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  1. Long-term use of lithium and risk of colorectal adenocarcinoma

    DEFF Research Database (Denmark)

    Pottegård, Anton; Ennis, Zandra Nymand; Hallas, Jesper;

    2016-01-01

    diagnosed with incident colorectal adenocarcinoma during 2000-2012 (n=36 248). Using a matched case-control approach, we estimated the association between long-term use (⩾5 years) of lithium and risk of colorectal adenocarcinoma using conditional logistic regression. RESULTS: Long-term use of lithium was......BACKGROUND: Lithium accumulates in the colon and inhibits the enzyme GSK-3β that possesses anti-carcinogenic effects. We therefore examined the association between lithium use and colorectal cancer risk in a nationwide study. METHODS: We used the Danish Cancer Registry to identify all patients......, 0.66-1.55; distal colon: 1.52 (95% CI, 1.05-2.20); and rectum: 0.80 (95% CI, 0.50-1.30). CONCLUSIONS: Lithium use was not associated with an overall increased risk of colorectal adenocarcinoma. The variation by subsite warrants further investigation....

  2. Long term results of mandibular distraction

    Directory of Open Access Journals (Sweden)

    Batra Puneet

    2006-03-01

    Full Text Available Mandibular distraction osteogenesis has become a popular surgical modality due to its many advantages over conventional orthognathic surgical procedures. However, in spite of the technique having been used for over 15 years, no concrete long term results are available regarding the stability of results. We discuss the various studies which have reported either in favour or against the stablility of results after distraction. We report a series of 6 cases (3 unilateral and 3 bilateral distraction where distraction was carried out before puberty and followed them up to seven years after removal of distractors. This case series shows that results achieved by distraction osteogenesis are unstable or best unpredictable with respect to producing a permanent size increase in the mandible. The role of the distraction osteogenesis in overcoming the pterygomassetric sling is questionable. We suggest a multicenter study with adequate patient numbers treated with a similar protocol and documented after growth cessation to have meaningful conclusions on the debate of distraction osteogenesis versus orthognathic surgery.

  3. Rare long-term survivors of pancreatic adenocarcinoma without curative resection.

    Science.gov (United States)

    Oh, Stephen Y; Edwards, Alicia; Mandelson, Margaret T; Lin, Bruce; Dorer, Russell; Helton, W Scott; Kozarek, Richard A; Picozzi, Vincent J

    2015-12-28

    Long-term outcome data in pancreatic adenocarcinoma are predominantly based on surgical series, as resection is currently considered essential for long-term survival. In contrast, five-year survival in non-resected patients has rarely been reported. In this report, we examined the incidence and natural history of ≥ 5-year survivors with non-resected pancreatic adenocarcinoma. All patients with pancreatic adenocarcinoma who received oncologic therapy alone without surgery at our institution between 1995 and 2009 were identified. Non-resected ≥ 5-year survivors represented 2% (11/544) of all non-resected patients undergoing treatment for pancreatic adenocarcinoma, and 11% (11/98) of ≥ 5-year survivors. Nine patients had localized tumor and 2 metastatic disease at initial diagnosis. Disease progression occurred in 6 patients, and the local tumor bed was the most common site of progression. Six patients suffered from significant morbidities including recurrent cholangitis, second malignancy, malnutrition and bowel perforation. A rare subset of patients with pancreatic cancer achieve long-term survival without resection. Despite prolonged survival, morbidities unrelated to the primary cancer were frequently encountered and a close follow-up is warranted in these patients. Factors such as tumor biology and host immunity may play a key role in disease progression and survival. PMID:26730170

  4. Long-term control of T2-T3 rectal adenocarcinoma with radiotherapy alone

    International Nuclear Information System (INIS)

    Purpose: To analyze the long-term result of patients presenting with T2-T3 rectal adenocarcinoma treated with curative intent by radiotherapy (RT) alone, using a combination of contact RT, external beam RT, and brachytherapy with an iridium implant. Patients were considered unsuitable for surgery because of the presence of severe comorbidity or because they did not consent to surgery and the possibility of a permanent stoma. Methods and Materials: Between 1986 and 1998, 63 patients (56 staged with endorectal ultrasonography) were entered into a pilot study. Patients had to have T2-T3, N0-N1, M0 adenocarcinoma of the middle or lower rectum involving less than two-thirds of the circumference. RT began with contact X-rays (80 Gy in 3 fractions for 21 days), followed by external beam RT (39 Gy in 13 fractions for 17 days) with a concomitant boost (4 Gy in 4 fractions). After a 4-6-week interval, an iridium implant delivered a completion dose of 20 Gy to the tumor. No chemotherapy was given. Results: The median age of the patients was 72 years. Of the 63 patients, 41 had T2 and 22 had T3 tumors. The mean distance of the tumor from the anal verge was 3.6 cm. All patients completed treatment according to the protocol, except for 7 for whom brachytherapy was not performed. With a median follow-up time of 54 months, the primary local tumor control rate was 63%; after salvage surgery, the ultimate pelvic control was 73% (46 of 63). The 5-year overall survival rate was 64.4%, and for 42 patients aged <80 years, it was 78% with 10 patients alive and well at ≥10 years. No severe Grade 3-4 toxicity was seen. Acute proctitis was seen in most patients but did not require treatment interruption. Late rectal bleeding occurred in 24 patients. Only 1 required blood transfusion. Good anorectal function was maintained in 92% of living patients. The T stage was a strong prognostic factor, with a 5-year overall survival rate of 84% and 53% for T2 and T3 lesions, respectively, in

  5. Endoscopic Management of Attic Cholesteatoma: Long-Term Results.

    Science.gov (United States)

    Alicandri-Ciufelli, Matteo; Marchioni, Daniele; Kakehata, Seiji; Presutti, Livio; Villari, Domenico

    2016-10-01

    The main application of endoscopic surgery relies on the middle ear cholesteatoma surgical treatment, although for a definitive validation and acceptance by scientific community, long-term results are needed about recurrent and residual rates of the pathology. The aim of the present paper was to analyze the single institution experience with the long-term results of surgical treatment of attic cholesteatoma. PMID:27565391

  6. HLA-E expression in cervical adenocarcinomas: association with improved long-term survival

    Directory of Open Access Journals (Sweden)

    Spaans Vivian M

    2012-09-01

    Full Text Available Abstract Background Cervical cancer is the third most common cancer in women worldwide. The most common histopathological subtype is cervical squamous cell carcinoma (SCC, 75-80%, followed by adenocarcinoma (AC and adenosquamous carcinoma (ASC; together 15-20%. Rising incidence rates of AC have been observed relative and absolute to SCC and evidence is accumulating that cervical AC is a distinct clinical entity. Cervical SCC, ASC, and AC are caused by a persistent infection with high-risk human papillomavirus (HPV and failed control of the immune system plays a pivotal role in the carcinogenesis of all three histopathological subtypes. Human leukocyte antigen E (HLA-E, a non-classical HLA class Ib molecule, plays an important role in immune surveillance and immune escape of virally infected cells. In this study we investigated HLA-E expression in three well-defined cohorts of cervical AC, ASC, and SCC patients, and determined whether HLA-E expression was associated with histopathological parameters and patient survival. Methods and results HLA-E expression was assessed by immunohistochemistry on formalin-fixed, paraffin-embedded tissue sections of 79 SCC, 38 ASC, and 75 AC patients. All patients included were International Federation of Gynaecology and Obstetrics stage I-II and underwent radical hysterectomy with lymphadenectomy as primary treatment. Significant differences between the histopathological subgroups were detected for age distribution, HPV positivity, HPV type distribution, tumour size, tumour infiltration depth, lymph-vascular space invasion, and adjuvant radiotherapy. High expression of HLA-E was found in 107/192 (56% cervical carcinomas, with significantly more overexpression in cervical AC compared to SCC and ASC (37/79 SCC, 18/38 ASC, and 52/75 AC; P = 0.010. High HLA-E expression in cervical AC was associated with favourable long term disease-specific and recurrence-free survival (P = 0.005 and P = 0

  7. Long-term results of trismus release in noma patients.

    Science.gov (United States)

    Bisseling, P; Bruhn, J; Erdsach, T; Ettema, A M; Sautter, R; Bergé, S J

    2010-09-01

    Noma, also known as cancrum oris, is an infectious disease that results in a loss of orofacial tissue, due to gangrene of soft and bony tissue. It is especially seen in young children in the sub-Saharan region. Among the sequelae of patients who survive noma, trismus is one of the most disabling. This retrospective research studied the long-term results of trismus release in noma patients. Thirty-six patients could be traced in the villages and were included in the study. The mean mouth opening in this group was 10.3mm (95% CI: 7.0; 13.6mm) and the mean period after discharge from hospital was 43 months. Better mouth opening was observed in patients who continued physiotherapy after discharge, were older, and those with a 'soft' (vs. 'hard') inner and outer cheek on palpation. The result of trismus release in noma patients in the long term was extremely poor in this study.

  8. Fourteen-Year Long-Term Results after Gastric Banding

    Directory of Open Access Journals (Sweden)

    Christine Stroh

    2011-01-01

    Full Text Available Background. Gastric banding (GB is a common bariatric procedure that is performed worldwide. Weight loss can be substantial after this procedure, but it is not sufficient in a significant portion of patients. Long-term rates for associated complications increase with every year of follow up, and only a few long-term studies have been published that examine these rates. We present our results after 14 years of postoperative follow up. Methods. Two hundred patients were operated upon form 01.02.1995 to 31.01.2009. Data collection was performed prospectively. In retrospective analysis, we analyzed weight loss, short- and long-term complications, amelioration of comorbidities and long-term outcome. Results. The mean postoperative follow up time was 94.4 months (range 2–144. The follow up rate was 83.5%. The incidence of postoperative complications for slippage was 2.5%, for pouch dilatation was 9.5%, for band migration was 5.5% and 12.0% for overall band removal. After 14 years, the reoperation rate was 30.5% with a reoperation rate of 2.2% for every year of follow up. Excess weight loss was 40.2% after 1 year, 46.3% after 2 years, 45.9% after 3 years, 41.9% after five years, 33.3% after 8 years, 30.8% after 10 years, 33.3% after 12 years and 15.6% after 14 years of follow up. Conclusion. The complication and reoperation rate after GB is high. Nevertheless, GB is still a therapeutic option in morbid obese patients, but the criteria for patient selection should be carefully evaluated.

  9. Advanced gastric adenocarcinoma. Influence of preoperative radiation therapy on toxicity and long-term survival rates

    International Nuclear Information System (INIS)

    The surgical treatment of gastric cancer has better long-term survival rates when performed in patients with early gastric cancer. Worse results are obtained in treatment of advanced gastric cancer. Most patients in west centers are treated in advanced stages. A great number of them go through a surgical treatment unable by itself to cure them. the frequent local recurrence caused by failure of the surgical treatment has been keeping poor survival rates in patients with advanced gastric cancer for decades. The desire of improving survival is the reason of the use of adjuvant therapies. This paper achieved the retrospective study of the influence of preoperative radiation therapy (2000 cGy) in long-term survival rates (120 months) of patients with advanced gastric cancer on stages IIIa, IIIb and IV. The possible injuries caused in the liver and kidney were observed also as well as first group was treated by surgical and radiation therapies and the second received surgical treatment only. There was no statistical difference between the two groups when sex, age, race, occurrence of other diseases, nutritional assessment, TNM stage, occurrence of obstruction or bleeding caused by tumor, surgical procedure and hepatic and renal function were considered. Survival rates and changes on hepatic and renal function were statistically compared. The results showed a statistic improvement on the long-term survival rates of stage IIIa patients treated by preoperative radiation therapy. No statistic difference was observed on hepatic or renal function between the groups. No adverse influence of radiation therapy method was detected by the used parameters. There was no statistical difference between the two groups when immediate surgical complications were considered. (author)

  10. Management of bilateral breast carcinoma: long-term results.

    Science.gov (United States)

    Goksel, Hüsnü A; Yagmurdur, Mahmut C; Karakayali, Hamdi; Moray, Gokhan; Demirhan, Beyhan; Isiklar, Iclal; Bilgin, Nevzat; Haberal, Mehmet

    2004-01-01

    The aim of this study was to document the clinical features and long-term outcomes in 43 cases of bilateral breast carcinoma. All the women were diagnosed by a single surgeon who had evaluated 13,443 patients with breast-related complaints over a 40-year period. At the initial cancer diagnosis, 28 patients (65%) were of premenopausal age ( 46 years; group 2). The median interval between initial and subsequent cancer was 24 months (range, 12-288 months) in group 1 and 20 months (range, 14-252 months) in group 2 (P > 0.05). The distribution of initial cancer types based on pathological examination was ductal adenocarcinoma in 28 (65%) cases; lobular carcinoma in 5 (12%) cases; comedocarcinoma in 5 (12%) cases; papillary carcinoma in 2 (4.5%) cases; papillary combined with squamous cell carcinoma in 1 (2%) case; and lobular combined with medullary carcinoma in 2 (4.5%) cases. There were no significant differences between the groups with respect to the distribution of types of surgery used for the initial and subsequent carcinomas. Tumor locations were symmetrical in 26 (60%) patients. The mean palpable mass sizes for the initial and subsequent tumors in group 1 were 3 +/- 1.4 (range, 1-8 cm) and 1.3 +/- 0.5 cm (range, 1-2 cm), respectively. The corresponding means for group 2 were 2.3 +/- 1.8 (range, 0.9-7 cm) and 1.3 +/- 0.5 cm (range, 1-2 cm). The 10- and 20-year disease-free survival rates for group 1 versus group 2 were 32% versus 27% and 10% versus 8%, respectively. The rates of axillary lymph node metastasis from the primary cancer in groups 1 and 2 were statistically similar; however, the rate of axillary lymph node metastasis from subsequent cancer in group 1 was significantly higher than that in group 2 (P = 0.02). The lactation period (after each child born) in group 1 was significantly longer than that in group 2 (P = 0.04). Group 1 had a higher rate of distant metastasis at 20 years (P = 0.03), but the groups' local recurrence rates at this stage were

  11. Salvage radical prostatectomy: indications, complications and long-term results

    International Nuclear Information System (INIS)

    Before the PSA era, radiation failures, diagnosed on clinical grounds, were not detected until most tumors were locally advanced. When combined with needle biopsy of the prostate, a rising PSA level allows us to detect radiation failures earlier, when the cancer may still be confined within the prostate or immediate periprostatic tissue and local therapy may effectively eradicate all remaining cancer. Nevertheless, salvage local therapy -- whether with surgery, interstitial irradiation therapy, or cryotherapy -- has been accompanied by substantial complications and the benefits, in terms of long-term cancer control, have not been well documented Candidates for salvage radical prostatectomy should have biopsy-proven local recurrence and should be in excellent health with a life expectancy of > 10 years. The initial tumor, before radiotherapy, should have been organ-confined (T1 or T2) and the PSA level should have normalized ( 10 ng/ml few patients had an undetectable PSA at 5 years. However, clinical local control was excellent and the actuarial cancer-specific survival rate at 8 years was 85%. Salvage radical prostatectomy is a technically challenging procedure and complication rates are higher than after standard radical prostatectomy. The most common complications are rectal injuries, incontinence, bladder neck strictures, and impotence. In the Baylor series, complications were more likely in patients who had prior lymphadenectomy and brachytherapy (31%) compared with those who had external beam therapy alone (9%). Rectal injuries have been reported in 5% to 15% of patients compared with less than 1% in standard radical prostatectomy patients. Incontinence persists in 25% to 60% of patients and 25% of our patients have required an artificial urinary sphincter. The availability of PSA to monitor the results of radiation therapy, combined with the ease of ultrasound-directed needle biopsy of the prostate, now allows the detection of local recurrence earlier than

  12. Long term results of radiotherapy of degenerative joint diseases

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, H.; Freislederer, R.

    1982-04-01

    At the Radiologic Department of the Staedt. Krankenhaus Passau, 473 patients with degenerative diseases in the big joints and the spine were irradiated with the caesium unit between 1971 and 1979. Among these patients, 249 could be followed up during a prolonged period (1/2 to 9 years, i.e. 4.2 years on an average). According to the categories of v. Pannewitz, 11% were pain-free at this moment, 21% showed an essential improvement, 29% showed an improvement, and 39% were not influenced by the treatment. 13.5% showed recurrent pains; these were mentioned as 'not influenced' in the statistical analysis. It is proved that the relief of pain does not depend on the age of the patients, but on the anamnesis period, the results of the X-ray examiantion, and the degree of the restriction of mobility. Due to the delay of irradiation, a preliminary treatment mostly produces a less favorable radiotherapeutic result. Compared with other therapeutic methods, the long term results of radiotherapy of degenerative joint diseases are generally favorable. This conclusion is also confirmed by the results of patients checked up more than five years after the treatment.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    OpenAIRE

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

    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 prospec...

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

    OpenAIRE

    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 prospec...

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

    Science.gov (United States)

    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.

  17. Long Term Corrosion/Degradation Test Six Year Results

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Directory of Open Access Journals (Sweden)

    Naseem ul Gani

    2014-11-01

    Full Text Available 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.

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

    Science.gov (United States)

    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

  20. Long-term results of trismus release in noma patients.

    NARCIS (Netherlands)

    Bisseling, P.; Bruhn, J.; Erdsach, T.; Ettema, A.M.; Sautter, R.; Berge, S.J.

    2010-01-01

    Noma, also known as cancrum oris, is an infectious disease that results in a loss of orofacial tissue, due to gangrene of soft and bony tissue. It is especially seen in young children in the sub-Saharan region. Among the sequelae of patients who survive noma, trismus is one of the most disabling. Th

  1. Brachytherapy in Lip Carcinoma: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Guibert, Mireille, E-mail: mireilleguib@voila.fr [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); David, Isabelle [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Vergez, Sebastien [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); Rives, Michel [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Filleron, Thomas [Department of Epidemiology, Claudius Regaud Institut, Toulouse (France); Bonnet, Jacques; Delannes, Martine [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France)

    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.

  2. Esthesioneuroblastoma: clinical course, long-term results of treatment

    Directory of Open Access Journals (Sweden)

    T. D. Tabolinovskaya

    2016-01-01

    Full Text Available This rare tumor from a group of neuroendocrine neoplasms was studied. The material for the study was the data of 78 patients with esthesioneuroblastoma who had been treated and followed up at the N.N. Blokhin Russian Cancer Research Center in the period 1965 to 2014. Information on hospital statistics, clinical features, methods, and treatment results were presented. The possibilities of using the TNM classification for the nasal cavity, ethmoidal sinuses, and nasopharynx were assessed to determine the anatomic extent of primary tumor. The findings contribute to the solution of problems in the diagnosis and treatment of esthesioneuroblastoma at the present stage. 

  3. Long-term results of PRRT in advanced bronchopulmonary carcinoid

    Energy Technology Data Exchange (ETDEWEB)

    Mariniello, Annapaola; Bodei, Lisa; Baio, Silvia Melania; Gilardi, Laura; Colandrea, Marzia; Papi, Stefano; Grana, Chiara Maria [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Tinelli, Carmine [IRCCS Foundation Policlinico San Matteo, Epidemiology and Biometric Unit, Pavia (Italy); Valmadre, Giuseppe [Presidio Ospedaliero E. Morelli AOVV, Sondalo (Italy); Fazio, Nicola [European Institute of Oncology, Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, Milan (Italy); Galetta, Domenico [European Institute of Oncology, Thoracic Surgery Division, Milan (Italy); Paganelli, Giovanni [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine and Radiometabolic Units, Meldola (Italy)

    2016-03-15

    Peptide receptor radionuclide therapy (PRRT) for the treatment of neuroendocrine tumours (NET) has been explored for almost two decades, but there are still few trials that have exclusively investigated well-differentiated and moderately differentiated NET arising from the respiratory tree. Thus, the aim of this study was to explore the outcome in patients affected by bronchopulmonary carcinoid (BPC) following PRRT. We retrospectively analysed 114 patients with advanced stage BPC consecutively treated with PRRT at the European Institute of Oncology, Milan, from 1997 to 2012 and followed until October 2014. The objective responses, overall survival (OS) and progression-free survival (PFS) were rated, and three different PRRT protocols ({sup 90}Y-DOTATOC vs. {sup 177}Lu-DOTATATE vs. {sup 90}Y-DOTATOC + {sup 177}Lu-DOTATATE) were compared with regard to their efficacy and tolerability. The median OS (evaluated in 94 of the 114 patients) was 58.8 months. The median PFS was 28.0 months. The {sup 177}Lu-DOTATATE protocol resulted in the highest 5-year OS (61.4 %). Morphological responses (partial responses + minor responses) were obtained in 26.5 % of the cohort and were associated with longer OS and PFS. The {sup 90}Y-DOTATOC + {sup 177}Lu-DOTATATE protocol provided the highest response rate (38.1 %). Adverse events were mild in the majority of patients. However, haematological toxicity negatively affected survival. No severe (grade 3/4) serum creatinine increase was observed. Patients treated with {sup 90}Y-DOTATOC alone more frequently showed a mild/moderate decrease in renal function. In patients treated with chemotherapy before PRRT had a shorter OS and PFS, and a higher risk of developing nephrotoxicity. In a large cohort of patients with advanced BPC treated in a ''real-world'' scenario and followed up for a median of 45.1 months (range 2 - 191 months), PRRT proved to be promising in prolonging survival and delaying disease progression. Despite

  4. Long-term results of our modified Nuss procedure

    International Nuclear Information System (INIS)

    Though many authors have reported modifications of the Nuss procedure and complications have been reduced, life-threatening complications such as serious infections or massive bleeding should always be considered. For the past seven years we have modified the Nuss procedure to make the bar tunnel extrapleurally using an endoscope to reduce serious complications. We used our modified method to repair the pectus excavatum of 24 prepubescent patients, ages ranging from 4 to 12 years old. The average time for surgery was 280 minutes for the early quarter series and 192 minutes for the late. Pneumothorax occurred in 10 patients (41.7%), but continuous suction drainage was not necessary. Five athelectasis were observed and resulted in spontaneous remission. One bar displacement and one parasternal costal cartilage deformity also occurred but there were no other complications. Bar removal was performed in 16 patients at an average of 28.7 months after the primary operation. After the bar removal, the CT Index increased about 10% in the early period (0-3 months); after which values remained stable and within a normal range in the follow up period (6-49 months). Though our modified Nuss procedure requires more time than the original procedure, we believe it is safer. (author)

  5. Artificial Urinary Sphincter: Long-Term Results and Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Drogo K. Montague

    2012-01-01

    Full Text Available The published evidence concerning the safety, efficacy, and patient satisfaction for implantation of the current model of the artificial urinary sphincter (AS 800 in men with post prostatectomy urinary incontinence was the objective of this review. A Pub Med English language literature search from 1995 to 2011 was performed. A majority of men who undergo AUS implantation for post prostatectomy urinary incontinence achieve satisfactory results (0 to 1 pad per day. Infection rates range from 0.46 to 7%, cuff erosion rates range from 3.8 to 10%, and urethral atrophy ranges from 9.6 to 11.4%. Kaplan-Meier 5 year projections for freedom from any reoperation were 50% for a small series and 79.4% for a larger series. Kaplan-Meier projections for freedom from mechanical failure were 79% at 5 years and 72% at 10 years. In another series 10 year projections for freedom from mechanical failure were 64%. Although the artificial urinary sphincter (AUS is the gold standard for the treatment of this disorder, most men will continue to need at least one pad per day for protection, and they are subject to a significant chance of future AUS revision or replacement.

  6. Long-term outcome of sports injuries : results after inpatient treatment

    NARCIS (Netherlands)

    Dekker, R; van der Sluis, CK; Groothoff, JW; Eisma, WH; ten Duis, HJ

    2003-01-01

    Objective: To investigate whether sports injuries result in long-term disabilities and handicaps and to establish variables with a prognostic value for the occurrence of these long-term consequences. Materials and methods: All patients older than 17 years of age and admitted to the University Hospit

  7. Significance of preoperative C-reactive protein as a parameter of the perioperative course and long-term prognosis in squamous cell carcinoma and adenocarcinoma of the oesophagus

    Institute of Scientific and Technical Information of China (English)

    Ines Gockel; Kathrin Dirksen; Claudia M Messow; Theodor Junginger

    2006-01-01

    AIM: C-reactive protein (CRP) is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter of the perioperative course and long-term prognosis in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus.METHODS: Serum CRP was determined preoperatively in 291 of 371 patients undergoing oesophagectomy for cancer from December 1989 to March 2004. Median patient age was 59 (28-79) year,82.5% of patients were males. Squamous cell carcinoma was diagnosed in 151(51.9%) and adenocarcinoma in 122 patients. Transhiatal oesophagectomy was done in 151 (51.9%) patients and 134 (46.0%) patients underwent the abdominothoracic procedure.RESULTS: In 127 (43.6%) patients the preoperative serum CRP concentration was within the normal range (<5 mg/dL), elevated CRP levels were measured in 164 (56.4%) patients. Tumour extension (P<0.0005)and the number of lymph nodes affected by metastatic spread (P=0.015) were significantly increased in the group with elevated CRP levels. Among the perioperative parameters both the number of blood transfusions (P =0.006) and the general complication rate (P=0.002)were higher in patients with elevated preoperative CRP levels. The long-term survival rate of 13.6 (0-109.8)mo was poorer in the group with elevated CRP levels compared to 18.9 (0-155.4) mo in the group with normal CRP levels (log-rank test:P=0.107). Multivariate analysis with backward variables selection identified preoperative CRP as an independent prognostic factor of the long-term prognosis in patients with oesophageal carcinoma, with a hazard ratio of 1.182 (95% confidence interval: 1.030-1.356).CONCLUSION: The preoperative serum CRP-level is an easily determined independent prognostic marker in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus.

  8. Long-term results of palatal implants for obstructive sleep apnea.

    Science.gov (United States)

    Neruntarat, Chairat

    2011-07-01

    Successful results of palatal implants in the treatment of obstructive sleep apnea (OSA) have been reported in the short term; however, there are limited data in the long-term results. The aim of this study was to evaluate the long-term results and to determine factors that predicted the responders in patients undergoing palatal implants in the treatment of OSA. A study was undertaken on 92 OSA patients. Palatal implants were conducted to stiffen the soft palate and data were analyzed. Patients tolerated the procedure well. They were examined between 26 and 32 months after the operation (mean 28.9 ± 4.8). Age range was 25-65 years (38.4 ± 10.5) and BMI was 27.3 ± 2.4 kg/m. The mean preoperative ESS score was 12.3 ± 2.6 and long-term ESS was 7.9 ± 1.8 (p LSAT and long-term LSAT were 87.4 ± 6.7 and 89.2 ± 4.8%, respectively (p < 0.01). The mean AHI decreased from 21.7 ± 6.8 to 10.8 ± 4.8 (p < 0.001). Forty-eight (52.2%) patients had long-term surgical response. Responders had significantly lower preoperative BMI, AHI, and MMP level than non-responders. Implant extrusion occurred in seven patients (7.6%) and palatal abscess in one patient (1.1%). Bleeding and airway obstruction were not encountered. Palatal implants in carefully selected patients suffering from mild OSA, give fairly good long-term results and have a low complication rate. PMID:21298386

  9. Short- and Long-Term Results of Open Versus Laparoscopic Appendectomy

    NARCIS (Netherlands)

    H.A. Swank; E.J. Eshuis; M.I. van Berge Henegouwen; W.A. Bemelman

    2011-01-01

    Clinical advantages of laparoscopic appendectomy have been shown in numerous trials and reviews. Most of these advantages are small and of limited clinical relevance, while laparoscopic operation costs are reported to be higher. The present study compares short- and long-term results of conventional

  10. Long-term Results of the Posteromedial Release in the Treatment of Idiopathic Clubfoot

    NARCIS (Netherlands)

    van Gelder, Janke H.; van Ruiten, Alward G. P.; Visser, Jan D.; Maathuis, Patrick G. M.

    2010-01-01

    Background: Short-term follow-up studies show good results in foot function, after surgical treatment of idiopathic clubfeet. Long-term follow-up studies are rare and probably represent a mixture of experience of different treating orthopedic surgeons. The purpose of this study is to present the lon

  11. Long-Term Results of Incisional Hernia Repair with Concomitant Abdominoplasty in Postbariatric Patients

    Directory of Open Access Journals (Sweden)

    Iljin Aleksandra

    2016-05-01

    Full Text Available The aim of the study was evaluation of long-term results after simultaneous incisional hernia repair and abdominoplasty in patients following RYGB (Roux-en-Y Gastric By-pass and estimation of quality of life before and after this complex operation.

  12. Long-term results of Talent endografts for endovascular abdominal aortic aneurysm repair

    NARCIS (Netherlands)

    Verhoeven, Bart A. N.; Waasdorp, Evert J.; Gorrepati, Madhu L.; van Herwaarden, Joost A.; Vos, Jan Albert; Wille, Jan; Moll, Frans L.; Zarins, Christopher K.; de Vries, Jean Paul P. M.

    2011-01-01

    Background: Since the introduction of endovascular aneurysm repair (EVAR), long-term follow-up studies reporting single-device results are scarce. In this study, we focus on EVAR repair with the Talent stein graft (Medtronic, Santa Rosa, Calif). Methods: Between July 2000 and December 2007, 365 pati

  13. Long-term results after repair of ruptured and non-ruptured abdominal aortic aneurysm

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    Kuzmanović Ilija B.

    2004-01-01

    Full Text Available INTRODUCTION Abdominal aortic aneurysm can be repaired by elective procedure while asymptomatic, or immediately when it is complicated - mostly due to rupture. Treating abdominal aneurysm electively, before it becomes urgent, has medical and economical reason. Today, the first month mortality after elective operations of the abdominal aorta aneurysm is less than 3%; on the other hand, significant mortality (25%-70% has been recorded in patients operated immediately because of rupture of the abdominal aneurysm. In addition, the costs of elective surgical treatment are significantly lower. OBJECTIVE The objective of this study is to compare long-term survival of patients that underwent elective or immediate repair of abdominal aortic aneurysm (due to rupture, and to find out the factors influencing the long-term survival of these patients. MATERIAL AND METHODS Through retrospective review of prospectively collected data of the Institute for Cardiovascular Diseases of Clinical Center of Serbia, Belgrade, 56 patients that had elective surgery and 35 patients that underwent urgent operation due to rupture of abdominal aneurysm were followed up. Only the patients that survived 30 postoperative days were included in this review, and were followed up (ranging from 2 to 126 months. Electively operated patients were followed during 58.82 months on the average (range 7 to 122, and urgently operated were followed over 52.26 months (range 2 to 126. There was no significant difference of the length of postoperative follow-up between these two groups. RESULTS During this period, out of electively operated and immediately operated patients, 27 and 22 cases died, respectively. There was no significant difference (p>0,05a of long-term survival between these two groups. Obesity and early postoperative complications significantly decreased long-term survival of both electively and immediately operated patients. Graft infection, ventral hernia, aneurysm of

  14. Long-term results of complex left ventricular reconstruction surgery: case report.

    Science.gov (United States)

    Letsou, George V; Forrester, Matthew; Frazier, O H

    2011-01-01

    Left ventricular reconstruction is advocated as a surgical option for patients with severe congestive heart failure. Despite initial enthusiasm for this procedure, reports of long-term results are sparse. Herein, we describe a particularly gratifying case of left ventricular reconstruction in a 43-year-old man, who continues to have excellent left ventricular function 10 years postoperatively. This approach may be a reasonable alternative to cardiac transplantation in patients who lack other treatment options.

  15. Long-Term Results of Gamma Knife Radiosurgery for Intracranial Meningioma

    OpenAIRE

    Jang, Chang Ki; Jung, Hyun Ho; Chang, Jong Hee; Chang, Jin Woo; Park, Yong Gou; Chang, Won Seok

    2015-01-01

    Background The predominant treatment modality for meningioma is surgical resection. However, gamma knife radiosurgery is also an important treatment modality for meningioma that is small or cannot be completely removed because of its location. In this study, we evaluated the effectiveness and long-term results of radiosurgical treatment for meningioma in our institution. Methods We studied 628 patients (130 men and 498 women) who underwent gamma knife radiosurgery for intracranial meningioma,...

  16. Long term results of anterior corpectomy and fusion for cervical spondylotic myelopathy.

    Directory of Open Access Journals (Sweden)

    Rui Gao

    Full Text Available 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.

  17. Surgical and conservative treatment of patients with congenital scoliosis: α search for long-term results

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2011-06-01

    Full Text Available Abstract Background In view of the limited data available on the conservative treatment of patients with congenital scoliosis (CS, early surgery is suggested in mild cases with formation failures. Patients with segmentation failures will not benefit from conservative treatment. The purpose of this review is to identify the mid- or long-term results of spinal fusion surgery in patients with congenital scoliosis. Methods Retrospective and prospective studies were included, reporting on the outcome of surgery in patients with congenital scoliosis. Studies concerning a small numbers of cases treated conservatively were included too. We analyzed mid-term (5 to 7 years and long-term results (7 years or more, both as regards the maintenance of the correction of scoliosis and the safety of instrumentation, the early and late complications of surgery and their effect on quality of life. Results A small number of studies of surgically treated patients were found, contained follow-up periods of 4-6 years that in the most cases, skeletal maturity was not yet reached, and few with follow-up of 36-44 years. The results of bracing in children with congenital scoliosis, mainly in cases with failure of formation, were also studied. Discussion Spinal surgery in patients with congenital scoliosis is regarded in short as a safe procedure and should be performed. On the other hand, early and late complications are also described, concerning not only intraoperative and immediate postoperative problems, but also the safety and efficacy of the spinal instrumentation and the possibility of developing neurological disorders and the long-term effect these may have on both lung function and the quality of life of children. Conclusions Few cases indicate the long-term results of surgical techniques, in the natural progression of scoliosis. Similarly, few cases have been reported on the influence of conservative treatment. In conclusion, patients with segmentation failures

  18. Unintentional Long-Term Esophageal Stenting due to a Complete Response in a Patient with Stage UICC IV Adenocarcinoma of the Gastroesophageal Junction

    Science.gov (United States)

    Paeschke, Anna; Bojarski, Christian; Küpferling, Susanne; Hucklenbroich, Thomas; Siegmund, Britta; Daum, Severin

    2016-01-01

    Endoscopic stent implantation is a common short-treatment option in palliative settings in patients with esophageal cancer. Advanced disease is associated with low survival rates; therefore, data on the long-term outcome are limited. So far, cases of long-term remission or even cure of metastasized adenocarcinoma of the gastroesophageal junction or stomach (AGS) have only been reported from Asia. A 51-year-old male patient primarily diagnosed with metastasized adenocarcinoma of the gastroesophageal junction (GEJ) [type I, cT3cN+cM1 (hep), CEA positive, UICC stage IV] received palliative esophageal stenting with a self-expandable metal stent. As disease progressed after four cycles with epirubicin, oxaliplatin, and capecitabin, treatment was changed to 5-FU and Irinotecan. The patient did not return after 5 cycles of FOLFIRI, but presented 4 years later with mild dysphagia. Endoscopy surprisingly revealed no relevant stenosis or stent migration. Repeated histological analyses of a residual mass at the GEJ did not detect malignancy. Since the initially diagnosed hepatic metastases were no longer detectable by computed tomography, cure from esophageal cancer was assumed. Dysphagia was ascribed to esophageal motility disorder by a narrowed esophageal lumen after long-term stenting. Thus, endoscopic stent implantation is an important method in palliative treatment of dysphagia related to AGS. New systemic treatment strategies like trastuzumab in Her2neu positive cases or new VEGF-inhibitors like ramucirumab will lead to more long-time survivors with AGS. In conclusion, future endoscopic treatment strategies in AGS represent a challenge for the development of new stent techniques in either extraction or programmed complete dissolution. PMID:27462189

  19. Long-Term Results of Endoscopic Lumbar Discectomy by "Destandau's Technique"

    Science.gov (United States)

    Kamble, Bhavna; Patond, Kisan

    2016-01-01

    Study Design Prospective study. Purpose The aim of the study was to present long-term results from a 10-year follow-up after endoscopic lumbar discectomy (ELD) by "Destandau's technique". Overview of Literature Endoscopic disc surgery by Destandau's technique using ENDOSPINE Karl Storz system is a relatively new technique. It was introduced in 1993. It has been gaining popularity among the spine surgeons, as it is attractive for small skin incision and allows a gentle and excellent tissue dissection with excellent visualization. Many authors have published results of their own studies; however, in all these studies the long-term follow up of the patients has not been emphasized. Methods A total of 21 patients selected on basis of strict inclusion criteria's underwent ELD from November 2004 to March 2005. Surgery outcome was assessed by using "Prolo's Anatomic-Functional-Economic Rating System" (1986). Patients were followed up to 10 years. In addtion, we compared the results of our study with other studies. Results Outcomes were excellent in 17 patients (80.95%), good in 3 (14.28%) and fair in 1 (4.78%), with no patients having a poor result. In our study, 19 patients (90.47%) were able to resume their previous works/jobs, and only 2 (9.52%) needed to change their jobs for lighter work. No patient retired from his or her previous daily routine following the operation. Conclusions The initial and long-term results are very good for endoscopic lumbar discectomy by Destandau's technique. In properly selected patients it is a safe and minimally invasive technique, and we recommend ELD in properly selected patients. PMID:27114770

  20. Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lux, Anja; Lund-Andersen, Henrik;

    2014-01-01

    PURPOSE: To report long-term results, prognostic factors and cataract surgery after diabetic vitrectomy. METHODS: Retrospective review of patient files from a large diabetes centre between 1996 and 2010. Surgical history was obtained from the Danish National Patient Register. Follow-up intervals...... were 3 months and 1, 3, 5 and 10 years after surgery. RESULTS: In total, 167 patients had diabetic vitrectomy indicated for non-clearing vitreous haemorrhage (47%) and tractional retinal detachment (53%). The proportion of patients with visual acuity ≥0.3 increased from 29% before surgery to 60% after...... 3 months (p surgery to 0.3 after 3 months (p

  1. Twenty-Year Experience of Heart Transplantation: Early and Long-Term Results

    Science.gov (United States)

    Lee, Jae-Hong; Yeom, Sang Yoon; Hwang, Ho Young; Choi, Jae-Woong; Cho, Hyun-Jai; Lee, Hae-Young; Huh, Jae-Hak; Kim, Ki-Bong

    2016-01-01

    Background We evaluated early and long-term results after heart transplantation (HTPL). Methods One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients. PMID:27525232

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

    International Nuclear Information System (INIS)

    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.

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

    Science.gov (United States)

    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

  4. Use of Contact Lenses in Eyes with Severe Keratoconus: Long-term Results

    Directory of Open Access Journals (Sweden)

    Zerrin Tuncer

    2012-05-01

    Full Text Available Pur po se: To evaluate the long-term results of rigid gas permeable (RGP contact lenses in severe keratoconic eyes. Ma te ri al and Met hod: Severe keratoconic eyes with RGP contact lenses were evaluated retrospectively. Re sults: Long-term follow-up results of RGP contact lenses applied to 59 eyes of 42 patients (25 women, 17 men with a diagnosis of severe keratoconus were analyzed. Follow-up period was 3 to 12 years (mean: 6.57±3.60. The mean age at first exam was 25.88±9.10 years, the mean corneal curve K1 was 6.49±0.40 mm and K2 was 5.91±0.40 mm. Mean visual acuities with spectacles and contact lenses were 0.26±0.10 lines (0.63±0.20 logMAR and 0.66±0.20 lines (0.20±0.10 logMAR, respectively. The difference between both visual acuities was statistically significant (p=0.0001. At the last visit, the mean visual acuity with RGP contact lenses was 0.68±0.20 lines (0.19±0.10 logMAR. There was no statistically significant difference in visual acuity between first and last examinations with contact lenses (p=0.32. During the long-term follow-up period, apical scarring developed in 17 eyes. Only the 2 eyes of one patient needed penetrating keratoplasty after 6 years of RGP contact lens use. Dis cus si on: Use of RGP contact lenses should be considered before penetrating keratoplasty in cases of severe keratoconus. (Turk J Ophthalmol 2012; 42: 202-6

  5. Long-term results after Boston brace treatment in adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Steen Harald

    2009-08-01

    Full Text Available Abstract Background Few studies have evaluated long-term outcome after bracing using validated health related quality of life outcome measures. The aim of the present study was to evaluate the long-term outcome in adolescent idiopathic scoliosis (AIS 12 years or more after treatment with the Boston brace. Methods 109 (80% of 135 patients (7 men with AIS treated with the Boston brace at a mean of 19.2 (range 12–28 years previously responded to long-term follow-up examination. All patients (n = 109 answered a standardised questionnaire including demographics, work status, treatment, Global Back Disability Question, Oswestry Disability Index (ODI (100-worst possible, General Function Score (GFS (100 – worst possible, EuroQol (EQ-5D (1 – best possible, EQ-VAS (100 – best possible and Scoliosis Research Society -22 (SRS – 22 (5 – best possible. Clinical and radiological examination was obtained in 86 patients. Results The magnitude of the primary prebrace major curve was in average 33.4° (range 20 – 52. At weaning and at the last follow-up the corresponding values were 28.3° (9–56 and 34.2° (8 – 87, respectively. The mean age at follow-up was 35 (27 – 46 years. Work status was: full time (80%, on sick-leave (3%, on rehabilitation (4%, disability pension (4%, homemaker (7%, students (2%, 7% had changed their job because of back pain. 88% had had delivered a baby, 55% of them had pain in pregnancy. Global back status was excellent or good in 81%. The mean (standard deviation ODI was 6.4 (9.8, GFS 5.4 (10.5, EQ-5D 0.84 (0.2, SRS-22: pain 4.2 (0.8, mental health 4.2 (0.7, self-image 3.9 (0.7, function 4.1 (0.6, satisfaction with treatment 3.7 (1.0. 28% had taken physiotherapy for back pain the last year and 12% had visited a doctor. Conclusion Long-term results were satisfactory in most patients with AIS treated with the Boston brace.

  6. Long-term results of LINAC-based stereotactic radiosurgery for acoustic neuroma: The Greek experience

    Directory of Open Access Journals (Sweden)

    Kalogeridi Maria-Aggeliki

    2009-01-01

    Full Text Available Purpose: To estimate the value of LINAC-based stereotactic radiosurgery (SRS for the long-term local control of unilateral acoustic neuromas. Materials and Methods: Twenty patients (median age 66; range 57-80 years with unilateral acoustic neuroma underwent LINAC-based SRS from May 2000 through June 2004 with a dose of 11-12 Gy. The follow-up period ranged from 36 to 84 months (median follow-up period: 55 months. Before SRS none of the patients had useful hearing. The follow-up consisted of repeat imaging studies and clinical examination for assessment of facial and trigeminal nerve function at 6-month intervals for the first year and yearly thereafter. Results: Eleven tumors (58% decreased in size and eight (42% remained stable. One tumor showed a minor increase in size on the MRI done 6 months after SRS in comparison with the pretreatment MRI; however, a subsequent decrease was noticed on the next radiographic assessment and the tumor remained stable from then on. None of the tumors increased in size in the long-term follow-up, thus giving an overall growth control of 100% for the patients in this study. None of the patients had useful hearing before SRS, so hearing level was not assessed during follow-up. No patient developed new, permanent facial or trigeminal neuropathy. Conclusion: LINAC-based SRS with 11-12 Gy provides excellent tumor control in acoustic neuroma and has low toxicity even after long-term follow-up.

  7. Long-term results of stomach-conserving therapy in gastric MALT lymphoma

    International Nuclear Information System (INIS)

    Purpose: To evaluate long-term results of stomach-conserving therapy and to assess the value of histological probable minimal residual disease (pMRD) in predicting outcome in patients with gastric MALT lymphoma. Materials and methods: We studied 115 patients with stage I-II2 gastric MALT lymphoma treated between 1975 and 2002. Initially, first-line treatment consisted of radiotherapy only. Since 1994 most patients were primarily treated with Helicobacter pylori eradication; radiotherapy was used in case of eradication failure. To assess the value of pMRD, first follow-up biopsy samples classified as compete remission (CR) according to classical clinico-pathological criteria and biopsy samples 1 year after assessment of histological CR were reviewed; results were related to outcome. Results: Following radiotherapy only (n = 56) 96% achieved a clinical CR; 10-year cancer-specific survival rate was 94%. Following H. pylori eradication only (n = 35) CR-rate was 43% and after additional treatment 89%; 5-year cause-specific survival was 93%. There was no difference in relapse rate following initial histological CR or pMRD. Conclusions: Patients with early stage gastric MALT lymphoma have a favorable long-term outcome following conservative treatment. Outcome after H. pylori eradication followed by delayed radiotherapy on indication was excellent. In our series pMRD was not associated with increased risk of recurrence

  8. Congenital penile curvature: long-term results of operative treatment using the plication procedure

    Institute of Scientific and Technical Information of China (English)

    S.-S.Lee; E.Meng; E-RChuang; C.-Y.Yen; S.-Y.Chang; D.-S.Yu; G.-H.Sun

    2004-01-01

    Aim: To determine the long-term outcome, effectiveness and patient satisfaction of congenital penile curvature correction by plication of tunica albuginea. Methods: From January 1992 to January 2002, 106 young patients underwent surgical correction of congenital penile curvature by corporeal plication. Indications for operation were difficult or impossible vaginal penetration and cosmetic problems. The technique of corporeal plication consists of placing longitudinal plication sutures of 2-zero braided polyester on the convex side of the curvature until the curvature is corrected when erection is artificially induced. Results of this procedure were obtained by retrospective chart reviews and questionnaires via mail. Long-term follow-up ranged from 11 to 132 (mean 69.3) months and data were available for 68 patients. Results: Penile straightening was excellent in 62 patients (91%) and good with less than 15 degree of residual curvature in 6 patients (9 %). Sixty-seven patients reported no change in erectile rigidity or maintenance postoperatively, while 1 described early detumescence. Shortening of the penis without functional problems was noted by 26 patients (38 %). Thirty-Five patients (51%) reported feeling palpable indurations (suture knots) on the penis. Temporary numbness of glans penis was described in 3 patients. Overall, 60 patients were very satisfied, 6 satisfied, 2 unsatisfied. Conclusion: Corporeal plication is an effective and durable procedure with a high rate of patient satisfaction. (Asian J Androl 2004 Sep; 6: 273-276)

  9. Long-term results of surgical release of de Quervain's stenosing tenosynovitis.

    Science.gov (United States)

    Scheller, Alexander; Schuh, Ralph; Hönle, Wolfgang; Schuh, Alexander

    2009-10-01

    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

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

    International Nuclear Information System (INIS)

    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/m2 d1, 5FU 800 mg/m2 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

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

    Science.gov (United States)

    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. PMID:24923155

  12. Long-term results of golimumab therapy for rheumatoid arthritis. Therapy compliance issues

    Directory of Open Access Journals (Sweden)

    N. V. Chichasova

    2016-01-01

    Full Text Available The goal of therapy for rheumatoid arthritis (RA is to suppress inflammation, to prevent or delay destructive changes in the joints, and to normalize functions during the longest monitoring of the course of RA. The data of randomized controlled trials and national registries are of great importance to a clinician. The paper reviews the literature data characterizing the long-term results of RA therapy with the tumor necrosis factor-α inhibitor golimumab (GLM and patient compliance with the therapy. Treatment with GLM at the registered subcutaneous dose of 50 mg once every 4 weeks gives rise to an effect in the vast majority of patients regardless of the type of previous ineffective therapy, the dose of concurrently administered methotrexate, the number of previous ineffective disease-modifying antirheumatic drugs, and the use and nonuse of glucocorticoids. GLM is characterized by a long-term (as long as 5 years effect with suppressed progression of destruction, functional recovery, and satisfactory tolerability with no additional risk for adverse events as the therapy is continued.

  13. First Results on Long-Term Multiwavelength Variability Analysis in Mrk 421

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    Racero Elena

    2013-12-01

    Full Text Available Due to the broad-band nature of the emission from blazars, strong efforts are being placed in recent years on simultaneous multiwavelength campaigns as a way to understand the mechanisms responsible for the acceleration of ultra-relativistic particles in these objects. The present work aims at providing a systematic study of the broadband long-term variability properties of the TeV blazar, Mrk 421, by gathering archival multiwavelength data spanning nearly two decades in time over several energy bands, from radio frequencies through x-rays to high and very high γ-ray energies. The lightcurves at these energies have been characterized over long periods (≈months using several statistical methods, in order to study variability over long-term timescales and the dependence of this variability with flux and energy, aiming ultimately at shedding some light onto the physical mechanisms that drive blazar emission. We present in this work the preliminary results of the variability analysis for Mrk 421, and it will be extended in the future to see if the properties found are particular of this source or if they can be extended to the blazar class.

  14. Comparison of long-term Moscow and Danish NLC observations: statistical results

    Directory of Open Access Journals (Sweden)

    P. Dalin

    2006-11-01

    Full Text Available Noctilucent clouds (NLC are the highest clouds in the Earth's atmosphere, observed close to the mesopause at 80–90 km altitudes. Systematic NLC observations conducted in Moscow for the period of 1962–2005 and in Denmark for 1983–2005 are compared and statistical results both for seasonally summarized NLC parameters and for individual NLC appearances are described. Careful attention is paid to the weather conditions during each season of observations. This turns out to be a very important factor both for the NLC case study and for long-term data set analysis. Time series of seasonal values show moderate similarity (taking into account the weather conditions but, at the same time, the comparison of individual cases of NLC occurrence reveals substantial differences. There are positive trends in the Moscow and Danish normalized NLC brightness as well as nearly zero trend in the Moscow normalized NLC occurrence frequency but these long-term changes are not statistically significant. The quasi-ten-year cycle in NLC parameters is about 1 year shorter than the solar cycle during the same period. The characteristic scale of NLC fields is estimated for the first time and it is found to be less than 800 km.

  15. Homeopathic medical practice: Long-term results of a cohort study with 3981 patients

    Directory of Open Access Journals (Sweden)

    Baur Roland

    2005-11-01

    Full Text Available Abstract Background On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions. Methods In a prospective, multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland, data from all patients (age >1 year consulting the physician for the first time were observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from 0 to 10 and quality of life at baseline, and after 3, 12, and 24 months. Results A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 ± 13.1 years; 71% women, 39.9 ± 12.4 years and 1,130 children (52% boys, 6.5 ± 3.9 years; 48% girls, 7.0 ± 4.3 years. Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 ± 8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Disease severity decreased significantly (p Conclusion Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.

  16. Therapy-related leukemia as a result of long-term chemotherapy for non-small cell lung cancer

    International Nuclear Information System (INIS)

    Recent advances in chemotherapy have prolonged the survival of lung cancer patients. However, there have been reports of patients who suffer therapy-related leukemia after chemotherapy. A 64-year-old woman was given a diagnosis of adenocarcinoma (T4N0M0 stage IIIB) in 2004, and received chemotherapy with cisplatin and other drugs from 2004 to 2009, and radiotherapy for brain metastasis in 2008. In January 2009, she was admitted to our hospital with low-grade fever, fatigue, and prolonged neutropenia. A peripheral blood smear revealed a predominance of circulating myeloblasts. Examination of the bone marrow aspirate confirmed acute myelogenous leukemia. We think that therapy-related leukemia developed because of long-term chemotherapy and radiotherapy. Therapy-related leukemia can develop in lung cancer patients who undergo long-term therapy. (author)

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

    Science.gov (United States)

    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. PMID:26991883

  18. Anemia and long-term outcome in adjuvant and neoadjuvant radiochemotherapy of stage II and III rectal adenocarcinoma: The Freiburg experience (1989-2002)

    Institute of Scientific and Technical Information of China (English)

    Christian Weissenberger; Michael Henke; Michael Geissler; Florian Otto; Annette Barke; Karl Henne; Georg von Plehn; Alex Rein; Christine Müller; Susanne Bartelt

    2006-01-01

    AIM: To evaluate the long-term outcome of standard 5-FU based adjuvant or neoadjuvant radiochemotherapy and to identify the predictive factors, especially anemia before and after radiotherapy as well as hemoglobin increase or decrease during radiotherapy.METHODS: Two hundred and eighty-six patients with Union International Contre Cancer (UICC) stage Ⅱ and Ⅲ rectal adenocarcinomas, who underwent resection by conventional surgical techniques (low anterior or abdominoperineal resection), received either postoperative (n = 233) or preoperative (n = 53)radiochemotherapy from January 1989 until July 2002.Overall survival (OAS), cancer-specific survival (CSS),disease-free survival (DFS), local-relapse-free (LRS) and distant-relapse-free survival (DRS) were evaluated using Kaplan-Meier, Log-rank test and Cox's proportional hazards as statistical methods. Multivariate analysis was used to identify prognostic factors. Median follow-up time was 8 years.RESULTS: Anemia before radiochemotherapy was an independent prognostic factor for improved DFS (risk ratio 0.76, P=0.04) as well as stage, grading, R status (free radial margins), type of surgery, carcinoembryonic antigen (CEA) levels, and gender. The univariate analysis revealed that anemia was associated with impaired LRS (better local control) but with improved DFS. In contrast,hemoglobin decrease during radiotherapy was an independent risk factor for DFS (risk ratio 1.97, P = 0.04).During radiotherapy, only 30.8% of R0-resected patients suffered from hemoglobin decrease compared to 55.6% if R1/2 resection was performed (P=0.04). The 5-year OAS, CSS, DFS, LRS and DRS were 47.0%, 60.0%,41.4%, 67.2%, and 84.3%, respectively. Significant differences between preoperative and postoperative radiochemotherapy were not found.CONCLUSION: Anemia before radiochemotherapy and hemoglobin decrease during radiotherapy have no predictive value for the outcome of rectal cancer. Stage,grading, R status (free radial margins), type of

  19. Age at treatment and long-term performance results in medulloblastoma

    International Nuclear Information System (INIS)

    Medulloblastoma is highly radioresponsive, and recent treatment results have improved greatly since the introduction of megavoltage machine in 1960s. There is increasing evidence for the potential cure of medulloblastoma if properly treated in its early stages. The curable group represents approximately 75% of diagnosed patients. Long-term treatment effects were examined in this study. The study reveals age-dependent late effects in learning ability; the patients less than 4-years-old at treatment had major learning problems; patients of 5 to 7 years old performed at satisfactory-to-low passing levels in school work; patients older than 8 years old had no major intellectual impairment. Short stature was common when growth potential was present at the time of therapy, but endocrine tests were generally negative. These observations indicate special educational requirement needs, especially for children treated at a young age

  20. Cystic Dilation of Extrahepatic Bile Ducts in Adulthood: Diagnosis, Surgical Treatment and Long. Term Results

    Directory of Open Access Journals (Sweden)

    G. Belli

    1998-01-01

    Full Text Available To evaluate the long-term results of surgery for choledohal cyst in adulthood, a series of 13 patients over the age of 16 operated on for choledochal cyst during a period of six years and followed-up for a minimum of 3 years was analyzed. Patients with type I and IVa cysts underwent extrahepatic cyst resection and Roux-en-Y hepatico-jejunostomy. Choledochoceles (type III were managed endoscopically. No operative mortality or morbidity occurred. Type I and III cysts showed almost ideal follow-up with no sign of stricture on HIDA scan. One type IVa cyst patients developed recurrent cholangitis due to anastomotic stricture, managed percutaneously. Whenever possible, complete cyst resection and Roux-en-Y reconstruction is the treatment of choice for all extrahepatic biliary cysts. Intra- and extrahepatic dilatations are adequately treated by extrahepatic resection and careful endoscopic or radiologic surveillance. Small choledochoceles can be safely managed by endoscopic sphincterotomy.

  1. Final results of a long-term, clinical follow-up in fatty liver patients

    DEFF Research Database (Denmark)

    Dam-Larsen, Sanne; Becker, Ulrik; Franzmann, Maria-Benedicte;

    2009-01-01

    OBJECTIVE: There is increasing focus on non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to conduct a long-term clinical follow-up of patients with biopsy-confirmed fatty liver without inflammation or significant fibrosis (pure fatty liver), to analyse for potential risk....... All admissions, discharge diagnoses and causes of death during follow-up were collected. All surviving patients were invited to a clinical follow-up. RESULTS: The follow-up period was 20.4 and 21.0 years, respectively, for the NAFLD and alcoholic fatty liver disease (AFLD) groups. Two NAFLD patients...... of death. Patients with AFLD died primarily from cirrhosis and other alcohol-related disorders, whereas in patients with NAFLD the main causes of death were cardiovascular disease and cancer. CONCLUSIONS: For patients with pure non-alcoholic fatty liver, survival was good and independent...

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

    Science.gov (United States)

    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. PMID:20937619

  3. Transanal endoscopic microsurgery in 143 consecutive patients with rectal adenocarcinoma. Results from a Danish multicenter study

    DEFF Research Database (Denmark)

    Baatrup, G; Breum, B; Qvist, N;

    2009-01-01

    Aim: The long term results are presented on total survival, cancer specific survival and recurrence in 143 consecutive patients treated with transanal endoscopic microsurgery (TEM) for adenocarcinoma of the rectum. Methods: Four Danish centres established in 1995 a database for registration of al....... Tumours larger than 3 cm should not be treated with TEM for cure....

  4. Phytothermotherapy with fermenting alpine grass in knee osteoarthritis: mid-long term results

    Directory of Open Access Journals (Sweden)

    P. Bortoli

    2011-09-01

    Full Text Available This is an observational study of the mid-long-term results of a single course of phytothermotherapy with grass baths (group A, 54 patients, of a course of usual medical care (group B, 58 patients and of a course of physiokinesistherapy (FKT, group C, 30 patients in knee osteoarthritis. For each group of consecutively treated patients we evaluated the Lequesne algo-functional Index, the drug consumption, the frequency of the patient-physician contacts and laboratory or radiological examinations after 10-15 days of treatment and at 3, 6, 9 and 12 months with blind telephonic follow-up. The mean Lequesne-score at basal time was 7.5±3.3, 11.9±5.3 and 11.0±2.7 in group A, B and C respectively. In each group this score diminished at the end of the treatment (p<0.001. At 3, 6, 9 and 12 months the score remained lower than at basal time in group A (p<0.001 and group B (p<0.01, but not in group C. Drug consumption, patientphysician contacts and lab examinations were 5 times lower in group A than in group B and group C at basal time and throughout the follow-up. The study underlines the mid-long term efficacy of grass baths on both pain and functionality in knee osteoarthritis; this effect, compared to basal values, was even more evident at 3 and 6 months than that of usual medical care. FKT shows improvement only at the end of the treatment, but not long-lastingly.

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

    International Nuclear Information System (INIS)

    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 20 months, 4 patients (4 of 35; 11.4%) required 1 additional treatment session (group III), and 1 patient (1 of 35; 2.9%) had a catheter placed at the end of the study period (group IV). Drainage time in group I was significantly shorter than those in groups II, III, and IV (p 0.05). The majority of complications, such as catheter displacement and leakage, were classified as minor; however, 2 patients (5.7%) with hemobilia were noted. Complications increased according to the need for reintervention. In conclusion, balloon dilation and percutaneous drainage placement is safe and effective, and it has long-term patency for children with BAS after liver transplantation. Because of prolonged treatment time, reintervention may be necessary, thereby increasing the complication rate. Balloon dilation and percutaneous drainage

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

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Toshinori, E-mail: h-toshi@komakihp.gr.jp; 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

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

    International Nuclear Information System (INIS)

    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 cm3. 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

  8. Long-term result of guided nerve regeneration with an inert microporous polytetrafluoroethylene conduit

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective: To evaluate the long-term outcome of Polytetrafluoroethylene (PTFE) conduit in nerve repair and to provide more evidence in view of its potential application to achieve a satisfactory functional recovery in clinical settings. Methods: Thirty-six Wistar rats had their right sciatic nerve transected and were repaired with either conventional microsuture technique (Control group, n=18) or a PTFE conduit with a gap of 5 mm left between the nerve stumps (PTFE group, n=18). At 6 and 9 months after the operation, electrophysiological assessment and measurement of gastrocnemius muscle weight were conducted and morphology of the regenerated nerves were studied with image analysis. Results: At 6 months postoperatively, the nerve conduction velocity recovered to 60.86% and 54.36% (P>0.05), and the gastrocnemius muscle weight recovered to 50.89% and 46.11% (P>0.05) in the Control group and the PTFE group respectively. At 9 months postoperatively, the recovery rate was 65.99% and 58.79% for NCV (P>0.05), and 52.56% and 47.89% for gastrocnemius muscle weight (P>0.05) in the Control group and the PTFE group respectively. Regenerated nerve fibers in the PTFE group had a regular round shape with no fragmentation, wrinkling or splitting of the myelin sheath. Image analysis revealed that the ratio of the myelin area to the total fiber area was larger at 9 months than at 6 months in both groups (P<0.01). Conclusions: Microporous PTFE conduit may be an alternative for nerve repair allowing of guided nerve regeneration and functional recovery with no obvious adverse effect at long-term.

  9. Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy

    International Nuclear Information System (INIS)

    Purpose: Salvage radical prostatectomy (RP) may potentially cure patients who have isolated local prostate cancer recurrence after radiotherapy (RT). We report the long-term cancer control associated with salvage RP in a consecutive cohort of patients and identify the variables associated with disease progression and cancer survival. Methods and Materials: A total of 100 consecutive patients underwent salvage RP with curative intent for biopsy-confirmed, locally recurrent, prostate cancer after RT. Disease progression after salvage RP was defined as a prostate-specific antigen (PSA) level of ≥0.2 ng/mL or by initiation of androgen deprivation therapy. Cancer-specific mortality was defined as active clinical disease progression despite castration. Cox regression analysis was used to evaluate these endpoints. The median follow-up from RT was 10 years (range, 3-27 years) and from salvage RP was 5 years (range, 1-20 years). Results: Overall, the 5-year progression-free probability was 55% (95% confidence interval, 46-64%), and the median progression-free interval was 6.4 years. The preoperative PSA level was the only significant pretreatment predictor of disease progression in the multivariate analysis (p = 0.01). The 5-year progression-free probability for patients with a preoperative PSA level of 10 ng/mL was 86%, 55%, and 37%, respectively. The 10-year and 15-year cancer-specific mortality after salvage RP was 27% and 40%, respectively. The median time from disease progression to cancer-specific death was 10.3 years (95% confidence interval, 7.6-12.9). After multivariate analysis, the preoperative serum PSA level and seminal vesicle or lymph node status correlated independently with disease progression. Conclusions: Greater preoperative PSA levels are associated with disease progression and cancer-specific death. Long-term control of locally recurrent prostate cancer after definitive RT is possible when salvage RP is performed early in the course of recurrent

  10. LINAC-radiosurgery for nonsecreting pituitary adenomas. Long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Runge, M.J.R.; Maarouf, M.; Hunsche, S.; Ruge, M.I.; El Majdoub, F.; Treuer, H.; Sturm, V. [Koeln Univ. (Germany). Dept. of Stereotaxy and Functional Neurosurgery; Kocher, M.; Mueller, R.P. [Koeln Univ. (Germany). Dept. of Radiation Oncology; Voges, J. [Magdeburg Univ. (Germany). Dept. of Stereotactic Neurosurgery

    2012-04-15

    Stereotactic linear accelerator-based radiosurgery (LINAC-RS) is increasingly used for microsurgically inaccessible or recurrent pituitary adenomas. This single-center study evaluates the long-term follow-up after LINAC-RS of nonsecreting pituitary adenomas (NSA). Patients and methods: Between 1992 and August 2008, 65 patients with NSA were treated. Patient treatment and follow-up were conducted according to a prospective protocol. Indications for LINAC-RS were (1) tumor recurrence or (2) residual tumor. Three patients were treated primarily. For analysis of prognostic factors, patients were grouped according to epidemiological or treatment-associated characteristics. Results: A total of 61 patients with a follow-up {>=} 12 months (median 83 months, range 15-186 months, longest follow-up of published radiosurgery series) were evaluated with regard to their clinical, radiological, and endocrinological course. The median tumor volume was 3.5 ml ({+-} 4.3 ml, range 0.3-17.3 ml) treated with a median surface and maximum dose of 13.0 Gy and 29.7 Gy, respectively. Local tumor control was achieved in 98%. One patient died of unrelated cause after 36 months and 1 patient developed a radiation-induced seizure disorder. Visual complications did not occur. In 37 of 41 patients (90.2%), pituitary function remained stable. Maximum dose to the pituitary {<=} 16 Gy and female gender were positive prognostic factors for the preservation of pituitary function. Conclusion: LINAC-RS is a minimally invasive, safe, and effective treatment for recurrent NSA or microsurgically inaccessible residual tumor. LINAC-RS yielded a high rate of local long-term tumor control with a small number of radiation-induced side effects. (orig.)

