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Sample records for contracture long-term results

  1. Radiotherapy in early-stage Dupuytren's contracture. Long-term results after 13 years

    International Nuclear Information System (INIS)

    Betz, Nicolas; Ott, Oliver J.; Sauer, Rolf; Fietkau, Rainer; Adamietz, Boris; Keilholz, Ludwig

    2010-01-01

    Background and Purpose: In early-stage Dupuytren's contracture, radiotherapy is applied to prevent disease progression. Long-term outcome and late toxicity of the treatment were evaluated in a retrospective analysis. Patients and Methods: Between 12/1982 and 02/2006, 135 patients (208 hands) were irradiated with orthovoltage (120 kV; 20 mA; 4-mm Al filter), in two courses with five daily fractions of 3.0 Gy to a total dose of 30 Gy; separated by a 6- to 8-week interval. The extent of disease was described according to a modified classification of Tubiana et al. Long-term outcome was analyzed at last follow-up between 02/2008 and 05/2008 with a median follow-up of 13 years (range, 2-25 years). Late treatment toxicity and objective reduction of symptoms as change in stage and numbers of nodules and cords were evaluated and used as evidence to assess treatment response. Results: According to the individual stages, 123 cases (59%) remained stable, 20 (10%) improved, and 65 (31%) progressed. In stage N 87% and in stage N/I 70% remained stable or even regressed. In more advanced stages, the rate of disease progression increased to 62% (stage I) or 86% (stage II). 66% of the patients showed a long-term relief of symptoms (i.e., burning sensations, itching and scratching, pressure and tension). Radiotherapy did not increase the complication rate after surgery in case of disease progression and only minor late toxicity (skin atrophy, dry desquamation) could be observed in 32% of the patients. There was no evidence for a second malignancy induced by radiotherapy. Conclusion: After a mean follow-up of 13 years radiotherapy is effective in prevention of disease progression and improves patients' symptoms in early-stage Dupuytren's contracture (stage N, N/I). In case of disease progression after radiotherapy, a ''salvage'' operation is still feasible. (orig.)

  2. Severe Spastic Contractures and Diabetes Mellitus Independently Predict Subsequent Minimal Trauma Fractures Among Long-Term Care Residents.

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    Lam, Kuen; Leung, Man Fuk; Kwan, Chi Wai; Kwan, Joseph

    2016-11-01

    The study aimed to examine the epidemiology of hypertonic contractures and its relationship with minimal trauma fracture (MTF), and to determine the incidence and predictors of (MTF) in long-term care residents. This was a longitudinal cohort study of prospectively collected data. Participants were followed from March 2007 to March 2016 or until death. A 300-bed long-term care hospital in Hong Kong. All long-term care residents who were in need of continuous medical and nursing care for their activities of daily living. Information on patients' demographic data, severe contracture defined as a decrease of 50% or more of the normal passive range of joint movement of the joint, and severe limb spasticity defined by the Modified Ashworth Scale higher than grade 3, medical comorbidities, functional status, cognitive status, nutritional status including body mass index and serum albumin, past history of fractures, were evaluated as potential risk factors for subsequent MTF. Three hundred ninety-six residents [148 males, mean ± standard deviation (SD), age = 79 ± 16 years] were included for analysis. The presence of severe contracture was highly prevalent among the study population: 91% of residents had at least 1 severe contracture, and 41% of residents had severe contractures involving all 4 limbs. Moreover, there were a significant proportion of residents who had severe limb spasticity with the elbow flexors (32.4%) and knee flexors (33.9%) being the most commonly involved muscles. Twelve residents (3%) suffered from subsequent MTF over a median follow-up of 33 (SD = 30) months. Seven out of these 12 residents died during the follow-up period, with a mean survival of 17.8 months (SD = 12.6) after the fracture event. The following 2 factors were found to independently predict subsequent MTF in a multivariate Cox regression: bilateral severe spastic knee contractures (hazard ratio = 16.5, P contractures are common morbidities in long-term care residents

  3. Long-Term Resolution of Severe Ankle Contractures Using Botulinum Toxin, Serial Casting, Splinting, and Motor Retraining.

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    Leung, Joan; Stroud, Katarina

    2018-01-01

    Purpose: Serial casting for ankle contractures is traditionally performed in prone, a position that patients may not easily tolerate. Also, although serial casting is effective in correcting contracture, its effect dissipates quickly. This case report describes a procedure for performing casting for ankle contractures in a supine or sitting position. It also describes a process that enables the effect of serial casting to be maintained long term. Client Description: The client was an adult who had suffered traumatic brain injury and severe bilateral ankle contractures. Intervention: He received botulinum toxin and serial casting for his bilateral ankle contractures, one ankle at 8 months and the other at 13 months after the injury. He then underwent a programme of splinting and motor training. Measures and Outcome: The client gained more than 40° dorsiflexion for both ankles after receiving botulinum toxin injections and serial casting. The improvement in ankle range enabled him to progress to walking practice. Ankle splinting was gradually reduced. On discharge at 25 months post-injury, the ankle joint range was maintained. Implications: The use of botulinum toxin and serial casting, followed by an intensive programme of splinting and motor training, may be an option to consider for effective long-term resolution of severe contractures after acquired brain injury.

  4. NEUROORTHOPEDICAL APPROACH TO THE CORRECTION OF EQUINES CONTRACTURE IN PATIENTS WITH SPASTIC PARALYSIS

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    Valery Vladimirovich Umnov

    2014-03-01

    Full Text Available The frequency of recurrent contractures of the joints of the lower limb after their correction by means of tendon-muscle plasty remains significant. Therefore, the search for effective ways to correct contractures with the most resistant long-term result is relevant. The objective of the study is to improve treatment outcomes of equinus contracture in children with spastic paralysis. Materials and methods. We analyzed the results of correction of contractures in joints of lower limbs in 40 patients with cerebral palsy and the influence of spasticity of patognomonic muscles on them. The mean age was 6 years 7 months. In addition, for the correction of hypertonus of triceps muscle of tibia, the 330 lower limb segments were performed selective neurotomy of appropriate motor branches of the general tibial nerve. This operation in 304 cases was combined with achilloplastics or Strayer operation. Results. A mean degree of correlation between the degree of contracture in the ankle and increased tone of triceps tibia was determined (r value ranged from 0.451 to 0.487. Short-term results of the combined neuroorthopedic method for correction of contractures were good in estimating within 1 year post surgery, but a study of its short-run effect requires long-term follow-up.

  5. Radiotherapy in early stage dupuytren's contracture

    International Nuclear Information System (INIS)

    Adamietz, B.; Sauer, R.; Gruenert, J.

    2001-01-01

    Purpose: In early stage Dupuytren's contracture radiotherapy was applied to prevent disease progression. Long-term results and late toxicity of this treatment were evaluated in a retrospective analysis. Patients and Methods: Between 1982 and 1994, 99 patients (176 hands) received orthovoltage radiotherapy, which consisted of two courses with 5 x 3 Gy (total dose: 30 Gy, daily fractionated; 120 kV, 4 mm Al), separated by a 6 to 8-week pause. The Dupuytren's contracture was staged according to the classification of Tubiana et al. The long-term outcome was analyzed at last follow-up between July and November 1999. The median follow-up was 10 years (range 7-18 years). Late toxicity was assessed using the LENT-SOMA criteria. Results: In Stage N 84% and Stage N/I 67% of cases remained stable. 65% of the cases in Stage I and 83% in Stage II showed progressive nodules and cords. In case of progression we saw no complications after a second radiotherapy or salvage operation. Conclusion: Radiotherapy effectively prevents disease progression for early stage Dupuytren's contracture (Stage N, N/I). Moreover, in case of disease progression despite radiotherapy salvage surgery is still feasible. (orig.) [de

  6. Avoiding unfavorable results in postburn contracture hand

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    Bhattacharya, Sameek

    2013-01-01

    Deformities of the hands are a fairly common sequel of burn especially in the developing world. This is because of high incidence of burns, limited access to standard treatment and rehabilitation. The best outcome of a burnt hand is when deformities are prevented from developing. A good functional result is possible when due consideration is paid to hands during resuscitation, excisional surgery, reconstructive surgery and physiotherapy. The post-burns deformities of hand develop due direct thermal damage or secondary to intrinsic minus position due to oedema or vascular insufficiency. During the acute phase the concerns are, maintenance circulation minimize oedema prevent unphysiological positioning and wound closure with autogenous tissue as soon as possible. The rehabilitation program during the acute phase starts from day one and goes on till the hand has healed and has regained full range of motion. Full blown hand contractures are challenging to correct and become more difficult as time passes. Long-standing cases often land up with attenuation of extensor apparatus leading to swan neck and boutonniere deformity, muscle shortening and bony ankylosis. The major and most common pitfall after contracture release is relapse. The treatment protocol of contracture is solely directed towards countering this tendency. This article aims to guide a surgeon in obtaining optimal hand function and avoid pit falls at different stages of management of hand burns. The reasons of an unfavourable outcome of a burnt hand are possible lack of optimal care in the acute phase, while planning and performing reconstructive procedure and during aftercare and rehabilitation. PMID:24501479

  7. Biceps brachii long head overactivity associated with elbow flexion contracture in brachial plexus birth palsy.

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    Sheffler, Lindsey C; Lattanza, Lisa; Sison-Williamson, Mitell; James, Michelle A

    2012-02-15

    The etiology of elbow flexion contracture in children with brachial plexus birth palsy remains unclear. We hypothesized that the long head of the biceps brachii muscle assists with shoulder stabilization in children with brachial plexus birth palsy and that overactivity of the long head during elbow and shoulder activity is associated with an elbow flexion contracture. Twenty-one patients with brachial plexus birth palsy-associated elbow flexion contracture underwent testing with surface electromyography. Twelve patients underwent repeat testing with fine-wire electromyography. Surface electrodes were placed on the muscle belly, and fine-wire electrodes were inserted bilaterally into the long and short heads of the biceps brachii. Patients were asked to perform four upper extremity tasks: elbow flexion-extension, hand to head, high reach, and overhead ball throw. The mean duration of muscle activity in the affected limb was compared with that in the contralateral, unaffected limb, which was used as a control. Three-dimensional motion analysis, surface dynamometry, and validated function measures were used to evaluate upper extremity kinematics, elbow flexor-extensor muscle imbalance, and function. The mean activity duration of the long head of the biceps brachii muscle was significantly higher in the affected limb as compared with the contralateral, unaffected limb during hand-to-head tasks (p = 0.02) and high-reach tasks (p = 0.03). No significant differences in mean activity duration were observed for the short head of the biceps brachii muscle between the affected and unaffected limbs. Isometric strength of elbow flexion was not significantly higher than that of elbow extension in the affected limb (p = 0.11). Overactivity of the long head of the biceps brachii muscle is associated with and may contribute to the development of elbow flexion contracture in children with brachial plexus birth palsy. Elbow flexion contracture may not be associated with an elbow

  8. Intrinsic contractures of the hand.

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    Paksima, Nader; Besh, Basil R

    2012-02-01

    Contractures of the intrinsic muscles of the fingers disrupt the delicate and complex balance of intrinsic and extrinsic muscles, which allows the hand to be so versatile and functional. The loss of muscle function primarily affects the interphalangeal joints but also may affect etacarpophalangeal joints. The resulting clinical picture is often termed, intrinsic contracture or intrinsic-plus hand. Disruption of the balance between intrinsic and extrinsic muscles has many causes and may be secondary to changes within the intrinsic musculature or the tendon unit. This article reviews diagnosis, etiology, and treatment algorithms in the management of intrinsic contractures of the fingers. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Quantitative and temporal differential recovery of articular and muscular limitations of knee joint contractures; results in a rat model.

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    Trudel, Guy; Laneuville, Odette; Coletta, Elizabeth; Goudreau, Louis; Uhthoff, Hans K

    2014-10-01

    Joint contractures alter the mechanical properties of articular and muscular structures. Reversibility of a contracture depends on the restoration of the elasticity of both structures. We determined the differential contribution of articular and muscular structures to knee flexion contractures during spontaneous recovery. Rats (250, divided into 24 groups) had one knee joint surgically fixed in flexion for six different durations, from 1 to 32 wk, creating joint contractures of various severities. After the fixation was removed, the animals were left to spontaneously recover for 1 to 48 wk. After the recovery periods, animals were killed and the knee extension was measured before and after division of the transarticular posterior muscles using a motorized arthrometer. No articular limitation had developed in contracture of recent onset (≤2 wk of fixation, P > 0.05); muscular limitations were responsible for the majority of the contracture (34 ± 8° and 38 ± 6°, respectively; both P contractures of recent onset (1 and 2 wk of fixation, respectively). Long-lasting contractures (≥4 wk of fixation) presented articular limitations, irreversible in all 12 durations of recovery compared with controls (all 12 P contractures of recent onset were primarily due to muscular structures, and they were reversible during spontaneous recovery. Long-lasting contractures were primarily due to articular structures and were irreversible. Comprehensive temporal and quantitative data on the differential reversibility of mechanically significant alterations in articular and muscular structures represent novel evidence on which to base clinical practice. Copyright © 2014 the American Physiological Society.

  10. DupuytrEn Treatment EffeCtiveness Trial (DETECT): a protocol for prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1:1:1, multicentre trial comparing the effectiveness and cost of collagenase clostridium histolyticum, percutaneous needle fasciotomy and limited fasciectomy as short-term and long-term treatment strategies in Dupuytren's contracture.

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    Räisänen, Mikko P; Karjalainen, Teemu; Göransson, Harry; Reito, Aleksi; Kautiainen, Hannu; Malmivaara, Antti; Leppänen, Olli V

    2018-03-28

    Dupuytren's contracture (DC) is a chronic fibroproliferative disorder of the palmar fascia which leads to flexion contracture in one or more fingers. There is no definitive cure for DC, and treatment aims at relieving symptoms by releasing the contracture using percutaneous or operative techniques. We planned a prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1:1:1, multicentre trial comparing the effectiveness and cost of (1) collagenase clostridium histolyticum injection followed by limited fasciectomy in non-responsive cases, (2) percutaneous needle fasciotomy followed by limited fasciectomy in non-responsive cases and (3) primary limited fasciectomy during short-term and long-term follow-up for Tubiana I-III stages DC. We will recruit participants from seven national centres in Finland. Primary outcome is the rate of success in the treatment arm at 5 years after recruitment. Success is a composite outcome comprising (1) at least 50% contracture release from the date of recruitment and (2) participants in a patient-accepted symptom state (PASS). Secondary outcomes are (1) angle of contracture, (2) quick disabilities of the arm, a shoulder and hand outcome measure (QuickDASH), (3) perceived hand function, (4) EQ-5D-3L, (5) rate of major adverse events, (6) patient's trust of the treatment, (7) global rating, (8) rate of PASS, (9) rate of minimal clinically important improvement, (10) expenses, (11) progression of disease, (12) progression-free survival, (13) favoured treatment modality, (14) patients achieving full contracture release and >50% improvement and (15) patient satisfaction with the treatment effect. Predictive factors for achieving the PASS will also be analysed. The protocol was approved by the Tampere University Hospital Institutional Review Board and Finnish Medicine Agency. The study will be performed according to the principles of good clinical practice. The results of the trial will be disseminated as

  11. Eyelid contracture may indicate recurrent basal cell carcinoma, even after Mohs' micrographic surgery.

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    Ong, Lorraine Y; Lane, Carol M

    2009-01-01

    Mohs' micrographic surgery (MMS) is an effective means of margin control in the management of periocular basal cell carcinomas (BCC). We describe three cases of recurrent BCC that presented with progressive eyelid contracture after MMS. They illustrate high-risk factors for recurrence, namely large tumor size, medial canthal location, previous treatment, and aggressive histological features. Careful long-term surveillance with serial photography may identify early eyelid contracture and thus assist in the detection of recurrent BCC after MMS and improve patient outcome.

  12. Deltoid contracture: a case with multiple muscle contractures.

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    Chen, Hsin-Chang; Huang, Tung-Fu; Chou, Po-Hsin; Chen, Tain-Hsiung

    2008-11-01

    Deltoid contracture is relatively uncommon. The literature consists primarily of case reports and few articles on large case series. The pathogenesis has been well studied. Muscle contractures can occur in the deltoid, biceps, triceps, gluteus and quadriceps muscles; however, cases of multiple muscle contractures are rare. We reported a patient with multiple contractures of the bilateral deltoid, bilateral gluteus, and bilateral quadriceps muscles, who had received repeated intramuscular injections during childhood and adulthood. The radiographic, including magnetic resonance imaging (MRI), features of the bone and joint abnormalities are presented. Some literatures reported that damage to the structures of the body due to intramuscular injection is related to the site of injection, age of the patient, and the volume, pH, chemical composition, and diffusional capacity of the injectate. Our patient had muscular contracture induced by needle injection regardless of her age, medication and injection site.

  13. Collagenase injections for the treatment of single cords in cases of Dupuytren’s contracture – a prospective intervention study of long-term experience with Xiapex

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    Fischer, Lisa Maria

    2017-04-01

    Full Text Available Introduction: The gold standard in the treatment of Dupuytren’s contracture is surgical therapy. Alternatives are percutaneous needle fasciotomy and radiation in exceptional cases. Injection treatments with Xiapex (Pfizer are a new therapy option. This collagenase, extracted from clostridium histolyticum, is used to break down the affected tissue cords. The objective of this study is to examine the effect and long-term success of treatment with Xiapex.Methods: In this study, Xiapex treatment was conducted on a sample group of 19 patients with Dupuytren’s contracture. The injection was placed either on the cord at the level of the metacarpophalangeal (MCP joint (n=17 or of the proximal interphalangeal (PIP joint (n=7. Break-up of the cord occurred 24 hours after the injection. The neutral zero method was used to assess the extent of movement. The Michigan Hand Outcomes Questionnaire (MHQ was selected for evaluation of the general hand function in 16 patients. The WHO-5 and the EQ-5D VAS Score were used as a measure of the patients’ satisfaction and their state of health. All values were collected both pre-injection as well as 1 year post-injection.Results: Out of 19 patients in our sample group, 16 patients (≈84% benefitted in terms of improvement in mobility. Overall, the range of movement increased by Ø 26° in the affected finger. A separate assessment demonstrated that:The range of movement increased by 77% in the MCP joint. The extent of movement pre-injection was Ø (0-28-78 and post-injection it was Ø (0-9-81 with an improvement of Ø 22°. In the PIP joint, only slight improvement was observed (Ø pre (0-27-93; post (0-24-95.The MHQ increased from Ø 76% (R: 32–97% to 81% (R: 39–100%.The painfulness decreased from Ø 19% (R: 0–55% to Ø11% (R: 0–55%, corresponding to Ø 43%. Satisfaction increased in 72% of patients by Ø 21%.According to WHO-5, patient satisfaction pre-injection was Ø 20 (R: 11–25, and 1 year after

  14. Simultaneous bilateral contracture of the infraspinatus muscle.

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    Franch, J; Bertran, J; Remolins, G; Fontecha, P; Díaz-Bertrana, M C; Durall, I

    2009-01-01

    A case of bilateral fibrotic contracture of the infraspinatus muscles in a five-year-old Belgian Shepherd dog is described. The dog was presented with progressive forelimb lameness with postural and gait abnormalities three months after an episode of overexertion. When walking, the lower part of both forelimbs swung in a lateral arc causing a circumduction movement and in the standing position, the dog showed elbow adduction with external rotation of the distal part of both front limbs. Orthopaedic examination revealed bilateral atrophy of both infraspinatus and supraspinatus muscles and restriction in the range of motion of both shoulders, especially when attempting abduction and flexion. No specific findings were observed in the shoulder or elbow radiographs but hyperechogenic areas were evident in the ultrasonographic examination of both infraspinatus muscles. A diagnosis of fibrotic contracture of both infraspinatus muscles was established and bilateral tenectomy of the insertion tendons of the infraspinatus muscles was performed. Complete recovery of the animal was achieved after the surgery, which was confirmed in a long-term follow-up (10 months). In conclusion, physical examination and ultrasonography allowed a proper diagnosis of the condition, and tenectomy of the infraspinatus muscles resulted in a complete recovery of the patient even with bilateral involvement.

  15. Localized type Volkmann's contracture treated with tendon transfer and tension-reduced early mobilization

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    Kaji, Yoshio; Nakamura, Osamu; Yamaguchi, Konosuke; Tobiume, Sachiko; Yamamoto, Tetsuji

    2017-01-01

    Abstract Rationale: For localized type Volkmann's contracture, in which degeneration of the flexor digitorum profundus (FDP) muscle to one or two fingers and restriction of finger extension occur, dissection or excision of the affected muscle is usually recommended. However, these surgical procedures need relatively wide exposure of the muscle, because the FDP muscle is in the deep portion of the forearm. Patient concerns: In this report, the case of a 35-year-old woman with localized type Volkmann's contracture is presented. Her left forearm had been compressed with an industrial roller 4 months earlier, and severe flexion contracture of the long finger and mild flexion contracture of the ring finger developed gradually. Diagnoses: localized type Volkmann's contracture. Intervention: Five months after the injury, transection of the FDP tendon to the long finger and transfer of the transected tendon to the FDP tendon to the index finger was performed after adjusting the tonus of these two tendons using a small skin incision. This procedure was followed by a tension-reduced early mobilization technique in which a tension-reduced position of the tendon suture site was maintained by taping the long finger to the volar side of the index finger, and then immediate active range of motion (ROM) exercise was started. Outcomes: Within 9 weeks after surgery, full ROM had been regained. Lessons: Using the treatment procedure presented in this case report, a good clinical result was obtained in a minimally invasive manner. PMID:28072735

  16. Plantarflexion Contracture in the mdx Mouse

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    Garlich, Michael W.; Baltgalvis, Kristen A.; Call, Jarrod A.; Dorsey, Lisa L.; Lowe, Dawn A.

    2012-01-01

    Objective Contractures are a major clinical issue for patients with muscular dystrophies. However, it is unknown whether contractures are present in the widely used mdx mouse model of Duchenne muscular dystrophy. Therefore, the objectives of this study were to develop methods to measure muscle contractures in mice, to determine whether plantarflexion contractures are present in mdx mice, and to analyze the composition of the major muscles involved. Design Hindlimbs of eight wild type and six mdx mice were assessed every 2 wks during the course of a 12-wk study. Assessments included range of motion and in vivo torques about the ankle. At the end of the study, mice were euthanized, and muscles were analyzed for composition. Results The mdx mice had ~10 degrees less dorsiflexion, increased passive torque moving the ankle into dorsiflexion, and an increased passive-to-active torque ratio relative to wild type mice. Gastrocnemius muscle composition alterations included increased wet mass, decreased protein content, and increased collagen. Conclusions The results indicate that mdx mice have plantarflexion contractures similar to those seen in children with Duchenne muscular dystrophy. In future studies, these measures can be used to assess strategies to slow the progression of contractures that occur with muscular dystrophies. PMID:21403594

  17. Contractures and involuntary muscle overactivity in severe brain injury.

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    Pohl, Marcus; Mehrholz, Jan; Rockstroh, Günter; Rückriem, Stefan; Koch, Rainer

    2007-04-01

    The aim of the present study was to evaluate the association of contractures with an increase or reduction of non-spastic muscle overactivity due to severe cerebral damage. Forty-five patients with tetraparesis after severe cerebral damage were investigated. Three groups were defined based on the presence of spasticity (revealed as resistance to passive stretch (= hypertonia)), and the presence of contracture of the relevant knee joint: Group(s) (17 patients with hypertonia without contracture), Group(s+c) (20 patients with hypertonia and contracture), and Group(c) (eight patients without hypertonia and with contracture). In all groups spontaneous involuntary muscle activity was assessed continuously over a 12-hour period through isometric measurement of knee joint flexion torque. A mathematical algorithm differentiated an hourly muscle activity spectrum (PI(h)). The frequency of peaks (peaks(h)) from the activity spectrum was determined. We revealed that Group(s) had higher PI(h) and more frequent peaks(h) compared with Group(s+c) and Group(c) (p0.05). The presence of contractures was associated with lower involuntary muscle overactivity in terms of lower PI(h) and less frequent peaks(h), indicating that contractures may be associated with reduced non-spastic positive features of the upper motor neurone syndrome in patients with severe brain damage.

  18. Long-term sequel of posterolateral rotatory instability of the elbow: a case report

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    Cheng Chun-Ying

    2010-01-01

    Full Text Available Abstract The natural course of untreated posterior lateral rotatory instability of the elbow is unclear. A case of elbow arthrosis with progressing deformity and flexion contracture after an episode of elbow dislocation about 20 years ago presented the possibility the long term outcome of untreated posterior lateral rotatory instability of the elbow.

  19. Contracture deformity (image)

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    A contracture is a fixed tightening of muscle, tendons, ligaments, or skin. It prevents normal movement of the associated ... injury such as a severe burn can cause contracture of the skin. The skin becomes scarred and ...

  20. Functional reconstruction of ischemic contracture in the

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    TANG Hao

    2011-04-01

    Full Text Available 【Abstract】Objective: To discuss the method of functional reconstruction of ischemic contracture in the lower limb and propose a classification protocol for ischemic contracture in the lower limb based on its severity and prognosis. Methods: A total of 42 patients with ischemic contracture in the lower limb were included in this study. According to different types of disturbance and degrees of severity, surgical reconstructions consisting of nerve decompression, tendon lengthening or transfer, intrinsic foot muscle release and sural-tibial nerve anastomosis were performed in every patient. Results: Postoperatively, all patients were able to walk on flat ground. Drop foot was corrected in 10 patients, and 5 patients still felt some difficulty during stair activity. Split Achilles tendon transfer to flexor hallucis longus tendon was performed in 12 patients, and their walking stability was improved. Seven patients accepted ipsilateral suraltibial nerve anastomosis, and sensitivity recovery reached to S2 in 2 patients and S3 in 5 patients. Conclusions: Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb. Key words: Ischemic contracture; Classification; Recovery of function

  1. Pronation-Supination Motion Is Altered in a Rat Model of Post-Traumatic Elbow Contracture.

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    Dunham, Chelsey L; Castile, Ryan M; Chamberlain, Aaron M; Galatz, Leesa M; Lake, Spencer P

    2017-07-01

    The elbow joint is highly susceptible to joint contracture, and treating elbow contracture is a challenging clinical problem. Previously, we established an animal model to study elbow contracture that exhibited features similar to the human condition including persistent decreased range of motion (ROM) in flexion-extension and increased capsule thickness/adhesions. The objective of this study was to mechanically quantify pronation-supination in different injury models to determine if significant differences compared to control or contralateral persist long-term in our animal elbow contracture model. After surgically inducing soft tissue damage in the elbow, Injury I (anterior capsulotomy) and Injury II (anterior capsulotomy with lateral collateral ligament transection), limbs were immobilized for 6 weeks (immobilization (IM)). Animals were evaluated after the IM period or following an additional 6 weeks of free mobilization (FM). Total ROM for pronation-supination was significantly decreased compared to the uninjured contralateral limb for both IM and FM, although not different from control limbs. Specifically, for both IM and FM, total ROM for Injury I and Injury II was significantly decreased by ∼20% compared to contralateral. Correlations of measurements from flexion-extension and pronation-supination divulged that FM did not affect these motions in the same way, demonstrating that joint motions need to be studied/treated separately. Overall, injured limbs exhibited persistent motion loss in pronation-supination when comparing side-to-side differences, similar to human post-traumatic joint contracture. Future work will use this animal model to study how elbow periarticular soft tissues contribute to contracture.

  2. CT diagnosis of gluteal muscle contracture in children

    International Nuclear Information System (INIS)

    Wang Longsheng; Bao Jiaqi; Pan Zhili; Hu Kefei; Jiang Jiatan; Zhang Hongliang; Sun Jun; Yuan Yi

    2004-01-01

    Objective: To investigate the CT manifestations of gluteal muscle contracture (GMC) in children. Methods: Sixty-one cases of GMC diagnosed by CT and proved by surgery and pathology were studied with 20 cases of non-GMC as the control group. Results: 57 cases (93.4%) were bilateral contracture and 4 cases (6.6%) were unilateral contracture in 61 cases of GMC; The main CT manifestations were as follows: (1) gluteal muscle volume shrunk. There were 118 (100.0%) sides of gluteus maximus contracture , 16 ( 13.6 %) sides of gluteus medius contracture , 12 ( 10.2 %) sides of piriformis contracture, 4 (3.4%) sides of gluteus minimus contracture, 4 (3.4%) sides of capsula articularis contracture; (2) calcification and necrosis in injection zones. There were 95 (80.5%) sides of gluteal calcification and 24 (20.3%) sides of gluteal necrosis; (3) stripe crispation fascia. There were 81 stripes crispation fascia located outboard laterals of gluteus maximus, 36 located inboard laterals of the latter; (4) gluteal muscle clearance widened. There were 38 (32.2%) sides of light degree gluteal muscle contracture, 53 (44.9%) sides of middle degree, and 27 (22.9%) sides of heavy degree. Conclusion: CT can accurately diagnose GMC and it plays an important role in the evaluation of pathological extent and degree of GMC

  3. Hamstring contractures in children with spastic cerebral palsy result from a stiffer extracellular matrix and increased in vivo sarcomere length.

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    Smith, Lucas R; Lee, Ki S; Ward, Samuel R; Chambers, Henry G; Lieber, Richard L

    2011-05-15

    Cerebral palsy (CP) results from an upper motoneuron (UMN)lesion in the developing brain. Secondary to the UMNl esion,which causes spasticity, is a pathological response by muscle - namely, contracture. However, the elements within muscle that increase passive mechanical stiffness, and therefore result in contracture, are unknown. Using hamstring muscle biopsies from pediatric patients with CP (n =33) and control (n =19) patients we investigated passive mechanical properties at the protein, cellular, tissue and architectural levels to identify the elements responsible for contracture. Titin isoform, the major load-bearing protein within muscle cells, was unaltered in CP. Correspondingly, the passive mechanics of individual muscle fibres were not altered. However, CP muscle bundles, which include fibres in their constituent ECM, were stiffer than control bundles. This corresponded to an increase in collagen content of CP muscles measured by hydroxyproline assay and observed using immunohistochemistry. In vivo sarcomere length of CP muscle measured during surgery was significantly longer than that predicted for control muscle. The combination of increased tissue stiffness and increased sarcomere length interact to increase stiffness greatly of the contracture tissue in vivo. These findings provide evidence that contracture formation is not the result of stiffening at the cellular level, but stiffening of the ECM with increased collagen and an increase of in vivo sarcomere length leading to higher passive stresses.

  4. Early results of surgical intervention for elbow deformity in cerebral palsy based on degree of contracture.

    Science.gov (United States)

    Carlson, Michelle G; Hearns, Krystle A; Inkellis, Elizabeth; Leach, Michelle E

    2012-08-01

    Elbow flexion posture, caused by spasticity of the muscles on the anterior surface of the elbow, is the most common elbow deformity seen in patients with cerebral palsy. This study retrospectively evaluated early results of 2 surgical interventions for elbow flexion deformities based on degree of contracture. We hypothesized that by guiding surgical treatment to degree of preoperative contracture, elbow extension and flexion posture angle at ambulation could be improved while preserving maximum flexion. Eighty-six patients (90 elbows) were treated for elbow spasticity due to cerebral palsy. Seventy-one patients (74 elbows) were available for follow-up. Fifty-seven patients with fixed elbow contractures less than 45° were surgically treated with a partial elbow muscle lengthening, which included partial lengthening of the biceps and brachialis and proximal release of the brachioradialis. Fourteen patients (17 elbows) with fixed elbow contractures ≥ 45° had a more extensive full elbow release, with biceps z-lengthening, partial brachialis myotomy, and brachioradialis proximal release. Age at surgery averaged 10 years (range, 3-20 y) for partial lengthening and 14 years (range, 5-20 y) for full elbow release. Follow-up averaged 22 months (range, 7-144 mo) for partial lengthening and 18 months (range, 6-51 mo) for full elbow release. Both groups achieved meaningful improvement in flexion posture angle at ambulation, active and passive extension, and total range of motion. Elbow flexion posture angle at ambulation improved by 57° and active extension increased 17° in the partial lengthening group, with a 4° loss of active flexion. In the full elbow release group, elbow flexion posture angle at ambulation improved 51° and active extension improved 38°, with a loss of 19° of active flexion. Surgical treatment of spastic elbow flexion in cerebral palsy can improve deformity. We obtained excellent results by guiding the surgical intervention by the amount of

  5. Long-term follow-up results of umbilical hernia repair.

    Science.gov (United States)

    Venclauskas, Linas; Jokubauskas, Mantas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

    2017-12-01

    Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias ( 30 kg/m 2 , diabetes and wound infection were independent risk factors for umbilical hernia recurrence. The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m 2 , diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

  6. [Gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis: a report of 52 cases].

    Science.gov (United States)

    Wang, Cheng-xiang; Gong, Yu-suo; Li, Sheng-hua; Liu, Hai-ping; Chai, Xi-ping

    2011-07-01

    To investigate clinical efficacy and significance of gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis. From January 2008 to June 2010,52 patients with gluteal muscle contracture induced knee osteoarthritis were reviewed. Among the patients,15 patients were male and 37 patients were female, ranging in age from 15 to 45 years, with an average of 35 years. Eighteen patients had left knee osteoarthritis, 30 patients had right osteoarthritis, and 4 patients had double knee osteoarthritis. All the patients were treated with gluteal muscle contracture release. Lysholm knee score was used to evaluate therapeutic effects before and after operation. All the patients were followed up,and the duration ranged from 12 to 37 years,with a mean of 15 months. The Lysholm knee score improved from preoperative (68.12 +/- 0.78) points to postoperative (91.23 +/- 0.47) points at the last follow-up, the difference had statistical difference (t=31.269, Pmuscle contracture release is effective to relieve symptoms of gluteal muscles contracture and knee osteoarthritis. The patients with gluteal muscle contracture should be treated early so as to prevent effects of gluteal muscle contracture on knee joint, slow down degeneration of knee joint at early stage, and prevent occurrence of knee osteoarthritis.

  7. TREATMENT OF POSTTRAUMATIC ISCHEMIC CONTRACTURES OF THE THUMB

    Directory of Open Access Journals (Sweden)

    K. S. Melikhov

    2010-01-01

    Full Text Available Results of surgical treatment of 21 patients with posttraumatic ischemic contractures of the first finger of a hand were analyzed. The working classification in which there are three degrees of a contracture depending on size of deficiency of a dermal cord of the first interdigital interval was offered. Advanced tactics of surgical treatment of such pathology was developed. Thus, during the first stage we carried out abduction of the first finger by the elimination of cicatrical, muscle and arthrogenic contracture components. At the second stage of treatment, if it was necessary, active opposition of the first finger was restored.

  8. 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

    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

  9. 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.

  10. Effects of contracture on gait kinematics: A systematic review.

    Science.gov (United States)

    Attias, Michael; Chevalley, Odile; Bonnefoy-Mazure, Alice; De Coulon, Geraldo; Cheze, Laurence; Armand, Stéphane

    2016-03-01

    Contractures of a major joint in the lower limbs may impair human walking in addition to other daily living activities. A contracture is defined as the inability of a joint to perform the full range of motion and excessive resistance during passive mobilization of the joint. Few studies have reported methods describing how to evaluate contractures. Understanding the association among all of these studies seems essential to improve patient management. Therefore, we conducted a systematic review on this topic to elucidate the influence of contractures on gait kinematics. An electronic search in the literature will be conducted. Studies were screened by title and abstract and full texts were evaluated secondarily for definitive inclusion. The quality of the included studies was assessed independently by the two review authors with the Modified Quality Assessment Checklist. The included studies were separated into three categories: pathological contracture versus healthy controls (descriptive), simulated contracture versus healthy controls (experimental), and pre- and post-kinematics after surgical muscle lengthening (surgery). From a total of 4402 references, 112 original articles were selected, and 28 studies were identified in this systematic review. No significant difference between raters was observed on the total score of the Modified Quality Assessment Checklist. Contractures influence walking depending on the location (muscle) and the contracture level (muscle-tendon length). After giving a definition of contracture, this review identified some contracture alterations, such as plantarflexion, knee flexion and hip flexion contractures, with a kinematic description and presented possible different compensations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. OK-432 sclerotherapy in head and neck lymphangiomas: long-term follow-up result.

    Science.gov (United States)

    Yoo, Jae Chul; Ahn, Youngjin; Lim, Yune Syung; Hah, J Hun; Kwon, Tack-Kyun; Sung, Myung-Whun; Kim, Kwang Hyun

    2009-01-01

    Nonsurgical treatments, such as sclerotherapy have been attempted for head and neck lymphagiomas. Of the available sclerosing agents, picibanil has shown satisfactory short-term treatment results in many studies, but no study has presented long-term treatment results. Accordingly, in the present study, the authors retrospectively reviewed the long-term treatment results of picibanil sclerotherapy. Fifty-five lymphangioma patients who underwent picibanil sclerotherapy were enrolled. Data about initial and long-term response, recurrence, and excision rate were collected. Initial response rates were 83.5 percent and long-term response rates were 76.3 percent. Initial and the long-term response rate were equally good for lymphangioma.

  12. New perspectives on the development of muscle contractures following central motor lesions

    DEFF Research Database (Denmark)

    Pingel, Jessica; Bartels, Else Marie; Nielsen, Jens Bo

    2017-01-01

    Muscle contractures are common in patients with central motor lesions, but the mechanisms responsible for the development of contractures are still unclear. Increased or decreased neural activation, protracted placement of a joint with the muscle in a short position and muscle atrophy have been...... suggested to be involved, but none of these mechanisms are sufficient to explain the development of muscle contractures alone. Here we propose that changes in tissue homeostasis in the neuro-muscular-tendon-connective tissue complex is at the heart of the development of contractures, and that an integrated...... physiological understanding of the interaction between neural, mechanical and metabolic factors, as well as genetic and epigenetic factors, is necessary in order to unravel the mechanisms that result in muscle contractures. We hope thereby to contribute to a reconsideration of how and why muscle contractures...

  13. Contracture deformity

    Science.gov (United States)

    ... PA: Elsevier Saunders; 2014:chap 126. Skalsky AJ, McDonald CM. Prevention and management of limb contractures in ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  14. Multiple collagenase injections are safe for treatment of Dupuytren's contractures.

    Science.gov (United States)

    Gajendran, Varun K; Hentz, Vincent; Kenney, Deborah; Curtin, Catherine M

    2014-07-01

    The authors report the case of a 65-year-old, right-hand-dominant man who had severe Dupuytren's disease with multiple cords and flexion contractures of the metacarpophalangeal and proximal interphalangeal joints of both hands and underwent repeated collagenase injections for treatment. Collagenase has been shown to be safe and effective in the treatment of Dupuytren's contractures when administered as a single dose, but the results of multiple injections over a prolonged period are unknown. Antibodies to collagenase develop in all patients after several treatments, raising concerns about safety and efficacy as a result of sensitization from repeated exposures. The antibodies generated as a result of repeated exposure to collagenase could theoretically render it less effective with time and could also lead to immune reactions as severe as anaphylaxis. The authors present the case of a single patient who experienced continued correction of his contractures with only minor and self-limited adverse reactions after administration of 12 collagenase doses through 15 injections during a 4-year period. Over time, the injections continued to be effective at correcting metacarpophalangeal joint contractures, but less effective at correcting proximal interphalangeal joint contractures. The patient did eventually require a fasciectomy, but the safety and modest success of the repeated collagenase injections shows promise for a less invasive treatment with a better risk profile than open fasciectomy. Although further studies are needed, repeated administration of collagenase appears to be safe and modestly effective for severe Dupuytren's contractures, although a fasciectomy may ultimately be required in the most severe cases. Copyright 2014, SLACK Incorporated.

  15. Long-term outcome after mastectomy with immediate breast reconstruction

    DEFF Research Database (Denmark)

    Stralman, K.; Mollerup, C.L.; Kristoffersen, U.S.

    2008-01-01

    INTRODUCTION: The purpose of this study was to investigate long term outcome for women who had undergone mastectomy and immediate breast reconstruction. MATERIAL AND METHODS: Patient files of 167 immediately reconstructed breast cancer patients were reviewed for late surgical complications....... Furthermore, information of local recurrence rate, radiotherapy and death was obtained from the Danish Breast Cancer Cooperative Group register. Histopatological high and low risk patients were compared with respect to locoregional recurrence rate, recurrence free survival and death. Unpaired t...... found no increase in the occurrence of capsular contracture in our study group in patients who received radiotherapy. CONCLUSION: Immediate breast reconstruction seems to be oncologically safe. Breast reconstruction performed with implants was associated with a higher risk of late complications...

  16. New perspectives on the development of muscle contractures following central motor lesions.

    Science.gov (United States)

    Pingel, J; Bartels, E M; Nielsen, J B

    2017-02-15

    Muscle contractures are common in patients with central motor lesions, but the mechanisms responsible for the development of contractures are still unclear. Increased or decreased neural activation, protracted placement of a joint with the muscle in a short position and muscle atrophy have been suggested to be involved, but none of these mechanisms are sufficient to explain the development of muscle contractures alone. Here we propose that changes in tissue homeostasis in the neuromuscular-tendon-connective tissue complex is at the heart of the development of contractures, and that an integrated physiological understanding of the interaction between neural, mechanical and metabolic factors, as well as genetic and epigenetic factors, is necessary in order to unravel the mechanisms that result in muscle contractures. We hope thereby to contribute to a reconsideration of how and why muscle contractures develop in a way which will open a window towards new insight in this area in the future. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

  17. Surgical Treatment of Dupuytren's Contracture; Results and Complications of Surgery: Our Experience.

    Science.gov (United States)

    Khan, Parwez Sajad; Iqbal, Shabir; Zaroo, Inam; Hayat, Humera

    2010-12-01

    Dupuytren's disease is one of the fibro-proliferative conditions affecting the palmar and digital fascia. This disease has been known to surgeons and treated by them for at least 200 years. Dupuytren's disease is very common in Northern Europe and also in countries inhabited by immigrants from Northern Europe. Dupuytren's contracture is stated to be uncommon in Indian subcontinent and very little has been written about this disease in India. The authors have however come across 30 patients with Dupuytren's contracture and they are the subject of this paper, with special emphasis on its surgical correction and complications of surgical treatment. Patients were categorized into stages I, II and III as per the severity of disease. Regional fasciectomy was performed in 90% of the patients and extensive fasciectomy in 10% of patients. Most of wounds were closed by primary closure with z-plasty. In rest of the patients free skin grafts were used to close the wound, when primary closure was not possible. The patients were followed up regularly for 5 years and the results of surgical treatment were categorized into excellent, good, fair and poor. The results were excellent in 23 patients (76.66%), good in six patients (20%) and fair in one patient (3.33%). Post operative edema and some stiffness was seen in two patients. Wound infection was seen in one patient and haematoma in one patient. The correct surgical technique and meticulous post operative care is needed to achieve higher rates of correction and to limit the complications and recurrence.

  18. Long-term results of peripheral arterial disease rehabilitation

    NARCIS (Netherlands)

    Menard, J.R.; Smith, H.E.; Riebe, D.; Braun, C.M.; Blissmer, B.; Patterson, R.B.

    2004-01-01

    Purpose Although the Peripheral Arterial Disease Rehabilitation Program (PADRx) improves walking ability and quality of life over brief periods of follow-up, the long-term durability of results has not been established. This study examined functional status, walking ability, and quality of life in

  19. Gluteal muscle fibrosis with abduction contracture of the hip.

    Science.gov (United States)

    Al Bayati, Mohammed Ali; Kraidy, Bakir Kadhum

    2016-03-01

    Gluteal muscle fibrosis with hip contracture is a rare condition and causes major disability; literature reports are sparse. The aim of this study is to present, for the first time in Iraq and the region, a case series of gluteal fibrosis and the results of surgical treatment. Seven children--six boys and one girl--diagnosed as having gluteal muscle fibrosis with hip contracture, were investigated and treated by open surgical release of fibrotic bands and physiotherapy. All patients improved dramatically over the subsequent weeks, and were able to sit and squat in the normal position. Gluteal muscle fibrosis with hip contracture is present in Iraq and more awareness is needed for early diagnosis. Surgical treatment provided excellent results. More studies are needed to delineate the aetiology of the condition.

  20. Contractures and muscle disease.

    Science.gov (United States)

    Walters, R Jon

    2016-08-01

    Contractures are one of a handful of signs in muscle disease, besides weakness and its distribution, whose presence can help guide us diagnostically, a welcome star on the horizon. Contractures are associated with several myopathies, some with important cardiac manifestations, and consequently are important to recognise; their presence may also provide us with a potential satisfying 'penny dropping' diagnostic moment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. In Vitro Contracture Test Results and Anaesthetic Management of a Patient with Emery-Dreifuss Muscular Dystrophy for Cardiac Transplantation

    Directory of Open Access Journals (Sweden)

    Frank Schuster

    2012-01-01

    Full Text Available Emery-Dreifuss muscular dystrophy (EDMD is a hereditary neuromuscular disorder characterized by slowly progressive muscle weakness, early contractures, and dilated cardiomyopathy. We reported an uneventful general anaesthesia using total intravenous anaesthesia (TIVA for cardiac transplantation in a 19-year-old woman suffering from EDMD. In vitro contracture test results of two pectoralis major muscle bundles of the patient suggest that exposition to triggering agents does not induce a pathological sarcoplasmic calcium release in the lamin A/C phenotype. However, due to the lack of evidence in the literature, we would recommend TIVA for patients with EDMD if general anaesthesia is required.

  2. Long-term results after fibroid embolization; Langzeitergebnisse nach Myomembolisation

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Huelsbeck, S. [Medizinischer Klinikverbund Flensburg, Akademisches Lehrkrankenhaus des Universitaetsklinikums Schleswig-Holstein, Abt. Diagnostische und interventionelle Radiologie/Neuroradiologie, Ev.-Luth. Diakonissenanstalt zu Flensburg, Flensburg (Germany)

    2008-07-15

    Fibroids (leiomyoma) are the most frequent benign tumors of the uterus during female reproductive age. In the case of clinical symptoms, uterine artery embolization (UAE) is a well established treatment option for symptomatic fibroids, resulting in promising long-term results. In order to estimate long-term success after UAE, reduction of fibroids and uterus volume is less important than complete improvement and disappearance of fibroid-related symptoms. In addition to a high technical success rate and a low perioperative complication rate, UAE results in high short-term and long-term patient satisfaction (>87%) and improvement of symptoms (>81%). Candidates for UAE should be informed about potential reinterventions in terms of repeated UAE (up to 18% of cases) or surgical treatment options. (orig.) [German] Myome sind die haeufigsten gutartigen soliden Tumoren des weiblichen Genitaltrakts im reproduktiven Alter. Bei klinischen Beschwerden stellt die Uterusarterienembolisation (UAE) zur Therapie des symptomatischen Uterus myomatosus einen fest etabliertes Verfahren dar, das mit viel versprechenden Langzeitergebnissen aufwarten kann. Im Vordergrund der Abschaetzung eines lang andauernden Therapieerfolgs nach UAE stehen weniger die Volumenreduktion eines dominanten Myoms bzw. des gesamten Uterus nach der Behandlung, sondern vielmehr die Besserung oder das voellige Verschwinden der von der Patientin initial vor der UAE angegebenen (myombedingten) Beschwerden. Neben einer hohen technischen Erfolgsrate und geringen perioperativen Komplikationsrate fuehrt die fachkundig durchgefuehrte UAE sowohl im Kurz- als auch Langzeitverlauf zu einem hohen Mass an Patientenzufriedenheit (>87%), verbunden mit einer deutlichen Symptombesserung (>81%). Ueber eine Reintervention (in bis zu ca. 18% der Faelle) im Sinne einer erneuten UAE oder einer operativen Massnahme sollten die Patientinnen allerdings im Vorfeld aufgeklaert werden. (orig.)

  3. Myofibroblast Upregulators are Elevated in Joint Capsules in Posttraumatic Contractures

    OpenAIRE

    Hildebrand, Kevin A.; Zhang, Mei; Hart, David A.

    2007-01-01

    We hypothesized specific growth factors are increased in the elbow capsules of patients with post traumatic elbow contractures. A model of surgically induced joint contracture in rabbit knees was developed to study the growth factor expression in joint contractures. This study demonstrates this model mimics the human condition and analyzes how the growth factor levels decrease with time in rabbit knees with contractures. Reverse transcription polymerase chain reaction was used to measure mRNA...

  4. [Diagnosis and treatment of unilateral gluteal muscle contracture].

    Science.gov (United States)

    Chen, Xiaoliang; Tang, Xueyang; Jiang, Xin; Wang, Daoxi; Peng, Mingxing; Liu, Lijun

    2011-05-01

    To investigate the pathogenesis, diagnosis, and treatment of unilateral gluteal muscle contracture. Between January 1990 and September 2009, 41 patients with unilateral gluteal muscle contracture were treated and the clinical data were retrospectively analysed. Among them, 24 were male and 17 were female with an age range from 6 to 29 years (mean, 12 years). Thirty-nine patients had a definite history of repeat intragluteal injection. The locations were the left side in 9 cases and the right side in 32 cases. The main clinical manifestations included lameness and abnormal gait. The medical examination showed pelvic oblique and relative inequality of lower limbs with a mean difference of 2.1 cm (range, 1.2-3.8 cm) in the distance form navel to malleolus medials. The X-ray films of pelvis showed outpouching trochanter of femur and pelvic oblique. The CT scans showed no abnormal finding except pelvic oblique and gluteal muscle contracture. The arc longitudinal incision was made into the posterolateral area nearby the greater trochanter and then lysis of the gluteal muscles was performed, followed by the skin traction of both legs and rehabilitation exercise. All incisions healed by first intention. Forty-one patients were followed up 1-20 years (mean, 5 years), and the signs of gluteal muscle contracture disappeared. After 1 year of operation, 34 patients had equal leg length, 5 patients had mild pelvic oblique, and 2 patients had obvious pelvic oblique. According to LIU Guohui et al. evaluation standard, the results were excellent in 33 cases, good in 6 cases, and poor in 2 cases with an excellent and good rate of 95.12% at 1 year after operation. Unilateral gluteal muscle contracture leads to pelvic oblique and inequality of lower limbs, and it can be cured with the surgical release of the gluteal muscle contracture by the arc longitudinal incision into the posterolateral area nearby the greater trochanter, combined with postoperative skin traction and

  5. Contracture of Slow Striated Muscle during Calcium Deprivation

    Science.gov (United States)

    Irwin, Richard L.; Hein, Manfred M.

    1963-01-01

    When deprived of calcium the slow striated muscle fibers of the frog develop reversible contractures in either hypertonic or isotonic solutions. While calcium deprivation continues because of a flowing calcium-free solution the muscles relax slowly and completely. Restoration of calcium during contracture relaxes the muscle promptly to initial tension. When relaxed during calcium lack the return of calcium does not change tension and the muscle stays relaxed. When contractures are induced by solutions containing small amounts of calcium relaxation does not occur or requires several hours. The rate of tension development depends upon the rate at which calcium moves outward since the contractures develop slower in low concentrations of calcium and are absent or greatly slowed in a stagnant calcium-free solution. Withdrawal of calcium prevents the contractile responses to ACh, KCl, or electrical stimulation through the nerve. Muscles return to their original excitability after calcium is restored. Origin of the contractures is unrelated to nerve activity since they are maximal during transmission failure from calcium lack, occur in denervated muscles, and are not blocked by high concentrations of d-tubocurarine, procaine, or atropine. The experiments also indicate that the contractures do not originate from repetitive activity of muscle membranes. The findings are most simply explained by relating the outward movement of calcium as a link for initiating contraction in slow type striated muscle. PMID:14065284

  6. Static Progressive Orthoses for Elbow Contracture: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Bin Chen

    2017-01-01

    Full Text Available Background. As one of the most common musculoskeletal complications following trauma, elbow contracture is a frequent source of disabled daily activities. Conventional interventions are inadequate to provide favorable outcome. The static progressive orthoses are getting popular in the treatment of this problem. Objective. The purpose of this review was to assess the effectiveness of static progressive orthoses for elbow contracture. Methods. Literatures when written in English published during 1 January 1997 and 31 January 2017 were searched in the following databases: Web of Science, Cochrane Library, PubMed, and EBSCOhost. Articles are quality-assessed by two assessors, each article was summarized in evidence tables, and a narrative synthesis was also performed. Results. Ten clinical trials were included. The study design and outcome measures used varied. Significant immediate improvement in the range of motion was reported by all studies, and those effects were still significant at follow-up. No significant difference was shown between static progressive and dynamic orthoses for elbow contracture in one randomized control trial. Conclusions. Current low-quality evidence suggested that static progressive orthoses provided assistance for elbow contracture through improving range of motion. Further research is recommended using high-quality randomized controlled trials.

  7. 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.

  8. Nils Silfverskiöld (1888-1957) and gastrocnemius contracture.

    Science.gov (United States)

    Singh, Dishan

    2013-06-01

    Nils Silfverskiöld was an orthopaedic surgeon, Swedish aristocrat, bon vivant, Olympic gymnast, left wing intellectual and anti-Nazi who described that the force required to dorsiflex the ankle in spastic equinus contracture decreased with knee flexion in isolated gastrocnemius contracture. He advocated detaching the origins of the gastrocnemii from the femur and reattaching them to the tibia. The Silfverskiöld knee flexion test has now also been adapted to distinguish between isolated gastrocnemius contracture and combined shortening of the gastrocnemius-soleus complex in non-spastic contracture by measuring the range of ankle dorsiflexion with the knee flexed and the knee straight. Copyright © 2012 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  9. [Joint contractures in nursing textbooks].

    Science.gov (United States)

    Bartoszek, G; Meyer, G; Thiesemann, R

    2014-01-01

    The transparency criteria of the German statutory health insurance on joint contracture prevention have led to controversies about the appropriate assessment, prevention and treatment as well as to various actions in nursing practice. However, appropriate nursing assessments and proven treatment options are lacking so far. It is unclear whether textbooks on nursing reflect these uncertainties. Search for textbooks on nursing through internet-based search engines and publisher registers, data extraction by one investigator and control by a second. A total of 35 textbooks with contributions on joint contractures were identified of which 25 included a definition, causes/risk factors are presented in 32 textbooks and assessments are presented in 5 books. Most often positioning into a physiological or functional neutral position and passive moving of limbs are recommended as passive prophylaxis. Recommended therapeutic and preventive options do not differ. None of the textbooks reflect that there is a lack of scientific knowledge on the subject. Textbooks on nursing do not deal with complete and scientific sound information on joint contractures.

  10. Use of preputial skin for coverage of post-burn contractures of fingers in children

    Directory of Open Access Journals (Sweden)

    Mohammed I Zaroo

    2011-01-01

    Full Text Available Objective: Hand burns are common injuries. Children frequently sustain burn injuries, especially to their hands. Contractures are a common sequel of severe burns around joints. The prepuce, or foreskin, has been used as a skin graft for a number of indications. We conducted this study to evaluate the feasibility of utilising the preputial skin for the management of post-burn contractures of fingers in uncircumcised male children. Materials and Methods: Preputial skin was used for the coverage of released contractures of fingers in 12 patients aged 2-6 years. The aetiology of burns was "Kangri" burn in eight patients and scalding in four patients. Six patients had contracture in two fingers, four patients in one finger, and two patients had contractures in three fingers. Results: None of the patients had graft loss, and all the wounds healed within 2 weeks. All patients had complete release of contractures without any recurrence. Hyperpigmentation of the grafts was observed over a period of time, which was well accepted by the parents. Conclusions: Preputial skin can be used successfully for male children with mild-to-moderate contractures of 2-3 fingers for restoration of the hand function, minimal donor site morbidity.

  11. Glenohumeral abduction contracture in children with unresolved neonatal brachial plexus palsy.

    Science.gov (United States)

    Eismann, Emily A; Little, Kevin J; Laor, Tal; Cornwall, Roger

    2015-01-21

    Following neonatal brachial plexus palsy, the Putti sign-obligatory tilt of the scapula with brachiothoracic adduction-suggests the presence of glenohumeral abduction contracture. In the present study, we utilized magnetic resonance imaging (MRI) to quantify this glenohumeral abduction contracture and evaluate its relationship to shoulder joint deformity, muscle atrophy, and function. We retrospectively reviewed MRIs of the thorax and shoulders obtained before and after shoulder rebalancing surgery (internal rotation contracture release and external rotation tendon transfer) for twenty-eight children with unresolved neonatal brachial plexus palsy. Two raters measured the coronal positions of the scapula, thoracic spine, and humeral shaft bilaterally on coronal images, correcting trigonometrically for scapular protraction on axial images. Supraspinatus, deltoid, and latissimus dorsi muscle atrophy was assessed, blinded to other measures. Correlations between glenohumeral abduction contracture and glenoid version, humeral head subluxation, passive external rotation, and Mallet shoulder function before and after surgery were performed. MRI measurements were highly reliable between raters. Glenohumeral abduction contractures were present in twenty-five of twenty-eight patients, averaging 33° (range, 10° to 65°). Among those patients, abductor atrophy was present in twenty-three of twenty-five, with adductor atrophy in twelve of twenty-five. Preoperatively, greater abduction contracture severity correlated with greater Mallet global abduction and hand-to-neck function. Abduction contracture severity did not correlate preoperatively with axial measurements of glenohumeral dysplasia, but greater glenoid retroversion was associated with worse abduction contractures postoperatively. Surgery improved passive external rotation, active abduction, and hand-to-neck function, but did not change the abduction contracture. A majority of patients with persistent shoulder weakness

  12. Long-Term Results of Mitral Valve Repair

    Directory of Open Access Journals (Sweden)

    Francisco Diniz Affonso da Costa

    Full Text Available Abstract Introduction: Current guidelines state that patients with severe mitral regurgitation should be treated in reference centers with a high reparability rate, low mortality rate, and durable results. Objective: To analyze our global experience with the treatment of organic mitral regurgitation from various etiologies operated in a single center. Methods: We evaluated all surgically treated patients with organic mitral regurgitation from 2004-2017. Patients were evaluated clinically and by echocardiography every year. We determined early and late survival rates, valve related events and freedom from recurrent mitral regurgitation and tricuspid regurgitation. Valve failure was defined as any mitral regurgitation ≥ moderate degree or the need for reoperation for any reason. Results: Out of 133 patients with organic mitral regurgitation, 125 (93.9% were submitted to valve repair. Mean age was 57±15 years and 52 patients were males. The most common etiologies were degenerative disease (73 patients and rheumatic disease (34 patients. Early mortality was 2.4% and late survival was 84.3% at 10 years, which are similar to the age- and gender-matched general population. Only two patients developed severe mitral regurgitation, and both were reoperated (95.6% at 10 years. Freedom from mitral valve failure was 84.5% at 10 years, with no difference between degenerative and rheumatic valves. Overall, late ≥ moderate tricuspid regurgitation was present in 34% of the patients, being more common in the rheumatic ones. The use of tricuspid annuloplasty abolished this complication. Conclusion: We have demonstrated that mitral regurgitation due to organic mitral valve disease from various etiologies can be surgically treated with a high repair rate, low early mortality and long-term survival that are comparable to the matched general population. Concomitant treatment of atrial fibrillation and tricuspid valve may be important adjuncts to optimize long-term

  13. Passive movements for the treatment and prevention of contractures.

    Science.gov (United States)

    Prabhu, Rama K R; Swaminathan, Narasimman; Harvey, Lisa A

    2013-12-28

    analysis. Both studies had a low risk of bias. One within-participant study involving 20 participants (40 limbs) measured ankle joint mobility and reported a mean between-group difference of four degrees (95% confidence interval (CI), two to six degrees) favouring the experimental group. Both studies measured spasticity with the Modified Ashworth Scale, but the results were not pooled because of clinical heterogeneity. Neither study reported a clinically or statistically relevant reduction in spasticity with PMs. In one study, the mean difference on a tallied 48-point Modified Ashworth Scale for the upper limbs was one of 48 points (95% CI minus two to four points), and in the other study, the median difference on a six-point Modified Ashworth Scale for the ankle plantar flexor muscles was zero points (95% CI minus one to zero points). In both studies, a negative between-group difference indicated a reduction in spasticity in the experimental group compared with the control group. One study with a total of 102 participants investigated the short-term effects on pain. The mean difference on a zero to 24-point pain scale was -0.4 points in favour of the control group (95% CI -1.4 to 0.6 points). The GRADE level of evidence about the effects of PMs on joint mobility, spasticity and pain is very low. Neither study examined quality of life, activity limitations or participation restrictions or reported any adverse events. It is not clear whether PMs are effective for the treatment and prevention of contractures.

  14. Leg contracture in mice after single and multifractionated 137Cs exposure

    International Nuclear Information System (INIS)

    Masuda, K.; Hunter, N.; Stone, H.B.; Withers, H.R.

    1987-01-01

    This is a report of studies of time-dose relationships for post-irradiation leg contractures in mice. The isoeffect doses for various degrees of contracture, measured 250 days after irradiation, increased with the number of fractions, but not with the overall treatment times, throughout 30 days. The isoeffect curves relating the total doses for given levels of responses to the doses per fraction were steeper for leg contractures than for acute skin reactions. The alpha/beta ratios ranged from 1.4 to 5.0 Gy, depending on the degrees of contracture. They were less than the 7.5 to 50 Gy for acute skin reactions as determined in previous experiments using the same animals and irradiation systems. Thus, the data resembled those from other slowly-responding normal tissues such as the spinal cord, kidney and lung. The leg contracture consisted of dermatogenic, myogenic, and arthrogenic components; after the mice were sacrificed there was residual contracture following removal of the skin and muscle. Inhibition of bone growth accounted for only a small proportion of the contracture. The overall response reflected responses of several tissue types

  15. Leg contracture in mice after single and multifractionated 137Cs exposure

    Energy Technology Data Exchange (ETDEWEB)

    Masuda, K.; Hunter, N.; Stone, H.B.; Withers, H.R.

    1987-08-01

    This is a report of studies of time-dose relationships for post-irradiation leg contractures in mice. The isoeffect doses for various degrees of contracture, measured 250 days after irradiation, increased with the number of fractions, but not with the overall treatment times, throughout 30 days. The isoeffect curves relating the total doses for given levels of responses to the doses per fraction were steeper for leg contractures than for acute skin reactions. The alpha/beta ratios ranged from 1.4 to 5.0 Gy, depending on the degrees of contracture. They were less than the 7.5 to 50 Gy for acute skin reactions as determined in previous experiments using the same animals and irradiation systems. Thus, the data resembled those from other slowly-responding normal tissues such as the spinal cord, kidney and lung. The leg contracture consisted of dermatogenic, myogenic, and arthrogenic components; after the mice were sacrificed there was residual contracture following removal of the skin and muscle. Inhibition of bone growth accounted for only a small proportion of the contracture. The overall response reflected responses of several tissue types.

  16. Post-burn scars and scar contractures

    Directory of Open Access Journals (Sweden)

    Goel Arun

    2010-10-01

    Full Text Available The mortality and morbidity from burns have diminished tremendously over the last six to seven decades. However, these do not truly reflect whether the victim could go back to society as a useful person or not and lead a normal life because of the inevitable post-burn scars, contractures and other deformities which collectively have aesthetic and functional considerations. This article gives an overview of the post-burn scars and scar contractures, especially their prevention, minimisation and principles of management.

  17. Free myocutaneous flap transfer to treat congenital Volkmann's contracture of the forearm.

    Science.gov (United States)

    Rubin, G; Palti, R; Gurevitz, S; Yaffe, B

    2015-07-01

    The purpose of this study is to report our experience with free functional muscle transfer procedures for the late sequelae of the rare condition of congenital Volkmann's ischaemic contracture of the forearm. Four children, with an average age of 9.5 years (range 1.5-17), were treated and were followed for a mean of 6 years (range 1-14). Two patients had dorsal forearm contractures, and two had both flexor and extensor forearm contractures. We carried out free functional muscle transfers to replace the flexor or extensor muscles. The functional result was assessed according to the classification system of Hovius and Ultee. All patients had wrist contractures and skeletal involvement with limb length discrepancy that influenced the outcome. All five transferred muscles survived and improved the function of the hand in three of the four patients. LEVEL OF EVIDENCE 4. © The Author(s) 2014.

