP (P = .012). The higher rate of complications in primary TEP was not statistically significant. These findings suggest that primary and secondary TEP are equally safe and effective procedures. Primary TEP should be preferred because of avoiding a second surgical intervention and allowing early voice restoration with a considerable psychological impact.

  1. Percutaneous Therapy of Ureteral Obstructions and Leak After Renal Transplantation: Long-Term Results

    SciTech Connect

    Aytekin, Cueneyt Boyvat, Fatih; Harman, Ali; Ozyer, Umut; Colak, Turan; Haberal, Mehmet

    2007-11-15

    The purpose of this study was to evaluate the long-term outcome of percutaneous therapy of ureteral complications after renal transplantation. Between January 2000 and June 2006 we percutaneously treated 26 renal transplant patients with ureteral obstruction (n=19) and leak (n=7). Obstructions were classified as early (<2 months after transplantation) or late (>2 months). Patients with leak were treated with nephro-ureteral catheter placement and subsequent double-J stenting. Balloon dilatation, stent placement, and basket extraction were used to treat ureteral obstructions. Patients were followed with ultrasonography. No major procedure-related complication occurred. The mean follow-up time was 34.3 months (range: 6 to 74 months). Initial clinical success was achieved in all 19 patients with obstruction and 6 of 7 patients with leak. Four of 9 early obstructions and 4 of 10 late obstructions recurred during the follow-up. All recurrences were initially managed again with percutaneous methods, including cutting balloon technique and metallic stent placement. Although there was no recurrence in patients with successfully treated leak, stricture was seen at the previous leak site in two patients. These strictures were also successfully managed percutaneously. We conclude that in the treatment of ureteral obstruction and leak following renal transplantation, percutaneous therapy is an effective alternative to surgery. However, further interventions are usually needed to maintain long-term patency.

  2. The comparison of the long term results of international time synchronization determinated by the two technologies of time transfer.

    NASA Astrophysics Data System (ADS)

    Hu, Jinlun

    The author carried out comparison and analysis for the long term results of international time synchronization which are determinated by the two technologies of time transfer (Loran-C and GPS). Some results of Shanghai Observatory time laboratory have been obtained.

  3. [Long-Term Care Preferences Among Individuals of Advanced Age in Germany: Results of a Population-Based Study].

    PubMed

    Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

    2017-03-07

    The need for long-term care is expected to increase markedly in the next decades as a result of demographic ageing. Consequently, it is important to know the long-term care preferences. This study investigated the long-term care preferences among older individuals in Germany. Based on a systematic review and expert interviews, a questionnaire was designed to assess long-term care preferences. Data were gathered from a representative telephone survey of the German population (n=1,006; 65 years and above) in 2015. The mean age was 75.2 years (±6.6 years, ranging from 65 to 96 years). While nearly 90% of the individuals preferred home care, other care settings such as nursing care abroad were mostly undesired. In case of home care, most of the individuals preferred care provided by friends/family or formal caregivers, whereas the idea of all-day care services (such as employed private caregivers) was less popular. With respect to home care, additional services such as household assistance, transportation services, and emergency call systems were highly valued by the study participants, whereas continual supervision throughout the day was seen as less important. In case of inpatient care, more than 90% of the individuals preferred a private room, with the inpatient facility located near home or close to relatives' homes. A wide range of activities was appreciated. Given these preferences, it is assumed that there is a gap between expectations (preferences) and reality (utilization) regarding long-term care in Germany. Interventions aimed at minimizing this gap are urgently needed. For example, strategies to raise the awareness of private long-term care provision might be fruitful.

  4. Long-Term Hydrologic Monitoring Program Sampling and Analysis Results for 2011 at Rulison, Colorado

    SciTech Connect

    2012-05-10

    The U.S. Department of Energy (DOE) Office of Legacy Management conducted annual sampling at the Rulison, Colorado, Site for the Long-Term Hydrologic Monitoring Program (LTHMP) on May 18, 2011. The samples were shipped to the U.S. Environmental Protection Agency (EPA) Radiation and Indoor Environments National Laboratory in Las Vegas, Nevada, for analysis. All requested analyses were successfully completed, with the exception of the determination of tritium concentration by the enrichment method. The laboratory no longer provides that service. Samples were analyzed for gamma-emitting radionuclides by high-resolution gamma spectrometry and for tritium using the conventional method. Starting in 2012, DOE will retain a different laboratory that provides the enriched tritium analysis service.

  5. Long-Term Hydrologic Monitoring Program Sampling and Analysis Results for 2012 at Rulison, Colorado

    SciTech Connect

    2012-12-06

    The U.S. Department of Energy (DOE) Office of Legacy Management conducted annual sampling at the Rulison, Colorado, site for the Long-Term Hydrologic Monitoring Program (LTHMP) on May 8, 2012. The samples were shipped to GEL Laboratories in Charleston, South Carolina, for analysis. All requested analyses were successfully completed. Samples were analyzed for gamma-emitting radionuclides by high-resolution gamma spectrometry; tritium was analyzed using two methods. The conventional tritium method has a detection limit on the order of 400 pCi/L, and a select set of samples was analyzed for tritium using the enriched method, which has a detection limit on the order of 3 pCi/L.

  6. Evaluating long-term performance of in situ vitrified waste forms: Methodology and results

    SciTech Connect

    McGrail, B.P.; Olson, K.M.

    1992-11-01

    In situ vitrification (ISV) is an emerging technology for the remediation of hazardous and radioactive waste sites. The concept relies on the principle of Joule heating to raise the temperature of a soil between an array of electrodes above the melting temperature. After cooling, the melt solidifies into a massive glass and crystalline block similar to naturally occurring obsidian. Determining the long-term performance of ISV products in a changing regulatory environment requires a fundamental understanding of the mechanisms controlling the dissolution behavior of the material. A series of experiments was performed to determine the dissolution behavior of samples produced from the ISV processing of typical soils from the Idaho National Engineering Laboratory subsurface disposal area. Dissolution rate constant measurements were completed at 90{degrees}C over the pH range 2 to 11 for one sample obtained from a field test of the ISV process.

  7. Evaluating long-term performance of in situ vitrified waste forms: Methodology and results

    SciTech Connect

    McGrail, B.P.; Olson, K.M.

    1992-11-01

    In situ vitrification (ISV) is an emerging technology for the remediation of hazardous and radioactive waste sites. The concept relies on the principle of Joule heating to raise the temperature of a soil between an array of electrodes above the melting temperature. After cooling, the melt solidifies into a massive glass and crystalline block similar to naturally occurring obsidian. Determining the long-term performance of ISV products in a changing regulatory environment requires a fundamental understanding of the mechanisms controlling the dissolution behavior of the material. A series of experiments was performed to determine the dissolution behavior of samples produced from the ISV processing of typical soils from the Idaho National Engineering Laboratory subsurface disposal area. Dissolution rate constant measurements were completed at 90[degrees]C over the pH range 2 to 11 for one sample obtained from a field test of the ISV process.

  8. Medulloblastoma in childhood: long-term results of treatment. [X rays; /sup 60/Co

    SciTech Connect

    Broadbent, V.A.; Barnes, N.D.; Wheeler, T.K.

    1981-07-01

    Thirty-one children under the age of 15 years with verified medulloblastoma were treated at Addenbrookes Hospital from 1940 to 1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom eight were examined. All these patients showed some residual problems, but five were leading active lives and had only minor physical disability. There was evidence of disturbance in growth in all the children. Growth hormone secretion in response to exercise was, however, normal in five of six patients tested. Frank mental retardation was present in three children. A raised resing TSH level was found in two children, one of whom had a multinodular goiter. Long-term follow-up of children who survive medulloblastoma is clearly necessary and consideration should perhaps be given to revision of current treatment regimes in very young children.

  9. Long-term follow-up results of foot and ankle tuberculosis in Turkey.

    PubMed

    Gursu, Sarper; Yildirim, Timur; Ucpinar, Hanifi; Sofu, Hakan; Camurcu, Yalkin; Sahin, Vedat; Sahin, Nursu

    2014-01-01

    The incidence of tuberculosis has been increasing, especially in the past 2 decades. Skeletal tuberculosis is very rare compared with the frequency of the pulmonary form. In the present study, we have shared our long-term experience with foot and ankle tuberculosis, providing information about the different aspects of the disease. A total of 70 patients with foot and ankle tuberculosis, treated from 1983 to 2005, were evaluated. The mean patient age was 34.4 (range 7 to 85) years at the diagnosis. The mean interval between the first symptoms and the diagnosis was 26.4 months (range 1 month to 15 years). The mean follow-up period was 21.7 (range 8 to 30) years. The infection affected both the joint and the bones in 29 patients, only the joints in 13, only the bones in 22, and the soft tissues alone in the remaining 6 patients. The most common joint location was the tibiotalar joint. The talus was the most commonly infiltrated bone. All patients underwent biopsy, and 28 patients underwent additional surgical procedures. In 18 patients (25.7%), 1 to 4 recurrences developed during the follow-up period. In the last follow-up visits, either severe destruction of the bones or end-stage arthrosis was evident in 39 patients (55.7%), especially in those with osseous tuberculosis. Foot and ankle tuberculosis is very rare. The diagnosis of the disease will often be late owing to the lack of pathognomonic findings. A histopathologic evaluation should not be omitted in cases with suspicion. The incidence of residual deformity or end-stage arthrosis has been high in the long term; however, the patients will usually be without any symptoms.

  10. Acute gouty arthritis complicated with acute ST elevation myocardial infarction is independently associated with short- and long-term adverse non-fatal cardiac events.

    PubMed

    Liu, Kuan-Liang; Lee, Hsin-Fu; Chou, Shing-Hsien; Lin, Yen-Chen; Lin, Chia-Pin; Wang, Chun-Li; Chang, Chi-Jen; Hsu, Lung-An

    2014-01-01

    Large epidemiologic studies have associated gouty arthritis with the risk of coronary heart disease. However, there has been a lack of information regarding the outcomes for patients who have gout attacks during hospitalization for acute myocardial infarction. We reviewed the data of 444 consecutive patients who were admitted to our hospital between 2005 and 2008 due to acute ST elevation myocardial infarction (STEMI). The clinical outcomes were compared between patients with gout attack and those without. Of the 444, 48 patients with acute STEMI developed acute gouty arthritis during hospitalization. The multivariate analysis identified prior history of gout and estimated glomerular filtration rate as independent risk factors of gout attack for patients with acute STEMI (odds ratio (OR) 21.02, 95 % CI 2.96-149.26, p = 0.002; OR 0.92, 95 % CI 0.86-0.99, p = 0.035, respectively). The in-hospital mortality and duration of hospital stay did not differ significantly between the gouty group and the non-gouty group (controls). During a mean follow-up of 49 ± 28 months, all-cause mortality and stroke were similar for both groups. Multivariate Cox regression showed that gout attack was independently associated with short- and long-term adverse non-fatal cardiac events (hazard ratio (HR) 1.88, 95 % CI 1.09-3.24, p = 0.024; HR 1.82, 95 % CI 1.09-3.03, p = 0.022, respectively). Gout attack among patients hospitalized due to acute STEMI was independently associated with short-term and long-term rates of adverse non-fatal cardiac events.

  11. Long-term results of radiotherapy in the treatment of pituitary adenomas in children and adolescents

    SciTech Connect

    Grigsby, P.W.; Thomas, P.R.; Simpson, J.R.; Fineberg, B.B.

    1988-12-01

    A retrospective review was performed of 11 children and adolescents (less than 19 years of age) with diagnosed pituitary adenomas. The patients were treated with subtotal resection and postoperative irradiation (S + R) or with irradiation alone (RT) at the Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University Medical Center, from January 1958 through December 1982. Patient conditions at diagnosis were acromegaly in one, Nelson's syndrome in one, prolactinoma in three, chromophobe adenoma in three, and Cushing's disease in three. Median follow-up was 15.6 years (range 6.3-29.5 years). Only two patients have had failure: one at 8.6 years and the other at 20.7 years following treatment. All four patients with visual field (VF) defects at diagnosis underwent S + R, with only one developing recurrent disease. The remaining seven patients, who did not have VF defects, received RT only, and there has been one failure in this group. None have suffered long-term visual complications. All have been able to continue school and/or work. Three of eight females have borne children. Hypopituitarism requiring medication occurred in all who received S + R and in four of seven who received RT only.

  12. [Long-term results of conventional aortic valve replacement for small aortic annulus].

    PubMed

    Miura, Y; Miyairi, T; Kitamura, T; Kigawa, I; Fukuda, S

    2006-04-01

    We studied cardiac function, clinical outcome and quality of life (QOL) long after aortic valve replacement for pure aortic stenosis. Forty-four patients in small group [St. Jude Medical (SJM) 17 HP, 19 A], and 69 patients in non-small group (19 HP, 21 A, 23 A) operated on from 1984 to 2004 were enrolled in this study. We assessed the clinical data, aortic pressure gradient, left ventricular mass index (LVMI), and ejection fraction (EF) by preoperative and postoperative echocardiography. Moreover to evaluate QOL after the operation, we performed SF-36 used for the evaluation of health and QOL worldwide. Mean follow-up is 7.1 +/- 4.8 years in small group, and 6.8 +/- 4.6 years in non-small group. There were 2 hospital deaths in small group, and 1 in non-small group. The actual survival rate at 10-year were 89.2% in small group, and 85.6% in non-small group. There was no significant difference in hospital mortality, LVMI, long-term survival rate, and the scores of SF-36 between the 2 groups. The use of small sized prosthetic valves in patients with small aortic annulus might be justified when there is no patient-prosthesis mismatch.

  13. Long-term results of intraoperative electron beam radiation therapy for nonmetastatic locally advanced pancreatic cancer

    PubMed Central

    Chen, Yingtai; Che, Xu; Zhang, Jianwei; Huang, Huang; Zhao, Dongbing; Tian, Yantao; Li, Yexiong; Feng, Qinfu; Zhang, Zhihui; Jiang, Qinglong; Zhang, Shuisheng; Tang, Xiaolong; Huang, Xianghui; Chu, Yunmian; Zhang, Jianghu; Sun, Yuemin; Zhang, Yawei; Wang, Chengfeng

    2016-01-01

    Abstract To assess prognostic benefits of intraoperative electron beam radiation therapy (IOERT) in patients with nonmetastatic locally advanced pancreatic cancer (LAPC) and evaluate optimal adjuvant treatment after IOERT. A retrospective cohort study using prospectively collected data was conducted at the Cancer Hospital of the Chinese Academy of Medical Sciences, China National Cancer Center. Two hundred forty-seven consecutive patients with nonmetastatic LAPC who underwent IOERT between January 2008 and May 2015 were identified and included in the study. Overall survival (OS) was calculated from the day of IOERT. Prognostic factors were examined using Cox proportional hazards models. The 1-, 2-, and 3-year actuarial survival rates were 40%, 14%, and 7.2%, respectively, with a median OS of 9.0 months. On multivariate analysis, an IOERT applicator diameter < 6 cm (hazards ratio [HR], 0.67; 95% confidence interval [CI], 0.47–0.97), no intraoperative interstitial sustained-release 5-fluorouracil chemotherapy (HR, 0.46; 95% CI, 0.32–0.66), and receipt of postoperative chemoradiotherapy followed by chemotherapy (HR, 0.11; 95% CI, 0.04–0.25) were significantly associated with improved OS. Pain relief after IOERT was achieved in 111 of the 117 patients, with complete remission in 74 and partial remission in 37. Postoperative complications rate and mortality were 14.0% and 0.4%, respectively. Nonmetastatic LAPC patients with smaller size tumors could achieve positive long-term survival outcomes with a treatment strategy incorporating IOERT and postoperative adjuvant treatment. Chemoradiotherapy followed by chemotherapy might be a recommended adjuvant treatment strategy for well-selected cases. Intraoperative interstitial sustained-release 5-fluorouracil chemotherapy should not be recommended for patients with nonmetastatic LAPC. PMID:27661028

  14. Long-term treatment of rheumatoid arthritis with sulphasalazine, gold, or penicillamine: a comparison using life-table methods.

    PubMed Central

    Situnayake, R D; Grindulis, K A; McConkey, B

    1987-01-01

    Life-table analysis was applied to the records of 317 patients with rheumatoid arthritis (RA) treated with sulphasalazine (SAS), 201 treated with sodium aurothiomalate (gold), and 163 with penicillamine. They comprised all those treated in our department with these drugs between January 1973 and July 1984. Risks of treatment termination for all reasons were similar for each drug at five years (gold 92%, penicillamine 83%, SAS 81%). The risk of treatment termination due to inefficacy was less for gold (29.5%) than for penicillamine (38.1%) or sulphasalazine (41.2%). Adverse effects, however, led to withdrawal of gold in 57%, penicillamine in 41.2%, and SAS in 37%; the most effective drugs appeared most toxic. Serious adverse effects were much more common in association with gold (17.4%) and penicillamine (12.3%) than with SAS (1.6%). Sulphasalazine appears as well tolerated over long periods in RA as gold or penicillamine and is associated with fewer serious adverse effects; of these drugs, it might therefore be considered the agent of first choice. PMID:2883939

  15. Treatment of chronic lateral ankle instability using the Broström-Gould procedure in athletes: long-term results

    PubMed Central

    RUSSO, ADRIANO; GIACCHÈ, PAOLO; MARCANTONI, ENRICO; ARRIGHI, ANNALISA; MOLFETTA, LUIGI

    2016-01-01

    Purpose this study was conducted to evaluate long-term results following treatment of chronic lateral ankle instability using the Broström-Gould technique in athletes. Methods eighteen athletes involved in competitive sports at different levels, who suffered from chronic lateral ankle instability, underwent Broström-Gould ligamentoplasty between 2000 and 2005. The results of the surgery were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results the results at 10–15 years of follow-up were excellent in 94.5% of these cases and good in the remaining 5.5%. An increase of 31.2 points in the AOFAS scale score was recorded at follow-up (with the score rising to 98.8, from 67.6 preoperatively). All the athletes returned to their respective sports at the same level as prior to the surgery. Imaging at long-term follow-up showed no signs of arthritic degeneration. Conclusions the results of this study show that the Broström-Gould technique is an effective procedure for the treatment of chronic lateral ankle instability in the athlete, giving excellent long-term results. Level of evidence therapeutic case series, level IV. PMID:27602349

  16. Long-term results of autologous stem cell transplantation for primary refractory or relapsed Hodgkin's lymphoma.

    PubMed

    Majhail, Navneet S; Weisdorf, Daniel J; Defor, Todd E; Miller, Jeffrey S; McGlave, Philip B; Slungaard, Arne; Arora, Mukta; Ramsay, Norma K C; Orchard, Paul J; MacMillan, Margaret L; Burns, Linda J

    2006-10-01

    Autologous hematopoietic stem cell transplantation (ASCT) has become standard therapy for primary refractory (PR REF) or relapsed (REL) Hodgkin's lymphoma (HL); however, more than half of these patients eventually relapse and die of their disease. We studied long-term outcomes and evaluated factors influencing progression-free survival (PFS) in 141 patients with PR REF or REL HL who underwent ASCT between 1985 and 2003. Median age at ASCT was 30 years (range, 7-60 years); 21 patients had PR REF, and 120 had REL HL. With a median follow-up of 6.3 years (range, 1-20 years), the probability of PFS at 5 and 10 years was 48% (95% confidence interval [CI], 39%-57%) and 45% (95% CI, 36%-54%) and that of overall survival (OS) was 53% (95% CI, 44%-62%) and 47% (95% CI, 37%-57%), respectively. Transplant-related mortality at 100 days was 1.4%. Among 45 5- to 20-year survivors, no late relapses of HL were observed. In multivariate analysis, 3 factors were independently predictive of poor PFS: chemoresistant disease (relative risk [RR], 2.9; 95% CI, 1.7-5.0), B-symptoms at pretransplantation relapse (RR, 2.1; 95% CI, 1.3-3.4), and presence of residual disease at the time of transplantation (RR, 2.3; 95% CI, 1.1-4.8). Patients with 0 or 1 of these 3 adverse factors (low-risk disease) had a 5-year PFS of 67% (95% CI, 55%-79%) compared with 37% (95% CI, 22%-52%) in those with 2 factors (intermediate-risk group) and 9% (95% CI, 0-20%) in those with all 3 factors (high-risk group) (P < .001). The rates of OS at 5 years were 71% (95% CI, 60%-82%), 49% (95% CI, 33%-65%) and 13% (95% CI, 0-27%) in the 3 groups, respectively (P < .001). ASCT is associated with durable PFS in appropriately selected patients with PR REF or REL HL. Using a simple prognostic model, we can identify patients with high-risk disease who have predictably unfavorable outcome after ASCT and require novel therapeutic approaches. A risk-adapted approach should be followed in determining treatment options for

  17. Long-term results of femoral revision with the Wagner Self-Locking stem.

    PubMed

    Regis, Dario; Sandri, Andrea; Bonetti, Ingrid

    2013-09-01

    Femoral revision total hip arthroplasty may be a complex procedure due to extensive periprosthetic bone loss. Fluted, tapered stems provide secure axial and rotational stability in the distal femur. We retrospectively evaluated the long-term outcome of the cementless Wagner Self-Locking prosthesis (Sulzer Orthopedics Ltd, Winterthur, Switzerland). From 1992 to 1998, 68 consecutive femoral revisions were performed in 66 patients using the Wagner tapered stem. Twenty-five patients deceased for unrelated causes without additional surgery. The studied group consisted of 41 hips in 41 patients, 12 males and 29 females, aged from 29 to 80 years (mean 61 years). Thirty-five hips (85.4%) included severe deficiency of bone stock. A transfemoral approach was carried out in 32 cases (78%). Bone grafting was never supplemented. Average follow-up was 13.9 years (range 10.4 to 15.8 years). Clinical evaluation was performed using Harris Hip Score (HHS). Osseointegration of the stem and progression of periprosthetic bone remodelling were assessed radiographically. Five stems required rerevision because of deep infection (2), progressive subsidence (2) complicated by hip instability and head-neck disassembly, and old dislocation following acetabular component failure (1). Four hips (9.7%) dislocated, and 8 stems (19.5%) subsided significantly. Average HHS improved from 33 points preoperatively to 75 points at the latest follow-up examination (p < 0.001). Thirty-three of the 36 unrevised stems (91.7%) had radiographic evidence of bone ingrowth. A constant or decreased resorption of the femoral bone was detected in 34/36 patients (94.4%). The cumulative survival rates at 15.8 years with femoral revision for any reason and for stem failure as the end points were 92.0% and 96.6%, respectively. The current study documents the efficacy of distal fixation to the diaphysis in revision of bone-deficient femoral components, supporting the use of tapered, fluted stems. Higher

  18. The treatment of giant cell tumors by curettage and filling with acrylic cement. Long-term functional results.

    PubMed

    Segura, J; Albareda, J; Bueno, A L; Nuez, A; Palanca, D; Seral, F

    1997-01-01

    Curettage and filling with acrylic cement in the treatment of para-articular giant cell tumor (GCT) has multiple advantages as compared to other methods; nonetheless, the possibility of progression in arthrosis is still a drawback. The literature does not report long-term functional results when this method was used. Four cases are presented with a mean long-term follow-up of 13.5 years (minimum 11, maximum 18). Clinical results, evaluated by the Enneking system (18), were excellent, and there were no radiological modifications, so that we believe that this is the method to choose for Campanacci stage I and II GCT (1), and in some stage III cases, as joint function is not compromised in time.

  19. Long-term results using LigaSure™ 5 mm instrument for treatment of Zenker's diverticulum.

    PubMed

    Andersen, Michelle Fog; Trolle, Waldemar; Anthonsen, Kristian; Nielsen, Hans Ulrik; Homøe, Preben

    2017-04-01

    The purpose of the present study was to evaluate the long-term results and patient's satisfaction of a new approach using the LigaSure™ 5 mm instrument for treatment of Zenker's diverticulum (ZD) and to compare with other long-term results using traditional treatment modalities. Between December 2011 and August 2013, a total of 23 patients with ZD underwent endoscopic surgery using the LigaSure™ technique in our department. A retrospective evaluation of the surgery was based on medical records and additionally a long-term follow-up was performed using a standardized questionnaire that was send to all patients. The questions dealt with complaints according to a visual analog scale (VAS) and were sent a minimum of one year after the surgery (mean time 22 months, range 12-32 month). The overall response rate was 91%. The mean age of the patients was 69 years (range 37-89 years). The patients reported nine for overall satisfaction on the VAS (range 0-10: 10 being very content and 0 very uncontent, 25 and 75% quartiles: 7 and 10) regarding the final outcome of their surgery, although several of the patients had continuous symptoms within the first postoperative year. Eight patients (38%) reported no symptoms at all. Our results suggest that endoscopic management of ZD with the LigaSure™ 5 mm instrument is a minimally invasive, fast and safe method with solid long-term outcome with relief of symptoms and patient satisfaction. This new operative instrument was not found inferior to traditional endoscopic techniques and is now the standard treatment method for ZD in our departments.

  20. [Effects of long-term isolation and anticipation of significant event on sleep: results of the project "Mars-520"].

    PubMed

    Zavalko, I M; Rasskazova, E I; Gordeev, S A; Palatov, S Iu; Kovrov, G V

    2013-01-01

    The purpose of the research was to study effect of long-term isolation on night sleep. The data were collected during international ground simulation of an interplanetary manned flight--"Mars-500". The polysomnographic recordings of six healthy men were performed before, four times during and after 520-days confinement. During the isolation sleep efficiency and delta-latency decreased, while sleep latency increased. Post-hoc analysis demonstrate significant differences between background and the last (1.5 months before the end of the experiment) measure during isolation. Frequency of nights with low sleep efficiency rose on the eve of the important for the crew events (simulation of Mars landing and the end of the confinement). Two weeks after the landing simulation, amount of the nights with a low sleep efficiency significantly decreased. Therefore, anticipation of significant event under condition of long-term isolation might result in sleep worsening in previously healthy men, predominantly difficulties getting to sleep.

  1. Long-term Results after CT-Guided Percutaneous Ethanol Ablation for the Treatment of Hyperfunctioning Adrenal Disorders

    PubMed Central

    Frenk, Nathan Elie; Sebastianes, Fernando; Lerario, Antonio Marcondes; Fragoso, Maria Candida Barisson Villares; Mendonca, Berenice Bilharinho; de Menezes, Marcos Roberto

    2016-01-01

    OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. RESULTS: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macronodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. CONCLUSION: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyperfunctioning adrenal disorders and is not without risks. PMID:27759849

  2. Developmental methamphetamine exposure results in short- and long-term alterations in hypothalamic-pituitary-adrenal axis-associated proteins

    PubMed Central

    Zuloaga, Damian G.; Siegel, Jessica A.; Acevedo, Summer F.; Agam, Maayan; Raber, Jacob

    2013-01-01

    Developmental exposure to methamphetamine (MA) causes long-term behavioral and cognitive deficits. One pathway through which MA might induce these deficits is by elevating glucocorticoid levels. Glucocorticoid overexposure during brain development can lead to long-term disruptions in the hypothalamic-pituitary-adrenal (HPA) axis. These disruptions affect the regulation of stress responses and may contribute to behavioral and cognitive deficits reported following developmental MA exposure. Furthermore, alterations in proteins associated with the HPA axis, including vasopressin, oxytocin, and glucocorticoid receptors (GR), are correlated with disruptions in mood and cognition. We therefore hypothesized that early MA exposure will result in short- and long-term alterations in the expression of HPA axis-associated proteins. Male mice were treated with MA (5 mg/kg daily) or Saline from postnatal day (P) 11–20. At P20 and P90, mice were perfused and their brains processed for vasopressin, oxytocin, and GR-immunoreactivity within HPA axis-associated regions. At P20, there was a significant decrease in the number of vasopressin-immunoreactive cells and area occupied by vasopressin-immunoreactiviy in the paraventricular nucleus (PVN) of MA-treated mice, but no difference in oxytocin-immunoreactivity in the PVN, or GR-immunoreactivity in the hippocampus or PVN. In the central nucleus of the amygdala, area occupied by GR-immunoreactivity was decreased by MA. At P90, the number of vasopressin-immunoreactive cells was still decreased, but the area occupied by vasopressin-immunoreactivity no longer differed from Saline controls. No effects of MA were found on oxytocin or GR-immunoreactivity at P90. Thus developmental MA exposure has short- and long-term effects on vasopressin-immunoreactivity and short-term effects on GR-immunoreactivity. PMID:23860125

  3. Developmental methamphetamine exposure results in short- and long-term alterations in hypothalamic-pituitary-adrenal-axis-associated proteins.

    PubMed

    Zuloaga, Damian G; Siegel, Jessica A; Acevedo, Summer F; Agam, Maayan; Raber, Jacob

    2013-01-01

    Developmental exposure to methamphetamine (MA) causes long-term behavioral and cognitive deficits. One pathway through which MA might induce these deficits is by elevating glucocorticoid levels. Glucocorticoid overexposure during brain development can lead to long-term disruptions in the hypothalamic-pituitary-adrenal (HPA) axis. These disruptions affect the regulation of stress responses and may contribute to behavioral and cognitive deficits reported following developmental MA exposure. Furthermore, alterations in proteins associated with the HPA axis, including vasopressin, oxytocin, and glucocorticoid receptors (GR), are correlated with disruptions in mood and cognition. We therefore hypothesized that early MA exposure will result in short- and long-term alterations in the expression of HPA axis-associated proteins. Male mice were treated with MA (5 mg/kg daily) or saline from postnatal day (P) 11 to P20. At P20 and P90, mice were perfused and their brains processed for vasopressin, oxytocin, and GR immunoreactivity within HPA axis-associated regions. At P20, there was a significant decrease in the number of vasopressin-immunoreactive cells and the area occupied by vasopressin immunoreactivity in the paraventricular nucleus (PVN) of MA-treated mice, but no difference in oxytocin immunoreactivity in the PVN, or GR immunoreactivity in the hippocampus or PVN. In the central nucleus of the amygdala, the area occupied by GR immunoreactivity was decreased by MA. At P90, the number of vasopressin-immunoreactive cells was still decreased, but the area occupied by vasopressin immunoreactivity no longer differed from saline controls. No effects of MA were found on oxytocin or GR immunoreactivity at P90. Thus developmental MA exposure has short- and long-term effects on vasopressin immunoreactivity and short-term effects on GR immunoreactivity.

  4. Long-Term Exposure to Constituents of Fine Particulate Air Pollution and Mortality: Results from the California Teachers Study

    PubMed Central

    Ostro, Bart; Lipsett, Michael; Reynolds, Peggy; Goldberg, Debbie; Hertz, Andrew; Garcia, Cynthia; Henderson, Katherine D.; Bernstein, Leslie

    2010-01-01

    Background Several studies have reported associations between long-term exposure to ambient fine particulate matter (PM) and cardiovascular mortality. However, the health impacts of long-term exposure to specific constituents of PM2.5 (PM with aerodynamic diameter ≤ 2.5 μm) have not been explored. Methods We used data from the California Teachers Study, a prospective cohort of active and former female public school professionals. We developed estimates of long-term exposures to PM2.5 and several of its constituents, including elemental carbon, organic carbon (OC), sulfates, nitrates, iron, potassium, silicon, and zinc. Monthly averages of exposure were created using pollution data from June 2002 through July 2007. We included participants whose residential addresses were within 8 and 30 km of a monitor collecting PM2.5 constituent data. Hazard ratios (HRs) were estimated for long-term exposure for mortality from all nontraumatic causes, cardiopulmonary disease, ischemic heart disease (IHD), and pulmonary disease. Results Approximately 45,000 women with 2,600 deaths lived within 30 km of a monitor. We observed associations of all-cause, cardiopulmonary, and IHD mortality with PM2.5 mass and each of its measured constituents, and between pulmonary mortality and several constituents. For example, for cardiopulmonary mortality, HRs for interquartile ranges of PM2.5, OC, and sulfates were 1.55 [95% confidence interval (CI), 1.43–1.69], 1.80 (95% CI, 1.68–1.93), and 1.79 (95% CI, 1.58–2.03), respectively. Subsequent analyses indicated that, of the constituents analyzed, OC and sulfates had the strongest associations with all four outcomes. Conclusions Long-term exposures to PM2.5 and several of its constituents were associated with increased risks of all-cause and cardiopulmonary mortality in this cohort. Constituents derived from combustion of fossil fuel (including diesel), as well as those of crustal origin, were associated with some of the greatest risks

  5. Juvenile idiopathic arthritis in adulthood: fulfilment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage

    PubMed Central

    Oliveira-Ramos, Filipa; Eusébio, Mónica; M Martins, Fernando; Mourão, Ana Filipa; Furtado, Carolina; Campanilho-Marques, Raquel; Cordeiro, Inês; Ferreira, Joana; Cerqueira, Marcos; Figueira, Ricardo; Brito, Iva; Santos, Maria José; Melo-Gomes, José A; Fonseca, João Eurico

    2016-01-01

    Objectives To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage. Methods Patients with JIA registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index—articular (JADI-A) and Juvenile Arthritis Damage Index—extra-articular (JADI-E) damage index and disease activity were analysed. Results 426 patients were included. Most of patients with systemic JIA fulfilled criteria for Adult Still's disease. 95.6% of the patients with rheumatoid factor (RF)-positive polyarthritis and 57.1% of the patients with RF-negative polyarthritis matched criteria for rheumatoid arthritis (RA). 38.9% of the patients with extended oligoarthritis were classified as RA while 34.8% of the patients with persistent oligoarthritis were classified as spondyloarthritis. Patients with enthesitis-related arthritis fulfilled criteria for spondyloarthritis in 94.7%. Patients with psoriatic arthritis maintained this classification. Patients with inactive disease had lower disease duration, lower diagnosis delay and corticosteroids exposure. Longer disease duration was associated with higher HAQ, JADI-A and JADI-E. Higher JADI-A was also associated with biological treatment and retirement due to JIA disability and higher JADI-E with corticosteroids exposure. Younger age at disease onset was predictive of higher HAQ, JADI-A and JADI-E and decreased the chance of inactive disease. Conclusions Most of the included patients fulfilled classification criteria for adult rheumatic diseases, maintain active disease and have functional impairment. Younger age at disease onset was predictive

  6. [Comparative analysis of long-term results of treating chronic prostatis with the use of the Andro-Gin device].

    PubMed

    Alekseev, M Ia; Golubchikov, V A

    2002-01-01

    Follow-up examinations covered 91 patients aged from 20 to 60 years with chronic prostatitis (CP) history 1-18 years. The primary examination has found that 79.1% examinees has CP complicated with sexual dysfunction, disturbed spermatogenesis and psychoneurological disorders. In one group of CP patients etiopathogenetic treatment of CP was combined with magneto-laser-electrostimulation of the prostate provided by the unit Andro-Gin. This combined treatment proved more effective as it induced long-term remission (two years and longer) in 60.5% patients. Unsatisfactory results were minimal. Without use of the unit unsatisfactory results were recorded in 35% patients.

  7. [Long-term results of endoprosthesis of the hip joint with Plus-Endoprosthetic prosthesis].

    PubMed

    Neverov, V A; Kurbanov, S Kh; Serb, S K

    2011-01-01

    An experience and results with using endoprosthesis of the hip joint with Plus-Endoprosthetic prosthesis in 937 (1018 operations) patients were analyzed. The period of follow-up observations was 12 years. Distinctive characteristics of the endoprosthesis are described. Specific behavior of this construction in patients with diseases and damages of the hip joint are shown. Results and complications of the endoprosthesis operations are analyzed. In whole, excellent and good results were obtained in 99.42% of cases, satisfactory - in 0.47%, unsatisfactory - in 0.11%.

  8. Initial and Long-Term Results of Endovascular Therapy for Chronic Total Occlusion of the Subclavian Artery

    SciTech Connect

    Babic, Srdjan; Sagic, Dragan; Radak, Djordje; Antonic, Zelimir; Otasevic, Petar; Kovacevic, Vladimir; Tanaskovic, Slobodan; Ruzicic, Dusan; Aleksic, Nikola; Vucurevic, Goran

    2012-04-15

    Purpose: To study the initial and long-term results of angioplasty and primary stenting for the treatment of chronic total occlusion (CTO) of the subclavian artery (SA). Materials and Methods: From January 1999 to February 2010, 56 patients (25 men with a mean age of 58 {+-} 8 years) underwent endovascular treatment for CTO of the SA. Duplex scans and arteriograms confirmed occlusion in all cases. Indications for recanalization were subclavian steal syndrome in 33 patients (58.1%), arm claudication in 13 patients (23.2%), and coronary ischemia in 7 patients (12.5%) who had a history of previous coronary artery bypass grafting that included left internal thoracic artery graft. Three patients (5.4%) were treated before the scheduled coronary artery bypass surgery, which included left internal thoracic artery graft. After successful recanalization, all arteries were stented, and all of the patients were followed-up at 1, 3, 6, and 12 months after surgery and annually thereafter. Results: Successful recanalization of the SA was achieved in 46 patients (82.1%), and the complication rate was 7.1%. During follow-up (mean 40 {+-} 26 months; range 2 to 125), the primary patency rates after 1 and 3 years were 97.9% and 82.7%, respectively. At the end of follow-up, 76% of the arteries showed no evidence of restenosis. Univariate analysis failed to identify any variable predictive of long-term patency of successfully recanalized SA. Conclusion: Percutaneous transluminal angioplasty with stenting of the complete total occlusion of the SA is a safe and effective procedure associated with low risks and good long-term results.

  9. Long-Term Frozen Storage of Urine Samples: A Trouble to Get PCR Results in Schistosoma spp. DNA Detection?

    PubMed Central

    Fernández-Soto, Pedro; Velasco Tirado, Virginia; Carranza Rodríguez, Cristina; Pérez-Arellano, José Luis; Muro, Antonio

    2013-01-01

    Background Human schistosomiasis remains a serious worldwide public health problem. At present, a sensitive and specific assay for routine diagnosis of schistosome infection is not yet available. The potential for detecting schistosome-derived DNA by PCR-based methods in human clinical samples is currently being investigated as a diagnostic tool with potential application in routine schistosomiasis diagnosis. Collection of diagnostic samples such as stool or blood is usually difficult in some populations. However, urine is a biological sample that can be collected in a non-invasive method, easy to get from people of all ages and easy in management, but as a sample for PCR diagnosis is still not widely used. This could be due to the high variability in the reported efficiency of detection as a result of the high variation in urine samples’ storage or conditions for handling and DNA preservation and extraction methods. Methodology/Principal Findings We evaluate different commercial DNA extraction methods from a series of long-term frozen storage human urine samples from patients with parasitological confirmed schistosomiasis in order to assess the PCR effectiveness for Schistosoma spp. detection. Patientś urine samples were frozen for 18 months up to 7 years until use. Results were compared with those obtained in PCR assays using fresh healthy human urine artificially contaminated with Schistosoma mansoni DNA and urine samples from mice experimentally infected with S. mansoni cercariae stored frozen for at least 12 months before use. PCR results in fresh human artificial urine samples using different DNA based extraction methods were much more effective than those obtained when long-term frozen human urine samples were used as the source of DNA template. Conclusions/Significance Long-term frozen human urine samples are probably not a good source for DNA extraction for use as a template in PCR detection of Schistosoma spp., regardless of the DNA method of

  10. [Long-term results of lateral rhinotomy with medial maxillo-ethmoidectomy].

    PubMed

    Delank, K W; Franzen, W; Hüttenbrink, K B; Stoll, W

    1994-05-01

    Functional and cosmetic results in 93 patients were analysed on average at 42 months after lateral rhinotomy and medial maxilloethmoidectomy. The rate of postoperative complications was 11.8%. The final cosmetic result was more than 1 year postoperatively satisfactory or better in 93.1% after osteoclastic and in 97.8% after osteoplastic lateral rhinotomy. 38.7% of the patients suffered from different postoperative complaints. The main problems were endonasal crusting, hypaesthesia in the V2 region, olfactory dysfunction and epiphora. Considering the results neither the rate of complications nor the cosmetic outcome are critical as usually mentioned in the literature. However, the rate of other different problems complained by the patients postoperatively give reason to add alternative oncosurgical procedures like midfacial degloving and endoscopic techniques, to the general operative repertoire of a hospital.

  11. Excellent long-term results of the Müller acetabular reinforcement ring in primary total hip arthroplasty

    PubMed Central

    Sirka, Aurimas; Clauss, Martin; Tarasevicius, Sarunas; Wingstrand, Hans; Stucinskas, Justinas; Robertsson, Otto; Emil Ochsner, Peter; Ilchmann, Thomas

    2016-01-01

    Background and purpose — The original Müller acetabular reinforcement ring (ARR) shows favorable medium-term results for acetabular reconstruction in total hip arthroplasty, where it is used when the acetabular bone stock is deficient. However, there are no data regarding long-term survival of the device. We therefore investigated long-term survival and analyzed radiological modes of failure. Patients and methods — Between 1984 and 2002, 321 consecutive primary arthroplasties using an ARR were performed in 291 patients. The mean follow-up time was 11 (0–25) years, and 24 hips were lost to follow-up. For survival analysis, we investigated 321 hips and the end of the follow-up was the date of revision, date of death, or the last patient contact date with implant still in situ. Radiological assessment was performed for 160 hips with a minimum of 10 years of follow-up and with radiographs of sufficient quality. It included evaluation of osteolysis, migration, and loosening. Results — 12 ARR THAs were revised: 1 isolated ARR revision for aseptic loosening, 4 revisions of the ARR and the stem for aseptic loosening, 6 for infection, and 1 for recurrent dislocation. The cumulative revision rate for all components, for any reason, at 20 years was 15% (95% CI: 10–22), while for the ARR only it was 7% (95% CI: 4–12) for any reason and 3.4% (95% CI: 1–9) for aseptic loosening. 21 (13%) of 160 ARR THAs examined had radiological changes: 7 had osteolysis but were not loose, and 14 were radiologically loose but were not painful and not revised. Interpretation — Our data suggest that the long-term survival of the ARR is excellent. PMID:26471881

  12. Long term results from the first US low NOx conversion of a tangential lignite fired unit

    SciTech Connect

    McCarthy, K.; Woldehanna, S.; Grusha, J.; Heinz, G.

    1999-07-01

    Lignite fueled tangential furnaces, when compared to those burning bituminous coal, have unique design and operating requirements which obligate careful assessment for successful low NOx retrofit. Recently, a Foster Wheeler Energy Corporation Tangential Low NOx (TLN) system was installed at Cooperative Power/United Power Association (CP/UPA) lignite fired Coal Creek Unit No. 2. The system has not only achieved the plant's annual NOx emission compliance requirements, but has also substantially improved furnace operating conditions. After nearly one year of operation, the systems performance has continued to support these results. A second unit is scheduled for retrofit in the Spring of 1999. These results are an important milestone for tangential low NOx technology and serve as a forerunner for future low NOx conversions involving low rank coals.

  13. Forecast of long term coal supply and mining conditions: Model documentation and results

    NASA Technical Reports Server (NTRS)

    1980-01-01

    A coal industry model was developed to support the Jet Propulsion Laboratory in its investigation of advanced underground coal extraction systems. The model documentation includes the programming for the coal mining cost models and an accompanying users' manual, and a guide to reading model output. The methodology used in assembling the transportation, demand, and coal reserve components of the model are also described. Results presented for 1986 and 2000, include projections of coal production patterns and marginal prices, differentiated by coal sulfur content.

  14. Long-term Results of Small-incision Lenticule Extraction in High Myopia

    PubMed Central

    Yıldırım, Yusuf; Alagöz, Cengiz; Demir, Abdülvahit; Ölçücü, Onur; Özveren, Mehmet; Ağca, Alper; Özgürhan, Engin Bilge; Demirok, Ahmet

    2016-01-01

    Objectives: To evaluate two-year results of small-incision lenticule extraction (SMILE) for correction of high myopia. Materials and Methods: Forty-five eyes of 35 patients with mean spherical equivalent (SE) of -7.10±0.95 D who underwent routine SMILE by a single surgeon and were followed for at least 2 years were analyzed by retrospective chart review. SMILE was performed with a Visumax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). Follow-up intervals were at 1, 6, 12, and 24 months after surgery. Uncorrected and best corrected distance visual acuity (CDVA), corneal wavefront measurements, and all complications were recorded. Results: After 2 years, 86% of eyes with plano target had an uncorrected distant visual acuity (VA) of 20/20 or better. Two percent of eyes lost 1 line of CDVA, while 32% gained 1 line. The mean SE after 2 years was -0.30±0.50 D. Corneal total high-order aberrations (HOA) increased from 0.43 to 0.92 μm at postoperative 12 months. There were metallic foreign bodies at the corneal interface in 1 eye of 1 patient which caused no decrease in VA. Conclusion: SMILE for high myopia seems safe and effective in light of two-year follow-up results. The procedure caused a moderate increase in HOA. PMID:28058160

  15. Results of long-term carcinogenicity studies of chlorine in rats.

    PubMed

    Soffritti, M; Belpoggi, F; Lenzi, A; Maltoni, C

    1997-12-26

    Four groups, each of 50 male and 50 female Sprague-Dawley rats, of the colony used in the Cancer Research Center of Bentivoglio of the Ramazzini Foundation, 12 weeks old at the start of the study, received drinking water containing sodium hypochlorite, resulting in concentrations of active chlorine of 750, 500, and 100 mg/l (treated groups), and tap water (active chlorine < 0.2 mg/l) (control group), respectively, for 104 weeks. Among the female rats of the treated groups, an increased incidence of lymphomas and leukemias has been observed, although this is not clearly dose related. Moreover, sporadic cases of some tumors, the occurrence of which is extremely unusual among the untreated rats of the colony used (historical controls), were detected in chlorine-exposed animals. The results of this study confirm the results of the experiment of the United States National Toxicology Program (1991), which showed an increase of leukemia among female Fischer 344/N rats following the administration of chlorine (in the form of sodium hypochlorite and chloramine) in their drinking water. The data here presented call for further research aimed at quantifying the oncogenic risks related to the chlorination of drinking water, to be used as a basis for consequent public health measures.

  16. Long-term results of enriched environment and erythropoietin after hypobaric hypoxia in rats.

    PubMed

    Hralová, M; Angerová, Y; Gueye, T; Bortelová, J; Svestková, O; Zima, T; Lippertová-Grünerová, M

    2013-01-01

    After global cerebral hypoxia, many patients are severely disabled even after intensive neurorehabilitation. Secondary mechanisms of brain injury as a result of biochemical and physiological events occur within a period of hours to months, and provide a window of opportunity for therapeutic intervention. Erythropoietin (EPO) has been shown to be neuroprotective in the brain subjected to a variety of injuries. Fifty-nine 3-month-old male Wistar rats were randomly distributed to experimental groups with respect to the housing (enriched environment - EE, standard housing - SH), to hypoxia exposure, and to EPO treatment. An acute mountain sickness model was used as a hypobaric hypoxia simulating an altitude of 8000 m. One half of the animals received erythropoietin injections, while the others were injected saline. Spatial memory was tested in a Morris water maze (MWM). The escape latency and the path length were measured. Better spatial learning in MWM was only seen in the group that received erythropoietin together with enriched environment. EPO administration itself had no influence on spatial memory. The results were very similar for both latencies and path lengths. These results support the idea that after brain injuries, the recovery can be potentiated by EPO administration combined with neurorehabilitation.

  17. Radiosynoviorthesis in hemophilic joints with yttrium-90 citrate and rhenium-186 sulfide and long term results.

    PubMed

    Teyssler, Petr; Taborska, Katerina; Kolostova, Katarina; Bobek, Vladimir

    2013-01-01

    Repeated bleeding in the joint cavities is the most annoying symptom and often has disabling effects in patients with hemophilia (PWH). Our aim was to study the effect of radiosynovectomy (RSO) with beta particle-emitting radiocolloids in the treatment of hemorhagic arthropathy. We have treated 22 joints from 18 patients with hemophilia A, from April 2008 to February 2012, 5 knees, 11 elbows and 6 ankles. Joints were divided into two Groups, those treated with yttrium-90-citrate ((90)Y-C) (5 knees, 2 of them twice)-Group I and those with rhenium-186-sulfide ((186)Re-S) (11 elbows, 1 of them treated twice and 6 ankles)-Group II. A total of 25 treatments. Follow-up period was 3 months, 1 year and 3 years. Results showed a favourable subjective and a better objective result in all 5 joints of Group I and in 15/17 joints of Group II, respectively. Follow-up after 3 months showed significant improvement in Hemophilia Join Health Score (HJHS) after 20 treatments and steady score after 5 treatments. After 1 year, 19 treated joints had improved for the first time, 3 remained steady and 3 were not examined. After 3 years, 9 treated joints were HJHS steady, while 16 were not examined. One year after treatment, 13/14 joints of patients, aged 6-23 years showed better HJHS score, while 9/11 joints of patients aged 26-51 years, showed better HJHS. Synovial membrane thickness as measured by MRI in 8 joints, before and 3 months after treatment was not related to prognosis. In conclusion, in a small group of hemophilic patients with hemorrhagic arthropathy treated with (90)Y-C and with (186)Re-S, our study showed good results irrespective of age in 22/25 treatments after 3 months or 1 year. The thickness of synovial membrane in the 8 joints studied was not related to prognosis.

  18. Factors influencing the long-term results of abdominal aortic aneurysm repair.

    PubMed

    Geroulakos, G; Lumley, J S; Wright, J G

    1997-01-01

    The incidence of late graft complications such as para-anastomotic aneurysms, aortoenteric fistulas and graft infections following abdominal aortic aneurysm (AAA) repair is a major determinant of its overall benefit, yet most published reports of AAA repair have concentrated almost exclusively on the early postoperative mortality and morbidity. Accurate knowledge regarding the incidence of late complications is essential to making any decision regarding the operative vs nonoperative management of AAAs. A similar analysis must be applied to endovascular repair of AAAs before this technique is accepted as an alternative method of treating AAAs. In this article we review the current knowledge and understanding on the late results following aortic aneurysm repair.

  19. Impact of agricultural management practices on DOC leaching - results of a long-term lysimeter study

    NASA Astrophysics Data System (ADS)

    Wagner, A.; Ollesch, G.; Seeger, J.; Meißner, R.; Rode, M.

    2009-04-01

    Dissolved organic carbon (DOC) fluxes are recently increasing in surface waters of humid climate regions. Due to its substantial importance for leaching processes, aquatic foodwebs, and drinking water purification a better understanding of sources and pathways of DOC is needed. Therefore this study aims to analyse and simulate DOC fluxes in agricultural ecosystems with selected crop rotations. A data set of 24 lysimeters of the UFZ Lysimeter station at Falkenberg (Saxony-Anhalt) covering nine years of DOC investigation has been selected and examined. The data set covers a wide range of climatic conditions with deviating management practices for grasslands and agricultural crop rotations. The monthly DOC concentrations assessed in the leached water range from 2.4 to 34.1 mg /l. DOC concentrations depend on temperature, precipitation and discharge. The type of crop grown on the lysimeter is an important trigger for DOC leaching - especially lysimeters used as pasture, or planted with rape and carrots exhibit high DOC concentrations. Management practices and fertilizer application modify the leaching of DOC and offer potentials to reduce DOC losses. The results form the basis of further process simulation studies and upscaling of the results to the small catchment scale.

  20. New emission deterioration rates for gasoline cars - Results from long-term measurements

    NASA Astrophysics Data System (ADS)

    Borken-Kleefeld, Jens; Chen, Yuche

    2015-01-01

    Vehicle emission control systems have been found to degrade with use resulting in increasing emission rates with vehicle age. Standard European data for deterioration factors have only been based on a sample of vehicles with limited high mileage ranges, with only few Euro 3 and Euro 4 vehicles, and on laboratory tests only. Here we present deterioration rates derived from more than 110‧000 records collected over the past thirteen years from on-road emission remote sensing in Zurich/Switzerland. Deterioration rates for hot NOx and CO emissions of older gasoline vehicles are much lower than assumed so far, but significantly higher for Euro 3 and Euro 4 cars. There is no evidence of high emitters but equipment gradually degrades across the fleet. Deterioration rates do not seem to depend on engine load. Routine idle emission tests have not resulted in measurable emission reductions of the inspected vehicles. National emission inventories should be updated in the light of this new data.

  1. Shoreline variability from days to decades: Results of long-term video imaging

    NASA Astrophysics Data System (ADS)

    Pianca, C.; Holman, R.; Siegle, E.

    2015-03-01

    The present work characterizes the time-space scales of variability and forcing dependencies of a unique 26 year record of daily to hourly shoreline data from a steep beach at Duck, North Carolina. Shoreline positions over a 1500 m alongshore span were estimated using a new algorithm called ASLIM based on fitting the band of high light intensity in time exposure images to a local Gaussian fit, with a subsequent Kalman filter to reduce noise and uncertainty. Our findings revealed that the shoreline change at long times scales dominates seasonal variability, despite that wave forcing had only 2% variance at interannual frequencies. The shoreline response presented 66% of the variance at interannual scales. These results were not expected since from wave forcing it would have been expected that the shoreline response should similarly lack interannual variability, but we found it to be dominated by this scale. The alongshore-mean shoreline time series revealed no significant annual cycle. However, there are annual oscillations in the shoreline response that are coherent with wave forcing and deserves further explanations. The pier was found to have a significant influence on shoreline behavior since restricts the seasonal longshore transport between the sides, resulting in a seasonally reversing sediment accumulation. Thus, there is a significant annual peak in shoreline variability that is coherent with the annual forcing but becomes insignificant in the longshore-average.

  2. Long-term results with autogenous tissue repair of traumatic extremity vascular injuries.

    PubMed Central

    McCready, R A; Logan, N M; Daugherty, M E; Mattingly, S S; Crocker, C; Hyde, G L

    1987-01-01

    With extensive vascular injuries in which a vascular conduit is required, there is controversy as to whether an autogenous or prosthetic graft is preferable. The authors reviewed their experience with 91 extremity arterial injuries in which autogenous tissue was used to repair vascular injuries of the extremities. Twenty-two patients also had concomitant repair of associated venous injuries with autogenous vein grafts. Ten patients required amputations, despite patent grafts in five patients, because of severe muscle necrosis. Two patients had thrombosis of their vein grafts develop in the early postoperative period but did not require amputation. The authors identified only one late vein graft failure in a patient in whom an infected pseudoaneurysm developed. Three patients with extensive soft tissue injuries had infection develop in vein grafts, with subsequent massive bleeding that ultimately required arterial ligation. Among the 22 patients with repair of their venous injuries, occlusion of popliteal vein repairs was documented in two patients and suspected in three others. The remainder of patients had satisfactory results. The excellent results obtained in the vast majority of the authors' patients with extremity vascular injuries reinforces their preference for using autogenous tissue whenever a vascular conduit is required. Exceptions include patients with extensive soft tissue loss precluding adequate graft coverage, the repair of large vessels, and life-threatening emergencies when there is insufficient time to harvest and prepare a vein. PMID:3689017

  3. Physeal injuries of the distal tibia: long-term results in 376 patients

    PubMed Central

    Binder, Harald; Platzer, Patrick; Schulz, Martin; Hajdu, Stefan; Vécsei, Vilmos

    2009-01-01

    The aim of this study was to evaluate our treatment of distal tibial physeal injuries retrospectively and explain the relationship between the trauma mechanism, the radiographic injury pattern, the subsequent therapy and the functional outcome, as well as to further deduce and verify prognostic criteria. At the Department of Trauma Surgery, Vienna Medical University, 419 children and adolescent patients with physeal injuries of the distal tibia were treated from 1993 to 2007, of these 376 were included in our study and evaluated retrospectively. Seventy-seven displaced physeal fractures of the distal tibia were reconstructed anatomically by open or closed reduction and produced 95% excellent results. A perfect anatomical reduction, if necessary by open means, should be achieved to prevent a bone bridge with subsequent epiphysiodesis and post-traumatic deformities due to growth inhibition and/or retardation. PMID:19662414

  4. Lumbar discal herniation in the elderly: long-term results of chymopapain chemonucleolysis.

    PubMed

    Benoist, M; Parent, H; Nizard, M; Lassale, B; Deburge, A

    1993-10-01

    Very few reports in the literature have dealt with lumbar disc herniation in the elderly and its treatment by chymopapain chemonucleolysis. Between September 1981 and May 1991, 42 patients aged between 60 and 80 years were treated by chemonucleolysis for lumbar disc herniation. The clinical symptoms and signs, similar to those observed in younger patients, were well correlated with a clear picture of discal herniation on the CT scan without any associated stenosis. At the last follow-up (mean 4.5 years) satisfactory results were obtained in 78% of the patients. No complication were observed. It is concluded that in the rare cases of discal herniation in the elderly, chymopapain chemonucleolysis should be considered as a safe and efficacious alternative to surgery.

