WorldWideScience

Sample records for term yielding results

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

    Science.gov (United States)

    Irena F. Creed; Adam T. Spargo; Julia A. Jones; Jim M. Buttle; Mary B. Adams; Fred D. Beall; Eric G. Booth; John L. Campbell; Dave Clow; Kelly Elder; Mark B. Green; Nancy B. Grimm; Chelcy Miniat; Patricia Ramlal; Amartya Saha; Stephen Sebestyen; Dave Spittlehouse; Shannon Sterling; Mark W. Williams; Rita Winkler; Huaxia. Yao

    2014-01-01

    Climate warming is projected to affect forest water yields but the effects are expected to vary.We investigated how forest type and age affect water yield resilience to climate warming. To answer this question, we examined the variability in historical water yields at long-term experimental catchments across Canada and the United States over 5-year cool and warm...

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

    Science.gov (United States)

    Creed, Irena F; Spargo, Adam T; Jones, Julia A; Buttle, Jim M; Adams, Mary B; Beall, Fred D; Booth, Eric G; Campbell, John L; Clow, Dave; Elder, Kelly; Green, Mark B; Grimm, Nancy B; Miniat, Chelcy; Ramlal, Patricia; Saha, Amartya; Sebestyen, Stephen; Spittlehouse, Dave; Sterling, Shannon; Williams, Mark W; Winkler, Rita; Yao, Huaxia

    2014-01-01

    Climate warming is projected to affect forest water yields but the effects are expected to vary. We investigated how forest type and age affect water yield resilience to climate warming. To answer this question, we examined the variability in historical water yields at long-term experimental catchments across Canada and the United States over 5-year cool and warm periods. Using the theoretical framework of the Budyko curve, we calculated the effects of climate warming on the annual partitioning of precipitation (P) into evapotranspiration (ET) and water yield. Deviation (d) was defined as a catchment's change in actual ET divided by P [AET/P; evaporative index (EI)] coincident with a shift from a cool to a warm period – a positive d indicates an upward shift in EI and smaller than expected water yields, and a negative d indicates a downward shift in EI and larger than expected water yields. Elasticity was defined as the ratio of interannual variation in potential ET divided by P (PET/P; dryness index) to interannual variation in the EI – high elasticity indicates low d despite large range in drying index (i.e., resilient water yields), low elasticity indicates high d despite small range in drying index (i.e., nonresilient water yields). Although the data needed to fully evaluate ecosystems based on these metrics are limited, we were able to identify some characteristics of response among forest types. Alpine sites showed the greatest sensitivity to climate warming with any warming leading to increased water yields. Conifer forests included catchments with lowest elasticity and stable to larger water yields. Deciduous forests included catchments with intermediate elasticity and stable to smaller water yields. Mixed coniferous/deciduous forests included catchments with highest elasticity and stable water yields. Forest type appeared to influence the resilience of catchment water yields to climate warming, with conifer and deciduous catchments more susceptible to

  3. Exploring the performance of the SEDD model to predict sediment yield in eucalyptus plantations. Long-term results from an experimental catchment in Southern Italy

    Science.gov (United States)

    Porto, P.; Cogliandro, V.; Callegari, G.

    2018-01-01

    In this paper, long-term sediment yield data, collected in a small (1.38 ha) Calabrian catchment (W2), reafforested with eucalyptus trees (Eucalyptus occidentalis Engl.) are used to validate the performance of the SEdiment Delivery Distributed Model (SEDD) in areas with high erosion rates. At first step, the SEDD model was calibrated using field data collected in previous field campaigns undertaken during the period 1978-1994. This first phase allowed the model calibration parameter β to be calculated using direct measurements of rainfall, runoff, and sediment output. The model was then validated in its calibrated form for an independent period (2006-2016) for which new measurements of rainfall, runoff and sediment output are also available. The analysis, carried out at event and annual scale showed good agreement between measured and predicted values of sediment yield and suggested that the SEDD model can be seen as an appropriate means of evaluating erosion risk associated with manmade plantations in marginal areas. Further work is however required to test the performance of the SEDD model as a prediction tool in different geomorphic contexts.

  4. Care initiation area yields dramatic results.

    Science.gov (United States)

    2009-03-01

    The ED at Gaston Memorial Hospital in Gastonia, NC, has achieved dramatic results in key department metrics with a Care Initiation Area (CIA) and a physician in triage. Here's how the ED arrived at this winning solution: Leadership was trained in and implemented the Kaizen method, which eliminates redundant or inefficient process steps. Simulation software helped determine additional space needed by analyzing arrival patterns and other key data. After only two days of meetings, new ideas were implemented and tested.

  5. Long Term Evaluation of Yield Stability Trend for Cereal Crops in Iran

    Directory of Open Access Journals (Sweden)

    mehdi nassiri mahalati

    2016-05-01

    Full Text Available During the last few decades cereals yield have increased drastically at the national level however, information about yield stability and its resistance to annual environmental variability are scare. In this study long term stability of grin yield of wheat, barley, rice, corn and overall cereals in Iran were evaluated during a 40-year period (1971-2011. Stability analysis was conducted using two different methods. In the first method the residuals of regression between crop yield and time (years were calculated as stability index. For this different segmented regression models including linear, bi-linear and tri-linear were fitted to yield trend data and the best model for each crop was selected based on statistical measures. Absolute residuals (the difference between actual and predicted yields for each year as well as relative residuals (absolute residuals as percent of predicted yield were estimated. In the second method yield stability was estimated from the slope of the regression line between average annual yield of all cereals (environmental index and the yield of each crop in the same year. Results indicted that in wheat and barley absolute and relative residuals were increased during the study period leading to reduction of stability despite considerable yield increment. However, for rice and corn residuals followed a decreasing trend and therefore yield stability of these crops was increased during the last 40 years. The same result was obtained with the environmental index but in this method reduction of yield stability in barley was lower than wheat. Based on the results, yield and yield stability of cereals crops in Iran increased during the last 40 years. However, the percentage increase in stability is lower than that of yield. Application of nitrogen fertilizers was led to reduction in stability. Yield stability of wheat, barley, rice, corn and overall cereals was improved with increasing their cultivated area.

  6. Does heavy traffic have long term implications for crop yields?

    DEFF Research Database (Denmark)

    Nielsen, J. Aa.; Munkholm, Lars Juhl; Schjønning, Per

    Danish soils are subject to increasingly heavier traffic. Today, wheel loads of 6-12 tons are common on e.g. slurry tankers, combines and sugar beet harvesters. Field trials were started in Denmark in spring 2010 to answer the question: "does heavy traffic have long term implications for crop...... by the contractors delivering the machinery for the experimentation. Each year, spring barley (Hordeum vulgare L.) was established after the compaction treatments. s.ince 2013, investigations on biological tillage (root growth by pioneering crops) have been added to the trials. Significant yield losses up to 12.5 dt...

  7. An analytical model of nonproportional scintillator light yield in terms of recombination rates

    International Nuclear Information System (INIS)

    Bizarri, G.; Moses, W. W.; Singh, J.; Vasil'ev, A. N.; Williams, R. T.

    2009-01-01

    Analytical expressions for the local light yield as a function of the local deposited energy (-dE/dx) and total scintillation yield integrated over the track of an electron of initial energy E are derived from radiative and/or nonradiative rates of first through third order in density of electronic excitations. The model is formulated in terms of rate constants, some of which can be determined independently from time-resolved spectroscopy and others estimated from measured light yield efficiency as a constraint assumed to apply in each kinetic order. The rates and parameters are used in the theory to calculate scintillation yield versus primary electron energy for comparison to published experimental results on four scintillators. Influence of the track radius on the yield is also discussed. Results are found to be qualitatively consistent with the observed scintillation light yield. The theory can be applied to any scintillator if the rates of the radiative and nonradiative processes are known

  8. ExEP yield modeling tool and validation test results

    Science.gov (United States)

    Morgan, Rhonda; Turmon, Michael; Delacroix, Christian; Savransky, Dmitry; Garrett, Daniel; Lowrance, Patrick; Liu, Xiang Cate; Nunez, Paul

    2017-09-01

    EXOSIMS is an open-source simulation tool for parametric modeling of the detection yield and characterization of exoplanets. EXOSIMS has been adopted by the Exoplanet Exploration Programs Standards Definition and Evaluation Team (ExSDET) as a common mechanism for comparison of exoplanet mission concept studies. To ensure trustworthiness of the tool, we developed a validation test plan that leverages the Python-language unit-test framework, utilizes integration tests for selected module interactions, and performs end-to-end crossvalidation with other yield tools. This paper presents the test methods and results, with the physics-based tests such as photometry and integration time calculation treated in detail and the functional tests treated summarily. The test case utilized a 4m unobscured telescope with an idealized coronagraph and an exoplanet population from the IPAC radial velocity (RV) exoplanet catalog. The known RV planets were set at quadrature to allow deterministic validation of the calculation of physical parameters, such as working angle, photon counts and integration time. The observing keepout region was tested by generating plots and movies of the targets and the keepout zone over a year. Although the keepout integration test required the interpretation of a user, the test revealed problems in the L2 halo orbit and the parameterization of keepout applied to some solar system bodies, which the development team was able to address. The validation testing of EXOSIMS was performed iteratively with the developers of EXOSIMS and resulted in a more robust, stable, and trustworthy tool that the exoplanet community can use to simulate exoplanet direct-detection missions from probe class, to WFIRST, up to large mission concepts such as HabEx and LUVOIR.

  9. Weed Diversity Affects Soybean and Maize Yield in a Long Term Experiment in Michigan, USA.

    Science.gov (United States)

    Ferrero, Rosana; Lima, Mauricio; Davis, Adam S; Gonzalez-Andujar, Jose L

    2017-01-01

    Managing production environments in ways that promote weed community diversity may enhance both crop production and the development of a more sustainable agriculture. This study analyzed data of productivity of maize (corn) and soybean in plots in the Main Cropping System Experiment (MCSE) at the W. K. Kellogg Biological Station Long-Term Ecological Research (KBS-LTER) in Michigan, USA, from 1996 to 2011. We used models derived from population ecology to explore how weed diversity, temperature, and precipitation interact with crop yields. Using three types of models that considered internal and external (climate and weeds) factors, with additive or non-linear variants, we found that changes in weed diversity were associated with changes in rates of crop yield increase over time for both maize and soybeans. The intrinsic capacity for soybean yield increase in response to the environment was greater under more diverse weed communities. Soybean production risks were greatest in the least weed diverse systems, in which each weed species lost was associated with progressively greater crop yield losses. Managing for weed community diversity, while suppressing dominant, highly competitive weeds, may be a helpful strategy for supporting long term increases in soybean productivity. In maize, there was a negative and non-additive response of yields to the interaction between weed diversity and minimum air temperatures. When cold temperatures constrained potential maize productivity through limited resources, negative interactions with weed diversity became more pronounced. We suggest that: (1) maize was less competitive in cold years allowing higher weed diversity and the dominance of some weed species; or (2) that cold years resulted in increased weed richness and prevalence of competitive weeds, thus reducing crop yields. Therefore, we propose to control dominant weed species especially in the years of low yield and extreme minimum temperatures to improve maize yields

  10. Influence of Previous Crop on Durum Wheat Yield and Yield Stability in a Long-term Experiment

    Directory of Open Access Journals (Sweden)

    Anna Maria Stellacci

    2011-02-01

    Full Text Available Long-term experiments are leading indicators of sustainability and serve as an early warning system to detect problems that may compromise future productivity. So the stability of yield is an important parameter to be considered when judging the value of a cropping system relative to others. In a long-term rotation experiment set up in 1972 the influence of different crop sequences on the yields and on yield stability of durum wheat (Triticum durum Desf. was studied. The complete field experiment is a split-split plot in a randomized complete block design with two replications; the whole experiment considers three crop sequences: 1 three-year crop rotation: sugar-beet, wheat + catch crop, wheat; 2 one-year crop rotation: wheat + catch crop; 3 wheat continuous crop; the split treatments are two different crop residue managements; the split-split plot treatments are 18 different fertilization formulas. Each phase of every crop rotation occurred every year. In this paper only one crop residue management and only one fertilization treatment have been analized. Wheat crops in different rotations are coded as follows: F1: wheat after sugar-beet in three-year crop rotation; F2: wheat after wheat in three-year crop rotation; Fc+i: wheat in wheat + catch crop rotation; Fc: continuous wheat. The following two variables were analysed: grain yield and hectolitre weight. Repeated measures analyses of variance and stability analyses have been perfomed for the two variables. The stability analysis was conducted using: three variance methods, namely the coefficient of variability of Francis and Kannenberg, the ecovalence index of Wricke and the stability variance index of Shukla; the regression method of Eberhart and Russell; a method, proposed by Piepho, that computes the probability of one system outperforming another system. It has turned out that each of the stability methods used has enriched of information the simple variance analysis. The Piepho

  11. Going Solar Yields Long-Term Economical, Educational Benefits

    Science.gov (United States)

    von Moos, Brian

    2009-01-01

    Going solar is not an easy decision, but a long-term investment with a potentially substantial up-front cost. While some schools have enough capital in reserve, can raise bond money, or can solicit sufficient donations, many schools rely on creative financial programs to make a solar energy system economically feasible. Thinking about going solar…

  12. Yield gap analysis in long-term experiments with intensive rice cultivation

    International Nuclear Information System (INIS)

    Laureles, E.V.; Correa, T. Jr.; Buresh, R.J.