  18. Serial casting for elbow flexion contractures in neonatal brachial plexus palsy.

    Science.gov (United States)

    Duijnisveld, B J; Steenbeek, D; Nelissen, R G H H

    2016-09-02

    The objective of this study was to evaluate the effectiveness of serial casting of elbow flexion contractures in neonatal brachial plexus palsy. A prospective consecutive cohort study was performed with a median follow-up of 5 years. Forty-one patients with elbow flexion contractures ≥ 30° were treated with serial casting until the contracture was ≤ 10°, for a maximum of 8 weeks. Range of motion, number of recurrences and patient satisfaction were recorded and analyzed using Wilcoxon signed-rank and Cox regression tests. Passive extension increased from a median of -40° (IQR -50 to -30) to -15° (IQR -10 to -20, p casting had to be prematurely replaced by night splinting due to complaints. Serial casting improved elbow flexion contractures, although recurrences were frequent. The severity of elbow flexion contracture is a predictor of recurrence. We recommend more research on muscle degeneration and determinants involved in elbow flexion contractures to improve treatment strategies and prevent side-effects.

  19. Percutaneous Needle Tenotomy for the Treatment of Muscle and Tendon Contractures in Adults With Brain Damage: Results and Complications.

    Science.gov (United States)

    Coroian, Flavia; Jourdan, Claire; Froger, Jérome; Anquetil, Claire; Choquet, Olivier; Coulet, Bertand; Laffont, Isabelle

    2017-05-01

    To study the results and complications of percutaneous needle tenotomy for superficial retracted tendons in patients with brain damage. Prospective observational study. University hospital. Patients with severe brain damage (N=38; mean age, 60.7y; age range, 24-93y; 21 women) requiring surgical management of contractures and eligible for percutaneous needle tenotomy were enrolled between February 2015 and February 2016. The percutaneous needle tenotomy gesture was performed by a physical medicine and rehabilitation physician trained by an orthopedic surgeon, under local or locoregional anesthesia. Treated tendons varied among patients. All patients were evaluated at 1, 3, and 6 months to assess surgical outcomes (joint range of motion [ROM], pain, and functional improvement) while screening for complications. Improvements in ROM (37/38) and contractures-related pain (12/12) were satisfactory. Functional results were satisfactory (Goal Attainment Scale score ≥0) for most patients (37/38): nursing (n=12), putting shoes on (n=8), getting in bed or sitting on a chair (n=6), verticalization (n=7), transfers and gait (n=8), and grip (n=2). Five patients had complications related to the surgical gesture: cast-related complications (n=2), hand hematoma (n=2), and cutaneous necrosis of the Achilles tendon in a patient with previous obliterative arteriopathy of the lower limbs (n=1). Percutaneous needle tenotomy yields good results in the management of selected superficial muscle and tendon contractures. The complications rate is very low, and this treatment can be an alternative to conventional surgery in frail patients with neurologic diseases. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Contribution of denervated muscle to contractures after neonatal brachial plexus injury: not just muscle fibrosis.

    Science.gov (United States)

    Nikolaou, Sia; Liangjun, Hu; Tuttle, Lori J; Weekley, Holly; Christopher, Wylie; Lieber, Richard L; Cornwall, Roger

    2014-03-01

    We investigated the contribution of muscle fibrosis to elbow flexion contractures in a murine model of neonatal brachial plexus injury (NBPI). Four weeks after NBPI, biceps and brachialis fibrosis were assessed histologically and compared with the timing of contracture development and the relative contribution of each muscle to contractures. Modulus of elasticity and hydroxyproline (collagen) content were measured and correlated with contracture severity. The effect of halofuginone antifibrotic therapy on fibrosis and contractures was investigated. Elbow contractures preceded muscle fibrosis development. The brachialis was less fibrotic than the biceps, yet contributed more to contractures. Modulus and hydroxyproline content increased in both elbow flexors, but neither correlated with contracture severity. Halofuginone reduced biceps fibrosis but did not reduce contracture severity. Contractures after NBPI cannot be explained solely by muscle fibrosis, arguing for investigation of alternate pathophysiologic targets for contracture prevention and treatment. Copyright © 2013 Wiley Periodicals, Inc.

  1. Are mechanically sensitive regulators involved in the function and (patho)physiology of cerebral palsy-related contractures?

    Science.gov (United States)

    Pingel, Jessica; Suhr, Frank

    2017-08-01

    Skeletal muscle tissue is mechanosensitive, as it is able to sense mechanical impacts and to translate these into biochemical signals making the tissue adapt. Among its mechanosensitive nature, skeletal muscle tissue is the largest metabolic organ of the human body. Disturbances in skeletal muscle mechanosensing and metabolism cause and contribute to many diseases, i.e. muscular dystrophies/myopathies, cardiovascular diseases, COPD or diabetes mellitus type 2. A less commonly focused muscle-related disorder is clinically known as muscle contractures that derive from cerebral palsy (CP) conditions in young and adults. Muscle contractures are characterized by gradually increasing passive muscle stiffness resulting in complete fixation of joints. Different mechanisms have been identified in CP-related contractures, i.e. altered calcium handling, altered metabolism or altered titin regulation. The muscle-related extracellular matrix (ECM), specifically collagens, plays a role in CP-related contractures. Herein, we focus on mechanically sensitive complexes, known as costameres (Cstms), and discuss their potential role in CP-related contractures. We extend our discussion to the ECM due to the limited knowledge of its role in CP-related contractures. The aims of this review are (1) to summarize CP-related contracture mechanisms, (2) to raise novel hypotheses on the genesis of contractures with a focus on Cstms, and (3) to stimulate novel approaches to study CP-related contractures.

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

    DEFF Research Database (Denmark)

    Andersen, Michelle Fog; Trolle, Waldemar; Anthonsen, Kristian

    2017-01-01

    The purpose of the present study was to evaluate the long-term results and patient's satisfaction of a new approach using the LigaSure™ 5 mm instrument for treatment of Zenker's diverticulum (ZD) and to compare with other long-term results using traditional treatment modalities. Between December ...... to traditional endoscopic techniques and is now the standard treatment method for ZD in our departments.......The purpose of the present study was to evaluate the long-term results and patient's satisfaction of a new approach using the LigaSure™ 5 mm instrument for treatment of Zenker's diverticulum (ZD) and to compare with other long-term results using traditional treatment modalities. Between December......%) reported no symptoms at all. Our results suggest that endoscopic management of ZD with the LigaSure™ 5 mm instrument is a minimally invasive, fast and safe method with solid long-term outcome with relief of symptoms and patient satisfaction. This new operative instrument was not found inferior...

  3. Bentall operation in 375 patients: long-term results and predictors of death.

    Science.gov (United States)

    Varrica, Alessandro; Satriano, Angela; de Vincentiis, Carlo; Biondi, Andrea; Trimarchi, Santi; Ranucci, Marco; Menicanti, Lorenzo; Frigiola, Alessandro

    2014-01-01

    The Bentall operation is a 40-year-old standardized procedure for treating aortic valve diseases and aneurysms involving the aortic root. The study aim was to analyze the results and predictors of long-term outcome after the Bentall procedure for aortic root diseases. Between January 1990 and December 2007, a total of 375 patients (296 males, 79 females) underwent the Bentall operation at the authors' institution. Bicuspid aortic valve (BAV) was present in 91 patients, and Marfan syndrome in 13. Thirty-six patients were treated as emergencies, and 30 for acute dissection. A concomitant surgical procedure was performed in 78 patients. The operative procedure included both classic Bentall and button techniques. Follow up data were obtained from hospital and office records and from telephone contacts. Kaplan-Meier survival analysis and Cox regression analysis were performed to investigate the predictors of long-term outcome. The overall in-hospital mortality was 4.5%, and after elective operations was 2.3%. A 20-year long-term follow up included 32 late deaths, of which 14 were cardiac-related. Freedom from late all-cause mortality at 5, 10, and 15 years was 97.1%, 81.9%, and 53.9%, respectively. At univariate analysis, long-term mortality was associated with age, diabetes, BAV, NYHA class III/IV, emergency treatment, cardiopulmonary bypass time, and coronary artery bypass grafting. Independent predictors of long-term mortality were age (OR 1.16; CI: 1.08-1.23), emergency surgery (OR 28; CI: 4-192) and BAV (OR 3; CI: 1.3-6.9). The Bentall procedure is a safe and durable operation, with a very good early and long-term results and a low rate of reoperation. In the present series, age, BAV and emergency surgery were important independent predictors of mortality.

  4. Cyclosporine therapy in inflammatory bowel disease: short-term and long-term results.

    Science.gov (United States)

    Gurudu, S R; Griffel, L H; Gialanella, R J; Das, K M

    1999-09-01

    Intravenous cyclosporine therapy followed by oral cyclosporine therapy reduce the need for urgent surgery in steroid-refractory inflammatory bowel disease (IBD). Our objective is to report short- and long-term results of cyclosporine therapy in IBD patients. Thirteen patients with steroid-refractory IBD, seven patients with ulcerative colitis (UC), and six patients with Crohn's disease (CD) were treated with intravenous cyclosporine (4 mg/kg/day) for a mean period of 11.4+/-2.8 days (range, 4-15 days). Subsequently the patients were started on oral cyclosporine (8 mg/kg/day) and followed for a mean of 10.3+/-10 months (range, 1-30 months). Twelve patients responded to intravenous cyclosporine therapy. One patient with UC developed sepsis on the fourth day of intravenous cyclosporine therapy and needed urgent colectomy. Nine of 12 initial responders (6 patients with UC and 3 patients with CD) relapsed during follow-up despite oral cyclosporine and underwent elective surgery. One patient with CD relapsed 3 months after discontinuation of oral cyclosporine. Only two patients with CD are in long-term remission. There were no long-term side effects in any of the 13 treated patients. In conclusion, intravenous cyclosporine was effective in inducing remission or significant improvement in 12 of 13 patients with steroid-refractory IBD. However, with subsequent oral cyclosporine the remission could be maintained only for a short while. Each of the six patients with UC needed colectomy and three of the five patients with CD had intestinal resection within 12 months despite oral cyclosporine therapy.

  5. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol-Surgical Treatment of Neurological Hip Flexion Contracture.

    Science.gov (United States)

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

  6. Long-term results of hysteroscopic myomectomy for abnormal uterine bleeding

    NARCIS (Netherlands)

    Emanuel, M. H.; Wamsteker, K.; Hart, A. A.; Metz, G.; Lammes, F. B.

    1999-01-01

    To analyze the efficacy of transcervical resection of submucous myomas and to identify prognostic factors for long-term results. Two-hundred eighty-five women were treated with transcervical resection of submucous myomas without endometrial ablation. In case of incomplete resection a repeat

  7. 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.

  8. Long-term hearing result using Kurz titanium ossicular implants.

    Science.gov (United States)

    Hess-Erga, Jeanette; Møller, Per; Vassbotn, Flemming Slinning

    2013-05-01

    Titanium implants in middle ear surgery were introduced in the late 90s and are now frequently used in middle ear surgery. However, long-term studies of patient outcome are few and have only been published in subgroups of patients. We report the long-term effect of titanium middle ear implants for ossicular reconstruction in chronic ear disease investigated in a Norwegian tertiary otological referral centre. Retrospective chart reviews were performed for procedures involving 76 titanium implants between 2000 and 2007. All patients who underwent surgery using the Kurz Vario titanium implant were included in the study. Audiological parameters using four frequencies, 0.5, 1, 2, and 3 kHz, according to AAO-HNS guidelines, was assessed pre and postoperatively. Otosurgical procedures, complications, revisions, and extrusion rates were analyzed. The study had no dropouts. The partial ossicular replacement prosthesis (PORP) was used in 44 procedures and the total ossicular replacement prosthesis (TORP) in 32 procedures, respectively. Mean follow-up was 5.2 years (62 months). The ossiculoplasties were performed as staging procedures or in combination with other chronic ear surgery. The same surgeon performed all the procedures. A postoperative air-bone gap of ≤ 20 dB was obtained in 74 % of the patients, 82 % for the Bell (PORP) prosthesis, and 63 % for the Arial (TORP) prosthesis. The extrusion rate was 5 %. We conclude that titanium ossicular implants give stable and excellent long-term hearing results.

  9. Minimally invasive soft tissue release of foot and ankle contracture secondary to stroke.

    Science.gov (United States)

    Boffeli, Troy J; Collier, Rachel C

    2014-01-01

    Lower extremity contracture associated with stroke commonly results in a nonreducible, spastic equinovarus deformity of the foot and ankle. Rigid contracture deformity leads to gait instability, pain, bracing difficulties, and ulcerations. The classic surgical approach for stroke-related contracture of the foot and ankle has been combinations of tendon lengthening, tendon transfer, osteotomy, and joint fusion procedures. Recovery after traditional foot and ankle reconstructive surgery requires a period of non-weightbearing that is not typically practical for these patients. Little focus has been given in published studies on minimally invasive soft tissue release of contracture. We present the case of a 61-year-old female with an equinovarus foot contracture deformity secondary to stroke. The patient underwent Achilles tendon lengthening, posterior tibial tendon Z lengthening, and digital flexor tenotomy of each toe with immediate weightbearing in a walking boot, followed by transition to an ankle-foot orthosis. The surgical principles and technique tips are presented to demonstrate our minimally invasive approach to release of foot and ankle contracture secondary to stroke. The main goal of this approach is to improve foot and ankle alignment for ease of bracing, which, in turn, will improve gait, reduce the risk of falls, decrease pain, and avoid the development of pressure sores. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. New minimally invasive option for the treatment of gluteal muscle contracture.

    Science.gov (United States)

    Ye, Bin; Zhou, Panyu; Xia, Yan; Chen, Youyan; Yu, Jun; Xu, Shuogui

    2012-12-01

    Gluteal muscle contracture is a clinical syndrome that involves contracture and distortion of the gluteal muscles and fascia fibers due to multiple causes. Physical examination demonstrates a characteristic gait due to hip adduction and internal thigh rotation. This study introduces a new minimally invasive method for surgical release of gluteal muscle contracture. Patients with gluteal muscle contracture were assigned to 4 categories: type A, contracture occurred mainly in the iliotibial tract; type B, contracture occurred in the Iliotibial tract and gluteus maximus; type C1, movement of the contraction band was palpable and a snapping sound was audible during squatting; and type C2, movement of the contraction band was not palpable or almost absent and a snapping sound was audible during squatting. This classification method allowed prediction of the anatomic location of these pathological contractures and determination of the type of surgery required. Four critical points were used to define the operative field and served as points to mark a surgical incision smaller than 4 mm. The contracture was easily released in this carefully marked operative field without causing significant neurovascular damage. Over a period of 5 years, between March 2003 and June 2008, the authors treated 1059 patients with this method and achieved excellent outcomes. Most patients were fully active within 12 weeks, with the assistance of an early postoperative rehabilitation program. The most significant complication was a postoperative periarticular hematoma, which occurred in 3 patients within 10 days postoperatively and required surgical ligation of the bleeding vessel. Copyright 2012, SLACK Incorporated.

  11. Influence of different degrees of bilateral emulated contractures at the triceps surae on gait kinematics: The difference between gastrocnemius and soleus.

    Science.gov (United States)

    Attias, M; Bonnefoy-Mazure, A; De Coulon, G; Cheze, L; Armand, S

    2017-10-01

    Ankle plantarflexion contracture results from a permanent shortening of the muscle-tendon complex. It often leads to gait alterations. The objective of this study was to compare the kinematic adaptations of different degrees of contractures and between isolated bilateral gastrocnemius and soleus emulated contractures using an exoskeleton. Eight combinations of contractures were emulated bilaterally on 10 asymptomatic participants using an exoskeleton that was able to emulate different degrees of contracture of gastrocnemius (biarticular muscle) and soleus (monoarticular muscle), corresponding at 0°, 10°, 20°, and 30° ankle plantarflexion contracture (knee-flexed and knee-extended). Range of motion was limited by ropes attached for soleus on heel and below the knee and for gastrocnemius on heel and above the knee. A gait analysis session was performed to evaluate the effect of these different emulated contractures on the Gait Profile Score, walking speed and gait kinematics. Gastrocnemius and soleus contractures influence gait kinematics, with an increase of the Gait Profile Score. Significant differences were found in the kinematics of the ankles, knees and hips. Contractures of soleus cause a more important decrease in the range of motion at the ankle than the same degree of gastrocnemius contractures. Gastrocnemius contractures cause greater knee flexion (during the stance phase) and hip flexion (during all the gait cycle) than the same level of soleus contractures. These results can support the interpretation of the Clinical Gait Analysis data by providing a better understanding of the effect of isolate contracture of soleus and gastrocnemius on gait kinematics. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Long-term results of the corridor operation for atrial fibrillation

    NARCIS (Netherlands)

    van Hemel, N. M.; Defauw, J. J.; Kingma, J. H.; Jaarsma, W.; Vermeulen, F. E.; de Bakker, J. M.; Guiraudon, G. M.

    1994-01-01

    To investigate the long-term results of the corridor operation in the treatment of symptomatic atrial fibrillation refractory to drug treatment. The corridor operation is designed to isolate from the left and right atrium a conduit of atrial tissue connecting the sinus node area with the

  13. Prevalence of scar contractures after burn : A systematic review

    NARCIS (Netherlands)

    Oosterwijk, Anouk M; Mouton, Leonora J; Schouten, Hennie; Disseldorp, Laurien M; van der Schans, Cees P.; Nieuwenhuis, Marianne K

    OBJECTIVE: Burn scar contractures are the pathological outcome of excessive scarring and ongoing scar contraction. Impairment of joint range of motion is a threat to performing activities in daily living. To direct treatment strategies to prevent and/or correct such contractures, insight into the

  14. Capsular contracture and possible implant rupture: is magnetic resonance imaging useful?

    Science.gov (United States)

    Paetau, Alyssa A; McLaughlin, Sarah A; McNeil, Rebecca B; Sternberg, Erez; TerKonda, Sarvam P; Waldorf, James C; Perdikis, Galen

    2010-03-01

    Currently, magnetic resonance imaging is considered the accepted standard to evaluate breast implant integrity. To evaluate its utility in diagnosing ruptured silicone implants in the setting of capsular contracture and to correlate the preoperative assessment of implant integrity with or without magnetic resonance imaging with operative findings, 319 capsulectomies (171 patients with capsular contractures) were retrospectively reviewed. Preoperative magnetic resonance imaging was done on 160 implants, whereas the remaining 159 were evaluated using only physical examination and/or mammography. Postoperative results were analyzed to determine the sensitivity, specificity, and accuracy of preoperative magnetic resonance imaging in comparison with clinical and/or mammography evaluation alone. Although occasionally valuable, overall, preoperative magnetic resonance imaging was no more accurate than clinical evaluation with or without mammography in predicting implant status: magnetic resonance imaging 124 of 160 (78 percent) and clinical 121 of 159 (76 percent; p = 0.77). In the setting of capsular contracture, physical examination with or without mammogram is as accurate as magnetic resonance imaging in determining implant integrity. Although magnetic resonance imaging is a sensitive diagnostic tool, in symptomatic patients with capsular contracture, it cannot be viewed as infallible.

  15. Neuro-musculoskeletal simulation of instrumented contracture and spasticity assessment in children with cerebral palsy.

    Science.gov (United States)

    van der Krogt, Marjolein Margaretha; Bar-On, Lynn; Kindt, Thalia; Desloovere, Kaat; Harlaar, Jaap

    2016-07-16

    Increased resistance in muscles and joints is an important phenomenon in patients with cerebral palsy (CP), and is caused by a combination of neural (e.g. spasticity) and non-neural (e.g. contracture) components. The aim of this study was to simulate instrumented, clinical assessment of the hamstring muscles in CP using a conceptual model of contracture and spasticity, and to determine to what extent contracture can be explained by altered passive muscle stiffness, and spasticity by (purely) velocity-dependent stretch reflex. Instrumented hamstrings spasticity assessment was performed on 11 children with CP and 9 typically developing children. In this test, the knee was passively stretched at slow and fast speed, and knee angle, applied forces and EMG were measured. A dedicated OpenSim model was created with motion and muscles around the knee only. Contracture was modeled by optimizing the passive muscle stiffness parameters of vasti and hamstrings, based on slow stretch data. Spasticity was modeled using a velocity-dependent feedback controller, with threshold values derived from experimental data and gain values optimized for individual subjects. Forward dynamic simulations were performed to predict muscle behavior during slow and fast passive stretches. Both slow and fast stretch data could be successfully simulated by including subject-specific levels of contracture and, for CP fast stretches, spasticity. The RMS errors of predicted knee motion in CP were 1.1 ± 0.9° for slow and 5.9 ± 2.1° for fast stretches. CP hamstrings were found to be stiffer compared with TD, and both hamstrings and vasti were more compliant than the original generic model, except for the CP hamstrings. The purely velocity-dependent spasticity model could predict response during fast passive stretch in terms of predicted knee angle, muscle activity, and fiber length and velocity. Only sustained muscle activity, independent of velocity, was not predicted by our model. The

  16. Free groin flap for recurrent severe contractures of the neck in children

    Science.gov (United States)

    Ghosh, Abhishek; Jayakumar, R.

    2010-01-01

    Context: Severe post burns contracture in children not only leads to functional impairment but also has profound psychological impact on the child. Untreated neck contractures have been shown to inhibit mandibular growth. Skin grafting in children has a higher rate of recurrence and in these cases a thin pliable flap seems to provide a durable solution. Aim: To study the feasibility of using primarily thinned free groin flap in the treatment of recurrent neck contractures in children. Materials and Methods: Five patients, in the age group of 5–10 years, with recurrent neck contractures and operated between 2005 and 2008 were included in this study. The sternomental distance, lateral flexion angle and cervicomental angle were measured preoperatively, postoperatively and during the subsequent follow-up visits. The patients were followed up for a period between 1 and 3 years with a mean of 29 months. Results: All the flaps survived. The cervicomental angle improved significantly to 90–105°, the lateral flexion angle improved to 35–45° and the sternomental distance increased considerably. Conclusions: Recurrent post burns contracture of the neck in children causes not only functional and aesthetic impairment but also psychological problems. A free microthinned groin flap provides a very attractive solution for this problem and should be seen as an effective alternative in recurrent cases. PMID:21321662

  17. Free groin flap for recurrent severe contractures of the neck in children

    Directory of Open Access Journals (Sweden)

    Ghosh Abhishek

    2010-10-01

    Full Text Available Context: Severe post burns contracture in children not only leads to functional impairment but also has profound psychological impact on the child. Untreated neck contractures have been shown to inhibit mandibular growth. Skin grafting in children has a higher rate of recurrence and in these cases a thin pliable flap seems to provide a durable solution. Aim : To study the feasibility of using primarily thinned free groin flap in the treatment of recurrent neck contractures in children. Materials and Methods: Five patients, in the age group of 5-10 years, with recurrent neck contractures and operated between 2005 and 2008 were included in this study. The sternomental distance, lateral flexion angle and cervicomental angle were measured preoperatively, postoperatively and during the subsequent follow-up visits. The patients were followed up for a period between 1 and 3 years with a mean of 29 months. Results: All the flaps survived. The cervicomental angle improved significantly to 90-105°, the lateral flexion angle improved to 35-45° and the sternomental distance increased considerably. Conclusions: Recurrent post burns contracture of the neck in children causes not only functional and aesthetic impairment but also psychological problems. A free micro-thinned groin flap provides a very attractive solution for this problem and should be seen as an effective alternative in recurrent cases.

  18. Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking.

    Science.gov (United States)

    Attias, M; Bonnefoy-Mazure, A; De Coulon, G; Cheze, L; Armand, S

    2016-10-01

    Contracture is a permanent shortening of the muscle-tendon-ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking. An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus). Sixteen combinations of contractures were emulated on the unilateral and bilateral muscles of nine healthy participants. Two sessions of gait analysis were performed at weekly intervals to assess the reliability of the emulated contractures. Discrete variables were extracted from the kinematics to analyse the reliability. The exoskeleton did not affect normal walking when contractures were not emulated. Kinematic reliability varied from poor to excellent depending on the targeted muscle. Reliability was good for the bilateral and unilateral gastrocnemius, soleus, and tibialis posterior as well as the bilateral hamstring and unilateral hip adductors. The exoskeleton can be used to replicate contracture on healthy participants. The exoskeleton will allow us to differentiate primary and compensatory effects of muscle contractures on gait kinematics. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    Directory of Open Access Journals (Sweden)

    Alberto Nicodemo

    2014-01-01

    Full Text Available Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

  20. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    Science.gov (United States)

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible. PMID:24707293

  1. Hypothenar hammer syndrome: long-term results of vascular reconstruction.

    Science.gov (United States)

    Endress, Ryan D; Johnson, Craig H; Bishop, Allen T; Shin, Alexander Y

    2015-04-01

    To evaluate long-term patency rates and related outcomes after vascular reconstruction of hypothenar hammer syndrome and identify patient- or treatment-related factors that may contribute to differences in outcome. We used color flow ultrasound to determine the patency of 18 vein graft reconstructions of the ulnar artery at the wrist in 16 patients. Validated questionnaires evaluated patients' functional disability with the Disabilities of the Arm, Shoulder, and Hand score, pain with the visual analog scale, and cold intolerance with the Cold Intolerance Symptom Severity survey. Patient demographics, clinical data, and surgical factors were analyzed for association with graft failure. Patients were asked to grade the result of treatment on a scale of 0 to 10. Of 18 grafts, 14 (78%) were occluded at a mean of 118 months postoperatively. Patients with patent grafts had significantly less disability related to cold intolerance according to the Cold Intolerance Symptom Severity survey in addition to significantly less pain on the visual analog scale. There was no statistical difference in Disabilities of the Arm, Shoulder, and Hand scores between patients with patent or occluded grafts. Patients graded the result significantly higher in patent reconstructions. We noted a higher incidence of graft occlusion than previously reported at a mean follow-up of 9.8 years, which represents a long-duration follow-up study of surgical treatment of hypothenar hammer syndrome. Despite a high percentage of occlusion, overall, patients remained satisfied with low functional disability and all would recommend surgical reconstruction. This study suggests that improved outcomes may result from patent grafts in the long term. Prognostic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Long-term results of combined ESWL and ERCP treatment of chronic calcific pancreatitis.

    Science.gov (United States)

    Korpela, Taija; Udd, Marianne; Tenca, Andrea; Lindström, Outi; Halttunen, Jorma; Myrskysalo, Sanna; Mikkola, Arto; Kylänpää, Leena

    2016-07-01

    Extracorporeal shock wave lithotripsy (ESWL) combined with endotherapy (ET) is the standard treatment for pancreatic duct stones (PDS) in chronic pancreatitis (CP). Our aim was to report the short- and long-term results of ESWL and ET. Consecutively treated 83 patients with symptomatic PDS using ESWL and ET. Success was defined (i) technically: PDS fragmentation and clearance obtained and (ii) clinically: improvement/resolution of pain. To get information on quality of life, we conducted a phone survey whereby we contacted 64 (89%) patients. The long-term results are presented in those patients with ≥2 years follow-up. Treated PDS with median size of 10 (5-25) mm were located in the head, body, or the tail of the pancreas in 78, 4, and 1 patients, respectively. The primary results were that technical success was achieved in 69 patients (83%) and clinical success in 66 patients (80%). Fourteen patients had technical failure, but eight of them became free of pain. Thus, clinical success can be considered to have been achieved in 74 of 83 patients (89%). In patients with persistent pseudocyst (PC) at the time of ESWL (n = 19), the PC disappeared in a year in 14 patients (74%). The long-term results were obtained from 61 (73%) ESWL- and ET-treated patients. The median follow-up for them was 53 months (range: 24-124) and 57 patients (93%) became pain-free or had less pain. For patients with CP and PDS ESWL combined with ET is an effective and safe treatment giving favorable long-term results.

  3. Cyclooxygenase-2 inhibitor celecoxib attenuates joint contracture following immobilization in rat knees.

    Science.gov (United States)

    Ozawa, Junya; Kaneguchi, Akinori; Tanaka, Ryo; Kito, Nobuhiro; Moriyama, Hideki

    2016-10-24

    The aim of this study is to clarify the following two points: First, whether a cyclooxygenase-2 mediated pathway is involved in the formation of immobilization-induced joint contracture and, second, the effectiveness of oral administration of non-steroidal anti-inflammatory drug celecoxib (CBX) for the prevention of myogenic and arthrogenic contracture following immobilization in a rat model. Thirty male rats were randomly divided into three groups: immobilization (Im), Im + CBX, and control (n = 10 each). External fixation immobilized the right knee joint of Im and Im + CBX groups in flexion for 3 weeks. 50 mg/kg of CBX was administrated daily to the Im + CBX group during this period. The passive range of motion (ROM) of knee joints was measured before and after transection of knee flexor muscles and myogenic and arthrogenic ROM restrictions were calculated. The semitendinosus muscles and knee joints were investigated histologically to elucidate factors responsible for contracture. Myogenic ROM restrictions were exhibited both in Im and Im + CBX groups (44 ± 5 and 36 ± 8 °, respectively), but restrictions significantly decreased in the Im + CBX group compared to the Im group. Significant reductions of the muscle length ratios (Rt/Lt) and sarcomere number ratios (Rt/Lt) in knee flexor semitendinosus muscle, which are responsible for myogenic contracture, were also seen both in Im group (92 ± 5 and 92 ± 4 %, respectively) and Im + CBX group (97 ± 3 and 97 ± 3 %, respectively), but were inhibited by CBX administration (P muscle shortening following immobilization. These results imply that inflammation and nociception are involved in myogenic contracture formation independently of joint immobilization, and that CBX is effective in preventing joint contracture following immobilization in rats.

  4. Radiosurgery of craniopharyngiomas. Results of long-term follow-up

    International Nuclear Information System (INIS)

    Kida, Yoshihisa; Hasegawa, Toshinori; Yoshimoto, Masayuki; Koike, Johzi; Kobayashi, Tatsuya

    2007-01-01

    Long-term follow-up results of craniopharyngiomas after radiosurgery are reported. Among 125 cases of craniopharyngioma, long-term follow-up more than 6 months is obtained in 108 cases. Majority of the cases have had surgical excision before radiosurgery. The tumors, 19 mm in mean diameter were treated with the mean maximum dose of 22.1 Gy and with the marginal dose of 11.6 Gy. The final radiological outcomes during 63 months of mean follow-up showed 9 complete responses (CRs), 61 partial responses (PRs), 1 minor response (MR), 19 no changes (NCs) and 18 PGs, indicating the response rate of 65% and the control rate of 83% respectively. Neurological and endocrinological signs were improved in 18%, unchanged in 53% and worsened in 15% of cases, meanwhile 8% of the patients were dead. Small and solid tumors were the best indication for radiosurgery due to excellent tumor control as well as no adverse effects. They may have a good chance for complete remission. In conclusion a sufficient tumor resection with microsurgery is required and subsequent radiosurgery is most adequate for treating craniopharyngiomas. (author)

  5. Z-plasty for severe gluteal muscle contracture in children.

    Science.gov (United States)

    Zha, Kun; Liu, GuoHui; Yang, Shuhua; Cao, Faqi

    2016-12-01

    To review the records of 363 patients with severe gluteal muscle contracture to determine its mechanism, underlying pathology, and treatment outcome. Records of 136 males and 227 females aged 5 to 18 (mean, 12.2) years who underwent Z-plasty for bilateral (n=347) or unilateral (n=16) severe gluteal muscle contracture were reviewed. Severe gluteal muscle contracture was classified as typical (n=52) or special (n=311). The typical type is associated with symptoms of positive out-toe gait, Ober sign, back-extending test, cross-leg test, squatting with knee side-by-side test, and hip dysfunction. It is further subdivided into mild (n=0), moderate (n=40), or severe (n=12). The special type is associated with additional symptoms of pelvic tilt and leg length discrepancy (4 cm in 48 hips). 311 hips had pelvic tilt and 47 hips had lumbar compensatory scoliosis. Treatment outcome was assessed at 6 months. Hip functional score was assessed at the final follow-up. The mean hospitalisation period was 11 days. After a mean follow-up of 1.5 years, the mean hip functional score improved from 8.03 to 11.69; improvement was higher in children (age 5-13 years) than in adolescents (age 14-18 years) [3.7 vs. 2.9, p4 cm, and intra-operatively the contracture band severely affected the joint capsule. The third patient did not comply with postoperative exercises. Surgical treatment for severe gluteal muscle contracture achieved good outcome.

  6. Long-term results of surgically-assisted maxillary protraction.

    Science.gov (United States)

    Nevzatoğlu, Sirin; Küçükkeleş, Nazan

    2014-05-01

    The long-term treatment results of surgically-assisted facemask therapy were assessed by a comparison of the immediate protraction effects with those seen at five years review. Nine patients treated with a corticotomy-assisted maxillary protraction protocol were recalled five years following protraction. Cephalometric films taken before treatment (T0), immediately after maxillary protraction (T1) and five years after treatment (T2) were compared. The short-term results of surgically-assisted facemask therapy showed significant skeletal and soft tissue changes. After five years, the profile and dental relationships were well maintained and a cephalometric analysis revealed a stable vertical increase but only partially maintained soft tissue changes with loss of sagittal advancement. There was significant upper incisor proclination providing dental camouflage. Patients who are treated with corticotomy-assisted maxillary advancement should be very carefully selected. Assessment criteria include a low mandibular plane angle Class III patients who have severe maxillary retrognathism unable to be treated by conventional orthopaedic correction alone; patients who have almost completed growth and missed the chance of earlier orthopaedic correction, as well as patients who are not willing to accept bimaxillary orthognathic surgery, may be successfully treated.

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

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Takuya, E-mail: okabone@gmail.com; Yamaguchi, Masato, E-mail: masato03310402@yahoo.co.jp [Kobe University Hospital, Department of Radiology (Japan); Muradi, Akhmadu, E-mail: muradiakhmadu@gmail.com; Nomura, Yoshikatsu, E-mail: y_katsu1027@yahoo.co.jp [Kobe University Hospital, Center for Endovascular Therapy (Japan); Uotani, Kensuke, E-mail: uotani@tenriyorozu.jp [Tenri Hospital, Department of Radiology (Japan); Idoguchi, Koji, E-mail: idoguchi@ares.eonet.ne.jp [Kobe University Hospital, Center for Endovascular Therapy (Japan); Miyamoto, Naokazu, E-mail: naoka_zu@yahoo.co.jp; Kawasaki, Ryota, E-mail: kawaryo1999@yahoo.co.jp [Hyogo Brain and Heart Center at Himeji, Department of Radiology (Japan); Taniguchi, Takanori, E-mail: tan9523929@yahoo.co.jp [Tenri Hospital, Department of Radiology (Japan); Okita, Yutaka, E-mail: yokita@med.kobe-u.ac.jp [Kobe University Hospital, Department of Cardiovascular Surgery (Japan); Sugimoto, Koji, E-mail: kojirad@med.kobe-u.ac.jp [Kobe University Hospital, Department of Radiology (Japan)

    2013-08-01

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

  8. Finger island flaps for treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints

    Directory of Open Access Journals (Sweden)

    T. S. Antonova

    2016-12-01

    Full Text Available Soft tissue defect will form after operative treatment of the dermato-desmogenic flexion contractures of fingers interphalangeal joints of the 2–3 grades after excision of the scar. Using the island flaps (Littler at the central vascular pedicle is one of the classical methods of plastic closure of such defects. Goal. To study the effectiveness of the surgical treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints of the fingers by using finger island flaps at the central vascular or neuro-vascular pedicle. Materials and methods. 14 operations were carried out on 13 patients for removing dermato-desmogenic flexion contractures of proximal interphalangeal (PIP joints of triphalangeal fingers over a 2-year period (2013–2015. The group included patients with a flexion contracture of the 2–3 grades PIP joints of triphalangeal fingers. Operations were performed on average 5 months after the injury (from 1.5 up to 16 months. Finger island flap in all cases was taken from adjacent finger by using the blood supply of their common finger artery. In all cases the island flap on the central pedicel was used, in 9 cases digital nerve was included in the pedicle (Littler. Closure of donor wound was made with free-skin grafts. Permanent splinting of the hand with extension of the interphalangeal joints and moderate flexion of the metacarpophalangeal joints were performed during 7–8 days after surgery, then exercise therapy was prescribed. Results. The results were estimated 6 and 12 months after surgery. All the results were regarded as excellent. In 5 cases of using the flap on a vascular pedicle flap hypoesthesia was detected, that has not led to dysfunction of the hand. Contracture recurrence during follow-up was not observed. Conclusions. Using the surgery for treatment of dermato-desmogenic flexion contractures of proximal interphalangeal joints of the fingers with the island flaps at the central vascular or neuro

  9. Factors associated with upper extremity contractures after cervical spinal cord injury: A pilot study.

    Science.gov (United States)

    Hardwick, Dustin; Bryden, Anne; Kubec, Gina; Kilgore, Kevin

    2018-05-01

    To examine the prevalence of joint contractures in the upper limb and association with voluntary strength, innervation status, functional status, and demographics in a convenience sample of individuals with cervical spinal cord injury to inform future prospective studies. Cross-sectional convenience sampled pilot study. Department of Veterans Affairs Research Laboratory. Thirty-eight participants with cervical level spinal cord injury. Not applicable. Contractures were measured with goniometric passive range of motion. Every joint in the upper extremity was evaluated bilaterally. Muscle strength was measured with manual muscle testing. Innervation status was determined clinically with surface electrical stimulation. Functional independence was measured with the Spinal Cord Independence Measure III (SCIM-III). Every participant tested had multiple joints with contractures and, on average, participants were unable to achieve the normative values of passive movement in 52% of the joints tested. Contractures were most common in the shoulder and hand. There was a weak negative relationship between percentage of contractures and time post-injury and a moderate positive relationship between percentage of contractures and age. There was a strong negative correlation between SCIM-III score and percentage of contractures. Joint contractures were noted in over half of the joints tested. These joint contractures were associated with decreased functional ability as measured by the SCIM-III. This highlights the need the need for detailed evaluation of the arm and hand early after injury as well as continued monitoring of joint characteristics throughout the life course of the individual with tetraplegia.

  10. Perineal burn contractures: An experience in tertiary hospital of a Himalayan state

    Directory of Open Access Journals (Sweden)

    Thakur Jagdeep

    2008-01-01

    Full Text Available Perineal burn contracture is a rare burn sequel. We conducted a retrospective analysis of cases with perineal burn contractures managed in a tertiary care centre of a Himalayan state. We found that all cases sustained burn injury from burning firewood and the time of presentation was two to six years after the burn injury. We analyzed our treatment method and have classified these contractures into two types.

  11. Degree of Contracture Related to Residual Muscle Shoulder Strength in Children with Obstetric Brachial Plexus Lesions.

    Science.gov (United States)

    van Gelein Vitringa, Valerie M; van Noort, Arthur; Ritt, Marco J P F; van Royen, Barend J; van der Sluijs, Johannes A

    2015-12-01

     Little is known about the relation between residual muscle strength and joint contracture formation in neuromuscular disorders. This study aimed to investigate the relation between residual muscle strength and shoulder joint contractures in children with sequelae of obstetric brachial plexus lesion (OBPL). In OBPL a shoulder joint contracture is a frequent finding. We hypothesize that residual internal and external rotator strength and their balance are related to the extent of shoulder joint contracture.  Clinical assessment was performed in 34 children (mean 10.0 years) with unilateral OBPL and Narakas classes I-III. External and internal rotation strengths were measured with the shoulder in neutral position using a handheld dynamometer. Strength on the affected side was given as percentage of the normal side. Contracture was assessed by passive internal and external rotations in degrees (in 0° abduction). Mallet classification was used for active shoulder function.  External and internal rotation strengths on the affected side were approximately 50% of the normal side and on average both equally affected: 56% (SD 18%) respectively 51% (SD 27%); r  = 0.600, p  = 0.000. Residual strengths were not related to passive internal or external rotation ( p  > 0.200). Internal rotation strength ( r  =  - 0.425, p muscle strength influence contracture formation cannot be confirmed in this study. Our results are of interest for the understanding of contracture formation in OBPL.

  12. Genetics Home Reference: Dupuytren contracture

    Science.gov (United States)

    ... contract. The increased number of myofibroblasts in this disorder cause abnormal contraction of the fascia and produce excess amounts ... protein called type III collagen. The combination of abnormal contraction and excess type III ... risk factors for developing Dupuytren contracture may ...

  13. Concomitant Contracture of the Knee and Ankle Joint After Gastrocnemius Muscle Rupture: A Case Report.

    Science.gov (United States)

    Ryu, Dong Jin; Kim, Joon Mee; Kim, Bom Soo

    Injury of the medial head of the gastrocnemius, also called "tennis leg," is known to heal uneventfully in most cases with compression and immobilization therapy. Failure to heal or long-term complications, including ongoing pain and pes equinus, have been documented in only a limited number of case reports. To the best of our knowledge, a severe concomitant contracture of the knee and ankle joint as a consequence of a maltreated gastrocnemius muscle rupture has not been previously reported in English-language reports. The purpose of the present study was to report a serious complication of neglected tennis leg with a review of the published data. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Injection-induced gluteus muscle contractures: diagnosis with the "reverse Ober test" and surgical management.

    Science.gov (United States)

    Scully, William F; White, Klane K; Song, Kit M; Mosca, Vincent S

    2015-03-01

    Adoption rates are increasing in the United States and other developed countries. A large proportion of adopted children have been found to have unsuspected medical diagnoses, including orthopedic problems. One condition, termed injection-induced gluteus maximus contracture, has been previously described in several case series and can be difficult to diagnose if unfamiliar with this condition. By reviewing the etiology and pathoanatomy of this problem, as well as the typical examination findings, including the near-pathognomonic-positive "reverse Ober test," treating providers will be better prepared to recognize and properly treat this condition. This is a retrospective review of 4 patients treated at our institution for injection-induced gluteus maximus contracture. Patient history, physical examination findings, and treatment outcomes were recorded. All had undergone surgical treatment through a longitudinal incision along the posterior margin of the iliotibial band, with division of thickened, contracted gluteus tissue down to the ischial tuberosity. All 4 of the patients were adopted from orphanages in developing countries. Chief complaints of the patients varied, but physical examination findings were very consistent. Three of the 4 patients had undergone rotational osteotomies for presumed femoral retroversion before their diagnosis and treatment for injection-induced gluteus maximus contracture. All patients had concave, atrophic buttock contours and numerous punctate buttock scars. All walked with an out-toed gait and had marked apparent femoral retroversion. Each patient was found to have full hip adduction when the hip was extended but a hip abduction contracture when the hip was flexed. This finding of increasing abduction as an extended/adducted hip is flexed to 90 degrees is described as a positive "reverse Ober test." After surgical treatment, all hips could adduct to neutral from full extension to full flexion. Although common in some countries

  15. Radiotherapy in early stage dupuytren's contracture; Die Radiotherapie des Morbus Dupuytren im Fruehstadium. Langzeitresultate nach einer medianen Nachbeobachtungszeit von 10 Jahren

    Energy Technology Data Exchange (ETDEWEB)

    Adamietz, B.; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Keilholz, L. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Praxis fuer Strahlentherapie, Klinikum Fuerth (Germany); Gruenert, J. [Abt. fuer Plastische und Handchirurgie der Chirurgischen Universitaetsklinik Erlangen-Nuernberg, Erlangen (Germany)

    2001-11-01

    Purpose: In early stage Dupuytren's contracture radiotherapy was applied to prevent disease progression. Long-term results and late toxicity of this treatment were evaluated in a retrospective analysis. Patients and Methods: Between 1982 and 1994, 99 patients (176 hands) received orthovoltage radiotherapy, which consisted of two courses with 5 x 3 Gy (total dose: 30 Gy, daily fractionated; 120 kV, 4 mm Al), separated by a 6 to 8-week pause. The Dupuytren's contracture was staged according to the classification of Tubiana et al. The long-term outcome was analyzed at last follow-up between July and November 1999. The median follow-up was 10 years (range 7-18 years). Late toxicity was assessed using the LENT-SOMA criteria. Results: In Stage N 84% and Stage N/I 67% of cases remained stable. 65% of the cases in Stage I and 83% in Stage II showed progressive nodules and cords. In case of progression we saw no complications after a second radiotherapy or salvage operation. Conclusion: Radiotherapy effectively prevents disease progression for early stage Dupuytren's contracture (Stage N, N/I). Moreover, in case of disease progression despite radiotherapy salvage surgery is still feasible. (orig.) [German] Hintergrund: Im Fruehstadium des Morbus Dupuytren wird die externe Radiotherapie mit dem Ziel eingesetzt, den progressiven Verlauf der Erkrankung zu verhindern. Eine aktuelle Langzeitverlaufskontrolle soll die Ergebnisse und Nebenwirkungen der Radiotherapie darstellen. Patienten und Methode: Wir untersuchten 99 Patienten (176 Haende), welche sich von 1982-1994 einer Radiotherapie an unserer Klinik unterzogen. Jeder Patient erhielt zwei Serien einer Radiotherapie mit jeweils 5 x 3 Gy (Gesamtdosis 30 Gy, 120 kV, 4 mm Al, Bestrahlungspause von 6-8 Wochen nach 15 Gy). Die Beugekontraktur wurde nach Tubiana et al. eingeteilt. Von Juli bis November 1999 erfolgte nach einer medianen Nachbeobachtungszeit von 10 Jahren (7-18 Jahre) eine Kontrolluntersuchung. Die

  16. Prevention of Cutaneous Tissue Contracture During Removal of Craniofacial Implant Superstructures for CT and MRI Studies

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    Maureen Sullivan

    2010-04-01

    Full Text Available Objectives: Head and neck cancer patients who have lost facial parts following surgical intervention frequently require craniofacial implant retained facial prostheses for restoration. Many craniofacial implant patients require computed tomography and magnetic resonance imaging scans as part of their long-term follow-up care. Consequently removal of implant superstructures and peri-abutment tissue management is required for those studies. The purpose of the present paper was to describe a method for eliminating cranial imaging artifacts in patients with craniofacial implants.Material and Methods: Three patients wearing extraoral implant retained facial prostheses needing either computed tomography or magnetic resonance imaging studies were discussed. Peri-implant soft tissues contracture after removal of percutaneous craniofacial implant abutments during computed tomography and magnetic resonance imaging studies was prevented using a method proposed by authors. The procedure involves temporary removal of the supra-implant components prior to imaging and filling of the tissue openings with polyvinyl siloxane dental impression material.Results: Immediately after filling of the tissue openings with polyvinyl siloxane dental impression material patients were sent for the imaging studies, and were asked to return for removal of the silicone plugs and reconnection of all superstructure hardware after imaging procedures were complete. The silicone plugs were easily removed with a dental explorer. The percutaneous abutments were immediately replaced and screwed into the implants which were at the bone level.Conclusions: Presented herein method eliminates the source of artifacts and prevents contracture of percutaneous tissues upon removal of the implant abutments during imaging.

  17. Angioleiomyoma: A Rare Cause of Fixed Flexion Contracture of the Elbow

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    Asterios Dramis

    2006-01-01

    Full Text Available We describe an unusual case of a patient presented with a painless fixed flexion contracture of the elbow due to an angioleiomyoma. This benign smooth muscle tumour should be considered in the differential diagnosis of flexion contractures of the elbow.

  18. Digital flexor musculotendinous contracture in two Devon Rex cats.

    Science.gov (United States)

    Thom, Leonie K; Pool, Roy R; Malik, Richard

    2017-03-01

    Clinical summary: A 13-year-old, spayed Devon Rex with unilateral digital flexor musculotendinous contracture of the forelimb was treated by surgical tenotomy. The condition improved transiently, but recurred rapidly and became bilateral. Histopathologic analysis of necropsy tissues resulted in a morphologic diagnosis of fibromyositis of the antebrachial muscles causing contracture and flexural deformity of the carpi and phalanges of both thoracic limbs. A search for similar cases yielded the clinical notes of a second cat, a 10-year-old, spayed Devon Rex, also with bilateral disease. This second case responded well to surgical tenotomy but tissue biopsies were not obtained to permit microscopic assessment of the underlying pathologic process. Relevance and novel information: Acquired and permanent contracture of the digital flexor muscles and/or tendons of the forelimbs is a rare and poorly described condition of cats. The very limited number of documented cases describing disease affecting one or more digits (but not the carpus) infers a causal link with onychectomy, but reported histopathologic changes have been limited to the tendons. The two cases described in this report suffered contracture of the carpus and all digits bilaterally, one without previous onychectomy and the other 9 years after onychectomy. There were novel histopathologic findings in the muscles of the one case for which biopsy material was available. Information gained from these two cases provides a new perspective for the investigation and treatment of future cases. Specifically, consideration should be given to an underlying immune-mediated myopathic process and a possible genetic predisposition in the Devon Rex breed. Currently, the poorly understood etiopathogenesis hinders our ability to definitively recommend treatment options, which might include corticosteroids and other forms of immunosuppressive therapy.

  19. Is ankle contracture after stroke due to abnormal intermuscular force transmission?

    Science.gov (United States)

    Diong, Joanna; Herbert, Robert D

    2015-02-01

    Contracture after stroke could be due to abnormal mechanical interactions between muscles. This study examined if ankle plantarflexor muscle contracture after stroke is due to abnormal force transmission between the gastrocnemius and soleus muscles. Muscle fascicle lengths were measured from ultrasound images of soleus muscles in five subjects with stroke and ankle contracture and six able-bodied subjects. Changes in soleus fascicle length or pennation during passive knee extension at fixed ankle angle were assumed to indicate intermuscular force transmission. Changes in soleus fascicle length or pennation were adjusted for changes in ankle motion. Subjects with stroke had significant ankle contracture. After adjustment for ankle motion, 9 of 11 subjects demonstrated small changes in soleus fascicle length with knee extension, suggestive of intermuscular force transmission. However, the small changes in fascicle length may have been artifacts caused by movement of the ultrasound transducers. There were no systematic differences in change in fascicle length (median between-group difference adjusting for ankle motion = -0.01, 95% CI -0.26-0.08 mm/degree of knee extension) or pennation (-0.05, 95% CI -0.15-0.07 degree/ degree of knee extension). This suggests ankle contractures after stroke were not due to abnormal (systematically increased or decreased) intermuscular force transmission between the gastrocnemius and soleus.

  20. Audit of long-term and short-term liabilities

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    Korinko M.D.

    2017-03-01

    Full Text Available The article determines the importance of long-term and short-term liabilities for the management of financial and material resources of an enterprise. It reviews the aim, objects and information generators for realization of audit of short-term and long-term obligations. The organizing and methodical providing of audit of long-term and short-term liabilities of an enterprise are generalized. The authors distinguish the stages of realization of audit of long-term and short-term liabilities, the aim of audit on each of the presented stages, and recommend methodical techniques. It is fixed that it is necessary to conduct the estimation of the systems of internal control and record-keeping of an enterprise by implementation of public accountant procedures for determination of volume and maintenance of selection realization. After estimating the indicated systems, a public accountant determines the methodology for realization of public accountant verification of long-term and short-term liabilities. The analytical procedures that public accountants are expedient to use for realization of audit of short-term and long-term obligations are determined. The authors suggest the classification of the educed defects on the results of the conducted public accountant verification of short-term and long-term obligations.

  1. Are mechanically sensitive regulators involved in the function and (patho)physiology of cerebral palsy-related contractures?

    DEFF Research Database (Denmark)

    Pingel, Jessica; Suhr, Frank

    2017-01-01

    mechanosensing and metabolism cause and contribute to many diseases, i.e. muscular dystrophies/myopathies, cardiovascular diseases, COPD or diabetes mellitus type 2. A less commonly focused muscle-related disorder is clinically known as muscle contractures that derive from cerebral palsy (CP) conditions in young...... role in CP-related contractures. The aims of this review are (1) to summarize CP-related contracture mechanisms, (2) to raise novel hypotheses on the genesis of contractures with a focus on Cstms, and (3) to stimulate novel approaches to study CP-related contractures....

  2. [Etiological analysis and significance of anterior knee pain induced by gluteal muscles contracture].

    Science.gov (United States)

    Zhao, Gang; Liu, Yu-jie; Wang, Jun-liang; Qi, Wei; Qu, Feng; Yuan, Bang-tuo; Wang, Jiang-tao; Shen, Xue-zhen; Liu, Yang; Zhu, Juan-li

    2014-12-01

    To explore causes of gluteal muscle contracture induced anterior knee pain and curative effect of arthroscopic release. From March 2002 to August 2013,36 patients with gluteal muscle contracture induced anterior knee pain were treated, including 15 males, 21 females, aged from 9 to 40 years old with an average (18.7±7.2) years old; the courses of diseases ranged from 4 to 30 years. The clinical manifestations involved limited to symmelia, positive Ober sign, buttocks touch contracture belts, knee and patella slide to lateral when doing squat activities. All patients were performed gluteal muscle contracture release under arthroscopic. Postoperative complications were observed, Kujala scoring before and after operation was used for compare curative effect. All patients were followed up with an average of 29 months. The incision were healed well, and no complications were occurred. Postoperative Kujala score were improved more than preoperative. Gluteal muscle contracture release could alleviate hypertension of lateral patella, and palys an important role in preventing patellofemoral arthritis.

  3. [Advances in the research of prevention and treatment of postburn contractures of hand].

    Science.gov (United States)

    Wang, K A; Wu, G S; Sun, Y; Xia, Z F

    2017-01-20

    Scar contracture deformity, which can lead to dysfunction of hand and low quality of life, is one of the common complication after hand burns. The prevention measures of scar contracture after hand burns include large skin grafting, prevention of infection, insistence on wearing pressure gloves, use of silicone sheets, wearing orthosis, accepting proper physical therapy, and early functional exercise. The primary treatments of postburn contractures of the hand are surgery, drugs, laser treatment, and rehabilitation therapy. Excision of scars, release of muscle, joints or bones, and soft tissue transplantation are the core of surgery. Laser treatment has a bright future but still needs to be further studied. Additionally, some novel treatments such as molecular targeted therapy, cell therapy, fat injection, and botulinum toxin injection will play important roles in prevention and treatment of postburn contractures in the future. The purpose of this article is to review the literature concerning postburn contractures of the hand, and summarize the present situation of prevention and treatment of such disease comprehensively.

  4. Impaired growth of denervated muscle contributes to contracture formation following neonatal brachial plexus injury.

    Science.gov (United States)

    Nikolaou, Sia; Peterson, Elizabeth; Kim, Annie; Wylie, Christopher; Cornwall, Roger

    2011-03-02

    The etiology of shoulder and elbow contractures following neonatal brachial plexus injury is incompletely understood. With use of a mouse model, the current study tests the novel hypothesis that reduced growth of denervated muscle contributes to contractures following neonatal brachial plexus injury. Unilateral brachial plexus injuries were created in neonatal mice by supraclavicular C5-C6 nerve root excision. Shoulder and elbow range of motion was measured four weeks after injury. Fibrosis, cross-sectional area, and functional length of the biceps, brachialis, and subscapularis muscles were measured over four weeks following injury. Muscle satellite cells were cultured from denervated and control biceps muscles to assess myogenic capability. In a comparison group, shoulder motion and subscapularis length were assessed following surgical excision of external rotator muscles. Shoulder internal rotation and elbow flexion contractures developed on the involved side within four weeks following brachial plexus injury. Excision of the biceps and brachialis muscles relieved the elbow flexion contractures. The biceps muscles were histologically fibrotic, whereas fatty infiltration predominated in the brachialis and rotator cuff muscles. The biceps and brachialis muscles displayed reduced cross-sectional and longitudinal growth compared with the contralateral muscles. The upper subscapularis muscle similarly displayed reduced longitudinal growth, with the subscapularis shortening correlating with internal rotation contracture. However, excision of the external rotators without brachial plexus injury caused no contractures or subscapularis shortening. Myogenically capable satellite cells were present in denervated biceps muscles despite impaired muscle growth in vivo. Injury of the upper trunk of the brachial plexus leads to impaired growth of the biceps and brachialis muscles, which are responsible for elbow flexion contractures, and impaired growth of the subscapularis

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

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    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. Reduced satellite cell population may lead to contractures in children with cerebral palsy.

    Science.gov (United States)

    Smith, Lucas R; Chambers, Henry G; Lieber, Richard L

    2013-03-01

    Satellite cells are the stem cells residing in muscle responsible for skeletal muscle growth and repair. Skeletal muscle in cerebral palsy (CP) has impaired longitudinal growth that results in muscle contractures. We hypothesized that the satellite cell population would be reduced in contractured muscle. We compared the satellite cell populations in hamstring muscles from participants with CP contracture (n=8; six males, two females; age range 6-15y; Gross Motor Function Classification System [GMFCS] levels II-V; 4 with hemiplegia, 4 with diplegia) and from typically developing participants (n=8; six males, two females, age range 15-18y). Muscle biopsies were extracted from the gracilis and semitendinosus muscles and mononuclear cells were isolated. Cell surface markers were stained with fluorescently conjugated antibodies to label satellite cells (neural cell adhesion molecule) and inflammatory and endothelial cells (CD34 and CD4 respectively). Cells were analyzed using flow cytometry to determine cell populations. After gating for intact cells a mean of 12.8% (SD 2.8%) were determined to be satellite cells in typically developing children, but only 5.3% (SD 2.3%; p0.05) suggesting the isolation procedure was valid. A reduced satellite cell population may account for the decreased longitudinal growth of muscles in CP that develop into fixed contractures or the decreased ability to strengthen muscle in CP. This suggests a unique musculoskeletal disease mechanism and provides a potential therapeutic target for debilitating muscle contractures. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  7. Prevalence of joint contractures and muscle weakness in people with multiple sclerosis.

    Science.gov (United States)

    Hoang, Phu Dinh; Gandevia, Simon C; Herbert, Robert D

    2014-01-01

    To investigate the prevalence of joint contracture (limited passive range of joint motion) and muscle weakness in a population with multiple sclerosis (MS). A secondary aim was to establish normative data of functional tests of mobility and balance of people with MS who are still ambulant. Cross-sectional study. People with MS living in metropolitan Sydney, Australia. 330 people with MS living in metropolitan Sydney, Australia were randomly sampled on 23 July 2009 from the MS Australia register and invited to participate. Passive range of motion of large joints of the limbs and muscle strength. Tests of walking and balance were also conducted. 156 people (109 females, 47 males; mean age 54.2 years; mean time since diagnosis 14.9 years) agreed to participate and were assessed. Fifty-six per cent (56%) of participants had contracture in at least one major joint of upper or lower limb. The most common site of contracture was the ankle (43.9%). Seventy per cent (70%) of participants had muscle weakness in one or more muscle groups. As muscle weakness, joint contractures were present at early stage of MS and the prevalence was associated with the progression of the disease. These data show that in addition to muscle weakness joint contractures are highly prevalent among people with MS, especially in the ankle joint. This implicates that prevention of contracture is crucial in providing rehabilitation to people with MS.

  8. Aberrant femoral torsion presenting with frog-leg squatting mimicking gluteal muscle contracture.

    Science.gov (United States)

    Chiang, Chia-Ling; Tsai, Meng-Yuan; Chang, Wei-Ning; Chen, Clement Kuen-Huang

    2012-04-01

    Patients with frog-leg squatting have restricted internal rotation and adduction of the affected hips during sitting or squatting. In the surgical literature, the cause generally has been presumed to arise from and be pathognomonic for gluteal muscle contracture. However, we have encountered patients with frog-leg squatting but without gluteal muscle contracture. We therefore raised the following questions: What are the imaging features of patients with frog-leg squatting? Do conditions other than gluteal muscle contracture manifest frog-leg squatting? We retrospectively reviewed the MR images of 67 patients presenting with frog-leg squatting from April 1998 to July 2010. There were four females and 63 males; their mean age was 22.2 years (range, 4-50 years). During MRI readout, we observed aberrant axes of some femoral necks and obtained additional CT to measure femoral torsion angles in 59 of the 67 patients. MR images of 27 (40%) patients had signs of gluteal muscle contracture. Twenty-two (33%) patients (40 femora) had aberrant femoral torsion, including diminished anteversion (range, 6°-0°; average, 3.9°) in 11 femora of eight patients and femoral retroversion (range, muscle contracture or aberrant femoral torsion. The observation of aberrant femoral torsion was not anticipated before imaging studies. In addition to gluteal muscle contracture, aberrant femoral torsion can be a cause of frog-leg squatting. Level II, diagnostic study. See the guidelines for Authors for a complete description of levels of evidence.

  9. Prolonged blockade of the brachial plexus for the early rehabilitation of children with posttraumatic elbow contractures

    Directory of Open Access Journals (Sweden)

    D. V. Zabolotsky

    2015-01-01

    Full Text Available Objective. Improvement of surgical treatment outcomes in children with post-traumatic elbow contractures. Materials and methods. The study is based on the diagnostic findings of 48 children with post-traumatic elbow contractures who were treated at the Turner Scientific and Research Institute for Children’s Orthopedics. All children underwent complex rehabilitation after reconstructive intra-articular surgery to work out passive motions in the elbow using ARTROMOT-E2 device. The patients of the study group started rehabilitation in the first days after reconstructive intra-articular surgery in the background of prolonged blockade of the brachial plexus. In the control group, the rehabilitation was carried out traditionally on the 6th day after surgery without regional anesthesia. The patients of the study group were supplied with Contiplex SU perinural catheters for prolonged blockade of the brachial plexus using ultrasound (Edge SonoSite and neurostimulation (Stimuplex® HNS12 before surgery. For perioperative blockade of the brachial plexus we used intermittent injection of 0.5% ropivacaine (2 mg / kg. The severity of pain at the stages of rehabilitation was assessed using 10-point grading scale (FPS-R. The range of active and passive motions in the joints was evaluated by measuring the range of motions with a fleximeter. Results. Intermittent injection of ropivacaine before rehabilitation allowed to correct post-traumatic elbow contractures in children in the first days after surgery associated with the minimum subjective pain level and stable hemodynamic parameteres, accompanied with a significant increase of the elbow motion range in comparison with the group of the patients who were not performed regional anesthesia . Conclusion. Prolonged blockade of the brachial plexus in rehabilitation treatment of children with post-traumatic contractures provides appropriate analgesic and myoneural block components from the 1st day after intra

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

    Directory of Open Access Journals (Sweden)

    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

  11. Mid- and long-term clinical results of surgical therapy in unicameral bone cysts

    Directory of Open Access Journals (Sweden)

    Hagmann Sébastien

    2011-12-01

    Full Text Available Abstract Background Unicameral (or simple bone cysts (UBC are benign tumours most often located in long bones of children and adolescents. Pathological fractures are common, and due to high recurrence rates, these lesions remain a challenge to treat. Numerous surgical procedures have been proposed, but there is no general consensus of the ideal treatment. The aim of this investigation therefore was to study the long-term outcome after surgical treatment in UBC. Methods A retrospective analysis of 46 patients surgically treated for UBC was performed for short and mid-term outcome. Clinical and radiological outcome parameters were studied according to a modified Neer classification system. Long-term clinical information was retrieved via a questionnaire at a minimum follow-up of 10 years after surgery. Results Forty-six patients (17 female, 29 male with a mean age of 10.0 ± 4.8 years and with histopathologically confirmed diagnosis of UBC were included. Pathological fractures were observed in 21 cases (46%. All patients underwent surgery for UBC (35 patients underwent curettage and bone grafting as a primary therapy, 4 curettage alone, 3 received corticoid instillation and 4 decompression by cannulated screws. Overall recurrence rate after the first surgical treatment was 39% (18/46, second (17.4% of all patients and third recurrence (4.3% were frequently observed and were addressed by revision surgery. Recurrence was significantly higher in young and in male patients as well as in active cysts. After a mean of 52 months, 40 out of 46 cysts were considered healed. Prognosis was significantly better when recurrence was observed later than 30 months after therapy. After a mean follow-up of 15.5 ± 6.2 years, 40 patients acknowledged clinically excellent results, while five reported mild and casual pain. Only one patient reported a mild limitation of range of motion. Conclusions Our results suggest satisfactory overall long-term outcome for the

  12. Presence of Biofilms on Polyurethane-Coated Breast Implants: Preliminary Results.

    Science.gov (United States)

    Rieger, Ulrich M; Djedovic, Gabriel; Pattiss, Alexander; Raschke, Gregor F; Frei, Reno; Pierer, Gerhard; Trampuz, Andrej

    2016-01-01

    Polyurethane-coated breast implants seem to be associated with lower medium- and long-term capsular contracture rates in comparison to textured or smooth implant surfaces. Although the etiology of capsular contracture is uncertain, bacterial biofilms have been suggested to trigger chronic peri-implant inflammation, eventually leading to capsular contracture. It is unknown whether polyurethane-coated implants are less prone to biofilm colonization than other implant surfaces. We extracted data from patient records included in a prospective cohort between 2008 and 2011. All patients who underwent removal of polyurethane-coated implants were included in this current study and screened for presence of biofilms by sonication. In addition, implant- and patient-related data were analyzed. Of the ten included polyurethane-coated breast implants, six had been inserted for reconstructive purposes and four for aesthetic reasons. The median implant indwelling time was 28.3 mo. Overall, sonication cultures were positive in 50% of implants. Propionibacterium acnes and coagulase-negative staphylococci were the predominant pathogens isolated from biofilm cultures. Like other implant surfaces, polyurethane-coated implants are prone to biofilm colonization. Further investigations are needed to determine why capsular contracture rates seem to be lower in polyurethane implants than in other implant surfaces. Notably, in this study, 40% of the implants were explanted from breasts with severe capsular contracture.