  11. Long-term results of diaphragmatic plication in adults with unilateral diaphragm paralysis

    Directory of Open Access Journals (Sweden)

    Okay Tamer

    2010-11-01

    Full Text Available Abstract Background In this study we aimed to evaluate the long-term outcome of diaphragmatic plication for symptomatic unilateral diaphragm paralysis. Methods Thirteen patients who underwent unilateral diaphragmatic plication (2 patients had right, 11 left plication between January 2003 and December 2006 were evaluated. One patient died postoperatively due to sepsis. The remaining 12 patients [9 males, 3 females; mean age 60 (36-66 years] were reevaluated with chest radiography, flouroscopy or ultrasonography, pulmonary function tests, computed tomography (CT or magnetic resonance imaging (MRI, and the MRC/ATS dyspnea score at an average of 5.4 (4-7 years after diaphragmatic plication. Results The etiology of paralysis was trauma (9 patients, cardiac by pass surgery (3 patients, and idiopathic (1 patient. The principle symptom was progressive dyspnea with a mean duration of 32.9 (22-60 months before surgery. All patients had an elevated hemidiaphragm and paradoxical movement radiologically prior to surgery. There were partial atelectasis and reccurent infection of the lower lobe in the affected side on CT in 9 patients. Atelectasis was completely improved in 9 patients after plication. Preoperative spirometry showed a clear restrictive pattern. Mean preoperative FVC was 56.7 ± 11.6% and FEV1 65.3 ± 8.7%. FVC and FEV1 improved by 43.6 ± 30.6% (p Conclusions Diaphragmatic plication for unilateral diaphragm paralysis decreases lung compression, ensures remission of symptoms, and improves quality of life in long-term period.

  12. Long-Term Results Following Postoperative Radiotherapy for Soft Tissue Sarcomas of the Extremity

    Energy Technology Data Exchange (ETDEWEB)

    McGee, Lisa [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Indelicato, Daniel J., E-mail: dindelicato@floridaproton.org [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Dagan, Roi; Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Knapik, Jacquelyn A.; Reith, John D. [Department of Pathology, University of Florida College of Medicine, Gainesville, Florida (United States); Scarborough, Mark T.; Gibbs, C. Parker [Department of Orthopedics, University of Florida College of Medicine, Gainesville, Florida (United States); Marcus, Robert B. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Zlotecki, Robert A. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States)

    2012-11-15

    Purpose: To review long-term outcomes following postoperative radiotherapy (RT) for extremity soft tissue sarcoma (STS) and identify variables affecting the therapeutic ratio. Methods and Materials: Between 1970 and 2008, 173 patients with localized extremity STS were treated with postoperative radiation. No patients received prior irradiation. Sixteen percent of tumors had recurred after initial surgery alone; 89% of tumors were high grade. The median patient age was 57 years (range, 18-86 years). Sixty-one percent underwent >1 surgery before RT in an attempt to achieve wide negative margins. Final margin status was negative in 70% and marginal or microscopically positive in 30%. The median time between final surgery and start of RT was 40 days. The median RT dose was 65 Gy (range, 49-74 Gy). The median follow-up for all patients was 10.4 years and 13.2 years among survivors. Results: At 10 years, local control (LC), cause-specific survival (CSS), and overall survival (OS) rates were 87%, 80%, and 70%, respectively, with 89% of local failures occurring within 3 years after treatment. On multivariate analysis, age >55 years (82% vs 93%, P<.05) and recurrent presentation (67% vs 91%, P<.05) were associated with inferior 10-year LC. The LC according to final margin status was 90% for wide negative margins vs 79% for marginal/microscopically positive margins (P=.08). Age >55 years and local recurrence were associated with inferior CSS and OS on multivariate analysis. Twelve percent of patients experienced grade 3+ toxicity; 12 of these occurred in patients with tumors of the proximal lower extremity, with the most common toxicity of pathologic fracture occurring in 6.3%. Conclusions: This large single-institution series confirms that postoperative RT for STS of the extremities provides good long-term disease control with acceptable toxicity. Our experience supports recurrent presentation and older age as adverse prognostic factors for LC.

  13. Long-term Results of an Analytical Assessment of Student Compounded Preparations

    OpenAIRE

    Roark, Angie M.; Anksorus, Heidi N.; Shrewsbury, Robert P.

    2014-01-01

    Objective. To investigate the long-term (ie, 6-year) impact of a required remake vs an optional remake on student performance in a compounding laboratory course in which students’ compounded preparations were analyzed.

  14. Aphakia correction with retropupillary fixated iris-claw lens (Artisan – long-term results

    Directory of Open Access Journals (Sweden)

    Schallenberg M

    2013-12-01

    Full Text Available Maurice Schallenberg,1,2 Dirk Dekowski,1 Angela Hahn,1 Thomas Laube,1,3 Klaus-Peter Steuhl,1 Daniel Meller11Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; 2HELIOS Klinikum Wuppertal, Wuppertal, Germany; 3Zentrum für Augenheilkunde PD Dr Laube, Düsseldorf, GermanyPurpose: To evaluate the technique, safety, and efficacy of the retropupillary implantation of iris-claw intraocular lenses in a long-term follow-up study.Patients and methods: This retrospective study included 31 eyes of 31 patients who underwent an Artisan aphakic intraocular lens implantation between January 2006 and February 2011 at the University Hospital Essen, Essen, Germany and at the Zentrum für Augenheilkunde PD Dr Laube, Düsseldorf, Germany. Preoperative data collected included demographics, etiology of aphakia, previous surgeries, preoperative eye pathology, intraocular pressure, clinical signs of endothelial cell loss, and best corrected visual acuity. Operative data and postoperative outcomes included the best corrected visual acuity, lens position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, development of macular edema, and other complications.Results: Thirty-one patients were included. The mean follow-up was 25.2 months (range: 4–48 months. The mean best corrected visual acuity postoperatively was 0.64 logarithm of the minimum angle of resolution (logMAR and varied from 0 logMAR to 3 logMAR. Some patients had a low visual acuity preoperatively because of preoperative eye pathologies. In 22 patients the visual acuity improved, in two patients the visual acuity remained unchanged, and seven patients showed a decreased visual acuity. Complications were peaked pupils (n=10 and retinal detachment in one case. Four patients showed an iris atrophy and high intraocular pressure was observed only in one patient. Subluxation of the intraocular lens, endothelial cell loss, and

  15. Long-term results after primary infrapopliteal angioplasty for limb ischemia; Langzeitergebnisse nach Ballonangioplastie kruraler Arterien

    Energy Technology Data Exchange (ETDEWEB)

    Alfke, H. [Klinikum Luedenscheid (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Vannucchi, A. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Froelich, J.J. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Klinikum Bad Hersfeld (Germany). Klinik fuer Radiologie und Nuklearmedizin; El-Sheik, M.; Wagner, H.J. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Vivantes-Klinikum im Friedrichshain (Germany). Inst. fuer Radiologie und Interventionelle Therapie

    2007-08-15

    Purpose: To evaluate the technical success rate, procedure-related complications, and clinical long-term results for patients who underwent infrapopliteal angioplasty. Materials and Methods: We retrospectively evaluated all patients who underwent infrapopliteal angioplasty to treat critical chronic limb ischemia or severe claudication from 1/1997 to 12/1999. We excluded patients with acute (< 2 weeks) limb ischemia. Procedure-related data were prospectively documented in a database and analyzed with a focus on the technical success rate and procedure-related complications. In addition all clinical documents were analyzed, and a follow-up examination was performed or telephone interviews were conducted with patients, relatives and referring doctors for follow-up. The primary end points were the limb salvage rate and patient survival rate. The secondary end points included the complication rate, technical success rate, and walking distance. Results: 112 patients with a mean age of 72 years (41 women, 71 men) underwent crural angioplasty on 121 limbs. Four patients suffered from severe claudication (Rutherford category 3) and all others had critical chronic limb ischemia (category 4 to 6). The complication rate was 2.7 %. The technical success rate was 92 %. The ankle brachial index increased from 0.59 to 0.88. The mean walking distance increased significantly from 52 {+-} 66 to 284 {+-} 346 meters at the time of follow-up. The limb salvage rate was 83.6 % after one year and 81.1 % after three years. The mean survival rate according to Kaplan-Meier was 79.4 %, 69.2 %, and 54.2 % at 1, 2, and 3 years, respectively. Patients with at least one patent run-off vessel after angioplasty had a significantly better limb salvage rate. Diabetes was not a risk factor for limb salvage. Conclusion: Infrapopliteal angioplasty shows a high technical success rate with an acceptable complication rate. The clinical long-term success seems favorable if a least one open run-off vessel was

  16. INTRAARTICULAR INJECTION OF HYALURONIC ACID AFTER ARTHROSCOPIC LAVAGE OF THE KNEE: LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    Lidia Vladimirovna Luchikhina

    2013-01-01

    Full Text Available Objective: to evaluate the efficiency of arthroscopic lavage in combination with subsequent injection of hyaluronic acid into the joint cavity at shortand long-term follow-ups. Subjects and methods. Eighty-two patients with knee osteoarthrosis (OA were examined in accordance with the American College of Rheumatology criteria. Group 1 consisted of 40 patients only after arthroscopic lavage; Group 2 comprised 42 patients who were administered hyaluronic acid after arthroscopic lavage. Clinical evaluation encompassed pain while walking, resting, and moving (by a visual analogue scale, limited ability in covering 100 m (by a 5-point scale, general clinical evaluation (by a 5-point ordinal scale, the presence or absence of pain after 100-m walking, as well as resting pain (its presence or absence. Results. The treatment effect evaluated using different indicators was comparably positive in both groups within 3 months. Following 3 months of therapy, its effect remained stable and even better in Group 2. The latter showed a particularly noticeable superiority a year later. Thus, there were excellent and good results in 88 and 47.5% in Groups 2 and 1, respectively. The clinical symptoms of the disease were absent in 58% in Group 2 and in only 15% in Group 1. Moreover, Group 1 showed worsening and 20% of the patients had no effect. This trend was also seen while evaluating the therapeutic effectiveness in different periods. Thus, after therapy, no substantial difference was found in both groups, but 3 months later this difference was as many as 0.8 scores and a year later Group 2 had many points in its favor (1.2 scores. Conclusion. Arthroscopic lavage followed by the administration of hyaluronic acid makes it possible to prevent the negative effect of a washing liquid on the metabolism and structure of the articular cartilage and to achieve a long-term effect against the major clinical symptoms (joint pain and function affecting the quality of life. The

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

    Directory of Open Access Journals (Sweden)

    Asghar Elmi

    2013-01-01

    Full Text Available 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.

  18. Advanced head and neck cancer: Long-term results of chemo-radiotherapy, complications and induction of second malignancies

    OpenAIRE

    Munker, Reinhold; Purmale, L.; Aydemir, Ü.; Reitmeier, M.; Pohlmann, H.; Schorer, H.; Hartenstein, R.

    2001-01-01

    Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investig...

  19. Long term results of Gamma Knife surgery for trigeminal neuralgia using 90 Gy distal to root entry zone protocol

    OpenAIRE

    Yu, CP; Fan, YW; Leung, KM

    2014-01-01

    OBJECT: Gamma Knife surgery (GKS) is one of the options for medically refractory trigeminal neuralgia (TN), but long term results were regarded as inferior to microvascular decompression (MVD). The authors reported the long term results of treating primary TN by GKS, using a high dose non root entry zone protocol. METHODS: 64 patients between March 1995 and June 2013 were included. Minimum follow up time was 12 months. Mean age was 62 years. Follow up duration was mean 76 months (median 61 mo...

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

    Energy Technology Data Exchange (ETDEWEB)

    Cuttino, Laurie W., E-mail: lcuttino@mcvh-vcu.edu [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Vicini, Frank [Michigan Healthcare Professionals/21st Century Onoclogy, Farmington Hills, Michigan (United States); Todor, Dorin [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Julian, Thomas [Allegheny Hospital, Temple School of Medicine, Pittsburgh, Pennsylvania (United States); Mukhopadhyay, Nitai [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States)

    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

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

    Science.gov (United States)

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

    2016-08-01

    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

  2. Cyclosporine A in Ullrich Congenital Muscular Dystrophy: Long-Term Results

    Directory of Open Access Journals (Sweden)

    Luciano Merlini

    2011-01-01

    Full Text Available Six individuals with Ullrich congenital muscular dystrophy (UCMD and mutations in the genes-encoding collagen VI, aging 5–9, received 3–5 mg/kg of cyclosporine A (CsA daily for 1 to 3.2 years. The primary outcome measure was the muscle strength evaluated with a myometer and expressed as megalimbs. The megalimbs score showed significant improvement (P=0.01 in 5 of the 6 patients. Motor function did not change. Respiratory function deteriorated in all. CsA treatment corrected mitochondrial dysfunction, increased muscle regeneration, and decreased the number of apoptotic nuclei. Results from this study demonstrate that long-term treatment with CsA ameliorates performance in the limbs, but not in the respiratory muscles of UCMD patients, and that it is well tolerated. These results suggest considering a trial of CsA or nonimmunosuppressive cyclosporins, that retains the PTP-desensitizing properties of CsA, as early as possible in UCMD patients when diaphragm is less compromised.

  3. Long-term scenarios of energy use and carbon emissions: Summary of results

    International Nuclear Information System (INIS)

    Energy use in developing countries has risen more quickly than in the industrialized world, with a consequent increase in the developing world's share in global modern energy use from 16% in 1970 to 24% in 1987. As a result, while the developing countries' share of carbon dioxide emissions is small today, it is growing rapidly. The following is a brief summary of the aggregate results derived from the work on long-term energy and carbon emissions scenarios for China, India, Indonesia, Korea, Argentina, Brazil, Mexico, Venezuela, Nigeria, Ghana, Sierra Leone and the sic members of the Gulf Cooperation Council (GCC). The countries experience varying rates of population growth between 1985 and 2025. The fastest growth rates occur in Africa - particularly in Nigeria and Ghana - and in the GCC. In Korea and China, where the governments have implemented policies to control the expansion of the population, the growth rates remain significantly lower. The economic growth rates correspond with national projections and/or expert judgment. GDP shows a wide variance across the study countries; and in each country distinct factors account for the differences in rates of growth. Argentina, for example, experiences a relatively slow increase in GDP as the foundation of its economy moves away from manufacturing and towards agriculture-based industry. In contrast, Korea's development of its less energy-intensive industries continues to fuel high rates of economic growth between 1985 and 2025

  4. Long-Term Efficacy of Prism Adaptation on Spatial Neglect: Preliminary Results on Different Spatial Components

    Directory of Open Access Journals (Sweden)

    Maria Luisa Rusconi

    2012-01-01

    Full Text Available This study describes the long-term effectiveness on spatial neglect recovery of a 2-week treatment based on prism adaptation (PA. Seven right-brain-damaged patients affected by chronic neglect were evaluated before, after two weeks of the PA treatment and at a follow-up (variable between 8 and 30 months after the end of PA. Neglect evaluation was performed by means of BIT (conventional and behavioral, Fluff Test, and Comb and Razor Test. The results highlight an improvement, after the PA training, in both tasks performed using the hand trained in PA treatment and in behavioral tasks not requiring a manual motor response. Such effects extend, even if not significantly, to all BIT subtests. These results support previous findings, showing that PA improves neglect also on imagery tasks with no manual component, and provide further evidence for long-lasting efficacy of PA training. Dissociations have been found with regard to PA efficacy on peripersonal, personal, and representational neglect, visuospatial agraphia and neglect dyslexia. In particular, we found no significant differences between the pre-training and post-training PA session in personal neglect measures, and a poor recovery of neglect dyslexia after PA treatment. The recruitment of a larger sample could help to confirm the effectiveness of the prismatic lenses with regard to the different clinical manifestations of spatial neglect.

  5. Long-term efficacy of prism adaptation on spatial neglect: preliminary results on different spatial components.

    Science.gov (United States)

    Rusconi, Maria Luisa; Carelli, Laura

    2012-01-01

    This study describes the long-term effectiveness on spatial neglect recovery of a 2-week treatment based on prism adaptation (PA). Seven right-brain-damaged patients affected by chronic neglect were evaluated before, after two weeks of the PA treatment and at a follow-up (variable between 8 and 30 months after the end of PA). Neglect evaluation was performed by means of BIT (conventional and behavioral), Fluff Test, and Comb and Razor Test. The results highlight an improvement, after the PA training, in both tasks performed using the hand trained in PA treatment and in behavioral tasks not requiring a manual motor response. Such effects extend, even if not significantly, to all BIT subtests. These results support previous findings, showing that PA improves neglect also on imagery tasks with no manual component, and provide further evidence for long-lasting efficacy of PA training. Dissociations have been found with regard to PA efficacy on peripersonal, personal, and representational neglect, visuospatial agraphia and neglect dyslexia. In particular, we found no significant differences between the pre-training and post-training PA session in personal neglect measures, and a poor recovery of neglect dyslexia after PA treatment. The recruitment of a larger sample could help to confirm the effectiveness of the prismatic lenses with regard to the different clinical manifestations of spatial neglect.

  6. Long-term results and complications after treatment of bilateral fractures of the mandibular condyle.

    Science.gov (United States)

    Forouzanfar, Tymour; Lobbezoo, Frank; Overgaauw, Maarten; de Groot, Annemijn; Kommers, Sofie; van Selms, Maurits; van den Bergh, Bart

    2013-10-01

    The purpose of this study was to investigate the long-term results of conservative treatment of bilateral condylar fractures and to study the influence of possible functional impairment on intensity of pain and associated disability. We studied 71 patients (mean (SD) age 33 (14) years) with conservatively treated bilateral condylar fractures. Traffic crashes (n=42, 59%) and falls (n=20, 28%) were the main cause of the fractures. Forty-one patients (58%) were re-examined after about 90 months (mean 86, range 3-193). Five of the 41 (12%) had developed malocclusion, but did not experience any pain in the temporomandibular joint according to the Research Diagnostic Criteria for Temporomandibular Disorders. There was a significant negative relation between the presence of pain and the duration of follow up (p=0.02). Increasing age was significantly related to reduction in the intensity of pain (p=0.03). Of the remaining 30 patients who were not followed up, 2 had had bilateral sagittal split osteotomy and 1 a Le Fort I osteotomy. One patient had had orthodontic correction for a malocclusion. Including the five malocclusion patients, at least 9 of the total of 71 (13%) developed a malocclusion after conservative treatment. Functional impairment had no influence on the intensity of pain or pain-related disability in the patients with malocclusion after conservatively treated bilateral condylar fractures. This report may therefore be of value in the debate about whether open or closed treatment is better for bilateral mandibular condylar fractures. PMID:23375048

  7. Long term results of polytetrafluoroethylene in above knee femoropopliteal bypass for critical ischaemia.

    LENUS (Irish Health Repository)

    Kavanagh, E G

    2012-02-03

    Ninety-six consecutive above-knee femoropopliteal bypasses, using polytetrafluoroethylene (PTFE) preferentially, were performed for limb-threatening ischaemia. Cumulative primary graft patency was 68 per cent, 49 per cent and 36 per cent and limb salvage 93 per cent, 85 per cent and 75 per cent at 1, 3 and 5 yr respectively. As a result of poor long term survival (51 per cent at 5 yr), and the healing of remedial lesions before graft occlusion, 68 patients (72 per cent) required no further intervention. Eighteen secondary bypasses were undertaken, 12 using ipsilateral saphenous vein. In this group of elderly patients with poor life expectancy, where a limited operation is desirable, the use of PTFE provided excellent limb salvage with low morbidity. Although we can no longer justify our continued use of PTFE in every case of critical ischaemia because of its inferior patency to autogenous vein, we continue to use it preferentially in patients whose lifespan is likely to be short and in cases where a remedial lesion is present.

  8. CT-guided interstitial HDR brachytherapy for recurrent glioblastoma multiforme. Long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Tselis, N.; Roeddiger, S.; Filipowicz, I.; Kontova, M.; Heyd, R.; Zamboglou, N. [Offenbach Hospital (Germany). Dept. of Radiotherapy and Interdisciplinary Oncology; Kolotas, C. [Offenbach Hospital (Germany). Dept. of Radiotherapy and Interdisciplinary Oncology; Hirslanden Medical Center, Aarau (Switzerland). Inst. of Radiotherapy; Birn, G. [Offenbach Hospital (Germany). Dept. of Neurosurgery; Fountzilas, G.; Selviaridis, P. [Aristotle Univ. of Thessaloniki School of Medicine, Thessaloniki (Greece); Baltas, D.; Anagnostopoulos, G. [Offenbach Hospital (Germany). Dept. of Medical Physics and Engineering

    2007-10-15

    Background and Purpose: Recurrences of glioblastoma multiforme (GBM) within previously irradiated volumes pose a serious therapeutic challenge. This retrospective study evaluates the long-term tumor control of recurrent GBM treated with interstitial high-dose-rate brachytherapy (HDR-BRT). Patients and Methods: Between 1995 and 2003, 84 patients were treated for recurrent cerebral GBM located within previously irradiated volumes. All patients had received adjuvant external radiotherapy following primary surgery, with a focal dose up to 60 Gy. The median recurrent tumor volume was 51 cm{sup 3} (3-207 cm{sup 3}), and the HDR-BRT consisted of an afterloading {sup 192}Ir implant which delivered a median dose of 40 Gy (30-50 Gy). Catheter implantation was implemented using interactive computed tomography (CT) guidance under local anesthesia and sedoanalgesia. Results: After a median follow-up of 61 months, 5/84 patients (6%) were alive. The median post-BRT survival was 37 weeks, and the median overall survival 78 weeks. Moderate to severe complications occurred in 5/84 cases (6%). Conclusion: For patients with recurrences of GBM within previously irradiated volumes, CT-guided interstitial HDR-BRT is a feasible treatment option that can play an important role in providing palliation. (orig.)

  9. Long-term result of Memokath urethral sphincter stent in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Sett Pradipkumar

    2002-11-01

    Full Text Available Abstract Background Memokath urethral sphincter stents are used to facilitate bladder emptying in patients with spinal cord injury, but long term follow-up has not been reported. Methods Case series of ten men with spinal cord injury who underwent insertion of Memokath stents and were followed for up to nine years. Results Within four years, the stent had to be removed in nine out of ten patients because of: extensive mucosal proliferation causing obstruction to the lumen of the stent; stone around the proximal end of the stent, incomplete bladder emptying, and recurrent urinary infections; migration of the stent into the bladder related to digital evacuation of bowels; large residual urine; concretions within the stent causing obstruction to flow of urine, and partial blockage of the stent causing frequent episodes of autonomic dysreflexia. In one patient the stent continued to function satisfactorily after nine years. Conclusions The Memokath stent has a role as a temporary measure for treatment of detrusor-sphincter dyssynergia in selected SCI patients who do not get recurrent urinary infection and do not require manual evacuation of bowels.

  10. 2015 Long-Term Hydrologic Monitoring Program Sampling and Analysis Results Report for Project Rulison, Co

    Energy Technology Data Exchange (ETDEWEB)

    Findlay, Rick [Navarro Research and Engineering, Oak Ridge, TN (United States); Kautsky, Mark [US Department of Energy, Washington, DC (United States). Office of Legacy Management

    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.

  11. 2015 Long-Term Hydrologic Monitoring Program Sampling and Analysis Results at Rio Blanco, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    Findlay, Rick [Nararro Research and Engineering, Oak Ridge, TN (United States); Kautsky, Mark [US Department of Energy, Washington, DC (United States). Office of Legacy Management

    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.

  12. Surgery for acquired cholesteatoma in children: long-term results and recurrence of cholesteatoma.

    Science.gov (United States)

    Stangerup, S E; Drozdziewicz, D; Tos, M; Trabalzini, F

    1998-08-01

    The aim of the study was to evaluate the long-term results after surgery for acquired cholesteatoma in children and to contribute to the search for predictors of recurrence. During a 15-year period, 114 children underwent surgery. The patients were re-evaluated with a median observation time of 5.8 years. At the last re-evaluation 85 per cent of the ears were dry with an intact drum. Recurrence of cholesteatoma developed in 27 ears. The cumulated total recurrence rate was 24 per cent using the incidence rate calculation, applying Kaplan-Meier survival analysis the corresponding recurrence was 33 per cent. Recurrent disease occurred significantly more frequently in children younger than eight years, with a negative pre-operative Valsalva, with ossicular resorption and with large cholesteatomas. In conclusion, young children with poor Eustachian tube function and a large cholesteatoma with erosion of the ossicular chain, are at special risk of recurrence and should be observed for several years after surgery. PMID:9850315

  13. Spinal epidural neurostimulation for treatment of acute and chronic intractable pain: initial and long term results.

    Science.gov (United States)

    Richardson, R R; Siqueira, E B; Cerullo, L J

    1979-09-01

    Spinal epidural neurostimulation, which evolved from dorsal column stimulation, has been found to be effective in the treatment of acute and chronic intractable pain. Urban and Hashold have shown that it is a safe, simplified alternative to dorsal column stimulation, especially because laminectomy is not required if the electrodes are inserted percutaneously. Percutaneous epidural neurostimulation is also advantageous because there can be a diagnostic trial period before permanent internalization and implantation. This diagnostic and therapeutic modality has been used in 36 patients during the past 3 years at Northwestern Memorial Hospital. Eleven of these patients had acute intractable pain, which was defined as pain of less than 1 year in duration. Initial postimplantation results from the 36 patients indicate that spinal epidural neurostimulation is most effective in treating the intractable pain of diabetes, arachnoiditis, and post-traumatic and postamputation neuroma. Long term follow-up, varying from 1 year to 3 years postimplantation in the 20 initially responding patients, indicates that the neurostimulation continues to provide significant pain relief (50% or greater) in a majority of the patients who experienced initial significant pain relief.

  14. Radiologic Predictors for Clinical Stage IA Lung Adenocarcinoma with Ground Glass Components: A Multi-Center Study of Long-Term Outcomes.

    Directory of Open Access Journals (Sweden)

    Zhao Li

    Full Text Available This study was to define preoperative predictors from radiologic findings for the pathologic risk groups based on long-term surgical outcomes, in the aim to help guide individualized patient management.We retrospectively reviewed 321 consecutive patients with clinical stage IA lung adenocarcinoma with ground glass component on computed tomography (CT scanning. Pathologic diagnosis for resection specimens was based on the 2011 IASLC/ATS/ERS classification of lung adenocarcinoma. Patients were classified into different pathologic risk grading groups based on their lymph node status, local regional recurrence and overall survival. Radiologic characteristics of the pulmonary nodules were re-evaluated by reconstructed three-dimension CT (3D-CT. Univariate and multivariate analysis identifies independent radiologic predictors from tumor diameter, total volume (TV, average CT value (AVG, and solid-to-tumor (S/T ratio. Receiver operating characteristic curves (ROC studies were carried out to determine the cutoff value(s for the predictor(s. Univariate cox regression model was used to determine the clinical significance of the above findings.A total of 321 patients with clinical stage IA lung adenocarcinoma with ground glass components were included in our study. Patients were classified into two pathologic low- and high- risk groups based on their distinguished surgical outcomes. A total of 134 patients fell into the low-risk group. Univariate and multivariate analyses identified AVG (HR: 32.210, 95% CI: 3.020-79.689, P<0.001 and S/T ratio (HR: 12.212, 95% CI: 5.441-27.408, P<0.001 as independent predictors for pathologic risk grading. ROC curves studies suggested the optimal cut-off values for AVG and S/T ratio were-198 (area under the curve [AUC] 0.921, 2.9 (AUC 0.996 and 54% (AUC 0.907, respectively. The tumor diameter and TV were excluded for the low AUCs (0.778 and 0.767. Both the cutoff values of AVG and S/T ratio were correlated with pathologic

  15. Cosmetic Evaluation of long term results following intraoperative radiotherapy (IORT) of conservative surgery for breast carcinoma

    International Nuclear Information System (INIS)

    Introduction In breast conserving therapy (BCT) of breast cancer, cosmetic results have become next to tumor-related outcome parameters a criterion of increasing awareness. The aim of this study is the evaluation of long term cosmetic results after conservative surgery and intraoperative radiotherapy with 10 Gy electrons (IOERT), followed by whole breast radiotherapy (WBRT) with 50-54 Gy. Patients and Methods From October 1998 to October 2005, 818 patients (median age 57.89 years) were treated by IOERT during breast conserving surgery, 12 of them for bilateral cancer. 32 patients were referred to mastectomy within primary treatment, 50 were reported as dead at the beginning of the study, 4 patients had developed an in-breast-recurrence and had been salvaged by secondary mastectomy, and in 41 cases an intercurrent dissemination was noted. All 679 remaining patients were invited in written form to participate in the cosmesis study. 403 of them (59.4%) have answered and were object of the evaluation (August 2006 to April 2007). To provide reproducible examination conditions, a standardized photo-documentation in four positions (frontal, loose-hanging and elevated arms; left and right lateral, elevated arms) was accomplished. Patients and treating physicians evaluated the cosmetic results separately within a 5-point-score (Excellent, Good, Moderate, Bad, Complications). Patient-, tumor- and treatment-related factors were investigated with regard to possible impact on the cosmetic outcome in all patients (group 1). A separate subgroup analysis was carried out for 261 patients with a follow-up of at least three years after completion of local treatment (group 2). For computation of the statistic correlation between the variables and the cosmetic evaluation the rank correlation coefficients Kendall's τ Spearman's ρ were used. A correlation is significant below a p-value of 0.05. Results The self-assessment of the patients in group 1 yielded around 69% excellent, 25

  16. Long-term results of radiotherapy in primary carcinoma of the vagina

    Energy Technology Data Exchange (ETDEWEB)

    Hegemann, Stefan; Willich, Normann [University Hospital, Muenster (Germany). Dept. of Radiotherapy and Radiation Oncology; Schaefer, Ulrich [University Hospital, Muenster (Germany). Dept. of Radiotherapy and Radiation Oncology; Lippe Hospital, Lemgo (Germany). Dept. of Radiotherapy; Lelle, Ralph [University Hospital, Muenster (Germany). Dept. of Gynecology and Gynecologic Oncology; Micke, Oliver [University Hospital, Muenster (Germany). Dept. of Radiotherapy and Radiation Oncology; Franziskus Hospital, Bielefeld (Germany). Dept. of Radiotherapy and Radiation Oncology

    2009-03-15

    Background: The long-term results of radiotherapy in primary carcinoma of the vagina are not well defined. Patients and Methods: The treatment results of 41 patients with primary malignancies of the vagina were analyzed. The mean follow-up period was 77.3 months (2.3-404 months). The predominant histology was squamous cell carcinoma, FIGO stages I: n = 7 (17.1%), II: n = 13 (31.7%), III: n = 13 (31.7%), and IVa: n = 8 (19.5%). Radiotherapy was the primary treatment for all patients. None of the patients had undergone prior surgery for vaginal carcinoma. The majority of patients received pelvic irradiation, including treatment of the inguinal lymphatics (median dose: 50 Gy). 26 patients received additional intravaginal brachytherapy. Results: Overall, 21 patients (51.2%) achieved complete remission, 17 patients (41.5%) had partial responses, and three patients (7.3%) had no change or progressive disease. The total median survival of the analyzed patients was 41.3 months. The 1-year survival probability was 85.4%, the 5-year survival probability 40.6%, and the 10-year survival probability 27.2%. Univariate analysis revealed a survival advantage for earlier tumor stages (FIGO I and II) compared to advanced stages (FIGO III and IV), with a median survival of 58.1 months compared to 26.8 months. Treatment side effects were tolerable and easily managed. Conclusion: Definite radiotherapy is the treatment of choice for primary carcinomas of the vagina. Considering that primary malignancies of the vagina are typically diseases of the elderly, it should be noted that radiotherapy is especially well tolerated in this population. (orig.)

  17. Long-term Results of Breast-conserving Surgery and Radiation Therapy in Early Breast Cancer

    International Nuclear Information System (INIS)

    To evaluate the long-term results after breast-conserving surgery and radiation therapy in early breast cancer in terms of failure, survival, and cosmesis. One hundred fifty-four patients with stage I and II breast cancer were treated with conservative surgery plus radiotherapy between January 1992 and December 2002 at the Keimyung University Dongsan Medical Center. According to TNM stage, 93 patients were stage I, 50 were IIa, and 11 were IIb. The affected breasts were irradiated with 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks with a boost irradiation dose of 10∼16 Gy to the excision site. Chemotherapy was administered in 75 patients and hormonal therapy in 92 patients with tamoxifen. Follow-up periods were 13∼179 months, with a median of 92.5 months. The 5- and 10-year overall survival rates were 97.3% and 94.5%, respectively. The 5- and 10-year disease-free survival (5YDFS and 10YDFS, respectively) rates were 92.5% and 88.9%, respectively; the ultimate 5YDFS and 10YDFS rates after salvage treatment were 93.9% and 90.2%, respectively. Based on multivariate analysis, only the interval between surgery and radiation therapy (≤6 weeks vs. >6 weeks, p=0.017) was a statistically significant prognostic factor for DFS. The major type of treatment failure was distant failure (78.5%) and the most common distant metastatic site was the lungs. The cosmetic results were good-to-excellent in 96 patients (80.7%). Conservative surgery and radiation for early stage invasive breast cancer yielded excellent survival and cosmetic results. Radiation therapy should be started as soon as possible after breast-conserving surgery in patients with early breast cancer, ideally within 6 weeks

  18. Long-term Results of Breast-conserving Surgery and Radiation Therapy in Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Byun, Sang Jun [Dongsan Medical Center, Daegu (Korea, Republic of)

    2009-09-15

    To evaluate the long-term results after breast-conserving surgery and radiation therapy in early breast cancer in terms of failure, survival, and cosmesis. One hundred fifty-four patients with stage I and II breast cancer were treated with conservative surgery plus radiotherapy between January 1992 and December 2002 at the Keimyung University Dongsan Medical Center. According to TNM stage, 93 patients were stage I, 50 were IIa, and 11 were IIb. The affected breasts were irradiated with 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks with a boost irradiation dose of 10{approx}16 Gy to the excision site. Chemotherapy was administered in 75 patients and hormonal therapy in 92 patients with tamoxifen. Follow-up periods were 13{approx}179 months, with a median of 92.5 months. The 5- and 10-year overall survival rates were 97.3% and 94.5%, respectively. The 5- and 10-year disease-free survival (5YDFS and 10YDFS, respectively) rates were 92.5% and 88.9%, respectively; the ultimate 5YDFS and 10YDFS rates after salvage treatment were 93.9% and 90.2%, respectively. Based on multivariate analysis, only the interval between surgery and radiation therapy ({<=}6 weeks vs. >6 weeks, p=0.017) was a statistically significant prognostic factor for DFS. The major type of treatment failure was distant failure (78.5%) and the most common distant metastatic site was the lungs. The cosmetic results were good-to-excellent in 96 patients (80.7%). Conservative surgery and radiation for early stage invasive breast cancer yielded excellent survival and cosmetic results. Radiation therapy should be started as soon as possible after breast-conserving surgery in patients with early breast cancer, ideally within 6 weeks.

  19. Long-term results of radiotherapy in patients with chronic palmo-plantar eczema or psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Sumila, M.; Notter, M.; Bodis, S.; Gruber, G. [State Hospital, Aarau (Switzerland). Inst. of Radiation Oncology; Itin, P. [State Hospital, Aarau (Switzerland). Dept. of Dermatology

    2008-04-15

    Background and Purpose: Radiotherapy (RT) is well accepted for therapy-refractory palmo-plantar eczema or psoriasis, despite of lacking evidence regarding beneficial long term effects. Furthermore, the optimal irradiation dose is unknown. We evaluated the outcome of RT with two different RT single/total dose (SD/TD) treatment policies. Patients and Methods: 28 consecutive patients with therapy-refractory eczema (n = 22) or psoriasis (n = 6) of palms and/or soles were irradiated twice a week either with a D{sub max} SD of 1 Gy (6/98-5/03; median TD: 12 Gy) or 0.5 Gy (6/03-7/04; median TD: 5 Gy). Median age was 52 years (27-71), median follow-up 20 months (4-76). Totally 88 regions were treated, 49 with 1 Gy, 39 with 0.5 Gy SD. Eight different symptoms were scored from 0 (absent) -3 (severe), giving a possible sum score of 0-24. Patients' rating of RT result was also documented (worse/stable/better/complete remission). Results: The sum score was 15 (6-23) before RT, 2 (0-16) at the end of RT, and 1 (0-21) at last follow-up, respectively. The improvement was highly significant in both treatment regimens. Better or complete remission by the patients were reported in 44 and 39 (= 83 out of 88) localisations, that was often stable during the follow-up. 5 (6%) regions in 3 (11%) patients didn't benefit from RT. Conclusion: RT reveals excellent results in palmo-plantar eczema or psoriasis. We recommend a SD of 0.5 Gy twice a week up to a TD of 4-5 Gy. (orig.)

  20. 10 m standpipe tests on oil sands tailings: long-term experimental results and prediction

    Energy Technology Data Exchange (ETDEWEB)

    Jeeravipoolvarn, S.; Scott, J.D.; Chalaturnyk, R.J. [Alberta Univ., Edmonton, AB (Canada). Dept. of Civil and Environmental Engineering; Canadian Natural Resources Ltd., Edmonton, AB (Canada). Natural Resources Engineering Facility

    2009-08-15

    Large volumes of high water content tailings composed of sand, silt, clay, and bitumen are produced during oil sands mining operations in northern Alberta. The tailings segregate during deposition, with the fines settling into tailings ponds. This paper presented the results of long-term, self-weight consolidation tests at the University of Alberta that were conducted to study material behaviour. Three large 10 m high standpipe tests were set up in 1982 to simulate large-scale compression behaviour of oil sands tailings in a controlled environment. Fine tailings and two mixes of fine tailings and sand were used. This paper presented the experimental results of the behaviour of a class of material that compresses with almost no dissipation of excess pore pressure. The fine tailings in standpipe 1 strained more than 30 per cent over the 25 year monitoring period by self-weight with very little to no effective stress developing. The mix of fine tailings and sand in standpipe 3 compressed with a significant effective stress development. The tailings in standpipe 1 can be regarded as a class of material where a reduction in volume is not governed by a unique relationship between effective stress and void ratio, whereas the tailings in standpipe 3 can be categorized as slurry with conventional behaviour. A numerical model with appropriate material constitutive relationships was developed in order to investigate the capability of the finite strain consolidation theory on these tailings. Numerical results, compared with the performance of the standpipe tests, showed that the theory overestimated the compression behaviour of the standpipe 1 material, but it could predict the standpipe 3 consolidation behaviour. It was concluded that the amount of creep depends on time and the state of the fines void ratio. Further study on compressibility- and hydraulic-conductivity-related phenomena would improve the consolidation prediction for this class of material. 18 refs., 1 tab., 27

  1. Treatment of generalized social phobia : Results at long-term follow-up

    NARCIS (Netherlands)

    Scholing, A; Emmelkamp, PMG

    1996-01-01

    This study investigated the long-term follow-up effectiveness-of (cognitive-)behavioural group and individual treatments for generalized social phobia. Patients were reassessed 18 months after they had finished one of the following treatment packages: (1) exposure in vivo; (2) cognitive therapy foll

  2. The impact of health behaviour on long term sickness absence : Results from DWECS/DREAM

    NARCIS (Netherlands)

    Christensen, Karl B.; Lund, Thomas; Labriola, Merete; Bultmann, Ute; Villadsen, Ebbe

    2007-01-01

    Long term sickness absence (LTSA) is a major public health problem. We examined the impact of four, potentially modifiable, health behaviours, such as smoking, alcohol consumption, leisure time physical activity, and the associated variable of body mass index on the risk of subsequent LTSA. This was

  3. Treatment of fear of blushing, sweating, or trembling - Results at long-term follow-up

    NARCIS (Netherlands)

    Scholing, A; Emmelkamp, PMG

    1996-01-01

    This study investigated the long-term effectiveness of cognitive-behavioral treatments for patients with a specific type of social phobia: fear of showing bodily symptoms (blushing, sweating, or trembling). Patients were reassessed 18 months after they had finished one of the following treatments: (

  4. Comments on results of a long-term low-level microwave exposure of rats

    NARCIS (Netherlands)

    Rongen, E. van; Rhoon, G.C. van; Aleman, A.; Kelfkens, G.; Kromhout, H.; Leeuwen, F.E. van; Savelkoul, H.F.J.; Wadman, W.J.; Weerdt, R.D.H.J. van de; Zwamborn, A.P.M.

    2011-01-01

    In a recent publication in this Transactions, Adang concluded that long-term exposure to RF electromagnetic fields may have effects on survival and on blood parameters in rats. The Electromagnetic Fields Committee of the Health Council of The Netherlands disputes this conclusion.

  5. Comments on "results of a long-term low-level microwave exposure of rats'

    NARCIS (Netherlands)

    Rongen, E.; Rhoon, van G.C.; Aleman, A.; Kelfkens, G.; Kromhout, H.; Leeuwen, van F.E.; Savelkoul, H.F.J.

    2011-01-01

    In a recent publication in this Transactions, Adang et al. concluded that long-term exposure to RF electromagnetic fields may have effects on survival and on blood parameters in rats. The Electromagnetic Fields Committee of the Health Council of The Netherlands disputes this conclusion

  6. Comments on "Results of a Long-Term Low-Level Microwave Exposure of Rats"

    NARCIS (Netherlands)

    van Rongen, Eric; van Rhoon, Gerard C.; Aleman, Andre; Kelfkens, Gert; Kromhout, Hans; van Leeuwen, Flora E.; Savelkoul, Huub F. J.; Wadman, Wytse J.; van de Weerdt, Rik D. H. J.; Zwamborn, A. Peter M.

    2011-01-01

    In a recent publication in this TRANSACTIONS, Adang et al. concluded that long-term exposure to RF electromagnetic fields may have effects on survival and on blood parameters in rats. The Electromagnetic Fields Committee of the Health Council of The Netherlands disputes this conclusion.

  7. Long-Term Effects of Induced Hypothermia on Local and Systemic Inflammation - Results from a Porcine Long-Term Trauma Model

    Science.gov (United States)

    Horst, K.; Eschbach, D.; Pfeifer, R.; Relja, B.; Sassen, M.; Steinfeldt, T.; Wulf, H.; Vogt, N.; Frink, M.; Ruchholtz, S.; Pape, H. C.; Hildebrand, F.

    2016-01-01

    Background Hypothermia has been discussed as playing a role in improving the early phase of systemic inflammation. However, information on the impact of hypothermia on the local inflammatory response is sparse. We therefore investigated the kinetics of local and systemic inflammation in the late posttraumatic phase after induction of hypothermia in an established porcine long-term model of combined trauma. Materials & Methods Male pigs (35 ± 5kg) were mechanically ventilated and monitored over the study period of 48 h. Combined trauma included tibia fracture, lung contusion, liver laceration and pressure-controlled hemorrhagic shock (MAP < 30 ± 5 mmHg for 90 min). After resuscitation, hypothermia (33°C) was induced for a period of 12 h (HT-T group) with subsequent re-warming over a period of 10 h. The NT-T group was kept normothermic. Systemic and local (fracture hematoma) cytokine levels (IL-6, -8, -10) and alarmins (HMGB1, HSP70) were measured via ELISA. Results Severe signs of shock as well as systemic and local increases of pro-inflammatory mediators were observed in both trauma groups. In general the local increase of pro- and anti-inflammatory mediator levels was significantly higher and prolonged compared to systemic concentrations. Induction of hypothermia resulted in a significantly prolonged elevation of both systemic and local HMGB1 levels at 48 h compared to the NT-T group. Correspondingly, local IL-6 levels demonstrated a significantly prolonged increase in the HT-T group at 48 h. Conclusion A prolonged inflammatory response might reduce the well-described protective effects on organ and immune function observed in the early phase after hypothermia induction. Furthermore, local immune response also seems to be affected. Future studies should aim to investigate the use of therapeutic hypothermia at different degrees and duration of application. PMID:27144532

  8. Long-term results of symptomatic fibroids treated with uterine artery embolization: In conjunction with MR evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of)], E-mail: mdkim@cha.ac.kr; Lee, Hyun Seok [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Lee, Mee Hwa [Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Kim, Hee Jin [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Cho, Jin Ho; Cha, Sun Hee [Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of)

    2010-02-15

    Objective: The aim of the present study is to determine long-term clinical efficacy of uterine fibroid embolization (UFE) for symptomatic fibroids in conjunction with MR evaluation. Materials and methods: Sixteen patients with a follow-up period of 4 years or longer were analyzed retrospectively. Ages ranged from 27 to 45 (mean 39.5) years. Mean follow-up periods were 5.8 years (range: 4.1-6.9 years). The symptom changes, in terms of menorrhagia and dysmenorrhea and bulk-related symptoms, were assessed. The primary embolic agent was polyvinyl alcohol particle (250-710 {mu}m). All patients underwent preprocedural and long-term follow up MR imaging. Uterine volumes were calculated using MRI. Results: Symptom improvements were reported for menorrhagia (8/9, 88.9%), dysmenorrhea (5/5, 100%), and bulk-related symptoms (7/9, 77.8%) at long-term follow up. Two patients (12.5%) had symptom recurrences at long-term follow-up. Tumor regrowth from incomplete infarction was a cause of recurrence in one patient and newly developed leiomyomas in the other one. One patient underwent hysterectomy because endometriosis developed 4 years after UFE. Of the 14 necrotic myomas on short-term follow up MR after UFE, eight (57.1%) demonstrated maintaining necrosis with further shrinkage and six (42.9%) were no longer visualized on long-term follow up MR images. Overall, the mean volume reduction rates of the predominant fibroid and uterus were 80.5%, 36.7% at long-term follow up, respectively. Conclusion: UFE is an effective treatment for symptomatic fibroids with an acceptable long-term success rate. Long-term MR imaging after UFE revealed persistent necrotic fibroid, non-visualization of fibroids and tumor regrowth when incompletely infarcted.

  9. Long-term results of symptomatic fibroids treated with uterine artery embolization: In conjunction with MR evaluation

    International Nuclear Information System (INIS)

    Objective: The aim of the present study is to determine long-term clinical efficacy of uterine fibroid embolization (UFE) for symptomatic fibroids in conjunction with MR evaluation. Materials and methods: Sixteen patients with a follow-up period of 4 years or longer were analyzed retrospectively. Ages ranged from 27 to 45 (mean 39.5) years. Mean follow-up periods were 5.8 years (range: 4.1-6.9 years). The symptom changes, in terms of menorrhagia and dysmenorrhea and bulk-related symptoms, were assessed. The primary embolic agent was polyvinyl alcohol particle (250-710 μm). All patients underwent preprocedural and long-term follow up MR imaging. Uterine volumes were calculated using MRI. Results: Symptom improvements were reported for menorrhagia (8/9, 88.9%), dysmenorrhea (5/5, 100%), and bulk-related symptoms (7/9, 77.8%) at long-term follow up. Two patients (12.5%) had symptom recurrences at long-term follow-up. Tumor regrowth from incomplete infarction was a cause of recurrence in one patient and newly developed leiomyomas in the other one. One patient underwent hysterectomy because endometriosis developed 4 years after UFE. Of the 14 necrotic myomas on short-term follow up MR after UFE, eight (57.1%) demonstrated maintaining necrosis with further shrinkage and six (42.9%) were no longer visualized on long-term follow up MR images. Overall, the mean volume reduction rates of the predominant fibroid and uterus were 80.5%, 36.7% at long-term follow up, respectively. Conclusion: UFE is an effective treatment for symptomatic fibroids with an acceptable long-term success rate. Long-term MR imaging after UFE revealed persistent necrotic fibroid, non-visualization of fibroids and tumor regrowth when incompletely infarcted.

  10. Treatment of intracranial aneurysms by flow diverter devices: Long-term results from a single center

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, Francesco, E-mail: frabriga@unina.it [Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Napoli, Manuela, E-mail: napoli.manuela@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Leone, Giuseppe, E-mail: g.leonemd@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Marseglia, Mariano, E-mail: mariano-marseglia@libero.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Mariniello, Giuseppe, E-mail: giuseppe.mariniello@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Caranci, Ferdinando, E-mail: ferdinando.caranci@unina.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Tortora, Fabio, E-mail: fabiotor@libero.it [Chair of Neuroradiology, “Magrassi Lanzara” Clinical-Surgical Department, Second University of Naples, Viale Colli Aminei 21, 80131 Naples (Italy); Maiuri, Francesco, E-mail: frmaiuri@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy)

    2014-09-15

    Highlights: • We report the long-term results (2–4 years) with Flow Diverter Devices (FDD) from a single-center. • We recommend the use of FDD for large-neck aneurysms of the ICA syphon. • We think that more sophisticate FDD will reduce the incidence of technical adverse events. - Abstract: Objectives: Flow-Diverter Devices (FDD) are a new generation stents designed for the treatment of the intracranial aneurysms. This article reports the long-term results (2–4 years) of this treatment from a single-center. Methods: From November 2008 to January 2012, 35 patients (29 females and 6 males; mean age 53.9 y) with 39 intracranial aneurysms were treated by FDD. Five patients (14.3%) had ruptured aneurysms and 30 (85.7%) had no previous hemorrhage. The procedures were performed in 5 patients (14.3%) with SILK and in 30 (85.7%) with PED. In 3 patients FDDs were used as a second treatment after failure of previous coiling (2 cases) or stenting (one case). The 39 aneurysms were in supraclinoid ICA in 26 (66.7%), cavernous ICA in 2 (5.1%), PCoA in 4 (10.2%), MCA in 5 (12.9%), SCA in 1 (2.6%) and PICA in 1 (2.6%). The aneurysms were small (<10 mm) in 32 cases (82%), large (11–25 mm) in 6 (15.3%) and giant in 1 (2.6%). The occlusion rate according to the aneurysm location, size and neck and the complications were evaluated. Results: Peri-procedural complications included transient dysarthria (2 patients), vasospasm with acute intra-stent aggregation (one), microwire rupture (one) and failure of the stent opening (one). The follow-up was made between 24 and 62 months (mean 41 months); clinical examination and CTA were performed at 1, 3, 6 and 12 months after the procedure. The complete occlusion was confirmed by CTA and DSA. MRI with angiographic-studies was taken every year. Complete occlusion was obtained in 35 aneurysms (92.1%) and subtotal in 3 (7.9%). Complete occlusion occurred at 3 months in 24 cases (68.6%), within 3 and 6 months in 9 (25.7%). The rate and

  11. Short and long term follow up results of (the versatile) reverse sural artery flap

    International Nuclear Information System (INIS)

    This study was designed to see the long and short term outcome of the reverse sural artery flap. Study Design: Case series. Patients and Methods: From January 2009 to December 2011, data was collected and analyzed for this study.Eighty nine patients with wounds on the ankle, heel, sole, distal leg, and foot were included in the study. They were followed up at 01 week, 02 weeks, and then 4 weekly for 06 months and at one year time from operation. They were examined for necrosis, congestion, surgical site infection, dehiscence of suture line, epidermolysis, donor site infection and functional outcome. Results: Most of the flaps healed nicely but two (2.25%) failed completely. Six flaps were delayed. However early follow up (within 04 weeks) revealed that there was partial loss of the distal 1-1.5 cm of flap in 04 patients (4.50%). Two patients (2.25%) developed superficial surgical site infection. Six patients (6.74%) developed venous congestion of the flaps which recovered within two weeks. Other minor complications included dehiscence of suture line in 3 patients (3.37%), and superficial Epidermolysis in four (4.50%) (Table-2). Twenty two patients (24.72%) returned to their work in 12-16 weeks, 31 (34.83%) in 16-20 weeks and 36 (40.45%) in 20-24 weeks. Long term follow-up to 06 months revealed hypertrophic scars at the donor site in three patients (4.91%) and recurrence of ulcer in 2 patients (3.27%). Conclusion: The sural fasciocutaneous flap provides reliable supple and durable most single-stage coverage of wounds of the distal third of the leg, heel, and foot with the results comparable to free-tissue transfer. (author)

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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. PMID:25884713

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

    International Nuclear Information System (INIS)

    To evaluate retrospectively the results of radiotherapy for periarthritis of the shoulder 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]. 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'. Low-dose radiotherapy for periarthropathy of the shoulder was highly effective and yielded long-lasting improvement of pain and motility without side effects

  15. Long-Term Effects of Induced Hypothermia on Local and Systemic Inflammation - Results from a Porcine Long-Term Trauma Model.

    Directory of Open Access Journals (Sweden)

    K Horst

    Full Text Available Hypothermia has been discussed as playing a role in improving the early phase of systemic inflammation. However, information on the impact of hypothermia on the local inflammatory response is sparse. We therefore investigated the kinetics of local and systemic inflammation in the late posttraumatic phase after induction of hypothermia in an established porcine long-term model of combined trauma.Male pigs (35 ± 5kg were mechanically ventilated and monitored over the study period of 48 h. Combined trauma included tibia fracture, lung contusion, liver laceration and pressure-controlled hemorrhagic shock (MAP < 30 ± 5 mmHg for 90 min. After resuscitation, hypothermia (33°C was induced for a period of 12 h (HT-T group with subsequent re-warming over a period of 10 h. The NT-T group was kept normothermic. Systemic and local (fracture hematoma cytokine levels (IL-6, -8, -10 and alarmins (HMGB1, HSP70 were measured via ELISA.Severe signs of shock as well as systemic and local increases of pro-inflammatory mediators were observed in both trauma groups. In general the local increase of pro- and anti-inflammatory mediator levels was significantly higher and prolonged compared to systemic concentrations. Induction of hypothermia resulted in a significantly prolonged elevation of both systemic and local HMGB1 levels at 48 h compared to the NT-T group. Correspondingly, local IL-6 levels demonstrated a significantly prolonged increase in the HT-T group at 48 h.A prolonged inflammatory response might reduce the well-described protective effects on organ and immune function observed in the early phase after hypothermia induction. Furthermore, local immune response also seems to be affected. Future studies should aim to investigate the use of therapeutic hypothermia at different degrees and duration of application.

  16. Long-term results of tracheostomy for severe obstructive sleep apnea syndrome.

    Science.gov (United States)

    Haapaniemi, J J; Laurikainen, E A; Halme, P; Antila, J

    2001-01-01

    Severe obstructive sleep apnea (OSAS) is most often accompanied by metabolic syndrome, obesity, diabetes and coronary disease. In its most severe form, it is a life-threatening condition, requiring active and immediate help. Nasal continuous positive airway pressure (CPAP) is the most efficient nonsurgical treatment for patients with OSAS. However, for anatomical, disease-related and subjective reasons, many patients cannot accept this treatment. A permanent tracheostomy may be one alternative in such patients who, in addition, often suffer from extreme obesity and severe heart disease. In this paper, we describe the long-term follow-up results of 7 patients suffering from OSAS and treated with permanent tracheostomy. All the patients (5 men, 2 women) were diagnosed using the static charge sensitive bed method and night-time oximetry for sleep analysis. The mean body mass index (BMI) of the patients ranged from 34 to 60 and the age from 41 to 64 years. All the patients had severe OSAS and long periods of low oxygen saturation (SaO2) levels. Six patients had a CPAP trial before tracheostomy. Only 2 patients tolerated the trial but, despite the continuous use of CPAP, they were nonresponders. Permanent tracheostomy was done according to normal routine in each patient. After primary healing of 2 days, they used silver cannulae, which also allowed them to speak. The patients were evaluated every year after the tracheostomy. After some practical difficulties including proper maintenance of the cannula, all the patients quickly learned the correct management. In postoperative sleep studies, nadir SaO2 levels had improved significantly, obstructive apneas had disappeared and the subjective quality of life had improved. No marked changes in BMI were found.

  17. The Erlangen Dose Optimization Trial for radiotherapy of benign painful shoulder syndrome. Long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Hertel, S.; Gaipl, U.S.; Frey, B.; Schmidt, M.; Fietkau, R. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany)

    2014-04-15

    To evaluate the long-term efficacy of pain reduction by two dose-fractionation schedules for radiotherapy of painful shoulder syndrome. Between February 2006 and February 2010, 312 evaluable patients were recruited for this prospective trial. All patients received low-dose orthovoltage radiotherapy. One course consisted of 6 fractions in 3 weeks. In the case of insufficient pain remission after 6 weeks, a second course was administered. Patients were randomly assigned to one of two groups to receive single doses of either 0.5 or 1.0 Gy. Endpoint was pain reduction. Pain was measured before radiotherapy, as well as immediately after (early response), 6 weeks after (delayed response) and approximately 3 years after (long-term response) completion of radiotherapy using a questionnaire-based visual analogue scale (VAS) and a comprehensive pain score (CPS). Median follow-up was 35 months (range 11-57). The overall early, delayed and long-term response rates for all patients were 83, 85 and 82%, respectively. The mean VAS scores before treatment and those for early, delayed and long-term response in the 0.5- and 1.0-Gy groups were 56.8±23.7 and 53.2±21.8 (p=0.16); 38.2±36.1 and 34.0±24.5 (p=0.19); 33.0±27.2 and 23.7±22.7 (p=0.04) and 27.9±25.8 and 32.1±26.9 (p=0.25), respectively. The mean CPS values before treatment and those for early, delayed and long-term response were 9.7±3.0 and 9.5±2.7 (p=0.31); 6.1±3.6 and 5.4±3.6 (p=0.10); 5.3±3.7 and 4.1±3.7 (p=0.05) and 4.0±3.9 and 5.3±4.4 (p=0.05), respectively. No significant differences in the quality of the long-term response were found between the 0.5- and 1.0-Gy arms (p=0.28). Radiotherapy is an effective treatment for the management of benign painful shoulder syndrome. For radiation protection reasons, the dose for a radiotherapy series should not exceed 3.0 Gy. (orig.)

  18. The Erlangen Dose Optimization Trial for radiotherapy of benign painful shoulder syndrome. Long-term results

    International Nuclear Information System (INIS)

    To evaluate the long-term efficacy of pain reduction by two dose-fractionation schedules for radiotherapy of painful shoulder syndrome. Between February 2006 and February 2010, 312 evaluable patients were recruited for this prospective trial. All patients received low-dose orthovoltage radiotherapy. One course consisted of 6 fractions in 3 weeks. In the case of insufficient pain remission after 6 weeks, a second course was administered. Patients were randomly assigned to one of two groups to receive single doses of either 0.5 or 1.0 Gy. Endpoint was pain reduction. Pain was measured before radiotherapy, as well as immediately after (early response), 6 weeks after (delayed response) and approximately 3 years after (long-term response) completion of radiotherapy using a questionnaire-based visual analogue scale (VAS) and a comprehensive pain score (CPS). Median follow-up was 35 months (range 11-57). The overall early, delayed and long-term response rates for all patients were 83, 85 and 82%, respectively. The mean VAS scores before treatment and those for early, delayed and long-term response in the 0.5- and 1.0-Gy groups were 56.8±23.7 and 53.2±21.8 (p=0.16); 38.2±36.1 and 34.0±24.5 (p=0.19); 33.0±27.2 and 23.7±22.7 (p=0.04) and 27.9±25.8 and 32.1±26.9 (p=0.25), respectively. The mean CPS values before treatment and those for early, delayed and long-term response were 9.7±3.0 and 9.5±2.7 (p=0.31); 6.1±3.6 and 5.4±3.6 (p=0.10); 5.3±3.7 and 4.1±3.7 (p=0.05) and 4.0±3.9 and 5.3±4.4 (p=0.05), respectively. No significant differences in the quality of the long-term response were found between the 0.5- and 1.0-Gy arms (p=0.28). Radiotherapy is an effective treatment for the management of benign painful shoulder syndrome. For radiation protection reasons, the dose for a radiotherapy series should not exceed 3.0 Gy. (orig.)

  19. Long-Term Effects of Induced Hypothermia on Local and Systemic Inflammation - Results from a Porcine Long-Term Trauma Model

    OpenAIRE

    Horst, K.; Eschbach, D.; Pfeifer, R.; Relja, B; Sassen, M.; T. Steinfeldt; Wulf, H; N Vogt; Frink, M.; Ruchholtz, S.; Pape, H. C.; F. Hildebrand

    2016-01-01

    Background Hypothermia has been discussed as playing a role in improving the early phase of systemic inflammation. However, information on the impact of hypothermia on the local inflammatory response is sparse. We therefore investigated the kinetics of local and systemic inflammation in the late posttraumatic phase after induction of hypothermia in an established porcine long-term model of combined trauma. Materials & Methods Male pigs (35 ± 5kg) were mechanically ventilated and monitored ove...

  20. Long-term results of endovascular therapy for proximal subclavian arterial obstructive lesions

    Institute of Scientific and Technical Information of China (English)

    WANG Ke-qin; LIAO Chuan-jun; ZHANG Yang; WANG Zhong-gao; YANG Bao-zhong; YUAN Chao; ZHANG Wang-de; YUAN Biao; XING Tong; SONG Sheng-han; LI Tan

    2010-01-01

    Background Endovascular therapy is a treatment option for localized occlusion of the subclavian artery. In this report the long-term experience with 59 patients is presented.Methods Between June 1998 and September 2008, we used endovascular therapy to treat 61 subclavian arterial obstructive lesions in 59 patients (46 males and 13 females, 34-82 years of age with a mean age (61.9±11.0) years). Twenty patients (34%) had clinical symptoms due to vertebrobasilar insufficiency, 26 (44%) had disabling arm ischemia, and 13 (22%) had both symptoms. We performed all procedures under local anesthesia. The approaches were from the femoral artery (n=47), brachial artery (n=\\, involving bilateral subclavian disease) or both (n=11). Sixty stents were implanted. All patients were followed-up at 1,3, 6, and 12 months post-procedure, and annually thereafter. Results We achieved technical success in 58 (95.1%) arteries, all of which were stented. There were three technical failures; two were due to the inability to cross over an occlusion, necessitating the switch to an axillo-axillary bypass, and the third was due to shock after digital subtraction angiography and prior to stenting. Arterial stenosis pre- and post-stenting was (83.6±10.8)% and (2.5±12.5)% (P <0.01). Clinical success was achieved in 55 of the 59 patients (93.4%). Of the four clinical failures, three were technical and the remaining patient had a stent thrombosis. Systolic blood pressure difference between the two brachial arteries was (44.7±18.5) vs. (2.2±3.9) mmHg (P <0.01). Primary patency was 98% at 12 months, 93% at 24 months, and 82% at 5 years. Five patients were lost to follow-up by 12 months post-stenting. Significant recurrent obstruction developed in five patients with resumption of clinical symptoms. The overall survival rate was 98.2% at 12 months, 89.5% at 24 months, and 84.5% at 5 years.Conclusions Endovascular therapy for proximal subclavian arterial obstructive lesions is effective and

  1. Coronary stenting in 1000 consecutive patients. Long-term clinical and angiographic results.

    Science.gov (United States)

    Colombo, A; Di Mario, C; Reimers, B; Blengino, S; Akiyama, T; Ferraro, M; Martini, G; Di Francesco, L; Finci, L

    1997-01-01

    Coronary stent implantation has become an accepted treatment for selected patients but the long-term outcome after stent implantation has not been investigated in a large unselected population. This study reports clinical and angiographic results after coronary stent implantation in a consecutive group of 1000 patients treated between November 1989 and June 1994. A total of 2012 stents were implanted in 1216 lesions. The anticoagulation regimen after successful stenting was abolished in the last 499 patients, treated with aspirin and ticlopidina. Complex lesions (type B2, type C lesions and chronic total occlusions) were less frequent in the group with anticoagulation (67%, 355/529 lesions) than in the group without anticoagulation (76%, 485/641; p < 0.01). Vessel size was also significantly smaller in the group with no anticoagulation (3.21 +/- 0.50 mm vs 2.89 +/- 0.70 mm; p < 0.001). Procedural success was achieved in 96% of cases. Major complications occurred in 49 pts, including death (1%), emergency bypass surgery (2.7%), and myocardial infarction (2.1%). Subacute stent thrombosis, observed in 2.6% of the patients treated with anticoagulation, decreased to 1% in the last 499 patients receiving only antiplatelet drugs after high pressure stent expansion controlled with intravascular ultrasound (p < 0.05). Angiographic follow-up was obtained at a mean interval of 6.6 +/- 3.0 months in 718 patients (75% of the eligible candidates). The global restenosis rate (greater than 50% diameter stenosis) was 22%, with no statistically significant difference in patients with and without anticoagulation after stenting. Clinical follow-up was available in 890 patients at a mean interval of 14 +/- 17 months. Late cardiac events occurred in 251 patients and included: 159 repeat coronary angioplasties for restenosis (20%), 114 coronary angioplasties for de novo lesions (10%), 33 elective by-pass surgery operations (3.7%) and 42 late deaths (4.7%). At the most recent follow

  2. The impact of health behaviour on long term sickness absence: results from DWECS/DREAM

    DEFF Research Database (Denmark)

    Christensen, Karl B; Lund, Thomas; Labriola, Merete;

    2007-01-01

    Long term sickness absence (LTSA) is a major public health problem. We examined the impact of four, potentially modifiable, health behaviours, such as smoking, alcohol consumption, leisure time physical activity, and the associated variable of body mass index on the risk of subsequent LTSA.......61 and 2.05 respectively after adjustment for age, family status, socio economic status, school education, physical and psychosocial work environment exposures and diagnosed disease. In men, effect estimates were smaller and only borderline significant in the fully-adjusted model. The etiologic fraction...