    2007-01-01

    The long-term continuous cropping experiment at IRRI is cultivated with three rice crops in a year, making it the world's most intensively cropped long-term rice experiment. The availability of comprehensive rice production records, compiled weather data, and tested crop models provides a means to evaluate long-term trends in measured and potential yields and yield gaps in this rice production system. Yield trends were assessed using the highest yielding cultivar in each cropping season from 1979 to 2005. Potential yield of the highest yielding cultivar in each season was determined using three rice models (ORYZA, TERM, and CERES) run with the actual transplanting and harvest dates for the cultivar. The yield gap was determined from the difference between the simulated potential grain yield and the measured grain yield. Measured and potential yields and the yield gap varied across seasons and years. Measured yields were higher in the dry season than in the early and late wet seasons. The yield gap tended to be higher in the wet season than in the dry season. Climatic parameters, particularly solar radiation, influenced the performance of rice cultivars. The relatively larger yield gaps in the late wet season than in the dry season were associated with increased spikelet sterility. The cumulative measured yield for the three annual rice crop was near 80 percent of the annual yield potential in years with best practices for fertilizer N and crop management. The long term trends suggest that effective timing and rates of N fertilization and effective control of diseases were critical in achieving 80 percent of the annual yield potential

  13. Long-term Miscanthus Yields Influenced by Location, Genotype, Row Distance, Fertilization and Harvest Season

    DEFF Research Database (Denmark)

    Ugilt Larsen, Søren; Jørgensen, Uffe; Kjeldsen, Jens Bonderup

    2014-01-01

    Long-term yield studies in perennial crops like miscanthus are important to determine mean annual energy yield and the farmer’s economy. In two Danish field trials, annual yield of two miscanthus genotypes was followed over a 20-year period. The trials were established in 1993 on loamy sand...

  14. Computer simulation of yielding supports under static and short-term dynamic load

    Directory of Open Access Journals (Sweden)

    Kumpyak Oleg

    2018-01-01

    Full Text Available Dynamic impacts that became frequent lately cause large human and economic losses, and their prevention methods are not always effective and reasonable. The given research aims at studying the way of enhancing explosion safety of building structures by means of yielding supports. The paper presents results of numerical studies of strength and deformation property of yielding supports in the shape of annular tubes under static and short-term dynamic loading. The degree of influence of yielding supports was assessed taking into account three peculiar stages of deformation: elastic; elasto-plastic; and elasto-plastic with hardening. The methodology for numerical studies performance was described using finite element analysis with program software Ansys Mechanical v17.2. It was established that rigidity of yielding supports influences significantly their stress-strain state. The research determined that with the increase in deformable elements rigidity dependence between load and deformation of the support in elastic and plastic stages have linear character. Significant reduction of the dynamic response and increase in deformation time of yielding supports were observed due to increasing the plastic component. Therefore, it allows assuming on possibility of their application as supporting units in RC beams.

  15. Donor management parameters and organ yield: single center results.

    Science.gov (United States)

    Marshall, George Ryne; Mangus, Richard S; Powelson, John A; Fridell, Jonathan A; Kubal, Chandrashekhar A; Tector, A Joseph

    2014-09-01

    Management of organ donors in the intensive care unit is an emerging subject in critical care and transplantation. This study evaluates organ yield outcomes for a large number of patients managed by the Indiana Organ Procurement Organization. This is a retrospective review of intensive care unit records from 2008-2012. Donor demographic information and seven donor management parameters (DMP) were recorded at admission, consent, 12 h after consent, and before procurement. Three study groups were created: donors meeting 0-3, 4, or 5-7 DMP. Active donor Organ Procurement Organization management began at consent; so, data analysis focuses on the 12-h postconsent time point. Outcomes included organs transplanted per donor (OTPD) and transplantation of individual solid organs. Complete records for 499 patients were reviewed. Organ yield was 1415 organs of 3992 possible (35%). At 12 h, donors meeting more DMP had more OTPD: 2.2 (0-3) versus 3.0 (4) versus 3.5 (5-7) (P organ except intestine. Oxygen tension, vasopressor use, and central venous pressure were the most frequent independent predictors of organ usage. There were significantly more organs transplanted for donors meeting all three of these parameters (4.5 versus 2.7, P organs, with analysis of individual parameters suggesting that appropriate management of oxygenation, volume status, and vasopressor use could lead to more organs procured per donor. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Second mid-term business plan results

    International Nuclear Information System (INIS)

    Kusakabe, Masashi; Matsushita, Satoru; Miyahara, Nobuyuki

    2011-01-01

    This feature presented the second mid-term business plan results of National Institute of Radiological Sciences (NIRS). NIRS started its second five-year-term project in 2006, focusing on radiation life science research, and radiation protection and emergency medicine. The radiation life science research had been conducted at research centers on heavy charged particle therapy for cancer treatment, assessment of radiation effects for radiotherapy, and molecular imaging for early diagnosis and treatment planning. NIRS also provided international open laboratory for experts of many fields to collaborate to enhance the levels of radiological sciences. Fundamental technology center had supported research centers through technology development. (T. Tanaka)

  17. Modeling Long Term Corn Yield Response to Nitrogen Rate and Crop Rotation

    Directory of Open Access Journals (Sweden)

    Laila Alejandra Puntel

    2016-11-01

    Full Text Available Improved prediction of optimal N fertilizer rates for corn (Zea mays L. can reduce N losses and increase profits. We tested the ability of the Agricultural Production Systems sIMulator (APSIM to simulate corn and soybean (Glycine max L. yields, the economic optimum N rate (EONR using a 16-year field-experiment dataset from central Iowa, USA that included two crop sequences (continuous corn and soybean-corn and five N fertilizer rates (0, 67, 134, 201, and 268 kg N ha-1 applied to corn. Our objectives were to: a quantify model prediction accuracy before and after calibration, and report calibration steps; b compare crop model-based techniques in estimating optimal N rate for corn; and c utilize the calibrated model to explain factors causing year to year variability in yield and optimal N. Results indicated that the model simultaneously simulated well long-term crop yields response to N (relative root mean square error, RRMSE of 19.6% before and 12.3% after calibration, which provided strong evidence that important soil and crop processes were accounted for in the model. The prediction of EONR was more complex and had greater uncertainty than the prediction of crop yield (RRMSE of 44.5% before and 36.6% after calibration. For long-term site mean EONR predictions, both calibrated and uncalibrated versions can be used as the 16-yr mean differences in EONR’s were within the historical N rate error range (40 to 50 kg N ha-1. However, for accurate year-by-year simulation of EONR the calibrated version should be used. Model analysis revealed that higher EONR values in years with above normal spring precipitation were caused by an exponential increase in N loss (denitrification and leaching with precipitation. We concluded that long term experimental data were valuable in testing and refining APSIM predictions. The model can be used as a tool to assist N management guidelines in the US Midwest and we identified five avenues on how the model can add

  18. Modeling Long-Term Corn Yield Response to Nitrogen Rate and Crop Rotation.

    Science.gov (United States)

    Puntel, Laila A; Sawyer, John E; Barker, Daniel W; Dietzel, Ranae; Poffenbarger, Hanna; Castellano, Michael J; Moore, Kenneth J; Thorburn, Peter; Archontoulis, Sotirios V

    2016-01-01

    Improved prediction of optimal N fertilizer rates for corn ( Zea mays L. ) can reduce N losses and increase profits. We tested the ability of the Agricultural Production Systems sIMulator (APSIM) to simulate corn and soybean ( Glycine max L. ) yields, the economic optimum N rate (EONR) using a 16-year field-experiment dataset from central Iowa, USA that included two crop sequences (continuous corn and soybean-corn) and five N fertilizer rates (0, 67, 134, 201, and 268 kg N ha -1 ) applied to corn. Our objectives were to: (a) quantify model prediction accuracy before and after calibration, and report calibration steps; (b) compare crop model-based techniques in estimating optimal N rate for corn; and (c) utilize the calibrated model to explain factors causing year to year variability in yield and optimal N. Results indicated that the model simulated well long-term crop yields response to N (relative root mean square error, RRMSE of 19.6% before and 12.3% after calibration), which provided strong evidence that important soil and crop processes were accounted for in the model. The prediction of EONR was more complex and had greater uncertainty than the prediction of crop yield (RRMSE of 44.5% before and 36.6% after calibration). For long-term site mean EONR predictions, both calibrated and uncalibrated versions can be used as the 16-year mean differences in EONR's were within the historical N rate error range (40-50 kg N ha -1 ). However, for accurate year-by-year simulation of EONR the calibrated version should be used. Model analysis revealed that higher EONR values in years with above normal spring precipitation were caused by an exponential increase in N loss (denitrification and leaching) with precipitation. We concluded that long-term experimental data were valuable in testing and refining APSIM predictions. The model can be used as a tool to assist N management guidelines in the US Midwest and we identified five avenues on how the model can add value toward

  19. Modeling long-term yield trends of Miscanthusxgiganteus using experimental data from across Europe

    DEFF Research Database (Denmark)

    Lesur, Claire; Jeuffroy, Marie-Hélène; Makowski, David

    2013-01-01

    and the ceiling phases and (ii) to determine whether M. giganteus ceiling phase is followed by a decline phase where yields decrease across years. Data were analyzed through comparisons between a set of statistical growth models. The model that best fitted the experimental data included a decline phase....... The decline intensity and the value of several other model parameters, such as the maximum yield reached during the ceiling phase or the duration of the establishment phase, were highly variable. The highest maximum yields were obtained in the experiments located in the southern part of the studied area....... giganteus is known to have an establishment phase during which annual yields increased as a function of crop age, followed by a ceiling phase, the duration of which is unknown. We built a database including 16 European long-term experiments (i) to describe the yield evolution during the establishment...

  20. A Methodology to Infer Crop Yield Response to Climate Variability and Change Using Long-Term Observations

    Directory of Open Access Journals (Sweden)

    Manfred A. Lange

    2013-11-01

    Full Text Available A new methodology to extract crop yield response to climate variability and change from long-term crop yield observations is presented in this study. In contrast to the existing first-difference approach (FDA, the proposed methodology considers that the difference in value between crop yields of two consecutive years reflects necessarily the contributions of climate and management conditions, especially at large spatial scales where both conditions may vary significantly from one year to the next. Our approach was applied to remove the effect of non-climatic factors on crop yield and, hence, to isolate the effect of the observed climate change between 1961 and 2006 on three widely crops grown in three Mediterranean countries—namely wheat, corn and potato—using national-level crop yield observations’ time-series. Obtained results show that the proposed methodology provides us with a ground basis to improve substantially our understanding of crop yield response to climate change at a scale that is relevant to large-scale estimations of agricultural production and to food security analyses; and therefore to reduce uncertainties in estimations of potential climate change effects on agricultural production. Furthermore, a comparison of outputs of our methodology and FDA outputs yielded a difference in terms of maize production in Egypt, for example, that exceeds the production of some neighbouring countries.

  1. Long-term conventional and no-tillage effects on field hydrology and yields of a dryland crop rotation

    Science.gov (United States)

    Semiarid dryland crop yields with no-till, NT, residue management are often greater than stubble-mulch, SM, tillage as a result of improved soil conditions and water conservation, but information on long-term tillage effects on field hydrology and sustained crop production are needed. Our objective ...

  2. Long term results of mandibular distraction

    Directory of Open Access Journals (Sweden)

    Batra Puneet

    2006-03-01

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

  3. Analyzing and modelling the effect of long-term fertilizer management on crop yield and soil organic carbon in China.

    Science.gov (United States)

    Zhang, Jie; Balkovič, Juraj; Azevedo, Ligia B; Skalský, Rastislav; Bouwman, Alexander F; Xu, Guang; Wang, Jinzhou; Xu, Minggang; Yu, Chaoqing

    2018-06-15

    This study analyzes the influence of various fertilizer management practices on crop yield and soil organic carbon (SOC) based on the long-term field observations and modelling. Data covering 11 years from 8 long-term field trials were included, representing a range of typical soil, climate, and agro-ecosystems in China. The process-based model EPIC (Environmental Policy Integrated Climate model) was used to simulate the response of crop yield and SOC to various fertilization regimes. The results showed that the yield and SOC under additional manure application treatment were the highest while the yield under control treatment was the lowest (30%-50% of NPK yield) at all sites. The SOC in northern sites appeared more dynamic than that in southern sites. The variance partitioning analysis (VPA) showed more variance of crop yield could be explained by the fertilization factor (42%), including synthetic nitrogen (N), phosphorus (P), potassium (K) fertilizers, and fertilizer NPK combined with manure. The interactive influence of soil (total N, P, K, and available N, P, K) and climate factors (mean annual temperature and precipitation) determine the largest part of the SOC variance (32%). EPIC performs well in simulating both the dynamics of crop yield (NRMSE = 32% and 31% for yield calibration and validation) and SOC (NRMSE = 13% and 19% for SOC calibration and validation) under diverse fertilization practices in China. EPIC can assist in predicting the impacts of different fertilization regimes on crop growth and soil carbon dynamics, and contribute to the optimization of fertilizer management for different areas in China. Copyright © 2018. Published by Elsevier B.V.

  4. 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.

  5. 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.).

  6. Comparison of Domestic and Foreign Commercial Brown Layer Hens in Terms of Yield Characteristics in Free-Range Raising System

    Directory of Open Access Journals (Sweden)

    İsmail Türker

    2017-07-01

    Full Text Available This research was carried out under producer conditions to determine the appropriate hen material to be used in the free range laying system. For this purpose, the foreign brown commercial layer genotype which coded YB and native brown egg layer Atak-S genotype was compared in terms of yield and egg quality characteristics. This study included 150 hens from each genotype and a total of 300 chickens were used. Each genotype divided into three groups among themselves and 50 hens were raised each group. In the poultry house with deep-litter ground system, 5 chickens were raised in the unit area (m2 and, 4 m2 grazing area was allocated per each hen in the grazing area. The pullets that hatched on the same day were obtained from a commercial firm at 16 weeks of age. The study was carried out until 80 weeks of age. Egg yield and egg quality characteristics were determined during this period. There was no difference between the genotypes in terms of 50% egg yield age, egg weight, hen-day egg yield, hen-house egg yield, viability, albumen index, yolk index, haugh unit and yolk color. In contrast, the difference between the genotypes was found to be important in terms of body weight at weeks of 18th and 80th age, feed consumption, feed conversation ratio, shape index, shell thickness, density, meat-blood spot ratio and egg shell color. In this study, genotypes were not superior to each other in terms of all traits. However, as a result of the economic analyzes made in consideration of market conditions and observations made in terms of animal sensitivities, it was concluded that the Atak-S genotype was more suitable for free-range egg production system.