  13. Iliac hyperdense line: a new X-ray sign of gluteal muscle contracture

    International Nuclear Information System (INIS)

    Cai Jinhua; Gan Lanfeng; Zheng Helin; He Ling; Yu Guorong

    2003-01-01

    Objective: To elucidate the relationship between gluteal muscle contracture (GMC) and the iliac hyperdense line on pelvic plain film, and to explore how the iliac hyperdense line is formed. Methods: The pelvic plain films of 103 cases with GMC confirmed by operation and those of 200 individuals as control were analyzed. Pelvic CT scanning was performed in 8 cases GMC and 13 cases of normal controls. Results: The iliac hyperdense line at the side of sacroiliac joint was found on the pelvic plain film in 85 of 103 cases with GMC and 5 of 200 in control group. In 103 cases of GMC, the iliac hyperdense line was detected in 81 of 88 patients beyond 5 years, and 83 of 94 was mostly the gluteus maximus contracture. In control group, pelvic CT showed that the outer cortex of posterior ilium at the level of sacroiliac joint appeared as an oblique plane, oriented from posteromedial side to anterolateral side, while in GMC group, the oblique plane became steeper and almost oriented posteroanteriorly. In addition, the posterior part of the ilium which gave the attachment of contracted gluteus maximus muscle deformed and widened. Conclusion: The iliac hyperdense line on the pelvic plain film is resulted from the long and persistent pulling effect of contracted gluteus maximus muscle, which causes the change the oblique plane of posterior ilium into a posteroanterior course parallel to the X-ray beam

  14. 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.)

  15. Physical therapy in patients with disorders of consciousness: Impact on spasticity and muscle contracture.

    Science.gov (United States)

    Thibaut, A; Wannez, S; Deltombe, T; Martens, G; Laureys, S; Chatelle, C

    2018-01-01

    the other hand, PT, time since injury and medication seemed to be associated with the presence of muscle contracture. Our results suggest that, in subacute and chronic patients with DOC, PT could have an impact on patients' spasticity and muscles contractures. Beside PT, other factors such as time since onset and medication seem to influence the development of muscle contractures. These findings support the need for frequent PT sessions and regular re-evaluation of the overall spastic treatment for patients with DOC.

  16. Endovascular occlusion of intracranial wide-necked aneurysms with stenting (Neuroform) and coiling: mid-term and long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Sedat, Jacques; Chau, Yves; Mondot, Lydiane [CHU Nice, Unite de Neurointerventionnelle, Hopital St. Roch, Nice (France); Vargas, Julian; Szapiro, Jacek; Lonjon, Michel [CH Bastia, Service de Neurochirurgie, Bastia (France)

    2009-06-15

    Coiling associated with placement of self-expandable intracranial stents has amplified the treatment of intracranial wide-necked aneurysms, but the durability of this treatment and the existence of delayed recurrence are not yet well known. The purpose of this report is to present our experience with the Neuroform Stent associated with coiling and to evaluate complications, effectiveness, and long-term results of this technique. A retrospective study of 42 patients with wide-necked cerebral aneurysms treated with the Neuroform Stent was performed. Mean aneurysm size was 11.3 mm. Mean neck size was 5.33 mm. All patients were treated with coiling and stenting. Clinical and angiographic follow-up was available in 38 patients (90.5%). The overall follow-up time ranged from 6 months to 5 years (mean, 42 months), but most of the patients (92%) had a follow-up period superior to 1 year. Successful deployment of 41 stents (97%) was obtained. Permanent procedural morbidity was observed in only one patient (2.4%). Long-term complete aneurysmal occlusion was obtained in 27 patients (71%). Aneurysmal regrowth was observed in four patients (9.5%) on the first control angiogram. After the first control angiogram, no delayed recanalization or regrowth was observed. During the follow-up period, there were no hemorrhagic events, no delayed thrombosis, and no stent displacement. Our results demonstrate the effectiveness of the technique, a small rate of procedural complications, and long-term tolerance of the Neuroform Stent. Despite some evidence of early aneurysmal recurrence, long-term durability of stent-assisted aneurysm occlusion is stable after the first year. (orig.)

  17. [Effectiveness of dorsal metacarpal island flap for treating scar contracture of finger web].

    Science.gov (United States)

    Qian, Jun; Rui, Yongjun; Zhang, Quanrong; Xue, Mingyu; Zhang, Zhihai

    2011-11-01

    To investigate the effectiveness of dorsal metacarpal island flap for treating scar contracture of the finger web. Between June 2009 and December 2010, 10 patients with scar contracture of the finger web were treated. There were 6 males and 4 females with an average age of 30 years (range, 14-57 years). Scar contracture was caused by injury in 8 cases, by burn in 1 case, and by operation in 1 case. The locations were the 1st web space in 1 case, the 2nd web space in 3 cases, the 3rd web space in 5 cases, and the 4th web space in 1 case. The disease duration was 3 to 9 months with an average of 5 months. The maximum abduction was 10-20 degrees. After web space scar release, the dorsal metacarpal island flap (3.5 cm x 1.2 cm-4.0 cm x 2.0 cm in size) was used to reconstruct web space (2.0 cm x 1.0 cm-3.0 cm x 1.8 cm in size). The donor site was directly sutured or repaired with local flaps. At 2 days after operation, necrosis occurred in 1 flap, which healed by extractive treatment. The other flaps survived and wound healed by first intention; all the flaps at donor sites survived and incision healed by first intention. Ten patients were followed up 6 to 15 months (mean, 9 months). The reconstructed web space had good appearance, the maximum abduction was 80 degrees in 1 case of the 1st web space scars contracture, and the maximum abduction was 35-45 degrees (mean, 40 degrees) in the other 9 cases. In 8 scar patients causing by injury, no scar contracture recurred during follow-up. It can achieve good results in appearance and function to use dorsal metacarpal island flap for treating scar contracture of the finger web.

  18. Genetics Home Reference: hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis

    Science.gov (United States)

    ... Hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis Printable PDF Open All Close All Enable Javascript ... Fibrosing Poikiloderma with Tendon Contractures, Myopathy, and Pulmonary ... Lung, and Blood Institute (NHLBI): Pulmonary Function Tests National ...

  19. Recovery of Action Potentials and Twitches after K-contractures in Frog Skeletal Muscle(Physiology)

    OpenAIRE

    Atsuko, Suzuki; Ibuki, Shirakawa; Kazunari, Noguchi; Hirohiko, Kishi; Haruo, Sugi; Department of Physiology, School of Medicine, Teikyo University:(Present office)Department of Physical Therapy, Health Science University; Department of Physiology, School of Medicine, Teikyo University; Department of Physiology, School of Medicine, Teikyo University; Department of Physiology, School of Medicine, Teikyo University; Department of Physiology, School of Medicine, Teikyo University

    2004-01-01

    To give information about intracellular Ca^ translocation during and after K-contractures in vertebrate skeletal muscle fibers, we examined recovery of action potentials and twitches after interruption and spontaneous relaxation of K-contractures at low temperature (3℃) that greatly reduced the rate of Ca^ reuptake by the sarcoplasmic reticulum. On membrane repolarization interrupting K-contractures, the amplitude of both action potentials and twitches recovered quickly, while the falling pha...

  20. Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results.

    Science.gov (United States)

    Nadjmi, N; Schutyser, F; Van Erum, R

    2006-10-01

    Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The follow-up period was 13-65 months (mean 35+/-16.3 SD). A trans-sinusal maxillary distractor was placed intraorally at each side of the maxilla. The distraction vector was predicted using specialist software, and was transferred to the patients using stereolithographic models and individual templates. A (high) Le Fort I type osteotomy was performed. The amount of activation varied from 8 to 17.5 mm (mean 13.1+/-2.9 SD). Soft and hard tissue formation resulted in complete healing across the distraction gaps. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse. Wit's appraisal was used to measure the stability of the long-term distraction results. Results up to 5 years after distraction showed considerable maxillary advancement with long-term stability. Ongoing growth of the facial skeleton must be considered when distraction osteogenesis is chosen in growing patients.

  1. 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.

  2. Long term results of compression sclerotherapy.

    Science.gov (United States)

    Labas, P; Ohradka, B; Cambal, M; Reis, R; Fillo, J

    2003-01-01

    To compare the short and long term results of different techniques of compression sclerotherapy. In the past 10 years the authors treated 1622 pts due to chronic venous insufficiency. There were 3 groups of patients: 1) Pts treated by Sigg's technique using Aethoxysclerol, 2) Pts treated by Fegan's technique with Fibrovein, and 3) Pts treated by Fegan's procedure, but using a combination of both sclerosants. In all cases, the techniques of empty vein, bubble air, uninterrupted 6-week compression and forced mobilisation were used. In the group of pats. treated by Sigg's procedure, the average cure rate was 67.47% after 6 months, 60.3% after 5 years of follow-up. In Fegan's group this rate was 83.6% after 6 months and 78.54% after 5 year assessment. Statistically, significant differences were found only by the disappearance of varices and reduction of pain in favour of Fegan's technique. In the group of pts treated by Fegan's (Aethoxysclerol + Fibrovein) this rate after 5 years was 86%. The only statistically significant difference was found by the disappearance of varices in favour of Fegan's technique using a combination of 2 detergent sclerosants. Sclerotherapy is effective when properly executed in any length of vein no matter how dilated it has become. The recurrences are attributed more to inadequate technique than to the shortcoming of the procedure. Sclerotherapy is miniinvasive, with few complications, and can be repeated on out-patient basis. (Tab. 1, Ref. 22.).

  3. Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats.

    Science.gov (United States)

    Iwasawa, Hiroyuki; Nomura, Masato; Sakitani, Naoyoshi; Watanabe, Kosuke; Watanabe, Daichi; Moriyama, Hideki

    2016-12-01

    Contractures are a prevalent and potentially severe complication in patients with neurologic disorders. Although heat, cold, and stretching are commonly used for treatment of contractures and/or spasticity (the cause of many contractures), the sequential effects of these modalities remain unclear. Using an established rat model with spinal cord injury with knee flexion contracture, we sought to determine what combination of heat or cold before stretching is the most effective for treatment of contractures derived from spastic paralyses and investigated which treatment leads to the best (1) improvement in the loss of ROM; (2) restoration of deterioration in the muscular and articular factors responsible for contractures; and (3) amelioration of histopathologic features such as muscular fibrosis in biceps femoris and shortening of the joint capsule. Forty-two adolescent male Wistar rats were used. After spasticity developed at 2 weeks postinjury, each animal with spinal cord injury underwent the treatment protocol daily for 1 week. Knee extension ROM was measured with a goniometer by two examiners blinded to each other's scores. The muscular and articular factors contributing to contractures were calculated by measuring ROM before and after the myotomies. We quantitatively measured the muscular fibrosis and the synovial intima length, and observed the distribution of collagen of skeletal muscle. The results were confirmed by a blinded observer. The ROM of heat alone (34° ± 1°) and cold alone (34° ± 2°) rats were not different with the numbers available from that of rats with spinal cord injury (35° ± 2°) (p = 0.92 and 0.89, respectively). Stretching after heat (24° ± 1°) was more effective than stretching alone (27° ± 3°) at increasing ROM (p contractures. Although quantification of muscular fibrosis in the rats with spinal cord injury (11% ± 1%) was higher than that of controls (9% ± 0.4%) (p = 0.01), no difference was found between spinal cord

  4. Long-term smoking results in haemostatic dysfunction in chronic ...

    African Journals Online (AJOL)

    Background: Smoking has been known to cause endothelial dysfunction and bronchial carcinoma and duration of smoking has been implicated in the effects of smoking on regular smokers. This study evaluated the effects of long-term smoking on some coagulation markers in chronic smokers. Materials and Methods: A ...

  5. Flexor origin slide for contracture of spastic finger flexor muscles: a retrospective study.

    Science.gov (United States)

    Thevenin-Lemoine, Camille; Denormandie, Philippe; Schnitzler, Alexis; Lautridou, Christine; Allieu, Yves; Genêt, François

    2013-03-06

    Contracture of the wrist and extrinsic finger flexor and pronator muscles is a common consequence of central nervous system disorders. The proximal release of the extrinsic flexor and pronator muscles was first described by Page and Scaglietti for a Volkmann contracture. The aim of the present study was to assess the amount of increase in extension and the improvements in global hand function that can be expected following this lengthening procedure in patients with central nervous system disorders. A single-center retrospective review of patients with central nervous system lesions and contractures of the wrist and extrinsic finger flexor and forearm pronator muscles, causing aesthetic, hygienic, or functional impairment, was carried out. The Page-Scaglietti technique was used for all interventions. Before the operation, motor nerve blocks were used to distinguish between spasticity and contractures with surgical intervention only for contractures. The Zancolli and House classifications were used to evaluate improvements. Data from fifty-four hands and fifty patients (thirty-five men and fifteen women) were evaluated. The mean duration of follow-up (and standard deviation) was 26 ± 21 months (range, three to 124 months). The mean gain (and standard deviation) in wrist extension with fingers extended was 67° ± 25° (range, -10° to 110°). Preoperatively, no hands were classified as Zancolli Group 1, whereas twenty-five hands were classified as Zancolli Group 1 at the latest follow-up review. Ten nonfunctional hands (rated as House Group 0 or Group 1) became functional as a supporting hand postoperatively. Zancolli and House classifications increased significantly (p contracture of the intrinsic muscles, which required further intervention. The Page-Scaglietti technique appears to improve range of motion and function in people with wrist and finger contractures due to central nervous system disorders.

  6. Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long-term results.

    Science.gov (United States)

    Becker, D A; Cofield, R H

    1989-03-01

    Fifty-four shoulders in fifty-one patients were followed for an average of thirteen years (range, two to twenty-three years) after surgical tenodesis of the long head of the biceps brachii for the treatment of chronic tendinitis. At an average of six months postoperatively, in all but three shoulders (forty-eight patients) some benefit was evident. However, after a longer follow-up, a satisfactory result was achieved in only twenty-eight shoulders (approximately 50 per cent). About one-third of the shoulders continued to be pain-free, and in eight shoulders (15 per cent) an additional operation was performed. Tenodesis of the long head of the biceps tendon, therefore, was not an effective treatment for tendinitis over the long term.

  7. Validity of gait parameters for hip flexor contracture in patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Lee Sang Hyeong

    2011-01-01

    Full Text Available Abstract Background Psoas contracture is known to cause abnormal hip motion in patients with cerebral palsy. The authors investigated the clinical relevance of hip kinematic and kinetic parameters, and 3D modeled psoas length in terms of discriminant validty, convergent validity, and responsiveness. Methods Twenty-four patients with cerebral palsy (mean age 6.9 years and 28 normal children (mean age 7.6 years were included. Kinematic and kinetic data were obtained by three dimensional gait analysis, and psoas lengths were determined using a musculoskeletal modeling technique. Validity of the hip parameters were evaluated. Results In discriminant validity, maximum psoas length (effect size r = 0.740, maximum pelvic tilt (0.710, maximum hip flexion in late swing (0.728, maximum hip extension in stance (0.743, and hip flexor index (0.792 showed favorable discriminant ability between the normal controls and the patients. In convergent validity, maximum psoas length was not significantly correlated with maximum hip extension in stance in control group whereas it was correlated with maximum hip extension in stance (r = -0.933, p Conclusions Maximum pelvic tilt, maximum psoas length, hip flexor index, and maximum hip extension in stance were found to be clinically relevant parameters in evaluating hip flexor contracture.

  8. Long term results of childhood dysphonia treatment.

    Science.gov (United States)

    Mackiewicz-Nartowicz, Hanna; Sinkiewicz, Anna; Bielecka, Arleta; Owczarzak, Hanna; Mackiewicz-Milewska, Magdalena; Winiarski, Piotr

    2014-05-01

    The aim of this study was to assess the long term results of treatment and rehabilitation of childhood dysphonia. This study included a group of adolescents (n=29) aged from 15 to 20 who were treated due to pediatric hyperfunctional dysphonia and soft vocal fold nodules during their pre-mutational period (i.e. between 5 and 12 years of age). The pre-mutational therapy was comprised of proper breathing pattern training, voice exercises and psychological counseling. Laryngostroboscopic examination and perceptual analysis of voice were performed in each patient before treatment and one to four years after mutation was complete. The laryngostroboscopic findings, i.e. symmetry, amplitude, mucosal wave and vocal fold closure, were graded with NAPZ scale, and the GRBAS scale was used for the perceptual voice analysis. Complete regression of the childhood dysphonia was observed in all male patients (n=14). Voice disorders regressed completely also in 8 out of 15 girls, but symptoms of dysphonia documented on perceptual scale persisted in the remaining seven patients. Complex voice therapy implemented in adolescence should be considered as either the treatment or preventive measure of persistent voice strain, especially in girls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. 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.

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

    International Nuclear Information System (INIS)

    Kim, Man Deuk; Lee, Hyun Seok; Lee, Mee Hwa; Kim, Hee Jin; Cho, Jin Ho; Cha, Sun Hee

    2010-01-01

    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.

  11. Mid- and long-term clinical results of surgical therapy in unicameral bone cysts.

    Science.gov (United States)

    Hagmann, Sébastien; Eichhorn, Florian; Moradi, Babak; Gotterbarm, Tobias; Dreher, Thomas; Lehner, Burkhard; Zeifang, Felix

    2011-12-13

    Unicameral (or simple) bone cysts (UBC) are benign tumours most often located in long bones of children and adolescents. Pathological fractures are common, and due to high recurrence rates, these lesions remain a challenge to treat. Numerous surgical procedures have been proposed, but there is no general consensus of the ideal treatment. The aim of this investigation therefore was to study the long-term outcome after surgical treatment in UBC. A retrospective analysis of 46 patients surgically treated for UBC was performed for short and mid-term outcome. Clinical and radiological outcome parameters were studied according to a modified Neer classification system. Long-term clinical information was retrieved via a questionnaire at a minimum follow-up of 10 years after surgery. Forty-six patients (17 female, 29 male) with a mean age of 10.0 ± 4.8 years and with histopathologically confirmed diagnosis of UBC were included. Pathological fractures were observed in 21 cases (46%). All patients underwent surgery for UBC (35 patients underwent curettage and bone grafting as a primary therapy, 4 curettage alone, 3 received corticoid instillation and 4 decompression by cannulated screws). Overall recurrence rate after the first surgical treatment was 39% (18/46), second (17.4% of all patients) and third recurrence (4.3%) were frequently observed and were addressed by revision surgery. Recurrence was significantly higher in young and in male patients as well as in active cysts. After a mean of 52 months, 40 out of 46 cysts were considered healed. Prognosis was significantly better when recurrence was observed later than 30 months after therapy. After a mean follow-up of 15.5 ± 6.2 years, 40 patients acknowledged clinically excellent results, while five reported mild and casual pain. Only one patient reported a mild limitation of range of motion. Our results suggest satisfactory overall long-term outcome for the surgical treatment of UBC, although short-and mid-term

  12. Renal Angiomyolipoma: Mid- to Long-Term Results Following Embolization with Onyx

    Energy Technology Data Exchange (ETDEWEB)

    Thulasidasan, Narayanan, E-mail: narayanant@doctors.net.uk; Sriskandakumar, Srividhiya; Ilyas, Shahzad; Sabharwal, Tarun [Guy’s & St Thomas’ NHS Foundation Trust, Department of Interventional Radiology (United Kingdom)

    2016-12-15

    PurposePercutaneous transcatheter embolization is currently the preferred treatment for ruptured or enlarging renal angiomyolipoma (AML), although the optimum choice of embolic material has not yet been established. We present mid- to long-term outcomes following embolization of AMLs with Onyx.Materials and MethodsTen AMLs in seven patients (including two with tuberous sclerosis) were embolized with Onyx. Patients were followed-up clinically, with tumour size and renal function measured pre- and post-procedure.ResultsMean pre-treatment AML size was 63.4 mm (range 42–100). Mean clinical follow-up was 431.4 days (range 153–986) and imaging follow-up 284.2 days (range 30–741). There was no haemorrhage from treated lesions within the follow-up period. Of patients who had cross-sectional imaging pre- and post-procedure, mean decrease in AML size of 22 mm was seen after Onyx embolization (p = 0.0058, 95 % CI 9.13–34.87). No significant difference between serum creatinine was seen pre- and post-procedure (p = 0.54, 95 % CI 8.63–4.85).ConclusionsOnyx embolization of renal AMLs is effective in the medium to long term, with theoretical benefits in safety and durability of result.

  13. Contracture Coupling of Slow Striated Muscle in Non-Ionic Solutions and Replacement of Calcium, Sodium, and Potassium

    Science.gov (United States)

    Irwin, Richard L.; Hein, Manfred M.

    1964-01-01

    The development of contracture related to changes of ionic environment (ionic contracture coupling) has been studied in the slowly responding fibers of frog skeletal muscle. When deprived of external ions for 30 minutes by use of solutions of sucrose, mannitol, or glucose, the slow skeletal muscle fibers, but not the fast, develop pronounced and easily reversible contractures. Partial replacement of the non-ionic substance with calcium or sodium reduces the development of the contractures but replacement by potassium does not. The concentration of calcium necessary to prevent contracture induced by a non-ionic solution is greater than that needed to maintain relaxation in ionic solutions. To suppress the non-ionic-induced contractures to the same extent as does calcium requires several fold higher concentrations of sodium. Two types of ionic contracture coupling occur in slow type striated muscle fibers: (a) a calcium deprivation type which develops maximally at full physiological concentration of external sodium, shows a flow rate dependency for the calcium-depriving fluid, and is lessened when the sodium concentration is decreased by replacement with sucrose; (b) a sodium deprivation type which occurs maximally without external sodium, is lessened by increasing the sodium concentration, and has no flow rate dependency for ion deprivation. Both types of contracture are largely prevented by the presence of sufficient calcium. There thus seem to be calcium- and sodium-linked processes at work in the ionic contracture coupling of slow striated muscle. PMID:14127603

  14. Assessment and affects hamstrings contracture on the formation of posture defects in children of preschool age

    Directory of Open Access Journals (Sweden)

    Magda Kucharczuk-Kopycińska

    2016-12-01

    Results. Executed tests shown that 47,5% from examined group of children have fault posture. Occurrence of hamstrings contracture, which was diagnosed in 40%, disrupts pelvis balance causing oblique position of pelvis. Conclusion. 1. Posture faults are major problem in our population. During examination near half of the group possessed at least one of the fault posture. 2. Hamstrings contracture disrupts pelvis balance causing oblique position of pelvis. Further it leads to increase frequency of fault posture. 3. Proper rehabilitation can prevent hamstring contracture, in advance prevents also occurrence of fault posture. 4. Rehabilitation study, in which analysis of specified anthropometric points and a few functional tests will be a component, can detect and correct diagnose fault posture among children.

  15. Phorbol 12,13-dibutyrate-induced protein kinase C activation triggers sustained contracture in human myometrium in vitro.

    Science.gov (United States)

    Massenavette, Laurence; Paul, Wilène; Corriveau, Stéphanie; Pasquier, Jean-Charles; Rousseau, Éric

    2017-09-01

    Although physiologic transition from rhythmic contractions to uterine retraction postpartum remains a poorly understood process, it has been shown that the latter is essential in the prevention of hemorrhage and its negative consequences. To investigate the transition from oscillatory contractions to tonic contracture in human myometrium after delivery, a mechanism purported to facilitate postpartum hemostasis. Protein kinase C (PKC) plays a key regulatory role in human uterine contractions because it can prevent dephosphorylation of regulatory proteins and sensitize the contractile machinery to low Ca 2+ . Thus, activation of PKC by phorbol 12,13-dibutyrate (PDBu) may act as a strong uterotonic agent. Uterine biopsies were obtained from consenting women undergoing elective caesarian delivery at term without labor (N = 19). Isometric tension measurements were performed on uterine strips (n = 114). The amplitudes and area under the curve of phasic contractions and tonic responses were measured and compared. A total of 1 μM PDBu was added to the isolated organ baths, and maximal tension of the uterine contracture was determined in the absence and presence of either 1 μM of staurosporine, 100 nM nifedipine, or 10 μM cyclopiazonic acid to assess the role of PKC and calcium sensitivity on uterine contractility. On the addition of PDBu on either basal or oxytocin-induced activity, consistent contractures were obtained concomitant with complete inhibition of phasic contractions. After a 30-minute incubation period, the mean amplitude of the PDBu-induced tone represented 65.3% of the amplitude of spontaneous contraction. Staurosporine, a protein kinase inhibitor, induced a 91.9% inhibition of PDBu contractures, a process not affected by nifedipine or cyclopiazonic acid, thus indicating that this mechanism is largely Ca 2+ independent. Pharmacologic activation of PKC leads to a significant contracture of the myometrium. Together, these data suggest that the up

  16. Multidisciplinary conservative management in classical Volkmann's contracture: A case report

    NARCIS (Netherlands)

    Reinders, M.F.; Geertzen, J.H.B.; Eisma, W.H.

    1996-01-01

    This clinical note describes the case of a nine-year-old girl with classical Volkmann's contracture of the left forearm. The report demonstrates the results and follow-up of conservative orthotic management used as a mode of treatment by a multidisciplinary team. When using an orthosis it is

  17. Long-Term Results of Laparoscopic Sleeve Gastrectomy for Morbid Obesity: 5 to 8-Year Results.

    Science.gov (United States)

    Gadiot, Ralph P M; Biter, L Ulas; van Mil, Stefanie; Zengerink, Hans F; Apers, J; Mannaerts, Guido H H

    2017-01-01

    Although long-term results of sleeve gastrectomy (LSG) remain scarce in the literature, its popularity as a stand-alone procedure has accounted for a global increase in LSG performance. In this retrospective study, the authors present 5 to 8-year follow-up results in terms of weight loss, failure/revision rate, and comorbidity resolution from a single center. A prospectively maintained database was reviewed for patients who underwent LSG between 2007 and 2010. Data analysis on weight loss, comorbid conditions, revision surgery, and mortality was conducted. Median percentage excess BMI loss (%EBMIL) was 59.0, and 53.9 %, and median percentage total weight loss (%TWL) was 25.1, and 22.9 % at 5 and 8 years, respectively. Revision to gastric bypass due to insufficient weight loss or gastroesophageal reflux disease (GERD) was performed in 42 patients (15.2 %). Resolution of comorbid condition was achieved in 91 % of patients with obstructive sleep apnea syndrome (OSAS), 68 % of patients with type 2 diabetes (T2DM), 53 % of patients with hypertension, and 25 % of patients with dyslipedemia. Loss to follow-up rate was 45 % at 5 years, 28 % at 6 years, 23 % at 7 years, and 13 % at 8 years. This study adds to the currently available data confirming the LSG to be a safe and effective procedure at long term. Data from high-volume studies are needed to establish the definite role of the LSG in the spectrum of bariatric procedures.

  18. Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

    Directory of Open Access Journals (Sweden)

    Agarwal Pawan

    2004-01-01

    Full Text Available Severe post burn neck contracture results in difficult intubation, which can be life threatening and can result in multiple serious complications and sequels. Thirty patients with age ranging from 12 to 50 years were operated under local tumescent anesthesia supplemented with intravenous ketamine for release of post burn neck contracture and split skin grafted. This technique obviates the need for endotracheal intubation. There were no complications attributed to this anesthesia technique. There was no graft loss and blood loss was minimal.

  19. Acquired muscle contractures in the dog and cat. A review of the literature and case report.

    Science.gov (United States)

    Taylor, J; Tangner, C H

    2007-01-01

    Canine and feline muscle contracture is reported to affect several different muscles, is associated with a number of predisposing factors, and a varying prognosis depending upon which muscle is affected. Most patients suffer some form of trauma weeks to months before the contracture is present. The clinical signs include: lameness, pain, weakness, decreased range of motion, a firmness noted throughout the entire muscle, and usually a characteristic gait. Pre-disposing factors for muscle contracture include: compartment syndrome, infection, trauma, repetitive strains, fractures, infectious diseases, immune-mediated diseases, neoplasia, and ischaemia. There does appear to be some breed and age predilection, however, the sex of the animal does not have an appreciable influence. In general, muscle contractures of the forelimb respond better to treatment and carry a better prognosis than muscle contractures of the hindlimb.

  20. 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

  1. Congenital contractural arachnodactyly Síndrome de la arcnodactilia contractural: estudio de un caso esporádico y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Betty Nishikuni

    1991-02-01

    Full Text Available

    The Congenital Contractural Arachnodactyly Syndrome is a heredltary disorder of connective tissue characterized by multiple congenital contractures, arachnodactyly, dolichostenomella, kyphoscollosis, abnormalities of the external ears and autosomal dominant inheritance. Nearly 50 cases have previously been reported. A new sporadic case is presented. Some clinical and genetic aspects, differential diagnosis and therapeutic approach of this syndrome are discussed.

    El síndrome de la aracnodactilia contractural es una alteración hereditaria del tejido conectivo, caracterizada por múltiples contracturas congénitas, aracnodactilia, dolicostenomelia, cifoescoliosis, dismorfia de los pabellones auriculares y un patrón de herencia autonómico dominante. Se han Informado aproximadamente 50 casos, a los cuales se adiciona uno nuevo, esporádico. Se discuten algunos aspectos clínicos y genéticos, el diagnóstico diferencial y el manejo de estos pacientes.

  2. [Insertion of gluteus maximus tendo-chilles lengthening with Z-shaped for the treatment of severe gluteal muscle contracture].

    Science.gov (United States)

    Chen, Huan-shi; Yang, Xiao-long

    2015-06-01

    To investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture. From 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared. Twenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (Pmuscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good. For severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

  3. Treatable Bedridden Elderly―Recovery from Flexion Contracture after Cortisol Replacement in a Patient with Isolated Adrenocorticotropic Hormone Deficiency

    Science.gov (United States)

    Tanaka, Takamasa; Terada, Norihiko; Fujikawa, Yoshiki; Fujimoto, Takushi

    2016-01-01

    Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder with diverse clinical presentations. A 79-year-old man was bedridden for six months due to flexion contractures of the bilateral hips and knees, along with hyponatremia. He was diagnosed with IAD based on the results of endocrine tests. After one month of corticosteroid replacement, he recovered and was able to stand up by himself. Although flexion contracture is a rare symptom of IAD, steroid replacement therapy may be effective, even for seemingly irreversibly bedridden elderly patients. In bedridden elderly patients with flexion contractures, we should consider and look for any signs of adrenal insufficiency. PMID:27746435

  4. Treatable Bedridden Elderly -Recovery from Flexion Contracture after Cortisol Replacement in a Patient with Isolated Adrenocorticotropic Hormone Deficiency.

    Science.gov (United States)

    Tanaka, Takamasa; Terada, Norihiko; Fujikawa, Yoshiki; Fujimoto, Takushi

    Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder with diverse clinical presentations. A 79-year-old man was bedridden for six months due to flexion contractures of the bilateral hips and knees, along with hyponatremia. He was diagnosed with IAD based on the results of endocrine tests. After one month of corticosteroid replacement, he recovered and was able to stand up by himself. Although flexion contracture is a rare symptom of IAD, steroid replacement therapy may be effective, even for seemingly irreversibly bedridden elderly patients. In bedridden elderly patients with flexion contractures, we should consider and look for any signs of adrenal insufficiency.

  5. Congenital contractural arachnodactyly with neurogenic muscular atrophy: case report

    Directory of Open Access Journals (Sweden)

    Scola Rosana Herminia

    2001-01-01

    Full Text Available We report the case of a 3-1/2-year-old girl with hypotonia, multiple joint contractures, hip luxation, arachnodactyly, adducted thumbs, dolichostenomelia, and abnormal external ears suggesting the diagnosis of congenital contractural arachnodactyly (CCA. The serum muscle enzimes were normal and the needle electromyography showed active and chronic denervation. The muscle biopsy demonstrated active and chronic denervation compatible with spinal muscular atrophy. Analysis of exons 7 and 8 of survival motor neuron gene through polymerase chain reaction did not show deletions. Neurogenic muscular atrophy is a new abnormality associated with CCA, suggesting that CCA is clinically heterogeneous.

  6. Reconstruction of cervical scar contracture using axial thoracic flap based on the thoracic branch of the supraclavicular artery.

    Science.gov (United States)

    Ma, Xianjie; Li, Yang; Wang, Lu; Li, Weiyang; Dong, Liwei; Xia, Wei; Su, Yingjun

    2014-09-01

    Cervical scar contracture causes both physical and psychological distress for burn patients. Many pedicle flaps or skin grafting have been suggested for reconstruction of cervical scar contracture with variable results in the literature. The authors present the axial thoracic flap based on the thoracic branch of the supraclavicular artery (TBSA) for reconstruction of cervical scar contracture. Postburn scar contractures in anterior neck region of 66 patients had been reconstructed with the axial pattern thoracic flaps based on the TBSA, including 1 expanded and 10 nonexpanded pedicle flaps, and 9 expanded and 46 nonexpanded island pedicle flaps, during 1988 through 2012. After removing and releasing the cervical scar contracture, the flap was designed in the thoracic region. The axial artery of the flap is the TBSA bifurcating from the intersection point of sternocleidomastoid muscle and omohyoid muscle with several concomitant veins as the axial veins. The flap can be designed in a large area within the borders of the anterior border of the trapezius muscle superiorly, the middle part of the deltoid muscle laterally, the midsternal line medially, and the level 3 to 4 cm below nipples inferiorly. After incisions were made along the medial, inferior, and lateral border, dissection was performed toward the pedicle. Donor site was closed directly in expanded cases and with skin grafting in nonexpanded cases. Cervical scar contractures were repaired with good functional and cosmetic results in 64 cases among this cohort. Flap tip necrosis in other 2 cases, caused by postoperative hematoma, was repaired by skin grafting. The color and texture of all flaps were fitted with those of the surrounding skin. The donor sites all healed primarily. The flap sensation in the thoracic region regained in the early stage postoperatively and that in cervical area recovered completely after 6 months according to the report of the patients. With reliable blood supply based on the

  7. Long-term safety and effectiveness of style 410 highly cohesive silicone breast implants

    DEFF Research Database (Denmark)

    Hedén, Per; Bronz, Giorgio; Elberg, Jens Jørgen

    2009-01-01

    years after implantation. Capsular contracture was the most common complication noted at the physical examination, occurring for 5.3% of implants, and there were no cases of grade 4 capsular contracture. The postimplantation rates for lactation and reproductive problems and breast disease were lower...

  8. 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.)

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

    International Nuclear Information System (INIS)

    Runge, M.J.R.; Maarouf, M.; Hunsche, S.; Ruge, M.I.; El Majdoub, F.; Treuer, H.; Sturm, V.; Kocher, M.; Mueller, R.P.; Voges, J.

    2012-01-01

    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.)

  10. Long-term results after aortic valve-sparing operation (David I).

    Science.gov (United States)

    Shrestha, Malakh; Baraki, Hassina; Maeding, Ilona; Fitzner, Sebastian; Sarikouch, Samir; Khaladj, Nawid; Hagl, Christian; Haverich, Axel

    2012-01-01

    Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8-83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI)≤AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low.

  11. Long-term results of irradiation for paraganglioma

    International Nuclear Information System (INIS)

    Krych, Aaron J.; Foote, Robert L.; Brown, Paul D.; Garces, Yolanda I.; Link, Michael J.

    2006-01-01

    Purpose: The management of paragangliomas is controversial. Observation, surgery, external-beam radiotherapy (EBRT), and stereotactic radiosurgery (SRS) may, alone or in combination, be appropriate, depending on the size and extent of the tumor, previous treatment, and patient age, general health, and neurologic condition. Few data exist regarding long-term tumor control and late effects after EBRT or SRS. Methods and Materials: We performed a retrospective review of all patients treated with EBRT or SRS for paraganglioma at our institution between 1967 and 1994. The endpoints of the study were tumor control and late complications. Results: The 33 patients in this study had a median follow-up of 13 years (range, 4 months to 36 years). The 10-year tumor control rate was 92% (95% confidence interval, 75-98%). At the last follow-up visit, no patient had developed a radiation-induced malignancy. Conclusion: External-beam RT and SRS are safe and effective for enlarging and/or symptomatic paragangliomas. The risk of developing a delayed radiation-induced malignancy after EBRT or SRS is low. This risk must be weighed against the significant immediate and permanent risk of cranial nerve deficits if the tumor is untreated or is surgically resected. This risk must also be weighed against the immediate but low risk of surgical mortality

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

    International Nuclear Information System (INIS)

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

    1985-11-01

    Leaching studies of SRL-131 simulated defense nuclear waste glass have been carried out to two years duration, in leachants that simulate groundwaters of different ionic strengths. The leachability of SRL-131 glass followed the trend: deionized water > silicate water > salt brine = simulated groundwater at 40 0 C and deionized water = simulated groundwater > silicate water > salt brine at 90 0 C. The results are in general agreement with calculations using the PHREEQE geochemical code and indicate a sometimes complex sequence temperature dependent of mineral precipitation and redissolution. The calculations done in this study have illustrated the complexity of the precipitation sequence of mineral phases as a function of reaction progress. Complex, temperature dependent, precipitation/dissolution sequences have also been observed in experiments using natural materials, such as sea water and basaltic glass. The results of this two-year study point to the need for further work in establishing the thermodynamics of the observed phases and the relationship of these phases to the thermodynamically favored suite of phases for any given waste form/host rock/groundwater system. In order to study these phases, very long-term experiments may be necessary so that the phases grow to sizes which can be studied. In addition, geochemical codes should be used to better understand the experiments, to design leach test matrices, and to help predict the long-term results of experiments. The combination of long-term experiments and geochemical codes should lead to an improved method for forecasting the long-term behavior of a nuclear waste repository. 15 refs., 3 figs., 4 tabs

  13. Prevalence of functioning and disability in older patients with joint contractures: a cross-sectional study.

    Science.gov (United States)

    Fischer, U; Müller, M; Strobl, R; Bartoszek, G; Meyer, G; Grill, E

    2015-06-01

    Joint contractures are a common problem for older, frail people, particularly in rehabilitation, nursing home and homecare settings. Joint contractures are underreported and sparsely empirically investigated despite their high prevalence. The objective of this study was to examine the prevalence of functional impairments, activity limitations and participation restrictions of patients with joint contractures using the International Classification of Functioning, Disability and Health (ICF) as a framework. We also examined contextual factors as potential mediators for functioning and disability. Cross-sectional study- Three acute-geriatric hospitals in and around Munich (Germany). Patients aged 65 and over with confirmed joint contractures requiring rehabilitation care. The patients were asked to answer a questionnaire that comprised 124 categories of the ICF. Patients' problems in functioning were registered separately for each category. Data were collected through face-to-face interviews with patients and health professionals and from patients' medical records. One hundred and fifty patients were eligible and agreed to participate. Mean age was 82.5 years (SD: 7.4), 64.8% of the patients were female. Problems in "muscle power functions" (95.9%) and "driving human-powered transportation" (89,6%) were those most frequently identified. 'Health services, systems and policies' (98,6%) was the most frequent environmental facilitator. Aged persons with joint contractures experience high levels of disability. Specifically, mobility, participation restrictions and interactions with the environment emerged as important issues of our study. Mobility and support by others were frequently mentioned as aspects relevant for persons with joint contractures. These aspects have to be considered when assessing the impact of joint contractures.

  14. Leksell Gamma Knife radiosurgery of the jugulotympanic glomus tumor: long-term results.

    Science.gov (United States)

    Liscak, Roman; Urgosik, Dusan; Chytka, Tomas; Simonova, Gabriela; Novotny, Josef; Vymazal, Josef; Guseynova, Khumar; Vladyka, Vilibald

    2014-12-01

    Glomus tumors usually display indolent behavior, and the effectiveness of radiation in stopping their growth can be assessed after long-term follow-up. Currently only midterm results of radiosurgery are available, so the authors included patients treated by Gamma Knife at least 10 years ago in this study to obtain a perspective of long-term results. During the period from 1992 to 2003, the Gamma Knife was used to treat 46 patients with glomus tumors. The age of the patients ranged from 21 to 79 years (median 56 years). Gamma Knife radiosurgery was the primary treatment in 17 patients (37%). Open surgery preceded radiosurgery in 46% of cases, embolization in 17%, and fractionated radiotherapy in 4%. The volume of the tumor ranged from 0.2 to 24.3 cm(3) (median 3.6 cm(3)). The minimal dose to the tumor margin ranged between 10 and 30 Gy (median 20 Gy). One patient was lost for follow-up after radiosurgery. Clinical follow-up was available in 45 patients and 44 patients were followed with MRI in a follow-up period that ranged from 12 to 217 months (median 118 months). Neurological deficits improved in 19 (42%) of 45 patients and deteriorated in 2 patients (4%). Tumor size decreased in 34 (77%) of 44 patients with imaging follow-up, while an increase in volume was observed in 1 patient (2%) 182 months after radiosurgery and Gamma Knife treatment was repeated. One patient underwent another Gamma Knife treatment for secondary induced meningioma close to the glomus tumor 98 months after initial radiosurgical treatment. Seven patients died 22-96 months after radiosurgery (median 48 months), all for unrelated reasons. Radiosurgery has proved to be a safe treatment with a low morbidity rate and a reliable long-term antiproliferative effect.

  15. Long term results of trabeculectomy surgery

    Directory of Open Access Journals (Sweden)

    Ferhat Evliyaoğlu

    2015-09-01

    Full Text Available Objective: Evaluation of long-term results of primary trabeculectomy operation Methods: The cases that are followed up with diagnosis of glaucoma in Okmeydanı Training and Research Hospital Eye Clinic between January 2000 and December 2001 were evaluated retrospectively. All of the cases, despite maximum therapy, have high intraocular pressure (IOP, undergone primary trabeculectomy operation, are followed at least 6 months and regularly followed through 10 years were included in this study. IOP with or without medical treatment 18mmg or less than 18 mmHg accepted as successful. IOL pressure measured with applanation tonometry. Results: 89 eyes of 70 cases were included in this study. The cases included in the study, 42 male (60%, and 28 (40% were female. The mean age was 63.65±12.18 years. Preoperative intraocular pressure determined as 30.36 ± 3.2 mmHg. In the follow up examination mean intra ocular pressure was 15.31 ± 1.2 mmHg at 1st month, 15.47± 1.1mmHg at 3rd month, 15.02±1.8 mmHg at 6th month, 15.34± 2.1 mmHg at 1st year, 15.82 ± 2.1mmHg at 2nd year, 17.06 ± 2.3mmHg at 5th year and 18.02 ± 2.2 mmHg at 10th year. Statistical analysis of these data showed significant decreased of intra ocular pressure in the post operative period in compare to the preoperative period, 1st month, 3rd month, 6th month, 1st year, 2nd year, 5th year an 10th year (p < 0.01. The follow-up period in the study was 91.10 ± 40.15 months (6-120 months. Conclusion: Primary trabeculectomy can be considered as an alternative treatment procedure especially in patients who does not use drugs regularly and unable to attend regular medical examination. J Clin Exp Invest 2015; 6 (3: 263-268

  16. PREDICTIVE FACTORS OF DIFFICULT INTUBATION IN POST BURN NECK CONTRACTURE – A STUDY OF 30 CONSECUTIVE CASES

    Directory of Open Access Journals (Sweden)

    Vijay

    2015-06-01

    Full Text Available The peri - operative management of post - burn contractures of the neck is a challenge not only to the surgeon but also the anaesthesiologist. A proper co - ordination between them is needed for providing a hassle - free patient care. This is a prospective study done on 30 consecutive patients of post burn contractures of the neck to compare the surgeon’s assessment of the type and pattern of post - burn contracture of the neck and the anaesthesiologist’s assessment of the airway. T he association of this with the peri - operative management of patients was also studied. The data analysed was type of contracture , mento - sternal distance , and preoperative grading of the airway. The method of securing intra - operative airway was documented . A direct co - relation was noted between the type of contracture with the Mallampatti grading of the airway and the sterno - mental distance. All type III contractures required release before intubation. In conclusion , it is advisable for the surgeon to be w ell - versed with the anaesthesiologist’s assessment of the airway and the anaesthesiologist to aware of the types of neck contracture in order to properly plan and execute the peri - operative management of these patients.

  17. Long-term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis in the pediatric population.

    Science.gov (United States)

    Merino-Ingelmo, Raquel; Santos-de Soto, José; Coserria-Sánchez, Félix; Descalzo-Señoran, Alfonso; Valverde-Pérez, Israel

    2014-05-01

    Percutaneous pulmonary valvuloplasty is the preferred interventional procedure for pulmonary valve stenosis. The aim of this study was to evaluate the effectiveness of this technique, assess the factors leading to its success, and determine the long-term results in the pediatric population. The study included 53 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty between December 1985 and December 2000. Right ventricular size and functional echocardiographic parameters, such as pulmonary regurgitation and residual transvalvular gradient, were assessed during long-term follow-up. Peak-to-peak transvalvular gradient decreased from 74 mmHg [interquartile range, 65-100 mmHg] to 20 mmHg [interquartile range, 14-34 mmHg]. The procedure was unsuccessful in 2 patients (3.77%). The immediate success rate was 73.58%. Follow-up ranged from 10 years to 24 years (median, 15 years). During follow-up, all patients developed late pulmonary regurgitation which was assessed as grade II in 58.4% and grade III in 31.2%. There was only 1 case of long-term restenosis (2.1%). Severe right ventricular dilatation was observed in 27.1% of the patients. None of the patients developed significant right ventricular dysfunction. Pulmonary valve replacement was not required in any of the patients. Percutaneous balloon valvuloplasty is an effective technique in the treatment of pulmonary valve stenosis with good long-term results. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

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

    Science.gov (United States)

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

    2015-10-01

    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. We studied 628 patients (130 men and 498 women) who underwent gamma knife radiosurgery for intracranial meningioma, which is radiologically diagnosed, from Jan 2008 to Nov 2012. We included patients with single lesion meningioma, and followed up after 6 months with imaging, and then at 24 months with a clinical examination. Patients with high-grade meningioma or multiple meningiomas were excluded. We analyzed each of the factors associated with progression free survival. The median patient's age was 56.8 years. Maximal dosage was 27.8 Gy and marginal dosage was 13.9 Gy. The overall tumor control rate was 95%. Twenty-eight patients (4.4%) showed evidence of tumor recurrence. Ninety-eight patients (15%) developed peritumoral edema (PTE) after gamma-knife surgery; two of them (2%) underwent surgical resections due to PTE. Nine patients had craniotomy and tumor removal after gamma knife surgery. Gamma knife surgery for intracranial meningioma has proven to be a safe and effective treatment tool with successful long-term outcomes. Gamma knife radiosurgery can be especially effective in cases of remnant meningioma after surgical resection or where PTE is not present.

  19. Long term results of kissing stents in the aortic bifurcation

    NARCIS (Netherlands)

    Hinnen, J.W.; Konickx, M.A.; Meerwaldt, Robbert; Kolkert, J.L.P.; van der Palen, Jacobus Adrianus Maria; Huisman, A.B.

    2015-01-01

    BACKGROUND: To evaluate the long-term outcome after aortoiliac kissing stent placement and to analyze variables, which potentially influence the outcome of endovascular reconstruction of the aortic bifurcation. METHODS: All patients treated with aortoiliac kissing stents at our institution between

  20. 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.

  1. Long-term results of irradiation for patients with progressive GRAVES' ophthalmopathy

    International Nuclear Information System (INIS)

    Marquez, Sheri D.; Lum, Bert L.; McDougall, I. Ross; Katkuri, Shobha; Levin, Peter S.; MacManus, Michael; Donaldson, Sarah S.

    2001-01-01

    Purpose: To determine the long-term outcome of radiotherapy (RT) in patients with progressively symptomatic thyroid eye disease and to evaluate the potential long-term sequelae. Methods and Materials: Four hundred fifty-three patients provided written informed consent and received retrobulbar RT for Graves' ophthalmopathy at Stanford University Medical Center; 197 with ≥1 year of follow-up were retrospectively analyzed. Of the 197 patients, 189 received RT to the bilateral retrobulbar regions, and 4 received unilateral RT. The technical information was unavailable for 4 patients. Patients were assessed by chart review, telephone interview, questionnaire, and multidisciplinary physician examination. Eye impairment was scored using the SPECS system. The end point review included the before and after treatment SPECS score, surgical intervention, and patient satisfaction. Potential complications, including cataract development, retinopathy, and tumor formation, were investigated. Multivariate analyses were performed to assess the prognostic variables. Results: Improvement or resolution was 89% for soft-tissue findings; 70% for proptosis; 85% for extraocular muscle dysfunction; 96% for corneal abnormalities; and 67% for sight loss. The response to RT may take >6 months to stabilize. Factors predictive of response varied in the individual SPECS categories but included the initial SPECS score, pretreatment thyroid status, female gender, a 20-Gy RT dose, and a history of hypertension. Nonpredictive factors included a history of tobacco use, diabetes mellitus, steroids, and prior cataracts. Only 16% required surgical intervention to preserve their vision or restore binocular vision. Twenty-two patients (12%) developed cataracts after irradiation (median 11 years). No patient developed a tumor within the RT field during the follow-up period (range 1-29 years). Ninety-eight percent of patients were pleased with their results, and 2% believed their symptoms progressed

  2. Muscle diseases with prominent joint contractures: Main entities and diagnostic strategy.

    Science.gov (United States)

    Eymard, B; Ferreiro, A; Ben Yaou, R; Stojkovic, T

    2013-01-01

    Muscle diseases may have various clinical manifestations including muscle weakness, atrophy or hypertrophy and joint contractures. A spectrum of non-muscular manifestations (cardiac, respiratory, cutaneous, central and peripheral nervous system) may be associated. Few of these features are specific. Limb joint contractures or spine rigidity, when prevailing over muscle weakness in ambulant patients, are of high diagnostic value for diagnosis orientation. Within this context, among several disorders, four groups of diseases should systematically come to mind including the collagen VI-related myopathies, the Emery-Dreifuss muscular dystrophies, the SEPN1 and FHL1 related myopathies. More rarely other genetic or acquired myopathies may present with marked contractures. Diagnostic work-up should include a comprehensive assessment including family history, neurological, cardiologic and respiratory evaluations. Paraclinical investigations should minimally include muscle imaging and electromyography. Muscle and skin biopsies as well as protein and molecular analyses usually help to reach a precise diagnosis. We will first describe the main muscle and neuromuscular junction diseases where contractures are typically a prominent symptom of high diagnostic value for diagnosis orientation. In the following chapters, we will present clues for the diagnostic strategy and the main measures to be taken when, at the end of the diagnostic work-up, no definite muscular disease has been identified. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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

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    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.

  4. Long-term results after aortic valve-sparing operation (David I)†

    Science.gov (United States)

    Shrestha, Malakh; Baraki, Hassina; Maeding, Ilona; Fitzner, Sebastian; Sarikouch, Samir; Khaladj, Nawid; Hagl, Christian; Haverich, Axel

    2012-01-01

    OBJECTIVE Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. METHODS More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8–83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. RESULTS There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI) ≤ AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. CONCLUSIONS: Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low. PMID:21632258

  5. Muscle contracture diagnosis: the role of sonoelastography.

    Science.gov (United States)

    Bruschetta, Daniele; Milardi, Demetrio; Trimarchi, Fabio; DI Mauro, Debora; Valenti, Andrea; Arrigo, Alessandro; Valenti, Barbara; Santoro, Giuseppe; Cascio, Filippo; Vaccarino, Gianluigi; Cacciola, Alberto

    2016-12-01

    Sonoelastography plays today a major role in musculoskeletal disease, showing minor muscle injuries not well appreciable in conventional B-mode ultrasonography and integrating it in major muscle injuries diagnosis. The aim of this study was to demonstrate the ability of elastosonography in the diagnosis of muscular contracture in football players presenting negative basic echography. We examined twenty-two football players using basic echography and elastosonography approximately 24-48 hours after the traumatic event and we subsequently re-evaluated them after two weeks. Conventional echography showed, in the early stage, no muscle injuries; in twenty-two out of twenty-two patients, sonoelastography had instead underlined a heterogeneous colorimetric map, related to decreased elasticity in the area of the muscle contracture. An evaluation effected 1-2 weeks later showed a clear improvement of the sonoelastographic appearance. This information will be useful for prognostication, post-traumatic monitoring and to detect subclinical changes in MIs even before there are changes on the routine B-mode ultrasound.

  6. PERIPHERAL APPLICATION OF REPETITIVE PULSE MAGNETIC STIMULATION ON JOINT CONTRACTURE FOR MOBILITY RESTORATION: CONTROLLED RANDOMIZED STUDY

    Directory of Open Access Journals (Sweden)

    Efthimios J. Kouloulas

    2016-10-01

    Full Text Available Background: Joint contracture is a limitation in the passive or active range of motion (ROM of a joint, where in addition to the mobility limiting factor the pain is also present. Repetitive pulsed Magnetic Stimulation (rPMS appears to be an effective, non-invasive and safety solution for treating this condition. Therefore aim of this study was to evaluate the effect of rPMS in treating joint contracture. Methods: 30 subjects with joint contracture in the knee were enrolled in this study and divided respectively into Treatment and Control group. The treatment group were delivered with rPMS therapy. The control group was delivered with conventional physiotherapy method (ultrasound. The primary outcome measurements were: 1. Mobility evaluation by goniometry (ROM in degrees while performing flexion and Patient Functional Assessment Questionnaire (PFAQ for ability to perform Activities of Daily Living (ADL and 2. Pain evaluation by 10-point Visual Analog Scale (VAS for pain perception. Absence of adverse events was set as a secondary measure. Results: The results of the study show statistical difference (p<0.05 between the levels of improvement of all studied parameters while comparing between both groups. The results suggest greater immobility restoration and pain relieving effect of the rPMS in comparison to conventional physiotherapy method. Conclusion: rPMS an effective and safe non-invasive method for mobility restoration and pain relief in case of joint contractures. This study suggests the method as beneficial and quality of life ameliorating among patients suffering from immobilized joints accompanied by pain.

  7. Long-term results after endoscopic drainage and necrosectomy of symptomatic pancreatic fluid collections.

    Science.gov (United States)

    Seewald, Stefan; Ang, Tiing Leong; Richter, Hugo; Teng, Karl Yu Kim; Zhong, Yan; Groth, Stefan; Omar, Salem; Soehendra, Nib

    2012-01-01

    To determine the immediate and long-term results of endoscopic drainage and necrosectomy for symptomatic pancreatic fluid collections. The data of 80 patients with symptomatic pancreatic fluid collections (mean diameter: 11.7 cm, range 3-20; pseudocysts: 24/80, abscess: 20/80, infected walled-off necrosis: 36/80) referred for endoscopic management from October 1997 to March 2008 were analyzed retrospectively. Endoscopic drainage techniques included endoscopic ultrasound (EUS)-guided aspiration (2/80), EUS-guided transenteric drainage (70/80) and non-EUS-guided drainage across a spontaneous transenteric fistula (8/80). Endoscopic necrosectomy was carried out in 49/80 (abscesses: 14/20; infected necrosis: 35/36). Procedural complications were bleeding (12/80), perforation (7/80), portal air embolism (1/80) and Ogilvie Syndrome (1/80). Initial technical success was achieved in 78/80 (97.5%) and clinical resolution of the collections was achieved endoscopically in 67/80 (83.8%), with surgery required in 13/80 (perforation: four; endoscopically inaccessible areas: two; inadequate drainage: seven). Within 6 months five patients required surgery due to recurrent fluid collections; over a mean follow up of 31 months, surgery was required in four more patients due to recurrent collections as a consequence of underlying pancreatic duct abnormalities that could not be treated endoscopically. The long-term success of endoscopic treatment was 58/80 (72.5%). Endoscopic drainage of symptomatic pancreatic fluid collections is safe and effective, with excellent immediate and long-term results. Endoscopic necrosectomy has a risk of serious complications. The underlying pancreatic duct abnormalities must be addressed to prevent recurrence of fluid collections. © 2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.

  8. Primary abductor hip contracture as diagnostic, prognostic and therapeutic problem in child hip pathology

    Directory of Open Access Journals (Sweden)

    Pajić Miloš

    2007-01-01

    Full Text Available Coxa obliqua represents a special functional entity in the pathology of the child hip. Authors have confirmed the results of S.L. Weissman and B. Strinovic which claimed that the abductor contracture of the hip was a primary congenital condition that developed as a result of intrauterine malposition, leading later to the contralateral adductor contracture. Critical period for the development of complications was between 6 and 8 month after birth, adductor contracture might keep persisting together with the development of acetabular dysplasia, and later on with ipsilateral subluxation. This malformation has usually been diagnosed within 3 and 6 months of age. It could be connected with some other signs of malposition, such as plagiocephaly, torticollis or infantile thoracic C scoliosis. For the diagnosis of coxa obliqua, the examination of hips in the prone position was very important and the ultrasonic and radiological examinations were crucial. The applied treatment used to be exclusively physical rehabilitation. Wide diapering has been contraindicated. In this study, we included 2,500 newborns, 1,300 boys and 1,200 girls (5,000 hips. In 22 cases of coxa obliqua (10‰, the excellent results were obtained in 96% of cases. In two unsuccessfully treated cases, a contralateral dysplasia developed, and in one untreated, subluxation. The authors are advocating a systematic and early detection and treatment of the primary coxa obliqua. .

  9. Frequency of the superior rectus muscle overaction/contracture syndrome in unilateral fourth nerve palsy.

    Science.gov (United States)

    Molinari, Andrea; Ugrin, Maria Cristina

    2009-12-01

    Superior oblique palsy is accompanied in most cases by overaction of the muscle's ipsilateral antagonist, the inferior oblique muscle. Overaction and contracture of the ipsilateral superior rectus muscle in patients with unilateral fourth (trochlear) nerve palsy is seldom discussed in the literature. The purpose of this study is to evaluate the frequency of superior rectus muscle overaction/contracture syndrome in patients with unilateral trochlear nerve palsy. The records of 198 patients with unilateral trochlear nerve palsy examined by the authors between July 1987 and July 2008 were reviewed retrospectively. All patients underwent complete eye examination with measurement of the deviation in the 9 positions of gaze and with the head tilted to both sides in all cooperative patients. Selection criteria for superior rectus muscle overaction/contracture syndrome in these patients were as follows: vertical deviation of 15(Delta) or larger in primary position, equal or larger hypertropia with the ipsilateral forced tilt test than with the eyes looking straight ahead, more than 5(Delta) hypertropia of the affected eye in horizontal gaze to the same side, hypertropia in all upgazes, and overaction of the contralateral superior oblique muscle. Of 198 patients, 33 (16.6%) met the selection criteria for superior rectus muscle overaction/contracture syndrome. Superior rectus muscle overaction/contracture syndrome frequently occurs in unilateral superior oblique palsy.

  10. The role of ultrasonography in the diagnosis of gluteal muscle contracture.

    Science.gov (United States)

    Li, Qiu; Lingyan, Zhang; Yan, Luo; Yulan, Peng

    2011-02-01

    To evaluate the use of ultrasonography (US) in the diagnosis of gluteal muscle contracture (GMC) by analysis of its imaging characteristics. Thirty-nine patients suspected of having GMC due to abnormal gait underwent pre-operative US. The diagnosis of GMC was confirmed by surgery in 27 patients. Six patients were diagnosed with congenital hip dysplasia, and the remaining six patients were diagnosed with sciatic nerve damage, post-poliomyelitis sequelae, and myasthenia gravis. For the patients with GMC, US showed muscle thinning and hyperechoic strips (specific for muscular contracture) in the muscles involved. In three patients with GMC, the strips were integrated into muscle bundles, demonstrating both strong and weak sonographic echoes. The sensitivity and specificity of the diagnosis of GMC using the presence of strips were 88.9% and 83.3%, respectively, and using muscle thinning, the sensitivity and specificity were 92.6% and 50%, respectively. The contracture strips, as measured by US, were significantly smaller than the actual measurements at the time of surgery, but there was a significant correlation between the two measurements (r = 0.814, P muscle (91.8%), and the lowest rate was found in the piriformis muscle (52.9%). Ultrasonography is a valuable tool for the diagnosis of GMC, especially for the detection of specific contracture strips in involved muscles. Its role in the pre-operative diagnosis of GMC also provides surgical planning that can guide subsequent treatment.

  11. Half of the adults who present to hospital with stroke develop at least one contracture within six months: an observational study.

    Science.gov (United States)

    Kwah, Li Khim; Harvey, Lisa A; Diong, Joanna H L; Herbert, Robert D

    2012-01-01

    What is the incidence of contractures six months after stroke? Can factors measured within four weeks of stroke predict the development of elbow, wrist, and ankle contractures six months later? Prospective cohort study. Consecutive sample of 200 adults with stroke admitted to a Sydney hospital. Loss of range of motion in major joints of the body was measured using a 4-point ordinal contracture scale. In addition, elbow extension, wrist extension, and ankle dorsiflexion range of motion were measured using torque-controlled procedures. Potential predictors of contracture were age, pre-morbid function, severity of stroke, muscle strength, spasticity, motor function, and pain. Measurements were obtained within four weeks of stroke and at six months after stroke. 52% of participants developed at least one contracture. Incidence of contracture varied across joints from 12% to 28%; shoulders and hips were most commonly affected. Muscle strength was a significant predictor of elbow, wrist, and ankle joint range. Prediction models explained only 6% to 20% of variance in elbow, wrist, and ankle joint range. About half of all patients with stroke develop at least one contracture within six months of stroke. Incidence of contractures across all joints ranged from 12% to 28%. Muscle strength is a significant predictor of elbow, wrist, and ankle contractures but cannot be used to accurately predict contractures in these joints. Copyright © 2012 Australian Physiotherapy Association. Published by .. All rights reserved.

  12. 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

    and followed up during the proceeding 1.5 years regarding onset of long-term sickness absence. RESULTS: Long-term sickness absence among female employees was associated with role conflict, low reward, and poor management quality. Demands for hiding emotions and high emotional demands predicted long......-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...... and management quality among female employees, and through reducing emotional demands and demands for hiding emotions among male employees....