  5. [Long-term results of pisiform bone transposition in lunate necrosis].

    PubMed

    Erbs, G; Böhm, E

    1984-06-01

    Kienböcks disease is one of the most frequent manifestations of avascular necrosis. Multiple different surgical and conservative methods for treatment have been described. The transposition of pisiform on its vascular pedicle to replace the reamed out necrotic portion of the lunate has permitted revascularization and healing of the lunate. In the following article, the operative technique is described and the results of a five year follow-up study on 32 patients who underwent this operation are presented. On the basis of this study, we found, even in advanced cases of Kienböcks disease, that 50% of the 14 followed-up patients became free of symptoms or had pain only under stressful conditions.

  6. Vascularised pisiform bone graft. Indications, technique and long-term results.

    PubMed

    Kuhlmann, J Norbert; Kron, Cédric; Boabighi, André; Baux, Serge; Mimou, Maurice

    2003-08-01

    The authors report their experience with the use of a vascularised pisiform bone graft based on the dorsal branch of the ulnar artery to provide osseous support and an efficient vascular aid especially in non-unions of the carpal navicular bone with avascular necrosis of its proximal pole and in stage III Kienböck's disease. The pisiform can replace the proximal pole of the navicular bone in totality. When implanted into the lunate, it stops its collapse and helps to revascularize it. The authors present the results achieved in 14 patients (12 male, 2 female), of which eight had a follow-up longer than 5 years The technique appears as an interesting alternative to carpectomies and partial intracarpal fusions which are usually proposed in advanced cases of these conditions.

  7. Results of a Long-Term Demonstration of an Optical Multi-Gas Monitor on ISS

    NASA Technical Reports Server (NTRS)

    Mudgett, Paul; Pilgrim, Jeffrey S.

    2015-01-01

    Previously at SAMAP we reported on the development of tunable diode laser spectroscopy (TDLS) based instruments for measuring small gas molecules in real time. TDLS technology has matured rapidly over the last 5 years as a result of advances in low power diode lasers as well as better detection schemes. In collaboration with two small businesses Vista Photonics, Inc. and Nanoracks LLC, NASA developed a 4 gas TDLS based monitor for an experimental demonstration of the technology on the International Space Station (ISS). Vista invented and constructed the core TDLS sensor. Nanoracks designed and built the enclosure, and certified the integrated monitor as a payload. The device, which measures oxygen, carbon dioxide, ammonia and water vapor, is called the Multi-Gas Monitor (MGM). MGM measures the 4 gases every few seconds and records a 30 second moving average of the concentrations. The relatively small unit draws only 2.5W. MGM was calibrated at NASA-Johnson Space Center in July 2013 and launched to ISS on a Soyuz vehicle in November 2013. Installation and activation of MGM occurred in February 2014, and the unit has been operating nearly continuously ever since in the Japanese Experiment Module. Data is downlinked from ISS about once per week. Oxygen and carbon dioxide data is compared with that from the central Major Constituents Analyzer. Water vapor data is compared with dew point measurements made by sensors in the Columbus module. The ammonia channel was tested by the crew using a commercial ammonia inhalant. MGM is remarkably stable to date. Results of 18 months of operation are presented and future applications including combustion product monitoring are discussed.

  8. Elder-clowning in long-term dementia care: Results of a pilot study

    PubMed Central

    Kontos, Pia; Miller, Karen-Lee; Colobong, Romeo; Lazgare, Luis Ivan Palma; Binns, Malcolm; Low, Lee-Fay; Surr, Claire; Naglie, Gary

    2016-01-01

    Objectives To assess the effects of elder-clowning on moderate to severe behavioral and psychological symptoms of dementia (BPSD) in nursing home residents with dementia, primarily of the Alzheimer’s type. Design Before-after study. Setting Nursing home. Participants Twenty-three nursing home residents with moderate to severe BPSD defined by the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) score of ≥10, and their care aides. Intervention A pair of elder-clowns visited all residents twice weekly (approximately 10 minutes per visit) for 12 weeks. They utilized improvisation, humor and empathy, as well as expressive modalities such as song, musical instruments, and dance to individualize resident engagement. Measurements Primary outcomes were BPSD measured by the NPI-NH, quality of life measured by Dementia Care Mapping (DCM), and nursing burden of care measured by the Modified Nursing Care Assessment Scale (M-NCAS). Secondary outcomes included occupational disruptiveness measured by the NPI-NH, agitation measured by the Cohen Mansfield Agitation Inventory (CMAI), and psychiatric medication use. Results Over 12 weeks, NPI-NH scores significantly declined (t22 = −2.68, p = 0.01) and DCM quality of life scores significantly improved (F1,50 = 23.09, p < 0.001). CMAI agitation scores decreased nominally, but was not statistically significant (t22 = −1.86, p = 0.07). The occupational disruptiveness score significantly improved (t22 = −2.58, p = 0.02), yet there was no appreciable change in M-NCAS scores of staff burden of care. Conclusion Results suggest that elder-clowning reduced moderate to severe BPSD of nursing home residents with dementia, primarily of the Alzheimer’s type. Elder-clowning is a promising intervention that may improve Alzheimer’s dementia care for nursing home residents. PMID:26889843

  9. Long-term results of breast cancer irradiation treatment with low-dose-rate external irradiation

    SciTech Connect

    Pierquin, Bernard; Tubiana, Maurice . E-mail: maurice.tubiana@biomedicale.univ-paris5.fr; Pan, Camille; Lagrange, Jean-Leon; Calitchi, Elie; Otmezguine, Yves

    2007-01-01

    Purpose: The aim of this study was to assess beam therapy with low-dose-rate (LDR) external irradiation in a group of patients with breast cancer. Methods and Materials: This trial compared, from 1986 to 1989, patients with advanced breast cancer treated either by conventional fractionation or low-dose-rate (LDR) external radiotherapy (dose-rate 15 mGy/min, 5 sessions of 9 Gy delivered on 5 consecutive days). Results: A total of 21 patients were included in the fractionated therapy arm. At follow-up 15 years after treatment, 7 local recurrences had occurred, 3 patients had died of cancer, 18 patients were alive, 10 were without evidence of disease, and 6 had evidence of disease. A total of 22 patients had been included in the LDR arm of the study. Of these, 11 had received a dose of 45 Gy; thereafter, in view of severe local reactions, the dose was reduced to 35 Gy. There was no local recurrence in patients who had received 45 Gy, although there were 2 local recurrences among the 11 patients after 35 Gy. The sequelae were severe in patients who received 45 Gy but were comparable to those observed in patients treated by fractionated radiotherapy who received 35 Gy. The higher efficacy of tumor control in patients treated by LDR irradiation as well as the lower tolerance of normal tissue are probably related to the lack of repopulation. Conclusion: Although the patient numbers in this study are limited, based on our study results we conclude that the data for LDR irradiation are encouraging and that further investigation is warranted.

  10. Long-Term Results of Conformal Radiotherapy for Progressive Airway Amyloidosis

    SciTech Connect

    Truong, Minh Tam; Kachnic, Lisa A.; Grillone, Gregory A.; Bohrs, Harry K.; Lee, Richard; Sakai, Osamu; Berk, John L.

    2012-06-01

    Purpose: To evaluate the efficacy of conformal external beam radiotherapy (RT) for local control of progressive airway amyloidosis. Methods and Materials: We conducted a retrospective review of patients with biopsy-proven progressive airway amyloidosis treated with conformal RT between 2000 and 2006 at Boston Medical Center. The patients were evaluated for performance status and pulmonary function, with computed tomography and endoscopy after RT compared with the pretreatment studies. Local control was defined as the lack of progression of airway wall thickening on computed tomography imaging and stable endobronchial deposits by endoscopy. Results: A total of 10 symptomatic airway amyloidosis patients (3 laryngeal and 7 tracheobronchial) received RT to a median total dose of 20 Gy in 10 fractions within 2 weeks. At a median follow-up of 6.7 years (range, 1.5-10.3), 8 of the 10 patients had local control. The remaining 2 patients underwent repeat RT 6 and 8.4 months after initial RT, 1 for persistent bronchial obstruction and 1 for progression of subglottic amyloid disease with subsequent disease control. The Eastern Cooperative Oncology Group performance status improved at a median of 18 months after RT compared with the baseline values, from a median score of 2 to a median of 1 (p = .035). Airflow (forced expiratory volume in 1 second) measurements increased compared with the baseline values at each follow-up evaluation, reaching a 10.7% increase (p = .087) at the last testing (median duration, 64.8 months). Acute toxicity was limited to Grade 1-2 esophagitis, occurring in 40% of patients. No late toxicity was observed. Conclusions: RT prevented progressive amyloid deposition in 8 of 10 patients, resulting in a marginally increased forced expiratory volume in 1 second, and improved functional capacity, without late morbidity.

  11. Flow barrier system for long-term high-level-waste isolation: Experimental results

    SciTech Connect

    Conca, J.L.; Apted, M.J.; Zhou, W.; Arthur, R.C.; Kessler, J.H.

    1998-10-01

    A flow barrier system (FBS) that includes a Richards barrier acts in an unsaturated hydrogeologic system to prevent the advective flow of water down through the barrier. Thus, an FBS placed above any solid waste material buried in the unsaturated zone could greatly aid in isolating the waste by keeping the waste away from flowing water. The FBS, consisting of a layer of highly conductive, fine-grained material overlying a sloped gravel layer, is proposed to isolate high-level radioactive waste (HLW) at a candidate disposal facility located in the unsaturated zone at Yucca Mountain in Nevada. A series of laboratory experiments were conducted to (a) assure that the FBS of a specific design can divert the anticipated maximum advective flow (under ideal conditions as well as for the case of a disturbed interface between the two layers caused by, for example, improper initial emplacement or faulting due to seismic activity), (b) investigate water inhibition into the gravel, and (c) measure the diffusion coefficient of the tuff gravel under partially saturated conditions. The main results show that (a) the FBS used in the study can divert point-source flow rates as high as 2.6 {times} 10{sup 5} {ell}/yr; (b) this FBS will continue performing with offsets of the interface as great as 50 cm or more; (c) after 12 months of testing, moisture penetrates the gravel only several grain diameters; and (d) the gravel effective diffusion coefficient is <10{sup {minus}11} cm{sup 2}/s under such low partial saturations. These results indicate that a properly designed FBS can be successful at isolating the HLW under the anticipated range of environmental conditions that exist both now and in the future at Yucca Mountain.

  12. Strategy for long-term 3D cloud-resolving simulations over the ARM SGP site and preliminary results

    NASA Astrophysics Data System (ADS)

    Lin, W.; Liu, Y.; Song, H.; Endo, S.

    2011-12-01

    Parametric representations of cloud/precipitation processes continue having to be adopted in climate simulations with increasingly higher spatial resolution or with emerging adaptive mesh framework; and it is only becoming more critical that such parameterizations have to be scale aware. Continuous cloud measurements at DOE's ARM sites have provided a strong observational basis for novel cloud parameterization research at various scales. Despite significant progress in our observational ability, there are important cloud-scale physical and dynamical quantities that are either not currently observable or insufficiently sampled. To complement the long-term ARM measurements, we have explored an optimal strategy to carry out long-term 3-D cloud-resolving simulations over the ARM SGP site using Weather Research and Forecasting (WRF) model with multi-domain nesting. The factors that are considered to have important influences on the simulated cloud fields include domain size, spatial resolution, model top, forcing data set, model physics and the growth of model errors. The hydrometeor advection that may play a significant role in hydrological process within the observational domain but is often lacking, and the limitations due to the constraint of domain-wide uniform forcing in conventional cloud system-resolving model simulations, are at least partly accounted for in our approach. Conventional and probabilistic verification approaches are employed first for selected cases to optimize the model's capability of faithfully reproducing the observed mean and statistical distributions of cloud-scale quantities. This then forms the basis of our setup for long-term cloud-resolving simulations over the ARM SGP site. The model results will facilitate parameterization research, as well as understanding and dissecting parameterization deficiencies in climate models.

  13. Automatic lighting controls demonstration: Long-term results. Final report, July 1991

    SciTech Connect

    Rubinstein, F.

    1991-10-18

    An advanced electronically ballasted lighting control system was installed in a portion of an office building to measure the energy and demand savings. The lighting control system used an integrated lighting control scenario that included daylight following, lumen depreciation correction, and scheduling. The system reduced lighting energy on weekdays by 62% and 51% in the north and south daylit zones, respectively, compared to a reference zone that did not have controls. During the summer, over 75% energy savings were achieved on weekdays in the north daylit zone. Even in the south interior zone, which benefitted lime from daylight, correction strategies and adjustment of the aisleway lights to a low level resulted in energy use of only half that of the reference zone. Although, in general, the savings varied over the year due to changing daylight conditions, the energy reduction achieved with controls could be fit using a simple analytical model. Significant savings also occurred during core operating hours when it is more expensive to supply and use energy. Compared to the usage in the reference zone, energy reductions of 49%, 44%, and 62% were measured in the south daylight, south interior, and north daylight zones, respectively, during core operating hours throughout the year. Lighting energy usage on weekends decreased dramatically in the zones with controls, with the usage in the north daylit zone only 10% that of the reference zone. A simple survey developed to assess occupant response to the lighting control system showed that the occupants were satisfied with the light levels provided.

  14. Long-term results of related myeloablative stem-cell transplantation to cure sickle cell disease.

    PubMed

    Bernaudin, Françoise; Socie, Gérard; Kuentz, Mathieu; Chevret, Sylvie; Duval, Michel; Bertrand, Yves; Vannier, Jean-Pierre; Yakouben, Karima; Thuret, Isabelle; Bordigoni, Pierre; Fischer, Alain; Lutz, Patrick; Stephan, Jean-Louis; Dhedin, Nathalie; Plouvier, Emmanuel; Margueritte, Geneviève; Bories, Dominique; Verlhac, Suzanne; Esperou, Hélène; Coic, Lena; Vernant, Jean-Paul; Gluckman, Eliane

    2007-10-01

    Allogeneic hematopoietic stem-cell transplantation (HSCT) is the only curative treatment for sickle cell disease (SCD); nevertheless, its use has been limited by the risk of transplantation-related mortality (TRM). Between November 1988 and December 2004, 87 consecutive patients with severe SCD ranging from 2 to 22 years of age received transplants in France. Cerebral vasculopathy was the principal indication for transplantation (55 patients). All the patients received grafts from a sibling donor after a myeloablative conditioning regimen (CR). The only change in the CR during the study period was the introduction of antithymocyte globulin (ATG) in March 1992. The rejection rate was 22.6% before the use of ATG but 3% thereafter. With a median follow-up of 6 years (range, 2.0 to 17.9 years), the overall and event-free survival (EFS) rates were 93.1% and 86.1%, respectively. Graft versus host disease (GVHD) was the main cause of TRM. Importantly, cord blood transplant recipients did not develop GVHD. No new ischemic lesions were detected after engraftment, and cerebral velocities were significantly reduced. The outcome improved significantly with time: the EFS rate among the 44 patients receiving transplants after January 2000 was 95.3%. These results indicate that HLA-identical sibling HSCT after myeloablative conditioning with ATG should be considered as a standard of care for SCD children who are at high risk for stroke.

  15. Long-Term Results and Prognostic Factors of Gastric Cancer Patients with Microscopic Peritoneal Carcinomatosis

    PubMed Central

    Liu, Xiaowen; Cai, Hong; Sheng, Weiqi; Wang, Yanong

    2012-01-01

    Background Clinical significance of microscopic peritoneal carcinomatosis remained unclear. The aim of this study was to evaluate the prognostic value of microscopic peritoneal carcinomatosis in gastric cancer. Methods From 1996 to 2007, 4426 patients underwent gastrectomy for gastric cancer at Fudan University Shanghai Cancer Center. The clinical and pathological data were reviewed to identify patients with microscopic peritoneal carcinomatosis (group 1). The clinicopathological features and prognosis were examined. Additionally, 242 stage-matched gastric cancer patients without microscopic peritoneal carcinomatosis (group 2) and 118 with macroscopic peritoneal carcinomatosis (group 3) were selected as control groups. Results Microscopic peritoneal carcinomatosis was found in 121 patients. There were 85 males and 36 females (2.36:1). There was a higher incidence rate of large size tumor (≥5 cm) (P = 0.045), Borrmann IV (P = 0.000), and serosal invasion (P = 0.000) in gastric cancer with microscopic peritoneal carcinomatosis compared with the control group. The 5-year survival rate of gastric cancer with microscopic peritoneal carcinomatosis was 24%, significantly poorer than that of the stage-matched control group but better than that of patients with macroscopic peritoneal carcinomatosis. The independent prognostic factors identified included pathological stage and operative curability. Conclusions The presence of microscopic peritoneal carcinomatosis was associated with worse prognosis for gastric cancer, but curative surgery showed potential to improve prognosis. PMID:22615966

  16. Corrective osteotomy for malunited metacarpal fractures: long-term results of a novel technique.

    PubMed

    Karthik, K; Tahmassebi, R; Khakha, R S; Compson, J

    2015-10-01

    Symptomatic malunited metacarpal fractures can significantly affect hand function. We retrospectively reviewed the results of our technique of corrective osteotomy in 14 malunited metacarpal fractures (12 patients) with an average age of 30 years (range 18-49) from January 2005 to December 2011. The dominant hand was involved in nine patients and all except one were male. The malunited metacarpals demonstrated mean dorsal apex angulation of 43° (range 33°-72°) with apparent metacarpal shortening. All except three cases had rotational deformity. All patients underwent surgical correction of the deformity using our described technique of closing wedge osteotomy using temporary intramedullary K-wire and plate fixation. At a mean follow-up of 46 months (range 12-78), the DASH scores improved significantly (p < 0.001). All our patients scored 'excellent' according to the Büchler criteria and at final follow-up had returned to pre-injury work and sports activities. Our technique is safe, easily performed and can be adapted to correct a range of deformities. Level of evidence: Level IV.

  17. Electric response audiometry in infants and preschool children. Long-term control of the results.

    PubMed

    Garrubba, V; Grandori, F; Lamoretti, M; Nicolai, P; Zanetti, D; Antonelli, A R

    1991-01-01

    Two hundred and four infants and preschool children (mean age 2 years and 7 months +/- 9 months) with auditory impairment according to ABR and ECochG data, and 33 subjected to SVR were followed up for periods ranging from 1 year to 4 years and 6 months until a reliable conventional pure tone audiogram was obtained. One hundred and fifty-one children had conductive hearing loss, 75 sensorineural, 7 had ABR indicating disorders of the central auditory pathways, 5 were normal. Hit, false positive and false negative rates resulted as follows: 58.62%, 17.24% and 24.14% for SVR: 98.37%, 1.63% and 0% for ABR; 99.15%, 0.85% and 0% for ECochG. In the group with sensorineural hearing loss, 75% of the children gave ECochG detectable responses at 90 dB nHL, against 51.5% with ABR. With 1 kHz tonebursts, 64% of the tested subjects gave threshold responses to ECochG and 12% to ABR. The best strategy for children who failed the behavioral hearing tests, or in whom these tests were not applicable, was that based on ABR and middle ear impedance measures, complemented, when necessary, by ECochG.

  18. [Transcatheter ablation of atrioventricular accessory pathways. Immediate results and long-term follow-up].

    PubMed

    Silva Oropeza, E; Frank, R; Fontaine, G; Tonet, J; Lascault, G; Gallais, Y; Poulain, F; Grosgogeat, Y

    1994-01-01

    We present the immediate results and follow-up, from our initial serie of patients, where radiofrequency was attempted to ablate atrio-ventricular accessory pathways. Initiation policy included direct current-shocks following every unsuccessful radiofrequency session. Initial ablation success rate with radiofrequency solely was 75% (17/22), same as when direct current-shocks were associated 80% (8/10); but accessory pathway conduction recurrence was present only in this latter (6/10). During follow-up period of 18 to 25 months, from the recurrence group, one patient had spontaneous delta-wave disappearance, and four more required two to three ablation sessions. Permanent elimination with both methods was attained in 91% (20/22 pathways), and all patients remain asymptomatic, and drug free. There were one acute major complication, but no deaths. Because of its superior initial success rate, minor technical requirements, and their economical implications, radiofrequency catheter ablation of accessory pathways is the first choice of treatment. At our institution, direct current-shock remain an alternative method whenever a serious tachycardia prevents radiofrequency treatment.

  19. Results from a long-term study of a portable field robot in urban terrain

    NASA Astrophysics Data System (ADS)

    Lundberg, Carl; Reinhold, Roger; Christensen, Henrik I.

    2007-04-01

    The military have a considerable amount of experience from using robots for mine clearing and bomb removal. As new technology emerges it is necessary to investigate the possibly to expand robot use. This study has investigated an Army company, specialized in urban operations, while fulfilling their tasks with the support of a PackBot Scout. The robot was integrated and deployed as an ordinary component of the company and included modifying and retraining a number of standard behaviors to include the robot. This paper reports on the following issues: evaluation of missions where the platform can be deployed, what technical improvements are the most desired, and what are the new risks introduced by use of robots? Information was gathered through observation, interviews, and a questionnaire. The results indicate the robot to be useful for reconnaissance and mapping. The users also anticipated that the robot could be used to decrease the risks of IEDs by either triggering or by neutralising them with a disruptor. The robot was further considered to be useful for direct combat if armed, and for placing explosive loads against, for example, a door. Autonomous rendering of maps, acquiring images, two-way audio, and improved sensing such as IR were considered important improvements. The robot slowing down the pace of the unit was considered to be the main risk when used in urban operations.

  20. Long-term test results from a West Valley actinide-doped reference glass

    SciTech Connect

    Fortner, J.A.; Gerding, T.J.; Bates, J.K.

    1995-07-01

    Results from drip tests designed to simulate unsaturated conditions in the proposed Yucca Mountain Repository are reported for an actinide-doped glass (reference glass ATM-10) used as a model waste form. These tests have been ongoing for nearly 7 years, with data collected on solution composition (including transuranics), colloid formation and disposition, glass corrosion layers, and solid secondary phases. This test is unique because of its long elapsed time, high content of thorium and transuranics, use of actual groundwater from the proposed site area, use of contact between the glass and sensitized stainless steel in the test, and the variety of analytical procedures applied to the components. Some tests have been terminated, and scanning electron microscopy (SEM) and analytical transmission electron microscopy (AEM) were used to directly measure glass corrosion and identify secondary phases. Other tests remain ongoing, with periodic sampling of the water that had contacted the glass. The importance of integrated testing has been demonstrated, as complex interactions between the glass, the groundwater, and the sensitized stainless steel have been observed. Secondary phases include smectite clay, iron silicates, and brockite. Actinides, except neptunium, concentrate into stable secondary phases. The release of actinides is then controlled by the behavior of these phases.

  1. Revision of trabeculectomy filtering blebs with mitomycin C: Long term results

    PubMed Central

    Tulidowicz-Bielak, Maria; Kosior-Jarecka, Ewa; Żarnowski, Tomasz

    2016-01-01

    Aim: The aim of the study is to assess the outcomes of transconjunctival mitomycin C (MMC)-augmented revision in eyes with failed trabeculectomy. Materials and Methods: This is a retrospective, noncomparative case series. One hundred and twenty-one eyes of 113 consecutive glaucoma patients with previously failed trabeculectomy who underwent transconjunctival revision with at least 12 months of follow-up were initially included in the study. The success was determined on the basis of intraocular pressure (IOP) alone. The main outcome measures were IOP, best-corrected distance visual acuity, complications, bleb appearance, lens status, visual field progression, and time between primary trabeculectomy and MMC revision. The main purpose of the study was to determine the efficacy of a single MMC-augmented needle revision. Results: Mean follow-up was 2.3 years. Twelve months after revision, IOP had declined from 26.1 ± 8.4 mmHg to 14.1 ± 4.8 mmHg (P < 0.05) and remained 16.0 ± 5.6 mmHg at 24 months, 15.7 ± 5.8 mmHg at 48 months, and 15.2 ± 4.0 mmHg at 60 months. Complete success was achieved in 53% of cases, 84% achieved qualified success, and 16% were classified as failures 12 months after revision. Early complications developed in 45 of the initial 121 eyes (37.2%). Conclusions: Transconjunctival MMC-augmented revision appears to be a safe and useful tool in reducing IOP and re-establishing filtration after trabeculectomy failure. This simple procedure has a high rate of success and helps avoid other surgical interventions which are more destructive for the conjunctiva. PMID:27958205

  2. Long-term results of forearm lengthening and deformity correction by the Ilizarov method.

    PubMed

    Orzechowski, Wiktor; Morasiewicz, Leszek; Krawczyk, Artur; Dragan, Szymon; Czapiński, Jacek

    2002-06-30

    Background. Shortening and deformity of the forearm is most frequently caused by congenital disorders or posttraumatic injury. Given its complex anatomy and biomechanics, the forearm is clearly the most difficult segment for lengthening and deformity correction.
    Material and methods. We analyzed 16 patients with shortening and deformity of the forearm, treated surgically, using the Ilizarov method in our Department from 1989 to 2001. in 9 cases 1-stage surgery was sufficient, while the remaining 7 patients underwent 2-5 stages of treatment. At total of 31 surgical operations were performed. The extent of forearm shortening ranged from 1,5 to 14,5 cm (5-70%). We development a new fixator based on Schanz half-pins.
    Results. The length of forearm lengthening per operative stage averaged 2,35 cm. the proportion of lengthening ranged from 6% to 48% with an average of 18,3%. The mean lengthening index was 48,15 days/cm. the per-patient rate of complications was 88% compared 45% per stage of treatment, mostly limited rotational mobility and abnormal consolidation of regenerated bone.
    Conclusions. Despite the high complication rate, the Ilizarov method is the method of choice for patients with forearm shortenings and deformities. Treatment is particularly indicated in patients with shortening caused by disproportionate length of the ulnar and forearm bones. Treatment should be managed so as cause the least possible damage to arm function, even at the cost of limited lengthening. Our new stabilizer based on Schanz half-pins makes it possible to preserve forearm rotation.

  3. [Long-term results of surgery for cervical spondylotic myelopathy using open-door laminoplasty].

    PubMed

    Ryba, L; Chaloupka, R; Repko, M; Cienciala, J

    2015-01-01

    PURPOSE OF THE STUDY Cervical spondylotic myelopathy (CSM) is a serious disease which, in its advanced form, can markedly disable the patient. The aim of the present work was a prospective evaluation of a group of CSM patients treated by open-door laminoplasty. MATERIAL AND METHODS We evaluated 89 patients (59 men and 30 women; average age, 62 years; range, 39 to 81 years) who underwent surgery in the years 2001 to 2011. The average follow-up was 76 months. The patients were examined neurologically, radiologically, by magnetic resonance imaging (MRI) or CT. All of them had quadruparetic disability and showed signs of myelopathy on MRI examination. We used a modified Hirabayashi technique of open-door laminoplasty. We evaluated the surgery time, intra-operative blood loss, neurological deficit on the modified Japanese Orthopaedic Society (mJOA) scale, intra- and postoperative complications, neck pain (NP) and extremity pain (EP) on the visual analogue scale (VAS) and a radiographic sagittal profile change after laminoplasty. RESULTS The average operative time was 117 minutes and the average intra-operative blood loss was 330 ml. The average mJOA score of 12.7 before surgery improved to 14.4. Two patients (2.25 %) showed persisting deterioration of neurological symptoms, conditions of six patients (6.75 %) were assessed as stable and the remaining 81 patients (91 %) showed varying degrees of both subjective and objective amelioration/improvement. Infection was recorded as the most frequent complication (7.8 %). C5 paresis reported in the literature did not occur in our group. One patient (1.1 %) had a moderate epidural haemorrhage. The pre-operative VAS NP score of 5.4 improved to 3.2 and the VAS EP score of 7.7 improved to 4.4. The average value for the radiographic sagittal profile changed from -18.2 pre-operatively to -16.5 post-operatively. CONCLUSIONS Laminoplasty remains the basic surgical option for CSM treatment, particularly in progressive cases of the

  4. Treatments of osteoarthritis of the distal radioulnar joint: long-term results of three procedures.

    PubMed

    Minami, Akio; Iwasaki, Norimasa; Ishikawa, Jun-Ichi; Suenaga, Naoki; Yasuda, Kazunori; Kato, Hiroyuki

    2005-01-01

    Sixty-one wrists in 61 patients with osteoarthritis of the distal radioulnar joint treated by three consecutive procedures (20 Darrach, 25 Sauvé-Kapandji and 16 hemiresection-interposition arthroplastic procedures) were retrospectively evaluated. We preferred to perform Darrach's procedure in even the early stages of osteoarthritis of the distal radioulnar joint prior to introduction of Sauvé-Kapandji and hemirestion-interposition arthroplastic procedures. Subsequently the hemirestion-interposition arthroplasty was indicated when the triangular fibrocartilage cartilage was intact or could be reconstructed and the Sauvé-Kapandji when the triangular fibrocartilage complex could not be reconstructed or there was positive ulnar variance of more than 5 mm even though the triangular fibrocartilage complex was functional. Patient's age at operation averaged 59.8 years. There were 36 men and 25 women. There were 38 primary and 23 secondary osteoarthritis cases. Post-operative pain, range of motion, grip strength, return to work status; and radiographic results were evaluated. At the five- to 14-year (average, ten years) follow-up evaluation, relief of pain from Darrach procedure was inferior to the Sauvé-Kapandji procedure and hemiresection-interposition arthroplasty although this was not statistically significant. After both the Sauvé-Kapandji procedure and hemiresection-inteposition arthroplasty, post-operative improvements in flexion and extension of the wrist had statistical significance. Post-operative improvements in pronation and supination of the forearm showed statistical significances after all procedures. Improvements of post-operative grip strength and return to an original job in the Sauvé-Kapandji procedure and hemiresection-interposition arthroplasty were statistically superior to those with a Darrach's procedure. There were many post-operative complications following the Darrach's procedure. Darrach's procedure is better indicated for severe

  5. Long-Term Results of Concurrent Chemoradiotherapy for Advanced N2-3 Stage Nasopharyngeal Carcinoma

    PubMed Central

    Wang, Xue; Chen, Meng; Wu, Jing; Xu, Jian-Hua; Qian, Pu-Dong; Guo, Wen-Jie; Jiang, Xue-Song; Zhu, Huan-Feng; Gu, Jia-Jia; Wu, Jian-Feng; Zhang, Ye-wei; He, Xia

    2015-01-01

    Background N-stage is related to distant metastasis in nasopharyngeal carcinoma (NPC) patients. The purpose of this study was to evaluate the efficacy and toxicity of different nedaplatin-based chemotherapy regimens in advanced N2-3 stage NPC patients treated with intensity modulated radiation therapy (IMRT). Patients and Methods Between April 2005 and December 2009, a total of 128 patients with N2-3 advanced NPC were retrospectively analyzed. Patients were treated with IMRT concurrent with 2 cycles of chemotherapy consisting of either nedaplatin plus paclitaxel (NP group, n = 67) or nedaplatin plus fluorouracil and paclitaxel (NFP group, n = 61). Two to four cycles of adjuvant chemotherapy were then administered every 21 days following concurrent chemoradiotherapy. Results With a median follow-up of 60 months, the 5-year overall survival (OS), progression-free survival (PFS), local-regional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) for all patients were 81.4%, 71.5%, 87.8% and 82.0%, respectively. No significant difference in PFS (66.6% vs. 76.7%, P = 0.212) and LRRFS rates (89.0% vs. 86.3%, P = 0.664) was observed between the NP and NFP groups. The 5-year OS (75.4% vs. 88.5%, P = 0.046) and DMFS (75.1% vs. 89.0%, P = 0.042) rate were superior in the NFP group compared with the NP group. The NFP group had a higher incidence of grade 3–4 acute toxicities including bone marrow suppression (leukopenia: χ2 = 3.935, P = 0.047; anemia: χ2 = 9.760, P = 0.002; thrombocytopenia: χ2 = 8.821, P = 0.003), and both liver and renal dysfunction (χ2 = 5.206, P = 0.023) compared with the NP group. Late toxicities were moderate and no difference was observed between the two groups. Conclusion IMRT concurrent with nedaplatin-based chemotherapy is an advocated regimen for patients with advanced N2-3 stage NPC. Patients with advanced N2-3 stage may be better candidates for the NFP regimen although this regimen was associated with a high acute

  6. The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan

    PubMed Central

    Abe, Tomonobu; Ito, Hideki; Mutsuga, Masato; Fujimoto, Kazuro; Terazawa, Sachie; Narita, Yuji; Oshima, Hideki; Usui, Akihiko

    2016-01-01

    ABSTRACT Mitral valve surgery has changed with the wide acceptance of mitral valve repair. The aim of this study is to obtain the long-term results of patients who underwent mitral valve replacement (MVR) using a biological prosthesis in contemporary practice in Japan. From January 1990 to December 2013, 76 patients underwent MVR using a biological prosthesis with or without concomitant surgery. Data were obtained by means of a questionnaire and a telephone interview. The mean follow-up period was 4.26 years. The etiologies of the patients included dilated cardiomyopathy (DCM) (n=20 [26.3%]), ischemic mitral regurgitation (n=7 [9.2%]). There is a trend towards decreasing number of rheumatic and degenerative disease and increasing number of DCM and ischemic mitral regurgitation. Three patients (3.9%) died in the perioperative period. The 5- and 10-year overall survival rates were 69.6% and 31.7%, respectively. The 5- and 10-year freedom from valve related death were 95.6% and 80.6 %, respectively. The linearized rates of valve-related complications were as follows: thromboembolism (0.63%/patient/year), bleeding (1.25%/patient/year). One patient underwent reoperation for structural degeneration 13 years after the first operation. The present study shows the long-term results of mitral valve replacement with bioproshtesis in a contemporary case series. The practice pattern is changing. The low rate of valve-related complication justify the current patient selection. PMID:28008192

  7. Low-dose-rate brachytherapy for patients with transurethral resection before implantation in prostate cancer. Long-term results

    PubMed Central

    Prada, Pedro J.; Anchuelo, Javier; Blanco, Ana García; Payá, Gema; Cardenal, Juan; Acuña, Enrique; Ferri, María; Vázquez, Andrés; Pacheco, Maite; Sanchez, Jesica

    2016-01-01

    ABSTRACT Objectives We analyzed the long-term oncologic outcome for patients with prostate cancer and transurethral resection who were treated using low-dose-rate (LDR) prostate brachytherapy. Methods and Materials From January 2001 to December 2005, 57 consecutive patients were treated with clinically localized prostate cancer. No patients received external beam radiation. All of them underwent LDR prostate brachytherapy. Biochemical failure was defined according to the “Phoenix consensus”. Patients were stratified as low and intermediate risk based on The Memorial Sloan Kettering group definition. Results The median follow-up time for these 57 patients was 104 months. The overall survival according to Kaplan-Meier estimates was 88% (±6%) at 5 years and 77% (±6%) at 12 years. The 5 and 10 years for failure in tumour-free survival (TFS) was 96% and respectively (±2%), whereas for biochemical control was 94% and respectively (±3%) at 5 and 10 years, 98% (±1%) of patients being free of local recurrence. A patient reported incontinence after treatment (1.7%). The chronic genitourinary complains grade I were 7% and grade II, 10%. At six months 94% of patients reported no change in bowel function. Conclusions The excellent long-term results and low morbidity presented, as well as the many advantages of prostate brachytherapy over other treatments, demonstrates that brachytherapy is an effective treatment for patients with transurethral resection and clinical organ-confined prostate cancer. PMID:27136466

  8. LONG-TERM STABILITY TESTING RESULTS USING SURROGATES AND SORBENTS FOR SAVANNAH RIVER SITE ORGANIC AND AQUEOUS WASTESTREAMS - 10016

    SciTech Connect

    Burns, H.

    2009-11-10

    The U.S. Department of Energy (DOE) has tasked MSE Technology Applications, Inc. (MSE) with evaluating the long-term stability of various commercially available sorbent materials to solidify two organic surrogate wastestreams (both volatile and nonvolatile), a volatile organic surrogate with a residual aqueous phase, an aqueous surrogate, and an aqueous surrogate with a residual organic phase. The Savannah River Site (SRS) Legacy and F-Canyon plutonium/uranium extraction (PUREX) process waste surrogates constituted the volatile organic surrogates, and various oils constituted the nonvolatile organic surrogates. The aqueous surrogates included a rainwater surrogate and an aqueous organic surrogate. MSE also evaluated the PUREX surrogate with a residual aqueous component with and without aqueous type sorbent materials. Solidification of the various surrogate wastestreams listed above was performed from 2004 to 2006 at the MSE Test Facility located in Butte, Montana. This paper summarizes the comparison of the initial liquid release test (LRT) values with LRT results obtained during subsequent sampling events in an attempt to understand and define the long-term stability characteristics for the solidified wastestreams.

  9. Deferiprone versus deferoxamine in thalassemia intermedia: Results from a 5-year long-term Italian multicenter randomized clinical trial.

    PubMed

    Calvaruso, Giuseppina; Vitrano, Angela; Di Maggio, Rosario; Lai, Eliana; Colletta, Grazia; Quota, Alessandra; Gerardi, Calogera; Rigoli, Luciana Concetta; Sacco, Massimiliano; Pitrolo, Lorella; Maggio, Aurelio

    2015-07-01

    In patients with thalassemia intermedia (TI), such as beta-TI, alpha-thalassemia (mainly HbH disease and mild/moderate forms of HbE/beta-thalassemia), iron overload is an important challenge in terms of diagnosis, monitoring, and treatment. Moreover, to date, the only possible chelators available are deferoxamine, deferasirox, and deferiprone. Here, we report the first 5-year long-term randomized clinical trial comparing the effectiveness of deferiprone versus deferoxamine in patients with TI. Body iron burden, which was determined by measuring serum ferritin levels in the same patient over 5 years and analyzed according to the generalized linear mixed model (GLMM), showed a linear decrease over time in the mean serum ferritin levels in both treatment groups (P-value = 0.035). The overall period of observation was 235.2 person-years for the deferiprone patients compared with 214.3 person-years for the deferoxamine patients. The results of the log-rank test suggested that the deferiprone treatment did not affect survival compared with the deferoxamine treatment (P-value = 0.360). The major adverse events observed included gastrointestinal symptoms and joint pain or arthralgia. Neutropenia and agranulocytosis were also detected, suggesting needing of strict hematological control. In conclusion, long-term iron chelation therapy with deferiprone is associated with an efficacy and safety similar to that of deferoxamine, suggesting that this drug is an alternative option in cases in which deferoxamine and deferasirox are contraindicated.

  10. Dynamic self-regulating prosthesis (protesi autoregolantesi dinamica): the long-term results in the treatment of primary inguinal hernias.

    PubMed

    Valenti, Gabriele; Baldassarre, Emanuele; Testa, Alessandro; Arturi, Alessandro; Torino, Giovanni; Campisi, Costantino; Capuano, Giorgio

    2006-03-01

    The dynamic self-regulating prosthesis (protesi autoregolantesi dinamica, PAD) is a double-layered prosthesi, in use since 1992 in inguinal hernia repair. In 1999, we published the short-term results on 500 patients and herein we report the long-term follow-up. Five hundred eighty-five PAD procedures were performed on 500 adult male, unselected patients. Hernias were unilateral in 415 patients, were bilateral in 85 patients, were direct in 197 patients (33.7%), were indirect in 269 patients (46.0%), and were combined in 119 patients (20.3%). Four hundred sixty-four patients were alive at the follow-up period of minimum 5 years, whereas 36 died (7.2%) of causes unrelated to the hernia. No information was available on 73 patients (14.6%). Therefore, the follow-up was consisted of 391 patients (78.2%) with 469 hernias. The recurrence and testicular atrophy rates were nil. Three patients (0.77%) presented chronic pain and 18 (4.6%) suffered persistent discomfort or paresthesia. A hydrocoele was observed in one patient (0.2%). The long-term data confirm the efficacy of the dynamic self-regulating posthesis hernioplasty. We propose it as a standard of care in all cases of primary inguinal hernia in adult males, retaining it as a definitive and comfortable solution.

  11. Long-term results of immunomodulatory treatment in children and adolescents with multiple sclerosis: the Italian experience.

    PubMed

    Ghezzi, Angelo; Amato, Maria Pia; Annovazzi, Pietro; Capobianco, Marco; Gallo, Paolo; La Mantia, Loredana; Marrosu, Maria Giovanna; Martinelli, Vittorio; Milani, Nicoletta; Moiola, Lucia; Patti, Francesco; Pozzilli, Carlo; Trojano, Maria; Zaffaroni, Mauro; Comi, Giancarlo

    2009-06-01

    The main objective of this study is to evaluate the effect of immunomodulatory agents (IMAs) (Interferon-Beta, Glatiramer Acetate) in a large cohort of multiple sclerosis (MS) patients with disease onset in childhood or adolescence, treated before 16 years of age, after a long-term follow-up. A total of 130 patients were identified, 77 were treated with Avonex, 39 with Rebif/Betaferon, 14 with Copaxone. After a mean (SD) treatment duration of 53.6 +/- 27.0, 59.9 +/- 39.5 and 74.6 +/- 35.5 months, respectively, the relapse rate decreased significantly. The final EDSS score was unchanged with respect to the initial score. Similar results were also observed in subjects who continued a long-term follow-up after they were included in an observational study in 2004, and in subjects who were treated before 12 years of age. The frequency of clinical and laboratory adverse events was similar to that observed in adult patients. To conclude, IMAs were effective and well tolerated in paediatric patients with MS.

  12. Excess Body Mass Index Loss at 3 Months: A Predictive Factor of Long-Term Result after Sleeve Gastrectomy

    PubMed Central

    Philouze, Guillaume; Voitellier, Eglantine; Lacaze, Laurence; Huet, Emmanuel; Gancel, Antoine; Prévost, Gaëtan

    2017-01-01

    Introduction. Laparoscopic Sleeve Gastrectomy (SG) is considered as successful if the percentage of Excess Body Mass Index Loss (% EBMIL) remains constant over 50% with long-term follow-up. The aim of this study was to evaluate whether early % EBMIL was predictive of success after SG. Methods. This retrospective study included patients who had SG with two years of follow-up. Patients had follow-up appointments at 3 (M3), 6, 12, and 24 months (M24). Data as weight and Body Mass Index (BMI) were collected systematically. We estimated the % EBMIL necessary to establish a correlation between M3 and M24 compared to % EBMIL speeds and calculated a limit value of % EBMIL predictive of success. Results. Data at operative time, M3, and M24 were available for 128 patients. Pearson test showed a correlation between % EBMIL at M3 and that at M24 (r = 0.74; p < 0.0001). % EBMIL speed between surgery and M3 (p = 0.0011) was significant but not between M3 and M24. A linear regression analysis proved that % EBMIL over 20.1% at M3 (p < 0.0001) predicted a final % EBMIL over 50%. Conclusions. % EBMIL at M3 after SG is correlated with % EBMIL in the long term. % EBMIL speed was significant in the first 3 months. % EBMIL over 20.1% at M3 leads to the success of SG. PMID:28250984

  13. The “Purse-string” Technique for Shoulder Stabilization, Description of the Technique, Long term Results and Literature Review

    PubMed Central

    Arealis, Georgios; Rodrigues, Joana Bento; Hope, Natalie; Levy, Ofer

    2017-01-01

    Background: Over the last 2 decades arthroscopic stabilization and Bankart repair has gained popularity due to the advances in materials and surgical techniques. Results of arthroscopic stabilization have been similar to open without the risks of it. The number of anchors used has been suggested to be very important in “spot-weld” arthroscopic stabilization however the “purse-string” technique (PST) can achieve similar results using only one anchor. We describe technique and long term results from using the PST and search the literature for other papers regarding PST. Methods: Between 2003 and 2013 a total of 193 patients were operated. Patients included those with anterior instability. Using PubMed relevant studies reporting results of PST were identified. Results: Mean follow up was 2 (range 0.5 to 3) years. 9 (4.7%) patients experienced recurrent instability. Almost all patients (97%) returned to their sporting and leisure activities and all professional athletes went back to the same sport. One more UK centre reported 6.1% recurrence in 114 patients at 4 years follow up. These results are similar to the published 11% recurrence of instability after “spot-weld” arthroscopic techniques at 11 years clinical follow-up. Conclusion: This study indicates that PST is safe and effective alternative method for the treatment of anterior shoulder instability. In this technique with one anchor simultaneous repair of labrum, creation of an anterior bumper and capsular shift can be achieved. It has the advantage of being cheaper, faster yet efficient with good long term results and leaves space for revision anchors in case of recurrence.

  14. Intravitreal Bevacizumab with or without Triamcinolone for Refractory Diabetic Macular Edema: Long-term Results of a Clinical Trial

    PubMed Central

    Shoeibi, Nasser; Ahmadieh, Hamid; Entezari, Morteza; Yaseri, Mehdi

    2013-01-01

    Purpose To report the long-term results of intravitreal bevacizumab (IVB) injection alone or combined, at the time of first IVB injection, with intravitreal triamcinolone acetonide (IVT) for treatment of refractory diabetic macular edema (DME). Methods In this randomized clinical trial, 115 eyes of 101 patients with refractory DME were enrolled and randomly assigned to one of the three study arms: the IVB group (41 eyes) received three consecutive injections of 1.25 mg IVB at 6-week intervals; the IVB/IVT group (37 eyes) additionally received 2 mg of IVT at the time of first IVB injection; and the control (sham injection) group. Patients in the IVB and IVB/IVT groups were followed for a mean of 13.3 months and received retreatment with IVB alone whenever indicated. Main outcome measures were best corrected visual acuity (BCVA) and central macular thickness (CMT). Results At the last follow up, CMT decreased significantly in the IVB group (p=0.013) but it was not significant (p=0.13) in the IVB/IVT group. Mean CMT improvement was 91 (95% CI, 20 to 161) microns and 57 (95% CI, -18 to 133) microns in the IVB and IVB/IVT groups, respectively. Mean BCVA improvement from baseline was 0.28 (95% CI, 0.18 to 0.38) logMAR (P=0.017) in the IVB group and 0.19 (95% CI, 0.08 to 0.30) logMAR (P=0.001) in the IVB/IVT group. There was no difference between the two groups in terms of visual improvment (p=0.42). In generalized linear mixed model, only the time interval between the last injection and CMT measurement was statistically significant (P=0.04). The same results were repeated for visual acuity (P=0.03). Conclusion Three loading doses of IVB (added doses if required) have long-term beneficial effects for treatment of refractory DME. Adding triamcinolone to this regimen provides no additional long-term benefit. PMID:23943683

  15. Long-term Testing Results for the 2008 Installation of LED Luminaires at the I-35 West Bridge in Minneapolis

    SciTech Connect

    Kinzey, Bruce R.; Davis, Robert G.

    2014-09-30

    This document reports the long-term testing results from an extended GATEWAY project that was first reported in “Demonstration Assessment of Light-Emitting Diode (LED) Roadway Lighting at the I-35W Bridge, in Minneapolis, MN,” August 2009. That original report presented the results of lighting the newly reconstructed I 35W Bridge using LEDs in place of conventional high-pressure sodium (HPS) roadway luminaires, comparing energy use and illuminance levels with a simulated baseline condition. That installation was an early stage implementation of LED lighting and remains one of the oldest installations in continued operation today. This document provides an update of the LED system’s performance since its installation in September 2008.

  16. Functional changes following distraction osteogenesis treatment of asymmetric mandibular growth deviation in unilateral juvenile idiopathic arthritis: a prospective study with long-term follow-up.

    PubMed

    Nørholt, S E; Pedersen, T K; Herlin, T

    2013-03-01

    In juvenile idiopathic arthritis (JIA), temporomandibular joint involvement is a frequent complication leading to deficient mandibular growth. Occurring unilaterally this will give rise to mandibular and maxillary asymmetry that will affect the soft tissue and the muscles and result in complex dentofacial anomaly. In the case of severe dentofacial malformation, orthognathic surgery is the only treatment option. Vertical osseodistraction of the mandibular ramus has been suggested as a means of rectifying the mandibular growth deviation and soft-tissue problems. Whether such treatment introduces dysfunctional side effects of the temporomandibular joint and muscles has been debated and concern has been raised that treatment impairs the patient's mouth opening capacity and mandibular movement. The present study prospectively evaluated 23 patients with JIA and mandibular asymmetry caused by unilateral temporomandibular joint arthritis. The authors found a clinical effect on the asymmetry with only minor subjective complaints and limited objective changes in functional parameters.

  17. Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009–2010)

    PubMed Central

    2012-01-01

    Background Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview) among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Methods Data on former as well as current smokers’ socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs) and 95% confidence interval (CI) of the broad number of variables on successful cessation of smoking. Results Among females the quit rate was 30.4% compared to 37.9% in males (p < 0.01). Former smokers declared concerns about the health hazard of smoking (60.8%) and the high price of cigarettes (11.6%) as primary reasons for smoking cessation. Older age, high education attainment, awareness of smoking health consequences was associated with long-term quitting among both genders. Also employed males had over twice the probability of giving up smoking compared with unemployed, and being religious did not contribute to successful smoking cessation. Conclusion Results indicated that smoking cessation policies focused on

  18. Association between rheumatoid arthritis disease activity, progression of functional limitation and long-term risk of orthopaedic surgery: combined analysis of two prospective cohorts supports EULAR treat to target DAS thresholds

    PubMed Central

    Nikiphorou, Elena; Norton, Sam; Young, Adam; Carpenter, Lewis; Dixey, Josh; Walsh, David Andrew; Kiely, Patrick

    2016-01-01

    Objectives To examine the association between disease activity in early rheumatoid arthritis (RA), functional limitation and long-term orthopaedic episodes. Methods Health Assessment Questionnaire (HAQ) disability scores were collected from two longitudinal early RA inception cohorts in routine care; Early Rheumatoid Arthritis Study and Early Rheumatoid Arthritis Network from 1986 to 2012. The incidence of major and intermediate orthopaedic surgical episodes over 25 years was collected from national data sets. Disease activity was categorised by mean disease activity score (DAS28) annually between years 1 and 5; remission (RDAS≤2.6), low (LDAS>2.6–3.2), low-moderate (LMDAS≥3.2–4.19), high-moderate (HMDAS 4.2–5.1) and high (HDAS>5.1). Results Data from 2045 patients were analysed. Patients in RDAS showed no HAQ progression over 5 years, whereas there was a significant relationship between rising DAS28 category and HAQ at 1 year, and the rate of HAQ progression between years 1 and 5. During 27 986 person-years follow-up, 392 intermediate and 591 major surgeries were observed. Compared with the RDAS category, there was a significantly increased cumulative incidence of intermediate surgery in HDAS (OR 2.59 CI 1.49 to 4.52) and HMDAS (OR 1.8 CI 1.05 to 3.11) categories, and for major surgery in HDAS (OR 2.48 CI 1.5 to 4.11), HMDAS (OR 2.16 CI 1.32 to 3.52) and LMDAS (OR 2.07 CI 1.28 to 3.33) categories. There was no significant difference in HAQ progression or orthopaedic episodes between RDAS and LDAS categories. Conclusions There is an association between disease activity and both poor function and long-term orthopaedic episodes. This illustrates the far from benign consequences of persistent moderate disease activity, and supports European League Against Rheumatism treat to target recommendations to secure low disease activity or remission in all patients. PMID:26979104

  19. Percutaneous transluminal angioplasty for atherosclerotic stenosis of the intracranial cerebral arteries. initial results and long-term follow-up.

    PubMed

    Hyodo, A; Kato, N; Nakai, Y; Anno, I; Sato, H; Okazaki, M; Matsumaru, Y; Nose, T

    1999-11-01

    Percutaneous transluminal angioplasty (PTA) was carried out 52 times for 49 lesions in 47 cases of atheroscrelotic stenosis of the intracranial or skull base cerebral arteries. The stenotic lesions involved the middle cerebral artery in 21 cases, the basilar artery in eight cases, the internal carotid artery (petrous-supraclinoid portion) in 15 cases, and the intracranial vertebral artery in five cases. Nearly all cases were symptomatic, such as TIA or stroke, and the degree of stenosis ranged from 70 to 99 percent, with a mean of 80 percent. PTA was performed using a STEALTH balloon angioplasty catheter. In these trials, PTA was successfully performed (as indicated by a residual stenosis under 50%) 41 times. The initial success rate was 79% and stenosis was reduced from 80% to 25%. Clinical follow-up was performed from 7 to 84 months with a mean of 44 months. During this period, death due to myocardial infarction or pneumonia occurred in five cases, stroke related to previous PTA occurred ih one case (due to re-stenosis) and stroke unrelated tl? previous PTA occurred in two cases. Angiographic follow-up was performed in 31 cases after 41 successful PTA procedures. Re-stenosis was seen in 20% of the cases, symptomrltic complications occurred in 6%, and asymptomatic complications occurred in 6% of the cases. One case suffered severe subarachnoid hemorrhage just after the PTA due to preexisting aneurysm rupture and he died a week after the PTA. So mortality in this series was 2%. From the results described here, we may conclude that PTA of the intracranial or skull base cerebral artery is technically feasible, and it can be performed with relatively low risk. From our results, it may be a useful method and effective for long-term survival of patients. But results from a larger number of patients and more long-term follow-up data are still necessary in order to evaluate the safety and usefulness of this method.