  7. 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)

  8. Wheat Yield Trend and Soil Fertility Status in Long Term Rice-Rice-Wheat Cropping System

    Directory of Open Access Journals (Sweden)

    Nabin Rawal

    2015-12-01

    Full Text Available A long-term soil fertility experiment under rice-rice-wheat system was performed to evaluate the long term effects of inorganic fertilizer and manure applications on soil properties and grain yield of wheat. The experiment began since 1978 was laid out in randomized complete block design with 9 treatments replicated 3 times. From 1990 onwards, periodic modifications have been made in all the treatments splitting the plots in two equal halves of 4 x 3 m2 leaving one half as original. In the original treatments, recent data revealed that the use of Farm Yard Manure (FYM @10 t ha-1 gave significantly (P≤0.05 higher yield of 2.3 t ha-1 in wheat, whereas control plot gave the lowest grain yield of 277 kg ha-1. Similarly, in the modified treatments, the use of FYM @10 t ha-1 along with inorganic Nitrogen (N and Potassium oxide (K2O @ 50 kg ha-1 produced significantly (P≤0.05 the highest yield of 2.4 t/ha in wheat. The control plot with an indigenous nutrient supply only produced wheat yield of 277 kg ha-1 after 35th year completion of rice-rice-wheat system. A sharp decline in wheat yields was noted in minus N, phosphorus (P, Potassium (K treatments during recent years. Yields were consistently higher in the N:P2O5:K2O and FYM treatments than in treatments, where one or more nutrients were lacking. The application of P2O5 and K2O caused a partial recovery of yield in P and K deficient plots. There was significant (P≤0.05 effect of use of chemical fertilizers and manure on soil properties. The soil analysis data showed an improvement in soil pH (7.8, soil organic matter (4.1%, total N content (0.16%, available P (503.5 kg P2O5 ha-1 and exchangeable K (137.5 kg K2O ha-1 in FYM applied treatments over all other treatments. The findings showed that the productivity of the wheat can be increased and sustained by improving nutrient through the integrated use of organic and inorganic manures in long term.

  9. 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

  10. Chlorella vulgaris vs cyanobacterial biomasses: Comparison in terms of biomass productivity and biogas yield

    International Nuclear Information System (INIS)

    Mendez, Lara; Mahdy, Ahmed; Ballesteros, Mercedes; González-Fernández, Cristina

    2015-01-01

    Highlights: • Cyanobacteria and C. vulgaris were compared in terms of growth and methane production. • Biomasses were subjected to anaerobic digestion without applying any disruption method. • Cyanobacteria showed an increased methane yield in comparison with C. vulgaris. - Abstract: The aim of the present study was to compare cyanobacteria strains (Aphanizomenon ovalisporum, Anabaena planctonica, Borzia trilocularis and Synechocystis sp.) and microalgae (Chlorella vulgaris) in terms of growth rate, biochemical profile and methane production. Cyanobacteria growth rate ranged 0.5–0.6 day −1 for A. planctonica, A. ovalisporum and Synecochystis sp. and 0.4 day −1 for B. tricularis. Opposite, C. vulgaris maximum growth rate was double (1.2 day −1 ) than that of cyanobacteria. Regarding the methane yield, microalgae C. vulgaris averaged 120 mL CH 4 g COD in −1 due to the presence of a strong cell wall. On the other hand, anaerobic digestion of cyanobacteria supported higher methane yields. B. trilocularis and A. planctonica presented 1.42-fold higher methane yield than microalgae while this value was raised to approximately 1.85-fold for A. ovalisporum and Synechochystis sp. In the biogas production context, this study showed that the low growth rates of cyanobacteria can be overcome by their increased anaerobic digestibility when compared to their microalgae counterpartners, such is the case of C. vulgaris

  11. NUMERICAL SIMULATION OF YIELDING SUPPORTS IN THE SHAPE OF ANNULAR TUBES UNDER STATIC AND SHORT-TERM DYNAMIC LOADING

    Directory of Open Access Journals (Sweden)

    Oleg G. Kumpyak

    2017-12-01

    Full Text Available Occurrence of extreme man-made impacts on buildings and structures has become frequent lately as a consequence of condensed explosives or explosive combustion of gas- vapor or air-fuel mixtures. Such accidents involve large human and economic losses, and their prevention methods are not always effective and reasonable. The given research aims at studying the way of enhancing explosion safety of building structures by means of yielding supports. The paper presents results of numerical studies (finite element, 3D nonlinear of strength and deformability of yielding supports in the shape of annular tubes under static and short-term dynamic loading. The degree of influence of yielding supports was assessed taking into account three peculiar stages of deformation: elastic; elasto-plastic; elasto-plastic with hardening. The methodology for numerical studies performance was described. It was established that rigidity of yielding supports influences significantly their stress-strain state. The research determined that with increase of deformable elements rigidity dependency between load and deformation of yielding supports in elastic and plastic stages have linear character. Significant reduction of dynamic response and increase of deformation time of yielding supports was observed by increasing the plastic component. Therefore it allows assuming on possibility of their application as supporting units in reinforced concrete constructions

  12. [Effect of long-term application of NPK fertilizer on maize yield and yellow soil nutrients sustainability in Guizhou, China].

    Science.gov (United States)

    Liu, Yan Ling; Li, Yu; Zhang, Ya Rong; Huang, Xing Cheng; Zhang, Wen An; Jiang, Tai Ming

    2017-11-01

    A long-term fertilization field experiment was conducted to investigate the effect of nitrogen (N), phosphorus (P), and potassium (K) fertilizer on maize relative yield, yield-increasing effect and the changes of nutrients in yellow soil in Guizhou Province. Five fertilizer combinations were evaluated, including balanced fertilization (NPK) and nutrient deficiency treatments (N, NK, NP, and PK). The maize relative yield, contribution efficiency of N, P, K fertilizer application, sustainability index of soil N, P, K nutrients, and other indicators were measured. The results revealed that the balanced fertilization (NPK) significantly increased maize yield, and the average yield under each treatment ranked as: NPK>NP>NK>PK>CK. The contribution efficiency and agronomic efficiency of N, P, K fertilizer application was N>P>K. The fertilization dependence was ranked as: combined application of N, P and K>N>P>K. But in the lack of P treatment (NK), the maize relative yield significantly decreased at a speed of 1.4% per year, with the contribution efficiency and fertilization dependence of applied P significantly increasing at a speed of 2.3% per year and 1.4% per year, respectively. Over time, the effect of P fertilizer on maize yield gradually became equal to that of N fertilizer. The pH and soil organic matter content were the lowest in the P-lack treatment (NK), while they were higher in the N-lack treatment (PK). The application of chemical P significantly improved the sustainability index of soil P, but the application of chemical N and K did not significantly change the sustainability index of soil N and K nutrients compared to the N- and K-lack treatments, respectively. In summary, the use of balanced fertilizer application is critical for achieving high maize yield in typical yellow soil regions in Guizhou Province. P and N fertilizers are equally important for improving maize yield, and long-term application of unbalanced chemical fertilizer, especially the lack

  13. Institutional Ownership, Board of Directors and Yield Spreads in Long- and Medium-term Corporate Bonds and Sukuk

    Directory of Open Access Journals (Sweden)

    Noriza Mohd Saad

    2018-01-01

    Full Text Available Previous studies documented that type of investor significantly affects the performance of bonds and sukuk. These studies showed that the yield to maturity (YTM of bonds and sukuk are significantly associated with institutional investors. This association is because institutional investors actively monitor the performance of bonds and sukuk. Apart from the type of investor, the roles played by the board of directors (BOD in decision making significantly influence the performance of bonds and sukuk, especially the YTM. This study aims to investigate the relationship between institutional ownerships and the BOD and yield spreads of long- and medium-term corporate bonds and sukuk. Data are obtained from firm issuers’ annual reports, Bond Info Hub of Malaysia Central Bank, Department of Malaysia Statistics and Bloomberg from 2000 to 2014. The study employed unbalanced panel data approach for multivariate robust regression, OLS, fixed-effect, and random-effect models. Results revealed that the presence of top-six institutional investors and characteristics of the BOD exert a significant negative effect on the yield spreads. The findings are also consistent with the agency cost of debt theory, which suggests that long-term bonds carry a lower cost of defaults than medium-term bonds.

  14. Long-term results of PTFE grafts.

    Science.gov (United States)

    Hedin, Ulf

    2015-01-01

    Vascular surgeons are essential in "lifeline" creation for hemodialysis patients and should be the central player in any multidisciplinary access service together with nephrologists, dialysis staff and interventional radiology. In this position, access surgeons are involved in complicated clinical decision making regarding primary and secondary access selection, which throughout the last decade has been largely aided, and influenced, by national and international guidelines as well as other initiatives. These recommendations, unanimously and appropriately, advocate the placement of native fistulas over synthetic grafts (the majority grafts from expanded polytetrafluoroethylene, ePTFE, herein referred to as PTFE) based on the superiority of fistulas with respect to complications such as infections and thrombosis. Nevertheless, the use of PTFE grafts for hemodialysis access is an accepted and firmly established alternative to native fistulas where data today reveal unwanted consequences to overinterpretation of established guidelines such as increased catheter use. This information highlights a need for an adjustment of access selection strategies based on patient-centered algorithms. Here, available results on PTFE graft performance in hemodialysis access is recapitulated, with respect to both conventional grafts and technical modifications, and conclude with a modified approach to primary access selection.

  15. Long-term effects of lowland properties system on soil physicochemical properties and rice yield in Ashanti Region of Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Obalum, S. E.; Oppong, J.; Nwite, J. C.; Watanabe, Y.; Buri, M. M.; Igwe, C. A.; Wakatsuki, T.

    2012-11-01

    Lowland sawah is viewed as a sustainable alternative to traditional rice culture in West Africa. Sawah (a bund-demarcated, puddled, leveled, and water-regulated rice field) has received growing research attention lately, but no data exist yet on the systems long-term agronomic impact. In a clayey inland-valley soil in southern Ghana, 10-year-old sawah plots (OSP), fresh sawah plots (FSP), and non-sawah plots (NSP) were maintained under both ponded and nonponded conditions in 2007. The OSP enhanced soil status of exchangeable nutrients compared to NSP. There were relative improvements in soil bulk density, total porosity, and field moisture content (OSP = FSP > NSP), with clear benefits of ponding over non-ponding in OSP. The NSP was so unsustainable that it showed less favourable values of these variables than an adjacent fallowed plot. These soil variables deteriorated with time, with significant differences in FSP. Soil moisture retention data for tension range of 0-300 kPa depicted the importance of puddling and ponding. During 2001-2009, OSP consistently out-yielded NSP by five times on average. During 2007-2009 when all three plots co-existed, grain yields averaged 5.80, 4.80 and 1.10 Mg ha-1 in OSP, FSP and NSP, respectively. In 2007 yields, OSP minus FSP was higher than NSP; in 2008/2009, the opposite prevailed. These results highlight the agronomic benefits of continuous sawah-based rice production. Although the positive effects of puddling on the soil hydrophysical properties were largely responsible for the wide margin in yield between sawah and traditional systems, other yield-enhancing factors, particularly bunds for water control, were also lacking in the latter. (Author) 37 refs.

  16. Estimation of the yield of poplars in plantations of fast-growing species within current results

    Directory of Open Access Journals (Sweden)

    Martin Fajman

    2009-01-01

    Full Text Available Current results are presented of allometric yield estimates of the poplar short rotation coppice. According to a literature review it is obvious that yield estimates, based on measurable quantities of a growing stand, depend not only on the selected tree specie or its clone, but also on the site location. The Jap-105 poplar clone (P. nigra x P. maximowiczii allometric relations were analyzed by regression methods aimed at the creation of the yield estimation methodology at a testing site in Domanínek. Altogether, the twelve polynomial dependences of particular measured quantities approved the high empirical data conformity with the tested regression model (correlation index from 0.9033 to 0.9967. Within the forward stepwise regression, factors were selected, which explain best examined estimates of the total biomass DM; i.e. d.b.h. and stem height. Furthermore, the KESTEMONT’s (1971 mo­del was verified with a satisfying conformity as well. Approving presented yield estimation methods, the presented models will be checked in a large-scale field trial.

  17. Reverse transcription using random pentadecamer primers increases yield and quality of resulting cDNA

    DEFF Research Database (Denmark)

    Stangegaard, Michael; Dufva, I.H.; Dufva, Hans Martin

    2006-01-01

    oligonucleotides (pentadecamers) consistently, yielded at least 2 fold as much cDNA as did random hexamers using either-poly(A) RNA or an amplified version of messenger RNA (aRNA) as a template. The cDNA generated using pentadecamers did not differ in size distribution or the amount of incorporated label compared...... with cDNA generated with random hexamers. The increased efficiency of priming using random pentadecamers resulted in reverse transcription of > 80% of the template aRNA, while random hexamers induced reverse transcription of only 40% of the template aRNA. This suggests a better coverage...... that random pentadecamers can replace random hexamers in reverse transcription reactions on both poly(A) RNA and amplified RNA, resulting in higher cDNA yields and quality....