  13. Splinting after contracture release for Dupuytren's contracture (SCoRD: protocol of a pragmatic, multi-centre, randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chojnowski Adrian J

    2008-04-01

    Full Text Available Abstract Background Splinting as part of the overall post-surgical management of patients after release of Dupuytren's contracture has been widely reported, though there is variation in practice and criteria for using it. The evidence on its effectiveness is sparse, of poor quality and contradictory with studies reporting negative and positive effects. Methods/Design A multi-centre, pragmatic, randomized, controlled trial is being conducted to evaluate the effect of static night splinting for six months on hand function, range of movement, patient satisfaction and recurrence at 1 year after fasciectomy or dermofasciectomy. Using a centrally administered computer randomization system consented patients will be allocated to one of two groups: i splint group who will be given a static splint at approximately 10 to 14 days after surgery to be worn for 6 months at night time only as well as hand therapy; ii non-splint group, who will receive hand therapy only. The primary outcome measure is the patient-reported Disabilities of the Arm, Hand and Shoulder Questionnaire (DASH. Secondary outcomes are total active flexion and extension of fingers, patient satisfaction and recurrence of contracture. Outcome measures will be collected prior to surgery, 3 months, 6 months and 1 year after surgery. Using the DASH as the primary outcome measure, where a difference of 15 points is considered to be a clinically important difference a total of 51 patients will be needed in each group for a power of 90%. An intention-to-treat analysis will be used. Discussion This pragmatic randomized controlled trial will provide much needed evidence on the clinical effectiveness of post-operative night splinting in patients who have undergone fasciectomy or dermofasciectomy for Dupuytren's contracture of the hand. Trial Registration Current Controlled Trials ISRCTN 57079614

  14. Long-term functional, subjective and psychological results after single digit replantation.

    Science.gov (United States)

    Chen, Jing; Zhang, Ai Xian; Chen, Qing Zhong; Mu, Shuai; Tan, Jun

    2018-03-01

    The aim of this study was to analyse the long-term functional, subjective, and psychological results after single-digit replantation. Thirty cases of digital replantation (14 thumbs, 12 index fingers, 2 middle fingers, 1 ring finger, and 1 little finger) in 30 patients (7 females and 23 males) with a mean age of 44.2 years (20-65 years) were evaluated at the end of a mean follow-up time of 36 months (19-50 months). The active range of motion of joints, grip and pinch strength, cutaneous sensibility, upper-extremity functioning, and subjective satisfaction were determined using the Disability of Arm, Shoulder, and Hand (DASH) questionnaire and the Michigan Hand Outcomes questionnaire (MHQ). Psychological sequelae, including depression, anxiety, and posttraumatic stress disorder (PTSD), were assessed. A correlation analysis among variables was also performed. The mean score for the DASH questionnaire was 6.6 (range: 0-39.2). The symptom of cold intolerance occurred in 53% of the patients. Two patients were diagnosed with depression, and only one patient exhibited PTSD. The DASH score had a good statistical correlation with total grip strength, pinch grip strength, and static two-point discrimination (S-2PD) (P digit replantation are very low at long-term follow-up. Level IV, therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  15. Digital flexor tendon contracture treated by tenectomy: different clinical presentations in three cats

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    Quentin Cabon

    2015-07-01

    Full Text Available Case series summary Three cats, Siamese or Siamese cross, were presented with a chronic thoracic limb weightbearing lameness. Previous anti-inflammatory administrations were unable to improve lameness consistently in the three cats. Two of the three cats had undergone onychectomy several years before presentation. A permanent flexion of the proximal interphalangeal joint of one or more digits, associated with a difficult and painful extension of the proximal interphalangeal joint, was noticed during orthopedic examination. A digital flexor tendon contracture was suspected and confirmed with radiographic examination. Surgical exploration was then performed. For all cats, treatment consisted of a tenectomy or tenotomy of the superficial and deep digital flexor tendons in order to release the contracture. The three cats responded well to the surgical treatment and became sound around 2–4 weeks after surgery. Relevance and novel information Digital flexor tendon contracture is rarely reported as a cause of lameness in cats. It should be considered in a differential diagnosis of feline lameness whenever onychectomy has been performed in the past. The precise etiology that explains this tendon contracture is unknown, but trauma or breed predisposition could represent potential causes.

  16. Osteogenesis imperfecta with joint contractures: Bruck syndrome

    International Nuclear Information System (INIS)

    Blacksin, M.F.; Pletcher, B.A.; David, M.

    1998-01-01

    We describe an Egyptian boy with osteogenesis imperfecta who was born with thumb contractures and bilateral antecubital pterygia. He was seen at 16 months of age with femur and tibial fractures, thoracic vertebral compression fractures, scoliosis and Wormian bones. The findings are consistent with a diagnosis of Bruck syndrome. (orig.)

  17. Long-term functional, subjective and psychological results after single digit replantation

    Directory of Open Access Journals (Sweden)

    Jing Chen

    2018-03-01

    Full Text Available Objective: The aim of this study was to analyse the long-term functional, subjective, and psychological results after single-digit replantation. Methods: Thirty cases of digital replantation (14 thumbs, 12 index fingers, 2 middle fingers, 1 ring finger, and 1 little finger in 30 patients (7 females and 23 males with a mean age of 44.2 years (20–65 years were evaluated at the end of a mean follow-up time of 36 months (19–50 months. The active range of motion of joints, grip and pinch strength, cutaneous sensibility, upper-extremity functioning, and subjective satisfaction were determined using the Disability of Arm, Shoulder, and Hand (DASH questionnaire and the Michigan Hand Outcomes questionnaire (MHQ. Psychological sequelae, including depression, anxiety, and posttraumatic stress disorder (PTSD, were assessed. A correlation analysis among variables was also performed. Results: The mean score for the DASH questionnaire was 6.6 (range: 0–39.2. The symptom of cold intolerance occurred in 53% of the patients. Two patients were diagnosed with depression, and only one patient exhibited PTSD. The DASH score had a good statistical correlation with total grip strength, pinch grip strength, and static two-point discrimination (S-2PD (P < 0.05. Several aspects of the MHQ were also statistically relevant to some or all of the three objective results. Furthermore, the grip strength showed significant correlation with DASH and most aspects of the MHQ in multivariate logistic regression analysis (P < 0.05. Conclusion: Total grip strength is the most important factor positively related to subjective outcomes. The incidence rates of psychological symptoms after digit replantation are very low at long-term follow-up. Level of evidence: Level IV, therapeutic study. Keywords: Digit Replantation, DASH score, Posttraumatic stress disorder

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

    Science.gov (United States)

    Chaby, Lauren E; Cavigelli, Sonia A; White, Amanda; Wang, Kayllie; Braithwaite, Victoria A

    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. 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 [F (1, 12) = 5.000, P 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 [T (1, 14) = 2.240, P = 0.04; T (1, 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.

  19. Long-term results of modified Bentall procedure using flanged composite aortic prosthesis.

    Science.gov (United States)

    Tamura, Kiyoshi; Arai, Hirokuni; Kawaguchi, Satoru; Makita, Satoru; Miyagi, Naoto; Watanabe, Taiju; Fujiwara, Tatsuki

    2013-01-01

    We have been using the flanged composite aortic prosthesis and Carrel button technique to re-attach the coronary ostia in aortic root replacement procedures at our institution over the last twenty five years. Our objective was to evaluate the long-term results of aortic root replacement with this technique. A total of 73 patients from January 1984 to August 2010 were included in this study. The median age was 52.7 ± 14.4 years (range 28-80 years). There were 48 male and 25 female patients. 44 patients (60.3%) had annuloaortic ectasia, and 15 patients (20.5%) had acute type A aortic dissection. Marfan syndrome was recognized in 12 patients (16.5%). The early mortality rate was 5.5% (n = 4). Causes of death were multiple organ failures in two patients and sepsis in another two patients. The actuarial survival rate was 84.2% at 5 years, 64.3% at 15 years and 51.9% at 25 years. Only one patient with aortitis needed a reoperation because of coronary pseudoaneurysm after 23 years from the previous operation. This modified Bentall procedure is reliable and safe, with superior long-term survival and a low rate of aortic reoperation.

  20. Long term results of Epi-LASIK and LASEK for myopia.

    Science.gov (United States)

    Yuksel, Nilay; Bilgihan, Kamil; Hondur, Ahmet M; Yildiz, Burcin; Yuksel, Erdem

    2014-06-01

    To evaluate the long term clinical and confocal results of mechanical (Epi-LASIK) versus alcohol-assisted laser epithelial keratomileusis (LASEK) for correction of myopia. Gazi University Medical School, Department of Ophthalmology, Ankara, Turkey. Retrospective study. Twenty-two eyes treated with LASEK and twenty eyes treated with Epi-LASIK were evaluated with a mean follow-up duration of 45 months. Mechanical separation of the epithelium was performed with Lasitome epithelial separator, and alcohol-assisted separation with 25s application of 18% alcohol. Laser ablation was performed with the ESIRIS laser. All patients were examined daily until epithelial closure; at 1, 3, 6, and 12 months; and every year subsequently. Main outcome measures were uncorrected visual acuity (UCVA), manifest refraction, haze, and gray scale value in confocal microscopy, efficacy and safety indexes. Preoperative myopic spherical equivalent refraction was -4.65 ± 1.74 D in the LASEK and -3.87 ± 1.30 D in the Epi-LASIK-treated eyes (p=0.36). Of both LASEK and Epi-LASIK-treated eyes, 95% achieved 20/25 or better final UCVA. The grade of haze and mean gray scale value in confocal microscopy were similar in LASEK and Epi-LASIK-treated eyes at all postoperative periods. The efficacy index was 0.94 in LASEK group and 0.96 in Epi-LASIK group (p=0.44). The safety index was 1.01 in LASEK group and 1.02 in Epi-LASIK group (p=0.42). Both LASEK and Epi-LASIK offer safe and effective correction of myopia in the long term. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  1. Comparison of long-term results of laparoscopic and endoscopic exploration of common bile duct

    Directory of Open Access Journals (Sweden)

    Rai Sarabjit

    2006-01-01

    Full Text Available Background: To compare long term results of laparoscopic and endoscopic exploration of common bile duct, to assess post-procedure quality of life. Materials and Methods: From September 1992 to August 2003, we performed 4058 cholecystectomies, out of which 479 (11.80% patients had choledocholithiasis. There were 163 males and 316 females. Mean age was 63.65 ± 5.5 years. These patients were put in two groups. In the first group of 240 patients, a majority of patients underwent two-stage procedures. ERCP/ES was performed in 210 (87.50% cases. In the second group of 239 patients, a majority of patients underwent single-stage procedures. ERCP/ES was done in 32 (13.38% cases. Results: Mortality was zero in both groups. Morbidity was 15.1% in first group and 7.5% in second group. Mean hospital stay was 11.7 ± 3.2 days in first group and 6.2 ± 2.1 days in second group. Average operative time was 95.6 ± 20 minutes in first group and 128.4 ± 32 minutes in second group. Completed questionnaires received from 400 (83.50% patients revealed better long-term results in the second group. Clinical features of low-grade cholangitis were seen in 20% of patients who underwent ES. Hence the post-procedure quality of life in patients who underwent single-stage procedures was definitely much better, because of minimal damage of sphincter of Oddi. Conclusions: Single-stage laparoscopic operations provide better results and shorter hospital stay. Damage to sphincter of Oddi should be minimal, to avoid long-term low-grade cholangitis. In young patients, the operation of choice should be single-stage laparoscopic procedure with absolutely no damage to sphincter of Oddi.

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

    Energy Technology Data Exchange (ETDEWEB)

    Vaidya, Jayant S., E-mail: jayant.vaidya@ucl.ac.uk [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Baum, Michael [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Tobias, Jeffrey S. [Department of Radiation Oncology, University College London Hospitals, London (United Kingdom); Wenz, Frederik [Radiation Oncology and Gynaecology, University Medical Centre of Mannheim (Germany); Massarut, Samuele [Surgery and Radiation Oncology, Centro di Riferimento Oncologico (CRO), Aviano (Italy); Keshtgar, Mohammed [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Hilaris, Basil [Radiation Oncology, Our Lady of Mercy, New York Medical College, New York (United States); Saunders, Christobel [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Williams, Norman R.; Brew-Graves, Chris [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Corica, Tammy [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Roncadin, Mario [Surgery and Radiation Oncology, Centro di Riferimento Oncologico (CRO), Aviano (Italy); Kraus-Tiefenbacher, Uta; Suetterlin, Marc [Radiation Oncology and Gynaecology, University Medical Centre of Mannheim (Germany); Bulsara, Max [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Joseph, David [Radiation Oncology, Sir Charles Gairdner Hospital and School of Surgery, University of Western Australia, Perth (Australia)

    2011-11-15

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

  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.; Tóth, 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. 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.

    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

  5. 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

  6. Long-term results after primary infrapopliteal angioplasty for limb ischemia

    International Nuclear Information System (INIS)

    Alfke, H.; Marburg Univ.; Vannucchi, A.; Froelich, J.J.; Klinikum Bad Hersfeld; El-Sheik, M.; Wagner, H.J.; Vivantes-Klinikum im Friedrichshain

    2007-01-01

    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

  7. 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.

  8. Retrograde Intrarenal Surgery for Symptomatic Renal Sinus Cysts: Long-Term Results and Literature Review.

    Science.gov (United States)

    Mancini, Vito; Cormio, Luigi; d'Altilia, Nicola; Benedetto, Giuseppe; Ferrarese, Paolo; Balzarro, Matteo; Defidio, Lorenzo; Carrieri, Giuseppe

    2018-05-02

    To report the long-term multicenter experience with retrograde intrarenal holmium-laser incision (RIR-HoLI) in the management of symptomatic renal sinus cysts (RSCs). In the literature, RIR-HoLI has been shown to be a safe and effective treatment, but there are only a few reports regarding long-term results and reproducibility of this procedure. From June 2010 to June 2015, 14 patients with symptomatic RSCs underwent RIR-HoLI. The mean age was 52.1 ± 11.28 years (range 28-77) and the mean cyst size was 53.2 ± 14.23 mm (range 35-90). In all cases, contrast-enhanced computer tomography (CT) showed compression of the renal pelvis by the cyst (no malignancy). Surgical outcome was assessed in terms of symptoms improvement (measured by Visual Analogue Scale [VAS] for pain) and renal ultrasound findings at 3-6-12 months postoperatively and then yearly. CT scan was carried out at 12 months follow-up. RIR-HoLI was successful in all patients. The mean operative time was 47.8 ± 13.54 min (range 30-80) and mean hospital stay was 3.5 days (range 2-5). There were 2 Clavien grade II complications (flank pain and urgency delaying discharge). After surgery, all patients -became asymptomatic (VAS score change, p = 0.0001). One patient had persistence of a small cyst (10 mm). Mean follow-up is 44 ± 17.24 months (range 24-84); all patients remained asymptomatic, with no signs of recurrence. RIR-HoLI proved to be a safe and effective treatment for symptomatic RSCs. In our experience, it provided excellent long-term results and was reproducible at 4 different -institutions. © 2018 S. Karger AG, Basel.

  9. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  10. Physical therapy intervention for an adolescent with a knee flexion contracture and diagnosis of multiple pterygium syndrome.

    Science.gov (United States)

    Bellamy, Sandra Gail; Gibbs, Karen; Lazaro, Rolando

    2007-01-01

    The purpose of this case report is to describe a course of physical therapy for a client with a rare genetic condition, multiple pterygium syndrome (MPS). MPS is a rare genetic disorder characterized by connective tissue webbing across multiple joints, dysmorphic facies, and various visceral and skeletal deformities. Before the patient commenced physical therapy, surgical amputation was recommended for the client's knee flexion contracture. The client's treatment plan included stretching, manual therapy, and resisted exercise. Long-term outcomes were decreased back and knee pain and improved range of motion, strength, and ambulation. Therapists using techniques to improve joint range of motion in clients with MPS should be aware that pterygia may include contractile tissue, nerves, and blood vessels and there may be underlying skeletal deformity or weakness in these areas. Children with MPS are at high risk of developing scoliosis and should be appropriately assessed in early childhood.

  11. Afferent Innervation, Muscle Spindles, and Contractures Following Neonatal Brachial Plexus Injury in a Mouse Model.

    Science.gov (United States)

    Nikolaou, Sia; Hu, Liangjun; Cornwall, Roger

    2015-10-01

    We used an established mouse model of elbow flexion contracture after neonatal brachial plexus injury (NBPI) to test the hypothesis that preservation of afferent innervation protects against contractures and is associated with preservation of muscle spindles and ErbB signaling. A model of preganglionic C5 through C7 NBPI was first tested in mice with fluorescent axons using confocal imaging to confirm preserved afferent innervation of spindles despite motor end plate denervation. Preganglionic and postganglionic injuries were then created in wild-type mice. Four weeks later, we assessed total and afferent denervation of the elbow flexors by musculocutaneous nerve immunohistochemistry. Biceps muscle volume and cross-sectional area were measured by micro computed tomography. An observer who was blinded to the study protocol measured elbow flexion contractures. Biceps spindle and muscle fiber morphology and ErbB signaling pathway activity were assessed histologically and immunohistochemically. Preganglionic and postganglionic injuries caused similar total denervation and biceps muscle atrophy. However, after preganglionic injuries, afferent innervation was partially preserved and elbow flexion contractures were significantly less severe. Spindles degenerated after postganglionic injury but were preserved after preganglionic injury. ErbB signaling was inactivated in denervated spindles after postganglionic injury but ErbB signaling activity was preserved in spindles after preganglionic injury with retained afferent innervation. Preganglionic and postganglionic injuries were associated with upregulation of ErbB signaling in extrafusal muscle fibers. Contractures after NBPI are associated with muscle spindle degeneration and loss of spindle ErbB signaling activity. Preservation of afferent innervation maintained spindle development and ErbB signaling activity, and protected against contractures. Pharmacologic modulation of ErbB signaling, which is being investigated as a

  12. Long term results of pyeloplasty in adults

    International Nuclear Information System (INIS)

    Tayib, Abdul Malik

    2004-01-01

    To determine the presenting systems, complications, stone coincidence in adult patients with primary ureteropelvic junction (UPJ) obstruction seen at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia. We are also reporting the success rate and long term results of adult pyeloplasty. We reviewed the records of 34 patients who underwent 37 pyeloplasty operations during the period January 1992 through to June 2002. The preoperative radiological diagnosis made by intravenous urogram or renal isotopes scan. We excluded from our study patients with previous history of passage of stones, renal or ureteral surgeries, large renal pelvis stone that may cause UPJ obstruction or abnormalities that may lead to secondry UPJ obstruction such as vesicoureteral reflux. There were 28 male patients and 8 females, their age varied between 16 and 51-years, the mean age was 36.1 years, and 18 (52.9%) patients had concomitant renal stones. Ispsilateral split renal function improved by 3-7% post pyeloplasty in 23 patients, while in one patient the function stayed the same, and in another patient the split function reduced by 4%. T1/2 renal isotopes washout time became less than 15 minutes in 19 patients and less than 20 minutes in 6 patients. Intravenous urogram revealed disappearence of the obstruction at UPJ in 7 patients while in 2 patients it became poorly functioning. Anderson Hynes pyeloplasty is an excellent procedure for treating UPJ obstruction in adults. Our success rate is comparable to the international repoted rates, while our study revealed a higher incidence of concomitant renal stones than the international studies. (author)

  13. 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.

  14. Practical implications for RPV irradiation surveillance under long term operation based on latest research results

    International Nuclear Information System (INIS)

    Hein, H.; Keim, E.; Barthelmes, J.; Schnabel, H.

    2015-01-01

    The international programs CARISMA, CARINA and LONGLIFE belong to the research programs which have been performed during the last 10 years to study the irradiation behavior of RPV steels under long term operation of more than 60 years. Some characteristic but different irradiated RPV steels used in Pressurized Water Reactors have been extensively investigated in each of those three programs. Whereas the CARISMA and CARINA programs were mainly focused on material testing to study the irradiation-induced change of material properties in terms of fracture toughness, the main objective of LONGLIFE was to investigate the change of microstructure with various analysis techniques and to understand the mechanisms behind. In this way it was possible to get a comprehensive material characterization in terms of macro-physical properties and micro-structural features for a number of RPV steels which have been studied at different irradiation levels up to 8*10 19 cm -2 (E > 1 MeV). The essential macro-physical and micro-structural results are summarized, in particular regarding the impact of copper and nickel, and the neutron flux on the irradiation behavior and with respect to possible late irradiation effects under long term operation. Moreover, the change of material properties is linked with embrittlement mechanisms such as formation of element specific precipitations, segregations, and matrix defects. Well-known trend curves are also applied to the measured T 41 and T 0 data in order to assess their appropriateness for long term operation. Based on the comprehensive available data base, practical implications for RPV irradiation surveillance programs under long term operation are highlighted with respect to issues like material specific application of reference temperature concepts, data scattering, prediction of high fluence behavior and how to cope with possible late irradiation effects. Finally, best practices for RPV irradiation surveillance programs are suggested from

  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. Osteogenesis imperfecta with joint contractures: Bruck syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Blacksin, M.F. [Department of Radiology, University of Medicine and Dentistry of New Jersey, 150 Bergen St., Rm. C320, Newark, NJ 07103-2426 (United States); Pletcher, B.A. [Center for Human and Molecular Genetics, Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (United States); David, M. [Department of Radiology, Newark-Beth Israel Medical Center, Newark, New Jersey (United States)

    1998-02-01

    We describe an Egyptian boy with osteogenesis imperfecta who was born with thumb contractures and bilateral antecubital pterygia. He was seen at 16 months of age with femur and tibial fractures, thoracic vertebral compression fractures, scoliosis and Wormian bones. The findings are consistent with a diagnosis of Bruck syndrome. (orig.) With 1 fig., 5 refs.

  17. Degree of Contracture Related to Residual Muscle Shoulder Strength in Children with Obstetric Brachial Plexus Lesions

    NARCIS (Netherlands)

    van Gelein Vitringa, V. M.; van Noort, A.; Ritt, M.J.P.F.; van Royen, B.J.; van der Sluijs, J.A.

    2015-01-01

    Background and Objectives Little is known about the relation between residual muscle strength and joint contracture formation in neuromuscular disorders. This study aimed to investigate the relation between residual muscle strength and shoulder joint contractures in children with sequelae of

  18. Quality of life in older individuals with joint contractures in geriatric care settings.

    Science.gov (United States)

    Heise, Marco; Müller, Martin; Fischer, Uli; Grill, Eva

    2016-09-01

    The purpose of this study was to analyze the association between functioning and disability and quality of life (QoL) in older individuals with joint contractures in the geriatric care setting. More specifically, this study aimed to identify determinants of QoL out of a defined set of contracture-related categories of the International Classification of Functioning, Disability and Health (ICF). Participants for this multicenter cross-sectional survey were recruited from acute geriatric rehabilitation hospitals, nursing homes, and community nursing facilities in Germany between February and October 2013. QoL was assessed using the validated German version of the EQ-5D index score and the EQ-5D visual analog scale (VAS). Manual and automatic variable selection methods were used to identify the most relevant variables out of 125 contracture-related ICF categories. A total of 241 eligible participants (34.9 % male, mean age 80.1 years) were included. The final models contained 14 ICF categories as predictors of the EQ-5D index score and 15 categories as predictors of the EQ-5D VAS. The statistically significant ICF categories from both models were 'muscle power functions (b730),' 'memory functions (b144),' 'taking care of plants (d6505),' 'recreation and leisure (d920),' 'religion and spirituality (d930),' 'drugs (e1101),' and 'products and technology for personal use in daily living (e115).' We identified the most relevant ICF categories for older individuals with joint contractures and their health-related quality of life. These items describe potential determinants of QoL which may provide the basis for future health interventions aiming to improve QoL for the patients with joint contractures.

  19. A study of the long-term effect of malar fat repositioning in face lift surgery: short-term success but long-term failure.

    Science.gov (United States)

    Hamra, Sam T

    2002-09-01

    In 1990, the author reported on a series of 403 cases of deep plane face lifts, the first published technique describing the repositioning of the cheek fat, known as malar fat, in face lift surgery. This study examines the long-term results of 20 of the original series in an attempt to determine what areas of the rejuvenated face (specifically, the malar fat) showed long-term improvement. The results were judged by comparing the preoperative and long-term postoperative views in a half-and-half same-side hemiface photograph. The anatomy of the jawline (superficial musculoaponeurotic system [SMAS]), the nasolabial fold (malar fat), and the periorbital diameter were evaluated. The results confirmed that repositioning of the SMAS remained for longer than improvement in the nasolabial fold and that the vertical diameter of the periorbit did not change at all. The early results of malar fat repositioning shown at 1 to 2 years were successful, but the long-term results showed failure of the early improvement, manifested by recurrence of the nasolabial folds. There was, however, continuation of the improved results of the forehead lift and SMAS maneuvers of the original procedure. The conclusion is that only a direct excision will produce a permanent correction of the aging nasolabial fold.

  20. Very long-term sequelae of craniopharyngioma.

    Science.gov (United States)

    Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M

    2017-06-01

    Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after

  1. Results of long-term measurement of 222Rn concentrations in outdoor atmosphere

    International Nuclear Information System (INIS)

    Holy, K.; Boehm, R.; Polaskova, A.; Hola, O.

    1998-01-01

    Results are reported of the authors' long-term measurement of 222 Rn concentrations in the outdoor atmosphere. The measurements started in 1987 and were performed at a height of 1.5 m over a grass-covered ground surface, using till 1991 a Lucas type scintillation chamber and later a large volume scintillation chamber. Graphs are presented and discussed of the course of average monthly radon concentration in 1987-1996 and of annual courses of radon concentration for different time intervals of the day over 1991 to 1995. (A.K.)

  2. Long-term Results of the Patients with Regional Transient Osteoporosis

    Directory of Open Access Journals (Sweden)

    Kenan Akgün

    2002-09-01

    Full Text Available Transient regional osteoporosis is an uncommon cause of hip pain. It affects mostly healthy middle-aged men, and women in the third trimester of pregnancy. The aetiology is unknown. Eight patients (3 females, 5males who were diagnosed as transient regional osteoporosis of hip were included in the study. Long-term results of all the patients were evaluated. Their mean follow-up duration was 5.1 years. Following every hip involvement, after a mean duration of 6.6 months, all the patients were asymptomatic and returned to full activitiy without residual effects. Both hips were affected in 5 patients, in 4 of which the involvement was migratory. Migratory involvement duration ranged from 3 months to 4 years. In conclusion, Transient regional osteoporosis is self-limiting and resolves symptomatically and radiologically within some months of presentation.

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

    International Nuclear Information System (INIS)

    Chin, H.W.; Maruyama, Y.

    1984-01-01

    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

  4. Non Surgical Treatment of Established Forearm’s Volkmann Contracture in Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Seyed Ali Hosseini

    2010-04-01

    Full Text Available The acute compartment syndrome of the forearm is rare and may therefore be easily missed. Although many clinicians will not see such a patient during their entire career, profound knowledge of the symptoms is required to recognize the syndrome in time. Besides immediate identification of the compartment syndrome early surgical treatment is mandatory to avoid its devastating consequences. Then the functional results can be good, but it can't be correct in child because of more chance to survive necrotic muscle and regain motion with splinting and hand therapy. This study reported the nonsurgical treatment for ischemic contracture of hand and forearm due to displaced supra-condylar fracture of the humorous at 6 years old boy, after fixed contractures.

  5. Dupuytren’s contracture of hand and its medical and social review

    Directory of Open Access Journals (Sweden)

    V. O. Vishnevskiy

    2014-02-01

    Full Text Available Introduction Dupuytren's contracture is a disease of connective tissue with the affection of palmar aponeurosis, frequently with chronic recurrent course, the flexion deformities of fingers and dysfunction of the hand. It composed 11,8 % among of all types of the hand pathology. The mostly it develops in men of middle-aged and elderly. At young age it occurs more rarely, but with fast progressing current, which in 67 % of cases leads to impaired ability to perform professional hand-work and in 3 % patients to physical inability. Predisposing factors for this fibromatosis are numerous, but one of the popular opinion among of authors is a hereditary character of disease. In clinical practice, the most frequently used fourth degree’s classification of Dupuytren's contracture includes severity of deformation and function disorders of the hand. It is correspond to the normative standards of medical and social expertise The aim of research: to specify the most optimal methods of surgical treatment, the criteria of medical and social examination and rehabilitation, clinical and labor prognosis, indications to establishment of disability after operations concerning of Dupuytren’s contracture. In our clinic was performed three methods of operation: aponeurotomia “open hand”, partial aponeuroectomia, total aponeuroectomia. Errors in the treatment of palmar fibromatosis we shared on: preoperated, intraoperated and associated with violations of the mode of rehabilitation. The next clinical observation of 68 patients (up to 3 years after surgery with Dupuytren’s contracture of hand showed the recurrence rate amounted to 31,7%, and physical inability level is 5,9% of cases. In our opinion the most optimal operative methodic is total aponeuroectomia with rational surgical approaches. Clinical and labour prognosis depends on the manifestations of disease which can develop regardless of the stage, methods of treatment and patient's age. Disadvantageous

  6. Reconstruction of hand contracture by reverse ulnar perforator flap

    Directory of Open Access Journals (Sweden)

    Cengiz Eser

    2016-04-01

    Full Text Available Hand burn scar contractures affect patients in aesthetic and functional aspects. After releasing these scars, the defects should be repaired. The reconstruction methods include primary suturation, Z plasty, skin grafting, local or free flaps, etc. All methods have their own advantages and disadvantages. One of the most useful flaps is the reverse ulnar perforator flap. We performed a two-staged procedure for repairing a post-burn contracture release defect in a 40-year-old male. In the first stage we applied reverse ulnar perforator flap for the hand defect, and ulnar artery and vein repair in the second stage. In conclusion, this two-staged procedure is a non-primary but useful option for hand and finger defects and prevents major vascular structure damage of the forearm. [Hand Microsurg 2016; 5(1.000: 40-43

  7. Camptodactyly: A Phenotype of Dupuytren′s Contracture

    Directory of Open Access Journals (Sweden)

    Kamleader Singh

    1985-01-01

    Full Text Available A 15 year old boy had permanent flexion contractures at proximal interphalangeal joints of the little and ring fingers of both hands, along with slight hemiatrophy of face and bilateral mild ptosis. The hand deformity superficially resembled. Dupuytren′s contacture. This combination of features does not fit with the syndromes described so far, whose one of, the components is camptodactyly.

  8. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  9. Long-term Results of Percutaneous Ethanol Injection for the Treatment of Hepatocellular Carcinoma in Korea

    International Nuclear Information System (INIS)

    Sung, Yon Mi; Choi, Don Gil; Lim, Hyo K.

    2006-01-01

    To evaluate the long-term follow-up results of percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC) in Korea. Sixty-eight nodular HCCs initially detected in 64 patients, were subjected to US-guided PEI as a first-line treatment. Long-term survival rates, local tumor progression rates, and complications were evaluated, as were the influences of tumor size and Child-Pugh class on these variables. No major complications occurred. The overall survival rates of the 64 patients at three and five years were 71% and 39%, and their cancer-free survival rates were 22% and 15%, respectively. The overall survival rate of patients with a small HCC (≤ 2 cm) was significantly higher (p = 0.014) than that of patients with a medium-sized HCC (≤ 2 cm). The overall survival rate of patients with Child- Pugh class A was significantly higher (p = 0.049) than that of patients with Child- Pugh class B. Of 59 cases with no residual tumor, local tumor progression was observed in ablation zones in 18, and this was not found to be significantly influenced by tumor size or Child-Pugh class. The results of our investigation of the long-term survival rates of PEI in HCC patients in Korea (a hepatitis B virus-endemic area) were consistent with those reported previously in hepatitis C endemic areas. Patients with a smaller tumor or a better liver function exhibited superior survival rates

  10. Bentall procedure using cryopreserved valved aortic homografts: mid- to long-term results.

    Science.gov (United States)

    Christenson, Jan T; Sierra, Jorge; Trindade, Pedro T; Dominique, Didier; Kalangos, Afksendiyos

    2004-01-01

    The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 +/- 21 years (range, 15-74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 +/- 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6-72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft.

  11. Passive mechanical properties of gastrocnemius muscles of people with ankle contracture after stroke.

    Science.gov (United States)

    Kwah, Li Khim; Herbert, Robert D; Harvey, Lisa A; Diong, Joanna; Clarke, Jillian L; Martin, Joshua H; Clarke, Elizabeth C; Hoang, Phu D; Bilston, Lynne E; Gandevia, Simon C

    2012-07-01

    To investigate the mechanisms of contracture after stroke by comparing passive mechanical properties of gastrocnemius muscle-tendon units, muscle fascicles, and tendons in people with ankle contracture after stroke with control participants. Cross-sectional study. Laboratory in a research institution. A convenience sample of people with ankle contracture after stroke (n=20) and able-bodied control subjects (n=30). Not applicable. Stiffness and lengths of gastrocnemius muscle-tendon units, lengths of muscle fascicles, and tendons at specific tensions. At a tension of 100N, the gastrocnemius muscle-tendon unit was significantly shorter in participants with stroke (mean, 436mm) than in able-bodied control participants (mean, 444mm; difference, 8mm; 95% confidence interval [CI], 0.2-15mm; P=.04). Muscle fascicles were also shorter in the stroke group (mean, 44mm) than in the control group (mean, 50mm; difference, 6mm; 95% CI, 1-12mm; P=.03). There were no significant differences between groups in the mean stiffness or length of the muscle-tendon units and fascicles at low tension, or in the mean length of the tendons at any tension. People with ankle contracture after stroke have shorter gastrocnemius muscle-tendon units and muscle fascicles than control participants at high tension. This difference is not apparent at low tension. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. The interaction of short-term and long-term memory in phonetic category formation

    Science.gov (United States)

    Harnsberger, James D.

    2002-05-01

    This study examined the role that short-term memory capacity plays in the relationship between novel stimuli (e.g., non-native speech sounds, native nonsense words) and phonetic categories in long-term memory. Thirty native speakers of American English were administered five tests: categorial AXB discrimination using nasal consonants from Malayalam; categorial identification, also using Malayalam nasals, which measured the influence of phonetic categories in long-term memory; digit span; nonword span, a short-term memory measure mediated by phonetic categories in long-term memory; and paired-associate word learning (word-word and word-nonword pairs). The results showed that almost all measures were significantly correlated with one another. The strongest predictor for the discrimination and word-nonword learning results was nonword (r=+0.62) and digit span (r=+0.51), respectively. When the identification test results were partialed out, only nonword span significantly correlated with discrimination. The results show a strong influence of short-term memory capacity on the encoding of phonetic detail within phonetic categories and suggest that long-term memory representations regulate the capacity of short-term memory to preserve information for subsequent encoding. The results of this study will also be discussed with regards to resolving the tension between episodic and abstract models of phonetic category structure.

  13. Biceps Tendon Lengthening Surgery for Failed Serial Casting Patients With Elbow Flexion Contractures Following Brachial Plexus Birth Injury.

    Science.gov (United States)

    Nath, Rahul K; Somasundaram, Chandra

    2016-01-01

    Assessment of surgical outcomes of biceps tendon lengthening (BTL) surgery in obstetric brachial plexus injury (OBPI) patients with elbow flexion contractures, who had unsuccessful serial casting. Serial casting and splinting have been shown to be effective in correcting elbow flexion contractures in OBPI. However, the possibilities of radial head dislocations and other complications have been reported in serial casting and splinting. Literature indicates surgical intervention when such nonoperative techniques and range-of-motion exercises fail. Here, we demonstrated a significant reduction of the contractures of the affected elbow and improvement in arm length to more normal after BTL in these patients, who had unsuccessful serial casting. Ten OBPI patients (6 girls and 4 boys) with an average age of 11.2 years (4-17.7 years) had BTL surgery after unsuccessful serial casting. Mean elbow flexion contracture was 40° before and 37° (average) after serial casting. Mean elbow flexion contracture was reduced to 8° (0°-20°) post-BTL surgical procedure with an average follow-up of 11 months. This was 75% improvement and statistically significant (P casting. These OBPI patients in our study had 75% significant reduction in elbow flexion contractures and achieved an improved and more normal length of the affected arm after the BTL surgery when compared to only 7% insignificant reduction and no improvement in arm length after serial casting.

  14. Long-term potentiation and long-term depression: a clinical perspective

    Directory of Open Access Journals (Sweden)

    Timothy V.P. Bliss

    2011-01-01

    Full Text Available Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke.

  15. Long-term biodosimetry Redux

    International Nuclear Information System (INIS)

    Simon, Steven L.; Bouville, Andre

    2016-01-01

    This paper revisits and reiterates the needs, purposes and requirements of bio-dosimetric assays for long-term dose and health risk assessments. While the most crucial need for bio-dosimetric assays is to guide medical response for radiation accidents, the value of such techniques for improving our understanding of radiation health risk by supporting epidemiological (long-term health risk) studies is significant. As new cohorts of exposed persons are identified and new health risk studies are undertaken with the hopes that studying the exposed will result in a deeper understanding of radiation risk, the value of reliable dose reconstruction is underscored. The ultimate application of biodosimetry in long-term health risk studies would be to completely replace model-based dose reconstruction-a complex suite of methods for retrospectively estimating dose that is commonly fraught with large uncertainties due to the absence of important exposure-related information, as well as imperfect models. While biodosimetry could potentially supplant model-based doses, there are numerous limitations of presently available techniques that constrain their widespread application in health risk research, including limited ability to assess doses received far in the past, high cost, great inter-individual variability, invasiveness, higher than preferred detection limits and the inability to assess internal dose (for the most part). These limitations prevent the extensive application of biodosimetry to large cohorts and should be considered a challenge to researchers to develop new and more flexible techniques that meet the demands of long-term health risk research. Events in recent years, e.g. the Fukushima reactor accident and the increased threat of nuclear terrorism, underscore that any event that results in significant radiation exposures of a group of people will also produce a much larger population, exposed at lower levels, but that likewise needs (or demands) an exposure

  16. "Popeye muscle" morphology in OBPI elbow flexion contracture.

    Science.gov (United States)

    Coroneos, Christopher J; Maizlin, Zeev V; DeMatteo, Carol; Gjertsen, Deborah; Bain, James R

    2015-01-01

    The pathophysiology of elbow flexion contracture (EFC) in obstetrical brachial plexus injury (OBPI) is not established. In basic science models, neonatal denervation leads to impaired muscle growth. In clinical studies, diminished growth is correlated with extent of denervation, and improved with surgical repair. In EFC, the biceps are clinically short and round vs the contralateral size, termed the "Popeye muscle". The objective of this study was to determine if the biceps morphology (muscle belly and tendon length) in arms with EFC secondary to OBPI is different vs the contralateral. This is a retrospective matched-cohort study. Patients with unilateral EFC (>20°) secondary to OBPI were identified (median = 6.6 years, range = 4.7-16.8). A blinded radiologist used computed tomography to measure length of the biceps short head muscle belly, and tendon bilaterally using standardised anatomical landmarks. Twelve patients were analyzed. The biceps muscle belly in the injured arm was shorter in all patients vs contralateral, mean difference = 3.6 cm (80%), p muscle belly and overall length, but longer tendon vs normal. This is termed the "Popeye muscle" for its irregular morphology. Findings are consistent with impaired limb growth in denervation.

  17. How Does the Ca2+-paradox Injury Induce Contracture in the Heart?—A Combined Study of the Intracellular Ca2+ Dynamics and Cell Structures in Perfused Rat Hearts—

    International Nuclear Information System (INIS)

    Mani, Hiroki; Tanaka, Hideo; Adachi, Tetsuya; Ikegawa, Masaya; Dai, Ping; Fujita, Naohisa; Takamatsu, Tetsuro

    2015-01-01

    The calcium (Ca 2+ )-paradox injury of the heart, induced by restoration of extracellular Ca 2+ after its short-term depletion, is known to provoke cardiomyocyte contracture. However, undetermined is how the Ca 2+ -paradox provokes such a distinctive presentation of myocytes in the heart. To address this, we imaged sequential intracellular Ca 2+ dynamics and concomitant structures of the subepicardial ventricular myocytes in fluo3-loaded, Langendorff-perfused rat hearts produced by the Ca 2+ paradox. Under rapid-scanning confocal microscopy, repletion of Ca 2+ following its depletion produced high-frequency Ca 2+ waves in individual myocytes with asynchronous localized contractions, resulting in contracture within 10 min. Such alterations of myocytes were attenuated by 5-mM NiCl 2 , but not by verapamil, SEA0400, or combination of ryanodine and thapsigargin, indicating a contribution of non-specific transmembrane Ca 2+ influx in the injury. However, saponin-induced membrane permeabilization of Ca 2+ showed no apparent contracture despite the emergence of high-frequency Ca 2+ waves, indicating an essential role of myocyte-myocyte and myocyte-extracellular matrix (ECM) mechanical connections in the Ca 2+ paradox. In immunohistochemistry Ca 2+ depletion produced separation of the intercalated disc that expresses cadherin and dissipation of β-dystroglycan located along the sarcolemma. Taken together, along with the trans-sarcolemmal Ca 2+ influx, disruption of cell-cell and cell-ECM connections is essential for contracture in the Ca 2+ -paradox injury

  18. The effects of denervation, reinnervation, and muscle imbalance on functional muscle length and elbow flexion contracture following neonatal brachial plexus injury.

    Science.gov (United States)

    Weekley, Holly; Nikolaou, Sia; Hu, Liangjun; Eismann, Emily; Wylie, Christopher; Cornwall, Roger

    2012-08-01

    The pathophysiology of paradoxical elbow flexion contractures following neonatal brachial plexus injury (NBPI) is incompletely understood. The current study tests the hypothesis that this contracture occurs by denervation-induced impairment of elbow flexor muscle growth. Unilateral forelimb paralysis was created in mice in four neonatal (5-day-old) BPI groups (C5-6 excision, C5-6 neurotomy, C5-6 neurotomy/repair, and C5-T1 global excision), one non-neonatal BPI group (28-day-old C5-6 excision), and two neonatal muscle imbalance groups (triceps tenotomy ± C5-6 excision). Four weeks post-operatively, motor function, elbow range of motion, and biceps/brachialis functional lengths were assessed. Musculocutaneous nerve (MCN) denervation and reinnervation were assessed immunohistochemically. Elbow flexion motor recovery and elbow flexion contractures varied inversely among the neonatal BPI groups. Contracture severity correlated with biceps/brachialis shortening and MCN denervation (relative axon loss), with no contractures occurring in mice with MCN reinnervation (presence of growth cones). No contractures or biceps/brachialis shortening occurred following non-neonatal BPI, regardless of denervation or reinnervation. Neonatal triceps tenotomy did not cause contractures or biceps/brachialis shortening, nor did it worsen those following neonatal C5-6 excision. Denervation-induced functional shortening of elbow flexor muscles leads to variable elbow flexion contractures depending on the degree, permanence, and timing of denervation, independent of muscle imbalance. Copyright © 2012 Orthopaedic Research Society.

  19. Cost-effectiveness in the management of Dupuytren's contracture. A Canadian cost-utility analysis of current and future management strategies.

    Science.gov (United States)

    Baltzer, H; Binhammer, P A

    2013-08-01

    In Canada, Dupuytren's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy (PNA). Injectable collagenase will soon be available. The optimal management of Dupuytren's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren's contracture it and the threshold at which collagenase is cost-effective. We developed an expected-value decision analysis model for Dupuytren's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Cost-effectiveness, one-way sensitivity and variability analyses were performed using standard thresholds for cost effective treatment ($50 000 to $100 000/QALY gained). Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger. The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. Collagenase was cost-effective relative to and preferred over aponeurotomy at $875 and $470 per course of treatment, respectively. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing.

  20. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture

    Energy Technology Data Exchange (ETDEWEB)

    Ribuffo, Diego; Lo Torto, Federico [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Giannitelli, Sara M. [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Urbini, Marco; Tortora, Luca [Surface Analysis Laboratory, Department of Mathematics and Physics, University “Roma Tre”, Via della Vasca Navale 84, 00146 Rome (Italy); INFN — National Institute of Nuclear Physics, Section of Roma Tre, Via della Vasca Navale 84, 00146 Rome (Italy); Mozetic, Pamela; Trombetta, Marcella [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Basoli, Francesco; Licoccia, Silvia [Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, Via della Ricerca Scientifica 1, 00173 Rome (Italy); Tombolini, Vincenzo [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Spencer-Lorillard Foundation, Viale Regina Elena 291, 00161 Rome (Italy); Cassese, Raffaele [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Scuderi, Nicolò [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); and others

    2015-12-01

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture. - Highlights: • The debate continues whether to perform breast reconstruction before or after PMRT. • Radiation therapy may alter implant material, concurring to capsular contracture. • In this work, irradiated implants were investigated by a multi-technique approach. • Radiation-induced alterations could be evidenced by ATR/FTIR and ToF-SIMS. • Reported alteration might represent a co-factor underlying capsular contracture.

  1. Epidermolytic hyperkeratosis with a rare digital contracture

    Directory of Open Access Journals (Sweden)

    Das Sudip

    2007-01-01

    Full Text Available A sixteen year-old male patient with no history of consanguinity in the family, reported with patchy, thickened lichenified plaques over the whole body. Some areas had normal skin while some were Blaschkoid lesions. The child had delayed milestones along with hypogonadism. Digital contracture with palmoplantar keratoderma was present. Histopathology showed characteristic vacuolar degeneration of the upper epidermis and suprabasilar keratinocytes with hyperkeratosis.

  2. Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases.

    Science.gov (United States)

    Pugliese, Raffaele; Forgione, Antonello; Sansonna, Fabio; Ferrari, Giovanni Carlo; Di Lernia, Stefano; Magistro, Carmelo

    2010-03-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique that aims at reducing or abolishing skin incisions and potentially also postoperative pain. The purpose of this study was to analyse operative and long-term results of a series of hybrid transvaginal cholecystectomy. Between July 2007 and May 2009, transvaginal NOTES cholecystectomy for symptomatic cholelithiasis was performed by a hybrid technique in 18 women (mean age 54 years), including four women with a body mass index >30 kg/m(2). Dissection was conducted in the first four cases by a round-tip unipolar electrode (UE) introduced through the operative channel of the endoscope coming from the vagina and in the last 14 cases by a ultrasonic scalpel (US) introduced through a 5-mm abdominal port. The short-term outcomes and the long-term results of the two methods were compared. The transvaginal approach entailed no intraoperative complication and no conversion. The overall mean duration of procedures was 75 min (range 40-190). In the first four cases (UE), the operating time was 148 min (range 140-190), whilst in the last 14 (US), it was considerably shorter, 53 min (range 40-60, p < 0.01). We experienced one biliary leak in the UE group, whilst morbidity with US was nil (p < 0.005). The biliary leak healed in 7 days with nasobiliary drainage. No other complications were encountered in either group. The mean follow-up was 12 months (range 1-22), and none of the patients has complained of dyspareunia or other colpotomy-related complications so far. Until specifically designed endoscopic tools are available for NOTES, the hybrid technique with US dissection conducted through a 5-mm port should be preferred in transvaginal cholecystectomy in order to shorten the duration of surgery and make this approach effective, safe and reproducible. After a mean follow-up of 1 year, none of our patients has complained of any problem related to transvaginal approach.

  3. Long-Term Symbolic Learning

    National Research Council Canada - National Science Library

    Kennedy, William G; Trafton, J. G

    2007-01-01

    What are the characteristics of long-term learning? We investigated the characteristics of long-term, symbolic learning using the Soar and ACT-R cognitive architectures running cognitive models of two simple tasks...

  4. Long-term results of repeated anti-vascular endothelial growth factor therapy in eyes with retinal pigment epithelial tears.

    Science.gov (United States)

    Moreira, Carlos A; Arana, Luis A; Zago, Rommel J

    2013-02-01

    To evaluate the long-term results of retinal pigment epithelium tears in eyes treated with repeated anti-vascular endothelial growth factor (VEGF) therapy. Five patients with retinal pigment epithelial tears (without foveal center involvement) after anti-VEGF injection were studied retrospectively. Mean follow-up time was 52 months, with measurements of visual acuity and evaluation of macular findings by angiography and optical coherence tomography during this period. All eyes had a persistent submacular neovascular membrane 30 days after the tear. An anti-VEGF drug was reinjected until the membranes stopped leaking. The mean initial visual acuity immediately after the tear was 20/160, and the mean final visual acuity was 20/60. The number of anti-VEGF reinjections varied from two to eight during the follow-up period. Long-term optical coherence tomography analysis showed reduced fluid and remodeling of the torn retinal pigment epithelium. Long-term visual results with repeated anti-VEGF therapy are not as devastating as suggested previously. Visual acuity and metamorphopsia improve with time as long as the neovascular membrane is inactive. Optical coherence tomography changes in the macular area reflect the visual acuity improvement.

  5. Pediatric polytrauma : Short-term and long-term outcomes

    NARCIS (Netherlands)

    vanderSluis, CK; Kingma, J; Eisma, WH; tenDuis, HJ

    Objective: To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods: Ail pediatric polytrauma patients (Injury Severity Score of greater than or equal to 16, less than

  6. Hippocampal Focal Knockout of CBP Affects Specific Histone Modifications, Long-Term Potentiation, and Long-Term Memory

    Science.gov (United States)

    Barrett, Ruth M; Malvaez, Melissa; Kramar, Eniko; Matheos, Dina P; Arrizon, Abraham; Cabrera, Sara M; Lynch, Gary; Greene, Robert W; Wood, Marcelo A

    2011-01-01

    To identify the role of the histone acetyltransferase (HAT) CREB-binding protein (CBP) in neurons of the CA1 region of the hippocampus during memory formation, we examine the effects of a focal homozygous knockout of CBP on histone modifications, gene expression, synaptic plasticity, and long-term memory. We show that CBP is critical for the in vivo acetylation of lysines on histones H2B, H3, and H4. CBP's homolog p300 was unable to compensate for the loss of CBP. Neurons lacking CBP maintained phosphorylation of the transcription factor CREB, yet failed to activate CREB:CBP-mediated gene expression. Loss of CBP in dorsal CA1 of the hippocampus resulted in selective impairments to long-term potentiation and long-term memory for contextual fear and object recognition. Together, these results suggest a necessary role for specific chromatin modifications, selectively mediated by CBP in the consolidation of memories. PMID:21508930

  7. Relationship between flexion contractures of the joints of the lower extremities and the sagittal profile of the spine in patients with cerebral palsy: a preliminary report

    Directory of Open Access Journals (Sweden)

    Valery V. Umnov

    2016-11-01

    Full Text Available Background. The considerable incidence of kyphosis in patients with cerebral palsy (CP causes back pain and aggravates movement disorders. However, few studies have investigated the pathogenesis of this condition. Aim. To identify the relationship between patient motor abilities, the severity of flexion contractures of the knee and hip joints and spinal sagittal profile changes, and the impact on the latter by surgical correction of flexion contracture of the knee joint. Material and methods. The study cohort included 17 pediatric CP patients (11 boys and 6 girls with a mean age of 13.1 ± 1.3 (range, 10–16 years and level 2–4 spastic diplegia according to the Gross Motor Function Classification System. The relationship between radiological indicators of the spine sagittal profile and motor abilities of children, as well as the severity of flexion contractures at the hip and knee, and the degree of insufficiency of the active extension of the knee were investigated. Of these 17 patients, 12 underwent surgery to correct flexion contracture of the knee, which involved lengthening of leg flexors, to analyze the impact of contracture on the sagittal profile of the spine. The following radiological indicators were assessed: angle of thoracic kyphosis (CC, lordosis angle (UL of the lumbar spine, and sacral inclination angle (SS. The study included patients with a CC of at least 30°. Results. Results of an X-ray study showed that the severity of kyphosis was 50.7° ± 2.1°, lordosis was 30.3° ± 4.3°, and SS was 30.5° ± 3.3°. There was a significant association between kyphosis and flexion contracture of the knee joint, as well as between lordosis and insufficient active extension of the knee joint. After elimination of the flexion contracture of the knee, the degree of severity of the CC (thoracic kyphosis was unchanged, while UL (lordosis angle and SS (sacral inclination angle increased by approximately 10°. Conclusion. The severity of

  8. Results of a Long-Term Spectral and Photometric Monitoring of the Herbig Ae Star HD 179218

    Science.gov (United States)

    Kozlova, O. V.; Alekseev, I. Yu.

    2017-06-01

    We present the results of the long-term spectroscopic and photometric monitoring of the Herbig Ae star HD 179218. The high-resolution spectra (R = 20000) were made on the 2.6-m telescope at the Crimean Astrophysical Observatory (CrAO) in the regions of Hα emission line. The photometric observations were obtained on 1.25-m telescope AZT-11 (CrAO) equipped with the UBVRI electrophotometer-polarimeter. Our results showed that Hα emission parameters demonstrate the long- term variability on the time scale about 4000 days. The same variability is observed in the change of the stellar brightness in V-band. The unusual behavior the V-I color index depending on the stellar brightness in the V-band can be concluded that around the star there is an additional source of IR-radiation. We believe that the obtained results can be explained by the presence in the vicinity of HD 179218 a low-mass component.

  9. Primary Self-Expandable Nitinol Stent Placement in Focal Lesions of Infrarenal Abdominal Aorta: Long Term Results

    International Nuclear Information System (INIS)

    Lastovickova, Jarmila; Peregrin, Jan H.

    2008-01-01

    Purpose. To evaluate the technical and clinical success, safety and long term results of percutaneous transluminal angioplasty/self-expandable nitinol stent placement of infrarenal abdominal aorta focal lesions. Materials and Methods. Eighteen patients underwent PTA of focal atherosclerotic occlusive disease of distal abdominal aorta. Two symptomatic occlusions and 16 stenoses in 10 male and 8 female patients (mean age 68.2 years) were treated with primary self-expandable nitinol stent placement. Results. Primary self-expandable nitinol stent placement was technically successful in all 18 procedures; clinical success was achieved in 100% of patients. No complications associated with the procedure occurred. During the 49.4 months of mean follow up (range 3-96, 4 months) all treated aortic segments remained patent. Conclusions. Endovascular treatment (primary self-expandable nitinol stent placement) of focal atherosclerotic lesions of distal abdominal aorta is a safe method with excellent primary technical and clinical success rates and favourable Long term results

  10. Plantar fibromatosis and Dupuytren’s contracture in an adolescent

    Directory of Open Access Journals (Sweden)

    Nikolić Jelena

    2011-01-01

    Full Text Available Background. Fibromatosis represents a wide group of benign, locally proliferative disorders of fibroblasts. Dupuytren` s disease is a benign proliferative disease of palmar aponeurosis which usually affects adults between 40 and 60 years of age. Ledderhose`s disease or plantar fibromatosis is plantar equivalent of Dupuyten`s disease most often affecting middle- aged and older men, usually bilateral, represented with painless nodule in the medial division of plantar fascia. Case report. We presented a 19-year old adolescent that turned to a plastic surgeon complaining to his small finger contracture. He noticed palmar thickening with nodule over the metacarpophalangeal joint of small finger of his right hand when he was 16 years old. A year later a finger started to band. During physical checkup we noticed plantar nodule that also had his father and grandmother. Magnetic resonance and tumor biopsy confirmed a suspicion on plantar fibromatosis - Ledderhose`s disease. Clinical exam of the hand clearly led to a conclusion that the patient had Dupuytren`s contracture with pretendinous cord over the small finger flexor tendons and lack of extension of proximal interphalangeal (PIP joint. On the extensor side of the PIP joints there were Garrod`s nodes. The patient refused surgical treatment of plantar tumor, but agreed to surgical correction of finger contracture. Conclusion. Despite the fact that Dupuytren`s disease and plantar fibromatosis are diseases of adults, the possibility of conjoint appearance of these forms of fibromatosis in adolescent period of life should be kept in mind especially in patients with strong genetic predisposition.

  11. Competitive short-term and long-term memory processes in spatial habituation.

    Science.gov (United States)

    Sanderson, David J; Bannerman, David M

    2011-04-01

    Exposure to a spatial location leads to habituation of exploration such that, in a novelty preference test, rodents subsequently prefer exploring a novel location to the familiar location. According to Wagner's (1981) theory of memory, short-term and long-term habituation are caused by separate and sometimes opponent processes. In the present study, this dual-process account of memory was tested. Mice received a series of exposure training trials to a location before receiving a novelty preference test. The novelty preference was greater when tested after a short, rather than a long, interval. In contrast, the novelty preference was weaker when exposure training trials were separated by a short, rather than a long interval. Furthermore, it was found that long-term habituation was determined by the independent effects of the amount of exposure training and the number of exposure training trials when factors such as the intertrial interval and the cumulative intertrial interval were controlled. A final experiment demonstrated that a long-term reduction of exploration could be caused by a negative priming effect due to associations formed during exploration. These results provide evidence against a single-process account of habituation and suggest that spatial habituation is determined by both short-term, recency-based memory and long-term, incrementally strengthened memory.

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

    Directory of Open Access Journals (Sweden)

    Nathan Elie Frenk

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

  13. Effects of Formica ants on soil fauna-results from a short-term exclusion and a long-term natural experiment.

    Science.gov (United States)

    Lenoir, Lisette; Bengtsson, Jan; Persson, Tryggve

    2003-02-01

    Wood ants (Formica spp.) were hypothesised to affect the composition and greatly reduce the abundance of large-sized soil fauna by predation. This was tested in two ways. Firstly, a 4-year-long experimental study was carried out in a mixed forest. Five ant-free 1.3-m(2) plots were created by fenced exclosures within an ant territory. Five nearby plots had fences with entrances for the ants. In addition, five non-fenced control plots were selected. Soil fauna (e.g. Coleoptera, Diptera larvae, Collembola and Araneae) was sampled during the summers of 1997-2000. The soil fauna was affected by the exclosures but there was no detectable effect of ants on the soil fauna. Secondly, soil fauna was studied within a large-scale natural experiment in which the long-term (30 years) effects of red wood ants could be assessed inside and outside ant territories. This long-term natural experiment revealed no significant effects of ants on the abundance or composition of soil fauna. The results from the two studies indicate that the effects of wood ants on soil fauna are fairly small. The hypothesis that wood ants are key-stone predators on soil fauna could, thus, not be supported.

  14. Laparoscopic central pancreatectomy: Our technique and long-term results in 14 patients

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    Palanisamy Senthilnathan

    2015-01-01

    Full Text Available Introduction: Conventional pancreatic resections may be unnecessary for benign tumours or for tumours of low malignant potential located in the neck and body of pancreas. Such extensive resections can place the patient at increased risk of developing postoperative exocrine and endocrine insufficiency. Central pancreatectomy is a plausible surgical option for the management of tumours located in these locations. Laparoscopic approach seems appropriate for such small tumours situated deep in the retroperitoneum. Aims: To assess the technical feasibility, safety and long-term results of laparoscopic central pancreatectomy in patients with benign and low malignant potential tumours involving the neck and body of pancreas. Settings and Design: This study was an observational study which reports a single-centre experience with laparoscopic central pancreatectomy over a 9-year period. Materials and Methods: 14 patients underwent laparoscopic central pancreatectomy from October 2004 to September 2013. These included patients with tumours located in the neck and body of pancreas that were radiologically benign-looking tumours of less than 3 cm in size. Statistical Analysis Used: The statistical analysis was done using GraphPad Prism software. Results: The mean age of patients was 48.93 years. The mean operative time was 239.7 min. Mean blood loss was 153.2 ml. Mean postoperative ICU stay was 1.2 days and overall mean hospital stay was 8.07 days. There were no mortalities and no major postoperative complications. Margins were negative in all cases and with a median follow-up of 44 months, there was no recurrence. Conclusions: Laparoscopic central pancreatectomy is a feasible procedure with acceptable morbidity. In the long term, there were no recurrences and pancreatic function was well preserved.

  15. Serial casting versus stretching technique to treat knee flexion contracture in children with spina bifida: a comparative study.

    Science.gov (United States)

    Al-Oraibi, S; Tariah, Hashem Abu; Alanazi, Abdullah

    2013-01-01

    Severe knee contractures that develop soon after muscle imbalance may not improve with stretching exercises and splinting. An alternative treatment is serial casting, which has been used to promote increased range of motion. The purpose of this study was to compare the effectiveness of using serial casting and passive stretching approaches to treat knee flexion contracture in children with spina bifida. In a pre/post randomized controlled study, ten participants were included in the serial casting group, while eight participants were included in the passive stretching intervention group. The degree of knee extension was measured at baseline, immediately after intervention, and at a one-year follow-up using a standard goniometer. Both groups showed significant improvements in the degree of flexion contracture at the post-treatment evaluation and the follow-up evaluation. The serial casting group showed significant improvements in knee flexion contracture at the post-treatment evaluation, t (9)=13.4, p casting group compared with passive stretching group in relation to the degree of flexion contracture were found at the immediate post-treatment evaluation, F(1, 15)=246, p=0.0001, and the one-year follow-up evaluation, F (1, 15)=51.5, p=0.0001. The outcomes of this study provide the first evidence that serial casting may be a useful intervention in treating knee flexion contracture in children with spina bifida. However, further investigations into serial casting, as well as investigations into the use of serial casting with other interventions, are warranted.

  16. Long-Term Memory Performance in Adult ADHD.

    Science.gov (United States)

    Skodzik, Timo; Holling, Heinz; Pedersen, Anya

    2017-02-01

    Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

  17. Gluteal muscle contracture: diagnosis and management options

    Science.gov (United States)

    Rai, Saroj; Meng, Chunqing; Wang, Xiaohong; Chaudhary, Nabin; Jin, Shengyang; Yang, Shuhua; Wang, Hong

    2017-01-01

    Gluteal muscle contracture (GMC), a debilitating disease, exists all over the globe but it is much more prevalent in China. Patients typically present with abduction and external rotation of the hip and are unable to bring both the knees together while squatting. Multiple etiologies have been postulated, the commonest being repeated intramuscular injection into the buttocks. The disease is diagnosed primarily by clinical features but radiological features are necessary for the exclusion of other pathological conditions. Non-operative treatment with physiotherapy can be tried before surgery is considered but it usually fails. Different surgical techniques have been described and claimed to have a better outcome of one over another but controversy still exists. Based on published literatures, the clinical outcome is exceptionally good in all established methods of surgery. However, endoscopic surgery is superior to conventional open surgery in terms of cosmetic outcome with fewer complications. Nevertheless, its use has been limited by lack of adequate knowledge, instrumentations, and some inherent limitations. Above all, post-operative rehabilitation plays a key role in better outcome, which however should be started gradually. PMID:28059055

  18. Long-term results of Ahmed glaucoma valve implantation in Egyptian population

    Directory of Open Access Journals (Sweden)

    Eman Elhefney

    2018-03-01

    Full Text Available AIM: To evaluate the long-term results and complications of Ahmed glaucoma valve (AGV implantation in a cohort of Egyptian patients. METHODS: A retrospective study of 124 eyes of 99 patients with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 5y was performed. All patients underwent complete ophthalmic examination and intraocular pressure (IOP measurement before surgery and at 1d, weekly for the 1st month, 3, 6mo, and 1y after surgery and yearly afterward for 5y. IOP was measured by Goldmann applanation tonometry and/or Tono-Pen. Complications and the number of anti-glaucoma medications needed were recorded. Success was defined as IOP less than 21 mm Hg with or without anti-glaucoma medication and without additional glaucoma surgery. RESULTS: Mean age was 23.1±19.9y. All eyes had at least one prior glaucoma surgery. IOP was reduced from a mean of 37.2±6.8 to 19.2±5.2 mm Hg after 5y follow-up with a reduced number of medications from 2.64±0.59 to 1.81±0.4. Complete and qualified success rates were 31.5% and 46.0% respectively at the end of follow-up. The most common complications were encapsulated cyst formation in 51 eyes (41.1%, complicated cataract in 9 eyes (7.25%, recessed tube in 8 eyes (6.45%, tube exposure in 6 eyes (4.8% and corneal touch in 6 eyes (4.8%. Other complications included extruded AGV, endophthalmitis and persistent hypotony. Each of them was recorded in only 2 eyes (1.6%. CONCLUSION: Although refractory glaucoma is a difficult problem to manage, AGV is effective and relatively safe procedure in treating refractory glaucoma in Egyptian patients with long-term follow-up. Encapsulated cyst formation was the most common complication, which limits successful IOP control after AGV implantation. However, effective complications management can improve the rate of success.

  19. Long-term characteristics of nuclear emulsion

    International Nuclear Information System (INIS)

    Naganawa, N; Kuwabara, K

    2010-01-01

    Long-term characteristics of the nuclear emulsion so called 'OPERA film' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  20. Long-term characteristics of nuclear emulsion

    Science.gov (United States)

    Naganawa, N.; Kuwabara, K.