  3. Excellent long-term results with iliac stenting in local anesthesia for post-thrombotic syndrome

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Just, Sven; Foegh, Pia;

    2015-01-01

    BACKGROUND: Only 20% of iliac veins will recanalize on anticoagulation (AC) treatment alone and may, therefore, develop venous obstruction after iliofemoral deep venous thrombosis (DVT). A considerable number of these patients will suffer from post-thrombotic syndrome (PTS) leading to impaired qu...... stent was 89% (17/19) and 16 patients (84 %) had almost or total symptom relief at follow-up. CONCLUSION: Endovascular stenting of iliac obstruction in local anesthesia is minimally invasive and shows excellent long-term outcomes for patients suffering from PTS....

  4. Long-term results of transpedicle body augmenter in treating burst fractures

    Directory of Open Access Journals (Sweden)

    Li Allen

    2007-01-01

    Full Text Available Background: Short-segment fixation alone to treat thoracolumbar burst fractures is common but it has a 20-50% incidence of implant failure and rekyphosis. A transpedicle body augmenter (TpBA to reinforce the vertebral body via posterior approach has been reported to prevent implant failure and increase the clinical success rate in treating burst fracture. This article is to evaluate the long-term results of short-segment fixation with TpBA for treatment of thoracolumbar burst fractures. Materials and Methods: Patients included in the study had a single-level burst fracture involving T11-L2 and no distraction or rotation element with limited neurological deficit. Patients in the control group (n = 42 were treated with short-segment posterior instrumentation alone, whereas patients in the augmented group (n = 90 were treated with a titanium spacer designed for transpedicle body reconstruction. The follow-up was 48-101 months. The radiographic and clinical results were evaluated and compared by Student′s t test and Fisher′s exact test. Results: The blood loss, operation time and hospitalization were similar in both the groups. The immediate postoperative anterior vertebral restoration rate of the augmented group was similar to that of the control group (97.6% ± 2.4% vs . 96.6% ± 3.2%. The final anterior vertebral restoration was greater in the augmented group than in the control group (93.3% ± 3.4% vs . 62.5% ± 11.2%. Immediate postoperative kyphotic angles were not significantly different between the groups (3.0° ± 1.8° vs . 5.1° ± 2.3°. The final kyphotic angles were less in the augmented group than the control group (7.3° ± 3.5° vs . 20.1° ± 5.4°. The augmented group had less ( P < 0.001 implant failure [0% (n=0 vs . 23.8% (n=10] for the control group and more patients ( P < 0.001 with no pain or minimal or occasional pain (Grade P1 or P2 than the control group [90.0% (n=81 vs . 66.7% (n=28]. All patients in the augmented

  5. Cholinergic pairing with visual activation results in long-term enhancement of visual evoked potentials.

    Directory of Open Access Journals (Sweden)

    Jun Il Kang

    Full Text Available Acetylcholine (ACh contributes to learning processes by modulating cortical plasticity in terms of intensity of neuronal activity and selectivity properties of cortical neurons. However, it is not known if ACh induces long term effects within the primary visual cortex (V1 that could sustain visual learning mechanisms. In the present study we analyzed visual evoked potentials (VEPs in V1 of rats during a 4-8 h period after coupling visual stimulation to an intracortical injection of ACh analog carbachol or stimulation of basal forebrain. To clarify the action of ACh on VEP activity in V1, we individually pre-injected muscarinic (scopolamine, nicotinic (mecamylamine, alpha7 (methyllycaconitine, and NMDA (CPP receptor antagonists before carbachol infusion. Stimulation of the cholinergic system paired with visual stimulation significantly increased VEP amplitude (56% during a 6 h period. Pre-treatment with scopolamine, mecamylamine and CPP completely abolished this long-term enhancement, while alpha7 inhibition induced an instant increase of VEP amplitude. This suggests a role of ACh in facilitating visual stimuli responsiveness through mechanisms comparable to LTP which involve nicotinic and muscarinic receptors with an interaction of NMDA transmission in the visual cortex.

  6. Long-term results and complications of preoperative radiation in the treatment of rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reed, W.P.; Garb, J.L.; Park, W.C.; Stark, A.J.; Chabot, J.R.; Friedmann, P.

    1988-02-01

    A retrospective study of 149 patients with rectal cancer diagnosed between 1972 and 1979 was undertaken to compare survival, disease-free survival, recurrence sites, and long-term complications of 40 patients who received 4000 to 4500 rads of preoperative adjuvant radiotherapy (radiation group) with those of 109 patients treated by resection alone (control group). After a mean follow-up of 84 months and 99 months, respectively, survival of the irradiated patients was significantly better than that of controls (68% versus 52%, p less than 0.05). Disease-free survival of those patients rendered free of disease by treatment was also superior for the irradiated group (84% versus 57%, p less than 0.005). Local recurrence without signs of distant metastases developed only one-third as often in irradiated patients (6% versus 18%). Distant metastases, alone or in combination with local recurrence, were also less common after radiation (12% versus 27%). Second primary tumors developed in 15% and 10% of the respective groups, a difference that was not statistically significant. When we consider the survival benefit of preoperative radiation therapy, long-term complications were relatively mild. Delayed healing of the perineum was noted in two irradiated patients. Persistent diarrhea was severe enough to warrant treatment in only one case, and one patient required a colostomy for intestinal obstruction from pelvic fibrosis.

  7. Long-term results and complications of preoperative radiation in the treatment of rectal cancer

    International Nuclear Information System (INIS)

    A retrospective study of 149 patients with rectal cancer diagnosed between 1972 and 1979 was undertaken to compare survival, disease-free survival, recurrence sites, and long-term complications of 40 patients who received 4000 to 4500 rads of preoperative adjuvant radiotherapy (radiation group) with those of 109 patients treated by resection alone (control group). After a mean follow-up of 84 months and 99 months, respectively, survival of the irradiated patients was significantly better than that of controls (68% versus 52%, p less than 0.05). Disease-free survival of those patients rendered free of disease by treatment was also superior for the irradiated group (84% versus 57%, p less than 0.005). Local recurrence without signs of distant metastases developed only one-third as often in irradiated patients (6% versus 18%). Distant metastases, alone or in combination with local recurrence, were also less common after radiation (12% versus 27%). Second primary tumors developed in 15% and 10% of the respective groups, a difference that was not statistically significant. When we consider the survival benefit of preoperative radiation therapy, long-term complications were relatively mild. Delayed healing of the perineum was noted in two irradiated patients. Persistent diarrhea was severe enough to warrant treatment in only one case, and one patient required a colostomy for intestinal obstruction from pelvic fibrosis

  8. St. Jude Medical and CarboMedics Mechanical Heart Valves in the Aortic Position: Comparison of Long-Term Results

    OpenAIRE

    Kandemir, Ozer; Tokmakoglu, Hilmi; Yildiz, Ulku; TEZCANER, Tevfik; Yorgancioglu, A. Cem; Gunay, Ilhan; Suzer, Kaya; Zorlutuna, Yaman

    2006-01-01

    We designed this study to compare long-term results of St. Jude Medical and CarboMedics mechanical heart valves in the aortic position. We retrospectively analyzed the results of 174 consecutive patients who received either a St. Jude (n=80) or a CarboMedics (n=94) mechanical aortic valve from March 1992 through October 2004.

  9. Radiotherapy for benign achillodynia. Long-term results of the Erlangen Dose Optimization Trial

    Energy Technology Data Exchange (ETDEWEB)

    Ott, Oliver J.; Jeremias, Carolin; Gaipl, Udo S.; Frey, Benjamin; Schmidt, Manfred; Fietkau, Rainer [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany)

    2015-12-15

    The aim of this study was to evaluate the long-term efficacy of two dose-fractionation schedules for radiotherapy of achillodynia. Between February 2006 and February 2010, 112 evaluable patients were recruited for this prospective trial. All patients received orthovoltage radiotherapy. One course consisted of 6 fractions/3 weeks. In the case of insufficient remission of pain after 6 weeks, a second series was performed. Patients were randomly assigned to receive either single doses of 0.5 or 1.0 Gy. The endpoint was pain reduction. Pain was measured before, right after (early response), 6 weeks after (delayed response), and approximately 2 years after radiotherapy (long-term response) with a questionnaire-based visual analogue scale (VAS) and a comprehensive pain score (CPS). The median follow-up was 24 months (range, 11-56). The overall early, delayed, and long-term response rates for all patients were 84 %, 88 %, and 95 %, respectively. The mean VAS values before treatment for early, delayed, and long-term responses for the 0.5-Gy and 1.0-Gy groups were 55.7 ± 21.0 and 58.2 ± 23.5 (p = 0.53), 38.0 ± 23.2 and 30.4 ± 22.6 (p = 0.08), 35.5 ± 25.9 and 30.9 ± 25.4 (p = 0.52), and 11.2 ± 16.4 and 15.3 ± 18.9 (p = 0.16), respectively. The mean CPS values before treatment for early, delayed, and long-term responses were 8.2 ± 3.0 and 8.9 ± 3.3 (p = 0.24), 5.6 ± 3.1 and 5.4 ± 3.3 (p = 0.76), 4.4 ± 2.6 and 5.3 ± 3.8 (p = 0.58), and 2.2 ± 2.9 and 2.8 ± 3.3 (p = 0.51), respectively. No significant differences in long-term response quality between the two arms was found (p = 0.73). Radiotherapy is a very effective treatment for the management of benign achillodynia. For radiation protection, the dose for a radiotherapy series should not exceed 3.0 Gy. (orig.) [German] Ziel war die Untersuchung der Langzeiteffektivitaet zweier Dosisfraktionierungskonzepte bei der Strahlentherapie von Patienten mit Achillodynie. Zwischen 2006 und 2010 wurden 112 auswertbare

  10. Long-term results of the surgical treatment of Peyronie's disease with plaque incision and grafting

    Institute of Scientific and Technical Information of China (English)

    David J Ralph

    2011-01-01

    Peyronie's disease is frequently associated with erectile dysfunction,and a variety of other comorbid disorders,including diabetes,hypertension,dyslipidemia and low testosterone.Two-thirds of patients with Peyronie's disease are likely to have risk factors for arterial disease and therefore worsening long-term erectile function.1 The severe emotional distress that occurs is,in part,due to the deformity,but mainly due to the penile shortening that occurs in almost all patients with up to 50% of them being clinically depressed.It is imperative therefore that the stretched penile length is measured preoperatively so that the patients realize that the length loss postoperatively is mainly due to the disease itself and not to the surgery.

  11. Precipitate phases in type 316 austenitic stainless steel resulting from long-term high temperature service

    International Nuclear Information System (INIS)

    The precipitate phases in a type 316 steel superheater tube which failed by creep were studied by using a newly developed X-ray internal standard technique and scanning transmission electron microscopy. The precipitate phases identified were sigma, M23C6 and eta; the eta phase was the predominant precipitate in the sample. The major effect of the formation of large amounts of eta phase is the removal of molybdenum from solid solution, causing a decline in long-term creep strength. By comparing the precipitate phases of the failed tube with laboratory-tested specimens it was possible to estimate the mean exposure temperature of the failed tube. This was found to be approximately 923 K (6500C) and was about 80 K above the design temperature. (Auth.)

  12. Dutch iliac stent trial : Long-term results in patients randomized for primary or selective stent placement

    NARCIS (Netherlands)

    Klein, W.M.; van der Graaf, Y.; Seegers, J.; Spithoven, J.H.; Buskens, E.; van Baal, J.G.; Buth, J.; Moll, F.L.; Overtoom, T.T.C.; van Sambeek, M.R.H.M.; Mali, W.P.T.M.

    2006-01-01

    Purpose: To determine long-term results of the prospective Dutch Iliac Stent Trial. Materials and Methods: The study protocol was approved by local institutional review boards. All patients gave written informed consent. Two hundred seventy-nine patients (201 men, 78 women; mean age, 58 years) with

  13. Long-term results after a triple arthrodesis of the hindfoot: function and satisfaction in 36 patients

    NARCIS (Netherlands)

    I.B. de Groot (Ingrid); M. Reijman (Max); H.A.F. Luning (Hilco); J.A.N. Verhaar (Jan)

    2008-01-01

    textabstractThe long-term functional results of a triple arthrodesis of the hindfoot are not well known. In this retrospective cohort study we therefore investigated pain, function and alignment of the tibiotalar joint, patient satisfaction with the procedure and the prevalence of osteoarthritis (OA

  14. Radiotherapy for benign calcaneodynia. Long-term results of the Erlangen Dose Optimization (EDO) trial

    Energy Technology Data Exchange (ETDEWEB)

    Ott, Oliver J.; Jeremias, Carolin; Gaipl, Udo S.; Frey, Benjamin; Schmidt, Manfred; Fietkau, Rainer [University Hospital Erlangen, Dept. of Radiation Oncology, Erlangen (Germany)

    2014-07-15

    The goal of this work was to evaluate the long-term efficacy of two dose-fractionation schedules for radiotherapy of calcaneodynia. Between February 2006 and February 2010, 457 evaluable patients were recruited for this prospective trial. All patients received orthovoltage radiotherapy. One course consisted of 6 fractions/3 weeks. In case of insufficient remission of pain after 6 weeks a second series was performed. Patients were randomly assigned to receive either single doses of 0.5 or 1.0 Gy. Endpoint was pain reduction. Pain was measured before, right after (early response), 6 weeks (delayed response), and approximately 2.5 years after radiotherapy (long-term response) with a questionnaire-based visual analogue scale (VAS) and a comprehensive pain score (CPS). The median follow-up was 32 months (range 9-57 months). The overall early, delayed, and long-term response rates for all patients were 87, 88, and 95 %. The mean VAS values before treatment, for early, delayed, and long-term response for the 0.5 and 1.0 Gy groups were 65.5 ± 22.1 and 64.0 ± 20.5 (p = 0.19), 34.8 ± 24.7 and 39.0 ± 26.3 (p = 0.12), 25.1 ± 26.8 and 28.9 ± 26.8 (p = 0.16), and 16.3 ± 24.3 and 14.1 ± 19.7 (p = 0.68). The mean CPS values before treatment, for early, delayed, and log-term response were 10.1 ± 2.7 and 10.0 ± 3.0 (p = 0.78), 5.6 ± 3.7 and 6.0 ± 3.9 (p = 0.34), 4.0 ± 4.1 and 4.3 ± 3.6 (p = 0.26), and 2.1 ± 3.3 and 2.3 ± 3.2 (p = 0.34), respectively. No significant differences in long-term response quality between the two arms were found (p = 0.50). Radiotherapy is a very effective treatment for the management of benign calcaneodynia. For radiation protection reasons, the dose for a RT series should not exceed 3.0 Gy. (orig.) [German] Untersuchung der Langzeiteffektivitaet zweier Dosisfraktionierungskonzepte bei der Strahlentherapie von Patienten mit Calcaneodynie. Zwischen 2006 und 2010 wurden 457 auswertbare Patienten in diese prospektive und randomisierte Phase

  15. Long-term changes in cognitive bias and coping response as a result of chronic unpredictable stress during adolescence

    Directory of Open Access Journals (Sweden)

    Lauren eChaby

    2013-07-01

    Full Text Available Animals that experience adverse events in early life often have life-long changes to their physiology and behavior. Long-term effects of stress during early life have been studied extensively, but less attention has been given to the consequences of negative experiences solely during the adolescent phase. Adolescence is a particularly sensitive period of life when regulation of the glucocorticoid stress hormone response matures and specific regions in the brain undergo considerable change. Aversive experiences during this time might, therefore, be expected to generate long-term consequences for the adult phenotype. Here we investigated the long-term effects of exposure to chronic unpredictable stress during adolescence on adult decision making, coping response, cognitive bias, and exploratory behavior in rats. Rats exposed to chronic unpredictable stress (e.g. isolation, crowding, cage tilt were compared to control animals that were maintained in standard, predictable conditions throughout development. Unpredictable stress during adolescence resulted in a suite of long-term behavioral and cognitive changes including a negative cognitive bias (F1,12 = 5.000, P < 0.05, altered coping response (T1,14 = 2.216, P = 0.04, and accelerated decision making (T1,14 = 3.245, P = 0.01. Exposure to chronic stress during adolescence also caused a short-term increase in boldness behaviors; in a novel object test 15 days after the last stressor, animals exposed to chronic unpredictable stress had decreased latencies to leave a familiar shelter and approach a novel object (T1,14 = 2.240, P = 0.04; T1,14 = 2.419, P = 0.03, respectively. The results showed that stress during adolescence has long-term impacts on behavior and cognition that affect the interpretation of ambiguous stimuli, behavioral response to adverse events, and how animals make decisions. Stress during adolescence also induced short-term changes in the way animals moved around a novel environment.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. Long-term results of percutaneous self-expandable metallic stents in malignant biliary obstruction

    International Nuclear Information System (INIS)

    Evaluation of the long-term follow-up data of 155 patients with inoperable malignant biliary obstruction who received percutaneous placement of self expandable metallic stent (EMS) and external beam radiotherapy (EBR) combined with self-expandable metallic stent. One-hundred sixty EMS were inserted in 155 patients with inoperable malignant biliary obstruction. One-hundred forty-three patients (Group A) were inserted EMS alone. Twelve patients (Group B) underwent external radiotherapy (40∼45 Gy) after stent insertion. We compared to the Group A and Group B about survival, stent patency and administration. The mean length of survival for the entire group was 111±87 days, while the mean period of patency for all stents was 103±74. We found no statistically significant difference in patient survival or stent patency periods in regard to the level and cause of obstruction. Prolongation of actuarial survival was observed in Group B (316±231 days) as compared to Group A (126±85 days,). Mean length of survival rate and mean period of stent patency rate were not significantly different in regard to the level, cause of obstruction and each stent. External radiotherapy combined EMS could achieve effective palliation and improve the quality of life in selected patients with malignant biliary obstruction. (author)

  18. [Clinical and functional analysis of long-term results of uvulopalatopharyngoplasty].

    Science.gov (United States)

    Fernández Julián, E; Esparcia Navarro, M; García Callejo, F J; Orts Alborch, M H; Morant Ventura, A; de la Fuente, L; Sánchez, F; Marco Algarra, J

    2002-04-01

    In order to evaluate the clinical and functional effectiveness of uvulopalatopharyngoplasty (UPPP) in chronic roncopathy, we studied the subjective improvement of operated patients and compared to pulsioximetry findings before and after surgery. A follow-up was made on 72 patients entitled of chronic roncopathy--51 with obstructive sleep apnea syndrome (OSAS) and 21 with simple snoring-, for a mean period of time of 41 months. Preoperatory study included on ENT exploration, fibre optic endoscopy, Müller maneuver, pharyngeal CT, value of daytime sleepiness with Epworth's scale, espirometry and pulsioximetry, and the postoperatory study included of pulsioximetry and a health questionnaire over snoring and daytime sleepiness. Snoring improved or disappeared in 13 of 21 patients (61.8%), and daytime sleepiness did it in 26 of 39 (66.6%). Therapeutic failure in snoring was mainly due to an increase in the body mass index. After UPPP in OSAS, only 21 patients (41.1%) showed all positive response criteria (decrease into ODI > or = 50% or in absolute values or = 85%). UPPP failed in long term evaluation in the rest of individuals. Patient selection is mandatory to optimize clinical response of UPPP for snoring, without OSAS success depends on body mass index, respiratory disturbances ratios and the eventual presence of another upper airways collapses below velopharyngeal segment. PMID:12185904

  19. [Long-term clinical results with Procera AllCeram full-ceramic crowns].

    Science.gov (United States)

    Galindo, Martha L; Hagmann, Edgar; Marinello, Carlo P; Zitzmann, Nicola U

    2006-01-01

    The aim of this prospective clinical study was to investigate the long-term survival rate of Procera AllCeram full-ceramic crowns, which were fabricated with aluminiumoxide cores. In 50 patients, 155 Procera crowns with a conventional or reduced core (porcelain collar) were placed on natural abutment teeth. 78% of this group (39 patients with 135 crowns) were examined between May and August 2005 according to the modified USPHS-Criteria. These crowns had been in place for a period of one to 92 months (mean 55 months). Almost half of the crowns were located in the molar region, while 28% were premolars and 24% anterior crowns. Due to one crown fracture the cumulative survival rate was 99% after five and seven years. The clinical success was achieved irrespective of the tooth position, tooth vitality, the preparation margin and the cementum medium used (composite resin or glasionomer cement). In addition, survival was neither influenced by the core design with reduced or conventional margin nor by the core thickness, which measured regularly 0.6 mm in the majority of the specimens. Based on the present findings, it can be concluded that Procera AllCeram is a predictable technique for metal-free, esthetic full-ceramic crowns in the anterior and posterior region. PMID:16989114

  20. Does the use of extended criteria donors influence early and long-term results of lung transplantation?

    OpenAIRE

    Schiavon, Marco; Falcoz, Pierre-Emmanuel; Santelmo, Nicola; Massard, Gilbert

    2011-01-01

    A best evidence topic was constructed according to a structured protocol. The question addressed was whether the presence of extended criteria donors influences the early and long-term results in patients referred for lung transplantation. Of the 30 papers found using a report search, 14 presented the best evidence to answer the clinical question. The authors, journal, date, country of publication, study type, group studied, relevant outcomes and results of these papers are given. In total, w...

  1. 赵氏人工气管临床应用远期随访%Long-term results of ZHAO's artificial trachea

    Institute of Scientific and Technical Information of China (English)

    赵凤瑞; 张银合; 杨金龙; 田礼新; 黄昱

    2008-01-01

    Objective To report the long-term results of clinical application of ZHAO's artificial trachea.Introduce the indication and technical key point. Methods Seven patients undergoing long-segment resection of trachea received tracheal reconstruction with ZHAO's artificial traches. There were 3 ocstoid adenocarcinomas and 4 benign cases including 3 trauma patients. Four benign patients had tracheostomy before admission; two of them with closed upper trachea lost the ability of speech. The length of tracheal de-fect were 5.5-8.0 cm, the length of artificial trachea were 3.0-4.5 cm. Reconstruction procedure was two-staged. With plastic surgery technique, a "sandwich" pedicle artificial trachea was made, of which the inner surface was skin, outer coveting was platysma, a memory-alloy mesh was in between. Results Two patients required intubation for 5 days. Five patients could speak normally,wald around and have normal food in first postoperative day. Three malignant patients died. One died from trachon-innominate arterial fistular, 2 died from acute pulmonary embolism end systemic malignancy 1.5 year later. Four benign patients survived 3 - 5 years with normal life and word. Conclusion The design of ZHAO's artificial trachea is practicable. The artificial material comparatively copes with tracheal anatomy and physiology. It is an alternative choice for tracheal reconstruction after more than half length long-segment resection. It is suitable for both malignancy and binign condition.%目的 报道临床应用赵氏人工气管远期结果,介绍手术适应证及技术要点.方法 回顾性分析3例气管腺样囊性癌、4例良性疾病(3例为外伤后气管缺损)气管大段切除后赵氏人工气管重建术者转归.良性者就医时均已做过气管切开,2例近端气管闭锁,不能说话.气管切除长度5.5-8.0Cm,人工气管长度3.0-4.5 cm.分两期手术,用整形外科技术制备成内面为皮肤,外面为颈阔肌,中间夹有记忆合金网,即带

  2. Long-Term Results of Cataract Surgery in Patients with Unilateral Childhood Cataract

    Directory of Open Access Journals (Sweden)

    Suzan Güven Yılmaz

    2012-03-01

    Full Text Available Pur po se: To evaluate the long-term visual outcome and to determine the surgical complications after cataract surgery in patients with unilateral childhood cataract. Ma te ri al and Met hod: We retrospectively reviewed the records of 18 cases with unilateral childhood cataract who had undergone cataract surgery before the age of seven. Primary intraocular lens (IOL implantation was made in children who were older than 1 year of age. Secondary IOL implantation was made after 18 months in children who were operated before the age of 1 year and were left aphakic. Occlusion therapy was performed to all children for amblyopia postoperatively. Visual acuity and complications were evaluated in a mean follow-up period of 4.8 years. Re sults: The mean age of the 18 patients (9 female/9 male at the time of surgery was 43.6±33.7(1-84 months. Eleven (61% patients had cataract surgery after 1 year of age. Secondary IOL implantation was performed at mean 28th month in 4 of 7 aphakic patients (57% who had cataract surgery before one year of age. In 3 (43% aphakic patients, secondary IOL implantation could not be performed because of ocular pathologies such as microophthalmia. Final visual acuity was 0.5 or better in 7 eyes (39%, between 0.1 and 0.5 in 6 eyes (33%, and worse than 0.1 - in 5 eyes (28%. Of 5 eyes that had visual acuity worse than 0.1, 4 (80% had at least one additional ocular pathology such as microphthalmia, strabismus and nystagmus. Nd:YAG laser posterior capsulotomy was performed at mean 8th month in 7 of 8 (87% children whose posterior capsules were left intact at surgery. Dis cus si on: Favorable visual outcomes can be achieved with surgical intervention and complementary amblyopia treatment in children with unilateral cataract. Preoperative microphthalmia, nystagmus and strabismus are not entirely an obstacle to visual development, but they are important factors leading to low visual acuity. (Turk J Ophthalmol 2012; 42: 103-10

  3. Long-Term Outcomes of the Treatment of Unresectable (Stage III - IVDuctal Pancreatic Adenocarcinoma Using Metabolically Supported Chemotherapy (MSCT: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Iyikesici

    2016-08-01

    Full Text Available Introduction Metabolically supported chemotherapy (MSCT, is defined as the application of standard chemotherapy protocols concomitant to the administration of pharmacological doses of regular insulin and the development of hypoglycemia, and following fasting starting the previous day. This study aims to present the effects of MSCT on the overall survival of locally advanced and metastatic (stage III and stage IV, respectively, or simply unresectable pancreatic adenocarcinoma patients. Material and methods This study is a retrospective analysis of a prospectively maintained database of patients. It includes all patients that applied to our clinic between July 2012 and December 2014 that were diagnosed with unresectable (stage III-IV pancreatic adenocarcinoma. The demographic data of all the patients as well as the chemotherapy regimen received, date of treatment initiation, date of disease remission, mortality and overall survival of all patients were analyzed using SPSS 20.0. Patient follow-up was performed by means of CT and PET-CT scans. Results 33 patients, 24(73% males and 9(27% females, were included in our study. The majority, 27(81% patients, had metastatic disease at the time of diagnosis and were stage IV. While 11(33% of the patients were treated using a gemcitabine-based protocol, 13(39% received FOLFIRINOX. 9(27% of the patients were initially treated using gemcitabine, but began receiving FOLFIRINOX following progression as second-line chemotherapy. Statistical analysis revealed a median survival of 19.5 months and a 1-year survival rate of 82.5%. Presently, 18(54% of the patients remain healthy and alive, free of disease progression with ECOG performance statuses ranging between Grade 0 -1. 4(22% of these patients ultimately underwent radical pancreatic surgery: 3(17% having undergone pancreaticoduodenectomies (Whipple procedures and 1(5% having undergone a distal pancreatectomy. Conclusion This study demonstrates that a

  4. Long-term functional results of adult intra-articular distal humeral fractures treated by open reduction and plate osteosynthesis

    OpenAIRE

    Urguden, Mustafa; Soyuncu, Yetkin; Aslan, Tevfik

    2004-01-01

    Objectives: We assessed the long-term functional results of surgical treatment of distal intra-articular humeral fractures, together with the factors having influence on the outcome. Methods: Thirty-four patients (25 males, 9 females; mean age 38 years; range 20 to 78 years) who were treated by open reduction and plate osteosynthesis were retrospectively evaluated. All fractures were type C according to the AO classification. Five patients had open fractures. Thirty-three patients had surg...

  5. Long-term Exposure to Ambient Air Pollution and Serum Leptin in Older Adults: Results from the MOBILIZE Boston Study

    Science.gov (United States)

    Wang, Yi; Eliot, Melissa N.; Kuchel, George A.; Schwartz, Joel; Coull, Brent A.; Mittleman, Murray A.; Lipsitz, Lewis A.; Wellenius, Gregory A.

    2014-01-01

    Objective Long-term exposure to traffic-related air pollution has been linked to increased risk of obesity and diabetes and may be associated with higher serum levels of the adipokine leptin, but this hypothesis has not been previously evaluated in humans. Methods In a cohort of older adults, we estimated the association between serum leptin concentrations and two markers of long-term exposure to traffic pollution, adjusting for participant characteristics, temporal trends, socioeconomic factors, and medical history. Results An interquartile range increase (0.11 µg/m3) in annual mean residential black carbon was associated with 12% (95% CI: 3%, 22%) higher leptin levels. Leptin levels were not associated with residential distance to major roadway. Conculsions If confirmed, these findings support the emerging evidence suggesting that certain sources of traffic pollution may be associated with adverse cardiometabolic effects. PMID:25192230

  6. Long-term results of total body irradiation in adults with acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, Simone; Zich, Alexander; Budach, Volker; Jahn, Ulrich; Neumann, Oliver [Charite University Medicine, Department of Radiation Oncology, Berlin (Germany); Martus, Peter [University Tuebingen, Institute of Clinical Epidemiology and Applied Biostatistics, Tuebingen (Germany); Arnold, Renate [Charite University Medicine, Campus CVK, Department of Hematology and Oncology, Bone Marrow Transplant Unit, Berlin (Germany)

    2014-05-15

    The aim of this chart review of adult patients treated for acute lymphoblastic leukemia (ALL) with total body irradiation (TBI) was to evaluate early and late toxicity and long-term outcome. A total of 110 adult patients (34 ± 12 years) with ALL underwent TBI (6 fractions of 2 Gy for a total of 12 Gy) as a part of the treatment regimen before transplantation. Treatment-related toxicity, mortality, and hematologic outcome are reported. Mean follow-up was 70 months. The 2- and 5-year leukemia-free survival rates were 78 and 72 %, respectively. In all, 29 % (32/110) patients suffered from medullary recurrence after a median time of 7 months. Gender was the only statistically significant prognostic factor in terms of overall survival in favor of female patients. Treatment-related mortality and overall survival after 2 and 5 years were 16 and 22 %, and 60 and 52.7 %, respectively. The most frequent late reaction wascGVHD of the skin (n = 33, 30 %). In addition, 15.5 % (17/110 patients) suffered pulmonary symptoms, and 6 patients developed lung fibrosis. Eyes were frequently affected by the radiation (31/110 = 28 %); 12 of 110 patients (11 %) presented with symptoms from osteoporosis, 5 of 110 patients (4.5 %) developed hypothyreosis and 2 patients diabetes mellitus. Of the male patients, 11 % reported erectile dysfunction or loss of libido, while 2 of 36 women reported menopausal syndrome at the mean time of 28 months after treatment with requirement for substitution. No women became pregnant after treatment. No acute or late cardiac toxicities were documented in our patients. No secondary malignancies were documented. Although hematologic outcome was in the upper range of that reported in the literature, treatment-related mortality (TRM) and medullary recurrences remain a challenge. Sophisticated radiation techniques allow for decreasing toxicity to certain organs and/or dose escalation to the bone marrow in highly selected patients in order to improve therapeutic

  7. Clopidogrel plus long-term aspirin after femoro-popliteal stenting. The CLAFS project: 1- and 2-year results

    Energy Technology Data Exchange (ETDEWEB)

    Strecker, Ernst-Peter K.; Boos, Irene B.L.; Goettmann, Dieter; Vetter, Sylvia [Department of Imaging, Interventional Radiology, and Nuclear Medicine, Diakonissen Hospital, Diakonissenstrasse 28, 76199, Karlsruhe (Germany)

    2004-02-01

    The aim of this study was to determine the patency rate after femoro-popliteal stenting followed by oral clopidogrel plus long-term aspirin. In a prospective trial, 31 patients with a total of 33 femoro-popliteal artery lesions (21 stenoses, 12 occlusions; 24 femoral, 9 popliteal) were treated with flexible tantalum stents after unsuccessful percutaneous transluminal angioplasty (PTA) preceded by local fibrinolysis in 5 of 12 patients with total occlusion. Post-interventionally, oral aspirin 100 mg was started simultaneously for the long term and was combined with an oral loading dose of 300 mg clopidogrel, followed by 75 mg clopidogrel daily for 28 days. Patients were followed for at least 12 months (maximum 34 months) by clinical examination, Doppler pressure measurement, color and duplex sonography, and angiography in case of suspicion of restenosis. In a retrospective analysis, the results were compared with those of historical groups of patients having received aspirin only (41 patients) or a long-term high-dose low molecular weight heparin (LMWH)+aspirin treatment (42 patients). Three small puncture aneurysms were treated successfully by conservative means and were categorized as minor bleeding complication. Cumulative primary patency rate (PPR) was 76{+-}7.5% (1 year), and 70{+-}9.6% (2 years) in the clopidogrel+aspirin group, thus being tendentiously better than in the aspirin-only group showing 75{+-}4.6% (1 year), and 50{+-}8.1% (2 years). Long-term high-dose LMWH+aspirin treatment showed 87{+-}5.8% (1 year), and 72{+-}9.1% (2 years), thus being superior to the other treatment regimes, with a statistically significant difference (p<0.05) between the LMWH+aspirin and the aspirin group. Clopidogrel plus aspirin is a safe medication regimen and may be effective in the prevention of early stent thrombosis. Mid- and long-term patency rate seems to be intermediate as compared with other therapeutic regimens. The LMWH+aspirin seems to be superior compared with

  8. Long-term results of vaginal repairs with and without xenograft reinforcement

    DEFF Research Database (Denmark)

    Mouritsen, Lone; Kronschnabl, M.; Lose, G.

    2010-01-01

    The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse. Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated by a validated questionnaire and anatomy...... to literature. Xenograft reinforcement might improve results...

  9. Advanced gastric adenocarcinoma. Influence of preoperative radiation therapy on toxicity and long-term survival rates; Adenocarcinoma gastrico avancado. Analise da toxicidade e da influencia da radioterapia pre-operatoria nos indices de sobrevivencia a longo prazo

    Energy Technology Data Exchange (ETDEWEB)

    Malzoni, Carlos Eduardo

    1996-12-31

    The surgical treatment of gastric cancer has better long-term survival rates when performed in patients with early gastric cancer. Worse results are obtained in treatment of advanced gastric cancer. Most patients in west centers are treated in advanced stages. A great number of them go through a surgical treatment unable by itself to cure them. the frequent local recurrence caused by failure of the surgical treatment has been keeping poor survival rates in patients with advanced gastric cancer for decades. The desire of improving survival is the reason of the use of adjuvant therapies. This paper achieved the retrospective study of the influence of preoperative radiation therapy (2000 cGy) in long-term survival rates (120 months) of patients with advanced gastric cancer on stages IIIa, IIIb and IV. The possible injuries caused in the liver and kidney were observed also as well as first group was treated by surgical and radiation therapies and the second received surgical treatment only. There was no statistical difference between the two groups when sex, age, race, occurrence of other diseases, nutritional assessment, TNM stage, occurrence of obstruction or bleeding caused by tumor, surgical procedure and hepatic and renal function were considered. Survival rates and changes on hepatic and renal function were statistically compared. The results showed a statistic improvement on the long-term survival rates of stage IIIa patients treated by preoperative radiation therapy. No statistic difference was observed on hepatic or renal function between the groups. No adverse influence of radiation therapy method was detected by the used parameters. There was no statistical difference between the two groups when immediate surgical complications were considered. (author) 112 refs., 34 tabs.

  10. Requirements on Long-Term Accessibility and Preservation of Research Results with Particular Regard to Their Provenance

    Directory of Open Access Journals (Sweden)

    Andreas Weber

    2016-04-01

    Full Text Available Since important national and international funders of research projects require statements on the long-term accessibility of research results, many new solutions appeared to fulfil these demands. The solutions are implemented on various scopes, starting from specific solutions for one research group up to solutions with a national focus (i.e., the RADAR project. While portals for globally standardized research data (e.g., climate data are available, there is currently no provision for the large amount of data resulting from specialized research in individual research foci, the so called long-tail of sciences. In this article we describe the considerations regarding the implementation of a local research data repository for the Collaborative Research Centre (CRC 840. The main focus will be on the examination of requirements for, and an agenda of, a possible technical implementation. Requirements were derived from a more theoretical examination of similar projects and relevant literature, diverse discussions with researchers and project leaders, by analysis of existing publication data, and finally the prototypical implementation with refining iterations. Notably, the discussions with the researchers lead to new features going beyond the challenges of the mere long-term preservation of research data. Besides the need for an infrastructure that permits long-term preservation and retrieval of research data, our system will allow the reconstruction of the complete provenance of published research results. This requirement is a serious diversification of the problem, because it creates the need to qualify additional transformation data, describing the transformation process from primary research data to research results.

  11. Long-term results of vaginal repairs with and without xenograft reinforcement

    DEFF Research Database (Denmark)

    Mouritsen, Lone; Kronschnabl, M.; Lose, G.

    2010-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse. METHODS: Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated by a vali......INTRODUCTION AND HYPOTHESIS: The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse. METHODS: Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated......: Recurrence rates defined by POPQ plus symptoms were low compared to literature. Xenograft reinforcement might improve results....

  12. Long-Term Results of Partial Nasal Reconstructions with Indian Flap

    Directory of Open Access Journals (Sweden)

    Iljin Aleksandra

    2015-12-01

    Full Text Available The aim of the study was clinical evaluation of the results following reconstruction with the Indian flap in patients with partial nasal defects, and estimation of their postoperative life quality in functional and aesthetic aspects.

  13. Long-term Results of 185 Consecutive Osseointegrated Hearing Device Implantations

    DEFF Research Database (Denmark)

    Calvo Bodnia, Nadia; Foghsgaard, Søren; Nue Møller, Martin;

    2014-01-01

    OBJECTIVE: To determine the occurrence and type of perioperative and postoperative complications in patients implanted with an osseointegrated hearing device (OHD) (also known as BAHA/BAHS) and compare results in children, adults, and elderly and for different surgical techniques. STUDY DESIGN...

  14. Long-term results after simple versus complex stenting of coronary artery bifurcation lesions

    DEFF Research Database (Denmark)

    Maeng, Michael; Holm, Niels Ramsing; Erglis, Andrejs;

    2013-01-01

    Objectives This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study. Background Randomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy. Methods ...

  15. The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Safety and Hygienic Results

    NARCIS (Netherlands)

    Dinther, J.J.S. van; Vercruysse, J.Ph.LPW; Camp, S.; Foer, B. De; Casselman, J.; Somers, T.; Zarowski, A.; Cremers, C.W.R.J.; Offeciers, E.

    2015-01-01

    OBJECTIVE: To present the safety and hygienic results of a 5-year longitudinal study in a pediatric population undergoing surgery for extensive cholesteatoma using a canal wall up approach with bony obliteration of the mastoid and epitympanic space. STUDY DESIGN: Retrospective consecutive study. PAT

  16. Patterns of Failure Following Multimodal Treatment for Medulloblastoma: Long-Term Follow-up Results at a Single Institution

    OpenAIRE

    Lee, Dong Soo; Cho, Jaeho; Kim, Se Hoon; Kim, Dong-seok; Shim, Kyu Won; Lyu, Chuhl Joo; Han, Jung Woo; Suh, Chang-Ok

    2014-01-01

    Purpose The purpose of this study is to investigate the long-term results and appropriateness of radiation therapy (RT) for medulloblastoma (MB) at a single institution. Materials and Methods We analyzed the clinical outcomes of 106 patients with MB who received RT between January 1992 and October 2009. The median age was 7 years (range, 0 to 50 years), and the proportion of M0, M1, M2, and M3 stages was 60.4%, 8.5%, 4.7%, and 22.6%, respectively. The median total craniospinal irradiation (CS...

  17. Dataset Preservation for the Long Term: Results of the DareLux Project

    OpenAIRE

    Eugène Dürr; Kees van der Meer; Wim Luxemburg; Ronald Dekker

    2008-01-01

    The purpose of the DareLux (Data Archiving River Environment Luxembourg) Project was the preservation of unique and irreplaceable datasets, for which we chose hydrology data that will be required to be used in future climatic models. The results are: an operational archive built with XML containers, the OAI-PMH protocol and an architecture based upon web services. Major conclusions are: quality control on ingest is important; digital rights management demands attention; and cost aspects of in...

  18. SURGICAL TECHNIQUE, SHORT- AND LONG-TERM RESULTS OF THE HORSESHOE KIDNEY TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    Sh. R. Galeev

    2015-01-01

    Full Text Available The experience of horseshoe kidney transplant operations is significantly restricted. Transplant surgeons often refuse to use horseshoe kidney due to a number of serious abnormalities of vessels and upper urinary tract in these organs. However, the constant shortage of donor organs and an increase in patients on the waiting list for kidney transplantation make us reconsider our approach to the selection of donor organs. The aim of this work was to demonstrate our result of horseshoe kidney transplantation. 

  19. Long term results of pectus excavatum in adult women after the nuss procedure

    International Nuclear Information System (INIS)

    Surgical treatment of pectus excavatum in adult women was challenging and the results have not been discussed. In adults with pectus excavatum, asymmetric deformity is common and becomes a critical factor for the repair using the Nuss procedure. Out of 556 surgically treated patients using the Nuss procedure in my own experience, 86 (62: male, 24: female) were more than 18 years old. In order to show cosmetic results of the breast, 10 adult female patients who underwent removal of Pectus bars were included in this study. All cases showed mild to severe asymmetric deformity. In preoperative and post-bar removal CT examinations, a CT slice at the nipple level was selected and measured bilateral chest heights (L/R ratio), sternal twist angle and CT index at this level. Comparison of average chest height L/R ratio (from 1.09 to 1.065), sternal twist angle (from 22.1 deg to 18.40 deg) and CT index (from 0.204 to 0.26) before and after the Nuss procedure showed significant improvement. In conclusion, cosmetic results of the breast in adult women after the Nuss procedure were mostly good. However, asymmetry of the chest wall in the CT examination remained in some cases. Further surgical modification is required for adult patients. (author)

  20. Long-term results of tibialis posterior tendon transfer for drop-foot

    OpenAIRE

    Yeap, J.S.; Birch, R; Singh, D

    2001-01-01

    Twelve patients with drop-foot secondary to sciatic or common peroneal nerve palsy treated with transfer of the tibialis posterior tendon were followed-up for a mean of 90 (24–300) months. In 10 patients the results were 'excellent' or 'good'. In 11 patients grade 4 or 5 power of dorsiflexion was achieved, although the torque, as measured with a Cybex II dynamometer, and generated by the transferred tendon, was only about 30% of the normal side. Seven patients were able to dorsiflex their foo...

  1. LONG TERM FOLLOW UP RESULTS OF RUPTURE TENDO CALCANEUM TREATED BY LINDHOLM TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Sibaji

    2015-11-01

    Full Text Available INTRODUCTION: Rupture of tendon calcaneum is a common problem.There are proponents of both conservative and operative methods.Inadequate strength and re ruptures are frequent. To address both the problems we have chosen Lindholm technique and doing it for last 20 yrs with very good results. MATERIALS AND METHODS: From January 1994 to August 2013, 112 consecutive patients were treated by this method, 85 cases were fresh ruptures, 23 were neglected ruptures and four cases were re rupture after operation done elsewhere. Torn tendo calcaneum was repaired by Kessler suture, it was then augmented with two 8cm by 1cm turn down flap of gastrosoleus apponeurosis. Skin suture was done with utmost care. BK pop cast was done in equinus position of ankle for four weeks, followed by gradual weight bearing with heel raised shoe for six months. RESULTS: All patients went back to their pre injury activity level. In four patients there were superficial skin infection which healed without skin necrosis. One patient needed rotation flap. Evaluation was done by modified Rupp score. It was found to be excellent in 47% cases good in 43% cases and fair in 8% cases. CONCLUSION: Lindholm technique was originally described for neglected cases, we used it in all cases to avoid any complication in fresh cases and found it universally successful.

  2. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

    Directory of Open Access Journals (Sweden)

    Tan Andrew HC

    2011-06-01

    Full Text Available Abstract Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008. Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA shoulder rating scale and the Simple Shoulder Test (SST score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

  3. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Sarac A

    2014-04-01

    Full Text Available Atilla Sarac,1 Artan Jahollari,1 Sureyya Talay,1 Sevket Ozkaya,2 Ertugrul Ozal1 1Department of Cardiovascular Medicine, Samsun Medical Park Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey Objective: The aim of this study is to present our 7-year results of external valvuloplasty for isolated great saphenous vein (GSV insufficiency. Methods: External valvuloplasty was applied in 83 patients with isolated GSV insufficiency. Follow-up consisted of venous color duplex scanning performed on the first postoperative day, the first postoperative month, and then annually. Valvular insufficiency, venous reflux, and venous thrombosis formation in the saphenofemoral junction were the main outcomes. Results: A complete clinical and radiological healing was observed in 50 patients (60%. In 13 cases (15.6%, a secondary surgical treatment was performed consisting of vena saphena magna high ligation/stripping and varicose vein excisions, mainly due to severe and progressive vena saphena magna valvular insufficiency and clinical persistence of symptoms. Eight patients (9.6% developed superficial vein thrombosis, and only one patient (1.2% developed deep vein thrombosis. Contact was lost from 32 patients (38.5% for different reasons. Conclusion: External valvuloplasty is an effective surgical technique for selected cases of isolated GSV insufficiency without extensive varicose dilatations. This alternative method can be safely administered as an alternative to high ligation and conventional GSV stripping. Keyword: vein, saphenous, insufficiency, external valv, valvuloplasty, varicosis

  4. The long-term results of benign bile duct strictures reconstruction

    Directory of Open Access Journals (Sweden)

    Čolović Radoje B.

    2003-01-01

    infarction and 1 due to stroke. Out of 151 alive fully followed pts, good result (pts symptom-free as after standard cholecystectomy was achieved in 121 (80,13%, satisfactory (mild occasional symptoms but not cholangitis in 27 (17,88% and unsatisfactory result in 3 pts (2%, 2 of which were successfully reoperated (1 passed into group with good and 1 into group with satisfactory results.

  5. Dataset Preservation for the Long Term: Results of the DareLux Project

    Directory of Open Access Journals (Sweden)

    Eugène Dürr

    2008-08-01

    Full Text Available The purpose of the DareLux (Data Archiving River Environment Luxembourg Project was the preservation of unique and irreplaceable datasets, for which we chose hydrology data that will be required to be used in future climatic models. The results are: an operational archive built with XML containers, the OAI-PMH protocol and an architecture based upon web services. Major conclusions are: quality control on ingest is important; digital rights management demands attention; and cost aspects of ingest and retrieval cannot be underestimated. We propose a new paradigm for information retrieval of this type of dataset. We recommend research into visualisation tools for the search and retrieval of this type of dataset.

  6. Surface electromagnetic impedance and geomagnetic activity: results of long term observation

    Science.gov (United States)

    Lemperger, István; Menvielle, Menvielle; Wesztergom, Viktor; Bencze, Pál; Szendrői, Judit; Novák, Attila; Kis, Árpád; Szalai, Sándor

    2014-05-01

    The magnetotelluric (MT) method is one of the most useful geophysical tool to discover even the deep subsurface structures. The target function of the MT data processing is the surface electromagnetic (EM) impedance. In case of practical MT exploration the surface EM impedance is computed based on a simplification related to the nature of the ionospheric source of the surface EM signals. Assuming that the ionospheric current systems result in homogeneous surface electromagnetic variations, the uncertainty of the computed surface electromagnetic impedance tensor depends only the duration of the EM observation. However the surface EM field can only be approached by plane waves in certain time periods and besides given uncertainty. The EM impedance may be sensitive to magnetospheric and -indirectly- interplanetary circumstances and solar activity. Four years continuous observation of telluric and surface geomagnetic components allowed to perform a representative survey to discover if geomagnetic activity has any effect on observed EM impedance tensor. Geomagnetic indices (Dst, ULF-index, ASY-H, SYM-H) have been used to classify dates according to geomagnetic activity. Processing to estimate the mean surface EM impedance tensor has been performed in each dataset, each class separately. The sensitivity and the characteristics of the answer of the EM impedance tensor to the geomagnetic disturbances seems to be definite. This presentation aims to briefly summarize the preliminary results of our study based on the unique dataset of the Széchenyi István Geophysical Obsevatory (Intermagnet code:NCK). In addition, pointing out the limitations of the routine way of practical MT data processing and interpretation is an important duty of this study. This study was supported by the TAMOP-4.2.2.C-11/1/KONV-2012-0015 (Earth-system) project sponsored by the EU and European Social Foundation.

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

    Science.gov (United States)

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

    International Nuclear Information System (INIS)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Truong, Minh Tam, E-mail: mitruong@bu.edu [Department of Radiation Oncology, Amyloid Treatment and Research Program, Boston University School of Medicine, Boston Medical Center, Boston, MA (United States); Kachnic, Lisa A. [Department of Radiation Oncology, Amyloid Treatment and Research Program, Boston University School of Medicine, Boston Medical Center, Boston, MA (United States); Grillone, Gregory A. [Department of Otolaryngology, Amyloid Treatment and Research Program, Boston University School of Medicine, Boston Medical Center, Boston, MA (United States); Bohrs, Harry K.; Lee, Richard [Department of Radiation Oncology, Amyloid Treatment and Research Program, Boston University School of Medicine, Boston Medical Center, Boston, MA (United States); Sakai, Osamu [Department of Radiology, Amyloid Treatment and Research Program, Boston University School of Medicine, Boston Medical Center, Boston, MA (United States); Berk, John L. [Department of Medicine, Amyloid Treatment and Research Program, Boston University School of Medicine, Boston Medical Center, Boston, MA (United States)

    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.

  10. Long-term aging of cast stainless steels: Mechanisms and resulting properties

    International Nuclear Information System (INIS)

    Mechanical property data are presented from Charpy-impact, tensile, and J-R curve tests for several heats of cast stainless steel aged up to 10,000 h at 450, 400, 350, 320 and 290 deg. C. The results indicate that thermal aging increases the tensile strength and decreases the impact energy, JIC, and tearing modules of the steels. Also, the ductile-to-brittle transition curve shifts to higher temperatures. The ferrite content and concentration of carbon in the steel have a strong effect on the overall process of low-temperature embrittlement. The low-carbon CF-3 steels are the most resistant and the molybdenum-containing high-carbon CF-8M steels are the most susceptible to low-temperature embrittlement. Microstructural data indicate that three processes contribute to embrittlement of cast stainless steels, viz., Cr-rich α' and G-phase precipitation in the ferrite, and carbide precipitation on the austenite/ferrite phase boundary. The influence of nitrogen content and ferrite distribution on loss of toughness are discussed. The data also indicate that existing correlations do not accurately represent the embrittlement behavior over the temperature range 280-450 deg. C, i.e., extrapolation of high temperature data to reactor temperatures may not be valid for some compositions of cast stainless steel. (author)

  11. Long-term aging of cast stainless steels: Mechanisms and resulting properties

    International Nuclear Information System (INIS)

    Mechanical property data are presented from Charpy-impact, tensile, and J-R curve tests for several heats of cast stainless steel aged up to 10,000 h at 450, 400, 350, 320, and 2900C. The results indicate that thermal aging increases the tensile strength and decreases the impactenergy, J/sub IC/ and tearing modulus of the steels. Also, the ductile-to-brittle transition curve shifts to higher temperatures. The low-carbon CF-3 steels were the most resistant and the molybdenum-containing high-carbon CF-8M steels were the most susceptible to low-temperature embrittlement. The influence of nitrogen content and distribution of ferrite on loss of toughness are discussed. Data also indicate that existing correlations do not accurately represent the embrittlement behavior over the temperature range 280 to 4500C, i.e., extrapolation of high-temperature data to reactor temperatures may not be valid for some compositions of cast stainless steels. 13 refs., 13 figs., 2 tabs

  12. Results of long-term genetic monitoring of animal populations chronically irradiated in the radiocontaminated areas

    Energy Technology Data Exchange (ETDEWEB)

    Goncharova, R.; Riabokon, N. [Institute of Genetics and Cytology, National Academy of Sciences of Belarus, Minsk (Belarus)

    1998-03-01

    The artificial geochemical land where all organisms lived and will live under the conditions of increased level of radiation was set up due to the Chernobyl disaster in 1986. An urgent necessity for studying the various biological effects of chronic influence of low intensity radiation on both individual organisms and populations arose. Combined cytogenetic and radioecological investigations in wild populations of terrestrial small mammals (bank vole = Clethrionomys glareolus, Schreber and yellow-necked mouse = Apodemus flavicollus, Melchior) and in laboratory mice have been carried out by our laboratory since 1986. Our test organisms have contacted closely with low intensity radiation in the radiocontaminated areas of Belarus and absorbed low whole-body dose. We study the following problems: dynamics of radionuclide concentration in wild populations of small rodents; dynamics of mutation process in somatic and germ cells over many generations as well as embryonal lethality; dynamics of population density, age and sex structure of mammalian populations. The large part of results obtained are presented here. (J.P.N.)

  13. [Long-term results of airways' injury after a methane explosion].

    Science.gov (United States)

    Sikora, Łukasz; Misiołek, Maciej; Krzywiecki, Andrzej; Lisowska, Graźyna; Paluch, Zbigniew; Kawecki, Marek; Namysłowski, Grzegorz

    2011-01-01

    Injuries caused by thermal trauma more and more often affect people and they are an important problem of contemporary medicine. It is connected with the civilization development. Burn concerns not only the exterior integuments of the body but also airways, in those cases, the death rate among those who were injured with the thermal trauma increases. The treatment of both the burns and their complications is a long-lasting process, involving many specialists of various disciplines, and not always does it bring the wanted effects. The aim of the study was the assessment of the late morphological sequels inside the larynx and ventilation efficiency as a result of thermal inhalation trauma in the airways of the coal miners after the methane explosion. The methodology of examinations consisted of subjective evaluation of ventilation efficacy by MRC scale and ventilating rate measurement FEV1, FVC, FEV1%, PEF, MEF50, PIF, MIF 50, FIV. The morphological larynx evaluation was conducted based on videolaryngoscopy. 23 injured coal miners, who had been burnt at work in coal mines in 2003 in the methane explosion, were put under scrutiny. All the above mentioned examinations were done to the study group, but also to the specially selected control group, 23 coal miners. During the ventilating rates analysis in the study group, their lower values were noticed in comparison to the control group, however, the values were still within the clinical norms. Videolaryngoscopy showed hypertrophy of the laryngeal tissues. PMID:21574495

  14. Subareolar breast cancer: long-term results with conservative surgery and radiation therapy

    International Nuclear Information System (INIS)

    Purpose: It has been suggested that patients presenting with breast cancers within 2 cm of the nipple areolar complex represent a relative contraindication to conservative management due to either a compromised cosmetic result associated with sacrifice of the nipple areolar complex, reluctance to include the entire nipple areolar complex in the conedown field, or increased risk of multicentricity. We have reviewed our experience of conservatively treated patients with specific reference to the subset of patients presenting with tumors within 2 cm of the nipple areolar complex. Methods and Materials: Between January 1970 and December 1989, 1014 patients with early stage breast cancer were treated at Yale-New Haven Hospital by excisional biopsy with or without axillary lymph node dissection. Of the 1014 charts reviewed, a total of 98 patients fulfilled the criteria of having a central/subareolar breast cancer. Reexcision was performed on only 16 patients. Following conservative surgery, patients were treated with radiation therapy to the intact breast to a total median dose of 48 Gy with conedown to a total of 64 Gy. Adjuvant systemic therapy and regional nodal irradiation were administered as clinically indicated. Results: As of December 1993, the median follow-up for the 98 patients in this study was 9.03 years. The majority of patients had presented with either a palpable mass or a mammographically detected lesion. Three patients presented with Paget's disease, five with nipple discharge, and seven with nipple inversion. Ten of the 98 patients had the nipple areolar complex sacrificed at the time of surgery, while the remaining 88 patients had the entire nipple areolar complex included in the conedown field. Four of these 88 patients had the nipple partially blocked during the electron conedown. There were no significant complications associated with including the entire nipple areolar complex within the conedown field to a median dose of 64 Gy. Six of the 98

  15. Long-term results of pneumatic dilation for achalasia: A 15 years' experience

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos; Jannis Kountouras; George Paroutoglou; Athanasios Beltsis; Christos Zavos; Basilios Papaziogas; Kostas Mlimidis

    2005-01-01

    AIM: Although most patients with achalasia respond to pneumatic dilation, one-third experienced recurrence, and prolonged follow-up studies on parameters associated with various outcomes are scanty. In this retrospective study, we reported a 15-years' experience with pneumatic dilation treatment in patients with primary achalasia, and determined whether previously described predictors of outcome remain significant after endoscopic dilation.METHODS: Between September 1989 and September 2004, 39 consecutive patients with primary symptomatic achalasia (diagnosed by clinical presentation, esophagoscopy,barium esophagogram, and manometry) who received balloon dilation were followed up at regular intervals in person or by phone interview. Remission was assessed by a structured interview and a previous symptoms score.The median dysphagia-free duration was calculated by Kaplan-Meier analysis.RESULTS: Symptoms were dysphagia (n = 39, 100%),regurgitation (n =23, 58.7%), chest pain (n = 4, 10.2%),and weight loss (n = 26, 66.6%). A total of 74 dilations were performed in 39 patients; 13 patients (28%) underwent a single dilation, 17 patients (48.7%) required a second procedure within a median of 26.7 mo (range 5-97 mo), and 9 patients (23.3%) underwent a third procedure within a median of 47.8 mo (range 37-120 mo). Post-dilation lower esophageal sphincter (LES) pressure, assessed in 35 patients, has decreased from a baseline of 35.8±10.4-10.0±7.1 mmHg after the procedure. The median follow-up period was 9.3 years (range 0.5-15 years). The dysphagiafree duration by Kaplan-Meier analysis was 78%, 61%and 58.3% after 5, 10 and 15 years respectively.CONCLUSION: Balloon dilation is a safe and effective treatment for primary achalasia. Post-dilation LES pressure estimation may be useful in assessing response.

  16. Long-Term Creep Behavior of the Intervertebral Disc: Comparison between Bioreactor Data and Numerical Results

    Directory of Open Access Journals (Sweden)

    APG eCastro

    2014-11-01

    Full Text Available The Loaded Disc Culture System (LDCS is an Intervertebral Disc (IVD-oriented bioreactor developed by the VU Medical Center (VUmc, Amsterdam, The Netherlands, which has the capacity of maintaining up to 12 IVDs in culture, for approximately 3 weeks after extraction. Using this system, 8 goat IVDs were provided with the essential nutrients and submitted to compression tests without losing their biomechanical and physiological properties, for 22 days. Based on previous reports (Detiger et al., 2013; Paul et al., 2013, 2012, 4 of these IVDs were kept in physiological condition (control and the other 4 were previously injected with chondroitinase ABC (CABC, in order to promote Degenerative Disc Disease (DDD. The loading profile intercalated 16h of activity loading with 8h of loading recovery to express the standard circadian variations.The displacement behavior of these 8 IVDs along the first 2 days of the experiment was numerically reproduced, using an IVD osmo-poro-hyper-viscoelastic and fiber-reinforced Finite Element (FE model. The simulations were run on a custom FE solver (Castro et al., 2014.The analysis of the experimental results allowed concluding that the effect of the CABC injection was only significant in 2 of the 4 IVDs. The 4 control IVDs showed no signs of degeneration, as expected. In what concerns to the numerical simulations, the IVD FE model was able to reproduce the generic behavior of the two groups of goat IVDs (control and injected. However, some discrepancies were still noticed on the comparison between the injected IVDs and the numerical simulations, namely on the recovery periods. This may be justified by the complexity of the pathways for DDD, associated with the multiplicity of physiological responses to each direct or indirect stimulus. Nevertheless, one could conclude that ligaments, muscles and IVD covering membranes could be added to the FE model, in order to improve its accuracy and properly describe the recovery

  17. Transitioning MODIS to VIIRS observations for Land: Surface Reflectance results, Status and Long-term Prospective

    Science.gov (United States)

    Vermote, E.

    2015-12-01

    Surface reflectance is one of the key products from VIIRS and as with MODIS, is used in developing several higher-order land products. The VIIRS Surface Reflectance (SR) IP is based on the heritage MODIS Collection 5 product (Vermote et al. 2002). The quality and character of surface reflectance depends on the accuracy of the VIIRS Cloud Mask (VCM) and aerosol algorithms and of course on the adequate calibration of the sensor. Early evaluation of the VIIRS SR product in the context of the maturity of the operational processing system known as the Interface Data Processing System (IDPS), has been a major focus of work to-date, but is now evolving into the development of a VIIRS suite of Climate Data Records produced by the NASA Land Science Investigator Processing System (SIPS). We will present the calibration performance and the role of the surface reflectance in calibration monitoring, the performance of the cloud mask with a focus on vegetation monitoring (no snow conditions), the performance of the aerosol input used in the atmospheric correction with quantitative results of the performance of the SR product over AERONET sites. Based on those elements and further assessment, we will address the readiness of the SR product for the production of higher-order land products such as Vegetation Indices, Albedo and LAI/FPAR, the its application to agricultural monitoring and in particular the integration of VIIRS data into the global agricultural monitoring (GLAM) system developed at UMd. Finally from the lessons learned, we will articulate a set of critical recommendations to ensure consistency and continuity of the JPSS mission with the MODIS data record.

  18. CT-guided radiofrequency ablation of osteoid osteoma: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Cioni, Roberto; Armillotta, Nicola; Bargellini, Irene; Zampa, Virna; Cappelli, Carla; Vagli, Paola; Bartolozzi, Carlo [Department of Oncology, Transplants and Advanced Technologies in Medicine, Division of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56126, Pisa (Italy); Boni, Giuseppe [Division of Nuclear Medicine, University of Pisa, Via Roma 67, 56126, Pisa (Italy); Marchetti, Stefano; Consoli, Vincenzo [Department of Orthopedics, University of Pisa, Via Roma 67, 56126, Pisa (Italy)

    2004-07-01

    The aim of the study was to assess the safety and efficacy of CT-guided percutaneous radiofrequency (RF) ablation of osteoid osteoma (OO). From 1997 to 2001, RF ablation was performed on 38 patients with OO, diagnosed clinically and by radiography, scintigraphy, contrast-enhanced MRI, and CT. Treatment was performed via percutaneous (n=29) or surgical (n=9) access, under CT guidance in all cases, with an 18-gauge straight electrode. Patients were discharged within 24 h and followed up clinically (at 1 week and every 6-12 months) and with MRI (at 6 months) and scintigraphy (after 1 year). The technical success rate was 100%. Complications occurred in two patients, consisting in local skin burns. The follow-up range was 12-66 months (mean {+-} SD, 35.5{+-}7.5 months). Prompt pain relief and return to normal activities were observed in 30 of 38 patients. Persistent pain occurred in eight patients; two patients refused further RF ablation and were treated surgically; RF ablation was repeated in six cases achieving successful results in five. One patient reported residual pain and is being evaluated for surgical excision. Primary and secondary clinical success rates were 78.9 (30/38 patients) and 97% (35/36 patients), respectively. CT-guided RF ablation of OO is safe and effective. Persistent lesions can be effectively re-treated. Several imaging modalities are needed for the diagnosis of OO and for the follow-up after treatment, particularly in patients with persistent symptoms. (orig.)