  18. SiO2-Ta2O5 sputtering yields: simulated and experimental results

    International Nuclear Information System (INIS)

    Vireton, E.; Ganau, P.; Mackowski, J.M.; Michel, C.; Pinard, L.; Remillieux, A.

    1994-09-01

    To improve mirrors coating, we have modeled sputtering of binary oxide targets using TRIM code. First, we have proposed a method to calculate TRIM input parameters using on the one hand thermodynamic cycle and on the other hand Malherbe's results. Secondly, an iterative processing has provided for oxide steady targets caused by ionic bombardment. Thirdly, we have exposed a model to get experimental sputtering yields. Fourthly, for (Ar - SiO 2 ) pair, we have determined that steady target is a silica one. A good agreement between simulated and experimental yields versus ion incident angle has been found. For (Ar - Ta 2 O 5 ) pair, we have to introduce preferential sputtering concept to explain discrepancy between simulation and experiment. In this case, steady target is tantalum monoxide. For (Ar - Ta(+O 2 ) pair, tantalum sputtered by argon ions in reactive oxygen atmosphere, we have to take into account new concept of oxidation stimulated by ion beam. We have supposed that tantalum target becomes a Ta 2 O 5 one in reactive oxygen atmosphere. Then, following mechanism is similar to previous pair. We have obtained steady target of tantalum monoxide too. Comparison between simulated and experimental sputtering yields versus ion incident angle has given very good agreement. By simulation, we have found that tantalum monoxide target has at least 15 angstrom thickness. Those results are compatible with Malherbe's and Taglauer's ones. (authors)

  19. Prediction of yield and long-term failure of oriented polypropylene: kinetics and anisotropy

    NARCIS (Netherlands)

    van Erp, T.B.; Reynolds, C.T.; Peijs, T.; van Dommelen, J.A.W.; Govaert, L.E.

    2009-01-01

    The time-dependent yield and failure behavior of off-axis loaded uniaxially oriented polypropy-lene tape is investigated. The yield and failure behavior is described with an anisotropic vis-coplastic model. A viscoplastic flow rule is used with an equivalent stress, based on Hill’sanisotropic yield

  20. Early Extinction after Fear Conditioning Yields a Context-Independent and Short-Term Suppression of Conditional Freezing in Rats

    Science.gov (United States)

    Chang, Chun-hui; Maren, Stephen

    2009-01-01

    Extinction of Pavlovian fear conditioning in rats is a useful model for therapeutic interventions in humans with anxiety disorders. Recently, we found that delivering extinction trials soon (15 min) after fear conditioning yields a short-term suppression of fear, but little long-term extinction. Here, we explored the possible mechanisms underlying…

  1. Cover crop rotations in no-till system: short-term CO2 emissions and soybean yield

    Directory of Open Access Journals (Sweden)

    João Paulo Gonsiorkiewicz Rigon

    Full Text Available ABSTRACT: In addition to improving sustainability in cropping systems, the use of a spring and winter crop rotation system may be a viable option for mitigating soil CO2 emissions (ECO2. This study aimed to determine short-term ECO2 as affected by crop rotations and soil management over one soybean cycle in two no-till experiments, and to assess the soybean yields with the lowest ECO2. Two experiments were carried out in fall-winter as follows: i triticale and sunflower were grown in Typic Rhodudalf (TR, and ii ruzigrass, grain sorghum, and ruzigrass + grain sorghum were grown in Rhodic Hapludox (RH. In the spring, pearl millet, sunn hemp, and forage sorghum were grown in both experiments. In addition, in TR a fallow treatment was also applied in the spring. Soybean was grown every year in the summer, and ECO2 were recorded during the growing period. The average ECO2 was 0.58 and 0.84 g m2 h–1 with accumulated ECO2 of 5,268 and 7,813 kg ha–1 C-CO2 in TR and RH, respectively. Sunn hemp, when compared to pearl millet, resulted in lower ECO2 by up to 12 % and an increase in soybean yield of 9% in TR. In RH, under the winter crop Ruzigrazz+Sorghum, ECO2 were lower by 17%, although with the same soybean yield. Soil moisture and N content of crop residues are the main drivers of ECO2 and soil clay content seems to play an important role in ECO2 that is worthy of further studies. In conclusion, sunn hemp in crop rotation may be utilized to mitigate ECO2 and improve soybean yield.

  2. Analysis of effects of updated decay and fission yield data on ORIGEN 2 results

    International Nuclear Information System (INIS)

    Daniel, P.R.

    1993-01-01

    Work has been performed to improve the accuracy of ORIGEN2 results by updating both the decay library and the fission yield data in the cross-section library. This effort was performed under the auspices of Oak Ridge National Laboratory (ORNL) to ensure that ORIGEN2 uses the most up-to-date data. The impact of the new data was then quantitatively evaluated by solving a set of standard light water reactor (LWR) problems solved with ORIGEN2. The ORIGEN code, developed at ORNL in the late 1960's, is a point depletion code used to determine the composition and characteristics of spent fuel. The results from calculations performed with the code often form the basis for the study and design of reprocessing plants, spent-fuel shipping casks, waste treatment systems, and disposal facilities. The decay data were updated using data from ENDF/B-VI; fission yield data were updated using data from ENDF/B-V. The impact of these new data was then evaluated

  3. Strong morphological and crystallographic texture and resulting yield strength anisotropy in selective laser melted tantalum

    International Nuclear Information System (INIS)

    Thijs, Lore; Montero Sistiaga, Maria Luz; Wauthle, Ruben; Xie, Qingge; Kruth, Jean-Pierre; Van Humbeeck, Jan

    2013-01-01

    Selective laser melting (SLM) makes use of a high energy density laser beam to melt successive layers of metallic powders in order to create functional parts. The energy density of the laser is high enough to melt refractory metals like Ta and produce mechanically sound parts. Furthermore, the localized heat input causes a strong directional cooling and solidification. Epitaxial growth due to partial remelting of the previous layer, competitive growth mechanism and a specific global direction of heat flow during SLM of Ta result in the formation of long columnar grains with a 〈1 1 1〉 preferential crystal orientation along the building direction. The microstructure was visualized using both optical and scanning electron microscopy equipped with electron backscattered diffraction and the global crystallographic texture was measured using X-ray diffraction. The thermal profile around the melt pool was modeled using a pragmatic model for SLM. Furthermore, rotation of the scanning direction between different layers was seen to promote the competitive growth. As a result, the texture strength increased to as large as 4.7 for rotating the scanning direction 90° every layer. By comparison of the yield strength measured by compression tests in different orientations and the averaged Taylor factor calculated using the viscoplastic self-consistent model, it was found that both the morphological and crystallographic texture observed in SLM Ta contribute to yield strength anisotropy

  4. Long-term effects of conventional and reduced tillage systems on soil condition and yield of maize

    Science.gov (United States)

    Rátonyi, Tamás; Széles, Adrienn; Harsányi, Endre

    2015-04-01

    As a consequence of operations which neglect soil condition and consist of frequent soil disturbance, conventional tillage (primary tillage with autumn ploughing) results in the degradation and compaction of soil structure, as well as the reduction of organic matter. These unfavourable processes pose an increasing economic and environmental protection problem today. The unfavourable physical condition of soils on which conventional tillage was performed indicate the need for preserving methods and tools. The examinations were performed in the multifactorial long-term tillage experiment established at the Látókép experiment site of DE MÉK. The experiment site is located in the Hajdúság loess ridge (Hungary) and its soil is loess-based calcareous chernozem with deep humus layer. The physical soil type is mid-heavy adobe. The long-term experiment has a split-split plot design. The main plots are different tillage methods (autumn ploughing, spring shallow tillage) without replication. In this paper, the effect of conventional and reduced (shallow) tillage methods on soil conditions and maize yield was examined. A manual penetrometer was used to determine the physical condition and compactedness of the soil. The soil moisture content was determined with deep probe measurement (based on capacitive method). In addition to soil analyses, the yield per hectare of different plots was also observed. In reduced tillage, one compacted layer is shown in the soil resistance profile determined with a penetrometer, while there are two compacted layers in autumn ploughing. The highest resistance was measured in the case of primary tillage performed at the same depth for several years in the compacted (pan disk) layer developed under the developed layer in both treatments. The unfavourable impact of spring shallow primary tillage on physical soil conditions is shown by the fact that the compaction of the pan disk exceed the critical limit value of 3 MPa. Over the years, further

  5. Long-term Low Radiation Decreases Leaf Photosynthesis, Photochemical Efficiency and Grain Yield in Winter Wheat

    DEFF Research Database (Denmark)

    Mu, H; Jiang, D; Wollenweber, Bernd

    2010-01-01

    the impact of low radiation on crop growth, photosynthesis and yield. Grain yield losses and leaf area index (LAI) reduction were less than the reduction in solar radiation under both shading treatment in both cultivars. Compared with the control (S0), grain yield only reduced 6.4 % and 9.9 % under 22.......0-22.9 % (S1) and 29.5-49.6 % (S2), which was consistent with the reduction in radiation. The reduction in LAI was partially compensated by increases in the fraction of the top and bottom leaf area to the total leaf area, which facilitated to intercept more solar radiation by the canopy. The decrease......Low radiation reduces wheat grain yield in tree-crop intercropping systems in the major wheat planting area of China. Here, two winter wheat (Triticum aestivum L) cultivars, Yangmai 158 (shading tolerant) and Yangmai 11 (shading sensitive), were shaded from jointing to maturity to evaluate...

  6. Medium-Term Results After Treatment of Recalcitrant Lateral Epicondylitis

    Science.gov (United States)

    Meknas, Khaled; Al Hassoni, Thabit N.; Odden-Miland, Åshild; Castillejo, Miguel; Kartus, Jüri

    2013-01-01

    Background: Recalcitrant lateral epicondylitis (elbow extensor–origin tendinosis) is a common cause of elbow pain with many treatment options. In the present study, the medium-term results after open release and radiofrequency microtenotomy are reported. Hypothesis: Microtenotomy would provide long-term pain relief that was as good as the open release method. Study Design: Prospective, randomized trial. Methods: Twenty-four patients randomized to either open release or microtenotomy were assessed after 5 to 7 years. Clinical examination and dynamic infrared thermography (DIRT) of both elbows were performed preoperatively and at the medium-term follow-up. Magnetic resonance imaging (MRI) of both elbows was performed at the medium-term follow-up. Results: Significant pain reduction was found using a visual analog scale (VAS) at the medium-term follow-up in both groups compared with the preoperative assessment (P lateral epicondylitis. The hypothesis was thus verified. PMID:26535247

  7. Detection of field significant long-term monotonic trends in spring yields

    Czech Academy of Sciences Publication Activity Database

    Ledvinka, O.; Lamačová, Anna

    2015-01-01

    Roč. 29, č. 5 (2015), s. 1463-1484 ISSN 1436-3240 Institutional support: RVO:67179843 Keywords : Cross-correlation * Groundwater monitoring * Serial correlation * Spring yields * Trend analysis Subject RIV: DA - Hydrology ; Limnology OBOR OECD: Hydrology Impact factor: 2.237, year: 2015

  8. Medium term results of Avon patellofemoral joint replacement

    Directory of Open Access Journals (Sweden)

    Praveen K Sarda

    2011-01-01

    Conclusion: The Avon patellofemoral joint replacement provides predictably good results and excellent survivorship in the medium term, for isolated patellofemoral arthritis. However, progression of tibiofemoral arthritis remains unpredictable and therefore patient selection is crucial to ensure success. Clicking remains a potential problem and can compromise the postoperative results in upto 15% of the cases.

  9. The latest results from source term research. Overview and outlook

    Energy Technology Data Exchange (ETDEWEB)

    Herranz, Luis E. [Centro de Investigaciones Energeticas Medio Ambientales y Tecnologica (CIEMAT), Madrid (Spain); Haste, Tim [Centre d' Etudes de Cadarache, Paul-Lez-Durance (France). Institut de Radioprotection et de Surete Nucleaire (IRSN); Kaerkelae, Teemu [VTT Technical Research Centre of Finland Ltd, Espoo (Finland)

    2016-12-15

    Source term research has continued internationally for more than 30 years, increasing confidence in calculations of the potential radioactive release to the environment after a severe reactor accident. Important experimental data have been obtained, mainly under international frameworks such as OECD/NEA and EURATOM. Specifically, Phebus FP provides major insights into fission product release and transport. Results are included in severe accident analysis codes. Data from international projects are being interpreted with a view to further improvements in these codes. This paper synthesizes the recent main outcomes from source term research on these topics, and on source term mitigation. It highlights knowledge gaps remaining and discusses ways to proceed. Aside from this further knowledge-driven research, there is consensus on the need to assess the source term predictive ability of current system codes, taking account of scale-up from experiment to reactor conditions.

  10. Equity yields

    NARCIS (Netherlands)

    Vrugt, E.; van Binsbergen, J.H.; Koijen, R.S.J.; Hueskes, W.

    2013-01-01

    We study a new data set of dividend futures with maturities up to ten years across three world regions: the US, Europe, and Japan. We use these asset prices to construct equity yields, analogous to bond yields. We decompose the equity yields to obtain a term structure of expected dividend growth

  11. 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

  12. Recent Results from Lohengrin on Fission Yields and Related Decay Properties

    Science.gov (United States)

    Serot, O.; Amouroux, C.; Bidaud, A.; Capellan, N.; Chabod, S.; Ebran, A.; Faust, H.; Kessedjian, G.; Köester, U.; Letourneau, A.; Litaize, O.; Martin, F.; Materna, T.; Mathieu, L.; Panebianco, S.; Regis, J.-M.; Rudigier, M.; Sage, C.; Urban, W.