    2010-02-01

    Long-term characteristics of the nuclear emulsion so called ``OPERA film'' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

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

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    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. Lethal congenital contracture syndrome (LCCS) and other lethal arthrogryposes in Finland--an epidemiological study.

    Science.gov (United States)

    Pakkasjärvi, Niklas; Ritvanen, Annukka; Herva, Riitta; Peltonen, Leena; Kestilä, Marjo; Ignatius, Jaakko

    2006-09-01

    Arthrogryposis multiplex congenita is a heterogeneous group of disorders characterized by multiple contractures with an estimated frequency of 1 in 3,000 births. With improving diagnostic methods, increasing numbers of fetuses with arthrogryposis are found. The pathogenetic mechanisms are relatively well known but the epidemiology and genetics of the prenatally lethal forms of arthrogryposis are less well known. In this study we collected all cases of a multiple contractures diagnosed in Finland during 1987-2002 including live born infants, stillbirths, and terminated pregnancies. Ninety-two cases of 214 suffered intrauterine demise (68 selective pregnancy terminations and 24 stillbirths) and 58 died in infancy. In 141 out of these cases the diagnosis could be included within lethal arthrogryposes, with a prevalence of 1 in 6,985 (1.43/10,000) births. Of these, 59 had spinal cord pathology at autopsy and thus were of neurogenic origin. Thirty-nine cases had lethal congenital contracture syndrome (LCCS) clinically characterized by total immobility of the fetus at all ultrasound examinations (12 weeks or later), multiple joint contractures in both upper and lower limbs, hydrops, and fetal death before the 32nd week of pregnancy. LCCS is noted as a unique Finnish disorder with a prevalence of 1 in 25,250 (0.40/10,000) births and is a major cause of lethal arthrogryposis in Finland.

  3. Long-Term Dynamics of Autonomous Fractional Differential Equations

    Science.gov (United States)

    Liu, Tao; Xu, Wei; Xu, Yong; Han, Qun

    This paper aims to investigate long-term dynamic behaviors of autonomous fractional differential equations with effective numerical method. The long-term dynamic behaviors predict where systems are heading after long-term evolution. We make some modification and transplant cell mapping methods to autonomous fractional differential equations. The mapping time duration of cell mapping is enlarged to deal with the long memory effect. Three illustrative examples, i.e. fractional Lotka-Volterra equation, fractional van der Pol oscillator and fractional Duffing equation, are studied with our revised generalized cell mapping method. We obtain long-term dynamics, such as attractors, basins of attraction, and saddles. Compared with some existing stability and numerical results, the validity of our method is verified. Furthermore, we find that the fractional order has its effect on the long-term dynamics of autonomous fractional differential equations.

  4. Bladder Contracture – A Rare and Serious Side Effect of Intravesical Bacillus Calmette-Guérin Therapy

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    Cindy Garcia

    2016-01-01

    Full Text Available Instillation of intravesical bacillus Calmette-Guérin (BCG is an effective treatment for non-muscle invasive bladder cancer (NMIBC. The high incidence of side effects may limit its tolerability in patients. Local side effects including cystitis and hematuria are common but generally self-limiting. Bladder contractures are a rare but serious consequence of BCG treatment. In this case, an 82 year-old male developed BCG reactivation and subsequent bladder contractures following transurethral resection of the prostate (TURP three years post-BCG. To our knowledge, this is the first reported case of BCG reactivation post-TURP leading to the rare but serious effect of bladder contractures.

  5. Long-term results of endoscopic stenting and surgical drainage for biliary stricture due to chronic pancreatitis

    NARCIS (Netherlands)

    Smits, M. E.; Rauws, E. A.; van Gulik, T. M.; Gouma, D. J.; Tytgat, G. N.; Huibregtse, K.

    1996-01-01

    A retrospective evaluation was made of the long-term results of endoscopic stenting in 58 patients with benign biliary stricture due to chronic pancreatitis. Immediate relief of jaundice and cholestasis was achieved in all patients after endoscopic stent insertion. Median follow-up was 49 months.

  6. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    OpenAIRE

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this stu...

  7. Near-Term Actions to Address Long-Term Climate Risk

    Science.gov (United States)

    Lempert, R. J.

    2014-12-01

    Addressing climate change requires effective long-term policy making, which occurs when reflecting on potential events decades or more in the future causes policy makers to choose near-term actions different than those they would otherwise pursue. Contrary to some expectations, policy makers do sometimes make such long-term decisions, but not as commonly and successfully as climate change may require. In recent years however, the new capabilities of analytic decision support tools, combined with improved understanding of cognitive and organizational behaviors, has significantly improved the methods available for organizations to manage longer-term climate risks. In particular, these tools allow decision makers to understand what near-term actions consistently contribute to achieving both short- and long-term societal goals, even in the face of deep uncertainty regarding the long-term future. This talk will describe applications of these approaches for infrastructure, water, and flood risk management planning, as well as studies of how near-term choices about policy architectures can affect long-term greenhouse gas emission reduction pathways.

  8. Very-long-term and short-term chromatic adaptation: are their influences cumulative?

    Science.gov (United States)

    Belmore, Suzanne C; Shevell, Steven K

    2011-02-09

    Very-long-term (VLT) chromatic adaptation results from exposure to an altered chromatic environment for days or weeks. Color shifts from VLT adaptation are observed hours or days after leaving the altered environment. Short-term chromatic adaptation, on the other hand, results from exposure for a few minutes or less, with color shifts measured within seconds or a few minutes after the adapting light is extinguished; recovery to the pre-adapted state is complete in less than an hour. Here, both types of adaptation were combined. All adaptation was to reddish-appearing long-wavelength light. Shifts in unique yellow were measured following adaptation. Previous studies demonstrate shifts in unique yellow due to VLT chromatic adaptation, but shifts from short-term chromatic adaptation to comparable adapting light can be far greater than from VLT adaptation. The question considered here is whether the color shifts from VLT adaptation are cumulative with large shifts from short-term adaptation or, alternatively, does simultaneous short-term adaptation eliminate color shifts caused by VLT adaptation. The results show the color shifts from VLT and short-term adaptation together are cumulative, which indicates that both short-term and very-long-term chromatic adaptation affect color perception during natural viewing. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. 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

  10. Long-term results of aortic root repair using the reimplantation technique.

    Science.gov (United States)

    David, Tirone E; Armstrong, Susan; Manlhiot, Cedric; McCrindle, Brian W; Feindel, Christopher M

    2013-03-01

    Aortic valve sparing is frequently performed to treat patients with aortic root aneurysm, but there is an inadequate amount of information regarding its long-term durability. This study examines the long-term results of reimplantation of the aortic valve in patients with aortic root aneurysms. From August 1989 to December 2010, 296 consecutive patients had reimplantation of the aortic valve into a tubular Dacron graft. Their mean age was 45 years (range, 11-79 years), and 78% were men. Of the patients, 36% had Marfan syndrome and 11% had bicuspid aortic valve. Patients were followed prospectively with periodic images of the aortic root and remaining aorta. The mean follow-up was 6.9 ± 4.5 years. There were 21 patients at risk at 15 years. There were 4 operative and 18 late deaths. The survival at 5, 10, and 15 years was 95.1% ± 3.5%, 93.1% ± 4.4%, and 76.5% ± 18%, respectively. Only 3 patients required reoperation on the aortic valve; all 3 patients had the Bentall procedure. Freedom from reoperation at 5, 10, and 15 years was 99.7% ± 2.0%, 97.8% ± 5.3%, and 97.8% ± 5.3%, respectively. During follow-up, moderate aortic insufficiency developed in 9 patients, and severe aortic insufficiency developed in 2 patients. Freedom from moderate or severe aortic insufficiency at 5, 10, and 15 years was 98.3% ± 3.5%, 92.9% ± 6.5%, and 89.4% ± 12%, respectively. The function of the aortic valve implanted inside a tubular Dacron graft remains normal at 15 years in most patients after this type of aortic valve-sparing operation. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  11. Nociception contributes to the formation of myogenic contracture in the early phase of adjuvant-induced arthritis in a rat knee.

    Science.gov (United States)

    Kaneguchi, Akinori; Ozawa, Junya; Moriyama, Hideki; Yamaoka, Kaoru

    2017-07-01

    It is unknown how joint contracture is generated in inflamed joints. This study aimed to clarify the role of nociception on the formation of joint contracture secondary to arthritis. Monoarthritis was induced by intra-articular injections of complete Freund's adjuvant (CFA) into rat knees. On day 5 after CFA injection, the passive extension range of motion (ROM) of knee joints were measured, both before and after myotomy of knee flexors, to evaluate the extent of muscular contribution to CFA-induced joint contracture. The steroidal anti-inflammatory drug dexamethasone could prevent ROM restrictions completely, both before and after myotomy. On the other hand, the opioid analgesic drug morphine did not prevent the development of restricted ROM observed after myotomy, while it did before myotomy. This indicates that nociception contributes to joint contracture through alterations in muscular structure (myogenic factors). Next, we tested the hypothesis that nociception-induced reflexive flexor muscle contractions cause myogenic contracture in arthritic joints. To do this, chemical denervation was performed by Botulinum toxin type A (BTX-A) injections into knee flexor muscles, simultaneously with CFA injections into the knee. As expected, BTX-A could alleviate ROM restrictions observed before myotomy. These findings suggest that nociceptive-related muscle contractions play an essential role in the formation of joint contracture. Thus, our study indicates that analgesic management during an early stage of joint arthritis is an essential mean to prevent the formation of joint contracture. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1404-1413, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  12. Efficacy and safety of collagenase Clostridium histolyticum injection for Dupuytren contracture: report of 40 cases.

    Science.gov (United States)

    Alberton, F; Corain, M; Garofano, A; Pangallo, L; Valore, A; Zanella, V; Adani, R

    2014-12-01

    Dupuytren's disease (DD) is a fibroproliferative pathology that affects the palmar aponeurosis causing the development of nodules and collagen cords and the progressive flexion of the fingers. The standard procedure is surgical fasciectomy, followed by high recurrence rates. Collagenase Clostridium histolyticum (CCH) injection represents an innovative noninvasive approach to the treatment of DD. This prospective study was designed to examine the efficacy and safety of CCH injection performed in the outpatient, using local anesthesia. Forty patients [32 metacarpophalangeal (MP), 8 proximal interphalangeal (PIP)] with Dupuytren's contracture of at least 20° for MP joint and any degree for PIP joint were included. The mean age was 66. All joints were treated with a single vial of collagenase injection and manual breaking of the cord 24 h after. All adverse effects (AEs) were monitored. Patients were checked 7, 30, 90, and 180 days after the injection. Primary endpoint was a reduction in digit contracture within 0°-5° of normal extension. Secondary endpoints were the improvement of range of motion, the evaluation of AEs incidence, and cost-effectiveness of collagenase treatment. About 67.5 % of patients obtained a clinical success. At 6 months, a further 7.5% attained the same result. The mean contracture of treated joints was 5.3º for MP and 6.8° for PIP joints. Twenty-three patients had one or more mild-to-moderate side effects. The use of collagenase appears to be an effective and safe method for the treatment of Dupuytren's contracture. Therapeutic success was achieved in a significant percentage of patients. The incidence of side effects was higher, but they were local reactions of short duration. The use of a single collagenase vial in patients treated in day surgery appears more cost-effective than surgery.

  13. Long Term Financing of Infrastructure

    OpenAIRE

    Sinha, Sidharth

    2014-01-01

    Infrastructure projects, given their long life, require long term financing. The main sources of long term financings are insurance and pension funds who seek long term investments with low credit risk. However, in India household financial savings are mainly invested in bank deposits. Insurance and pension funds account for only a small percentage of household financial savings. In addition most infrastructure projects do not qualify for investment by insurance and pension funds because of t...

  14. 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.

    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

  15. Evaluation of long term leaching of borosilicate glasses

    International Nuclear Information System (INIS)

    Lanza, F.; Parnisari, E.

    1978-01-01

    For the evaluation of long term hazard of glass, data on long term glass leaching are needed. Moreover for long term leaching a model of homogeneous dissolution seems reasonable and ask for confirmation. Tests were performed at 30 0 , 80 0 , 100 0 , using an apparatus of the Soxhlet type, to 3.600 hours. Results were obtained as a weight loss and analysed following a relation with time composed by a parabolic and a linear part. Analysis of the surface layer using energy dispersion X ray spectrometry were performed. A critical analysis of the results and of the apparatus is presented

  16. Long-term results after atrial correction of complete transposition of the great arteries.

    Science.gov (United States)

    Merlo, M; de Tommasi, S M; Brunelli, F; Abbruzzese, P A; Crupi, G; Ghidoni, I; Casari, A; Pitì, A; Mamprin, F; Parenzan, L

    1991-02-01

    This study presents the late results for the first 104 consecutive patients surviving and atrial repair for transposition of the great arteries (TGA) between January 1971 and December 1978 (group 1). Mean follow-up was 12 years (range, 0.1 to 17.7 years). The actuarial survival rate at 18 years was 84.2% (70% confidence limits, 79% to 88%) for simple TGA and 93.7% (70% confidence limits, 84% to 97%) for complex TGA. Nine of the 11 deaths were sudden. Two (2.6%) of the 78 late survivors operated on for simple TGA are in New York Heart Association functional class III or IV versus 4 (26.7%) of the 15 survivors with complex TGA; the other patients are doing very well. To better assess long-term results, we report the findings for randomly obtained electrocardiograms, Holter monitor recordings, radionuclide angiographic studies, and cardiac catheterizations performed in 1987 in a larger group of 159 long-term survivors of atrial repair operated on at Ospedale Riuniti di Bergamo from January 1971 to December 1984 (group 2), which includes all of group 1. The findings confirm that the arterial switch repair is the procedure of choice for complex TGA and that there is a major incidence (approximately 10%) of systemic right ventricular dysfunction and rhythm disturbances after the atrial repair. On the other hand, our late survival rate at 18 years of 84% for simple TGA with 97.5% of the patients in functional class I is a result that should be kept in mind, especially in institutions where the arterial switch is a relatively new approach and presumably is a higher risk to cause early death.

  17. Long-term results after carotid artery stenting. Restenosis after carotid artery stenting using self-expandable stent

    International Nuclear Information System (INIS)

    Matsumoto, Yasushi; Furui, Eisuke; Tsuboi, Ken; Takahashi, Akira; Ezura, Masayuki

    2008-01-01

    Carotid artery stenting has emerged as an acceptable treatment alternative in patients with carotid artery stenosis. Although early clinical results of carotid artery stenting have shown promise, long, term clinical results remain less certain. We report the frequency, management, and clinical results of in-stent restenosis after carotid artery stenting using a self-expandable stent. Between August 1998 and September 2004, 80 carotid artery stenting procedures in 78 patients were performed. We evaluated 76 of the 80 procedures in 75 of the 78 patients treated during this period who had a minimum 6-month clinical and imaging (ultrasound and/or magnetic resonance angiography) follow-up. Recurrent stenosis (≥50%) after carotid artery stenting occurred in 3 (3.9%) patients. The recurrent stenosis occurred within one year after the procedure in all cases. The low rate of in-stent restenosis using self-expandable stent suggested that carotid artery stenting may be an effective alternative treatment for carotid artery stenosis, but more data of long-term follow-up are required. (author)

  18. Modeling long-term dynamics of electricity markets

    International Nuclear Information System (INIS)

    Olsina, Fernando; Garces, Francisco; Haubrich, H.-J.

    2006-01-01

    In the last decade, many countries have restructured their electricity industries by introducing competition in their power generation sectors. Although some restructuring has been regarded as successful, the short experience accumulated with liberalized power markets does not allow making any founded assertion about their long-term behavior. Long-term prices and long-term supply reliability are now center of interest. This concerns firms considering investments in generation capacity and regulatory authorities interested in assuring the long-term supply adequacy and the stability of power markets. In order to gain significant insight into the long-term behavior of liberalized power markets, in this paper, a simulation model based on system dynamics is proposed and the underlying mathematical formulations extensively discussed. Unlike classical market models based on the assumption that market outcomes replicate the results of a centrally made optimization, the approach presented here focuses on replicating the system structure of power markets and the logic of relationships among system components in order to derive its dynamical response. The simulations suggest that there might be serious problems to adjust early enough the generation capacity necessary to maintain stable reserve margins, and consequently, stable long-term price levels. Because of feedback loops embedded in the structure of power markets and the existence of some time lags, the long-term market development might exhibit a quite volatile behavior. By varying some exogenous inputs, a sensitivity analysis is carried out to assess the influence of these factors on the long-run market dynamics

  19. 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.

  20. Resulting long-term intestinal motility in dogs following construction of a reversed jejunal segment after extensive small bowel resection.

    Science.gov (United States)

    Uchiyama, M; Iwafuchi, M; Ohsawa, Y; Yagi, M; Iinuma, Y; Ohtani, S

    1994-10-01

    To evaluate the long-term function and effective motility of a reversed jejunal segment after extensive small bowel resection, the authors continuously measured postoperative bowel motility during interdigestive and postprandial periods in conscious dogs 6 to 10 months after surgery. The long-term findings were compared with previously reported short-term results measured 2 to 4 weeks after the operation. In the long-term follow-up dogs with a 20-cm reversed jejunal segment constructed after extensive (75% to 80%) small bowel resection, the fasting duodenal migrating myoelectric (or motor) complex (MMC) was often interrupted in the jejunum above the reversed segment, and did not migrate smoothly to the reversed segment or terminal ileum. The MMCs arising from the duodenum predominantly propagated to the ileum through the inherent anatomic continuity of the bowel. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum, above the proximal anastomosis. These findings are similar to those of the MMC propagation pattern noted 2 to 4 weeks after surgery. However, the postprandial duration without duodenal MMC activity was significantly shorter in the dogs with long-term follow-up than in those with short-term follow-up (both were longer than in control dogs). Marked dilatation of the jejunum and reversed jejunal segment was noted across the proximal anastomosis. These results suggest that the transit time and passage of intestinal contents can be delayed and stagnated for at least 10 months after extensive small bowel resection with a 20-cm reversed jejunal segment.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    International Nuclear Information System (INIS)

    Wienand, B.

    2015-01-01

    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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  3. Simulating the effect of muscle weakness and contracture on neuromuscular control of normal gait in children.

    Science.gov (United States)

    Fox, Aaron S; Carty, Christopher P; Modenese, Luca; Barber, Lee A; Lichtwark, Glen A

    2018-03-01

    Altered neural control of movement and musculoskeletal deficiencies are common in children with spastic cerebral palsy (SCP), with muscle weakness and contracture commonly experienced. Both neural and musculoskeletal deficiencies are likely to contribute to abnormal gait, such as equinus gait (toe-walking), in children with SCP. However, it is not known whether the musculoskeletal deficiencies prevent normal gait or if neural control could be altered to achieve normal gait. This study examined the effect of simulated muscle weakness and contracture of the major plantarflexor/dorsiflexor muscles on the neuromuscular requirements for achieving normal walking gait in children. Initial muscle-driven simulations of walking with normal musculoskeletal properties by typically developing children were undertaken. Additional simulations with altered musculoskeletal properties were then undertaken; with muscle weakness and contracture simulated by reducing the maximum isometric force and tendon slack length, respectively, of selected muscles. Muscle activations and forces required across all simulations were then compared via waveform analysis. Maintenance of normal gait appeared robust to muscle weakness in isolation, with increased activation of weakened muscles the major compensatory strategy. With muscle contracture, reduced activation of the plantarflexors was required across the mid-portion of stance suggesting a greater contribution from passive forces. Increased activation and force during swing was also required from the tibialis anterior to counteract the increased passive forces from the simulated dorsiflexor muscle contracture. Improvements in plantarflexor and dorsiflexor motor function and muscle strength, concomitant with reductions in plantarflexor muscle stiffness may target the deficits associated with SCP that limit normal gait. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Long-Term Patency of Lymphovenous Anastomoses: A Systematic Review.

    Science.gov (United States)

    Tourani, Saam S; Taylor, G Ian; Ashton, Mark W

    2016-08-01

    With advancements in technology and microsurgical techniques, lymphovenous anastomosis has become a popular reconstructive procedure in the treatment of chronic lymphedema. However, the long-term patency of these anastomoses is not clear in the literature. A systematic review of the MEDLINE and EMBASE databases was performed to assess the reported long-term patency of lymphovenous anastomoses. A total of eight studies satisfied the inclusion criteria. Pooled data from four similar experiments in normal dogs showed an average long-term (≥5 months) patency of 52 percent. The only experiment in dogs with chronic lymphedema failed to show any long-term patency. The creation of peripheral lymphovenous anastomoses with a moderate long-term patency rate has become technically possible. However, the long-term results in chronic lymphedema are limited.

  5. Methods for Minimization and Management of Variability in Long-Term Groundwater Monitoring Results

    Science.gov (United States)

    2015-12-01

    DECEMBER 2015 Poonam Kulkarni Charles Newell Claire Krebs Thomas McHugh GSI Environmental, Inc. Britt Sanford ProHydro Distribution...based on an understanding of the short-term variability and long-term attenuation rate at a particular site ( McHugh et al., 2015a). The...time is independent of these parameters ( McHugh et al., 2015c). The relative trade-off between monitoring frequency and time required to

  6. Feasibility of an Exoskeleton-Based Interactive Video Game System for Upper Extremity Burn Contractures.

    Science.gov (United States)

    Schneider, Jeffrey C; Ozsecen, Muzaffer Y; Muraoka, Nicholas K; Mancinelli, Chiara; Della Croce, Ugo; Ryan, Colleen M; Bonato, Paolo

    2016-05-01

    Burn contractures are common and difficult to treat. Measuring continuous joint motion would inform the assessment of contracture interventions; however, it is not standard clinical practice. This study examines use of an interactive gaming system to measure continuous joint motion data. To assess the usability of an exoskeleton-based interactive gaming system in the rehabilitation of upper extremity burn contractures. Feasibility study. Eight subjects with a history of burn injury and upper extremity contractures were recruited from the outpatient clinic of a regional inpatient rehabilitation facility. Subjects used an exoskeleton-based interactive gaming system to play 4 different video games. Continuous joint motion data were collected at the shoulder and elbow during game play. Visual analog scale for engagement, difficulty and comfort. Angular range of motion by subject, joint, and game. The study population had an age of 43 ± 16 (mean ± standard deviation) years and total body surface area burned range of 10%-90%. Subjects reported satisfactory levels of enjoyment, comfort, and difficulty. Continuous joint motion data demonstrated variable characteristics by subject, plane of motion, and game. This study demonstrates the feasibility of use of an exoskeleton-based interactive gaming system in the burn population. Future studies are needed that examine the efficacy of tailoring interactive video games to the specific joint impairments of burn survivors. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  7. The Time Course of the Loss and Recovery of Contracture Ability in Frog Striated Muscle Following Exposure to Ca-Free Solutions

    Science.gov (United States)

    Milligan, J. V.

    1965-01-01

    Using area under the contracture curve to quantitate contractures, the diffusion coefficient of calcium ions within the frog toe muscle during washout in a calcium-free solution and subsequent recovery after reintroduction of calcium to the bathing solution was calculated to be about 2 x 10-6 cm2/sec. The diffusion coefficient measured during washout was found to be independent of temperature or initial calcium ion concentration. During recovery it was found to decrease if the temperature was lowered. This was likely due to the repolarization occurring after the depolarizing effect of the calcium-free solution. The relation between contracture area and [Ca]o was found to be useful over a wider range than that between maximum tension and [Ca]o. The normalized contracture areas were larger at lower calcium concentrations if the contractures were produced with cold potassium solutions or if NO3 replaced Cl in the bathing solutions. Decreasing the potassium concentration of the contracture solution to 50 mM from 115 mM did not change the relation between [Ca]o and the normalized area. If the K concentration of the bathing solution was increased, the areas were decreased at lower concentrations of Ca. PMID:14324991

  8. Long-term results after CT-guided percutaneous ethanol ablation for the treatment of hyper functioning adrenal disorders

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  9. Long-term results after CT-guided percutaneous ethanol ablation for the treatment of hyper functioning adrenal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Frenk, Nathan Elie; Sebastianes, Fernando; Lerario, Antonio Marcondes; Fragoso, Maria Candida Barisson Villares; Mendonca, Berenice Bilharinho [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina; Menezes, Marcos Roberto de, E-mail: menezesmr@gmail.com [Instituto do Cancer do Estado de Sao Paulo, SP (Brazil)

    2016-10-15

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

  10. The French program on the spent nuclear fuel long term evolution: Major results, uncertainties and new requirements

    International Nuclear Information System (INIS)

    Ferry, Cecile; Poinssot, Christophe; Gras, Jean-Marie

    2006-01-01

    conditions; oxidation kinetics of UO 2 and spent fuel are assessed by coupling a microscopic approach with macroscopic classical methods; - in water, this boundary condition corresponds to the nominal scenario after the breaching of the canister during geological disposal; in this case, the effect of water a radiolysis on the spent fuel matrix dissolution is investigated. An overview of the state of knowledge on the long-term behaviour of spent fuel under these various conditions has been provided by Ferry et al. (2005). This report constitutes the scientific synthesis due at the term of the law. This state of the art was derived from the results obtained under the PRECCI project as well as from a review of the literature and some of the data issued from the 5. PRDC European project 'Spent Fuel Stability under Repository Conditions' (Poinssot et al, 2005). Regarding these results, this paper presents for each initial operational question and concept, the main scientific issues, the major results obtained since 1999, and the remaining uncertainties. The new requirements in the frame of a broader context which includes transport and in-pool storage issues are also identified. The contents of this paper is as follows: 1 Introduction; 2 The retrievability of spent fuel assemblies after storage; 2.1 Main scientific issues; 2.2 Major results; 2.2.1 Mechanical evolution of the cladding and structural materials; 2.2.2 Specific case of the defected fuel rods - Evolution of the spent fuel pellets; 2.3 Remaining uncertainties and new requirements for each operational context; 3 The treatment of spent fuel after a long period of storage; 3.1 Main scientific issues; 3.2 Major results; 3.3 Remaining uncertainties and new requirements; 4 The definition of the radionuclide source terms; 4.1 Main scientific issues; 4.2 Major results; 4.3 Remaining uncertainties and new requirements for each operational context; 5 The compatibility between dry storage and subsequent disposal; 5.1 Main

  11. Early and long-term results of a valve-sparing operation for Marfan syndrome.

    Science.gov (United States)

    Birks, E J; Webb, C; Child, A; Radley-Smith, R; Yacoub, M H

    1999-11-09

    We have previously described the experience, rationale, and development of a valve preserving technique, but its role in patients with Marfan syndrome has not previously been defined. Here, we attempt to determine the early and long-term results, timing, and determinants of outcome of this operation in patients with Marfan syndrome. Since 1979, 82 patients (73.2% of all patients with Marfan syndrome undergoing resection of aneurysm of the ascending aorta) were operated on using this technique. Ages ranged from 2 to 69 years (mean, 33.9 years). In all, there were 4 early deaths (4.9%), 2 with acute dissection and 2 with chronic aneurysm operated on as emergencies. There were no early deaths in 67 patients operated on electively. Actuarial survival for patients operated for chronic aneurysm was 94.2%, 94.2%, and 94.2% at 1, 5, and 10 years, respectively; that for acute dissection was 72.7%, 63. 6%, and 63.6%; and that for chronic dissection was 100%, 85.7%, and 75.0%. The probability of needing reoperation was 5.7%, 17.3%, and 17.3% at 1, 5, and 10 years. There were no instances of infective endocarditis or thromboembolic complications except in 2 patients operated on early in the series who had cusp extension. At the end of the follow-up, trivial or no aortic regurgitation was demonstrated in 33.3%, mild in 45.6%, moderate in 21.1%, and severe in 0. Valve-sparing operations are feasible in most patients with Marfan syndrome; they are applicable to patients with both dissection and chronic aneurysm. The early and long-term results are encouraging. Results are better in the absence of dissection, and prophylactic operation is warranted in some cases.

  12. Polydimethylsiloxane Injection Laryngoplasty for Unilateral Vocal Fold Paralysis: Long-Term Results.

    Science.gov (United States)

    Mattioli, Francesco; Bettini, Margherita; Botti, Cecilia; Busi, Giulia; Tassi, Sauro; Malagoli, Andrea; Molteni, Gabriele; Trebbi, Marco; Luppi, Maria Pia; Bergamini, Giuseppe; Presutti, Livio

    2017-07-01

    To analyze the long-term objective, perceptive, and subjective outcomes after endoscopic polydimethylsiloxane (PDMS) injection laryngoplasty in unilateral vocal fold paralysis. A retrospective study carried out between January 2008 and January 2012. Head and Neck Department, University Hospital of Modena, Modena, Italy. This was a retrospective analysis of 26 patients with unilateral vocal fold paralysis who underwent endoscopic injection of PDMS under general anesthesia. A voice evaluation protocol was performed for all patients, which included videolaryngostroboscopy, maximum phonation time, fundamental frequency, analysis of the harmonic structure of the vowel /a/ and the word /aiuole/, Grade of Dysphonia, Instability, Roughness, Breathiness, Asthenia, and Strain scale, and Voice Handicap Index. The protocol was performed before surgery, in the immediate postoperative period, and at least 3 years after surgery. The mean follow-up period was 73 months (range 39-119 months). The statistical analysis showed a significant improvement (P injection laryngoplasty with PDMS guarantees long-lasting effects over time. No complications were reported in our series. Injection laryngoplasty with PDMS can be considered to be a minimally invasive and safe technique for the treatment of unilateral vocal fold paralysis. Moreover, it allows very good and stable results to be obtained over time, avoiding repeated treatments and improving the quality of life of the patients. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Does pregnancy influence long-term results of bariatric surgery?

    Science.gov (United States)

    Quyên Pham, Thu; Pigeyre, Marie; Caiazzo, Robert; Verkindt, Hélène; Deruelle, Philippe; Pattou, François

    2015-01-01

    Bariatric surgery is performed mostly on obese women of reproductive age. Many authors have studied pregnancy outcomes after bariatric surgery. Only a small number of studies have analyzed the impact of maternity on the results of bariatric surgery. To study the effect of pregnancy on long-term outcomes of bariatric surgery. Lille University Hospital. A retrospective study was conducted on 591 women aged 18 to 42 years who had undergone laparoscopic adjustable gastric band (LAGB) surgery or laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery between 1996 and 2012. A comparison of the results after a 5-year follow-up was performed between patients who became pregnant after their bariatric surgery (pregnant group, n = 84) and postoperative nonpregnant women (nonpregnant group, n = 507). At the 5-year visit, 84.8% patients were seen. The preoperative body mass index (BMI) was the same in the 2 groups (pregnant group: 47.8±6.9 kg/m(2); nonpregnant group: 47.5±7.2 kg/m(2); P = .755). The percentage of excess weight loss (%EWL) was lower in the pregnant group at 2 years (pregnant group = 45.9±24.6%; nonpregnant group = 56.9±28.6%, P = .002) but was similar at 5 years (47.7±27.7% versus 49.9±28.9%, P = .644). The decrease in co-morbidities was similar after 5 years. The gestational weight gain (GWG) was higher when the band was deflated during pregnancy (GWG =+12.7±10.5 kg) compared to the band without fluid removal (GWG =+4.9±7 kg) or laparoscopic Roux-en-Y gastric bypass (GWG =+4.4±1.1 kg) (Pbariatric surgery slows down postoperative weight loss but does not affect weight results at 5-year follow-up. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  14. Long-term urethral catheterisation.

    Science.gov (United States)

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  15. Modeling Wettability Variation during Long-Term Water Flooding

    Directory of Open Access Journals (Sweden)

    Renyi Cao

    2015-01-01

    Full Text Available Surface property of rock affects oil recovery during water flooding. Oil-wet polar substances adsorbed on the surface of the rock will gradually be desorbed during water flooding, and original reservoir wettability will change towards water-wet, and the change will reduce the residual oil saturation and improve the oil displacement efficiency. However there is a lack of an accurate description of wettability alternation model during long-term water flooding and it will lead to difficulties in history match and unreliable forecasts using reservoir simulators. This paper summarizes the mechanism of wettability variation and characterizes the adsorption of polar substance during long-term water flooding from injecting water or aquifer and relates the residual oil saturation and relative permeability to the polar substance adsorbed on clay and pore volumes of flooding water. A mathematical model is presented to simulate the long-term water flooding and the model is validated with experimental results. The simulation results of long-term water flooding are also discussed.

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

    International Nuclear Information System (INIS)

    Ott, O.J.; Hertel, S.; Gaipl, U.S.; Frey, B.; Schmidt, M.; Fietkau, R.

    2014-01-01

    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.)

  17. Long-term results after lung transplantation using organs from circulatory death donors: a propensity score-matched analysis†.

    Science.gov (United States)

    Sabashnikov, Anton; Patil, Nikhil P; Popov, Aron-Frederik; Soresi, Simona; Zych, Bartlomiej; Weymann, Alexander; Mohite, Prashant N; García Sáez, Diana; Zeriouh, Mohamed; Wahlers, Thorsten; Choi, Yeong-Hoon; Wippermann, Jens; Wittwer, Thorsten; De Robertis, Fabio; Bahrami, Toufan; Amrani, Mohamed; Simon, André R

    2016-01-01

    Due to organ shortage in lung transplantation (LTx), donation after circulatory death (DCD) has been implemented in several countries, contributing to an increasing number of organs transplanted. We sought to assess long-term outcomes after LTx with organs procured following circulatory death in comparison with those obtained from donors after brain death (DBD). Between January 2007 and November 2013, 302 LTxs were performed in our institution, whereby 60 (19.9%) organs were retrieved from DCD donors. We performed propensity score matching (DCD:DBD = 1:2) based on preoperative donor and recipient factors that were significantly different in univariate analysis. After propensity matching, there were no statistically significant differences between the groups in terms of demographics and preoperative donor and recipient characteristics. There were no significant differences regarding intraoperative variables and total ischaemic time. Patients from the DCD group had significantly higher incidence of primary graft dysfunction grade 3 at the end of the procedure (P = 0.014), and significantly lower pO2/FiO2 ratio during the first 24 h after the procedure (P = 0.018). There was a trend towards higher incidence of the need for postoperative extracorporeal life support in the DCD group. Other postoperative characteristics were comparable. While the overall cumulative survival was not significantly different, the DCD group had significantly poorer results in terms of bronchiolitis obliterans syndrome (BOS)-free survival in the long-term follow-up. Long-term results after LTx with organs procured following DCD are in general comparable with those obtained after DBD LTx. However, patients transplanted using organs from DCD donors have a predisposition for development of BOS in the longer follow-up. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Long-term memory, sleep, and the spacing effect.

    Science.gov (United States)

    Bell, Matthew C; Kawadri, Nader; Simone, Patricia M; Wiseheart, Melody

    2014-01-01

    Many studies have shown that memory is enhanced when study sessions are spaced apart rather than massed. This spacing effect has been shown to have a lasting benefit to long-term memory when the study phase session follows the encoding session by 24 hours. Using a spacing paradigm we examined the impact of sleep and spacing gaps on long-term declarative memory for Swahili-English word pairs by including four spacing delay gaps (massed, 12 hours same-day, 12 hours overnight, and 24 hours). Results showed that a 12-hour spacing gap that includes sleep promotes long-term memory retention similar to the 24-hour gap. The findings support the importance of sleep to the long-term benefit of the spacing effect.

  19. Mild erythrocytopenia is the most frequent long-term sequel after peptide receptor radionuclide Therapy: Results of long-term follow-up in more than 500 Patients from a single centre

    International Nuclear Information System (INIS)

    Schmidt, J.; Kulkami, H.R.; Baum, R.P.; Menghui, Y.

    2015-01-01

    Full text of publication follows. Aim: Peptide receptor radionuclide therapy (PRRT) is highly effective in well differentiated neuroendocrine neoplasms (NENs) and lends a benefit in overall survival of several years. Renal toxicity is a well-known adverse effect of PRRNT. Hematological toxicity as possible long-term sequel has been hardly examined. Therefore we investigated the effect of PRRT on the hematological status (erythrocytes, leukocytes, thrombocytes) of patients who received individualized therapy at our centre. Materials and Methods: Out of over 500 patients, 59 chemotherapy naive patients with well-differentiated NENs who were treated with at least 3 cycles of PRRT with 177 Lu- and/or 90 Y- labeled DOTATATE/DOTATOC and long-term follow-up were selected for this analysis. Blood counts were documented before the first cycle and repeated at monthly intervals between further cycles and during re-staging examinations after PRRT for many years. Comparisons were done between the hematological status before the first cycle and the one 3 years after the last cycle of PRRT. Results: All 3 cell lines were significantly decreased 3 years after the last radionuclide therapy (erythrocytes, leukocytes: p=0,000; thrombocytes: p=0,002; confidence interval 95%). But only erythrocytes showed a significant decrement, i.e., below the reference level of our in-house laboratory (mean value ± standard deviation: (4.07 ± 0.69)/l; reference level: 4.1-5.4/l). Conclusions: Mild erythrocytopenia is the most frequent long-term sequel after PRRT. Although it has to be considered that repeated cycles probably cause impoverishment in bone marrow reserve (or red cell precursors), PRRT achieves both significant improvement in clinical symptoms and excellent palliation. Thus it remains a safe procedure if performed at specialized centres with interdisciplinary and long-term care. (authors)

  20. Do textured breast implants decrease the rate of capsular contracture compared to smooth implants?

    Science.gov (United States)

    Cifuentes, Ignacio; Dagnino, Bruno; Rada, Gabriel

    2017-08-31

    The use of breast implants for aesthetic and reconstructive purposes has become one of the most common procedures performed by plastic surgeons. Several breast implants models exist. They differ in their size, filling, shape and characteristic of the shell, which can be smooth or textured. Capsular contracture is one of the main complications of breast implants. It has been suggested that the use of textured implants could reduce the incidence of capsular contracture. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified 15 studies overall, of which 13 were randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded the use of textured breast implants probably decreases the risk of capsular contracture, however, they might be associated to an increased risk of anaplastic large cell lymphoma.

  1. Long-term mental wellbeing of adolescents and young adults diagnosed with venous thromboembolism: results from a multistage mixed methods study.

    Science.gov (United States)

    Højen, A A; Sørensen, E E; Dreyer, P S; Søgaard, M; Larsen, T B

    2017-12-01

    Essentials Long-term mental wellbeing of adolescents and young adults with venous thromboembolism is unclear. This multistage mixed methods study was based on Danish nationwide registry data and interviews. Mental wellbeing is negatively impacted in the long-term and uncertainty of recurrence is pivotal. The perceived health threat is more important than disease severity for long-term mental wellbeing. Background Critical and chronic illness in youth can lead to impaired mental wellbeing. Venous thromboembolism (VTE) is a potentially traumatic and life-threatening condition. Nonetheless, the long-term mental wellbeing of adolescents and young adults (AYAS) with VTE is unclear. Objectives To investigate the long-term mental wellbeing of AYAS (aged 13-33 years) diagnosed with VTE. Methods We performed a multistage mixed method study based on data from the Danish nationwide health registries, and semistructured interviews with 12 AYAS diagnosed with VTE. An integrated mixed methods interpretation of the findings was conducted through narrative weaving and joint displays. Results The integrated mixed methods interpretation showed that the mental wellbeing of AYAS with VTE had a chronic perspective, with a persistently higher risk of psychotropic drug purchase among AYAS with a first-time diagnosis of VTE than among sex-matched and age-matched population controls and AYAS with a first-time diagnosis of insulin-dependent diabetes mellitus. Impaired mental wellbeing was largely connected to a fear of recurrence and concomitant uncertainty. Therefore, it was important for the long-term mental wellbeing to navigate uncertainty. The perceived health threat played a more profound role in long-term mental wellbeing than disease severity, as the potential life threat was the pivot which pointed back to the initial VTE and forward to the perception of future health threat and the potential risk of dying of a recurrent event. Conclusion Our findings show that the long-term

  2. Long-term results of Ahmed glaucoma valve implantation in Egyptian population.

    Science.gov (United States)

    Elhefney, Eman; Mokbel, Tharwat; Abou Samra, Waleed; Kishk, Hanem; Mohsen, Tarek; El-Kannishy, Amr

    2018-01-01

    To evaluate the long-term results and complications of Ahmed glaucoma valve (AGV) implantation in a cohort of Egyptian patients. A retrospective study of 124 eyes of 99 patients with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 5y was performed. All patients underwent complete ophthalmic examination and intraocular pressure (IOP) measurement before surgery and at 1d, weekly for the 1 st month, 3, 6mo, and 1y after surgery and yearly afterward for 5y. IOP was measured by Goldmann applanation tonometry and/or Tono-Pen. Complications and the number of anti-glaucoma medications needed were recorded. Success was defined as IOP less than 21 mm Hg with or without anti-glaucoma medication and without additional glaucoma surgery. Mean age was 23.1±19.9y. All eyes had at least one prior glaucoma surgery. IOP was reduced from a mean of 37.2±6.8 to 19.2±5.2 mm Hg after 5y follow-up with a reduced number of medications from 2.64±0.59 to 1.81±0.4. Complete and qualified success rates were 31.5% and 46.0% respectively at the end of follow-up. The most common complications were encapsulated cyst formation in 51 eyes (41.1%), complicated cataract in 9 eyes (7.25%), recessed tube in 8 eyes (6.45%), tube exposure in 6 eyes (4.8%) and corneal touch in 6 eyes (4.8%). Other complications included extruded AGV, endophthalmitis and persistent hypotony. Each of them was recorded in only 2 eyes (1.6%). Although refractory glaucoma is a difficult problem to manage, AGV is effective and relatively safe procedure in treating refractory glaucoma in Egyptian patients with long-term follow-up. Encapsulated cyst formation was the most common complication, which limits successful IOP control after AGV implantation. However, effective complications management can improve the rate of success.

  3. 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

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

    International Nuclear Information System (INIS)

    Strecker, Ernst-Peter K.; Boos, Irene B.L.; Goettmann, Dieter; Vetter, Sylvia

    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 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 CLAFS

  5. Changing incentives for long-term gas contracts

    International Nuclear Information System (INIS)

    Bohi, D.R.

    1992-01-01

    There is much concern about the absence of long-term gas contracts with fixed price and quantity conditions, which until recent years was the standard way of doing business in the gas industry. These types of contracts performed a valuable service in the development of the gas industry, and there comparative absence today is sometimes thought to be one reason for the current malaise in the industry. One hears the argument that there must be some kind of 'market failure' that prevents buyers and sellers from entering into these long term arrangements, and recent changes in state and federal regulations are often cited as the cause of the problem. The purpose of the author's remarks is to argue that what is taken as a breakdown in the market may be simply a reaction to a decline in economic incentives to enter into long-term contracts with rigid price and quantity terms. This is, in other words, simply one more aspect of change in the gas business that Frank Heintz referred to in his opening remarks this morning. The author starts by giving a brief description of the motives for engaging in long-term contracts, and then describes how incentives to use long-term contracts have declined for both gas buyers and gas sellers. He concludes that the decline in the use of long-term contracts is not cause for regulatory concern, but a result of the continuing transformation of the gas business to one that more closely resembles other commodity markets

  6. Long-term visual associations affect attentional guidance.

    Science.gov (United States)

    Olivers, Christian N L

    2011-06-01

    When observers perform a visual search task, they are assumed to adopt an attentional set for what they are looking for. The present experiment investigates the influence of long-term visual memory associations on this attentional set. On each trial, observers were asked to search a display for a grayscale version of a known traffic sign. On each trial, a distractor sign was drawn in full color. This color could either be related or unrelated to the target sign. Distractors interfered more with search when their color was related (e.g. red when the target was a stop sign), implying that long-term color associations resulted in inadvertent attentional guidance, even though color was irrelevant to the task. The results add to the growing body of evidence that long-term memory representations automatically affect attentional orienting. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. An unusual case of rapidly progressive contractures: Case report and brief review

    Directory of Open Access Journals (Sweden)

    Subasree R

    2008-01-01

    Full Text Available An 8-year-old boy, diagnosed as cervical dystonia, was referred to our tertiary center. After a trivial trauma he had developed painful lumps in the axial region, which was followed by restricted movements of neck, shoulder, and abdominal muscles over 4 months. He had kyphoscoliosis, torticollis, rigid abdomen, and multiple muscle contractures. He also had short great toes. A detailed skeletal survey showed calcification in the soft tissues surrounding the shoulder anterior chest wall, thorax, and paraspinal muscles; there was also beaking of vertebrae, which was confirmed by CT thorax. This report showcases the diagnostic challenge posed by myositis ossificans progressiva, which can rarely cause rapidly progressing muscle contractures. A brief review of literature is also presented.

  8. Predictors for success of internal urethrotomy in patients with urethral contracture following perineal repair of pelvic fracture urethral injuries.

    Science.gov (United States)

    Hong, Young-Kwon; Choi, Kyung-Hwa; Lee, Young-Tae; Lee, Seung-Ryeol

    2017-05-01

    Internal urethrotomy (IU) in patients with urethral contracture following perineal repair of pelvic fracture urethral injuries (PRPFUI) is troublesome. We evaluated the clinical factors affecting the surgical outcome of IU for urethral contracture after PRPFUI. We retrospectively reviewed the records of 35 patients who underwent IU for urethral contracture after PRPFUI between March 2004 and June 2013. Ages of patients ranged from 18 to 50, and their follow-up duration was more than 1year after IU. The urethral contracture was confirmed by retrograde urethrogram or cysto-urethroscopy. Success was defined as greater than 15mL/s of peak urinary flow rate at 1year after IU without any clinical evidence of urethral contracture. Success rates were investigated according to the number of IU. Age, body mass index, urethral defect length before PRPFUI, time interval between the original urethral injury and the PRPFUI or between a previous operation and the PRPFUI, time interval between the PRPFUI and the urethral contracture, number of PRPFUI performed, and the type of urethral lengthening procedure were compared between patients with and without success according to the number of IU. Among the 35 patients, the overall success rate of IU was 37% (13/35) during the mean follow-up period of 53 months (range: 17-148 months). There were 8 and 5 patients with success in first and second IU, respectively. However, there was no success after third IU. Urethral defect length before PRPFUI was significantly shorter in patients with success who underwent first and second IU (p<0.05). There were significant differences of success between patients with and without previous repeated failures of PRPFUI in first and second IU (p<0.05). Short urethral defect length and no previous surgical failures before PRPFUI are good prognostic factors for IU following PRPFUI. Only one or two IUs will be helpful in patients with urethral contracture following PRPFUI. Copyright © 2017 Elsevier Ltd

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

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  10. Opening remarks for a panel discussion on short-term vs long-term procurement

    International Nuclear Information System (INIS)

    Courtenay, R.H.

    1990-01-01

    Long-term contracting in the late 1970's and early 1980's is blamed for some of the inequities that plague the uranium industry today. Utilities are obliged to pay prices far above prevailing levels and relatively low cost producers are forced to shut down while watching less efficient suppliers stay in business thanks to their long term supply agreements. Furthermore, it is argued that long-term contracts have contributed to supply instability by forcing the buildup of surplus inventories and by supporting excess incremental production by suppliers who have a baseload of long-term contracts. The depressed prices resulting from this oversupply are in turn jeopardizing future resource development and damaging supply reliability. In summary, the author's argument is that supply reliability will be greatly enhanced by the assurance of adequate primary supply from traditional sources such as Canada. This will not happen without long-term contracts. This conclusion may not be expected coming from a representative of Canada's largest uranium producer. But the final comment is less self serving. Many of the critics of long term contracts apparently expect a continuing and plentiful supply of East Bloc uranium to the spot market. A further question is to what extent East Bloc suppliers will eventually require long-term contracts in order to maintain production facilitates in economies that are no longer centrally planned, and where there is open competition for capital. Ultimately, reliability of supply from the non-traditional suppliers may also depend on long-term contracts

  11. Short- and long-term results of laparoscopic surgery for transverse colon cancer.

    Science.gov (United States)

    Hirasaki, Yoshinori; Fukunaga, Masaki; Sugano, Masahiko; Nagakari, Kunihiko; Yoshikawa, Seiitirou; Ouchi, Masakazu

    2014-07-01

    We investigated the feasibility of laparoscopic surgery for transverse colon cancer (TCC) by examining the results of this procedure, and comparing the short- and long-term outcomes with those for right-sided and sigmoid colon cancer (OSCC). The subjects consisted of 117 patients with TCC. Their complications, forms of recurrence and disease-free and 5-year survival rates were compared to those of 564 patients with OSCC. There were no significant between-group differences in the patient background. The average length of the operation in the TCC group was 215 min and that in the OSCC group was 184 min (p < 0.05). There were also no significant between-group differences in the average blood loss, which was 83.9 and 70.5 g, respectively. No significant difference was observed between groups by stage in terms of the disease-free survival rates, which were 94.4 and 79.1 % for stage II and III in the TCC group, and 92.4 and 78.8 % for stage II and III in the OSCC group. The incidence of intraoperative and postoperative complications was low, and the five-year survival rate was favorable. As favorable results of laparoscopic colectomy (LAC) for TCC were also obtained at other sites in a multicenter randomized controlled trial, LAC is expected to become a standard therapy for TCC.

  12. Electrophysiological and histological changes in extrinsic muscles proximal to post burn contractures of hand.

    Science.gov (United States)

    Bhattacharya, V; Purwar, Shammi; Joshi, D; Kumar, M; Mandal, S; Chaudhuri, G R; Bhattacharya, S

    2011-06-01

    Burn scar hand contractures of variable degree are frequently encountered. Although the forearm is apparently spared, it was clinically observed that there was disuse atrophy in the unburnt extrinsic forearm muscles. Usually the clinicians do not give much importance to this fact. The girth at the midforearm was significantly reduced as compared to normal side. The flexion of the hand joints are governed by two components (a) intrinsic and (b) extrinsic muscles. The intrinsic muscles are directly involved in the contracted tissue. Therefore it was thought essential to evaluate the extrinsic group of muscles for their contribution in the final functional recovery following corrective surgery. Thirty patients having unilateral post thermal burn contracture sparing forearm were studied. A detailed clinical evaluation was made including grade of contracture and reduction in the forearm girth. The forearm unburnt muscles were evaluated by preoperative electrophysiological studies. Intraoperative biopsies were taken from these muscles for histopathological examination. On histopathological examination, there were significant abnormal changes in the form of muscle fiber atrophy, fibrolipomatous tissue replacement of atrophic muscle fibers and sarcolemmal changes. These changes were directly proportional to the severity of contractures. The electrophysiological studies showed proportionate changes in the form of reduction in amplitude, duration and interference. This study suggests that if these changes are mild and in reversible stage, they will favourably affect the functional recovery following surgery. However if these changes are of severe grade and irreversible, in spite of adequate surgery, splinting and physiotherapy, the functional recovery may not be complete. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  13. Energy in 2010 - 2020. Long term challenges; Energie 2010-2020. Les defis du long terme

    Energy Technology Data Exchange (ETDEWEB)

    Dessus, Benjamin [ed.] [Centre National de la Recherche Scientifique (CNRS), 75 - Paris (France)

    2000-02-02

    This report presents the results of a workshop intending to anticipate the long term challenges, to guide better the short term power options, to understand the available political, economical and technical assumptions for the prospective world situation, to give some strategic hints on the necessary transition. Indeed, the difficult issue which the workshop tried to tackle was how should we prepare to reveal the energetic challenge of the development of the eight to ten billion inhabitants of our Planet in the next century without jeopardizing its existence. The energetic problems, a hardcore of the international preoccupation of both growth and environment, as it was recently evidenced by the climatic conference in Kyoto, have ever been the object of a particular attention on the part of General Commissariat of Plan. Thus, the commission 'Energy in 2010 - 2020' has been instituted in April 1996 in order to update the works done in 1990 - 1991 by the commission 'Energy 2010'. Soon it occurred to this new commission the task of illuminating its works by a long term (2050 - 2100) world prospective analysis of the challenges and problems linked to energy, growth and environment. In conclusion, this document tried to find answers to questions like: - which are the risks the energy consumption augmentation entail? - can we control them by appropriate urbanism and transport policies or technological innovation?. Four options for immediate action are suggested: - the energy efficiency should become a priority objective of policies; -coping with the long term challenges requires acting at present; - building the transition between governmental leadership and market; - taking profit of all the possible synergies between short and long term planning.

  14. Long-term results of salvage radiotherapy for the treatment of recurrent cervical carcinoma after prior surgery

    International Nuclear Information System (INIS)

    Haasbeek, Cornelis J.A.; Uitterhoeve, Apollonia L.J.; Velden, Jacobus van der; Gonzalez, Dionisio Gonzalez; Stalpers, Lukas J.A.

    2008-01-01

    Abstarct: Background and purpose: Tumor recurrence after surgery for cervical carcinoma is associated with high fatality and morbidity, forming a major therapeutic challenge. This paper presents our experience with treatment of this patient group by salvage radiotherapy with curative intent. Materials and methods: Thirty-five patients with a pelvic recurrence after hysterectomy received high-dose radiotherapy. A retrospective analysis of long-term outcome and prognostic factors was performed. Results: After a median follow-up period of 12.1 years, actuarial 2-,5- and 10-year overall survival rates were 66%, 43% and 33%; disease-free survival rates were 62%, 45% and 41%, respectively. Pelvic control rates at 2-,5- and 10-years were 77%, 69% and 62%. Unfavorable prognostic factors on univariate analysis for survival were: recurrence extending to the pelvic wall versus central recurrence, early recurrence after surgery, external boost versus brachytherapy boost, low total dose and high age. Only a brachytherapy boost and a long interval between surgery and recurrence were significant on multivariate analysis. Severe complications (≥grade 3) were seen in 6 patients (17%; actuarial after 5 years, 21%). Conclusions: Salvage radiotherapy for recurrent cervical carcinoma following surgery may result in 40-50% long-term disease-free survival and an acceptable risk of severe treatment complications, even in patient with recurrences extending to the pelvic wall

  15. Long-term associative learning predicts verbal short-term memory performance.

    Science.gov (United States)

    Jones, Gary; Macken, Bill

    2018-02-01

    Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term memory system separate from long-term knowledge. Using natural language corpora, we show experimentally and computationally that performance on three widely used measures of short-term memory (digit span, nonword repetition, and sentence recall) can be predicted from simple associative learning operating on the linguistic environment to which a typical child may have been exposed. The findings support the broad view that short-term verbal memory performance reflects the application of long-term language knowledge to the experimental setting.

  16. The Structure and Content of Long-Term and Short-Term Mate Preferences

    Directory of Open Access Journals (Sweden)

    Peter K. Jonason

    2013-12-01

    Full Text Available This study addresses two limitations in the mate preferences literature. First, research all-too-often relies on single-item assessments of mate preferences precluding more advanced statistical techniques like factor analysis. Second, when factor analysis could be done, it exclusively has done for long-term mate preferences, at the exclusion of short-term mate preferences. In this study (N = 401, we subjected 20 items designed to measure short- and long-term mate preferences to both principle components (n = 200 and confirmatory factor analysis (n = 201. In the long-term context, we replicated previous findings that there are three different categories of preferences: physical attractiveness, interpersonal warmth, and social status. In the short-term context, physical attractiveness occupied two parts of the structure, social status dropped out, and interpersonal warmth remained. Across short- and long-term contexts, there were slight changes in what defined the shared dimensions (i.e., physical attractiveness and interpersonal warmth, suggesting prior work that applies the same inventory to each context might be flawed. We also replicated sex differences and similarities in mate preferences and correlates with sociosexuality and mate value. We adopt an evolutionary paradigm to understand our results.

  17. 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.

  18. The Boyd–McLeod procedure for tennis elbow: mid- to long-term results

    Science.gov (United States)

    Jeavons, Richard; Richards, Ian; Bayliss, Neil

    2014-01-01

    Background Tennis elbow is a common condition that usually responds to conservative measures. In refractory cases, surgical intervention is indicated. A plethora of surgical techniques have been described. We report the mid- to long-term outcomes of the Boyd–McLeod procedure for refractory tennis elbow. Methods A retrospective analysis and current review of patients that had undergone the Boyd–McLeod procedure over a 12-year period was undertaken. Demographics, time to discharge, length of follow-up and outcome scores were collected. Results Seventy patients underwent surgery. Mean time to discharge was 15.35 weeks, with 88% successful outcomes. Fifty-four patients were available for current follow-up at mean of 5.52 years (range 1.17 years to 11.49 years). Range of motion in all patients was unchanged. There were no revision procedures. Mean (SD) Mayo Elbow Performance Score was 90.85 (13.11), with 75.5% returning a good or excellent score and 24.5% a fair outcome. The mean (SD) Oxford Elbow Score was 44.04 (6.92); mean (SD) pain score was 89.5 (17.58); mean (SD) function score was 95.34 (9.59) and mean (SD) socio-psychological score was 91.50 (17.01). Overall, 83% of patients had an Oxford Elbow Score of 43 or greater, suggesting excellent outcome. Conclusions We show that the Boyd–McLeod procedure is an excellent option over both the short- and long-term for refractory tennis elbow. PMID:27582946

  19. Long-term results of radiotherapy for 104 patients with Graves' orbitopathy

    International Nuclear Information System (INIS)

    Qu Baolin; Yang Dong; Feng Linchun; Luo Zhiyuan

    2008-01-01

    Objective: To evaluate the long-term outcome and the sequelae of Graves' orbitopathy treated with radiotherapy, and to specify the prognostic factors. Methods: From 1979 to 1999, 104 patients with progressive Graves' orbitopathy were treated with conventional orbital radiotherapy. Post globe and pituitary irradiation of 25-35 Gy was given to 56 patients, which was followed by a boost of 15-20 Gy to the pituitary. Follow-up time was 7.5 - 25.0 years. The result of radiotherapy was analyzed. Results: Overall response rate was 71.1%. The response rate of patients with soft-tissue infiltration, corneal involvement, proptosis, sight loss and extraocular muscle dysfunction was 88.4%, 75.1%, 55.6%, 68.8% and 64.4%, respectively. Twelve patients (11.5%) developed cataracts 2.5-18.3 years (median 11.2 years) after irradiation. One patient developed left-eye retinopathy 3.2 years after irradiation. No patient developed secondary tumor within the irradiation field. Conclusions: Orbital radiotherapy for progressive Graves' orbitopathy, being effective and safe, can control the disease progression and improve the symptoms. The side effect of radiotherapy is fewer than other treatment modalities. (authors)

  20. Fibrous Myopathy as a Complication of Repeated Intramuscular Injections for Chronic Headache

    Directory of Open Access Journals (Sweden)

    R Burnham

    2006-01-01

    Full Text Available Two cases of fibrous myopathy associated with repeated, long-term intramuscular injections for treatment of chronic temporomandibular joint pain and chronic headache, respectively, are described. Both patients developed severe, function-limiting contractures in upper and lower extremity muscles used as injection sites. In one of the cases, the contractures were painful. Electrophysiological testing, magnetic resonance imaging and muscle biopsy results were all consistent with myopathy and replacement of skeletal muscle with noncontractile fibrous tissue. These cases are presented to increase awareness of fibrous myopathy and to promote surveillance for this serious potential complication of long-term intramuscular injections in chronic headache and other pain patients.

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

    International Nuclear Information System (INIS)

    Hu Haibo; Jiang Shiliang; Dai Ruping; Huang Lianjun; Xu Zhongying; Zhao Shihua; Zheng Hong; Ling Jian; Xie Ruolan

    2002-01-01

    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) cm 2 vs (1.99 +- 0.45) cm 2 vs (1.44 +- 0.42) cm 2 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

  2. Long-term multipactor discharge in multicarrier systems

    International Nuclear Information System (INIS)

    Anza, S.; Vicente, C.; Gimeno, B.; Boria, V. E.; Armendariz, J.

    2007-01-01

    A new mechanism of long-term multipactor in multicarrier systems is studied employing both analytical and numerical methods. In particular, the investigation is focused on the impact that a realistic secondary emission yield at low energies produces on the development of long term multipactor. A novel analytical model for this interperiod charge accumulation is presented using the traditional multipactor theory for parallel plates, and approximating the multicarrier signal as a single-carrier signal modulated by a pulsed signal envelope. The analytical predictions are verified by numerical simulations for a typical rectangular waveguide. The analytical and numerical results demonstrate that the susceptibility of the system to develop a long-term multipactor discharge increases with higher values of low-energy secondary emission yield

  3. Primary hydatid disease of the femur: unsuspected and incidental MRI findings with long-term curative results on medical treatment alone

    International Nuclear Information System (INIS)

    Poyanli, A.; Sencer, S.; Akan, K.; Poyanli, O.; Sayrak, H.

    2001-01-01

    This report describes the early magnetic resonance imaging (MRI) findings and long-term follow-up results of albendazole treatment in a 16-year-old girl with primary hydatid disease of the femur diagnosed incidentally during the course of a post-traumatic knee infection. As far as we know, this is the first report of the early MRI findings and long-term outcome of medical treatment in primary hydatid disease of the femur in this age group. (orig.)

  4. Primary hydatid disease of the femur: unsuspected and incidental MRI findings with long-term curative results on medical treatment alone

    Energy Technology Data Exchange (ETDEWEB)

    Poyanli, A.; Sencer, S. [Dept. of Radiology, Istanbul Faculty of Medicine (Turkey); Akan, K.; Poyanli, O. [Dept. of Orthopaedics and Traumatology, Goeztepe SSK Educational Hospital, Istanbul (Turkey); Sayrak, H. [Dept. of Pathology, Goeztepe SSK Educational Hospital, Istanbul (Turkey)

    2001-11-01

    This report describes the early magnetic resonance imaging (MRI) findings and long-term follow-up results of albendazole treatment in a 16-year-old girl with primary hydatid disease of the femur diagnosed incidentally during the course of a post-traumatic knee infection. As far as we know, this is the first report of the early MRI findings and long-term outcome of medical treatment in primary hydatid disease of the femur in this age group. (orig.)

  5. [Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

    Science.gov (United States)

    Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

    2017-01-01

    Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

  6. CLIMATE CHANGE: LONG-TERM TRENDS AND SHORT-TERM OSCILLATIONS

    Institute of Scientific and Technical Information of China (English)

    GAO Xin-quan; ZHANG Xin; QIAN Wei-hong

    2006-01-01

    Identifying the Northern Hemisphere (NH) temperature reconstruction and instrumental data for the past 1000 years shows that climate change in the last millennium includes long-term trends and various oscillations. Two long-term trends and the quasi-70-year oscillation were detected in the global temperature series for the last 140 years and the NH millennium series. One important feature was emphasized that temperature decreases slowly but it increases rapidly based on the analysis of different series. Benefits can be obtained of climate change from understanding various long-term trends and oscillations. Millennial temperature proxies from the natural climate system and time series of nonlinear model system are used in understanding the natural climate change and recognizing potential benefits by using the method of wavelet transform analysis. The results from numerical modeling show that major oscillations contained in numerical solutions on the interdecadal timescale are consistent with that of natural proxies. It seems that these oscillations in the climate change are not directly linked with the solar radiation as an external forcing. This investigation may conclude that the climate variability at the interdecadal timescale strongly depends on the internal nonlinear effects in the climate system.