  19. Long-term follow-up results of percutaneous balloon mitral valvuloplasty in mitral stenosis with severe pulmonary hypertension

    International Nuclear Information System (INIS)

    Objective: To assess long-term results (more than 5-year) after percutaneous balloon mitral valvuloplasty (PBMV) on mitral stenosis (MS) with severe pulmonary hypertension. Methods: Thirty patients after PBMV underwent critical evaluations including echocardiography, chest film and clinical status throughout the follow-up period (6.4 +- 1.4 years). Results: Before and after PBMV and at follow-up, mean mitral valve areas were (1.19 +- 0.32) cm2 vs (1.99 +- 0.45) cm2 vs (1.44 +- 0.42) cm2 respectively (P<0.01 respectively). Restenosis rate was 53.3% at the end of follow-up. There were twenty-eight (93.3%) patients who obtained at least I class (NYHA class) improvement in cardiac function shortly after PBMV. At the end of follow-up, twenty-two (73.3%) patients were still in class I or II without mitral re-operation or repeated valvuloplasty. Conclusions: Long-term follow-up results after PBMV in mitral stenosis with severe pulmonary hypertension was satisfied, and PBMV can be an excellent therapy to improve the clinical status of such patients

  20. Low-dose-rate brachytherapy for patients with transurethral resection before implantation in prostate cancer: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Prada, Pedro J.; Anchuelo, Javier; Blanco, Ana Garcia; Paya, Gema; Cardenal, Juan; Acuña, Enrique; Ferri, Maria [Department of Radiation Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain); Vazquez, Andres; Pacheco, Maite; Sanchez, Jesica [Department of Radiation Physics, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain)

    2016-01-15

    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. (author)

  1. Anti-vascular endothelial growth factors for choroidal neovascularization secondary to choroidal osteoma: Long-term results

    Directory of Open Access Journals (Sweden)

    T Lekha

    2015-01-01

    Full Text Available Choroidal osteoma is an uncommon benign osseous intraocular tumor typically seen unilaterally in young women. Visual loss can occur due to choroidal neovascularization (CNV complicating osteoma. We report a rare case of bilateral choroidal osteoma with secondary CNV in a young male and the long-term results following anti-vascular endothelial growth factor (VEGF therapy. A 30-year-old male with history of defective vision in both eyes since several years and recent worsening in the right eye (RE since 2 months was found to have bilateral macular osteoma with CNV in the RE based on clinical evaluation, fluorescein angiography, optical coherence tomography, and ultrasonography. Intravitreal injection of ranibizumab at monthly intervals for three doses resulted in resolution of CNV and remained stable for 5 years. Recurrent CNV detected 6 years later responded to an injection of intravitreal bevacizumab and has remained stable till date. Anti-VEGF therapy stabilized the secondary CNV in our patient for 7 years with satisfactory structural and functional outcome, demonstrating the long-term efficacy of this modality of treatment.

  2. Long-term Results of a First-Generation Annealed Highly Cross-Linked Polyethylene in Young, Active Patients.

    Science.gov (United States)

    Ranawat, Chitranjan S; Ranawat, Amar S; Ramteke, Alankar A; Nawabi, Danyal; Meftah, Morteza

    2016-01-01

    The survivorship of total hip arthroplasty in younger patients is dependent on the wear characteristics of the bearing surfaces. Long-term results with conventional polyethylene in young patients show a high failure rate. This study assessed the long-term results of a first-generation annealed highly cross-linked polyethylene (HCLPE) in uncemented total hip arthroplasty in young, active patients. Between 1999 and 2003, 112 total hip arthroplasty procedures performed in 91 patients with an average University of California Los Angeles activity score of 8 and mean age of 53 years (range, 24-65 years) were included from a prospective database. In all patients, a 28-mm metal femoral head on annealed HCLPE (Crossfire; Stryker, Mahwah, New Jersey) was used. At minimum 10-year follow-up (11.5±0.94 years), Kaplan-Meier survivorship was 97% for all failures (1 periprosthetic infection and 1 late dislocation) and 100% for mechanical failure (no revisions for osteolysis or loosening). This study showed low revision rates for wear-related failure and superior survivorship in young, active patients. Oxidation causing failure of the locking mechanism has not been a problem with Crossfire for up to 10 years. PMID:26811959

  3. Long-term results of 2-mm punch grafting in patients with vitiligo vulgaris and segmental vitiligo : effect of disease activity

    NARCIS (Netherlands)

    Fongers, A.; Wolkerstorfer, A.; Nieuweboer-Krobotova, L.; Krawczyk, P.; Toth, G. G.; van der Veen, J. P. W.

    2009-01-01

    Background Punch grafting is a simple and frequently used technique for the treatment of stable vitiligo, resistant to medical therapy. However, studies reporting long-term results are exceptional. Objectives To evaluate the long-term results of 2-mm punch grafting in patients with vitiligo vulgaris

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

    Science.gov (United States)

    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.

  5. Microbial borehole observatories deployed within the oceanic crust: Design considerations and initial results from long-term colonization experiments (Invited)

    Science.gov (United States)

    Orcutt, B. N.; Bach, W.; Becker, K.; Fisher, A. T.; Hulme, S.; Toner, B. M.; Wheat, C. G.; Edwards, K. J.; Iodp Expedition 327 Shipboard Party

    2010-12-01

    Borehole observatories developed for long-term sampling and monitoring in the subseafloor of the deep ocean must satisfy design and operation requirements that are similar to systems deployed on land. Many of these systems are used to achieve simultaneous hydrologic, geochemical and microbiological goals, requiring innovative design, installation, and operation. There are major logistical challenges for subseafloor observatories, the foremost being having to remotely access sites kilometers underwater using multiple oceanographic platforms (drill ship, surface ship, submersible, remotely-operated vehicle) and reliance on autonomous devices that are serviced only after several years. Contamination of the analytical environment is probable during installation operations, requiring vigilance during analysis for interpretation. Subseafloor observatories also require self-contained and robust instrumentation that can withstand long-term exposure to seawater at high pressures, elevated temperatures, a variety of redox conditions, and little to no access to external power. Although subseafloor borehole observatories have been in development for hydrologic monitoring for two decades, the inclusion of experimentation to examine the deep biosphere in the marine subsurface has only recently been developed. Results from some of the first microbial colonization experiments in young basaltic rocks on the eastern flank of the Juan de Fuca Ridge demonstrate in situ microbial-mineral interactions that can be identified using complementary geochemical and microbiological techniques. Mineral surfaces were first colonized by iron oxidizing bacteria, and as fluid composition changed, the microbial community became dominated by Firmicutes bacteria, some of which are phylogenetically similar to microbial communities observed in the terrestrial deep biosphere.

  6. High-dose rate brachytherapy of prostatic adenocarcinoma in combination with external beam radiotherapy. A long-term follow-up of the first 50 patients at one center

    Energy Technology Data Exchange (ETDEWEB)

    Lennernaes, B. [Dept. of Oncology, Sahlgrenska Univ. Hospital (Sweden); Holmaeng, S. [Dept. of Urology, Sahlgrenska Univ. Hospital (Sweden); Hedelin, H. [Kaernsjukhuset, Skoevde (Sweden)

    2002-10-01

    Aim: To report the long-term follow-up of 50 patients with prostatic adenocarcinoma (PAC) by high-dose rate brachytherapy in combination with external beam radiotherapy. Patients and methods: Between 1988 and 1995, 50 patients were treated with external beam radiotherapy delivered in 2 Gy fractions to a total dose of 50 Gy. Brachytherapy was delivered in two 10 Gy fractions. The mean follow-up time was 7.2 years. Results: 42 patients are alive and four patients have deceased of prostatic adenocarcinoma. Of the remaining patients, 40 have a PSA<1 ng/l. 41 patients were interviewed during the year 2000 and 91% of these were satisfied with the treatment. Four (8%) patients reported grade III/IV side effects. Ten of the 41 patients reported that they still had an erection allowing intercourse. Half of those who developed an erectile dysfunction did so in direct connection with the treatment. In the others erectile dysfunction developed gradually during the first 48 months after the treatment. Conclusion: The combined treatment gave an exceptionally good local control (86%). The method represents a promising curative treatment, but the effect can be double edged. The small number of patients in this study restricts a more conclusive statement concerning this treatment modality. (orig.) [German] Ziel: Monoinstitutioneller Erfahrungsbericht zur Behandlung des Prostatakarzinoms mit kombinierter externer und HDR-Brachytherapie. Patienten und Methoden: Von 1988 bis 1995 wurden 50 Patienten mit einem Prostataadenokarzinom kombiniert extern und interstitiell behandelt. Die perkutane Radiotherapie erfolgte bei einer Einzeldosis von 2 Gy bis zu einer Gesamtreferenzdosis von 50 Gy. Die Brachtherapie folgte mittels zweier HDR-Fraktionen von je 10 Gy. Die mediane Nachbeobachtungszeit betrug 7,2 Jahre. Ergebnisse: 42 Patienten sind am Leben, vier starben am Prostataadenokarzinom. Von den ueberlebenden Patienten haben 40 einen PSA-Wert <1 ng/l. 41 Patienten wurden waehrend des Jahres

  7. Long-Term Outcomes of the Treatment of Unresectable (Stage III - IV)Ductal Pancreatic Adenocarcinoma Using Metabolically Supported Chemotherapy (MSCT): A Retrospective Study

    OpenAIRE

    Mehmet Salih Iyikesici; Ayshe Slocum; Engin Turkmen; Ovunc Akdemir; Abdul Kadir Slocum; Turgut Ipek; Erhun Eyuboglu; Ferhan Bulent Berkarda

    2016-01-01

    Introduction Metabolically supported chemotherapy (MSCT), is defined as the application of standard chemotherapy protocols concomitant to the administration of pharmacological doses of regular insulin and the development of hypoglycemia, and following fasting starting the previous day. This study aims to present the effects of MSCT on the overall survival of locally advanced and metastatic (stage III and stage IV, respectively), or simply unresectable pancreatic adenocarcinoma patients. Mater...

  8. Determinants of long-term fatigue in breast cancer survivors: results of a prospective patient cohort study

    NARCIS (Netherlands)

    Schmidt, M.E.; Chang-Claude, J.; Seibold, P.; Vrieling, A.; Heinz, J.; Flesch-Janys, D.; Steindorf, K.

    2015-01-01

    OBJECTIVE: Fatigue is among the most distressing symptoms across the breast cancer continuum. However, little is known about the factors contributing to long-term persisting fatigue. Therefore, we explored determinants of long-term physical, affective, and cognitive fatigue in a prospective cohort o

  9. Does the use of extended criteria donors influence early and long-term results of lung transplantation?

    Science.gov (United States)

    Schiavon, Marco; Falcoz, Pierre-Emmanuel; Santelmo, Nicola; Massard, Gilbert

    2012-02-01

    A best evidence topic was constructed according to a structured protocol. The question addressed was whether the presence of extended criteria donors influences the early and long-term results in patients referred for lung transplantation. Of the 30 papers found using a report search, 14 presented the best evidence to answer the clinical question. The authors, journal, date, country of publication, study type, group studied, relevant outcomes and results of these papers are given. In total, we recorded 10 retrospective studies that considered all the donor criteria for comparing marginal donors (MDs) and standard donors. On the one hand, six of them showed no difference between the two groups in terms of early and long-term results. On the other hand, four studies demonstrated a negative impact of MDs on various early outcomes (mortality, primary graft dysfunction, duration of mechanical ventilation, length of stay in intensive care unit), whereas no significant negative influence on survival has ever been described when screening MD results. More precisely, when analysing the role of individual factors of marginality, as done in two of the 14 studies, a significant negative impact was observed for a low level of PaO(2) at the time of harvesting, positive bronchoscopy and smoking history. More specifically, the first two criteria have been validated by several authors, both in multicentre and cohort studies. Finally, the importance of avoiding the donation of the lung from an MD to a high-risk recipient emerged, whereas the association with single or bilateral transplants remains more controversial. Hence, current evidence suggests that there are no contraindications-given the absence of negative impact on survival-for the use of MDs for the transplant of a proposed standard receiver. However, given the low level of evidence of published studies, caution is necessary in order to avoid organ shortage, despite these encouraging results. PMID:22159257

  10. The long term results of pediatric esotropia surgery performed according to new scheme of muscle recession / resection

    Directory of Open Access Journals (Sweden)

    Zolotarev А.V.

    2011-12-01

    Full Text Available The purpose of the investigation is to evaluate the long term results of surgical treatment in children with esotropia, operated according to new scheme of muscle procedures. Materials. The retrospective analysis of surgical treatment in 50 children with esotropia was made. The new scheme of muscle recession / resection was used. Results. The duration of monitoring was 1-5 years. More then half of all patients has ortotropia, even in cases with 25° primary deviation angle. Almost 40% of patients has increasing of visual acuity of amblyopic eye and binocular functions. Conclusion. The new scheme of muscle recession / resection allows to receive ortotropia after surgical treatment in large esotropia and avoid the reoperations. Using of the new scheme of strabismus surgery don't increase the quantity of secondary exodeviation

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Long-term results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Shuai Zheng

    Full Text Available BACKGROUND: Ganglionated plexi (GP ablation has been become an adjunct to pulmonary vein isolation (PVI. This study describes the long-term results of minimally invasive surgical PVI, ablation of GPs, and exclusion of the left atrial appendage for atrial fibrillation (AF. METHODS: Long-term follow-up of 55 months was performed in 139 consecutive patients (age 58.3±20.8 years with symptomatic, drug-refractory lone AF who underwent minimally invasive surgical PVI, GPs ablation, and exclusion of the left atrial appendage. Success was defined as freedom from AF, atrial flutter, or atrial tachycardia off antiarrhythmic drugs. RESULTS: AF was paroxysmal in 77.7%, persistent in 12.2% and long-standing persistent in 10.1%. Single-procedure success rate was 71.7%, 59.4% and 46.6% at 12, 24 and 60 months respectively. Single-procedure success rate was 72.9%, 62.6% and 51.8% for paroxysmal AF, 64.7%, 35.3%, and 28.2% for persistent AF, 71.4%, 64.3% and 28.6% for long-standing persistent AF at 12, 24 and 60 months respectively. Duration of AF>24 months (hazard ratio [HR]: 3.09, 95% confidence interval [CI]: 1.51 to 6.32; p = 0.002, left atrial diameter≥40 mm (HR: 4.03, 95% CI: 1.88 to 8.65; p<0.001, early recurrence of AF (HR: 4.66, 95% CI: 2.25 to 9.63; p<0.001 independently predicted long-term recurrence of AF. There was no procedure-related death. One patient converted to median sternotomy because of uncontrolled bleeding. Two patients underwent perioperative cerebrovascular events. CONCLUSIONS: At nearly 5-year of clinical follow-up, single-procedure success rate of minimally invasive surgical PVI with GP ablation was 51.8% for paroxysmal AF, 28.2% for persistent AF, 28.6% for long-standing persistent AF after initial procedure. Patients with AF duration≤24 months, left atrial diameter<40 mm and no early recurrence of AF, had favorable outcomes.

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

    Directory of Open Access Journals (Sweden)

    Kaleta Dorota

    2012-11-01

    Full Text Available Abstract 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  Conclusion Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake.

  14. Evaluation of long-term cosmetic results and complications following breast conserving surgery and radiation therapy for breast cancer

    International Nuclear Information System (INIS)

    Long-term cosmetic outcomes and complications were evaluated in 109 patients with breast cancer who had been treated by breast conservation therapy. Patients received radiation therapy at Kyoto University Hospital following quadrantectomy and level II or III axillary node dissection. Factors that might influence long-term cosmetic results were also analyzed. Irradiation to the breast was administered in 2 Gy fractions, 5 times a week for a total of 50 Gy in all patients. Cobalt-60 γ-rays were used in 108 patients with the exception of 1 patient who received 6 Mev X-ray. Some patients with positive or close margins received boost irradiation of 10 Gy using electron beams to the primary tumor bed. Cosmetic outcome was assessed by both a scoring method and breast retraction assessment (BRA). Forty-seven percent of patients were assessed as excellent to good before radiation therapy. The percent of excellent to good decreased shortly after termination of radiation therapy, but gradually improved and stabilized by 3 years. Seventy percent of patients showed a score of excellent to good 5 years after treatment. The average BRA of the 109 patients was 3.0 cm. This did not change between 3 and 5 years after treatment. A significant correlation between cosmetic score and BRA was shown at all follow-up times. Factors such as age over 50 years (p=0.008), tumor location in the outer quadrant (p=0.02) and boost irradiation (p=0.03) significantly affected the cosmetic score. Arm edema and restriction of shoulder movement were observed in 22% and 49% at the start of radiation therapy, these improved within approximately 3 years and 1 year after treatment, respectively. Mild skin change was observed in 60% of patients even 5 years after treatment. The results indicate that cosmetic outcome after breast conservation therapy is clinically acceptable, and the complication rate is low. (author)

  15. Evaluation of long-term cosmetic results and complications following breast conserving surgery and radiation therapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fujishiro, Satsuki; Mitsumori, Michihide; Kokubo, Masaki; Nagata, Yasushi; Sasai, Keisuke; Hiraoka, Masahiro [Kyoto Univ. (Japan). Hospital; Kodama, Hiroshi

    1999-12-01

    Long-term cosmetic outcomes and complications were evaluated in 109 patients with breast cancer who had been treated by breast conservation therapy. Patients received radiation therapy at Kyoto University Hospital following quadrantectomy and level II or III axillary node dissection. Factors that might influence long-term cosmetic results were also analyzed. Irradiation to the breast was administered in 2 Gy fractions, 5 times a week for a total of 50 Gy in all patients. Cobalt-60 {gamma}-rays were used in 108 patients with the exception of 1 patient who received 6 Mev X-ray. Some patients with positive or close margins received boost irradiation of 10 Gy using electron beams to the primary tumor bed. Cosmetic outcome was assessed by both a scoring method and breast retraction assessment (BRA). Forty-seven percent of patients were assessed as excellent to good before radiation therapy. The percent of excellent to good decreased shortly after termination of radiation therapy, but gradually improved and stabilized by 3 years. Seventy percent of patients showed a score of excellent to good 5 years after treatment. The average BRA of the 109 patients was 3.0 cm. This did not change between 3 and 5 years after treatment. A significant correlation between cosmetic score and BRA was shown at all follow-up times. Factors such as age over 50 years (p=0.008), tumor location in the outer quadrant (p=0.02) and boost irradiation (p=0.03) significantly affected the cosmetic score. Arm edema and restriction of shoulder movement were observed in 22% and 49% at the start of radiation therapy, these improved within approximately 3 years and 1 year after treatment, respectively. Mild skin change was observed in 60% of patients even 5 years after treatment. The results indicate that cosmetic outcome after breast conservation therapy is clinically acceptable, and the complication rate is low. (author)

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

    International Nuclear Information System (INIS)

    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

  17. Repair of complete atrioventricular septal defect in infants with down syndrome: outcomes and long-term results.

    Science.gov (United States)

    Tumanyan, Margarita R; Filaretova, Olga V; Chechneva, Vera V; Gulasaryan, Ruben S; Butrim, Iuliia V; Bockeria, Leo A

    2015-01-01

    In clinical practice, the combination of congenital heart disease (CHD) with malformations of other organs occurs in about 10 % of cases, including chromosomal disease with heart defects, which are observed mainly with certain syndromes. In the Bakoulev SCCS (Moscow, Russian Federation), from 01.2005 to 01.2011, complete atrioventricular septal defect (CAVSD) repair was performed on 163 patients (5.6 ± 3.0 months) with Down Syndrome (DS) using the single-patch (n = 40) and the two-patch (n = 123) methods. The control group consisted of 214 infants aged 6.49 ± 3.03 months with CAVSD and normal karyotype. A retrospective cohort study was made, as well as a comparative analysis of the immediate (up to 30 days) and long-term (12-75 months, at the average of 56 ± 15) results of the repair of CAVSD in infants with DSand normal karyotype/chromosome set (NK). During the hospital treatment period, we registered the following complications: pulmonary hypertensive crises in 6 % (n = 9) of patients with DS and in 10 % (n = 21) of infants with NK, infectious complications in 21% (n = 34) of patients with DS and in 8% (n = 17) of infants with NK. Squeal structures in groups were differentiated. The doses and duration of cardiotonic support in the NK patients were significantly higher in comparison with the DS patients (7.5 ± 2.1 days vs 3.4 ± 1.15 days, p Down syndrome. Concerning the long-term results, there was no significant difference (Gehan-Wilcoxon test) in actuarial freedom from reoperation after repair of CAVSD between DS and NK groups (p Down Syndrome in patients significantly increases the risk of severe co-morbidities that have a significant impact on the recovery period, as well as on life expectancy even after successful CHD correction. PMID:25099029

  18. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

    2013-11-01

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

  19. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure

  20. Combined management of retroperitoneal sarcoma with dose intensification radiotherapy and resection: Long-term results of a prospective trial.

    LENUS (Irish Health Repository)

    Smith, Myles J F

    2014-01-07

    Late failure is a challenging problem following resection of retroperitoneal sarcoma (RPS). We investigated the effects of preoperative XRT plus dose escalation with early postoperative brachytherapy (BT) on long-term survival and recurrence in RPS.

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

    Science.gov (United States)

    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

  2. Long-term results from a randomized phase II trial of neoadjuvant combined-modality therapy for locally advanced rectal cancer

    International Nuclear Information System (INIS)

    This study evaluated the effectiveness and safety of preoperative chemoradiotherapy with capecitabine in patients with locally advanced resectable rectal cancer. This report summarizes the results of the phase II study together with long-term (5-year) follow-up. Between June 2004 and January 2005, 57 patients with operable, clinical stage II-III adenocarcinoma of the rectum entered the study. Radiation dose was 45 Gy delivered as 25 fractions of 1.8 Gy. Concurrent chemotherapy with oral capecitabine 825 mg/m2 twice daily was administered during radiotherapy and at weekends. Surgery was scheduled 6 weeks after the completion of the chemoradiotherapy. Patients received four cycles of postoperative chemotherapy comprising either capecitabine 1250 mg/m2 bid days 1-14 every 3 weeks or bolus i.v. 5-fluorouracil 425 mg/m2/day and leucovorin 20 mg/m2/day days 1-5 every 4 weeks (choice was at the oncologist's discretion). Study endpoints included complete pathological remission, proportion of R0 resections and sphincter-sparing procedures, toxicity, survival parameters and long-term (5-year) rectal and urogenital morbidity assessment. One patient died after receiving 27 Gy because of a pulmonary embolism. Fifty-six patients completed radiochemotherapy and had surgery. Median follow-up time was 62 months. No patients were lost to follow-up. R0 resection was achieved in 55 patients. A complete pathological response was observed in 5 patients (9.1%); T-, N- and overall downstaging rates were 40%, 52.9% and 49.1%, respectively. The 5-year overall survival rate, recurrence-free survival, and local control was 61.4% (95% CI: 48.9-73.9%), 52.4% (95% CI: 39.3-65.5%), and 87.4% (95% CI: 75.0-99.8%), respectively. In 5 patients local relapse has occurred; dissemination was observed in 19 patients and secondary malignancies have occurred in 2 patients. The most frequent side-effect of the preoperative combined therapy was dermatitis (grade 3 in 19 patients). The proportion of

  3. Hydrogeological characterization based on the results of long term monitoring in the Mizunami Underground Research Laboratory Project

    Science.gov (United States)

    Takeuchi, R.; Ohyama, T.; Matsuoka, T.; Saegusa, H.; Takeuchi, S.

    2009-12-01

    The Mizunami Underground Research Laboratory (MIU) is now under construction by the Japan Atomic Energy Agency in the Cretaceous Toki granite in the Tono area of central Japan. Conceptual design of the MIU consists of two 1,000 m shafts (the Main Shaft and the Ventilation Shaft) and horizontal research galleries. The MIU project is a broad scientific study of the deep geological environment as a base for the research and development for geological disposal of nuclear wastes. One of the main goals is to establish comprehensive techniques for investigation, analysis and assessment of the deep geological environment in fractured crystalline rock. The project is being implemented in three overlapping phases: Surface-based Investigation (Phase I), Construction (Phase II) and Operation (Phase III), with a total duration of 20 years. In Phase I, surface investigations were carried out in a stepwise manner in order to obtain information of the geological environment at the site scale (about 2km square). Geological modeling and simulations of various kinds had been carried out in order to synthesize these investigation results. Two NNW-trending faults, which are important for hydrogeological characterization, are included in the model. One of the faults (fault A) strikes through the site in the immediate vicinity of the Main Shaft and another fault (fault B) strikes through the southern part of the MIU construction site. In Phase II, field investigations have been carried out in and around the MIU construction site. For hydrogeological characterization, long term monitoring of hydraulic pressure, surface tilt and self-potential have been carried out on surface and in the research galleries to obtain information on changes of groundwater flow due to shaft excavation. The results of the long term monitoring focused on fault A are as follows: - The hydraulic pressure responses are observed in surface boreholes in and around the MIU construction site and the galleries. The

  4. Long-term results of oncoplastic breast surgery with latissimus dorsi flap reconstruction: a pilot study of the objective cosmetic results and patient reported outcome

    OpenAIRE

    Kim, Kyeong-Deok; Kim, Zisun; Kuk, Jung Cheol; Jeong, Jaehong; Choi, Kyu Sung; Hur, Sung Mo; Jeong, Gui Ae; Chung, Jun Chul; Cho, Gyu Seok; Shin, Eung Jin; Kim, Hyung Chul; Kang, Sang-Gue; Lee, Min Hyuk; Lim, Cheol Wan

    2016-01-01

    Purpose The goal of oncoplastic breast surgery is to restore the appearance of the breast and improve patient satisfaction. Thus, the assessment of cosmetic results and patient-reported outcomes (PROs) using appropriately constructed and validated instruments is essential. The aim of the present study was to assess the long-term objective cosmetic results and corresponding PROs after oncoplastic breast surgery. Methods Cosmetic results were assessed by the patients, a medical panel, and a com...

  5. Off-pump anteroapical aneurysm plication for left ventricular post-infarction aneurysm: long-term results

    Institute of Scientific and Technical Information of China (English)

    HUANG Xin-sheng; ZHOU Qi-wen; GU Cheng-xiong; YANG Jun-feng; WEI Hua; LI Jing-xing; YU Yang; FANG Ying; LIU Rui; LI Hai-tao

    2012-01-01

    Background The temporal response to off-pump anteroapical aneurysm plication has not been well defined.We have evaluated the long-term clinical and functional results of this technique and compared the efficacy with the patch modeling repair.Methods From March 2005 to May 2010,163 (115 men and 48 women) consecutive patients were operated on for post-infarction left ventricular aneurysm (LVA),54 patients underwent patch remodeling (group A) and 109 patients underwent off-pump anteroapical aneurysm plication repair (group B).All patients had simultaneous coronary revascularization,other operative procedures included septoplasty in eight and ablation of ventricular tachycardia in six.Follow-up ranged from 1 to 5 years,short-term and mid-term outcomes,including complications,cardiac function,and mortality,were assessed.Results Early mortality was 1.8% for all patients (group A 1 death vs.group B 2 deaths,not significant (NS)).Peri-operative support included intraaortic balloon pumping in 16 (9.8%),(group A 6 patients vs.group B 10 patients,NS)and inotropic drugs in 84 (51.5%),(group A 34 vs.group B 50,NS).During a mean follow-up of (3.7±0.8) years,eight patients died,with four due to cardiac-related causes.No patient required transplantation,and two required use of an implantable cardioverter-defibrillator for ventricular tachycardia.Survival at 1 and 5 years was 95% and 86%,respectively.It did not differ significantly between group A and group B.Functional class improved from 2.90±0.59 to 1.65±0.54 among the mid-term survivors (P <0.001),with no significant difference between the two groups.Pre-operative risk factors for mortality or poor function were ejection fraction (EF) <0.35 (OR=7.9,95% CI 1.6-40.0); congestive heart failure (CHF) (OR=4.4,95% CI 1.0-19.0); end-systolic volume index (ESVI) >80 ml/m2 (OR=3.7,95% C/ 1.0-14.0); and advanced age >70 years (OR=2.4,95% C/ 1.0-12.0).Conclusions The technique of off-pump anteroapical aneurysm

  6. Total hysterectomy and anterior vaginal wall suspension for concurrent uterine and bladder prolapses: Long-term anatomical results of additional vault and/or posterior compartment prolapse repair

    Directory of Open Access Journals (Sweden)

    Dominic Lee

    2015-03-01

    Conclusion: At long-term follow-up, nearly one in five apical recurrences in these two surgical groups was observed with stable results in the anterior compartment. The posterior compartment required the least surgical intervention.

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

    Science.gov (United States)

    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

  8. Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Gunderson Ragnhild

    2011-08-01

    Full Text Available Abstract Background It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. Methods 272 (78% of 360 patients, 251 (92% women, responded to follow-up examination at a mean of 24.7 (range 16 - 32 years after Boston brace treatment. Fifty-eight (21% patients had late-onset juvenile and 214 had adolescent idiopathic scoliosis. All patients had clinical and radiological examination and answered a standardised questionnaire including work status, demographics, General Function Score (GFS (100 - worst possible and Oswestry Disability Index (ODI (100 - worst possible, EuroQol (EQ-5D (1 - best possible, EQ-VAS (100 - best possible, and Scoliosis Research Society - 22 (SRS - 22 (5 - best possible. Results The mean age at follow-up was 40.4 (31-48 years. The prebrace major curve was in average 33.2 (20 - 57°. At weaning and at the last follow-up the corresponding values were 28.3 (1 - 58° and 32.5 (7 - 80°, respectively. Curve development was similar in patients with late-onset juvenile and adolescent start. The prebrace curve increased > 5° in 31% and decreased > 5° in 26%. Twenty-five patients had surgery. Those who did not attend follow-up (n = 88 had a lower mean curve at weaning: 25.4 (6-53°. Work status was 76% full-time and 10% part-time. Eighty-seven percent had delivered a baby, 50% had pain in pregnancy. The mean (SD GFS was 7.4 (10.8, ODI 9.3 (11.0, EQ-5D 0.82 (0.2, EQ-VAS 77.6 (17.8, SRS-22: pain 4.1 (0.8, mental health 4.1 (0.6, self-image 3.7 (0.7, function 4.0 (0.6, satisfaction with treatment 3.7 (1.0. Surgical patients had significantly reduced scores for SRS-physical function and self-image, and patients with curves ≥ 45° had reduced self-image. Conclusion Long-term results were

  9. The long-term clinical and MRI results following eccentric calf muscle training in chronic Achilles tendinosis

    Energy Technology Data Exchange (ETDEWEB)

    Gaerdin, Anna; Shalabi, Adel [Karolinska University Hospital/Huddinge, Departments of Radiology, Karolinska Institutet, Clintec, Stockholm (Sweden); Movin, Tomas [Karolinska University Hospital/Huddinge, Karolinska Institutet, Departments of Orthopedics, Stockholm (Sweden); Svensson, Leif [Karolinska Institutet, Karolinska University Hospital/Huddinge, Departments of Medical Physics, Stockholm (Sweden)

    2010-05-15

    To evaluate the long-term results following eccentric calf-muscle training in patients with chronic Achilles tendinopathy. A total of 24 patients with chronic Achilles tendinopathy were included in a study evaluating MRI findings and clinical symptoms before and after 3 months of daily eccentric calf-muscle strength training. Median duration of symptoms was 18 months (range 6-120). Four of the patients did not perform the prescribed treatment for different reasons and were followed for 14 months. The resulting 20 treated patients completed 4.2-year (range 29-58 months) follow up. Tendon volume was evaluated by using 3D seed growing technique and signal abnormalities were visually semi-quantitatively graded. Level of pain and performance was categorized using a questionnaire completed by the patient. In the symptomatic treated patients, median intensity level of pain decreased from moderate/severe at time of inclusion to mild at follow up (p < 0.05). Median level of performance increased from severe impairment at time of inclusion to normal at follow up (p < 0.05). 12 out of 20 patients had raised intratendinous signal at time of inclusion compared to 2 out of 20 patients at follow up (p < 0.001). Mean tendon-volume measured 6.7 cm{sup 3} (SD 2.0) at time of inclusion and 6.4 cm{sup 3} (SD 2.0) at follow up (p = 0.18). The four symptomatic non-treated tendons did not improve regarding pain, performance, intratendinous signal or tendon volume. We found decreased pain, improved performance and decreased intratendinous signal both compared to index examination and immediately after the 3 months training regimen in a 4.2-year clinical and MRI follow up, in a group of patients treated with heavy loaded eccentric calf-muscle training for chronic Achilles tendinopathy. The improvements were greater at 4.2-year follow up, despite no further active treatment, than immediately after the treatment. This may indicate a good long-term prognosis for Achilles tendinosis patients

  10. Long-term use of doxycycline can improve chronic asthma and possibly remodeling: the result of a pilot observation

    Directory of Open Access Journals (Sweden)

    Bhattacharyya P

    2012-08-01

    Full Text Available Parthasarathi Bhattacharyya, Rantu Paul, Partha Bhattacharjee, Arko Ghosh, Ratna Dey, Malabika Ghosh, Madan SharmaInstitute of Pulmocare and Research, CB 16, Salt Lake, Sector 1, Kolkata-700064, IndiaAbstract: Progressive loss of lung function and reversibility characterize chronic asthma. The conventional therapy is targeted to control the disease without targeting the loss of lung function or reversibility. In a prospective real-world observation of long-term use of add-on doxycycline as a matrix-metalloproteinase inhibitor, we documented significant improvement in lung function with possible reversal of remodeling.Background: Chronic asthma shows progressive decline in lung function with reduction or even loss of reversibility secondary to remodeling. A set of endopeptidase enzymes known as matrix metalloproteinases are intimately related to the pathogenesis of asthma and remodeling. The inhibition of matrix metalloproteinases is recognized as a prospective way of treating asthma and its corresponding structural remodeling.Methods: In a randomized, prospective, real-world study, we have observed the change in lung function (spirometry with an add-on of long-term doxycycline to standard asthma therapy as per the Global Initiative for Asthma guidelines in a small asthmatic population. The change in terms of forced expiratory volume (FEV1, forced vital capacity (FVC, percent of FEV1 (FEV1%, and forced expiratory flow (FEF25–75 were noted following variable duration of doxycycline therapy.Results: There has been a global improvement in all the parameters in all the six patients suggesting improvement in obstruction, and reduction in air trapping following a treatment of add-on doxycycline for a mean duration of 162.83 ± 83.07 days. Of the changes seen, the post bronchodilator FEV1, the FVC, and the FEF25–75 showed significant improvements with the P-value set at 0.004, 0.054, and 0.031, respectively. There was also evidence of the reversal

  11. Long term effectiveness on prescribing of two multifaceted educational interventions: results of two large scale randomized cluster trials.

    Directory of Open Access Journals (Sweden)

    Nicola Magrini

    Full Text Available 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

  12. Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases

    Directory of Open Access Journals (Sweden)

    Huang HL

    2016-05-01

    Full Text Available Hsuan-Li Huang,1 Jyh-Ming Jimmy Juang,2 Hsin-Hua Chou,1,3 Chien-An Hsieh,1 Shih-Jung Jang,1 Shih-Tsung Cheng,1,3 Yu-Lin Ko1,3 1Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, 2Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, 3School of Medicine, Tzu Chi University, Hualien, Taiwan Purpose: To investigate the clinical outcomes of endovascular therapy (EVT in octogenarians and nonoctogenarians with peripheral arterial disease. Methods: A retrospective analysis of 511 patients (654 affected legs who underwent EVT between July 2005 and December 2013 was conducted in a prospectively maintained database. Immediate results and long-term vascular outcomes were analyzed and compared between octogenarians and nonoctogenarians. Results: Octogenarians were more likely to be female and have atrial fibrillation (AF, whereas nonoctogenarians had higher rates of obesity, claudication, and medical comorbidities. There were no differences in the rates of EVT success, 30-day major adverse vascular events, and 6-month functional improvement between groups. Over the 10-year follow-up period, the rates of 3-year limb salvage, sustained clinical success, freedom from major cerebrovascular and cardiovascular events, and composite vascular events were similar between groups, but the survival rate was better in nonoctogenarians than in octogenarians (73% vs 63%, respectively, P=0.004. In Cox regression analysis, dependence on dialysis and AF were significant predictors of death (odds ratio [OR] 4.44 in dialyzed and 2.83 in AF patients, major cerebrovascular and cardiovascular events (OR 3.49 and 2.45, and composite vascular events (OR 3.14 and 2.25. Conclusion: EVT in octogenarians was feasible, without an increased risk of periprocedural complications. The

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

    Directory of Open Access Journals (Sweden)

    E M Swart

    Full Text Available 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.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.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.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 clustered orthodox Protestant community

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

    Science.gov (United States)

    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.

  15. Mid-Long Term Results in the Arthroscopic Selective Capsular Release and Manipulation Treatment of Frozen Shoulder

    Science.gov (United States)

    Celik, Haluk; Seckin, Mustafa Faik; Kara, Adnan; Camur, Savas; Kilinc, Eray; Akman, Senol

    2014-01-01

    Objectives: Our aim was to present mid-long term functional outcomes of patients who underwent arthroscopic selective capsular release and manipulation for frozen shoulder refractory to conservative treatment. Methods: Between 2006 and 2012, 32 patients presented to our clinic with the diagnosis of frozen shoulder. 24 shoulders of 22 patients treated with arthroscopic selective capsular release and manipulation were included in the study. Functional results were analyzed with Constant shoulder score. The mean follow-up was 4.3 years (range 1-7 years). Results: We detected an average increase in passive range of motion in flexion 72°, abduction 90°, abduction-internal rotation 33°, and abduction-external rotation 38°, adduction-external rotation at 37° compared to the preoperative status. Constant shoulder score increased by an average of 44 points after surgery. Eighteen (82%) patients were satisfied with the operation. Three of four patients whose symptoms persisted had resistant diabetes mellitus. Conclusion: Frozen shoulder is one of the most well-known causes of shoulder pain and disability. Although surgery has a good rate of success it does not help in all cases. Unsatisfactory results may be experienced in patients who have diabetes mellitus as a confounding factor.

  16. Long-term results of Troidl's technique of endoscopic pneumatic dilatation for achalasia of the esophagus. A prospective clinical trial.

    Science.gov (United States)

    Eypasch, E; Troidl, H; Sommer, H; Vestweber, K H

    1987-01-01

    In a prospective clinical trial, 26 consecutive patients underwent endoscopic pneumatic dilatation over a 10-year period. Dilatation was achieved by means of a balloon attached to a normal gastrointestinal fiberscope. With the endoscope in an inverse position, the device was placed in the cardia and the dilatation process was monitored macroscopically. Before dilatation, patients suffered from dysphagia (92%), reduced speed of swallowing (100%), symptom aggravation under stress (73%), weight loss (50%), aspiration, pain, regurgitation, and vomiting. After dilatation and long-term follow-up (mean of 5 years), symptoms could be markedly reduced, especially the speed of eating and symptom aggravation under stress. Excellent and good results (Visick scale) were achieved in 76%. Fair results were achieved in 20%. To date, perforation and other complications have not occurred. Mortality was zero. Our series was an uncontrolled trial, so the results are hardly comparable to other studies. Furthermore, the small number of patients in our study represents a weak point with regard to complications. We conclude that the main advantages of the procedure are its simplicity and practicability. The simple procedure may be the method of choice in elderly patients. Of course, no final decision can be made until a well-designed controlled trial has been carried out.

  17. Epicondylopathia humeri (EPH) and peritendinitis humeroscapularis (PHS): evaluation of radiation therapy long-term results and literature review

    International Nuclear Information System (INIS)

    Background: The effectiveness of radiotherapy (RT) for degenerative inflammatory disorders has been clinically documented in historical studies, but long-term follow-up and assessment with objective criteria are still not available. Patients and methods: From 1986 to 1991, 200 consecutive patients with symptomatic epicondylopathia humeri (EPH, n=104) and peritendinitis humeroscapularis (PHS, n=96) were referred to our clinic. All patients were refractory to conventional therapy prior to irradiation. One hundred fifty-six patients with 192 sites (due to bilateral symptoms) received a full treatment course and were available for long-term follow-up, i.e. 83 patients with 93 elbows and 73 patients with 89 shoulders. The treatment response was evaluated with regard to pain symptoms grouped into five categories (pain at strain, pain at night, persistent pain during daytime, pain at rest and morning stiffness) and four grades (none, mild, moderate and severe) and with regard to established orthopedic scores (Morrey score and Constant and Murley score). The analysis was performed before and 6 weeks after RT and at last follow-up. All joints received two RT series applied in three weekly fractions (EPH, 6x1 Gy (total 12 Gy); PHS, 6x0.5 Gy (total 6 Gy)). The second RT series started 6 weeks after the first RT series. The minimum follow-up was 1 year for both groups and the mean follow-up reached 4 years (range 1-8 years). Results: Fifty elbows (43 patients) and 44 shoulders (39 patients) achieved complete pain relief in all pain categories; 24 elbows and 28 shoulders substantially improved, i.e. had only minor symptoms. Thus, 74 elbows and 72 shoulders responded to RT. Nineteen elbows (17 patients) had surgery after RT due to persisting symptoms or subjective dissatisfaction; 17 shoulders (12 patients) were non-responders and five of those were operated on; seven elbows and one shoulder were completely free of pain after surgery. The mean Morrey score improved by 18 points

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  20. Immediate endoscopic management of complete iatrogenic anterior urethral injuries: A case series with long-term results

    Directory of Open Access Journals (Sweden)

    Maheshwari Pankaj N

    2005-11-01

    Full Text Available Abstract Background Urethral injury produces partial or complete disruption of the urethral integrity. Advances in endourology have made endoscopic management of most of these injuries feasible without greatly compromising the final result. We report our institutional experience of immediate endoscopic realignment of complete iatrogenic anterior urethral injury. Methods From May 1997 to May 2003, seven patients with complete anterior urethral disruption were managed by immediate endoscopy guided splinting of urethra. Retrograde urethroscopy, combined with fluoroscopic guidance and in some cases antegrade cystoscopy through a suprapubic stab cystostomy was performed. A guide wire was negotiated across the disruption. Later, a 16 F Foley catheter was placed for 1–3 weeks. Patients were followed up at 1, 3, 6 and 12 months and then yearly to assess the long-term outcome of endoscopic management. Results Immediate endoscopic realignment was achieved in all patients. Three patients developed recurrence at six months; that was treated by optical urethrotomy. Only one patient developed multiple recurrences over an average follow-up of 49.2 months (range 7 to 74 months. He was offered open end-to-end urethroplasty at twenty months after third recurrence. Thus immediate endoscopic realignment avoided any further intervention in four patients (57.14%; while after an additional optical urethrotomy, urethroplasty could be avoided in six patients (87.2%. Conclusion Immediate endoscopic realignment of traumatic urethral disruption is a feasible, safe and effective treatment modality for management of patients with iatrogenic complete anterior urethral injuries.

  1. Impaired decision making on the Balloon Analogue Risk Task as a result of long-term alcohol use.

    Science.gov (United States)

    Campbell, James A; Samartgis, Jodi R; Crowe, Simon F

    2013-01-01

    The Balloon Analogue Risk Task (BART) is an experimental measure of risk taking that has commonly been employed to measure the risk taking behavior of nonclinical populations. Previous research has indicated that the task measures a unique aspect of behavioral disinhibition, but there has not as yet been focus upon the possible impact of other aspects of cognitive processing on performance. The current study investigated the cognitive factors related to performance of the BART in an alcohol-using sample. Seventeen individuals with long-term alcohol use were matched for age and education to a group of 17 nonusing participants. The results indicated that the alcohol-using group pumped the balloons on the BART to a lesser extent than did the nonusing group across all trials on the task. The results indicate that the alcohol-using group made less "optimal" decisions on the BART most notably due to neuropsychological impairment in the domains of immediate memory and executive functioning. PMID:24215387

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Stecher, D. [IBACOS, Inc., Pittsburgh, PA (United States); Brozyna, K. [IBACOS, Inc., Pittsburgh, PA (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Bixler, Nathan E.; Osborn, Douglas.; 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).

  5. Endovascular internal carotid artery trapping for ruptured blood blister-like aneurysms: long-term results from a single centre

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Byong-Cheol [Dongguk University Ilsan Hospital, Department of Neurosurgery, Goyang (Korea, Republic of); Kwon, O-Ki; Oh, Chang Wan; Bang, Jae Seung; Hwang, Gyojun [Seoul National University Bundang Hospital, Department of Neurosurgery, Seongnam, Gyeonggi (Korea, Republic of); Jin, Sung-Chul [Inje University Haeundae Paik Hospital, Department of Neurosurgery, Busan (Korea, Republic of); Park, Hyun [Gyeongsang National University Hospital, Department of Neurosurgery, Gyeongsangnam-do (Korea, Republic of)

    2014-03-15

    Endovascular internal carotid artery (ICA) trapping was performed to treat ruptured blood blister-like aneurysms (BBAs). The aim of this study was to evaluate the procedural risks and long-term follow-up results. The records of 11 consecutive patients with BBAs who underwent endovascular ICA trapping between 2005 and 2010 were reviewed. Clinical outcomes were assessed with modified Rankin Scale (mRS) scores. Endovascular ICA trapping was performed in 11 patients as either the primary treatment (7 patients) or the secondary treatment (4 patients) after the patient underwent other treatments. Three patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass when balloon test occlusion (BTO) revealed inadequate collateral circulation. In the primary ICA trapping group (seven patients), six patients had good outcomes (mRS 0 in five, mRS 1 in one), and one patient had a poor outcome (mRS 6: dead). In the secondary ICA trapping group (four patients), two patients had good outcomes (mRS 0), and two patients had poor outcomes (mRS 4, 5). All ten of the surviving patients were clinically stable during the follow-up period (mean 39 months). A radiological follow-up of nine patients (mean 22 months) demonstrated stable occlusion, with the exception of one reopening of the ICA because of coil migration. Perfusion studies of nine patients (mean: 23 months) demonstrated no perfusion decrease. Endovascular ICA trapping is an effective and durable treatment for BBAs. (orig.)

  6. Treatment and long-term results in children with acute myeloid leukaemia treated according to the AIEOP AML protocols.

    Science.gov (United States)

    Pession, A; Rondelli, R; Basso, G; Rizzari, C; Testi, A M; Fagioli, F; De Stefano, P; Locatelli, F

    2005-12-01

    Since 1982, four consecutive studies on childhood acute myeloid leukaemia (AML) (namely LAM-82, -87, -87M and -92) have been conducted in Italy by the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP) group. The induction therapy of the first three studies consisted of daunorubicin and cytarabine structured in a 3+7 backbone. In the most recent protocol (LAM92), patients received two induction courses including idarubicin, cytarabine and etoposide. Patients with acute promyelocytic leukaemia (20% of diagnoses) were included in LAM-87 and 87M studies. Postremissional therapy significantly changed over time, with an ever-increasing role given to stem cell transplantation (SCT). The long-term outcome of patients enrolled in the LAM-82, 87 and 87M studies was comparable, whereas that of children treated according to LAM-92 study was significantly better (P<0.005). Either allogeneic or autologous SCT was employed as consolidation therapy in more than 75% of cases enrolled in this latter study. Patients enrolled in the LAM-92 study were stratified in standard and high-risk groups with different outcome (67 vs 47%, respectively, P=0.04). Altogether, the results obtained in these four studies have permitted a progressive refinement of treatment, contributing to the structure of the ongoing LAM-2002 protocol that stratifies patients according to the presence of definite genetic anomalies and response to induction therapy.

  7. Endovascular internal carotid artery trapping for ruptured blood blister-like aneurysms: long-term results from a single centre

    International Nuclear Information System (INIS)

    Endovascular internal carotid artery (ICA) trapping was performed to treat ruptured blood blister-like aneurysms (BBAs). The aim of this study was to evaluate the procedural risks and long-term follow-up results. The records of 11 consecutive patients with BBAs who underwent endovascular ICA trapping between 2005 and 2010 were reviewed. Clinical outcomes were assessed with modified Rankin Scale (mRS) scores. Endovascular ICA trapping was performed in 11 patients as either the primary treatment (7 patients) or the secondary treatment (4 patients) after the patient underwent other treatments. Three patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass when balloon test occlusion (BTO) revealed inadequate collateral circulation. In the primary ICA trapping group (seven patients), six patients had good outcomes (mRS 0 in five, mRS 1 in one), and one patient had a poor outcome (mRS 6: dead). In the secondary ICA trapping group (four patients), two patients had good outcomes (mRS 0), and two patients had poor outcomes (mRS 4, 5). All ten of the surviving patients were clinically stable during the follow-up period (mean 39 months). A radiological follow-up of nine patients (mean 22 months) demonstrated stable occlusion, with the exception of one reopening of the ICA because of coil migration. Perfusion studies of nine patients (mean: 23 months) demonstrated no perfusion decrease. Endovascular ICA trapping is an effective and durable treatment for BBAs. (orig.)

  8. Nitrous Oxide Production at a Fully Covered Wastewater Treatment Plant: Results of a Long-Term Online Monitoring Campaign.

    Science.gov (United States)

    Kosonen, Heta; Heinonen, Mari; Mikola, Anna; Haimi, Henri; Mulas, Michela; Corona, Francesco; Vahala, Riku

    2016-06-01

    The nitrous oxide emissions of the Viikinmäki wastewater treatment plant were measured in a 12 month online monitoring campaign. The measurements, which were conducted with a continuous gas analyzer, covered all of the unit operations of the advanced wastewater-treatment process. The relation between the nitrous oxide emissions and certain process parameters, such as the wastewater temperature, influent biological oxygen demand, and ammonium nitrogen load, was investigated by applying online data obtained from the process-control system at 1 min intervals. Although seasonal variations in the measured nitrous oxide emissions were remarkable, the measurement data indicated no clear relationship between these emissions and seasonal changes in the wastewater temperature. The diurnal variations of the nitrous oxide emissions did, however, strongly correlate with the alternation of the influent biological oxygen demand and ammonium nitrogen load to the aerated zones of the activated sludge process. Overall, the annual nitrous oxide emissions of 168 g/PE/year and the emission factor of 1.9% of the influent nitrogen load are in the high range of values reported in the literature but in very good agreement with the results of other long-term online monitoring campaigns implemented at full-scale wastewater-treatment plants. PMID:27218458

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

    Science.gov (United States)

    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.

  10. The role of long-term doxycycline in patients of idiopathic pulmonaryfibrosis: The results of an open prospective trial

    Directory of Open Access Journals (Sweden)

    Bhattacharyya Parthasarathi

    2009-01-01

    Full Text Available Objective: To evaluate the effect of long term use of doxycycline in IPF patients. Materials and Methods: Patients of IPF, selected randomly from out patient services and diagnosed on the basis of HRCT chest, were put on doxycycline in an open prospective trial. They were followed up with monitoring of subjective well being along with measurement of pulse rate and arterial oxygen saturation at rest and after a fixed and certain exercise, forced vital capacity, six minutes walk test, St Georges Respiratory questionnaire, and serial chest X-rays. Results: Out of seven patients put on doxycycline, six of them continued the drug for a mean period of 531.43 (± 328.88 days. All the patients tolerated the drug well and had shown uniform subjective and overall objective improvement in all the parameters concerned; the change in the radiological parameter being statistically significant. Conclusion: Doxycycline merits an appropriate clinical trial in the management of idiopathic pulmonary fibrosis. This widely used and relatively safe drug can add a new dimension to the therapeutic regimen. However, further in-depth studies will be required to evaluate its role in the management of IPF.

  11. The influence of periportal (pipestem fibrosis on long term results of surgical treatment for schistosomotic portal hypertension

    Directory of Open Access Journals (Sweden)

    Ferraz Álvaro Antônio Bandeira

    2003-01-01

    Full Text Available AIM: To evaluate the degree of influence that periportal fibrosis has on clinical development and the long term results of surgical treatment on patients with hepatic-splenic schistosomiasis with previous gastrointestinal hemorrhages. METHODS: During the period of 1992-1998, 111 patients underwent surgical treatment for the treatment of hepatic-splenic schistosomiasis with previous gastrointestinal hemorrhages. The degree of fibrosis was classified as: degree I - the portal spaces show a rich increase of young connective cells, a slight collagen production and a varying presence of inflammatory infiltrate. The periportal blade unchangeable (29/111; degree II - there is an expansion of the connective tissue with the emission of radial collagen septa, producing a star shaped aspect (38/111; degree III - the connective septa form bridges with other portal spaces or with the vein, with evident angiomatoid neo-formation (44/111. CONCLUSION: The patients with periportal fibrosis degree I present recurrent hemorrhages statistically less than patients with periportal fibrosis degrees II and III, and that the intensity of the periportal fibrosis is not the only pathophysiological factor of the esophageal varices, gastric varices, prevalence of post-operative portal vein thrombosis and hematological and biochemical alterations of the patients with pure mansoni schistosomiasis.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    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.

  15. Post-assessment of pre-stressed containment structures by evaluation of monitored long term deformation results

    International Nuclear Information System (INIS)

    The comparison of monitored long term deformations of containment structures with calculated values achieved by using design material parameters shows occasionally considerable deviations, partly caused by conservative assumptions in the containments design phase. Systematic post-assessment and adaption of the decisive parameters attains better coincidence. In the present investigation measured long-term deformations are first of all compared to pre-calculated values based on the material parameters defined in the design phase. Afterwards, the deformations deviations are minimized by repeating the calculation with assessed material parameters. This method appears to be a suitable method to predict the future containment structure long-term behavior and to achieve a possible life-time extension. The presented investigation was performed as part of NUGENIA ACCEPPT project which researches the ageing of concrete containment structures in nuclear power plants

  16. Long Term Follow up Results of the Arthroscopic Treatment of the Talus Osteochondral Lesions (Tol) and the Factors that Effect Results

    OpenAIRE

    Gökkuş, Kemal; Aydın, Ahmet Turan

    2014-01-01

    Objectives: The arthroscopic debritment, curettage and multidrilling /microfracture is well known and established method of treatment. However the factors that effect prognosis is still controversy at recent literature. The aim of this study is to present and evaluate the factors that effects the long term follow up results of our patients. Methods: 56 patients who admitted to our clinic with chronic ankle pain and diagnosed as TOL treated with arthroscopic debritement, curettage and multidri...

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

    OpenAIRE

    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 intrigu...

  18. Impact of burnout and psychosocial work characteristics on future long-term sickness absence. Prospective results of the Danish PUMA-study among human service workers

    DEFF Research Database (Denmark)

    Borritz, Marianne; Christensen, KB; Rugulies, R;

    2010-01-01

    Objectives: The objective of this study was to examine if burnout and psychosocial factors predicted long-term sickness absence (>2 weeks) at work unit level. Methods: Data were collected prospectively at 82-work units in human services (PUMA cohort, PUMA: Danish acronym for Burnout, Motivation...... and Job satisfaction) followed up during the proceeding 18 months regarding onset of long-term sickness absence. Questionnaire data regarding burnout and psychosocial factors were aggregated at work unit level. We used Poisson regression models with psychosocial factors and burnout as predictors of long......-term sickness absence for more than 18 months based on data from a national absence register. Results: Long-term sickness absence was predicted by psychosocial factors and by burnout at work unit level. Conclusion: To reduce sickness absence, organizations within human services should improve the psychosocial...

  19. Mexico's long-term energy outlook : results of a detailed energy supply and demand simulation

    Energy Technology Data Exchange (ETDEWEB)

    Conzelmann, G. [Argonne National Laboratory, Argonne, IL (United States); Quintanilla, J. [Nacional de Autonoma de Mexico Univ., Mexico City (Mexico). Direccion General de Servicios de Computo Academico; Aguilar, V. [Secretaria de Energia, Mexico City (Mexico); Conde, L.A. [Inst. Nacional de Ecologia, Mexico City (Mexico); Fernandez, J. [Comision Federal de Electricidad, Mexico City (Mexico); Mar, E. [Inst. Mexicano del Petroleo, Mexico City (Mexico); Martin del Campo, C.; Serrato, G.; Ortega, R. [Nacional de Autonoma de Mexico Univ., Mexico City (Mexico). Facultad de Ingenieria

    2006-04-15

    This article discussed the results of a bottom-up analysis of Mexico's energy markets which was conducted using an energy and power evaluation program. The program was used to develop energy market forecasts to the year 2025. In the first phase of the study, dynamic optimization software was used to determine the optimal, least-cost generation system expansion path to meet growing demand for electricity. A separate model was used to determine the optimal generating strategy of mixed hydro-thermal electric power systems. In phase 2, a nonlinear market-based approach was used to determine the energy supply and demand balance for the entire energy system, as well as the response of various segments of the energy system to changes in energy price and demand levels. Basic input parameters included information on the energy system structure; base-year energy statistics; and, technical and policy constraints. A total of 14 scenarios were modelled to examine variations in load growth, sensitivities to changes in projected fuel prices, variations in assumed natural gas availability, system reliability targets, and the potential for additional nuclear capacity. Forecasts for the entire energy system were then developed for 4 scenarios: (1) reference case; (2) limited gas scenario; (3) renewable energy; and (4) additional nuclear power generation capacity. Results of the study showed that Mexico's crude oil production is projected to increase annually by 1 per cent to 2025. Imports of petroleum products resulting from the country's rapidly growing transportation sector will increase. Demand for natural gas is expected to outpace projected domestic production. The long-term market outlook for Mexico's electricity industry shows a heavy reliance on natural gas-based generating technologies. It was concluded that alternative results for a constrained-gas scenario showed a substantial shift to coal-based generation and associated effects on the natural gas

  20. Long-term results of non-valved Glaucoma drainage implant surgery and glaucoma drainage implant combined with trabeculectomy

    Directory of Open Access Journals (Sweden)

    Teruhiko Hamanaka

    2014-01-01

    Full Text Available Purpose: The purpose was to investigate the efficacy and complications of nonvalved glaucoma drainage implant (GDI surgery and GDI combined with trabeculectomy. Subjects and Methods: Serial Japanese patients who received GDI were retrospectively investigated. The survival rate of eyes was analyzed using the Kaplan-Meier method, defining death as: (1 Intraocular pressure (IOP <6 mmHg, or ≥22 mmHg, and <20% reduction of preoperative IOP, (2 additional glaucoma surgery, (3 loss of light perception. Prognostic factors of age, sex, previous surgery, type of glaucoma, synechial closure, preoperative IOP, type of GDI (single-, double-plate Molteno, Baerveldt 350 and GDI combined with trabeculectomy were investigated employing proportional hazards analysis. Results: One hundred and twenty-four eyes of 109 patients aged 53.3 ± 7.8 years old were analyzed. Types of GDI were single-plate (15.3%, double-plate Molteno (71.8%, and Baerveldt 350 (12.9%. The results of survival rate analysis were 86.1, 71.1, 71.1, and 64.6% for 1, 3, 5, and 10 years respectively. Thirty-four eyes (27.4% died because of uncontrolled IOP (19.4%, loss of light perception (5.6%, and additional glaucoma surgery (2.4%. Single-plate Molteno was the only risk factor for failure. Persistent unphysiological hypotony (0.8% and bullous keratopathy (5.6% were observed. Conclusion: Nonvalved GDI surgery and GDI combined with trabeculectomy using nonabsorbable tube ligature proved to be an excellent device for any type of glaucoma in Japanese patients. Hypotony and corneal endothelial loss are the most serious complication in the long-term results of our patients.

  1. Clopidogrel plus long-term aspirin after femoro-popliteal stenting. The CLAFS project: 1- and 2-year results

    NARCIS (Netherlands)

    Strecker, E.P.; Boos, I.B.; Gottmann, D.; Vetter, S.

    2004-01-01

    The aim of this study was to determine the patency rate after femoro-popliteal stenting followed by oral clopidogrel plus long-term aspirin. In a prospective trial, 31 patients with a total of 33 femoro-popliteal artery lesions (21 stenoses, 12 occlusions; 24 femoral, 9 popliteal) were treated with

  2. Long-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Schmiegelow, K; Forestier, E; Hellebostad, M;

    2010-01-01

    Analysis of 2668 children with acute lymphoblastic leukemia (ALL) treated in two successive Nordic clinical trials (Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL-92 and ALL-2000) showed that 75% of all patients are cured by first-line therapy, and 83% are long-term survivors...

  3. Whipple's operation for carcinoma of the pancreatic head and the ampullary region. Short-and long-term results

    DEFF Research Database (Denmark)

    Sørensen, M B; Banner, Jytte; Rokkjaer, M;

    1998-01-01

    In this retrospective review short- and long-term perspectives have been evaluated for 108 patients who, during 1982 through 1992, had Whipple's operation performed for carcinoma of the pancreatic head (PC, n=63) or the ampullary region (AC, n=45). In 24 patients the operation was not radical (21...

  4. US-Guided Vacuum-Assisted Biopsy of Microcalcifications in Breast Lesions and Long-Term Follow-Up Results

    Science.gov (United States)

    Kim, Hua Sun; Kim, Eun-Kyung; Kwak, Jin Young; Son, Eun Ju; Oh, Ki Keun

    2008-01-01

    Objective To evaluate the diagnostic accuracy of the use of an ultrasonography (US)-guided vacuum-assisted biopsy for microcalcifications of breast lesions and to evaluate the efficacy of the use of US-guided vacuum-assisted biopsy with long-term follow-up results. Materials and Methods US-guided vacuum-assisted biopsy cases of breast lesions that were performed between 2002 and 2006 for microcalcifications were retrospectively reviewed. A total of 62 breast lesions were identified where further pathological confirmation was obtained or where at least two years of mammography follow-up was obtained. These lesions were divided into the benign and malignant lesions (benign and malignant group) and were divided into underestimated group and not-underestimated lesions (underestimated and not-underestimated group) according to the diagnosis after a vacuum-assisted biopsy. The total number of specimens that contained microcalcifications was analyzed and the total number of microcalcification flecks as depicted on specimen mammography was analyzed to determine if there was any statistical difference between the groups. Results There were no false negative cases after more than two years of follow-up. Twenty-nine lesions were diagnosed as malignant (two invasive carcinomas and 27 carcinoma in situ lesions). Two of the 27 carcinoma in situ lesions were upgraded to invasive cancers after surgery. Among three patients diagnosed with atypical ductal hyperplasia, the diagnosis was upgraded to a ductal carcinoma in situ after surgery in one patient. There was no statistically significant difference in the number of specimens with microcalcifications and the total number of microcalcification flecks between the benign group and malignant group of patients and between the underestimated group and not-underestimated group of patients. Conclusion US-guided vacuum-assisted biopsy can be an effective alternative to stereotactic-guided vacuum-assisted biopsy in cases where

  5. Preoperative radio-chemotherapy in early breast cancer patients: Long-term results of a phase II trial

    International Nuclear Information System (INIS)

    Purpose: This phase II trial aimed to investigate the efficacy of concurrent radio- (RT) and chemotherapy (CT) in the preoperative setting for operable, non-metastatic breast cancer (BC) not amenable to initial breast-conserving surgery (BCS). Patients and methods: From 2001 to 2003, 59 women were included. CT consisted of four cycles of 5-FU, 500 mg/m2/d, continuous infusion (d1–d5) and vinorelbine, 25 mg/m2 (d1 and d6). Starting concurrently with the second cycle, RT delivered 50 Gy to the breast and 46 Gy to the internal mammary and supra/infra-clavicular areas. Breast surgery and lymph node dissection were then performed. Adjuvant treatment consisted of a 16 Gy boost to the tumor bed after BCS, FEC (four cycles of fluorouracil 500 mg/m2, cyclophosphamide 500 mg/m2, and epirubicin 100 mg/m2, d1; d21) for pN1-3 and hormone-therapy for positive hormone receptors BC. Results: The in-breast pathological complete response rate was 27%. BCS was performed in 41 (69%) pts. Overall and distant-disease free survivals at 5 years were respectively 88% [95% CI 80–98] and 83% [95% CI 74–93] whereas locoregional and local controls were 90% [95% CI 82–97] and 97% [95% CI 92–100]. Late toxicity (CTCAE-V3) was assessed in 51 pts (86%) with a median follow-up of 7 years [5–8]. Four (8%) experienced at least one grade III toxicities (one telangectasia and three fibroses). Cosmetic results, assessed in 35 of the 41 pts (85%) who retained their breasts, were poor in four pts (11%). Conclusion: Preoperative concurrent administration of RT and CT is an effective regimen. Long-term toxicity is moderate. This association deserves further evaluations in prospective trials.