    2014-05-01

    The Lohengrin mass spectrometer is one of the 40 instruments built around the reactor of the Institute Laue-Langevin (France) which delivers a very intense thermal neutron flux. Usually, Lohengrin was combined with a high-resolution ionization chamber in order to obtain good nuclear charge discrimination within a mass line, yielding an accurate isotopic yield determination. Unfortunately, this experimental procedure can only be applied for fission products with a nuclear charge less than about 42, i.e. in the light fission fragment region. Since 2008, a large collaboration has started with the aim of studying various fission aspects, mainly in the heavy fragment region. For that, a new experimental setup which allows isotopic identification by γ-ray spectrometry has been developed and validated. This technique was applied on the 239Pu(nth,f) reaction where about 65 fission product yields were measured with an uncertainty that has been reduced on average by a factor of 2 compared with what was that previously available in nuclear data libraries. The same γ-ray spectrometric technique is currently being applied to the study of the 233U(nth,f) reaction. Our aim is to deduce charge and mass distributions of the fission products and to complete the experimental data that exist mainly for light fission fragments. The measurement of 41 mass yields from the 241Am(2nth,f) reaction has been also performed. In addition to these activities on fission yield measurements, various new nanosecond isomers were discovered. Their presence can be revealed from a strong deformed ionic charge distribution compared to a 'normal' Gaussian shape. Finally, a new neutron long-counter detector designed to have a detection efficiency independent of the detected neutron energy has been built. Combining this neutron device with a Germanium detector and a beta-ray detector array allowed us to measure the beta-delayed neutron emission probability Pn of some important fission products for reactor

  13. 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.)

  14. Maximum sustainable yield and species extinction in a prey-predator system: some new results.

    Science.gov (United States)

    Ghosh, Bapan; Kar, T K

    2013-06-01

    Though the maximum sustainable yield (MSY) approach has been legally adopted for the management of world fisheries, it does not provide any guarantee against from species extinction in multispecies communities. In the present article, we describe the appropriateness of the MSY policy in a Holling-Tanner prey-predator system with different types of functional responses. It is observed that for both type I and type II functional responses, harvesting of either prey or predator species at the MSY level is a sustainable fishing policy. In the case of combined harvesting, both the species coexist at the maximum sustainable total yield (MSTY) level if the biotic potential of the prey species is greater than a threshold value. Further, increase of the biotic potential beyond the threshold value affects the persistence of the system.

  15. 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...

  16. A unified inelastic constitutive equation in terms of anisotropic yield function

    International Nuclear Information System (INIS)

    Inoue, T.; Imatani, S.

    1989-01-01

    In order to describe the material behavior under complicated loading conditions, inelastic constitutive equations accounting for the plasticity-creep interaction have been proposed by several researchers. However, these models are developed to predict the hardening and/or softening phenomena during the inelastic deformation processes, and two important features still remain to be considered; material anisotropy induced by the prior deformation history and inelastic flow or, in another word, directionality of the inelastic strain rate. This paper deals with a unified constitutive model capable of expressing both the deformation-induced anisotropy and the anisotropic flow. In the first part of the paper, an anisotropic yield function which can simulate both the Bauschinger effect and the cross effect is proposed. Then, the excess stress theory is applied to a viscoplastic constitutive relationship so as to describe the plasticity-creep interaction behavior. The experimental verification is carried out for SUS304 stainless steel at 650 degrees C in a biaxial stress state. Moreover, a generalized flow rule of the inelastic strain rate is also developed, by which the description of the ratcheting process can be improved

  17. 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.

  18. Long-term rotation and tillage effects on soil structure and crop yield

    DEFF Research Database (Denmark)

    Munkholm, Lars Juhl; Heck, R; Deen, B

    2013-01-01

    long-term rotation and tillage treatment experiment on a Canadian silt loam soil. Topsoil measurements were carried out for three different rotations: R1, (C–C–C–C) continuous corn (Zea mays L.), R6, (C–C–O(RC), B(RC)) corn, corn, oats (Avena fatua L.) and spring barley (Hordeum vulgare L.) and R8, (C......–C–S–S) corn, corn, soybean (Glycine max L.), soybean. A red clover (Trifolium pretense L.) cover crop was under seeded in oats and spring barley in R6. In 2010, first year corn was grown in R6 and R8. The tillage treatments included no tillage, NT and mouldboard ploughing, MP. Topsoil structural quality...

  19. Long-term experiment with orchard floor management systems: influence on apple yield and chemical composition.

    Science.gov (United States)

    Slatnar, Ana; Licznar-Malanczuk, Maria; Mikulic-Petkovsek, Maja; Stampar, Franci; Veberic, Robert

    2014-05-07

    The study focuses on the response of apple primary and secondary metabolism and some important quality parameters to three living mulch treatments, classical herbicide fallow, and black polypropylene strip application in two apple cultivars. Primary and secondary metabolites were analyzed after 10 years of ground cover experiments. Soluble solids, firmness, and color measurements indicate differences among orchard floor management treatments. Significantly, lower levels of individual sugars have been measured in fruit of different living mulch treatments compared with fruit harvested from trees subjected to the herbicide strip treatment. Total sugar content was higher in fruit of the herbicide strip treatment in both cultivars analyzed. Significantly higher levels of total organic acids were only detected in 'Pinova' fruit of the Festuca ovina L. treatment. Long-term response of both cultivars to living mulch treatments indicated that apples increase the accumulation of almost all analyzed individual phenolic compounds.

  20. Grain yield and crop N offtake in response to residual fertilizer N in long-term field experiments

    DEFF Research Database (Denmark)

    Petersen, Jens; Thomsen, Ingrid Kaag; Mattsson, L.

    2010-01-01

    in four long-term (>35 yr) field experiments, we measured the response of barley (grain yield and N offtake at crop maturity) to six rates (0, 30, 60, 90, 120 and 150 kg N/ha) of mineral fertilizer N (Nnew) applied in subplots replacing the customary long-term plot treatments of fertilizer inputs (Nprev......). Rates of Nprev above 50-100 kg N/ha had no consistent effect on the soil N content, but this was up to 20% greater than that in unfertilized treatments. Long-term unfertilized plots should not be used as control to test the residual value of N in modern agriculture with large production potentials....... Although the effect of mineral Nprev on grain yield and N offtake could be substituted by Nnew within a range of previous inputs, the value of Nprev was not eliminated irrespective of Nnew rate. Provided a sufficient supply of plant nutrients other than N, the use-efficiency of Nnew did not change...

  1. Long-term yield effects of establishment method and weed control in willow for short rotation coppice (SRC)

    DEFF Research Database (Denmark)

    Larsen, Søren Ugilt; Jørgensen, Uffe; Kjeldsen, Jens Bonderup

    2014-01-01

    matter (DM) yield was measured over 6 harvest rotations corresponding to 16 years. In 1st rotation, yield differed significantly between establishment methods with highest yield for 1.8 m rods (10.4 Mg ha−1 year−1), intermediate yield for cuttings and 0.2 m billets (8.6 and 8.5 Mg ha−1 year−1...... establishment methods; 1) vertical planting of standard 0.2 m cuttings; 2) horizontal planting of 0.1 m billets; 3) horizontal planting of 0.2 m billets; 4) horizontal planting of 1.8 m rods. All establishment methods were combined with mechanical and chemical weed control during the establishment year. Dry......, respectively) and lowest for 0.1 m billets (5.6 Mg ha−1 year−1). No differences were found in 2nd rotation. Over 1st and 2nd rotation, mechanical weed control resulted in significantly lower yield than chemical control when combined with 0.1 m billets. Cuttings and 1.8 m rods were compared over 1st, 2nd, 3rd...

  2. 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.

  3. Long-term Trends in Coral Reef Fish Yields and Exploitation Rates of Commercial Species from Coastal Kenya

    OpenAIRE

    Kaunda-Arara, B.; Rose, G.A.; Muchiri, M.S.; Kaka, R.

    2003-01-01

    Analysis of long-term (1978–2001) marine fisheries data showed that Kenyan coralreefs produced an estimated 2–4 metric t/km2/year of demersal fish. A rapid overall decline in landings occurred during the 1990s. Yields (t/km2/year) showed bimodal peaks in 1982 (2.98) and 1991 (2.90). The average total landings dropped by 55% during the last decade following peak landings in 1982. Landings of the commercially important families (e.g., Siganidae, Lethrinidae, Lutjanidae and Serran...

  4. Defining Primary Care Shortage Areas: Do GIS-based Measures Yield Different Results?

    Science.gov (United States)

    Daly, Michael R; Mellor, Jennifer M; Millones, Marco

    2018-02-12

    To examine whether geographic information systems (GIS)-based physician-to-population ratios (PPRs) yield determinations of geographic primary care shortage areas that differ from those based on bounded-area PPRs like those used in the Health Professional Shortage Area (HPSA) designation process. We used geocoded data on primary care physician (PCP) locations and census block population counts from 1 US state to construct 2 shortage area indicators. The first is a bounded-area shortage indicator defined without GIS methods; the second is a GIS-based measure that measures the populations' spatial proximity to PCP locations. We examined agreement and disagreement between bounded shortage areas and GIS-based shortage areas. Bounded shortage area indicators and GIS-based shortage area indicators agree for the census blocks where the vast majority of our study populations reside. Specifically, 95% and 98% of the populations in our full and urban samples, respectively, reside in census blocks where the 2 indicators agree. Although agreement is generally high in rural areas (ie, 87% of the rural population reside in census blocks where the 2 indicators agree), agreement is significantly lower compared to urban areas. One source of disagreement suggests that bounded-area measures may "overlook" some shortages in rural areas; however, other aspects of the HPSA designation process likely mitigate this concern. Another source of disagreement arises from the border-crossing problem, and it is more prevalent. The GIS-based PPRs we employed would yield shortage area determinations that are similar to those based on bounded-area PPRs defined for Primary Care Service Areas. Disagreement rates were lower than previous studies have found. © 2018 National Rural Health Association.

  5. 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.

  6. Impacts of Near-Term Climate Change on Irrigation Demands and Crop Yields in the Columbia River Basin

    Science.gov (United States)

    Rajagopalan, K.; Chinnayakanahalli, K. J.; Stockle, C. O.; Nelson, R. L.; Kruger, C. E.; Brady, M. P.; Malek, K.; Dinesh, S. T.; Barber, M. E.; Hamlet, A. F.; Yorgey, G. G.; Adam, J. C.

    2018-03-01

    Adaptation to a changing climate is critical to address future global food and water security challenges. While these challenges are global, successful adaptation strategies are often generated at regional scales; therefore, regional-scale studies are critical to inform adaptation decision making. While climate change affects both water supply and demand, water demand is relatively understudied, especially at regional scales. The goal of this work is to address this gap, and characterize the direct impacts of near-term (for the 2030s) climate change and elevated CO2 levels on regional-scale crop yields and irrigation demands for the Columbia River basin (CRB). This question is addressed through a coupled crop-hydrology model that accounts for site-specific and crop-specific characteristics that control regional-scale response to climate change. The overall near-term outlook for agricultural production in the CRB is largely positive, with yield increases for most crops and small overall increases in irrigation demand. However, there are crop-specific and location-specific negative impacts as well, and the aggregate regional response of irrigation demands to climate change is highly sensitive to the spatial crop mix. Low-value pasture/hay varieties of crops—typically not considered in climate change assessments—play a significant role in determining the regional response of irrigation demands to climate change, and thus cannot be overlooked. While, the overall near-term outlook for agriculture in the region is largely positive, there may be potential for a negative outlook further into the future, and it is important to consider this in long-term planning.

  7. Combined use of Azolla and loach suppressed paddy weeds and increased organic rice yield: second season results

    Directory of Open Access Journals (Sweden)

    Weiguo Cheng

    2015-01-01

    Full Text Available Organic farming uses alternatives to agricultural chemicals such as synthetic fertilizers and pesticides. The primary challenge in organic rice farming is controlling weeds without using herbicides and improving rice yield without chemical fertilizers. In our previous paper entitled as combined use of Azolla and loach suppressed weed Monochoria vaginalis and increased rice yield without agrochemicals, we reported the first year rice growth season results from an in situ container experiment. The experiment was designed with 4 treatments—control (with neither Azolla nor loach, Azolla (Azolla alone, loach (loach alone, and Az+Lo (combined Azolla and loach—with 3 replications each. The first year results showed that combined use of Azolla and loach was successful in weed suppression and increase in rice yield in 2012. In this paper, we report the second year results from the continuous container experiment in 2013. M.vaginalis emergences were very low in second year rice growth season on all treatments. Compared first year, the rice yields decreased in second year on all treatments due to different weather condition and with or without organic soybean oil cake application between two rice growth seasons. The second year results also showed the raising loach had a stronger effect to increase tiller and panicle numbers, and spikelet number per panicle, then improve rice yields to 2.3 times than control. The Azolla residues left from first year have weaker effect on rice growth and yield, but increase soil organic matter accumulation at second year. The two years study indicated that combined use of Azolla and loach can meet two of the greatest challenges in organic rice production: providing effective weed control and improving rice nutrition without agrochemicals.

  8. 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

  9. 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.

  10. Cultural transmission results in convergence towards colour term universals

    Science.gov (United States)

    Xu, Jing; Dowman, Mike; Griffiths, Thomas L.

    2013-01-01

    As in biological evolution, multiple forces are involved in cultural evolution. One force is analogous to selection, and acts on differences in the fitness of aspects of culture by influencing who people choose to learn from. Another force is analogous to mutation, and influences how culture changes over time owing to errors in learning and the effects of cognitive biases. Which of these forces need to be appealed to in explaining any particular aspect of human cultures is an open question. We present a study that explores this question empirically, examining the role that the cognitive biases that influence cultural transmission might play in universals of colour naming. In a large-scale laboratory experiment, participants were shown labelled examples from novel artificial systems of colour terms and were asked to classify other colours on the basis of those examples. The responses of each participant were used to generate the examples seen by subsequent participants. By simulating cultural transmission in the laboratory, we were able to isolate a single evolutionary force—the effects of cognitive biases, analogous to mutation—and examine its consequences. Our results show that this process produces convergence towards systems of colour terms similar to those seen across human languages, providing support for the conclusion that the effects of cognitive biases, brought out through cultural transmission, can account for universals in colour naming. PMID:23486436

  11. 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.