  7. Sleeve Gastrectomy: Correlation of Long-Term Results with Remnant Morphology and Eating Disorders.

    Science.gov (United States)

    Tassinari, Daniele; Berta, Rossana D; Nannipieri, Monica; Giusti, Patrizia; Di Paolo, Luca; Guarino, Daniela; Anselmino, Marco

    2017-11-01

    Remnant dimension is considered one of the crucial elements determining the success of sleeve gastrectomy (SG), and dilation of the gastric fundus is often believed to be the main cause of failure. The main outcome of this study is to find correlations between remnant morphology in the immediate post-operative stage, its dilation in years, and the long-term results. The second purpose aims to correlate preoperative eating disorders, taste alteration, hunger perception, and early satiety with post-SG results. Remnant morphology was evaluated, in the immediate post-operative stage and over the years (≥2 years), through X-ray of the oesophagus-stomach-duodenum calculating the surface in anteroposterior (AP) and right anterior oblique projection (RAO). Presurgery diagnosis of eating disorders and their evaluation through "Eating Disorder Inventory-3" (EDI3) during follow-up were performed. Change in taste perception, sense of appetite, and early satiety were evaluated. Patients were divided into two groups: "failed SGs (EWL50%). There were a total of 50 patients (37 F, 13 M), with mean age 52 years, preoperative weight 131 ± 21.8 kg, and BMI 47.4 ± 6.8 kg/m 2 . Post-operative remnant mean dimensions overlapped between the two groups. On a long-term basis, an increase of 57.2 and 48.4% was documented in the AP and RAO areas respectively. In "failed" SGs, dilation was significantly superior to "efficient" SGs (AP area 70.2 vs 46.1%; RAO area 59.3 vs 39%; body width 102% vs 41.7%). Preoperative eating disorders were more present in efficient SGs than in failed SGs with the exception of sweet eating. There were no significant changes to taste perception during follow-up. Fifty-two percent of efficient SGs vs 26% of failed SGs reported a persistent lack of sense of hunger; similarly, 92.5 vs 78% declared the persistence of a sense of early satiety. The two groups did not statistically differ as far as all the variables of the EDI3 are concerned. On a long-term

  8. Long-term results after aortic valve replacement with the Biocor PSB stentless xenograft in the elderly.

    Science.gov (United States)

    Luciani, G B; Santini, F; Auriemma, S; Barozzi, L; Bertolini, P; Mazzucco, A

    2001-05-01

    This study seeks to define the long-term results after Biocor PSB stentless aortic valve replacement (AVR) in elderly patients, including the effects of No-React treatment. We reviewed the outcomes of 106 consecutive patients, aged 70+/-6 years, having Biocor PSB (93 standard, 13 No-React) AVR between October 1992 and October 1996. There were three early deaths (3%) and 15 late deaths (15%), during a mean follow-up of 5.8+/-1.6 years. At 8 years, survival was 82%+/-4% and freedom from cardiac death was 94%+/-3%. Freedom from valve failure was 92%+/-4% at 8 years (No-React: 92%+/-8% at 4 years). Replacement of the xenograft was required in 5 patients. Freedom from reoperation was 91%+/-4% at 8 years (No-React: 92%+/-8% at 4 years). Four bleeding and two embolic events were recorded: overall valve-related event-free survival was 81%+/-7% at 8 years (No-React: 76%+/-12% at 4 years). Age of long-term survivors averaged 77+/-5 years and their New York Heart Association status was 1.3+/-0.6 (versus 2.9+/-0.6 preoperatively, p = 0.01). Satisfactory freedom from cardiac events and from valve deterioration added to uniform improvement in functional status despite advanced age and high prevalence of comorbid conditions make AVR with the Biocor PSB xenograft a valid long-term therapy for the elderly. No-React treatment does not influence xenograft durability.

  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 total lymphoid irradiation in the treatment of cardiac allograft rejection

    International Nuclear Information System (INIS)

    Wolden, Suzanne L.; Tate, David J.; Hunt, Sharon A.; Strober, Samuel; Hoppe, Richard T.

    1997-01-01

    Purpose: To evaluate the short and long-term effects of total lymphoid irradiation (TLI) in the treatment of cardiac transplant rejection. Methods and Materials: Between 1986 and 1995, 48 courses of TLI were delivered to 47 cardiac transplant patients. In 37 patients, TLI was administered for intractable allograft rejection despite conventional therapy while 10 patients received TLI prophylactically. The prescribed radiation dose was 8 Gy in 0.8 Gy fractions twice weekly to mantle and inverted-Y plus spleen fields. Postirradiation follow-up ranged from 6 months to 9.1 years, with a mean of 3.1 years. Results: The actual mean dose was 7.3 Gy delivered over a mean of 39 days. Fifty-six percent of patients required treatment delay or abbreviation because of thrombocytopenia, leukopenia, infection, or unrelated problems. In patients treated for intractable rejection, rejection rates dropped from 0.46 to 0.14 and to 0.06 episodes/patient/month before, during, and after TLI (p < 0.0001). Rejection rates continued to drop throughout follow-up. Prednisone requirements decreased from 0.41 mg/kg before treatment to 0.21 mg/kg afterward (p < 0.0001). The ratio of helper to cytotoxic-suppressor T-cells decreased during TLI from 1.33 to 0.89, and remained low at 0.44, 2-4 months after treatment. Infection rates were not increased and two patients developed malignancy. Rejection rates were high during prophylactic treatment and this protocol was abandoned. Three-year actuarial survival after irradiation was 60% for patients with intractable rejection and 70% for the prophylactic cohort. Conclusion: TLI is an effective treatment for control of intractable cardiac rejection. Episodes of rejection and steroid dosage requirements are decreased for up to 9.1 years. A possible mechanism of action is long term alteration in T-lymphocyte subsets. Patients experience transient bone marrow suppression but no increase in infection or bleeding. Long-term complications of TLI are not

  11. Impact of long-term and short-term therapies on seminal parameters

    Directory of Open Access Journals (Sweden)

    Jlenia Elia

    2013-04-01

    Full Text Available Aim: The aim of this work was: i to evaluate the prevalence of male partners of subfertile couples being treated with long/short term therapies for non andrological diseases; ii to study their seminal profile for the possible effects of their treatments on spermatogenesis and/or epididymal maturation. Methods: The study group was made up of 723 subjects, aged between 25 and 47 years. Semen analysis was performed according to World Health Organization (WHO guidelines (1999. The Superimposed Image Analysis System (SIAS, which is based on the computerized superimposition of spermatozoa images, was used to assess sperm motility parameters. Results: The prevalence of subjects taking pharmacological treatments was 22.7% (164/723. The prevalence was 3.7% (27/723 for the Short-Term Group and 18.9% (137/723 for the Long-Term Group. The subjects of each group were also subdivided into subgroups according to the treatments being received. Regarding the seminal profile, we did not observe a significant difference between the Long-Term, Short-Term or the Control Group. However, regarding the subgroups, we found a significant decrease in sperm number and progressive motility percentage in the subjects receiving treatment with antihypertensive drugs compared with the other subgroups and the Control Group. Conclusions: In the management of infertile couples, the potential negative impact on seminal parameters of any drugs being taken as Long-Term Therapy should be considered. The pathogenic mechanism needs to be clarified.

  12. Customer loyalty in the South African long-term insurance industry

    Directory of Open Access Journals (Sweden)

    Leon du Plessis

    2013-04-01

    Full Text Available The primary objective of this study is to investigate the influence of selected independent variables, two-way communication and conflict handling on intentional customer loyalty via Customer Relationship Management (CRM as the intervening variable within the South African long-term insurance environment. Primary data were gathered using a questionnaire, with items referring to Customer Relationship Management, customer loyalty, two-way communication and conflict handling. The sample consisted of 254 customers in four customer walk-in centres of a long-term insurance provider in South Africa. Data were factor-analysed. One independent variable, conflict handling, exerted a statistically significant positive influence on the intervening variable (CRM, whilst two-way communication exerted a statistically significant negative influence on the intervening variable. This variable (CRM positively influenced the dependent variable (customer loyalty. If long-term insurance organisations communicate timeously and accurately, and are skilled in conflict handling, greater loyalty will be created amongst customers. The study revealed that the majority of customers (51.53% strongly agree that two-way communication is an important dimension that underpins Customer Relationship Management and their relationship with a long-term insurance organisation. The empirical results indicate a negative relationship between the perceived two-way communication by a long-term insurance organisation and CRM at the insurance provider in South Africa. In terms of conflict handling, the study revealed that the majority of customers (45.69% strongly agree that conflict handling is an important dimension that underpins Customer Relationship Management and their relationship with a long-term insurance organisation. The empirical results indicate a positive relationship between perceived conflict handling by a long-term insurance provider and CRM at the organisation in South

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

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  14. Short- and long-term eating habit modification predict weight change in overweight, post-menopausal women: results from the WOMAN Study

    Science.gov (United States)

    Gibbs, Bethany Barone; Kinzel, Laura S.; Gabriel, Kelley Pettee; Chang, Yue-fang; Kuller, Lewis H.

    2012-01-01

    Background Standard behavioral obesity treatment produces poor long-term results. Focusing on healthy eating behaviors, rather than caloric intake, may be an alternative strategy. Furthermore, important behaviors might differ for short- vs. long-term weight control. Objective To describe and compare associations between changes in eating behaviors and weight after 6 and 48 months Design Secondary analysis of data collected during a randomized weight loss intervention trial with 48-month follow-up Participants 465 overweight and obese postmenopausal women enrolled in the Women on the Move through Activity and Nutrition (WOMAN) Study Main outcome measures Changes in weight from baseline to 6 and 48 months. Statistical analyses performed Linear regression models examined the associations between 6- and 48-month changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight. Analyses were conducted in the combined study population and stratified by randomization group. Results At 6 months in the combined population, weight loss was independently associated with decreased desserts (pstudies should determine whether interventions targeting these behaviors could improve long-term obesity treatment outcomes. PMID:22939439

  15. Efficacy of Pelvisoft® Biomesh for cystocele repair: assessment of long-term results

    Directory of Open Access Journals (Sweden)

    Erwann Le Long

    2014-12-01

    Full Text Available Introduction and Hypothesis To our knowledge a study regarding the efficacy of Pelvisoft® Biomesh for cystocele repair has not previously been reported in the literature. The aim of our study was to assess the long-term efficacy, subjective outcomes and complications in the use of a non-synthetic porcine skin mesh graft (Pelvisoft® Biomesh associated with transvaginal anterior colporrhaphy in the treatment of cystocele prolapse. Materials and Methods A retrospective study was performed at a single centre. Thirty-three women aged 35-77 years underwent cystocele repair using Pelvisoft® graft between December 2005 and June 2009. Twenty-nine women who underwent transvaginal cystocele repair with Pelvisoft® Biomesh for over a 2 years period were assessed. Four patients were lost to follow-up. Cystocele repair was performed via the vaginal route using Pelvisoft®Biomesh implant by inserting it in the anterior vaginal wall. The median follow-up time was 54.0 months. The rate of recurrence was 17.3%. A total of 6.9% of patients presented early mesh exposure treated by conservative treatment. The mean PFDI-20 score was 72.2. Among sexually active women, the mean PISQ 12 was 33.9 but 56.2% had dyspareunia. After surgery, 6 patients had de novo intercourse. Our results show that the use of Pelvisoft® biomaterial associated with anterior colporrhaphy for cystocele repair appears to be safe with acceptable failure and complication rates at long term. Nevertheless, an adverse impact on sexual function was reported by the majority of patients.

  16. Long-term nitrogen regulation of forest carbon sequestration

    Science.gov (United States)

    Yang, Y.; Luo, Y.

    2009-12-01

    It is well established that nitrogen (N) limits plant production but unclear how N regulates long-term terrestrial carbon (C) sequestration in response to rising atmospheric C dioxide (CO2)(Luo et al., 2004). Most experimental evidence on C-N interactions is primarily derived from short-term CO2 manipulative studies (e.g. Oren et al., 2001; Reich et al., 2006a), which abruptly increase C inputs into ecosystems and N demand from soil while atmospheric CO2 concentration in the real world is gradually increasing over time (Luo & Reynolds, 1999). It is essential to examine long-term N regulations of C sequestration in natural ecosystems. Here we present results of a synthesis of more than 100 studies on long-term C-N interactions during secondary succession. C significantly accumulates in plant, litter and forest floor in most studies, and in mineral soil in one-third studies during stand development. Substantial increases in C stock are tightly coupled with N accretion. The C: N ratio in plant increases with stand age in most cases, but remains relatively constant in litter, forest floor and mineral soil. Our results suggest that natural ecosystems could have the intrinsic capacity to maintain long-term C sequestration through external N accrual, high N use efficiency, and efficient internal N cycling.

  17. Long-term results of percutaneous endoscopic gastrostomies

    Directory of Open Access Journals (Sweden)

    Faruk Aksoy

    2012-06-01

    Full Text Available Objectives: In order to provide enteral nutrition for patientsin intensive-care units who cannot be fed orally, weaimed to present our percutaneous endoscopic gastrostomy(PEG experience, which is a minimally invasivemethod.Materials and methods: In this study, 700 patients whoapplied to our clinic between January 2000 and June2011 and who had a PEG because they could not be fedorally were retrospectively assessed in terms of indications,complications, and results.Results: Among these patients, 400 (57% were maleand 300 (43% were female. Most of the patients withfeeding problems had also neurologically caused pathologies.After the PEG, 50 (7.1% patients had under-skininfections, 18 (2.5% patients had leakage from the edgeof the PEG, and 16 (2.0% patients had bleeding from theedge of the PEG.Conclusion: PEG is a secure and effective nutritionmethod as it can be performed with a minimally invasiveprocedure and it has low mortality and morbidity.

  18. Long-term selenium status in humans

    International Nuclear Information System (INIS)

    Baskett, C.K.; Spate, V.L.; Mason, M.M.; Nichols, T.A.; Williams, A.; Dubman, I.M.; Gudino, A.; Denison, J.; Morris, J.S.

    2001-01-01

    The association of sub-optimal selenium status with increased risk factors for some cancers has been reported in two recent epidemiological studies. In both studies the same threshold in selenium status was observed, below which, cancer incidence increased. To assess the use of nails as a biologic monitor to measure the long-term selenium status, an eight-year longitudinal study was undertaken with a group of 11 adult subjects, 5 women and 6 men. Selenium has been measured by instrumental neutron activation analysis. Differences between fingernails and toenails with be discussed. In addition, the results will be discussed in the context of the long-term stability of the nail monitor to measure selenium status during those periods when selenium determinants are static; and the changes that occur as a result of selenium supplementation. (author)

  19. Reforming Long-Term Care Funding in Alberta.

    Science.gov (United States)

    Crump, R Trafford; Repin, Nadya; Sutherland, Jason M

    2015-01-01

    Like many provinces across Canada, Alberta is facing growing demand for long-term care. Issues with the mixed funding model used to pay long-term care providers had Alberta Health Services concerned that it was not efficiently meeting the demand for long-term care. Consequently, in 2010, Alberta Health Services introduced the patient/care-based funding (PCBF) model. PCBF is similar to activity-based funding in that it directly ties the complexity and care needs of long-term care residents to the payment received by long-term care providers. This review describes PCBF and discusses some of its strengths and weaknesses. In doing so, this review is intended to inform other provinces faced with similar long-term care challenges and contemplating their own funding reforms.

  20. Interventional devascularization for the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension: mid-term to long-term results

    International Nuclear Information System (INIS)

    Liu Wei; Chen Hongbo; Chen Gensheng; Zhang Weiping; Zheng Qun

    2009-01-01

    Objective: To assess the mid-term to long-term results of interventional devascularization in the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension. Methods: Interventional devascularization was performed in 49 patients with upper gastrointestinal hemorrhage due to portal hypertension caused by cirrhosis. The patients were followed up for 6-36 months after the procedure. The recurrence of bleeding, postoperative complications and outcome. were observed and analyzed. Results: The technical success rate was 98.0% (48 / 49) and the mortality was 2%. The re-bleeding occurrence rate at 1, 6, 12, 24 and 36 months was 0%, 2.1%, 12.5%, 24.5% and 27.9%, respectively. The causes of re-bleeding included re-rupture of varicose vein (25%), portal hypertensive gastropathy (58.3%) and peptic ulcer (16.7%). Conclusion: The interventional devascularization is a simple, safe and effective method for the treatment of upper gastrointestinal hemorrhage due to portal hypertension. (authors)

  1. Long-term deconditioning of gas-filled surge arresters

    Science.gov (United States)

    Stanković, Koviljka; Brajović, Dragan; Alimpijević, Mališa; Lončar, Boris

    2016-07-01

    The aim of this paper is to identify parameters that influence the long-term deconditioning effect of gas-filled surge arrester (GFSA) and to provide practical recommendations for mitigating this effect. Namely, after some period of time, on order of hours or days, during which there is no activation due to overvoltage, the deconditioning of GFSA occurs. This effect was observed experimentally within the paper. The observed parameters that could influence the long-term deconditioning effect were the following: shape of voltage load, gas type, gas pressure, interelectrode distance, electrode material, electrode surface topography as well as GFSA design such as two- or three-electrode configuration. According to the results obtained, it has been shown that the occurrence of long-term deconditioning in an insulating system, insulated by a noble gas at a subpressure and with small interelectrode distances, is a phenomenon that always occurs when the insulating system is at rest for about an hour. It has been found that the type of noble gas does not influence the long-term deconditioning. Analysis of such insulating systems' parameters, with a prospect of being used as GFSAs, has demonstrated that this phenomenon is less pronounced at higher pressures (for the same value of the pressure (p) and interelectrode distance (d) product) and for electrodes with microscopically embossed surfaces. According to the results that were obtained by noble gases and their mixtures, as well as the results that were obtained by mixtures of SF6 gas with noble gasses, it can be claimed with confidence that the effect of the long-term deconditioning is an electrode effect. It has also been established that the deconditioning effect does not depend on the electrode material except in the case of electrodes made out of noble metals, which reduce the effect. Based on these results, it can be recommended that the working point of GFSAs be set (according to the DC breakdown voltage value) at a

  2. 长时程增强与长时程抑制的研究%Advances in long - term potentiation and long - term depression

    Institute of Scientific and Technical Information of China (English)

    张敬军; 夏作理

    2000-01-01

    The impairment of learning and memory function in the central nervous system(CNS)is one of the main features of aging and Alzheimer' s disease (AD). Many experimental results have showed that long- term memory(LTM) is related to long- term potentiation(LTP) and long- term depression (LTD). They intluenee each other. The relationship between LTP and LTD is complex. Therefore, it is important to study the learning and memory mechanism from LTP、LTD and gene expression in the CNS.

  3. Pneumatic-type dynamic traction and flexion splint for treating patients with extension contracture of the metacarpophalangeal joint.

    Science.gov (United States)

    Nakayama, Jun; Horiki, Mituru; Denno, Kakurou; Ogawa, Kazunori; Oka, Hisao; Domen, Kazuhisa

    2016-02-01

    Collateral ligament shortening causes extension contractures of the metacarpophalangeal joint, and dynamic flexion splinting has been widely used to treat these contractures; however, there are various problems with these approaches. We developed a novel, pneumatic-type dynamic traction and flexion splint to solve these problems. A total of 25 fingers were treated with the dynamic traction and flexion splint for 8 weeks. Every 2 weeks, the average metacarpophalangeal joint flexion angle, total active motion, grasp strength, and pain scores were assessed. The finger flexion angle was significantly greater at the final evaluation, starting after 6 weeks of treatment (p < 0.05), than prior to treatment. Similarly, the total active motion results improved significantly over 8 weeks. Our results show that use of the dynamic traction and flexion splint improves patient finger functioning and flexural angle. The dynamic traction and flexion (DTF) splint appears to be effective for treating patients. © The International Society for Prosthetics and Orthotics 2015.

  4. Long-term applicability of the new ILAE definition of epilepsy. Results from the PRO-LONG study.

    Science.gov (United States)

    Beretta, Simone; Carone, Davide; Zanchi, Clara; Bianchi, Elisa; Pirovano, Marta; Trentini, Claudia; Padovano, Giada; Colombo, Matteo; Cereda, Diletta; Scanziani, Sofia; Giussani, Giorgia; Gasparini, Sara; Bogliun, Graziella; Ferrarese, Carlo; Beghi, Ettore

    2017-09-01

    The new epilepsy definition adopted by the International League Against Epilepsy (ILAE) includes patients with one unprovoked seizure with a probability of further seizures, similar to the general recurrence risk after two unprovoked seizures, occurring in a 10-year period. Long-term follow-up of patients diagnosed after a single seizure is needed to assess the applicability of the new epilepsy definition in clinical practice. Patients with newly diagnosed epilepsy were recruited retrospectively with a minimum follow-up of 10 years. Patients were stratified in two groups depending on the occurrence of one (new definition, ND) or two or more unprovoked seizures (traditional definition, TD) at the time of epilepsy diagnosis and compared for disease characteristics and factors predicting seizure recurrence. The primary outcome was the occurrence of a new unprovoked seizure during follow-up in the ND group. The secondary outcome was the achievement of an early remission in both groups. Among 1,006 patients with newly diagnosed epilepsy, 152 (15.1%) were diagnosed after a single seizure. Compared to patients diagnosed using the TD, patients diagnosed according to the ND showed a higher proportion of subjects with an abnormal neurologic examination (19.9% vs. 13.7%, p = 0.0504) and with focal seizures (69.3% vs. 60.4%, p = 0.0021). The two samples differed in the presence of at least one of the factors predicting seizure recurrence (focal seizures or abnormal findings in at least one among the following: neurologic examination, electroencephalography [EEG], and neuroimaging) (94.6% vs. 89.1%, p = 0.0376). Long-term recurrence in patients diagnosed with the new definition was 83.6% at 10 years and 89.1% at 15 years. The probability of early remission did not differ between the two groups. Our results support the applicability of the new epilepsy definition in clinical practice. Individual patient characteristics and a personalized diagnostic approach can justify

  5. Results of the long-term agreements on energy efficiency. Results 2011; Resultatenbrochure convenanten Meerjarenafspraken energie-efficientie 2011

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-15

    The Dutch long-term agreement on Energy Efficiency with various sectors of the industry, the food and beverages industry and the services sector is a covenant aimed at enhancing energy efficiency among medium-sized enterprises. Participants in the covenant include businesses, the Dutch government and the Competent Authority Environmental Protection Act. Participation of businesses means that they must make energy efficiency plans, take measures and deliver annual results for monitoring. In this report the results of 2011 are presented [Dutch] De Meerjarenafspraken Energie-Efficientie met verschillende sectoren uit de industrie, de voedings- en genotmiddelenindustrie en de dienstensector, is een convenant gericht op het bevorderen van de energie-efficientie bij middelgrote bedrijven. Deelnemers aan het convenant zijn de bedrijven, de Rijksoverheid en het Bevoegd Gezag Wet Milieubeheer. Voor bedrijven betekent deelname dat zij energiebesparingplannen maken, maatregelen nemen en dat zij jaarlijks de resultaten hiervan aanleveren voor de monitoring. In dit rapport worden de resultaten van 2011 gepresenteerd.

  6. Somatic mosaicism of a point mutation in the dystrophin gene in a patient presenting with an asymmetrical muscle weakness and contractures

    NARCIS (Netherlands)

    Helderman-van den Enden, A. T. J. M.; Ginjaar, H. B.; Kneppers, A. L. J.; Bakker, E.; Breuning, M. H.; de Visser, M.

    2003-01-01

    We describe a patient with somatic mosaicism of a point mutation in the dystrophin gene causing benign muscular dystrophy with an unusual asymmetrical distribution of muscle weakness and contractures. To our knowledge this is the first patient with asymmetrical weakness and contractures in an

  7. Long-term outcome for gastric marginal zone lymphoma treated with radiotherapy

    DEFF Research Database (Denmark)

    Wirth, A; Gospodarowicz, M; Aleman, B M P

    2013-01-01

    We evaluated the long-term results of radiotherapy for patients with gastric marginal zone lymphoma (GMZL).......We evaluated the long-term results of radiotherapy for patients with gastric marginal zone lymphoma (GMZL)....

  8. Industrial Foundations as Long-Term Owners

    DEFF Research Database (Denmark)

    Thomsen, Steen; Poulsen, Thomas; Børsting, Christa Winther

    Short-termism has become a serious concern for corporate governance, and this has inspired a search for institutional arrangements to promote long-term decision-making. In this paper, we call attention to long-term ownership by industrial foundations, which is common in Northern Europe but little...... known in the rest of the world. We use a unique Danish data set to document that industrial foundations are long-term owners that practice long-term governance. We show that foundation ownership is highly stable compared to other ownership structures. Foundation-owned companies replace managers less...... frequently. They have conservative capital structures with low financial leverage. They score higher on an index of long-termism in finance, investment, and employment. They survive longer. Overall, our paper supports the hypothesis that corporate time horizons are influenced by ownership structures...

  9. Long-term associative learning predicts verbal short-term memory performance

    OpenAIRE

    Jones, Gary; Macken, Bill

    2017-01-01

    Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term...

  10. 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....

  11. 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

  12. Long-term results of the Weber operation for chronic ankle instability: 37 patients followed for 20-30 years

    NARCIS (Netherlands)

    de Vries, Jasper; Struijs, Peter A. A.; Raaymakers, Ernst L. F. B.; Marti, René K.

    2005-01-01

    BACKGROUND: The Weber operation is an anatomical reconstruction of the anterior talofibular ligament with the plantaris tendon. Few long-term studies have been published. METHODS: We evaluated 40 ankles in 37 patients (19 women) at an average of 24 years after the procedure. RESULTS: At follow-up,

  13. Transverse musculocutaneous gracilis flap for treatment of capsular contracture in tertiary breast reconstruction.

    Science.gov (United States)

    Pülzl, Petra; Huemer, Georg M; Schoeller, Thomas

    2015-02-01

    Capsular contracture is a common complication associated with implant-based breast reconstruction and augmentation leading to pain, displacement, and rupture. After capsulectomy and implant exchange, the problem often reappears. We performed 52 deepithelialized free transverse musculocutaneous gracilis (TMG) flaps in 33 patients for tertiary breast reconstruction or augmentation of small- and medium-sized breasts. The indications for implant removal were unnatural feel and emotion of their breasts with foreign body feel, asymmetry, pain, and sensation of cold. Anyway, most of the patients did not have a severe capsular contracture deformity. The TMG flap is formed into a cone shape by bringing the tips of the ellipse together. Depending on the contralateral breast, the muscle can also be shaped in an S-form to get more projection if needed. The operating time for unilateral TMG flap breast reconstruction or augmentation was on average 3 hours and for bilateral procedure 5 hours. One patient had a secondary revision of the donor site due to disruption of the normal gluteal fold. Eighty percent of the unilateral TMG flap reconstructions had a lipofilling procedure afterward to correct small irregularities or asymmetry. The advantages of the TMG flap such as short harvesting time, inconspicuous donor site, and the possibility of having a natural breast shape make it our first choice to treat capsular contracture after breast reconstruction and augmentation.

  14. Clinical and impression cytology findings of amniotic membrane and oral mucosal membrane transplantation for the management of socket contracture.

    Science.gov (United States)

    Kurtul, Bengi Ece; Erdener, Ugur; Mocan, Mehmet Cem; Irkec, Murat; Orhan, Mehmet

    2014-01-01

    To investigate and compare the cytopathological and clinical effects of amniotic membrane transplantation (AMT) and oral mucosal membrane transplantation (OMMT) in socket contraction. Twelve patients who could not be fitted with ocular prosthesis due to socket contracture were included in this study. Seven patients underwent AMT and 5 patients underwent OMMT. Thirteen patients who had healthy sockets were included as control group. Depth of inferior fornix, degree of inflammation, extent of the socket contracture and socket volume were measured in the preoperative period and at sixth and twelfth weeks postoperatively. Impression cytology of conjunctival fornices and tear transforming growth factor beta-1 (TGFβ1) levels were determined. In the AMT group, socket volume and lower fornix depth values were significantly higher (P=0.030 and P=0.004 respectively) and inflammation levels and impression cytology stages (P=0.037 and P=0.022 respectively) were significantly lower in postoperative period compared to preoperative period. In the OMMT group, no statistical differences were found in terms of clinical parameters, inflammation levels and impression cytology stages of preoperative versus postoperative values. Preoperative tear TGFβ1 levels were higher in AMT and OMMT groups compared to the control group (25.5 ng/mL, 26.3 ng/mL and 21.7 ng/mL respectively). Decreased tear TGFβ1 levels were observed in both the AMT and OMMT groups postoperatively (median decrease value=2.1 ng/mL and 2.7 ng/mL respectively). AMT is associated with postoperative improvement in inferior fornix depth, socket volume, inflammation and impression cytology levels and may be a more proper alternative method than OMMT in the management of socket contracture.

  15. Short- and long-term reproducibility of radioisotopic examination of gastric emptying

    Energy Technology Data Exchange (ETDEWEB)

    Jonderko, K. (Silesian School of Medicine, Katowice (Poland). Dept. of Gastroenterology)

    1990-01-01

    Reproducibility of gastric emptying (GE) of a radiolabelled solid meal was assessed. The short-term reproducibility was evaluated on the basis of 12 paired GE examinations performed 1-3 days apart. Twelve paired GE examinations taken 3-8 months apart enabled long-term reproducibility assessment. Reproducibility of GE parameters was expressed in terms of the coefficient of variation, CV. No significant between-day variation of solid GE was found either regarding the short-term or the long-term reproducibility. Although slightly higher CV values characterized the long-term reproducibility of the GE parameters considered, the variations of the differences between repeated GE examinations did not differ significantly between short- and long-term GE reproducibility. The results obtained justify the use of radioisotopic GE measurement for the assessment of early and late results of pharmacologic or surgical management. (author).

  16. Long-term results of accelerated radiation treatment for advanced head and neck cancer

    International Nuclear Information System (INIS)

    Lamb, D.S.; Morum, P.E.; Denham, J.W.; Gray, A.J.

    1998-01-01

    Background and purpose: This report presents long-term follow-up data from a prospective but unrandomized trial of a continuous 3.5-week course of accelerated radiation treatment (ART) used as primary treatment for patients with loco-regionally advanced head and neck cancer. Materials and methods: Ninety-three patients in three centres in New Zealand and Australia were treated with ART (59.40 Gy in 33 fractions over 24-25 days). Their disease originated from three anatomical regions (oral cavity, 35 patients; pharynx, 31 patients; larynx, 27 patients). Seventy-nine of these patients had stage III or IV cancers. Results: Follow-up ranged from 68 to 203 months (median 139 months). Loco-regional (LR) failure occurred in 52 patients leading to a 10-year actuarial expectation of LR control of 38%. The actuarial expectation of LR control at 10 years was highly dependent on stage and for stage III, IVA and IVB patients it was 57±8.1%, 32±1.7% and 7±0.5%, respectively. Multivariate analysis could not confirm an independent impact of primary site or histological differentiation on LR failure. Two patients died of acute toxicity of treatment and six patients developed grade 3/4 late complications affecting soft tissues only, yielding an actuarial expectation of complications of this severity at 5 years of 9%. No cases of osteoradionecrosis or myelitis were observed. Conclusion: This ART, which has proved easy to use at a number of large and small centres, has produced encouraging long-term LR control at a cost of limited soft tissue morbidity. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  17. Short-term and long-term effects of violent media on aggression in children and adults.

    Science.gov (United States)

    Bushman, Brad J; Huesmann, L Rowell

    2006-04-01

    To test whether the results of the accumulated studies on media violence and aggressive behavior are consistent with the theories that have evolved to explain the effects. We tested for the existence of both short-term and long-term effects for aggressive behavior. We also tested the theory-driven hypothesis that short-term effects should be greater for adults and long-term effects should be greater for children. Meta-analysis. Children younger than 18 years and adults. Violent media, including TV, movies, video games, music, and comic books. Measures of aggressive behavior, aggressive thoughts, angry feelings, physiological arousal (eg, heart rate, blood pressure), and helping behavior. Effect size estimates were combined using meta-analytic procedures. As expected, the short-term effects of violent media were greater for adults than for children whereas the long-term effects were greater for children than for adults. The results also showed that there were overall modest but significant effect sizes for exposure to media violence on aggressive behaviors, aggressive thoughts, angry feelings, arousal levels, and helping behavior. The results are consistent with the theory that short-term effects are mostly due to the priming of existing well-encoded scripts, schemas, or beliefs, which adults have had more time to encode. In contrast, long-term effects require the learning (encoding) of scripts, schemas, or beliefs. Children can encode new scripts, schemas, and beliefs via observational learning with less interference and effort than adults.

  18. Arthroscopically-Asissted Achilles Tendon Repair; Long-Term Results

    OpenAIRE

    Turgut, Ak?n; Asfuro?lu, Mert Zeynel

    2014-01-01

    Objectives: The ruptures of the Achilles tendon (AT) are relatively common. Since there is no consensus on the best method of the repair of the AT; the treatment is determined on the preference of the surgeon and the patient. The study evaluating the cadaveric and short term clinical results done by our clinic in 2002, has shown us that arthroscopically Achilles tendon repair can be good choise in achilles tendon ruptures. Methods: Fortyfour patients who underwent arthroscopically assisted ac...

  19. Results on long-term performances and laboratory tests of the L3 RPC system at LEP

    CERN Document Server

    Alviggi, M G; Conventi, F; De Asmundis, R; Della Pietra, M; Della Volpe, D; Patricelli, S; Paolucci, P; Piccolo, D; Sciacca, C; Sekhniaidze, G

    2003-01-01

    The RPC detectors in the L3 experiment at LEP work as a trigger system for the Forward-Backward Muon Spectrometer. It consists of 192 bi-gap RPCs working in streamer mode. We monitored the behaviour of the system over seven years of data taking at LEP. To investigate the ageing of the RPCs after this long-term operation, we report the main results obtained from 1994 to 2000, together with the results of tests performed on some RPC chambers in our test site in Napoli with cosmic rays after the dismantling of L3.

  20. The histone deacetylase HDAC4 regulates long-term memory in Drosophila.

    Science.gov (United States)

    Fitzsimons, Helen L; Schwartz, Silvia; Given, Fiona M; Scott, Maxwell J

    2013-01-01

    A growing body of research indicates that pharmacological inhibition of histone deacetylases (HDACs) correlates with enhancement of long-term memory and current research is concentrated on determining the roles that individual HDACs play in cognitive function. Here, we investigate the role of HDAC4 in long-term memory formation in Drosophila. We show that overexpression of HDAC4 in the adult mushroom body, an important structure for memory formation, resulted in a specific impairment in long-term courtship memory, but had no affect on short-term memory. Overexpression of an HDAC4 catalytic mutant also abolished LTM, suggesting a mode of action independent of catalytic activity. We found that overexpression of HDAC4 resulted in a redistribution of the transcription factor MEF2 from a relatively uniform distribution through the nucleus into punctate nuclear bodies, where it colocalized with HDAC4. As MEF2 has also been implicated in regulation of long-term memory, these data suggest that the repressive effects of HDAC4 on long-term memory may be through interaction with MEF2. In the same genetic background, we also found that RNAi-mediated knockdown of HDAC4 impairs long-term memory, therefore we demonstrate that HDAC4 is not only a repressor of long-term memory, but also modulates normal memory formation.

  1. 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.

  2. Long-Term Outcomes of Cultivated Limbal Epithelial Transplantation: Evaluation and Comparison of Results in Children and Adults

    Directory of Open Access Journals (Sweden)

    Anita Ganger

    2015-01-01

    Full Text Available Purpose. To compare the long-term clinical outcomes of cultivated limbal epithelial transplantation (CLET in children and adults with limbal stem cell deficiency. Design. Retrospective case series. Methods. Case records of patients with limbal stem cell deficiency (LSCD who underwent CLET from April 2004 to December 2014 were studied. Outcome measures were compared in terms of anatomical success and visual improvement. Parameters for total anatomical success were avascular, epithelized, and clinically stable corneal surface without conjunctivalization, whereas partial anatomical success was considered when mild vascularization (sparing centre of cornea and mild conjunctivalization were noted along with complete epithelization. Results. A total of 62 cases underwent the CLET procedure: 38 (61.3% were children and 24 (38.7% were adults. Patients with unilateral LSCD (33 children and 21 adults had autografts and those with bilateral LSCD (5 children and 3 adults had allografts. Amongst the 54 autografts partial and total anatomical success were noted in 21.2% and 66.6% children, respectively, and 19.0% and 80.9% in adults, respectively (p value 0.23. Visual improvement of 1 line and ≥2 lines was seen in 57.5% and 21.2% children, respectively, and 38% and 38% in adults, respectively (p value 0.31. Conclusion. Cultivated limbal epithelial transplantation gives good long-term results in patients with LSCD and the outcomes are comparable in children and adults.

  3. Californium-252 Brachytherapy Combined With External-Beam Radiotherapy for Cervical Cancer: Long-Term Treatment Results

    International Nuclear Information System (INIS)

    Lei Xin; Qian Chengyuan; Qing Yi; Zhao Kewei; Yang Zhengzhou; Dai Nan; Zhong Zhaoyang; Tang Cheng; Li Zheng; Gu Xianqing; Zhou Qian; Feng Yan; Xiong Yanli; Shan Jinlu; Wang Dong

    2011-01-01

    Purpose: To observe, by retrospective analysis, the curative effects and complications due to californium-252 ( 252 Cf) neutron intracavitary brachytherapy (ICBT) combined with external-beam radiotherapy (EBRT) in the treatment of cervical cancer. Methods and Materials: From February 1999 to December 2007, 696 patients with cervical cancer (Stages IB to IIIB) were treated with 252 Cf-ICBT in combination of EBRT. Of all, 31 patients were at Stage IB, 104 at IIA, 363 at IIB, 64 at IIIA, and 134 at IIIB. Californium-252 ICBT was delivered at 7–12 Gy per insertion per week, with a total dose of 29–45 Gy to reference point A in three to five insertions. The whole pelvic cavity was treated with 8-MV X-ray external irradiation at 2 Gy per fraction, four times per week. After 16–38 Gy of external irradiation, the center of the whole pelvic field was blocked with a 4-cm-wide lead shield, with a total external irradiation dose of 44–56 Gy. The total treatment course was 5 to 6 weeks. Results: Overall survival rate at 3 and 5 years for all patients was 76.0% and 64.9%, respectively. Disease-free 3- and 5-year survival rates of patients were 71.2% and 58.4%, respectively. Late complications included vaginal contracture and adhesion, radiation proctitis, radiation cystitis, and inflammatory bowel, which accounted for 5.8%, 7.1%, 6.2%, and 4.9%, respectively. Univariate analysis results showed significant correlation of stage, age, histopathologic grade, and lymph node status with overall survival. Cox multiple regression analysis showed that the independent variables were stage, histopathologic grade, tumor size, and lymphatic metastasis in all patients. Conclusion: Results of this series suggest that the combined use of 252 Cf-ICBT with EBRT is an effective method for treatment of cervical cancer.

  4. Long Term Monitoring of Microbial Induced Soil Strengthening Processes

    Science.gov (United States)

    Saneiyan, S.; Ntarlagiannis, D.; Werkema, D. D., Jr.; Colwell, F. S.; Ohan, J.

    2016-12-01

    Soil strengthening/stabilization processes are used to address some of soil quality issues. Microbial induced calcite precipitation (MICP) is a promising soil stabilization process that could offer long term solution by overcoming problems of commonly used methods (e.g. injecting cement slurry). MICP can be applied in larger spatial scales, allowing the enhanced soils to be maintained in an economic sustainable and environmental friendly way. Methods are sought for the long term monitoring of MICP enhanced soils. The spectral induced polarization (SIP) method is one promising method due to sensitivity on such processes and the ability for long term, even autonomous, operation as well as cost effectiveness. Previous laboratory tests showed the sensitivity of the SIP method on soil strengthening as a result of abiotic calcite precipitation. We extended this work to biotic calcite precipitation through MICP. Early results suggest that the MICP formed calcite is denser and could provide improved strengthening capabilities. Our results are supported by geophysical (SIP and shear-wave velocity), geo-chemical and microbiological monitoring. Destructive analysis and visualization (scanning electron imaging - SEM) is expected to provide conclusive evidence on the MICP long term effectiveness.

  5. Hypoxic Prostate/Muscle PO2 Ratio Predicts for Outcome in Patients With Localized Prostate Cancer: Long-Term Results

    International Nuclear Information System (INIS)

    Turaka, Aruna; Buyyounouski, Mark K.; Hanlon, Alexandra L.; Horwitz, Eric M.; Greenberg, Richard E.; Movsas, Benjamin

    2012-01-01

    Purpose: To correlate tumor oxygenation status with long-term biochemical outcome after prostate brachytherapy. Methods and Materials: Custom-made Eppendorf PO 2 microelectrodes were used to obtain PO 2 measurements from the prostate (P), focused on positive biopsy locations, and normal muscle tissue (M), as a control. A total of 11,516 measurements were obtained in 57 men with localized prostate cancer immediately before prostate brachytherapy was given. The Eppendorf histograms provided the median PO 2 , mean PO 2 , and % 2 ratio on BF. Results: With a median follow-up time of 8 years, 12 men had ASTRO BF and 8 had Phoenix BF. On multivariate analysis, P/M PO 2 ratio 2 ratio 2 ratio) significantly predicts for poor long-term biochemical outcome, suggesting that novel hypoxic strategies should be investigated.

  6. Temporal gene expression profiling of the rat knee joint capsule during immobilization-induced joint contractures.

    Science.gov (United States)

    Wong, Kayleigh; Sun, Fangui; Trudel, Guy; Sebastiani, Paola; Laneuville, Odette

    2015-05-26

    Contractures of the knee joint cause disability and handicap. Recovering range of motion is recognized by arthritic patients as their preference for improved health outcome secondary only to pain management. Clinical and experimental studies provide evidence that the posterior knee capsule prevents the knee from achieving full extension. This study was undertaken to investigate the dynamic changes of the joint capsule transcriptome during the progression of knee joint contractures induced by immobilization. We performed a microarray analysis of genes expressed in the posterior knee joint capsule following induction of a flexion contracture by rigidly immobilizing the rat knee joint over a time-course of 16 weeks. Fold changes of expression values were measured and co-expressed genes were identified by clustering based on time-series analysis. Genes associated with immobilization were further analyzed to reveal pathways and biological significance and validated by immunohistochemistry on sagittal sections of knee joints. Changes in expression with a minimum of 1.5 fold changes were dominated by a decrease in expression for 7732 probe sets occurring at week 8 while the expression of 2251 probe sets increased. Clusters of genes with similar profiles of expression included a total of 162 genes displaying at least a 2 fold change compared to week 1. Functional analysis revealed ontology categories corresponding to triglyceride metabolism, extracellular matrix and muscle contraction. The altered expression of selected genes involved in the triglyceride biosynthesis pathway; AGPAT-9, and of the genes P4HB and HSP47, both involved in collagen synthesis, was confirmed by immunohistochemistry. Gene expression in the knee joint capsule was sensitive to joint immobility and provided insights into molecular mechanisms relevant to the pathophysiology of knee flexion contractures. Capsule responses to immobilization was dynamic and characterized by modulation of at least three

  7. Roles of TGF-β/Smad signaling pathway in pathogenesis and development of gluteal muscle contracture.

    Science.gov (United States)

    Zhang, Xintao; Ma, Yukun; You, Tian; Tian, Xiaopeng; Zhang, Honglei; Zhu, Qi; Zhang, Wentao

    2015-02-01

    Gluteal muscle contracture (GMC) is a chronic fibrotic disease of gluteal muscles which is characterized by excessive deposition of collagen in the extracellular matrix. Transforming growth factor (TGF)-βs have been shown to play an important role in the progression of GMC. However, the underlying mechanisms are not entirely clear. We sought to explore the expression of TGF-β/Smad pathway proteins and their downstream targets in gluteal muscle contracture disease. The expression levels of collagens type I/III, TGF-β1, Smad2/3/4/7 and PAI-1 (plasminogen activator inhibitor type 1) in gluteal muscle contraction (GMC) patients were measured using immunohistochemistry, reverse transcription and polymerase chain reaction (RT-PCR) and western blot assays. The expressions of collagens type I/III and TGF-β1 were significantly increased in the contraction band compared with unaffected muscle. In addition, R-Smad phosphorylation and Smad4 protein expression in the contraction band were also elevated, while the expression of Smad7 was significantly decreased in the fibrotic muscle of the GMC patients compared to the unaffected adjacent muscle. The protein and mRNA levels of PAI-1 were also remarkably increased in the contraction band compared with adjacent muscle. Immunohistochemical analysis also demonstrated that the expression levels of TGF-β1 and PAI-1 were higher in contraction band than those in the adjacent muscle. Our data confirm the stimulating effects of the TGF-β/Smad pathway in gluteal muscle contracture disease and reveal the internal changes of TGF-β/Smad pathway proteins and their corresponding targets in gluteal muscle contracture patients.

  8. Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

    OpenAIRE

    Kim, Jinkyung; Han, Woosok

    2012-01-01

    Objectives To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents? and organizational characteristics. Results The most significant predictors of employee-...

  9. Long-term results in patients with low-grade nodular non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Aviles, A.; Diaz-Maqueo, J.C.; Sanchez, E.; Cortes, H.D.; Ayala, J.R.; Oncology Hospital, Mexico City; National Medical Center, Mexico City

    1991-01-01

    One hundred and eighteen patients with nodular non-Hodgkin's lymphoma were randomized to receive either chemotherapy alone or chemotherapy plus radiotherapy (total nodal or involved field irradiation). Although the complete remission rate was similar in the three programs (about 90%) the relapse-free survival rate (RFS) among patients with complete remission was significantly higher in the groups treated with chemotherapy plus radiotherapy than among those treated with chemotherapy alone. The 7-year RFS in the groups treated with total node irradiation and involved field irradiation was 71% and 66% respectively, compared to only 33% in the group treated by chemotherapy alone (p<0.01). The results suggest that combined chemoradiotherapy may achieve complete long-term remission and potential cure in more than 60% of patients with nodular low-grade non-Hodgkin's lymphoma. Toxicity was moderate in all three arms. Bulky disease and a high level of lactic dehydrogenase were associated with a poor prognosis. (orig.)

  10. The roles of long-term phonotactic and lexical prosodic knowledge in phonological short-term memory.

    Science.gov (United States)

    Tanida, Yuki; Ueno, Taiji; Lambon Ralph, Matthew A; Saito, Satoru

    2015-04-01

    Many previous studies have explored and confirmed the influence of long-term phonological representations on phonological short-term memory. In most investigations, phonological effects have been explored with respect to phonotactic constraints or frequency. If interaction between long-term memory and phonological short-term memory is a generalized principle, then other phonological characteristics-that is, suprasegmental aspects of phonology-should also exert similar effects on phonological short-term memory. We explored this hypothesis through three immediate serial-recall experiments that manipulated Japanese nonwords with respect to lexical prosody (pitch-accent type, reflecting suprasegmental characteristics) as well as phonotactic frequency (reflecting segmental characteristics). The results showed that phonotactic frequency affected the retention not only of the phonemic sequences, but also of pitch-accent patterns, when participants were instructed to recall both the phoneme sequence and accent pattern of nonwords. In addition, accent pattern typicality influenced the retention of the accent pattern: Typical accent patterns were recalled more accurately than atypical ones. These results indicate that both long-term phonotactic and lexical prosodic knowledge contribute to phonological short-term memory performance.

  11. Compensation for PKMζ in long-term potentiation and spatial long-term memory in mutant mice.

    Science.gov (United States)

    Tsokas, Panayiotis; Hsieh, Changchi; Yao, Yudong; Lesburguères, Edith; Wallace, Emma Jane Claire; Tcherepanov, Andrew; Jothianandan, Desingarao; Hartley, Benjamin Rush; Pan, Ling; Rivard, Bruno; Farese, Robert V; Sajan, Mini P; Bergold, Peter John; Hernández, Alejandro Iván; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

    2016-05-17

    PKMζ is a persistently active PKC isoform proposed to maintain late-LTP and long-term memory. But late-LTP and memory are maintained without PKMζ in PKMζ-null mice. Two hypotheses can account for these findings. First, PKMζ is unimportant for LTP or memory. Second, PKMζ is essential for late-LTP and long-term memory in wild-type mice, and PKMζ-null mice recruit compensatory mechanisms. We find that whereas PKMζ persistently increases in LTP maintenance in wild-type mice, PKCι/λ, a gene-product closely related to PKMζ, persistently increases in LTP maintenance in PKMζ-null mice. Using a pharmacogenetic approach, we find PKMζ-antisense in hippocampus blocks late-LTP and spatial long-term memory in wild-type mice, but not in PKMζ-null mice without the target mRNA. Conversely, a PKCι/λ-antagonist disrupts late-LTP and spatial memory in PKMζ-null mice but not in wild-type mice. Thus, whereas PKMζ is essential for wild-type LTP and long-term memory, persistent PKCι/λ activation compensates for PKMζ loss in PKMζ-null mice.

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

    International Nuclear Information System (INIS)

    Sai, Heitetsu; Mitsumori, Michihide; Araki, Norio; Mizowaki, Takashi; Nagata, Yasushi; Nishimura, Yasumasa; Hiraoka, Masahiro

    2005-01-01

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

  13. Adverse event reporting in Czech long-term care facilities.

    Science.gov (United States)

    Hěib, Zdenřk; Vychytil, Pavel; Marx, David

    2013-04-01

    To describe adverse event reporting processes in long-term care facilities in the Czech Republic. Prospective cohort study involving a written questionnaire followed by in-person structured interviews with selected respondents. Long-term care facilities located in the Czech Republic. Staff of 111 long-term care facilities (87% of long-term care facilities in the Czech Republic). None. Sixty-three percent of long-term health-care facilities in the Czech Republic have adverse event-reporting processes already established, but these were frequently very immature programs sometimes consisting only of paper recording of incidents. Compared to questionnaire responses, in-person interview responses only partially tended to confirm the results of the written survey. Twenty-one facilities (33%) had at most 1 unconfirmed response, 31 facilities (49%) had 2 or 3 unconfirmed responses and the remaining 11 facilities (17%) had 4 or more unconfirmed responses. In-person interviews suggest that use of a written questionnaire to assess the adverse event-reporting process may have limited validity. Staff of the facilities we studied expressed an understanding of the importance of adverse event reporting and prevention, but interviews also suggested a lack of knowledge necessary for establishing a good institutional reporting system in long-term care.

  14. 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.

  15. Laser-assisted endoscopic third ventriculostomy: long-term results in a series of 202 patients

    NARCIS (Netherlands)

    van Beijnum, Janneke; Hanlo, Patrick W.; Fischer, Kathelijn; Majidpour, Mohsen M.; Kortekaas, Marlous F.; Verdaasdonk, Rudolf M.; Vandertop, W. Peter

    2008-01-01

    OBJECTIVE: Endoscopic third ventriculostomy is a well-known surgical option in the treatment of noncommunicating hydrocephalus. We studied complications and long-term success in 202 patients to demonstrate the safety and efficacy of laser-assisted endoscopic third ventriculostomy (LA-ETV) using a

  16. Sexuality and Physical Intimacy in Long Term Care: Sexuality, long term care, capacity assessment

    OpenAIRE

    Lichtenberg, Peter A.

    2014-01-01

    Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long term care settings. Because older adults in medical rehabilitation and long term care beds present with significant frailties, and often significant neurocognitive disorders it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literatur...

  17. Percutaneous Transluminal Angioplasty for Complete Membranous Obstruction of Suprahepatic Inferior Vena Cava: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Kucukay, Fahrettin, E-mail: fkucukay@hotmail.com [Turkiye Yuksek Ihtisas Hospital, Department of Interventional Radiology (Turkey); Akdogan, Meral, E-mail: akdmeral@yahoo.com [Turkiye Yuksek Ihtisas Hospital, Department of Gastroenterology (Turkey); Bostanci, Erdal Birol, E-mail: ebbostanci@yahoo.com [Turkiye Yuksek Ihtisas Hospital, Department of Gastrointestinal Surgery (Turkey); Ulus, Ahmet Tulga, E-mail: uluss@yahoo.com [Hacettepe University, Department of Cardiovascular Surgery (Turkey); Kucukay, Murat Bulent, E-mail: dr-mbk@hotmail.com [Lokman Hekim Hospital, Department of Internal Medicine (Turkey)

    2016-10-15

    PurposeTo determine the long-term results of percutaneous transluminal angioplasty (PTA) for a complete membranous obstruction of the suprahepatic inferior vena cava.MethodsPatients (n = 65) who were referred to the interventional unit for PTA for a complete membranous obstruction of the suprahepatic inferior vena cava between January 2006 and October 2014 were included in the study. Thirty-two patients (18 males, 14 females, mean age 35 ± 10.7, range 20–42 years) were treated. The patients presented with symptoms of ascites (88 %), pleural effusion (53 %), varicose veins (94 %), hepatomegaly (97 %), abdominal pain (84 %), and splenomegaly (40 %). Transjugular liver access set and re-entry catheter were used to puncture and traverse the obstruction from the jugular side. PTA balloon dilations were performed. The mean follow-up period was 65.6 ± 24.5 months. The objective was to evaluate technical success, complications, primary patency, and clinical improvement in the symptoms of the patients.ResultsThe technical success rate was 94 %. In two patients, obstruction could not be traversed. These patients underwent cavoatrial graft bypass surgery. There were no procedure-related complications. Clinical improvements were achieved in all patients within 3 months. The primary patency rate at 4 years was 90 %. There was no primary assisted patency. There was no need for metallic stent deployment in the cohort. The secondary patency rate at 4 years was 100 %.ConclusionsPercutaneous transluminal angioplasty for a complete membranous obstruction of the suprahepatic inferior vena cava is safe and effective, and the long-term results are excellent.

  18. Differences in health status between long-term and short-term benzodiazepine users.

    NARCIS (Netherlands)

    Zandstra, S.M.; Furer, J.W.; Lisdonk, E.H. van de; Bor, J.H.J.; Zitman, F.G.; Weel, C. van

    2002-01-01

    BACKGROUND: Despite generally accepted advice to keep treatment short, benzodiazepines are often prescibed for more than six months. Prevention of long-term benzodiazepine use could be facilitated by the utilisation of risk indicators for long-term use. However, the characteristics of long-term

  19. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

    Science.gov (United States)

    Gosz, J.

    2001-12-01

    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

  20. Long-Term Ecological Monitoring Field Sampling Plan for 2007

    International Nuclear Information System (INIS)

    T. Haney R. VanHorn

    2007-01-01

    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used to determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007 investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality

  1. Long-Term Ecological Monitoring Field Sampling Plan for 2007

    Energy Technology Data Exchange (ETDEWEB)

    T. Haney

    2007-07-31

    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007 investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.

  2. The histone deacetylase HDAC4 regulates long-term memory in Drosophila.

    Directory of Open Access Journals (Sweden)

    Helen L Fitzsimons

    Full Text Available A growing body of research indicates that pharmacological inhibition of histone deacetylases (HDACs correlates with enhancement of long-term memory and current research is concentrated on determining the roles that individual HDACs play in cognitive function. Here, we investigate the role of HDAC4 in long-term memory formation in Drosophila. We show that overexpression of HDAC4 in the adult mushroom body, an important structure for memory formation, resulted in a specific impairment in long-term courtship memory, but had no affect on short-term memory. Overexpression of an HDAC4 catalytic mutant also abolished LTM, suggesting a mode of action independent of catalytic activity. We found that overexpression of HDAC4 resulted in a redistribution of the transcription factor MEF2 from a relatively uniform distribution through the nucleus into punctate nuclear bodies, where it colocalized with HDAC4. As MEF2 has also been implicated in regulation of long-term memory, these data suggest that the repressive effects of HDAC4 on long-term memory may be through interaction with MEF2. In the same genetic background, we also found that RNAi-mediated knockdown of HDAC4 impairs long-term memory, therefore we demonstrate that HDAC4 is not only a repressor of long-term memory, but also modulates normal memory formation.

  3. Sleep Quality, Short-Term and Long-Term CPAP Adherence

    Science.gov (United States)

    Somiah, Manya; Taxin, Zachary; Keating, Joseph; Mooney, Anne M.; Norman, Robert G.; Rapoport, David M.; Ayappa, Indu

    2012-01-01

    Study Objectives: Adherence to CPAP therapy is low in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). The purpose of the present study was to evaluate the utility of measures of sleep architecture and sleep continuity on the CPAP titration study as predictors of both short- and long-term CPAP adherence. Methods: 93 patients with OSAHS (RDI 42.8 ± 34.3/h) underwent in-laboratory diagnostic polysomnography, CPAP titration, and follow-up polysomnography (NPSG) on CPAP. Adherence to CPAP was objectively monitored. Short-term (ST) CPAP adherence was averaged over 14 days immediately following the titration study. Long-term (LT) CPAP adherence was obtained in 56/93 patients after approximately 2 months of CPAP use. Patients were grouped into CPAP adherence groups for ST ( 4 h) and LT adherence ( 4 h). Sleep architecture, sleep disordered breathing (SDB) indices, and daytime outcome variables from the diagnostic and titration NPSGs were compared between CPAP adherence groups. Results: There was a significant relationship between ST and LT CPAP adherence (r = 0.81, p CPAP adherence groups had significantly lower %N2 and greater %REM on the titration NPSG. A model combining change in sleep efficiency and change in sleep continuity between the diagnostic and titration NPSGs predicted 17% of the variance in LT adherence (p = 0.006). Conclusions: These findings demonstrate that characteristics of sleep architecture, even on the titration NPSG, may predict some of the variance in CPAP adherence. Better sleep quality on the titration night was related to better CPAP adherence, suggesting that interventions to improve sleep on/prior to the CPAP titration study might be used as a therapeutic intervention to improve CPAP adherence. Citation: Somiah M; Taxin Z; Keating J; Mooney AM; Norman RG; Rapoport DM; Ayappa I. Sleep quality, short-term and long-term CPAP adherence. J Clin Sleep Med 2012;8(5):489-500. PMID:23066359

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

    Science.gov (United States)

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

    2006-09-01

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

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

    International Nuclear Information System (INIS)

    Ali, G.; Hameed, S.; Hassan, R.

    2015-01-01

    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)

  6. Physical activity after commitment lotteries: examining long-term results in a cluster randomized trial.

    Science.gov (United States)

    van der Swaluw, Koen; Lambooij, Mattijs S; Mathijssen, Jolanda J P; Schipper, Maarten; Zeelenberg, Marcel; Berkhout, Stef; Polder, Johan J; Prast, Henriëtte M

    2018-02-26

    To overcome self-control difficulties, people can commit to their health goals by voluntarily accepting deadlines with consequences. In a commitment lottery, the winners are drawn from all participants, but can only claim their prize if they also attained their gym-attendance goals. In a 52-week, three-arm trial across six company gyms, we tested if commitment lotteries with behavioral economic underpinnings would promote physical activity among overweight adults. In previous work, we presented an effective 26-week intervention. In the present paper we analyzed maintenance of goal attainment at 52-week follow-up and the development of weight over time. We compared weight and goal attainment (gym attendance ≥ 2 per week) between three arms that-in the intervention period- consisted of (I) weekly short-term lotteries for 13 weeks; (II) the same short-term lotteries in combination with an additional long-term lottery after 26 weeks; and (III) a control arm without lottery-deadlines. After a successful 26-week intervention, goal attainment declined between weeks 27 and 52 in the long-term lottery arm, but remained higher than in the control group. Goal attainment did not differ between the short-term lottery arm and control arm. Weight declined slightly in all arms in the first 13 weeks of the trial and remained stable from there on. Commitment lotteries can support regular gym attendance up to 52 weeks, but more research is needed to achieve higher levels of maintenance and weight loss.

  7. Long-term energy futures: the critical role of technology

    International Nuclear Information System (INIS)

    Grubler, A.

    1999-01-01

    The paper briefly reviews the results of a 5-year study conducted by IIASA jointly with the World Energy Council (WEC) on long term-energy perspectives. After summarizing the study's main findings, the paper addresses the crucial role of technological change in the evolution of long-term energy futures and in responding to key long-term uncertainties in the domains of energy demand growth, economics, as well as environmental protection. Based on most recent empirical and methodological findings, long-term dynamics of technological change portray a number of distinct features that need to be taken account of in technology and energy policy. First, success of innovation efforts and ultimate outcomes of technological are uncertain. Second, new, improved technologies are not a free good, but require continued dedicated efforts. Third, technological knowledge (as resulting from R and D and accumulation of experience, i.e. technological learning) exhibits characteristics of (uncertain) increasing returns. Forth, due to innovation - diffusion lags, technological interdependence, and infrastructure needs (network externalities), rates of change in large-scale energy systems are necessarily slow. This implies acting sooner rather than later as a contigency policy to respond to long-term social, economic and environmental uncertainties, most notably possible climate change. Rather than picking technological 'winners' the results of the IIASA-WEC scenario studies are seen most appropriate to guide technology and R and D portfolio analysis. Nonetheless, robust persistent patterns of technological change invariably occur across all scenarios. Examples of primising groups of technologies are given. The crucial importance of meeting long-energy demand in developing countries, assuring large-scale infrastructure investments, maintaining a strong and diversified R AND D protfolio, as well as to dvise new institutional mechnisms for technology development and diffusion for instance

  8. Long-Term Results of Transcatheter Closure of Patent Ductus Arteriosus in Infants Using Amplatzer Duct Occluder

    Science.gov (United States)

    Behjati-Ardakani, Mostafa; Behjati-Ardakani, Mohammad-Amin; Hosseini, Seyed-Habibolla; Noori, Noormohammad

    2013-01-01

    Objective Patent ductus arteriosus (PDA) is one of the most frequently seen congenital heart diseases. Its closure is recommended because of the risk of infective endocardis, as well as morbidity and mortality in the long. The aim of this study was to assess the long term results of the transcatheter closure of PDA in infants using amplatzer duct occlude (ADO). Methods From May 2004 to September 2011, forty eight infants underwent transcatheter closure of PDA. A lateral or right anterior oblique view aortogram was done to locate PDA and to measure its size. Before discharge, repeat aortogram was performed to evaluate eventual residual shunt and to confirm the appropriate deployment of the ADO. Follow up evaluations were done with transthoracic echocardiography at discharge, 1 month, 6 months, 12 months and yearly thereafter. Findings The mean age of patients at procedure was 9.18±2.32 (range 3 to 12) months, mean weight 6.73±1.16 (range 4.5 to 10.1) kg. The PDA occluded completely in 20 out of the 48 patients. Twenty four patients had trivial or mild shunt and two patients had moderate residual shunt which disappeared in one patient within 24 hours and other patient with moderate shunt in 1 month. One patient (age 8 months) had mild LPA stenosis. The device emobolization occurred in two patients, immediately after the procedure in one and during night in the other patient Conclusion The long term results suggested that transcatheter closure of PDA using Amplatzer duct occluder is a safe and effective treatment in infants less than 1 year of age with minimal complications. PMID:24427494

  9. Long term storage techniques for 85Kr

    International Nuclear Information System (INIS)

    Foster, B.A.; Pence, D.T.; Staples, B.A.

    1975-01-01

    As new nuclear fuel reprocessing plants go on stream, the collection of fission product 85 Kr will be required to avoid potential local release problems and long-term atmospheric buildup. Storage of the collected 85 Kr for a period of at least 100 years will be necessary to allow approximately 99.9 percent decay before it is released. A program designed to develop and evaluate proposed methods for long-term storage of 85 Kr is discussed, and the results of a preliminary evaluation of three methods, high pressure steel cylinders, zeolite encapsulation, and clathrate inclusion are presented. (U.S.)

  10. Institutionalization and Organizational Long-term Success

    Directory of Open Access Journals (Sweden)

    Denise L. Fleck

    2007-05-01

    Full Text Available Institutionalization processes have an ambivalent effect on organizational long-term success. Even though they foster organizational stability and permanence, they also bring about rigidity and resistance to change. As a result, successful organizations are likely to lose their competitive advantage over time. The paper addresses this issue through the investigation of the institutionalization processes of two long-lived companies: General Electric, a firm that has been a long-term success and its rival, Westinghouse, which was broken up after eleven decades of existence. The longitudinal, multilevel analysis of firms and industry has identified two different modes of organizational institutionalization. The reactive mode gives rise to rigidity and change resistance, much like institutional theory predicts; the proactive mode, on the other hand, neutralizes those negative effects of institutionalization processes. In the reactive mode, structure predominates. In the proactive mode, agency plays a major role in organizational institutionalization, and in managing the organization’s relations with the environment, clearly contributing to environmental institutionalization.

  11. 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...

  12. Short- and long-term eating habit modification predicts weight change in overweight, postmenopausal women: results from the WOMAN study.