  20. Long term follow up results of sequential left internal thoracic artery grafts on severe left anterior descending artery disease

    PubMed Central

    2010-01-01

    Purpose Several alternative procedures have been proposed to achieve complete revascularization in the presence of diffuse left anterior descending coronary artery (LAD) disease. With the extensive use of internal thoracic artery grafts in coronary artery bypass procedures, sequential anastomosis of the left internal thoracic artery (LITA) to LAD has gained popularity in these challenging cases. The long term results of sequential LITA to LAD anstomosis were examined in this study. Patients and Methods In order to determine the long term results of the sequential revascularization of LAD by LITA graft, 41 out of 49 patients operated between January 2001 and December 2005 were selected for control coronary arteriography. The median period for control coronary arteriography was 64 months. Results Seventy five anastomoses were found to be fully patent (91,46%) among the 82 sequential LITA anastomoses (41 LITA grafts) on the LAD at a median follow-up period of 64 months (53 to 123 months). Among the 41 LITA grafts used for this purpose, 36 were found intact (complete patency of the proximal and distal anastomoses) (87,8%). Two LITA grafts (4 anastomoses) were found to be totally occluded (4,87%). The proximal anastomosis of the LITA graft was observed to be 90% stenotic in one patient (1,21%). In one patient tight stenosis of the distal anastomosis line was observed (1,21%), while in another patient 70% narrowing of LITA lumen after the proximal anastomosis was detected (1,21%). Conclusion We strongly beleive that sequential LITA grafting of LAD is a safe alternative in the presence of severe LAD disease to achieve complete revascularization of the anterior myocardium with patency rates not much differing from conventional single LITA to LAD anastomosis. PMID:20958964

  1. Bladder Function Preservation With Brachytherapy, External Beam Radiation Therapy, and Limited Surger in Bladder Cancer Patients: Long-Term Results

    SciTech Connect

    Aluwini, Shafak; Rooij, Peter H.E. van; Kirkels, Wim J.; Boormans, Joost L.; Kolkman-Deurloo, Inger-Karina K.; Wijnmaalen, Arendjan

    2014-03-01

    Purpose: To report long-term results of a bladder preservation strategy for muscle-invasive bladder cancer (MIBC) using external beam radiation therapy and brachytherapy/interstitial radiation therapy (IRT). Methods and Materials: Between May 1989 and October 2011, 192 selected patients with MIBC were treated with a combined regimen of preoperative external beam radiation therapy and subsequent surgical exploration with or without partial cystectomy and insertion of source carrier tubes for afterloading IRT using low dose rate and pulsed dose rate. Data for oncologic and functional outcomes were prospectively collected. The primary endpoints were local recurrence-free survival (LRFS), bladder function preservation survival, and salvage cystectomy-free survival. The endpoints were constructed according to the Kaplan-Meier method. Results: The mean follow-up period was 105.5 months. The LRFS rate was 80% and 73% at 5 and 10 years, respectively. Salvage cystectomy-free survival at 5 and 10 years was 93% and 85%. The 5- and 10-year overall survival rates were 65% and 46%, whereas cancer-specific survival at 5 and 10 years was 75% and 67%. The distant metastases-free survival rate was 76% and 69% at 5 and 10 years. Multivariate analysis revealed no independent predictors of LRFS. Radiation Therapy Oncology Group grade ≥3 late bladder and rectum toxicity were recorded in 11 patients (5.7%) and 2 patients (1%), respectively. Conclusions: A multimodality bladder-sparing regimen using IRT offers excellent long-term oncologic outcome in selected patients with MIBC. The late toxicity rate is low, and the majority of patients preserve their functional bladder.

  2. Long-term treatment with PP2 after spinal cord injury resulted in functional locomotor recovery and increased spared tissue

    PubMed Central

    Rosas, Odrick R.; Torrado, Aranza I.; Santiago, Jose M.; Rodriguez, Ana E.; Salgado, Iris K.; Miranda, Jorge D.

    2014-01-01

    The spinal cord has the ability to regenerate but the microenvironment generated after trauma reduces that capacity. An increase in Src family kinase (SFK) activity has been implicated in neuropathological conditions associated with central nervous system trauma. Therefore, we hypothesized that a decrease in SFK activation by a long-term treatment with 4-amino-5-(4-chlorophenyl)-7-(t-butyl)pyrazolo[3,4-d]pyramidine (PP2), a selective SFK inhibitor, after spinal cord contusion with the New York University (NYU) impactor device would generate a permissive environment that improves axonal sprouting and/or behavioral activity. Results demonstrated that long-term blockade of SFK activation with PP2 increases locomotor activity at 7, 14, 21 and 28 days post-injury in the Basso, Beattie, and Bresnahan open field test, round and square beam crossing tests. In addition, an increase in white matter spared tissue and serotonin fiber density was observed in animals treated with PP2. However, blockade of SFK activity did not change the astrocytic response or infiltration of cells from the immune system at 28 days post-injury. Moreover, a reduced SFK activity with PP2 diminished Ephexin (a guanine nucleotide exchange factor) phosphorylation in the acute phase (4 days post-injury) after trauma. Together, these findings suggest a potential role of SFK in the regulation of spared tissue and/or axonal outgrowth that may result in functional locomotor recovery during the pathophysiology generated after spinal cord injury. Our study also points out that ephexin1 phosphorylation (activation) by SFK action may be involved in the repulsive microenvironment generated after spinal cord injury. PMID:25657738

  3. Speech and language development after cochlear implantation in children with bony labyrinth malformations: long-term results.

    PubMed

    Catli, Tolgahan; Uckan, Burcu; Olgun, Levent

    2015-11-01

    The aim of this study was to investigate speech and language development after long-term cochlear implantation in children with bony labyrinth malformations (BLMs) and to present the surgical findings in this group of patients. The auditory and linguistic skills of 21 children who had BLM were assessed in this study. They were implanted between 1998 and 2009. Twenty-two sex-matched and age-matched implantees without BLM were evaluated as the control group. To compare speech perception and speech intelligibility between the groups, the categories of auditory performance (CAP) test and speech intelligibility rating (SIR) test, respectively, were administered. The Turkish version of the Test of Early Language Development (TELD-3-T) was administered to evaluate and compare the linguistic skills of the groups. Surgical findings and complications were also analyzed. Implanted anomalies were common cavity in five patients, incomplete partition type 1 in 5 patients, and incomplete partition type 2 in 11 patients. The CAP and SIR scores were significantly higher in the control group (p < 0.05), but the TELD-3-T test scores were comparable among the groups (p > 0.05). Based on the specific type of malformation, the CAP and SIR scores were comparable between the subgroups (p > 0.05). No perioperative complications occurred in the control group. However, various perioperative complications (gusher, etc.) and surgical difficulty occurred in the anomaly group. The malformation group had unsatisfactory results with regard to speech perception skills; however, this group and the non-anomalous group exhibited comparable long-term results on linguistic development.

  4. Results of long-term carcinogenicity bioassays on Coca-Cola administered to Sprague-Dawley rats.

    PubMed

    Belpoggi, Fiorella; Soffritti, Morando; Tibaldi, Eva; Falcioni, Laura; Bua, Luciano; Trabucco, Francesca

    2006-09-01

    Coca-Cola was invented in May 1886 in Atlanta, Georgia by a pharmacist who, by accident or design, mixed carbonated water with the syrup of sugar, phosphoric acid, caffeine, and other natural flavors to create what is known as "the world's favorite soft drink." Coca-Cola is currently sold in more than 200 countries and in early 2000, the company sold its 10 billionth unit case of Coca-Cola branded products. Given the worldwide consumption of Coca-Cola, a project of experimental bioassays to study its long-term effects when administered as substitute for drinking water on male and female Sprague-Dawley rats was planned and executed. The objective of the project was to study whether and how long-term consumption of Coca-Cola affects the basic tumorigram of test animals. The bioassays were performed on rats beginning at different ages, namely: (a) on males and females exposed since embryonic life or from 7 weeks of age; and (b) on males and females exposed from 30, 39, or 55 weeks of age. Overall, the project included 1999 rats. During the biophase, data were collected on fluid and feed consumption, body weight, and survival. Animals were kept under observation until spontaneous death and underwent complete necropsy. The results indicate: (a) an increase in body weight in all treated animals; (b) a statistically significant increase of the incidence in females, both breeders and offspring, bearing malignant mammary tumors; (c) a statistically significant increase in the incidence of exocrine ademonas of the pancreas in both male and female breeders and offspring; and (d) an increased incidence, albeit not statistically significant, of pancreatic islet cell carcinomas in females, a malignant tumor which occurs very rarely in our historical controls. On the basis of the results of this study, excessive consumption of regular soft-drinks should be generally discouraged, in particular for children and adolescents.

  5. A possible long-term activity cycle for ι Horologii: First results from SPI-HKα project

    NASA Astrophysics Data System (ADS)

    Flores, Matías G.; Buccino, Andrea P.; Saffe, Carlos E.; Mauas, Pablo J. D.

    2017-02-01

    In order to detect stellar activity cycles and study possible star-planet interactions (SPIs), we have been developing the HKα and SPI-HKα projects since 1999 and 2012 respectively. In this work, we present preliminary results of possible SPIs from studies of chromospheric activity and look for possible correlations between stellar activity and stellar/planetary parameters. We find that for stars with a similar Teff, stellar activity increases with the mass of the planet, similar to results from previous works. However, stellar ages can also play a role, and a larger stellar sample is needed to verify these trends. We also note that some of these stars present a remarkably high level of chromospheric activity, comparable even with RSCvn or BY Dra active stars. In addition, we do not observe any correlation between stellar activity and semi-major axis. We present the first long-term activity study of the star ι Horologii, a young solar-type star that hosts a non-transiting Jovian planet and exhibits a high activity level. We analysed our own spectra, obtained between 2002 and 2015, in conjunction with public HARPS (High Accuracy Radial velocity Planet Searcher) observations. We calculated the Ca II indexes derived from the 987 Complejo Astronómico El Leoncito (CASLEO) and HARPS spectra and converted them to the Mt Wilson scale. We found a long-term activity cycle of ˜5 yr which fits the active sequence of Böhm-Vitense. The amplitude of this longer cycle is irregular, as was also observed for the shorter cycle. This phenomenon could be attributable to an antisymmetric distribution of active regions on the stellar surface.

  6. Evaluating long-term effects of heroin-assisted treatment: the results of a 6-year follow-up.

    PubMed

    Güttinger, Franziska; Gschwend, Patrick; Schulte, Bernd; Rehm, Jürgen; Uchtenhagen, Ambros

    2003-04-01

    Since January 1994, heroin-assisted treatment for opiate addicts has been available in Switzerland. This is the first report of the long-term effects of this form of treatment. The report examines subjects who entered a study involving medical prescription of opiates (Projekt zur ärztlichen Verschreibung von Betäubungsmitteln; PROVE) in Switzerland between January 1994 and March 1995 (n = 366). Opiates were dispensed in eight treatment centres. A follow-up was conducted 6 years after treatment entry. Two groups were assessed: clients who have continuously been on heroin-assisted treatment since entry into the PROVE study or who re-entered this treatment, and ex-clients who had discontinued heroin-assisted treatment at the time of follow-up. Two kinds of comparisons were conducted. Firstly, conditions at treatment entry were compared to 6-year follow-up outcomes, and secondly, outcomes were compared between clients still on heroin-assisted treatment and those who had been discharged. It was found that 46% of the clients still alive were on heroin-assisted treatment at the time of follow-up. A comparison of the present living conditions showed very little difference between those in treatment and those who had terminated treatment. Compared to the situation at entry, the results of the follow-up showed a significant decrease in the use of illegal substances, illegal income and most other variables concerning social conditions, but they also showed an increase in unemployment and reliance on social benefits. Heroin-assisted treatment is thus efficacious in the long-term course of treatment and is still effective after termination of treatment with respect to living conditions and use of illicit substances.

  7. Are the good functional results from arthroscopic repair of massive rotator cuff injuries maintained over the long term?☆

    PubMed Central

    Miyazaki, Alberto Naoki; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Checchia, Sérgio Luiz; Yonamine, Alexandre Maris

    2015-01-01

    Objective To evaluate whether the good and excellent functional results from arthroscopic repair of massive rotator cuff tears are maintained over the long term. Methods From the sample of the study conducted by our group in 2006, in which we evaluated the functional results from arthroscopic repair of massive rotator cuff tears, 35 patients were reassessed, 8 years after the first evaluation. The inclusion criteria were that these patients with massive rotator cuff tears operated by means of an arthroscopic technique, who participated in the previous study and achieved good or excellent outcomes according to the UCLA criteria. Patients whose results were not good or excellent in the first evaluation according to the UCLA criteria were excluded. Results Among the 35 patients reassessed, 91% of them continued to present good and excellent results (40% excellent and 51% good), while 3% presented fair results and 6% poor results. The time interval between the first and second evaluations was 8 years and the minimum length of follow-up since the immediate postoperative period was 9 years (range: 9–17 years), with an average of 11.4 years. Conclusion The good and excellent results from arthroscopic repair of massive rotator cuff tears were mostly maintained (91%), with the same level of function and satisfaction, even though 8 years had passed since the first assessment, with a follow-up period averaging 11.4 years. PMID:26962491

  8. Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective

    PubMed Central

    Deshpande, Sanjeev; Munoli, Amarnath

    2010-01-01

    Context: With the increasing emphasis on well-sculpted facial features, today there is a growing need for tools to augment the facial skeleton; either for cosmetic reasons or to re-contour deformities-congenital, post-traumatic and post-ablative. The limitations of autogenous materials has lead to evolution of numerous 'alloplasts', of which, high-density porous polyethylene (HDPE) seems to be a promising alternative. Aims: To evaluate the long term results of HDPE in facial skeletal augmentation in terms of achieving desired facial contour, patient satisfaction and complications. Settings: A tertiary care referral centre in a metropolitan set-up. Design: Case Series Materials and Methods: All patients undergoing HDPE implant insertion for facial skeletal augmentation between July 2001 and November 2009 were included in the study. A total of 70 HDPE implants were inserted in 44 patients. All procedures were performed by a single surgeon following standardized pre, intra and post-operative protocols. The results were evaluated with respect to improvement in facial contour desired and achieved, overall patient satisfaction and complications encountered. Results: The study included 44 patients with a male:female ratio of 1:1, a mean age of 25.09 years (14 to 58 years) and a mean follow-up of 45.34 months (0.5 to 100 months). HDPE implants were used to augment the nasal dorsum, maxilla, malar eminence, chin, mandibular body and angle, orbital rim and frontal region. The overall recontouring afforded by the HDPE implants was good, with most patients reporting satisfactory results. There were seven complications (10%), including three cases of deviation (4.29%), three cases of exposure (4.29%) and one case of sub-clinical infection (1.43%). None however necessitated implant removal. Nasal dorsal HDPE implants, especially those involving secondary surgery, suffered a much higher complication rate compared to other implants. Conclusions: HDPE is an alternative to

  9. Stereotactic radiosurgery for vestibular schwannomas: average 10-year follow-up results focusing on long-term hearing preservation.

    PubMed

    Watanabe, Shinya; Yamamoto, Masaaki; Kawabe, Takuya; Koiso, Takao; Yamamoto, Tetsuya; Matsumura, Akira; Kasuya, Hidetoshi

    2016-12-01

    OBJECTIVE The aim of this study was to reappraise long-term treatment outcomes of stereotactic radiosurgery (SRS) for vestibular schwannomas (VSs). The authors used a database that included patients who underwent SRS with a unique dose-planning technique, i.e., partial tumor coverage designed to avoid excess irradiation of the facial and cochlear nerves, focusing on tumor control and hearing preservation. Clinical factors associated with post-SRS tumor control and long-term hearing preservation were also analyzed. METHODS This institutional review board-approved, retrospective cohort study used the authors' prospectively accumulated database. Among 207 patients who underwent Gamma Knife SRS for VSs between 1990 and 2005, 183 (who were followed up for at least 36 post-SRS months) were studied. The median tumor volume was 2.0 cm(3) (range 0.05-26.2 cm(3)). The median prescribed dose at the tumor periphery was 12.0 Gy (range 8.8-15.0 Gy; 12.0 Gy was used in 171 patients [93%]), whereas tumor portions facing the facial and cochlear nerves were irradiated with 10.0 Gy. As a result, 72%-99% of each tumor was irradiated with the prescribed dose. The mean cochlear doses ranged from 2.3 to 5.7 Gy (median 4.1 Gy). RESULTS The median durations of imaging and audiometric follow-up were 114 months (interquartile range 73-144 months) and 59 months (interquartile range 33-109 months), respectively. Tumor shrinkage was documented in 110 (61%), no change in 48 (27%), and enlargement in the other 22 (12%) patients. A further procedure (FP) was required in 15 (8%) patients. Thus, the tumor growth control rate was 88% and the clinical control rate (i.e., no need for an FP) was 92%. The cumulative FP-free rates were 96%, 93%, and 87% at the 60th, 120th, and 180th post-SRS month, respectively. Six (3%) patients experienced facial pain, and 2 developed transient facial palsy. Serviceable hearing was defined as a pure tone audiogram result better than 50 dB. Among the 66 patients with

  10. Long-Term Care

    MedlinePlus

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  11. Results of the "Komplast" experiment on the long-term exposure of materials specimens on the ISS surface

    NASA Astrophysics Data System (ADS)

    Shumov, Andrey; Novikov, Lev

    The "Komplast" materials experiment was designed by the Khrunichev State Research and Production Space Center together with Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University and other Russian scientific institutes, and has been carried out since 1998. The aim of the experiment is to study the complex effects of space factors on specimens of various materials. Eight “Komplast” panels fitted with material specimens equipped UV-sensors and temperature sensors were located on the International Space Station (ISS) Functional Cargo Block (FGB) module exterior surface. The panels were sent into orbit with the FGB when it launched on November 20, 1998. Two of these panels were subsequently returned to Earth by Space Shuttle Discovery after 12 years of LEO exposure. The uniqueness of the "Komplast" experiment determined by long duration of open space exposure, which is much longer than in other similar experiments. For example LDEF: 1984-1990, МЕЕР (Space Station «Mir»): 1996-1997, MISSE-1, -2 (ISS): 1,5-2 years. In this work reveals laboratory research results of some materials specimens, which had been exposed on “Komplast” panels. A distinctive feature of this research was additional irradiation of specimens by atomic oxygen and electrons with energies of ~ 1-8 MeV in laboratory. In the interpretation of the experiment results was taken into account the specimens exposure temperature conditions on the ISS exterior surface and the conditions of their sunlit, defined by the above-mentioned sensors readings. Lot of attention was paid to the investigation of rubber materials specimens. The deformation, mechanical and relaxation characteristics were defined for the specimens. Also were investigations the seals-ability of model rubber seals after the long-term outer exposure. It was determined conservation volumetric deformation and relaxation characteristics of the exposed specimens and the localization of structural changes in the thin

  12. Long-Term Protection against Diphtheria in the Netherlands after 50 Years of Vaccination: Results from a Seroepidemiological Study

    PubMed Central

    Swart, E. M.; van Gageldonk, P. G. M.; de Melker, H. E.; van der Klis, F. R.; Berbers, G. A. M.; Mollema, L.

    2016-01-01

    Background and Aims To evaluate the National Immunisation Programme (NIP) a population-based cross-sectional seroepidemiological study was performed in the Netherlands. We assessed diphtheria antitoxin levels in the general Dutch population and in low vaccination coverage (LVC) areas where a relatively high proportion of orthodox Protestants live who decline vaccination based on religious grounds. Results were compared with a nationwide seroepidemiological study performed 11 years earlier. Methods In 2006/2007 a national serum bank was established. Blood samples were tested for diphtheria antitoxin IgG concentrations using a multiplex immunoassay for 6383 participants from the national sample (NS) and 1518 participants from LVC municipalities. A cut-off above 0.01 international units per ml (IU/ml) was used as minimum protective level. Results In the NS 91% of the population had antibody levels above 0.01 IU/ml compared to 88% in the 1995/1996 serosurvey (p<0.05). On average, 82% (vs. 78% in the 1995/1996 serosurvey, p<0.05) of individuals from the NS born before introduction of diphtheria vaccination in the NIP and 46% (vs. 37% in the 1995/1996 serosurvey, p = 0.11) of orthodox Protestants living in LVC areas had antibody levels above 0.01 IU/ml. Linear regression analysis among fully immunized individuals (six vaccinations) without evidence of revaccination indicated a continuous decline in antibodies in both serosurveys, but geometric mean antibodies remained well above 0.01 IU/ml in all age groups. Conclusions The NIP provides long-term protection against diphtheria, although antibody levels decline after vaccination. As a result of natural waning immunity, a substantial proportion of individuals born before introduction of diphtheria vaccination in the NIP lack adequate levels of diphtheria antibodies. Susceptibility due to lack of vaccination is highest among strictly orthodox Protestants. The potential risk of spread of diphtheria within the geographically

  13. Does ORIF of an OCD Loose Body Result in Healing and Long Term Maintenance of Knee Function?

    PubMed Central

    Magnussen, Robert A.; Carey, James L.; Spindler, Kurt P.

    2013-01-01

    Background Osteochondritis dissecans (OCD) can progress to loose body formation resulting in a Grade IV defect. The decision to fix versus excise the loose body is controversial. Published operative fixation outcomes are small case series with short follow-up. Hypothesis Operative fixation (ORIF) of the loose body into the grade IV defect will heal and approximate “normal” knee function at long-term follow-up. Study Design Case series Methods Twelve patients were identified who underwent ORIF of a knee OCD loose body into the Grade IV osteochondral defects ranging in size from 2.0 to 8.0 cm2 (mean 3.5 cm2). After 12 weeks, hardware was removed and healing was assessed. Long-term outcomes were assessed with a Knee injury and Osteoarthritis Outcome Score (KOOS) and a Marx activity score. Results Arthroscopy for screw removal revealed stable healing in 92% (11/12) of patients. No patients required subsequent surgery for a loose body. At an average of 9.2 years follow-up (range 3.8-15.8 years) 83 % (10/12) of patients completed the KOOS. KOOS subscale scores for pain (mean 87.8, range 67-100), other symptoms (mean 81.8, range 61-96), function in activities of daily living (mean 93.1, range 72-100), and sports and recreation function (mean 74.0, range 40-100) were not significantly lower than published age matched controls. However the KOOS subscale for knee related quality of life (mean 61.9, range 31-88) was significantly lower (p = 0.003). Conclusions Operative fixation of Grade IV OCD loose bodies results in stable fixation. At an average 9 years after surgery, patients did not have symptoms of osteoarthritis pain and had normal function in activities of daily life. However, patients reported significantly lower knee related quality of life. Operative fixation of OCD loose bodies is a better alternative to lesion excision. PMID:19204369

  14. Long Term Effectiveness on Prescribing of Two Multifaceted Educational Interventions: Results of Two Large Scale Randomized Cluster Trials

    PubMed Central

    Magrini, Nicola; Formoso, Giulio; Capelli, Oreste; Maestri, Emilio; Nonino, Francesco; Paltrinieri, Barbara; Giovane, Cinzia Del; Voci, Claudio; Magnano, Lucia; Daya, Lisa; Marata, Anna Maria

    2014-01-01

    Introduction Information on benefits and risks of drugs is a key element affecting doctors’ prescribing decisions. Outreach visits promoting independent information have proved moderately effective in changing prescribing behaviours. Objectives Testing the short and long-term effectiveness on general practitioners’ prescribing of small groups meetings led by pharmacists. Methods Two cluster open randomised controlled trials (RCTs) were carried out in a large scale NHS setting. Ad hoc prepared evidence based material were used considering a therapeutic area approach - TEA, with information materials on osteoporosis or prostatic hyperplasia - and a single drug oriented approach - SIDRO, with information materials on me-too drugs of 2 different classes: barnidipine or prulifloxacin. In each study, all 115 Primary Care Groups in a Northern Italy area (2.2 million inhabitants, 1737 general practitioners) were randomised to educational small groups meetings, in which available evidence was provided together with drug utilization data and clinical scenarios. Main outcomes were changes in the six-months prescription of targeted drugs. Longer term results (24 and 48 months) were also evaluated. Results In the TEA trial, one of the four primary outcomes showed a reduction (prescription of alfuzosin compared to tamsulosin and terazosin in benign prostatic hyperplasia: prescribing ratio −8.5%, p = 0.03). Another primary outcome (prescription of risedronate) showed a reduction at 24 and 48 months (−7.6%, p = 0.02; and −9,8%, p = 0.03), but not at six months (−5.1%, p = 0.36). In the SIDRO trial both primary outcomes showed a statistically significant reduction (prescription of barnidipine −9.8%, p = 0.02; prescription of prulifloxacin −11.1%, p = 0.04), which persisted or increased over time. Interpretation These two cluster RCTs showed the large scale feasibility of a complex educational program in a NHS setting, and its potentially

  15. Induced damage in Carrara Marble as a result of long-term low-magnitude environmental stresses

    NASA Astrophysics Data System (ADS)

    Voigtlaender, Anne; Leith, Kerry; Krautblatter, Michael; Walter, Jens M.

    2015-04-01

    Damage of intact rock is commonly driven by the interaction of long-term low-magnitude external environmental stresses in combination with surface chemistry, rather than short-term loading in excess of intact rock strength. In order to determine the contribution of environmental stresses to the propagation of micro- and macroscopic fractures under natural environmental conditions we undertook long-term three-point bending tests on large size Carrara Marble specimens. The interaction of mechanical stresses induced by external loading and corrosive conditions (e.g. the presence of water) at the tip of a pre-existing crack is termed stress corrosion. We investigate stress corrosion below saw cut notches in wet and dry samples of Carrara Marble (M1-5, each 10cm x 10cm x 110cm). These were pre-loaded to about 66% of their assumed ultimate strength (determined by the fracture toughness (Kic) calculated for the crack tip). Two marble beams (M1, M3) were initially loaded to 22% and three (M2, M4, M5) to 55% of Kic. CaC03 saturated water was continuously dripped in the notch of samples --M1-4 to create corrosive conditions, while M5 was kept dry. After a three-week bedding period, loading on sample M1 was increased to 55%, M2 and M5 to 77% and M3 and M4 to 85% of Kic respectively. The tests were interrupted prior to failure of the specimens in order to allow the assessment of the crack-tip structure. During the testing period we used classical strain gages and acoustic emission sensors to measure strain and elastic stress changes through coda wave interferometry. Temperature and humidity were monitored and the outflowing fluid was collected for future analysis, throughout. The effect of induced damage on residual intrinsic stresses was evaluated using neutron diffraction on the SALSA instrument at the Institute Laue-Langevin (ILL, Grenoble, France), while texture measurements were undertaken using the X-ray goniometer at the Geoscience Center, University Göttingen, and

  16. Mean PB To Failure - Initial results from a long-term study of disk storage patterns at the RACF

    NASA Astrophysics Data System (ADS)

    Caramarcu, C.; Hollowell, C.; Rao, T.; Strecker-Kellogg, W.; Wong, A.; Zaytsev, S. A.

    2015-12-01

    The RACF (RHIC-ATLAS Computing Facility) has operated a large, multi-purpose dedicated computing facility since the mid-1990’s, serving a worldwide, geographically diverse scientific community that is a major contributor to various HEPN projects. A central component of the RACF is the Linux-based worker node cluster that is used for both computing and data storage purposes. It currently has nearly 50,000 computing cores and over 23 PB of storage capacity distributed over 12,000+ (non-SSD) disk drives. The majority of the 12,000+ disk drives provide a cost-effective solution for dCache/XRootD-managed storage, and a key concern is the reliability of this solution over the lifetime of the hardware, particularly as the number of disk drives and the storage capacity of individual drives grow. We report initial results of a long-term study to measure lifetime PB read/written to disk drives in the worker node cluster. We discuss the historical disk drive mortality rate, disk drive manufacturers' published MPTF (Mean PB to Failure) data and how they are correlated to our results. The results help the RACF understand the productivity and reliability of its storage solutions and have implications for other highly-available storage systems (NFS, GPFS, CVMFS, etc) with large I/O requirements.

  17. a New Site at Central Amazonia Dedicated to Long Term Cloud Properties Observations - Description, First Results and Future Perspectives.

    NASA Astrophysics Data System (ADS)

    Pauliquevis, T.; Barbosa, H. M.; Adams, D. K.; Artaxo, P.; Cirino, G. G.; Barja Gonzalez, B.; Correia, A. L.; Gomes, H. B.; Gouveia, D. A.; Padua, M. B.; Rosario, N. M. E. D.; Souza, R. A. F. D.; Nascimento dos Santos, R. M.; Sapucci, L.; Portela, B. T.

    2014-12-01

    Amazon basin during the wet season is one of the few places on Earth where "natural atmosphere", as it is expected to be in pre-industrial era, can be observed. Atmosphere in clean Amazonia can be regarded as a baseline state of tropical atmosphere. Its hydrological cycle is extreme active, as well as its convection. Several scientific questions with respect to convection remain unclear. Diurnal cycle of convection is far from adequately represented in numeric models. Precipitation typically occurs in models in the first few hours in the morning, whereas actual rain occurs mostly in the early afternoon. Convection parameterizations lack the ability to represent it adequately due to the models coarse resolution of parameterizations compared to the spatial scale of shallow convection. An adequate comprehension of shallow to deep convection transition is critical to improve convection representation in models. To reach this goal, long term measurements that could characterize clouds and convection diurnal cycle are fundamental. The implementation of ACONVEX (Atmospheric CONVection EXperiment) site, situated 50 km upwind from the megacity of Manaus ( -2.894263S°, -59.971452W) aims to fill the existent gap in long term measurements. It is designed to make measurements for more than 10 yrs, and characterize cloud properties in a climatological perspective. The site started its operation in August, 2011, initially with the Raman Lidar. Present time instrumentation set comprises: 1) UV Lidar Raman, 2) CIMEL Sunphotometer, 3) MultiFilter shadow band Radiometer (MFR), 4) GNSS/GPS Receiver, 5) Vertical Pointing Radar, 6) Disdrometer, 7) Ceilometer, 8) Met station. Two sky imagers and a microwave radiometer are about to be operated and will be able to derive 1) Cloud Cover, 2) Cloud Top and Cloud Base Heights, 3) Liquid Water Content, 4) Integrated Precipitable Water, 5) PBL Height, 6) Rain Rate (vertical profile and at surface). In this poster we discuss the site in more

  18. AMMA-CATCH a Hydrological, Meteorological and Ecological Long Term Observatory on West Africa : Some Recent Results

    NASA Astrophysics Data System (ADS)

    Galle, S.; Grippa, M.; Peugeot, C.; Bouzou Moussa, I.; Cappelaere, B.; Demarty, J.; Mougin, E.; Lebel, T.; Chaffard, V.

    2015-12-01

    AMMA-CATCH is a multi-scale observation system dedicated to long-term monitoring of the water cycle, the vegetation dynamics and their interaction with climate and water resources in West Africa. In the context of the global change, long-term observations are required to i) gain understanding in eco-hydrological processes over this highly contrasted region, ii) help their representation in Earth System Models, and iii) detect trends and infer their impacts on water resources and living conditions. It is made of three meso-scale sites (~ 1°x1°) in Mali, Niger and Benin, extending along the West African eco-climatic gradient. Within this regional window (5° by 9°), each of the three sites comprises a multi-scale set-up which helps documenting the components of the hydrologic budget and the evolutions of the surface conditions over a range of time scales: raingages, piezometers, river discharge stations, soil moisture and temperature profiles, turbulent fluxes measurements, LAI/biomass monitoring. This observation system has been continuously generating coherent datasets for 10 to 25 years depending on the datasets. It is jointly operated by French and African (Mali, Niger and Benin) research institutions. The data-base is available to the community through the website (www.amma-catch.org). AMMA-CATCH is a member of the French critical zone observatory network "Réseau des Bassins Versants", (RBV). AMMA-CATH participates to several global or regional observation networks, such as FluxNet, CarboAfrica, International Soil Moisture Networks (ISMN) and to calibration/validation campaigns for satellite missions such as SMOS (CNES, ESA), MEGHA-TROPIQUES (France/India) or SWAP(NASA). AMMA-CATCH fills a gap over a region, West Africa, where environmental data are largely lacking, and thus, it can usefully contribute to the international networking effort for environmental monitoring and research. Recent results on regional evolution of land cover, rainfall intensity and

  19. ARE PROTO-PLANETARY NEBULAE SHAPED BY A BINARY? RESULTS OF A LONG-TERM RADIAL VELOCITY STUDY

    SciTech Connect

    Hrivnak, Bruce J.; Lu Wenxian; Bohlender, David; Morris, S. C.; Woodsworth, Andrew W.; Scarfe, C. D. E-mail: wen.lu@valpo.edu E-mail: David.Bohlender@nrc-cnrc.gc.ca

    2011-06-10

    The shaping of the nebula is currently one of the outstanding unsolved problems in planetary nebula (PN) research. Several mechanisms have been proposed, most of which require a binary companion. However, direct evidence for a binary companion is lacking in most PNs. We have addressed this problem by obtaining precise radial velocities of seven bright proto-planetary nebulae (PPNs), objects in transition from the asymptotic giant branch to the PN phases of stellar evolution. These have F-G spectral types and have the advantage over PNs of having more and sharper spectral lines, leading to better precision. Our observations were made in two observing intervals, 1991-1995 and 2007-2010, and we have included in our analysis some additional published and unpublished data. Only one of the PPNs, IRAS 22272+5435, shows a long-term variation that might tentatively be attributed to a binary companion, with P > 22 yr, and from this, limiting binary parameters are calculated. Selection effects are also discussed. These results set significant restrictions on the range of possible physical and orbital properties of any binary companions: they have periods greater than 25 yr or masses of brown dwarfs or super-Jupiters. While not ruling out the binary hypothesis, it seems fair to say that these results do not support it.

  20. Long-term exposure to benzalkonium chloride disinfectants results in change of microbial community structure and increased antimicrobial resistance.

    PubMed

    Tandukar, Madan; Oh, Seungdae; Tezel, Ulas; Konstantinidis, Konstantinos T; Pavlostathis, Spyros G

    2013-09-03

    The effect of benzalkonium chlorides (BACs), a widely used class of quaternary ammonium disinfectants, on microbial community structure and antimicrobial resistance was investigated using three aerobic microbial communities: BACs-unexposed (DP, fed a mixture of dextrin/peptone), BACs-exposed (DPB, fed a mixture of dextrin/peptone and BACs), and BACs-enriched (B, fed only BACs). Long-term exposure to BACs reduced community diversity and resulted in the enrichment of BAC-resistant species, predominantly Pseudomonas species. Exposure of the two microbial communities to BACs significantly decreased their susceptibility to BACs as well as three clinically relevant antibiotics (penicillin G, tetracycline, ciprofloxacin). Increased resistance to BACs and penicillin G of the two BACs-exposed communities is predominantly attributed to degradation or transformation of these compounds, whereas resistance to tetracycline and ciprofloxacin is largely due to the activity of efflux pumps. Quantification of several key multidrug resistance genes showed a much higher number of copies of these genes in the DPB and B microbial communities compared to the DP community. Collectively, our findings indicate that exposure of a microbial community to BACs results in increased antibiotic resistance, which has important implications for both human and environmental health.

  1. Long-Term Results from Evaluation of Advanced New Construction Packages in Test Homes: Lake Elsinore, Californi

    SciTech Connect

    Stecher, D.; Brozyna, K.

    2013-08-01

    This report presents the long-term evaluation results from a hot-dry climate project that examines the room-to-room temperature conditions that exist in a high performance envelope, the performance of a simplified air distribution system, and a comparison of modeled energy performance with measured energy use. The project, a prototype house built by K. Hovnanian Homes’ Ontario Group, is located in Lake Elsinore, Riverside County, California, and achieves a 50% level of whole house source energy savings with respect to the Building America (BA) Benchmark Definition 2009 (Hendron and Engebrecht 2010). Temperature measurements in three rooms indicate that the temperature difference between the measured locations and the thermostat were within recommendations 90.3% of the time in heating mode and 99.3% of the time in cooling mode. The air distribution system is operating efficiently with average delivered temperatures adequate to facilitate proper heating and cooling and only minor average temperature differences observed between the system’s plenum and farthest register. Monitored energy use results for the house indicate that it is using less energy than predicted from modeling. A breakdown of energy use according to end use determined little agreement between comparable values.

  2. REVIEW OF RESULTS FOR THE OECD/NEA PHASE VII BENCHMARK: STUDY OF SPENT FUEL COMPOSITIONS FOR LONG TERM DISPOSAL

    SciTech Connect

    Radulescu, Georgeta; Wagner, John C

    2011-01-01

    This paper summarizes the problem specification and compares participants results for the OECD/NEA/WPNCS Expert Group on Burn-up Credit Criticality Safety Phase VII Benchmark Study of Spent Fuel Compositions for Long-Term Disposal. The Phase VII benchmark was developed to study the ability of relevant computer codes and associated nuclear data to predict spent fuel isotopic compositions and corresponding keff values in a cask configuration over the time duration relevant to spent nuclear fuel (SNF) disposal. The benchmark was divided into two sets of calculations: (1) decay calculations out to 1,000,000 years for provided pressurized-water-reactor (PWR) UO2 discharged fuel compositions and (2) burnup credit criticality calculations for a representative cask model at selected time steps. Contributions from 15 organizations and companies in 10 countries were submitted to the Phase VII benchmark exercise. This paper provides a description of the Phase VII benchmark and detailed comparisons of the participants isotopic compositions and keff values that were calculated with a diversity of computer codes and nuclear data sets. Differences observed in the calculated time-dependent nuclide densities are attributed to different decay data or code-specific numerical approximations. The variability of the keff results is consistent with the evaluated uncertainty associated with cross-section data.

  3. Long-term PAH monitoring results from the Anacostia River active capping demonstration using polydimethylsiloxane (PDMS) fibers.

    PubMed

    Lampert, David J; Lu, Xiaoxia; Reible, Danny D

    2013-03-01

    In this paper, the long-term monitoring results for hydrophobic organic compounds, specifically polycyclic aromatic hydrocarbons (PAHs), from a field demonstration of capping contaminated sediments at the Anacostia River in Washington DC are presented and analyzed. In situ pore water concentrations in field-contaminated sediments in the demonstration caps were quantified using a polydimethylsiloxane (PDMS)-based passive sampling device. High resolution vertical pore water concentration profiles were measured using the device and were used to infer fate and transport of polycyclic aromatics hydrocarbons (PAHs) at the site. The derived pore water concentrations were compared with observed bioaccumulation and solid-phase concentration profiles to infer contaminant migration rates and mechanisms. Observed pore water concentrations were found to be a better predictor of bioaccumulation than solid-phase concentrations. Solid-phase concentrations were low in cores which implied containment of contamination; however pore water profiles showed that contaminant migration had occurred in the first few years after cap placement. The discrepancy is the result of the low sorption capacity of the sand. Because of surface re-contamination, low sorption capacity in the demonstration caps and strong tidal pumping effects, steady state contaminant profiles were reached in the caps several years after placement. Despite re-contamination at the surface, steady state concentrations in the capped areas showed decreased contamination levels relative to the control area.

  4. Long-Term Results from Evaluation of Advanced New Construction Packages in Test Homes: Lake Elsinore, California

    SciTech Connect

    Stecher, D.; Brozyna, K.

    2013-08-01

    This report presents the long-term evaluation results from a hot-dry climate project that examines the room-to-room temperature conditions that exist in a high performance envelope, the performance of a simplified air distribution system, and a comparison of modeled energy performance with measured energy use. The project, a prototype house built by K. Hovnanian Homes' Ontario Group, is located in Lake Elsinore, Riverside County, California, and achieves a 50% level of whole house source energy savings with respect to the Building America (BA) Benchmark Definition 2009 (Hendron and Engebrecht 2010). Temperature measurements in three rooms indicate that the temperature difference between the measured locations and the thermostat were within recommendations 90.3% of the time in heating mode and 99.3% of the time in cooling mode. The air distribution system is operating efficiently with average delivered temperatures adequate to facilitate proper heating and cooling and only minor average temperature differences observed between the system's plenum and farthest register. Monitored energy use results for the house indicate that it is using less energy than predicted from modeling. A breakdown of energy use according to end use determined little agreement between comparable values.

  5. SOARCA Peach Bottom Atomic Power Station Long-Term Station Blackout Uncertainty Analysis: Convergence of the Uncertainty Results

    SciTech Connect

    Bixler, Nathan E.; Osborn, Douglas M.; Sallaberry, Cedric Jean-Marie; Eckert-Gallup, Aubrey Celia; Mattie, Patrick D.; Ghosh, S. Tina

    2014-02-01

    This paper describes the convergence of MELCOR Accident Consequence Code System, Version 2 (MACCS2) probabilistic results of offsite consequences for the uncertainty analysis of the State-of-the-Art Reactor Consequence Analyses (SOARCA) unmitigated long-term station blackout scenario at the Peach Bottom Atomic Power Station. The consequence metrics evaluated are individual latent-cancer fatality (LCF) risk and individual early fatality risk. Consequence results are presented as conditional risk (i.e., assuming the accident occurs, risk per event) to individuals of the public as a result of the accident. In order to verify convergence for this uncertainty analysis, as recommended by the Nuclear Regulatory Commission’s Advisory Committee on Reactor Safeguards, a ‘high’ source term from the original population of Monte Carlo runs has been selected to be used for: (1) a study of the distribution of consequence results stemming solely from epistemic uncertainty in the MACCS2 parameters (i.e., separating the effect from the source term uncertainty), and (2) a comparison between Simple Random Sampling (SRS) and Latin Hypercube Sampling (LHS) in order to validate the original results obtained with LHS. Three replicates (each using a different random seed) of size 1,000 each using LHS and another set of three replicates of size 1,000 using SRS are analyzed. The results show that the LCF risk results are well converged with either LHS or SRS sampling. The early fatality risk results are less well converged at radial distances beyond 2 miles, and this is expected due to the sparse data (predominance of “zero” results).

  6. Unconventional Implant Placement IV. Implant Placement through Impacted Teeth to Avoid Invasive Surgery. Long-term Results of 3 Cases.

    PubMed

    Mithridade, Davarpanah; Serge, Szmukler-Moncler; Keyvan, Davarpanah; Nedjoua, Capelle-Ouadah; Georgy, Demurashvili; Philippe, Rajzbaum

    2015-01-01

    This paper presents the long-term data of patients that have been treated with an unconventional implant placement protocol to avoid an invasive surgery when edentulism was caused by an impacted tooth. In 2009, the follow-up of this unconven-tional protocol was 2 to 3.5 years; this article documents now the long-term 5- to 8-year follow-up of 3 patients and 5 im-plants. Over this period of time, implant stability was maintained without complications. This unconventional protocol opens intriguing possibilities; however, more patients with long-term follow-up are warranted before endorsing it in routine appli-cation. Nonetheless, it might suggest that there is still room to revisit one of the leading concepts in dental implantology.

  7. What happens in an estuary doesn't stay there: patterns of biotic connectivity resulting from long term ecological research

    USGS Publications Warehouse

    Mather, Martha E.; Finn, John T.; Kennedy, Christina G.; Deegan, Linda A.; Smith, Joseph M.

    2013-01-01

    The paucity of data on migratory connections and an incomplete understanding of how mobile organisms use geographically separate areas have been obstacles to understanding coastal dynamics. Research on acoustically tagged striped bass (Morone saxatilis) at the Plum Island Ecosystems (PIE) Long Term Ecological Research site, Massachusetts, documents intriguing patterns of biotic connectivity (i.e., long-distance migration between geographically distinct areas). First, the striped bass tagged at PIE migrated southward along the coast using different routes. Second, these tagged fish exhibited strong fidelity and specificity to PIE. For example, across multiple years, tagged striped bass resided in PIE waters for an average of 1.5-2.5 months per year (means: 51-72 days; range 2-122 days), left this estuary in fall, then returned in subsequent years. Third, this specificity and fidelity connected PIE to other locations. The fish exported nutrients and energy to at least three other coastal locations through biomass added as growth. These results demonstrate that what happens in an individual estuary can affect other estuaries. Striped bass that use tightly connected routes to feed in specific estuaries should have greater across-system impacts than fish that are equally likely to go anywhere. Consequently, variations in when, where, and how fish migrate can alter across-estuary impacts.

  8. Long-term monitoring of sleep apnea at home in heart failure patients: preliminary results from the HHH study.

    PubMed

    Pinna, G D; Maestri, R; Gobbi, E; Capomolla, S; Campana, C; Emdin, M; Di Lenarda, A; La Rovere, M T; Andrews, D; Johnson, P; Mortara, A; Sleight, P

    2004-01-01

    Sleep apnea is very common in patients with chronic heart failure (CHF) and has important implications in terms of morbidity, mortality and clinical management. Home respiratory telemonitoring might constitute a potential low-cost, widely-applicable alternative to traditional polysomnography in the evaluation and long-term monitoring of breathing disorders in these patients. In this paper we briefly describe the technological infrastructure and present preliminary results of the European Community multicountry trial HHH (Home or Hospital in Heart Failure), which is currently testing a novel system for home telemonitoring of cardiorespiratory signals in CHF patients. The recording and transmitting devices are suitable to be self-managed by the patient. We give a detailed report on the prevalence of nocturnal respiratory disorders at the beginning of the one-year follow-up and on their persistency over the following recordings (one per month). These preliminary findings clearly indicate that intermittent home telemonitoring of respiratory signals based on patient's self-management is feasible in CHF patients and the compliance is high. Reported statistics unambiguously confirm the high prevalence of nocturnal breathing disorders in these patients and clearly show that this phenomenon tends to persist over time.

  9. Benzene, an experimental multipotential carcinogen: results of the long-term bioassays performed at the Bologna Institute of Oncology.

    PubMed Central

    Maltoni, C; Ciliberti, A; Cotti, G; Conti, B; Belpoggi, F

    1989-01-01

    In 1976, a systematic and integrated project of long-term carcinogenicity bioassays began at the Bentivoglio Experimental Unit of the Bologna Institute of Oncology. The Bologna experiments proved for the first time that benzene is an experimental carcinogen. These experiments demonstrated that benzene is carcinogenic when administered by ingestion and by inhalation and that it cause tumors in the various tested animal models (Sprague-Dawley rats, Wistar rats, Swiss mice, and RF/J mice). They also showed that benzene is a multipotential carcinogen, as it produces a variety of neoplasias in one or more of the tested animal models, including Zymbal gland carcinomas, carcinomas of the oral cavity, nasal cavities, skin, forestomach, and mammary glands, as well as angiosarcomas of the liver, hemolymphoreticular neoplasias, tumors of the lung, and possibly hepatomas. The Bologna experiments also indicated a clear-cut dose-response relationship in benzene carcinogenesis. This report presents the up-to-date results of the Bologna project. The need for more experimental research aimed at assessing the carcinogenic effects of low doses of benzene, of chemical mixtures containing benzene, and of benzene substitutes is emphasized. Also recommended are more comprehensive epidemiological investigations, extended to all types of malignancies, with particular regard to lung carcinomas. PMID:2792037

  10. Image and role of the consultant dietitian in long-term care: results from a survey of three Midwestern States.

    PubMed

    Finn, S C; Foltz, M B; Ryan, A S

    1991-07-01

    Consultant dietitians and other health care professionals in three states were surveyed to determine the image and role of consultant dietitians in long-term care. Data were derived from telephone interviews with nursing home personnel in Illinois, Indiana, and Ohio. Chi 2 Analysis was used to determine whether health professionals' perceived image and job functions of consultant dietitians were significantly different from the perceptions of consultant dietitians. Overall, respondents held positive views of consultant dietitians. More than half of the respondents said the image of consultant dietitians had improved over the past 5 years. More than half of nursing directors, dietitians, dietary managers, and medical directors responded that consultant dietitians spent adequate time in facilities to do their jobs. Results of the study indicate that consultant dietitians believe that they are viewed by other health professionals as they actually are: competent, knowledgeable, well-respected, and involved in direct patient care functions. The next challenge is for more consultant dietitians to build on this base and become proactive, developing strong franchises and more opportunities for the profession.

  11. Predictors of acculturative hassles among Vietnamese refugees in Norway: Results from a long-term longitudinal study.

    PubMed

    Tingvold, Laila; Vaage, Aina Basilier; Allen, James; Wentzel-Larsen, Tore; van Ta, Thong; Hauff, Edvard

    2015-10-01

    We investigated acculturative hassles in a community cohort of Vietnamese refugees in Norway (n = 61), exploring cross-sectional data and longitudinal predictors of acculturative hassles using data from their arrival in Norway in 1982 (T1), with follow up in 1985 (T2) and in 2005-2006 (T3). To our knowledge, this is the first longitudinal study of predictors of acculturative hassles in a refugee population. Results indicated that more communication problems and less Norwegian language competence were related to most hassles at T3. Higher psychological distress, lower quality of life, lower self-reported state of health, and less education at T3 were associated with higher levels of hassles at T3. More psychological distress at T2 and less education at arrival (T1) were significant predictors for more acculturative hassles at T3. These data suggest that addressing psychological distress during the early phase in a resettlement country may promote long-term refugee adjustment and, in particular, reduce exposure to acculturative hassles.

  12. Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

    SciTech Connect

    Bhat, Rajesh McBride, Kieran; Chakraverty, Sam; Vikram, Raghunandan; Severn, Alison

    2007-11-15

    Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary stenosis in 21 patients, recurrent lesions in 15, and immature fistulas in 5. A PCB was used alone in 17 cases, but was followed by a larger standard balloon in 33 cases. Follow-up included ultrasound, flow analysis and urea reduction ratio, and ranged from 2 to 30 months (mean 14 months). Results. The technical success rate was 98%. All procedures were relatively painless. Two PCBs burst and 4 leaked, but without causing any morbidity. Nineteen fistulas were still working at last follow-up. Primary patency rates at 6, 12, and 24 months using Kaplan-Meier analysis were 88%, 73%, and 34%, respectively, and the primary assisted patencies were 90%, 75%, and 50%, respectively. Conclusion. PCB angioplasty has high technical success and low complication rates. The long-term patency rates are favorable for PCB angioplasty and compare favorably with other series.

  13. Long-term reduction in (137)Cs concentration in food crops on coral atolls resulting from potassium treatment.

    PubMed

    Robison, William L; Stone, E L; Hamilton, T F; Conrado, C L

    2006-01-01

    Bikini Island was contaminated on March 1, 1954 by the Bravo detonation (U.S. nuclear test series, Castle) at Bikini Atoll. About 90% of the estimated dose from nuclear fallout to potential island residents is from cesium-137 ((137)Cs) transferred from soil to plants that are consumed by residents. Thus, radioecology research efforts have been focused on removing (137)Cs from soil and/or reducing its uptake into vegetation. Most effective was addition of potassium (K) to soil that reduces (137)Cs concentration in fruits to 3-5% of pretreatment concentrations. Initial observations indicated this low concentration continued for some time after K was last applied. Long-term studies were designed to evaluate this persistence in more detail because it is very important to provide assurance to returning populations that (137)Cs concentrations in food (and, therefore, radiation dose) will remain low for extended periods, even if K is not applied annually or biennially. Potassium applied at 300, 660, 1260, and 2070 kg ha(-1) lead to a (137)Cs concentration in drinking-coconut meat that is 34, 22, 10, and about 4% of original concentration, respectively. Concentration of (137)Cs remains low 8-10 y after K is last applied. An explanation for this unexpected result is discussed.

  14. Mid-to long-term results of revision total hip replacement in patients aged 50 years or younger.

    PubMed

    Lee, P T H; Lakstein, D L; Lozano, B; Safir, O; Backstein, J; Gross, A E

    2014-08-01

    Revision total hip replacement (THR) for young patients is challenging because of technical complexity and the potential need for subsequent further revisions. We have assessed the survivorship, functional outcome and complications of this procedure in patients aged < 50 years through a large longitudinal series with consistent treatment algorithms. Of 132 consecutive patients (181 hips) who underwent revision THR, 102 patients (151 hips) with a mean age of 43 years (22 to 50) were reviewed at a mean follow-up of 11 years (2 to 26) post-operatively. We attempted to restore bone stock with allograft where indicated. Using further revision for any reason as an end point, the survival of the acetabular component was 71% (sd 4) and 54% (sd 7) at ten- and 20 years. The survival of the femoral component was 80% (sd 4) and 62% (sd 6) at ten- and 20 years. Complications included 11 dislocations (6.1%), ten periprosthetic fractures (5.5%), two deep infections (1.1%), four sciatic nerve palsies (2.2%; three resolved without intervention, one improved after exploration and freeing from adhesions) and one vascular injury (0.6%). The mean modified Harris Hip Score was 41 (10 to 82) pre-operatively, 77 (39 to 93) one year post-operatively and 77 (38 to 93) at the latest review. This overall perspective on the mid- to long-term results is valuable when advising young patients on the prospects of revision surgery at the time of primary replacement.

  15. Long-Term Reduction in 137Cs Concentration in Food Crops on Coral Atolls Resulting from Potassium Treatment

    SciTech Connect

    Robison, W; Stone, E; Hamilton, T; Conrado, C

    2005-04-08

    Bikini Island was contaminated March 1, 1954 by the Bravo detonation (U.S nuclear test series, Castle) at Bikini Atoll. About 90% of the estimated dose from nuclear fallout to potential island residents is from cesium-137 ({sup 137}Cs) transferred from soil to plants that are consumed by residents. Thus, radioecology research efforts have been focused on removing {sup 137}Cs from soil and/or reducing its uptake into vegetation. Most effective was addition of potassium (K) to soil that reduces {sup 137}Cs concentration in fruits to 3-5% of pretreatment concentrations. Initial observations indicated this low concentration continued for some time after K was last applied. Long-term studies were designed to evaluate this persistence in more detail because it is very important to provide assurance to returning populations that {sup 137}Cs concentrations in food (and, therefore, radiation dose) will remain low for extended periods, even if K is not applied annually or biennially. Potassium applied at 300, 660, 1260, and 1970 kg ha{sup -1} lead to a {sup 137}Cs concentration in drinking coconut meat that is 34, 22, 10, and about 4 % of original concentration, respectively. Concentration of {sup 137}Cs remains low 8 to 10 y after K is last applied. An explanation for this unexpected result is discussed.

  16. Long-Term Reduction in 137Cs Concentration in Food Crops on Coral Atolls Resulting from Potassium Treatment

    SciTech Connect

    Robison, W L; Stone, E L; Hamilton, T F; Conrado, C L

    2004-04-14

    Bikini Island was contaminated March 1, 1954 by the Bravo detonation (U.S nuclear test series, Castle) at Bikini Atoll. About 90% of the estimated dose from nuclear fallout to potential island residents is from cesium-137 ({sup 137}Cs) transferred from soil to plants that are consumed by residents. Thus, radioecology research efforts have been focused on removing {sup 137}Cs from soil and/or reducing its uptake into vegetation. Most effective was addition of potassium (K) to soil that reduces {sup 137}Cs concentration in fruits to 3-5% of pretreatment concentrations. Initial observations indicated this low concentration continued for some time after K was last applied. Long-term studies were designed to evaluate this persistence in more detail because it is very important to provide assurance to returning populations that {sup 137}Cs concentrations in food (and, therefore, radiation dose) will remain low for extended periods, even if K is not applied annually or biennially. Potassium applied at 300, 660, 1260, and 2070 kg ha{sup -1} lead to a {sup 137}Cs concentration in drinking coconut meat that is 34, 22, 10, and about 4% of original concentration, respectively. Concentration of {sup 137}Cs remains low 8 to 10 y after K is last applied. An explanation for this unexpected result is discussed.

  17. Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long-term follow up study.

    PubMed Central

    Weir, C. J.; Murray, G. D.; Dyker, A. G.; Lees, K. R.

    1997-01-01

    OBJECTIVE: To determine whether raised plasma glucose concentration independently influences outcome after acute stroke or is a stress response reflecting increased stroke severity. DESIGN: Long-term follow up study of patients admitted to an acute stroke unit. SETTING: Western Infirmary, Glasgow. SUBJECTS: 811 patients with acute stroke confirmed by computed tomography. Analysis was restricted to the 750 non-diabetic patients. MAIN OUTCOME MEASURES: Survival time and placement three months after stroke. RESULTS: 645 patients (86%) had ischaemic stroke and 105 patients (14%) haemorrhagic stroke. Cox's proportional hazards modelling with stratification according to Oxfordshire Community Stroke Project categories identified increased age (relative hazard 1.36 per decade; 95% confidence interval 1.21 to 1.53), haemorrhagic stroke (relative hazard 1.67; 1.22 to 2.28), time to resolution of symptoms > 72 hours (relative hazard 2.15; 1.15 to 4.05), and hyperglycaemia (relative hazard 1.87; 1.43 to 2.45) as predictors of mortality. The effect of glucose concentration on survival was greatest in the first month. CONCLUSIONS: Plasma glucose concentration above 8 mmol/l after acute stroke predicts a poor prognosis after correcting for age, stroke severity, and stroke subtype. Raised plasma glucose concentration is therefore unlikely to be solely a stress response and should arguably be treated actively. A randomised trial is warranted. PMID:9158464

  18. A long-term study of 277 cases of equine sinonasal disease. Part 2: treatments and results of treatments.

    PubMed

    Tremaine, W H; Dixon, P M

    2001-05-01

    The treatments of 277 horses with equine sinonasal disease (1984-1996), described by Tremaine and Dixon (2001), are reported here. Long-term (median duration 24 months) outcomes of treatment of the more common disorders were good, with 92% of horses with sinonasal mycosis, 84% with primary sinusitis, 82% with sinus cysts, 78% with dental sinusitis and 75% with sinonasal trauma reported to have complete remission of clinical signs. However, only 33% of horses with progressive ethmoidal haematoma (PEH) and 12% with sinonasal neoplasia reported long term remission of clinical signs.