  12. Quantifying long-term responses of crop yield and nitrate leaching in an intensive farmland using agro-eco-environmental model.

    Science.gov (United States)

    Sun, Mei; Huo, Zailin; Zheng, Yanxia; Dai, Xiaoqin; Feng, Shaoyuan; Mao, Xiaomin

    2018-02-01

    Quantitatively ascertaining and analyzing long-term responses of crop yield and nitrate leaching on varying irrigation and fertilization treatments are focal points for guaranteeing crop yield and reducing nitrogen loss. The calibrated agricultural-hydrological RZWQM2 model was used to explore the long-term (2003-2013) transport processes of water and nitrogen and the nitrate leaching amount into groundwater in summer maize and winter wheat rotation field in typical intensive plant area in the North China Plain, Daxing district of Beijing. Simulation results showed that application rates of irrigation and nitrogen fertilizer have couple effects on crop yields and nitrogen leaching of root zone. When both the irrigation and fertilizer for summer maize and winter wheat were 400mm and 400kgNha -1 , respectively, nitrate leaching into groundwater accounted for 47.9% of application amount of nitrogen fertilizer. When application amount of irrigation is 200mm and fertilization is 200kgNha -1 , NUPE (nitrogen uptake efficiency), NUE (nitrogen use efficiency), NPFP (nitrogen partial factor productivity), and W pi (irrigation water productive efficiency) were in general higher than that under other irrigation and fertilization condition (irrigation from 104-400mm, fertilizer 104-400kgNha -1 ). Irrigation bigger than 200mm could shorten the response time of nitrate leaching in deeper soil layer in different irrigation treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Application of DSSAT-CROPGRO-Cotton Model to Assess Long Term (1924-2012) Cotton Yield under Different Irrigation Management Strategies

    Science.gov (United States)

    Adhikari, P.; Gowda, P. H.; Northup, B. K.; Rocateli, A.

    2017-12-01

    In this study a well calibrated and validated DSSAT-CROPGRO-Cotton model was used for assessing the irrigation management in the Texas High Plains (THP). Long term (1924-2012) historic lint yield were simulated under different irrigation management practices which were commonly used in the THP. The simulation treatments includes different amount of irrigation water high (H; 6.4 mm d-1), medium (M; 3.2 mm d-1) and low (L; 0 mm d-1) during emergence (S1), vegetative (S2) and maturity (S3) stage. The combination of these treatments resulted into 27 treatments. The amount and date of irrigation for each stage were obtained from the recent cotton irrigation experiment at Halfway, TX (Brodovsky, et al., 2015). Similarly, calibrated model was also used to observe the effect of plantation date on crop yield in the THP regions.

  14. A comparison of short-term dispersion estimates resulting from various atmospheric stability classification methods

    International Nuclear Information System (INIS)

    Mitchell, A.E. Jr.

    1982-01-01

    Four methods of classifying atmospheric stability class are applied at four sites to make short-term (1-h) dispersion estimates from a ground-level source based on a model consistent with U.S. Nuclear Regulatory Commission practice. The classification methods include vertical temperature gradient, standard deviation of horizontal wind direction fluctuations (sigma theta), Pasquill-Turner, and modified sigma theta which accounts for meander. Results indicate that modified sigma theta yields reasonable dispersion estimates compared to those produced using methods of vertical temperature gradient and Pasquill-Turner, and can be considered as a potential economic alternative in establishing onsite monitoring programs. (author)

  15. Pediatric laparoscopic sleeve gastrectomy in Turkey: Short-term results.

    Science.gov (United States)

    Ates, Ufuk; Ergun, Ergun; Gollu, Gulnur; Sozduyar, Sumeyye; Can, Ozlem Selvi; Yagmurlu, Aydin

    2018-05-01

    Obesity is one of the most rapidly increasing health problems in children. Laparoscopic sleeve gastrectomy (LSG) is one of the best treatment options and is feasible and safe in children. The aim of this study was to present the short-term results of a laparoscopic sleeve gastrectomy series in children. Children who underwent LSG in 2014-2017 were included in the study. Charts were investigated retrospectively and short-term weight loss was analyzed. Patients who had surgery in 2014-2017 were included in the study. There were six girls and two boys, and the median age was 15 years (range, 11-18 years). Mean weight was 159.25 ± 19.78 kg, and mean body mass index was 61.05 ± 8.5 kg/m 2 . Mean operation time was 70 min (range, 65-90 min), mean hospital stay was 5.1 days (range, 3-7 days), and mean follow up was 19.2 months (range, 1-43 months). Of these patients, five had hypertension and were under medication and two of these five also had hyperinsulinemia. One of the five children had Bardet-Biedl syndrome and one had bronchial asthma. After operation, medication was stopped in four of the eight children. At the time of writing, six patients were doing well without postoperative complications, or the need for reoperation. Even though the follow-up period was short and the number of patients was small, LSG was a feasible and promising surgical method for morbidly obese children. A multidisciplinary approach and lifelong behavior therapy are key steps for success. © 2018 Japan Pediatric Society.

  16. Different methods to define utility functions yield similar results but engage different neural processes

    Directory of Open Access Journals (Sweden)

    Marcus Heldmann

    2009-10-01

    Full Text Available Although the concept of utility is fundamental to many economic theories, up to now a generally accepted method determining a subject’s utility function is not available. We investigated two methods that are used in economic sciences for describing utility functions by using response-locked event-related potentials in order to assess their neural underpinnings. For defining the certainty equivalent (CE, we used a lottery game with probabilities to win p=0.5, for identifying the subjects’ utility functions directly a standard bisection task was applied. Although the lottery tasks’ payoffs were only hypothetical, a pronounced negativity was observed resembling the error related negativity (ERN previously described in action monitoring research, but this occurred only for choices far away from the indifference point between money and lottery. By contrast, the bisection task failed to evoke an ERN irrespective of the responses’ correctness. Based on these findings we are reasoning that only decisions made in the lottery task achieved a level of subjective relevance that activates cognitive-emotional monitoring. In terms of economic sciences, our findings support the view that the bisection method is unaffected by any kind of probability valuation or other parameters related to risk and in combination with the lottery task can, therefore, be used to differentiate between payoff and probability valuation.

  17. Long-term results after proximal thoracic aortic redo surgery.

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    Martin Czerny

    Full Text Available OBJECTIVE: To evaluate early and mid-term results in patients undergoing proximal thoracic aortic redo surgery. METHODS: We analyzed 60 patients (median age 60 years, median logistic EuroSCORE 40 who underwent proximal thoracic aortic redo surgery between January 2005 and April 2012. Outcome and risk factors were analyzed. RESULTS: In hospital mortality was 13%, perioperative neurologic injury was 7%. Fifty percent of patients underwent redo surgery in an urgent or emergency setting. In 65%, partial or total arch replacement with or without conventional or frozen elephant trunk extension was performed. The preoperative logistic EuroSCORE I confirmed to be a reliable predictor of adverse outcome- (ROC 0.786, 95%CI 0.64-0.93 as did the new EuroSCORE II model: ROC 0.882 95%CI 0.78-0.98. Extensive individual logistic EuroSCORE I levels more than 67 showed an OR of 7.01, 95%CI 1.43-34.27. A EuroSCORE II larger than 28 showed an OR of 4.44 (95%CI 1.4-14.06. Multivariate logistic regression analysis identified a critical preoperative state (OR 7.96, 95%CI 1.51-38.79 but not advanced age (OR 2.46, 95%CI 0.48-12.66 as the strongest independent predictor of in-hospital mortality. Median follow-up was 23 months (1-52 months. One year and five year actuarial survival rates were 83% and 69% respectively. Freedom from reoperation during follow-up was 100%. CONCLUSIONS: Despite a substantial early attrition rate in patients presenting with a critical preoperative state, proximal thoracic aortic redo surgery provides excellent early and mid-term results. Higher EuroSCORE I and II levels and a critical preoperative state but not advanced age are independent predictors of in-hospital mortality. As a consequence, age alone should no longer be regarded as a contraindication for surgical treatment in this particular group of patients.

  18. 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.

  19. Yield and economic performance of organic and conventional cotton-based farming systems--results from a field trial in India.

    Science.gov (United States)

    Forster, Dionys; Andres, Christian; Verma, Rajeev; Zundel, Christine; Messmer, Monika M; Mäder, Paul

    2013-01-01

    The debate on the relative benefits of conventional and organic farming systems has in recent time gained significant interest. So far, global agricultural development has focused on increased productivity rather than on a holistic natural resource management for food security. Thus, developing more sustainable farming practices on a large scale is of utmost importance. However, information concerning the performance of farming systems under organic and conventional management in tropical and subtropical regions is scarce. This study presents agronomic and economic data from the conversion phase (2007-2010) of a farming systems comparison trial on a Vertisol soil in Madhya Pradesh, central India. A cotton-soybean-wheat crop rotation under biodynamic, organic and conventional (with and without Bt cotton) management was investigated. We observed a significant yield gap between organic and conventional farming systems in the 1(st) crop cycle (cycle 1: 2007-2008) for cotton (-29%) and wheat (-27%), whereas in the 2(nd) crop cycle (cycle 2: 2009-2010) cotton and wheat yields were similar in all farming systems due to lower yields in the conventional systems. In contrast, organic soybean (a nitrogen fixing leguminous plant) yields were marginally lower than conventional yields (-1% in cycle 1, -11% in cycle 2). Averaged across all crops, conventional farming systems achieved significantly higher gross margins in cycle 1 (+29%), whereas in cycle 2 gross margins in organic farming systems were significantly higher (+25%) due to lower variable production costs but similar yields. Soybean gross margin was significantly higher in the organic system (+11%) across the four harvest years compared to the conventional systems. Our results suggest that organic soybean production is a viable option for smallholder farmers under the prevailing semi-arid conditions in India. Future research needs to elucidate the long-term productivity and profitability, particularly of cotton and

  20. Yield and economic performance of organic and conventional cotton-based farming systems--results from a field trial in India.

    Directory of Open Access Journals (Sweden)

    Dionys Forster

    Full Text Available The debate on the relative benefits of conventional and organic farming systems has in recent time gained significant interest. So far, global agricultural development has focused on increased productivity rather than on a holistic natural resource management for food security. Thus, developing more sustainable farming practices on a large scale is of utmost importance. However, information concerning the performance of farming systems under organic and conventional management in tropical and subtropical regions is scarce. This study presents agronomic and economic data from the conversion phase (2007-2010 of a farming systems comparison trial on a Vertisol soil in Madhya Pradesh, central India. A cotton-soybean-wheat crop rotation under biodynamic, organic and conventional (with and without Bt cotton management was investigated. We observed a significant yield gap between organic and conventional farming systems in the 1(st crop cycle (cycle 1: 2007-2008 for cotton (-29% and wheat (-27%, whereas in the 2(nd crop cycle (cycle 2: 2009-2010 cotton and wheat yields were similar in all farming systems due to lower yields in the conventional systems. In contrast, organic soybean (a nitrogen fixing leguminous plant yields were marginally lower than conventional yields (-1% in cycle 1, -11% in cycle 2. Averaged across all crops, conventional farming systems achieved significantly higher gross margins in cycle 1 (+29%, whereas in cycle 2 gross margins in organic farming systems were significantly higher (+25% due to lower variable production costs but similar yields. Soybean gross margin was significantly higher in the organic system (+11% across the four harvest years compared to the conventional systems. Our results suggest that organic soybean production is a viable option for smallholder farmers under the prevailing semi-arid conditions in India. Future research needs to elucidate the long-term productivity and profitability, particularly of cotton

  1. 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

  2. Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

    International Nuclear Information System (INIS)

    Bratby, M.J.; Walker, W.J.

    2009-01-01

    Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

  3. Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

    Energy Technology Data Exchange (ETDEWEB)

    Bratby, M.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom); Walker, W.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom)], E-mail: wjwalker@doctors.org.uk

    2009-04-15

    Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

  4. When Field Experiments Yield Unexpected Results: Lessons Learned from Measuring Selection in White Sands Lizards

    Science.gov (United States)

    Hardwick, Kayla M.; Harmon, Luke J.; Hardwick, Scott D.; Rosenblum, Erica Bree

    2015-01-01

    Determining the adaptive significance of phenotypic traits is key for understanding evolution and diversification in natural populations. However, evolutionary biologists have an incomplete understanding of how specific traits affect fitness in most populations. The White Sands system provides an opportunity to study the adaptive significance of traits in an experimental context. Blanched color evolved recently in three species of lizards inhabiting the gypsum dunes of White Sands and is likely an adaptation to avoid predation. To determine whether there is a relationship between color and susceptibility to predation in White Sands lizards, we conducted enclosure experiments, quantifying survivorship of Holbrookia maculate exhibiting substrate-matched and substrate-mismatched phenotypes. Lizards in our study experienced strong predation. Color did not have a significant effect on survival, but we found several unexpected relationships including variation in predation over small spatial and temporal scales. In addition, we detected a marginally significant interaction between sex and color, suggesting selection for substrate matching may be stronger for males than females. We use our results as a case study to examine six major challenges frequently encountered in field-based studies of natural selection, and suggest that insight into the complexities of selection often results when experiments turn out differently than expected. PMID:25714838

  5. Research Results of Bioenergetics Factors Influence on Crop Production Yields Increase

    Directory of Open Access Journals (Sweden)

    A. P. Grishin

    2018-01-01

    Full Text Available The results of a fundamental research is presented confirming two hypotheses concerning the process of a crop harvest forming and transpiration as the two main bio-energetic factors of fertility. Transpiration is a thermodynamic process in an open self-organizing system, which has a dissipative random character. Transpiration consumes about 95 percent of the water consumed by the plant. (Purpose of research The research objective is to obtain results confirming two hypotheses, according to which the efficiency of the process of crop formation is due to transpiration as a bio-energy factor of fertility and its components: photosynthetic exergy and thermal exergy. (Methods and materials The basic principles of thermodynamic systems self-organization, as well as methods of experimental studies of the principle of subordination to the parameter of the order in which the system control variable is dependent on parameter of the order. The relation of the order parameter (thermal exergy of solar radiation (SR and the variable control (transpiration was determined. The values of the correlation coefficients of these two processes have a value close to one. This confirms that transpiration is a dissipative self-organizing process underlying the transpiration irrigation mechanism. It is revealed that a fractal dimension of a time series of transpiration of cucumber with natural light, a potato is artificial, and their probability haracteristics: the mathematical expectation, standard deviation and variance. (Results and discussion We received confirmation of the scientific hypothesis about the influence of limiting climatic factors on the theoretical limit of plant productivity and fractal dimension of transpiration as an indicator of production processes in crop production. (Conclusions We put forward supplemental scientific hypothesis about the influence of limiting climatic factors on the theoretical limit of plant productivity. It was showed that

  6. Gun Shows and Gun Violence: Fatally Flawed Study Yields Misleading Results

    Science.gov (United States)

    Hemenway, David; Webster, Daniel; Pierce, Glenn; Braga, Anthony A.