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

    International Nuclear Information System (INIS)

    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 cm3 (range, 0.01–35.1 cm3), 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.

  7. Long-term results of Galeazzi-equivalent injuries in adolescents--open reduction and internal fixation of the ulna.

    Science.gov (United States)

    Cha, Soo Min; Shin, Hyun Dae; Jeon, Je Hyung

    2016-03-01

    We diagnosed 10 Galeazzi-equivalent injuries. We report the radiological and clinical results at the end of growth in adolescents, including the results of ulnar lengthening. This study included 10 Galeazzi-equivalent injuries (seven patients requiring open reduction and three requiring closed reduction for ulnar lesions) seen since 2004. The periosteum was entrapped around the fractured physis in five patients and the extensor carpi ulnaris to the periosteum was interposed in two patients. Among the seven patients, ulnar lengthening was performed in only three patients. Ulnar variances at the time of the lengthening were -6, -6, and -5 mm. Gradual lengthening was performed. Radiologic abnormalities, including the ulnar variances, were investigated at the end of growth. In addition, pain scores, the range of wrist motion, and grip strength were evaluated and compared with nonlengthened ulnas. The mean age of the patients at the final follow-up was 19.7 years, and the mean total follow-up period was 6 years. The final ulnar variances were -5, -5, -3, and 0 mm in four patients with nonlengthened ulnas among the seven patients. Three patients with lengthened ulnas showed final neutral variances. In four nonlengthened ulnas, three ulnas bowed to the radial side and two ulnar heads had an inclined and deformed shape. Joint mismatch of the distal radioulnar joint surface was found in one patient with lengthened and one with nonlengthened ulnas. Three patients with nonlengthened ulnas showed decreased range of wrist motions. Comparison of contralateral grip strength indicated a significant difference between patients with or without lengthened ulnas. Long-term follow-up after Galeazzi-equivalent injuries may be essential to check for premature epiphyseal closure, length discrepancies, or joint incongruency. A procedure for a shortened ulna could be needed; however, the appropriate time and degree of lengthening remain to be investigated.

  8. Long-term results of graded pneumatic dilatation under endoscopic guidance in patients with primary esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Ahmet Dobrucali; Yusuf Erzin; Murat Tuncer; Ahmet Dirican

    2004-01-01

    AIM: Achalasia is the best known primary motor disorder of the esophagus in which the lower esophageal sphincter(LES) has abnormally high resting pressure and incomplete relaxation with swallowing. Pneumatic dilatation remains the first choice of treatment. The aims of this study were to determine the long term clinical outcome of treating achalasia initially with pneumatic dilatation and usefulness of pneumatic dilatation technique under endoscopic observation without fluoroscopy.METHODS: A total of 65 dilatations were performed in 43patients with achalasia [23 males and 20 females, the mean age was 43 years (range, 19-73)]. All patients underwent an initial dilatation by inflating a 30 mm balloon to 15 psi under endoscopic control. The need for subsequent dilatation was based on symptom assessment. A 3.5 cm balloon was used for repeat procedures.RESULTS: The 30 mm balloon achieved a satisfactory result in 24 patients (54%) and the 35 mm ballon in 78% of the remainder (14/18). Esophageal perforation as a short-term complication was observed in one patient (2.3%). The only late complication encountered was gastroesophageal reflux in 2 (4%) patients with a good response to dilatation. The mean follow-up period was 2.4 years (6 mo - 5 years). Of the patients studied, 38 (88%) were relieved of their symptoms after only one or two sessions. Five patients were referred for surgery(one for esophageal perforation and four for persistent or recurrent symptoms). Among the patients whose follow up information was available, the percentage of patients in remission was 79% (19/24) at 1 year and54% (7/13) at 5 years.CONCLUSION: Performing balloon dilatation under endoscopic observation as an outpatient procedure is simple, safe and efficacious for treating patients with achalasia and referral of surgical myotomy should be considered for patients who do not respond to medical therapy or individuals that do not desire pneumatic dilatations.

  9. The Behaviours of Cementitious Materials in Long Term Storage and Disposal of Radioactive Waste. Results of a Coordinated Research Project

    International Nuclear Information System (INIS)

    Radioactive waste with widely varying characteristics is generated from the operation and maintenance of nuclear power plants, nuclear fuel cycle facilities, research laboratories and medical facilities. This waste must be treated and conditioned, as necessary, to provide waste forms acceptable for safe storage and disposal. Many countries use cementitious materials (concrete, mortar, etc.) as a containment matrix for immobilization, as well as for engineered structures of disposal facilities. Radionuclide release is dependent on the physicochemical properties of the waste forms and packages, and on environmental conditions. In the use of cement, the diffusion process and metallic corrosion can induce radionuclide release. The advantage of cementitious materials is the added stability and mechanical support during storage and disposal of waste. Long interim storage is becoming an important issue in countries where it is difficult to implement low level waste and intermediate level waste disposal facilities, and in countries where cement is used in the packaging of waste that is not suitable for shallow land disposal. This coordinated research project (CRP), involving 24 research organizations from 21 Member States, investigated the behaviour and performance of cementitious materials used in an overall waste conditioning system based on the use of cement - including waste packaging (containers), waste immobilization (waste form) and waste backfilling - during long term storage and disposal. It also considered the interactions and interdependencies of these individual elements (containers, waste, form, backfill) to understand the processes that may result in degradation of their physical and chemical properties. The main research outcomes of the CRP are summarized in this report under four topical sections: (i) conventional cementitious systems; (ii) novel cementitious materials and technologies; (iii) testing and waste acceptance criteria; and (iv) modelling long

  10. US-Guided Vacuum-Assisted Biopsy of Microcalcifications in Breast Lesions and Long-Term Follow-Up Results

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hua Sun; Kim, Min Jung; Kim, Eun Kyung; Kwak, Jin Young [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Son, Eun Ju; Oh, Ki Keun [Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-12-15

    To evaluate the diagnostic accuracy of the use of an ultrasonography (US)-guided vacuum-assisted biopsy for microcalcifications of breast lesions and to evaluate the efficacy of the use of US-guided vacuum-assisted biopsy with long-term follow-up results. US-guided vacuum-assisted biopsy cases of breast lesions that were performed between 2002 and 2006 for microcalcifications were retrospectively reviewed. A total of 62 breast lesions were identified where further pathological confirmation was obtained or where at least two years of mammography follow-up was obtained. These lesions were divided into the benign and malignant lesions (benign and malignant group) and were divided into underestimated group and not-underestimated lesions (underestimated and not-underestimated group) according to the diagnosis after a vacuum-assisted biopsy. The total number of specimens that contained microcalcifications was analyzed and the total number of microcalcification flecks as depicted on specimen mammography was analyzed to determine if there was any statistical difference between the groups. There were no false negative cases after more than two years of follow- up. Twenty-nine lesions were diagnosed as malignant (two invasive carcinomas and 27 carcinoma in situ lesions). Two of the 27 carcinoma in situ lesions were upgraded to invasive cancers after surgery. Among three patients diagnosed with atypical ductal hyperplasia, the diagnosis was upgraded to a ductal carcinoma in situ after surgery in one patient. There was no statistically significant difference in the number of specimens with microcalcifications and the total number of microcalcification flecks between the benign group and malignant group of patients and between the underestimated group and not-underestimated group of patients. US-guided vacuum-assisted biopsy can be an effective alternative to stereotactic-guided vacuum-assisted biopsy in cases where microcalcifications are visible with the use of high

  11. Long-term follow-up of MCL patients treated with single-agent ibrutinib: updated safety and efficacy results

    Science.gov (United States)

    Blum, Kristie A.; Martin, Peter; Goy, Andre; Auer, Rebecca; Kahl, Brad S.; Jurczak, Wojciech; Advani, Ranjana H.; Romaguera, Jorge E.; Williams, Michael E.; Barrientos, Jacqueline C.; Chmielowska, Ewa; Radford, John; Stilgenbauer, Stephan; Dreyling, Martin; Jedrzejczak, Wieslaw Wiktor; Johnson, Peter; Spurgeon, Stephen E.; Zhang, Liang; Baher, Linda; Cheng, Mei; Lee, Dana; Beaupre, Darrin M.; Rule, Simon

    2015-01-01

    Ibrutinib, an oral inhibitor of Bruton tyrosine kinase, is approved for patients with mantle cell lymphoma (MCL) who have received one prior therapy. We report the updated safety and efficacy results from the multicenter, open-label phase 2 registration trial of ibrutinib (median 26.7-month follow-up). Patients (N = 111) received oral ibrutinib 560 mg once daily, and those with stable disease or better could enter a long-term extension study. The primary end point was overall response rate (ORR). The median patient age was 68 years (range, 40-84), with a median of 3 prior therapies (range, 1-5). The median treatment duration was 8.3 months; 46% of patients were treated for >12 months, and 22% were treated for ≥2 years. The ORR was 67% (23% complete response), with a median duration of response of 17.5 months. The 24-month progression-free survival and overall survival rates were 31% (95% confidence interval [CI], 22.3-40.4) and 47% (95% CI, 37.1-56.9), respectively. The most common adverse events (AEs) in >30% of patients included diarrhea (54%), fatigue (50%), nausea (33%), and dyspnea (32%). The most frequent grade ≥3 infections included pneumonia (8%), urinary tract infection (4%), and cellulitis (3%). Grade ≥3 bleeding events in ≥2% of patients were hematuria (2%) and subdural hematoma (2%). Common all-grade hematologic AEs were thrombocytopenia (22%), neutropenia (19%), and anemia (18%). The prevalence of infection, diarrhea, and bleeding was highest for the first 6 months of therapy and less thereafter. With longer follow-up, ibrutinib continues to demonstrate durable responses and favorable safety in relapsed/refractory MCL. The trial is registered to www.ClinicalTrials.gov as #NCT01236391. PMID:26059948

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

    Directory of Open Access Journals (Sweden)

    Kienast B

    2010-02-01

    Full Text Available Abstract 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 AO-FAS-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.

  13. Surgical excision of developmental retrorectal cysts: results with long-term follow-up from a single institution.

    Science.gov (United States)

    Rosa, Gennaro; Lolli, Paola; Vergine, Marco; El-Dalati, Ghassan; Malleo, Giuseppe

    2012-12-01

    Developmental cysts are very rare lesions occurring in the retrorectal space, and include epidermoid, dermoid, tailgut cysts and teratomas. There is little information on their natural history and biologic behavior, although a recent paper reported a greater incidence of malignant transformation than previously thought. The diagnosis requires high-resolution imaging, and complete surgical excision is the treatment of choice. In this paper we analyzed short- and long-term results of surgical excision of six retrorectal developmental cysts observed at our institution over a period of 11 years. All patients were women, three were referred with an infected perineal fistula/pelvic abscess after having undergone drainage surgery elsewhere. In these three patients, excision was attempted through a trans-perineal approach, which was technically demanding and ultimately incomplete because of the intense surrounding inflammation. Multiple re-interventions were required for tumor recurrence, and two of them still present an occasional perineal discharge. In the other three patients, a trans-perineal or trans-anal route was employed according to tumor location, without any recurrence at a median follow-up of 118.5 months. Final pathologic diagnosis included five tailgut cysts and one teratoma. This paper shows that the treatment of developmental cysts may be very challenging, especially when they are associated with a concomitant fistula/abscess and are not correctly diagnosed at presentation. In our experience, healing was finally achieved in four patients out of six. All the lesions were benign, and no malignant transformation was observed during follow-up, even in tumors partially resected. PMID:22864760

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

    Science.gov (United States)

    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.

  15. Cinco pacientes, once colgajos libres: resultados a largo plazo Five patients, eleven free flaps: long-term results

    Directory of Open Access Journals (Sweden)

    C. Olvera Caballero

    2006-09-01

    Full Text Available Los colgajos libres resuelven problemas complejos. En situaciones en donde existe gran pérdida de tejidos u otros métodos reconstructivos han fracasado se puede lograr restablecer la forma y la función utilizándolos. En este trabajo se presentan cinco pacientes en los que se usaron once colgajos libres (2 por paciente en cuatro casos, tres en otro y sus resultados a largo plazo con un mínimo de seguimiento de 7 años y un máximo de 17 años. Las indicaciones para utilizar más de un colgajo libre en un paciente son: reponer un primer colgajo perdido, por complejidad del problema, por experiencia del cirujano o por deseo expreso del paciente para una reconstrucción similar. En nuestra serie, la complejidad del problema fue la principal indicación de usar este método doble y triple. Cuatro pacientes recibieron los colgajos en los miembros inferiores y uno en la cara. Las etiologías encontradas fueron: secuelas de quemaduras en dos casos, secuelas posttraumáticas en otros dos y secuelas postquirúrgicas y de mielomeningocele en uno. Se utilizaron cuatro colgajos de dorsal ancho, cinco escapulares, uno de peroné y uno de gracilis. El seguimiento a largo plazo nos permite mostrar la gran adaptabilidad de los colgajos libres, su resistencia y su valor como procedimiento reconstructivo de primera opciónFree flaps are useful to solve complex problems. Whenever there is an extensive loss of tissues or when other reconstructive methods have failed, they may provide the means to restore shape and function. This paper deals with five patients in whom eleven free flaps were used (two in four patients and three in one more case to solve complex problems. Furthermore, long-term results are reported, with follow-up ranging from 7 to 17 years Indications to use more than one free flap in a patient are: replacing a first flap that was lost, a highly complex problem, the surgeon’s expertise, or when the patient wish for a similar reconstruction. In

  16. Long-term impact of celebrity suicide on suicidal ideation: Results from a population-based study

    OpenAIRE

    Fu, KW; Yip, PSF

    2007-01-01

    Background: The short-term effect of celebrity suicide on the overall suicide rate is widely known, but long-term effects remain unclear. Objective: To examine whether celebrity suicide is associated with suicidal ideation over a longer period. Design: This is a study on the effect of the suicide of a famous Hong Kong entertainment celebrity, who committed suicide on 1 April 2003, on suicide thoughts of the community. A population-based survey was conducted between December 2003 and July 2004...

  17. Changing forest water yields in response to climate warming: results from long-term experimental watershed sites across North America

    OpenAIRE

    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

    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 partitioni...

  18. Long-term use of doxycycline can improve chronic asthma and possibly remodeling: the result of a pilot observation

    OpenAIRE

    Bhattacharyya, Parthasarathi

    2012-01-01

    Parthasarathi Bhattacharyya, Rantu Paul, Partha Bhattacharjee, Arko Ghosh, Ratna Dey, Malabika Ghosh, Madan SharmaInstitute of Pulmocare and Research, CB 16, Salt Lake, Sector 1, Kolkata-700064, IndiaAbstract: Progressive loss of lung function and reversibility characterize chronic asthma. The conventional therapy is targeted to control the disease without targeting the loss of lung function or reversibility. In a prospective real-world observation of long-term use of add-on doxycycline as a ...

  19. Long-term changes in cognitive bias and coping response as a result of chronic unpredictable stress during adolescence

    OpenAIRE

    Victoria Braithwaite

    2013-01-01

    Animals that experience adverse events in early life often have life-long changes to their physiology and behavior. Long-term effects of stress during early life have been studied extensively, but less attention has been given to the consequences of negative experiences solely during the adolescent phase. Adolescence is a particularly sensitive period of life when regulation of the glucocorticoid “stress” hormone response matures and specific regions in the brain undergo considerable change. ...

  20. Percutaneous vertebroplasty in 1,253 levels: results and long-term effectiveness in a single centre

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore; Mastrangeli, Roberta; Petrella, Maria Chiara; Massari, Francesco; Ursone, Antonio; Simonetti, Giovanni [Universita di Roma ' ' Tor Vergata' ' , Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Rome (Italy)

    2009-01-15

    Several authors claim that vertebroplasty (PVT) is a successful technique, but long-term effectiveness is still debated. Our goal was to evaluate the effectiveness of PVT in patients with symptomatic vertebral fractures that had not responded to conservative treatment. In our centre, 624 patients with 1,253 compression fractures were treated by PVT. Imaging studies, clinical visits and short- and long-term follow-up were assessed by visual analogue scale (VAS) testing of pain. Statistical analysis was performed to evaluate pain response after PVT (paired two-tailed t-test) and to assess any differences in pain due to different lesions (ANOVA test). We found a statistically significant improvement in the patients' quality of life, particularly in pain (P<0.001). The average VAS value pre-PVT was 8.0{+-}2.5, which significantly dropped to 1.5{+-}0.4 by 12 months. There were no significant differences in pain response between the groups of patients with different underlying disease. There was a low complication rate in our study. PVT should be considered the treatment of choice in vertebral fractures with refractory pain. With strict evaluation of the clinical indications and subspecialised operators, long-term effectiveness is probable. (orig.)

  1. Long-term results of single-session percutaneous drainage and ethanol sclerotherapy in simple renal cysts

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey)]. E-mail: akincid@hotmail.com; Akhan, Okan [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey); Ozmen, Mustafa [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey); Gumus, Burcak [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey); Ozkan, Orhan [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey); Karcaaltincaba, Musturay [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey); Cil, Barbaros [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey); Haliloglu, Mithat [Department of Radiology, School of Medicine, Hacettepe University, Shhiye, Ankara TR-06100 (Turkey)

    2005-05-01

    Purpose: To demonstrate the efficacy and long-term results of the single-session ethanol sclerotherapy in simple renal cysts. Materials and methods: Ninety-eight cysts in 97 patients (range: 18-76 years; mean age, 54 years) were included in the study. Indications were determined as flank pain in 74, hydronephrosis in 12, hypertension in 8, patient reassurance due to increasing cyst size in three patients. Mean follow-up period was 24.4 months. Procedures were performed with the guidance of fluoroscopy and ultrasonography at all times using 5-7 Fr pigtail catheters. After the cystogram that was obtained in all cases, 95% ethanol with a volume of 30-40% of the cyst volume was used as a sclerosing agent on an outpatient basis. Maximum volume of the injected ethanol was 200 ml. Follow-up examinations were performed 1, 3, 6 and 12 months after the procedure and once every year thereafter. Results: Average cyst volume reduction was 93% at the end of the first year. The cysts disappeared completely in 17 (17.5%) patients. After the procedure, in 67 (90%) patients improvement in flank pain was noted. Sixty-one (82%) patients were free of pain and in 6 (8%) of them the pain decreased. Normotension was obtained in 7 (87.5%) of the 8 hypertensive patients and no hydronephrosis was detected in 10 (83.3%) of the 12 patients after the procedure. Second intervention was required in 2 (2%) patients due to recurrence of cysts and related symptoms. One (1%) patient had small retroperitoneal hematoma that resolved spontaneously and in another (1%) patient spontaneous hemorrhage was detected into the cyst 1 year after the procedure. No other complication was detected during the procedure and follow-up. Conclusion: Percutaneous treatment of simple renal cysts with single-session sclerotherapy is a safe, effective and minimally invasive procedure and can be used as an alternative to multiple-session sclerotherapy with comparable results. High volume, up to 200 ml ethanol can be used

  2. Plant diversity induces a shift of DOC concentration over time - results from long term and large scale experiment

    Science.gov (United States)

    Lange, Markus; Gleixner, Gerd

    2016-04-01

    Plant diversity has been demonstrated as a crucial factor for soil organic carbon (SOC) storage. The horizontal SOC formation in turn is strongly impacted by the relative small but consistent flow of dissolved organic carbon (DOC) in soils. In this process, pore water leaches plant material and already stored SOC while simultaneously these leachates are transported downwards. However, there is a big uncertainty about the drivers of DOC flux; in particular about the importance of biological processes. We investigated the impact of plant diversity and other biotic drivers on DOC concentrations and total DOC fluxes (concentration × sampled water amount). In addition, we considered abiotic factors such as weather and soil conditions to assess the relative importance of biotic and abiotic drivers and how their importance changes over time. We used a comprehensive data set, gathered in the frame of the long-term biodiversity experiment "The Jena Experiment". Permanent monitoring started directly after establishment of the field site in 2002 and is still running. This enabled us to trace the impact of plant communities with their increasing establishment over the time on DOC concentration. We found the amount of sampled pore water best explained by rainfall, while it was not related to plant associated variables. Directly after establishing the experimental site, DOC concentrations were highest and then decreasing with time. In the first period of the experiment plant diversity had no or even a slightly negative impact on DOC concentrations. The direction of the plant diversity effect on DOC concentrations changed over time; namely in later phases we observed highest DOC concentrations on plots with high plant diversity. Moreover, DOC concentrations were negatively affected by increased amounts of sampled pore water indicating a dilution effect. Even though this impact was highly significant; its effect size was even less pronounced at later time points. In summary

  3. Long-term result of endoscopic Histoacryl(r) (N-butyl-2-cyanoacrylate) injection for treatment of gastric varices

    Institute of Scientific and Technical Information of China (English)

    Eun Jung Kang; Young Deok Cho; Hong Soo Kim; Boo Sung Kim; Soung Won Jeong; Jae Young Jang; Joo Young Cho; Sae Hwan Lee; Hyun Gun Kim; Sang Gyune Kim; Young Seok Kim; Young Koog Cheon

    2011-01-01

    AIM: To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl(R) for treatment of gastric variceal bleeding and prophylaxis. METHODS: Between January 1994 and March 2010 at SoonChunHyang University Hospital, a total of 127 patients with gastric varices received Histoacryl(R) injections endoscopically. One hundred patients underwent endoscopic Histoacryl(R) injections because of variceal bleeding, the other 27 patients received such injections as a prophylactic procedure. RESULTS: According to Sarin classification, 56 patients were GOV1, 61 patients were GOV2 and 10 patients were IGV. Most of the varices were large (F2 or F3, 111 patients). The average volume of Histoacryl(R) per each session was 1.7 ± 1.3 cc and mean number of sessions was 1.3 ± 0.6. (1 session-98 patients, 2 sessions-25 patients, ≥ 3 sessions-4 patients). Twenty-seven patients with high risk of bleeding (large or fundal or RCS+ or Child C) received Histoacryl(R) injection as a primary prophylactic procedure. In these patients, hepatitis B virus was the major etiology of cirrhosis, 25 patients showed GOV1 or 2 (92.6%) and F2 or F3 accounted for 88.9% (n = 24).The rate of initial hemostasis was 98.4% and recurrent bleeding within one year occurred in 18.1% of patients.Successful hemostasis during episodes of rebleeding was achieved in 73.9% of cases. Median survival was 50 mo (95% CI 30.5-69.5). Major complications occurred in 4patients (3.1%). The rebleeding rate in patients with hepatocellular carcinoma or GOV2 was higher than in those with other conditions. None of the 27 subjects who were treated prophylactically experienced treatment-related complications. Cumulative survival rates of the 127 patients at 6 mo, 1, 3, and 5 years were 92.1%, 84.2%,64.2%, and 45.3%, respectively. The 6 mo cumulative survival rate of the 27 patients treated prophylactically was 75%.CONCLUSION: Histoacryl(R) injection therapy is an effective treatment for gastric varices and also

  4. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    International Nuclear Information System (INIS)

    years were 48.6%, 22.8%, and 75.1%, respectively. Conventional radiotherapy was effective in preventing tumor growth of pituitary adenomas. But the effect of reducing hormone levels in functioning adenomas appeared to require several years after radiotherapy in most cases. Because hypopituitarism occurs in the late period after radiotherapy, long-term follow-up is necessary and mandatory. (author)

  5. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchida, Emiko; Sakai, Kunio; Matsumoto, Yasuo; Sugita, Tadashi; Sasamoto, Ryuta [Niigata Univ. (Japan). School of Medicine

    1999-09-01

    years were 48.6%, 22.8%, and 75.1%, respectively. Conventional radiotherapy was effective in preventing tumor growth of pituitary adenomas. But the effect of reducing hormone levels in functioning adenomas appeared to require several years after radiotherapy in most cases. Because hypopituitarism occurs in the late period after radiotherapy, long-term follow-up is necessary and mandatory. (author)

  6. Long Term Sorption Diffusion Experiment (LTDE-SD). Performance of main in situ experiment and results from water phase measurements

    Energy Technology Data Exchange (ETDEWEB)

    Widestrand, Henrik; Byegaard, Johan; Nilsson, Kersti; Hoeglund, Susanne; Gustafsson, Erik (Geosigma AB, Uppsala (Sweden)); Kronberg, Magnus (Swedish Nuclear Fuel and Waste Management Co. (Sweden))

    2010-12-15

    The LTDE-SD experiment, (Long Term Sorption Diffusion Experiment) aimed at increasing the scientific knowledge of sorption and diffusion under in situ conditions and to provide data for performance and safety assessment calculations. Performance and results of the in situ experiment phase are presented in the report. In total, 21 radionuclide trace elements and one stable trace element were injected, circulated and sampled for approx6.5 months in a closed borehole section. The trace elements represented non-sorbing tracers and sorbing tracers for which the sorption was dominated by a cation exchange mechanism, a surface complexation mechanism, or dependent on an electrochemical reduction in order to reach the tetravalent state (oxidation state IV) considered very strongly sorbing. The borehole section in contact with the tracer labelled groundwater consisted in part of a natural fracture surface and a borehole section in the unaltered matrix rock, devoid of natural fractures. Water samples were regularly extracted and analysed for trace element concentration and a few ion exchange speciation and filtered samplings were also conducted. Independent colloid filtering and chemical speciation calculations were performed in support the evaluation. Sorption was demonstrated for a series of elements present in the experiment. The amounts lost of the different respective tracers from the aqueous phase follow very well the general understanding of the relative sorption strength of the tracers, as inferred from e.g. batch sorption experiments and dynamic in situ tracer experiments. The chemical speciation calculations of the different tracers were in line with the results of the ion exchange speciation performed during the experiment. With the exception of UO{sub 2} 2+ carbonate complexes formed, no strong indications were obtained that aqueous complexation prevents adsorption under the chemical conditions of the experiment. The 20 nm filtered sampling indicated that

  7. Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis

    OpenAIRE

    Lange, Johan Emil; Steen, Harald; Gunderson, Ragnhild; Brox, Jens Ivar

    2011-01-01

    Background It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. Methods 272 (78%) of 360 patients, 251 (92%) women, responded to follow-up examination at a mean of 24.7 (range 16 - 32) years after Boston brace treatment. Fifty-eight (21%) patient...

  8. Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis

    OpenAIRE

    Gunderson Ragnhild; Steen Harald; Lange Johan; Brox Jens

    2011-01-01

    Abstract Background It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. Methods 272 (78%) of 360 patients, 251 (92%) women, responded to follow-up examination at a mean of 24.7 (range 16 - 32) years after Boston brace treatment. Fifty-eight (21%...

  9. Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies

    OpenAIRE

    Pan, An; Malik, Vasanti S; Hao, Tao; Willett, Walter C.; Mozaffarian, Dariush; Hu, Frank B.

    2013-01-01

    Objective: To examine the long-term relationship between changes in water and beverage intake and weight change. Subjects Prospective cohort studies of 50 013 women aged 40-64 in the Nurses’ Health Study (NHS, 1986-2006), 52 987 women aged 27-44 in the NHS II (1991-2007), and 21 988 men aged 40-64 in the Health Professionals Follow-up Study (1986-2006) without obesity and chronic diseases at baseline. Measures We assessed the association of weight change within each 4-year interval with chang...

  10. Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies

    OpenAIRE

    Pan, An; Malik, Vasanti S; Hao, Tao; Willett, Walter C.; Mozaffarian, Dariush; Hu, Frank B.

    2013-01-01

    Objective To examine the long-term relationship between changes in water and beverage intake and weight change. Subjects Prospective cohort studies of 50 013 women aged 40-64 in the Nurses’ Health Study (NHS, 1986-2006), 52 987 women aged 27-44 in the NHS II (1991-2007), and 21 988 men aged 40-64 in the Health Professionals Follow-up Study (1986-2006) without obesity and chronic diseases at baseline. Measures We assessed the association of weight change within each 4-year interval with change...

  11. Reirradiation for recurrent head and neck cancer with salvage interstitial pulsed-dose-rate brachytherapy. Long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Strnad, Vratislav; Lotter, Michael; Kreppner, Stephan; Fietkau, Rainer [University Hospital Erlangen, Dept. of Radiation Oncology, Erlangen (Germany)

    2015-01-10

    To assess the long-term results of protocol-based interstitial pulsed-dose-rate (PDR) brachytherapy as reirradiation combined with simultaneous chemotherapy and interstitial hyperthermia in selected patients with recurrent head and neck tumors. A total of 104 patients with biopsy-proven recurrent head and neck cancer were treated with interstitial PDR brachytherapy. Salvage surgery had also been undergone by 53/104 (51 %) patients (R1 or R2 resection in > 80 % of patients). Salvage brachytherapy alone was administered in 81 patients (78 %), with a median total dose of 56.7 Gy. Salvage brachytherapy in combination with external beam radiotherapy (EBRT) was performed in 23/104 patients (32 %), using a median total dose of D{sub REF} = 24 Gy. Simultaneously to PDR brachytherapy, concomitant chemotherapy was administered in 58/104 (55.8 %) patients. A single session of interstitial hyperthermia was also used to treat 33/104 (31.7 %) patients. The analysis was performed after a median follow-up of 60 months. Calculated according to Kaplan-Meier, local tumor control rates after 2, 5, and 10 years were 92.5, 82.4, and 58.9 %, respectively. Comparing results of salvage PDR brachytherapy with or without simultaneous chemotherapy, the 10-year local control rates were 76 vs. 39 % (p= 0014), respectively. No other patient- or treatment-related parameters had a significant influence on treatment results. Soft tissue necrosis or bone necrosis developed in 18/104 (17.3 %) and 11/104 (9.6 %) patients, respectively, but only 3 % of patients required surgical treatment. PDR interstitial brachytherapy with simultaneous chemotherapy is a very effective and, in experienced hands, also a safe treatment modality in selected patients with head and neck cancer in previously irradiated areas. (orig.) [German] Es erfolgte die Analyse der Langzeitergebnisse einer protokollbasierten interstitiellen Brachytherapie (Re-Bestrahlung) mit simultaner Chemotherapie und interstitieller Hyperthermie

  12. Long-term results of forward intensity-modulated radiation therapy for patients with early-stage breast cancer

    International Nuclear Information System (INIS)

    To observe long-term clinical outcomes for patients with early-stage breast cancer treated with forward intensity-modulated radiation therapy (IMRT), including local control and clinical toxicities. We retrospectively analyzed a total of 214 patients with stage I-II breast cancer who were treated with breast conserving surgery followed by adjuvant breast radiation therapy between 2001 and 2008. All patients were treated using forward IMRT. The whole breast was irradiated to a dose of 50 to 50.4 Gy followed by an 8 to 12 Gy electron boost to the surgical bed. The median age was 46 years (range, 21 to 82 years) and the medial follow-up time was 7.3 years (range, 2.4 to 11.7 years). Stage T1 was 139 (65%) and T2 was 75 (35%), respectively. Ipsilateral breast recurrence was observed in 3 patients. The 5- and 10-year local control rates were 99.1% and 97.8%, respectively. The cosmetic outcome was evaluated according to the Harvard scale and 89.4% of patients were scored as excellent or good. The whole breast radiation therapy as an adjuvant treatment using a forward IMRT technique showed excellent long-term local control as well as favorable outcomes of toxicity and cosmesis.

  13. Long-term results of forward intensity-modulated radiation therapy for patients with early-stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Boram; Suh, Hyun Suk; Lee, Ji Hae; Lee, Kyung Ja; Lee, Rena; Moon, Byung In [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    To observe long-term clinical outcomes for patients with early-stage breast cancer treated with forward intensity-modulated radiation therapy (IMRT), including local control and clinical toxicities. We retrospectively analyzed a total of 214 patients with stage I-II breast cancer who were treated with breast conserving surgery followed by adjuvant breast radiation therapy between 2001 and 2008. All patients were treated using forward IMRT. The whole breast was irradiated to a dose of 50 to 50.4 Gy followed by an 8 to 12 Gy electron boost to the surgical bed. The median age was 46 years (range, 21 to 82 years) and the medial follow-up time was 7.3 years (range, 2.4 to 11.7 years). Stage T1 was 139 (65%) and T2 was 75 (35%), respectively. Ipsilateral breast recurrence was observed in 3 patients. The 5- and 10-year local control rates were 99.1% and 97.8%, respectively. The cosmetic outcome was evaluated according to the Harvard scale and 89.4% of patients were scored as excellent or good. The whole breast radiation therapy as an adjuvant treatment using a forward IMRT technique showed excellent long-term local control as well as favorable outcomes of toxicity and cosmesis.

  14. The Impact of the Acute Results on the Long - Term Outcome after the Treatment of In- stent Restenosis: A Serial Intravascular Ultrasound Study

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Stenting reduces acute complications and restenosis compared to balloon angioplasty and other devices. However, in- stent restenosis (ISR) is an important clinical problem. The current serial intravascular ultrasound (IVUS)analysis was undertaken to determine whether the acute results obtained during the treatment of ISR influence the long term results and whether this is true for patients treated with and without adjunct brachytherapy.

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

    Directory of Open Access Journals (Sweden)

    David N Franz

    Full Text Available 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.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%.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 multisystem manifestations of TSC in a

  16. [Stabilizing the social and health status of drug dependent patients with methadone. Long-term maintainance therapy--Vienna results].

    Science.gov (United States)

    Loimer, N; Werner, E; Hollerer, E; Pfersmann, V; Schmid-Siegel, B; Presslich, O

    1991-01-01

    On September 25th, 1987 methadone was legalized in Austria for therapeutic use in drug addiction treatment in case of: 1. Long-term drug addiction with intravenous application of the drug, and several unsuccessful withdrawal therapies and/or 2. opiate addiction through intravenous application of the drug along with an existing HIV-1 infection. Since than, 291 patients were treated with methadone at the drug-dependency outpatient clinic of the Psychiatric Clinic of the University of Vienna. In 1990, 96 patients treated for more than one year were investigated using a standardized questionnaire. The image in which crime, prostitution, poverty, ill health all merge was broken by this decriminalization. Methadone treatment offers a first step toward social rehabilitation for drug addicts who have been living as criminals on the fringe of society.

  17. Long-term results of the randomized phase III trial EORTC 18991 of adjuvant therapy with pegylated interferon alfa-2b versus observation in resected stage III melanoma

    NARCIS (Netherlands)

    A.M.M. Eggermont (Alexander); S. Suciu (Stefan); A. Testori (Alessandro); M. Santinami (Mario); W.H.J. Kruit (Wim); J. Marsden; C.J.A. Punt (Cornelis); F. Salès (François); R. Dummer (Reinhard); C. Robert (Caroline); D. Schadendorf (Dirk); P. Patel (Poulam); G. de Schaetzen (Gaetan); A. Spatz (Alan); U. Keilholz (Ulrich)

    2012-01-01

    textabstractPurpose: Adjuvant pegylated interferon alfa-2b (PEG-IFN-α-2b) was approved for treatment of resected stage III melanoma in 2011. Here, we present long-term follow-up results of this pivotal trial. Patients and Methods: In all, 1,256 patients with resected stage III melanoma were randomly

  18. [Favourable long-term results from cemented total hip arthroplasty combined with acetabular bone impaction grafting in patients under the age of 50

    NARCIS (Netherlands)

    Busch, V.J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2007-01-01

    OBJECTIVE: Determination of long-term results of hip replacements in patients who, at the time of operation, were under the age of 50. Procedures whereby an existing acetabulum defect was filled with bone chips that were impacted into a strong layer, after which a cemented total hip prosthesis was i

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

    Energy Technology Data Exchange (ETDEWEB)

    Degteva, M.O.; Kozheurov, V.P.; Vorobiova, M.I. [Ural research Center for Radiation Medicine, Chelyabinsk (Russian Federation)

    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.

  20. Efficacy and safety of nimesulide long term administration in patients with osteoarthritis: results of 12-months open controlled study DINAMO (long term administration of nimesulide in osteoarthritis multifactor assessment

    Directory of Open Access Journals (Sweden)

    L I Alexeeva

    2009-01-01

    Full Text Available Objective. To compare efficacy and safety of nimesulide and paracetamol in treatment of patients with osteoarthritis (OA during 12 months. Material and methods. 40 women (mean age 66,8±5,1 years with knee osteoarthritis (II-III stage according to Kellgren-Lawrence having intensive pain (>40 mm on VAS were included. Group 1 pts (n=20 received nimesulide 200-100 mg/day. Group 2 pts were treated with paracetamol till 3 g/day. WOMAC was used as efficacy measure. Safety was assessed with endoscopic examination of upper gastrointestinal tract, ECG, blood pressure and ECG Holter monitoring, clinical and biochemical blood parameters. Statistical significance of differences was assessed with Student’s t-test, χ2 and Fisher exact test Results. WOMAC index decreased during treatment from 1182,7±345,9 to 698,4±351,1 for nimesulide and from 1136,4±313,8 to 1031,6±21 for paracetamol (p<0,05. There were 6 cases of gastrointestinal complications and 4 cases of hypertension development or deterioration in each group. Coronary heart disease developed or deteriorated in 4 patients receiving nimesulide but not in control group. Liver function tests did not deteriorated during treatment with nimesulide. Conclusion. Nimesulide was more effective than paracetamol in treatment of OA. But risk of cardiovascular complications development during treatment with NSAIDs requires serious attention. Nimesulide did not induced liver damage during long term treatment.

  1. 回缩性睾丸的临床研究%Long term follow-up results of testicular retraction

    Institute of Scientific and Technical Information of China (English)

    郭祥; 李爽; 王军; 郭晖; 雷伟; 李刚; 马慧; 杨春雷; 程银涛

    2014-01-01

    目的:通过评价回缩性睾丸患睾临床转归时间为临床治疗回缩性睾丸提供参考。方法回顾性分析了本院40例2004年3月至2009年9月被诊断为回缩睾丸的患儿,所有的患儿在随访时评价睾丸收缩性、位置、睾丸体积,并根据随访结果分为回缩组、正常组、固定组。结果40个患儿,21例单侧回缩睾丸(52.5%),19双侧回缩睾丸(47.5%)。他们的平均年龄为(3±2.7)岁,评价随访时间为(4.1±1.6)年。59例回缩睾丸,27例(45.7%)成功降入阴囊,23例(39.0%)保持回缩,9例患者(15.3%)为睾丸未降或睾丸体积变小行睾丸固定术。40例患者中平均随访(4.4±1.7)年。正常组平均随访时间为(4.1±1.3)年,回缩组平均随访时间为(5.2±1.7)年,固定组平均随访时间为(3.7±1.6)年。正常组平均诊断年龄为(4.3±3.2)年,回缩组平均诊断年龄为(2.3±1.6)年,固定组平均诊断年龄(1.3±0.8)年。固定组与正常组相比较,固定组平均诊断年龄小于正常组的平均诊断年龄(P <0.05)。结论回缩性睾丸有需行外科睾丸固定术的干预的风险,且年龄越小被诊断为回缩性睾丸的患者有需行外科睾丸固定术干预的风险越高。%Objective To make a reference for clinical surgery operation intervention of retractile testis through long-term follow-up of testisvolume and position. Methods A retrospective analysis of 40 cases in our hospital diagnosed with testicular retraction was carried out in the study. According to the follow-up results of testicular shrinkage, position and testicular volume, the patients were divided into the retraction group, the normal group, the fixed group. Results Of 40 patients, 21 cases had unilateral testicular retraction (52.5%), 19 (47.5%) had bilateral testicular retraction. Their average age was (3±2.7)years, evaluation and follow-up was (4.1±1.6)years. Among 59 cases

  2. Sniff-Like Patterned Input Results in Long-Term Plasticity at the Rat Olfactory Bulb Mitral and Tufted Cell to Granule Cell Synapse

    Science.gov (United States)

    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

  3. Sniff-Like Patterned Input Results in Long-Term Plasticity at the Rat Olfactory Bulb Mitral and Tufted Cell to Granule Cell Synapse

    Directory of Open Access Journals (Sweden)

    Mahua Chatterjee

    2016-01-01

    Full Text Available 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.

  4. Effects of a dietary intervention on gastrointestinal symptoms after prostate cancer radiotherapy: Long-term results from a randomized controlled trial

    International Nuclear Information System (INIS)

    Background and purpose: To evaluate the long-term effects of dietary intervention on gastrointestinal symptoms after highly dose-escalated radiotherapy for localized prostate cancer, using boost with protons or high-dose-rate brachytherapy. Materials and methods: Patients were randomized to an intervention group (n = 64) advised to reduce insoluble dietary fiber and lactose intake, or to a standard care group (n = 66) advised to continue their usual diet. Gastrointestinal symptoms, other domains of health-related quality of life (HRQOL), and dietary intake were evaluated for ⩽24 months post-radiotherapy with the European Organization for Research and Treatment of Cancer quality-of-life questionnaires QLQ-C30 and QLQ-PR25, Gastrointestinal Side Effects Questionnaire, and Food Frequency Questionnaire. The effect of the intervention on gastrointestinal symptoms was evaluated using generalized estimating equations. Results: Dietary intervention had no obvious effect on long-term gastrointestinal symptoms or HRQOL. The intervention group markedly reduced their dietary fiber and lactose intake during radiotherapy, but adherence tended to decline over time. The vast majority of long-term gastrointestinal symptoms were reported as ‘a little’, with a noticeable difference from pre-treatment only for unintentional stool leakage, limitations on daily activities, and mucus discharge. Conclusion: Long-term gastrointestinal symptoms were predominantly mild, and dietary intervention was not superior to a usual diet in preventing these symptoms

  5. Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joon Woo; Myung, Jae Sung; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seong Nam, Gyeongi-do (Korea); Park, Kun Woo; Yeom, Jin S. [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Seong Nam, Gyeongi-do (Korea); Kim, Ki-Jeong; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Seong Nam, Gyeongi-do (Korea)

    2010-07-15

    To evaluate the short-term and long-term effects of fluoroscopically guided caudal epidural steroid injection (ESI) for the management of degenerative lumbar spinal stenosis (DLSS) and to analyze outcome predictors. All patients who underwent caudal ESI in 2006 for DLSS were included in the study. Response was based on chart documentation (aggravated, no change, slightly improved, much improved, no pain). In June 2009 telephone interviews were conducted, using formatted questions including the North American Spine Society (NASS) patient satisfaction scale. For short-term and long-term effects, age difference was evaluated by the Mann-Whitney U test, and gender, duration of symptoms, level of DLSS, spondylolisthesis, and previous operations were evaluated by Fisher's exact test. Two hundred and sixteen patients (male: female = 75:141; mean age 69.2 years; range 48{proportional_to}91 years) were included in the study. Improvements (slightly improved, much improved, no pain) were seen in 185 patients (85.6%) after an initial caudal ESI and in 189 patients (87.5%) after a series of caudal ESIs. Half of the patients (89/179, 49.8%) replied positively to the NASS patient satisfaction scale (1 or 2). There were no significant outcome predictors for either the short-term or the long-term responses. Fluoroscopically guided caudal ESI was effective for the management of DLSS (especially central canal stenosis) with excellent short-term and good long-term results, without significant outcome predictors. (orig.)

  6. Analytical results of a long-term aquifer test conducted near the Rio Grande, Albuquerque, New Mexico, with a section on piezometric-extensometric test results

    Science.gov (United States)

    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.

  7. Improved external valvuloplasty, intravenous laser photocoagulation and local sclerotheraphy treatment of primary deep venous valvular insufficiency: long term result

    Science.gov (United States)

    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.

  8. Autologous hematopoietic cell transplantation following high-dose immunosuppressive therapy for advanced multiple sclerosis: long-term results.

    Science.gov (United States)

    Bowen, J D; Kraft, G H; Wundes, A; Guan, Q; Maravilla, K R; Gooley, T A; McSweeney, P A; Pavletic, S Z; Openshaw, H; Storb, R; Wener, M; McLaughlin, B A; Henstorf, G R; Nash, R A

    2012-07-01

    The purpose of the study was to determine the long-term safety and effectiveness of high-dose immunosuppressive therapy (HDIT) followed by autologous hematopoietic cell transplantation (AHCT) in advanced multiple sclerosis (MS). TBI, CY and antithymocyte globulin were followed by transplantation of autologous, CD34-selected PBSCs. Neurological examinations, brain magnetic resonance imaging and cerebrospinal fluid (CSF) for oligoclonal bands (OCB) were serially evaluated. Patients (n=26, mean Expanded Disability Status Scale (EDSS)=7.0, 17 secondary progressive, 8 primary progressive, 1 relapsing/remitting) were followed for a median of 48 months after HDIT followed by AHCT. The 72-month probability of worsening ≥1.0 EDSS point was 0.52 (95% confidence interval, 0.30-0.75). Five patients had an EDSS at baseline of ≤6.0; four of them had not failed treatment at last study visit. OCB in CSF persisted with minor changes in the banding pattern. Four new or enhancing lesions were seen on MRI, all within 13 months of treatment. In this population with high baseline EDSS, a significant proportion of patients with advanced MS remained stable for as long as 7 years after transplant. Non-inflammatory events may have contributed to neurological worsening after treatment. HDIT/AHCT may be more effective in patients with less advanced relapsing/remitting MS.

  9. Results from Long-Term Optical Monitoring of the Soft X-Ray Transient SAX J1810.8-2609

    CERN Document Server

    Zhu, Ling; Wyrzykowski, Lukasz

    2012-01-01

    In this paper we report the long-term optical observation of the faint soft X-ray transient SAX J1810.8-2609 from OGLE and MOA. We have focused on the 2007 outburst, and also did the cross-correlate between its optical light curves and the quasi-simultaneous X-ray observations from swift. Both the optical and X-ray light curves of 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 slightly 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 the optical flux during rebrightening. It implies variation of the physical environment of the outer disk, even the source stayed in low-hard state during the whole outburs...

  10. Long-term collections

    CERN Multimedia

    Collectes à long terme

    2007-01-01

    The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

  11. Changing forest water yields in response to climate warming: results from long-term experimental watershed sites across North America

    Science.gov (United States)

    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

  12. Chimeric Allografts Induced by Short-Term Treatment With Stem Cell Mobilizing Agents Result in Long-Term Kidney Transplant Survival Without Immunosuppression: II, Study in Miniature Swine.

    Science.gov (United States)

    Cameron, A M; Wesson, R N; Ahmadi, A R; Singer, A L; Hu, X; Okabayashi, T; Wang, Y; Shigoka, M; Fu, Y; Gao, W; Raccusen, L C; Montgomery, R A; Williams, G M; Sun, Z

    2016-07-01

    Transplantation is now lifesaving therapy for patients with end-stage organ failure but requires lifelong immunosuppression with resultant morbidity. Current immunosuppressive strategies inhibit T cell activation and prevent donor-recipient engagement. Therefore, it is not surprising that few host cells are demonstrated in donor grafts. However, our recent small animal studies found large numbers of recipient stem cells present after transplantation and pharmacological mobilization, resulting in a chimeric, repopulated organ. We now confirm these findings in a well-characterized large animal preclinical model. Here, we show that AMD3100 and FK506 mobilization of endogenous stem cells immediately post kidney transplantation combined with repeat therapy at 1, 2, and 3 months led to drug-free long-term survival in maximally immunologically mismatched swine. Three long-term recipients have stable chimeric transplants, preserved antidonor skin graft responses, and normal serum creatinine levels despite withdrawal of all medication for 3 years. PMID:26748958

  13. Long-term results of a randomized phase III trial of TPF induction chemotherapy followed by surgery and radiation in locally advanced oral squamous cell carcinoma

    OpenAIRE

    Zhong, Lai-ping; Zhang, Chen-Ping; Ren, Guo-xin; Guo, Wei; William, William N.; Hong, Christopher S.; Sun, Jian; ZHU, HAN-GUANG; Tu, Wen-yong; Li, Jiang; Cai, Yi-li; Yin, Qiu-ming; WANG, LI-ZHEN; Wang, Zhong-he; Hu, Yong-jie

    2015-01-01

    Previously, we conducted a randomized phase III trial of TPF (docetaxel, cisplatin, and 5-fluorouracil) induction chemotherapy in surgically managed locally advanced oral squamous cell carcinoma (OSCC) and found no improvement in overall survival. This study reports long-term follow-up results from our initial trial. All patients had clinical stage III or IVA locally advanced OSCC. In the experimental group, patients received two cycles of TPF induction chemotherapy (75mg/m2 docetaxel d1, 75m...

  14. Long-term survival results of a randomized trial comparing gemcitabine/cisplatin and methotrexate/vinblastine/doxorubicin/cisplatin in patients with locally advanced and metastatic bladder cancer

    DEFF Research Database (Denmark)

    Roberts, J T; von der Maase, H; Sengeløv, L;

    2006-01-01

    PURPOSE: To compare long-term survival in patients with locally advanced and metastatic transitional cell carcinoma (TCC) of the urothelium treated with gemcitabine plus cisplatin (GC) or methotrexate/vinblastine/doxorubicin/cisplatin (MVAC). PATIENTS AND METHODS: Efficacy data from a large....... These results strengthen the role of GC as a standard of care in patients with locally advanced and metastatic transitional-cell carcinoma (TCC)....

  15. Histocompatibility and Long-Term Results of the Follicular Unit-Like Wigs after Xenogeneic Hair Transplantation: An Experimental Study in Rabbits

    OpenAIRE

    Yu Sun; Feng Lu; Ge Liu; Zhi-Dan Zhang; Zijie Zhang; Zhi-Qi Hu

    2011-01-01

    Objective. This study was designed to observe the histocompatibility and long-term results of wigs after xenogeneic hair transplantation and to explore the possibility of industrial products in clinical application. Methods. The human hair and melted medical polypropylene were preceded into the follicular unit-like wigs according to the natural follicular unit by extrusion molding. 12 New Zealand rabbits were used as experimental animals for wigs transplantation. The histocompatibility of pol...

  16. Long-term side effects of radiotherapy for pediatric localized neuroblastoma. Results from clinical trials NB90 and NB94

    Energy Technology Data Exchange (ETDEWEB)

    Ducassou, Anne [Institut Claudius Regaud, Departement de Radiotherapie, Toulouse (France); Gambart, Marion; Munzer, Caroline; Rubie, Herve [Hopital des Enfants, Departement d' Onco-Hematologie Pediatrique, Toulouse (France); Padovani, Laetitia [Centre Hospitalier et Universitaire, Departement de Radiotherapie, Marseille (France); Carrie, Christian; Claude, Line [Centre Leon Berard, IHOP, Departement de Radiotherapie, Lyon (France); Haas-Kogan, Daphne [University of California, Department of Radiation Oncology, San Francisco (United States); Bernier-Chastagner, Valerie [Centre Alexis Vautrin, Departement de Radiotherapie, Nancy (France); Demoor, Charlotte [Centre Rene Gauducheau, Departement de Radiotherapie, Nantes (France); Helfre, Sylvie [Institut Curie, Departement de Radiotherapie, Paris (France); Bolle, Stephanie [Institut Gustave Roussy, Departement de Radiotherapie, Villejuif (France); Leseur, Julie [Centre Eugene Marquis, Departement de Radiotherapie, Rennes (France); Huchet, Aymeri [Centre Hospitalier et Universitaire, Departement de Radiotherapie, Bordeaux (France); Valteau-Couanet, Dominique [Institut Gustave Roussy, Departement d' Onco-Hematologie Pediatrique, Villejuif (France); Schleiermacher, Gudrun [Institut Curie, Departement d' Onco-Hematologie Pediatrique, Paris (France); Coze, Carole [Aix-Marseille Univ et APHM, Hopital d' Enfants de la Timone, Departement d' hemato-Oncologie Pediatrique, Marseille (France); Defachelles, Anne-Sophie [Centre Oscar Lambret, Departement d' Onco-Hematologie Pediatrique, Lille (France); Marabelle, Aurelien [IHOP, Departement d' Onco-Hematologie Pediatrique, Lyon (France); Ducassou, Stephane [Hopital des Enfants, Departement d' Onco-Hematologie Pediatrique, Bordeaux (France); Devalck, Christine [Hopital des enfants Reine Fabiola, Departement d' Onco-hematologie Pediatrique, Bruxelles (Belgium); Gandemer, Virginie [Centre hospitalier, Departement d' Onco-Hematologie Pediatrique, Rennes (France); Munzer, Martine [Centre hospitalier, Departement d' Onco-hematologie Pediatrique, Reims (France); Laprie, Anne [Institut Claudius Regaud, Departement de Radiotherapie, Toulouse (France); Universite Toulouse III Paul Sabatier, Toulouse (France); INSERM, Toulouse (France); Collaboration: Neuroblastoma study group and radiotherapy group of the French Society of Children with Cancer (SFCE)

    2015-07-15

    Neuroblastoma (NB) is the most frequent indication for extracranial pediatric radiotherapy. As long-term survival of high-risk localized NB has greatly improved, we reviewed treatment-related late toxicities in pediatric patients who received postoperative radiotherapy (RT) for localized NB within two French prospective clinical trials: NB90 and NB94. From 1990-2000, 610 children were enrolled. Among these, 35 were treated with induction chemotherapy, surgery, and RT. The recommended RT dose was 24 Gy at ≤ 2 years, 34 Gy at > 2 years, ± a 5 Gy boost in both age groups. The 22 patients still alive after 5 years were analyzed. The median follow-up time was 14 years (range 5-21 years). Late effects after therapy occurred in 73 % of patients (16/22), within the RT field for 50 % (11/22). The most frequent in-field effects were musculoskeletal abnormalities (n = 7) that occurred only with doses > 31 Gy/1.5 Gy fraction (p = 0.037). Other effects were endocrine in 3 patients and second malignancies in 2 patients. Four patients presented with multiple in-field late effects only with doses > 31 Gy. After a median follow-up of 14 years, late effects with multimodality treatment were frequent. The most frequent effects were musculoskeletal abnormalities and the threshold for their occurrence was 31 Gy. (orig.) [German] Das Neuroblastom (NB) ist die haeufigste Indikation fuer eine extrakranielle paediatrische Strahlentherapie. Da sich beim lokalisierten Hochrisiko-NB das langfristige Ueberleben stark verbessert hat, ueberprueften wir die behandlungsbedingte spaete Toxizitaet bei paediatrischen Patienten, die im Rahmen zweier prospektiver klinischer Studien in Frankreich (NB90 und NB94) eine postoperative Strahlentherapie (RT) bei lokalisiertem NB erhalten hatten. Von 1990-2000 wurden 610 Kinder eingeschlossen. Von diesen wurden 35 mit Chemotherapie, Chirurgie und RT behandelt. Die empfohlene Bestrahlungsdosis war 24 Gy bei ≤ 2 Jahren, 34 Gy bei > 2 Jahren, ± 5-Gy

  17. Deferiprone versus deferoxamine in sickle cell disease: results from a 5-year long-term Italian multi-center randomized clinical trial.

    Science.gov (United States)

    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. PMID:24814618

  18. CT-guided radiofrequency (RF) ablation of osteoid osteoma. Clinical long-term results; CT-gesteuerte Radiofrequenz(RF)-Ablation von Osteoidosteomen. Klinische Langzeitergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Diethard; Clasen, S.; Schaefer, J.F.; Rempp, H.; Koenig, C.W.; Claussen, C.D. [Universitaetsklinikum Tuebingen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Duda, S.; Truebenbach, J. [Juedisches Krankenhaus, Berlin (Germany). Radiologen Praxis; Erdtmann, B. [Radiologie Zentrum Stuttgart, Bad Cannstatt (Germany). Praxis; Pereira, P.L. [SLK-Kliniken, Heilbronn (Germany). Klinik fuer Radiologie, Minimal-Invasive Therapien und Nuklearmedizin

    2011-04-15

    Purpose: To evaluate CT-guided radiofrequency (RF) ablation of osteoid osteoma using internally cooled monopolar RF electrodes for technical success, complications and clinical long-term success. Materials and Methods: Between April 1999 and July 2009, 23 patients were treated under general anesthesia with CT-guided RF ablation using an internally cooled monopolar single RF electrode (Cool-tip, Valleylab, TycoHealthcare, Boulder, USA; active tip: 10 mm). For the removal of the nidus, we used either a manual or an automated drill. The technical success was evaluated by a CT scan (MSCT, Siemens Medical Solutions, Forchheim). The clinical long-term success was investigated by questioning patients prior to discharge, and after 6, 12 and 18 months. After 18 months, patients were interviewed on an annual basis. Results: The technical success rate was 100 %. The nidus was located in n = 19 cases at the lower extremity and in n = 4 cases at the upper extremity. Minor complications were observed for n = 2 patients. The mean hospitalization time was 1.5 d (1-2 d). The mean follow-up was 75.9 months (18-120 months) for n = 23 patients. No local recurrence was observed. One patient had intermediate pain one week after RF ablation without recurrent symptoms. Conclusion: CT-guided RF ablation using an internally cooled monopolar single RF electrode is an effective and safe minimally invasive method for the treatment of osteoid osteoma with excellent clinical long-term success. (orig.)

  19. Long term morphological modelling

    DEFF Research Database (Denmark)

    Kristensen, Sten Esbjørn; Deigaard, Rolf; Taaning, Martin;

    2010-01-01

    A morphological modelling concept for long term nearshore morphology is proposed and examples of its application are presented and discussed. The model concept combines parameterised representations of the cross-shore morphology, with a 2DH area model for waves, currents and sediment transport in...

  20. Long-Term Collections

    CERN Multimedia

    Comité des collectes à long terme

    2011-01-01

    It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

  1. Long-term study of ovine pulmonary adenocarcinogenesis in sheep with marginal vs. sufficient nutritional selenium supply: results from computed tomography, pathology, immunohistochemistry, JSRV-PCR and lung biochemistry.

    Science.gov (United States)

    Humann-Ziehank, Esther; Renko, Kostja; Bruegmann, Michael L; Devi, Vemuri Rama; Hewicker-Trautwein, Marion; Andreae, Arnim; Ganter, Martin

    2013-10-01

    The impact of selenium (Se) in carcinogenesis is still debatable due to inconsistent results of observational studies, recent suspicion of diabetic side effects and e.g. dual roles of glutathione peroxidases (GPx). Previously, our group introduced long-term studies on lung carcinogenesis using the jaagtsiekte sheep retrovirus (JSRV) induced ovine pulmonary adenocarcinoma (OPA) as an innovative animal model. The present report describes the results of sufficient (0.2 mg Se/kg dry weight (dw)) vs. marginal (CT) evaluation of lung cancer progression, final pathological examination, evidence of pro-viral JSRV-DNA in lung, lymph nodes and broncho-alveolar lavage cells as well as biochemical analysis of Se, GPx1 and thioredoxin reductase (TrxR) activity in lung tissue were recorded. Additionally, immunohistochemical determination of GPx1 expression in unaffected and neoplastic lung cells was implemented. The feeding regime caused significant differences in Se concentration and GPx1 activity in lung tissue between groups, whereas TrxR activity remained unaffected. JSRV was evident in broncho-alveolar lavage cells, lung tissue and lung lymph nodes. Quarterly executed CT could not demonstrate differences in lung cancer proliferation intensity. Necropsy and histopathology substantiated CT findings. Immunohistochemical analysis of GPx1 in lung tissue suggested a coherency of GPx1 immunolabelling intensity in dependence of tumour size. It was concluded that the model proved to be suitable for long-term studies of lung cancer proliferation including the impact of modifiable nutritional factors. Proliferation of OPA was unaffected by marginal vs. sufficient nutritional Se supply.

  2. [Early complications and long-term results of the LeVeen peritoneo-venous shunt in the treatment of refractory ascites].

    Science.gov (United States)

    Arciero, G; Di Blasio, V; Botta, V; Rossi, M; Pigna, F; Di Tora, A

    1996-11-01

    Results concerning 14 cirrhotic patients who underwent LeVeen peritoneo-venous shunt for refractory or complicated ascites are discussed. The most relevant early complications regard coagulation disorders (35.7%) with a 14.3% postoperative mortality. The functional result appears largely satisfactory, also in terms of long-term efficiency. Utility of a wide evacuation of ascitic fluid during the operation is underlined. Ascites drainage at operation doesn't compromise shunt function or renal resumption, furthermore it may prevent some life-threatening complications like DIC, esophageal varices rupture and congestive heart failure. PMID:9072716

  3. Parental knowledge reduces long term anxiety induced by false-positive test results after newborn screening for cystic fibrosis

    NARCIS (Netherlands)

    Vernooij-van Langen, A.M.M.; Pal, S.M. van der; Reijntjens, A.J.T.; Loeber, J.G.; Dompeling, E.; Dankert-Roelse, J.E.

    2014-01-01

    Background: False-positive screening results in newborn screening for cystic fibrosis may lead to parental stress, family relationship problems and a changed perception of the child's health. Aim of the study: To evaluate whether parental anxiety induced by a false positive screening result disappea

  4. Long-term tolerability of tolterodine extended release in children 5-11 years of age: results from a 12-month, open-label study

    DEFF Research Database (Denmark)

    Nijman, Rien J M; Borgstein, Niels G; Ellsworth, Pamela;

    2007-01-01

    events (AEs) and the incidence and reasons for withdrawals. Visits were scheduled at 3, 6, 9, and 12 mo, and investigators were instructed to report all AEs. At 6 and 12 mo, vital signs were recorded and a physical examination was performed. RESULTS: A total of 318 patients were enrolled (double...... (7%), nasopharyngitis (5%), headache (5%), and abdominal pain (4%); 111 (35%) patients withdrew. The most common reasons for withdrawal were lack of efficacy (12%), symptom improvement (8%), and withdrawn consent (6%). Ten patients (3%) withdrew because of AEs. CONCLUSION: Long-term treatment...

  5. Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system

    Science.gov (United States)

    Sollitto, Francesco; Loizzi, Domenico; Di Gennaro, Francesco; Scarascia, Daniele; Carlucci, Annalisa; Giudice, Giuseppe; Armenio, Andrea; Ludovico, Rossana; Loizzi, Michele

    2016-01-01

    Background We report short and long-term results with the dedicated Synthes® titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. Methods We retrospectively analyzed (January 2010 to December 2014) 27 consecutive patients (22 males, 5 females; range 16–83 years, median age 60 years), treated with this system: primary [3] and secondary [8] chest wall tumor; flail chest [5]; multiple ribs fractures [5]; sternal dehiscence-diastasis [3]; sternal fracture [1]; sternoclavicular joint dislocation [1]; Poland syndrome [1]. Short-term results were evaluated as: operating time, post-operative morbidity, mortality, hospital stay; long-term results as: survival, plates-related morbidity, spirometric values, chest pain [measured with Verbal Rating Scale (VRS) and SF12 standard V1 questionnaire]. Results Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115–430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5–129 days). At a median follow-up of 20 months (range: 1–59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. Conclusions An optimal chest wall stabilization and reconstruction was achieved with the Synthes® titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time

  6. Microstructure and diffraction pattern changes resulted from long-term aging of martensite CuZnAlMnNi shape memory alloy

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Microstructures of a CuZnAlMnNi shape memory alloy in the as-quenched and long-term aged conditions were investigated by transmission electron microscopy. Aged for one year in martensite phase, an equilibrium (-phase with fcc structure was observed in the M18R martensite matrix, accompanied by the appearance of a novel diffraction pattern. By analysis, it was suggested that the novel pattern results from the (-phase and the martensite matrix remaining in seven fine plates which produce intense secondary diffraction effect when the diffraction beams enter from one phase into another.

  7. High versus low-pressure balloon inflation during multilinktrade mark stent implantation: acute and long-term angiographic results.