  19. The medical heritage concept: a model for assuring comparable laboratory results in long-term longitudinal studies.

    PubMed

    Copeland, B E; Pesce, A J

    1992-01-01

    The success of a three or four decade health monitoring program depends upon the constancy and stability of the laboratory measurement data. This paper describes a prospective model which has been implemented as part of a 30-year health care program developed for the benefit of a particular group of residents who have lived for more than two years within five miles of an industrial plant which processed uranium metal and contaminated the surrounding area. Effective long-term laboratory monitoring (20 to 40 years) requires (1) a stable analytical base to establish comparability of all data collected, (2) innovative computer based record keeping, and (3) two selected reference populations which reflect method bias and widespread population change bias. To meet this need for comparability, the long-term Medical Heritage comparability concept was developed. This is an approach to the determination, storage, and retrieval of the laboratory data obtained on each specific participant in such a manner that all of that participant's data are internally comparable and continually traceable to definitive and/or reference methods developed by the National Institute for Standards and Technology and the Centers for Disease Control and the National Committee for Clinical Laboratory Standards. Systematic long-term documentation differentiates the Medical Heritage 30 to 40 year concept from the current short-term two- to three-year data continuity systems. As a model for long-term medical monitoring, the Medical Heritage comparability concept gives validity to individual patient care monitoring decisions.

  20. The Results of Short-Term Bilingual Exchanges Keep on Ticking: Long-Term Impacts of Brief Bilingual Exchanges

    ERIC Educational Resources Information Center

    Mady, Callie

    2011-01-01

    This article presents the long-term impacts of brief bilingual (English/French) exchanges as identified by past exchange participants through questionnaire and interview responses. The findings indicate that former exchange participants (a) have confidence in their language abilities, (b) continue to use their second language, (c) choose leisure…

  1. Long-term results of Tokyo Children's Cancer Study Group trials for childhood acute lymphoblastic leukemia, 1984-1999.

    PubMed

    Tsuchida, M; Ohara, A; Manabe, A; Kumagai, M; Shimada, H; Kikuchi, A; Mori, T; Saito, M; Akiyama, M; Fukushima, T; Koike, K; Shiobara, M; Ogawa, C; Kanazawa, T; Noguchi, Y; Oota, S; Okimoto, Y; Yabe, H; Kajiwara, M; Tomizawa, D; Ko, K; Sugita, K; Kaneko, T; Maeda, M; Inukai, T; Goto, H; Takahashi, H; Isoyama, K; Hayashi, Y; Hosoya, R; Hanada, R

    2010-02-01

    We report the long-term results of Tokyo Children's Cancer Study Group's studies L84-11, L89-12, L92-13, and L95-14 for 1846 children with acute lymphoblastic leukemia, which were conducted between 1984 and 1999. The value of event-free survival (EFS)+/-s.e. was 67.2+/-2.2% at 10 years in L84-11, which was not improved in the following two studies, and eventually improved to 75.0+/-1.8% at 10 years in L95-14 study. The lower EFS of the L89-12 reflected a high rate of induction failure because of infection and delayed remission in very high-risk patients. The L92-13 study was characterized by short maintenance therapy; it resulted in poor EFS, particularly in the standard-risk (SR) group and boys. Females did significantly better than males in EFS in the early three studies. The gender difference was not significant in overall survival, partly because >60% of the males survived after the testicular relapse. Randomized studies in the former three protocols revealed that intermediate- or high-dose methotrexate therapy significantly reduced the testicular relapse rate. In the L95-14 study, gender difference disappeared in EFS. Contrary to the results of larger-scale studies, the randomized control study in the L95-14 reconfirmed with updated data that dexamethasone 8 mg/m(2) had no advantage over prednisolone 60 mg/m(2) in the SR and intermediate-risk groups. Prophylactic cranial irradiation was assigned to 100, 80, 44, and 44% of the patients in the studies, respectively. Isolated central nervous system relapse rates decreased to <2% in the last two trials. Secondary brain tumors developed in 12 patients at 8-22 years after cranial irradiation. Improvement of the remission induction rates and the complete omission of irradiation are currently main objectives in our studies.

  2. Long-Term Results of Brachytherapy With Temporary Iodine-125 Seeds in Children With Low-Grade Gliomas

    SciTech Connect

    Korinthenberg, Rudolf; Neuburger, Daniela; Trippel, Michael; Ostertag, Christoph; Nikkhah, Guido

    2011-03-15

    Purpose: To retrospectively review the results of temporary I-125 brachytherapy in 94 children and adolescents with low-grade glioma. Methods and Materials: Treatment was performed in progressive tumors roughly spherical in shape with a diameter of up to 5 cm, including 79 astrocytomas, 5 oligodendrogliomas, 4 oligoastrocytomas, 1 ependymoma, and 5 other tumors. Location was suprasellar/chiasmal in 44, thalamic/basal ganglia in 18, hemispheric in 15, midbrain/pineal region in 13, and lower brainstem in 3. Initially, 8% of patients were free of symptoms, 47% were symptomatic but not disabled, and 30% were slightly, 6% moderately, and 3% severely disabled. Results: 5- and 10-year survival was 97% and 92%. The response to I-125 brachytherapy over the long term was estimated after a median observation period of 38.4 (range, 6.4-171.0) months. At that time, 4 patients were in complete, 27 in partial, and 18 in objective remission; 15 showed stable and 30 progressive tumors. Treatment results did not correlate with age, sex, histology, tumor size, location, or demarcation of the tumor. Secondary treatment became necessary in 36 patients, including 19 who underwent repeated I-125 brachytherapy. At final follow-up, the number of symptom-free patients had risen to 21%. Thirty-eight percent showed symptoms without functional impairment, 19% were slightly and 11% moderately disabled, and only 4% were severely disabled. Conclusions: Response rates similar to those of conventional radiotherapy or chemotherapy can be anticipated with I-125 brachytherapy in tumors of the appropriate size and shape. We believe it to be a useful contribution to the treatment of low-grade gliomas in children.

  3. Early Significant Tumor Volume Reduction After Radiosurgery in Brain Metastases From Renal Cell Carcinoma Results in Long-Term Survival

    SciTech Connect

    Kim, Wook Ha; Kim, Dong Gyu; Han, Jung Ho; Paek, Sun Ha; Chung, Hyun-Tai; Park, Chul-Kee; Kim, Chae-Yong; Kim, Yong Hwy; Kim, Jin Wook; Jung, Hee-Won

    2012-04-01

    Purpose: To retrospectively evaluate survival of patients with brain metastasis from renal cell carcinoma (RCC) after radiosurgery. Patients and Methods: Between 1998 and 2010, 46 patients were treated with radiosurgery, and the total number of lesions was 99. The mean age was 58.9 years (range, 33-78 years). Twenty-six patients (56.5%) had a single brain metastasis. The mean tumor volume was 3.0 cm{sup 3} (range, 0.01-35.1 cm{sup 3}), and the mean marginal dose prescribed was 20.8 Gy (range, 12-25 Gy) at the 50% isodose line. A patient was classified into the good-response group when the sum of the volume of the brain metastases decreased to less than 75% of the original volume at a 1-month follow-up evaluation using MRI. Results: As of December 28, 2010, 39 patients (84.8%) had died, and 7 (15.2%) survived. The overall median survival time was 10.0 {+-} 0.4 months (95% confidence interval, 9.1-10.8). After treatment, local tumor control was achieved in 72 (84.7%) of the 85 tumors assessed using MRI after radiosurgery. The good-response group survived significantly longer than the poor-response group (median survival times of 18.0 and 9.0 months, respectively; p = 0.025). In a multivariate analysis, classification in the good-response group was the only independent prognostic factor for longer survival (p = 0.037; hazard ratio = 0.447; 95% confidence interval, 0.209-0.953). Conclusions: Radiosurgery seems to be an effective treatment modality for patients with brain metastases from RCC. The early significant tumor volume reduction observed after radiosurgery seems to result in long-term survival in RCC patients with brain metastases.

  4. Ecological Controls on Biogeochemical Fluxes in the Western Antarctic Peninsula: Long-Term Observations and Inverse Food Web Model Results

    NASA Astrophysics Data System (ADS)

    Ducklow, H. W.; Sailley, S. F.; Stammerjohn, S. E.; Saba, G. K.; Doney, S. C.

    2014-12-01

    Sea ice in the Western Antarctic Peninsula (WAP) region is both highly variable and rapidly changing. In the Palmer Station region, the ice season duration has decreased by 92 days since 1978. The sea-ice changes affect ocean stratification and freshwater balance; and in turn impact every component of the polar marine ecosystem. Long-term observations from the WAP shelf region show a pattern of chlorophyll (Chl) variability with three to five years of negative Chl anomalies interrupted by one or two years of positive anomalies. Observations and results from an inverse food-web model show that these low and high Chl regimes differed significantly from each other, with high primary productivity and net community production (NCP) associated with the high Chl years and vice-versa. Gross primary production averaged 40 mmolC m-2 d-1 in the low Chl years and 100 mmolC m-2 d-1 in the high Chl years, with 30-40% going to NCP across regimes. Only the food web in the southern region in high Chl years was dominated by large phytoplankton and krill, whereas in in all other cases, foodwebs were dominated by small phytoplankton and microzooplankton. These contrasts were strongest between the northern, low Chl years and southern, high Chl years, consistent with earlier north to south observations of sea ice and ecosystem change along the WAP. The relative importance of major bulk carbon flows did not differ substantially between high and low Chl years. Both the northern/low Chl and southern/high Chl regimes had roughly equal proportions of NCP, although its composition reflected shifts in dominance by large versus small plankton. These results suggest that food webs dominated by smaller phytoplankton and grazers have pathways that funnel production into NCP, and likely, export.

  5. Breast-Conserving Treatment in the Elderly: Long-Term Results of Adjuvant Hypofractionated and Normofractionated Radiotherapy

    SciTech Connect

    Kirova, Youlia M. Campana, Francois; Savignoni, Alexia; Laki, Fatima; Muresan, Marius; Dendale, Remi; Bollet, Marc A.; Salmon, Remy J.; Fourquet, Alain

    2009-09-01

    Purpose: To evaluate the long-term cause-specific survival (CSS), locoregional recurrence-free survival (LRFS), and metastases-free survival (MFS) in elderly breast cancer patients receiving adjuvant normofractionated (NF) or hypofractionated (HF) radiotherapy (RT). Methods and Materials: Between 1995 and 1999, 367 women aged {>=}70 years with nonmetastatic Stage T1 or T2 tumors were treated by breast-conserving surgery and adjuvant RT at the Institut Curie. They underwent wide tumor excision with or without lymph node dissection followed by RT. They received either a NF-RT schedule, which delivered a total dose of 50 Gy (25 fractions, 5 fractions weekly) to the whole breast, followed by a boost to the tumor bed when indicated, or a HF-RT schedule, which delivered a total dose of 32.5 Gy (five fractions of 6.5 Gy, once weekly) with no subsequent boost. The HF-RT schedule was indicated for the more elderly patients. Results: A total of 317 patients were in the NF-RT group, with 50 in the HF-RT group. The median follow-up was 93 months (range, 9-140). The 5- and 7-year CSS, LRFS, and MFS rates were similar in both groups. The 5-year NF-RT and HF-RT rate was 96% and 95% for CSS, 95% and 94% for LRFS, and 94% and 95% for MFS, respectively. The 7-year NF-RT and HF-RT rate was 93% and 87% for CSS, 93% and 91% for LRFS, and 92% and 93% for MFS, respectively. Conclusion: According to the findings from this retrospective study, the HF-RT schedule is an acceptable alternative to NF-RT for elderly patients. However, large-scale prospective randomized trials are needed to confirm these results.

  6. Spot Scanning-Based Proton Therapy for Intracranial Meningioma: Long-Term Results From the Paul Scherrer Institute

    SciTech Connect

    Weber, Damien C.; Schneider, Ralf; Goitein, Gudrun; Koch, Tamara; Ares, Carmen; Geismar, Jan H.; Schertler, Andreas; Bolsi, Alessandra; Hug, Eugen B.

    2012-07-01

    Background: To assess the long-term clinical results of spot scanning proton therapy (PT) in the treatment of intracranial meningiomas. Patients and Methods: Thirty-nine patients with meningioma (histologically proven 34/39) were treated with PT between July 1997 and January 2010. Thirty-two (82.1%) patients were treated as primary treatment (exclusive PT, n = 8; postoperative PT, n = 24). Mean age was 48.3 {+-} 17.9 years and 32 (82.1%) patients had skull base lesions. For patients undergoing surgery, 24 patients had a diagnosis of World Health Organization (WHO) Grade I and 10 of a WHO Grade II/III meningioma, respectively. The female-to-male ratio was 3.3. The median administered dose was 56.0 Gy (relative biologic effectiveness [RBE]) (range, 52.2-66.6) at 1.8-2.0 Gy (RBE) per fraction. Gross tumor volume (GTV) ranged from 0.76 to 546.5 cm{sup 3} (median, 21.5). Late toxicity was assessed according to Common Terminology Criteria for Adverse Events version 3.0. Mean follow-up time was 62.0 months and all patients were followed for >6 months. Results: Six patients presented with tumor recurrence and 6 patients died during follow-up, of which 4 of tumor progression. Five-year actuarial local control and overall survival rates were 84.8% and 81.8%, respectively, for the entire cohort and 100% for benign histology. Cumulative 5-year Grade {>=}3 late toxicity-free survival was 84.5%. On univariate analysis, LC was negatively influenced by WHO grade (p = 0.001), GTV (p = 0.013), and male gender (p = 0.058). Conclusions: PT is a safe and effective treatment for patients with untreated, recurrent, or incompletely resected intracranial meningiomas. WHO grade and tumor volume was an adverse prognostic factor for local control.

  7. Lymphoid irradiation in intractable rheumatoid arthritis. Long-term followup of patients treated with 750 rads or 2,000 rads

    SciTech Connect

    Soden, M.; Hassan, J.; Scott, D.L.; Hanly, J.G.; Moriarty, M.; Whelan, A.; Feighery, C.; Bresnihan, B.

    1989-05-01

    Twenty patients with intractable rheumatoid arthritis were randomized to receive 750 or 2,000 rads of lymphoid irradiation (LI) in a double-blind comparative study, and were followed for a maximum of 48 months (mean 40 months) after treatment. During followup, sustained immunomodulation (including lymphopenia, particularly of the T helper cell subset; reduced ratio of helper cells to suppressor cells; and impaired in vitro lymphocyte proliferation in response to phytohemagglutinin and pokeweed mitogen) was observed. Significant improvements in early morning stiffness, Ritchie articular index, pain score, grip strength, and 15-meter walk time were observed in both treatment groups, but these were not sustained through the followup period. Progressive joint damage was observed radiologically in both groups during followup. Thus, LI induced sustained immunosuppression, but resulted in only short-lived clinical improvement and was associated with progressive joint erosion in these patients.

  8. Results from long-term detection of mixing layer height: ceilometer and comparison with Radio-Acoustic Sounding System

    NASA Astrophysics Data System (ADS)

    Schäfer, Klaus; Emeis, Stefan; Jahn, Carsten; Tuma, Michael; Münkel, Christoph; Suppan, Peter

    2012-11-01

    The mixing layer height (MLH) is an important factor which influences exchange processes of ground level emissions. The continuous knowledge of MLH is supporting the understanding of processes directing air quality. If the MLH is located near to the ground, which occurs mainly during winter and night-time, air pollution can be high due to a strongly limited air mass dilution. Since 2006 different methods for long-term continuous remote sensing of mixing layer height (MLH) are operated in Augsburg. The Vaisala ceilometers LD40 and CL31 are used which are eye-safe commercial mini-lidar systems. The ceilometer measurements provide information about the range-dependent aerosol concentration; gradient minima within this profile mark the borders of mixed layers. Special software for these ceilometers provides routine retrievals of lower atmosphere layering from vertical profiles of laser backscatter data. The radiosonde data from the station Oberschleissheim near Munich (about 50 km away from Augsburg city) are also used for MLH determination. The profile behavior of relative humidity (strong decrease) and virtual potential temperature (inversion) of the radiosonde agree mostly well with the MLH indication from ceilometer laser backscatter density gradients. A RASS (Radio-Acoustic Sounding System) from Metek is applied which detects the height of a turbulent layer characterized by high acoustic backscatter intensities due to thermal fluctuations and a high variance of the vertical velocity component as well as the vertical temperature profile from the detection of acoustic signal propagation and thus temperature inversions which mark atmospheric layers. These data of RASS measurements are the input for a software-based determination of MLH. A comparison of the results of the remote sensing methods during simultaneous measurements was performed. The information content of the different remote sensing instruments for MLH in dependence from different weather classes was

  9. Long-term results of combined liver-kidney transplantation for primary hyperoxaluria type 1: the French experience.

    PubMed

    Compagnon, Philippe; Metzler, Philippe; Samuel, Didier; Camus, Christophe; Niaudet, Patrick; Durrbach, Antoine; Lang, Philippe; Azoulay, Daniel; Duvoux, Christophe; Bayle, Francois; Rivalan, Joseph; Merville, Pierre; Pascal, Gerard; Thervet, Eric; Bensman, Albert; Rostaing, Lionel; Deschenes, Georges; Morcet, Jeff; Feray, Cyrille; Boudjema, Karim

    2014-12-01

    Primary hyperoxaluria type 1 (PH1) is a hepatic metabolic defect leading to end-stage renal failure. The posttransplant recurrence of kidney disease can suggest a need for combined liver-kidney transplantation (LKT). However, the risk of LKT is theoretically far higher than the risk of kidney-alone transplantation (KAT). An unselected consecutive series of 54 patients with PH1 was analyzed according to the type of transplantation initially performed between May 1979 and June 2010 at 10 French centers. The duration of dialysis, extrarenal lesions, age, and follow-up were similar between the groups. Postoperative morbidity and mortality did not differ between the groups, and 10-year patient survival rates were similar for the LKT (n = 33) and KAT groups (n = 21; 78% versus 70%). Kidney graft survival at 10 years was better after LKT (87% versus 13%, P < .001) . Four patients (12.1%) lost their first kidney graft in the LKT group, whereas 19 (90%) did in the KAT group (P < .001). The recurrence of oxalosis occurred in 11 renal grafts (52%) in the KAT group but in none in the LKT group (P < .001). End-stage renal failure resulting from rejection was also higher in the KAT group (19% versus 9%, P < 0.0001). A second kidney transplant was performed for 15 patients (71%) in the KAT group versus 4 patients (12%) in the LKT group (P < 0.001). In conclusion, LKT for PH1 provides better kidney graft survival, less rejection, and similar long-term patient survival and is not associated with an increased short-term mortality risk. LKT must be the first-line treatment for PH1 patients with end-stage renal disease.

  10. Predictors of Long-Term Results After Treatment of Iliac Artery Obliteration by Transluminal Angioplasty and Stent Deployment

    SciTech Connect

    Funovics, M.A.; Lackner, B.; Cejna, M.; Peloschek, P.; Sailer, J.; Philipp, M.O.; Maca, T.; Ahmadi, A.; Minar, E.; Lammer, J.

    2002-10-15

    Purpose: To investigate initial and long-term success rate after percutaneous treatment of iliac artery occlusion with angioplasty and stent deployment. To investigate the influence of vascular comorbidity, lesion length, stent placement and lesion coverage as possible predictors of outcome. Methods: Between January 1994 and December 1999, 80 iliac recanalizations were performed on 78 patients, median age 61.1 {+-}11.5 (SD) years. All patients were followed up by clinical examinations, duplex ultrasound and intravenous digital subtraction angiography. Mean follow-up time was 2.0 {+-} 1.53 (SD) years.Multivariate Cox regression analysis was used to determine the influence of cofactors on patency. Results: One, 2 and 4 years after recanalization, primary patency was 78.1%, 74.5% and 64.0%; secondary patency was 88.8%, 88.8% and 77.9%, respectively.Patients with shorter occlusions, complete lesion coverage and patent ipsilateral femoral arteries had significantly longer patency rates.Complications included inguinal hematoma (n=1), technical failure (n=3) aortic dissection (n=1), embolic occlusions (n=7), gluteal claudication (n=1) and genital necrosis after subsequent urethral surgery in one patient with contralateral occlusion and ipsilateral overstenting of the internal iliac artery with subsequent stenosis. Complications were of permanent clinical significance in seven of 78 (9%) of the patients. In 17 (22%) cases, percutaneous reintervention was performed with angioplasty in the stent (n=16) or deployment of a new stent (n=1). Conclusion: Endoluminal stent placement has its place in an interdisciplinary therapeutic approach as a viable therapeutic alternative to major transabdominal bypass surgery and can be performed with comparable complication rates. Patients with short occlusions, patent femoral arteries, and stents covering the entire occlusion have significant longer patency.

  11. Posttraumatic severe infection of the ankle joint - long term results of the treatment with resection arthrodesis in 133 cases.

    PubMed

    Kienast, Benjamin; Kiene, J; Gille, J; Thietje, R; Gerlach, U; Schulz, A P

    2010-02-26

    Although there is a clear trend toward internal fixation for ankle arthrodesis, there is general consensus that external fixation is required for cases of posttraumatic infection. We retrospectively evaluated the technique and clinical long term results of external fixation in a triangular frame for cases of posttraumatic infection of the ankle. From 1993 to 2006 a consecutive series of 155 patients with an infection of the ankle was included in our study. 133 cases of the advanced "Gächter" stage III and IV were treated with arthrodesis. We treated the patients with a two step treatment plan. After radical debridement and sequestrectomy the malleoli and the joint surfaces were resected. An AO fixator was applied with two Steinmann-nails inserted in the tibia and in the calcaneus and the gap was temporary filled with gentamicin beads as the first step. In the second step we performed an autologous bone graft after a period of four weeks. The case notes were evaluated regarding trauma history, medical complaints, further injuries and illnesses, walking and pain status and occupational issues. Mean age at the index procedure was 49.7 years (18-82), 104 patients were male (67.1%). Follow up examination after mean 4.5 years included a standardised questionnaire and a clinical examination including the criteria of the AOFAS-Score and radiographs. 92.7% of the cases lead to a stable arthrodesis. In 5 patients the arthrodesis was found partly-stable. In six patients (4,5%) the infection was not controllable during the treatment process. These patients had to be treated with a below knee amputation. The mean AOFAS score at follow up was 63.7 (53-92). Overall there is a high degree of remaining disability. The complication rate and the reduced patient comfort reserve this method mainly for infection. Joint salvage is possible in the majority of cases with an earlier stage I and II infection.

  12. Ultrafine particles in four European urban environments: Results from a new continuous long-term monitoring network

    NASA Astrophysics Data System (ADS)

    Hofman, J.; Staelens, J.; Cordell, R.; Stroobants, C.; Zikova, N.; Hama, S. M. L.; Wyche, K. P.; Kos, G. P. A.; Van Der Zee, S.; Smallbone, K. L.; Weijers, E. P.; Monks, P. S.; Roekens, E.

    2016-07-01

    To gain a better understanding on the spatiotemporal variation of ultrafine particles (UFPs) in urban environments, this study reports on the first results of a long-term UFP monitoring network, set up in Amsterdam (NL), Antwerp (BE), Leicester (UK) and London (UK). Total number concentrations and size distributions were assessed during 1-2 years at four fixed urban background sites, supplemented with mobile trailer measurements for co-location monitoring and additional short-term monitoring sites. Intra- and interurban spatiotemporal UFP variation, associations with commonly-monitored pollutants (PM, NOx and BC) and impacts of wind fields were evaluated. Although comparable size distributions were observed between the four cities, source-related differences were demonstrated within specific particle size classes. Total and size-resolved particle number concentrations showed clear traffic-related temporal variation, confirming road traffic as the major UFP contributor in urban environments. New particle formation events were observed in all cities. Correlations with typical traffic-related pollutants (BC and NOx) were obtained for all monitoring stations, except for Amsterdam, which might be attributable to UFP emissions from Schiphol airport. The temporal variation in particle number concentration correlated fairly weakly between the four cities (rs = 0.28-0.50, COD = 0.28-0.37), yet improved significantly inside individual cities (rs = 0.59-0.77). Nevertheless, considerable differences were still obtained in terms of particle numbers (20-38% for total particle numbers and up to 49% for size-resolved particle numbers), confirming the importance of local source contributions and the need for careful consideration when allocating UFP monitoring stations in heterogeneous urban environments.

  13. Long-term results of paclitaxel plus cisplatin with concurrent radiotherapy for loco-regional esophageal squamous cell carcinoma

    PubMed Central

    Zhu, Han-Ting; Ai, Da-Shan; Tang, Hua-Rong; Badakhshi, Harun; Fan, Jian-Hong; Deng, Jia-Ying; Zhang, Jun-Hua; Chen, Yun; Zhang, Zhen; Xia, Yi; Guo, Xiao-Mao; Jiang, Guo-Liang; Zhao, Kuai-Le

    2017-01-01

    AIM To evaluate the long-term effectiveness and late toxicities of paclitaxel (PTX) plus cisplatin (DDP) with concurrent radiotherapy for locally advanced esophageal squamous cancer. METHODS Between 2008 and 2011, 76 patients were enrolled in a phase II study on the treatment of loco-regionally advanced esophageal cancer with radiotherapy (68.4 Gy/44 fractions or 61.2 Gy/34 fractions) combined with 4-cycle chemotherapy consisting of DDP (25 mg/m2 per day for 3 d) and PTX (175 mg/m2 for 3 h). The primary endpoints were overall survival and progression-free survival, and the secondary endpoints were toxicity and the treatment failure pattern. RESULTS A total of 76 patients were enrolled in this study, of whom 63.2% finished the whole regimen. The 5-year survival rates for the per-protocol population and intent-to-treat population were 25.4% and 26.4%, respectively, and the median survival rates were 23.7 mo and 28.5 mo, respectively. Grade 3 or 4 late toxicity was observed in only one patient (heart failure). In log-rank analysis, the pretreatment stage (stage II + III: 36.1 mo vs stage IV: 14.9 mo) and the completed cycle (1-3 cycles: 16.1 mo vs 4 cycles: 35.5 mo) were significant prognostic factors (P = 0.037 < 0.05 and P = 0.013 < 0.05). CONCLUSION Radiotherapy combined with chemotherapy consisting of PTX and DDP is a safe and effective definitive treatment for loco-regionally advanced esophageal squamous cancer. PMID:28210091

  14. Ultrasound-guided percutaneous needle electrolysis in chronic lateral epicondylitis: short-term and long-term results

    PubMed Central

    Valera-Garrido, Fermín; Minaya-Muñoz, Francisco; Medina-Mirapeix, Francesc

    2014-01-01

    Background Ultrasound (US)-guided percutaneous needle electrolysis (PNE) is a novel minimally invasive approach which consists of the application of a galvanic current through an acupuncture needle. Objective To evaluate the clinical and ultrasonographic effectiveness of a multimodal programme (PNE, eccentric exercise (EccEx) and stretching) in the short term for patients with chronic lateral epicondylitis, and to determine whether the clinical outcomes achieved decline over time. Methods A one-way repeated measures study was performed in a clinical setting in 36 patients presenting with lateral epicondylitis. The patients received one session of US-guided PNE per week over 4–6 weeks, associated with a home programme of EccEx and stretching. The main outcome measures were severity of pain, disability (Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire), structural tendon changes (US), hypervascularity and patients’ perceptions of overall outcome. Measurements at 6, 26 and 52 weeks follow-up included recurrence rates (increase in severity of pain or disability compared with discharge), perception of overall outcome and success rates. Results All outcome measures registered significant improvements between pre-intervention and discharge. Most patients (n=30, 83.3%) rated the overall outcome as ‘successful’ at 6 weeks. The ultrasonographic findings showed that the hypoechoic regions and hypervascularity of the extensor carpi radialis brevis changed significantly. At 26 and 52 weeks, all participants (n=32) perceived a ‘successful’ outcome. Recurrence rates were null after discharge and at follow-up at 6, 26 and 52 weeks. Conclusions Symptoms and degenerative structural changes of chronic lateral epicondylitis are reduced after US-guided PNE associated with EccEx and stretching, with encouragingly low recurrences in the mid to long term. Trial registration number ClinicalTrials.gov identifier: NCT02085928. PMID:25122629

  15. Soil microbial community changes as a result of long-term exposure to a natural CO 2 vent

    NASA Astrophysics Data System (ADS)

    Oppermann, B. I.; Michaelis, W.; Blumenberg, M.; Frerichs, J.; Schulz, H. M.; Schippers, A.; Beaubien, S. E.; Krüger, M.

    2010-05-01

    The capture and geological storage of CO 2 can be used to reduce anthropogenic greenhouse gas emissions. To assess the environmental impact of potential CO 2 leakage from deep storage reservoirs on the abundance and functional diversity of microorganisms in near-surface terrestrial environments, a natural CO 2 vent (>90% CO 2 in the soil gas) was studied as an analogue. The microbial communities were investigated using lipid biomarkers combined with compound-specific stable carbon isotope analyses, the determination of microbial activities, and the use of quantitative polymerase chain reactions (Q-PCR). With this complementary set of methods, significant differences between the CO 2-rich vent and a reference site with a normal CO 2 concentration were detected. The δ 13C values of the plant and microbial lipids within the CO 2 vent demonstrate that substantial amounts of geothermal CO 2 were incorporated into the microbial, plant, and soil carbon pools. Moreover, the numbers of Archaea and Bacteria were highest at the reference site and substantially lower at the CO 2 vent. Lipid biomarker analyses, Q-PCR, and the determination of microbial activities showed the presence of CO 2-utilising methanogenic Archaea, Geobacteraceae, and sulphate-reducing Bacteria (SRB) mainly at the CO 2 vent, only minor quantities were found at the reference site. Stable carbon isotopic analyses revealed that the methanogenic Archaea and SRB utilised the vent-derived CO 2 for assimilatory biosynthesis. Our results show a shift in the microbial community towards anaerobic and acidophilic microorganisms as a consequence of the long-term exposure of the soil environment to high CO 2 concentrations.

  16. Spatial and temporal distribution of the dust deposition in Central Asia - results from a long term monitoring program

    NASA Astrophysics Data System (ADS)

    Groll, M.; Opp, Chr.; Aslanov, I.

    2013-06-01

    The aeolian transport of dust is an important process in Central Asia. Anthropogenic desertification and the desiccation of the Aral Sea have increased the overall dust emission and transport from this region and the local dust storm frequency during the last decades. Reliable ground data, however, are collected only sporadically, so the knowledge about the spatial and temporal distribution and dynamics of the dust deposition in the Aral Sea basin is fragmented and inconsistent at best. A long-term monitoring program was installed and sustained by three research projects. The results included in this article cover the dust deposition between 2003 and 2010 from 21 stations in Uzbekistan, Kazakhstan, and Turkmenistan. They confirm that the aeolian dust transport occurs mainly in the Southern direction. The highest average monthly deposition rate was registered in Uzbekistan (56.2 g m-2), while the percentage of months with a very intense (and potentially harmful) dust deposition flux was highest in Turkmenistan (36.4%). A majority of samples were collected during months with a dust deposition of less than 10.0 g m-2, while only 6% of all samples showed high monthly deposition intensities of more than 100 g m-2. The Kyzyl Kum, Kara Kum, and Aral Kum were identified as the main sources for aeolian dust in the Aral Sea basin. The impact of the Aral Kum as the dominant source of aeolian dust is limited to a region of approximately 500,000 km2 surrounding the former Aral Sea. The Kara Kum is characterized by a very high frequency of dust storms of a local and regional magnitude, and close to the Kyzyl Kum, monthly dust deposition rates of up to 9,600 g m-2 were registered. An analysis of the temporal distribution of the dust deposition showed a slight increase in the dust deposition activity and intensity between 2003 and 2010, with a strong inter-annual and seasonal dynamic. The highest average dust deposition was registered in June, and a second phase of intense dust

  17. Suppression of T cells results in long-term survival of mouse heart xenografts in C6-deficient rats.

    PubMed

    Wu, G; Korsgren, O; van Rooijen, N; Tibell, A

    2001-11-01

    The present study aimed to investigate the role of cellular immune response in the absence of membrane attack complex (MAC) formation in the concordant mouse-to-rat heart xenografting. Hearts from BALB/c mice were transplanted into the neck vessels of C6-competent (C6(+)) and C6-deficient (C6(-)) PVG rats. Liposome-encapsulated dichloro-methylene diphosphonate (Lip-Cl2MDP) was administered at a dose of 10 ml/kg 2 days before transplantation and every 5 days thereafter. Cyclosporine (CsA) was administered intramuscularly (i.m.) at a dose of 15 mg/kg per day. The heart xenografts were harvested for immuno-histological analysis at the time of rejection and the functioning grafts were removed at 70 days after transplantation. In untreated C6(+) rats, xeno-grafts survived for 2.3 +/- 0.5 days. Treatment with CsA or Lip-Cl(2)MDP in C6(+) rats did not significantly affect graft survival (2.5 +/- 0.6 and 2.3 +/- 0.4 days, respectively). In untreated C6(-) rats, xenografts survived for 5.0 +/- 0.6 days. However, Lip-Cl(2)MDP in C6(-) rats resulted in a prolongation of graft survival to 11 +/- 2.3 days (P < 0.05 vs. untreated C6(-) rats), while treatment with CsA alone in these rats led to more than 70 days' survival in four out of six grafts (61 +/- 16 days). In untreated C6(+) rats, immunohistology showed a severe myocardial necrosis and thrombosis with a scarce cellular infiltrate in the rejected xenografts. By contrast, in untreated C6(-) rats, xenografts were heavily infiltrated by macrophages and T cells. The number of macrophages, but not T cells, was markedly reduced in Lip-Cl(2)MDP-treated rats. In CsA-treated C6(-) rats, the grafts harvested at 70 days after transplantation had a normal morphology, with a minimal cellular infiltrate. Our data indicate that MAC-mediated injury plays an essential role in concordant xenograft rejection. Once this mechanism has been prevented, suppression of T cells allows for long-term xenograft survival.

  18. Long-Term Outcomes of Lumbar Spinal Stenosis: Eight-Year Results of the Spine Patient Outcomes Research Trial (SPORT)

    PubMed Central

    Lurie, Jon D.; Tosteson, Tor D.; Tosteson, Anna; Abdu, William A; Zhao, Wenyan; Morgan, Tamara S.; Weinstein, James N.

    2014-01-01

    Study Design Randomized trial with a concurrent observational cohort study Objective To compare 8-year outcomes of surgery to non-operative care for symptomatic lumbar spinal stenosis (SpS) Summary of Background Data Surgery for SpS has been shown to be more effective compared to non-operative treatment over four years, but longer-term data is less clear. Methods Surgical candidates from 13 centers in 11 U.S. states with at least 12 weeks of symptoms and confirmatory imaging were enrolled in a randomized cohort (RCT) or observational cohort (OBS). Treatment was standard decompressive laminectomy versus standard non-operative care. Primary outcomes were SF-36 bodily pain (BP) and physical function (PF) scales and the modified Oswestry Disability index (ODI) assessed at 6 weeks, 3 months, 6 months and yearly up to 8 years. Results 55% of RCT and 52% of OBS participants provided data at the 8-year follow-up. Intent-to-treat analyses showed no differences between randomized cohorts; however, 70% of those randomized to surgery and 52% of those randomized to non-operative had undergone surgery by 8 years. As-treated analyses in the RCT showed the early benefit for surgery out to 4 years converged over time with no significant treatment effect of surgery seen in years 6–8 for any of the primary outcomes. In contrast, the OBS group showed a stable advantage for surgery in all outcomes between years 5–8. Patients who were lost to follow-up were older, less well-educated, sicker, and had worse outcomes over the first 2 years in both surgery and non-operative arms. Conclusions Patients with symptomatic spinal stenosis show diminishing benefits of surgery in as-treated analyses of the RCT between 4–8 years while outcomes in the OBS group remained stable. Loss to follow-up of patients with worse early outcomes in both treatment groups could lead to overestimates of long-term outcomes, but likely not bias treatment effect estimates. PMID:25569524

  19. The efficacy and safety of reinstitution of tocilizumab in patients with relapsed active rheumatoid arthritis after long-term withdrawal of tocilizumab: retreatment of patients with rheumatoid arthritis with novel anti-IL-6 receptor antibody after a long-term interval following SAMURAI: the RONIN study.

    PubMed

    Sagawa, Akira

    2011-08-01

    We have evaluated the efficacy and safety of tocilizumab (TCZ) re-administration in patients with active rheumatoid arthritis (RA) who had previously received TCZ treatment for about 31 months. Four patients whose RA had been well-controlled with 8 mg/kg TCZ treatment every 4 weeks and had withdrawn from the treatment were enrolled. They resumed TCZ treatment after TCZ was authorized for RA treatment in Japan. Disease activity was assessed by the Disease Activity Score 28 using erythrocyte sedimentation rate (DAS28-ESR), and synovitis in the wrists and elbows was measured by ultrasonography at baseline and during follow-up. The mean DAS28-ESR was 6.32 before the first TCZ infusion. After fewer than 20 months of initial TCZ treatment, the mean DAS28-ESR decreased to 1.87. However, after withdrawal of TCZ treatment, the disease activity could not be sufficiently controlled with conventional disease-modifying antirheumatic drugs or biologic agents. The maximum interval between TCZ treatments was approximately 34 months. Following reinstatement of the TCZ treatment, within 12 months the mean DAS28-ESR improved from 5.21 to 2.87, with the synovitis in the wrists and elbow joints also showing great improvement. These findings demonstrate that TCZ retreatment in active RA patients who had relapsed after long-term discontinuation of TCZ treatment led to an improvement in the signs and symptoms of RA and in synovitis without any severe adverse events.

  20. An early oral health care program starting during pregnancy: results of a prospective clinical long-term study.

    PubMed

    Meyer, Karen; Geurtsen, Werner; Günay, Hüsamettin

    2010-06-01

    This study covers phase IV of a prospective clinical long-term study. Objective of this clinical investigation was to analyze the effects of a long-term prevention program on dental and oral health of teenagers at the age of 13 to 14 years. The entire study was subdivided into four phases. Phase I comprised an individual preventive care during pregnancy ("primary-primary prevention"); phase II assessed mothers and their young children until the age of 3 years ("primary prevention"); and in phase III, mothers and children at the age of 6 years were investigated. In phase IV of the study, the oral health of 13- to 14-year-old teenagers was examined (13.4 +/- 0.5 years; n = 29). All phases consisted of an examination, education about oral health care, and treatment based on the concept of an early oral health care promotion. The control group consisted of randomly selected adolescents at the same age (n = 30). The following clinical parameters were assessed: decayed/missing/filled teeth (DMF-T)/decayed, missing, and filled surface teeth index, hygiene index, papilla bleeding index, Periodontal Screening Index, and Streptococcus mutans/Lactobacillus concentration in saliva. The teenagers of the "prevention" group of phase IV of our prospective study revealed a share of 89.7% caries-free dentitions (65.5% sound; 24.2% caries-free with fillings). Mean DMF-T was 0.55 +/- 1.0. The control group showed a significantly higher mean DMF-T of 1.5 +/- 1.5 (p < 0.05) and revealed 56.7% of caries-free dentitions (30% sound, 26.7% caries-free with restorations). Our data clearly document that an early oral health care promotion starting during pregnancy may cause a sustained and long-term improvement of the oral health of children.

  1. Symptoms of depression and anxiety predict treatment response and long-term physical health outcomes in rheumatoid arthritis: secondary analysis of a randomized controlled trial

    PubMed Central

    Norton, Sam; Scott, David L.; Steer, Sophia; Hotopf, Matthew

    2016-01-01

    Objective. The aim of this analysis is to examine the longitudinal impact of symptoms of depression/anxiety on treatment response, long-term disease activity and physical disability in RA. Methods. Secondary analysis of clinical trial data was performed. Data were collected at baseline and at 6-monthly intervals for 2 years. The EuroQoL (EQ-5DTM) indicated depression/anxiety symptom severity. Our primary outcomes of interest were (i) DAS-28 and (ii) physical disability measured via the HAQ. Secondary outcomes were: tender and swollen joint counts, patient global assessment, ESR and odds of reaching clinical remission. Multilevel models were used to assess the impact of baseline and persistent depression/anxiety on outcomes over 2 years. Results. Data from 379 patients were included. After adjusting for covariates, baseline depression/anxiety symptoms were associated with increased DAS-28 outcomes and increased tender joint counts. Persistent depression/anxiety symptoms were associated with increased DAS-28 scores, HAQ scores, tender joint counts and patient global assessment of disease activity, and reduced odds of reaching clinical remission. Patients with symptoms of depression/anxiety at baseline also showed a 50% reduction in prednisolone treatment effect, in comparison with patients with no symptoms of depression/anxiety at baseline. Conclusion. Baseline and persistent symptoms of depression/anxiety are associated with poorer health outcomes over time, as well as reduced treatment response. Mental health should be routinely measured both in clinical practice and in research, and managed alongside rheumatological disease to optimize health outcomes. Further research is required to examine whether treatment of mental disorders can improve rheumatological outcomes. PMID:26350486

  2. Understanding the fate of black (pyrogenic) carbon in soil: Preliminary results from a long term field trial

    NASA Astrophysics Data System (ADS)

    Meredith, Will; Ascough, Philippa; Bird, Michael; Large, David; Shen, Licheng; Snape, Colin

    2014-05-01

    Black carbon (BC, also known as pyrogenic carbon) is an 'inert' form of carbon and has been proposed as a means of long-term carbon sequestration, particularly by amending soils and sediments with BC known as biochar. While there is abundant anecdotal evidence of biochar stability over extended timescales it is essential to gain a greater understanding of the degree and mechanisms of biochar degradation in the environment. This study aims to quantitatively assess the stability of biochar by investigating samples from field degradation trials first buried during 2009 in a tropical soil, and recovered after 12 and 36 month intervals. Catalytic hydropyrolysis (HyPy) is a novel analytical tool for the isolation of BC [1] in which high hydrogen pressure (150 bar) and a sulphided Mo catalyst reductively remove the non-BC fraction of the chars, and so isolate the most stable portion of the biochar, defined as BC(HyPy). This method also allows for the non-BC(HyPy) fraction of a sample, which from charcoal is known to include small ring PAHs (<7 rings) of pyrogenic origin to be recovered for molecular characterisation by GC-MS [2]. Biochars made from algae, sugarcane bagasse, and beech wood at 305, 414 and 512°C were emplaced under a variety of conditions allowing variables such as leaf cover, soil depth and pH to be investigated. Char stability (as measured by BC(HyPy) content) is dependent on both the feedstock and temperature of formation. HyPy is known to discriminate (in terms of BC isolation) against low temperature chars, composed of relatively small aromatic clusters [1], resulting in the low BC(HyPy) contents reported for the 305°C chars. Fresh charcoals, and those not subject to environmental degradation have display a similar distribution of aromatic clusters in the non-BC(HyPy) fraction, with 2 to 7 ring PAHs abundant [2]. However, environmentally degraded charcoals such as that from a Chinese river sediment, and an Australian river estuary [3] show a more

  3. Results of studies on long-term exposition of dormant forms of various organisms in outer space environment

    NASA Astrophysics Data System (ADS)

    Novikova, Nataliya; Gusev, Oleg; Sugimoto, Manabu; Deshevaya, Elena; Levinskikh, Margarita; Sychev, Vladimir; Okuda, Takashi; Orlov, Oleg; Alekseev, Victor; Poddubko, Svetlana; Polikarpov, Nikolay

    The planetary quarantine is one of the key problems of deep space exploration. Risks of the possible transfer of biological objects across interplanetary space should be necessarily assessed during space exploration. The risks associated with a possible transfer of biological objects and primarily microorganisms in interplanetary space is a priority for space studies We can assume, that on the exterior side of both unmanned and manned space stations there can be millions of microbial cells, many of which are in spore forms, the stability of which towards the unfavorable factors is extremely high. However, direct evidence to support this assumption, obtained only in recent years. “Biorisk” is an apparatus designed for conduction of space experiments focused on long-term exposition of latent stages of different forms of organism on the outer side of Russian Segment of International Space Station was developed and used in SSC RF - Institute for Biomedical Problems RAS. The purpose of this experiment is to determine the principle capability of preservation of life capacity in test-cultures of microorganisms during long-term exposure (comparable with the term of interplanetary flight) in space. The first experiment was performed using spores of bacteria (Bacillus) and fungi (Penicillium, Aspergillus and Cladosporium) housed in 3 boxes that were exposed to outer space for 7, 12 or 18 months. It was for the first time demonstrated that bacterial and fungal spores could survive an exposure to outer space during the time period comparable with the duration of a return mission to Mars. Moreover, the microbial strains proved viable and highly active. The second experiment was expanded by flying, in addition to the above spores, dormant forms of higher plants, insects, lower crustaceans and vertebrates. The 31-month experiment showed that, in spite of harsher than in the first study temperatures, some specimens remained viable and capable of further multiplication. In

  4. Vibrant Soundbridge implantable hearing device: critical review and single-surgeon short- and long-term results.

    PubMed

    Luetje, Charles M; Brown, Sandra A; Cullen, Robert D

    2010-09-01

    We conducted a retrospective descriptive study of a series of 31 consecutively presenting patients who had been implanted with the Vibrant Soundbridge middle ear hearing device. All implantations had been performed by the senior author. Three of these patients had undergone bilateral implantation, and 4 others had undergone subsequent explantation and reimplantation in response to known or suspected device failure, giving us a total of 34 ears and 38 implants. Our goal was to ascertain short- and long-term outcomes as measured by conventional audiometry (pure-tone average at 1 to 6 kHz) and long-term benefit as defined by the use or nonuse of the device. We found that at the initial activation session 2 months postoperatively, the average hearing thresholds were within 3 dB of the preoperative thresholds in all 34 ears and all 38 implants. The mean short-term gain at activation in the 38 implants was 28.1 dB. Nineteen patients (20 ears) were available for long-term evaluation, with the length of follow-up ranging from less than 1 year to 11 years (mean: 7.3). Of these 20 ears, 9 demonstrated further gain (mean: 10.8 dB) despite any natural hearing deterioration; of the remaining 11 ears, gain was unchanged in 2, diminished in 7 (mean: -3.6 dB), and gain data were unavailable in 2. In the final analysis, there were 20 user ears and 10 nonuser ears; 4 ears were lost to all follow-up. We conclude that direct-drive hearing with the Vibrant Soundbridge middle ear hearing device is beneficial and provides sustained audiometric gain. Factors that have a significant impact on patient use or nonuse include difficulty in obtaining audiologic support and the direct and indirect costs of the device. Without audiologic or financial support, some patients may choose to become nonusers and to either switch to conventional hearing aid amplification or become apathetic about hearing improvement.

  5. Long-Term Use of Everolimus in Patients with Tuberous Sclerosis Complex: Final Results from the EXIST-1 Study

    PubMed Central

    Franz, David N.; Belousova, Elena; Sparagana, Steven; Bebin, E. Martina; Frost, Michael D.; Kuperman, Rachel; Witt, Olaf; Kohrman, Michael H.; Flamini, J. Robert; Wu, Joyce Y.; Curatolo, Paolo; de Vries, Petrus J.; Berkowitz, Noah; Niolat, Julie; Jóźwiak, Sergiusz

    2016-01-01

    Background Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, has demonstrated efficacy in treating subependymal giant cell astrocytomas (SEGAs) and other manifestations of tuberous sclerosis complex (TSC). However, long-term use of mTOR inhibitors might be necessary. This analysis explored long-term efficacy and safety of everolimus from the conclusion of the EXIST-1 study (NCT00789828). Methods and Findings EXIST-1 was an international, prospective, double-blind, placebo-controlled phase 3 trial examining everolimus in patients with new or growing TSC-related SEGA. After a double-blind core phase, all remaining patients could receive everolimus in a long-term, open-label extension. Everolimus was initiated at a dose (4.5 mg/m2/day) titrated to a target blood trough of 5–15 ng/mL. SEGA response rate (primary end point) was defined as the proportion of patients achieving confirmed ≥50% reduction in the sum volume of target SEGA lesions from baseline in the absence of worsening nontarget SEGA lesions, new target SEGA lesions, and new or worsening hydrocephalus. Of 111 patients (median age, 9.5 years) who received ≥1 dose of everolimus (median duration, 47.1 months), 57.7% (95% confidence interval [CI], 47.9–67.0) achieved SEGA response. Of 41 patients with target renal angiomyolipomas at baseline, 30 (73.2%) achieved renal angiomyolipoma response. In 105 patients with ≥1 skin lesion at baseline, skin lesion response rate was 58.1%. Incidence of adverse events (AEs) was comparable with that of previous reports, and occurrence of emergent AEs generally decreased over time. The most common AEs (≥30% incidence) suspected to be treatment-related were stomatitis (43.2%) and mouth ulceration (32.4%). Conclusions Everolimus use led to sustained reduction in tumor volume, and new responses were observed for SEGA and renal angiomyolipoma from the blinded core phase of the study. These findings support the hypothesis that everolimus can safely reverse

  6. Long-term inhibition of cyclophilin D results in intracellular translocation of calcein AM from mitochondria to lysosomes.

    PubMed

    Shinohe, Daisuke; Kobayashi, Asuka; Gotoh, Marina; Tanaka, Kotaro; Ohta, Yoshihiro

    2017-01-01

    Cyclophilin D is a peptidyl-prolyl cis-trans isomerase localized in the mitochondrial matrix. Although its effects on mitochondrial characteristics have been well studied, its relation to the uptake of molecules by mitochondria remains unknown. Here, we demonstrated the effects of cyclophilin D on the intracellular translocation of calcein AM. Following addition of calcein AM to control cells or cells overexpressing wild-type cyclophilin D, calcein fluorescence was observed in mitochondria. However, long-term inhibition of cyclophilin D in these cells altered the localization of calcein fluorescence from mitochondria to lysosomes without changing mitochondrial esterase activity. In addition, depletion of glucose from the medium recovered calcein localization from lysosomes to mitochondria. This is the first demonstration of the effects of cyclophilin D on the intracellular translocation of molecules other than proteins and suggests that cyclophilin D may modify mitochondrial features by inducing the translocation of molecules to the mitochondria through the mechanism associated with cellular energy metabolism.

  7. An unusual case of the right subclavian artery aneurysm resulting from long-term repetitive blunt chest trauma.

    PubMed

    Matsuno, Yukihiro; Ishida, Narihiro; Shimabukuro, Katsuya; Takemura, Hirofumi

    2012-07-01

    This case report describes a right subclavian artery aneurysm secondary to long-term repetitive blunt trauma. A 62-year-old man with a right subclavian artery aneurysm had had a history of bird hunting using a shotgun that impacted substantially against his right clavicula and shoulder weekly for >20 years. The patient underwent open repair with partial sternotomy and distal balloon control. The aneurysmal sac was resected, and the right subclavian artery was reconstructed with a primary end-to-end anastomosis. Histopathologic examination of the resected aneurysmal wall revealed that all three layers of the arterial wall were comparatively intact, with fibrosis and lipid deposition in the intima and in various degrees of degeneration in the media, suggesting a true aneurysm.

  8. Investigation of unstabilized polyvinyl chloride (PVC) for use as a long-term UV dosimeter: preliminary results

    NASA Astrophysics Data System (ADS)

    Amar, Abdurazaq; Parisi, Alfio V.

    2012-08-01

    A new chemical UV dosimeter with a larger dose capacity than existing chemical dosimeters has been investigated for long-term UV measurements. Unstabilized polyvinyl chloride (PVC), cast in 40 µm thick film, has been found to respond to at least 745 SED (Standard Erythema Dose = 100 J m-2) of solar UV radiation, which is equivalent to about two to three summer weeks of exposure in subtropical sites. The UV-induced changes in the PVC dosimeter were quantified using a Fourier transform infrared spectrophotometer and the decrease in the absorption intensity of the 1064 cm-1 peak was employed to quantify these changes. Dose response curves have been established by relating the decrease in the PVC dosimeter's absorption intensity at 1064 cm-1 to the corresponding absolute and erythemal UV exposure dose.

  9. Transcorneal alternating current stimulation after severe axon damage in rats results in "long-term silent survivor" neurons.

    PubMed

    Henrich-Noack, Petra; Lazik, Stefanie; Sergeeva, Elena; Wagner, Sebastian; Voigt, Nadine; Prilloff, Sylvia; Fedorov, Anton; Sabel, Bernhard A

    2013-06-01

    Transcorneal alternating current stimulation (tACS) was proposed to decrease acute death of retinal ganglion cells after optic nerve transection in rats, but it is not known if cell survival is long-term and associated with functional restoration. We therefore evaluated the effects of tACS in a rat model of optic nerve crush using anatomical, electrophysiological and behavioural measures. Rats were trained in a brightness discrimination visual task and the retinal ganglion cell number was quantified with in vivo confocal neuroimaging. Thereafter, severe optic nerve crush or sham crush was performed and rats were treated under anaesthesia either with tACS or sham stimulation immediately after the lesion and on day 3, 7, 11, 15, 19 and 23. Brightness discrimination was evaluated for 6 weeks and retinal ganglion cells were counted in vivo on post-crush days 7 and 28. In additional rats we studied the influence of tACS on bioelectrical activity. On post-lesion day 28, the tACS-treated group showed a neuronal survival of 28.2% which was significantly greater than in sham operates (8.6%). All animals with optic nerve crush were significantly impaired in brightness discrimination and did not recover performance, irrespective to which group they belonged. In accordance with this, there was no significant influence of the stimulation on EEG power spectra. In conclusion, tACS induced long-term neuronal protection from delayed retrograde cell death, but in this case of severe axonal damage tACS did not influence functional restoration and EEG signals recorded over the visual cortex.

  10. Some results of long-term investigation population exposed as a result of release of radioactive wastes into the Techa River in Southern Urals

    SciTech Connect

    Degteva, M.O.; Kozheurov, V.P.; Vorobiova, M.I.

    1992-06-01

    This paper describes results of a long-term investigation of a population exposed to radioactive waste release in 1949-1956 into the Techa River in the Southern Urals. Systematic measurements of radionuclide concentration in the river waters, sediments, and floodplain soils and measurements of exposure gamma dose rates as well as studies of the radionuclide composition in the contaminated areas began in the summer of 1951. As a result of the contamination, 124,000 residents were exposed to radiation and 28,100 received significant doses in terms of health effect potential. Covered results include the following: estimation of external radiation doses; content of strontium-90 in humans and estimation of radionuclide ingestion rates; age-dependent model of strontium metabolism in the human body; evaluation of doses of internal irradiation; distribution of exposed population according to accumulated doses. 11 refs; 15 figs.