    2010-01-01

    A widely publicized but unpublished study of the relationship between gun shows and gun violence is being cited in debates about the regulation of gun shows and gun commerce. We believe the study is fatally flawed. A working paper entitled “The Effect of Gun Shows on Gun-Related Deaths: Evidence from California and Texas” outlined this study, which found no association between gun shows and gun-related deaths. We believe the study reflects a limited understanding of gun shows and gun markets and is not statistically powered to detect even an implausibly large effect of gun shows on gun violence. In addition, the research contains serious ascertainment and classification errors, produces results that are sensitive to minor specification changes in key variables and in some cases have no face validity, and is contradicted by 1 of its own authors’ prior research. The study should not be used as evidence in formulating gun policy. PMID:20724672

  7. Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.

    Science.gov (United States)

    Ewig, Christina; Bello, Amparo Hernández

    2009-03-01

    In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.

  8. Association between Empirically Estimated Monsoon Dynamics and Other Weather Factors and Historical Tea Yields in China: Results from a Yield Response Model

    Directory of Open Access Journals (Sweden)

    Rebecca Boehm

    2016-04-01

    Full Text Available Farmers in China’s tea-growing regions report that monsoon dynamics and other weather factors are changing and that this is affecting tea harvest decisions. To assess the effect of climate change on tea production in China, this study uses historical weather and production data from 1980 to 2011 to construct a yield response model that estimates the partial effect of weather factors on tea yields in China, with a specific focus on East Asian Monsoon dynamics. Tea (Camellia sinensis (L. Kunze has not been studied using these methods even though it is an important crop for human nutrition and the economic well-being of rural communities in many countries. Previous studies have approximated the monsoon period using historical average onset and retreat dates, which we believe limits our understanding of how changing monsoon patterns affect crop productivity. In our analysis, we instead estimate the monsoon season across China’s tea growing regions empirically by identifying the unknown breakpoints in the year-by-province cumulative precipitation. We find that a 1% increase in the monsoon retreat date is associated with 0.481%–0.535% reduction in tea yield. In the previous year, we also find that a 1% increase in the date of the monsoon retreat is associated with a 0.604% decrease in tea yields. For precipitation, we find that a 1% increase in average daily precipitation occurring during the monsoon period is associated with a 0.184%–0.262% reduction in tea yields. In addition, our models show that 1% increase in the average daily monsoon precipitation from the previous growing season is associated with 0.258%–0.327% decline in yields. We also find that a 1% decrease in solar radiation in the previous growing season is associated with 0.554%-0.864% decrease in tea yields. These findings suggest the need for adaptive management and harvesting strategies given climate change projections and the known negative association between excess

  9. Small Changes Yield Large Results at NIST's Net-Zero Energy Residential Test Facility.

    Science.gov (United States)

    Fanney, A Hunter; Healy, William; Payne, Vance; Kneifel, Joshua; Ng, Lisa; Dougherty, Brian; Ullah, Tania; Omar, Farhad

    2017-12-01

    The Net-Zero Energy Residential Test Facility (NZERTF) was designed to be approximately 60 % more energy efficient than homes meeting the 2012 International Energy Conservation Code (IECC) requirements. The thermal envelope minimizes heat loss/gain through the use of advanced framing and enhanced insulation. A continuous air/moisture barrier resulted in an air exchange rate of 0.6 air changes per hour at 50 Pa. The home incorporates a vast array of extensively monitored renewable and energy efficient technologies including an air-to-air heat pump system with a dedicated dehumidification cycle; a ducted heat-recovery ventilation system; a whole house dehumidifier; a photovoltaic system; and a solar domestic hot water system. During its first year of operation the NZERTF produced an energy surplus of 1023 kWh. Based on observations during the first year, changes were made to determine if further improvements in energy performance could be obtained. The changes consisted of installing a thermostat that incorporated control logic to minimize the use of auxiliary heat, using a whole house dehumidifier in lieu of the heat pump's dedicated dehumidification cycle, and reducing the ventilation rate to a value that met but did not exceed code requirements. During the second year of operation the NZERTF produced an energy surplus of 2241 kWh. This paper describes the facility, compares the performance data for the two years, and quantifies the energy impact of the weather conditions and operational changes.

  10. 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.

  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. 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.

  13. Surgical treatment of congenital mitral stenosis: medium-term results

    Directory of Open Access Journals (Sweden)

    Atik Fernando A.

    2003-01-01

    Full Text Available OBJECTIVE: For a cohort of patients with congenital mitral stenosis (CMS, to determine: patient outcomes, predictors of valve repairability and predictors of durability of valve repair. METHODS: From 1989 and 2002, 23 patients underwent surgical treatment of CMS, excluding those with common atrioventricular canal, and univentricular forms. The median age at operation was 15.5 months (range 2-204, and the median body weight was 11 Kg (range 4.5-51.6. Seventeen patients (73.9% had associated anomalies, including Shone's complex in nine (39.1% and pulmonary hypertension in 14 (60.9%. Mitral stenosis was severe in 14 patients (60.9% and moderate in the remaining (median trans-mitral gradient of 16 mmHg, range 8.5-32. Mitral valve repair was performed in 18 patients (78.3%, and valve replacement in five (21.7%. Repair techniques included papillary muscle splitting (n=10, excision of supravalvular ring (n=9 and commissurotomy (n=8. Twelve patients (52.2% required associated procedures. RESULTS: There were no early and late deaths at a mean follow-up of 58.5 ± 46.7 months (range 1-156. Mean hospital stay was 12.7 ± 8.2 days. There were no significant factors associated with unsuccessful valve repair. Actuarial freedom from reoperation at five years was 67.1% (CI 95%: 56.8% to 77.4%. The mitral valve repair group required reoperation in eight patients (44.4% (two early and six late, as opposed to one (20% in the replacement group. The presence of preoperative pulmonary hypertension was significantly related (p<0.005 to higher reoperation rates. All but two the followed patients are presently in functional class I and the echocardiography has shown less than 2+ mitral stenosis and/or regurgitation. CONCLUSION: Reoperations were the most important cause of morbidity at the medium-term follow-up of CMS. Preoperative pulmonary hypertension may predict the need for reoperation after mitral valve repair, which is the procedure of choice in CMS.

  14. Subintimal angioplasty in femoropopliteal region-Mid-term results

    International Nuclear Information System (INIS)

    Koecher, Martin; Cerna, Marie; Utikal, Petr; Kozak, Jiri; Sisola, Ivan; Thomas, Rohit P.; Bachleda, Petr; Drac, Petr; Sekanina, Zdenek; Langova, Katerina

    2010-01-01

    Purpose: Subintimal angioplasty is becoming more frequently used treatment option for patients with long arterial occlusions or diffuse atherosclerotic changes as an alternative to surgical treatment in claudicants especially in patients with critical limb ischemia. The aim of our article is to retrospectively assess mid-term outcomes of subintimal angioplasty of chronic arterial occlusions in femoropopliteal region followed clinically and by Doppler ultrasonography. Materials and methods: From May 2002 to December 2007, 133 femoropopliteal artery occlusions in 123 patients were indicated for subintimal recanalisation. The indications for treatment were intermittent claudications in 84 patients (63.15%) and critical limb ischemia in 49 patients (36.85%). The median length of lesions was 11.4 cm, range 2-30 cm. Except doppler ultrasonographic examination done 24 h after the procedure and clinical examination before discharge, both clinical and ultrasonographic examinations were performed 6 and 12 months after the procedure and yearly thereafter. Statistical analysis of our cohort was performed by Kaplan-Meier analysis, log-rank test and Cox regression. Results: Technical success was achieved in 86.46%. Primary patency rate was 83.1% (SE: 3.9%), 67.5% (SE: 5%), 58% (SE: 5.9%) a 48.4% (SE: 7.1%) at 6, 12, 24 and 36 months respectively. No statistically significant difference of primary patency was found between the group of claudicants and the group of patient with critical limb ischemia. Statistically significant prediction factors for primary patency were only the quality of the run off and the length of the occlusion. Limb salvage rate in our group of patients with critical limb ischemia was 80.8% at 12 months. Conclusion: Subintimal recanalisation is a simple and safe procedure for treatment of chronic peripheral arterial occlusions with high primary technical success rate, acceptable primary patency rate, low percentage of complications and mortality is as low as

  15. 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 ...

  16. 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

  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. Short-term and mid-term results with the Sorin Freedom Solo aortic valve.

    Science.gov (United States)

    Ustunsoy, Hasim; Yasim, Alptekin; Deniz, Hayati; Gokaslan, Gokhan; Ozcaliskan, Ozerdem

    2013-03-01

    The study aim was to present the short- and mid-term results for patients who underwent aortic valve replacement (AVR) with the Sorin Freedom Solo third-generation stentless prosthetic valve. AVR with a Sorin Freedom Solo valve was performed in 14 patients between March 2006 and March 2011. Patients aged > or = 60 years (male:female ratio 6:8; mean age 73.28 +/- 5.42 years) who required AVR with the Sorin Freedom Solo valve according to the surgeon's choice were included in the study. The valvular prosthesis was implanted in the supra-annular position, using a single suture line. Eight patients underwent an isolated AVR; combined interventions were carried out in the other patients due to concomitant cardiac disease. One patient died during the immediate perioperative period, and two more during the follow up, from non-cardiac causes. The mean maximum transvalvular gradient of patients with aortic stenosis was 88.1 +/- 20.2 mmHg, and this fell to 26.4 +/- 7.6 mmHg during the early postoperative period. The mean gradient at one year of follow up was further decreased to 19.4 +/- 5.3 mmHg. The left ventricular end-diastolic and end-systolic diameters were also significantly reduced, from 4.8 +/- 0.9 to 4.3 +/- 0.6 cm and from 3.2 +/- 0.6 to 2.8 +/- 5.3 cm, respectively. The average left ventricular ejection fraction was 60.2 +/- 4.9% preoperatively, and 63.2 +/- 2.1% at one year after surgery (p = NS). No paravalvular leakage, endocarditis, prosthesis failure or neurologic events were reported among patients. The Sorin Freedom Solo stentless valve has provided good early and intermediate-term results. Implantation of the prosthesis is straightforward, with low rates of morbidity and mortality. However, these data require further support from larger patient series and long-term follow up.

  19. Vegetable processing wastes addition to improve swine manure anaerobic digestion: Evaluation in terms of methane yield and SEM characterization

    International Nuclear Information System (INIS)

    Molinuevo-Salces, Beatriz; González-Fernández, Cristina; Gómez, Xiomar; García-González, María Cruz; Morán, Antonio

    2012-01-01

    Highlights: ► Vegetable waste as co-substrate for swine manure anaerobic digestion. ► Two hydraulic retention times of 25 and 15 d, respectively. ► SEM characterization of anaerobic sludges to observe microbial composition. ► Vegetable waste as co-substrate increases methane yields up to three times. ► Microbial composition changes after 120 d of digestion. -- Abstract: The effect of adding vegetable waste as a co-substrate in the anaerobic digestion of swine manure was investigated. The study was carried out at laboratory scale using semi-continuous stirred tank reactors working at 37 °C. Organic loading rates (OLRs) of 0.4 and 0.6 g VS L −1 d −1 were evaluated, corresponding to hydraulic retention times (HRTs) of 25 and 15 d, respectively. The addition of vegetable wastes (50% dw/dw) resulted in an improvement of 3 and 1.4-fold in methane yields at HRTs of 25 and 15 d, respectively. Changes on microbial morphotypes were studied by Scanning Electron Microscopy (SEM). Samples analyzed were sludge used as inoculum and digestate obtained from swine manure anaerobic reactors. SEM pictures demonstrated that lignocellulosic material was not completely degraded. Additionally, microbial composition was found to change to cocci and rods morphotypes after 120 d of anaerobic digestion.

  20. Long term effect of reduced dietary phosphorus on feed intake and milk yield in dry and lactating dairy cows

    DEFF Research Database (Denmark)

    Puggaard, Liselotte; Lund, Peter; Liesegang, A.