    Science.gov (United States)

    Caixeta, A M; Brito, F S; Rati, M; Perin, M A; da Luz, P L; Ramires, J A; Ambrose, J A; Martinez, E E

    2000-08-01

    We compared the impact of low and high-pressure balloon inflation on acute and late angiographic results of Multilink stent. Low-pressure balloon inflation (9.5 +/- 1.9 atm) was used in 43 stents and high pressure (17.1 +/- 1.5 atm) in 44. A larger immediate luminal gain was achieved in stents with high-pressure balloon inflation (1.80 +/- 0.26 vs. 1.47 +/- 0.62; P = 0.002), resulting in a larger mean diameter in this group (2.71 +/- 0.37 vs. 2.48 +/- 0.47; P = 0.017). At follow-up, a larger luminal diameter was achieved in the high pressure group (1.93 +/- 0.72 vs. 1.45 +/- 0.66; P = 0.002) and a trend to a lower rate of angiographic restenosis (15% vs. 38%, P = 0.08).

  8. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results *

    OpenAIRE

    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 patie...

  9. Long-term results of clubfoot treatment after more than 20 years, clinical, radiological and in gaitlab

    CERN Document Server

    Wachter, R K

    2001-01-01

    clinical, morphological findings correlated (p=0,041) as well as there was a connection to the static range of motion (p=0,001). Though, there was no significant correlation between the score and the dynamic range of motion, which represents the results of the gaitlab analysis. However the dynamic range of motion correlated to the R/L ratio significantly(p<0,0001). Finally the result of the enforced treatment of clubfoot was able to be assessed good as far as the subjective condition of patients is concerned, in spite of the poor morphological and radiological result after 20 years. Moreover it was proved by gaitlab analysis, that dynamic ankle mobility is influenced by talar flattening. In this retrospective study 19 patients with altogether 27 congenital clubfeet were evaluated. Five patients (26 %) were female and 14 patients (74 %) were male. Between the operation and the examination there was an average follow up time of 21,5 years. In 8 cases the method of Turco had been used and 19 feet had been tre...

  10. Intraoperative radiotherapy given as a boost for early breast cancer: Long-term clinical and cosmetic results

    International Nuclear Information System (INIS)

    Purpose: The standard radiotherapy (RT) of breast cancer consists of 50 Gy external beam RT (EBRT) to the whole breast followed by an electron boost of 10-16 Gy to the tumor bed, but this has several cosmetic disadvantages. Intraoperative radiotherapy (IORT) could be an alternative to overcome these. Methods and Materials: We evaluated 50 women with early breast cancer operated on in a dedicated IORT facility. Median dose of 10 Gy was delivered using 9-MeV electron beams. All patients received postoperative EBRT (50 Gy in 2 Gy fractions). Late toxicity and cosmetic results were assessed independently by two physicians according to the Common Terminology Criteria for Adverse Event v3.0 grading system and the European Organization for Research and Treatment of Cancer questionnaires. Results: After a median follow-up of 9.1 years (range, 5-15 years), two local recurrences were observed within the primary tumor bed. At the time of analysis, 45 patients are alive with (n = 1) or without disease. Among the 42 disease-free remaining patients, 6 experienced Grade 2 late subcutaneous fibrosis within the boost area. Overall, the scores indicated a very good quality of life and cosmesis was good to excellent in the evaluated patients. Conclusion: Our results confirm that IORT given as a boost after breast-conserving surgery is a reliable alternative to conventional postoperative fractionated boost radiation

  11. Insights into the impact and use of research results in a residential long-term care facility: a case study

    Directory of Open Access Journals (Sweden)

    Cranley Lisa A

    2012-09-01

    Full Text Available Abstract Background Engaging end-users of research in the process of disseminating findings may increase the relevance of findings and their impact for users. We report findings from a case study that explored how involvement with the Translating Research in Elder Care (TREC study influenced management and staff at one of 36 TREC facilities. We conducted the study at ‘Restwood’ (pseudonym nursing home because the Director of Care engaged actively in the study and TREC data showed that this site differed on some areas from other nursing homes in the province. The aims of the case study were two-fold: to gain a better understanding of how frontline staff engage with the research process, and to gain a better understanding of how to share more detailed research results with management. Methods We developed an Expanded Feedback Report for use during this study. In it, we presented survey results that compared Restwood to the best performing site on all variables and participating sites in the province. Data were collected regarding the Expanded Feedback Report through interviews with management. Data from staff were collected through interviews and observation. We used content analysis to derive themes to describe key aspects related to the study aims. Results We observed the importance of understanding organizational routines and the impact of key events in the facility’s environment. We gleaned additional information that validated findings from prior feedback mechanisms within TREC. Another predominant theme was the sense that the opportunity to engage in a research process was reaffirming for staff (particularly healthcare aides—what they did and said mattered, and TREC provided a means of having one’s voice heard. We gained valuable insight from the Director of Care about how to structure and format more detailed findings to assist with interpretation and use of results. Conclusions Four themes emerged regarding staff engagement with

  12. Binaries with a $\\delta$ Scuti component: Results from a long term observational survey, updated catalogue and future prospects

    CERN Document Server

    Liakos, Alexios

    2015-01-01

    Results from a six year systematic observational survey on candidate eclipsing binaries with a $\\delta$ delta Sct component are presented. More than a hundred systems with component(s) of A-F spectral types were observed in the frame of this survey in order to be checked for possible pulsational behaviour. The 14% (13 cases) of the currently known such systems were discovered during this survey. Using all the available information from the literature, an updated list with all the currently known systems of this type is presented, while possible correlations between their pulsational and binarity properties are discussed.

  13. Long-term results of clubfoot treatment after more than 20 years, clinical, radiological and in gaitlab

    International Nuclear Information System (INIS)

    In this retrospective study 19 patients with altogether 27 congenital clubfeet were evaluated. Five patients (26 %) were female and 14 patients (74 %) were male. Between the operation and the examination there was an average follow up time of 21,5 years. In 8 cases the method of Turco had been used and 19 feet had been treated by Achilles tendon lengthening and posterior capsulotomy. Reoperation had been necessary in 41 % of the feet because of relapse. For investigation the clubfoot score by Bensahel and Dimeglio was used. Further the talocalcaneal index and the R/L ratio, which indicates talar flattening, were determined. The subjective condition of the patients were ascertained and the patient's gait was analyzed by gaitlab. When the score by Bensahel and Dimeglio is divided into three equal sighted parts, 19 feet (70 %) are situated within the best third and 8 (30 %) feet are situated within the middle third. The average talocalcaneal index amounted to 53,4o (an index under 40o means adequate correction of clubfoot) and the average R/L ratio was 0,6 (normal: 0,37 ± 0,05). The average static range of motion amounted to 33o (normal: 68o) in comparison to the dynamic range of motion, which was average 17,9o (normal: 25o). In the statistical evaluation a correlation was found between the functional status of the score and the radiological results, as far as the score is concerned (p=0,002). The radiological outcome of the score and the clinical, morphological findings correlated (p=0,041) as well as there was a connection to the static range of motion (p=0,001). Though, there was no significant correlation between the score and the dynamic range of motion, which represents the results of the gaitlab analysis. However the dynamic range of motion correlated to the R/L ratio significantly(p<0,0001). Finally the result of the enforced treatment of clubfoot was able to be assessed good as far as the subjective condition of patients is concerned, in spite of the poor

  14. Lymphocytes with multiple chromosomal damages in a large cohort of West Siberia residents: Results of long-term monitoring.

    Science.gov (United States)

    Druzhinin, Vladimir; Bakanova, Maria; Fucic, Aleksandra; Golovina, Tatiana; Savchenko, Yana; Sinitsky, Maxim; Volobaev, Valentin

    2016-01-01

    Cells with specific multiple chromosome aberrations, defined as rogue cells (RC) have been described in different populations, predominantly those exposed to radiation. The frequency, etiology and related health risks have still not been elucidated due to their low frequency of occurrences and rarely performed studies. This study reports RC frequency using chromosome aberration (CA) assay in peripheral lymphocytes in the group of 3242 subjects, during a 30-year long follow-up study in a general rural and urban population, children environmentally exposed to radon, occupationally exposed population and lung cancer patients from the Kemerovo region (Siberia, Russian Federation). Results show that the highest RC frequency was present in children environmentally exposed to radon and the lowest in the general urban population. Total frequency of CA did not correlate with frequency of RC. Genotoxic analysis of air and water samples excluded anthropogenic pollution as a possible cause of genome damage and RC frequency. In 85% of RCs, double minutes, observed in a large number of human tumors, were present. Results of CA analysis suggested that radon and its decay products (alpha-emitters) were the leading factors causing RC in subjects exposed to high LET radiation. Thus, RC may be a candidate biomarker for exposure to this type of radiation. PMID:26731314

  15. Long term effects of preventive activities of youth health care in The Netherlands: results of a four-part study

    Directory of Open Access Journals (Sweden)

    Pieter A. Wiegersma

    2004-12-01

    Full Text Available

    Background. In this article the results are presented of a four part study on the effect of screening for scoliosis and (repeated well-care visits and freely accessible consultation hours at secondary schools, on the incidence and prevalence of (parasuicide, mental health, adolescent health compromising behaviour and lastly obesity.

    Methods. An ecologic case-referent study design was used with data from the Netherlands Bureau of Statistics, the Ministry of Defence, the 1992 High-School Student Study, all of the youth health care departments in The Netherlands and relevant censuses.

    Results. Attention to mental and physical health and health compromising behaviour, either during screening, open consultation hours or during well-care visits seems to be ineffective and in some instances even detrimental to youth health.

    Of the 18 different outcome measurements, 5 were significantly negative and none were significantly positive.

    Conclusions. This four part study does not support the hypothesis that on a population level, the preventive activities of youth health care departments such as screening for scoliosis, (more frequent well-care visits or offering open consultation hours at secondary schools, have a beneficial effect on prevention of (parasuicide, poor mental health, health compromising behaviour or obesity.

  16. Final results from TRIGA LEU fuel post-irradiation examination and evaluation following long term irradiation testing in the ORR

    International Nuclear Information System (INIS)

    The qualification testing of TRIGA-LEU (U-ZrH) fuels to high burnups in the ORR has been completed successfully over a 5-yr period. These fuels have included loadings of 20 wt %, 30 wt %, and 45 wt % uranium; 19.7% enriched. The irradiated fuel rods have been subjected to a comprehensive PIE following burnups of up to 64% of the U-235, exposures of 919 FPD and fast neutron fluences of 5x1021n/cm2. No limiting values were reached on fuel burnup. Fuel growth was as predicted. Evidence was shown of limited thermal migration of hydrogen. There was no pressure buildup inside the cladding. Fission product release from highly burned fuel doesn't appear to be significantly different from fresh fuel. The results have demonstrated that these fuels will retain their integrity to burnups well in excess of the design goals. (author). 5 figs, 3 tabs

  17. Concurrent cisplatin and radiotherapy for inoperable bladder cancer: long term results and prognostic predictors of local control and survival

    International Nuclear Information System (INIS)

    Therapeutic strategies for muscle invasive bladder cancer are currently evolving. A recent European randomized study has shown that neo-adjuvant chemotherapy does not improve the chance of cure or of conservative treatment. Concurrent chemotherapy and radiotherapy would provide better results but these is a need to identify by prognostic factors patients who may benefit from such a conservative strategy. Concurrent cisplatin and radiation therapy is a potentially locally curative treatment for 43 % of patients with muscle-invasive bladder cancer not candidates for radical surgery. Clinical T-stage and hydronephrosis have a significant and independent prognostic value on local control but appears not discriminant enough to select patients for conservative treatment. (authors)

  18. Research results of long-term use of new line of machines and tools for land surface and depth arrangement

    Directory of Open Access Journals (Sweden)

    Ercegović Đuro T.

    2010-01-01

    Full Text Available This paper presents the results of the application of the machines and tools for new technologies in plant production for two years of research. The comparative analysis of the influence of new technologies and new types of machines was done, and also the effect of conventional tillage systems on several agricultural crops (sunflower, commercial maize and wheat. During the experiment, we analyzed the effects of application of new line of machines to: physical properties of soil, morphological features of crops, use of energy and yield, and we also analyzed the economic aspects of the application. On the control plots, a conventional tillage system was simultaneously applied for comparative analysis of the previously mentioned factors. Trials were conducted on production plots of Maize Research Institute “Zemun Polje” in Krnješevci from October 2008 until July 2010.

  19. Long-Term Results from Evaluation of Advanced New Construction Packages in Test Homes. Martha's Vineyard, Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    Stecher, Dave [IBACOS, Inc., Pittsburgh, PA (United States); Allison, Katherine [IBACOS, Inc., Pittsburgh, PA (United States); Prahl, Duncan [IBACOS, Inc., Pittsburgh, PA (United States)

    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.

  20. PICARD SOL, a new ground-based facility for long-term solar radius measurements: first results

    Science.gov (United States)

    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.

  1. The long term response of birds to climate change: new results from a cold stage avifauna in northern England.

    Directory of Open Access Journals (Sweden)

    John R Stewart

    Full Text Available 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.

  2. The long term response of birds to climate change: new results from a cold stage avifauna in northern England.

    Science.gov (United States)

    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. PMID:25992609

  3. Long-Term Results of Brachytherapy for Carcinoma of the Penis Confined to the Glans (N- or NX)

    International Nuclear Information System (INIS)

    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 cm3 (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.

  4. Long-Term Results of a Randomized Trial in Locally Advanced Rectal Cancer: No Benefit From Adding a Brachytherapy Boost

    Energy Technology Data Exchange (ETDEWEB)

    Appelt, Ane L., E-mail: ane.lindegaard.appelt@rsyd.dk [Department of Oncology, Vejle Hospital, Vejle (Denmark); Faculty of Health Sciences, University of Southern Denmark, Odense (Denmark); Vogelius, Ivan R. [Department of Radiation Oncology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Pløen, John; Rafaelsen, Søren R.; Lindebjerg, Jan; Havelund, Birgitte M. [Danish Colorectal Cancer Group South, Vejle Hospital, Vejle (Denmark); Bentzen, Søren M. [Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland (United States); Jakobsen, Anders [Faculty of Health Sciences, University of Southern Denmark, Odense (Denmark); Danish Colorectal Cancer Group South, Vejle Hospital, Vejle (Denmark)

    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.

  5. Long-Term Results of a Randomized Trial in Locally Advanced Rectal Cancer: No Benefit From Adding a Brachytherapy Boost

    International Nuclear Information System (INIS)

    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

  6. Long-Term Results from Evaluation of Advanced New Construction Packages in Test Homes: Martha's Vineyard, Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Long-term quasi-periodicity of 4U 1636-536 resulting from accretion disc instability

    CERN Document Server

    Wisniewicz, Mateusz; Gondek-Rosinska, Dorota; Zdziarski, Andrzej A; Janiuk, Agnieszka

    2015-01-01

    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, 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, for the hot and cold phases. Our best model gives relatively low values of viscosity parameter for cold phase 0.01 and for h...

  8. Prognostic Significance of Immunoreactive Neutrophil Elastase in Human Breast Cancer: Long-Term Follow-Up Results in 313 Patients

    Directory of Open Access Journals (Sweden)

    Miwa Akizuki

    2007-03-01

    Full Text Available OBJECTIVE: We have measured the concentration of immunoreactive neutrophil elastase (ir-NE in the tumor extracts of 313 primary human breast cancers. Sufficient time has elapsed, and we are now ready to analyze its prognostic value in human breast cancer. METHODS: ir-NE concentration in tumor extracts was determined with an enzyme-linked immunosorbent assay that enables a rapid measurement of both free-form ir-NE and the α1-protease inhibitor-complexed form of ir-NE. We analyzed the prognostic value of this enzyme in human breast cancer in univariate and multivariate analyses. RESULTS: Patients with breast cancer tissue containing a high concentration of ir-NE had poor survival compared to those with a low concentration of ir-NE at the cutoff point of 9.0 µg/100 mg protein (P = .0012, which had been previously determined in another group of 49 patients. Multivariate stepwise analysis selected lymph node status (P= .0004; relative risk = 1.46 and ir-NE concentration (P= .0013; relative risk = 1.43 as independent prognostic factors for recurrence. CONCLUSIONS: Tumor ir-NE concentration is an independent prognostic factor in patients with breast cancer who undergo curative surgery. This enzyme may play an active role in tumor progression that leads to metastasis in human breast cancer.

  9. LONG-TERM RESULTS OF TRANSMYOCARDIAL LASER REVASCULARIZATION COMBINED WITH IMPLANTATION OF AUTOLOGOUS BONE MARROW MONONUCLEAR FRACTION IN THE TREATMENT OF CHRONIC ISCHEMIC HEART DISEAS

    Directory of Open Access Journals (Sweden)

    A. M. Chernyavsky

    2016-01-01

    Full Text Available Aim. Clinical and instrumental assessment of long-term results of autologous bone marrow cells (BMC implantation in laser channels in surgery of ischemic heart disease with diffuse and distal coronary disease.Materials and Methods. In the period of 2007–2008 35 CHD patients with diffuse and distal coronary disease underwent BMC implantation in laser channels during coronary artery bypass grafting (CABG. The control group consisted of 29 patients. All patients in this group underwent only direct myocardial revascularization (DMR. In the long-term period we examined only 30 patients of the first group. Clinical and instrumental assessment of the method efficacy was carried out in 2 weeks, 6 months and 6 years after surgery.Results. FC (NYHA mean value in indirect revascularization group significantly decreased from 2.57 ± 0.61 preoperatively to 1.77 ±0.66 in6 months after surgery (p = 0.043. After 6 years FC (NYHA was not significantly changed – 1.84 ± 0.42 (p = 0.053. Perfusion scintigraphy revealed a slight decrease of stable perfusion defect (SPD in the immediate postoperative period, a more pronounced reduction of SPD in 6 months after surgery. The average value of SPD before surgery was 20.46 ± 10.75%, in 2 weeks after the operation – 19.07 ± 9.69%, in 6 months after surgery – 15.22 ± 9.49%. In the long-term period (6 years SPD was 14.8 ± 8.43% (p = 0.047. A similar pattern was observed in the analysis of transient perfusion defect: baseline – 30 ± 2.2%, in 6 months – 15 ± 1.3%, in the long term period – 20 ± 6.1% (p = 0.047. The average value of left ventricular ejection fraction (LVEF before surgery was 55 ± 10.4%, in 2 weeks after the operation – 55.7 ± 9.3%, in 6 months – 56.7 ± 10%, after 6 years – 54 ± 12%. The dynamics is unauthentic (p = 0.068.Conclusion. BMC implantation in laser channels in addition to CABG is a safe and effective method of surgical treatment in case of CABG inability. The effect of

  10. Long-term therapy with oral treprostinil in pulmonary arterial hypertension failed to lead to improvement in important physiologic measures: results from a single center.

    Science.gov (United States)

    Chin, Kelly Marie; Ruggiero, Rosechelle; Bartolome, Sonja; Velez-Martinez, Mariella; Darsaklis, Konstantina; Kingman, Martha; Harden, Scarlet; Torres, Fernando

    2015-09-01

    Sustained-release oral treprostinil, an oral prostacyclin, led to significant improvement in 6-minute walk distance (6MWD) versus placebo in treatment-naive patients with pulmonary arterial hypertension (PAH) but failed to lead to significant improvement in two 16-week trials in patients receiving background PAH therapies (FREEDOM studies). Long-term studies are lacking. Our objective was to evaluate 6MWD, functional class, hemodynamics, and other long-term outcomes during oral treprostinil administration in PAH. Patients receiving oral treprostinil through the FREEDOM studies at our institution were included and were followed for up to 7 years. The primary end point was change in pulmonary vascular resistance (PVR) at first follow-up catheterization. Other end points included 6MWD, functional class, and other hemodynamic results. Thirty-seven patients received oral treprostinil for a median of 948 days, with 81%, 61%, and 47% continuing therapy at 1, 2, and 3 years, respectively. Mean treprostinil dose at 3, 12, and 24 months was 4.3 ± 2.3, 8.6 ± 3.2, and 11.7 ± 5.8 mg/24 h, respectively. Compared with pretreatment values, there was no significant change in 6MWD at 3 or 12 months, no improvement in functional class at 12 months, and no significant change in hemodynamics at the first follow-up catheterization (N = 34). Oral treprostinil dose was inversely associated with change in PVR (r = -0.42, P < 0.05), and change in PVR was numerically better among patients in the highest dosing quartile. No significant improvement in 6MWD, functional class, or hemodynamics versus pretreatment values was seen with long-term oral treprostinil therapy, potentially because of inability to achieve a clinically effective dose. PMID:26401252

  11. Combating the Urban Heat Island Effect: Results from a Long-Term Monitoring Study on Urban Green, White, and Black Roofs in New York City

    Science.gov (United States)

    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

  12. The main factors affecting the long-term outcomes in patients after acute cerebrovascular disorder: results of the LIS-2 study

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    S. Yu. Martsevich

    2016-01-01

    Full Text Available Aim. To evaluate the long-term prognosis of life in patients after cerebral stroke (MI and to identify the main factors influencing it.Material and methods. All patients (n=960 who had MI or transient ischemic attack in the period from 01.01.2009 to 31.12.2011, admitted to Lyubertsy district hospital №2, were included into the register of LIS-2. The primary endpoint was total mortality of patients.Results. The average age of patients was 72±9 years, 2/3 were women. 207 patients (21.7% died in the hospital, 753 were discharged from the hospital. Median follow-up was 2.8 (2.1, 3.5 years. 31.5% of the patients died during this period. The main cause of death (36% was re-MI, and 22.4% of patients died from the heart failure. The relative risk (RR of death was significantly increased with the age of patients (RR=1.1. The probability of death increased in the presence of diabetes mellitus (RR=1.4, alcohol abuse (RR=2.3, any signs of consciousness disorders in the acute phase of MI (RR=1.6, heart failure (RR=1.6, atrial fibrillation (RR=1.4. Patients who were treated with calcium channel blockers before admission to the hospital, had a lower risk of death than those who did not receive these drugs (RR=0.4. Prescription of ACE inhibitors at discharge from the hospital reduced significantly the risk of death in the long-term period (RR=0.7.Conclusion. High rate of long-term mortality in the LIS-2 register can be largely explained by the poor quality of primary and secondary prevention of cardiovascular events.

  13. Long-term results of the use of autogenous cortical bone columellas to replace the stapes at stapedectomy.

    Science.gov (United States)

    Bauer, Miklós; Pytel, József; Vóna, Ida; Gerlinger, Imre

    2011-05-01

    The first author has been using an autogenous cortical bone columella to replace the stapes removed during stapedectomy since 1965. The audiograms of 21 of the 271 patients operated on with this method between 1965 and 1989 (i.e. 7.7% of the possible candidates) were available 20-35 (average 26.8) years postoperatively. The operation could be regarded as successful in 20 and unsuccessful in 1 patient in the long run. The audiological data are presented individually as averages of the values obtained at 0.5, 1, 2 and 3 kHz. The averaged data (n = 21): preoperative air conduction, 58.27; bone conduction, 24.46; and air-bone gap, 33.81 dB. Postoperative best air conduction, 19.07; bone conduction, 14.10; and air-bone gap, 4.97 dB. Postoperative recent air conduction, 45.77; bone conduction, 38.45; and air-bone gap, 7.32 dB. The best values were measured 1-8 (average 1.57) years postoperatively. In relation to the postoperative best value, the recent value of the air-bone gap had deteriorated by 2.35 dB, and that of the bone conduction by 24.35 dB. The small air-bone gap indicates that the deterioration of the hearing is mainly caused by the deterioration of the function of the inner ear and not by that of the conductive apparatus. The progression of the deterioration differs individually (0.3-1.6, average 0.93 dB/year) and accelerates with age. This finding seems to be a problem that does not depend on the operative technique. The data show that the autogenous bone columella ensures the same good and lasting results as the alloplastic solutions; moreover, there is no problem with the incus-prosthesis connection.

  14. In situ replacement of infected vascular prosthesis with fresh arterial homograft: Early and long-term results in 18 patients

    Directory of Open Access Journals (Sweden)

    Pejkić Siniša

    2013-01-01

    Full Text Available Introduction. Graft infection is rightly considered one of the severest complications of vascular reconstruction. Treatment is non­standardized and associated with high mortality and morbidity rates. The choice of therapeutic modality depends upon variety of factors. One increasingly used option is in situ replacement of the infected prosthesis with the arterial allograft. Objective. The aim of this prospective nonrandomized study was to evaluate the effectiveness and durability of fresh arterial allograft as in situ substitute for the infected vascular prosthesis. Methods. During period of 2002-2005, 18 patients with the synthetic vascular graft infection underwent partial or complete prosthesis removal and secondary in situ reconstruction using the fresh arterial allograft, preserved under hypothermic conditions in buffered saline solution with an addition of antibiotics. Results. In 14 male and 4 female patients, meanaged 62 years, 8 aortic and 10 peripheral arterial infected prostheses were partially or completely replaced with the allograft. Operative mortality was 27.8% and amputation rate was 22.2%. Systemic sepsis at initial presentation and highly virulent nature of causative microorganisms were identified as significant negative prognostic factors (χ² test, p<0.05. During the long­term follow­up (mean 47 months, allograft aneurysm developed in three patients, requiring allograft explantation, followed in two cases by tertiary prosthetic reconstruction. Conclusion. Substitution of the infected prosthesis with the arterial allograft could be successful if used selectively - for less virulent and localized infections of extracavitary grafts. Close follow­up is mandatory for timely diagnosis of late homograft lesions and its eventual replacement with more durable prosthetic material.

  15. Long-term results in malignant pleural mesothelioma treated with neoadjuvant chemotherapy, extrapleural pneumonectomy and intensity-modulated radiotherapy

    International Nuclear Information System (INIS)

    We investigated the clinical outcome and the toxicity of trimodal therapy of malignant pleural mesothelioma (MPM) treated with neoadjuvant chemotherapy, extrapleural pneumonectomy (EPP) and adjuvant intensity-modulated radiotherapy (IMRT). Chemotherapy regimens included Cisplatin/Pemetrexed, Carboplatin/Pemetrexed and Cisplatin/Gemcitabine, followed by EPP. 62 patients completed the adjuvant radiotherapy. IMRT was carried out in two techniques, either step&shoot or helical tomotherapy. Median target dose was 48 Gy to 54 Gy. Toxicity was scored with the Common Terminology Criteria (CTC) for Adverse Events. We used Kaplan-Meier method to estimate actuarial rate of locoregional control (LRC), distant control (DC) and overall survival (OS), measured from the date of surgery. Rates were compared using the logrank test. For multivariate analysis the Cox proportional hazard model was used. The median OS, LRC and DC times were 20.4, 31.4 and 21.4 months. The 1-, 2-, 3-year OS rates were 63, 42, 28 %, the LRC rates were 81, 60, 40 %, and the DC rates were 62, 48, 41 %. We observed no CTC grade 4 or grade 5 toxicity. Step&shoot and helical tomotherapy were equivalent both in dosimetric characteristics and clinical outcome. Biphasic tumor histology was associated with worse clinical outcome compared to epitheloid histology. Mature clinical results of trimodal treatment for MPM were presented. They indicate that hemithoracic radiotherapy after EPP can be safely administered by either step&shoot IMRT and tomotherapy. However, the optimal prospective patient selection for this aggressive trimodal therapy approach remains unclear. This study can serve as a benchmark for current and future therapy concepts for MPM. The online version of this article (doi:10.1186/s13014-015-0575-5) contains supplementary material, which is available to authorized users

  16. Small Boreal Lake Ecosystem Evolution under the Influence of Natural and Anthropogenic Factors: Results of Multidisciplinary Long-Term Study

    Directory of Open Access Journals (Sweden)

    Liudmila Shirokova

    2016-07-01

    Full Text Available Small aquatic ecosystems of the boreal zone are known to be most sensitive indicators of on-going environmental change as well as local anthropogenic pressure, while being highly vulnerable to external impacts. Compared to rather detailed knowledge of the evolution of large and small lakes in Scandinavia and Canada, and large lakes in Eurasia, highly abundant small boreal lakes of northwest Russia have received very little attention, although they may become important centers of attraction of growing rural population in the near future. Here we present the results of a multidisciplinary, multi-annual study of a small boreal humic lake of NW Russia. A shallow (3 m and a deep (16 m site of this lake were regularly sampled for a range of chemical and biological parameters. Average multi-daily, summer-time values of the epilimnion (upper oxygenated layer of the lake provided indications of possible trends in temperature, nutrients, and bacterio-plankton concentration that revealed the local pollution impact in the shallow zone and overall environmental trend in the deep sampling point of the lake. Organic phosphorus, nitrate, and lead were found to be most efficient tracers of local anthropogenic pollution, especially visible in the surface layer of the shallow site of the lake. Cycling of trace elements between the epilimnion and hypolimnion is tightly linked to dissolved organic matter speciation and size fractionation due to the dominance of organic and organo-ferric colloids. The capacity of lake self-purification depends on the ratio of primary productivity to mineralization of organic matter. This ratio remained >1 both during winter and summer periods, which suggests a high potential of lake recovery from the input of allochthonous dissolved organic matter and local anthropogenic pollution.

  17. Long-term intrathecal morphine and bupivacaine in "refractory" cancer pain. I. Results from the first series of 52 patients.

    Science.gov (United States)

    Sjöberg, M; Appelgren, L; Einarsson, S; Hultman, E; Linder, L E; Nitescu, P; Curelaru, I

    1991-01-01

    Neither epidural (EDA) or intrathecal (IT) morphine nor EDA opiate + bupivacaine provides acceptable relief of some types of cancer pain, e.g. pain originating from mucocutaneous ulcers, deafferentation pain, continuous and intermittent visceral and ischaemic pain, and that occurring with body movement as a result of a fracture. To improve pain relief in such conditions, we gave combinations of morphine and bupivacaine through open IT-catheters to 52 patients with "refractory", severe (VAS 7-10 out of 10), complex cancer pain (Edmonton Stage-3), for periods of 1-305 (median = 23) days. The efficacy of the treatment was estimated from: 1) daily dosage (intraspinal and total opiates, and intraspinal bupivacaine), and 2) scores of non-opiate analgesic and sedative consumption, gait and daily activities, and amount and pattern of sleep. Forty-four patients obtained continuous and acceptable pain relief (VAS 0-2), 26 of them with daily doses of IT-bupivacaine of less than or equal to 30 mg/day (less than or equal to 1.5 mg/h). Higher IT-bupivacaine doses (greater than 60-305 mg/day), not always giving acceptable pain relief, were necessary in 13 patients with deafferentation pain from the spinal cord or brachial or lumbosacral plexuses or pain from the coeliac plexus, or from large, ulcerated mucocutaneous tumours. By combining IT-bupivacaine with IT-morphine, it was possible to use relatively low IT-morphine doses (10-25 mg/day during the first 2 months of treatment) in more than half of the patients. The IT-treatment significantly decreased the total (all routes) opiate consumption and significantly improved sleep, gait and daily activities. For the whole period of observation (6 months), the IT-treatment was assessed as adequate in 3.8%, good in 23.1%, very good in 59.6% and excellent in 13.5% of the cases. Adverse effects of the IT-bupivacaine (paraesthesiae, paresis, gait impairment, urinary retention, anal sphincter disturbances and orthostatic hypotension) did

  18. Long-term results of a randomized controlled trial evaluating preoperative chemotherapy in resectable non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Chen ZW

    2013-06-01

    Full Text Available Zhiwei Chen,* Qingquan Luo,* Hong Jian, Zhen Zhou, Baijun Cheng, Shun Lu, Meilin LiaoShanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equallyObjective: We aimed to evaluate whether preoperative chemotherapy provides benefits in the survival and prognosis of patients with non-small cell lung cancer (NSCLC in resectable stages I to IIIA, except T1N0. Methods: In this randomized, controlled trial, 356 patients with stage I (except for T1N0, II and IIIA NSCLC were assigned to either the preoperative chemotherapy plus surgery arm (179 patients or the primary surgery arm (177 patients. Both treatments were followed by adjuvant chemotherapy. The end point of this study included overall survival (OS, progression-free survival (PFS, and survival rate associated with clinical remission. Results: Statistical survival difference was found between the preoperative chemotherapy plus surgery arm and the surgery-alone arm. However, the median survival time (MST in the preoperative chemotherapy arm was lower than that of surgery-alone arm (MST, 45.42 months vs 57.59 months (P = 0.016. When comparing the effect of preoperative chemotherapy at each stage of NSCLC, a statistical survival difference was found in stage II NSCLC but not in stage I and IIIA (MST 40.86 months vs 80.81 months (P = 0.044. However, no statistically significant difference in PFS was noticed between the two arms, except for stage I NSCLC (hazard radio [HR] = 0.87; 95% CI, 0.561−1.629; P = 0.027. The survival rate was higher for patients who had clinical remission after preoperative chemotherapy, but the differences did not reach statistical significance (MST 42.10 months vs 35.33 months (P = 0.630. Conclusion: Preoperative chemotherapy did not show benefits in OS and PFS for stage I-IIIA NSCLC patients. Keywords: NSCLC, neoadjuvent, mitomycin, cisplatin, vindesine

  19. Implante de Schocket modificado em glaucomas refratários: resultados a longo prazo Modified Schocket implant for refractory glaucoma: long-term results

    Directory of Open Access Journals (Sweden)

    João Antonio Prata Jr

    2000-12-01

    Full Text Available Objetivo:Analisar os resultados a longo prazo obtidos com o implante de Schocket modificado. Métodos: Os prontuários de 45 pacientes (45 cirurgias submetidas ao implante de Schocket modificado com pelo menos um ano de acompanhamento foram analisados. Estudou-se as taxas de sucesso (sucesso=PoPurpose: To analyze long-term results of modified Schocket implant. Methods: The records of 45 patients (45 surgeries with at least one year follow-up who received a modified Schocket implant were analyzed. Comparisons were made regarding success rates (final IOP< 22 mmHg, survival time, diag- nosis, initial and final IOP, percentual postoperative intraocular pressure (IOP reduction and complications. Results: After a mean follow-up of 31.9 ± 19.9 months 28 cases (62.2% were considered successful. Mean survival time was 38.9 months and success probability around 30 months 0.74. Initial IOP was 37.2 ± 11.3 mmHg and final IOP was 16.3 ± 9.3 mmHg and postoperative IOP reduction was 49.6 ± 32.6%. Survival analysis in the different diagnosis groups (neovascular, congenital, aphakic, postkeratoplasty did not reveal statistical significance. Conclusion: The results suggest that the modified Schocket implant provides satisfactory long-term control of refrac- tory glaucomas.

  20. Long-term clinical results of autologous bone marrow CD 133+ cell transplantation in patients with ST-elevation myocardial infarction

    Science.gov (United States)

    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.

  1. Morphological heterogeneity of oral salivary gland carcinomas: a clinicopathologic study of 41 cases with long term follow-up emphasizing the overlapping spectrum of adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma.

    Science.gov (United States)

    Schwarz, Stephan; Müller, Maximilian; Ettl, Tobias; Stockmann, Philipp; Zenk, Johannes; Agaimy, Abbas

    2011-04-01

    We analyzed 41 oral salivary gland carcinomas from consecutive 290 salivary gland carcinoma database (14%) with emphasis on the histological spectrum and clinical outcome of adenoid cystic carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA). The cohort included 14 ACCs, 14 mucoepidermoid carcinomas (MECs), 8 PLGAs, 3 adenocarcinomas, not otherwise specified and 2 acinic cell carcinomas. Mean age was 48, 58 and 61 yrs for ACC, MEC and PLGA, respectively. Eight patients (19.5%) died of tumor at a mean interval of 66.5 months. ACC and PLGA showed similar mean age, gender distribution, predominant palatal localization, nodal metastasis, perineural invasion and MIB-1 index. However, ACC tended to show higher tumor stage and residual tumor (R1/R2) more frequently than PLGA, but this was statistically not significant. ACC and PLGA showed overlapping architectural patterns. However, ACCs displayed well organized basal-luminal differentiation, highlighted by CK5/CK7 immunostaining. In contrast, PLGA showed a disorganized histological and immunohistological pattern. C-Kit expression (CD117) was common in ACC, generally mirroring that of CK7 and virtually lacking in PLGA. Kaplan-Meier analysis demonstrated a similar clinical course for ACC and PLGA with 5 years survivals of 87% and 80%, respectively. Fluorescence in situ hybridization (FISH) performed on all 290 salivary carcinomas confirmed the specificity of the translocation t (11; 19) for MEC and its absence in all other carcinomas including ACC and PLGA. Our results emphasize the diversity of oral salivary gland carcinomas and the overlapping clinicopathological features of ACC and PLGA.

  2. Long-term alpha interferon and lamivudine combination therapy in non-responder patients with anti-HBe-positive chronic hepatitis B: Results of an open, controlled trial

    Institute of Scientific and Technical Information of China (English)

    M. Francesca Jaboli; Marco Montagnani; Antonio Colecchia; Davide Festi; Letizia Bacchi Reggiani; Enrico Roda; Giuseppe Mazzella; Carlo Fabbri; Stefania Liva; Francesco Azzaroli; Giovanni Nigro; Silvia Giovanelli; Francesco Ferrara; Anna Miracolo; Sabrina Marchetto

    2003-01-01

    AIM: To investigate the safety and efficacy of long-term combination therapy with alpha interferon and lamivudine in non-responsive patients with anti-HBe-positive chronic hepatitis B.METHODS: 34 patients received combination treatment (1 month lamivudine, 12 month lamivudine+interferon, 6month lamivudine), 24 received lamivudine (12 months),24 received interferon (12 months). Interferon was administered at 6 MU tiw and lamivudine at 100 mg orally once daily. Patients were followed up for 6 months after treatment.RESULTS: At the end of treatment, HBV DNA negativity rates were 88 % with lamivudine+interferon, 99 % with lamivudine and 55 % with interferon, (P=0.004, combination therapy vs. interferon, and P=0.001 lamivudine vs.interferon), and serum transaminase normalization rates were 84 %, 91% and 53 % (P=0.01 combination therapy vs. interferon, and P=0.012 lamivudine vs. interferon). Six months later, HBV DNA negativity rates were 44 % with lamivudine+interferon, 33 % with lamivudine and 25 % with interferon, and serum transaminase normalization rates were 61%, 42 % and 45 %, respectively, without statistical significance. No YMDD variants were observed with lamivudine+interferon (vs. 12 % with lamivudine). The combination therapy appeared to be safe. CONCLUSION: Although viral clearance and transaminase normalization are slower with long-term lamivudine+interferon than that with lamivudine alone, the combination regimen seems to provide more lasting benefits and to protect against the appearance of YMDD variants. Studies with other regimens regarding sequence and duration are needed.

  3. Long-Term Collections

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    Staff Association

    2016-01-01

    45 years helping in developing countries! CERN personnel have been helping the least fortunate people on the planet since 1971. How? With the Long-Term Collections! Dear Colleagues, The Staff Association’s Long-Term Collections (LTC) Committee is delighted to share this important milestone in the life of our Laboratory with you. Indeed, whilst the name of CERN is known worldwide for scientific discoveries, it also shines in the many humanitarian projects which have been supported by the LTC since 1971. Several schools and clinics, far and wide, carry its logo... Over the past 45 years, 74 projects have been supported (9 of which are still ongoing). This all came from a group of colleagues who wanted to share a little of what life offered them here at CERN, in this haven of mutual understanding, peace and security, with those who were less fortunate elsewhere. Thus, the LTC were born... Since then, we have worked as a team to maintain the dream of these visionaries, with the help of regular donat...

  4. Long-Term Collection

    CERN Multimedia

    Staff Association

    2016-01-01

    Dear Colleagues, As previously announced in Echo (No. 254), your delegates took action to draw attention to the projects of the Long-Term Collections (LTC), the humanitarian body of the CERN Staff Association. On Tuesday, 11 October, at noon, small Z-Cards were widely distributed at the entrances of CERN restaurants and we thank you all for your interest. We hope to have achieved an important part of our goal, which was to inform you, convince you and find new supporters among you. We will find out in the next few days! An exhibition of the LTC was also set up in the Main Building for the entire week. The Staff Association wants to celebrate the occasion of the Long-Term Collection’s 45th anniversary at CERN because, ever since 1971, CERN personnel have showed great support in helping the least fortunate people on the planet in a variety of ways according to their needs. On a regular basis, joint fundraising appeals are made with the Directorate to help the victims of natural disasters around th...

  5. Collectes à long terme

    CERN Document Server

    Collectes à long terme

    2014-01-01

    En cette fin d’année 2014 qui approche à grands pas, le Comité des Collectes à Long Terme remercie chaleureusement ses fidèles donatrices et donateurs réguliers pour leurs contributions à nos actions en faveur des plus démunis de notre planète. C’est très important, pour notre Comité, de pouvoir compter sur l’appui assidu que vous nous apportez. Depuis plus de 40 ans maintenant, le modèle des CLT est basé principalement sur des actions à long terme (soit une aide pendant 4-5 ans par projet, mais plus parfois selon les circonstances), et sa planification demande une grande régularité de ses soutiens financiers. Grand MERCI à vous ! D’autres dons nous parviennent au cours de l’année, et ils sont aussi les bienvenus. En particulier, nous tenons à remercier...

  6. Long term results of postoperative Intensity-Modulated Radiation Therapy (IMRT) in the treatment of Squamous Cell Carcinoma (SCC) located in the oropharynx or oral cavity

    International Nuclear Information System (INIS)

    To report our long-term results with postoperative intensity-modulated radiation therapy (IMRT) in patients suffering from squamous-cell carcinoma (SCC) of the oral cavity or oropharynx. Seventy five patients were retrospectively analyzed. Median age was 58 years and 84 % were male. 76 % of the primaries were located in the oropharynx. Surgery resulted in negative margins (R0) in 64 % of the patients while 36 % suffered from positive margins (R1). Postoperative stages were as follows: stage1:4 %, stage2:9 %, stage3:17 %, stage4a:69 % with positive nodes in 84 %. Perineural invasion (Pn+) and extracapsular extension (ECE) were present in 7 % and 29 %, respectively. All patients received IMRT using the step-and-shoot approach with a simultaneously integrated boost (SIB) in 84 %. Concurrent systemic therapy was applied to 53 patients, mainly cisplatin weekly. Median follow-up was 55 months (5–150). 13 patients showed locoregional failures (4 isolated local, 4 isolated neck, 5 combined) transferring into 5-year-LRC rates of 85 %. Number of positive lymph nodes (n > 2) and presence of ECE were significantly associated with decreased LRC in univariate analysis, but only the number of nodes remained significant in multivariate analysis. Overall treatment failures occurred in 20 patients (9 locoregional only, 7 distant only, 4 combined), transferring into 3-and 5-year-FFTF rates of 77 % and 75 %, respectively. The 3-and 5-year-OS rates were 80 % and 72 %, respectively. High clinical stage, high N stage, number of positive nodes (n > 2), ECE and Pn1 were significantly associated with worse FFTF and OS in univariate analysis, but only number of nodes remained significant for FFTF in multivariate analysis. Maximum acute toxicity was grade 3 in 64 % and grade 4 in 1 %, mainly hematological or mucositis/dysphagia. Maximum late toxicity was grade 3 in 23 % of the patients, mainly long-term tube feeding dependency. Postoperative IMRT achieved excellent LRC and good OS with

  7. The role of high-dose-rate brachytherapy boost in breast-conserving therapy: Long-term results of the Hungarian National Institute of Oncology

    International Nuclear Information System (INIS)

    Aim: To report the long-term results of high-dose-rate (HDR) brachytherapy (BT) boost for breast cancer patients treated with conservative surgery and radiotherapy. Materials and methods: Between 1995 and 2007, 100 early-stage breast cancer patients received an HDR BT boost after conservative surgery and whole breast irradiation. Ten patients (10%) received a single-fraction HDR boost of 8 - 10.35 Gy using rigid needles, while 90 (90%) were treated with a fractionated multi-catheter HDR BT boost. The latter consisted of 3 x 4 Gy (n = 19), 4.75 Gy (n = 70), and 2 x 6.4 Gy (n = 1). Breast cancer related events, cosmetic results and side effects were assessed. Results: At a median follow-up time of 94 months (range: 8 - 152) only 7 (7%) ipsilateral breast failures were observed for a 5- and 8-year actuarial rate of 4.5 and 7.0%, respectively. The 8-year disease-free, cancer-specific, and overall survival was 76.1, 82.8, and 80.4%, respectively. Cosmetic outcome was rated excellent in 17%, good in 39%, fair in 33%, and poor in 11%. Data on late radiation side effects were available for 91 patients (91%). Grade 3 fibrosis and grade 3 telangiectasia occurred in 6 (6.6%) and 2 (2.2%) patients, respectively. In univariate analysis only positive margin status had a significant negative effect on local control. Conclusions: HDR BT boost using multi-catheter implants produce excellent long-term local tumour control with acceptable cosmetic outcome and low rate of grade 3 late radiation side effects. (authors)

  8. Long-term results of a randomized phase III trial of TPF induction chemotherapy followed by surgery and radiation in locally advanced oral squamous cell carcinoma.

    Science.gov (United States)

    Zhong, Lai-ping; Zhang, Chen-ping; Ren, Guo-xin; Guo, Wei; William, William N; Hong, Christopher S; Sun, Jian; Zhu, Han-guang; Tu, Wen-yong; Li, Jiang; Cai, Yi-li; Yin, Qiu-ming; Wang, Li-zhen; Wang, Zhong-he; Hu, Yong-jie; Ji, Tong; Yang, Wen-jun; Ye, Wei-min; Li, Jun; He, Yue; Wang, Yan-an; Xu, Li-qun; Zhuang, Zhengping; Lee, J Jack; Myers, Jeffrey N; Zhang, Zhi-yuan

    2015-07-30

    Previously, we conducted a randomized phase III trial of TPF (docetaxel, cisplatin, and 5-fluorouracil) induction chemotherapy in surgically managed locally advanced oral squamous cell carcinoma (OSCC) and found no improvement in overall survival. This study reports long-term follow-up results from our initial trial. All patients had clinical stage III or IVA locally advanced OSCC. In the experimental group, patients received two cycles of TPF induction chemotherapy (75mg/m2 docetaxel d1, 75mg/m2 cisplatin d1, and 750mg/m2/day 5-fluorouracil d1-5) followed by radical surgery and post-operative radiotherapy; in the control group, patients received upfront radical surgery and post-operative radiotherapy. The primary endpoint was overall survival. Among 256 enrolled patients with a median follow-up of 70 months, estimated 5-year overall survival, disease-free survival, locoregional recurrence-free survival, and distant metastasis-free survival rates were 61.1%, 52.7%, 55.2%, and 60.4%, respectively. There were no significant differences in survival rates between experimental and control groups. However, patients with favorable pathologic responses had improved outcomes compared to those with unfavorable pathologic responses and to those in the control group. Although TPF induction chemotherapy did not improve long-term survival compared to surgery upfront in patients with stage III and IVA OSCC, a favorable pathologic response after induction chemotherapy may be used as a major endpoint and prognosticator in future studies. Furthermore, the negative results observed in this trial may be represent type II error from an underpowered study. Future larger scale phase III trials are warranted to investigate whether a significant benefit exists for TPF induction chemotherapy in surgically managed OSCC. PMID:26124084

  9. Long-term treatment with PP2 after spinal cord injur y resulted in functional locomotor recover y and increased spared tissue

    Institute of Scientific and Technical Information of China (English)

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

    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 ifeld test, round and square beam crossing tests. In addition, an increase in white matter spared tissue and sero-tonin ifber density was observed in animals treated with PP2. However, blockade of SFK activity did not change the astrocytic response or inifltration of cells from the immune system at 28 days post-injury. Moreover, a reduced SFK activity with PP2 diminished Ephexin (a guanine nucle-otide exchange factor) phosphorylation in the acute phase (4 days post-injury) after trauma. Together, these ifndings 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 pathophysiolo-gy 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.

  10. Radiofrequency ablation of high-grade dysplastic nodules in chronic liver disease: comparison with well-differentiated hepatocellular carcinoma based on long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Hyun; Lim, Hyo K.; Kim, Min Ju; Choi, Dongil; Rhim, Hyunchul [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea); Park, Cheol Keun [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea)

    2008-04-15

    This retrospective study compared the long-term results of percutaneous radiofrequency (RF) ablation for high-grade dysplastic nodules (DNs) and well-differentiated hepatocellular carcinomas (HCCs). Between April 1999 and December 2006, 20 patients with 21 high-grade DNs (range, 1.2-3.0 cm; mean, 1.9 cm) (group 1) and 49 with a well-differentiated HCC (range, 1.0-5.0 cm; mean, 2.3 cm) (group 2) underwent RF ablation. The technique effectiveness, local tumor progression, cancer-free and cumulative survivals using the Kaplan-Meier method were compared. The technique effectiveness rates at 1 year after RF ablation were 100% (19/19) and 94.1% (32/34) in groups 1 and 2, respectively (P > 0.05). The local tumor progression rates in groups 1 and 2 were 0% and 20.6% (7/34), respectively (P = 0.041). The local tumor progression in group 2 was seen on follow-up computed tomography 4-58 months (mean, 17 months) after RF ablation. The 1-, 3-, and 5-year cancer-free survival rates in groups 1 and 2 were 95.0% and 76.9%, 56.2% and 44.6%, and 38.5% and 24.8%, respectively (P > 0.05). The 1-, 3-, and 5-year cumulative survival rates in groups 1 and 2 were 100% and 97.9%, 73.0% and 68.0%, and 63.8% and 51.1%, respectively (P > 0.05). Percutaneous RF ablation is effective for treating high-grade DNs and well-differentiated HCCs. The long-term results after RF ablation of high-grade DNs may be improved compared with those of well-differentiated HCCs. (orig.)

  11. Radical cystectomy with orthotopic neobladder for invasive bladder cancer: a critical analysis of long term oncological, functional and quality of life results

    Directory of Open Access Journals (Sweden)

    Arnulf Stenzl

    2010-10-01

    Full Text Available PURPOSE: Analyze current knowledge and practice regarding tumor-related cystectomy with subsequent orthotopic neobladder both in male and female patients. DESIGN, SETTING, AND PARTICIPANTS: Evaluate literature predominantly from the last decade dealing with long-term experience in large numbers of patients with an orthotopic neobladder following cystectomy. Oncological outcome specific to an orthotopic neobladder, functional aspects such as urinary continence, renal function, sexual activity and other quality of life issues are elucidated. RESULTS: Local pelvic recurrences after urothelial bladder cancer occur in 7-12%. Urethral second primary tumors in male and female patients in contemporary series with bladder substitution are 4-6% and 1.4 o 4%, respectively. Upper tract recurrences vary between 2.4-17%. Complications regarding the upper urinary tract have dramatically diminished due to simplified forms of upper tract protection as well as a more refined technique of ureterointestinal anastomosis. Depending on the technique ureteroileal stenosis was lately reported to lie between 2.7 to 3.8%. Renal function remained stable in 96% after a mean follow-up of up to 5 years. Radical cystectomy in carefully selected patients has stood the test of time by providing adequate long-term survival and low local recurrence rates. Orthotopic bladder substitution does not compromise oncological outcome, yields excellent functional results, is cost effective compared to other types of urinary diversion, may improve quality of life and should therefore be the diversion of choice both in men and women. Chronological age is generally not a contraindication for cystectomy, but for orthotopic urinary diversion, tumor extent, functional pelvic floor deficits and general life expectancy are limiting factors.

  12. Pairing-specific long-term depression of Purkinje cell excitatory postsynaptic potentials results from a classical conditioning procedure in the rabbit cerebellar slice.

    Science.gov (United States)

    Schreurs, B G; Oh, M M; Alkon, D L

    1996-03-01

    1. Using a rabbit cerebellar slice preparation, we stimulated a classical conditioning procedure by stimulating parallel fiber inputs to Purkinje cells with the use of a brief, high-frequency train of eight constant-current pulses 80 ms before climbing fiber inputs to the same Purkinje cell were stimulated with the use of a brief, lower frequency train of three constant-current pulses. In all experiments, we assessed the effects of stimulation by measuring the peak amplitude of Purkinje cell excitatory postsynaptic potentials (EPSPs) to single parallel fiber test pulses. 2. Intradendritically recorded Purkinje cell EPSPs underwent a long-term (> 20 min) reduction in peak amplitude (30%) after paired stimulation of the parallel and climbing fibers but not after unpaired or parallel fiber alone stimulation. We call this phenomenon pairing-specific long-term depression (PSD). 3. Facilitation of the peak amplitude of a second EPSP elicited by a parallel fiber train occurred both before and after paired stimulation suggesting that the locus of depression was not presynaptic. Depression of the peak amplitude of a depolarizing response to focal application of glutamate following pairings of parallel and climbing fiber stimulation added support to a suggested postsynaptic locus of the PSD effect. 4. The application of aniracetam potentiated EPSP peak amplitude by 40%, but these values returned to baseline as a result of pairings. With the removal of aniracetam from the bath 20 min after pairings, normal levels of pairing-specific EPSP depression were observed, indicating that the effect did not result from direct desensitization of alpha-amino-3-hydroxy-5-methyl-4-isoxazole-proprionic acid (AMPA) receptors. 5. Incubation of slices in the protein kinase inhibitor H-7 potentiated EPSP peak amplitudes slightly (9%), but peak amplitudes returned to baseline levels after pairings. The net reduction in EPSP peak amplitude of classical conditioning.

  13. Changes in soil carbon and enzyme activity as a result of different long-term fertilization regimes in a greenhouse field.

    Directory of Open Access Journals (Sweden)

    Lili Zhang

    Full Text Available 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.

  14. Long-term results of low dose daily cisplatin chemotherapy used concurrently with modestly accelerated radiotherapy in locally advanced squamous cell carcinomas of the head neck cancer region

    Directory of Open Access Journals (Sweden)

    Pramod Kumar Gupta

    2014-01-01

    Full Text Available Introduction: Concurrent single agent cisplatin (CDDP with radiotherapy (RT improves outcomes in locally advanced squamous cell carcinomas of the head neck (LA-SCCHN. CDDP at 100 mg/m 2 at 3 weekly intervals raise compliance, hospitalization, and supportive care issues. Low dose daily CDDP was delivered with RT to evaluate its compliance, long-term safety and efficacy. Patients and Methods: During the period of month between November 2005 and May 2007, 52 patients of stage III/IV LA-SCCHN were given with conventional RT in a phased manner (dose-70 Gy/35 fractions/6 weeks along with daily CDDP (6 mg/m 2 ; capped 10 mg-30 cycles over 6 weeks. No hospitalization or antiemetic cover was planned. Compliance, acute and late toxicity were recorded as per Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer grading system and survival outcomes were evaluated. Results : The median follow-up was 63 months. 43 (83% cases complied with RT schedule and >28 cycles of CDDP was administered in 38 (73% cases. Confluent mucositis was seen in 65%, Grade III/IV dysphagia in 67%; 77% required enteral feed and hospitalization in 15%. There were four treatment related deaths. At 5 years, the loco-regional control was 25% (median-11 months and the overall survival was 31% (median-11 months. The 5 years actuarial rates of late Grade III/IV toxicity was 24%. Late swallowing difficulty/aspiration were seen in 17%; xerostomia-40%; ototoxicity-6%; nephrotoxicity-4%; and no second malignancy. Conclusion: Low dose cisplatin with moderately accelerated RT schedule appears feasible and logistically suitable "out-patient" option without increasing long-term toxicity in LA-SCCHN cancer region.

  15. Gender affects acute organ toxicity during radiochemotherapy for rectal cancer: Long-term results of the German CAO/ARO/AIO-94 phase III trial

    International Nuclear Information System (INIS)

    Introduction: The CAO/ARO/AIO-94 phase-III-trial demonstrated a significant improvement of preoperative chemoradiotherapy (CRT) versus postoperative CRT on local control for UICC stage II/III rectal cancer patients, but no effect on long-term survival. In this add-on evaluation, we investigated the association of gender and age with acute toxicity and outcome. Patients and methods: According to actual treatment analyses, 654 of 799 patients had received pre- (n = 406) or postoperative CRT (n = 248); in 145 patients postoperative CRT was not applied. Gender, age and clinicopathological parameters were correlated with CRT-associated acute toxicity and survival. Results: The 10-year survival was higher in women than in men, with 72.4% versus 65.6% for time to recurrence (p = 0.088) and 62.7% versus 58.4% for overall-survival (OS) (p = 0.066), as expected. For patients receiving CRT, women showed higher hematologic (p < 0.001) and acute organ toxicity (p < 0.001) in the entire cohort as well as in subgroup analyses according to pre- (p = 0.016) and postoperative CRT (p < 0.001). Lowest OS was seen in patients without acute toxicity (p = 0.0271). Multivariate analyses for OS showed that acute organ toxicity (p = 0.034) was beneficial while age (p < 0.001) was associated with worse OS. Discussion: Female gender is significantly associated with CRT-induced acute toxicity in rectal cancer. Acute toxicity during CRT may be associated with improved long-term outcome

  16. Cyst Ablation Using a Mixture of N-Butyl Cyanoacrylate and Iodized Oil in Patients with Autosomal Dominant Polycystic Kidney Disease: the Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Kim, See Hyung; Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2009-08-15

    We wanted to assess the long-term results of cyst ablation with using N-butyl cyanoacrylate (NBCA) and iodized oil in patients with autosomal dominant polycystic kidney disease (ADPKD) and symptomatic cysts. Cyst ablation using a mixture of NBCA and iodized oil was performed in 99 cysts from 21 patients who had such symptoms as abdominal distension and pain. The collapse or reaccumulation of the ablated cysts after the procedure was assessed during the follow-up period of 36 to 90 months. The treatment effects, including symptom relief, and the clinical data such as the blood pressure and serum creatinine levels were also assessed, together with the complications. The procedure was technically successful in all 99 cysts from the 21 patients. Any procedure-related significant complications were not detected. Seventy-seven of 99 cysts (78%) were successfully collapsed on the follow-up CT. Twenty-two cysts showed reaccumulation during long-term follow-up period. The clinical symptoms were relieved in 17 of the 21 patients (76%). Four of 12 patients (33%) with hypertension and two of six patients (33%) with azotemia were improved. End stage renal disease (ESRD) occurred in six of the 21 patients (28%) during the follow-up period. The mean age of ESRD in our patients was 57 years. The mean time interval for the development of ESRD was 19 months. Ablation using a mixture of NBCA and iodized oil may be an effective, safe method for obtaining symptom relief in patients with ADPKD.

  17. Changes in soil carbon and enzyme activity as a result of different long-term fertilization regimes in a greenhouse field.

    Science.gov (United States)

    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

  18. How Long Does it Take to Initiate a Child on Long-Term Invasive Ventilation? Results From A Canadian Pediatric Home Ventilation Program

    Directory of Open Access Journals (Sweden)

    Reshma Amin

    2015-01-01

    Full Text Available OBJECTIVE: To assess the length of stay required to initiate long-term invasive ventilation at the authors’ institution, which would inform future interventional strategies to streamline the in-hospital stay for these families.

  19. LONG TERM COLLECTIONS

    CERN Multimedia

    STAFF ASSOCIATION

    2010-01-01

    ACKNOWLEDGMENTS The Long-Term Collections (CLT) committee would like to warmly thank its faithful donors who, year after year, support our actions all over the world. Without you, all this would not be possible. We would like to thank, in particular, the CERN Firemen’s Association who donated 5000 CHF in the spring thanks to the sale of their traditional calendar, and the generosity of the CERN community. A huge thank you to the firemen for their devotion to our cause. And thank you to all those who have opened their door, their heart, and their purses! Similarly, we warmly thank the CERN Yoga Club once again for its wonderful donation of 2000 CHF we recently received. We would also like to tell you that all our projects are running well. Just to remind you, we are currently supporting the activities of the «Réflexe-Partage» Association in Mali; the training centre of «Education et Développement» in Abomey, Benin; and the orphanage and ...

  20. A comparative study on the medium-long term results of endovascular repair and open surgical repair in the management of ruptured abdominal aortic aneurysms

    Institute of Scientific and Technical Information of China (English)

    HAN Yan-shuo; ZHANG Jian; XIA Qian; LIU Zhi-min; ZHANG Xiao-yu; WU Xiao-yu; LUN Yu

    2013-01-01

    Background Although it is generally acknowledged that patients with ruptured abdominal aortic aneurysm (rAAA)obtain the greatest benefit from endovascular repair (EVAR),convincing evidence on the medium-long term effect is lacking.The aim of this study was to compare and summarize published results of rAAA that underwent EVAR with open surgical repair (OSR).Methods A search of publicly published literature was performed.Based on an inclusion and exclusion criteria,a systematic meta-analysis was undertaken to compare patient characteristics,complications,short term mortality and medium-long term outcomes.A random-effects model was used to pool the data and calculate pooled odds ratios and weighted mean differences.A quantitative method was used to analyze the differences between these two methods.Results A search of the published literature showed that fourteen English language papers comprising totally 1213 patients with rAAA (435 EVAR and 778 OSR) would be suitable for this study.Furthermore,13 Chinese studies were included,including 267 patients with rAAA totally,among which 238 patients received operation.The endovascular method was associated with more respiratory diseases before treatment (OR=1.81,P=0.01),while there are more patients with hemodynamic instability before treatment in OSR group (OR=1.53,P=0.031).Mean blood transfusion was 1328 ml for EVAR and 2809 ml for OSR (weighted mean difference (WMD) 1500 ml,P=0.014).The endovascular method was associated with a shorter stay in intensive care (WMD 2.34 days,P <0.001) and a shorter total postoperative stay (WMD 6.27 days,P <0.001).The pooled post-operative complication rate of respiratory system and visceral ischemia seldom occurred in the EVAR group (OR=0.48,P <0.001 and OR=0.28,P=0.043,respectively).The pooled 30-day mortality was 25.7% for EVAR and 39.6% for OSR,and the odds ratio was 0.53 (95% confidence interval (CI) 0.41-0.70,P <0.001).There was not,however,any significant reduction in

  1. The development of Korea's new long-term care service infrastructure and its results: focusing on the market-friendly policy used for expansion of the numbers of service providers and personal care workers.

    Science.gov (United States)

    Chon, Yongho

    2013-01-01

    One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system.

  2. CT-guided sympathicolysis in peripheral artery disease. Indications, patient selection and long-term results; CT-gesteuerte Sympathikolyse bei peripherer arterieller Verschlusskrankheit. Indikationen, Patientenauswahl, Langzeitergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Huttner, S.; Huttner, M.; Antes, G. [Abt. fuer Radiologie, Klinikum Kempten (Germany); Neher, M. [Abt. fuer Allgemein- und Viszeralchirurgie, Klinikum Kempten (Germany)

    2002-04-01

    Purpose: Assessment of long-term results of CT-guided lumbar sympathicolysis (LSL) in advanced peripheral arterial vascular disease (pavd). Establishment of a suitable patient selection. Patients and Methods: LSL was performed in 138 cases with Fontaine stages III (13%) and IV (87%). 250 consecutive patients were examined with a radionuclide perfusion study of the feet prior to and during peridural anaesthesia (PDA) in order to select suitable patients for LSL. LSL was not performed in patients with impaired perfusion under PDA (n = 112). Early and long-term results after one to five years were evaluated. Results: In 79% an initial improvement was found after LSL. After more than one year success was established in 38%. 49% of the cases had a progression of the disease. This is significantly better compared to a control group with conservative treatment and an initial improvement of 36%. After more than one year only 21% revealed an improvement. In 82% the disease was progressive. Diabetics showed also a positive response to LSL. Conclusion: LSL has a positive influence on the course of pvad in patients selected by radionuclide perfusion studies. Diabetes and angiographic findings do not play any first role in patient selection for LSL. (orig.) [German] Ziel: Pruefung der Langzeitergebnisse der CT-gesteuerten lumbalen Sympathikolyse (LSL) bei fortgeschrittener peripherer arterieller Verschlusskrankheit (pAVK). Erarbeitung einer geeigneten Patientenauswahl. Material und Methode: Bei 138 Faellen von pAVK im Stadium III (13%) und IV (87%) nach Fontaine wurde eine LSL durchgefuehrt. Zur Auswahl geeigneter Patienten erfolgte bei 250 konsekutiven Patienten eine nuklearmedizinische Perfusionsstudie der Fuesse vor und unter Periduralanaesthesie (PDA). Bei Verschlechterung der Durchblutung wurde auf eine LSL (n = 112) verzichtet. Ausgewertet wurden die klinischen Fruehergebnisse und die Ergebnisse nach 1 - 5 Jahren. Ergebnisse: Eine initiale Besserung des Stadiums AVK fand

  3. 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

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, Kavita K., E-mail: Kavita.mishra@ucsf.edu [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Quivey, Jeanne M.; Daftari, Inder K. [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Lawrence Berkeley National Laboratory, Berkeley, California (United States); Weinberg, Vivian [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Cole, Tia B. [The Tumori Foundation, San Francisco, California (United States); Patel, Kishan [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Castro, Joseph R.; Phillips, Theodore L. [Department of Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Lawrence Berkeley National Laboratory, Berkeley, California (United States); Char, Devron H. [The Tumori Foundation, San Francisco, California (United States); Department of Ophthalmology, University of California-San Francisco, San Francisco, California (United States); Department of Ophthalmology, Stanford University, Palo Alto, California (United States)

    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.