  11. Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population

    PubMed Central

    Barth, Swaantje; Haas, Johannes-Peter; Schlichtiger, Jenny; Molz, Johannes; Bisdorff, Betty; Michels, Hartmut; Hügle, Boris; Radon, Katja

    2016-01-01

    Objective Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. Methods In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models. Results Sixty-two percent of the study population was female; age range was 18–73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55–58%; general population 28%; 26–29%) and the anxiety/depression dimension (28%; 27–29% vs. 4%; 4–5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability. Conclusions HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future. PMID:27115139

  12. Long-term exposure to Myozyme results in a decrease of anti-drug antibodies in late-onset Pompe disease patients

    PubMed Central

    Masat, Elisa; Laforêt, Pascal; De Antonio, Marie; Corre, Guillaume; Perniconi, Barbara; Taouagh, Nadjib; Mariampillai, Kuberaka; Amelin, Damien; Mauhin, Wladimir; Hogrel, Jean-Yves; Caillaud, Catherine; Ronzitti, Giuseppe; Puzzo, Francesco; Kuranda, Klaudia; Colella, Pasqualina; Mallone, Roberto; Benveniste, Olivier; Mingozzi, Federico; Bassez, G.; Bedat-Millet, A. L.; Behin, A.; Eymard, B.; Leonard-Louis, S.; Stojkovic, T.; Canal, A.; Decostre, V.; Bouhour, F.; Boyer, F.; Castaing, Y.; Chapon, F.; Cintas, P.; Durieu, I.; Echaniz-Laguna, A.; Feasson, L.; Furby, A.; Hamroun, D.; Ferrer, X.; Solé, G.; Froissart, R.; Piraud, M.; Germain, D.; Benistan, K.; Guffon-Fouilhoux, N.; Journel, H.; Labauge, P.; Lacour, A.; Levy, A.; Magot, A.; Péréon, Y.; Minot-Myhié, M. -C.; Nadaj-Pakleza, A.; Nathier, C.; Orlikowski, D.; Pellegrini, N.; Petiot, P.; Praline, J.; Lofaso, F.; Prigent, H.; Dutry, A.; Renard, D.; Sacconi, S.; Desnuelle, C.; Salort-Campana, E.; Pouget, J.; Tiffreau, V.; Vincent, D.; Zagnoli, F.

    2016-01-01

    Immunogenicity of recombinant human acid-alpha glucosidase (rhGAA) in enzyme replacement therapy (ERT) is a safety and efficacy concern in the management of late-onset Pompe disease (LOPD). However, long-term effects of ERT on humoral and cellular responses to rhGAA are still poorly understood. To better understand the impact of immunogenicity of rhGAA on the efficacy of ERT, clinical data and blood samples from LOPD patients undergoing ERT for >4 years (n = 28) or untreated (n = 10) were collected and analyzed. In treated LOPD patients, anti-rhGAA antibodies peaked within the first 1000 days of ERT, while long-term exposure to rhGAA resulted in clearance of antibodies with residual production of non-neutralizing IgG. Analysis of  T cell responses to rhGAA showed detectable T cell reactivity only after in vitro restimulation. Upregulation of several cytokines and chemokines was detectable in both treated and untreated LOPD subjects, while IL2 secretion was detectable only in subjects who received ERT. These results indicate that long-term ERT in LOPD patients results in a decrease in antibody titers and residual production of non-inhibitory IgGs. Immune responses to GAA following long-term ERT do not seem to affect efficacy of ERT and are consistent with an immunomodulatory effect possibly mediated by regulatory T cells. PMID:27812025

  13. Severe extra-articular manifestations of rheumatoid arthritis in absence of concomitant joint involvement following long-term spontaneous remission. A case report.

    PubMed

    Lagrutta, Mariana; Alle, Gelsomina; Parodi, Roberto Leandro; Greca, Alcides Alejandro

    2016-01-01

    Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease occasionally associated with severe extra-articular manifestations, mostly in cases of longstanding highly active disease. We report the case of a 56 year-old woman diagnosed with active RA at the age of 40. After 5 years of high activity, her arthritis subsides spontaneously during pregnancy despite the lack of treatment with disease-modifying anti-rheumatic drugs. She remains without articular symptoms for 7 years, and then she develops a Felty's syndrome requiring steroid treatment and splenectomy. Following steroid withdrawal she develops pericarditis with massive serohematic pericardial effusion, still in absence of articular activity, and responds to immunosuppressive therapy and colchicine. We emphasize the unusual spontaneous and sustained joint remission without specific treatment, and the development of severe extra-articular manifestations of RA in absence of concomitant articular activity, as well as the importance of controlling inflammation.

  14. Evaluation of results obtained with corifollitropin alfa after poor ovarian response in previous cycle using recombinant follicular stimulating hormone in the long-term protocol

    PubMed Central

    Salgueiro, Lister L.; Rolim, Juliana R.; Moura, Bernardo R. L.; Machado, Suelen P. P.; Haddad, Carolina

    2016-01-01

    Objective This study evaluated the use of Corifollitropin alfa in patients with previous poor response to recombinant follicle stimulating hormone in long-term protocols using gonadotropin-releasing hormone. Methods Twenty-seven poor responders to previous treatment with the long term protocol using the recombinant follicle stimulating hormone (Group 1) were selected and then submitted to a second attempt using the same long term protocol with Corifollitropin alfa instead of the recombinant follicle stimulating hormone (Group 2). Ovarian down-regulation was achieved using subcutaneous administration of Leuprolide Acetate. Ovarian stimulation was performed with recombinant follicle stimulating hormone until the administration of human chorionic gonadotropin, followed by follicular aspiration (Group 1). Group 2 was submitted to this same protocol using Corifollitropin alfa instead of recombinant follicle stimulating hormone. Results There were significant differences in the number of aspirated oocytes, percentage of mature oocytes, amount of injected oocytes and transferred embryos - with all of these parameters being increased in the Corifollitropin alfa group. In addition, the rates of pregnancy and ongoing pregnancy were also significantly higher in the Corifollitropin alfa group. Conclusion The present study demonstrated that the use of Corifollitropin alfa in the long-term protocol could be a highly effective alternative for patients with poor ovarian response, who were unsuccessful in a previous treatment with In Vitro Fertilization - Intracytoplasmic Sperm Injection. PMID:27584604

  15. Sniff-Like Patterned Input Results in Long-Term Plasticity at the Rat Olfactory Bulb Mitral and Tufted Cell to Granule Cell Synapse

    PubMed Central

    Perez de los Cobos Pallares, Fernando; Loebel, Alex; Lukas, Michael

    2016-01-01

    During odor sensing the activity of principal neurons of the mammalian olfactory bulb, the mitral and tufted cells (MTCs), occurs in repetitive bursts that are synchronized to respiration, reminiscent of hippocampal theta-gamma coupling. Axonless granule cells (GCs) mediate self- and lateral inhibitory interactions between the excitatory MTCs via reciprocal dendrodendritic synapses. We have explored long-term plasticity at this synapse by using a theta burst stimulation (TBS) protocol and variations thereof. GCs were excited via glomerular stimulation in acute brain slices. We find that TBS induces exclusively long-term depression in the majority of experiments, whereas single bursts (“single-sniff paradigm”) can elicit both long-term potentiation and depression. Statistical analysis predicts that the mechanism underlying this bidirectional plasticity involves the proportional addition or removal of presynaptic release sites. Gamma stimulation with the same number of APs as in TBS was less efficient in inducing plasticity. Both TBS- and “single-sniff paradigm”-induced plasticity depend on NMDA receptor activation. Since the onset of plasticity is very rapid and requires little extra activity, we propose that these forms of plasticity might play a role already during an ongoing search for odor sources. Our results imply that components of both short-term and long-term olfactory memory may be encoded at this synapse. PMID:27747107

  16. Analytical results of a long-term aquifer test conducted near the Rio Grande, Albuquerque, New Mexico, with a section on piezometric-extensometric test results

    USGS Publications Warehouse

    Thorn, Conde R.; Heywood, Charles E.

    2001-01-01

    The City of Albuquerque, New Mexico, is interested in gaining a better understanding, both quantitative and qualitative, of the aquifer system in and around Albuquerque. Currently (2000), the City of Albuquerque and surrounding municipalities are completely dependent on ground-water reserves for their municipal water supply. This report presents the results of a long-term aquifer test conducted near the Rio Grande in Albuquerque. The long-term aquifer test was conducted during the winter of 1994-95. The City of Albuquerque Griegos 1 water production well was pumped continuously for 54 days at an average pumping rate of 2,331 gallons per minute. During the 54-day pumping and a 30-day recovery period, water levels were recorded in a monitoring network that consisted of 3 production wells and 19 piezometers located at nine sites. These wells and piezometers were screened in river alluvium and (or) the upper and middle parts of the Santa Fe Group aquifer system. In addition to the measurement of water levels, aquifer-system compaction was monitored during the aquifer test by an extensometer. Well-bore video and flowmeter surveys were conducted in the Griegos 1 water production well at the end of the recovery period to identify the location of primary water- producing zones along the screened interval. Analytical results from the aquifer test presented in this report are based on the methods used to analyze a leaky confined aquifer system and were performed using the computer software package AQTESOLV. Estimated transmissivities for the Griegos 1 and 4 water production wells ranged from 10,570 to 24,810 feet squared per day; the storage coefficient for the Griegos 4 well was 0.0025. A transmissivity of 13,540 feet squared per day and a storage coefficient of 0.0011 were estimated from the data collected from a piezometer completed in the production interval of the Griegos 1 well.

  17. Results of tricuspid valve surgery for functional tricuspid regurgitation: acute and long-term outcomes and predictors of failure.

    PubMed

    Pozzoli, Alberto; Buzzatti, Nicola; Vicentini, Luca; De Bonis, Michele; Alfieri, Ottavio

    2017-02-15

    The assessment and management of tricuspid valve disease evolved significantly in the last decade. Tricuspid regurgitation is a frequent heart valve disease and it is most often secondary, due to annular dilatation and leaflet tethering from right ventricular remodelling. The indications for tricuspid valve surgery are several and mainly related to the underlying disease, to the severity of the regurgitation and to the right ventricular function. Moreover, surgical tricuspid repair has been avoided for years, because of the erroneous concept that tricuspid regurgitation should disappear once the primary pathology on the left heart has been resolved. Instead, during the last few years, many investigators have reported evidence in favour of a more aggressive surgical approach to functional tricuspid regurgitation, recognising the risk of progressive tricuspid insufficiency in patients with annular dilatation and only moderate regurgitation (or less) at the time of surgery. This concept, along with the acute and long-term outcomes of tricuspid surgical repair techniques and tricuspid replacement are discussed in this review.

  18. Immediate and long-term results of mitral valve replacement with University of Cape Town mitral valve prosthesis

    PubMed Central

    Schrire, Velva; Barnard, Christiaan N.

    1970-01-01

    We describe seven years' experience with the University of Cape Town lenticular mitral valve prosthesis in 122 patients. All the patients had severe mitral valve disease. In 98 severe mitral stenosis was present with or without incompetence and in 24 the dominant or sole lesion was mitral incompetence. Other valves, particularly the tricuspid, were also frequently affected. The disability was severe or total in almost every patient. One hundred and five patients were discharged from hospital, and in 90 per cent of these the clinical improvement was most gratifying, with the disappearance of pulmonary oedema, paroxysmal dyspnoea, angina pectoris, and congestive cardiac failure. Return to full normal activity including physical work was the rule. The hospital mortality was 14 per cent and a further 38 per cent died during the follow-up period. The major post-operative complication was systemic embolism which could occur at any time after operation. The most important factor influencing the frequency of this complication was the nature of the valve seat. A bare steel seat was associated with a 100 per cent embolism, and a significant reduction occurred when a cloth-covered seat of Dacron-velour was introduced. Anticoagulant therapy appeared to prevent large or fresh clots but had no effect on the deposition of fibrin or platelet thrombi. The only other factor of importance was the age of the patient: after the age of 50 life expectancy and trouble-free long-term survival was reduced. Images PMID:5440520

  19. The transplantation of human fetal neuroretinal cells in advanced retinitis pigmentosa patients: results of a long-term safety study.

    PubMed

    Das, T; del Cerro, M; Jalali, S; Rao, V S; Gullapalli, V K; Little, C; Loreto, D A; Sharma, S; Sreedharan, A; del Cerro, C; Rao, G N

    1999-05-01

    The purpose of this study was to determine the long-term safety of transplanting human fetal neuroretinal cells (14 to 18 week gestational age) into a series of patients with advanced retinitis pigmentosa (RP). After obtaining informed consent, both hosts and mothers of donors were screened for transmissible diseases. Pre- and postoperative clinical exams, visual acuity, electroretinograms, and fluorescein angiograms were performed and visual field testing was attempted in each case. Surgically, an anterior approach through pars plana ciliaris was used. A retinotomy was performed in the paramacular area and a two-function cannula was introduced into the subretinal space to deliver a suspension of donor cells. The cell suspension carried approximately 4000 cells/microl; the volume injected did not exceed 150 microl. The patients were examined for periods ranging from 12 to 40 months posttransplantation. To date, no evidence of inflammation, infection, or overt rejection of the graft was noted in the host eye, neither was any change observed in the contralateral, unoperated eye. In conclusion, neuroretinal cells were injected into the subretinal space of 14 patients with advanced RP with no clinical appearance of detrimental effects at the time of surgery or up to 40 months postinjection except in 1 patient who developed retinal detachment. This sets the stage for a phase II clinical trial to determine the possible beneficial effects of this procedure in patients blinded by degenerative retinal disease.

  20. Results of long-term experimental studies on the carcinogenicity of ethylene-bis-dithiocarbamate (Mancozeb) in rats.

    PubMed

    Belpoggi, Fiorella; Soffritti, Morando; Guarino, Marina; Lambertini, Luca; Cevolani, Daniela; Maltoni, Cesare

    2002-12-01

    Mancozeb, an ethylene-bis-dithiocarbamate (EBDC), has been one of the most commonly used fungicides in commercial use for several decades. Nevertheless, up to now, no adequate published experimental studies on the carcinogenicity of Mancozeb have been published. Because of the importance of the compound and of the number of people potentially exposed (workers engaged in the production and use of the fungicide, people living in agricultural areas where the compound is sprayed, and people consuming polluted products), a long-term experimental study of Mancozeb was begun at the Cancer Research Center of the Ramazzini Foundation. Groups of 150 male and female Sprague-Dawley rats, 8 weeks old at the start of the treatment, were administered Mancozeb at the concentration of 1000, 500, 100, 10, and 0 ppm in feed supplied ad libitum for 104 weeks. At the end of the treatment, animals were kept under controlled conditions until spontaneous death. Mancozeb caused an increase in (1) total malignant tumors, (2) malignant mammary tumors, (3) Zymbal gland and ear duct carcinomas, (4) hepatocarcinomas, (5) malignant tumors of the pancreas, (6) malignant tumors of the thyroid gland, (7) osteosarcomas of the bones of the head, and (8) hemolymphoreticular neoplasias. On the basis of these data, Mancozeb must be considered a multipotent carcinogenic agent.

  1. Improved external valvuloplasty, intravenous laser photocoagulation and local sclerotheraphy treatment of primary deep venous valvular insufficiency: long term result

    NASA Astrophysics Data System (ADS)

    Wang, Chun-xi; Han, Li-na; Gu, Ying; Liang, Fa-qi; Zhang, Li; Liu, Hong-yi; Zhao, Wen-guang; Wang, Qi; Wang, Xiao-ling

    2007-11-01

    The purpose of this article is to report long-term follow-up of improved external vulvuloplasty, intravenous laser photocoagulation and local sclerotherapy treatment of primary deep venous valvular insufficiency in eight hundred and seventy-two patients from Nov. 2000 to May 2006. Patients were evaluated clinically and with duplex ultrasound at 1, 3, and 12 months, and yearly thereafter until the fifth year to assess treatment efficacy and adverse reactions. Successful occlusion of the great saphenous vein and absence of deep vein reflux on color Doppler imaging, were noted in 956 limbs of 852 cases( 1 month follow-up), 946 limbs of 842 cases (6 month to 1 year follow-up), 717 of 626 (1~2 year follow-up), 501 of 417 (2~3 year follow-up), 352 of 296 (3~5year follow-up), 142 of 106 (5 year follow-up) after initial treatment. The cumulative total number of recurrence of reflux was fifteen cases. The respective competence rate was 95.18%, 96.23%, 94.23%, 95.25%, 94.23% and 94.12%. Of note, all recurrence occurred before 9 months, with the majority noted before 3 months. Bruising was noted in 0.7% of patients, tightness along the course of treated vein in 1.0% of limbs. There have been no paresthesia of cases, skin burns and deep vein thrombosis.

  2. Micronutrients Measurement Quality Assurance Program: helping participants use interlaboratory comparison exercise results to improve their long-term measurement performance.

    PubMed

    Duewer, D L; Kline, M C; Sharpless, K E; Thomas, J B; Gary, K T; Sowell, A L

    1999-05-01

    Over the past decade, the Micronutrients Measurement Quality Assurance Program (M2QAP) at the National Institute of Standards and Technology (NIST) has administered nearly 40 interlaboratory comparison exercises devoted to fat-soluble vitamin-related analytes in human serum. While M2QAP studies have been used to help certify reference materials and to document the performance of analytical systems, the primary focus of the M2QAP has been, and remains, the improvement of among-participant measurement comparability for target analytes. Recent analysis of historical measurement performance indicated the most efficient mechanism for further improving measurement comparability among participants is the improvement of long-term (months to years) comparability within each laboratory. The summary reports for the M2QAP studies are being redesigned to provide more chemist-friendly analyses of participant performance, dissecting systematic and random components of measurement incomparability as functions of analyte level and time. This report documents the semantic and graphical tools developed to help interlaboratory-comparison-exercise participants interpret their own measurement performance.

  3. Changing forest water yields in response to climate warming: results from long-term experimental watershed sites across North America.

    PubMed

    Creed, Irena F; Spargo, Adam T; Jones, Julia A; Buttle, Jim M; Adams, Mary B; Beall, Fred D; Booth, Eric G; Campbell, John L; Clow, Dave; Elder, Kelly; Green, Mark B; Grimm, Nancy B; Miniat, Chelcy; Ramlal, Patricia; Saha, Amartya; Sebestyen, Stephen; Spittlehouse, Dave; Sterling, Shannon; Williams, Mark W; Winkler, Rita; Yao, Huaxia

    2014-10-01

    Climate warming is projected to affect forest water yields but the effects are expected to vary. We investigated how forest type and age affect water yield resilience to climate warming. To answer this question, we examined the variability in historical water yields at long-term experimental catchments across Canada and the United States over 5-year cool and warm periods. Using the theoretical framework of the Budyko curve, we calculated the effects of climate warming on the annual partitioning of precipitation (P) into evapotranspiration (ET) and water yield. Deviation (d) was defined as a catchment's change in actual ET divided by P [AET/P; evaporative index (EI)] coincident with a shift from a cool to a warm period - a positive d indicates an upward shift in EI and smaller than expected water yields, and a negative d indicates a downward shift in EI and larger than expected water yields. Elasticity was defined as the ratio of interannual variation in potential ET divided by P (PET/P; dryness index) to interannual variation in the EI - high elasticity indicates low d despite large range in drying index (i.e., resilient water yields), low elasticity indicates high d despite small range in drying index (i.e., nonresilient water yields). Although the data needed to fully evaluate ecosystems based on these metrics are limited, we were able to identify some characteristics of response among forest types. Alpine sites showed the greatest sensitivity to climate warming with any warming leading to increased water yields. Conifer forests included catchments with lowest elasticity and stable to larger water yields. Deciduous forests included catchments with intermediate elasticity and stable to smaller water yields. Mixed coniferous/deciduous forests included catchments with highest elasticity and stable water yields. Forest type appeared to influence the resilience of catchment water yields to climate warming, with conifer and deciduous catchments more susceptible to

  4. Acute and long-term dysphagia in critically ill patients with severe sepsis: results of a prospective controlled observational study.

    PubMed

    Zielske, Joerg; Bohne, Silvia; Brunkhorst, Frank M; Axer, Hubertus; Guntinas-Lichius, Orlando

    2014-11-01

    Dysphagia is a major risk factor for morbidity and mortality in critically ill patients treated in intensive care units (ICUs). Structured otorhinolaryngological data on dysphagia in ICU survivors with severe sepsis are missing. In a prospective study, 30 ICU patients with severe sepsis and thirty without sepsis as control group were examined using bedside fiberoptic endoscopic evaluation of swallowing after 14 days in the ICU (T1) and 4 months after onset of critical illness (T2). Swallowing dysfunction was assessed using the Penetration-Aspiration Scale (PAS). The Functional Oral Intake Scale was applied to evaluate the diet needed. Primary endpoint was the burden of dysphagia defined as PAS score >5. At T1, 19 of 30 severe sepsis patients showed aspiration with a PAS score >5, compared to 7 of 30 in critically ill patients without severe sepsis (p = 0.002). Severe sepsis and tracheostomy were independent risk factors for severe dysphagia with aspiration (PAS > 5) at T1 (p = 0.042 and 0.006, respectively). 4-month mortality (T2) was 57 % in severe sepsis patients compared to 20 % in patients without severe sepsis (p = 0.006). At T2, more severe sepsis survivors were tracheostomy-dependent and needed more often tube or parenteral feeding (p = 0.014 and p = 0.040, respectively). Multivariate analysis revealed tracheostomy at T1 as independent risk factor for severe dysphagia at T2 (p = 0.030). Severe sepsis appears to be a relevant risk factor for long-term dysphagia. An otorhinolaryngological evaluation of dysphagia at ICU discharge is mandatory for survivors of severe critical illness to plan specific swallowing rehabilitation programs.

  5. Adalimumab treatment optimization for psoriasis: Results of a long-term phase 2/3 Japanese study.

    PubMed

    Asahina, Akihiko; Ohtsuki, Mamitaro; Etoh, Takafumi; Gu, Yihua; Okun, Martin M; Teixeira, Henrique D; Yamaguchi, Yuji; Nakagawa, Hidemi

    2015-11-01

    The tumor necrosis factor-α inhibitor, adalimumab, is approved to treat moderate-to-severe plaque psoriasis (40 mg every-other-week or 80 mg every-other-week following inadequate response at 40 mg in Japan). This open-label extension (OLE) trial evaluated the optimal adalimumab dose for long-term efficacy and safety in Japanese patients with moderate-to-severe plaque psoriasis following a prior 24-week, phase 2/3, randomized, double-blind study. Of the 169 patients from the phase 2/3 trial, 147 entered the OLE on 40 mg (n = 89) or 80 mg (n = 58) adalimumab every-other-week. Patients on 40 mg with Psoriasis Area and Severity Index (PASI) of less than 50 could escalate to 80 mg. At week 52 (28 of OLE), patients entering the OLE on 80 mg were reduced to 40 mg, with the option to re-escalate. For patients entering the OLE on 40 mg, final PASI 50/75/90 response rates were 85.1%/73.3%/60.4%, respectively, including effects of dose escalation. Among patients whose dose was escalated, final PASI 50/75/90 response rates were 70.0%/53.3%/36.7%, respectively. For patients entering the OLE on 80 mg, final PASI 50/75/90 response rates were 92.5%/84.9%/73.6%, respectively, including effects of dose re-escalation. Overall incidence rates of adverse events (AE) and injection-site reaction AE declined over time; rates for serious AE and infections were generally stable. Clinically meaningful efficacy of adalimumab was sustained to 4 years. Dose escalation to 80 mg every-other-week for patients with suboptimal response to 40 mg every-other-week, and dose reduction to 40 mg every-other-week for patients satisfactorily controlled on 80 mg every-other-week, are viable strategies for adalimumab optimization.

  6. RESULTS FROM LONG-TERM OPTICAL MONITORING OF THE SOFT X-RAY TRANSIENT SAX J1810.8-2609

    SciTech Connect

    Zhu Ling; Di Stefano, Rosanne; Wyrzykowski, Lukasz

    2012-12-20

    In this paper, we report the long-term optical observation of the faint soft X-ray transient SAX J1810.8-2609 from the Optical Gravitational Lensing Experiment (OGLE) and Microlensing Observations in Astrophysics (MOA). We have focused on the 2007 outburst, and also cross-correlated its optical light curves and quasi-simultaneous X-ray observations from RXTE/Swift. Both the optical and X-ray light curves of the 2007 outburst show multi-peak features. Quasi-simultaneous optical/X-ray luminosity shows that both the X-ray reprocessing and viscously thermal emission can explain the observed optical flux. There is a slight X-ray delay of 0.6 {+-} 0.3 days during the first peak, while the X-ray emission lags the optical emission by {approx}2 days during the rebrightening stage, which suggests that X-ray reprocessing emission contributes significantly to the optical flux in the first peak, but the viscously heated disk origin dominates it during rebrightening. This implies variation of the physical environment of the outer disk, with even the source remaining in a low/hard state during the entire outburst. The {approx}2 day X-ray lag indicates a small accretion disk in the system, and its optical counterpart was not detected by OGLE and MOA during quiescence, which constrained it to be fainter than M{sub I} = 7.5 mag. There is a suspected short-time optical flare detected at MJD = 52583.5 with no detected X-ray counterpart; this single flux increase implies a magnetic loop reconnection in the outer disk, as proposed by Zurita et al. The observations cover all stages of the outburst; however, due to the low sensitivity of RXTE/ASM, we cannot conclude whether it is an optical precursor at the initial rise of the outburst.

  7. Changing forest water yields in response to climate warming: results from long-term experimental watershed sites across North America

    PubMed Central

    Creed, Irena F; Spargo, Adam T; Jones, Julia A; Buttle, Jim M; Adams, Mary B; Beall, Fred D; Booth, Eric G; Campbell, John L; Clow, Dave; Elder, Kelly; Green, Mark B; Grimm, Nancy B; Miniat, Chelcy; Ramlal, Patricia; Saha, Amartya; Sebestyen, Stephen; Spittlehouse, Dave; Sterling, Shannon; Williams, Mark W; Winkler, Rita; Yao, Huaxia

    2014-01-01

    Climate warming is projected to affect forest water yields but the effects are expected to vary. We investigated how forest type and age affect water yield resilience to climate warming. To answer this question, we examined the variability in historical water yields at long-term experimental catchments across Canada and the United States over 5-year cool and warm periods. Using the theoretical framework of the Budyko curve, we calculated the effects of climate warming on the annual partitioning of precipitation (P) into evapotranspiration (ET) and water yield. Deviation (d) was defined as a catchment's change in actual ET divided by P [AET/P; evaporative index (EI)] coincident with a shift from a cool to a warm period – a positive d indicates an upward shift in EI and smaller than expected water yields, and a negative d indicates a downward shift in EI and larger than expected water yields. Elasticity was defined as the ratio of interannual variation in potential ET divided by P (PET/P; dryness index) to interannual variation in the EI – high elasticity indicates low d despite large range in drying index (i.e., resilient water yields), low elasticity indicates high d despite small range in drying index (i.e., nonresilient water yields). Although the data needed to fully evaluate ecosystems based on these metrics are limited, we were able to identify some characteristics of response among forest types. Alpine sites showed the greatest sensitivity to climate warming with any warming leading to increased water yields. Conifer forests included catchments with lowest elasticity and stable to larger water yields. Deciduous forests included catchments with intermediate elasticity and stable to smaller water yields. Mixed coniferous/deciduous forests included catchments with highest elasticity and stable water yields. Forest type appeared to influence the resilience of catchment water yields to climate warming, with conifer and deciduous catchments more susceptible to

  8. Surgical Experience and Long-term Results of Baroreflex Activation Therapy for Heart Failure With Reduced Ejection Fraction.

    PubMed

    Weaver, Fred A; Abraham, William T; Little, William C; Butter, Christian; Ducharme, Anique; Halbach, Marcel; Klug, Didier; Lovett, Eric G; Madershahian, Navid; Müller-Ehmsen, Jochen; Schafer, Jill E; Senni, Michele; Swarup, Vijay; Wachter, Rolf; Zile, Michael R

    2016-01-01

    The purpose of this publication is to describe the intraoperative experience along with long-term safety and efficacy of the second-generation baroreflex activation therapy (BAT) system in patients with heart failure (HF) and reduced ejection fraction HF (HFrEF). In a randomized trial of New York Heart Association Class III HFrEF, 140 patients were assigned 1:1 to receive BAT plus medical therapy or medical therapy alone. Procedural information along with safety and efficacy data were collected and analyzed over 12 months. Within the cohort of 71 patients randomized to BAT, implant procedure time decreased with experience, from 106 ± 37 minutes on the first case to 83 ± 32 minutes on the third case. The rate of freedom from system- and procedure-related complications was 86% through 12 months, with the percentage of days alive without a complication related to system, procedure, or underlying cardiovascular condition identical to the control group. The complications that did occur were generally mild and short-lived. Overall, 12 months therapeutic benefit from BAT was consistent with previously reported efficacy through 6 months: there was a significant and sustained beneficial treatment effect on New York Heart Association functional Class, quality of life, 6-minute hall walk distance, plasma N-terminal pro-brain natriuretic peptide, and systolic blood pressure. This was true for the full trial cohort and a predefined subset not receiving cardiac resynchronization therapy. There is a rapid learning curve for the specialized procedures entailed in a BAT system implant. BAT system implantation is safe with the therapeutic benefits of BAT in patients with HFrEF being substantial and maintained for at least 1 year.

  9. Results from Long-term Optical Monitoring of the Soft X-Ray Transient SAX J1810.8-2609

    NASA Astrophysics Data System (ADS)

    Zhu, Ling; Di Stefano, Rosanne; Wyrzykowski, Lukasz

    2012-12-01

    In this paper, we report the long-term optical observation of the faint soft X-ray transient SAX J1810.8-2609 from the Optical Gravitational Lensing Experiment (OGLE) and Microlensing Observations in Astrophysics (MOA). We have focused on the 2007 outburst, and also cross-correlated its optical light curves and quasi-simultaneous X-ray observations from RXTE/Swift. Both the optical and X-ray light curves of the 2007 outburst show multi-peak features. Quasi-simultaneous optical/X-ray luminosity shows that both the X-ray reprocessing and viscously thermal emission can explain the observed optical flux. There is a slight X-ray delay of 0.6 ± 0.3 days during the first peak, while the X-ray emission lags the optical emission by ~2 days during the rebrightening stage, which suggests that X-ray reprocessing emission contributes significantly to the optical flux in the first peak, but the viscously heated disk origin dominates it during rebrightening. This implies variation of the physical environment of the outer disk, with even the source remaining in a low/hard state during the entire outburst. The ~2 day X-ray lag indicates a small accretion disk in the system, and its optical counterpart was not detected by OGLE and MOA during quiescence, which constrained it to be fainter than MI = 7.5 mag. There is a suspected short-time optical flare detected at MJD = 52583.5 with no detected X-ray counterpart; this single flux increase implies a magnetic loop reconnection in the outer disk, as proposed by Zurita et al. The observations cover all stages of the outburst; however, due to the low sensitivity of RXTE/ASM, we cannot conclude whether it is an optical precursor at the initial rise of the outburst.

  10. [Long-term results after a modified Sauvé-Kapandji procedure. Report on 105 post-traumatic cases].

    PubMed

    Zimmermann, R; Gabl, M; Angermann, P; Lutz, M; Pechlaner, S

    2003-07-01

    A modified Sauvé-Kapandji procedure was performed on 105 patients for a painfully limited range of motion and arthritis of the distal radioulnar joint following distal fracture of the radius ( n=81), the radius and ulna in the distal one-third ( n=18) and of the forearm shaft ( n=6). After an average of 8 years all patients were followed up clinically (motion, strength, pain) and radiographically (union of the arthrodesis, carpal translation, radioulnar distance). Rotation of the forearm had been improved by 53%. The amount of strength lay by 70% in comparison to the contralateral side. In 97% of the patients pain could be reduced. In all cases the arthrodesis had fused completely. An ulnar drift of the carpus was observed in 5% of the patients, and 74% of the patients showed radiological signs of approximation of the proximal ulnar stump to the radius. This reduction of the radioulnar distance amounted to less than 3 mm in 65% of the patients and lay between 3 and 5 mm in 29% of the patients. In none of the cases was direct contact between the ulna and the radius encountered.

  11. Evaluation of Long-term Outcomes of Correction of Severe Blepharoptosis with Advancement of External Levator Muscle Complex: Descriptive Statistical Analysis of the Results

    PubMed Central

    INNOCENTI, ALESSANDRO; MORI, FRANCESCO; MELITA, DARIO; DREASSI, EMANUELA; CIANCIO, FRANCESCO; INNOCENTI, MARCO

    2017-01-01

    Aim: Evaluation of long-term results after aponeurotic blepharoptosis correction with external levator muscle complex advancement. Patients and Methods: We carried out a retrospective study with medical record review of 20 patients (40 eyes) affected by bilateral aponeurotic moderate and severe ptosis who underwent primary surgery between January 2010 and December 2013. Criteria for outcome evaluations included 3-year postoperative follow-up of upper margin reflex index (uMRD) and symmetry. Results: 3-Year postoperative follow-up showed 17 (85%) cases of successful correction of ptosis and three cases (15%) showed partial success. Two eyes showed hypocorrection, while one eye was overcorrected. The symmetry was maintained in all patients except for the oldest. Conclusion: External superior levator advancement is an effective procedure for moderate and severe aponeurotic blepharoptosis correction, and establishes good long-term eyelid position and symmetry. PMID:28064228

  12. Quantification of key long-term risks at CO₂ sequestration sites: Latest results from US DOE's National Risk Assessment Partnership (NRAP) Project

    DOE PAGES

    Pawar, Rajesh; Bromhal, Grant; Carroll, Susan; ...

    2014-12-31

    Risk assessment for geologic CO₂ storage including quantification of risks is an area of active investigation. The National Risk Assessment Partnership (NRAP) is a US-Department of Energy (US-DOE) effort focused on developing a defensible, science-based methodology and platform for quantifying risk profiles at geologic CO₂ sequestration sites. NRAP has been developing a methodology that centers round development of an integrated assessment model (IAM) using system modeling approach to quantify risks and risk profiles. The IAM has been used to calculate risk profiles with a few key potential impacts due to potential CO₂ and brine leakage. The simulation results are alsomore » used to determine long-term storage security relationships and compare the long-term storage effectiveness to IPCC storage permanence goal. Additionally, we also demonstrate application of IAM for uncertainty quantification in order to determine parameters to which the uncertainty in model results is most sensitive.« less

  13. Quantification of key long-term risks at CO₂ sequestration sites: Latest results from US DOE's National Risk Assessment Partnership (NRAP) Project

    SciTech Connect

    Pawar, Rajesh; Bromhal, Grant; Carroll, Susan; Chu, Shaoping; Dilmore, Robert; Gastelum, Jason; Oldenburg, Curt; Stauffer, Philip; Zhang, Yingqi; Guthrie, George

    2014-12-31

    Risk assessment for geologic CO₂ storage including quantification of risks is an area of active investigation. The National Risk Assessment Partnership (NRAP) is a US-Department of Energy (US-DOE) effort focused on developing a defensible, science-based methodology and platform for quantifying risk profiles at geologic CO₂ sequestration sites. NRAP has been developing a methodology that centers round development of an integrated assessment model (IAM) using system modeling approach to quantify risks and risk profiles. The IAM has been used to calculate risk profiles with a few key potential impacts due to potential CO₂ and brine leakage. The simulation results are also used to determine long-term storage security relationships and compare the long-term storage effectiveness to IPCC storage permanence goal. Additionally, we also demonstrate application of IAM for uncertainty quantification in order to determine parameters to which the uncertainty in model results is most sensitive.

  14. [The long-term results of the application of the polypropylene mesh for the plastic correction of extensive laryngo-tracheostomas].

    PubMed

    Yagudin, R K; Yagudin, K F

    2016-01-01

    The objective of the present study was to estimate the long-term results of the closure of large laryngeal and tracheal stomas with the use of the polypropylene mesh. The study included 33 adult patients presenting with extensive laryngeal and tracheal stomas. A total of 34 surgical interventions were performed for alloplastic correction of these defects. The complete closure of the tracheal and laryngeal defects with the incorporation of the prosthesis and restoration of respiration was achieved in 88.2% of the alloplastic procedures. The long-term follow-up of the treated patients (median: 75 months) failed to reveal any signs of mesh rejection. Moreover, none of the patients reported an appreciable feeling of discomfort at the site of mesh localization. Thus, the results of the study indicate that the alloplastic correction of laryngeal and tracheal stomas with the implantation of the modern mesh prostheses from polypropylene monofilaments provides the safe and reliable alternative to autoplastic surgery. Low rigidity of the modern prosthetic meshes ensures good immediate results of implant survival in the absence of long-term complications associated with the durable presence of the polypropylene mesh on the neck.

  15. Long-term results using the straight tapered femoral cementless hip stem in total hip arthroplasty: a minimum of twenty-year follow-up.

    PubMed

    Ateschrang, Atesch; Weise, Kuno; Weller, Siegfried; Stöckle, Ulrich; de Zwart, Peter; Ochs, Björn Gunnar

    2014-08-01

    We report the first long-term results of a prospective cohort study after total hip arthroplasty using the cementless Bicontact hip stem. Between 1987 and 1990, 250 total hip arthroplasties in 236 patients were performed using the cementless Bicontact hip stem. The average follow-up was 22.8 years (20.4-24.8) and average age at index surgery was 58.1 years. Eighty-one patients died and 9 were lost to follow-up. We noted 11 stem revisions revealing an overall Kaplan Meier survival rate of 95.0% (CI 95%: 91.1-97.2%). The average Harris Hip Score revealed 81 points (range 24-93). The Bicontact hip stem demonstrated high survival rates despite high ages and osteopenic changes, which are equivalent to other long-term reports of cementless stem fixation.

  16. Effectiveness of venlafaxine, extended release formulation, in the short-term and long-term treatment of generalized anxiety disorder: results of a survival analysis.

    PubMed

    Montgomery, Stuart A; Mahé, Vincent; Haudiquet, Vincent; Hackett, David

    2002-12-01

    A survival analysis of data from two placebo-controlled, randomized, long-term (6-month) studies was used to examine the effectiveness of venlafaxine, extended release (XR) formulation, in patients with generalized anxiety disorder (GAD). Patients in a placebo-controlled, flexible-dose study received 75 to 225 mg/day venlafaxine XR, while patients in a placebo-controlled, fixed-dose study received once-daily venlafaxine XR doses of 37.5 mg, 75 mg, or 150 mg. The survival analysis was based on the clinician's decision to discontinue treatment in a placebo-controlled study and incorporated data from all patients who were randomized. In each study, placebo-treated patients discontinued treatment due to lack of efficacy more frequently and earlier than those receiving venlafaxine XR (p < 0.001, log-rank test). A dose-response relationship was apparent, with the lowest rate of withdrawal seen at the highest venlafaxine XR dose. Survival curves for discontinuations due to adverse events did not differ significantly in either study. These results were consistent with the conventional intent-to-treat efficacy assessments of changes in anxiety severity, highlighting the superiority of venlafaxine XR over placebo in the long-term treatment of GAD. Overall, these results demonstrate the clinical effectiveness of venlafaxine XR in the short-term and long-term treatment of GAD.

  17. Deferiprone versus deferoxamine in sickle cell disease: results from a 5-year long-term Italian multi-center randomized clinical trial.

    PubMed

    Calvaruso, Giusi; Vitrano, Angela; Di Maggio, Rosario; Ballas, Samir; Steinberg, Martin H; Rigano, Paolo; Sacco, Massimiliano; Telfer, Paul; Renda, Disma; Barone, Rita; Maggio, Aurelio

    2014-12-01

    Blood transfusion and iron chelation currently represent a supportive therapy to manage anemia, vasculopathy and vaso-occlusion crises in Sickle-Cell-Disease. Here we describe the first 5-year long-term randomized clinical trial comparing Deferiprone versus Deferoxamine in patients with Sickle-Cell-Disease. The results of this study show that Deferiprone has the same effectiveness as Deferoxamine in decreasing body iron burden, measured as repeated measurements of serum ferritin concentrations on the same patient over 5-years and analyzed according to the linear mixed-effects model (LMM) (p=0.822). Both chelators are able to decrease, significantly, serum ferritin concentrations, during 5-years, without any effect on safety (p=0.005). Moreover, although the basal serum ferritin levels were higher in transfused compared with non-transfused group (p=0.031), the changes over time in serum ferritin levels were not statistically significantly different between transfused and non-transfused cohort of patients (p=0.389). Kaplan-Meier curve, during 5-years of study, suggests that Deferiprone does not alter survival in comparison with Deferoxamine (p=0.38). In conclusion, long-term iron chelation therapy with Deferiprone was associated with efficacy and safety similar to that of Deferoxamine. Therefore, in patients with Sickle-Cell-Disease, Deferiprone may represent an effective long-term treatment option.

  18. [Risk factors for long-term result of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm].

    PubMed

    Ye, W; Di, X; Liu, Q; Li, Y J; Zheng, Y H; Zeng, R; Song, X J; Liu, Z L; Liu, C W

    2016-12-06

    Objective: To summarize results of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm(AIPA), and to analysis clinical predictors of long term major adverse clinical events(MACE). Methods: Retrospectively collected endovascular treatment for AIPA cases in Peking Union Medical College Hospital within 2000 to 2015. Twenty-nine cases with AIPA treated by endovascular therapy were enrolled in this study. Twenty five cases were male, range from 23 to 67 years old, mean age was (39.3±11.4) years old.Demographic characters, locations of aneurysms, type to auto-immune disease, immuno medical therapy, operation strategy and long term follow-up data were reported. Statistical analysis was made to verify clinical predictors of long-term MACE. Results: Among the 29 cases, 22 cases with bechet's disease, 4 cases with Takayasu's arteritis, 2 cases with systemic lupus erythematosus, 1 cases with polyarteritis nodosa. Eight cases had ruptured or pending ruptured pesudo-aneurysms, the rest 21 cases had dull pain or no overt symptome. Twenty-four cases had infra-renal artery aneurysms, two were para-and supra-renal artery, two were supra-celiac artery, and the rest one had multiple aneurysms involved thoracic and abdominal aorta.All the cases received regular immune medical therapy except the three emergency cases. All the operations were under general anaesthesia. Nineteen cases underwent classical Endovascular aortic aneurysm repair (EVAR), 5 cases underwent fenestration EVAR, the rest 5 cases underwent hybrid procedure. All the 29 operations were successful, without conversion to open surgery. Major peri-operation complication included 3 incision infection, 3 pulmonary infection. No death occurred. All the cases received regular follow-up from 1 to 120 months. There were five recurrence of pseudo-aneurysm, 1 case suffered from iliac limb occlusion. 5 cases received re-intervention procedure. No occlusion of revascularizal visceral artery was

  19. Long-term blood pressure variability in patients with rheumatoid arthritis (RA) and its impact on cardiovascular events and all-cause mortality in RA: a population-based comparative cohort study

    PubMed Central

    Myasoedova, Elena; Crowson, Cynthia S.; Green, Abigail B.; Matteson, Eric L.; Gabriel, Sherine E.

    2014-01-01

    Objectives To examine long-term visit-to-visit blood pressure (BP) variability in rheumatoid arthritis (RA) vs non-RA subjects and to assess its impact on cardiovascular events and mortality in RA. Methods Clinic BP measures were collected in a population-based incident cohort of RA patients (1987 ACR criteria met between 1/1/1995 and 1/1/2008) and non-RA subjects. BP variability was defined as within-subject standard deviation (SD) in systolic and diastolic BP. Results Study included 442 RA patients (mean age 55.5 years, 70% females) and 424 non-RA subjects (mean age 55.7 years, 69% females). RA patients had higher visit-to-visit variability in systolic BP (13.8±4.7 mm Hg), than non-RA subjects (13.0±5.2 mm Hg, p=0.004). Systolic BP variability declined after the index date in RA (p<0.001), but not in the non-RA cohort (p=0.73), adjusting for age, sex and calendar year of RA. During the mean follow-up of 7.1 years, 33 cardiovascular events and 57 deaths occurred in RA cohort. Visit-to-visit systolic BP variability was associated with increased risk of cardiovascular events (hazard ratio [HR] per 1 mm Hg increase in BP variability 1.12, 95% confidence interval [CI] 1.01-1.25); diastolic BP variability was associated with all-cause mortality in RA (HR 1.14, 95%CI 1.03-1.27), adjusting for systolic and diastolic BP, body mass index, smoking, diabetes, dyslipidemia, use of antihypertensives. Conclusion Patients with RA had higher visit-to-visit systolic BP variability vs non-RA subjects. There was a significant decline in systolic BP variability after RA incidence. Higher visit-to-visit BP variability was associated with adverse cardiovascular outcomes and all-cause mortality in RA. PMID:24986852

  20. [Kapandji-Sauvé procedure for chronic disorders of the distal radioulnar joint with special regard to the long-term results].

    PubMed

    Daecke, W; Martini, A K; Streich, N A

    2003-05-01

    We present the preliminary results of a retrospective study on 56 patients who underwent the Kapandji-Sauvé procedure for chronic disorders of the distal radioulnar joint (DRUJ). Outcome was assessed with special regard to the long-term results. The average follow-up was 5.9 years (1 to 12 years). 15 of the 56 operations were performed before 1996. Most procedures were performed because of secondary arthrosis or chronic dislocation of the DRUJ after distal radius fracture. Patients were assessed for pain, range of motion of wrist and forearm and radiological features. The DASH score and Mayo wrist score were used. Pain was improved in 94 % of the patients, but only 53 % were free of symptoms during heavy manual labour concerning the operated site. In four cases symptoms of ulnar impingement were found. Improvement in range of motion of wrist and forearm was significant. The post-operative DASH score was 22.6 +/- 20.0 and the Mayo wrist score was 79.5 +/- 14.6. One non-union of the DRUJ with consecutive fracture of the fixation screw and an algodystrophy in another case were found as postoperative complications. The only long-term complication consisted of a beginning humeroradial arthrosis ten years after the operation. The results demonstrate high patient satisfaction and reliable improvement in range of motion. Our results confirm the Kapandji-Sauvé procedure to be a reliable salvage procedure for arthrosis or chronic dislocation of the DRUJ even after long-term follow up.

  1. Results of medical studies during long-term manned flights on the orbital Salyut-6 and Soyuz complex

    NASA Technical Reports Server (NTRS)

    Yegorov, A. D. (Compiler)

    1979-01-01

    Results of tests made on the crews of the Salyut-6 and Soyuz complex are presented. The basic results of studies made before, during and after 96-day and 140-day flights are presented in 5 sections: characteristics of flight conditions in the orbital complex; the cardiovascular system; the motor sphere and vestibular analyzer; biochemical, hematologic and immunologic studies; and recovery measures in the readaptation period.

  2. ADHD Treatment with Once-Daily OROS Methylphenidate: Final Results from a Long-term Open-Label Study

    ERIC Educational Resources Information Center

    Wilens, Timothy; McBurnett, Keith; Stein, Mark; Lerner, Marc; Spencer, Thomas; Wolraich, Mark

    2005-01-01

    Objective: Few studies have assessed effectiveness and tolerability of stimulants when used for prolonged periods in children with attention-deficit/hyperactivity disorder (ADHD). This article presents final results from an open-label, multisite study of a once-daily formulation of methylphenidate (MPH), OROS[R] MPH. Method: Subjects received OROS…

  3. Visual Input Enhancement via Essay Coding Results in Deaf Learners' Long-Term Retention of Improved English Grammatical Knowledge

    ERIC Educational Resources Information Center

    Berent, Gerald P.; Kelly, Ronald R.; Schmitz, Kathryn L.; Kenney, Patricia

    2009-01-01

    This study explored the efficacy of visual input enhancement, specifically "essay enhancement", for facilitating deaf college students' improvement in English grammatical knowledge. Results documented students' significant improvement immediately after a 10-week instructional intervention, a replication of recent research. Additionally, the…

  4. [Long term results (5 years) of the first 50 consecutive operations following Mustard's technique for simple transposition of the great vessels].

    PubMed

    Bex, J P; Baillot, F; Pilichovski, P; Lemoine, G

    1977-04-01

    The long-term results of Mustard's operation for simple transposition of the great vessels have been studied in a homogenous series of the first 50 consecutive cases operated on by G. Lemoine. The overall mortality was 20% over the 5 year follow-up period. Serious arrhythmias or conduction defects can usually be picked up immediately postoperatively; on the other hand, stenosis of the venae cavae or of the pulmonary venous channels may come on very late and unexpectedly as growth takes place. Reoperation must be carried out to remove these stenoses when they are troublesome.

  5. [Long-term results of treatment of tuberculosis in patients who had not received a full basic course of antimycobacterial therapy].

    PubMed

    Valets'kyĭ, Iu M

    2002-01-01

    In those TB patients who had not received a full basic course of antimycobacterial therapy, long-term results of treatment are much worse (development of early and late recurrences comes to be more commonly seen--by as high as 6.43 and 5.03% respectively; transition to a chronic form by 20.29%, case mortality by 6.04%, with clinical cure recordable by 37.75% more seldom) than in those patients having received a full basic course of the above therapy.

  6. Long-term results of a clinical trial comparing isolated vaginal stimulation with combined treatment for women with stress incontinence

    PubMed Central

    Fürst, Maria Cláudia Bicudo; de Mendonça, Rafaela Rosalba; Rodrigues, Alexandre Oliveira; de Matos, Leandro Luongo; Pompeo, Antônio Carlos Lima; Bezerra, Carlos Alberto

    2014-01-01

    ABSTRACT Objective To determine the efficacy of stress urinary incontinence treatments adding pelvic floor muscle training to vaginal electrical stimulation. Methods Forty-eight women with stress urinary incontinence were randomized into 2 groups: 24 underwent isolated vaginal electrical stimulation, and 24 vaginal electrical stimulation plus pelvic floor muscle training. History, physical examination, voiding diary, perineum strength test, and urodynamic study were assessed. Comparisons were made for adherence to treatment, muscle strength improvement, urinary symptoms, and degree of satisfaction immediately, 12 and 96 months after treatment. Results Patients' degree of satisfaction on vaginal electrical stimulation, and on vaginal electrical stimulation plus pelvic floor muscle training immediately, 12 and 96 months post treatment, were, respectively: 88.2% versus 88.9% 64.7% versus 61.1% and 42.9% versus 28.6% (p>0.05). Conclusion Vaginal electrical stimulation associated to pelvic floor muscle training did not show better results than vaginal electrical stimulation alone. PMID:25003921

  7. [Long-term results of dental health examinations of employees of industrial enterprises with hazardous working conditions].

    PubMed

    Olesova, V N; Uiba, V V; Novozemtseva, T N; Remizova, A A; Olesov, E E

    2017-01-01

    The article analyzes the results of dental examination of employees with hazardous and normal working conditions in Atomenergomash enterprise with various dental care organization regimens and provides clear evidence of the effectiveness of serial attendances care in enterprise dental offices in terms of reduction in the dental treatment needs. Additional funding for departmental dental services was calculated by comparing the real cost of dental treatment and MHI tariffs allowing implementation of proposed dental care program.

  8. Results of a long-term study of vapor intrusion at four large buildings at the NASA Ames Research Center.

    PubMed

    Brenner, David

    2010-06-01

    Most of the published empirical data on indoor air concentrations resulting from vapor intrusion of contaminants from underlying groundwater are for residential structures. The National Aeronautics and Space Administration (NASA) Research Park site, located in Moffett Field, CA, and comprised of 213 acres, is being planned for redevelopment as a collaborative research and educational campus with associated facilities. Groundwater contaminated with hydrocarbon and halogenated hydrocarbon volatile organic compounds (VOCs) is the primary environmental medium of concern at the site. Over a 15-month period, approximately 1000 indoor, outdoor ambient, and outdoor ambient background samples were collected from four buildings designated as historical landmarks using Summa canisters and analyzed by the U.S. Environmental Protection Agency TO-15 selective ion mode. Both 24-hr and sequential 8-hr samples were collected. Comparison of daily sampling results relative to daily background results indicates that the measured trichloroethylene (TCE) concentrations were primarily due to the subsurface vapor intrusion pathway, although there is likely some contribution due to infiltration of TCE from the outdoor ambient background concentrations. Analysis of the cis-1,2-dichloroethylene concentrations relative to TCE concentrations with respect to indoor air concentrations and the background air support this hypothesis; however, this indicates that relative contributions of the vapor intrusion and infiltration pathways vary with each building. Indoor TCE concentrations were also compared with indoor benzene and background benzene concentrations. These data indicate significant correlation between background benzene concentrations and the concentration of benzene in the indoor air, indicating benzene was present in the indoor air primarily through infiltration of outdoor air into the indoor space. By comparison, measured TCE indoor air concentrations showed a significantly different

  9. Visual input enhancement via essay coding results in deaf learners' long-term retention of improved English grammatical knowledge.

    PubMed

    Berent, Gerald P; Kelly, Ronald R; Schmitz, Kathryn L; Kenney, Patricia

    2009-01-01

    This study explored the efficacy of visual input enhancement, specifically essay enhancement, for facilitating deaf college students' improvement in English grammatical knowledge. Results documented students' significant improvement immediately after a 10-week instructional intervention, a replication of recent research. Additionally, the results of delayed assessment documented students' significant retention of that improvement five and a half months beyond the instructional intervention period. Essay enhancement served to highlight, via a coding procedure, students' successful and unsuccessful production of discourse-required target grammatical structures. The procedure converted students' written communicative output into enhanced input for inducing noticing of grammatical form and, through essay revision, establishing form-meaning connections leading to acquisition. With its optimal design characteristics supported by theoretical and empirical research, essay enhancement is a highly effective methodology that can be easily implemented as primary or supplementary English instruction for deaf students. The results of this study hold great promise for facilitating deaf students' English language and literacy development and have broad implications for second-language research, teaching, and learning.

  10. Longitudinal long-term results of surgical treatment in patients with osteochondritis dissecans of the femoral condyles.

    PubMed

    Bruns, Juergen; Rayf, Mark; Steinhagen, Joern

    2008-05-01

    In a longitudinal study, we performed a second follow-up examination on patients suffering from osteochondritis dissecans at the femoral condyles 10 years after a first follow-up, which had been performed 10 years after surgical treatment. Results (clinical score; radiological signs of OA) were analysed depending on the stage of the epiphyseal plate at the time of surgery, the used surgical procedure was divided into retrograde and anterograde procedures, and removal of loose bodies depending on the stage of the lesion. The analysis clearly exhibited that JOCD patients demonstrated better results than AOCD patients. The clinical score obtained after 10 years improved significantly with time, particularly for JOCD patients. Overall, when a retrograde procedure had been used in cases with an intact cartilage layer clinical results were better than those obtained in patients in whom an anterograde procedure with restoration of the joint surface or simple removal of the loose fragments had been performed. After a mean follow-up of 20 years the mean OA-stage was 0.27 in JOCD patients, whereas in AOCD patients a mean OA-stage of 1.55 was detected. Worst OA-changes were detected in patients in whom acrylic glue had been used for refixation of the loose bodies.

  11. Cervical artificial disc replacement versus fusion in the cervical spine: a systematic review comparing long-term follow-up results from two FDA trials

    PubMed Central

    Mummaneni, Praveen V.; Amin, Beejal Y.; Wu, Jau-Ching; Brodt, Erika D.; Dettori, Joseph R.; Sasso, Rick C.