    Science.gov (United States)

    Barone Gibbs, Bethany; Kinzel, Laura S; Pettee Gabriel, Kelley; Chang, Yue-Fang; Kuller, Lewis H

    2012-09-01

    Standard behavioral obesity treatment produces poor long-term results. Focusing on healthy eating behaviors rather than energy intake may be an alternative strategy. In addition, important behaviors might differ for short- vs long-term weight control. Our aim was to describe and compare associations between changes in eating behaviors and weight after 6 and 48 months. We performed secondary analysis of data collected during a randomized weight-loss intervention trial with 48-month follow-up. We studied 481 overweight and obese postmenopausal women enrolled in the Women on the Move through Activity and Nutrition (WOMAN) Study. We measured changes in weight from baseline to 6 and 48 months. Linear regression models were used to examine the associations between 6- and 48-month changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight. Analyses were conducted in the combined study population and stratified by randomization group. At 6 months in the combined population, weight loss was independently associated with decreased desserts (Pstudies should determine whether interventions targeting these behaviors could improve long-term obesity treatment outcomes. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  13. 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)

    Pettersson, Anna; Nygren, Peter; Persson, Christina; Berglund, Anders; Turesson, Ingela; Johansson, Birgitta

    2014-01-01

    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

  14. Forecasting stock return volatility: A comparison between the roles of short-term and long-term leverage effects

    Science.gov (United States)

    Pan, Zhiyuan; Liu, Li

    2018-02-01

    In this paper, we extend the GARCH-MIDAS model proposed by Engle et al. (2013) to account for the leverage effect in short-term and long-term volatility components. Our in-sample evidence suggests that both short-term and long-term negative returns can cause higher future volatility than positive returns. Out-of-sample results show that the predictive ability of GARCH-MIDAS is significantly improved after taking the leverage effect into account. The leverage effect for short-term volatility component plays more important role than the leverage effect for long-term volatility component in affecting out-of-sample forecasting performance.

  15. Designing indicators of long-term energy supply security

    International Nuclear Information System (INIS)

    Jansen, J.C.; Van Arkel, W.G.; Boots, M.G.

    2004-01-01

    To our knowledge, so far amazingly little research work has been undertaken to construct meaningful indicators of long-run energy supply security for a particular nation or region. Currently, in addressing energy supply security, policy makers tend to emphasise short-term supply disruptions. In contrast, this pre-study accords with the broader Sustainability Outlook in considering the long-term perspective. This report starts with taking stock, in a concise way, of the official EU energy outlook and issues related to the opportunities to administer changes in the energy mix at the level of major energy use categories. Then a brief survey of relevant literature is made on long-term strategies to ensure survival of systems - be it biological, social, etc. - in an environment largely characterised by high uncertainty and a lot of unchartered territory. We found the work of Andrew Stirling very inspiring in this context. Based on his work and considering the limitations of the present research activity, we retained the Shannon index as the best 'simple' indicator of diversity. In the core of the report, the Shannon index is elaborated into four indicators of long-term energy supply security. Stepwise, additional aspects of long-term energy supply security are introduced. These aspects are: Diversification of energy sources in energy supply; Diversification of imports with respect to imported energy sources; Long-term political stability in regions of origin; The resource base in regions of origin, including the home region/country itself. After small adjustments to allow for data availability, these indicators were applied to the reference year 2030 of four long-term scenarios with data of base year 1995 and projections for underlying variables provided by the Netherlands Environmental Assessment Agency (MNP). Preliminary interpretation of the results suggests the usefulness of the indicators presented in this report. A second activity undertaken in this report was

  16. Long-term prisoner in prison isolation

    Directory of Open Access Journals (Sweden)

    Karolina Grudzińska

    2013-06-01

    Full Text Available Long-term prisoner belongs to a particular category of people who are imprisoned in prisons. On the one hand in this group are often heavily demoralized people who committed the most serious crimes, on the other hand it is a group of prisoners, who should be well thought out and programmed the impact of rehabilitation. The situation of man trapped for years poses in a complicated situation not only the prisoners, but also the entire prison staff. They have to take care of the fact that the prison isolation did not cause the state in which convicts form itself in learned helplessness and lack of skills for self-planning and decision-making. In addition, planning the rehabilitation impact of long-term prisoners should not be forgotten that these prisoners in the short or the long term will return to the libertarian environment therefore, should prevent any negative effects of long-term imprisonment. This article presents the main issues related to the execution of imprisonment against long-term prisoners. It is an attempt to systematize the knowledge of this category of people living in prison isolation.

  17. The long-term benefits of director stock ownership

    Directory of Open Access Journals (Sweden)

    Brian Bolton

    2009-11-01

    Full Text Available In October 2009, the United States Treasury Department and Congress considered new regulations requiring executives and directors to receive much of their compensation in the form of long-term stock. One concern with this is that it may have negative consequences by entrenching managers and directors over the long term. This study compares the potential benefits of long-term director ownership with the potential costs of entrenchment. Using the dollar amount of stock owned by independent directors, the results suggest that the incentive effect dominates any costs related to entrenchment: firms with greater stock ownership outperform other firms, regardless of the degree of managerial entrenchment that may be present. The implication for policy-makers is that providing directors with incentives through stock ownership can be a very effective corporate governance mechanism.

  18. Long-term frozen storage of urine samples: a trouble to get PCR results in Schistosoma spp. DNA detection?

    Science.gov (United States)

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

    2013-01-01

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

  19. 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

    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

  20. Independence of long-term contextual memory and short-term perceptual hypotheses: Evidence from contextual cueing of interrupted search.

    Science.gov (United States)

    Schlagbauer, Bernhard; Mink, Maurice; Müller, Hermann J; Geyer, Thomas

    2017-02-01

    Observers are able to resume an interrupted search trial faster relative to responding to a new, unseen display. This finding of rapid resumption is attributed to short-term perceptual hypotheses generated on the current look and confirmed upon subsequent looks at the same display. It has been suggested that the contents of perceptual hypotheses are similar to those of other forms of memory acquired long-term through repeated exposure to the same search displays over the course of several trials, that is, the memory supporting "contextual cueing." In three experiments, we investigated the relationship between short-term perceptual hypotheses and long-term contextual memory. The results indicated that long-term, contextual memory of repeated displays neither affected the generation nor the confirmation of short-term perceptual hypotheses for these displays. Furthermore, the analysis of eye movements suggests that long-term memory provides an initial benefit in guiding attention to the target, whereas in subsequent looks guidance is entirely based on short-term perceptual hypotheses. Overall, the results reveal a picture of both long- and short-term memory contributing to reliable performance gains in interrupted search, while exerting their effects in an independent manner.

  1. Neural correlates of long-term intense romantic love.

    Science.gov (United States)

    Acevedo, Bianca P; Aron, Arthur; Fisher, Helen E; Brown, Lucy L

    2012-02-01

    The present study examined the neural correlates of long-term intense romantic love using functional magnetic resonance imaging (fMRI). Ten women and 7 men married an average of 21.4 years underwent fMRI while viewing facial images of their partner. Control images included a highly familiar acquaintance; a close, long-term friend; and a low-familiar person. Effects specific to the intensely loved, long-term partner were found in: (i) areas of the dopamine-rich reward and basal ganglia system, such as the ventral tegmental area (VTA) and dorsal striatum, consistent with results from early-stage romantic love studies; and (ii) several regions implicated in maternal attachment, such as the globus pallidus (GP), substantia nigra, Raphe nucleus, thalamus, insular cortex, anterior cingulate and posterior cingulate. Correlations of neural activity in regions of interest with widely used questionnaires showed: (i) VTA and caudate responses correlated with romantic love scores and inclusion of other in the self; (ii) GP responses correlated with friendship-based love scores; (iii) hypothalamus and posterior hippocampus responses correlated with sexual frequency; and (iv) caudate, septum/fornix, posterior cingulate and posterior hippocampus responses correlated with obsession. Overall, results suggest that for some individuals the reward-value associated with a long-term partner may be sustained, similar to new love, but also involves brain systems implicated in attachment and pair-bonding.

  2. Neural correlates of long-term intense romantic love

    Science.gov (United States)

    Aron, Arthur; Fisher, Helen E.; Brown, Lucy L.

    2012-01-01

    The present study examined the neural correlates of long-term intense romantic love using functional magnetic resonance imaging (fMRI). Ten women and 7 men married an average of 21.4 years underwent fMRI while viewing facial images of their partner. Control images included a highly familiar acquaintance; a close, long-term friend; and a low-familiar person. Effects specific to the intensely loved, long-term partner were found in: (i) areas of the dopamine-rich reward and basal ganglia system, such as the ventral tegmental area (VTA) and dorsal striatum, consistent with results from early-stage romantic love studies; and (ii) several regions implicated in maternal attachment, such as the globus pallidus (GP), substantia nigra, Raphe nucleus, thalamus, insular cortex, anterior cingulate and posterior cingulate. Correlations of neural activity in regions of interest with widely used questionnaires showed: (i) VTA and caudate responses correlated with romantic love scores and inclusion of other in the self; (ii) GP responses correlated with friendship-based love scores; (iii) hypothalamus and posterior hippocampus responses correlated with sexual frequency; and (iv) caudate, septum/fornix, posterior cingulate and posterior hippocampus responses correlated with obsession. Overall, results suggest that for some individuals the reward-value associated with a long-term partner may be sustained, similar to new love, but also involves brain systems implicated in attachment and pair-bonding. PMID:21208991

  3. 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...

  4. Long term liquidity analysis of the firm

    Directory of Open Access Journals (Sweden)

    Jaroslav Gonos

    2009-09-01

    Full Text Available Liquidity control is a very difficult and important function. If the business is not liquid in the long term, it is under threatof bankruptcy, and on the other hand surplus of the cash in hand threaten its future efficiency, because the cash in hand is a sourceof only limited profitability. Long term liquidity is related to the ability of the short term and long term liabilities payment. Articleis trying to point out to the monitoring and analyzing of the long term liquidity in the concrete business, in this case the printing industrycompany. Hereby at the end of the article mentioned monitored and analyzed liquidity is evaluated in the five years time period.

  5. Treatment of the Upper Extremity Contracture/Deformities.

    Science.gov (United States)

    Oishi, Scott N; Agranovich, Olga; Pajardi, Giorgio E; Novelli, Chiara; Baindurashvili, Alexey G; Trofimova, Svetlana I; Abdel-Ghani, Hisham; Kochenova, Evgenia; Prosperpio, Giulietta; Jester, Andrea; Yilmaz, Güney; Şenaran, Hakan; Kose, Oksana; Butler, Lesley

    Patients with arthrogryposis multiplex congenita have a characteristic upper extremity resting posture consisting of internal rotation of the shoulders, elbow extension, flexed wrists, thumb-in palm deformities, and variable degrees of finger contractures. Treatment of these patients is aimed at improving independence and performance of activities of daily living. Although each area needs to be assessed independently for the most appropriate surgical procedure, often multiple areas can be addressed at the same operative setting. This limits the number of anesthetic exposures and cast immobilization time. The following is a synopsis of treatment strategies presented at the second international symposium on Arthrogryposis which took place in St Petersburg in September 2014.

  6. Long-term memory and volatility clustering in high-frequency price changes

    Science.gov (United States)

    oh, Gabjin; Kim, Seunghwan; Eom, Cheoljun

    2008-02-01

    We studied the long-term memory in diverse stock market indices and foreign exchange rates using Detrended Fluctuation Analysis (DFA). For all high-frequency market data studied, no significant long-term memory property was detected in the return series, while a strong long-term memory property was found in the volatility time series. The possible causes of the long-term memory property were investigated using the return data filtered by the AR(1) model, reflecting the short-term memory property, the GARCH(1,1) model, reflecting the volatility clustering property, and the FIGARCH model, reflecting the long-term memory property of the volatility time series. The memory effect in the AR(1) filtered return and volatility time series remained unchanged, while the long-term memory property diminished significantly in the volatility series of the GARCH(1,1) filtered data. Notably, there is no long-term memory property, when we eliminate the long-term memory property of volatility by the FIGARCH model. For all data used, although the Hurst exponents of the volatility time series changed considerably over time, those of the time series with the volatility clustering effect removed diminish significantly. Our results imply that the long-term memory property of the volatility time series can be attributed to the volatility clustering observed in the financial time series.

  7. Long-term complications in Hodgkin's lymphoma survivors.

    Science.gov (United States)

    Kilickap, Saadettin; Barista, Ibrahim; Ulger, Sukran; Celik, Ismail; Selek, Ugur; Güllü, Ibrahim; Yildiz, Ferah; Kars, Ayse; Ozisik, Yavuz; Tekuzman, Gülten

    2012-01-01

    Background. Although patients with Hodgkin's lymphoma (HL) achieve prolonged survival, long-term complications are a major cause of morbidity and mortality among long-term survivors of HL. Methods. We retrospectively evaluated long-term complications in 336 HL survivors treated between January 1990 and January 2006 at the Department of Medical Oncology of the Hacettepe University Institute of Oncology who were >16 years old at presentation. All patients were regularly followed up every 3 months for the first 2 years after complete response, biannually for 3 years, and annually after 5 years. Results. Median follow-up was 8.5 years. The mean age (±SD) of the patients at the time of diagnosis was 35.7 ± 13.1 years. The male to female ratio was 61%/39%. During follow-up, 29 second malignancies (8.6%) were diagnosed in 28 patients with HL; 22 were solid tumors and 7 were hematological malignancies. Forty-seven (14.0%) of all patients with HL were found to have thyroid abnormalities. During follow-up, 54 (16.1%) patients developed cardiovascular complications. Overall, 29 (8.6%) patients developed late pulmonary toxicities. The cumulative number of chronic viral infections was 13 (3.9%). Conclusions. Long-term survivors of HL need to be properly followed up not only for disease control but also for evaluation of possible late morbidities to minimize the consequences.

  8. Long-term environmental behaviour of radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Brechignac, F.; Moberg, L.; Suomela, M

    2000-04-01

    The radioactive pollution of the environment results from the atmospheric nuclear weapons testing (during the mid-years of twentieth century), from the development of the civilian nuclear industry and from accidents such as Chernobyl. Assessing the resulting radiation that humans might receive requires a good understanding of the long-term behaviour of radionuclides in the environment. This document reports on a joint European effort to advance this understanding, 3 multinational projects have been coordinated: PEACE, EPORA and LANDSCAPE. This report proposes an overview of the results obtained and they are presented in 6 different themes: (i) redistribution in the soil-plant system, (ii) modelling, (iii) countermeasures, (iv) runoff (v) spatial variations, and (vi) dose assessment. The long term behaviour of the radionuclides {sup 137}Cs, {sup 90}Sr and {sup 239-240}Pu is studied through various approaches, these approaches range from in-situ experiments designed to exploit past contamination events to laboratory simulations. A broad scope of different ecosystems ranging from arctic and boreal regions down to mediterranean ones has been considered. (A.C.)

  9. Long-term environmental behaviour of radionuclides

    International Nuclear Information System (INIS)

    Brechignac, F.; Moberg, L.; Suomela, M.

    2000-04-01

    The radioactive pollution of the environment results from the atmospheric nuclear weapons testing (during the mid-years of twentieth century), from the development of the civilian nuclear industry and from accidents such as Chernobyl. Assessing the resulting radiation that humans might receive requires a good understanding of the long-term behaviour of radionuclides in the environment. This document reports on a joint European effort to advance this understanding, 3 multinational projects have been coordinated: PEACE, EPORA and LANDSCAPE. This report proposes an overview of the results obtained and they are presented in 6 different themes: i) redistribution in the soil-plant system, ii) modelling, iii) countermeasures, iv) runoff v) spatial variations, and vi) dose assessment. The long term behaviour of the radionuclides 137 Cs, 90 Sr and 239-240 Pu is studied through various approaches, these approaches range from in-situ experiments designed to exploit past contamination events to laboratory simulations. A broad scope of different ecosystems ranging from arctic and boreal regions down to mediterranean ones has been considered. (A.C.)

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Correlates of preferences for autonomy in long-term care: results of a population-based survey among older individuals in Germany

    Directory of Open Access Journals (Sweden)

    Hajek A

    2018-01-01

    Full Text Available André Hajek,1 Thomas Lehnert,1 Annemarie Wegener,1 Steffi G Riedel-Heller,2 Hans-Helmut König1 1Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 2Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany Purpose: Thus far, there is little evidence concerning the factors associated with preferences for autonomy in long-term care. Therefore, the aim of the present study was to investigate the correlates of preferences for autonomy in long-term care among older individuals in Germany. Methods: Data were gathered from a population-based survey of the German population aged ≥65 years in 2015 (N=1,006. Results: Multiple logistic regressions revealed that preferences for freedom of choice for foods were positively associated with living with partner or spouse (OR: 1.5 [1.0–2.2], being born in Germany (OR: 1.9 [1.1–3.3], and lower self-rated health (OR: 1.3 [1.1–1.6]. Preferences for freedom in choosing bedtime and sleep duration were positively associated with lower age (OR: 1.1 [1.0–1.1] and having children (OR: 2.2 [1.0–4.9]. Preferences for customized living space were positively associated with being female (OR: 2.5 [1.4–4.5] and being born in Germany (OR: 3.7 [1.9–7.1]. Neither preferences for decent and sanitary housing nor preferences for shared decision-making were associated with any of the independent variables. Conclusion: Various independent variables were associated with preferences for autonomy in long-term care. This suggests that preferences for care-related autonomy are complex. Knowing these might help refine long-term care health services. Keywords: caregivers, older adult, long-term care, Germany

  12. Liquid nitrogen spray cryotherapy in Barrett's esophagus with high-grade dysplasia: long-term results.

    Science.gov (United States)

    Gosain, Sonia; Mercer, Kim; Twaddell, William S; Uradomo, Lance; Greenwald, Bruce D

    2013-08-01

    Liquid nitrogen endoscopic spray cryotherapy can safely and effectively eradicate high-grade dysplasia in Barrett's esophagus (BE-HGD). Long-term data on treatment success and safety are lacking. To assess the long-term safety and efficacy of spray cryotherapy in patients with BE-HGD. Single-center, retrospective study. Tertiary-care referral center. A total of 32 patients with BE-HGD of any length. Patients were treated with liquid nitrogen spray cryotherapy every 8 weeks until complete eradication of HGD (CE-HGD) and intestinal metaplasia (CE-IM) was found by endoscopic biopsy. Surveillance endoscopy with biopsies was performed for at least 2 years. CE-HGD, CE-IM, durability of response, disease progression, and adverse events. CE-HGD was 100% (32/32), and CE-IM was 84% (27/32) at 2-year follow-up. At last follow-up (range 24-57 months), CE-HGD was 31/32 (97%), and CE-IM was 26/32 (81%). Recurrent HGD was found in 6 (18%), with CE-HGD in 5 after repeat treatment. One patient progressed to adenocarcinoma, downgraded to HGD after repeat cryotherapy. BE segment length ≥3 cm was associated with a higher recurrence of IM (P = .004; odds ratio 22.6) but not HGD. No serious adverse events occurred. Stricture was seen in 3 patients (9%), all successfully dilated. Retrospective study design, small sample size. In patients with BE-HGD, liquid nitrogen spray cryotherapy has an acceptable safety profile and success rate for eliminating HGD and IM and is associated with a low rate of recurrence or progression to cancer with long-term follow-up. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  13. Distal joint contractures, mental retardation, characteristic face and growth retardation: Chitayat syndrome revisited.

    NARCIS (Netherlands)

    Wortmann, S.B.; Rodenburg, R.J.T.; Schwahn, B.; Smeitink, J.A.M.; Morava, E.

    2007-01-01

    We report on a patient with congenital distal limb contractures, characteristic face, prominent metopic sutures, narrow forehead, severe psychomotor and growth retardation, white matter lesions and failure to thrive. The child has many overlapping features with those reported previously by Chitayat.

  14. Long-term results of biopsy-guided selection and allocation of kidneys from older donors in older recipients.

    Science.gov (United States)

    Fernández-Lorente, L; Riera, L; Bestard, O; Carrera, M; Gomà, M; Porta, N; Torras, J; Melilli, E; Gil-Vernet, S; Grinyó, J M; Cruzado, J M

    2012-10-01

    In our old-for-old program, we discard or allocate older extended criteria donor kidneys to single (SKT) or dual kidney transplantation (DKT) depending on histological Remuzzi's score in recipients older than 60 years. Here, we analyze the long-term results of this program and try to identify independent predictors of patient and graft survival. Between December 1996 and January 2008, we performed 115 SKT and 88 DKT. Discard rate was 15%. Acute rejection incidence was higher in SKT than in DKT (22.6% vs. 11.4%, p = 0.04). Renal function was better in DKT than in SKT up to 5 years after transplantation. Surgical complications were frequent in DKT. Ten-year cumulative graft survival was significantly lower in the SKT group (31% vs. 53%, p = 0.03). In SKT, histological score 4 provided similar graft survival than 3 or less, whereas in DKT score 4, 5 or 6 displayed similar outcome. Finally, independent predictors of graft survival were history of major adverse cardiac event and 1-year serum creatinine, rather than SKT or DKT. In conclusion, this biopsy-guided old-for-old strategy resulted in acceptable long-term graft survival. Our results suggest that DKT should be considered for scores of 5 or 6 only. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  15. Long-term uranium supply-demand analyses

    International Nuclear Information System (INIS)

    1986-12-01

    It is the intention of this study to investigate the long-term uranium supply demand situation using a number of supply and demand related assumptions. For supply, these assumptions as used in the Resources and Production Projection (RAPP) model include country economic development status, and consequent lead times for exploration and development, uranium development status, country infrastructure, and uranium resources including the Reasonably Assured (RAR), Estimated Additional, Categories I and II, (EAR-I and II) and Speculative Resource categories. The demand assumptions were based on the ''pure'' reactor strategies developed by the NEA Working Party on Nuclear Fuel Cycle Requirements for the 1986 OECD (NEA)/IAEA reports ''Nuclear Energy and its Fuel Cycle: Prospects to 2025''. In addition for this study, a mixed strategy case was computed using the averages of the Plutonium (Pu) burning LWR high, and the improved LWR low cases. It is understandable that such a long-term analysis cannot present hard facts, but it can show which variables may in fact influence the long-term supply-demand situation. It is hoped that results of this study will provide valuable information for planners in the uranium supply and demand fields. Periodical re-analyses with updated data bases will be needed from time to time

  16. Long-term storage of spent nuclear fuel

    International Nuclear Information System (INIS)

    Kempe, T.F.; Martin, A.; Thorne, M.C.

    1980-06-01

    This report presents the results of a study on the storage of spent nuclear fuel, with particular reference to the options which would be available for long-term storage. Two reference programmes of nuclear power generation in the UK are defined and these are used as a basis for the projection of arisings of spent fuel and the storage capacity which might be needed. The characteristics of spent fuel which are relevant to long-term storage include the dimensions, materials and physical construction of the elements, their radioactive inventory and the associated decay heating as a function of time after removal from the reactor. Information on the behaviour of spent fuel in storage ponds is reviewed with particular reference to the corrosion of the cladding. The review indicates that, for long-term storage, both Magnox and AGR fuel would need to be packaged because of the high rate of cladding corrosion and the resulting radiological problems. The position on PWR fuel is less certain. Experience of dry storage is less extensive but it appears that the rate of corrosion of cladding is much lower than in water. Unit costs are discussed. Consideration is given to the radiological impact of fuel storage. (author)

  17. Long-term contracts vs. short-term trade of natural gas - a European perspective

    International Nuclear Information System (INIS)

    Neuhoff, Karsten; Hirschhausen, Christian von

    2005-01-01

    This paper analyses the economics of long-term gas contracts under changing institutional conditions, mainly gas sector liberalisation. The paper is motivated by the increasingly tense debate in continental Europe, UK and the US on the security of long-term gas supply. We discuss the main issues regarding long-term contracts, i.e. the changing role of the flexibility clause, the effect of abandoning the destination clause, and the strategic behaviour of producers between long-term sales and spot-sales. The literature suggests consumers and producers benefit from risk hedging through long-term contracts. Furthermore long-term contracts may reduce exercise of market power. Our analysis adds an additional benefit if the long-run demand elasticity is significantly lower than the short-run elasticity, both strategic producers and consumers benefit from lower prices and larger market volume. Some policy implications of the findings are also discussed. (Author)

  18. The uranium industry: long-term planning for short-term competition

    International Nuclear Information System (INIS)

    Vottero, X.; Georges Capus, G.

    2001-01-01

    Long term planning for short term competition Today, uranium producers face new challenges in terms of both production (new regulatory, environmental and social constraints) and market conditions (new sources of uranium supply, very low prices and tough competition). In such a context, long-term planning is not just a prerequisite to survive in the nuclear fuel cycle industry. In fact, it also contributes to sustaining nuclear electricity generation facing fierce competition from other energy sources in increasingly deregulated markets. Firstly, the risk of investing in new mining projects in western countries is growing because, on the one hand, of very erratic market conditions and, on the other hand, of increasingly lengthy, complex and unpredictable regulatory conditions. Secondly, the supply of other sources of uranium (uranium derived from nuclear weapons, uranium produced in CIS countries, ...) involve other risks, mainly related to politics and commercial restrictions. Consequently, competitive uranium supply requires not only technical competence but also financial strength and good marketing capabilities in order to anticipate long-term market trends, in terms of both demand and supply. It also requires taking into account new parameters such as politics, environment, regulations, etc. Today, a supplier dedicated to the sustainable production of nuclear electricity must manage a broad range of long-term risks inherent to the procurement of uranium. Taking into account all these parameters in a context of short-term, fast-changing market is a great challenge for the future generation. World Uranium Civilian Supply and Demand. (authors)

  19. Congenital heart disease in adolescents with gluteal muscle contracture.

    Science.gov (United States)

    You, Tian; Zhang, Xin-tao; Zha, Zhen-gang; Zhang, Wen-tao

    2015-02-01

    Gluteal muscle contracture (GMC), presented with hip abduction and external rotation when crouching, is common in several ethnicities, particularly in Chinese. It remains unclear that the reasons why these children are weak and have no choice to accept repeated intramuscular injection. Here, we found some unique cases which may be useful to explain this question. We describe a series of special GMC patients, who are accompanied with congenital heart disease (CHD). These cases were first observed in preoperative examinations of a patient with atrial septal defect (ASD), which was proved by chest X-ray and cardiac ultrasound. From then on, we gradually identified additional 3 GMC patients with CHD. The original patient with ASD was sent to cardiosurgery department to repair atrial septal first and received arthroscopic surgery later. While the other 3 were cured postoperative of ventricular septal defect (VSD), tetralogy of fallot (TOF), patent ductus arteriosus (PDA), respectively, and had surgery directly. The study gives us 3 proposals: (1) as to CHD children, it is essential to decrease the use of intramuscular injection, (2) paying more attention to cardiac examination especially cardiac ultrasound in perioperative period, and (3) taking 3D-CT to reconstruct gluteal muscles for observing contracture bands clearly in preoperation. However, more larger series of patients are called for to confirm these findings.

  20. Collagenase clostridium histolyticum for the treatment of Dupuytren's contracture: systematic review and economic evaluation.

    Science.gov (United States)

    Brazzelli, Miriam; Cruickshank, Moira; Tassie, Emma; McNamee, Paul; Robertson, Clare; Elders, Andrew; Fraser, Cynthia; Hernandez, Rodolfo; Lawrie, David; Ramsay, Craig

    2015-10-01

    Dupuytren's disease is a slowly progressive condition of the hand, characterised by the formation of nodules in the palm that gradually develop into fibrotic cords. Contracture of the cords produces deformities of the fingers. Surgery is recommended for moderate and severe contractures, but complications and/or recurrences are frequent. Collagenase clostridium histolyticum (CCH) has been developed as a minimally invasive alternative to surgery for some patients. To assess the clinical effectiveness and cost-effectiveness of collagenase as an alternative to surgery for adults with Dupuytren's contracture with a palpable cord. We searched all major electronic databases from 1990 to February 2014. Randomised controlled trials (RCTs), non-randomised comparative studies and observational studies involving collagenase and/or surgical interventions were considered. Two reviewers independently extracted data and assessed risk of bias of included studies. A de novo Markov model was developed to assess cost-effectiveness of collagenase, percutaneous needle fasciotomy (PNF) and limited fasciectomy (LF). Results were reported as incremental cost per quality-adjusted life-year (QALY) gained. Deterministic and probabilistic sensitivity analyses were undertaken to investigate model and parameter uncertainty. Five RCTs comparing collagenase with placebo (493 participants), three RCTs comparing surgical techniques (334 participants), two non-randomised studies comparing collagenase and surgery (105 participants), five non-randomised comparative studies assessing various surgical procedures (3571 participants) and 15 collagenase case series (3154 participants) were included. Meta-analyses of RCTs assessing CCH versus placebo were performed. Joints randomised to collagenase were more likely to achieve clinical success. Collagenase-treated participants experienced significant reduction in contracture and an increased range of motion compared with placebo-treated participants

  1. Price-signals and long term equilibrium. Reconsidering the organisation of electricity markets

    International Nuclear Information System (INIS)

    Finon, Dominique; Defeuilley, Christophe; Marty, Frederic

    2009-11-01

    The purpose of this article is to show that the reform of the electricity sector, based on a framework of interpretation in which the short-term/long-term articulation is made by the market price, does not result in an efficient result in terms of investment. After a presentation of a bibliographical review on investment in an uncertain context, the authors present a model of decentralised electricity markets which backs reforms. They highlight issues related to production investment which remain unresolved, and which may result in socially inefficient choices on the long term. They report an analysis of two solutions of industrial organisations, long term contracts and vertical and horizontal integration, which could solve these problems

  2. Constraints on the affinity term for modeling long-term glass dissolution rates

    International Nuclear Information System (INIS)

    Bourcier, W.L.; Carroll, S.A.; Phillips, B.L.

    1993-11-01

    Predictions of long-term glass dissolution rates are highly dependent on the form of the affinity term in the rate expression. Analysis of the quantitative effect of saturation state on glass dissolution rate for CSG glass (a simple analog of SRL-165 glass), shows that a simple (1-Q/K) affinity term does not match experimental results. Our data at 100 degree C show that the data is better fit by an affinity term having the form (1 - (Q/K) 1 /σ) where σ = 10

  3. Long term radioactive waste management

    International Nuclear Information System (INIS)

    Lavie, J.M.

    1984-01-01

    In France, waste management, a sensitive issue in term of public opinion, is developing quickly, and due to twenty years of experience, is now reaching maturity. With the launching of the French nuclear programme, the use of radioactive sources in radiotherapy and industry, waste management has become an industrial activity. Waste management is an integrated system dealing with the wastes from their production to the long term disposal, including their identification, sortage, treatment, packaging, collection and transport. This system aims at guaranteing the protection of present and future populations with an available technology. In regard to their long term management, and the design of disposals, radioactive wastes are divided in three categories. This classification takes into account the different radioisotopes contained, their half life and their total activity. Presently short-lived wastes are stored in the shallowland disposal of the ''Centre de la Manche''. Set up within the French Atomic Energy Commission (CEA), the National Agency for waste management (ANDRA) is responsible within the framework of legislative and regulatory provisions for long term waste management in France [fr

  4. Short-term memory and long-term memory are still different.

    Science.gov (United States)

    Norris, Dennis

    2017-09-01

    A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology-the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as "1, 3, 1" where there are 2 tokens of the digit "1" cannot be stored in the correct order simply by activating the representations of the digits "1" and "3" in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. 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

  6. Risk assessment for long-term post-accident sequences

    International Nuclear Information System (INIS)

    Ellia-Hervy, A.; Ducamp, F.

    1987-11-01

    Probabilistic risk analysis, currently conducted by the CEA (French Atomic Energy Commission) for the French replicate series of 900 MWe power plants, has identified accident sequences requiring long-term operation of some systems after the initiating event. They have been named long-term sequences. Quantification of probabilities of such sequences cannot rely exclusively on equipment failure-on-demand data: it must also take into account operating failures, the probability of which increase with time. Specific studies have therefore been conducted for a number of plant systems actuated during these long-term sequences. This has required: - Definition of the most realistic equipment utilization strategies based on existing emergency procedures for 900 MWe French plants. - Evaluation of the potential to repair failed equipment, given accessibility, repair time, and specific radiation conditions for the given sequence. - Definition of the event bringing the long-term sequence to an end. - Establishment of an appropriate quantification method, capable of taking into account the evolution of assumptions concerning equipment utilization strategies or repair conditions over time. The accident sequence quantification method based on realistic scenarios has been used in the risk assessment of the initiating event loss of reactor coolant accident occurring at power and at shutdown. Compared with the results obtained from conventional methods, this method redistributes the relative weight of accident sequences and also demonstrates that the long term can be a significant contribution to the probability of core melt

  7. Advancing nursing leadership in long-term care.

    Science.gov (United States)

    O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

    2010-05-01

    Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention.

  8. 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.

  9. Long-term result of cementless femoral stem in avascular necrosis of the hip.

    Science.gov (United States)

    Cheung, Kin W; Chiu, Kwok H; Chung, Kwong Y

    2015-01-01

    Avascular necrosis (AVN) of the hip may have extensive involvement of the proximal femur which may affect boney ingrowth into cementless femoral stems. From 1994 to 2004, 182 total hip arthroplasties (in 144 patients, 117 AVN hips and 65 non-AVN hips) were performed using hydroxyapatite coated femoral stems. All patients were followed up prospectively. Mean age was 51 years and mean follow-up 14.7 years (range 9.7-19.1 years). Four stems were revised because of aseptic loosening, 3 in AVN group and 1 in non-AVN group. The overall mechanical failure rate was 2.2%, the mechanical failure rate in AVN and non-AVN group was 2.6% and 1.5% respectively (p = 1). The 19.1 year survival using revision for aseptic loosening as an endpoint for AVN and non-AVN patients were 97.1% and 96.2% respectively (p = 0.654). Stable boney ingrowth was present in 99.5% hips. This study represents 1 of the largest series reporting the long-term follow-up of the use of cementless femoral stems in treating AVN of the hip. We report excellent long-term survival of cementless total hip arthroplasty used in managing AVN of the hip and is comparable to that seen in non-AVN total hip arthroplasty.

  10. Reconciling long-term cultural diversity and short-term collective social behavior.

    Science.gov (United States)

    Valori, Luca; Picciolo, Francesco; Allansdottir, Agnes; Garlaschelli, Diego

    2012-01-24

    An outstanding open problem is whether collective social phenomena occurring over short timescales can systematically reduce cultural heterogeneity in the long run, and whether offline and online human interactions contribute differently to the process. Theoretical models suggest that short-term collective behavior and long-term cultural diversity are mutually excluding, since they require very different levels of social influence. The latter jointly depends on two factors: the topology of the underlying social network and the overlap between individuals in multidimensional cultural space. However, while the empirical properties of social networks are intensively studied, little is known about the large-scale organization of real societies in cultural space, so that random input specifications are necessarily used in models. Here we use a large dataset to perform a high-dimensional analysis of the scientific beliefs of thousands of Europeans. We find that interopinion correlations determine a nontrivial ultrametric hierarchy of individuals in cultural space. When empirical data are used as inputs in models, ultrametricity has strong and counterintuitive effects. On short timescales, it facilitates a symmetry-breaking phase transition triggering coordinated social behavior. On long timescales, it suppresses cultural convergence by restricting it within disjoint groups. Moreover, ultrametricity implies that these results are surprisingly robust to modifications of the dynamical rules considered. Thus the empirical distribution of individuals in cultural space appears to systematically optimize the coexistence of short-term collective behavior and long-term cultural diversity, which can be realized simultaneously for the same moderate level of mutual influence in a diverse range of online and offline settings.

  11. Long-Term Results of Aortic Root Surgery in Marfan Syndrome Patients: A Single-Center Experience.

    Science.gov (United States)

    Nicolo, Francesco; Romeo, Francesco; Lio, Antonio; Bovio, Emanuele; Scafuri, Antonio; Bassano, Carlo; Polisca, Patrizio; Pellegrino, Antonio; Nardi, Paolo; Chiariello, Luigi; Ruvolo, Giovanni

    2017-07-01

    The study aim was to compare long-term results of Marfan syndrome (MFS) patients affected by aortic root disease undergoing aortic root replacement with the Bentall or David operation. Since 1994, a total of 59 patients has been followed at the authors' Marfan Center, having undergone either a Bentall operation (Bentall group, n = 30) or a David operation (David group, n = 29). No operative mortality was recorded. After 20 years (mean follow up 97 ± 82 months; range 1 to 369 months) no prosthesis-related major bleeding or thromboembolic events had been observed; the 20-year survival was 94 ± 6% in the Bentall group, and 100% in the David group (p = 0.32). Freedom from reintervention for aortic valve dysfunction was 100% in the Bentall group, and 75 ± 13% in the David group (p = 0.04). This inter-group difference became relevant after the first eight-year period of follow-up, and was mainly associated with a particular familiar genetic phenotype involving three out of four reoperated patients. Freedom from all-cause death, myocardial infarction, stroke, prosthetic valve-related complications, and reintervention on any aortic segment was 69 ± 12% in the Bentall group, and 67 ± 14% in the David group (p = 0.33). The Bentall and David operations are both associated with satisfactory long-term results in MFS patients. The low rate of valve prosthesis-related complications suggested that the Bentall operation would continue to be a standard surgical treatment. The reimplantation technique, adopted for less-dilated aortas, provides satisfactory freedom from reoperation. Careful attention should be paid to the reimplantation technique in patients affected by a serious familiar genetic phenotype.

  12. A universal long-term flu vaccine may not prevent severe epidemics

    Directory of Open Access Journals (Sweden)

    Blower Sally

    2010-04-01

    Full Text Available Abstract Background Recently, the promise of a new universal long-term flu vaccine has become more tangible than ever before. Such a vaccine would protect against very many seasonal and pandemic flu strains for many years, making annual vaccination unnecessary. However, due to complacency behavior, it remains unclear whether the introduction of such vaccines would maintain high and stable levels of vaccination coverage year after year. Findings To predict the impact of universal long-term flu vaccines on influenza epidemics we developed a mathematical model that linked human cognition and memory with the transmission dynamics of influenza. Our modeling shows that universal vaccines that provide short-term protection are likely to result in small frequent epidemics, whereas universal vaccines that provide long-term protection are likely to result in severe infrequent epidemics. Conclusions Influenza vaccines that provide short-term protection maintain risk awareness regarding influenza in the population and result in stable vaccination coverage. Vaccines that provide long-term protection could lead to substantial drops in vaccination coverage and should therefore include an annual epidemic risk awareness programs in order to minimize the risk of severe epidemics.

  13. Bethlem myopathy: An autosomal dominant myopathy with flexion contractures, keloids, and follicular hyperkeratosis.

    Science.gov (United States)

    Saroja, Aralikatte Onkarappa; Naik, Karkal Ravishankar; Nalini, Atcharayam; Gayathri, Narayanappa

    2013-10-01

    Bethlem myopathy and Ullrich congenital muscular dystrophy form a spectrum of collagenopathies caused by genetic mutations encoding for any of the three subunits of collagen VI. Bethlem phenotype is relatively benign and is characterized by proximal dominant myopathy, keloids, contractures, distal hyperextensibility, and follicular hyperkeratosis. Three patients from a single family were diagnosed to have Bethlem myopathy based on European Neuromuscular Centre Bethlem Consortium criteria. Affected father and his both sons had slowly progressive proximal dominant weakness and recurrent falls from the first decade. Both children aged 18 and 20 years were ambulant at presentation. All had flexion contractures, keloids, and follicular hyperkeratosis without muscle hypertrophy. Creatinine kinase was mildly elevated and electromyography revealed myopathic features. Muscle imaging revealed severe involvement of glutei and vasti with "central shadow" in rectus femoris. Muscle biopsy in the father showed dystrophic changes with normal immmunostaining for collagen VI, sarcoglycans, and dysferlin.

  14. Bethlem myopathy: An autosomal dominant myopathy with flexion contractures, keloids, and follicular hyperkeratosis

    Directory of Open Access Journals (Sweden)

    Aralikatte Onkarappa Saroja

    2013-01-01

    Full Text Available Bethlem myopathy and Ullrich congenital muscular dystrophy form a spectrum of collagenopathies caused by genetic mutations encoding for any of the three subunits of collagen VI. Bethlem phenotype is relatively benign and is characterized by proximal dominant myopathy, keloids, contractures, distal hyperextensibility, and follicular hyperkeratosis. Three patients from a single family were diagnosed to have Bethlem myopathy based on European Neuromuscular Centre Bethlem Consortium criteria. Affected father and his both sons had slowly progressive proximal dominant weakness and recurrent falls from the first decade. Both children aged 18 and 20 years were ambulant at presentation. All had flexion contractures, keloids, and follicular hyperkeratosis without muscle hypertrophy. Creatinine kinase was mildly elevated and electromyography revealed myopathic features. Muscle imaging revealed severe involvement of glutei and vasti with "central shadow" in rectus femoris. Muscle biopsy in the father showed dystrophic changes with normal immmunostaining for collagen VI, sarcoglycans, and dysferlin.

  15. Long-term results of pneumatic dilatation for relapsing symptoms of achalasia after Heller myotomy.

    Science.gov (United States)

    Legros, Ludivine; Ropert, Alain; Brochard, Charlène; Bouguen, Guillaume; Pagenault, Maël; Siproudhis, Laurent; Bretagne, Jean-François

    2014-09-01

    The aim of this study was to assess the efficacy and safety of pneumatic dilatation (PD) to treat symptom recurrence after Heller myotomy (HM). Consecutive patients receiving PD for relapsing symptoms following prior HM were included in this retrospective single-center study. Eckardt score ≤3 and/or ∆ Eckardt (difference between Eckardt score before and after dilatation) ≥3 defined the success of initial dilatation. Patients who maintained response longer than 2 months after initial dilatation were defined as short-term responders. Relapsers were offered further on-demand dilatation. Remission was defined as an Eckardt score ≤3 at the study endpoint. Kaplan-Meier survival curves were used to determine relapse rates. Eighteen patients (11 women, seven men) were included from January 2004 to January 2013. Ten patients had type I achalasia, and seven had type III, according to the Chicago classification. Thirty-nine PDs were performed (1.5 [1-2.25] per patient). All patients had short-term responses. The remission rate at the endpoint, after a median follow-up of 33 months, was 78%, but 44% were treated with on-demand PD during the follow-up interval. The proportions of patients without relapse and subsequent PD were 72% at 12 months, 65% at 24 and 36 months, and 49% at 48 months. No factors predictive of long-term response, particularly the type of achalasia, could be identified in this series. There were no perforations. In treating symptom recurrence following HM, PD was safe and effective over the long term when combined with subsequent PD. © 2014 John Wiley & Sons Ltd.

  16. Memory Vocabulary Learning Strategies and Long-Term Retention ...

    African Journals Online (AJOL)

    The present study was an attempt to compare the impact of teaching through memory strategies, where students were taught the meaning of new vocabulary items by giving them synonyms, antonyms, definitions and mini-contexts. The results were reflected in the students' short-term and long-term memory retention.

  17. Conversion of short-term to long-term memory in the novel object recognition paradigm.

    Science.gov (United States)

    Moore, Shannon J; Deshpande, Kaivalya; Stinnett, Gwen S; Seasholtz, Audrey F; Murphy, Geoffrey G

    2013-10-01

    It is well-known that stress can significantly impact learning; however, whether this effect facilitates or impairs the resultant memory depends on the characteristics of the stressor. Investigation of these dynamics can be confounded by the role of the stressor in motivating performance in a task. Positing a cohesive model of the effect of stress on learning and memory necessitates elucidating the consequences of stressful stimuli independently from task-specific functions. Therefore, the goal of this study was to examine the effect of manipulating a task-independent stressor (elevated light level) on short-term and long-term memory in the novel object recognition paradigm. Short-term memory was elicited in both low light and high light conditions, but long-term memory specifically required high light conditions during the acquisition phase (familiarization trial) and was independent of the light level during retrieval (test trial). Additionally, long-term memory appeared to be independent of stress-mediated glucocorticoid release, as both low and high light produced similar levels of plasma corticosterone, which further did not correlate with subsequent memory performance. Finally, both short-term and long-term memory showed no savings between repeated experiments suggesting that this novel object recognition paradigm may be useful for longitudinal studies, particularly when investigating treatments to stabilize or enhance weak memories in neurodegenerative diseases or during age-related cognitive decline. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Mid- and Long-Term Results of Endovascular Treatment in Thoracic Aorta Blunt Trauma

    Directory of Open Access Journals (Sweden)

    Luigi Irace

    2012-01-01

    Full Text Available Study Aim. Evaluation of results in blunt injury of the thoracic aorta (BAI endovascular treatment. Materials and Methods. Sixteen patients were treated for BAI. Thirteen patients had associated polytrauma, 4 of these had a serious hypotensive status and 4 had an hemothorax. In the remaining 3, two had a post-traumatic false aneurysm of the isthmus and 1 had a segmental dissection. In those 13 patients a periaortic hematoma was associated to hemothorax in 4. All patients were submitted to an endovascular treatment, in two cases the subclavian artery ostium was intentionally covered. Results. One patient died for disseminated intravascular coagulation. No paraplegia was recorded. No ischemic complications were observed. A type I endoleak was treated by an adjunctive cuff. During the followup (1–9 years 3 patients were lost. A good patency and no endoleaks were observed in all cases. One infolding and 1 migration of the endografts were corrected by an adjunctive cuff. Conclusion. The medium and long term results of the endovascular treatment of BAI are encouraging with a low incidence rate of mortality and complications. More suitable endo-suite and endografts could be a crucial point for the further improvement of these results.

  19. Expanding the clinical spectrum of hereditary fibrosing poikiloderma with tendon contractures, myopathy and pulmonary fibrosis due to FAM111B mutations.

    Science.gov (United States)

    Mercier, Sandra; Küry, Sébastien; Salort-Campana, Emmanuelle; Magot, Armelle; Agbim, Uchenna; Besnard, Thomas; Bodak, Nathalie; Bou-Hanna, Chantal; Bréhéret, Flora; Brunelle, Perrine; Caillon, Florence; Chabrol, Brigitte; Cormier-Daire, Valérie; David, Albert; Eymard, Bruno; Faivre, Laurence; Figarella-Branger, Dominique; Fleurence, Emmanuelle; Ganapathi, Mythily; Gherardi, Romain; Goldenberg, Alice; Hamel, Antoine; Igual, Jeanine; Irvine, Alan D; Israël-Biet, Dominique; Kannengiesser, Caroline; Laboisse, Christian; Le Caignec, Cédric; Mahé, Jean-Yves; Mallet, Stéphanie; MacGowan, Stuart; McAleer, Maeve A; McLean, Irwin; Méni, Cécile; Munnich, Arnold; Mussini, Jean-Marie; Nagy, Peter L; Odel, Jeffrey; O'Regan, Grainne M; Péréon, Yann; Perrier, Julie; Piard, Juliette; Puzenat, Eve; Sampson, Jacinda B; Smith, Frances; Soufir, Nadem; Tanji, Kurenai; Thauvin, Christel; Ulane, Christina; Watson, Rosemarie M; Khumalo, Nonhlanhla P; Mayosi, Bongani M; Barbarot, Sébastien; Bézieau, Stéphane

    2015-10-15

    Hereditary Fibrosing Poikiloderma (HFP) with tendon contractures, myopathy and pulmonary fibrosis (POIKTMP [MIM 615704]) is a very recently described entity of syndromic inherited poikiloderma. Previously by using whole exome sequencing in five families, we identified the causative gene, FAM111B (NM_198947.3), the function of which is still unknown. Our objective in this study was to better define the specific features of POIKTMP through a larger series of patients. Clinical and molecular data of two families and eight independent sporadic cases, including six new cases, were collected. Key features consist of: (i) early-onset poikiloderma, hypotrichosis and hypohidrosis; (ii) multiple contractures, in particular triceps surae muscle contractures; (iii) diffuse progressive muscular weakness; (iv) pulmonary fibrosis in adulthood and (v) other features including exocrine pancreatic insufficiency, liver impairment and growth retardation. Muscle magnetic resonance imaging was informative and showed muscle atrophy and fatty infiltration. Histological examination of skeletal muscle revealed extensive fibroadipose tissue infiltration. Microscopy of the skin showed a scleroderma-like aspect with fibrosis and alterations of the elastic network. FAM111B gene analysis identified five different missense variants (two recurrent mutations were found respectively in three and four independent families). All the mutations were predicted to localize in the trypsin-like cysteine/serine peptidase domain of the protein. We suggest gain-of-function or dominant-negative mutations resulting in FAM111B enzymatic activity changes. HFP with tendon contractures, myopathy and pulmonary fibrosis, is a multisystemic disorder due to autosomal dominant FAM111B mutations. Future functional studies will help in understanding the specific pathological process of this fibrosing disorder.

  20. Recurrence of Dupuytren's contracture: A consensus-based definition.

    Directory of Open Access Journals (Sweden)

    Hester J Kan

    Full Text Available One of the major determinants of Dupyutren disease (DD treatment efficacy is recurrence of the contracture. Unfortunately, lack of agreement in the literature on what constitutes recurrence makes it nearly impossible to compare the multiple treatments alternatives available today. The aim of this study is to bring an unbiased pool of experts to agree upon what would be considered a recurrence of DD after treatment; and from that consensus establish a much-needed definition for DD recurrence.To reach an expert consensus on the definition of recurrence we used the Delphi method and invited 43 Dupuytren's research and treatment experts from 10 countries to participate by answering a series of questionnaire rounds. After each round the answers were analyzed and the experts received a feedback report with another questionnaire round to further hone in of the definition. We defined consensus when at least 70% of the experts agreed on a topic.Twenty-one experts agreed to participate in this study. After four consensus rounds, we agreed that DD recurrence should be defined as "more than 20 degrees of contracture recurrence in any treated joint at one year post-treatment compared to six weeks post-treatment". In addition, "recurrence should be reported individually for every treated joint" and afterwards measurements should be repeated and reported yearly.This study provides the most comprehensive to date definition of what should be considered recurrence of DD. These standardized criteria should allow us to better evaluate the many treatment alternatives.

  1. 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)

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

    2016-03-01

    We report short and long-term results with the dedicated Synthes(®) titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. 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]. 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. 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 and post-operative hospital stay. Long-term

  2. A Long-term Plan for Kalk

    DEFF Research Database (Denmark)

    2017-01-01

    In this case, the author demonstrates together with the owner-manager of KALK A/S, Mr Rasmus Jorgensen, how to use the Family Business Map to frame a constructive discussion about long-term planning. The Family Business Map is a tool for long-term planning in family firms developed by Professor...

  3. Virtual Models of Long-Term Care

    Science.gov (United States)

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  4. Myalgias and muscle contractures as the presenting signs of Addison's disease.

    OpenAIRE

    Shapiro, M. S.; Trebich, C.; Shilo, L.; Shenkman, L.

    1988-01-01

    Severe generalized myalgias and muscle contractures of the lower extremities were the major initial manifestations of adrenal insufficiency in a 26 year old black male. The intensity of increased skin pigmentation was not fully appreciated until the patient's skin colour was compared to that of his brother. Replacement with physiological doses of gluco- and mineralocorticoids was associated with complete amelioration of symptomatology.

  5. Sleep facilitates long-term face adaptation

    OpenAIRE

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-01-01

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted imag...

  6. Muscle MRI findings in patients with limb girdle muscular dystrophy with calpain 3 deficiency (LGMD2A) and early contractures.

    Science.gov (United States)

    Mercuri, Eugenio; Bushby, Kate; Ricci, Enzo; Birchall, Daniel; Pane, Marika; Kinali, Maria; Allsop, Joanna; Nigro, Vincenzo; Sáenz, Amets; Nascimbeni, Annachiara; Fulizio, Luigi; Angelini, Corrado; Muntoni, Francesco

    2005-02-01

    Limb girdle muscular dystrophy 2A is a common variant secondary to mutations in the calpain 3 gene. A proportion of patients has early and severe contractures, which can cause diagnostic difficulties with other conditions. We report clinical and muscle magnetic resonance imaging findings in seven limb girdle muscular dystrophy 2A patients (four sporadic and three familial) who had prominent and early contractures. All patients showed a striking involvement of the posterior thigh muscles. The involvement of the other thigh muscles was variable and was related to clinical severity. Young patients with minimal functional motor impairment showed a predominant involvement of the adductors and semimembranosus muscles while patients with restricted ambulation had a more diffuse involvement of the posterolateral muscles of the thigh and of the vastus intermedius with relative sparing of the vastus lateralis, sartorius and gracilis. At calf level all patients showed involvement of the soleus muscle and of the medial head of the gastrocnemius with relative sparing of the lateral head. MRI findings were correlated to those found in two patients with the phenotype of limb girdle muscular dystrophy 2A without early contractures and the pattern observed was quite similar. However, the pattern observed in limb girdle muscular dystrophy 2A is different from that reported in other muscle diseases such as Emery-Dreifuss muscular dystrophy and Bethlem myopathy which have a significant clinical overlap with limb girdle muscular dystrophy 2A once early contractures are present. Our results suggest that muscle MRI may help in recognising patients with limb girdle muscular dystrophy 2A even when the clinical presentation overlaps with other conditions, and may therefore, be used as an additional investigation to target the appropriate biochemical and genetic tests.

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

    Science.gov (United States)

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

    2011-12-01

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

  8. Prevalence of Long-Term Opioid Use in Long-Stay Nursing Home Residents.

    Science.gov (United States)

    Hunnicutt, Jacob N; Chrysanthopoulou, Stavroula A; Ulbricht, Christine M; Hume, Anne L; Tjia, Jennifer; Lapane, Kate L

    2018-01-01

    Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). Cross-sectional. U.S. NHs (N = 13,522). Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow-up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use. Of all long-stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long-term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18-1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90-0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79-0.83). One in seven NH residents was prescribed opioids long-term. Recent guidelines on opioid prescribing for pain recommend reducing long-term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

  9. Long-term results after Ilizarov treatment for severe high-energy injuries of the elbow.

    Science.gov (United States)

    Fodor, Lucian; Ullmann, Yehuda; Soudry, Michael; Lerner, Alexander

    2009-06-01

    Clinical aspects, such as the long-term results after circular external fixation and functional rehabilitation after high-energy injuries of the elbow joint, have not received sufficient attention in the literature. Fourteen patients with high-energy elbow injuries were treated in our hospital over the last 15 years with a circular external fixation frame. The mechanism of injury was blast in eight patients, gunshot wounds in two, motor vehicle crash in two, and fall from height in two. Twelve patients had high-energy open periarticular fractures, nine had Gustillo-Anderson 3B fractures, and three had Gustillo-Anderson 3C fractures. Two patients suffered from closed high-energy periarticular elbow injuries. Seven patients had associated peripheral neurologic injuries and three had vascular injuries. Average Ilizarov fixation time was 20 weeks (range, 6-47 weeks). The follow-up period varied from 1.5 years to 11 years. The average arc of elbow flexion was 110.4 degrees and extension was 19.6 degrees. The average arc of forearm rotation was of 63.5 degrees for pronation (range, 5-90 degrees) and 63.2 degrees for supination (range, 5-90 degrees). The average Mayo Elbow Performance Index score was 84 points (range, 60-100) and the average Khalfayan functional score was 83.4 (range, 68.7-100). Long-term follow-up proved that the hinged Ilizarov/hybrid frame represents a useful instrument to provide stabilization of the elbow joint while facilitating early movements and physiotherapy. The main indication is patients who suffered from open high-energy contaminated fractures with extensive soft-tissue damage (e.g., blast, war injuries) and combined bone and ligaments injuries.

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

    Science.gov (United States)

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

    2013-01-01

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

  11. Long-term follow-up of psilocybin-facilitated smoking cessation.

    Science.gov (United States)

    Johnson, Matthew W; Garcia-Romeu, Albert; Griffiths, Roland R

    2017-01-01

    A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration. The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives. These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.

  12. Semantic and phonological contributions to short-term repetition and long-term cued sentence recall.

    Science.gov (United States)

    Meltzer, Jed A; Rose, Nathan S; Deschamps, Tiffany; Leigh, Rosie C; Panamsky, Lilia; Silberberg, Alexandra; Madani, Noushin; Links, Kira A

    2016-02-01

    The function of verbal short-term memory is supported not only by the phonological loop, but also by semantic resources that may operate on both short and long time scales. Elucidation of the neural underpinnings of these mechanisms requires effective behavioral manipulations that can selectively engage them. We developed a novel cued sentence recall paradigm to assess the effects of two factors on sentence recall accuracy at short-term and long-term stages. Participants initially repeated auditory sentences immediately following a 14-s retention period. After this task was complete, long-term memory for each sentence was probed by a two-word recall cue. The sentences were either concrete (high imageability) or abstract (low imageability), and the initial 14-s retention period was filled with either an undemanding finger-tapping task or a more engaging articulatory suppression task (Exp. 1, counting backward by threes; Exp. 2, repeating a four-syllable nonword). Recall was always better for the concrete sentences. Articulatory suppression reduced accuracy in short-term recall, especially for abstract sentences, but the sentences initially recalled following articulatory suppression were retained better at the subsequent cued-recall test, suggesting that the engagement of semantic mechanisms for short-term retention promoted encoding of the sentence meaning into long-term memory. These results provide a basis for using sentence imageability and subsequent memory performance as probes of semantic engagement in short-term memory for sentences.

  13. A Meta-Analysis of the Short- and Long-Term Results of Randomized Controlled Trials That Compared Laparoscopy-Assisted and Conventional Open Surgery for Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Hiroshi Ohtani, Yutaka Tamamori, Yuichi Arimoto, Yukio Nishiguchi, Kiyoshi Maeda, Kosei Hirakawa

    2011-01-01

    Full Text Available Purpose: We conducted a meta-analysis to evaluate and compare the short- and long-term results of laparoscopic colorectal surgery (LCRS and conventional open surgery (OCRS for colorectal cancer (CRC.Methods: We searched relevant papers published between January 1990 and May 2011. We analyzed the outcomes of each type of surgery over the short- and long-term periods.Results: In the short-term period, we found no significant differences in overall perioperative complications and anastomotic leakage between LCRS and OCRS groups. We found no significant differences in overall, distant, local and wound-site recurrence, overall mortality, 3 and 5 year disease-free survival rate, and cancer-related mortality between the 2 groups.Conclusions: LCRS has the benefits of reducing intraoperative blood loss, earlier resumption of oral intake, and shorter duration of hospital stay in the short-term. The long-term outcomes of LCRS seem to be similar to those of OCRS.

  14. Australia's long-term electricity demand forecasting using deep neural networks

    OpenAIRE

    Hamedmoghadam, Homayoun; Joorabloo, Nima; Jalili, Mahdi

    2018-01-01

    Accurate prediction of long-term electricity demand has a significant role in demand side management and electricity network planning and operation. Demand over-estimation results in over-investment in network assets, driving up the electricity prices, while demand under-estimation may lead to under-investment resulting in unreliable and insecure electricity. In this manuscript, we apply deep neural networks to predict Australia's long-term electricity demand. A stacked autoencoder is used in...

  15. Long-term results of bone-retinaculum-bone autograft for scapholunate instability.

    Science.gov (United States)

    Soong, Maximillian; Merrell, Gregory A; Ortmann, Fred; Weiss, Arnold-Peter C

    2013-03-01

    To report long-term follow-up of scapholunate interosseous ligament reconstruction with bone-retinaculum-bone autograft in patients with dynamic scapholunate instability. Of the 14 patients from the previously reported cohort who had bone-retinaculum-bone autograft for dynamic instability, 6 returned for clinical examination and radiographs, 3 were reached by telephone, and 2 were lost to follow-up. The remaining 3 had salvage procedures (2 total wrist arthrodeses and 1 proximal row carpectomy) between the prior report and the current study and thus reached an endpoint, at 2 to 4 years. For the 6 who returned, outcome measurements included scapholunate angle and gap, radiographic evidence of secondary arthritis, wrist extension and flexion, grip strength, and Mayo wrist score. Follow-up averaged 11.9 years (range, 10.7-14.1 y). Clinical and radiographic outcomes deteriorated moderately from the prior report. Mayo wrist score averaged 83. There were 3 failures, resulting in 1 proximal row carpectomy and 2 total wrist arthrodeses. Findings at repeat surgery in the failed group included an intact graft without any apparent abnormalities, a partially ruptured graft (after a subsequent re-injury), and a completely resorbed graft. Bone-retinaculum-bone autograft reconstruction is a viable treatment option for dynamic scapholunate instability in which the scaphoid and lunate can be reduced. Results may deteriorate but are similar to those reported previously from other techniques. Problems with graft strength or stiffness may necessitate further surgery. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  16. Long-term citrus organic farming strategy results in soil organic matter recovery

    Science.gov (United States)

    Novara, Agata; Pereira, Paulo; Barone, Ettore; Giménez Morera, Antonio; Keesstra, Saskia; Gristina, Luciano; Jordán, Antonio; Parras-Alcantara, Luis; Cerdà, Artemi

    2017-04-01

    ABSTRACT Soils play a key role in the Earth System (Keesstra et al., 2012; Brevick et al., 2015). Soils are a key resource for the human societies (Mol and Keesstra, 2012) and they are relevant to achieve the sustainability such as the United Nations Goals highlight (Keesstra et al., 2016). Agriculture soils, especially those under conventional tillage, are prone to organic matter mineralization, soil erosion, compaction and increase of greenhouse gases emission (Novara et al., 2011; Bruun et al., 2015; de Moraes et al., 2015; Choudhury et al., 2016; del Mar et al., 2016). The adoption of organic farming and sustainable management practices may provide a sustainable crop productivity, and in the meanwhile mitigate the negative impact of agriculture on ecosystem services benefits (Laudicina et al., 2015; Parras-Alcantara et al., 2015; 2016). The aim of this study was to examine, under field conditions, the long-term changes of soil organic matter under organic farming management in citrus orchards in Mediterranean environment and evaluate the ecosystem service on C sequestration in terms of economic benefits. The research was carried out at the Alcoleja Experimental Station located in the Cànyoles river watershed in the Eastern Spain on 45year old citrus plantation. Soil Organic Matter (SOM) content was monitored for 20 years at 6 different soil depth. The profitability of citrus plantation was estimated under conventional and organic management. Results showed that SOM in the 0-30 cm soil depth was the double after 20 years of organic farming management, ranging from 0.8 g kg-1 in 1995 to 1.5 g kg-1 in 2006. The highest SOM increase was in the top soil layer (368% of SOM increase in comparison to the initial SOM content) and decreased with soil depth. The effect of organic farming was relevant after 5 years since land management change, indicating that in Mediterranean environment the duration of long term studies should be higher than five years and proper policy

  17. Long-Term Stewardship Baseline Report and Transition Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  18. A group of patients with Marfan's syndrome, who have finger and toe contractures, displays tendons' alterations upon an ultrasound examination: are these features common among classical Marfan patients?

    Science.gov (United States)

    Melchiorre, Daniela; Pratelli, Elisa; Torricelli, Elena; Sofi, Francesco; Abbate, Rosanna; Matucci-Cerinic, Marco; Gensini, GianFranco; Pepe, Guglielmina

    2016-08-01

    The involvement of the musculoskeletal system with other mild pleiotropic manifestations represents a clinical criterion, called "systemic features," to d iagnose Marfan's syndrome. We aimed to investigate the features of the hands and feet redressable contractures present in a group of Marfan patients. In 13 patients with previously diagnosed Marfan's syndrome, an accurate clinical examination was performed. In particular the characterization of the musculoskeletal system by visual analogic scale to measure muscle pain (VAS) and muscle strength (MRC system) was carried out; the Beighton scale score was used to evaluate the articular hypermobility. Ultrasound examination (US) was performed to detect deep-superficial flexor tendons and extensor tendons of both hands, and the short and long flexor and extensor tendons of the fingers and toes in static and dynamic positions. The ImageJ program was adopted to measure a profile of tendon echo-intensity. A reduction of the thickness of all tendons was detected by US in our patients; the VAS and Beighton scale scores were in normal ranges. The profile of tendon echo-intensity showed different textural details in all Marfan patients. This study provides evidence for other contractures' localization, and for altered findings of the tendons in patients with Marfan syndrome and finger/toe contractures. These changes may be associated with structural modifications in connective tissue.

  19. Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study.