  4. Long-term outcomes from dose-escalated image-guided intensity-modulated radiotherapy with androgen deprivation: encouraging results for intermediate- and high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Wilcox SW

    2014-08-01

    Full Text Available Shea W Wilcox,1,4 Noel J Aherne,2,4 Linus C Benjamin,1 Bosco Wu,1 Thomaz de Campos Silva,3 Craig S McLachlan,4 Michael J McKay,3,5 Andrew J Last,1 Thomas P Shakespeare1–4 1North Coast Cancer Institute, Port Macquarie, NSW, Australia; 2North Coast Cancer Institute, Coffs Harbour, NSW, Australia; 3North Coast Cancer Institute, Lismore, NSW, Australia; 4The University of New South Wales, Rural Clinical School, Sydney, NSW, Australia; 5The University of Sydney, Sydney, NSW, Australia Purpose: Dose-escalated (DE radiotherapy in the setting of localized prostate cancer has been shown to improve biochemical disease-free survival (bDFS in several studies. In the same group of patients, androgen deprivation therapy (ADT has been shown to confer a survival benefit when combined with radiotherapy doses of up to 70 Gy; however, there is currently little long-term data on patients who have received high-dose intensity-modulated radiotherapy (IMRT with ADT. We report the long-term outcomes in a large cohort of patients treated with the combination of DE image-guided IMRT (IG-IMRT and ADT. Methods and materials: Patients with localized prostate cancer were identified from a centralized database across an integrated cancer center. All patients received DE IG-IMRT, combined with ADT, and had a minimum follow up of 12 months post-radiotherapy. All relapse and toxicity data were collected prospectively. Actuarial bDFS, metastasis-free survival, prostate cancer-specific survival, and multivariate analyses were calculated using the SPSS v20.0 statistical package. Results: Seven hundred and eighty-two eligible patients were identified with a median follow up of 46 months. Overall, 4.3% of patients relapsed, 2.0% developed distant metastases, and 0.6% died from metastatic prostate cancer. At 5-years, bDFS was 88%, metastasis-free survival was 95%, and prostate cancer-specific survival was 98%. Five-year grade 2 genitourinary and gastrointestinal toxicity was 2

  5. Early and long-term results of combined cardiac surgery and neoplastic resection in patients with concomitant severe heart disease and neoplasms

    Institute of Scientific and Technical Information of China (English)

    FU Qiang; LI Quan-zheng; LIANG De-gang; RUAN Xin-hua; WANG Zan-xin; WEI Min-xin

    2011-01-01

    Background It is a surgical dilemma when patients present with both severe heart disease and neoplasms. The best surgical treatment remains controversial. This study aimed to analyze the early and long-term results of simultaneous surgical treatment of severe heart disease and neoplasms.Methods We reviewed the clinical records of 15 patients who underwent simultaneous neoplastic resection and cardiac surgery between September 2006 and January 2011. There were 5 male and 10 female patients. The mean age was (59.2±12.5) years and the mean left ventricular ejection fraction was (57.4±11.0)%. All patients were followed up completely for a period of 12 to 51 months (mean, (33.1±11.2) months).Results Fifteen patients underwent simultaneous cardiac surgery and neoplastic resection. Cardiac procedures consisted of off pump coronary artery bypass grafting (n=7), aortic valve replacement (n=3), mitral valve replacement (n=3), mitral valve replacement with coronary artery bypass grafting (n=1) and left atrial myxoma resection (n=1). Neoplastic resection consisted of lung cancer resection (n=5). colonic cancer resection (n=3), gallbladder resection (n=1), colonic cancer resection with gallbladder resection (n=1), hysterectomy (n=2), hysterectomy with bilateral salpingo-oophorectomy (n=2) and left ovariectomy (n=1). Pathological examination confirmed malignant disease in 10 patients and benign disease in 5 patients. There were no perioperative myocardial infarctions, stroke, pericardial tamponade, renal failure or hospital deaths. The most frequent complications were atrial fibrillation (33.3%), pneumonia (26.7%), low cardiac output syndrome (6.7%) and delayed healing of surgical wounds (6.7%). There was 1 late death 42 months after surgery for recurrent malignant disease. At 1 and 3 years, survival rates were 100% (Kaplan-Meier method).Conclusions Simultaneous cardiac surgery and neoplastic resection was not associated with increased early or late morbidity or mortality

  6. Long-term treatment with metformin in obese, insulin-resistant adolescents: results of a randomized double-blinded placebo-controlled trial

    Science.gov (United States)

    van der Aa, M P; Elst, M A J; van de Garde, E M W; van Mil, E G A H; Knibbe, C A J; van der Vorst, M M J

    2016-01-01

    Background: As adolescents with obesity and insulin resistance may be refractory to lifestyle intervention therapy alone, additional off-label metformin therapy is often used. In this study, the long-term efficacy and safety of metformin versus placebo in adolescents with obesity and insulin resistance is studied. Methods: In a randomized placebo-controlled double-blinded trial, 62 adolescents with obesity aged 10–16 years old with insulin resistance received 2000 mg of metformin or placebo daily and physical training twice weekly over 18 months. Primary end points were change in body mass index (BMI) and insulin resistance measured by the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Secondary end points were safety and tolerability of metformin. Other end points were body fat percentage and HbA1c. Results: Forty-two participants completed the 18-month study (66% girls, median age 13 (12–15) years, BMI 30.0 (28.3 to 35.0) kg m−2 and HOMA-IR 4.08 (2.40 to 5.88)). Median ΔBMI was +0.2 (−2.9 to 1.3) kg m−2 (metformin) versus +1.2 (−0.3 to 2.4) kg m−2 (placebo) (P=0.015). No significant difference was observed for HOMA-IR. No serious adverse events were reported. Median change in fat percentage was −3.1 (−4.8 to 0.3) versus −0.8 (−3.2 to 1.6)% (P=0.150), in fat mass −0.2 (−5.2 to 2.1) versus +2.0 (1.2–6.4) kg (P=0.007), in fat-free mass +2.0 (−0.1 to 4.0) versus +4.5 (1.3 to 11.6) kg (P=0.047) and in ΔHbA1c +1.0 (−1.0 to 2.3) versus +3.0 (0.0 to 5.0) mmol mol−1 (P=0.020) (metformin versus placebo). Conclusions: Long-term treatment with metformin in adolescents with obesity and insulin resistance results in stabilization of BMI and improved body composition compared with placebo. Therefore, metformin may be useful as an additional therapy in combination with lifestyle intervention in adolescents with obesity and insulin resistance. PMID:27571249

  7. A long-term follow-up study of the remote result of lumbar discectomy versus conservative treatment for single-level lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Ke-dong HOU

    2012-09-01

    imaging, however, none of them presented obvious clinical symptoms. According to UCLA criteria, cephalad adjacent segment degeneration occurred in 8 patients (12% of CT group, and in 23 (22% of surgery group, and the incidence of cephalad adjacent segment degeneration was significantly higher in surgery group than in CT group (P < 0.05. Conclusions The height of morbid intervertebral space is remarkably lower, and less of them trigger clinical symptom from adjacent segment degeneration in patients treated with lumbar discectomy. Both conservative therapy and lumbar discectomy can obtain better long-term results for lumbar disc herniation.

  8. Establishing a Long-term 30 Year Global Solar Resource at 10 km Resolution: Preliminary Results From Test Processing and Continuing Plans

    Science.gov (United States)

    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

  9. Long-Term Results After High-Dose Radiotherapy and Adjuvant Hormones in Prostate Cancer: How Curable Is High-Risk Disease?

    International Nuclear Information System (INIS)

    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

  10. The roles of herbal remedies in survival and quality of life among long-term breast cancer survivors - results of a prospective study

    Directory of Open Access Journals (Sweden)

    Sullivan-Halley Jane

    2011-06-01

    Full Text Available Abstract Background Few data exist on survival or health-related quality of life (QOL related to herbal remedy use among long-term breast cancer survivors. The objective of this report is to examine whether herbal remedy use is associated with survival or the health-related QOL of these long-term breast cancer survivors. Methods In 1999-2000, we collected the information of herbal remedy use and QOL during a telephone interview with 371 Los Angeles Non-Hispanic/Hispanic white women who had survived more than 10 years after breast cancer diagnosis. QOL was measured using the Medical Outcomes Study Short Form-36 (SF-36 questionnaire. Patients were followed for mortality from the baseline interview through 2007. 299 surviving patients completed a second telephone interview on QOL in 2002-2004. We used multivariable Cox proportional hazards methods to estimate relative risks (RR and 95% confidence intervals (CI for mortality and applied multivariable linear regression models to compare average SF-36 change scores (follow-up - baseline between herbal remedy users and non-users. Results Fifty-nine percent of participants were herbal remedy users at baseline. The most commonly used herbal remedies were echinacea, herbal teas, and ginko biloba. Herbal remedy use was associated with non-statistically significant increases in the risks for all-cause (44 deaths, RR = 1.28, 95% CI = 0.62-2.64 and breast cancer (33 deaths, RR = 1.78, 95% CI = 0.72-4.40 mortality. Both herbal remedy users' and non-users' mental component summary scores on the SF-36 increased similarly from the first survey to the second survey (P = 0.16, but herbal remedy users' physical component summary scores decreased more than those of non-users (-5.7 vs. -3.2, P = 0.02. Conclusions Our data provide some evidence that herbal remedy use is associated with poorer survival and a poorer physical component score for health-related QOL among women who have survived breast cancer for at least

  11. Long-term effects of smoking cessation support in primary care: results of a two-year longitudinal study in Brazil

    Directory of Open Access Journals (Sweden)

    Nádia Cristina Pinheiro Rodrigues

    2016-06-01

    Full Text Available ABSTRACT Objective The objective of this study was to evaluate the long-term effects of a Brazilian smoking cessation support program and the factors that are associated with its success. Methods A longitudinal study was conducted from 2012 to 2014 with 84 patients enrolled in smoking cessation support groups in a Primary Care Center from a poor community in Rio de Janeiro (Brazil. Support was provided according to Brazilian Tobacco Control Program and consisted of cognitive behavioral therapy in addition to nicotine replacement therapy. Logistic regression and the Cox proportional hazard models were used in the analysis. Results There was an increase of 34%, 48% and 97% in the chances of patients stop smoking for at least six months, 12 months and 24 months, respectively, for each new session that the patient participated. Patients that attended three or more meetings had a 79% lower risk of returning to smoking than those who went to less than three meetings. Conclusions Although not all patients who were enrolled in the program could be contacted for the study, our results indicate that about 40% of patients are able to stay smoke-free for at least three months due to the smoking cessation program, but less than 20% are able to remain smoke-free for two years. Initiatives to improve adherence to cognitive behavioral therapy meetings according to the specificity of the population may increase the effectiveness of the program.

  12. DNI measurements in the South of Portugal: Long term results through direct comparison with global and diffuse radiation measurements and existing time series

    Science.gov (United States)

    Cavaco, A.; Canhoto, P.; Costa, M. J.; Collares-Pereira, M.

    2016-05-01

    The present work describes the measurement effort for direct normal irradiance (DNI) evaluation in the sunny south of Portugal, with a network of eight radiation measurement stations in several locations (including Évora) providing a good coverage of the region. This new initiative for DNI measurement will still need many years (typically 10 or more) to produce a time series which can claim having long term statistical value. This problem can, however, be temporarily mitigated by measuring DNI at the same time as GHI and DHI, in a place where long term series dating back, already exist for those two. It so happens that a long term series (20 years) of global and diffuse solar irradiation exists for the location Évora. So the expectation is to establish correlations with the goal of attributing at least some long term statistical significance to the short and recent DNI series. The paper describes the setup of the measuring stations and presents the preliminary measurements obtained. It further presents the first correlations of monthly averages between normal beam (DNI), global and diffuse radiation. It then uses these correlations, admittedly without acceptable statistical significance (short series of less than one year of measured data), to exemplify how to get a prediction of long term DNI for Évora. This preliminary obtained value is compared to that predicted by the commercial data from Meteonorm.

  13. 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

    Science.gov (United States)

    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.

  14. Long-Term Effects of the Life Skills Program IPSY on Substance Use: Results of a 4.5-Year Longitudinal Study.

    Science.gov (United States)

    Weichold, Karina; Blumenthal, Anja

    2016-01-01

    This study investigated the long-term effectiveness of a Life Skills program with regard to use and proneness to legal and illicit drug use across a 4.5-year study interval. The universal school-based Life Skills program IPSY (Information + Psychosocial Competence = Protection) against adolescent substance use was implemented over 3 years (basic program in grade 5 and booster sessions in grades 6 and 7). Over the same time period, it was evaluated based on a longitudinal quasi-experimental design with intervention and control group, including two follow-up assessments after program completion [six measurement points; N (T1) = 1657 German students; M age (T1) = 10.5 years]. Applying an HLM approach, results showed that participation in IPSY had a significant effect on the frequency of smoking, and proneness to illicit drug use, across the entire study period. In addition, shorter-term effects were found for the frequency of alcohol use in that intervention effects were evident until the end of program implementation but diminished 2 years later. Thus, IPSY can be deemed an effective intervention against tobacco use and proneness to and use of illicit drugs during adolescence; however, further booster sessions may be necessary in later adolescence to enhance youths' resistance skills when alcohol use becomes highly normative among peers. PMID:26202801

  15. Thermal Aging Study of a Dow Corning SE 1700 Porous Structure Made by Direct Ink Writing: 1-Year Results and Long-Term Predictions

    Energy Technology Data Exchange (ETDEWEB)

    Small, Ward [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pearson, Mark A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Maiti, Amitesh [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Metz, Thomas R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Duoss, Eric B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wilson, Thomas S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    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.

  16. A possible long-term activity cycle for {\\iota} Horologii: First results from the HK{\\alpha} & SPI-HK{\\alpha} projects

    CERN Document Server

    Flores, Matías G; Saffe, Carlos E; Mauas, Pablo J D

    2016-01-01

    To detect stellar activity cycles and study the possible star-planet interactions (SPI's), we have developed both HK$\\alpha$ and SPI-HK$\\alpha$ projects since 1999 and 2012 respectively. In this work, we present preliminary results of possible SPI's studying the chromospheric activity and look for possible correlations between stellar activity and stellar/planetary parameters. We find that for stars with similar T$_{eff}$, stellar activity increases with the mass of the planet, similar to 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, even comparable 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 $\\iota$ Horologii, a young solar-type star which hosts a non-transiting Jovian planet and presents a high acti...

  17. The endoscopic trans-fourth ventricle aqueductoplasty and stent placement for the treatment of trapped fourth ventricle: Long-term results in a series of 18 consecutive patients

    Directory of Open Access Journals (Sweden)

    Pasquale Gallo

    2012-01-01

    Full Text Available Background: Different surgical approaches have been described in the past to treat a trapped fourth ventricle (TFV but, unfortunately, these techniques showed a high rate of dysfunction and complications. During the last 10 years the development of neuroendoscopy has dramatically changed the outcome of these patients. Materials and Methods: We conducted a retrospective evaluation of the safety, effectiveness, and long-term outcome of endoscopic aqueductoplasty and stent placement, performed in 18 consecutive patients with symptomatic TFV through a trans-fourth ventricle approach between 1994 and 2010. Thirteen patients underwent endoscopic aqueductoplasty and stent placement and 5 patients underwent aqueductoplasty alone using a tailored suboccipital approach through the foramen of Magendie in prone or sitting position. Results: The mean age of the patients at the time of surgery was 15.2 years. All patients but 3 had a supratentorial ventriculoperitoneal shunt. Fifteen patients presented with slit supratentorial ventricles. At a mean followup of 90.8 months all patients experienced a stable clinical improvement. Only two complications were observed: A transient diplopia due to dysconjugate eye movements in one patient and a transient trochlear palsy in another one. Conclusions: Our experience and the literature review suggest that endoscopic trans-fourth ventricle aqueductoplasty and stent placement is a minimally invasive, safe, and effective technique for the treatment of TFV and should be strongly recommended, especially in patients with supratentorial slit ventricles.

  18. VALVULOPLASTIA MITRAL PERCUTÁNEA EN LA GESTANTE CON ESTENOSIS MITRAL. RESULTADOS A LARGO PLAZO / Percutaneous mitral valvuloplasty in pregnant women with mitral stenosis: long-term results

    Directory of Open Access Journals (Sweden)

    Julio C Echarte-Martínez

    2010-06-01

    Full Text Available Percutaneous mitral valvuloplasty can be performed during pregnancy without a high risk of maternal-fetal mortality. In Cuba, there was no precedent of the implementation of this technique in this kind of patients. Nine valvuloplasties were performed in pregnant women (using the Inoue method, form a total of 110 procedures carried out in a consecutive way between June 17th 1998 and June 30th 2004 at the Cardiology and Cardiovascular Surgery Institute, which were assessed up to June 17th 2009. The longest follow-up was 11 years, the minimum 6.26 years and the average 8.26 years. Before the valvuloplasty, the pregnant women were in the functional classes III and IV (New York Heart Association. The valvular areas measured by echo-planimetry were ≤1,01 cm2 . A patient presenting a valvular area of 1.52 cm2, showed after the valvuloplasty a moderated mitral insufficiency which evolved to a severe insufficiency at 26 weeks, being necessary a mitral valve replacement with no maternal or fetal complication. The other patients did not present adverse events during the long-term follow-up or any alteration in the development of the children. There was no mortality. Therefore, it can be concluded that the percutaneous mitral valvuloplasty is a feasible procedure in pregnant women with mitral stenosis and its results are maintained in the short, medium and long-run.

  19. Factors Associated With Optimal Long-Term Cosmetic Results in Patients Treated With Accelerated Partial Breast Irradiation Using Balloon-Based Brachytherapy

    International Nuclear Information System (INIS)

    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.

  20. Psychosocial work environment exposures as risk factors for long-term sickness absence among Danish employees: results from DWECS/DREAM

    DEFF Research Database (Denmark)

    Lund, Thomas; Labriola, Merete; Christensen, Karl Bang;

    2005-01-01

    OBJECTIVE: This study examines effects of psychosocial risk factors on long-term sickness absence, and investigates possible interactions between psychosocial and physical work environment risk factors. METHODS: A total of 5,357 employees were interviewed in 2000 regarding work environment and......-term sickness absence among men. No significant interactions between psychosocial and physical exposures were found for female or male employees. CONCLUSIONS: The study suggests a potential for reducing long-term sickness absence through interventions targeted toward reducing role conflict, and improving reward...

  1. The Effect of Hydroxyapatite Coating on Long-term Results of Total Hip Arthroplasty with Hydroxyapatite-coated Anatomic Femoral Stem

    Science.gov (United States)

    Im, Chae-Hyun; Kim, Dae-Hee; Heo, Ju-Yeong; Jang, Young-Jae

    2014-01-01

    Purpose To evaluate the clinical and radiological results, as well as the survival rate, associated with total hip arthroplasty using a hydroxyapatite (HA)-coated anatomical femoral stem at a follow-up of ≥12 years. Materials and Methods From April 1992 to May 1997, 86 patients (102 hips) underwent total hip arthroplasty with a HA-coated ABG I (Anatomical Benoist Giraud; Howmedica) hip prosthesis. The average age at the time of surgery was 53.4 years and the mean duration of follow-up was 17.1 years (range, 12.1-21.0 years). The Harris hip score (HHS) and radiographic assessments of thigh pain were used to evaluate the clinical results. We observed osteointegration, cortical hypertrophy, reactive line, calcar resorption and osteolysis around the femoral stems. The survival rate of the femoral stems was evaluated by using the span of time to a revision operation for any reasons was defined as the end point. Results The mean HHS was 50.5 preoperatively and 84.2 at the time of last follow-up. Osteolysis only around the HA-coated proximal portion of the femoral stem was observed in 72 hips, cortical hypertrophy all around the distal portion of the femoral stem was observed in 38 hips, and calcar resorption was observed in 44 hips. A reactive line was observed in 13 hips, but was unrelated to component loosening. Stem revision operations were performed in 24 (23%) hips due to osteolysis (14 hips), fracture (5 hips) and infection (5 hips). The femoral stem survival rate was 75% over the mean duration of follow-up. Conclusion Total hip arthroplasty using a HA-coated anatomical femoral stem showed necessitated a high rate of revision operations due to osteolysis around the femoral stem in this long term follow-up study.

  2. Long-term follow-up for bimanual microincision cataract surgery: comparison of results obtained by surgeons in training and experienced surgeons

    Directory of Open Access Journals (Sweden)

    Cavallini GM

    2016-05-01

    Full Text Available Gian Maria Cavallini, Tommaso Verdina, Matteo Forlini, Veronica Volante, Michele De Maria, Giulio Torlai, Caterina Benatti, Giancarlo Delvecchio Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy 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

  3. Autologous/reduced-intensity allogeneic stem cell transplantation vs autologous transplantation in multiple myeloma: long-term results of the EBMT-NMAM2000 study

    NARCIS (Netherlands)

    Gahrton, G.; Iacobelli, S.; Bjorkstrand, B.; Hegenbart, U.; Gruber, A.; Greinix, H.; Volin, L.; Narni, F.; Carella, A.M.; Beksac, M.; Bosi, A.; Milone, G.; Corradini, P.; Schonland, S.; Friberg, K.; Biezen, A. van; Goldschmidt, H.; Witte, T.J.M. de; Morris, C.; Niederwieser, D.; Garderet, L.; Kroger, N.

    2013-01-01

    Long-term follow-up of prospective studies comparing allogeneic transplantation to autologous transplantation in multiple myeloma is few and controversial. This is an update at a median follow-up of 96 months of the European Group for Blood and Marrow Transplantation Non-Myeloablative Allogeneic ste

  4. Is a long-term high-intensity exercise program effective and safe in patients with rheumatoid arthritis? Results of a randomized controlled trial.

    NARCIS (Netherlands)

    Jong, Z. de; Munneke, M.; Zwinderman, A.H.; Kroon, H.M.; Jansen, A.; Ronday, H.K.; Schaardenburg, D. van; Dijkmans, B.A.C.; Ende, C.H.M. van den; Breedveld, F.C.; Vliet Vlieland, T.P.M.; Hazes, J.M.W.

    2003-01-01

    OBJECTIVE: There are insufficient data on the effects of long-term intensive exercise in patients with rheumatoid arthritis (RA). We undertook this randomized, controlled, multicenter trial to compare the effectiveness and safety of a 2-year intensive exercise program (Rheumatoid Arthritis Patients

  5. Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes — results from the BASKET PROVE trial

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik;

    2013-01-01

    Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST......-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI)....

  6. Phase II Trial of Radiotherapy After Hyperbaric Oxygenation With Multiagent Chemotherapy (Procarbazine, Nimustine, and Vincristine) for High-Grade Gliomas: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Kazuhiko, E-mail: kogawa@med.u-ryukyu.ac.jp [Department of Radiology, University of the Ryukyus, Okinawa (Japan); Ishiuchi, Shogo [Department of Neurosurgery, University of the Ryukyus, Okinawa (Japan); Inoue, Osamu [Department of Hyperbaric Medicine, University of the Ryukyus, Okinawa (Japan); Yoshii, Yoshihiko [Department of Neurosurgery, University of the Ryukyus, Okinawa (Japan); Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba (Japan); Saito, Atsushi [Department of Neurosurgery, University of the Ryukyus, Okinawa (Japan); Department of Neurosurgery, Tsukuba Medical Center Hospital, Tsukuba (Japan); Watanabe, Takashi [Department of Neurosurgery, University of the Ryukyus, Okinawa (Japan); Iraha, Shiro [Department of Radiology, Okinawa South Medical Center, Okinawa (Japan); Department of Radiology, University of the Ryukyus, Okinawa (Japan); Toita, Takafumi; Kakinohana, Yasumasa; Ariga, Takuro; Kasuya, Goro; Murayama, Sadayuki [Department of Radiology, University of the Ryukyus, Okinawa (Japan)

    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.

  7. Phase II Trial of Radiotherapy After Hyperbaric Oxygenation With Multiagent Chemotherapy (Procarbazine, Nimustine, and Vincristine) for High-Grade Gliomas: Long-Term Results

    International Nuclear Information System (INIS)

    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.

  8. HIV gender-based vulnerabilities of women using drugs in long-term heterosexual relationships: baseline results from a randomized trial in Ukraine

    Directory of Open Access Journals (Sweden)

    Shulga, Liudmyla

    2012-07-01

    Full Text Available BACKGROUND: Sexual way of HIV transmission in Ukraine outweighs parenteral route since 2007. In response to situation change couple’s counseling for IDUs was introduced and is currently tested within randomized trial.METHODS: Baseline data were collected in June-September 2011: 548 IDU couples in 10 cities were surveyed and screened for HIV and Hepatitis C. Participants were recruited using respondent-driven sampling method. RESULTS: The average age of participants varied between 30 – 33 years old with women being 3 years younger. On many aspects drug using couples in long-term relationships share the same values as non-drug using couples. However, drug use resulted into specific HIV/STIs risks for the couple. Common reasons of being with the current partner included mutual understanding (98%; similar life styles (90%; understanding life with addiction (88%; and love (87%. At the same time, looking at the quality time partners spend together, it was found that mostly, they are connected by their drug use, fear of social exclusion and economical reasons. Although these factors are important for both men and women, they have a bigger impact on women and put them into more vulnerable position: 25% have children who in 59% of cases mostly live with mother and her partner; 40% live in a partner’s house; 30% are financially supported by partners; 77% women get drugs from partners and only 20% are first one to be injected. Trust also seems to be an issue. Thus, 83% of respondents believe that they know the HIV/STI status of their partner and 90% of those believe it to be negative, while 20% of those surveyed appeared to be HIV positive and about 30% Hepatitis C positive. CONCLUSIONS: Understanding characteristics of sexual partners is crucial for HIV prevention programme design and implementation.

  9. The specific role of fungal community structure on soil aggregation and carbon sequestration: results from long-term field study in a paddy soil

    Science.gov (United States)

    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 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 aggregate stability and C sequestration in tropical agricultural ecosystems.

  10. Deep crustal faults and the origin and long-term flank stability of Mt. Etna : First results from the CIRCEE cruise (Oct. 2013)

    Science.gov (United States)

    Gutscher, Marc-Andre; Dominguez, Stephane; Mercier de Lepinay, Bernard; Pinheiro, Luis; Babonneau, Nathalie; Cattaneo, Antonio; LeFaou, Yann; Barreca, Giovanni; Micallef, Aaron; Rovere, Marzia

    2014-05-01

    The relation between deep crustal faults and the origin of Mount Etna, the largest and most active volcano in Europe has long been suspected due to its unusual geodynamic location. Results from a new marine geophysical survey offshore Eastern Sicily reveal the detailed geometry (location, length, dip and orientation) of a two-branched 200-km long, lithospheric scale fault system, long sought for as being the cause of Mount Etna. Using high-resolution bathymetry and seismic profiling, we image a 60-km long, previously unidentified, NW trending fault with evidence of recent displacement at the seafloor, offsetting Holocene sediments. This newly identified fault connects NE of Catania, to a known 40-km long, offshore-onshore fault system dissecting the southeastern flank of Mount Etna, generally interpreted as purely gravitational collapse structures. Geological and morphological field studies together with earthquake focal mechanisms indicate active dextral strike-slip motion along the onshore and shallow offshore portion of this 40 + 60 km long segment. The southern 100 km branch of the fault is associated with a sub-vertical lithospheric scale tear fault showing pure down to the East normal faulting and a 500+m thick elongate basin marked by syn-tectonic Plio-quaternary sediment fill. Together they represent two kinematically distinct strands of the long sought "STEP" (Subduction Tear Edge Propagator) fault, whose expression at depth controls the position of Mount Etna. Both 100-km long branches of the fault system are mechanically capable of generating magnitude 7 earthquakes (e.g. - like the 1693 Catania earthquake, the strongest in Italian history, causing 40,000 deaths). We conclude this deep-rooted lithospheric weakness guides gradual down slope creep of Mount Etna and may lead to long-term catastrophic flank collapse with associated tsunami by large-scale mass wasting.

  11. Variables associated with disability in male and female long-term survivors from acute myocardial infarction. Results from the MONICA/KORA Myocardial Infarction Registry.

    Science.gov (United States)

    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. PMID:27002251

  12. Cocleostomia transcanal: resultados em longo prazo de um estudo de coorte Transcanal cochleostomy in cochlear implant surgery: long-term results of a cohort study

    Directory of Open Access Journals (Sweden)

    Michelle Lavinsky-Wolff

    2012-04-01

    Full Text Available A técnica de acesso combinado (TAC ao implante coclear (IC é uma variação da técnica clássica de mastoidectomia e timpanotomia posterior (MPTA. A TAC combina um acesso transcanal à cocleostomia com uma timpanotomia posterior reduzida para a inserção dos eletrodos. OBJETIVO: Avaliar e comparar a segurança e efetividade em longo prazo alcançados com a TAC e MPTA em pacientes submetidos a IC em um centro brasileiro. Desenho científico: Estudo de série. MATERIAL E MÉTODO: Pacientes submetidos a IC usando TAC e MPTA foram acompanhados em um estudo de coorte. Os desfechos avaliados foram complicações, avaliação audiométrica e radiológica pós-operatórias. RESULTADOS: Quarenta e quatro pacientes foram implantados usando a TAC e 31 usando MPTA. Não houve casos de paralisia facial, mastoidite, colesteatoma ou fístula após 3,4±1,0 anos. A avaliação radiológica da posição dos eletrodos a mediana de eletrodos fora da cóclea foi de 0 no grupo TAC e de 3 no MPTA (p The combined approach technique (CAT is a variation of the classical the mastoidectomy-posterior tympanotomy technique (MPTA that combines a transcanal approach to cochleostomy with a reduced posterior tympanotomy for insertion of electrodes. AIM: To compare and evaluate long-term safety and effectiveness outcomes obtained with the CAT and with MPTA approach in patients submitted to cochlear implant (CI surgery. Design: series study. METHODS: Patients who underwent CI using CAT or MPTA at a Brazilian center were followed in a cohort study. Main outcomes were complications,audiometric performance and radiological evaluation of electrode position. RESULTS: Fourty-four patients were implanted using CAT and 31 MPTA. There were no cases of facial nerve paralysis, mastoiditis, cholesteatoma or cerebrospinal fluid leaks after 3.4±1.0 years. Radiological evaluation of electrode position revealed that the median number of electrodes outside the cochlea was 0 in CAT and 3 in

  13. ARTHRODESIS OF THE FIRST METATARSOPHALANGEAL JOINT IN PATIENTS WITH RHEUMATOID ARTHRITIS AND HALLUX VALGUS: CHOICE OF TECHNIQUE OF ARTHRODESIS FIXATION, COMPLICATIONS AND LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    V. P. Pavlov

    2014-01-01

    a result of appropriate techniques of arthrodesis fixation. Positive long-term results (according to AOFAS questionnaire in 2.3 years after the operation were recorded in 97.8% of cases.

  14. Pneumobilia Resulting From Choledochoduodenal Fistula Secondary to Metastatic Colon Adenocarcinoma

    Science.gov (United States)

    Kramer, Scott; Tzimas, Demetrios; Saitta, Patrick

    2016-01-01

    Pneumobilia, or air within the biliary tree, is a poor prognostic indicator in a patient without prior biliary sphincterotomy. Differential diagnosis includes infection with gas-forming organisms, choledochoenteric fistula in the setting of gallstones or penetrating ulcer disease, malignant invasion from a primary liver or biliary tract tumor, or metastatic disease. Treatment depends on etiology and patient factors, but often requires surgical intervention. We report a patient with gastrointestinal bleeding in whom pneumobilia was incidentally noted on abdominal plain film. Computed tomography and endoscopy revealed the biliary-enteric fistula to be caused by metastatic colon adenocarcinoma invading the biliary tree. PMID:26958563

  15. Long-term environmental stewardship.

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Long-term results of treatment of cervical carcinoma in the United States in 1973, 1978, and 1983: Patterns of Care Study (PCS)

    International Nuclear Information System (INIS)

    Purpose: To extend the observations of patients with carcinoma of the cervix treated in 1973 for over 15 years, in 1978 for over 10 years, and in 1983 for over 5 years for survival and local control to compare treatment times and outcome. Methods and Materials: A nationwide survey of the patterns of practice in radiation therapy for patients with squamous carcinoma of the cervix collected pretreatment and treatment data using external surveyors who reviewed patients' records. Outcome information was updated for the three separate databases by mail survey. Overall survival, no evidence of disease (NED) survival, and local control curves by stage were plotted using the estimates derived by the Kaplan--Meier method. Results: Total number of patients surveyed was 1686: 937 patients in 1973, 565 patients in 1978, and 184 patients in 1983. These are the results from changes in treatment policy, particularly the increasing use of brachytherapy. Of Stage III patients, the percentage receiving brachytherapy was 60.5% in 1973, 76.5% in 1978, and 87.9% in 1983 (p < 0.001 by linear trend test). Also, there was an increased proportion in use of higher energy for external pelvic irradiation during the more recent time period, e.g., 28% in the 1973 study, 60% in the 1978 study, and 87% in the 1983 study compared to the usage of cobalt-60 equipment. Comparison of results including overall survival, local control, and NED survival for the three different time periods showed improvement in outcome for Stage III in 1983, but not Stages I and II. The 5-year survival for Stage III increased from 25% in the 1973 survey to 47% in the 1983 survey, a linear trend that is statistically significant (p = 0.02). Conclusion: The long-term results of radiotherapy for patients with carcinoma of the cervix show improved outcome for Stage III patients, which probably results from improved treatment, including higher energy for pelvic irradiation and increase in use of brachytherapy contributing

  17. Increase in soil stable carbon isotope ratio relates to loss of organic carbon: results from five long-term bare fallow experiments

    DEFF Research Database (Denmark)

    Menichetti, Lorenzo; Houot, Sabine; van Oort, Folkert;

    2015-01-01

    . However, experimental verification of the subtle isotopic shifts associated with SOC turnover under field conditions is scarce. We determined δ13C and SOC in soil sampled during 1929–2009 in the Ap-horizon of five European long-term bare fallow experiments kept without C inputs for 27–80 years...... not disclosed in our study, but the very similar kinetics measured across our five experimental sites suggest that overall site-specific factors (including climate) had a marginal influence and that it may be possible to isolate a general mechanism causing the enrichment, although pre-fallow land use may have...... examined. The overall estimate of the fractionation coefficient (ε) was −1.2 ± 0.3 ‰. This coefficient represents an important input to studies of long-term SOC dynamics in agricultural soils that are based on variations in 13C natural abundance. The variance of ε may be ascribed to site characteristics...

  18. Additional bone graft accelerates healing of clavicle non-unions and improves long-term results after 8.9 years: a retrospective study

    OpenAIRE

    Schnetzke, Marc; Morbitzer, Christian; Aytac, Sara; Erhardt, Matthias; Frank, Christian; Muenzberg, Matthias; Studier-Fischer, Stefan; Helbig, Lars; Suda, Arnold J.; Gruetzner, Paul-Alfred; Guehring, Thorsten

    2015-01-01

    Background Clavicle non-unions can occur after both conservative and operative treatment failure. Here, we investigated the outcome of patients with delayed fracture healing or non-unions of the clavicle. Patients underwent revision surgery by plate osteosynthesis of the clavicle with or without bone grafting. Our aim was to determine rates of bone healing and the functional long-term outcome. Methods The study population of 58 consecutive patients was divided into group 1 (n = 25; no bone gr...

  19. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer

    DEFF Research Database (Denmark)

    Maase, Hans von der; Sengeløv, Lisa; Roberts, James T.;

    2005-01-01

    PURPOSE: To compare long-term survival in patients with locally advanced       or metastatic transitional cell carcinoma (TCC) of the urothelium treated       with gemcitabine/cisplatin (GC) or       methotrexate/vinblastine/doxorubicin/cisplatin (MVAC). PATIENTS AND       METHODS: Efficacy data...... in patients with locally advanced or       metastatic TCC...

  20. Long-term performance of organic crop rotations in the tropics: First results from a high and a medium potential site in sub-humid Central Kenya

    OpenAIRE

    Zundel, Christine; Schneider, Monika; Musyoka, Martha; Muriuki, Anne; Vanlauwe, Bernard; Mucheru-Muna, Monica; Chabi-Olaye, Adenirin; Niggli, Urs

    2009-01-01

    Organic Agriculture is perceived by many stakeholders as a promising approach to increase food security in developing countries. However, only few attempts have been made so far to assess agronomic and economic performance of Organic Agriculture in these regions in a systematic way. The Research Institute of Organic Agriculture (FiBL), together with its partners, is presently establishing long-term comparisons of farming systems in various agro-ecological and socio-economic contexts to study ...

  1. Ten-year results from the long-term soil productivity study in aspen ecosystems of the northern Great Lakes region

    OpenAIRE

    Voldseth, Richard; Palik, Brian; Elioff, John

    2011-01-01

    Impacts of organic matter removal and compaction on soil physical and chemical properties and forest productivity are reported from the first 10 years of the Long-Term Soil Productivity Study in Great Lakes aspen ecosystems. Organic matter removal treatments included main bole, total tree harvest, and total tree harvest with forest floor removal. Compaction treatments included no compaction beyond normal levels from harvest, moderate compaction, and heavy compaction. Main bole harvest with...

  2. 18 years long-term results of facial port-wine stain (PWS) after photodynamic therapy (PDT)--a case report.

    Science.gov (United States)

    Yu, Wenxin; Ma, Gang; Qiu, Yajing; Chen, Hui; Jin, Yunbo; Yang, Xi; Hu, Xiaojie; Chang, Lei; Wang, Tianyou; Zhou, Henghua; Li, Wei; Lin, Xiaoxi

    2015-03-01

    Port-wine stain (PWS) is still a challenging condition for clinician to treat, because in the majority of cases, the stains are not lifted fully by treatment with laser therapy. Photodynamic therapy (PDT) was considered recently as a promising alternative treatment for PWS. We report here long-term follow-up measures 18 years on PWS lesion treated with PDT and the histological data of residual PWS.

  3. 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.

    Science.gov (United States)

    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. PMID:25739059

  4. Long-Term Results of Mini-Open Repair Technique in the Treatment of Acute Achilles Tendon Rupture: A Prospective Study.

    Science.gov (United States)

    Taşatan, Ersin; Emre, Tuluhan Yunus; Demircioğlu, Demet Tekdöş; Demiralp, Bahtiyar; Kırdemir, Vecihi

    2016-01-01

    An ideal surgical treatment of acute Achilles tendon rupture includes restoring the original length of the tendon, minimizing possible adhesions with the surrounding tissues, minimizing the risk of repeat rupture, alleviating wound problems, and providing an acceptable cosmetic outcome. In the mini-open repair technique, unlike the percutaneous repair technique, the quality of the tenodesis can be visualized without disturbing the healing potential of the surrounding tissues, thus minimizing wound problems. The purpose of the present study was to assess the long-term results of the mini-open repair technique in patients with acute Achilles tendon rupture. A total of 20 consecutive patients with acute Achilles tendon rupture, admitted to our inpatient clinic from October 2003 to March 2008, were included in the present study. The patients underwent Achilles tenodesis with the mini-open repair technique, and each patient was followed up for 5 years. The study was completed in April 2013. The surgical procedure was performed with the assistance of a device designed in our orthosis laboratories, similarly to that defined by Assal et al. Of the 20 patients, 18 were male and 2 were female. Their mean age was 39.3 (range 21 to 55) years. The Achilles tendon rupture was located on the left side in 15 patients (75%) and on the right side in 5 patients (25%). The mean follow-up duration was 58.5 (range 18 to 60) months and no complications occurred during the follow-up period, including repeat rupture, wound site infection, and sural nerve injury. The mean American Orthopaedic Foot and Ankle Society scale score for the patients was 99.2 (range 94 to 100) points at the final follow-up visit. All our patients were able to return to work and sporting activities. According to the Trillat scores, the outcome was excellent in 19 patients and good in 1 patient at the 18th postoperative month. No complaint, such as pain or loss of function, that might have a negative effect on the

  5. Long-Term Efficacy, Safety, and Pharmacokinetics of Drisapersen in Duchenne Muscular Dystrophy: Results from an Open-Label Extension Study

    Science.gov (United States)

    Goemans, Nathalie M.; Tulinius, Már; van den Hauwe, Marleen; Kroksmark, Anna-Karin; Buyse, Gunnar; Wilson, Rosamund J.; van Deutekom, Judith C.; de Kimpe, Sjef J.; Lourbakos, Afrodite; Campion, Giles

    2016-01-01

    Background Drisapersen induces exon 51 skipping during dystrophin pre-mRNA splicing and allows synthesis of partially functional dystrophin in Duchenne muscular dystrophy (DMD) patients with amenable mutations. Methods This 188-week open-label extension of the dose-escalation study assessed the long-term efficacy, safety, and pharmacokinetics of drisapersen (PRO051/GSK2402968), 6 mg/kg subcutaneously, in 12 DMD subjects. Dosing was once weekly for 72 weeks. All subjects had a planned treatment interruption (weeks 73–80), followed by intermittent dosing (weeks 81–188). Results Subjects received a median (range) total dose of 5.93 (5.10 to 6.02) mg/kg drisapersen. After 177 weeks (last efficacy assessment), median (mean [SD]) six-minute walk distance (6MWD) improved by 8 (-24.5 [161]) meters for the 10 subjects able to complete the 6MWD at baseline (mean age [SD]: 9.5 [1.9] years). These statistics include 2 subjects unable to complete the test at later visits and who scored “zero”. When only the 8 ambulant subjects at week 177 were taken into account, a median (mean [SD]) increase of 64 (33 [121]) meters in 6MWD was observed. Of 7 subjects walking ≥330 m at extension baseline, 5 walked farther at week 177. Of 3 subjects walking <330 m, 2 lost ambulation, while 1 declined overall but walked farther at some visits. Over the 188 weeks, the most common adverse events were injection-site reactions, raised urinary α1-microglobulin and proteinuria. Dystrophin expression was detected in all muscle biopsies obtained at week 68 or 72. Conclusion Drisapersen was generally well tolerated over 188 weeks. Possible renal effects, thrombocytopenia and injection-site reactions warrant continued monitoring. Improvements in the 6MWD at 12 weeks were sustained after 3.4 years of dosing for most patients. For a small, uncontrolled study, the outcomes are encouraging, as natural history studies would anticipate a decline of over 100 meters over a 3-year period in a comparable

  6. Long-term follow-up results of linear accelerator-based radiosurgery for vestibular schwannoma using serial three-dimensional spoiled gradient-echo MRI.

    Science.gov (United States)

    Matsuo, Takayuki; Okunaga, Tomohiro; Kamada, Kensaku; Izumo, Tsuyoshi; Hayashi, Nobuyuki; Nagata, Izumi

    2015-02-01

    We examined the characteristic changes in vestibular schwannoma (VS) volume after treatment with linear accelerator-based radiosurgery (LBRS) and the long-term therapeutic effects, by performing three-dimensional (3D) MRI evaluations of tumor volumes. We included 44 patients in whom tumor volume changes could be observed using 3D-spoiled gradient-echo MRI for at least 5 years. Examinations were performed every 3-4 months for the first 2 years after treatment and every 6-12 months thereafter. Enlargement or shrinkage was determined as a change of at least 20% from the volume at the time of treatment. The median observation period was 13.8 years (range, 5.5-19.5 years). The tumor control rates at 5 and 10 years after treatment and at the final MRI were 90.9%, 90.0%, and 88.6%, respectively. Tumor volume changes were categorized into the following four patterns: enlargement, five patients (11.4%); stable, three patients (6.8%); transient enlargement, 24 patients (54.5%); and direct shrinkage, 12 patients (27.3%). Bimodal peaks were observed in three of the 24 patients with transient enlargement. Tumor volume changes from 5 and 10 years post-LBRS to the final observation point were observed in 27 (64.2%) and 10 patients (33.3%), respectively. The long-term tumor volume changes observed after LBRS suggest that radiation exerts long-term effects on tumors. Furthermore, while transient enlargements in tumor volume were characteristic, true tumor enlargements should be characterized by increased volumes of more than two-fold and continued growth for at least 2 years. PMID:25443082

  7. Risk factors for Barrett's oesophagus and oesophageal adenocarcinoma: Results from the FINBAR study

    Institute of Scientific and Technical Information of China (English)

    Lesley A Anderson; RG Peter Watson; Seamus J Murphy; Brian T Johnston; Harry Comber; Jim Mc Guigan; John V Reynolds; Liam J Murray

    2007-01-01

    AIM: To investigate risk factors associated with Barrett's oesophagus and oesophageal adenocarcinoma.METHODS: This all-Ireland population-based case-control study recruited 224 Barrett's oesophagus patients, 227 oesophageal adenocarcinoma patients and 260 controls. All participants underwent a structured interview with information obtained about potential lifestyle and environmental risk factors.RESULTS: Gastro-oesophageal reflux was associated with Barrett's [OR 12.0 (95% CI 7.64-18.7)] and oesophageal adenocarcinoma [OR 3.48 (95% CI 2.25-5.41)]. Oesophageal adenocarcinoma patients were more likely than controls to be ex- or current smokers [OR 1.72 (95% CI 1.06-2.81) and OR 4.84 (95% CI 2.72-8.61) respectively] and to have a high body mass index [OR 2.69 (95% CI 1.62-4.46)]. No significant associations were observed between these risk factors and Barrett's oesophagus. Fruit but not vegetables were negatively associated with oesophageal adenocarcinoma [OR 0.50 (95% CI 0.30-0.86)].CONCLUSION: A high body mass index, a diet low in fruit and cigarette smoking may be involved in the progression from Barrett's oesophagus to oesophageal adenocarcinoma.

  8. Validation of Erosion 3D in Lower Saxony - Comparison between modelled soil erosion events and results of a long term monitoring project

    Science.gov (United States)

    Bug, Jan; Mosimann, Thomas

    2013-04-01

    Since 2000 water erosion has been surveyed on 400 ha arable land in three different regions of Lower Saxony (Mosimann et al. 2009). The results of this long-term survey are used for the validation of the soil erosion models such as USLE and Erosion 3D. The validation of the physically-based model Erosion 3D (Schmidt & Werner 2000) is possible because the survey analyses the effects (soil loss, sediment yield, deposition on site) of single thunder storm events and also maps major factors of soil erosion (soil, crop, tillage). A 12.5 m Raster DEM was used to model the soil erosion events.Rainfalldata was acquired from climate stations. Soil and landuse parameters were derived from the "Parameterkatalog Sachsen"(Michael et al. 1996). During thirteen years of monitoring, high intensity storms fell less frequently than expected. High intensity rainfalls with a return period of five or ten years usually occurred during periods of maximum plant cover.Winter events were ruled out because dataon snow melt and rainfallwere not measured. The validation is therefore restricted to 80 events. The validation consists of three parts. The first part compares the spatial distribution of the mapped soil erosion with the model results. The second part calculates the difference in the amount of redistributed soil. The third part analyses off-site effects such as sediment yield and pollution of water bodies. The validation shows that the overall result of erosion 3D is quite good. Spatial hotspots of soil erosion and of off-site effects are predicted correctly in most cases. However, quantitative comparison is more problematic, because the mapping allows only the quantification of rillerosion and not of sheet erosion. So as a rule,the predicted soil loss is higher than the mapped. The prediction of rill development is also problematic. While the model is capable of predicting rills in thalwegs, the modelling of erosion in tractor tracks and headlands is more complicated. In order to

  9. Long term behaviour of low and intermediate level waste packages under repository conditions. Results of a co-ordinated research project 1997-2002

    International Nuclear Information System (INIS)

    The development and application of approaches and technologies that provide long term safety is an essential issue in the disposal of radioactive waste. For low and intermediate level radioactive waste, engineered barriers play an important role in the overall safety and performance of near surface repositories. Thus, developing a strong technical basis for understanding the behaviour and performance of engineered barriers is an important consideration in the development and establishment of near surface repositories for radioactive waste. In 1993, a Co-ordinated Research Project (CRP) on Performance of Engineered Barrier Materials in Near Surface Disposal Facilities for Radioactive Waste was initiated by the IAEA with the twin goals of addressing some of the gaps in the database on radionuclide isolation and long term performance of a wide variety of materials and components that constitute the engineered barriers system (IAEA-TECDOC-1255 (2001)). However, during the course of the CRP, it was realized that that the scope of the CRP did not include studies of the behaviour of waste packages over time. Given that a waste package represents an important component of the overall near surface disposal system and the fact that many Member States have active R and D programmes related to waste package testing and evaluation, a new CRP was launched, in 1997, on Long Term Behaviour of Low and Intermediate Level Waste Packages Under Repository Conditions. The CRP was intended to promote research activities on the subject area in Member States, share information on the topic among the participating countries, and contribute to advancing technologies for near surface disposal of radioactive waste. Thus, this CRP complements the afore mentioned CRP on studies of engineered barriers. With the active participation and valuable contributions from twenty scientists and engineers from Argentina, Canada, Czech Republic, Egypt, Finland, India, Republic of Korea, Norway, Romania

  10. [A case of gastric adenosquamous carcinoma with peritoneal dissemination in which treatment with S-1 plus paclitaxel therapy resulted in improved long-term survival].

    Science.gov (United States)

    Hirano, Masamitsu; Ozamoto, Yuki; Ichinose, Masumi; Togawa, Takeshi; Takao, Nobuyuki; Mizumoto, Akiyoshi; Tatsuno, Manami; Yamamoto, Yoshihiro; Yonemura, Yutaka

    2014-07-01

    Gastric adenosquamous carcinoma is a rare malignancy with a poor prognosis. We recently performed palliative gastrectomy for a gastric adenosquamous carcinoma with peritoneal dissemination and provided a course of systemic chemotherapy with S-1 plus paclitaxel(PTX)after the surgery. No serious adverse events were observed, and treatment with S-1 plus PTX was continued for 1 year before being switched to adjuvant chemotherapy with S-1 alone for another year. The tumor maker levels normalized within 2 months of the initial treatment, and the peritoneal dissemination could no longer be detected by abdominal computed tomography(CT). The patient remained in clinical remission and maintained long-term survival of over 8 years. PMID:25131877

  11. High-altitude forest sensitivity to global warming: results from long-term and short-term analyses in the eastern italian alps

    Science.gov (United States)

    Carrer, Marco; Anfodillo, Tommaso; Urbinati, Carlo; Carraro, Vinicio

    Dendroecological (long-term) analysis and ecophysiological (short-term) monitoring were used interactively to study the responses of tree-ring growth to climate in timberline mixed forests (consisting of Larix decidua Mill., Picea abies (L.) Karst. and Pinus cembra (L.)) in the Italian Eastern Alps (2000-2100 m a.s.l.). Climate-growth linear response functions (LRF) revealed that warm temperatures in June and July have a positive effect on radial growth whereas precipitation during the vegetation period has no effect. Monitoring of the intra-annual radial growth dynamics using band dendrometers confirmed that the radial growth rate of the three species in June and July was greater when air temperatures were higher. Tree-ring formation lasted about 50-60 days (from mid-June to the beginning of August).

  12. Stem cell mobilisation by granulocyte-colony stimulating factor in patients with acute myocardial infarction. Long-term results of the REVIVAL-2 trial.

    Science.gov (United States)

    Steppich, Birgit; Hadamitzky, Martin; Ibrahim, Tareq; Groha, Philip; Schunkert, Heribert; Laugwitz, Karl-Ludwig; Kastrati, Adnan; Ott, Ilka

    2016-04-01

    Treatment with granulocyte-colony stimulating factor (G-CSF) mobilises cells from the bone marrow to the peripheral blood. Previous preclinical and early clinical trials may suggest that treatment with G-CSF leads to improved myocardial perfusion and function in acute or chronic ischaemic heart disease. In the REVIVAL-2 study we found that stem cell mobilisation by G-CSF does not influence infarct size, left ventricular function and coronary restenosis in patients with acute myocardial infarction (MI) that underwent successful percutaneous coronary intervention. The objective of the present analysis was to assess the impact of G-CSF treatment on seven-year clinical outcomes from the REVIVAL-2 trial. In the randomized, double-blind, placebo-controlled REVIVAL-2 study, 114 patients with the diagnosis of acute myocardial infarction were enrolled five days after successful reperfusion by percutaneous coronary intervention. Patients were assigned to receive 10 µg/kg G-CSF (n=56) or placebo (n=58) for five days. The primary endpoint for this long-term outcome analysis was the composite of death, myocardial infarction or stroke seven years after randomisation. The endpoint occurred in 14.3 % of patients in the G-CSF group versus 17.2 % assigned to placebo (p=0.67). The combined incidence of death or myocardial infarction occurred in 14.3 % of the patients assigned to G-CSF and 15.5 % of the patients assigned to placebo (p=0.85). In conclusion, these long-term follow-up data show that G-CSF does not improve clinical outcomes of patients with acute myocardial infarction.

  13. Impact of radiotherapy after mastectomy in patients with a breast cancer at intermediary risk: long term clinical results of the CRL C Val -d'Aurelle of Montpellier; Impact de la radiotherapie apres mastectomie chez les patientes atteintes de cancer du sein a risque intermediaire: resultat clinique a long terme du CRLC Val-d'Aurelle de Montpellier

    Energy Technology Data Exchange (ETDEWEB)

    Rat, F.; Lemanski, C.; Llacer Moscardo, C.; Rouanet, P.; Romieu, G.; Dubois, J.B.; Azria, D. [CRLC Val-D' Aurelle-Paul-Lamarque, 34 - Montpellier (France)

    2009-10-15

    Purpose: Despite the fact that the radiotherapy is a choice therapy to optimize the local regional control of breast cancers, its resort after mastectomy for patients suffering of breast cancer at recurrence intermediary risk is submitted to controversy. Only a little locoregional recurrences have been observed after radiotherapy. A very strong link between locoregional symptoms and metastases was enlightened. In view of these excellent locoregional results at long term, the futures studies must develop a systemic strategy adapted to the metastases progressive risk. (N.C.)

  14. Five-year field results and long-term effectiveness of 20 mg/kg liposomal amphotericin B (Ambisome for visceral leishmaniasis in Bihar, India.

    Directory of Open Access Journals (Sweden)

    Sakib Burza

    Full Text Available BACKGROUND: Visceral Leishmaniasis (VL; also known as Kala-azar is an ultimately fatal disease endemic in Bihar. A 2007 observational cohort study in Bihar of 251 patients with VL treated with 20 mg/Kg intravenous liposomal amphotericin B (Ambisome demonstrated a 98% cure rate at 6-months. Between July 2007 and August 2012, Médecins Sans Frontières (MSF and the Rajendra Memorial Research Institute (RMRI implemented a VL treatment project in Bihar, India-an area highly endemic for Leishmania donovani-using this regimen as first-line treatment. METHODS AND PRINCIPAL FINDINGS: Intravenous Ambisome 20 mg/kg was administered in four doses of 5 mg/kg over 4-10 days, depending on the severity of disease. Initial clinical cure at discharge was defined as improved symptoms, cessation of fever, and recession of spleen enlargement. This observational retrospective cohort study describes 8749 patients with laboratory-confirmed primary VL treated over a 5-year period: 1396 at primary healthcare centers, 7189 at hospital, and 164 at treatment camps. Initial clinical cure was achieved in 99.3% of patients (8692/8749; 0.3% of patients (26/8749 defaulted from treatment and 0.4% (31/8749 died. Overall, 1.8% of patients (161/8749 were co-infected with HIV and 0.6% (51/8749 with tuberculosis. Treatment was discontinued because of severe allergic reactions in 0.1% of patients (7/8749. Overall, 27 patients (0.3% were readmitted with post Kala-azar dermal leishmaniasis (PKDL. Risk factors for late presentation included female sex, age >15 years and being from a scheduled caste. In 2012, a long-term efficacy survey in the same area of Bihar determined relapse rates of VL after 5 years' intervention with Ambisome. Of 984 immunocompetent patients discharged between September 2010 and December 2011, 827 (84.0% were traced in order to determine their long-term outcomes. Of these, 20 patients (2.4% had relapsed or received further treatment for VL. Of those completing 6

  15. Sustained Improvement of Arterial Stiffness and Blood Pressure after Long-Term Rosuvastatin Treatment in Patients with Inflammatory Joint Diseases: Results from the RORA-AS Study.

    Directory of Open Access Journals (Sweden)

    Eirik Ikdahl

    Full Text Available Patients with inflammatory joint diseases (IJD have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of long-term rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx and aortic pulse wave velocity (aPWV, and blood pressure (BP in IJD patients with established atherosclerosis.Eighty-nine statin naïve IJD patients with carotid atherosclerotic plaque(s (rheumatoid arthritis n = 55, ankylosing spondylitis n = 23, psoriatic arthritis n = 11 received rosuvastatin for 18 months to achieve low-density lipoprotein cholesterol goal ≤1.8 mmol/L. Change in AIx (ΔAIx, aPWV (ΔaPWV, systolic BP (ΔsBP and diastolic BP (ΔdBP from baseline to study end was assessed by paired samples t-tests. Linear regression was applied to evaluate associations between cardiovascular disease (CVD risk factors, rheumatic disease specific variables and medication, and ΔAIx, ΔaPWV, ΔsBP and ΔdBP.AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end. The mean (95%CI changes were: ΔAIx: -0.34 (-0.03, -0.65% (p = 0.03, ΔaPWV: -1.69 (-0.21, -3.17m/s2 (p = 0.03, ΔsBP: -5.27 (-1.61, -8.93mmHg (p = 0.004 and ΔdBP -2.93 (-0.86, -5.00mmHg (p = 0.01. In linear regression models, ∆aPWV was significantly correlated with ΔsBP and ΔdBP (for all: p<0.001.There is an unmet need of studies evaluating CVD prevention in IJD patients. We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD. These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.ClinicalTrials.gov NCT01389388.

  16. Chemical and biochemical properties of Stagnic Albeluvisols organic matter as result of long-term agricultural management and native forest ecosystem

    Science.gov (United States)

    Astover, Alar; Kõlli, Raimo; Wojciech Szajdak, Lech

    2010-05-01

    Soil organic matter (SOM) is considered to be as the most important factor in soil forming, development and continuous functioning. Sequestrated into SOM organic carbon concentrations, pools and residence time in soil, as well acting intensity of interconnected with SOM edaphon are soil type specific or characteristic to certain soil types. In depending on soil moisture regime, calcareousness and clay content for each soil type certain soil organic carbon (SOC) retaining capacity and its vertical distribution pattern are characteristic. However, land use change (crop rotation, continuous cropping, no-tillage, melioration, rewetting) has greatest influence mainly on fabric of epipedon and biological functions of soil cover. Stagnic Albeluvisols are largely distributed at Tartu County. They form here more than half from arable soils. The establishment of long-term field trial and forest research area in these regions for biochemical analysis of Stagnic Albeluvisols' organic matter is in all respects justified. In 1989, an international long-term experiment on the organic nitrogen or IOSDV (Internationale Organische Stickstoffdauerdiingungsversuche) with three-field crop rotation (potato - spring wheat - spring barley) was started at Eerika near Tartu (58° 22.5' N; 26° 39.8' E) on Stagnic Albeluvisol. The main aims of this study were to determine the long-term effects of cropping systems on physico-chemical properties of soils and their productivity. The design of this field experiment is similar to other European network of IOSDV experiments. Before the establishment of this experiment in 1989 it was in set-aside state (5-6 years) as field-grass fallow. It was used as arable land in condition of state farm during 1957-83. Average agrochemical characteristics of the plough horizon of soil in the year of establishment were the following: humus content 17.1 g kg-1, total nitrogen content 0.9 g kg-1, C:N ratio 11 and pHKCl 6.3. DL soluble phosphorus content was 44 mg

  17. Urine screening for aminoacidopathies: is it beneficial? Results of a long-term follow-up of cases detected bny screening one millon babies.

    Science.gov (United States)

    Wilcken, B; Smith, A; Brown, D A

    1980-09-01

    One million 6-week-old infants were screened for aminoacidurias and the long-term follow-up analyzed to assess the benefits of the screening program. Apart from phenylketonuria, now normally detected by blood screening at five days, the most frequent abnormalities identified were cystinuria, histidinemia, Hartnup disease, and iminoglycinuria. Other disorders occurred less frequently than 1:100,000. Early diagnosis provided unequivocal clinical benefit only for phenylketonuria. There was probable benefit to patients with cystinuria, homocystinuria, argininosuccinic aciduria, and to some patients with Hartnup disease. However, benefit of early diagnosis in these disorders, of which the combined incidence was 1:10,000, was not clear-cut; for example, in 68 cystinuric children, four had already developed renal stones despite close medical supervision and a regimen of increased fluid intake to the limits of tolerance. No patient detected with any other condition benefited, either because the condition appeared benign and was not treated, or because the disorder was serious or lethal and there was a bad outcome despite early diagnosis and treatment. Existing urine screening programs should explore the incidence and clinical significance of further biochemical abnormalities detectable in the newborn infant, but there is no indication at present for the initiation of new urine screening programs designed to detect only aminoacidurias. PMID:7411317

  18. The prosthetic (Teflon) central aortopulmonary shunt for cyanotic infants less than three weeks old: results and long-term follow-up.

    Science.gov (United States)

    Lamberti, J J; Campbell, C; Replogle, R L; Anagnostopoulos, C; Lin, C Y; Chiemmongkoltip, P; Arcilla, R

    1979-12-01

    The expanded microporous polytetrafluoroethylene (PTFE) 4 mm vascular prosthesis has been used to create a central aortopulmonary shunt in 20 critically ill infants less than 3 weeks old. The infants ranged from 1 to 18 days old (5.25 days), and from 1.5 to 4.0 kg (2.9 kg). Conduit length ranged from 2 to 6 cm (4 cm). Sixteen patients had atresia of the tricuspid or pulmonary valve. There were 6 early deaths (30%), only 1 of which was shunt related. The mean preoperative arterial oxygen saturation was 62% (range, 33 to 80%), and mean postoperative saturation was 87% (range, 78 to 90%). There were 5 late deaths, 1 probably caused by shunt failure. Nine long-term survivors have done well. Follow-up ranges from 1 to 36 months (18 months). Factors influencing conduit function are length, technical considerations, and pulmonary vascular resistance. Late restudy in 5 of 9 survivors confirms patency and demonstrates bidirectional pulmonary blood flow. Since PTFE shunt flow capability is fixed, the infant may require repair or a second shunt within 24 months of the initial procedure.

  19. Long-Term Effects of Maternal Medication on Global Quality of Life Measured with SEQOL. Results from the Copenhagen Perinatal Birth Cohort 1959�61

    Directory of Open Access Journals (Sweden)

    Soren Ventegodt

    2003-01-01

    Full Text Available The Copenhagen Perinatal Birth Cohort 1959�61 is a prospective longitudinal perinatal study that included all deliveries (over 20 weeks gestation, birthweight over 250 g that took place at the University Hospital (Rigshospitalet in Copenhagen, Denmark during the period of September 21, 1959 to December 21, 1961 and used in this follow-up study to investigate the connection between maternal medication during pregnancy and the quality of life of the child 31 to 33 years later. The latest follow-up study from the cohort was performed in 1993 and 7,222 of the surviving children were identified (now aged between 31 and 33 years and contacted with a nonanonymous questionnaire on several aspects of quality of life issues.There were 4,626 usable responses (f = 2,489, m = 2,131 corresponding to a response rate of 64.1%. Of the 12 groups of medication taking during pregnancy we found, before controlling (using multiple linear regression, that analgesics, chemotherapy, and psychopharmacologica showed links with the quality of life in the child 31 to 33 years later. Barbiturate use (95% was phenemal showed significant connection to quality of life. After controlling for social and pregnancy factors there was no correlation between quality of life and medication taken by the mother during pregnancy. From this study it is concluded the fetal exposure to the drugs examined showed no measurable long-term effects on quality of life.