    2012-01-01

    Study design: Systematic review. Clinical question: Does single-level unconstrained, semiconstrained, or fully constrained cervical artificial disc replacement (C-ADR) improve health outcomes compared with single-level anterior cervical discectomy and fusion (ACDF) in the long-term? Methods: A systematic review was undertaken for articles published up to October 2011. Electronic databases and reference lists of key articles were searched to identify US Food and Drug Administration (FDA) studies reporting long-term (≥ 48 months) follow-up results of C-ADR compared with ACDF. Non-FDA trials and FDA trials reporting outcomes at short-term or mid-term follow-up periods were excluded. Two independent reviewers assessed the strength of evidence using the GRADE criteria and disagreements were resolved by consensus. Results: Two FDA trials reporting outcomes following C-ADR (Bryan disc, Prestige disc) versus ACDF at follow-up periods of 48 months and 60 months were found (follow-up rates are 68.7% [318/463] and 50.1% [271/541], respectively). Patients in the C-ADR group showed a higher rate of overall success, greater improvements in Neck Disability Index, neck and arm pain scores, and SF-36 PhysicalComponent Scores at long-term follow-up compared with those in the ACDF group. The rate of adjacent segment disease was less in the C-ADR group versus the ACDF group at 60 months (2.9% vs 4.9%). Normal segmental motion was maintained in the C-ADR group. Furthermore, rates of revision and supplemental fixation surgical procedures were lower in the arthroplasty group. Conclusions: C-ADR is a viable treatment option for cervical herniated disc/spondylosis with radiculopathy resulting in improved clinical outcomes, maintenance of normal segmental motion, and low rates of subsequent surgical procedures at 4 to 5 years follow-up. More studies with long-term follow-up are warranted. PMID:23236315

  12. Californium-252 Brachytherapy Combined With External-Beam Radiotherapy for Cervical Cancer: Long-Term Treatment Results

    SciTech Connect

    Lei Xin; Qian Chengyuan; Qing Yi; Zhao Kewei; Yang Zhengzhou; Dai Nan; Zhong Zhaoyang; Tang Cheng; Li Zheng; Gu Xianqing; Zhou Qian; Feng Yan; Xiong Yanli; Shan Jinlu; Wang Dong

    2011-12-01

    Purpose: To observe, by retrospective analysis, the curative effects and complications due to californium-252 ({sup 252}Cf) neutron intracavitary brachytherapy (ICBT) combined with external-beam radiotherapy (EBRT) in the treatment of cervical cancer. Methods and Materials: From February 1999 to December 2007, 696 patients with cervical cancer (Stages IB to IIIB) were treated with {sup 252}Cf-ICBT in combination of EBRT. Of all, 31 patients were at Stage IB, 104 at IIA, 363 at IIB, 64 at IIIA, and 134 at IIIB. Californium-252 ICBT was delivered at 7-12 Gy per insertion per week, with a total dose of 29-45 Gy to reference point A in three to five insertions. The whole pelvic cavity was treated with 8-MV X-ray external irradiation at 2 Gy per fraction, four times per week. After 16-38 Gy of external irradiation, the center of the whole pelvic field was blocked with a 4-cm-wide lead shield, with a total external irradiation dose of 44-56 Gy. The total treatment course was 5 to 6 weeks. Results: Overall survival rate at 3 and 5 years for all patients was 76.0% and 64.9%, respectively. Disease-free 3- and 5-year survival rates of patients were 71.2% and 58.4%, respectively. Late complications included vaginal contracture and adhesion, radiation proctitis, radiation cystitis, and inflammatory bowel, which accounted for 5.8%, 7.1%, 6.2%, and 4.9%, respectively. Univariate analysis results showed significant correlation of stage, age, histopathologic grade, and lymph node status with overall survival. Cox multiple regression analysis showed that the independent variables were stage, histopathologic grade, tumor size, and lymphatic metastasis in all patients. Conclusion: Results of this series suggest that the combined use of {sup 252}Cf-ICBT with EBRT is an effective method for treatment of cervical cancer.

  13. Long-term environmental radioactive contamination of Europe due to the Chernobyl accident - Results of the Joint Danube Survey 2013.

    PubMed

    Maringer, Franz Josef; Ackerl, Claudia; Baumgartner, Andreas; Burger-Scheidlin, Christopher; Kocadag, Maria; Sterba, Johannes H; Stietka, Michael; Welch, Jan Matthew

    2017-02-27

    In the course of the Joint Danube Survey 3 (JDS3), coordinated by the International Commission for the Protection of the Danube River (ICPDR), laboratory ships travelled 2375km down the Danube River engaging in sampling, processing and on-board analyses during the summer of 2013. The results of the radiometric analysis of (90)Sr, (137)Cs and natural radionuclides in recent riverbed sediment are presented. The activity concentrations of (90)Sr and (137)Cs in Danube sediments have been found below 100Bq/kg.

  14. Binaries with a δ Scuti Component: Results from a Long-Term Observational Survey, Updated Catalog, and Future Prospects

    NASA Astrophysics Data System (ADS)

    Liakos, A.; Niarchos, P.

    2015-07-01

    Results are presented from a six-year systematic observational survey of candidate eclipsing binaries with a δ Sct component. More than one hundred systems with component(s) of spectral type A-F were observed in order to check for possible pulsational behavior. Some ˜14% (13 cases) among the currently known systems of this class were confirmed. We present an updated list of all currently known δ Sct systems in eclipsing binaries based on all available information from the literature. Possible correlations between their pulsational and binary properties are discussed.

  15. Externalizing Psychopathology and Marital Adjustment in Long-Term Marriages: Results from a Large Combined Sample of Married Couples

    PubMed Central

    Humbad, Mikhila N.; Donnellan, M. Brent; Iacono, William G.; Burt, S. Alexandra

    2009-01-01

    The current study evaluated the associations between externalizing psychopathology and marital adjustment in a combined sample of 1,805 married couples. We further considered the role of personality in these associations, as personality has been found to predict both the development of externalizing psychopathology as well as marital distress and instability. Diagnostic interviews assessed Conduct Disorder, adult symptoms of Antisocial Personality Disorder, and Alcohol Dependence. Personality was assessed using the Multidimensional Personality Questionnaire. The Dyadic Adjustment Scale was used to measure marital adjustment. Results indicate that more externalizing psychopathology, greater Negative Emotionality, and lower Communal Positive Emotionality were associated with reduced marital adjustment in both individuals and their spouses. Low Constraint was associated with reduced marital adjustment for individuals but not for their spouses. Multivariate analyses indicated externalizing psychopathology continued to predict marital adjustment even when accounting for overlap with personality. These results highlight the importance of examining the presence of externalizing psychopathology and the personality attributes of both members of a dyad when considering psychological predictors of marital adjustment. PMID:20141252

  16. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results*

    PubMed Central

    Maciel, Paula Curitiba; Veiga-Filho, Joel; de Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    BACKGROUND Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. OBJECTIVE To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. METHODS Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. RESULTS Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. CONCLUSION Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing. PMID:25054746

  17. Long-Term Results from Evaluation of Advanced New Construction Packages in Test Homes. Martha's Vineyard, Massachusetts

    SciTech Connect

    Stecher, Dave; Allison, Katherine; Prahl, Duncan

    2012-10-01

    This report presents a cold climate project located in West Tisbury, Massachusetts, on the island of Martha’s Vineyard, that examines the relationships among very energy efficient single-family residential thermal enclosures, room-to-room temperature variations, and simplified space conditioning systems. Each of the four homes studied has a single ductless heat pump unit (DHU) located in the main living space and radiant electric resistance panels in each bedroom with individual thermostatic controls. Results indicate that temperature fluctuations in the living room due to aggressive setup and setback of the DHU may contribute to higher percentages of time where the bedroom temperatures were within +/-2°F of the living room temperatures. Solar gains in the living room, door opening/closure and occupant manipulation of thermostats appear to have had a significant impact on room-to-room temperature differences, as would be expected.

  18. PICARD SOL, a new ground-based facility for long-term solar radius measurements: first results

    NASA Astrophysics Data System (ADS)

    Meftah, M.; Corbard, T.; Irbah, A.; Morand, F.; Ikhlef, R.; Renaud, C.; Hauchecorne, A.; Assus, P.; Chauvineau, B.; Crepel, M.; Dalaudier, F.; Djafer, D.; Fodil, M.; Laclare, F.; Lesueur, P.; Lin, M.; Poiet, G.

    2013-06-01

    PICARD SOL is the ground component of the PICARD mission and is operational since March 2011. A set of instruments including the replica of the space instrument and several atmospheric monitors was set up at Calern observatory in order to compare solar radius measured in space and on ground and to better understand and calibrate atmospheric effects on ground based measurements. SODISMII provides full disk images of the chromosphere and photosphere of the Sun in five narrow pass bands ranging from the near ultraviolet to the near infrared. Our preliminary results show a very good instrumental stability. After plate scale calibration using star doublet observations and corrections for atmospheric refraction, first estimates of the mean solar radius at the five wavelengths (393.37, 535.7, 607.1, 782.2, and 1025.0nm) are deduced from measurements recorded between May 2011 and December 2012.

  19. Long term follow-up results of dorsal root entry zone lesions for intractable pain after brachial plexus avulsion injuries.

    PubMed

    Chen, H J; Tu, Y K

    2006-01-01

    Brachial plexus avulsion injury is one of the major complications after traffic, especially motorcycle accidents and machine injuries. Intractable pain and paralysis of the affected limbs are the major neurological deficits. During the past 18 years, we have encountered and treated more than 500 cases with brachial plexus avulsion injuries. Dorsal root entry zone lesions (DREZ) made by thermocoagulation were performed for intractable pain in 60 cases. Forty cases were under regular follow-up for 5-18 years. In early postoperative stage, the pain relief rate was excellent or good in 32 cases (80%). The pain relief rate dropped to 60% in 5 year follow-up period and only 9 cases (50%) had excellent or good result in 10 year follow-up. Reconstructive procedures were performed in almost all patients in the last 10 years. Dorsal root entry zone lesion is an effective procedure for pain control after brachial plexus avulsion injuries.

  20. Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial

    PubMed Central

    Gohel, Manjit S; Barwell, Jamie R; Taylor, Maxine; Chant, Terry; Foy, Chris; Earnshaw, Jonothan J; Heather, Brian P; Mitchell, David C; Whyman, Mark R

    2007-01-01

    Objective To determine whether recurrence of leg ulcers may be prevented by surgical correction of superficial venous reflux in addition to compression. Design Randomised controlled trial. Setting Specialist nurse led leg ulcer clinics in three UK vascular centres. Participants 500 patients (500 legs) with open or recently healed leg ulcers and superficial venous reflux. Interventions Compression alone or compression plus saphenous surgery. Main outcome measures Primary outcomes were ulcer healing and ulcer recurrence. The secondary outcome was ulcer free time. Results Ulcer healing rates at three years were 89% for the compression group and 93% for the compression plus surgery group (P=0.73, log rank test). Rates of ulcer recurrence at four years were 56% for the compression group and 31% for the compression plus surgery group (P<0.01). For patients with isolated superficial reflux, recurrence rates at four years were 51% for the compression group and 27% for the compress plus surgery group (P<0.01). For patients who had superficial with segmental deep reflux, recurrence rates at three years were 52% for the compression group and 24% for the compression plus surgery group (P=0.04). For patients with superficial and total deep reflux, recurrence rates at three years were 46% for the compression group and 32% for the compression plus surgery group (P=0.33). Patients in the compression plus surgery group experienced a greater proportion of ulcer free time after three years compared with patients in the compression group (78% v 71%; P=0.007, Mann-Whitney U test). Conclusion Surgical correction of superficial venous reflux in addition to compression bandaging does not improve ulcer healing but reduces the recurrence of ulcers at four years and results in a greater proportion of ulcer free time. Trial registration Current Controlled Trials ISRCTN07549334. PMID:17545185

  1. Long-Term Results of Brachytherapy for Carcinoma of the Penis Confined to the Glans (N- or NX)

    SciTech Connect

    Crevoisier, Renaud de Slimane, Khemais; Sanfilippo, Nicholas; Bossi, Alberto; Albano, Maryvonne; Dumas, Isabelle; Wibault, Pierre; Fizazi, Karim; Gerbaulet, Alain; Haie-Meder, Christine

    2009-07-15

    Purpose: To analyze the results of exclusive interstitial low-dose-rate brachytherapy (BT) for squamous cell carcinoma (SCC) of the penis, strictly confined to the glans. Methods and Materials: A total of 144 patients with SSC of the glans penis were treated with BT. Inguinal nodal dissection was performed in 19% of patients (all N-). After circumcision, BT was performed using the hypodermic needle technique. Median iridium length per patients was 24 cm (range, 4-108) and median dose was 65 Gy (range, 37-75). Median treated volume was 22 cm{sup 3} (range, 5-110) and median reference isodose rate was 0.4 Gy/h (range, 0.2-1.2). Results: Median follow-up was 5.7 years (range, 0.5-29). The 10-year penile recurrence, inguinal lymph node recurrence, and inguinal nodal metastasis rates were: 20% (CI 95%, 11-29), 11% (CI 95%, 5-17), and 6% (CI 95%, 2-10), respectively. After salvage treatment, 86% patients with local failure were in a complete remission at last follow-up. The 10-year probability of avoiding penile surgery (for complication or local recurrence) was 72% (CI 95%, 62-82). The 10-year cancer-specific survival rate was 92% (CI 95%, 87-97). Diameter of tumor significantly increased the risk of recurrence (p = 0.02). The 10-year painful ulceration and stenosis risk rates were: 26% (CI 95%, 17-35) and 29% (CI 95%, 18-40), respectively. Seven patients required excision for necrosis. Treated volume and reference isodose rate significantly increased the risk of complications. Conclusion: BT is an effective conservative treatment for SCC confined to the glans. Salvage local treatment is effective. Dose rate should be limited to decrease toxicity.

  2. The long term response of birds to climate change: new results from a cold stage avifauna in northern England.

    PubMed

    Stewart, John R; Jacobi, Roger M

    2015-01-01

    The early MIS 3 (55-40 Kyr BP associated with Middle Palaeolithic archaeology) bird remains from Pin Hole, Creswell Crags, Derbyshire, England are analysed in the context of the new dating of the site's stratigraphy. The analysis is restricted to the material from the early MIS 3 level of the cave because the upper fauna is now known to include Holocene material as well as that from the Late Glacial. The results of the analysis confirm the presence of the taxa, possibly unexpected for a Late Pleistocene glacial deposit including records such as Alpine swift, demoiselle crane and long-legged buzzard with southern and/or eastern distributions today. These taxa are accompanied by more expected ones such as willow ptarmigan /red grouse and rock ptarmigan living today in northern and montane areas. Finally, there are temperate taxa normally requiring trees for nesting such as wood pigeon and grey heron. Therefore, the result of the analysis is that the avifauna of early MIS 3 in England included taxa whose ranges today do not overlap making it a non-analogue community similar to the many steppe-tundra mammalian faunas of the time. The inclusion of more temperate and woodland taxa is discussed in the light that parts of northern Europe may have acted as cryptic northern refugia for some such taxa during the last glacial. These records showing former ranges of taxa are considered in the light of modern phylogeographic studies as these often assume former ranges without considering the fossil record of those taxa. In addition to the anomalous combination of taxa during MIS 3 living in Derbyshire, the individuals of a number of the taxa are different in size and shape to members of the species today probably due to the high carrying capacity of the steppe-tundra.

  3. The Long Term Response of Birds to Climate Change: New Results from a Cold Stage Avifauna in Northern England

    PubMed Central

    Stewart, John R.

    2015-01-01

    The early MIS 3 (55–40 Kyr BP associated with Middle Palaeolithic archaeology) bird remains from Pin Hole, Creswell Crags, Derbyshire, England are analysed in the context of the new dating of the site’s stratigraphy. The analysis is restricted to the material from the early MIS 3 level of the cave because the upper fauna is now known to include Holocene material as well as that from the Late Glacial. The results of the analysis confirm the presence of the taxa, possibly unexpected for a Late Pleistocene glacial deposit including records such as Alpine swift, demoiselle crane and long-legged buzzard with southern and/or eastern distributions today. These taxa are accompanied by more expected ones such as willow ptarmigan /red grouse and rock ptarmigan living today in northern and montane areas. Finally, there are temperate taxa normally requiring trees for nesting such as wood pigeon and grey heron. Therefore, the result of the analysis is that the avifauna of early MIS 3 in England included taxa whose ranges today do not overlap making it a non-analogue community similar to the many steppe-tundra mammalian faunas of the time. The inclusion of more temperate and woodland taxa is discussed in the light that parts of northern Europe may have acted as cryptic northern refugia for some such taxa during the last glacial. These records showing former ranges of taxa are considered in the light of modern phylogeographic studies as these often assume former ranges without considering the fossil record of those taxa. In addition to the anomalous combination of taxa during MIS 3 living in Derbyshire, the individuals of a number of the taxa are different in size and shape to members of the species today probably due to the high carrying capacity of the steppe-tundra. PMID:25992609

  4. Postoperative interstitial brachytherapy in eyelid cancer: long term results and assessment of Cosmesis After Interstitial Brachytherapy scale

    PubMed Central

    Basu, Trinanjan; Chaudhary, Suresh; Chaukar, Devendra; Nadkarni, Mandar; GN, Manjunatha

    2014-01-01

    Purpose To analyse feasibility and safety of postoperative interstitial brachytherapy (IBRT) in patients of eyelid cancer treated primarily by surgical excision. Material and methods In this series, 8 patients with eyelid cancer were treated using postoperative interstitial brachytherapy. Patients were followed up for local control, cosmetic outcome, and acute and late toxicities. Cosmetic outcome was measured using a 6 point indigenous Cosmesis After Interstitial Brachytherapy (CAIB) scale. Results The patients were between 23-82 years (median: 71 years). There were 3 females and 5 males, and 3 patients had lesions in upper eyelid. Postoperative high-dose-rate brachytherapy was used in all with 2 catheters implanted in most of them (6 out of 8). Local control was calculated from end of treatment to last follow-up. At last follow-up, all patients remained locally controlled. Two patients had nodal recurrence 6 months after interstitial brachytherapy and were salvaged effectively by external beam radiotherapy. At last follow-up, 7 patients were loco-regionally controlled and one was lost to follow up. All patients had Radiation Therapy Oncology Group (RTOG) grade 1 acute toxicity and 2 had grade 1 Common Terminology Criteria for Adverse Events (CTCAE) version.3 late toxicities. The cosmesis score for the whole group ranged between 0-1 indicating excellent to very good cosmesis. Conclusions Postoperative high-dose-rate brachytherapy resulted in excellent disease control and cosmesis without significant acute or late toxicities. It is an effective modality for treatment of eyelid cancers in selected patients. Future prospective studies with the validation of CAIB scale would give us more insight to this effective yet often ignored modality of IBRT. PMID:25834578

  5. Combating the Urban Heat Island Effect: Results from a Long-Term Monitoring Study on Urban Green, White, and Black Roofs in New York City

    NASA Astrophysics Data System (ADS)

    Gaffin, S. R.; Kong, A. Y.; Hartung, E.; Hsu, B.; Roditi, A.; Rosenzweig, C.

    2011-12-01

    Urban heat island mitigation strategies include increasing urban vegetation and increasing the albedo of impervious surfaces. Vegetated "green" roofs can provide benefits to stormwater management, water quality, energy cost efficiency, and biodiversity in cities, but the body of research on green roofs in the US is not large and cities in the US have been slow to adopt green roofs. On the other hand, "high-albedo" white roofs have been applied more widely through projects such as New York City Cool Roofs. There are several major issues (e.g., albedo decline, product differences, and long-term temperature controls) about green and white roof performance versus typical black roofs with respect to urban heat island mitigation that have yet to be fully addressed. Here, we present data from an on-going, long-term study in New York City in which pilot, urban albedo enhancement and vegetation effects have been monitored at the building-scale since 2007. Although the urban heat island effect can be detected throughout the year, our objective for this paper was to compare green roof vegetation with those of the high-albedo roofs for their ability to reduce the electricity demand for cooling in the summer. Using energy balance methodology across our sites (three), we found that green and white roof membrane temperature peaks are on average 60°F (33°C) and 30° F (17°C), respectively, cooler than black roof temperature peaks, and that these alternative surfaces significantly reduce thermal stress to roof membranes. Interestingly, we found that industrial white membranes [thermoplastic polyolefin (TPO) and ethylene propylene diene monomer (EPDM)] stay cleaner longer, thereby, maintaining the high-albedo benefits longer than the painted roofs, which tend to lose their albedo properties rapidly. Results thus far suggest that more long-term research comparing the albedo and cooling benefits of green and white roofs to black roofs is necessary to understand temporal changes to

  6. Direct adsorption of low-density lipoprotein and lipoprotein(a) from whole blood: results of the first clinical long-term multicenter study using DALI apheresis.

    PubMed

    Bosch, T; Lennertz, A; Schenzle, D; Dräger, J

    2002-01-01

    Direct adsorption of lipoproteins (DALI) is the first low-density lipoprotein (LDL)-apheresis technique by which atherogenic LDL and lipoprotein(a) (Lp(a)) can be selectively removed from whole blood without plasma separation. The present study was performed to evaluate the efficacy, selectivity and safety of long-term DALI apheresis. Sixty-three hypercholesterolemic coronary patients were treated by weekly DALI sessions. Initial LDL-cholesterol (C) plasma levels averaged 238 +/- 87 mg/dl (range 130-681 mg/dl). On average, 34 sessions (1-45) were performed processing 1.5 patient blood volumes. The primary aim was to acutely reduce LDL-C by >or=60% per session. To this end, three different adsorber sizes could be employed, i.e., DALI 500, 750, and 1000, which were used in 4, 73, and 23% of the 2156 sessions, respectively. On average, 7387 ml of blood were processed in 116 min per session. This resulted in the following mean acute changes: LDL-C 198 --> 63 mg/dl (-69%), Lp(a) 86 --> 32 mg/dl (-64%), triglycerides 185 --> 136 mg/dl (-27%). HDL-C (-11%) and fibrinogen (-15%) were not significantly influenced. The mean long-term reduction of LDL-C was 42% compared to baseline while HDL-C slightly increased in the long run (+4%). The selectivity of LDL removal was good as recoveries of albumin, immunoglobulins, and other proteins exceeded 85%. Ninety-five percent of 2156 sessions were completely uneventful. The most frequent adverse effects were hypotension (1.2% of sessions) and paresthesia (1.1%), which were probably due to citrate anticoagulation. Access problems had to be overcome in 1.5%, adsorber and hardware problems in 0.5% of the sessions. In this multicenter long-term study, DALI apheresis proved to be an efficient, safe, and easy procedure for extracorporeal LDL and Lp(a) elimination.

  7. Antibody persistence and immunologic memory in children vaccinated with 4 doses of pneumococcal conjugate vaccines: Results from 2 long-term follow-up studies

    PubMed Central

    Wysocki, Jacek; Brzostek, Jerzy; Konior, Ryszard; Panzer, Falko G.; François, Nancy A.; Ravula, Sudheer M.; Kolhe, Devayani A.; Song, Yue; Dieussaert, Ilse; Schuerman, Lode; Borys, Dorota

    2017-01-01

    ABSTRACT To investigate long-term antibody persistence following the administration of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV), we present results of 2 follow-up studies assessing antibody persistence following 2 3+1 schedules up to 4 (NCT00624819 – Study A) and 5 years (NCT00891176 – Study B) post-booster vaccination. In Study A, antibody persistence was measured one, 2 and 4 years post-booster in children previously primed and boosted with PHiD-CV, or primed with the 7-valent pneumococcal conjugate vaccine (7vCRM) and boosted with either PHiD-CV or 7vCRM. In Study B, PHiD-CV was co-administered with meningococcal vaccines, and pneumococcal antibody persistence was measured 2, 3 and 5 years post-booster. An age-matched control group, unvaccinated against Streptococcus pneumoniae, was enrolled in Study A, allowing assessment of immunologic memory by administration of one dose of PHiD-CV to both primed (4 years post-booster) and unprimed 6-year-old children. Four years post-booster (Study A), antibody concentrations and opsonophagocytic activity (OPA) titers remained higher compared to the pre-booster timepoint, with no major differences between the 3 primed groups. Antibody persistence was also observed in Study B, with minimal differences between groups. The additional PHiD-CV dose administered 4 years post-booster in Study A elicited more robust immune responses in primed children than in unprimed children. Long-term serotype-specific antibody persistence and robust immunologic memory responses observed in these 2 studies suggest induction of long-term protection against pneumococcal disease after PHiD-CV vaccination. PMID:27736293

  8. Antibody persistence and immunologic memory in children vaccinated with 4 doses of pneumococcal conjugate vaccines: Results from 2 long-term follow-up studies.

    PubMed

    Wysocki, Jacek; Brzostek, Jerzy; Konior, Ryszard; Panzer, Falko G; François, Nancy A; Ravula, Sudheer M; Kolhe, Devayani A; Song, Yue; Dieussaert, Ilse; Schuerman, Lode; Borys, Dorota

    2016-10-13

    To investigate long-term antibody persistence following the administration of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV), we present results of 2 follow-up studies assessing antibody persistence following 2 3+1 schedules up to 4 (NCT00624819 - Study A) and 5 years (NCT00891176 - Study B) post-booster vaccination. In Study A, antibody persistence was measured one, 2 and 4 years post-booster in children previously primed and boosted with PHiD-CV, or primed with the 7-valent pneumococcal conjugate vaccine (7vCRM) and boosted with either PHiD-CV or 7vCRM. In Study B, PHiD-CV was co-administered with meningococcal vaccines, and pneumococcal antibody persistence was measured 2, 3 and 5 years post-booster. An age-matched control group, unvaccinated against Streptococcus pneumoniae, was enrolled in Study A, allowing assessment of immunologic memory by administration of one dose of PHiD-CV to both primed (4 years post-booster) and unprimed 6-year-old children. Four years post-booster (Study A), antibody concentrations and opsonophagocytic activity (OPA) titers remained higher compared to the pre-booster timepoint, with no major differences between the 3 primed groups. Antibody persistence was also observed in Study B, with minimal differences between groups. The additional PHiD-CV dose administered 4 years post-booster in Study A elicited more robust immune responses in primed children than in unprimed children. Long-term serotype-specific antibody persistence and robust immunologic memory responses observed in these 2 studies suggest induction of long-term protection against pneumococcal disease after PHiD-CV vaccination.

  9. Long-Term Results of a Randomized Trial in Locally Advanced Rectal Cancer: No Benefit From Adding a Brachytherapy Boost

    SciTech Connect

    Appelt, Ane L.; Vogelius, Ivan R.; Pløen, John; Rafaelsen, Søren R.; Lindebjerg, Jan; Havelund, Birgitte M.; Bentzen, Søren M.; Jakobsen, Anders

    2014-09-01

    Purpose/Objective(s): Mature data on tumor control and survival are presented from a randomized trial of the addition of a brachytherapy boost to long-course neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer. Methods and Materials: Between March 2005 and November 2008, 248 patients with T3-4N0-2M0 rectal cancer were prospectively randomized to either long-course preoperative CRT (50.4 Gy in 28 fractions, per oral tegafur-uracil and L-leucovorin) alone or the same CRT schedule plus a brachytherapy boost (10 Gy in 2 fractions). The primary trial endpoint was pathologic complete response (pCR) at the time of surgery; secondary endpoints included overall survival (OS), progression-free survival (PFS), and freedom from locoregional failure. Results: Results for the primary endpoint have previously been reported. This analysis presents survival data for the 224 patients in the Danish part of the trial. In all, 221 patients (111 control arm, 110 brachytherapy boost arm) had data available for analysis, with a median follow-up time of 5.4 years. Despite a significant increase in tumor response at the time of surgery, no differences in 5-year OS (70.6% vs 63.6%, hazard ratio [HR] = 1.24, P=.34) and PFS (63.9% vs 52.0%, HR=1.22, P=.32) were observed. Freedom from locoregional failure at 5 years were 93.9% and 85.7% (HR=2.60, P=.06) in the standard and in the brachytherapy arms, respectively. There was no difference in the prevalence of stoma. Explorative analysis based on stratification for tumor regression grade and resection margin status indicated the presence of response migration. Conclusions: Despite increased pathologic tumor regression at the time of surgery, we observed no benefit on late outcome. Improved tumor regression does not necessarily lead to a relevant clinical benefit when the neoadjuvant treatment is followed by high-quality surgery.

  10. Long-term results of first salvage treatment in CLL patients treated initially with FCR (fludarabine, cyclophosphamide, rituximab)

    PubMed Central

    Tam, Constantine S.; O’Brien, Susan; Plunkett, William; Wierda, William; Ferrajoli, Alessandra; Wang, Xuemei; Do, Kim-Anh; Cortes, Jorge; Khouri, Issa; Kantarjian, Hagop; Lerner, Susan

    2014-01-01

    Although fludarabine, cyclophosphamide, and rituximab (FCR) together are established as a standard first-line treatment of younger patients with chronic lymphocytic leukemia (CLL), there is little information to guide the management of patients with CLL refractory to, or who have relapsed after, receiving frontline FCR treatment. To define optimal salvage strategy and identify patients unsuitable for retreatment with FCR, we examined the survival and treatment outcome of 300 patients enrolled in a phase 2 study of FCR. After a median 142 months of follow-up, 156 patients developed progressive CLL, with a median survival of 51 months after disease progression. The duration of first remission (REM1) was a key determinant of survival after disease progression and first salvage. Patients with a short REM1 (<3 years) had a short survival period, irrespective of salvage therapy received; these patients have high unmet medical needs and are good candidates for investigation of novel therapies. In patients with a long REM1 (≥3 years), salvage treatment with either repeat FCR or lenalidomide-based therapy results in subsequent median survival exceeding 5 years; for these patients, FCR rechallenge represents a reasonable standard of care. PMID:25281606

  11. Long-term results of first salvage treatment in CLL patients treated initially with FCR (fludarabine, cyclophosphamide, rituximab).

    PubMed

    Tam, Constantine S; O'Brien, Susan; Plunkett, William; Wierda, William; Ferrajoli, Alessandra; Wang, Xuemei; Do, Kim-Anh; Cortes, Jorge; Khouri, Issa; Kantarjian, Hagop; Lerner, Susan; Keating, Michael J

    2014-11-13

    Although fludarabine, cyclophosphamide, and rituximab (FCR) together are established as a standard first-line treatment of younger patients with chronic lymphocytic leukemia (CLL), there is little information to guide the management of patients with CLL refractory to, or who have relapsed after, receiving frontline FCR treatment. To define optimal salvage strategy and identify patients unsuitable for retreatment with FCR, we examined the survival and treatment outcome of 300 patients enrolled in a phase 2 study of FCR. After a median 142 months of follow-up, 156 patients developed progressive CLL, with a median survival of 51 months after disease progression. The duration of first remission (REM1) was a key determinant of survival after disease progression and first salvage. Patients with a short REM1 (<3 years) had a short survival period, irrespective of salvage therapy received; these patients have high unmet medical needs and are good candidates for investigation of novel therapies. In patients with a long REM1 (≥3 years), salvage treatment with either repeat FCR or lenalidomide-based therapy results in subsequent median survival exceeding 5 years; for these patients, FCR rechallenge represents a reasonable standard of care.

  12. Long-term quasi-periodicity of 4U 1636-536 resulting from accretion disc instability

    NASA Astrophysics Data System (ADS)

    Wisniewicz, Mateusz; Zdziarski, Andrzej; Janiuk, Agnieszka; Rosinska, Dorota; Slowikowska, Agnieszka

    2016-07-01

    We present the results of a study of the low-mass X-ray binary 4U 1636-536. We have performed temporal analysis of all available RXTE/ASM, RXTE/PCA, Swift/BAT and MAXI data. We have confirmed the previously discovered quasi-periodicity of ˜45 d present during ˜2004, however we found it continued to 2006. At other epochs, the quasi-periodicity is only transient, and the quasi-period, if present, drifts. We have then applied a time-dependent accretion disc model to the interval with the significant X-ray quasi-periodicity. For our best model, the period and the amplitude of the theoretical light curve agree well with that observed. The modelled quasi-periodicity is due to the hydrogen thermal-ionization instability occurring in outer regions of the accretion disc. The model parameters are the average mass accretion rate (estimated from the light curves), and the accretion disc viscosity parameters, α_{cold} and α_{hot}, for the hot and cold phases, respectively. Our best model gives relatively low values of α_{cold} and α_{hot}.

  13. Treatment of malreduced pilon fracture: A case report and the result in the long-term follow-up

    PubMed Central

    Balioğlu, Mehmet Bulent; Akman, Yunus Emre; Bahar, Hakan; Albayrak, Akif

    2015-01-01

    Introduction The risk for post-traumatic osteoarthritis (POA) following tibial plafond joint trauma has been reported to be as high as 70–75%. In the treatment of more severe joint pathologies, with incongruity and intra-articular defects, internal or external fixations techniques may be required. Presentation of case We report the orthopedic management of a pilon fracture in a 30-year-old male with malunion and implant failure after initial mal-reduction of the fracture 9-months earlier. Tricortical iliac crest autologous bone grafting (TCG) was used in combination with internal fixation to restore distal tibial articular. The procedure resulted in a pain free ankle, sufficient range of motion for function and patient satisfaction. Discussion Early surgical intervention and anatomical reduction with appropriate fixation are recommended for intra-articular tibial pilon fractures. Autogenous bone grafting is a reliable treatment option to augment structural stability, bone defects and bone-healing. Indications for bone grafting include delayed union or nonunion, malunion, arthrodesis, limb salvage, and reconstruction of bone voids or defects. The application of TCG in the management of a malreduced tibial plafond fracture has not been described before. Conclusion We performed TCG with internal fixation in order to restore stability, congruency and alignment in a young patient in whom a biological restoration was feasible due to good bone quality. In suitable cases, TCG might provide an alternative to arthrodesis or arthroplasty. PMID:26724734

  14. Long-Term Efficacy and Safety Profile of Lanthanum Carbonate: Results for up to 6 Years of Treatment

    PubMed Central

    Hutchison, Alastair J.; Barnett, M. Edwina; Krause, Rolfdieter; Kwan, Jonathan T.C.; Siami, Ghodrat A.

    2008-01-01

    Background/Aims Lanthanum carbonate (LC, FOSRENOL®) is an effective phosphate binder for which tolerability and a safety profile have been reported in haemodialysis patients. Patients from previous studies entered a 2-year extension, enabling assessment of efficacy and safety for up to 6 years of LC monotherapy. Methods Patients from four previous trials entered this study. Results Ninety-three patients started the extension, with 22 entering a sixth year of LC treatment. Two-thirds of all patients received LC doses of 2,250 or 3,000 mg/day. Reductions in serum phosphate and calcium × phosphate product were maintained for up to 6 years. There were no new or unexpected adverse events (AEs), and no increase in the incidence of events with increasing treatment exposure. Over the complete duration of therapy, treatment-related AEs occurred in 25.8% of patients and were primarily gastrointestinal in nature. No clinically relevant changes in liver function tests were observed and there was no evidence of adverse effects on the liver, bone or the central nervous system. Conclusions LC monotherapy was effective and well tolerated for up to 6 years with no evidence of safety concerns or increased frequency of AEs. PMID:18667837

  15. Results of the Komplast experiment on the long-term exposure of materials specimens on the ISS surface

    NASA Astrophysics Data System (ADS)

    Shumov, A. E.; Novikov, L. S.; Shaevich, S. K.; Aleksandrov, N. G.; Smirnova, T. N.; Nikishin, E. F.; Chernik, V. N.; Petukhov, V. P.; Voronina, E. N.; Sedov, V. V.; Salnikova, I. A.; Babaevskiy, P. G.; Kozlov, N. A.; Deev, I. S.; Startsev, O. V.; Shindo, D. J.; Golden, J. L.; Kravchenko, M.

    2015-11-01

    The Komplast materials experiment was designed by Khrunichev State Research and Production Space Center together with Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University and other Russian scientific institutes, and has been carried out by Mission Control Moscow since 1998. The purpose of this experiment is to study the complex effect of the low Earth orbit environment on samples of various spacecraft materials. On November 20, 1998 the Komplast experiment began with the launch of the first International Space Station module Zarya, or Functional Cargo Block (FGB). Eight Komplast panels with samples of materials and sensors were installed on the outer surface of FGB module. Two of eight experiment panels were retrieved during Russian extravehicular activity in February 2011 after 12 years of space exposure and were subsequently returned to Earth by Space Shuttle "Discovery" on the STS-133/ULF-5 mission in March 2011. The article presents the results obtained from this unique long-duration experiment on board of the International Space Station.

  16. Long Term Maturation of Congenital Diaphragmatic Hernia Treatment Results: Toward Development of a Severity-Specific Treatment Algorithm

    PubMed Central

    Kays, David W.; Islam, Saleem; Larson, Shawn D.; Perkins, Joy; Talbert, James L.

    2015-01-01

    Objective To assess the impact of varying approaches to CDH repair timing on survival and need for ECMO when controlled for anatomic and physiologic disease severity in a large consecutive series of CDH patients. Summary Background Data Our publication of 60 consecutive CDH patients in 1999 showed that survival is significantly improved by limiting lung inflation pressures and eliminating hyperventilation. Methods We retrospectively reviewed 268 consecutive CDH patients, combining 208 new patients with the 60 previously reported. Management and ventilator strategy were highly consistent throughout. Varying approaches to surgical timing were applied as the series matured. Results Patients with anatomically less-severe left liver-down CDH had significantly increased need for ECMO if repaired in the first 48 hours, while patients with more-severe left liver-up CDH survived at a higher rate when repair was performed before ECMO. Overall survival of 268 patients was 78%. For those without lethal associated anomalies, survival was 88%. Of these, 99% of left liver-down CDH survived, 91% of right CDH survived. and 76% of left liver-up CDH survived. Conclusions This study shows that patients with anatomically less severe CDH benefit from delayed surgery while patients with anatomically more severe CDH may benefit from a more aggressive surgical approach. These findings show that patients respond differently across the CDH anatomic severity spectrum, and lay the foundation for the development of risk specific treatment protocols for patients with CDH. PMID:23989050

  17. Long-Term Results from Evaluation of Advanced New Construction Packages in Test Homes: Martha's Vineyard, Massachusetts

    SciTech Connect

    Stecher, D.; Allison, K.; Prahl, D.

    2012-10-01

    This report presents a cold climate project that examines the relationships among very energy efficient single-family residential thermal enclosures, room-to-room temperature variations, and simplified space conditioning systems. The project is located in West Tisbury, Massachusetts, on the island of Martha's Vineyard, and allowed for the comparison of room-to-room temperatures in four virtually identical houses that were all built to the same construction standard. The four homes each has a single ductless heat pump unit (DHU) located in the main living space and radiant electric resistance panels in each bedroom with individual thermostatic controls. Results indicate that temperature fluctuations in the living room due to aggressive setup and setback of the DHU may contribute to higher percentages of time where the bedroom temperatures were within +/-2 degrees F of the living room temperatures. Solar gains in the living room, door opening/closure and occupant manipulation of thermostats appear to have had a significant impact on room-to-room temperature differences, as would be expected.

  18. Outcomes of High-Dose-Rate Interstitial Brachytherapy in the Treatment of Locally Advanced Cervical Cancer: Long-term Results

    SciTech Connect

    Pinn-Bingham, Melva; Puthawala, Ajmel A.; Syed, A.M. Nisar; Sharma, Anil; DiSaia, Philip; Berman, Michael; Tewari, Krishnansu S.; Randall-Whitis, Leslie; Mahmood, Usama; Ramsinghani, Nilam; Kuo, Jeffrey; Chen, Wen-Pin; McLaren, Christine E.

    2013-03-01

    Purpose: The purpose of this study was to determine locoregional control (LRC), disease-free survival (DFS), and toxicity of high-dose-rate interstitial brachytherapy (HDR-ISBT) in the treatment of locally advanced cervical cancer. Methods and Materials: Between March 1996 and May 2009, 116 patients with cervical cancer were treated. Of these, 106 (91%) patients had advanced disease (International Federation of Gynecology and Obstetrics stage IIB-IVA). Ten patients had stage IB, 48 had stage II, 51 had stage III, and 7 had stage IVA disease. All patients were treated with a combination of external beam radiation therapy (EBRT) to the pelvis (5040 cGy) and 2 applications of HDR-ISBT to a dose of 3600 cGy to the implanted volume. Sixty-one percent of patients also received interstitial hyperthermia, and 94 (81%) patients received chemotherapy. Results: Clinical LRC was achieved in 99 (85.3%) patients. Three-year DFS rates were 59%, 67%, 71%, and 57% for patients with stage IB, II, III, and IVA disease, respectively. The 5-year DFS and overall survival rates for the entire group were 60% and 44%, respectively. Acute and late toxicities were within acceptable limits. Conclusions: Locally advanced cervical cancer patients for whom intracavitary BT is unsuitable can achieve excellent LRC and OS with a combination of EBRT and HDR-ISBT.

  19. Inflammatory abdominal aortic aneurysms and atherosclerotic abdominal aortic aneurysms--comparisons of clinical features and long-term results.

    PubMed

    Sasaki, S; Yasuda, K; Takigami, K; Yamauchi, H; Shiiya, N; Sakuma, M

    1997-03-01

    A total of 274 patients with abdominal aortic aneurysms due to atherosclerosis (AAA) and 16 patients with inflammatory abdominal aortic aneurysms (IAAA) were reviewed to compare and contrast the clinical characteristics of the 2 groups. The AAA group comprised 243 men and 31 women with a mean age of 69.2 +/- 0.4 (range 51-86) years. The IAAA group comprised 15 men and 1 woman with a mean age of 67.4 +/- 2.0 (range 53-81) years. Most patients with IAAA (12/16; 75.0%) had pain at presentation, whereas only 37 out of 274 patients (13.5%) with AAA had pain (p < 0.001). Fifty out of 274 patients (18.2%) with AAA were asymptomatic, the most common principal complaint being a pulsatile tumor, which was found in 150 out of 274 patients (54.7%; p < 0.005 vs IAAA). Regarding laboratory findings of inflammation, preoperative erythrocyte sedimentation rate values were elevated in 15 out of 16 (93.8%) patients, and C-reactive protein values were elevated in 13 out of 16 (81.3%) patients with IAAA. The incidence of perioperative complications was similar in the 2 groups. The 30-day postoperative mortality among AAA patients was 6.2% (17/274 cases), including 12 cases of non-ruptured and 5 cases of ruptured AAA; in contrast, no early deaths occurred among patients with IAAA. The cumulative 5-year survival rate was 80.2% for IAAA patients and 74.6% for AAA patients (NS). The results of our review suggest that careful diagnosis and intra- and postoperative management could lead to patients with IAAA having a similar survival rate to those with AAA.

  20. Nitrate sources and sinks in Elkhorn Slough, California: Results from long-term continuous in situ nitrate analyzers

    USGS Publications Warehouse

    Chapin, T.P.; Caffrey, J.M.; Jannasch, H.W.; Coletti, L.J.; Haskins, J.C.; Johnson, K.S.

    2004-01-01

    Nitrate and water quality parameters (temperature, salinity, dissolved oxygen, turbidity, and depth) were measured continuously with in situ NO 3 analyzers and water quality sondes at two sites in Elkhorn Slough in Central California. The Main Channel site near the mouth of Elkhorn Slough was sampled from February to September 2001. Azevedo Pond, a shallow tidal pond bordering agricultural fields further inland, was sampled from December 1999 to July 2001. Nitrate concentrations were recorded hourly while salinity, temperature, depth, oxygen, and turbidity were recorded every 30 min. Nitrate concentrations at the Main Channel site ranged from 5 to 65 ??M. The propagation of an internal wave carrying water from ???100 m depth up the Monterey Submarine Canyon and into the lower section of Elkhorn Slough on every rising tide was a major source of nitrate, accounting for 80-90% of the nitrogen load during the dry summer period. Nitrate concentrations in Azevedo Pond ranged from 0-20 ??M during the dry summer months. Nitrate in Azevedo Pond increased to over 450 ??M during a heavy winter precipitation event, and interannual variability driven by differences in precipitation was observed. At both sites, tidal cycling was the dominant forcing, often changing nitrate concentrations by 5-fold or more within a few hours. Water volume flux estimates were combined with observed nitrate concentrations to obtain nitrate fluxes. Nitrate flux calculations indicated a loss of 4 mmol NO3 m -2 d-1 for the entire Elkhorn Slough and 1 mmol NO 3 m-2 d-1 at Azevedo Pond. These results suggested that the waters of Elkhorn Slough were not a major source of nitrate to Monterey Bay but actually a nitrate sink during the dry season. The limited winter data at the Main Channel site suggest that nitrate was exported from Elkhorn Slough during the wet season. Export of ammonium or dissolved organic nitrogen, which we did not monitor, may balance some or all of the NO 3 flux.

  1. No evidence for consistent long-term growth stimulation of 13 tropical tree species: results from tree-ring analysis.

    PubMed

    Groenendijk, Peter; van der Sleen, Peter; Vlam, Mart; Bunyavejchewin, Sarayudh; Bongers, Frans; Zuidema, Pieter A

    2015-10-01

    The important role of tropical forests in the global carbon cycle makes it imperative to assess changes in their carbon dynamics for accurate projections of future climate-vegetation feedbacks. Forest monitoring studies conducted over the past decades have found evidence for both increasing and decreasing growth rates of tropical forest trees. The limited duration of these studies restrained analyses to decadal scales, and it is still unclear whether growth changes occurred over longer time scales, as would be expected if CO2 -fertilization stimulated tree growth. Furthermore, studies have so far dealt with changes in biomass gain at forest-stand level, but insights into species-specific growth changes - that ultimately determine community-level responses - are lacking. Here, we analyse species-specific growth changes on a centennial scale, using growth data from tree-ring analysis for 13 tree species (~1300 trees), from three sites distributed across the tropics. We used an established (regional curve standardization) and a new (size-class isolation) growth-trend detection method and explicitly assessed the influence of biases on the trend detection. In addition, we assessed whether aggregated trends were present within and across study sites. We found evidence for decreasing growth rates over time for 8-10 species, whereas increases were noted for two species and one showed no trend. Additionally, we found evidence for weak aggregated growth decreases at the site in Thailand and when analysing all sites simultaneously. The observed growth reductions suggest deteriorating growth conditions, perhaps due to warming. However, other causes cannot be excluded, such as recovery from large-scale disturbances or changing forest dynamics. Our findings contrast growth patterns that would be expected if elevated CO2 would stimulate tree growth. These results suggest that commonly assumed growth increases of tropical forests may not occur, which could lead to erroneous

  2. Lianas always outperform tree seedlings regardless of soil nutrients: results from a long-term fertilization experiment.

    PubMed

    Pasquini, Sarah C; Wright, S Joseph; Santiago, Louis S

    2015-07-01

    Lianas are a prominent growth form in tropical forests, and there is compelling evidence that they are increasing in abundance throughout the Neotropics. While recent evidence shows that soil resources limit tree growth even in deep shade, the degree to which soil resources limit lianas in forest understories, where they coexist with trees for decades, remains unknown. Regardless, the physiological underpinnings of soil resource limitation in deeply shaded tropical habitats remain largely unexplored for either trees or lianas. Theory predicts that lianas should be more limited by soil resources than trees because they occupy the quick-return end of the "leaf economic spectrum," characterized by high rates of photosynthesis, high specific leaf area, short leaf life span, affinity to high-nutrient sites, and greater foliar nutrient concentrations. To address these issues, we asked whether soil resources (nitrogen, phosphorus, and potassium), alone or in combination, applied experimentally for more than a decade would cause significant changes in the morphology or physiology of tree and liana seedlings in a lowland tropical forest. We found evidence for the first time that phosphorus limits the photosynthetic performance of both trees and lianas in deeply shaded understory habitats. More importantly, lianas always showed significantly greater photosynthetic capacity, quenching, and saturating light levels compared to trees across all treatments. We found little evidence for nutrient x growth form interactions, indicating that lianas were not disproportionately favored in nutrient-rich habitats. Tree and liana seedlings differed markedly for six key morphological traits, demonstrating that architectural differences occurred very early in ontogeny prior to lianas finding a trellis (all seedlings were self-supporting). Overall, our results do not support nutrient loading as a mechanism of increasing liana abundance in the Neotropics. Rather, our finding that lianas

  3. Recurrence of choledocholithiasis following endoscopic bile duct clearance: Long term results and factors associated with recurrent bile duct stones

    PubMed Central

    Konstantakis, Christos; Triantos, Christos; Theopistos, Vasileios; Theocharis, Georgios; Maroulis, Ioannis; Diamantopoulou, Georgia; Thomopoulos, Konstantinos

    2017-01-01

    AIM To evaluate the rate of recurrence of symptomatic choledocholithiasis and identify factors associated with the recurrence of bile duct stones in patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) for bile duct stone disease. METHODS All patients who underwent ERCP and EST for bile duct stone disease and had their bile duct cleared from 1/1/2005 until 31/12/2008 was enrolled. All symptomatic recurrences during the study period (until 31/12/2015) were recorded. Clinical and laboratory data potentially associated with common bile duct (CBD) stone recurrence were retrospectively retrieved from patients’ files. RESULTS A total of 495 patients were included. Sixty seven (67) out of 495 patients (13.5%) presented with recurrent symptomatic choledocholithiasis after 35.28 ± 16.9 mo while twenty two (22) of these patients (32.8%) experienced a second recurrence after 35.19 ± 23.2 mo. Factors associated with recurrence were size (diameter) of the largest CBD stone found at first presentation (10.2 ± 6.9 mm vs 7.2 ± 4.1 mm, P = 0.024), diameter of the CBD at the first examination (15.5 ± 6.3 mm vs 12.0 ± 4.6 mm, P = 0.005), use of mechanical lithotripsy (ML) (P = 0.04) and presence of difficult lithiasis (P = 0.04). Periampullary diverticula showed a trend towards significance (P = 0.066). On the contrary, number of stones, angulation of the CBD, number of ERCP sessions required to clear the CBD at first presentation, more than one ERCP session needed to clear the bile duct initially and a gallbladder in situ did not influence recurrence. CONCLUSION Bile duct stone recurrence is a possible late complication following endoscopic stone extraction and CBD clearance. It appears to be associated with anatomical parameters (CBD diameter) and stone characteristics (stone size, use of ML, difficult lithiasis) at first presentation. PMID:28101305

  4. Long-term outcome of adrenalectomy for metastasis resulting from colorectal cancer with other metastatic sites: A report of 3 cases

    PubMed Central

    Uemura, Mamoru; Kim, Ho Min; Ikeda, Masataka; Nishimura, Junichi; Hata, Taishi; Takemasa, Ichiro; Mizushima, Tsunekazu; Yamamoto, Hirofumi; Doki, Yuichiro; Mori, Masaki

    2016-01-01

    Metastasis to the adrenal glands is a relatively frequent observation at autopsy of patients that have succumbed to cancer. Long-term disease-free survival has been reported in patients following the resection of solitary adrenal metastasis resulting from colorectal cancer. In addition, following primary resection for colorectal cancer, solitary metastasis to the adrenal glands is rare, even in outpatients at routine follow-ups. Therefore, adrenal metastasis is usually detected in combination with multiple synchronous metastases at other sites in the terminal stages of cancer. Between 1998 and 2002, 3 patients with adrenal metastasis and other synchronous metastatic sites underwent surgery for adrenal metastasis at the Department of Gastroenterological Surgery at Osaka University. The other synchronous metastatic sites observed in the 3 patients consisted of lung and para-aortic lymph nodes. In total, 2 out of the 3 patients experienced long-term disease-free survival for >5 years following surgery and 1 patient underwent curative resection for recurrence of metastases in the liver and right adrenal gland 79 months subsequent to the initial resection for adrenal metastasis. All 3 patients survived for >90 months. In conclusion, aggressive surgical resection for adrenal metastasis and other metastatic sites resulting from colorectal cancer may result in a survival benefit in selected patients. PMID:27602101

  5. Long-term results of the GIMEMA VEL-03-096 trial in MM patients receiving VTD consolidation after ASCT: MRD kinetics' impact on survival.

    PubMed

    Ferrero, S; Ladetto, M; Drandi, D; Cavallo, F; Genuardi, E; Urbano, M; Caltagirone, S; Grasso, M; Rossini, F; Guglielmelli, T; Cangialosi, C; Liberati, A M; Callea, V; Carovita, T; Crippa, C; De Rosa, L; Pisani, F; Falcone, A P; Pregno, P; Oliva, S; Terragna, C; Musto, P; Passera, R; Boccadoro, M; Palumbo, A

    2015-03-01

    Polymerase chain reaction (PCR)-based minimal residual disease (MRD) analysis is a useful prognostic tool in multiple myeloma (MM), although its long-term impact still needs to be addressed. This report presents the updated results of the GIMEMA-VEL-03-096 trial. Thirty-nine MM patients receiving bortezomib-thalidomide-dexamethasone after autologous transplantation were monitored for MRD by both nested and real-time quantitative-PCR until relapse. Our data confirm the strong impact of MRD on survival: overall survival was 72% at 8 years median follow-up for patients in major MRD response versus 48% for those experiencing MRD persistence (P=0.041). In addition, MRD kinetics resulted predictive for relapse: indeed median remission duration was not reached for patients in major MRD response, 38 months for those experiencing MRD reappearance and 9 months for patients with MRD persistence (P<0.001). Moreover: (1) 26 patients achieving major MRD response (67%) benefit of excellent disease control (median TNT: 42 months); (2) MRD reappearance heralds relapse, with a TNT comparable to that of MRD persistence (9 versus 10 months, P=0.706); (3) the median lag between MRD reappearance and need for salvage treatment is 9 months. These results suggest the usefulness of a long-term MRD monitoring in MM patients and the need for maintenance or pre-emptive treatments ensuring durable responses.

  6. Long-term persistence of hepatitis B surface antigen and antibody induced by DNA-mediated immunization results in liver and kidney lesions in mice.

    PubMed

    Zi, Xiao-Yuan; Yao, Yu-Cheng; Zhu, Hai-Ying; Xiong, Jun; Wu, Xiu-Ju; Zhang, Nan; Ba, Yue; Li, Wen-Lin; Wang, Xin-Ming; Li, Jian-Xiu; Yu, Hong-Yu; Ye, Xu-Ting; Lau, Joseph T Y; Hu, Yi-Ping

    2006-04-01

    DNA-mediated immunization has been recognized as a new approach for prevention and treatment of hepatitis B virus (HBV) infection. However, the side effects of this approach have not been well described. Here we report that DNA-mediated immunization by intramuscular injection of plasmid DNA encoding HBV surface antigen (HBsAg) induced long-term persistence of HBsAg and HBsAg-specific antibody (anti-HBs) in the sera of the immunized BALB/c mice and resulted in liver and kidney lesions. The lesions persisted for 6 months after injection. Lesions were also found in normal mice injected with the sera from immunized mice, and in HBV-transgenic mice injected with anti-HBs antibody, or sera from immunized mice. Furthermore, lesions were accompanied by deposition of circulating immune complex (CIC) of HBsAg and anti-HBs antibody in the damaged organs. These results indicate that long-term persistence of HBsAg and anti-HBs in the immunized mice can result in deposited CIC in liver and kidney, and in development of lesions. The use of DNA containing mammalian replication origins, such as the plasmids used in this study, is not appropriate for human vaccines due to safety concerns relating to persistence of DNA; nevertheless, the safety of DNA-mediated immunization protocols still needs to be carefully evaluated before practical application.

  7. Long-term clinical results of autologous bone marrow CD 133+ cell transplantation in patients with ST-elevation myocardial infarction

    NASA Astrophysics Data System (ADS)

    Kirgizova, M. A.; Suslova, T. E.; Markov, V. A.; Karpov, R. S.; Ryabov, V. V.