    Science.gov (United States)

    Hoffman, Richard M; Lo, Mary; Clark, Jack A; Albertsen, Peter C; Barry, Michael J; Goodman, Michael; Penson, David F; Stanford, Janet L; Stroup, Antoinette M; Hamilton, Ann S

    2017-07-10

    Purpose To determine the demographic, clinical, decision-making, and quality-of-life factors that are associated with treatment decision regret among long-term survivors of localized prostate cancer. Patients and Methods We evaluated men who were age ≤ 75 years when diagnosed with localized prostate cancer between October 1994 and October 1995 in one of six SEER tumor registries and who completed a 15-year follow-up survey. The survey obtained demographic, socioeconomic, and clinical data and measured treatment decision regret, informed decision making, general- and disease-specific quality of life, health worry, prostate-specific antigen (PSA) concern, and outlook on life. We used multivariable logistic regression analyses to identify factors associated with regret. Results We surveyed 934 participants, 69.3% of known survivors. Among the cohort, 59.1% had low-risk tumor characteristics (PSA decision regret: 8.2% of those whose disease was managed conservatively, 15.0% of those who received surgery, and 16.6% of those who underwent radiotherapy. Factors associated with regret on multivariable analysis included reporting moderate or big sexual function bother (reported by 39.0%; OR, 2.77; 95% CI, 1.51 to 5.0), moderate or big bowel function bother (reported by 7.7%; OR, 2.32; 95% CI, 1.04 to 5.15), and PSA concern (mean score 52.8; OR, 1.01 per point change; 95% CI, 1.00 to 1.02). Increasing age at diagnosis and report of having made an informed treatment decision were inversely associated with regret. Conclusion Regret was a relatively infrequently reported outcome among long-term survivors of localized prostate cancer; however, our results suggest that better informing men about treatment options, in particular, conservative treatment, might help mitigate long-term regret. These findings are timely for men with low-risk cancers who are being encouraged to consider active surveillance.

  20. [Application of distal palm perforator mini-flap in repair of scar contracture of digital web-spaces].

    Science.gov (United States)

    Zhou, Xiao; Xu, Yajun; Rui, Yongjun; Shou, Kuishui; Yao, Qun

    2011-02-01

    To discuss the effectiveness of distal palm perforator mini-flap in the treatment of scar contracture of digital web-spaces. Between August 2008 and March 2010, 6 cases of scar contracture of digital web-spaces were treated, including 4 males and 2 females and aging 16-68 years (mean, 45 years). The causes were burn injury, twisting injury, and crush injury in 2 cases, respectively. The disease duration was from 3 months to 3 years. The affected digital web-spaces were from index finger to middle finger in 2 cases, from middle finger to ring finger in 3 cases, and from ring finger to small finger in 1 case. The maximum abduction degree of digital web-spaces was 5-10 degrees. The sizes and the depths of reshape of digital web-spaces disappeared. The defect size ranged from 20 mm x 8 mm to 30 mm x 13 mm after opening digital web-spaces. The size of the distal palm perforator mini-flap ranged from 25 mm x 10 mm to 35 mm x 15 mm. The donor sites were sutured directly. All 6 flaps survived and got primary healing. Incisions at donor sites healed by first intention. All patients were followed up 6-12 months. The reconstructed digital web-spaces had good appearance and soft texture. The range of motion of metacarpophalangeal joint was normal. The sizes and the depths of reshape of digital web-spaces were similar to normal ones. The maximum abduction degree of digital web-spaces was 40-60 degrees. There was no scar contracture of incision of palm. The shape of flaps and function of the fingers were satisfactory after 6-12 months of follow-up. It is an ideal method to treat scar contracture of digital web-spaces with distal palm perforator mini-flap.

  1. Optimizing hydraulic cleaning techniques for oiled coarse sediment beaches : long-term monitoring results

    International Nuclear Information System (INIS)

    Mauseth, G.S.; Graham, A.W.; Simon, J.; Sergy, G.A.

    2004-01-01

    This paper presents the results of a study in which shoreline cobbles in British Columbia were oiled with Bunker C oil and then hydraulically cleaned using a variety of water pressures and temperatures. The oiling took place in 1997. Epifauna and epiflora abundances were quantified prior to exposure, 28 to 72 hours and one year following treatment, and up to 6 years post-treatment. The study revealed that after six years of treatment, there was no statistical difference between any of the treatment groups, including the un-oiled, un-treated control or the oiled, treated control. The exposure to oil and a variety of pressure and temperature washing treatments did not differentially influence epibiota abundances 6 years after treatment. It was concluded that there is no long-term increased benefit or damage to the epibiota from hydraulic washing treatments. However, hydraulic cleaning can cause negative, short-term effects. Therefore, the immediate priority after an oil spill should be to remove the oil in order to limit remobilization. Organism abundances did not return to pre-treatment values. Even the un-oiled/un-treated control substances were significantly lower after 6 years, suggesting that extreme cold temperatures may have played a more important role in controlling organism abundances than did the oiling or treatments. 10 refs., 1 tab., 10 figs

  2. New results on long term aging tests for rad-waste container alloy selection

    Energy Technology Data Exchange (ETDEWEB)

    Alves, H.; Wahl, V.; Ibas, O.; Stenner, F. [ThyssenKrupp VDM GmbH, Altena (Germany)

    2004-07-01

    The current design of containers for high level nuclear waste proceeds on using an outer barrier of corrosion resistant Ni-based super alloy. The current alloy of choice is alloy 22 (UNS N06022). It is a quaternary Ni-Cr- Mo-W alloy system. The new but well established alloy 59 (UNS N06059) is an excellent equal or even a superior alternative to alloy 22 for the 10,000 years reliability being sought. Alloy 59 is a pure ternary alloy in the Ni-Cr-Mo alloy system. Objective of this paper is to present data comparing these two alloys. Therefore the behaviour of alloy 59 and alloy 22 was characterised after aging in air for 10,000 h and 20,000 h at different temperatures (200, 300 and 427 deg. C). Since the performance of weldments is of great concern, both welded and unwelded specimens were studied. Mechanical properties of the air aged alloys were measured at room temperature by tensile and notch impact-bending test. Thermal stability and aqueous corrosion are considered to be the key issues in the long-term performance of container materials proposed for the geological disposal of high level nuclear waste. The long-term thermal stability and corrosion resistance of the alloy 59 compared to alloy 22 is discussed. Corrosion resistance was evaluated in ASTM G28 A and 'green death' solution laboratory tests; hereby corrosion rates and depth of attack were determined. Metallo-graphical studies were performed in mill annealed and air aged conditions. The results of the aging tests at 10,000 h and 20,000 h show that alloy 59 is an equal or better candidate material due to its superior localised corrosion resistance behaviour (pitting and crevice corrosion resistance) and better thermal stability needed especially in multi-pass welding of thick sections. Therefore alloy 59 seems to be the most promising alternative to alloy 22. (authors)

  3. New results on long term aging tests for rad-waste container alloy selection

    International Nuclear Information System (INIS)

    Alves, H.; Wahl, V.; Ibas, O.; Stenner, F.

    2004-01-01

    The current design of containers for high level nuclear waste proceeds on using an outer barrier of corrosion resistant Ni-based super alloy. The current alloy of choice is alloy 22 (UNS N06022). It is a quaternary Ni-Cr- Mo-W alloy system. The new but well established alloy 59 (UNS N06059) is an excellent equal or even a superior alternative to alloy 22 for the 10,000 years reliability being sought. Alloy 59 is a pure ternary alloy in the Ni-Cr-Mo alloy system. Objective of this paper is to present data comparing these two alloys. Therefore the behaviour of alloy 59 and alloy 22 was characterised after aging in air for 10,000 h and 20,000 h at different temperatures (200, 300 and 427 deg. C). Since the performance of weldments is of great concern, both welded and unwelded specimens were studied. Mechanical properties of the air aged alloys were measured at room temperature by tensile and notch impact-bending test. Thermal stability and aqueous corrosion are considered to be the key issues in the long-term performance of container materials proposed for the geological disposal of high level nuclear waste. The long-term thermal stability and corrosion resistance of the alloy 59 compared to alloy 22 is discussed. Corrosion resistance was evaluated in ASTM G28 A and 'green death' solution laboratory tests; hereby corrosion rates and depth of attack were determined. Metallo-graphical studies were performed in mill annealed and air aged conditions. The results of the aging tests at 10,000 h and 20,000 h show that alloy 59 is an equal or better candidate material due to its superior localised corrosion resistance behaviour (pitting and crevice corrosion resistance) and better thermal stability needed especially in multi-pass welding of thick sections. Therefore alloy 59 seems to be the most promising alternative to alloy 22. (authors)

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

    International Nuclear Information System (INIS)

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

    2010-01-01

    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

  5. Reconsolidation of long-term memory in Aplysia.

    Science.gov (United States)

    Cai, Diancai; Pearce, Kaycey; Chen, Shanping; Glanzman, David L

    2012-10-09

    When an animal is reminded of a prior experience and shortly afterward treated with a protein synthesis inhibitor, the consolidated memory for the experience can be disrupted; by contrast, protein synthesis inhibition without prior reminding commonly does not disrupt long-term memory [1-3]. Such results imply that the reminding triggers reconsolidation of the memory. Here, we asked whether the behavioral and synaptic changes associated with the memory for long-term sensitization (LTS) of the siphon-withdrawal reflex in the marine snail Aplysia californica [4, 5] could undergo reconsolidation. In support of this idea, we found that when sensitized animals were given abbreviated reminder sensitization training 48-96 hr after the original sensitization training, followed by treatment with the protein synthesis inhibitor anisomycin, LTS was disrupted. We also found that long-term (≥ 24 hr) facilitation (LTF) [6], which can be induced in the monosynaptic connection between Aplysia sensory and motor neurons in dissociated cell culture by multiple spaced pulses of the endogenous facilitatory transmitter serotonin (5-HT) [7, 8], could be eliminated by treating the synapses with one reminder pulse of 5-HT, followed by anisomycin, at 48 hr after the original training. Our results provide a simple model system for understanding the synaptic basis of reconsolidation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Long-Term Prognosis of Plantar Fasciitis

    DEFF Research Database (Denmark)

    Hansen, Liselotte; Krogh, Thøger Persson; Ellingsen, Torkell

    2018-01-01

    , exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad. Study....... The risk was significantly greater for women (P heel...... regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us...

  7. Long-term dependence in exchange rates

    Directory of Open Access Journals (Sweden)

    A. Karytinos

    2000-01-01

    Full Text Available The extent to which exchange rates of four major currencies against the Greek Drachma exhibit long-term dependence is investigated using a R/S analysis testing framework. We show that both classic R/S analysis and the modified R/S statistic if enhanced by bootstrapping techniques can be proven very reliable tools to this end. Our findings support persistence and long-term dependence with non-periodic cycles for the Deutsche Mark and the French Franc series. In addition a noisy chaos explanation is favored over fractional Brownian motion. On the contrary, the US Dollar and British Pound were found to exhibit a much more random behavior and lack of any long-term structure.

  8. Long-term results of laryngotracheal resection for benign stenosis from a series of 109 consecutive patients.

    Science.gov (United States)

    D'Andrilli, Antonio; Maurizi, Giulio; Andreetti, Claudio; Ciccone, Anna Maria; Ibrahim, Mohsen; Poggi, Camilla; Venuta, Federico; Rendina, Erino Angelo

    2016-07-01

    Long-term results of patients undergoing laryngotracheal resection for benign stenosis are reported. This is the largest series ever published. Between 1991 and March 2015, 109 consecutive patients (64 males, 45 females; mean age 39 ± 10.9 years) underwent laryngotracheal resection for subglottic postintubation (93) or idiopathic (16) stenosis. Preoperative procedures included tracheostomy in 35 patients, laser in 17 and laser plus stenting in 18. The upper limit of the stenosis ranged between actual involvement of the vocal cords and 1.5 cm from the glottis. Airway resection length ranged between 1.5 and 6 cm (mean 3.4 ± 0.8 cm) and it was over 4.5 cm in 14 patients. Laryngotracheal release was performed in 9 patients (suprahyoid in 7, pericardial in 1 and suprahyoid + pericardial in 1). There was no perioperative mortality. Ninety-nine patients (90.8%) had excellent or good early results. Ten patients (9.2%) experienced complications including restenosis in 8, dehiscence in 1 and glottic oedema requiring tracheostomy in 1. Restenosis was treated in all 8 patients with endoscopic procedures (5 laser, 2 laser + stent, 1 mechanical dilatation). The patient with anastomotic dehiscence required temporary tracheostomy closed after 1 year with no sequelae. One patient presenting postoperative glottic oedema underwent permanent tracheostomy. Minor complications occurred in 4 patients (3 wound infections, 1 atrial fibrillation). Definitive excellent or good results were achieved in 94.5% of patients. Twenty-eight post-coma patients with neuropsychiatric disorders showed no increased complication and failure rate. Laryngotracheal resection is the definitive curative treatment for subglottic stenosis allowing very high success rate at long term. Early complications can be managed by endoscopic procedures achieving excellent and stable results over time. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio

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

    International Nuclear Information System (INIS)

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

    2007-01-01

    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

  10. Short-term versus long-term contracting for uranium enrichment services

    International Nuclear Information System (INIS)

    Rudy, G.P.

    1990-01-01

    The US Department of Energy (US DOE) is the world's largest and most experienced supplier of uranium enrichment services. Through the late 1970s and early 1980s, emerging market forces transformed what was once a monopoly into a highly competitive industry. In the early 1980's the DOE lost market share. But as we enter the 1990s, new market forces have emerged. The US DOE believes a responsible balance between long-term and short-term contracting will be the key to success and the key to assuring the long-term health and reliability of the nuclear fuel industry. The US DOE intends to be in this nuclear business for a long time and will continue to offer reliable and responsive services second to none

  11. Occipital Nerve Stimulation for Refractory Chronic Migraine: Results of a Long-Term Prospective Study.

    Science.gov (United States)

    Rodrigo, Dolores; Acin, Pilar; Bermejo, Pedro

    2017-01-01

    Refractory chronic migraine affects approximately 4% of the population worldwide and results in severe pain, lifestyle limitations, and decreased quality of life. Occipital nerve stimulation (ONS) refers to the electric stimulation of the distal branches of greater and lesser occipital nerves; the surgical technique has previously been described and has demonstrated efficacy in the treatment of a wide variety of headache disorders. The aim of this study is to evaluate the long-term efficacy and tolerability of ONS for medically intractable chronic migraine. Prospective, long-term, open-label, uncontrolled observational study. Single public university hospital. Patients who met the International Headache Society criteria for chronic migraine, all of them having been previously treated with other therapeutic alternatives, and who met all inclusion and exclusion criteria for neurostimulation, received the implantation of an ONS system after a positive psychological evaluation and a positive response to a preliminary occipital nerve blockage. The implantation was performed in 2 phases: a 10 day trial with implanted occipital leads connected to an external stimulator and, if more than 50% pain relief was obtained, permanent pulse generator implantation and connection to the previously implanted leads. After the surgery, the patients were thoroughly evaluated annually using different scales: pain Visual Analogue Scale (VAS), number of migraine attacks per month, sleep quality, functionality in social and labor activities, reduction in pain medication, patient satisfaction, tolerability, and reasons for termination. The average follow-up time was 9.4 ± 6.1 years, and 31 patients completed a 7-year follow-up period. Thirty-seven patients were enrolled and classified according to the location and quality of their pain, accompanying symptoms, work status, and psychological effects. Substantial pain reduction was obtained in most patients, and the VAS decreased by 4.9 ± 2

  12. 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.

  13. Long-term frozen storage of urine samples: a trouble to get PCR results in Schistosoma spp. DNA detection?

    Directory of Open Access Journals (Sweden)

    Pedro Fernández-Soto

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

  14. Implicit short- and long-term memory direct our gaze in visual search.

    Science.gov (United States)

    Kruijne, Wouter; Meeter, Martijn

    2016-04-01

    Visual attention is strongly affected by the past: both by recent experience and by long-term regularities in the environment that are encoded in and retrieved from memory. In visual search, intertrial repetition of targets causes speeded response times (short-term priming). Similarly, targets that are presented more often than others may facilitate search, even long after it is no longer present (long-term priming). In this study, we investigate whether such short-term priming and long-term priming depend on dissociable mechanisms. By recording eye movements while participants searched for one of two conjunction targets, we explored at what stages of visual search different forms of priming manifest. We found both long- and short- term priming effects. Long-term priming persisted long after the bias was present, and was again found even in participants who were unaware of a color bias. Short- and long-term priming affected the same stage of the task; both biased eye movements towards targets with the primed color, already starting with the first eye movement. Neither form of priming affected the response phase of a trial, but response repetition did. The results strongly suggest that both long- and short-term memory can implicitly modulate feedforward visual processing.

  15. [The application of delayed skin grafting combined traction in severe joint cicatricial contracture].

    Science.gov (United States)

    Xu, Zihan; Zhang, Zhenxin; Wang, Benfeng; Sun, Yaowen; Guo, Yadong; Gao, Wenjie; Qin, Gaoping

    2014-11-01

    To investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture. At the first stage, the joint cicatricial contracture was released completely with protection of vessels, nerves and tendons. The wound was covered with allogenetic skin or biomaterials. After skin traction for 7-14 days, the joint could reach the extension position. Then the skin graft was performed on the wound. 25 cases were treated from Mar. 2000 to May. 2013. Primary healing was achieved at the second stage in all the cases. The skin graft had a satisfactory color and elasticity. Joint function was normal. All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse, except for one case who didn' t have enough active exercise on shoulder joint. Delayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.

  16. Environmental radioactivity. Global transport, distribution and its long-term variation

    International Nuclear Information System (INIS)

    Hirose, Katsumi

    2015-01-01

    Fukushima Dai-ichi Nuclear Power Plant (F1NPP) accident, which occurred as a result of huge earthquake and resulting tsunami, had a severe impact on world communities as did Japanese, because of cause of serious radioactivity contamination in the environment. Long-term effects of radioactivity contamination from F1NPP are concerned. To assess the long-term environmental effects of the F1NPP accident, it is important to review the history of global radioactivity contamination, which started from Hiroshima and Nagasaki nuclear explosions in Aug. 1945. Radionuclides released in the environment as a result of atmospheric nuclear explosions, nuclear reactor accident and others are migrated between atmosphere, hydrosphere, biosphere and lithosphere according to natural processes. We describe long-term environmental behaviors of anthropogenic radionuclides derived from the atmospheric nuclear explosions and others, which is useful to predict the behaviors and fate of the F1NPP-derived radionuclides. (author)

  17. Muscle changes in brachial plexus birth injury with elbow flexion contracture: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Poeyhiae, Tiina H; Koivikko, Mika P; Lamminen, Antti E [University of Helsinki, Helsinki Medical Imaging Center, Helsinki (Finland); Peltonen, Jari I; Nietosvaara, A Y [Helsinki University Central Hospital, Hospital for Children and Adolescents, Helsinki (Finland); Kirjavainen, Mikko O [Helsinki University Central Hospital, Department of Orthopaedics and Traumatology, Helsinki (Finland)

    2007-02-15

    Muscle pathology of the arm and forearm in brachial plexus birth injury (BPBI) with elbow flexion contracture has not been evaluated with MRI. To determine whether limited range of motion of the elbow in BPBI is correlated with specific patterns of muscular pathology. For 15 BPBI patients, total active motion (TAM) of the elbow (extension-flexion) and the forearm (pronation-supination) were measured. MRI of the elbow joints and musculature allowed assessment of elbow congruency. Fatty infiltration and size reduction of the muscles were graded semiquantitatively. Mean TAM of the elbow was 113 (50 -140 ) and that of the forearm 91 (10 -165 ). The greater the size reduction of the brachioradialis muscle, the more diminished was elbow TAM. The more extensive the BPBI and muscle pathology of the pronator teres muscle, the more limited was the TAM of the forearm. Pathology of the supinator and brachialis muscles was evident in every patient. Extensive BPBI may result in marked limitation of TAM. Elbow flexion contracture seems to be caused mainly by brachialis muscle pathology. Prosupination of the forearm is better preserved when the pronator teres is not severely affected. MRI can reliably show the extent of muscle pathology in BPBI. (orig.)

  18. Muscle changes in brachial plexus birth injury with elbow flexion contracture: an MRI study

    International Nuclear Information System (INIS)

    Poeyhiae, Tiina H.; Koivikko, Mika P.; Lamminen, Antti E.; Peltonen, Jari I.; Nietosvaara, A.Y.; Kirjavainen, Mikko O.

    2007-01-01

    Muscle pathology of the arm and forearm in brachial plexus birth injury (BPBI) with elbow flexion contracture has not been evaluated with MRI. To determine whether limited range of motion of the elbow in BPBI is correlated with specific patterns of muscular pathology. For 15 BPBI patients, total active motion (TAM) of the elbow (extension-flexion) and the forearm (pronation-supination) were measured. MRI of the elbow joints and musculature allowed assessment of elbow congruency. Fatty infiltration and size reduction of the muscles were graded semiquantitatively. Mean TAM of the elbow was 113 (50 -140 ) and that of the forearm 91 (10 -165 ). The greater the size reduction of the brachioradialis muscle, the more diminished was elbow TAM. The more extensive the BPBI and muscle pathology of the pronator teres muscle, the more limited was the TAM of the forearm. Pathology of the supinator and brachialis muscles was evident in every patient. Extensive BPBI may result in marked limitation of TAM. Elbow flexion contracture seems to be caused mainly by brachialis muscle pathology. Prosupination of the forearm is better preserved when the pronator teres is not severely affected. MRI can reliably show the extent of muscle pathology in BPBI. (orig.)

  19. Percutaneous imaging-guided treatment of hydatid liver cysts: Do long-term results make it a first choice?

    International Nuclear Information System (INIS)

    Kabaalioglu, Adnan; Ceken, Kagan; Alimoglu, Emel; Apaydin, Ali

    2006-01-01

    Aim: To evaluate the long-term results of percutaneous imaging-guided treatment of hydatid liver cysts. Materials and methods: Sixty patients with 77 hydatid liver cysts underwent percutaneous treatment with ultrasonography (US) or computed tomography (CT) guidance. Absolute alcohol and hypertonic saline were used for sclerosing the cysts after aspiration. Prophylactic albendazole treatment was given before and after the procedures. Follow-up US and CT were obtained periodically, and changes in cyst morphology were recorded. Minimum follow-up period for the patients included in this study was 12 months. Serological correlation was also available for a group of patients. The outcome of the procedures were categorized into five groups based on morphological changes observed by imaging. Results: Procedures were regarded as successful in 80% and unsuccessful in 20% of patients. Failures most often occurred with type III cysts; less than half (39%) of the total type III cysts had a successful outcome. On the other hand, all type I cysts ended up with cure. Anaphylaxis, pneumotorax and severe pain interrupting the procedures were also among the reasons of failure. Conclusion: Percutaneous aspiration, injection and reaspiration (PAIR) of types I and II hydatid liver cysts is effective and safe in the long-term. Surgery should no longer be regarded as the first choice treatment in all hydatid liver cysts but should be reserved for type III and certain active type IV cysts

  20. Percutaneous imaging-guided treatment of hydatid liver cysts: Do long-term results make it a first choice?

    Energy Technology Data Exchange (ETDEWEB)

    Kabaalioglu, Adnan [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey)]. E-mail: adnank@akdeniz.edu.tr; Ceken, Kagan [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey); Alimoglu, Emel [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey); Apaydin, Ali [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey)

    2006-07-15

    Aim: To evaluate the long-term results of percutaneous imaging-guided treatment of hydatid liver cysts. Materials and methods: Sixty patients with 77 hydatid liver cysts underwent percutaneous treatment with ultrasonography (US) or computed tomography (CT) guidance. Absolute alcohol and hypertonic saline were used for sclerosing the cysts after aspiration. Prophylactic albendazole treatment was given before and after the procedures. Follow-up US and CT were obtained periodically, and changes in cyst morphology were recorded. Minimum follow-up period for the patients included in this study was 12 months. Serological correlation was also available for a group of patients. The outcome of the procedures were categorized into five groups based on morphological changes observed by imaging. Results: Procedures were regarded as successful in 80% and unsuccessful in 20% of patients. Failures most often occurred with type III cysts; less than half (39%) of the total type III cysts had a successful outcome. On the other hand, all type I cysts ended up with cure. Anaphylaxis, pneumotorax and severe pain interrupting the procedures were also among the reasons of failure. Conclusion: Percutaneous aspiration, injection and reaspiration (PAIR) of types I and II hydatid liver cysts is effective and safe in the long-term. Surgery should no longer be regarded as the first choice treatment in all hydatid liver cysts but should be reserved for type III and certain active type IV cysts.

  1. The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper.

    Science.gov (United States)

    Older Women's League, Washington, DC.

    Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

  2. Long- and Short-Term Cryptocurrency Volatility Components: A GARCH-MIDAS Analysis

    Directory of Open Access Journals (Sweden)

    Christian Conrad

    2018-05-01

    Full Text Available We use the GARCH-MIDAS model to extract the long- and short-term volatility components of cryptocurrencies. As potential drivers of Bitcoin volatility, we consider measures of volatility and risk in the US stock market as well as a measure of global economic activity. We find that S&P 500 realized volatility has a negative and highly significant effect on long-term Bitcoin volatility. The finding is atypical for volatility co-movements across financial markets. Moreover, we find that the S&P 500 volatility risk premium has a significantly positive effect on long-term Bitcoin volatility. Finally, we find a strong positive association between the Baltic dry index and long-term Bitcoin volatility. This result shows that Bitcoin volatility is closely linked to global economic activity. Overall, our findings can be used to construct improved forecasts of long-term Bitcoin volatility.

  3. The application of MRI in gluteal muscle contracture

    International Nuclear Information System (INIS)

    Zhao Tao; You Yuhua; Sun Jing; Cheng Kebin; Liu Wei; Qu Hui

    2003-01-01

    Objective: To evaluate the MRI findings and its diagnostic value in gluteal muscle contracture (GMC). Methods: Eleven clinic or operation confirmed GMC patients were examined by plain X-ray and MRI. Conventional T 1 WI and T 2 WI MR imaging were performed and FFE-T 2 WI (fast field echo-T 2 WI) was also scanned. CT scan was conducted in 5 cases. Results: 11 GMC patients were all diagnosed by MRI. Conventional T 1 WI and T 2 WI could only show the atrophy of gluteal muscles, while FFE-T 2 WI could directly show the fibrous band of gluteal muscle and its fascia, and the fibrous band appeared as low signal intensity on FFE-T 2 WI sequence. Conclusions: MRI is the efficient modality in imaging the fibrous band for GMC patients, and FFE-T 2 WI is the most valuable sequence. MRI is very helpful in the diagnosis and treatment of GMC

  4. Relationship between short and long term radon measurements

    International Nuclear Information System (INIS)

    Martinez, T.; Ramirez, D.; Navarrete, M.; Cabrera, L.; Ramirez, A.; Gonzalez, P.

    2000-01-01

    In this work the radon group of the Faculty of Chemistry at the National University of Mexico presents the results obtained in the establishment of a relation between the short and long term radon measures made with passive electret detectors E-PERM type LLT and HST. The measures were carried out inside single family dwellings (open house condition) located in the southeast of Mexico City (in Xochimilco) during the four seasons of the year 1997. A correlation was established between the short term measures (five days) and those of a long term for every season as well as an annual average, with an equation that relates them. The objective and advantage of this correlation are that with a short term measure it is possible to predict the annual mean radon concentration, that represents a saving of human and economic resources. (author)

  5. Long-term results of Heller myotomy without an antireflux procedure in achalasic patients.

    Science.gov (United States)

    Cortesini, Camillo; Cianchi, Fabio; Pucciani, Filippo

    2002-01-01

    Both open and laparoscopic myotomies have been used in the treatment of achalasia. Postoperative gastro-oesophageal reflux is among the commonly reported side effects of myotomy. The addition of an antireflux procedure to the standard surgical approach has given rise to controversy. The objective of our study was to determine whether or not an antireflux procedure should be used in addition to Heller myotomy. Over the period from 1980 to 1990, 94 patients (mean age: 47.9 years) with achalasia underwent Heller myotomy calibrated by intraoperative oesophageal manometry without fundoplication. In 1999-2000, all patients filled in a clinical questionnaire: all underwent radiographic oesophageal imaging, oesophageal manometry, ambulatory 24-h oesophageal pH monitoring, and oesophagogastroduodenoscopy, when necessary. Ten healthy age-matched subjects were compared in the manometric and radiological studies. Myotomy improved the clinical profiles and instrumental data results in all patients. Gastro-oesophageal reflux was present in 10 patients (10.6%); none of these 10 subjects presented oesophagitis. Heller open myotomy yields good long-term results. Intraoperative manometric calibration reduces the side effects of myotomy, such as gastro-oesophageal reflux. The addition of fundoplication is not justified in all patients.

  6. Long term wet spent nuclear fuel storage

    International Nuclear Information System (INIS)

    1987-04-01

    The meeting showed that there is continuing confidence in the use of wet storage for spent nuclear fuel and that long-term wet storage of fuel clad in zirconium alloys can be readily achieved. The importance of maintaining good water chemistry has been identified. The long-term wet storage behaviour of sensitized stainless steel clad fuel involves, as yet, some uncertainties. However, great reliance will be placed on long-term wet storage of spent fuel into the future. The following topics were treated to some extent: Oxidation of the external surface of fuel clad, rod consolidation, radiation protection, optimum methods of treating spent fuel storage water, physical radiation effects, and the behaviour of spent fuel assemblies of long-term wet storage conditions. A number of papers on national experience are included

  7. Long-Term Collections

    CERN Multimedia

    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...

  8. 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...

  9. Thoracic Outlet Syndrome and Volkmann's Contracture in a Field Hockey Player

    Directory of Open Access Journals (Sweden)

    Morgan Sawyer

    2016-05-01

    Full Text Available Background: A 19-year-old female field hockey player presents with bilateral upper trapezius and rhomboid tightness and spasm beginning in January of 2016. She has no previous history of upper back pain or injury. The student first reported the injury immediately after running sprints. She stated that she could not move or feel her fingers or hands. She presents with a visible hump on her left upper trapezius. She also has forward-rounded shoulders. She has regular and equal radial pulses. She has decreased sensation upon palpation of her fingers, hands and forearms. After extraneous exercise, the athlete’s hands, wrists and forearms go into contracture and flexion and she is unable to move from this position until manual extension is applied, or 10 or more minutes of rest occurs. She is TTP over her upper trapezius musculature. She had a positive Military Brace test. Differential Diagnosis: Based on evaluation, the athlete could simply just have upper trapezius musculature spasms. The diagnosis could also be shoulder impingement syndrome, due to the neurological signs and symptoms. Compartment syndrome could produce similar s/s that the athlete experiences, as well. Treatment: X-rays show no bony abnormalities and no extra ribs. The athlete’s injury has been treated with ice post-practice, heat pre-practice and upper body stretching exercises. Three days a week the athlete works on postural exercises that strengthen her back musculature. The athlete also receives combination therapy over her upper trapezius trigger points, along with massage and Hawkgrip technique over the same areas. Uniqueness: The uniqueness in this case is that the athlete has both TOS and Volkmann’s contracture. Volkmann’s contractures typically occur in pediatrics, which is another reason why this particular case is unique. Conclusion: This case allows other clinicians to understand the causes of TOS and the secondary s/s that TOS can potentially cause.

  10. Murine model of long term obstructive jaundice

    Science.gov (United States)

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A.; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

    2016-01-01

    Background With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of 3 murine models of obstructive jaundice. Methods C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Results 70% (7/10) of tCL mice died by Day 7, whereas majority 67% (10/15) of pCL mice survived with loss of jaundice. 19% (3/16) of LMHL mice died; however, jaundice continued beyond Day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 days after ligation but jaundice rapidly decreased by Day 7. The LHML group developed portal hypertension as well as severe fibrosis by Day 14 in addition to prolonged jaundice. Conclusion The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice but long term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. PMID:27916350

  11. [Comparative Cost Effectiveness of Clostridium Histolyticum Collagenase (Xiapex®) and Partial Fasciectomy for the Treatment of Dupuytren's Contracture in Austria].

    Science.gov (United States)

    Neuwirth, M; Binter, A; Pipam, W; Rab, M

    2016-08-01

    Since Dupuytren's contracture is a common disorder, the costs for its surgical treatment impose a considerable burden on the healthcare system. For the first time in the German-speaking area, this study aimed to provide a comparative cost-effectiveness analysis for partial fasciectomy vs. treatment with Clostridium histolyticum collagenase (CCH). A retrospective monocentric study of the period from 2012 to 2014 comprised 40 patients with previously untreated Dupuytren's contracture of one finger. 20 outpatients received one CCH treatment (Group 1), while 20 inpatients underwent partial fasciectomy (Group 2). The direct pre-interventional treatment and post-interventional costs were compared. The direct post-interventional and postoperative results were comparable. Group 1 (CCH) showed a mean reduction in contracture of 96.4%; in Group 2 (partial fasciectomy), this was 97.7%. There were fewer complications in Group 1 than in Group 2. Mean treatment costs in Group 1 were € 1 458.60 and in Group 2, € 5 315.20. Treatment with CCH is more cost effective than with partial fasciectomy. This is due to greater costs for personnel, time and surgical material, as well as the treatment of the more frequent complications in Group 2. Despite the limited comparability, our findings are consistent with the present international literature. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Inhibition of sarcoplasmic Ca2+-ATPase increases caffeine- and halothane-induced contractures in muscle bundles of malignant hyperthermia susceptible and healthy individuals

    Directory of Open Access Journals (Sweden)

    Roewer Norbert

    2005-06-01

    Full Text Available Abstract Background Malignant hyperthermia (MH is triggered by halogenated anaesthetics and depolarising muscle relaxants, leading to an uncontrolled hypermetabolic state of skeletal muscle. An uncontrolled sarcoplasmic Ca2+ release is mediated via the ryanodine receptor. A compensatory mechanism of increased sarcoplasmic Ca2+-ATPase activity was described in pigs and in transfected cell lines. We hypothesized that inhibition of Ca2+ reuptake via the sarcoplasmic Ca2+-ATPase (SERCA enhances halothane- and caffeine-induced muscle contractures in MH susceptible more than in non-susceptible skeletal muscle. Methods With informed consent, surplus muscle bundles of 7 MHS (susceptible, 7 MHE (equivocal and 16 MHN (non-susceptible classified patients were mounted to an isometric force transducer, electrically stimulated, preloaded and equilibrated. Following 15 min incubation with cyclopiazonic acid (CPA 25 μM, the European MH standard in-vitro-contracture test protocol with caffeine (0.5; 1; 1.5; 2; 3; 4 mM and halothane (0.11; 0.22; 0.44; 0.66 mM was performed. Data as median and quartiles; Friedman- and Wilcoxon-test for differences with and without CPA; p Results Initial length, weight, maximum twitch height, predrug resting tension and predrug twitch height of muscle bundles did not differ between groups. CPA increased halothane- and caffeine-induced contractures significantly. This increase was more pronounced in MHS and MHE than in MHN muscle bundles. Conclusion Inhibition of the SERCA activity by CPA enhances halothane- and caffeine-induced contractures especially in MHS and MHE skeletal muscle and may help for the diagnostic assignment of MH susceptibility. The status of SERCA activity may play a significant but so far unknown role in the genesis of malignant hyperthermia.

  13. X-ray diagnostic data on posttraumatic deforming arthrosis and elbow joint contracture

    International Nuclear Information System (INIS)

    Mironchuk, L.V.

    2010-01-01

    To investigate the most common complications of elbow joint injuries and their degree using x-ray findings at various types of traumas. Radiography is the main method of diagnosis of EJ injury consequences, among them the most frequent are arthrosis deformations and contractures, therefore the volume of EJ volume should be considered when determining the disease stages.

  14. Maize Stem Response to Long-Term Attack by Sesamia nonagrioides

    Directory of Open Access Journals (Sweden)

    Victor M. Rodriguez

    2018-04-01

    Full Text Available Plants defend themselves against herbivores by activating a plethora of genetic and biochemical mechanisms aimed at reducing plant damage and insect survival. The short-term plant response to insect attack is well understood, but less is known about the maintenance of this response over time. We performed transcriptomic and metabolomics analyses in order to identify genes and metabolites involved in the long-term response of maize to attack by the corn borer Sesamina nonagrioides. To determine the role of elicitors present in caterpillar secretions, we also evaluated the response of maize stem challenged with insect regurgitates. The integrative analysis of the omics results revealed that the long-term response in maize is characterized by repression of the primary metabolism and a strong redox response, mainly mediated by germin-like proteins to produce anti-nutritive and toxic compounds that reduce insect viability, and with the glutathione–ascorbate cycle being crucial to minimize the adverse effects of reactive oxygen species (ROS on the plant. Our results suggest that different defense mechanisms are involved in the long-term response compared to those reported during the early response. We also observed a marginal effect of the caterpillar regurgitates on the long-term defensive response.

  15. Long-Term Retardation of Uranium in the KURT Environment

    International Nuclear Information System (INIS)

    Baik, Min Hoon; Shin, Joo Do; Park, Tae Jin

    2016-01-01

    One of possibilities resolving this issue is to study the migration and retardation processes of radionuclides in the subsurface environments by using naturally occurring radionuclides as analogues of radioactive waste. To date, however, the long-term behavior of radionuclides in a granitic groundwater system is not yet fully understood. The ubiquitous presence of uranium (U) in rocks makes it an ideal natural analogue for studying the behaviors of radionuclides in a deep geological repository for the final disposal of HLW. In this study, long-term retardation behavior of natural uranium was investigated using granite rock samples taken from the KURT (KAERI Underground Research Tunnel), located in Daejeon city. The distribution of uranium and its binding mechanism in granite samples were investigated using the sequential chemical extraction (SCE) technique combined with X-ray diffraction (XRD) and ICP-MS methods. In this study, the long-term retardation of uranium in the KURT environment was investigated using SCE and EPMA techniques combined with ICP-MS and XRD. Results showed that long-term interaction of rock with groundwater can change U species and mineralize dissolved U, which can consequently contribute to the retardation of U in the fractured granitic rock environment. This study will help us to understand the long-term behavior of radionuclides migrating through the fractured granite rock and then enhance the reliability of the safety assessment for a HLW repository

  16. Assessing the associative deficit of older adults in long-term and short-term/working memory.

    Science.gov (United States)

    Chen, Tina; Naveh-Benjamin, Moshe

    2012-09-01

    Older adults exhibit a deficit in associative long-term memory relative to younger adults. However, the literature is inconclusive regarding whether this deficit is attenuated in short-term/working memory. To elucidate the issue, three experiments assessed younger and older adults' item and interitem associative memory and the effects of several variables that might potentially contribute to the inconsistent pattern of results in previous studies. In Experiment 1, participants were tested on item and associative recognition memory with both long-term and short-term retention intervals in a single, continuous recognition paradigm. There was an associative deficit for older adults in the short-term and long-term intervals. Using only short-term intervals, Experiment 2 utilized mixed and blocked test designs to examine the effect of test event salience. Blocking the test did not attenuate the age-related associative deficit seen in the mixed test blocks. Finally, an age-related associative deficit was found in Experiment 3, under both sequential and simultaneous presentation conditions. Even while accounting for some methodological issues, the associative deficit of older adults is evident in short-term/working memory.

  17. Measuring client experiences in long-term care in the Netherlands: a pilot study with the Consumer Quality Index Long-term Care

    Directory of Open Access Journals (Sweden)

    Kool Rudolf B

    2010-04-01

    Full Text Available Abstract Background This study aims to describe the development, testing and optimization of a new standard instrument, the Consumer Quality Index (CQ-index® Long-term Care, for measuring client experiences with long-term care in the Netherlands. Methods Three versions of the CQ-index questionnaires and protocols for study sampling and data collection were developed, designed for interviews with residents of nursing or residential care homes and postal surveys among representatives of psychogeriatric residents and homecare clients. From July to November 2006 a pilot study was conducted among 2,697 clients of 68 nursing or residential care homes, 2,164 representatives of clients in 57 psychogeriatric care institutions, and 1,462 clients of 19 homecare organizations. We performed psychometric analyses and descriptive analyses, and evaluated the pilot study. Results The pilot study showed the feasibility and usability of the instruments, supported the multidimensionality of the questionnaires and showed first findings on client experiences and possibilities for quality improvement. Nine scales applied to all care settings: shared decision making, attitude and courtesy, information, body care, competence and safety of care, activities, autonomy, mental well-being, and availability of personnel. The pilot resulted in three optimized questionnaires and recommendations for nationwide implementation. Conclusions The CQ-index® Long-term Care provides a good basis to investigate the quality of nursing homes, residential care homes and homecare from the clients' perspective. This standardized instrument enables a nationwide comparison of the quality of long-term care for the purpose of transparency and quality assurance.

  18. Long-Term Hydrologic Monitoring Program, Amchitka Island, Alaska

    International Nuclear Information System (INIS)

    1982-01-01

    The purpose of the Long-Term Hydrologic Monitoring Program for Amchitka Island, Alaska, is to obtain data that will assure the public safety, inform the public, the news media, and the scientific community relative to radiological contamination, and to document compliance with federal, state, and local antipollution requirements. Amchitka's geographical setting, climate, geology, hydrology, and ecology are described. Site history including event information for LONG SHOT in 1965, MILROW in 1969, and CANNIKIN in 1971 is described. Event related contamination has been observed only at the LONG SHOT site. At this site, tritium in concentrations below the drinking water standards has been observed in mud pits and wells in the area adjacent to surface ground zero. The Long-Term Hydrologic Monitoring Program for Amchitka is described. No radioactive venting, significant radioactive leakage, or bioenvironmental damage resulted from any of the nuclear tests on Amchitka

  19. Long-term aversive taste memory requires insular and amygdala protein degradation.

    Science.gov (United States)

    Rodriguez-Ortiz, Carlos J; Balderas, Israela; Saucedo-Alquicira, Fernando; Cruz-Castañeda, Paulina; Bermudez-Rattoni, Federico

    2011-03-01

    Some reports have shown that the ubiquitin-proteasome system (UPS) is necessary to degrade repressor factors to produce new proteins essential to memory consolidation. Furthermore, recent evidence suggests that memory updating also relies on protein degradation through the UPS. To evaluate whether degradation of proteins is part of the cellular events needed for long-term storage of taste aversion, we injected lactacystin--an UPS inhibitor--into the amygdala and/or insular cortex 30 min before the first or second training trials. The results revealed that degradation of proteins in either the amygdala or insular cortex suffices for long-term stabilization of first-time encounter taste aversion. On the other hand, lactacystin applied in the insula, but not in the amygdala, before the second training prevented long-term storage of updated information. Our results support that degradation of proteins by means of the UPS is required every time taste aversion is to be stored in long-term memory. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Decreasing Complications of Quadricepsplasty for Knee Contracture after Femoral Fracture Treatment with an External Fixator: Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Naoya Kashiwagi

    2013-01-01

    Full Text Available Introduction: In performing quadricepsplasty for contracture that develops after application of an external fixator for femoral fractures, surgeons must be aware of the potential risk for re-fracture and pin-related problems. The purpose of this report is to highlight these not well-detailed complications and to discuss specific findings and treatment suggestions.Case Report: 4 men (mean age, 40 years presenting with secondary to contracture that developed after application of an external fixator for femoral fractures were included in this study. The radiographs showed union across the fracture site however two of these patients couldn't stand on one leg raising suspicion about the union status. A computed tomographic image indeed demonstrated limited continuity of the cortex. Bone grafting was performed prior to quadricepsplasty. The mean extension and flexion before the quadricepsplasty were 0o and 570 , respectively. At the final follow-up examination, the mean active flexion of the knee had increased to 98o.Results: The incidence of re-fracture during and after quadricepsplasty has been reported to be between 10 and 25%. There are 2 preoperative features that may mislead surgeons into believing that complete union of the fractures has been attained: one is the patient's ability to stand on a single leg, and the other is the fact that plain radiographs may lend themselves to different interpretations. In such cases, computed tomography will provide evidence of the continuity of the cortical bone. Bone grafting in 2 of our patients is thought to have prevented the postoperative complications of re-fracture. Complications at pin sites induce contracture at surrounding structures. When extreme tightness of the skin is noted, a tension-releasing procedure such as a skin graft should be performed.Conclusion: In conclusion, re-fracture or pin-site contracture should be carefully managed before quadricepsplasty, because the patients who need a

  1. [Retrospective analysis of effects of metacarpus and phalanx traction on correction of scar contracture of hand after burn on the palm side].

    Science.gov (United States)

    Chunsheng, Hou; Qingye, Liu; Hongfei, Hao; Yuying, Dong; Feng, Wang; Jin, Lei

    2015-06-01

    To analyze the effects of metacarpus and phalanx traction on correction of scar contracture of hand after burn on the palm side retrospectively. A total of 32 patients with 39 affected hands with scar contracture on the palm side after burn were hospitalized from May 2010 to December 2014. Method of treatment: scar contracture was conservatively released followed by skin grafting, which was referred to as method A; Kirschner wire was inserted into the middle or distal phalanx of finger with contracture and the corresponding metacarpus in the shape of U for 2 to 7 weeks' traction, which was referred to as method B; traction frame was built based on the traction pile and anchor formed by Kirschner wire inserted through the second to the fifth metacarpus and distal phalanx of finger with contracture, and then the affected fingers were pulled into a straight position with rubber bands for 2 to 6 months, which was referred to as method C. Method A was used in patients who would be treated with thorough release of scar followed by skin grafting routinely. Method B was used in patients who would be treated with intramedullary Kirschner wire fixation after release of scar contracture and skin transplantation routinely. Method C was further used in patients when methods A and B failed to accomplish the expected result. Method C was used in the first place followed by method A in whom there might be vascular decompensation or exposure of tendon and bone after scar release, and those who failed to meet the expectation were treated with method C in addition. Patients who were unwilling to undergo surgery were treated with method C exclusively. During the course of treatment, the presence or absence of infection and slipping of Kirschner wire or its slitting through soft tissue were observed. The presence or absence of tendency of recurrence of scar contracture within 1 to 2 weeks after treatment was observed. The length of palmar skin measuring from the root of finger with

  2. Long-term neurodevelopmental outcome after fetal arrhythmia

    NARCIS (Netherlands)

    Lopriore, Enrico; Aziz, Muhammed I.; Nagel, Helene T.; Blom, Nico A.; Rozendaal, Lieke; Kanhai, Humphrey H. H.; Vandenbussche, Frank P. H. A.

    2009-01-01

    OBJECTIVE: The purpose of this study was to determine the long-term neurodevelopmental outcome in fetuses with severe tachy- or bradyarrhythmia. STUDY DESIGN: This was a follow-up study to assess the neurologic, mental, and psychomotor development in cases with fetal cardiac arrhythmia. RESULTS: A

  3. Numerical simulation of gender differences in a long-term microgravity exposure

    Science.gov (United States)

    Perez-Poch, Antoni

    The objective of this work is to analyse and simulate gender differences when individuals are exposed to long-term microgravity. Risk probability of a health impairment which may put in jeopardy a long-term mission is also evaluated. Computer simulations are becoming a promising research line of work, as physiological models become more and more sophisticated and reliable. Technological advances in state-of-the-art hardware technology and software allow nowadays for better and more accurate simulations of complex phenomena, such as the response of the human cardiovascular system to long-term exposure to microgravity. Experimental data for long-term missions are difficult to achieve and reproduce, therefore the predictions of computer simulations are of a major importance in this field. Our approach is based on a previous model developed and implemented in our laboratory (NELME: Numerical Evaluation of Long-term Microgravity Effects). The software simulates the behaviour of the cardiovascular system and different human organs, has a modular architecture, and allows to introduce perturbations such as physical exercise or countermeasures. The implementation is based on a complex electricallike model of this control system, using inexpensive software development frameworks, and has been tested and validated with the available experimental data. Gender differences have been implemented for this specific work, as an adjustment of a number of parameters that are included in the model. Women versus men physiological differences have been therefore taken into account, based upon estimations from the physiology bibliography. A number of simulations have been carried out for long-term exposure to microgravity. Gravity varying from Earth-based to zero, and time exposure are the two main variables involved in the construction of results, including responses to patterns of physical aerobical exercise, and also thermal stress simulating an extra-vehicular activity. Results show

  4. The use of Collagenase Clostridium Histolyticum in the management of Dupuytren's contracture-outcomes of a pilot study in a District General Hospital setting.

    Science.gov (United States)

    Murphy, Lynn E; Murphy, Karen M; Kilpatrick, Shauneen M; Thompson, Neville W

    2017-05-01

    Collagenase Clostridium Histolyticum (CCH) is a recognised treatment option for adult patients presenting with Dupuytren's contracture (DC). Twenty male patients with established DC were treated using CCH. The average metacarpophalangeal (MCP) joint and proximal interphalangeal joint (PIP) contractures pre-treatment were 52 0 (range, 0 - 75 0 ) and 35 0 (range, 0 - 84 0 ) respectively. The average DASH score pre-treatment was 24.2 points (range, 0 - 68.2 points). Patients were reviewed at lmonth, 3months and at an average of 23 months (17 to 27 months). MCP joint contractures significantly improved compared to pre-treatment and the improvement was maintained at latest follow up. PIP joint contractures did significantly improve but to a lesser degree and there was no significant improvement compared to pre-treatment beyond 3months. A trend for MCP and PIP joint contracture recurrence was observed at latest follow up but did not reach statistical significance. DASH scores significantly improved from pre-treatment and the improvement was maintained at latest follow up. At 3months, the average patient satisfaction score was 9.5 (range, 6 - 10), which decreased to 8.6 (range, 6 - 10) at latest follow up. We estimated a potential cost saving of approximately £70,000 by treating 20 patients using CCH compared to inpatient operative fasciectomy. CCH is a useful option in the management of DC in appropriately selected patients. Cost-effectiveness in the treatment of DC should be carefully considered.

  5. Representativeness of shorter measurement sessions in long-term indoor air monitoring.

    Science.gov (United States)

    Maciejewska, M; Szczurek, A

    2015-02-01

    Indoor air quality (IAQ) considerably influences health, comfort and the overall performance of people who spend most of their lives in confined spaces. For this reason, there is a strong need to develop methods for IAQ assessment. The fundamental issue in the quantitative determination of IAQ is the duration of measurements. Its inadequate choice may result in providing incorrect information and this potentially leads to wrong conclusions. The most complete information may be acquired through long-term monitoring. However it is typically perceived as impractical due to time and cost load. The aim of this study was to determine whether long-term monitoring can be adequately represented by a shorter measurement session. There were considered three measurable quantities: temperature, relative humidity and carbon dioxide concentration. They are commonly recognized as indicatives for IAQ and may be readily monitored. Scaled Kullback-Leibler divergence, also called relative entropy, was applied as a measure of data representativeness. We considered long-term monitoring in a range from 1 to 9 months. Based on our work, the representative data on CO2 concentration may be acquired while performing measurements during 20% of time dedicated to long-term monitoring. In the case of temperature and relative humidity the respective time demand was 50% of long-term monitoring. From our results, in indoor air monitoring strategies, there could be considered shorter measurement sessions, while still collecting data which are representative for long-term monitoring.

  6. Long-term risks of kidney living donation

    DEFF Research Database (Denmark)

    Maggiore, Umberto; Budde, Klemens; Heemann, Uwe

    2017-01-01

    Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science...... and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information...... to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors...

  7. Long-term effects of radiation

    International Nuclear Information System (INIS)

    Smith, J.; Smith, T.

    1981-01-01

    It is pointed out that sources of long-term damage from radiation are two-fold. People who have been exposed to doses of radiation from initial early fallout but have recovered from the acute effects may still suffer long-term damage from their exposure. Those who have not been exposed to early fallout may be exposed to delayed fallout, the hazards from which are almost exclusively from ingesting strontium, caesium and carbon isotopes present in food; the damage caused is relatively unimportant compared with that caused by the brief doses from initial radiation and early fallout. A brief discussion is presented of the distribution of delayed long-lived isotope fallout, and an outline is sketched of late biological effects, such as malignant disease, cataracts, retarded development, infertility and genetic effects. (U.K.)

  8. Long-Term Stability Testing Results Using Surrogates And Sorbents For Savannah River Site Organic And Aqueous Wastestreams - 10016

    International Nuclear Information System (INIS)

    Burns, H.

    2009-01-01

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

  9. Long-term results of intensity-modulated radiotherapy concomitant with chemotherapy for hypopharyngeal carcinoma aimed at laryngeal preservation

    Directory of Open Access Journals (Sweden)

    Tseng Szu-Wen

    2010-03-01

    Full Text Available Abstract Background The objective of this retrospective study is to investigate laryngeal preservation and long-term treatment results in hypopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT combined with chemotherapy. Methods Twenty-seven patients with hypopharyngeal carcinoma (stage II-IV were enrolled and underwent concurrent chemoradiotherapy. The chemotherapy regimens were monthly cisplatin and 5-fluorouracil for six patients and weekly cisplatin for 19 patients. All patients were treated with IMRT with simultaneous integrated boost technique. Acute and late toxicities were recorded based on CTCAE 3.0 (Common Terminology Criteria for Adverse Events. Results The median follow-up time for survivors was 53.0 months (range 36-82 months. The initial complete response rate was 85.2%, with a laryngeal preservation rate of 63.0%. The 5-year functional laryngeal, local-regional control, disease-free and overall survival rates were 59.7%, 63.3%, 51.0% and 34.8%, respectively. The most common greater than or equal to grade 3 acute and late effects were dysphagia (63.0%, 17 of 27 patients and laryngeal stricture (18.5%, 5 of 27 patients, respectively. Patients belonging to the high risk group showed significantly higher risk of tracheostomy compared to the low risk group (p = 0.014. Conclusions After long-term follow-up, our results confirmed that patients with hypopharyngeal carcinoma treated with IMRT concurrent with platinum-based chemotherapy attain high functional laryngeal and local-regional control survival rates. However, the late effect of laryngeal stricture remains a problem, particularly for high risk group patients.

  10. Long-term survivorship of stemless anatomical shoulder replacement.

    Science.gov (United States)

    Beck, Sascha; Beck, Verena; Wegner, Alexander; Dudda, Marcel; Patsalis, Theodor; Jäger, Marcus

    2018-01-24

    Like in many other joints, current shoulder replacement designs aim at bone preservation. According to the literature available, stemless total shoulder arthroplasty (TSA) compares favourably with stemmed designs in terms of function and survivorship of the implant. However, long-term results of stemless shoulder arthroplasty are still missing. Therefore, the aim of the present study was to evaluate long-term results of stemless anatomical TSA. Between 2006 and 2009, 51 shoulders in 46 patients were resurfaced using the Biomet Total Evolutive Shoulder System (TESS). Thirty-one shoulders in 26 patients who were aged 66.7 ± 10.0 (range 34-82) years were available for review at a mean follow-up of 94.7 ± 11.3 (76-124) months. The implant survival rate was 93.5% at eight years. The overall revision rate of the TESS implant was 9.7%. Radiolucent lines were found on the glenoid side of the TESS arthroplasty in 90.9% of the cases. All stemless humeral corolla implants showed solid fixation at follow-up. Clinical scores significantly improved at long-term follow-up (VAS from 8.1 ± 0.9 to 1.0 ± 1.2, p < 0.001; Quick-DASH from 67.9 ± 13.5 to 18.7 ± 16.5, p < 0.001 and Constant score from 14.7 ± 6.1 to 68.8 ± 13.2, p < 0.001). Stemless TSA has stood the test of time at eight years in terms of clinical scores, radiographic loosening, complication rates and implant survivorship.

  11. Presynaptic protein synthesis required for NT-3-induced long-term synaptic modulation

    Directory of Open Access Journals (Sweden)

    Je H

    2011-01-01

    Full Text Available Abstract Background Neurotrophins elicit both acute and long-term modulation of synaptic transmission and plasticity. Previously, we demonstrated that the long-term synaptic modulation requires the endocytosis of neurotrophin-receptor complex, the activation of PI3K and Akt, and mTOR mediated protein synthesis. However, it is unclear whether the long-term synaptic modulation by neurotrophins depends on protein synthesis in pre- or post-synaptic cells. Results Here we have developed an inducible protein translation blocker, in which the kinase domain of protein kinase R (PKR is fused with bacterial gyrase B domain (GyrB-PKR, which could be dimerized upon treatment with a cell permeable drug, coumermycin. By genetically targeting GyrB-PKR to specific cell types, we show that NT-3 induced long-term synaptic modulation requires presynaptic, but not postsynaptic protein synthesis. Conclusions Our results provide mechanistic insights into the cell-specific requirement for protein synthesis in the long-term synaptic modulation by neurotrophins. The GyrB-PKR system may be useful tool to study protein synthesis in a cell-specific manner.

  12. Long-term home care scheduling

    DEFF Research Database (Denmark)

    Gamst, Mette; Jensen, Thomas Sejr

    In several countries, home care is provided for certain citizens living at home. The long-term home care scheduling problem is to generate work plans spanning several days such that a high quality of service is maintained and the overall cost is kept as low as possible. A solution to the problem...... provides detailed information on visits and visit times for each employee on each of the covered days. We propose a branch-and-price algorithm for the long-term home care scheduling problem. The pricing problem generates one-day plans for an employee, and the master problem merges the plans with respect...

  13. 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......What do timescales - the notion that processes take place or can be viewed within a shorter or longer temporal range (Lemke 2005) - mean for the analysis of discourse? What are the methodological consequences of analyzing discourse at different timescales? It may be argued that discourse analysis...... in general has favored either the analysis of short term processes such as interviews, discussions, and lessons, or the analysis of non-processual entities such as (multimodal) texts, arguments, discursive repertoires, and discourses (in a Foucaultian sense). In contrast, analysis of long term processes...

  14. Nuclear Energy, Long Term Requirements

    International Nuclear Information System (INIS)

    Knapp, V.

    2006-01-01

    There are serious warnings about depletion of oil and gas and even more serious warnings about dangers of climate change caused by emission of carbon dioxide. Should developed countries be called to replace CO2 emitting energy sources as soon as possible, and the time available may not be longer then few decades, can nuclear energy answer the call and what are the requirements? Assuming optimistic contribution of renewable energy sources, can nuclear energy expand to several times present level in order to replace large part of fossil fuels use? Paper considers intermediate and long-term requirements. Future of nuclear power depends on satisfactory answers on several questions. First group of questions are those important for near and intermediate future. They deal with economics and safety of nuclear power stations in the first place. On the same time scale a generally accepted concept for radioactive waste disposal is also required. All these issues are in the focus of present research and development. Safer and more economical reactors are targets of international efforts in Generation IV and INPRO projects, but aiming further ahead these innovative projects are also addressing issues such as waste reduction and proliferation resistance. However, even assuming successful technical development of these projects, and there is no reason to doubt it, long term and large-scale nuclear power use is thereby not yet secured. If nuclear power is to play an essential role in the long-term future energy production and in reduction of CO2 emission, than several additional questions must be replied. These questions will deal with long-term nuclear fuel sufficiency, with necessary contribution of nuclear power in sectors of transport and industrial processes and with nuclear proliferation safety. This last issue is more political then technical, thus sometimes neglected by nuclear engineers, yet it will have essential role for the long-term prospects of nuclear power. The

  15. What are the differences between long-term, short-term, and working memory?

    OpenAIRE

    Cowan, Nelson

    2008-01-01

    In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rath...

  16. Memory Reactivation Enables Long-Term Prevention of Interference.

    Science.gov (United States)

    Herszage, Jasmine; Censor, Nitzan

    2017-05-22

    The ability of the human brain to successively learn or perform two competing tasks constitutes a major challenge in daily function. Indeed, exposing the brain to two different competing memories within a short temporal offset can induce interference, resulting in deteriorated performance in at least one of the learned memories [1-4]. Although previous studies have investigated online interference and its effects on performance [5-13], whether the human brain can enable long-term prevention of future interference is unknown. To address this question, we utilized the memory reactivation-reconsolidation framework [2, 12] stemming from studies at the synaptic level [14-17], according to which reactivation of a memory enables its update. In a set of experiments, using the motor sequence learning task [18] we report that a unique pairing of reactivating the original memory (right hand) in synchrony with novel memory trials (left hand) prevented future interference between the two memories. Strikingly, these effects were long-term and observed a month following reactivation. Further experiments showed that preventing future interference was not due to practice per se, but rather specifically depended on a limited time window induced by reactivation of the original memory. These results suggest a mechanism according to which memory reactivation enables long-term prevention of interference, possibly by creating an updated memory trace integrating original and novel memories during the reconsolidation time window. The opportunity to induce a long-term preventive effect on memories may enable the utilization of strategies optimizing normal human learning, as well as recovery following neurological insults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Long-term capital planning considering nuclear plant life-cycle management

    International Nuclear Information System (INIS)

    Negin, C.A.; Simpson, J.M.; Hostetler, D.R.

    1992-09-01

    The creation of a Life Cycle Management (LCM) group at utilities to evaluate the long term capital refurbishment needs is gaining favor. Among the functions of such groups can be the responsibility for recommending long term capital planning projects based on results of evaluations of systems, structures, and components that are not only essential to achieving the full current license term of operation, but also to extend the service life of the plant. Making such recommendations, in content and timing, requires the ability to view all recommendations in the context of an overall capital budget and long range outage impacts. This report illustrates an approach for creating a Long-Term Capital Plan with methods for deciding on, compiling, integrating, and presenting projects from the perspective of an LCM program for a nuclear power plant. It also addresses a rationale for capitalization of LCM program activities that would not be allowed under current accounting treatment

  18. Synaptic Transmission Optimization Predicts Expression Loci of Long-Term Plasticity.

    Science.gov (United States)

    Costa, Rui Ponte; Padamsey, Zahid; D'Amour, James A; Emptage, Nigel J; Froemke, Robert C; Vogels, Tim P

    2017-09-27

    Long-term modifications of neuronal connections are critical for reliable memory storage in the brain. However, their locus of expression-pre- or postsynaptic-is highly variable. Here we introduce a theoretical framework in which long-term plasticity performs an optimization of the postsynaptic response statistics toward a given mean with minimal variance. Consequently, the state of the synapse at the time of plasticity induction determines the ratio of pre- and postsynaptic modifications. Our theory explains the experimentally observed expression loci of the hippocampal and neocortical synaptic potentiation studies we examined. Moreover, the theory predicts presynaptic expression of long-term depression, consistent with experimental observations. At inhibitory synapses, the theory suggests a statistically efficient excitatory-inhibitory balance in which changes in inhibitory postsynaptic response statistics specifically target the mean excitation. Our results provide a unifying theory for understanding the expression mechanisms and functions of long-term synaptic transmission plasticity. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko

    2010-01-01

    The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

  20. Transcriptional abnormalities of hamstring muscle contractures in children with cerebral palsy.

    Science.gov (United States)

    Smith, Lucas R; Chambers, Henry G; Subramaniam, Shankar; Lieber, Richard L

    2012-01-01

    Cerebral palsy (CP) is an upper motor neuron disease that results in a spectrum of movement disorders. Secondary to the neurological lesion, muscles from patients with CP are often spastic and form debilitating contractures that limit range of motion and joint function. With no genetic component, the pathology of skeletal muscle in CP is a response to aberrant complex neurological input in ways that are not fully understood. This study was designed to gain further understanding of the skeletal muscle response in CP using transcriptional profiling correlated with functional measures to broadly investigate muscle adaptations leading to mechanical deficits.Biopsies were obtained from both the gracilis and semitendinosus muscles from a cohort of patients with CP (n = 10) and typically developing patients (n = 10) undergoing surgery. Biopsies were obtained to define the unique expression profile of the contractures and passive mechanical testing was conducted to determine stiffness values in previously published work. Affymetrix HG-U133A 2.0 chips (n = 40) generated expression data, which was validated for selected transcripts using quantitative real-time PCR. Chips were clustered based on their expression and those from patients with CP clustered separately. Significant genes were determined conservatively based on the overlap of three summarization algorithms (n = 1,398). Significantly altered genes were analyzed for over-representation among gene ontologies and muscle specific networks.The majority of altered transcripts were related to increased extracellular matrix expression in CP and a decrease in metabolism and ubiquitin ligase activity. The increase in extracellular matrix products was correlated with mechanical measures demonstrating the importance in disability. These data lay a framework for further studies and development of novel therapies.