  20. Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

    Science.gov (United States)

    Zhang, Yuan; Deng, Xu; Jiang, Dianming; Luo, Xiaoji; Tang, Ke; Zhao, Zenghui; Zhong, Weiyang; Lei, Tao; Quan, Zhengxue

    2016-05-01

    To assess the long-term clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) with a neotype nano-hydroxyapatite/polyamide 66 (n-HA/PA66) strut in the treatment of cervical spondylotic myelopathy (CSM). Fifty patients with CSM who underwent 1- or 2-level ACCF with n-HA/PA66 struts were retrospectively investigated. With a mean follow-up of 79.6 months, the overall mean JOA score, VAS and cervical alignment were improved significantly. At last follow-up, the fusion rate was 98%, and the subsidence rate of the n-HA/PA66 strut was 8%. The “radiolucent gap” at the interface between the n-HA/PA66 strut and the vertebra was further noted to evaluate the osteoconductivity and osseointegration of the strut, and the incidence of it was 62% at the last follow-up. Three patients suffered symptomatic adjacent segment degeneration (ASD). No significant difference was detected in the outcomes between 1- and 2-level corpectomy at follow-ups. In conclusion, the satisfactory outcomes in this study indicated that the n-HA/PA66 strut was an effective graft for cervical reconstruction. Moreover, the osteoconductivity and osseointegration of the strut is still need to be optimized for future clinical application owing to the notably presence of “radiolucent gap” in present study.

  1. Dynamic Strength and Accumulated Plastic Strain Development Laws and Models of the Remolded Red Clay under Long-Term Cyclic Loads: Laboratory Test Results

    Directory of Open Access Journals (Sweden)

    Li Jian

    2015-09-01

    Full Text Available The dynamic strength and accumulated plastic strain are two important parameters for evaluating the dynamic response of soil. As a special clay, the remolded red clay is often used as the high speed railway subgrade filling, but studies on its dynamic characteristics are few. For a thorough analysis of the suitability of the remolded red clay as the subgrade filling, a series of long-term cyclic load triaxial test under different load histories are carried out. Considering the influence of compactness, confining pressure, consolidation ratio, vibration frequency and dynamic load to the remolded red clay dynamic property, the tests obtain the development curves of the dynamic strength and accumulated plastic strain under different test conditions. Then, through curve fitting method, two different hyperbolic models respectively for the dynamic strength and accumulated plastic strain are built, which can match the test datum well. By applying the dynamic strength model, the critical dynamic strength of the remolded red clay are gained. Meanwhile, for providing basic datum and reference for relevant projects, all key parameters for the dynamic strength and accumulated plastic strain of the remolded red clay are given in the paper.

  2. Long-term results of adrenalectomy in patients with aldosterone-producing adenomas: multivariate analysis of factors affecting unresolved hypertension and review of the literature.

    Science.gov (United States)

    Lumachi, Franco; Ermani, Mario; Basso, Stefano M M; Armanini, Decio; Iacobone, Maurizio; Favia, Gennaro

    2005-10-01

    The long-term surgical cure rate of patients with primary aldosteronism varies widely, and causes of persistent hypertension are not completely established. We reviewed retrospectively charts from 98 patients (range, 19-70 years old) with aldosterone-producing adenomas who underwent unilateral adrenalectomy. At a median follow-up of 81 months (range, 18-186 months), the mean blood pressure values improved in 95 out of 98 (96.9%) patients, although hypertension was cured only in 71 out of 98 (72.4%) patients. Multivariate analysis using a logistic regression model adjusted for duration of follow-up showed that only age of the patients and duration of the disease independently correlated with unresolved hypertension. The cumulative odds ratio (OR), obtained using the logistic regression function, was 5.38 (95% CI 1.78-16.22), and the OR of single variables were 1.32 (95% CI 0.36-19.83) and 4.56 (95% CI 1.41-14.78), respectively. By using discriminant analysis to derive a classification function for the prediction of unresolved hypertension, a maximum predictive power of 75 per cent was achieved. In conclusion, in patients with an aldosterone-producing adenoma undergoing surgery, the combination of age and duration of hypertension gave the best predictive power of a linear classification function and represented the main independent risk factors affecting hypertension cure rate. PMID:16468537

  3. Perioperative growth hormone treatment increases nitrogen and fluid balance and results in short-term and long-term conservation of lean tissue mass

    DEFF Research Database (Denmark)

    Jensen, Martin Bach; Kissmeyer-Nielsen, Peter; Laurberg, Søren

    1998-01-01

    , 3.6 kg (2.1, 5.1) lean tissue mass, and 0.5 kg (-0.1, 1.2) fat mass. These reductions persisted 3 mo later. Compared with placebo, GH improved nitrogen balance, changes in lean tissue mass [gain of 4.0 kg (1.9, 6.0), P=0.001], and changes in total tissue mass [gain of 3.2 kg (1.6, 4.9), P=0.......001], but increased the loss of fat mass [loss of 0.7 kg (0.0, 1.5), P=0.049] on postoperative day 7. Three months later, the placebo-treated patients had lost 2.4 kg (0.7, 4.2) more lean tissue mass than GH-treated patients (P=0.009), whereas changes in total tissue and fat mass were not significantly different....... Hence, GH treatment enhanced the long-term regain of lean tissue mass....

  4. Forest soil nutrient status after 10 years of experimental acidification and base cation depletion : results from 2 long-term soil productivity sites in the central Appalachians

    Energy Technology Data Exchange (ETDEWEB)

    Adams, M.B. [United States Dept. of Agriculture Forest Service, Parsons, WV (United States); Burger, J.A. [Virginia Tech University, Blacks Burg, VA (United States)

    2010-07-01

    This study assessed the hypothesis that soil based cation depletion is an effect of acidic deposition in forests located in the central Appalachians. The effects of experimentally induced base cation depletion were evaluated in relation to long-term soil productivity and the sustainability of forest stands. Whole-tree harvesting was conducted along with the removal of dead wood litter in order to remove all aboveground nutrients. Ammonium sulfate fertilizer was added at annual rates of 40.6 kg S/ha and 35.4 kg N/h in order to increase the leaching of calcium (Ca) and magnesium (Mg) from the soil. A randomized complete block design was used in 4 or 5 treatment applications in a mixed hardwood experimental forest located in West Virginia and in a cherry-maple forest located in a national forest in West Virginia. Soils were sampled over a 10-year period. The study showed that significant changes in soil Mg, N and some other nutrients occurred over time. However, biomass did not differ significantly among the different treatment options used.

  5. Roux-En Y Gastric Bypass Results in Long-Term Remission of Hepatocyte Apoptosis and Hepatic Histological Features of Non-alcoholic Steatohepatitis

    Science.gov (United States)

    Schneck, Anne-Sophie; Anty, Rodolphe; Patouraux, Stéphanie; Bonnafous, Stéphanie; Rousseau, Déborah; Lebeaupin, Cynthia; Bailly-Maitre, Beatrice; Sans, Arnaud; Tran, Albert; Gugenheim, Jean; Iannelli, Antonio; Gual, Philippe

    2016-01-01

    The long-term effects of bariatric surgery on non-alcoholic steatohepatitis (NASH), focusing on liver injury and hepatocyte apoptosis, are not well-established. We here performed a longitudinal study with paired liver biopsies of nine morbidly obese women (median BMI: 42 [38.7; 45.1] kg/m2) with NASH with a median follow-up of 55 [44; 75] months after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. LRYGB surgery was associated with significant weight loss (median BMI loss −13.7 [−16.4; −9.5] kg/m2), improved hepatic steatosis in all patients (55.5% with total resolution), and resolution of hepatic inflammation and hepatocyte ballooning in 100 and 88.8% of cases, respectively. Alanine aminotransferase levels dropped to normal values while hepatic activated cleaved caspase-3 levels strongly decreased after a median follow-up of 55 months. Hepatocyte apoptosis, as evaluated by serum caspase-generated keratin-18 fragment, improved within the first year following LRYGB and these improvements persisted for at least 55 months. LRYGB in morbidly obese patients with NASH is thus associated with a long-lasting beneficial impact on hepatic steatohepatitis and hepatocyte death. PMID:27594839

  6. Analysing long term discursive processes

    DEFF Research Database (Denmark)

    Horsbøl, Anders

    which extend beyond the single interaction, for instance negotiations or planning processes, seems to have played a less important role, with studies such as Iedema 2001 and Wodak 2000 as exceptions. These long term processes, however, are central to the constitution and workings of organizations...... Change. Amsterdam: John Benjamins....

  7. Long term e-archiving

    OpenAIRE

    Dobratz, Susanne

    2002-01-01

    Conclusions of the breakout session "Long term e-archiving". Looking at the motto of this workshop “Gaining independence with e-Print archives and OAI” it suggests first of all that using e-Print publishing methods especially in the sense of a scholarly non-profit publishing independently from any commercial publishing house offers a unique chance to scientists.

  8. The long-term impact of early life poverty on orbitofrontal cortex volume in adulthood: results from a prospective study over 25 years.

    Science.gov (United States)

    Holz, Nathalie E; Boecker, Regina; Hohm, Erika; Zohsel, Katrin; Buchmann, Arlette F; Blomeyer, Dorothea; Jennen-Steinmetz, Christine; Baumeister, Sarah; Hohmann, Sarah; Wolf, Isabella; Plichta, Michael M; Esser, Günter; Schmidt, Martin; Meyer-Lindenberg, Andreas; Banaschewski, Tobias; Brandeis, Daniel; Laucht, Manfred

    2015-03-01

    Converging evidence has highlighted the association between poverty and conduct disorder (CD) without specifying neurobiological pathways. Neuroimaging research has emphasized structural and functional alterations in the orbitofrontal cortex (OFC) as one key mechanism underlying this disorder. The present study aimed to clarify the long-term influence of early poverty on OFC volume and its association with CD symptoms in healthy participants of an epidemiological cohort study followed since birth. At age 25 years, voxel-based morphometry was applied to study brain volume differences. Poverty (0=non-exposed (N=134), 1=exposed (N=33)) and smoking during pregnancy were determined using a standardized parent interview, and information on maternal responsiveness was derived from videotaped mother-infant interactions at the age of 3 months. CD symptoms were assessed by diagnostic interview from 8 to 19 years of age. Information on life stress was acquired at each assessment and childhood maltreatment was measured using retrospective self-report at the age of 23 years. Analyses were adjusted for sex, parental psychopathology and delinquency, obstetric adversity, parental education, and current poverty. Individuals exposed to early life poverty exhibited a lower OFC volume. Moreover, we replicated previous findings of increased CD symptoms as a consequence of childhood poverty. This effect proved statistically mediated by OFC volume and exposure to life stress and smoking during pregnancy, but not by childhood maltreatment and maternal responsiveness. These findings underline the importance of studying the impact of early life adversity on brain alterations and highlight the need for programs to decrease income-related disparities. PMID:25315195

  9. Promising long-term results with attenuated adverse effects by methotrexate-containing sequential chemoradiation therapy in locally advanced head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    To reduce severe acute and late toxicities without compromising organ preservation survival in patients with locoregionally advanced head and neck squamous cell carcinoma, we performed three-drug induction methotrexate-cisplatin-fluorouracil with weekly cisplatin-fluorouracil concurrent chemoradiation. Two induction courses of methotrexate (40 mg/m2/day, days 1, 8 and 15), cisplatin and 5-fluorouracil (25 and 750 mg/m2/day, days 1-4) were given in new diagnoses of patients with non-nasopharyngeal locoregionally advanced head and neck squamous cell carcinoma. Responders received concurrent chemoradiation with weekly cisplatin (20 mg/m2/day) and 5-fluorouracil (400 mg/m2/day) on day 1. Among 57 patients (58% with Stage IV and hypopharyngeal cancer), the rates of Grade 3-4 toxicity were 30 and 74% during induction and concurrent chemoradiotherapy (CCRT), respectively. A total of 49 patients completed induction and began concurrent chemoradiation; 47 (96%) completed all planned treatment. With a median follow-up of 62 months (range 19-83 months) for the current survivors, the 3-year overall and disease-specific survival estimates were 50 and 58%, respectively. The 3-year organ preservation survival was 74% in patients who achieved complete remission after concurrent chemoradiation, and 96% of current survivors are tracheotomy and feeding tube-free. No patient without local/regional failure suffered from distant metastasis. Methotrexate-cisplatin-fluorouracil induction chemotherapy followed by weekly cisplatin-fluorouracil concurrent chemoradiation is an acute and late toxicity-acceptable protocol without attenuating organ preservation survival in patients with locoregionally advanced head and neck squamous cell carcinoma. In this patient cohort with advanced head and neck squamous cell carcinoma, overall and organ preservation survivals were encouraging, and provided promising long-term benefits of this approach. (author)

  10. Adaptations in upper-body maximal strength and power output resulting from long-term resistance training in experienced strength-power athletes.

    Science.gov (United States)

    Baker, Daniel G; Newton, Robert U

    2006-08-01

    The purpose of this investigation was to observe changes in maximal upper-body strength and power and shifts in the load-power curve across a multiyear period in experienced resistance trainers. Twelve professional rugby league players who regularly performed combined maximal strength and power training were observed across a 4-year period with test data reported every 2 years (years 1998, 2000, and 2002). Upper-body strength was assessed by the 1 repetition maximum bench press and maximum power during bench press throws (BT Pmax) with various barbell resistances of 40-80 kg. During the initial testing, players also were identified as elite (n = 6) or subelite (n = 6), depending upon whether they participated in the elite first-division national league or second-division league. This subgrouping allowed for a comparison of the scope of changes dependent upon initial strength and training experience. The subelite group was significantly younger, less strong, and less powerful than the elite group, but no other difference existed in height or body mass in 1998. Across the 4-year period, significant increases in strength occurred for the group as a whole and larger increases were observed for the subelite than the elite group, verifying the limited scope that exists for strength gain in more experienced, elite resistance-trained athletes. A similar trend occurred for changes in BT Pmax. This long-term observation confirms that the rate of progress in strength and power development diminishes with increased strength levels and resistance training experience. Furthermore, it also indicates that strength and power can still be increased despite a high volume of concurrent resistance and endurance training. PMID:16937966

  11. The long-term impact of early life poverty on orbitofrontal cortex volume in adulthood: results from a prospective study over 25 years.

    Science.gov (United States)

    Holz, Nathalie E; Boecker, Regina; Hohm, Erika; Zohsel, Katrin; Buchmann, Arlette F; Blomeyer, Dorothea; Jennen-Steinmetz, Christine; Baumeister, Sarah; Hohmann, Sarah; Wolf, Isabella; Plichta, Michael M; Esser, Günter; Schmidt, Martin; Meyer-Lindenberg, Andreas; Banaschewski, Tobias; Brandeis, Daniel; Laucht, Manfred

    2015-03-01

    Converging evidence has highlighted the association between poverty and conduct disorder (CD) without specifying neurobiological pathways. Neuroimaging research has emphasized structural and functional alterations in the orbitofrontal cortex (OFC) as one key mechanism underlying this disorder. The present study aimed to clarify the long-term influence of early poverty on OFC volume and its association with CD symptoms in healthy participants of an epidemiological cohort study followed since birth. At age 25 years, voxel-based morphometry was applied to study brain volume differences. Poverty (0=non-exposed (N=134), 1=exposed (N=33)) and smoking during pregnancy were determined using a standardized parent interview, and information on maternal responsiveness was derived from videotaped mother-infant interactions at the age of 3 months. CD symptoms were assessed by diagnostic interview from 8 to 19 years of age. Information on life stress was acquired at each assessment and childhood maltreatment was measured using retrospective self-report at the age of 23 years. Analyses were adjusted for sex, parental psychopathology and delinquency, obstetric adversity, parental education, and current poverty. Individuals exposed to early life poverty exhibited a lower OFC volume. Moreover, we replicated previous findings of increased CD symptoms as a consequence of childhood poverty. This effect proved statistically mediated by OFC volume and exposure to life stress and smoking during pregnancy, but not by childhood maltreatment and maternal responsiveness. These findings underline the importance of studying the impact of early life adversity on brain alterations and highlight the need for programs to decrease income-related disparities.

  12. The long term stability of lidar calibrations

    DEFF Research Database (Denmark)

    Courtney, Michael; Gayle Nygaard, Nicolai

    Wind lidars are now used extensively for wind resource measurements. One of the requirements for the data to be accepted in support of project financing (so-called ‘banka-bility’) is to demonstrate the long-term stability of lidar cali-brations. Calibration results for six Leosphere WindCube li...

  13. Results from a Long-term Litter Decomposition Experiment in Canadian Forests and Their Use in Soil Carbon Model Verification and Development.

    Science.gov (United States)

    Trofymow, J. A.; Smyth, C.; Moore, T.; Prescott, C.; Titus, B.; Siltanen, M.; Visser, S.; Preston, C.; Nault, J.; Camire', C.; Fyles, J.; Kozak, L.; Kranabetter, M.; Kutny, L.; Morrison, I.; Smith, S.; Wein, R.; White, D.

    2007-12-01

    Climate and substrate quality have been shown to be key determinants of rates of litter decomposition, though other site factors can be important under certain conditions. The Canadian Intersite Decomposition Experiment (CIDET) was established in 1992 with the objective of providing data on the long-term rates of litter decomposition and nutrient mineralization for a range of forested ecoclimatic regions in Canada. Such data were needed to help verify the Carbon Budget Model - Canadian Forest Sector (CBM-CFS) used for national C accounting, as well as aid in the development of other soil C models. CIDET examined the annual decay, over a 12-year period from 1993 to 2004, of 10 standard foliar litters and 2 wood substrates at 18 forested upland and 3 wetland sites ranging from the cool temperate to subarctic regions. On a subset of sites and litter types, changes in litter C chemistry over time were also determined. Over the first 6 years, C/N ratio and iron increased, NMR showed an overall decline in O-alkyl C (carbohydrates) and increase in alkyl, aromatic, phenolic, and carboxyl C. Proximate analysis showed the acid unhydrolyzable residue (AUR) increases, but true lignin does not accumulate, in contrast to the conceptual ligno-cellulose model of decomposition. Overall litter decay during first phase of decomposition was related to initial litter quality (AUR and water soluble extract), winter precipitation, but not temperature. Decay rate "k" during second phase was related to temperature, initial litter quality (AUR and AUR/N), summer precipitation, but not soil N. In most cases decay had approached an asymptote before end of experiment, although decay rates during this semistable phase were low and difficult to quantify. However, the asymptotes were related to temperature suggesting decay in this phase is temperature dependant. Asymptotes were also related to summer precipitation and forest floor pH and C/N ratio. Comparisons of CIDET 12 year C mass remaining

  14. Toxicity report of once weekly radiation therapy for low-risk prostate adenocarcinoma: preliminary results of a phase I/II trial

    Directory of Open Access Journals (Sweden)

    Van Nguyen Thu

    2011-09-01

    Full Text Available Abstract Background Increasing clinical data supports a low α/β ratio for prostate adenocarcinoma, potentially lower than that of surrounding normal tissues. A hypofractionated, weekly radiation therapy (RT schedule should result in improved tumour control, reduced acute toxicity, and similar or decreased late effects. We report the toxicity profile of such treatment. Materials and Methods We conducted a multi-institution phase I/II trial of three-dimensional conformal radiation therapy (3D-CRT for favourable-risk prostate cancer (T1a-T2a, Gleason ≤ 6 and PSA Results Between 2006 and 2008, 80 patients were treated. No treatment interruptions occurred. The median follow-up is 33 months (range: 20-51. Maximal grade 1, 2, and 3 acute ( Conclusions Weekly RT with 45 Gy in 9 fractions is feasible and results in comparable toxicity. Long term tumour control and survival remain to be assessed.

  15. The impact of distal embolization and distal protection on long-term outcome in patients with ST elevation myocardial infarction randomized to primary percutaneous coronary intervention - results from a randomized study

    DEFF Research Database (Denmark)

    Lønborg, Jacob; Kelbæk, Henning; Helqvist, Steffen;

    2014-01-01

    (p=0.30), and 44.4% for patients treated with distal protection with DE compared to 17.9% for patients without DE (p=0.005). DE was not related to mortality (p=0.52) or reinfarction (p=0.52) among patients treated with standard PCI, but was related to higher rates of mortality (p=0.012) and......OBJECTIVES: The impact of angiographically visible distal embolization (DE) and distal protection occurring during primary percutaneous coronary intervention (PCI) on long-term outcome has not been studied in a contemporary ST-segment elevation myocardial infarction (STEMI) cohort. To evaluate the...... association between DE and long-term outcome in STEMI patients treated with primary PCI with or without distal protection. METHODS AND RESULTS: In this post-hoc analysis of a randomized study, 591 STEMI patients were randomized to conventional primary PCI or primary PCI with distal protection and followed for...

  16. Radiological placement of peripheral central venous access ports at the forearm. Technical results and long term outcome in 391 patients; Radiologische Implantation zentralvenoeser Portsysteme am Unterarm. Implantationsergebnisse und Langzeit-Follow-up bei 391 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Lenhart, M. [Sozialstiftung Bamberg (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Schaetzler, S. [Klinikum der Regensburg Univ. (Germany). Inst. fuer Roentgendiagnostik; Manke, C. [Klinikum Fulda (DE). Klinik fuer Diagnostische und Interventionelle Radiologie] (and others)

    2010-01-15

    To retrospectively analyze the technical result and long term outcome of central venous arm ports placed by radiologists. Over a 5-year period, 399 arm ports were implanted by radiologists in 391 patients. The system consists of a low profile titanium chamber and a silicone catheter. Ports were placed at the forearm after puncture of a vein proximally to the elbow under fluoroscopic guidance. In a retrospective analysis the technical results and the long term outcome were evaluated. Complications were documented according to the standards of the society of interventional radiology. In 391 patients a total of 98 633 catheter days were documented (1 - 1325 days, mean 252 days). Primary technical success was 99.25 % (396 / 399) with a 100 % secondary technical success rate. No severe procedural complications, e. g. pneumothorax or severe hemorrhage, were found. A total of 45 complications occurred (11.28 %, 0.45 / 1000 catheter days), including 8 portal pocket infections (27 - 205 days, mean 115 days). Fifteen ports were explanted because of complications. The complication rate corresponds to the data from subclavian ports and is less than the complication rates published in large surgical trials. Implantation of central-venous arm ports by radiologists is safe and minimally invasive. No severe immediate procedural complications occur due to the peripheral implantation site. Long term complication rates are comparable to other studies of radiological or surgical port implantation at different sites. (orig.)

  17. Long term behaviour of singularly perturbed parabolic degenerated equation

    CERN Document Server

    Faye, Ibrahima; Seck, Diaraf

    2011-01-01

    In this paper we consider models for short-term, mean-term and long-term morphodynamics of dunes and megariples. We give an existence and uniqueness result for long term dynamics of dunes. This result is based on a time-space periodic solution existence result for degenerated parabolic equation that we set out. Finally the mean-term and long-term models are homogenized.

  18. Long term stability of power systems

    Energy Technology Data Exchange (ETDEWEB)

    Kundur, P.; Gao, B. [Powertech Labs. Inc., Surrey, BC (Canada)

    1994-12-31

    Power system long term stability is still a developing subject. In this paper we provide our perspectives and experiences related to long term stability. The paper begins with the description of the nature of the long term stability problem, followed by the discussion of issues related to the modeling and solution techniques of tools for long term stability analysis. Cases studies are presented to illustrate the voltage stability aspect and plant dynamics aspect of long term stability. (author) 20 refs., 11 figs.

  19. Long term complications in juvenile diabetes mellitus

    OpenAIRE

    Nordwall, Maria

    2006-01-01

    Background/aim. The incidence of microvascular complications has been reported to be unchanged the last decades. However, in randomized clinical trials it has been shown that improved metabolic control can reduce the development of long term complications. It has been debated whether it is possible to achieve the same results in an unselected population. In a previous study we found a decreased incidence of overt nephropathy, but unchanged incidence of severe laser treated retinopathy in a po...

  20. Cutaneous oxalosis after long-term hemodialysis.

    Science.gov (United States)

    Abuelo, J G; Schwartz, S T; Reginato, A J

    1992-07-01

    A 27-year-old woman undergoing long-term hemodialysis developed cutaneous calcifications on her fingers. A skin biopsy specimen showed that the deposits were calcium oxalate. To our knowledge, only one previous article has reported pathologic and crystallographic studies on calcifications of the skin resulting from dialysis oxalosis. We speculate that vitamin C supplements, liberal tea consumption, an increased serum ionized calcium concentration, and the long duration of hemodialysis contributed to the production of these deposits.

  1. Timber joints under long-term loading

    DEFF Research Database (Denmark)

    Feldborg, T.; Johansen, M.

    This report describes tests and results from stiffness and strength testing of splice joints under long-term loading. During two years of loading the spicimens were exposed to cyclically changing relative humidity. After the loading period the specimens were short-term tested. The connectors were...... integral nail-plates and nailed steel and plywood gussets. The report is intended for designers and researchers in timber engineering....

  2. Diagnostic {sup 131}I whole-body scintigraphy 1 year after thyroablative therapy in patients with differentiated thyroid cancer: correlation of results to the individual risk profile and long-term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Berger, Frank [Ludwig-Maximilians University of Munich, Department of Clinical Radiology, Munich (Germany); Friedrich, Ulla; Knesewitsch, Peter; Hahn, Klaus [Ludwig-Maximilians University of Munich, Department of Nuclear Medicine, Munich (Germany)

    2011-03-15

    {sup 131}I whole-body scan (WBS) and serum thyroglobulin (TG) are important in detecting thyroid remnants or recurrent disease in patients with differentiated thyroid cancer. Usually, a diagnostic WBS is carried out 6 months after ablation to exclude residual disease. We retrospectively analysed results of a second routine diagnostic WBS and TG measurements at 1 year after thyroablation and correlated these to the risk profile of patients with long-term follow-up. A total of 197 patients were followed up after thyroidectomy and ablative {sup 131}I therapy. Follow-up included clinical examination, radioiodine WBS and thyroid-stimulating hormone (TSH), free thyroxine and TG measurements at 3-6 months and 1 year after ablation. WBS (+) patients received a therapeutic activity of {sup 131}I. The risk profile of patients was defined according to clinical results before the 1-year control. Clinical results at 1 year after ablation were analysed in correlation to the patient risk profile and long-term follow-up data (mean 7.2 years). One year after thyroablation, 95.8% of low-risk patients had no residual disease when diagnostic WBS was carried out using 370 MBq {sup 131}I; 4.2% of low-risk patients had residual disease at this time point. In the high-risk group of this cohort, 54.5% were disease-free 1 year after ablation, but 45.5% demonstrated residual disease. After the 1-year control, 94% of all applied radioiodine therapies were executed in the high-risk group, compared with 6% in the low-risk group (p < 0.01). A second routine WBS 1 year after thyroablation is not indicated in low-risk patients. Risk stratification according to the early clinical course effectively identified patients with higher likelihood of persistent or recurrent disease in the long-term follow-up. (orig.)

  3. Long-Term Effects of Methylphenidate on Neural Networks Associated with Executive Attention in Children with ADHD: Results from a Longitudinal Functional MRI Study

    Science.gov (United States)

    Konrad, Kerstin; Neufang, Susanne; Fink, Gereon R.; Herpertz-Dahlmann, Beate

    2007-01-01

    A longitudinal functional MRI study examines the effects of stimulants on neural activity in children with attention-deficit/hyperactivity disorder (ADHD). The results conclude that one year of methylphenidate treatment might be beneficial though insufficient to show normalization of neural correlates of attention.

  4. The effect of long term exposition at 540 °C on the empirical correlations for determination of mechanical properties of low alloy CrMoV steel from the results of Small Punch tests

    Directory of Open Access Journals (Sweden)

    Ondřej Dorazil

    2016-03-01

    Full Text Available The present paper describes the effect of long term exposure at 540 °C on the empirical correlations for determination of yield strength, tensile strength and FATT of 14MoV6-3 low alloy steel. Empirical correlations obtained for the pipe in as received state were compared with the results of standardized tensile, impact and Small Punch tests carried out on the testing materials cut of the three pipes of significantly different metallurgical quality and time of exposure at 540 °C.

  5. Concordance between Results of Medium-term Liver Carcinogenesis Bioassays and Long-term Findings for Carcinogenic 2-Nitropropane and Non-carcinogenic 1-Nitropropane in F344 Rats

    OpenAIRE

    Doi, Yuko; Tamano, Seiko; Kawabe, Mayumi; Sano,Masashi; Imai, Norio; Nakashima, Hironao; Furukawa, Fumio; Hagiwara, Akihiro; OTSUKA,MASANORI; Shirai, Tomoyuki

    2012-01-01

    This study was conducted to determine the concordance of results for a pair of structural isomers, 2-nitropropane (2-NP) and 1-nitropropane (1-NP), using the rat medium-term liver carcinogenesis bioassay (Ito test) and previously published long-term carcinogenicity tests. Male F344 rats were given a single intraperitoneal injection of DEN (200 mg/kg b.w.) to initiate hepatocarcinogenesis. After 2 weeks, they received per os 0, 0.8, 4 or 20 mg/kg/day of 2-NP or 1-NP six times a week and were s...

  6. Hypo-fractionated radiotherapy of breast cancer: long term results of a set of 80 cases treated in the radiotherapy department of the Oran university hospital

    International Nuclear Information System (INIS)

    The authors report the assessment of the local and locoregional control and of the acute and late toxicity of adjuvant hypo-fractionated radiotherapy in breast cancer treatment. During 1998, 80 women have been treated by conservative or radical surgery and hypo-fractionated tele-cobalto-therapy (36 Gy in five fractions of 3 Gy a week, and a boost of 15 Gy in five fractions in case of conservative surgery). Results are discussed in terms of local and locoregional recurrence, tolerance, late toxicity, global survival, and tumour classification. The irradiation scheme seems perfectly achievable but a greater number of patients and a longer follow-up are required to better assess the efficiency and aesthetic results. Short communication

  7. Long-term results of the Italian Association of Pediatric Hematology and Oncology (AIEOP) acute lymphoblastic leukemia studies, 1982-1995.

    Science.gov (United States)

    Conter, V; Aricò, M; Valsecchi, M G; Basso, G; Biondi, A; Madon, E; Mandelli, F; Paolucci, G; Pession, A; Rizzari, C; Rondelli, R; Zanesco, L; Masera, G

    2000-12-01

    The first multicentric approach to childhood acute lymphoblastic leukemia (ALL) treatment in Italy started in the early 1970s when the Associazione Italiana di Ematologia ed Oncologia Pediatrica (AIEOP) was founded. Since then the AIEOP has conducted nationwide chemotherapy protocols. Results obtained in three different periods (1982-1986, 1987-1990, 1991-1995) are reported here. Treatment schedules have been characterized by a progressive intensification of systemic therapy and by a progressive substitution of protracted intrathecal therapy for cranial irradiation as central nervous system (CNS) preventive therapy. In the third period cranial radiotherapy (CRT) has been administered only to patients at high risk of relapse or with CNS involvement at diagnosis (about 15% of the overall population). A progressive improvement of therapeutic results, with a steady reduction of isolated CNS relapse rates have been obtained in the three periods considered here. The AIEOP experience shows that CRT can be safely omitted in non-high risk patients, unless they are T-ALL patients with WBC count at the diagnosis > or =100,000/mm3, and that intensification of treatment allows the improvement of overall results with a reduction of the impact of NCI prognostic criteria. Over the years, AIEOP has also continued to foster active cooperation at an international level. In the ongoing AIEOP ALL 2000 study, conducted in cooperation with the BFM group, patients are stratified according to the presence of translocations t(9;22) and t(4;11) and to treatment response (either initial steroid therapy or induction) or minimal residual disease). This cooperation will allow an adequate recruitment of patients to answer relevant randomized questions in the context of a study in which patients are stratified according to minimal residual disease findings.

  8. Combined proton and photon irradiation for craniopharyngioma: Long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital

    International Nuclear Information System (INIS)

    Purpose: We report the results of the early cohort of patients treated for craniopharyngioma with combined proton-photon irradiation at the Massachusetts General Hospital and the Harvard Cyclotron Laboratory. Methods and Materials: Between 1981 and 1988, 15 patients with craniopharyngioma were treated in part or entirely with fractionated 160 MeV proton beam therapy. The group consisted of 5 children (median age, 15.9 years) and 10 adults (median age, 36.2 years). Median dose prescribed to the tumor was 56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median proton component was 26.9 CGE. Patients were treated after documented recurrence after initial surgery (n = 6) or after subtotal resection or biopsy (n = 9). None had had prior radiation therapy. Results: Median observation period of surviving patients (n = 11) was 13.1 years from radiotherapy. One patient was lost to follow-up with tumor control after 5.2 years. Actuarial 10-year survival rate was 72%. Four patients have died 5-9.1 years after treatment, two from local failure. Actuarial 5- and 10-year local control rates were 93% and 85%, respectively. The functional status of the living adult patients is unaltered from their preradiotherapy status; all of them continued leading normal or near normal working lives. None of the patients treated as a child had experienced recurrence of tumor. One child shows learning difficulties and slight retardation, comparable to his preradiotherapy status. The others have professional achievements within the normal range. Conclusion: Results in terms of survival and local control are comparable with other contemporary series. Although no formal neuropsychological testing was performed, the surrogate measures of lifestyle and professional accomplishments appear to be satisfactory

  9. Radiotherapy versus concurrent 5-day cisplatin and radiotherapy in locally advanced cervical carcinoma. Long-term results of a Phase III randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Nagy, Viorica; Coza, Ovidiu; Ghilezan, Nicolae [' Ion Chiricuta' Cancer Institute, Cluj-Napoca (Romania). Dept. of Radiation Oncology; ' Iuliu Hatieganu' Univ. of Medicine and Pharmacy, Cluj-Napoca (Romania); Ordeanu, Claudia; Todor, Nicolae [' Ion Chiricuta' Cancer Institute, Cluj-Napoca (Romania). Dept. of Radiation Oncology; Traila, Alexandru [' Ion Chiricuta' Cancer Institute, Cluj-Napoca (Romania). Dept. of Surgery; Rancea, Alin [' Iuliu Hatieganu' Univ. of Medicine and Pharmacy, Cluj-Napoca (Romania); ' Ion Chiricuta' Cancer Institute, Cluj-Napoca (Romania). Dept. of Surgery

    2009-03-15

    Purpose: To prove the superiority of concurrent radiochemotherapy (RTCT) over radiotherapy (RT) alone in locally advanced cervical carcinoma. Patients and Methods: In this randomized monocentric phase III study, 566 patients with squamous cell carcinoma of the cervix were included: 284 in arm A (RT) and 282 in arm B (concurrent RTCT with cisplatin 20 mg/m{sup 2} x 5 days). 238 patients (42%) were in stage IIB, 209 (37%) in stage IIIA, and 119 (21%) in stage IIIB. The median follow-up was 62.8 months. RT to the pelvis was delivered to a dose of 46 Gy/23 fractions. A cervical boost was given using the X-ray arch technique or high-dose-rate intracavitary brachytherapy at a dose of 10 Gy. Thereafter, patients were evaluated: those with good response optionally underwent surgery and the others continued RT until 64 Gy/pelvis (with or without CT according to randomization) and 14 Gy/central tumor volume. Results: The 5-year survival rate was statistically significantly superior in the concurrent RTCT group (74%) versus the RT group (64%; p < 0.05). In patients undergoing surgery after RT or RTCT, superior results were obtained, compared to the nonoperated patients: 5-year survival rate 86% versus 53% (p < 0.01). 192 failures were recorded: 109 (38%) after RT alone versus 83 (29%) after concurrent RTCT (p < 0.01). Conclusion: The results of this study prove the obvious superiority of concurrent RTCT with 5-day cisplatin compared to RT alone in patients with locally advanced cervical carcinoma, regarding local control (78% vs. 67%) and 5-year survival rates (74% vs. 64%). (orig.)

  10. Summary of intensive monitoring for radionuclides in fishery products after Fukushima accident and comparison to the results of long term monitoring program in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, Ken; Morita, Takami; Shigenobu, Yuya; Takagi, Kaori; Miki, Shizuho; Kaeriyama, Hideki; Ambe, Daisuke; Ono, Tsuneo [National Research Institute of Fisheries Science, Fisheries Research Agency, 2-12-4, Fukuura, Kanazawa, Yokohama, Kanagawa 236-8648 (Japan)

    2014-07-01

    Monitoring of artificial radionuclides in fishery products started in late 1950's and has over half a century history in Japan. Fisheries Agency (FA), Fisheries Research Agency (FRA) and prefectural organizations have been conducting the monitoring. The intensive monitoring of radioactive material in fishery products started in the late of March 2011 immediately after the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident for the coastal area faced to the Pacific Ocean in the eastern area of Japan and for the offshore area. The purpose of this monitoring is to avoid the distribution of fishery products containing radioactive cesium in concentration over the Japanese standard limit (Cs-134+Cs-137: 100 Bq/kg). Japanese monitoring data are opened to public on the FA's and FRA's web page. In this study, we resume the results of intensive monitoring started in 2011 and show the temporal change of concentration of radioactive cesium in fishery product. In Fukushima Prefecture, the ratio of samples exceeding the Japanese standard limit shows a steadily decreasing trend from 53% at Mar.- Jun. 2011 to below 3% at Jul. - Sep. 2013. In other prefectures, the ratio was 6.5% at Mar.- Jun. 2011 and fell gradually, and it has been below to 1% at Jul. - Sep. 2013. In presentation, we show the results of monitoring conducted in the coastal area and deeper water around Japan from long gamma ray measurements with ashed samples by high purified germanium gamma spectrometry. (authors)

  11. Post-chemoradiation intraoperative electron-beam radiation therapy boost in resected locally advanced rectal cancer: Long-term results focused on topographic pattern of locoregional relapse

    International Nuclear Information System (INIS)

    Background: Patients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT. Methods: A total of 335 patients with LARC [⩾cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed. Results: Median follow-up was 72.6 months (range, 4–205). In multivariate analysis distal margin distance ⩽10 mm [HR 2.46, p = 0.03], R1 resection [HR 5.06, p = 0.02], tumor regression grade 1–2 [HR 2.63, p = 0.05] and tumor grade 3 [HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC. Conclusions: Overall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment

  12. Long-term growth responses of ash addition and liming - Preliminary results from a pilot study; Laangtidseffekter paa skogsproduktion efter askaaterfoering och kalkning - Preliminaera resultat fraan en pilotstudie

    Energy Technology Data Exchange (ETDEWEB)

    Sikstroem, Ulf; Jacobson, Staffan (Skogsbrukets Forskningsinstitut (Skogforsk), Uppsala Science Park, SE-751 83 Uppsala (Sweden)); Johansson, Ulf (Swedish University of Agricultural Sciences, The Unit for field-based forest research, Box 17, SE-310 38 Simlaangsdalen (Sweden)); Kukkola, Mikko; Saarsalmi, Anna (Metla, P.O. Box 18, FIN-01301 Vantaa (Finland)); Holt-Hansen, Kjersti (Norsk Institutt for skog og landskap, P.B. 115, NO-1431 Aas (Norway))

    2009-04-15

    Under this pilot study with preliminary results revealed trends in the experimental material which indicated that the addition of ashes or lime in the coniferous forest on mineral soil can lead to reduced stem growth on land with low fertility, unchanged stem growth in medium productive land, while growth may increase land with high fertility. This applied to both periods of 5-15 years and in the longer term (17-23 years; lime). Hence, the hypothesis, regarding the growth being dependent on soil fertility expressed as fertility, could not be rejected. However, previously reported indications of a similar connection with the C/N ratio in the humus was not confirmed in this first evaluation of the material

  13. Multi-domain simulation of transient junction temperatures and resulting stress-strain behavior of power switches for long-term mission profiles

    Energy Technology Data Exchange (ETDEWEB)

    Drofenik, U.; Kovacevic, I.; Kolar, J. W. [Swiss Federal Institute of Technology, Power Electronic Systems Laboratory, Zuerich (Switzerland); Schmidt, R. [ABB Switzerland Ltd., Corporate Research, Baden-Daettwil (Switzerland)

    2008-07-01

    For lifetime estimation of power converters in traction applications, one method is to calculate numerically the stress-strain hysteresis curves of the interfaces silicon-solder-DCB and/or DCB-solder-baseplate inside the power modules. This can only be achieved if the transient junction temperatures in these layers are known for a defined mission profile. Therefore, one has to couple circuit simulation with thermal simulation and stress-strain computation. The second challenge of this problem is to perform this transient simulation taking into account switching losses in the {mu}s-range for mission profiles over a couple of minutes. In this paper we employ a new multi-domain simulation software to achieve results with reasonable computational effort. (author)

  14. ADHERENCE TO LONG-TERM TREATMENT OF CARDIOVASCULAR DISEASE AND NON-COMPLIANCE WITH MEDICAL RECOMMENDATIONS: THE OPINION OF PATIENTS AND PHYSICIANS BY THE RESULTS OF FOCUSED INTERVIEW

    Directory of Open Access Journals (Sweden)

    O. N. Semenova

    2014-01-01

    Full Text Available Aim. To study the subjective opinion of patients and doctors about their individual experiences with adherence to treatment for chronic cardiovascular diseases in the group focused interview of patients and their physicians.Material and methods. 3 groups of patients from clinical studies adhering to the doctor's recommendations (focus-group 1 and 3 groups of patients hospitalized for cardiovascular events, not adhering to recommendations after discharge (focus-group 2 and one focus-group of doctors were analyzed. Group discussion was performed by a moderator (experienced sociologist, with no medical training who was not familiar with the patients and physicians.Results. 47 patients (25 (53.2 % men and 22 (46.8% women and 6 doctors participated in the study. Paternalistic model of communication with doctors present in the minds of all patients. In patients of the first group this results in a full confidence in the doctor and compliance with all recommendations while in patients of the second group lack of care in the outpatient clinic makes them "offended" by the underestimation of their trust and causes non-compliance. Physicians intuitively divide patients into less and more "attractive" for themselves. This "division" on the one hand may have some predictive value in respect of patients’ adherence to a further treatment, and on the other hand, the "doctors’ prejudice" in relation to the patient may adversely effect the behavior of the patients and failure to follow the recommendations in the future.Conclusion. The significant paternalism on the part of the patient on the one hand increases the responsibility of the physician for his patient, and on the other hand – increases opportunities for his influence on the patients’ behavior.

  15. Application of cervical arthroplasty with Bryan cervical disc:long-term X-ray and magnetic resonance imaging follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; CHEN Zhong-qiang; LIU Zhong-jun

    2010-01-01

    Background Cervical disc arthroplasty is a new technique for treating degenerative cervical disease. Its goal is to avoid the degeneration of adjacent levels by preserving motion at the treated level. The aims of this study were to evaluate the radiologic outcomes of Bryan cervical disc replacement and the degenerative status of adjacent segments.Methods Twenty-two patients at a single center underwent discectomy and implantation of Bryan cervical disc. The mean follow-up period was 60 months (57-69 months). Twenty patients underwent single-level arthroplasty and two underwent arthroplasty at two levels. The levels of surgery included C3/4 (3 levels), C4/5 (2 levels), C5/6 (18 levels) and C6/7 (1 level). Radiographic evaluation included dynamic X-ray examination and magnetic resonance imaging (MRI) at baseline and at final follow-up.Results On X-ray examination, the range of motion (ROM) at the operated level was 7.2° (2.5°-13.0°) at baseline and 7.8° (1.0°-15.0°) at final follow-up (P >0.05). Heterotopic ossification around the prosthesis was observed in eight levels,and two levels showed loss of motion (ROM <2°). MRI showed worsening by a grade at the upper level in 2/22 patients,and worsening by a grade at the lower level in 3/22, according to Miyazaki's classification. No further impingement of the ligamentum flavum into the spinal canal was observed at adjacent levels, though the disc bulge was slightly increased at both the adjacent upper and lower levels at final follow-up.Conclusions Arthroplasty using Bryan cervical disc prosthesis resulted in favorable radiologic outcomes in this study.Disc degeneration at adjacent levels may be postponed by this technique.

  16. Microneurolysis and decompression of long thoracic nerve injury are effective in reversing scapular winging: Long-term results in 50 cases

    Directory of Open Access Journals (Sweden)

    Lyons Andrew B

    2007-03-01

    Full Text Available Abstract Background Long thoracic nerve injury leading to scapular winging is common, often caused by closed trauma through compression, stretching, traction, direct extrinsic force, penetrating injury, or neuritides such as Parsonage-Turner syndrome. We undertook the largest series of long thoracic nerve decompression and neurolysis yet reported to demonstrate the usefulness of long thoracic nerve decompression. Methods Winging was bilateral in 3 of the 47 patients (26 male, 21 female, yielding a total of 50 procedures. The mean age of the patients was 33.4 years, ranging from 24–57. Causation included heavy weight-lifting (31 patients, repetitive throwing (5 patients, deep massage (2 patients, repetitive overhead movement (1 patient, direct trauma (1 patient, motor bike accident (1 patient, and idiopathic causes (9 patients. Decompression and microneurolysis of the long thoracic nerve were performed in the supraclavicular space. Follow-up (average of 25.7 months consisted of physical examination and phone conversations. The degree of winging was measured by the operating surgeon (RKN. Patients also answered questions covering 11 quality-of-life facets spanning four domains of the World Health Organization Quality of Life questionnaire. Results Thoracic nerve decompression and neurolysis improved scapular winging in 49 (98% of the 50 cases, producing "good" or "excellent" results in 46 cases (92%. At least some improvement occurred in 98% of cases that were less than 10 years old. Pain reduction through surgery was good or excellent in 43 (86% cases. Shoulder instability affected 21 patients preoperatively and persisted in 5 of these patients after surgery, even in the 5 patients with persistent instability who experienced some relief from the winging itself. Conclusion Surgical decompression and neurolysis of the long thoracic nerve significantly improve scapular winging in appropriate patients, for whom these techniques should be considered

  17. Chemoradiation With Concomitant Boosts Followed by Radical Surgery in Locally Advanced Cervical Cancer: Long-term Results of the ROMA-2 Prospective Phase 2 Study

    Energy Technology Data Exchange (ETDEWEB)

    Ferrandina, Gabriella, E-mail: gabriella.ferrandina@libero.it [Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome (Italy); Gambacorta, Antonietta [Division of Radiotherapy, Catholic University of the Sacred Heart, Rome (Italy); Gallotta, Valerio [Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome (Italy); Smaniotto, Daniela [Division of Radiotherapy, Catholic University of the Sacred Heart, Rome (Italy); Fagotti, Anna [Gynecologic Surgery, University of Perugia, Terni (Italy); Tagliaferri, Luca [Division of Radiotherapy, Catholic University of the Sacred Heart, Rome (Italy); Foti, Elvira; Fanfani, Francesco [Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome (Italy); Autorino, Rosa [Division of Radiotherapy, Catholic University of the Sacred Heart, Rome (Italy); Scambia, Giovanni [Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome (Italy); Valentini, Vincenzo [Division of Radiotherapy, Catholic University of the Sacred Heart, Rome (Italy)

    2014-11-15

    Purpose: This prospective, phase 2 study aimed at assessing the efficacy of accelerated fractionation radiation therapy by concomitant boosts (CBs) associated with chemoradiation therapy (CRT) of the whole pelvis, in improving the rate of pathological complete response (pCR) to treatment in patients with International Federation of Gynaecology and Obstetrics (FIGO) stage IB2-IVA locally advanced cervical cancer. Methods and Materials: Neoadjuvant CRT included conformal irradiation of the whole pelvis with a total dose of 39.6 Gy (1.8 cGy/fraction, 22 fractions), plus additional irradiation of primary tumor and parametria with 10.8 Gy administered with CBs (0.9 cGy/fraction, 12 fractions, every other day). Concomitant chemotherapy included cisplatin (20 mg/m{sup 2}, days 1-4 and 26-30 of treatment), and capecitabine (1300 mg/m{sup 2}/daily, orally) during the first 2 and the last 2 weeks of treatment. Radical hysterectomy plus pelvic with or without aortic lymphadenectomy was performed within 6 to 8 weeks from CRT. Toxicity was recorded according to Radiation Therapy Oncology Group toxicity criteria and Chassagne grading system. Based on the Simon design, 103 cases were required, and the regimen would be considered active if >45 pCR were registered (α error = 0.05; β error = 0.1). Results: pCR was documented in 51 cases (50.5%), and the regimen was considered active, according to the planned statistical assumptions. At median follow-up of 36 months (range: 7-85 months), the 3-year local failure rate was 7%, whereas the 3-year disease-free and overall survival rates were 73.0% and 86.1%, respectively. Grade 3 leukopenia and neutropenia were reported in only 1 and 2 cases, respectively. Gastrointestinal toxicity was always grade 1 or 2. Conclusions: Addition of CBs in the accelerated fractionation modality to the whole pelvis chemoradiation followed by radical surgery results in a high rate of pathologically assessed complete response to CRT and a very

  18. Short Communication Impact of early enzyme-replacement therapy for mucopolysaccharidosis VI: results of a long-term follow-up of Brazilian siblings.

    Science.gov (United States)

    Franco, J F; Soares, D C; Torres, L C; Leal, G N; Cunha, M T; Honjo, R S; Bertola, D R; Kim, C A

    2016-01-01

    Mucopolysaccharidosis type VI (MPS VI) is an autosomal recessive multisystem lysosomal storage disorder, which is characterized by the deficiency of the enzyme arylsulfatase B encoded by the ARSB gene. Treatment of this disease with enzyme-replacement therapy (ERT) improves the clinical status of and generates hope for MPS VI patients. However, only few reports on patients with MPS VI treated before 5 years of age have been published. Thus, the objective of this study was to compare the clinical parameters of two sisters affected by MPS VI who started ERT at different ages (9 years and 1 year 5 months, respectively) and to determine the most relevant clinical impacts of early treatment after 85 months of evaluation. The treatment was well tolerated by both siblings. ERT in the younger sibling resulted in increased growth, an improved 6-minute walk test, less coarse face, slower progression of cardiac valve disease, and the absence of compressive myelopathy compared to that in her older sister. On the other hand, the older sibling had typical MPS VI phenotypic features before the commencement of ERT. Corneal clouding, clawed hands, and progressive skeletal changes were observed in both siblings despite the treatment. Both siblings displayed reduced frequencies of upper respiratory infections and apnea indices. This study emphasizes that early diagnosis and treatment of MPS VI are critical for a better disease outcome and to enhance the quality of life for these patients. PMID:26910003

  19. Long-term results for the uncemented Zweymuller/Alloclassic hip endoprosthesis. A 15-year minimum follow-up of 320 hip operations.

    Science.gov (United States)

    Suckel, Andreas; Geiger, Friedrich; Kinzl, Lothar; Wulker, Nikolaus; Garbrecht, Manfred

    2009-09-01

    A follow-up study of 15 (15-17) years of 320 consecutive Zweymuller total hip arthroplasties is presented. Age at surgery was 67 (29-99) years. A total of 164 (51.3%) patients had died. Clinical and radiological examinations were available for 97 (30.3%), phone interviews and radiological examinations for 4 (1.3%) hips, and phone follow-ups for 49 (15.3%). There were 6 (1.9%) patients who were lost to follow-up. The Harris Hip Score results in a median value of 88. According to the Kaplan-Meier method, a survival rate of the cup/inlay of 98% (95% confidence interval, 95%-99%) after 17 years was achieved. For the stem/head, the survival rate was 98% (95% confidence interval, 94%-99%). In 95.2% of patients, no operative revision was required. The rate of aseptic loosening was 2% for the acetabular and 1% for the femoral component. PMID:18789635

  20. The Prediction of Long-Term Coating Performance from Short-Term Electrochemical Data. Part 2; Comparison of Electrochemical Data to Field Exposure Results for Coatings on Steel

    Science.gov (United States)

    Contu, F.; Taylor, S. R.; Calle, L. M.; Hintze, P. E.; Curran, J. P.; Li, W.

    2009-01-01

    The pace of coatings development is limited by the time required to assess their corrosion protection properties. This study takes a step f orward from Part I in that it correlates the corrosion performance of organic coatings assessed by a series of short-term electrochemical measurement with 18-month beachside exposure results of duplicate pan els. A series of 19 coating systems on A36 steel substrates were test ed in a completely blind study using the damage tolerance test (DTT). In the DTT, a through-film pinhole defect is created, and the electro chemical characteristics of the defect are then monitored over the ne xt 4 to 7 days while immersed in 0.SM NaCl. The open circuit potentia l, anodic potentiostatic polarization tests and electrochemical imped ance spectroscopy were used to study the corrosion behavior of the co ating systems. The beachside exposure tests were conducted at the Ken nedy Space Center according to ASTM D610-01. It was found that for 79 % of the coatings systems examined, the 18 month beachside exposure r esults could be predicted by two independent laboratory tests obtained within 7 days.

  1. Long-term results of concurrent chemoradiotherapy using low-dose continuous infusion of 5-fluorouracil for stage II-III esophageal cancer

    International Nuclear Information System (INIS)

    To improve the local control of stage II-III esophageal cancer, we tried concurrent chemoradiotherapy with low-dose continuous infusion of 5-fluorouracil (5-FU) during the entire course of conventional radiotherapy. Forty-three eligible patients with stage II-III esophageal cancer were treated with conventional radiotherapy up to 60-70 Gy concurrently with continuous infusion of 5-FU (300 mg/m2 per 24 hours) for 5 days per week given over 5 to 7 weeks. All patients were followed up more than 5 years after starting the treatments. Although there were two treatment-related deaths, 88% of the patients (38/43) could complete the planned course of chemoradiotherapy. Response rate was 90%. The median survival time was 12.2 months, and the 2- and 5-year overall survival rates were 33% and 15%, respectively. Low-dose continuous infusion of 5-FU given during the entire course of conventional radiotherapy is feasible and seems to offer better results than radiotherapy alone in the treatment of stage II-III esophageal cancer. (author)

  2. Sexuality and affection among elderly German men and women in long-term relationships: results of a prospective population-based study.

    Directory of Open Access Journals (Sweden)

    Britta Müller

    Full Text Available Satisfaction with sexual activity i.e. sexual satisfaction and the importance of sexuality and affection were analysed using data from the German "Interdisciplinary Longitudinal Study of Adult Development" (ILSE. At three measurement points, 1993-1995, 1997-1998, and 2004-2006 i.e. subjects' ages of 63, 67, and 74 years, participants' reports about their affection and sexual activity were collected. The sample of completed records used for this study consisted of 194 urban non-institutionalised participants, 68% male, all living with partners. Median levels of sexual satisfaction were reported, fluctuating between the measurement points of ages 63 to 74. Between baseline, first and second follow-up no differences were found in levels of sexual satisfaction, though at measurement points age 63 and 67 women were more satisfied than men. When measured at age 74, affection was given a higher priority than sexual activity. Although men and women reported similar priorities, sexual activity and affection were more important for men than for women. Satisfaction within the relationship can be predicted by the importance of affection, but not by that of sexual activity. Our results confirm the thesis of the 'second language of sexuality': for humans in their later years affection seems to be more important than for younger individuals.

  3. Sexuality and affection among elderly German men and women in long-term relationships: results of a prospective population-based study.

    Science.gov (United States)

    Müller, Britta; Nienaber, Christoph A; Reis, Olaf; Kropp, Peter; Meyer, Wolfgang

    2014-01-01

    Satisfaction with sexual activity i.e. sexual satisfaction and the importance of sexuality and affection were analysed using data from the German "Interdisciplinary Longitudinal Study of Adult Development" (ILSE). At three measurement points, 1993-1995, 1997-1998, and 2004-2006 i.e. subjects' ages of 63, 67, and 74 years, participants' reports about their affection and sexual activity were collected. The sample of completed records used for this study consisted of 194 urban non-institutionalised participants, 68% male, all living with partners. Median levels of sexual satisfaction were reported, fluctuating between the measurement points of ages 63 to 74. Between baseline, first and second follow-up no differences were found in levels of sexual satisfaction, though at measurement points age 63 and 67 women were more satisfied than men. When measured at age 74, affection was given a higher priority than sexual activity. Although men and women reported similar priorities, sexual activity and affection were more important for men than for women. Satisfaction within the relationship can be predicted by the importance of affection, but not by that of sexual activity. Our results confirm the thesis of the 'second language of sexuality': for humans in their later years affection seems to be more important than for younger individuals. PMID:25369193

  4. Sustained High Quality of Life in a 5-Year Long Term Follow-up after Successful Ablation for Supra-Ventricular Tachycardia. Results from a large Retrospective Patient Cohort

    Directory of Open Access Journals (Sweden)

    Axel Meissner, Irini Stifoudi, Peter Weismüller, Max-Olav Schrage, Petra Maagh, Martin Christ, Thomas Butz, Hans-Joachim Trappe, Gunnar Plehn

    2009-01-01

    Full Text Available Introduction: The ablation of supraventricular tachycardias (SVT using radiofrequency energy (RF is a procedure with a high primary success rate. However, there is a scarcity of data regarding the long term outcome, particularly with respect to quality of life (QoL. Methods and Results: In this retrospective single-center study, 454 patients who underwent ablation of SVT between 2002 and 2007 received a detailed questionnaire addressing matters of QoL. The questionnaire was a modified version of the SF-36 Health Survey questionnaire and the Symptom Checklist – Frequency and Severity Scale. After a mean follow up of 4.5±1.3 years, 309 (68.1% of the contacted 454 patients (269 female, 59.2%, mean age 58+/-6.5 completed the questionnaire. Despite of 27% of relapses in the study group, 91.7% considered the procedure a long-term success. The remainder of patients experienced no change in (3.7% or worsening of (4.7% symptoms. There were no significant differences between the various types of SVT (p=1. QoL in patients with Atrio-Ventricular Nodal Reentry Tachycardia (AVNRT and Atrio-Ventricular Reentry Tachycardia (AVRT improved significantly (p<0.0005 respectively p<0.043, whereas QoL in patients with Ectopic Atrial Tachycardia (EAT showed a non-significant trend towards improvement. Main symptoms before ablation, such as tachycardia (91.5%, increased incidence of tachycardia episodes over time (78.1%, anxiety (55.5% and reduced physical capacity in daily life (52% were significantly improved after ablation (p<0.0001. Conclusion: The high acute ablation success of SVT persists for years in long term follow up and translates into a significant improvement of QoL in most patients.

  5. Long-Term Outcome and Morbidity After Treatment With Accelerated Radiotherapy and Weekly Cisplatin for Locally Advanced Head-and-Neck Cancer: Results of a Multidisciplinary Late Morbidity Clinic

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term outcome and morbidity after intensified treatment for locally advanced head-and-neck cancer. Methods and Materials: Between May 2003 and December 2007, 77 patients with Stage III to IV head-and-neck cancer were treated with curative intent. Treatment consisted of accelerated radiotherapy to a dose of 68 Gy and concurrent cisplatin. Long-term survivors were invited to a multidisciplinary outpatient clinic for a comprehensive assessment of late morbidity with special emphasis on dysphagia, including radiological evaluation of swallowing function in all patients. Results: Compliance with the treatment protocol was high, with 87% of the patients receiving at least five cycles of cisplatin and all but 1 patient completing the radiotherapy as planned. The 5-year actuarial disease-free survival and overall survival rates were 40% and 47%, respectively. Locoregional recurrence–free survival at 5 years was 61%. The 5-year actuarial rates of overall late Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) Grade 3 and Grade 4 toxicity were 52% and 25% respectively. Radiologic evaluation after a median follow-up of 44 months demonstrated impaired swallowing in 57% of the patients, including 23% with silent aspiration. Subjective assessment using a systematic scoring system indicated normalcy of diet in only 15.6% of the patients. Conclusion: This regimen of accelerated radiotherapy with weekly cisplatin produced favorable tumor control rates and survival rates while compliance was high. However, comprehensive assessment by a multidisciplinary team of medical and paramedical specialists revealed significant long-term morbidity in the majority of the patients, with dysphagia being a major concern.

  6. Long-Term Outcome and Morbidity After Treatment With Accelerated Radiotherapy and Weekly Cisplatin for Locally Advanced Head-and-Neck Cancer: Results of a Multidisciplinary Late Morbidity Clinic

    Energy Technology Data Exchange (ETDEWEB)

    Ruetten, Heidi, E-mail: h.rutten@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Pop, Lucas A.M.; Janssens, Geert O.R.J. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Takes, Robert P. [Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Knuijt, Simone [Department of Rehabilitation/Speech Pathology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Rooijakkers, Antoinette F. [Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Berg, Manon van den [Department of Gastroenterology-Dietetics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Merkx, Matthias A. [Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Herpen, Carla M.L. van [Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kaanders, Johannes H.A.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2011-11-15

    Purpose: To evaluate the long-term outcome and morbidity after intensified treatment for locally advanced head-and-neck cancer. Methods and Materials: Between May 2003 and December 2007, 77 patients with Stage III to IV head-and-neck cancer were treated with curative intent. Treatment consisted of accelerated radiotherapy to a dose of 68 Gy and concurrent cisplatin. Long-term survivors were invited to a multidisciplinary outpatient clinic for a comprehensive assessment of late morbidity with special emphasis on dysphagia, including radiological evaluation of swallowing function in all patients. Results: Compliance with the treatment protocol was high, with 87% of the patients receiving at least five cycles of cisplatin and all but 1 patient completing the radiotherapy as planned. The 5-year actuarial disease-free survival and overall survival rates were 40% and 47%, respectively. Locoregional recurrence-free survival at 5 years was 61%. The 5-year actuarial rates of overall late Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) Grade 3 and Grade 4 toxicity were 52% and 25% respectively. Radiologic evaluation after a median follow-up of 44 months demonstrated impaired swallowing in 57% of the patients, including 23% with silent aspiration. Subjective assessment using a systematic scoring system indicated normalcy of diet in only 15.6% of the patients. Conclusion: This regimen of accelerated radiotherapy with weekly cisplatin produced favorable tumor control rates and survival rates while compliance was high. However, comprehensive assessment by a multidisciplinary team of medical and paramedical specialists revealed significant long-term morbidity in the majority of the patients, with dysphagia being a major concern.

  7. Health policy model: long-term predictive results associated with the management of hepatitis C virus-induced diseases in Italy

    Science.gov (United States)

    Mennini, Francesco Saverio; Marcellusi, Andrea; Andreoni, Massimo; Gasbarrini, Antonio; Salomone, Salvatore; Craxì, Antonio

    2014-01-01

    Background At present, there are no specific nationwide epidemiological studies representing the whole Italian population. This study is aimed at describing the epidemiological and economic burden that HCV will generate in the next few years in Italy. Furthermore, the impact that future anti-HCV treatments may have on the burden of disease was considered. This analysis was developed for the period 2012–2030 from the perspective of the Italian National Health Service (NHS). Methods A published system dynamic model was adapted for Italy in order to quantify the HCV-infected population in terms of disease progression and the associated costs from 1950 to 2030. The model structure was based on transition probabilities reflecting the natural history of the disease. In order to estimate the efficacy of current anti-HCV treatment strategies for genotypes 1 and 4, the sustained virological response (SVR) rate in registration clinical trials for both boceprevir and telaprevir was estimated. It was assumed that the efficacy for patients treated with peginterferon + ribavirin was equal to the placebo arm of a randomized clinical trial (RCT) relating to boceprevir and telaprevir. For genotypes 2/3 patients it was assumed that treatment efficacy with dual therapy was equal to a SVR rate from the literature. According to the aim of this study, only direct health care costs (hospital admissions, drugs, treatment, and care of patients) incurred by the Italian NHS have been included in the model. Costs have been extrapolated using the published scientific literature available in Italy and actualized with the 2012 ISTAT (Istituto Nazionale di Statistica) Price Index system for monetary revaluation. Three different scenarios were assumed in order to evaluate the impact of future anti-HCV treatments on the burden of disease. Results Overall, in Italy, 1.2 million infected subjects were estimated in 2012. Of these, about 211,000 patients were diagnosed, while only about 11

  8. Aerosol Properties Over the Eastern US in July 2002: Comparison of Long-Term Measurements With Results From a Coupled Meteorology-Chemistry Model

    Science.gov (United States)

    Shankar, U.; Husain, L.; Khan, A. J.; Ahmed, T.; Adelman, Z.; Xiu, A.; Arunachalam, S.

    2007-12-01

    Elemental