    2015-11-01

    The aim of the study was investigate the long-term results of autologous bone marrow CD 133+ cell transplantation in patients with primary ST-Elevation Myocardial Infarction (STEMI). Methods and results: From 2006 to 2007, 26 patients with primary STEMI were included in an open randomized study. Patients were randomized to two groups: 1st - included patients underwent PCI and transplantation of autologous bone marrow CD 133+ cell (n = 10); 2nd - patients with only PCI (n = 16). Follow-up study was performed 7.70±0.42 years after STEMI and consisted in physical examination, 6-min walking test, Echo exam. Total and cardiovascular mortality in group 1 was lower (20% (n = 2) vs. 44% (n = 7), p = 0.1 and 22% (n = 2) vs. 25% (n = 4), (p=0.53), respectively). Analysis of cardiac volumetric parameters shows significant differences between groups: EDV of 100.7 ± 50.2 mL vs. 144.40±42.7 mL, ESV of 56.3 ± 37.8 mL vs. 89.7 ± 38.7 mL in 1st and 2nd groups, respectively. Data of the study showed positive effects of autologous bone marrow CD 133+ cell transplantation on the long-term survival of patients and structural status of the heart.

  8. Long-term Stability of Soft Tissue Esthetic Outcomes Following Conventional Single Implant Treatment in the Anterior Maxilla: 10-12 Year Results

    PubMed Central

    Rokn, A; Bassir, SH; Rasouli Ghahroudi, AA; Kharazifard, MJ; Manesheof, R

    2016-01-01

    Purpose: The present study aimed to evaluate the long-term stability of esthetic outcomes of soft tissue around maxillary anterior single-tooth implants after 10-to-12 years of loading. Methods: Patients who had been treated for single-tooth implants in the anterior maxilla between February 2000 and July 2002 were invited to participate in the study. All implants had been placed according to delayed implant placement and conventional loading protocols without any connective tissue graft or papilla preservation flaps. Pink Esthetic Score (PES) was rated using standardized clinical photographs to assess the esthetic outcomes of the implant treatment at the time of crown placement and at time of follow-up examination which was at least 10 years after the crown placement. Results: A total of 19 patients were included. The mean score of PES was 11.63 (SD 1.61; range 7-14) at baseline. After 10-to-12 years of function, a mean PES score of 11.05 (SD 2.09; range 6–14) was recorded. No significant differences were found in the esthetic outcomes, categorized based on clinically relevant levels, between the baseline and follow-up session (p>0.05). Conclusion: Within limitation of the present study, it can be concluded that the esthetic outcomes of soft tissue around the maxillary anterior single-tooth implants placed using conventional implant placement technique remained stable in the long-term. PMID:27990185

  9. Long-term solar-terrestrial observations

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The results of an 18-month study of the requirements for long-term monitoring and archiving of solar-terrestrial data is presented. The value of long-term solar-terrestrial observations is discussed together with parameters, associated measurements, and observational problem areas in each of the solar-terrestrial links (the sun, the interplanetary medium, the magnetosphere, and the thermosphere-ionosphere). Some recommendations are offered for coordinated planning for long-term solar-terrestrial observations.

  10. Short-term or long-term treatments with a phosphodiesterase-4 (PDE4) inhibitor result in opposing agonist-induced Ca2+ responses in endothelial cells

    PubMed Central

    Campos-Toimil, M; Keravis, T; Orallo, F; Takeda, K; Lugnier, C

    2008-01-01

    Background and purpose: We previously reported that agonist-induced rises in cytoplasmic Ca2+ concentration ([Ca2+]i) in human umbilical vein endothelial cells (HUVEC) were inhibited after a short-term (2 min) pre-treatment with cAMP-elevating agents. The aim of this work was to study the effects of longer term (8 h) pre-treatment with dibutyryl-cAMP (db-cAMP) or rolipram, a specific inhibitor of phosphodiesterase-4 (PDE4), on [Ca2+]i, cAMP levels and PDE activity and expression in HUVEC. Experimental approach: [Ca2+]i changes were measured in isolated HUVEC by Fura-2 imaging. Intracellular cAMP levels and PDE4 activity were assessed by enzyme-immunoassay and radio-enzymatic assay, respectively. PDE expression was measured by northern and western blot analysis. Key results: Long-term pre-treatment of HUVEC with rolipram or db-cAMP significantly increased ATP-, histamine- and thrombin-induced [Ca2+]i rises. Short-term pre-treatment with rolipram was associated with an increase in cAMP, whereas long-term pre-treatment was associated with a decrease in cAMP. Long-term pre-treatment with rolipram or db-cAMP induced a significant increase in PDE4 activity and the expression of 74 kDa-PDE4A and 73 kDa-PDE4B was specifically enhanced. All these effects were suppressed by cycloheximide. Conclusions and implications: Our data suggest that sustained inhibition of PDE4 by rolipram induced an increase in PDE4 activity, possibly as a compensatory mechanism to accelerate cAMP degradation and that PDE4A and PDE4B were implicated in the regulation of [Ca2+]i. Thus, isozyme-specific PDE4 inhibitors might be useful as therapeutic agents in diseases where [Ca2+]i handling is altered, such as atherosclerosis, hypertension and tolerance to β-adrenoceptor agonists. PMID:18311187

  11. Long-term results of arterial sympathectomy and artery reconstruction with vein bypass technique as a salvage procedure for severe digital ischemia.

    PubMed

    Savvidou, Christiana; Tsai, Tsu-Min

    2013-02-01

    The aim of this study is to present a combined treatment of arterial sympathectomy and artery reconstruction with vein bypass technique in patients with severe digital ischemia. In all, 22 patients representing 53 digits received treatment during a 15-year period. Skin color and trophic changes including ulcers, necrosis, and amputation; pain level according to the visual analog scale; and functional assessment based on the disabilities of the arm, shoulder, and hand questionnaire were recorded. After surgery, the skin discoloration improved, and the trophic changes healed in the majority of patients. Amputation was required in 2 cases. Pain and function improved significantly postoperatively. Based on the results of this study, vascular reconstruction combined with sympathectomy may be indicated on an individualized basis for patients with digital ischemia. This procedure can lead to healing of skin trophic changes, diminution of pain, avoidance of amputation, and long-term improvement in life quality.

  12. Influences of Biodynamic and Conventional Farming Systems on Quality of Potato (Solanum Tuberosum L.) Crops: Results from Multivariate Analyses of Two Long-Term Field Trials in Sweden

    PubMed Central

    Kjellenberg, Lars; Granstedt, Artur

    2015-01-01

    The aim of this paper was to present results from two long term field experiments comparing potato samples from conventional farming systems with samples from biodynamic farming systems. The principal component analyses (PCA), consistently exhibited differences between potato samples from the two farming systems. According to the PCA, potato samples treated with inorganic fertilizers exhibited a variation positively related to amounts of crude protein, yield, cooking or tissue discoloration and extract decomposition. Potato samples treated according to biodynamic principles, with composted cow manure, were more positively related to traits such as Quality- and EAA-indices, dry matter content, taste quality, relative proportion of pure protein and biocrystallization value. Distinctions between years, crop rotation and cultivars used were sometimes more significant than differences between manuring systems. Grown after barley the potato crop exhibited better quality traits compared to when grown after ley in both the conventional and the biodynamic farming system. PMID:28231216

  13. Influences of Biodynamic and Conventional Farming Systems on Quality of Potato (Solanum Tuberosum L.) Crops: Results from Multivariate Analyses of Two Long-Term Field Trials in Sweden.

    PubMed

    Kjellenberg, Lars; Granstedt, Artur

    2015-09-15

    The aim of this paper was to present results from two long term field experiments comparing potato samples from conventional farming systems with samples from biodynamic farming systems. The principal component analyses (PCA), consistently exhibited differences between potato samples from the two farming systems. According to the PCA, potato samples treated with inorganic fertilizers exhibited a variation positively related to amounts of crude protein, yield, cooking or tissue discoloration and extract decomposition. Potato samples treated according to biodynamic principles, with composted cow manure, were more positively related to traits such as Quality- and EAA-indices, dry matter content, taste quality, relative proportion of pure protein and biocrystallization value. Distinctions between years, crop rotation and cultivars used were sometimes more significant than differences between manuring systems. Grown after barley the potato crop exhibited better quality traits compared to when grown after ley in both the conventional and the biodynamic farming system.

  14. Efficacy and Safety of Long-term Coadministration of Fenofibrate and Ezetimibe in Patients with Combined Hyperlipidemia: Results of the EFECTL Study

    PubMed Central

    Yamashita, Shizuya; Nakaya, Noriaki; Sasaki, Jun; Kono, Suminori

    2017-01-01

    Aim: We investigated the safety and efficacy of a long-term combination therapy with fenofibrate and ezetimibe in Japanese patients with combined hyperlipidemia, in comparison with fenofibrate or ezetimibe alone. Methods: The study was a three-arm parallel-group, open-label randomized trial. Eligible patients were assigned to a combination therapy with fenofibrate (200 mg/day in capsule form or 160 mg/day in tablet form) and ezetimibe (10 mg/day), the fenofibrate monotherapy, or the ezetimibe monotherapy, which lasted for 52 weeks. The changes in serum low-density lipoprotein (LDL) cholesterol and triglycerides were the primary outcomes. Results: A total of 236 patients were assigned to one of the three treatments, and the number of patients included in the final analysis was 107 in the combination therapy, 52 in the fenofibrate monotherapy, and 51 in the ezetimibe monotherapy. Mean ± SD changes in LDL cholesterol were −24.2% ± 14.7% with combination therapy, −16.0% ± 16.0% with fenofibrate alone, and −17.4% ± 10.1% with ezetimibe alone. The combination therapy resulted in a significantly greater reduction in LDL cholesterol as compared with each monotherapy (p < 0.01 for each). The corresponding values for triglycerides were −40.0% ± 29.5%, −40.1% ± 28.7%, and −3.4% ± 32.6%, respectively. Fenofibrate use was associated with some changes in laboratory measurements, but there was no differential adverse effect between the combination therapy and fenofibrate monotherapy. Conclusion: The combination therapy with fenofibrate and ezetimibe substantially reduces concentrations of LDL cholesterol and triglycerides and is safe in a long-term treatment in Japanese patients with combined hyperlipidemia. PMID:27397061

  15. Hypoxic Prostate/Muscle PO{sub 2} Ratio Predicts for Outcome in Patients With Localized Prostate Cancer: Long-Term Results

    SciTech Connect

    Turaka, Aruna; Buyyounouski, Mark K.; Hanlon, Alexandra L.; Horwitz, Eric M.; Greenberg, Richard E.; Movsas, Benjamin

    2012-03-01

    Purpose: To correlate tumor oxygenation status with long-term biochemical outcome after prostate brachytherapy. Methods and Materials: Custom-made Eppendorf PO{sub 2} microelectrodes were used to obtain PO{sub 2} measurements from the prostate (P), focused on positive biopsy locations, and normal muscle tissue (M), as a control. A total of 11,516 measurements were obtained in 57 men with localized prostate cancer immediately before prostate brachytherapy was given. The Eppendorf histograms provided the median PO{sub 2}, mean PO{sub 2}, and % <5 mm Hg or <10 mm Hg. Biochemical failure (BF) was defined using both the former American Society of Therapeutic Radiation Oncology (ASTRO) (three consecutive raises) and the current Phoenix (prostate-specific antigen nadir + 2 ng/mL) definitions. A Cox proportional hazards regression model evaluated the influence of hypoxia using the P/M mean PO{sub 2} ratio on BF. Results: With a median follow-up time of 8 years, 12 men had ASTRO BF and 8 had Phoenix BF. On multivariate analysis, P/M PO{sub 2} ratio <0.10 emerged as the only significant predictor of ASTRO BF (p = 0.043). Hormonal therapy (p = 0.015) and P/M PO{sub 2} ratio <0.10 (p = 0.046) emerged as the only independent predictors of the Phoenix BF. Kaplan-Meier freedom from BF for P/M ratio <0.10 vs. {>=}0.10 at 8 years for ASTRO BF was 46% vs. 78% (p = 0.03) and for the Phoenix BF was 66% vs. 83% (p = 0.02). Conclusions: Hypoxia in prostate cancer (low mean P/M PO{sub 2} ratio) significantly predicts for poor long-term biochemical outcome, suggesting that novel hypoxic strategies should be investigated.

  16. Changes in Soil Carbon and Enzyme Activity As a Result of Different Long-Term Fertilization Regimes in a Greenhouse Field

    PubMed Central

    Zhang, Lili; Chen, Wei; Burger, Martin; Yang, Lijie; Gong, Ping; Wu, Zhijie

    2015-01-01

    In order to discover the advantages and disadvantages of different fertilization regimes and identify the best management practice of fertilization in greenhouse fields, soil enzyme activities involved in carbon (C) transformations, soil chemical characteristics, and crop yields were monitored after long-term (20-year) fertilization regimes, including no fertilizer (CK), 300 kg N ha-1 and 600 kg N ha-1 as urea (N1 and N2), 75 Mg ha-1 horse manure compost (M), and M with either 300 or 600 kg N ha-1 urea (MN1 and MN2). Compared with CK, fertilization increased crop yields by 31% (N2) to 69% (MN1). However, compared with CK, inorganic fertilization (especially N2) also caused soil acidification and salinization. In the N2 treatment, soil total organic carbon (TOC) decreased from 14.1±0.27 g kg-1 at the beginning of the long-term experiment in 1988 to 12.6±0.11 g kg-1 (P<0.05). Compared to CK, N1 and N2 exhibited higher soil α-galactosidase and β-galactosidase activities, but lower soil α-glucosidase and β-glucosidase activities (P<0.05), indicating that inorganic fertilization had different impacts on these C transformation enzymes. Compared with CK, the M, MN1 and MN2 treatments exhibited higher enzyme activities, soil TOC, total nitrogen, dissolved organic C, and microbial biomass C and N. The fertilization regime of the MN1 treatment was identified as optimal because it produced the highest yields and increased soil quality, ensuring sustainability. The results suggest that inorganic fertilizer alone, especially in high amounts, in greenhouse fields is detrimental to soil quality. PMID:25706998

  17. Long-term concentrations of ambient air pollutants and incident lung cancer in California adults: results from the AHSMOG study.Adventist Health Study on Smog.

    PubMed Central

    Beeson, W L; Abbey, D E; Knutsen, S F

    1998-01-01

    The purpose of this study was to evaluate the relationship of long-term concentrations of ambient air pollutants and risk of incident lung cancer in nonsmoking California adults. A cohort study of 6,338 nonsmoking, non-Hispanic, white Californian adults, ages 27-95, was followed from 1977 to 1992 for newly diagnosed cancers. Monthly ambient air pollution data were interpolated to zip code centroids according to home and work location histories, cumulated, and then averaged over time. The increased relative risk (RR) of incident lung cancer in males associated with an interquartile range (IQR) increase in 100 ppb ozone (O3) was 3.56 [95% confidence interval (CI), 1.35-9.42]. Incident lung cancer in males was also positively associated with IQR increases for mean concentrations of particulate matter <10 microm (PM10; RR = 5.21; CI, 1.94-13.99) and SO2 (RR = 2.66; CI, 1.62-4.39). For females, incident lung cancer was positively associated with IQR increases for SO2 (RR = 2.14; CI, 1.36-3.37) and IQR increases for PM10 exceedance frequencies of 50 microg/m3 (RR = 1.21; CI, 0.55-2.66) and 60 microg/m3 (RR = 1.25; CI, 0.57-2.71). Increased risks of incident lung cancer were associated with elevated long-term ambient concentrations of PM10 and SO2 in both genders and with O3 in males. The gender differences for the O3 and PM10 results appeared to be partially due to gender differences in exposure. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:9831542

  18. The specific role of fungal community structure on soil aggregation and carbon sequestration: results from long-term field study in a paddy soil

    NASA Astrophysics Data System (ADS)

    Murugan, Rajasekaran; Kumar, Sanjay

    2015-04-01

    Soil aggregate stability is a crucial soil property that affects soil biota, biogeochemical processes and C sequestration. The relationship between soil aggregate stability and soil C cycling is well known but the influence of specific fungal community structure on this relationship is largely unknown in paddy soils. The aim of the present study was to evaluate the long-term fertilisation (mineral fertiliser-MIN; farmyard manure-FYM; groundnut oil cake-GOC) effects on soil fungal community shifts associated with soil aggregates under rice-monoculture (RRR) and rice-legume-rice (RLR) systems. Fungal and bacterial communities were characterized using phospholipid fatty acids, and glucosamine and muramic acid were used as biomarkers for fungal and bacterial residues, respectively. Microbial biomass C and N, fungal biomass and residues were significantly higher in the organic fertiliser treatments than in the MIN treatment, for all aggregate sizes under both crop rotation systems. In general, fungal/bacterial biomass ratio and fungal residue C/bacterial residue C ratio were significantly higher in macroaggregate fractions (> 2000 and 250-2000 μm) than in microaggregate fractions (53-250 and <53 μm). In both crop rotation systems, the long-term application of FYM and GOC led to increased accumulation of saprotrophic fungi (SF) in aggregate fractions > 2000 μm. In contrast, we found that arbuscular mycorrhizal fungi (AMF) was surprisingly higher in aggregate fractions > 2000 μm than in aggregate fraction 250-2000 μm under MIN treatment. The RLR system showed significantly higher AMF biomass and fungal residue C/ bacterial residue C ratio in both macroaggregate fractions compared to the RRR system. The strong relationships between SF, AMF and water stable aggregates shows the specific contribution of fungi community on soil aggregate stability. Our results highlight the fact that changes within fungal community structure play an important role in shaping the soil

  19. Long-term efficacy and safety of mipomersen in patients with familial hypercholesterolaemia: 2-year interim results of an open-label extension

    PubMed Central

    Santos, Raul D.; Duell, P. Barton; East, Cara; Guyton, John R.; Moriarty, Patrick M.; Chin, Wai; Mittleman, Robert S.

    2015-01-01

    Aims To evaluate the efficacy and safety of extended dosing with mipomersen in patients with familial hypercholesterolaemia (HC) taking maximally tolerated lipid-lowering therapy. Methods and results A planned interim analysis of an ongoing, open-label extension trial in patients (n = 141) with familial HC receiving a subcutaneous injection of 200 mg mipomersen weekly plus maximally tolerated lipid-lowering therapy for up to 104 weeks. The mean changes in low-density lipoprotein cholesterol (LDL-C) from baseline to weeks 26 (n = 130), 52 (n = 111), 76 (n = 66), and 104 (n = 53) were −28, −27, −27, and −28%; and in apolipoprotein B −29, −28, −30, and −31%, respectively. Reductions in total cholesterol, non-high-density lipoprotein-cholesterol, and lipoprotein(a) were comparable with decreases in LDL-C and apolipoprotein B levels. Mean high-density lipoprotein cholesterol increased from baseline by 7 and 6% at weeks 26 and 52, respectively. The long-term safety profile of mipomersen was similar to that reported in the associated randomized placebo-controlled Phase 3 trials. Adverse events included injection site reactions and flu-like symptoms. There was an incremental increase in the median liver fat during the initial 6–12 months that appeared to diminish with continued mipomersen exposure beyond 1 year and returned towards baseline 24 weeks after last drug dose suggestive of adaptation. The median alanine aminotransferase level showed a similar trend over time. Conclusion Long-term treatment with mipomersen for up to 104 weeks provided sustained reductions in all atherosclerotic lipoproteins measured and a safety profile consistent with prior controlled trials in these high-risk patient populations. Clinicaltrials.gov NCT00694109. PMID:24366918

  20. Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

    SciTech Connect

    Das, Neelan Bratby, Mark J.; Shrivastava, Vivek; Cornall, Alison J.; Darby, Christopher R.; Boardman, Philip; Anthony, Susan; Uberoi, Raman

    2011-10-15

    Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa{sup Registered-Sign}, Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4-270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

  1. Changes in soil carbon and enzyme activity as a result of different long-term fertilization regimes in a greenhouse field.

    PubMed

    Zhang, Lili; Chen, Wei; Burger, Martin; Yang, Lijie; Gong, Ping; Wu, Zhijie

    2015-01-01

    In order to discover the advantages and disadvantages of different fertilization regimes and identify the best management practice of fertilization in greenhouse fields, soil enzyme activities involved in carbon (C) transformations, soil chemical characteristics, and crop yields were monitored after long-term (20-year) fertilization regimes, including no fertilizer (CK), 300 kg N ha-1 and 600 kg N ha-1 as urea (N1 and N2), 75 Mg ha-1 horse manure compost (M), and M with either 300 or 600 kg N ha-1 urea (MN1 and MN2). Compared with CK, fertilization increased crop yields by 31% (N2) to 69% (MN1). However, compared with CK, inorganic fertilization (especially N2) also caused soil acidification and salinization. In the N2 treatment, soil total organic carbon (TOC) decreased from 14.1±0.27 g kg-1 at the beginning of the long-term experiment in 1988 to 12.6±0.11 g kg-1 (P<0.05). Compared to CK, N1 and N2 exhibited higher soil α-galactosidase and β-galactosidase activities, but lower soil α-glucosidase and β-glucosidase activities (P<0.05), indicating that inorganic fertilization had different impacts on these C transformation enzymes. Compared with CK, the M, MN1 and MN2 treatments exhibited higher enzyme activities, soil TOC, total nitrogen, dissolved organic C, and microbial biomass C and N. The fertilization regime of the MN1 treatment was identified as optimal because it produced the highest yields and increased soil quality, ensuring sustainability. The results suggest that inorganic fertilizer alone, especially in high amounts, in greenhouse fields is detrimental to soil quality.

  2. Long-term follow-up for bimanual microincision cataract surgery: comparison of results obtained by surgeons in training and experienced surgeons

    PubMed Central

    Cavallini, Gian Maria; Verdina, Tommaso; Forlini, Matteo; Volante, Veronica; De Maria, Michele; Torlai, Giulio; Benatti, Caterina; Delvecchio, Giancarlo

    2016-01-01

    Purpose To determine the efficacy of bimanual microincision cataract surgery (B-MICS) performed by surgeons in training, evaluating clinical results, posterior capsule opacification (PCO) incidence, and clear corneal incision (CCI) architecture in a long-term follow-up and comparing results with those obtained by experienced surgeons. Patients and methods Eighty eyes of 62 patients operated on by three surgeons in training who used B-MICS technique for the first time were included in the study (Group A). Eighty eyes of 59 patients who underwent B-MICS by three experienced surgeons were included as a control group (Group B). Best corrected visual acuity, astigmatism, corneal pachymetry, and endothelial cell count were evaluated before surgery and at 1 month and 18 months after surgery. Anterior segment optical coherence tomography images were obtained to study the morphology of CCIs. PCO incidence was evaluated using EPCO2000 software. Results Out of 160 surgeries included in the study, mean best-corrected visual acuity improvement at 18 months was 0.343±0.246 logMAR for Group A, and 0.388±0.175 logMAR for Group B, respectively. We found no statistically significant induced astigmatism nor corneal pachymetry changes in either group, while we noticed a statistically significant endothelial cell loss postoperatively in both groups (P<0.05). In Group A, mean PCO score was 0.163±0.196, while for Group B, it was 0.057±0.132 (P=0.0025). Mean length and inclination of the CCIs for Group A and Group B were, respectively, 1,358±175 µm and 1,437±256 µm and 141.8°±6.4° and 148.7°±5.1°. As regards corneal architecture in the 320 CCIs considered, we found posterior wound retractions and endothelial gaps, respectively, 9.8% and 11.6% for Group A and 7.8% and 10.8% for Group B. Conclusion B-MICS performed by surgeons in training is an effective surgical technique even when assessed after a long-term follow-up. PCO incidence resulted in being higher for less

  3. Microsurgical DREZotomy for pain due to spinal cord and/or cauda equina injuries: long-term results in a series of 44 patients.

    PubMed

    Sindou, M; Mertens, P; Wael, M

    2001-05-01

    According to the literature estimations, 10-25% of patients with spinal cord and cauda equina injuries eventually develop refractory pain. Due to the fact that most classical neurosurgical methods are considered of little or no efficacy in controlling this type of pain, the authors had recourse to microsurgery in the dorsal root entry zone (DREZ). This article reports on the long-term results of the microsurgical approach to the dorsal root entry zone (DREZotomy) in a series of 44 patients suffering from unbearable neuropathic pain secondary to spine injury. The follow-up ranged from 1 to 20 years (6 years on average). The series includes 25 cases with conus medullaris, 12 with thoracic cord, four with cauda equina and three with cervical cord injuries. Surgery was performed in 37 cases at the pathological spinal cord levels that corresponded to the territory of the so-called 'segmental pain', and in seven cases, on the spinal cord levels below the lesion for 'infralesional pain' syndromes. The post-operative analgesic effect was considered to be 'good' when a patient's estimation of pain relief exceeded 75%, 'fair' if pain was reduced by 25-75%, and 'poor' when the residual pain was more than 75% of preoperative estimations. Immediate pain relief was obtained in 70% of patients and was long-lasting in 60% of the total series. The results varied essentially according to the distribution of pain. Good long-term results were obtained in 68% of the patients who had a segmental pain distribution, compared with 0% in patients with predominant infralesional pain. Regarding pain characteristics, a good result was obtained in 88% of the cases with predominantly paroxysmal pain, compared with 26% with continuous pain. There were no perioperative mortalities. Morbidity included cerebrospinal fluid leak (three patients), wound infection (two patients), subcutaneous hematoma (one patient) and bacteremia (in one patient). The above data justify the inclusion of DREZ

  4. Long-term safety assessment of trench-type surface repository at Chernobyl, Ukraine - computer model and comparison with results from simplified models

    SciTech Connect

    Haverkamp, B.; Krone, J.; Shybetskyi, I.

    2013-07-01

    The Radioactive Waste Disposal Facility (RWDF) Buryakovka was constructed in 1986 as part of the intervention measures after the accident at Chernobyl NPP (ChNPP). Today, the surface repository for solid low and intermediate level waste (LILW) is still being operated but its maximum capacity is nearly reached. Long-existing plans for increasing the capacity of the facility shall be implemented in the framework of the European Commission INSC Programme (Instrument for Nuclear Safety Co-operation). Within the first phase of this project, DBE Technology GmbH prepared a safety analysis report of the facility in its current state (SAR) and a preliminary safety analysis report (PSAR) for a future extended facility based on the planned enlargement. In addition to a detailed mathematical model, also simplified models have been developed to verify results of the former one and enhance confidence in the results. Comparison of the results show that - depending on the boundary conditions - simplifications like modeling the multi trench repository as one generic trench might have very limited influence on the overall results compared to the general uncertainties associated with respective long-term calculations. In addition to their value in regard to verification of more complex models which is important to increase confidence in the overall results, such simplified models can also offer the possibility to carry out time consuming calculations like probabilistic calculations or detailed sensitivity analysis in an economic manner. (authors)

  5. AT-57LONG-TERM CLINICAL RESULTS OF EXTENSIVE TUMOR REMOVAL FOLLOWED BY ACNU-BASED CHEMORADIOTHERAPY FOR 147 ANAPLASTIC GLIOMAS

    PubMed Central

    Takayuki, Yasuda; Masayuki, Nitta; Takashi, Maruyama; Taichi, Saito; Satoko, Ikuta; Yoshikazu, Okada; Hiroshi, Iseki; Yoshihiro, Muragaki

    2014-01-01

    INTRODUCTION: Recent randomized trials showed that highly extent of resection (EOR) and PCV chemoradiotherapy had therapeutic long-term efficacy to anaplastic glioma (AG). From 2000, we have consistently enforced extensive removal and ACNU-based chemoradiotherapy for AG. We report retrospective clinical results of a single institution. METHODS: We reviewed 147 cases of primary AG between 2000 and 2011 (Male : Female = 94:53, average age; 43.9 year-old). 69 were anaplastic astrocytoma (41%), 43 were anaplastic oligoastrocytoma (29%), and 44 were anaplastic oligodendroglioma (30%). The intraoperative MRI was performed in 133 cases (90%), and awake surgery was performed in 58 cases (39%). Gross-total removal was 46 (31%), partial removal was 89 (61%), and biopsy was 12 (8%) (average; 83%, median; 95%). After resection, 60 Gy radiotherapy and ACNU or PAV chemotherapy were performed. The average Mib-1 index was 15%. The mean observation periods were 57 months and 95% follow-up rate. RESULTS: Overall survival (OS) wasn't reached median. The 3y-OS was 82%, 5y-OSs was 72%, and 10y-OS was 66%. There was no statistical significance among AA, AOA, AO (5y-OS; 64%, 79%, 77%). The each 5 years survival rate of gross-total resection, partial resection, and biopsy were 83%, 70%, 39%, and there was statistical significance (P = 0.0024). Extent of resection (EOR) correlated OS in AA (P = 0.02) but not in oligodendroglial subtypes (P = 0.6). Statistical significant factors were EOR (P = 0.0024) and Mib-1 index (P = 0.013). The significant factors in multi variable analysis were EOR (more than 95% or not, HR 2.5) and Mib-1 index (more than 13% or not, HR 2.3). The median PFS was 8.3, and 5y-PFS was 59%,and 10y-PFS was 45%. CONCLUSION: Our long-term clinical results of AG treated with extensive resection and ACNU-based chemoradiotherapy were better than previous reports. The EOR contributed better prognosis especially for AA.

  6. Long-term Results of the UCSF-LBNL Randomized Trial: Charged Particle With Helium Ion Versus Iodine-125 Plaque Therapy for Choroidal and Ciliary Body Melanoma

    SciTech Connect

    Mishra, Kavita K.; Quivey, Jeanne M.; Daftari, Inder K.; Weinberg, Vivian; Cole, Tia B.; Patel, Kishan; Castro, Joseph R.; Phillips, Theodore L.; Char, Devron H.

    2015-06-01

    Purpose: Relevant clinical data are needed given the increasing national interest in charged particle radiation therapy (CPT) programs. Here we report long-term outcomes from the only randomized, stratified trial comparing CPT with iodine-125 plaque therapy for choroidal and ciliary body melanoma. Methods and Materials: From 1985 to 1991, 184 patients met eligibility criteria and were randomized to receive particle (86 patients) or plaque therapy (98 patients). Patients were stratified by tumor diameter, thickness, distance to disc/fovea, anterior extension, and visual acuity. Tumors close to the optic disc were included. Local tumor control, as well as eye preservation, metastases due to melanoma, and survival were evaluated. Results: Median follow-up times for particle and plaque arm patients were 14.6 years and 12.3 years, respectively (P=.22), and for those alive at last follow-up, 18.5 and 16.5 years, respectively (P=.81). Local control (LC) for particle versus plaque treatment was 100% versus 84% at 5 years, and 98% versus 79% at 12 years, respectively (log rank: P=.0006). If patients with tumors close to the disc (<2 mm) were excluded, CPT still resulted in significantly improved LC: 100% versus 90% at 5 years and 98% versus 86% at 12 years, respectively (log rank: P=.048). Enucleation rate was lower after CPT: 11% versus 22% at 5 years and 17% versus 37% at 12 years, respectively (log rank: P=.01). Using Cox regression model, likelihood ratio test, treatment was the most important predictor of LC (P=.0002) and eye preservation (P=.01). CPT was a significant predictor of prolonged disease-free survival (log rank: P=.001). Conclusions: Particle therapy resulted in significantly improved local control, eye preservation, and disease-free survival as confirmed by long-term outcomes from the only randomized study available to date comparing radiation modalities in choroidal and ciliary body melanoma.

  7. Long-term efficacy and safety results of taliglucerase alfa up to 36 months in adult treatment-naïve patients with Gaucher disease.

    PubMed

    Zimran, Ari; Durán, Gloria; Mehta, Atul; Giraldo, Pilar; Rosenbaum, Hanna; Giona, Fiorina; Amato, Dominick J; Petakov, Milan; Muñoz, Eduardo Terreros; Solorio-Meza, Sergio Eduardo; Cooper, Peter A; Varughese, Sheeba; Chertkoff, Raul; Brill-Almon, Einat

    2016-07-01

    Taliglucerase alfa is an intravenous enzyme replacement therapy approved for treatment of type 1 Gaucher disease (GD), and is the first available plant cell-expressed recombinant therapeutic protein. Herein, we report long-term safety and efficacy results of taliglucerase alfa in treatment-naïve adult patients with GD. Patients were randomized to receive taliglucerase alfa 30 or 60 U/kg every other week, and 23 patients completed 36 months of treatment. Taliglucerase alfa (30 U/kg; 60 U/kg, respectively) resulted in mean decreases in spleen volume (50.1%; 64.6%) and liver volume (25.6%; 24.4%) with mean increases in hemoglobin concentration (16.0%; 35.8%) and platelet count (45.7%; 114.0%), and mean decreases in chitotriosidase activity (71.5%; 82.2%). All treatment-related adverse events were mild to moderate in intensity and transient. The most common adverse events were nasopharyngitis, arthralgia, upper respiratory tract infection, headache, pain in extremity, and hypertension. These 36-month results of taliglucerase alfa in treatment-naïve adult patients with GD demonstrate continued improvement in disease parameters with no new safety concerns. These findings extend the taliglucerase alfa clinical safety and efficacy dataset. www.clinicaltrials.gov identifier NCT00705939. Am. J. Hematol. 91:656-660, 2016. © 2016 Wiley Periodicals, Inc.

  8. Long-term results of treatment with bosentan in adult Eisenmenger’s syndrome patients with Down’s syndrome related to congenital heart disease

    PubMed Central

    2013-01-01

    Background Patients with Down’s syndrome and shunt lesions are at high risk of developing pulmonary arterial hypertension (PAH) earlier than patients without Down’s syndrome. However, data on the efficacy of PAH-specific therapy in patients with Down’s syndrome are limited. The aim of this retrospective analysis was to determine the long-term efficacy of the dual endothelin receptor antagonist, bosentan, in Eisenmenger's syndrome (ES) patients with Down’s syndrome. Methods In this observational study adults with Down’s syndrome with a confirmed diagnosis of ES (World Health Organization functional class III) and receiving bosentan therapy and were followed up long term. Clinical evaluation at baseline and follow-up visits included resting transcutaneous arterial oxygen saturation and laboratory assessments. Exercise capacity was evaluated using a 6-minute walk test where transcutaneous arterial oxygen saturation at peak exercise (SpO2), 6-minute walk distance (6MWD) and Borg dyspnoea index were assessed. A full echocardiographic assessment was conducted at baseline and follow-up visits. Results Overall, seven adults (mean age 29.6 ± 11.2 years; 57% male) received bosentan at a starting dose of 62.5 mg twice daily. This was increased to the target dose of 125 mg twice daily 4 weeks later. All patients remained on bosentan until the end of the study. After a mean (± standard deviation) duration of 52.2 ± 3.9 months (range: 46.0–55.5 months), 6MWD had increased from 199.6 ± 69.1 metres to 303.7 ± 99.9 metres (P < 0.05) and SpO2 at the end of the 6-minute walk test had increased from 61.6 ± 7.6% to 74.7 ± 6.2% (P < 0.05). Echocardiography demonstrated a significant change in acceleration time from 62.9 ± 11.6 m/s to 83.0 ± 9.6 m/s (P = 0.0156), and acceleration time/ejection time ratio from the pulmonary flow from 0.24 ± 0.04 at baseline to 0.30 ± 0.02 (P = 0.0156) at final follow

  9. Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial

    SciTech Connect

    Spiliopoulos, Stavros Katsanos, Konstantinos; Karnabatidis, Dimitris; Diamantopoulos, Athanasios; Kagadis, George C.; Christeas, Nikolaos; Siablis, Dimitris

    2010-10-15

    The purpose of this study was to investigate the immediate and long-term results of cryoplasty versus conventional balloon angioplasty in the femoropopliteal artery of diabetic patients. Fifty diabetic patients (41 men, mean age 68 years) were randomized to cryoplasty (group CRYO; 24 patients with 31 lesions) or conventional balloon angioplasty (group COBA; 26 patients with 34 lesions) of the femoropopliteal artery. Technical success was defined as <30% residual stenosis without any adjunctive stenting. Primary end points included technical success, primary patency, binary in-lesion restenosis (>50%), and freedom from target lesion recanalization. Cox proportional hazards regression analysis was performed to adjust for confounding factors of heterogeneity. In total, 61.3% (19 of 31) in group CRYO and 52.9% (18 of 34) in group COBA were de novo lesions. More than 70% of the lesions were Transatlantic Inter-Society Consensus (TASC) B and C in both groups, and 41.4% of the patients in group CRYO and 38.7% in group COBA suffered from critical limb ischemia. Immediate technical success rate was 58.0% in group CRYO versus 64.0% in group COBA (p = 0.29). According to 3-year Kaplan-Meier estimates, there were no significant differences with regard to patient survival (86.8% in group CRYO vs. 87.0% in group COBA, p = 0.54) and limb salvage (95.8 vs. 92.1% in groups CRYO and COBA, respectively, p = 0.60). There was a nonsignificant trend of increased binary restenosis in group CRYO (hazard ratio [HR] 1.3; 95% CI 0.6-2.6, p = 0.45). Primary patency was significantly lower in group CRYO compared with group COBA (HR 2.2; 95% CI 1.1-4.3, p = 0.02). Significantly more repeat intervention events because of recurrent symptoms were required in group CRYO (HR 2.5; 95% CI 1.2-5.3, p = 0.01). Cryoplasty was associated with lower primary patency and more clinically driven repeat procedures after long-term follow-up compared with conventional balloon angioplasty.

  10. Establishing a Long-term 30 Year Global Solar Resource at 10 km Resolution: Preliminary Results From Test Processing and Continuing Plans

    NASA Astrophysics Data System (ADS)

    Stackhouse, P. W.; Mikovitz, J. C.; Cox, S. J.; Zhang, T.; Perez, R.; Schlemmer, J.; Sengupta, M.; Knapp, K. R.

    2014-12-01

    As renewable energy system become more prevalent, improved global long-term, up-to-date records are needed to better understand and quantify the solar resource and variability. Toward this end, a project involving NASA, DOE NREL, SUNY-Albany and the NOAA National Climatic Data Center (NCDC) was initiated to provide NREL with a solar resource mapping production system for improved depiction of global long-term solar resources that provides the capacity for continual updates. This new production system is made possible by the efforts of NOAA and NASA to completely reprocess the International Satellite Cloud Climatology Project (ISCCP) data set that provides satellite visible and infrared radiances together with retrieved cloud and surface properties on a 3-hourly basis beginning from July 1983 at an effective 10 km resolution. Thus, working with SUNY and NCDC, NASA will develop and test an improved production system that will yield an operational production system for NREL to continually update the Earth's solar resource. In this presentation, we provide a general overview of this project together with samples of the new solar irradiance mapped data products and comparisons to surface measurements at various locations across the world. Here, a three-year prototype of the anticipated ISCCP data set called GridSat is used to assess the algorithms and demonstrate the production system. GridSat maps together cross-calibrated visible and IR reflectances from all the world's geosynchronous satellites at 10 km and 3-hourly respectively. The results are shown and discussed in comparison to existing solar data products. Additionally, the solar irradiance values are compared to various Baseline Surface Radiation Network surface site measurements and other high quality surface measurements. The statistics of the agreement between the measurements and new satellite estimates are also reviewed. The team is now testing a beta release of the revised ISCCP data set through the NOAA

  11. Long-Term Results After High-Dose Radiotherapy and Adjuvant Hormones in Prostate Cancer: How Curable Is High-Risk Disease?

    SciTech Connect

    Zapatero, Almudena; Garcia-Vicente, Feliciano; Martin de Vidales, Carmen; Cruz Conde, Alfonso; Ibanez, Yamile; Fernandez, Inmaculada; Rabadan, Mariano

    2011-12-01

    Purpose: To analyze long-term outcome and prognostic factors for high-risk prostate cancer defined by National Comprehensive Cancer Network criteria treated with high-dose radiotherapy and androgen deprivation in a single institution. Methods and Materials: A total of 306 patients treated between 1995 and 2007 in a radiation dose-escalation program fulfilled the National Comprehensive Cancer Network high-risk criteria. Median International Commission on Radiation Units and Measurements radiation dose was 78 Gy (range, 66.0-84.1 Gy). Long-term androgen deprivation (LTAD) was administered in 231 patients, short-term androgen deprivation (STAD) in 59 patients, and no hormones in 16 patients. The Phoenix (nadir plus 2 ng/mL) consensus definition was used for biochemical control. Multivariate analysis was performed to determine the independent prognostic impact of clinical and treatment factors. Median follow-up time was 64 months (range, 24-171 months). Results: The actuarial overall survival at 5 and 10 years was 95.7% and 89.8%, respectively, and the corresponding biochemical disease-free survival (bDFS) was 89.5% and 67.2%, respectively. Fourteen patients (4.6%) developed distant metastasis. Multivariate analysis showed that Gleason score >7 (p = 0.001), pretreatment prostate-specific antigen (PSA) level >20 ng/mL (p = 0.037), higher radiation dose (p = 0.005), and the use of adjuvant LTAD vs. STAD (p = 0.011) were independent prognostic factors affecting bDFS in high-risk disease. The 5-year bDFS for patients treated with LTAD plus radiotherapy dose >78 Gy was 97%. Conclusions: For high-risk patients the present series showed that the use of LTAD in conjunction with higher doses (>78 Gy) of radiotherapy was associated with improved biochemical tumor control. We observed that the presence of Gleason sum >7 and pretreatment PSA level >20 ng/mL in the same patient represents a 6.8 times higher risk of PSA failure. These men could be considered for clinical trials with

  12. Long-term results of external auditory canal closure and mastoid obliteration in cochlear implantation after radical mastoidectomy: a clinical and radiological study.

    PubMed

    Vincenti, Vincenzo; Pasanisi, Enrico; Bacciu, Andrea; Bacciu, Salvatore

    2014-08-01

    Cochlear implant candidates with mastoid cavity present a significant challenge to safe cochlear implantation because of possible spread of infection to the inner ear as well as an increased risk of electrode array extrusion. Closure of the external auditory canal is one of the several surgical techniques utilized to block the potential entry routes for infection and to protect the implanted device. The main concern after external auditory canal closure is the risk of developing a cholesteatoma, which can lead to an asymptomatic erosion of the temporal bone and/or cochlear implant failure. In this study we present the results of very long-term (mean 12 years) clinical and radiological follow-up in 12 patients who underwent external auditory canal closure associated with mastoid and Eustachian tube obliteration to facilitate cochlear implantation. To date, with a mean ± SD follow-up of 12 ± 4.7 years (range 5-21 years), the only complication experienced was the breakdown of the EAC closure in one patient, successfully treated by performing a rotation skin flap. The results of this study confirmed that external auditory canal closure is a reliable technique in cochlear implantation after radical mastoidectomy provided that a rigorous surgical technique is performed. A right balance between the need to reduce costs and to avoid unnecessary doses of radiation to patients and the task of a radiological surveillance may be represented by performing computed tomography 12-18 months postoperatively and then, only if clinically warranted.

  13. Perceived organizational justice as a predictor of long-term sickness absence due to diagnosed mental disorders: results from the prospective longitudinal Finnish Public Sector Study.

    PubMed

    Elovainio, Marko; Linna, Anne; Virtanen, Marianna; Oksanen, Tuula; Kivimäki, Mika; Pentti, Jaana; Vahtera, Jussi

    2013-08-01

    Organizational justice perceptions have been suggested to be associated with symptoms of mental health but the nature of the association is unknown due to reporting bias (measurement error related to response style and reversed causality). In this study, we used prospective design and long-term (>9 days) sickness absence with psychiatric diagnosis as the outcome measure. Participants were 21,221 Finnish public sector employees (the participation rate at baseline in 2000-2002 68%), who responded to repeated surveys of procedural and interactional justice in 2000-2004 along with register data on sickness absence with a diagnosis of depression or anxiety disorders (822 cases). Results from logistic regression analyses showed that a one-unit increase in self-reported and work-unit level co-worker assessed interactional justice was associated with a 25-32% lower odds of sickness absence due to anxiety disorders. These associations were robust to adjustments for a variety of potential individual-level confounders including chronic disease (adjusted OR for self-reported interactional justice 0.77, 95% CI 0.65-0.91) and were replicated using co-worker assessed justice. Only weak evidence of reversed causality was found. The results suggest that low organizational justice is a risk factor for sickness absence due to anxiety disorders.

  14. Long-term Results from Cyclocryotherapy Applied to the 3O'clock and 9O'clock Positions in Blind Refractory Glaucoma Patients

    PubMed Central

    Kim, Byoung Seon; Kim, Young Jun; Seo, Seong Wook; Yoo, Ji Myong

    2015-01-01

    Purpose To report the long-term follow-up results after cyclocryotherapy, applied to the 3-o'clock and 9-o'clock positions in blind refractory glaucoma patients. Methods We retrospectively reviewed the charts of 19 blind patients, and a total of 20 eyes with refractory glaucoma who were treated with cyclocryotherapy. Cyclocryotherapy treatments were performed using a retinal cryoprobe. The temperature of each cyclocryotherapy spot was -80℃ and each spot was maintained in place for 60 seconds. Six cyclocryotherapy spots were placed in each quadrant, including the 3-o'clock and 9-o'clock positions. Results The mean baseline pretreatment intraocular pressure (IOP) in all eyes was 50.9 ± 12.5 mmHg, which significantly decreased to a mean IOP at last follow-up of 14.1 ± 7.1 mmHg (p < 0.001). The mean number of antiglaucoma medications that patients were still taking at last follow-up was 0.3 ± 0.6. Devastating post-procedure phthisis occurred in only one eye. Conclusions Cyclocryotherapy, performed at each quadrant and at the 3-o'clock and 9-o'clock position, is an effective way to lower IOP and, thus, is a reasonable treatment option for refractory glaucoma patients who experience with ocular pain and headaches. PMID:25646060

  15. Failure to Recognize Novelty after Extended Methamphetamine Self-Administration Results from Loss of Long-Term Depression in the Perirhinal Cortex

    PubMed Central

    Scofield, Michael D; Trantham-Davidson, Heather; Schwendt, Marek; Leong, Kah-Chung; Peters, Jamie; See, Ronald E; Reichel, Carmela M

    2015-01-01

    Exposure to methamphetamine (meth) can produce lasting memory impairments in humans and rodents. We recently demonstrated that extended access meth self-administration results in novel object recognition (NOR) memory deficits in rats. Recognition of novelty depends upon intact perirhinal (pRh) cortex function, which is compromised by meth-induced downregulation of GluN2B-containing N-methyl-D-aspartate (NMDA) receptors. NMDA receptors containing this subunit have a critical role in pRh long-term depression (LTD), one of the primary physiological processes thought to underlie object recognition memory. We hypothesized that meth-induced downregulation of GluN2B receptors would compromise pRh LTD, leading to loss of NOR memory. We found that meth self-administration resulted in an inability to induce pRh LTD following 1 Hz stimulation, an effect that was reversed with bath application of the NMDA receptor partial agonist D-cycloserine (DCS). In addition, pRh microinfusion of DCS restored meth-induced memory deficits. Furthermore, blockade of GluN2B-containing NMDA receptors with Ro 25-6981 prevented DCS restoration of pRh LTD in meth subjects. Thus, targeting pRh LTD may be a promising strategy to treat meth-induced cognitive impairment. PMID:25865928

  16. ProMACE-C-MOPP in aggressive non-Hodgkin's lymphoma. Long-term results in 45 patients treated in a single institution.

    PubMed

    Carrión, J R; Delgado, J R; Dominguez, S; Flores, E; Garcia, P; Jaen, J; Santos, J A

    1991-01-01

    Forty-five previously untreated patients with intermediate or high-grade non-Hodgkin's lymphoma were treated with the Pro-MACE-C-MOPP regimen (flexitherapy). The median age of the patients was 51 years, 51% had constitutional symptoms, 78% were in Ann Arbor stage III-IV, 40% had two or more involved extranodal sites and 87% had serum lactate dehydrogenase (LDH) above 225 U/l. Twenty-two (49%) patients had immunoblastic lymphoma (Working Formulation). Overall, 40% of the patients attained complete response (CR) and there were no relapses. The dose-limiting toxicity was myelosuppression (69% of the patients with WBC less than 1.9 x 10(9)/l). Three deaths were attributed primarily to chemotherapy, but another two patients died of long-term complications of therapy. After a median follow-up of 50 months (18-80), 15 patients (33%) were alive without lymphoma. Only histologic subtype (intermediate vs. high) and abdominal involvement were prognostic factors for CR rate. Our results indicate that ProMACE-C-MOPP is an effective regimen for intermediate-grade lymphomas. However, in high-risk patients the regimen seems to be less effective than originally reported.

  17. Thermal Aging Study of a Dow Corning SE 1700 Porous Structure Made by Direct Ink Writing: 1-Year Results and Long-Term Predictions

    SciTech Connect

    Small, Ward; Pearson, Mark A.; Maiti, Amitesh; Metz, Thomas R.; Duoss, Eric B.; Wilson, Thomas S.

    2015-11-13

    Dow Corning SE 1700 (reinforced polydimethylsiloxane) porous structures were made by direct ink writing (DIW). The specimens (~50% porosity) were subjected to various compressive strains (15, 30, 45%) and temperatures (room temperature, 35, 50, 70°C) in a nitrogen atmosphere (active purge) for 1 year. Compression set and load retention of the aged specimens were measured periodically during the study. Compression set increased with strain and temperature. After 1 year, specimens aged at room temperature, 35, and 50°C showed ~10% compression set (relative to the applied compressive deflection), while those aged at 70°C showed 20-40%. Due to the increasing compression set, load retention decreased with temperature, ranging from ~90% at room temperature to ~60-80% at 70°C. Long-term compression set and load retention at room temperature were predicted by applying time-temperature superposition (TTS). The predictions show compression set relative to the compressive deflection will be ~10-15% with ~70-90% load retention after 50 years at 15-45% strain, suggesting the material will continue to be mechanically functional. Comparison of the results to previously acquired data for cellular (M97*, M9760, M9763) and RTV (S5370) silicone foams suggests that the SE 1700 DIW porous specimens are on par with, or outperform, the legacy foams.

  18. Preliminary results of long term correlation analysis among earthquakes (M>4) occurrence and anomalous transients in Radon emission and Earth's emitted TIR radiation in Northeastern Italy

    NASA Astrophysics Data System (ADS)

    Riggio, Anna; Capobianco, Stefano; Genzano, Nicola; Lisi, Mariano; Tamaro, Alberto; Santulin, Marco; Sileo, Giancanio; Tramutoli, Valerio

    2016-04-01

    Looking toward the assessment of a multi-parametric system for dynamically updating seismic hazard estimates and earthquake short term (from days to weeks) forecast, a preliminary step is to identify those parameters (chemical, physical, biological, etc.) whose anomalous variations can be, to some extent, associated to the complex process of earthquake preparation. Among the other parameters claimed as possible indicators of an impending seismic activity, the anomalous variations of radon emissions and of Earth's thermally emitted infrared radiation (TIR), have been proposed, since long time, as potential earthquake precursors. In this paper the added value of a multi-parametric approach is evaluated by applying a similar statistical analysis (based on the general RST approach) to long-term time series of Radon and TIR data collected in Northern Italy. Preliminary results of the correlation analysis performed with earthquakes (M>4) clearly show a strong reduction of false positive (up to zero) as soon as the number of considered parameter pass from one (just Radon) to two (Radon & TIR anomalies) (contemporary) considered parameters.

  19. Implementing a Knowledge Translation Intervention in Long-Term Care: Feasibility Results From the Vitamin D and Osteoporosis Study (ViDOS)

    PubMed Central

    Kennedy, Courtney C.; Thabane, Lehana; Ioannidis, George; Adachi, Jonathan D.; Papaioannou, Alexandra

    2016-01-01

    Objectives To evaluate the feasibility of implementing an interdisciplinary, multifaceted knowledge translation intervention within long-term care (LTC) and to identify any challenges that should be considered in designing future studies. Design Cluster randomized controlled trial. Setting Forty LTC homes across the province of Ontario, Canada. Participants LTC teams composed of physicians, nurses, pharmacists, and other staff. Measurements Cluster-level feasibility measures, including recruitment, retention, data completion, and participation in the intervention. A process evaluation was completed by directors of care indicating which process/policy changes had been implemented. Results Recruitment and retention rates were 22% and 63%, respectively. Good fidelity with the intervention was achieved, including attendance at educational meetings. After ViDOS, 7 process indicators were being newly implemented by more than 50% of active intervention homes. Conclusion Despite recruitment and retention challenges, the multifaceted intervention produced a number of policy/process changes and had good intervention fidelity. This study is registered at ClinicalTrials.gov NCT01398527. PMID:24953541

  20. Superimposing Status Epilepticus on Neuron Subset-Specific PTEN Haploinsufficient and Wild Type Mice Results in Long-term Changes in Behavior

    PubMed Central

    Smith, Gregory D.; White, Jessika; Lugo, Joaquin N.

    2016-01-01

    We evaluated the effects of superimposing seizures on a genetic mutation with known involvement in both Autism Spectrum Disorder and in epilepsy. Neuron-subset specific (NS)-Pten heterozygous (HT) and wildtype (WT) adult mice received either intraperitoneal injections of kainic acid (20 mg/kg) to induce status epilepticus or the vehicle (saline). Animals then received a battery of behavioral tasks in order to evaluate activity levels, anxiety, repetitive-stereotyped behavior, social behavior, learning and memory. In the open field task, we found that HT mice after seizures showed a significant increase in total activity and total distance in the surround region of the open field. In the elevated plus maze task, we found that HT mice after seizures displayed increased total distance and velocity as compared to HT mice that did not undergo seizures and WT controls. In the social chamber test, we found the HT mice after seizures displayed an impairment in social behavior. These findings demonstrate that superimposing seizures on a genetic mutation can result in long-term alterations in activity and social behavior in mice. PMID:27819284

  1. Long-term administration of cocaine or serotonin reuptake inhibitors results in anatomical and neurochemical changes in noradrenergic, dopaminergic, and serotonin pathways.

    PubMed

    Horne, Malcolm K; Lee, Joohyung; Chen, Feng; Lanning, Katherine; Tomas, Doris; Lawrence, Andrew J

    2008-08-01

    The catechol and indole pathways are important components underlying plasticity in the frontal cortex and basal ganglia. This study demonstrates that administering rats either cocaine or a selective serotonin (or 5-hydroxytryptamine; 5-HT) reuptake inhibitor (SSRI) for 16 weeks results in reduced density of dopaminergic and noradrenergic terminals in the striatum and olfactory bulb, respectively, reflecting pruning of the terminal arbor of ventral midbrain dopaminergic and locus coeruleus noradrenergic neurones. In the striatum of cocaine-treated animals, basal dopamine levels, as well as cocaine-induced dopamine release, is diminished compared with controls. In contrast, serotonergic fibers, projecting from the raphe, sprout and have increased terminal density in the lateral septal nucleus and frontal cortex, following long-term cocaine or SSRI treatment. This is associated with elevated basal 5-HT and enhanced cocaine-induced 5-HT release in the frontal cortex. The anatomical and neurochemical changes in serotonergic fibers following cocaine or SSRI treatment may be explained by attenuated 5-HT(1A) autoreceptor function in the raphe. This study demonstrates extensive plasticity in the morphology and neurochemistry of the catechol and indole pathways that contribute to drug-induced plasticity of the corticostriatal (and other) projections. Moreover, our data suggest that drug-induced plastic adaptation is anatomically widespread and consequently, likely to have multiple and complex consequences.

  2. Effects of short- and long-term disturbance resulting from military maneuvers on vegetation and soils in a mixed prairie area.

    PubMed

    Leis, Sherry A; Engle, David M; Leslie, David M; Fehmi, Jeffrey S

    2005-12-01

    Loss of grassland species resulting from activities such as off-road vehicle use increases the need for models that predict effects of anthropogenic disturbance. The relationship of disturbance by military training to plant species richness and composition on two soils (Foard and Lawton) in a mixed prairie area was investigated. Track cover (cover of vehicle disturbance to the soil) and soil organic carbon were selected as measures of short- and long-term disturbance, respectively. Soil and vegetation data, collected in 1-m2 quadrats, were analyzed at three spatial scales (60, 10, and 1 m2). Plant species richness peaked at intermediate levels of soil organic carbon at the 10-m2 and 1-m2 spatial scales on both the Lawton and Foard soils, and at intermediate levels of track cover at all three spatial scales on the Foard soil. Species composition differed across the disturbance gradient on the Foard soil but not on the Lawton soil. Disturbance increased total plant species richness on the Foard soil. The authors conclude that disturbance up to intermediate levels can be used to maintain biodiversity by enriching the plant species pool.

  3. Factors Associated With Optimal Long-Term Cosmetic Results in Patients Treated With Accelerated Partial Breast Irradiation Using Balloon-Based Brachytherapy

    SciTech Connect

    Vicini, Frank A.; Keisch, Martin; Shah, Chirag; Goyal, Sharad; Khan, Atif J.; Beitsch, Peter D.; Lyden, Maureen; Haffty, Bruce G.

    2012-06-01

    Purpose: To evaluate factors associated with optimal cosmetic results at 72 months for early-stage breast cancer patients treated with Mammosite balloon-based accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,440 patients (1,449 cases) with early-stage breast cancer undergoing breast-conserving therapy were treated with balloon-based brachytherapy to deliver APBI (34 Gy in 3.4-Gy fractions). Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good (E/G) or fair/poor (F/P). Follow-up was evaluated at 36 and 72 months to establish long-term cosmesis, stability of cosmesis, and factors associated with optimal results. Results: The percentage of evaluable patients with excellent/good (E/G) cosmetic results at 36 months and more than 72 months were 93.3% (n = 708/759) and 90.4% (n = 235/260). Factors associated with optimal cosmetic results at 72 months included: larger skin spacing (p = 0.04) and T1 tumors (p = 0.02). Using multiple regression analysis, the only factors predictive of worse cosmetic outcome at 72 months were smaller skin spacing (odds ratio [OR], 0.89; confidence interval [CI], 0.80-0.99) and tumors greater than 2 cm (OR, 4.96, CI, 1.53-16.07). In all, 227 patients had both a 36-month and a 72-month cosmetic evaluation. The number of patients with E/G cosmetic results decreased only slightly from 93.4% at 3 years to 90.8% (p = 0.13) at 6 years, respectively. Conclusions: APBI delivered with balloon-based brachytherapy produced E/G cosmetic results in 90.4% of cases at 6 years. Larger tumors (T2) and smaller skin spacing were found to be the two most important independent predictors of cosmesis.

  4. Long-term results after aortic root replacement using self-assembled valve composite grafts in patients with small aortic annulus

    PubMed Central

    Urbanski, Paul P.; Dinstak, Witold; Rents, Wilko; Heinz, Nicolas; Diegeler, Anno

    2014-01-01

    OBJECTIVES The study was aimed to evaluate operative and long-term results after complete root replacement using self-assembled valve composite grafts in patients with a small aortic annulus. METHODS Among 547 consecutive patients who received the Bentall procedure between 2000 and 2012, a total of 29 patients (61 ± 10; range 42–79 years) had an annulus of ≤20 mm (mean 19.0 ± 0.9). Patients with a native aortic valve (22) suffered from stenosis, insufficiency or mixed defect in 10, 10 and 2 cases, respectively. Among the remaining 7 patients with an artificial aortic valve, there were 3 symptomatic prosthesis–patient mismatches, 3 valve prosthesis deteriorations (1 structural and 2 none-structural) and 1 paravalvular leak. Indication for aortic root replacement was true or false aneurysm, porcelain aorta and intraoperative aortic wall injury in 17, 6 and 6 patients, respectively. RESULTS The composite graft for complete aortic root replacement was assembled using a mechanical (26) or biological (3) valve prosthesis placed inside a vascular graft with a median size of 24 (range 22–26) mm. The margin of the tube beneath the valve was anastomosed to the aortic annulus, and coronary ostia were implanted in the usual manner. The mean transvalvular gradient at discharge was 10.8 ± 3.9 mmHg and remained virtually unchanged at the follow-up completed for all patients. Early mortality was 0. During the mean follow-up of 95.8 ± 43.7 months, 2 patients died (54 and 146 months after surgery) due to pulmonary embolism and myocardial infarction, respectively. CONCLUSIONS In patients with a small aortic annulus who need complete aortic root replacement, an oversizing of the valve can be easily achieved using modified, self-assembled composite grafts. Offering excellent haemodynamic characteristics, these grafts lead to prevention of prosthesis–patient mismatch and result in very good and durable functional and clinical results. PMID:24179177

  5. Long-Term Outcomes of Proximal Row Carpectomy: A Systematic Review of the Literature

    PubMed Central

    Chim, Harvey; Moran, Steven L.

    2012-01-01

    Purpose Proximal row carpectomy is a well-established technique for the management of wrist arthritis; however, patient selection and long-term durability of proximal row carpectomy is still a matter of controversy. Hence, we conducted a systematic review of the English literature to determine the best evidence on long-term outcomes following proximal row carpectomy. Methods A MEDLINE search using the term “proximal row carpectomy” was performed. A total of 192 studies were identified. All studies with 10 or more years of follow-up were included in the review. Data extracted included patient demographics, indications for surgery, previous surgery, outcome assessment, and information on complications and failures. Results A total of 147 patients from six studies met the inclusion criteria and were included in the study. The majority of patients were male and involved in manual labor. There was no significant difference between the preoperative and long-term postoperative motion. The weighted mean for postoperative grip strength was 68.4% compared with the contralateral side. Disabilities of the arm, shoulder, and hand; patient-rated wrist examination; and Mayo wrist scores were comparable to those reported for four-corner arthrodesis. There were 21 failures (14.3%) requiring re-operation. Failures were not associated with a specific preoperative diagnosis but distributed among patients with Kienböck disease, scaphoid nonunion advanced collapse, and scapholunate advanced collapse arthritis. Conclusions This systematic review confirms the long-term durability of proximal row carpectomy when used for the treatment of wrist arthritis. Although radiocapitate arthritis develops over time in most patients, the clinical significance of this finding is undetermined and does not necessarily correlate with failure of proximal row carpectomy. Poorer long-term outcomes are likely to result in patients engaged in heavy manual labor, whereas better outcomes may be

  6. The Effect of Long-Term Training Program on Balance in Children with Cerebral Palsy: Results of a Pilot Study for Individually Based Functional Exercises

    ERIC Educational Resources Information Center

    Uzun, Selda

    2013-01-01

    This study examines the effects of long-term training program on balance and center of pressure (COP) for four male children (13 years of age) with cerebral palsy (CP). These children were classified into one hemiplegic (level II), one diplegic (level II) and two quadriplegic children (levels III and II) using the Gross Motor Function…

  7. Effect of Relative Age in the First Grade of Primary School on Long-Term Scholastic Results: International Comparative Evidence Using PISA 2003

    ERIC Educational Resources Information Center

    Sprietsma, Maresa

    2010-01-01

    In this paper, we estimate the effect of pupil's relative age within the first grade of primary school on mathematics and reading test scores at age 15. The main objective is to evaluate the long-term causal effect of relative age in the first grades of primary school on pupil's test in 16 different countries. We use the national rule for…

  8. Comprehensive assessment of long-term effects of reducing intake of energy phase 2 (CALERIE Phase 2) screening and recruitment: Methods and results

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Comprehensive Assessment of the Long-term Effects of Reducing Intake of Energy Phase 2 (CALERIE) study is a systematic investigation of sustained 25% calorie restriction (CR) in non-obese humans. CALERIE is a multicenter (3 clinical sites, one coordinating center), parallel group, randomized con...

  9. Combination external beam radiation and brachytherapy boost with androgen deprivation for treatment of intermediate-risk prostate cancer: long-term results of CALGB 99809

    PubMed Central

    Hurwitz, Mark D.; Halabi, Susan; Archer, Laura; McGinnis, Lamar S.; Kuettel, Michael R.; DiBiase, Steven J.; Small, Eric J.

    2011-01-01

    Background Combined transperineal prostate brachytherapy (TPPB) and external beam radiation (EBRT) is widely used for treatment of prostate cancer. Long-term efficacy and toxicity results of a multicenter Phase II trial assessing combination of EBRT and TPPB boost with androgen deprivation therapy (ADT) for intermediate-risk prostate cancer are presented. Methods Intermediate-risk patients per MSKCC/NCCN criteria received six months of ADT, 45 Gy EBRT to the prostate and seminal vesicles, followed by TPPB with I125(100 Gy) or Pd103(90 Gy). Toxicity was graded using NCI CTC version 2 and RTOG late radiation morbidity scoring systems. Disease free survival (DFS) was defined as time from enrollment to progression (biochemical, local, distant or prostate cancer death). In addition to the protocol definition of biochemical failure (3 consecutive PSA rises >1.0ng/ml after 18 months from treatment start), the 1997 ASTRO consensus and Phoenix definitions were also assessed in defining DFS. The Kaplan-Meier method was used to estimate DFS and overall survival. Results 61/63 enrolled patients were eligible. Median follow-up was 73 months. Late grade 2 and 3 toxicity, excluding sexual dysfunction, occurred in 20% and 3% of patients. Six year DFS applying the protocol definition, 1997 ASTRO consensus, and Phoenix definitions was 87.1%, 75.1%, and 84.9%. 6 deaths occurred, only one was attributed to prostate cancer. 6 year overall survival was 96.1%. Conclusions In a cooperative setting, combination of EBRT and TPPB boost plus ADT resulted in excellent DFS with acceptable late toxicity for patients with intermediate-risk prostate cancer. PMID:22535500

  10. Long-Term Results after Placement of Aortic Bifurcation Self-Expanding Stents: 10 Year Mortality, Stent Restenosis, and Distal Disease Progression

    SciTech Connect

    Houston, J. Graeme Bhat, Raj; Ross, Rose; Stonebridge, Peter A.

    2007-02-15

    Purpose. To retrospectively evaluate the 10 year follow-up results in patients who had 'kissing' self-expanding stent aortic bifurcation reconstruction. Methods. Forty-three patients were treated with 'kissing' self-expanding stents for aortoiliac occlusive disease. Early follow-up with clinical and ankle brachial pressure indices (ABPI) was performed at 3, 6, 12, and 24 months and with intra-arterial digital subtraction angiography at 12-24 months; clinical and angiographic follow-up was performed for symptom recurrence up to 10 years after treatment. Retrospective record review was performed to assess mortality, clinical patency, angiographic patency, and secondary assisted patency of both stents and downstream peripheral vessels at 5 and 10 years follow-up. Results. The 2 year primary angiographic and secondary assisted stent patencies were 89% and 93%, respectively. At 10 years follow-up in 40 patients the mortality was 38% (due to myocardial infarction, stroke, chronic renal failure, malignancy, and liver failure). At 5 and 10 years follow-up the primary clinical stent patency was 82% and 68%, and the secondary assisted stent patency 93% and 86%, respectively. At 5 and 10 years, the distal vessel patency was 86% and 72%, and the secondary assisted distal vessel patency treated by surgical or endovascular techniques was 94% and 88%, respectively. At 10 years there was no limb loss. Conclusion. The long-term (10 year) results of aortic bifurcation arterial self-expanding stent placement in patients with arterial occlusive disease show a 10 year primary stent patency rate of 68% but a secondary assisted patency rate of 86%. In addition there is a high overall mortality due to other cardiovascular causes and the rate of distal disease progression and loss of patency is similar to the loss of stent patency rate.

  11. Phase II trial of pre-irradiation and concurrent temozolomide in patients with newly diagnosed anaplastic oligodendrogliomas and mixed anaplastic oligoastrocytomas: long term results of RTOG BR0131.

    PubMed

    Vogelbaum, Michael A; Hu, Chen; Peereboom, David M; Macdonald, David R; Giannini, Caterina; Suh, John H; Jenkins, Robert B; Laack, Nadia N; Brachman, David G; Shrieve, Dennis C; Souhami, Luis; Mehta, Minesh P

    2015-09-01

    We report on the long-term results of a phase II study of pre-irradiation temozolomide followed by concurrent temozolomide and radiotherapy (RT) in patients with newly diagnosed anaplastic oligodendroglioma (AO) and mixed anaplastic oligoastrocytoma. Pre-RT temozolomide was given for up to 6 cycles. RT with concurrent temozolomide was administered to patients with less than a complete radiographic response. Forty eligible patients were entered and 32 completed protocol treatment. With a median follow-up time of 8.7 years (range 1.1-10.1), median progression-free survival (PFS) is 5.8 years (95 % CI 2.0, NR) and median overall survival (OS) has not been reached (5.9, NR). 1p/19q data are available in 37 cases; 23 tumors had codeletion while 14 tumors had no loss or loss of only 1p or 19q (non-codeleted). In codeleted patients, 9 patients have progressed and 4 have died; neither median PFS nor OS have been reached and two patients who received only pre-RT temozolomide and no RT have remained progression-free for over 7 years. 3-year PFS and 6-year OS are 78 % (95 % CI 61-95 %) and 83 % (95 % CI 67-98 %), respectively. Codeleted patients show a trend towards improved 6-year survival when compared to the codeleted procarbazine/CCNU/vincristrine (PCV) and RT cohort in RTOG 9402 (67 %, 95 % CI 55-79 %). For non-codeleted patients, median PFS and OS are 1.3 and 5.8 years, respectively. These updated results suggest that the regimen of dose intense, pre-RT temozolomide followed by concurrent RT/temozolomide has significant activity, particularly in patients with 1p/19q codeleted AOs and MAOs.

  12. Advanced therapies in patients with congenital heart disease-related pulmonary arterial hypertension: results from a long-term, single center, real-world follow-up.

    PubMed

    Favilli, Silvia; Spaziani, Gaia; Ballo, Piercarlo; Fibbi, Veronica; Santoro, Gennaro; Chiappa, Enrico; Arcangeli, Chiara

    2015-06-01

    Pulmonary arterial hypertension (PAH) is a common finding in patients with congenital heart disease (CHD), and has relevant prognostic implications. The recent introduction of advanced therapies (AT) considerably improved the clinical outcome of these patients, but real-world data are still lacking. We aimed at reporting the results of a long-term follow-up of CHD patients with PAH undergoing AT, followed at a tertiary Center during the two last decades. The study population included a total of 34 patients with an established diagnosis of CHD-related PAH. In addition to conventional treatment, 97% of patients started AT during the follow-up. Over a median follow-up of 9 [3-31] years, 11 (32.4%) patients died: 7 of them were affected by Eisenmenger syndrome and the majority of patients were in NYHA class ≥3 at the time of death. Among the 23 patients who were alive at the last follow-up, the majority were in NYHA class I-II. Oxygen saturation and 6-min walking distance improved in all subjects within the first 6 months after starting of AT. One patient with ventricular septum defect and high pulmonary resistances was successfully treated with AT to lower resistances and underwent defect closure. A good clinical outcome was also observed in the subset (n = 8) with Down syndrome. The results of this real-world experience suggest that, despite a relatively high mortality rate mostly related to late commencement of AT, the clinical outcome of subjects with CHD-related PAH undergoing AT are characterized by a good quality of life and clinical improvement in most patients.

  13. Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

    PubMed Central

    Albayrak, Serdal; Ozturk, Sait; Durdag, Emre; Ayden, Ömer

    2016-01-01

    Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results. PMID:26933352

  14. Phase II Trial of Radiotherapy After Hyperbaric Oxygenation With Multiagent Chemotherapy (Procarbazine, Nimustine, and Vincristine) for High-Grade Gliomas: Long-Term Results

    SciTech Connect

    Ogawa, Kazuhiko; Ishiuchi, Shogo; Inoue, Osamu; Yoshii, Yoshihiko; Saito, Atsushi; Watanabe, Takashi; Iraha, Shiro; Toita, Takafumi; Kakinohana, Yasumasa; Ariga, Takuro; Kasuya, Goro; Murayama, Sadayuki

    2012-02-01

    Purpose: To analyze the long-term results of a Phase II trial of radiotherapy given immediately after hyperbaric oxygenation (HBO) with multiagent chemotherapy in adults with high-grade gliomas. Methods and Materials: Patients with histologically confirmed high-grade gliomas were administered radiotherapy in daily 2 Gy fractions for 5 consecutive days per week up to a total dose of 60 Gy. Each fraction was administered immediately after HBO, with the time interval from completion of decompression to start of irradiation being less than 15 minutes. Chemotherapy consisting of procarbazine, nimustine, and vincristine and was administered during and after radiotherapy. Results: A total of 57 patients (39 patients with glioblastoma and 18 patients with Grade 3 gliomas) were enrolled from 2000 to 2006, and the median follow-up of 12 surviving patients was 62.0 months (range, 43.2-119.1 months). All 57 patients were able to complete a total radiotherapy dose of 60 Gy immediately after HBO with one course of concurrent chemotherapy. The median overall survival times in all 57 patients, 39 patients with glioblastoma and 18 patients with Grade 3 gliomas, were 20.2 months, 17.2 months, and 113.4 months, respectively. On multivariate analysis, histologic grade alone was a significant prognostic factor for overall survival (p < 0.001). During treatments, no patients had neutropenic fever or intracranial hemorrhage, and no serious nonhematologic or late toxicities were seen in any of the 57 patients. Conclusions: Radiotherapy delivered immediately after HBO with multiagent chemotherapy was safe, with virtually no late toxicities, and seemed to be effective in patients with high-grade gliomas.

  15. Hematopoietic stem cell transplantation for paroxysmal nocturnal hemoglobinuria: long-term results of a retrospective study on behalf of the Gruppo Italiano Trapianto Midollo Osseo (GITMO)

    PubMed Central

    Santarone, Stella; Bacigalupo, Andrea; Risitano, Antonio M.; Tagliaferri, Elena; Di Bartolomeo, Erminia; Iori, Anna Paola; Rambaldi, Alessandro; Angelucci, Emanuele; Spagnoli, Alessandra; Papineschi, Federico; Tamiazzo, Stefania; Di Nicola, Marta; Di Bartolomeo, Paolo

    2010-01-01

    Background Paroxysmal nocturnal hemoglobinuria is an acquired clonal disorder of the hemopoietic stem cells for which the only curative treatment is allogeneic hematopoietic stem cell transplantation. Design and Methods The aim of this retrospective study was to assess the long-term clinical and hematologic results in 26 paroxysmal nocturnal hemoglobinuria patients who received hematopoietic stem cell transplantation in Italy between 1988 and 2006. The patients were aged 22 to 60 years (median 32 years). Twenty-three donors were HLA-identical (22 siblings and one unrelated) and 3 were HLA-mismatched (2 related and one unrelated). Results Fifteen patients received a myeloablative conditioning consisting of busulfan and cyclophosphamide (in all cases from identical donor) and 11 were given a reduced intensity conditioning (8 from identical donor and 3 from mismatched donor). The cumulative incidence of graft failure was 8% (4% primary and 4% secondary graft failure). Transplant-related mortality for all patients was 42% (26% and 63% for patients transplanted following myeloablative or reduced intensity conditioning, respectively). As of October 31, 2009, 15 patients (11 in the myeloablative conditioning group and 4 in the reduced intensity conditioning group) are alive with complete hematologic recovery and no evidence of paroxysmal nocturnal hemoglobinuria following a median follow-up of 131 months (range 30–240). The 10-year Kaplan-Meier probability of disease-free survival was 57% for all patients: 65% for 23 patients transplanted from identical donor and 73% for 15 patients transplanted with myeloablative conditioning. No thromboembolic event nor recurrence of the disease were reported following transplant. Conclusions The findings of this study confirm that most patients with paroxysmal nocturnal hemoglobinuria may be definitively cured with hematopoietic stem cell transplantation. PMID:20007144

  16. Impact of Distal Protection with Filter-Type Device on Long-term Outcome after Percutaneous Coronary Intervention for Acute Myocardial Infarction: Clinical Results with Filtrap®

    PubMed Central

    Teramoto, Ryota; Sakata, Kenji; Miwa, Kenji; Matsubara, Takao; Yasuda, Toshihiko; Inoue, Masaru; Okada, Hirofumi; Kanaya, Honin; Kawashiri, Masa-aki; Hayashi, Kenshi

    2016-01-01

    Aim: Although distal embolization during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) deteriorates cardiac function, whether distal protection (DP) can improve prognosis is still controversial. We investigated whether a filter-type DP device, Filtrap®, could improve long-term outcomes after PCI for AMI. Method: We studied 164 patients (130 men, mean age: 65.7 years) who underwent PCI. Patients were divided into two groups based on the use of Filtrap®. The occurrence of congestive heart failure (CHF) and major adverse cardiac events (MACE) defined as cardiac death, recurrent AMI, and target vessel revascularization were compared. Result: Between DP (n = 53, 41 men, mean age: 65.5 years) and non-DP (n = 111, 89 men, mean age: 65.8 years) groups, although there was significantly greater plaque area in the DP group than in the non-DP group, there were no significant differences in coronary reperfusion flow after PCI. Interestingly, patients with CHF in the non-DP group exhibited a higher CK level than those in the DP group. During a 2-year follow-up period, cumulative CHF was significantly lower in the DP group than in the non-DP group (log-rank p = 0.018), and there was no significant difference in the MACE rate (log-rank p = 0.238). The use of DP device could not predict MACE, but could predict CHF by multivariate analysis (odds ratio = 0.099, 95% CI: 0.02–0.42, p = 0.005). Conclusion: These results demonstrate that favorable clinical outcomes could be achieved by the filter-type DP device in AMI, particularly in patients with CHF. PMID:27251330

  17. Neoadjuvant Chemoradiation With Paclitaxel/Carboplatin for Selected Stage III Non-Small-Cell Lung Cancer: Long-Term Results of a Trimodality Phase II Protocol

    SciTech Connect

    Hehr, Thomas; Friedel, Godehard; Steger, Volker; Spengler, Werner; Eschmann, Susanne M.; Bamberg, Michael; Budach, Wilfried

    2010-04-15

    Purpose: To evaluate, in a Phase II trial conducted August 1998 through January 2001, the efficacy of neoadjuvant chemotherapy followed by chemoradiotherapy and definitive surgery in patients with locally advanced non-small-cell lung cancer (LA-NSCLC), Stages IIIA bulky and selected Stage IIIB. Patients and Methods: Staging of LA-NSCLC included computed tomography of cranium, thorax, and abdomen, whole-body positron emission tomography, and video mediastinoscopy. Induction chemotherapy with weekly paclitaxel and carboplatin was followed by hyperfractionated accelerated thoracic radiotherapy (45 Gy) with simultaneous weekly paclitaxel and carboplatin. Four to six weeks after completion of induction therapy, restaging and resection of primary tumor and lymph nodes was intended. Results: A total of 59 consecutive patients were enrolled, 25% with Stage IIIA bulky disease, 65% with Stage IIIB, and 10% with Stage IV (excluded from further analysis). Forty-one patients completed induction therapy; in 52.4% a functional (positron emission tomography) downstaging was proven. Thirty-two patients (59.3%) underwent complete tumor resection, and 5 patients had an exploratory thoracotomy only. Histopathologic downstaging was proven in 59.4% and complete response in 21.9%. Hospital mortality was 5.4%. Median duration of follow-up for living patients was 62.1 months. Overall median survival was 22.6 months, 58.2 months for completely resected patients. During induction chemotherapy, Grade 3/4 granulocytopenia occurred in 8% of patients; the most common Grade 3/4 toxicity of chemoradiation was esophagitis, in 26.4% of patients. Conclusions: Induction paclitaxel/carboplatin with hyperfractionated accelerated chemoradiotherapy followed by complete tumor resection demonstrates high efficacy in LA-NSCLC and offers a promising chance of long-term survival.

  18. Variables associated with disability in male and female long-term survivors from acute myocardial infarction. Results from the MONICA/KORA Myocardial Infarction Registry.

    PubMed

    Kirchberger, Inge; Heier, Margit; Amann, Ute; Kuch, Bernhard; Thilo, Christian; Meisinger, Christa

    2016-07-01

    Increasing attention is paid on functional limitations and disability among people with chronic diseases. However, only few studies have explored disability in persons with acute myocardial infarction (AMI). The objective of this study was to provide a description of disability and to identify determinants of disability in a population-based sample of long-term AMI survivors. The sample consisted of 1943 persons (35-85years) with AMI from the German population-based MONICA/KORA Myocardial Infarction Registry, who responded to a postal follow-up survey in 2011. Disability was assessed with the 12-item version of the World Health Organization Disability Schedule (WHODAS). Multivariate linear regression models were established in order to identify socioeconomic and clinical factors, risk factors and comorbidities which are associated with disability. The mean WHODAS score for the total sample was 7.86±9.38. The regression model includes 26 variables that explained 37.2% of the WHODAS variance. Most of the explained variance could be attributed to the presence of depression, female sex, joint disorders, digestive disorders, and stroke. Depression was the most important determinant of disability in both sexes. Replacement of single comorbidities by the total number of comorbidities resulted in a model with 15 variables explaining 31.9% of the WHODAS variance. Most of the variance was explained by the number of comorbidities. Further significant determinants of disability were female sex, low education level, angina pectoris, and no revascularization therapy. In AMI patients, the number of comorbidities and particularly the presence of depression are important determinants of disability and should be considered in post-AMI health care.

  19. Anterior cervical discectomy and interbody fusion with porous tantalum implant. Results in a series with long-term follow-up.

    PubMed

    Papacci, Fabio; Rigante, Luigi; Fernandez, Eduardo; Meglio, Mario; Montano, Nicola

    2016-11-01

    Few papers have been published about the anterior cervical discectomy and fusion (ACDF) with implant of porous tantalum cages. These studies included patients submitted to operation at a single level. To our knowledge, we report the results of the largest series of ACDF with implant of porous tantalum cages. Our series included patients operated at a single or double level with a long follow-up (FU). We also discuss the pertinent literature. Clinical and outcome data of 99 consecutive patients (47 men, 52 women) submitted to ACDF with implant of porous tantalum cages (Trabecular Metal TM-S Cervical Fusion Device, Zimmer Spine, Minneapolis, MN) from June 2007 to September 2012, were retrospectively reviewed. Mean FU was 67.47±19.63months. The changes in pain were assessed using the Visual Analogue Scale (VAS). Patients were evaluated pre-operatively and at FU with the Short Form-36 Score Health Survey Version 2.0 (SF-36v2) for Physical Health and Mental Health Scores and the Neck Disability Index. We globally found a statistically significant improvement of all evaluated scores. Patients operated at two levels experienced a statistically significant improvement of all scores, with no statistical difference compared to patients operated at one level. No major complications occurred post-operatively and at FU. Only one patient (operated at two level) experienced an infection during FU. We conclude that ACDF with porous tantalum cages is a safe procedure, with long term clinical benefits (also in patients operated at two levels) and a very low rate of complications.

  20. Long-term proteasomal inhibition in transgenic mice by UBB(+1) expression results in dysfunction of central respiration control reminiscent of brainstem neuropathology in Alzheimer patients.

    PubMed

    Irmler, Martin; Gentier, Romina J G; Dennissen, Frank J A; Schulz, Holger; Bolle, Ines; Hölter, Sabine M; Kallnik, Magdalena; Cheng, Jing Jun; Klingenspor, Martin; Rozman, Jan; Ehrhardt, Nicole; Hermes, Denise J H P; Gailus-Durner, Valérie; Fuchs, Helmut; Hrabě de Angelis, Martin; Meyer, Helmut E; Hopkins, David A; Van Leeuwen, Fred W; Beckers, Johannes

    2012-08-01

    Aging and neurodegeneration are often accompanied by a functionally impaired ubiquitin-proteasome system (UPS). In tauopathies and polyglutamine diseases, a mutant form of ubiquitin B (UBB(+1)) accumulates in disease-specific aggregates. UBB(+1) mRNA is generated at low levels in vivo during transcription from the ubiquitin B locus by molecular misreading. The resulting mutant protein has been shown to inhibit proteasome function. To elucidate causative effects and neuropathological consequences of UBB(+1) accumulation, we used a UBB(+1) expressing transgenic mouse line that models UPS inhibition in neurons and exhibits behavioral phenotypes reminiscent of Alzheimer's disease (AD). In order to reveal affected organs and functions, young and aged UBB(+1) transgenic mice were comprehensively phenotyped for more than 240 parameters. This revealed unexpected changes in spontaneous breathing patterns and an altered response to hypoxic conditions. Our findings point to a central dysfunction of respiratory regulation in transgenic mice in comparison to wild-type littermate mice. Accordingly, UBB(+1) was strongly expressed in brainstem regions of transgenic mice controlling respiration. These regions included, e.g., the medial part of the nucleus of the tractus solitarius and the lateral subdivisions of the parabrachial nucleus. In addition, UBB(+1) was also strongly expressed in these anatomical structures of AD patients (Braak stage #6) and was not expressed in non-demented controls. We conclude that long-term UPS inhibition due to UBB(+1) expression causes central breathing dysfunction in a transgenic mouse model of AD. The UBB(+1) expression pattern in humans is consistent with the contribution of bronchopneumonia as a cause of death in AD patients.

  1. Usefulness of Intraluminal Brachytherapy Combined With External Beam Radiation Therapy for Submucosal Esophageal Cancer: Long-Term Follow-Up Results

    SciTech Connect

    Ishikawa, Hitoshi; Nonaka, Tetsuo; Sakurai, Hideyuki; Tamaki, Yoshio; Kitamoto, Yoshizumi; Ebara, Takeshi; Shioya, Mariko; Noda, Shin-Ei; Shirai, Katsuyuki; Suzuki, Yoshiyuki; Takahashi, Takeo; Nakano, Takashi

    2010-02-01

    Purpose: To assess the efficacy of radiation therapy (RT) by using intraluminal brachytherapy (IBT) combined with external beam RT (EBRT) for submucosal esophageal cancer. Methods and Materials: Between 1991 and 2005, 59 consecutive patients received definitive RT without chemotherapy. IBT was performed after patients completed EBRT as a booster therapy for 17 patients, using low-dose-rate Cs-137 sources until 1997, and for 19 patients, using high-dose-rate Ir-192 sources thereafter. The long-term outcomes were investigated with a median follow-up time of 61 months. Results: Logoregional recurrences and distant metastases were observed in 14 patients and in 2 patients in the lung, respectively, and 5 patients were rescued by salvage treatments. The 5-year logoregional control and cause-specific survival rates were 75% and 76%, respectively. The 5-year cause-specific survival rate in the EBRT group was 62%, whereas the corresponding rate in the IBT group was 86% (p = 0.04). Multivariate analysis revealed that IBT was the most powerful predictor of survival but did not reach a significant level (p = 0.07). There were five esophageal ulcers in the IBT group, but no ulcers developed with small fractions of 3 Gy. Grade 2 or higher cardiorespiratory complications developed in 2 patients (5.6%) in the IBT group and in 3 patients (13.0%) in the EBRT group. Conclusions: Combining IBT with EBRT is suggested to be one of the preferable treatment modalities for medically inoperable submucosal esophageal cancer because of its preferable local control and survival probabilities, with appreciably less morbidity.

  2. Long-term safety and efficacy of dalfampridine for walking impairment in patients with multiple sclerosis: Results of open-label extensions of two Phase 3 clinical trials

    PubMed Central

    Goodman, Andrew D; Bethoux, Francois; Brown, Theodore R; Schapiro, Randall T; Cohen, Ron; Marinucci, Lawrence N; Henney, Herbert R

    2015-01-01

    Background: In Phase 3 double-blind trials (MS-F203 and MS-F204), dalfampridine extended release tablets 10 mg twice daily (dalfampridine-ER; prolonged-release fampridine in Europe; fampridine modified or sustained release elsewhere) improved walking speed relative to placebo in patients with multiple sclerosis (MS). Objectives: Evaluation of long-term safety and efficacy of dalfampridine-ER in open-label extensions (MS-F203EXT, MS-F204EXT). Methods: Patients received dalfampridine-ER 10 mg twice daily; and had Timed 25-Foot Walk (T25FW) assessments at 2, 14 and 26 weeks, and then every 6 months. Subjects were categorized as dalfampridine-ER responders or non-responders, based on their treatment response in the double-blind parent trials that assessed T25FW. Results: We had 269 patients enter MS-F203EXT and 154 patients complete it; for a maximum exposure of 5 years. We had 214 patients enter MS-F204EXT and 146 complete it; for a maximum exposure of 3.3 years. No new safety signals emerged and dalfampridine-ER tolerability was consistent with the double-blind phase. Improvements in walking speed were lost after dalfampridine-ER was discontinued in the parent trial, but returned by the 2-week assessment after re-initiation of the drug. Throughout the extensions, mean improvement in walking speed declined, but remained improved, among the double-blind responders as compared with non-responders. Conclusions: The dalfamipridine-ER safety profile was consistent with the parent trials. Although walking speed decreased over time, dalfampridine-ER responders continued to show improved walking speed, which was sustained compared with non-responders. PMID:25583832

  3. Long-term results of Dana-Farber Cancer Institute ALL Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000).

    PubMed

    Silverman, L B; Stevenson, K E; O'Brien, J E; Asselin, B L; Barr, R D; Clavell, L; Cole, P D; Kelly, K M; Laverdiere, C; Michon, B; Schorin, M A; Schwartz, C L; O'Holleran, E W; Neuberg, D S; Cohen, H J; Sallan, S E

    2010-02-01

    The Dana-Farber Cancer Institute (DFCI) acute lymphoblastic leukemia (ALL) Consortium has been conducting multi-institutional clinical trials in childhood ALL since 1981. The treatment backbone has included 20-30 consecutive weeks of asparaginase during intensification and frequent vincristine/corticosteroid pulses during the continuation phase. Between 1985 and 2000, 1457 children aged 0-18 years were treated on four consecutive protocols: 85-01 (1985-1987), 87-01 (1987-1991), 91-01 (1991-1955) and 95-01 (1996-2000). The 10-year event-free survival (EFS)+/-s.e. by protocol was 77.9+/-2.8% (85-01), 74.2+/-2.3% (87-01), 80.8+/-2.1% (91-01) and 80.5+/-1.8% (95-01). Approximately 82% of patients treated in the 1980s and 88% treated in the 1990s were long-term survivors. Both EFS and overall survival (OS) rates were significantly higher for patients treated in the 1990s compared with the 1980s (P=0.05 and 0.01, respectively). On the two protocols conducted in the 1990s, EFS was 79-85% for T-cell ALL patients and 75-78% for adolescents (age 10-18 years). Results of randomized studies revealed that dexrazoxane prevented acute cardiac injury without adversely affecting EFS or OS in high-risk (HR) patients, and frequently dosed intrathecal chemotherapy was an effective substitute for cranial radiation in standard-risk (SR) patients. Current studies continue to focus on improving efficacy while minimizing acute and late toxicities.

  4. Medical Status of 219 Children with Biliary Atresia Surviving Long-Term with their Native Livers: Results from a North American Multicenter Consortium

    PubMed Central

    Ng, Vicky Lee; Haber, Barbara H.; Magee, John C.; Miethke, Alexander; Murray, Karen F.; Michail, Sonia; Karpen, Saul J.; Kerkar, Nanda; Molleston, JeanP.; Romero, Rene; Rosenthal, Philip; Schwarz, Kathleen B.; Shneider, Benjamin L.; P.Turmelle, Yumirle; Alonso, Estella M.; Sherker, Averell H.; Sokol, Ronald J.

    2014-01-01

    Objectives To examine the medical status of children with biliary atresia (BA) with their native livers after hepatic portoenterostomy (HPE) surgery. Study design The Childhood Liver Disease Research and Education Network (ChiLDREN) database was utilized to examine subjects with BA living with their native livers 5 or more years after HPE and to describe the prevalence of subjects with BA with an “ideal” outcome, defined as no clinical evidence of chronic liver disease, normal liver biochemical indices (aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase, platelet count, total bilirubin, International Normalized Ratio, and albumin) and normal Health-Related Quality of Life (HRQOL) 5 or more years after HPE. Results Children with BA (n=219; 43% male) with median age 9.7 years were studied. Median age at HPE was 56 (range 7-125) days. Median age- and sex-adjusted height and weight Z-scores at 5 year follow-up were 0.487 (interquartile range [IQR]: -0.27 to 1.02) and 0.00 (IQR: -0.74 to 0.70), respectively. During the 12 preceding months, cholangitis and bone fractures occurred in 17% and 5.5%, respectively. HRQOL was reported normal by 53% of patients. However, only 1.8% met the study definition of “ideal” outcome. Individual tests of liver synthetic function (TB, Alb, and INR) were normal in 75%, 85% and 73% of the study cohort. Conclusion Cholangitis and fractures in long-term survivors underscore the importance of ongoing medical surveillance. Over 98% of this North American cohort of subjects with BA living with native livers 5 or more years after HPE have clinical or biochemical evidence of chronic liver disease. PMID:25015575

  5. Long-term environmental stewardship.

    SciTech Connect

    Nagy, Michael David

    2010-08-01

    The purpose of this Supplemental Information Source Document is to effectively describe Long-Term Environmental Stewardship (LTES) at Sandia National Laboratories/New Mexico (SNL/NM). More specifically, this document describes the LTES and Long-Term Stewardship (LTS) Programs, distinguishes between the LTES and LTS Programs, and summarizes the current status of the Environmental Restoration (ER) Project.

  6. Long-term urethral catheterisation.

    PubMed

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  7. Presynaptic long-term plasticity

    PubMed Central

    Yang, Ying; Calakos, Nicole

    2013-01-01

    Long-term synaptic plasticity is a major cellular substrate for learning, memory, and behavioral adaptation. Although early examples of long-term synaptic plasticity described a mechanism by which postsynaptic signal transduction was potentiated, it is now apparent that there is a vast array of mechanisms for long-term synaptic plasticity that involve modifications to either or both the presynaptic terminal and postsynaptic site. In this article, we discuss current and evolving approaches to identify presynaptic mechanisms as well as discuss their limitations. We next provide examples of the diverse circuits in which presynaptic forms of long-term synaptic plasticity have been described and discuss the potential contribution this form of plasticity might add to circuit function. Finally, we examine the present evidence for the molecular pathways and cellular events underlying presynaptic long-term synaptic plasticity. PMID:24146648

  8. Experimental Traumatic Brain Injury Results in Long-Term Recovery of Functional Responsiveness in Sensory Cortex but Persisting Structural Changes and Sensorimotor, Cognitive, and Emotional Deficits.

    PubMed

    Johnstone, Victoria P A; Wright, David K; Wong, Kendrew; O'Brien, Terence J; Rajan, Ramesh; Shultz, Sandy R

    2015-09-01

    Traumatic brain injury (TBI) is a leading cause of death worldwide. In recent studies, we have shown that experimental TBI caused an immediate (24-h post) suppression of neuronal processing, especially in supragranular cortical layers. We now examine the long-term effects of experimental TBI on the sensory cortex and how these changes may contribute to a range of TBI morbidities. Adult male Sprague-Dawley rats received either a moderate lateral fluid percussion injury (n=14) or a sham surgery (n=12) and 12 weeks of recovery before behavioral assessment, magnetic resonance imaging, and electrophysiological recordings from the barrel cortex. TBI rats demonstrated sensorimotor deficits, cognitive impairments, and anxiety-like behavior, and this was associated with significant atrophy of the barrel cortex and other brain structures. Extracellular recordings from ipsilateral barrel cortex revealed normal neuronal responsiveness and diffusion tensor MRI showed increased fractional anisotropy, axial diffusivity, and tract density within this region. These findings suggest that long-term recovery of neuronal responsiveness is owing to structural reorganization within this region. Therefore, it is likely that long-term structural and functional changes within sensory cortex post-TBI may allow for recovery of neuronal responsiveness, but that this recovery does not remediate all behavioral deficits.

  9. Tumor Location, Interval Between Surgery and Radiotherapy, and Boost Technique Influence Local Control After Breast-Conserving Surgery and Radiation: Retrospective Analysis of Monoinstitutional Long-Term Results

    SciTech Connect

    Knauerhase, Hellen; Strietzel, Manfred; Gerber, Bernd; Reimer, Toralf; Fietkau, Rainer

    2008-11-15

    Purpose: To obtain long-term data on local tumor control after treatment of invasive breast cancer by breast-conserving surgery and adjuvant radiotherapy (RT), in consideration of the interstitial high-dose-rate boost technique. Patients and Methods: A total of 263 women with 268 mammary carcinomas (International Union Against Cancer Stage I-IIB) who had undergone breast-conserving surgery and adjuvant RT between 1990 and 1994 were included. The potential risk factors for local recurrence-free survival were investigated. Results: During a median follow-up period of 94 months, 27 locoregional recurrences, 25 of which were in breast, were diagnosed. The cumulative rate of in-breast recurrence was 4.1% {+-} 1.4% at 5 years of follow-up and 9.9% {+-} 2.4% at 10 years. The multivariate analysis identified medial tumor location and delayed RT (defined as an interval of >2 months between surgery and the start of RT) as significant risk factors for in-breast recurrence in the overall study population. Medial tumor location vs. lateral/central location (hazard ratio, 2.48; 95% confidence interval, 1.06-5.84) resulted in a cumulative in-breast recurrence rate of 22.5% {+-} 8.3% vs. 6.9% {+-} 2.3% at 10 years. Delayed RT (hazard ratio, 2.84; 95% confidence interval, 1.13-7.13) resulted in a cumulative in-breast recurrence rate of 18.5% {+-} 6.2% vs. 6.8% {+-} 2.4% at 10 years. The multivariate analysis also showed that the risk of in-breast recurrence was lower after high-dose-rate boost therapy than after external beam boost therapy in patients with laterally/centrally located tumors (hazard ratio, 3.25; 95% confidence interval, 0.91-11.65). Conclusion: Tumor location, interval between surgery and RT, and boost technique might influence local control of breast cancer treated by breast-conserving surgery and RT.

  10. Preoperative Chemoradiation Therapy With Capecitabine/Oxaliplatin and Cetuximab in Rectal Cancer: Long-Term Results of a Prospective Phase 1/2 Study

    SciTech Connect

    Fokas, Emmanouil; Conradi, Lena; Weiss, Christian; Sprenger, Thilo; Middel, Peter; Rau, Tillman; Dellas, Kathrin; Kitz, Julia; Rödel, Franz; Sauer, Rolf; Rüschoff, Josef; Beissbarth, Tim; Arnold, Dirk; Ghadimi, B. Michael; Rödel, Claus; Liersch, Torsten

    2013-12-01

    Purpose: We have previously shown that the addition of cetuximab to chemoradiation therapy failed to improve complete response rates (pCR) in rectal cancer. Here we report the long-term results of the cetuximab added to preoperative radiation therapy with capecitabine and oxaliplatin (CET-CAPOX-RT) phase 1/2 study that evaluated preoperative chemoradiation with cetuximab, capecitabine, and oxaliplatin in patients with rectal cancer. Methods and Materials: The median follow-up was 63 months (range, 5-73 months). Sixty patients were enrolled; 3 patients were excluded due to protocol violation, and 4 died before surgery. Total mesorectal excision was performed in 53 patients, in 85% (n=45) with curative intention (M0-status). Secondary end points including overall survival (OS) disease-free survival (DFS) and cancer-specific survival (CSS) were calculated. The prognostic value of KRAS mutation status was also assessed. Results: Histopathological examination confirmed ypUICC stages 0 (n=4; pCR), I (n=17), II (n=10), III (n=14), and IV (n=8). For patients who underwent surgery (n=53), OS at 1, 3, and 5 years was 88.7%, 83%, and 75.5%, respectively, whereas CSS rates were 94.1%, 88.1%, and 78.1%, respectively. In the 45 patients who were treated with curative intent (M0), the OS rates at 1, 3, and 5 years were 91.1%, 88.9%, and 86.7%, respectively; whereas CSS rates were 97.6%, 95.2%, and 90.3%, respectively; and DFS rates were 90.7%, 88.3%, and 88.3%, respectively. We did not find any locoregional failure in patients with M0-status (n=45). Chronic toxicity was rare. KRAS mutations, as detected in 33.3%, showed no correlation with the clinicopathological parameters nor significance for either OS (P=.112), CSS (P=.264), or DFS (P=.565). Conclusions: Taken together, chemoradiation therapy combined with cetuximab is safe, feasible, and offers excellent survival rates. KRAS mutation status was not a predictive factor. Importantly, lack of improvement in pCR rate did not

  11. Results from IODP Leg 306: Long-term cooling trend in North Atlantic sea-surface temperatures during the last 5 Ma

    NASA Astrophysics Data System (ADS)

    Naafs, David; Hefter, Jens; Stein, Ruediger; Haug, Gerald

    2010-05-01

    In the early Pliocene global surface temperatures were several degrees warmer than today and ice sheets in the Northern Hemisphere had a limited extent [e.g., Haywood et al., 2005; Zachos et al., 2001]. This changed during the intensification of Northern Hemisphere glaciation (INHG) between 3.4 and 2.5 Ma (with a major step around 2.7 Ma), when global climate cooled and ice sheets in the Northern Hemisphere became more extensive [e.g., Zachos et al., 2001]. Here we present results from the first orbitally resolved (~ 4 ka resolution) record of Uk'37 based sea-surface temperature (SST) in the North Atlantic spanning the last 5 Ma. We used samples from the recently drilled IODP Site U1313, which is located in the North Atlantic at 41 oN and is a re-drill of DSDP Site 607. Our results show that the long-term cooling of SST in the North Atlantic began in the Early Pliocene around 4.1 Ma, which is earlier than previously thought. During the Pleistocene SST continued to cool and at the beginning of the mid-Pleistocene transition (MIS 40) glacial SST show a sudden drop to temperatures comparable to the LGM. At the same time the C37:4 alkenone, an indicator for arctic water masses [e.g., McClymont et al., 2008], became more abundant. We relate this to the influence of Arctic waters reaching far into the North Atlantic as the Arctic Front moved south during the peak glacial conditions of the Middle to Late Pleistocene. References: Haywood, A. M., P. Dekens, A. C. Ravelo, and M. Williams (2005), Warmer tropics during the mid-Pliocene? Evidence from alkenone paleothermometry and a fully coupled ocean-atmosphere GCM, Geochem. Geophys. Geosyst., 6(3), doi:10.1029/2004GC000799. McClymont, E. L., A. Rosell-Melé, G. H. Haug, and J. M. Lloyd (2008), Expansion of subarctic water masses in the North Atlantic and Pacific oceans and implications for mid-Pleistocene ice sheet growth, Paleoceanography, 23. Zachos, J., M. Pagani, L. Sloan, E. Thomas, and K. Billups (2001), Trends

  12. Response-specific progestin resistance in a newly characterized Ishikawa human endometrial cancer subcell line resulting from long-term exposure to medroxyprogesterone acetate.

    PubMed

    Zhao, Shunjun; Li, Genxia; Yang, Li; Li, Lei; Li, Hongyu

    2013-01-01

    Progestins, particularly medroxyprogesterone acetate (MPA), have for a long time been used as conservative treatment for young patients with clinical stage I, grade I endometrial carcinoma. However, more than 30% of patients with endometrial adenocarcinoma display resistance to endocrine therapies at the time of presentation and most cancer patients that initially respond to progestin treatment will at some point develop resistance, resulting in tumor progression. The cellular mechanisms underlying acquired resistance to progestin are poorly understood. In order to investigate the molecular mechanisms whereby human endometrial adenocarcinoma develops resistance to progestin therapy, we have undertaken to develop human endometrial adenocarcinoma cell lines that are resistant to the growth-inhibitory effects of progestins in vitro. A progestin-resistant subcell line of Ishikawa cells was developed from Ishikawa human endometrial adenocarcinoma cells by stepwise selection in increasing concentrations of the synthetic progestin, MPA, over ten months. The doubling time of the progestin-resistant cells (34.18±3.15 h) grown routinely in the medium containing 10 μM MPA was not significantly different from the doubling time of the parent Ishikawa cells (35.14±2.68 h) grown in the absence of MPA (t=-0.331, P=0.762). Moreover, the effect of treatment with MPA shifted from suppression of growth and invasiveness, as observed in the parent Ishikawa cells, to stimulation of growth and invasiveness in the progestin-resistant Ishikawa cells. The positive rates of estrogen receptor a (ERα) and progesterone receptor B (PRB) of the progestin-resistant Ishikawa cells were significantly reduced, whilst the positive rate of ERβ was significantly enhanced compared to the parent Ishikawa cells. These differences were statistically significant (P<0.05). Our results indicate that long-term treatment with MPA in Ishikawa cells may give rise to a resistance effect to MPA. When the

  13. The Development of a Long-Term, Continually Updated Global Solar Resource at 10 km Resolution: Preliminary Results From Test Processing and Continuing Plans

    NASA Technical Reports Server (NTRS)

    Stackhouse, P.; Perez, R.; Sengupta, M.; Knapp, K.; Cox, Stephen; Mikovitz, J. Colleen; Zhang, T.; Hemker, K.; Schlemmer, J.; Kivalov, S.

    2014-01-01

    Background: Considering the likelihood of global climatic weather pattern changes and the global competition for energy resources, there is an increasing need to provide improved and continuously updated global Earth surface solar resource information. Toward this end, a project was funded under the NASA Applied Science program involving the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC), National Renewable Energy Laboratory (NREL), the State University of New York/Albany (SUNY) and the NOAA National Climatic Data Center (NCDC) to provide NREL with a global long-term advanced global solar mapping production system for improved depiction of historical solar resources and variability and to provide a mechanism for continual updates of solar resource information. This new production system is made possible by the efforts of NOAA and NASA to completely reprocess the International Satellite Cloud Climatology Project (ISCCP) data set that provides satellite visible and infrared radiances together with retrieved cloud and surface properties on a 3-hourly basis beginning from July 1983. The old version of the ISCCP data provided this information for all the world TMs available geosynchronous satellite systems and NOAA TMs AVHRR data sets at a 30 km effective resolution. This new version aims to provide a new and improved satellite calibration at an effective 10 km resolution. Thus, working with SUNY, NASA will develop and test an improved production system that will enable NREL to continually update the Earth TM solar resource. Objective and Methods: In this presentation, we provide a general overview of this project together with samples of the new solar irradiance mapped data products and comparisons to surface measurements at various locations across the world. An assessment of the solar resource values relative to calibration uncertainty and assumptions are presented. Errors resulting assumptions in snow cover and background aerosol

  14. The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study

    PubMed Central

    Shin, Joon-Shik; Lee, Jinho; Kim, Me-riong; Shin, Byung-Cheul; Lee, Myeong Soo; Ha, In-Hyuk

    2014-01-01

    control group prevents validation of effectiveness, many patients showed favourable long-term outcomes. Trial registration number ClinicalTrials.gov Identifier: NCT01989403.

  15. Long-term outcome of stapled transanal rectal resection (STARR) versus stapled hemorrhoidopexys (STH) for grade III-IV hemorrhoids: preliminary results.

    PubMed

    Zanella, Simone; Spirch, Saverio; Scarpa, Marco; Ricci, Francesco; Lumachi, Franco

    2014-01-01

    Circular stapled transanal hemorrhoidopexy (STH) was first introduced by A. Longo for the correction of internal mucosal prolapse and obstructed defecation and in 1998, was proposed as alternative to conventional excisional hemorrhoidectomy. More recently, stapled transanal rectal resection (STARR) has gradually gained popularity, as the Longo procedure, in the treatment of hemorrhoids. The aim of our study was to evaluate the usefulness of STARR as alternative to STH in patients with grade III (n=218, 68.1%) and IV (n=102, 31.9%) hemorrhoids. A group of 320 consecutive patients (median age=51 years; range=16-85) underwent STH (n=281) or STARR (n=39) procedure. The rate of postoperative bleeding (53.8% vs. 74.4%, p<0.01) was significantly reduced in patients who underwent STARR procedure, which required a longer (45 ± 22 vs. 26 ± 11 min, p<0.01) operative time. There were no differences between groups with regard to use of painkillers, postoperative pain intensity, short- (three months) and long-term (one and three years) residual pain, soiling, incontinence and urgency. Patients treated with the STARR procedure had lower recurrence rate of hemorrhoids and a lower incidence of prolapse, both at one year (none vs. 1.4%, p=0.593 and 2.6% vs. 5.3%, p=0.396, respectively) and at two years (none vs. 6.8%, p=0.078 and none vs. 13.2%, p=0.012, respectively). The one-year (9.0 ± 1.8 vs. 9.4 ± 0.7, p=0.171) and two-year (9.6 ± 0.8 vs. 9.1 ± 1.7, p=0.072) general satisfaction was similar but higher in STARR patients than in the STH group. In conclusion, according to our preliminary results, the STARR procedure leads to a lower incidence of complications and recurrences and should be considered for patients with grade III or IV hemorrhoids previously selected for stapled hemorrhoidectomy, as a promising alternative to STH.

  16. Long-term results and recurrence patterns from SCOPE-1: a phase II/III randomised trial of definitive chemoradiotherapy +/− cetuximab in oesophageal cancer

    PubMed Central

    Crosby, T; Hurt, C N; Falk, S; Gollins, S; Staffurth, J; Ray, R; Bridgewater, J A; Geh, J I; Cunningham, D; Blazeby, J; Roy, R; Maughan, T; Griffiths, G; Mukherjee, S

    2017-01-01

    Background: The SCOPE-1 study tested the role of adding cetuximab to conventional definitive chemoradiotherapy (dCRT), and demonstrated greater toxicity and worse survival outcomes. We present the long-term outcomes and patterns of recurrence. Methods: SCOPE-1 was a phase II/III trial in which patients were randomised to cisplatin 60 mg m−2 (day 1) and capecitabine 625 mg m−2 bd (days 1–21) for four cycles +/− cetuximab 400 mg m−2 day 1 then by 250 mg m−2 weekly. Radiotherapy consisted of 50 Gy/25# given concurrently with cycles 3 and 4. Recruitment was between February 2008 and February 2012, when the IDMC recommended closure on the basis of futility. Results: About 258 patients (dCRT=129; dCRT+cetuximab (dCRT+C)=129) were recruited from 36 centres. About 72.9% (n=188) had squamous cell histology. The median follow-up (IQR) was 46.2 (35.9–48.3) months for surviving patients. The median overall survival (OS; months; 95% CI) was 34.5 (24.7–42.3) in dCRT and 24.7 (18.6–31.3) in dCRT+C (hazard ratio (HR)=1.25, 95% CIs: 0.93–1.69, P=0.137). Median progression-free survival (PFS; months; 95% CI) was 24.1 (15.3–29.9) and 15.9 (10.7–20.8) months, respectively (HR=1.28, 95% CIs: 0.94–1.75; P=0.114). On multivariable analysis only earlier stage, full-dose RT, and higher cisplatin dose intensity were associated with improved OS. Conclusions: The mature analysis demonstrates that the dCRT regimen used in the study provided useful survival outcomes despite its use in patients who were largely unfit for surgery or who had inoperable disease. Given the competing risk of systemic and local failure, future studies should continue to focus on enhancing local control as well as optimising systemic therapy. PMID:28196063

  17. Effect of oral beta-blocker on short and long-term mortality in patients with acute respiratory failure: results from the BASEL-II-ICU study

    PubMed Central

    2010-01-01

    Introduction Acute respiratory failure (ARF) is responsible for about one-third of intensive care unit (ICU) admissions and is associated with adverse outcomes. Predictors of short- and long-term outcomes in unselected ICU-patients with ARF are ill-defined. The purpose of this analysis was to determine predictors of in-hospital and one-year mortality and assess the effects of oral beta-blockers in unselected ICU patients with ARF included in the BASEL-II-ICU study. Methods The BASEL II-ICU study was a prospective, multicenter, randomized, single-blinded, controlled trial of 314 (mean age 70 (62 to 79) years) ICU patients with ARF evaluating impact of a B-type natriuretic peptide- (BNP) guided management strategy on short-term outcomes. Results