    2014-01-01

    Eighteen multiparous Holstein cows were used to study the long term effect of reducing dietary P concentration on intake of DM and milk yield, on blood levels of inorganic phosphate (Pi), Ca, vitamin D3, parathyroid hormone (PTH) as well as assessing bone turnover by the use of bone formation......) (2.1g P/kg DM) and High P (HP) (2.5g P/kg DM). After parturition and throughout lactation treatments were LP (2.3g P/kg DM), MP (2.8g P/kg DM) and HP (3.4g P/kg DM). Differences in dietary P were obtained by adding 0.60 and 1.19% mono-sodium phosphate per kg DM to MP and HP, respectively. The cows...... were fed restrictively pre-partum and for ad libitum intake from one week before expected calving and throughout the experiment. Due to a high number of health problems, LP treatment was terminated after sampling in week 12, and cows were shifted to HP and continued on this treatment until week 36...

  1. Long-term results of brachiocephalic artery percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Mc Namara, T.O.; Gardner, K.

    1990-01-01

    This paper establishes the ling-term and angiographic sequelae of percutaneous transluminal angioplasty (PTA) of stenoses of the origins of the brachycephalic arteries. From November of the proximal segments of the brachycephalic arteries. Clinical follow-up after PTA was 45 months. Two patients had recurrence of vertigo, after 16 and 75 months. There was no evidence of restenosis in the patient whose recurrence was after 16 months, but considerable restenosis was noted in the patient whose symptoms recurred after 75 months. That patient underwent successful repeated PTA

  2. Short term results of pterygium surgery with adjunctive amniotic ...

    African Journals Online (AJOL)

    2012-11-30

    Nov 30, 2012 ... Results: Thirty eyes of 30 consecutive patients were operated on. There were 14 ... prevalent in tropical Africa[2] as a result of its warm and dry climates. ... syndrome, ocular cicatricial pemphigoid, coverage of conjunctival ...

  3. Structural strength assessment of the reconstructed road structure in terms of the loading time and yield criterion

    Science.gov (United States)

    Mazurek, Grzegorz; Iwański, Marek

    2018-05-01

    This article reports the results of numerical simulations of the stress-strain states in the rebuilt road structure compared to the solutions contained in the Polish Catalogue, with the true characteristics of the layer materials taken into account. In the case analysed, a cold-recycled base layer with foamed bitumen as a recycling agent was used. The presented analysis is complementary to the mandatory in Poland procedure of mechanistic pavement design based on a linear elastic model. The temperature distribution in the road structure was analysed at the reference temperature of 40°C on the asphalt layer surface. The loading time was included in the computer simulations through the use of the classic generalized Maxwell model and thus the stiffness-time history of the layers had to be determined. For this purpose, the dynamic modulus E* tests of the loading time frequency from 0.1 Hz to 20 Hz were carried out, and the yield point was modelled using the Coulomb-Mohr failure criterion calculated on the basis of triaxial compression tests. The analytical solution to the problem was found with ABAQUS. The results demonstrate that the high temperature of asphalt layers and long loading time noticeably reduces the stiffness modulus in those layers. That reduction changes the principal stress levels, which significantly influences the shear stress both in the recycled base layer and in the subgrade soil. Should the yield point be exceeded rapidly in the recycled layer, the horizontal stresses in the asphalt layers will increase and adversely affect the durability of the reconstructed road pavement structure, especially in the zones of slow heavy vehicle traffic.

  4. Early and medium term results of the sleeve valve-sparing procedure for aortic root ectasia.

    Science.gov (United States)

    Gamba, Amando; Tasca, Giordano; Giannico, Floriana; Lobiati, Elisabetta; Skouse, Douglas; Galanti, Andrea; Martino, Antonello Stefano; Triggiani, Michele

    2015-04-01

    The aim of this retrospective study was to evaluate our experience of using a simplified aortic valve sleeve procedure to treat aortic root ectasia and aneurysms with or without aortic regurgitation. In experienced hands, 2 aortic valve-sparing procedures, ie, Yacoub and David, have yielded excellent long-term results in the treatment of aortic root aneurysms, with or without aortic regurgitation. However, these techniques are demanding and not widely used. Recently, a new and simplified valve-sparing technique, named "sleeve procedure," has been proposed, and has yielded encouraging early results. Ninety consecutive patients with aortic root aneurysms underwent sleeve procedures from October 2006 to October 2012. Follow-up data (clinical 100% complete and echocardiographic 93% complete) were acquired from our outpatient clinic or from the referring cardiologist. The mean age of the patients was 61.5 ± 12.5 years, 79% were male, 16 (18%) had a bicuspid valve, 3 had Marfan syndrome, and 2 had aortic dissection. Over a mean clinical follow-up of 34 ± 19 months, 2 patients died from noncardiac causes and 1 was reoperated on for the recurrence of aortic regurgitation. On follow-up echocardiography after a mean of 18 ± 9 months, aortic regurgitation was absent/negligible, mild or moderate in 62%, 37%, and 1% of patients, respectively, and the diameters of the annulus, Valsalva sinuses, and sinotubular junction were 27.3 + 2.2, 37.0 + 3.4, and 30.6 + 3.1 mm, respectively. Our encouraging early and medium term results suggest that the sleeve procedure is a safe and effective aortic valve-sparing technique for the treatment of aortic root ectasia and aneurysm. However, longer follow-up is needed in order to draw definitive conclusions. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2014-10-27

    Tennis elbow (TE) is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years). Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of tennis elbow should be made as there is lot of controversy regarding the treatment.

  6. Long term results of 125I for treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Bremner, W.F.; McDougall, I.R.; Greig, W.R.; Ratcliffe, J.G.

    1976-01-01

    125 I emits very low energy conversion and Auger electrons. This radionuclide has been used in place of 131 I with the hope of reducing the incidence of post treatment hypothyroidism. 303 of 360 patients treated have been reviewed. Originally very large doses of 125 I were prescribed (751-1,600 μCi/g) but 9 out of 15 patients (60%) became hypothyroid, therefore 4 smaller therapeutic regimes were employed. (1) 55 patients received doses of 200 μCi or less/g thyroid, 69% are euthyroid and 24% hypothyroid after an average of 33 months from treatment. (2) 87 patients received doses of 201-350 μCi/g thyroid, 67% are euthyroid and 21% hypothyroid after an average follow up of 30 months. (3) 70 patients received doses of 351-500 μCi/g thyroid, 77% are euthyroid and 18% hypothyroid 36 months after treatment and (4) 76 patients received doses of 501-750 μCi/g, 41% are euthyroid and 56% hypothyroid 49 months after therapy. No long term complications such as thyroid cancer or leukaemia have occurred but because 125 I does not eliminate or reduce the incidence of post treatment hypothyroidism it probably should not be used in preference to 131 I for the routine treatment of hyperthyroidism

  7. 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

  8. Simulating trends in crop yield and soil carbon in a long-term experiment - effects of rising CO2, N deposition and improved cultivation

    DEFF Research Database (Denmark)

    Berntsen, Jørgen; Petersen, Bjørn Molt; Olesen, Jørgen E.

    2006-01-01

    Measurements of crop yield and soil carbon in the Bad Lauchstädt long-term fertiliser experiment were analysed with the FASSET model. The model satisfactorily predicted yield and soil carbon development in four treatments: no fertiliser, mineral fertiliser, farmyard manure and farmyard manure plus...... was the use of new crop varieties and/or pesticides, while the increase in atmospheris CO2 and changes in local N deposition were of lesser importance. The rise in CO2 thus only explained 9-37% of the yield increase. The observed and simulated developments in soil carbon were quite different in the four...

  9. Long-term results of obstetric brachial plexus surgery

    OpenAIRE

    Kirjavainen , Mikko

    2010-01-01

    Background: Brachial plexus birth palsy (BPBP) most often occurs as a result of foetal-maternal disproportion. The C5 and C6 nerve roots of the brachial plexus are most frequently affected. In contrast, roots from the C7 to Th1 that result in total injury together with C5 and C6 injury, are affected in fewer than half of the patients. BPBP was first described by Smellie in 1764. Erb published his classical description of the injury in 1874 and his name became linked with the paralysis that is...

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

    Directory of Open Access Journals (Sweden)

    Naseem ul Gani

    2014-11-01

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

  11. Long-term results of the island flap palatal pushback.

    Science.gov (United States)

    Luce, E A; McClinton, M; Hoopes, J E

    1976-09-01

    We analyzed all 104 island flap pushback palatal repairs done through our Facial Rehabilitation Clinic in the period from 1965 to 1971. The results were compared to those in a group of 109 standard pushback repairs. The island flap group had a higher incidence of operative complications, of velopharyngeal insufficiency, and of secondary procedures to correct the latter. (The differences between the two groups were not statistically significant, however.) In this group of patients the island flap repair offered no particular advantage over the V-Y or the Dorrance pushback; in fact, it may have been deleterious. A hypothetical explanation for these results is offered, based on possible continuing osteogenesis by the transplanted mucoperiosteum, to produce an inflexible and poorly functioning velum.

  12. Brachytherapy in Lip Carcinoma: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-01

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

  13. Short Term Results of Arthroscopic Repair of Subscapularis Tendon Tear

    Directory of Open Access Journals (Sweden)

    Zohreh Zafarani

    2009-11-01

    Full Text Available Background:Despite being the largest rotator cuff tendon of the shoulder,the function and clinical relevance of subscapularis pathology has been largely ignored in the literature.Although many studies have focused on subscapularis tears recently,majority of them reported techniques for open repair. The advent of arthroscopy and   arthroscopic repair techniques has opened new frontiers in the diagnosis and repair of torn rotator cuff tendons, including the subscapularis.In this article,we review shortterm results of arthroscopic subscapularis repair. Method: Ten patients with subscapularis tendon tear of the rotator cuff were studied   prospectively including 8 men and 2 women with an average age of 49.7±12.8 years and an average delay in treatment of 23.3 months. Clinical outcomes, including the UCLAscore were assessed in all patients after 3 months of the surgery. Results: 6 patients were followed regularly for more than 6 months,while other 4 patients had a follow-up period of more than a year. The pain score improved from 1.75 to 9 and the UCLA score from 8.8 to 30.6.Conclusions: rthroscopic repair of subscapularis tendon tear results in significant subjective and objective improvement and high levels of patient satisfaction.  

  14. The role of episodic fire-related debris flows on long-term (103-104) sediment yields in the Middle Fork Salmon River Watershed, in central Idaho

    Science.gov (United States)

    Riley, K. E.; Pierce, J. L.; Hopkins, A.

    2010-12-01

    Episodic fire-related debris flows contribute large amounts of sediment and large woody debris to streams. This study evaluates fire-related sedimentation from small steep tributaries of the Middle Fork Salmon River (MFSR) in central Idaho to evaluate the timing, frequency, and magnitude of episodic fire-related sedimentation on long-term (10 3-10 4) sediment yields. The MFSR lies within the Northern Rocky Mountains and encompasses a range of ecosystems including high elevation (~3,000 -1,700 m) subalpine pine and spruce forests, mid-elevation (2650 - 1130 m) montane Douglas-fir and ponderosa pine-dominated forests and low elevation (~ 1,800 - 900 m) sagebrush steppe. Recent debris flow events in tributaries of the MFSR appear to primarily result from increased surface runoff, rilling, and progressive sediment bulking following high severity fires. This study estimates: 1) the volume of sediment delivered by four recent (1997-2008) fire-related debris flow events using real time kinematic GPS surveys, and 2) the timing of Holocene fire-related debris flow events determined by 14C dating charcoal fragments preserved in buried burned soils and within fire-related deposits. Our measured volumes of the four recent debris flow events are compared to two empirically derived volume estimates based on remotely sensed spatial data (burn severity and slope), measured geometric data (longitudinal profile, cross sectional area, flow banking angle), and precipitation records. Preliminary stratigraphic profiles in incised alluvial fans suggest that a large percentage of alluvial fan thickness is composed of fire-related deposits suggesting fire-related hillslope erosion is a major process delivering sediment to alluvial fans and to the MFSR. Fire-related deposits from upper basins compose ~71% of total alluvial fan thickness, while fire-related deposits from lower basins make up 36% of alluvial fan thickness. However, lower basins are less densely vegetated with small diameter

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

    Science.gov (United States)

    Bentkover, Stuart H

    2012-05-01

    This article presents a comprehensive clinical approach to plasma resurfacing for skin regeneration. Plasma technology, preoperative protocols, resurfacing technique, postoperative care, clinical outcomes, evidence-based results, and appropriate candidates for this procedure are discussed. Specific penetration depth and specific laser energy measurements are provided. Nitrogen plasma skin regeneration is a skin-resurfacing technique that offers excellent improvement of mild to moderate skin wrinkles and overall skin rejuvenation. It also provides excellent improvement in uniformity of skin color and texture in patients with hyperpigmentation with Fitzpatrick skin types 1 through 4. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Climate Change and Potassium Effects Under Different N-Fertilization Input on Potato (Solanum tuberosum L.) Yield in a Long Term Field Experiment

    Science.gov (United States)

    László, Márton, ,, Dr.

    2010-05-01

    achieved with poor N, P, K and Mg nutrient supply even with a normal quantity and distribution of rainfall. Yield was influenced by rainfall to a greater extent (Table 4) than by 150 kg ha-1 potassium combinations (NK, NPK, NPKMg). Drought and over rainfall negative effects were decreased by increasing N- doses with combinations of potassium, phosphorous and magnesium from 13 to 32% (Table 5 and 6). With the help of regression analysis it was found the polynomial correlation between rainfall and yield could be observed in the case of NK (Y'=381.65-2.95x+0.0056x2, n=72, R2=0.95), NPK (Y'=390.87-3.07x+0.0060x2, n=72, R2=0.96) and NPKMg (Y'=390.45-3.06x+0.0059x2, n=72, R2=0.96) nutrition systems. The optimum yield ranges between 17-20 t ha-1 at 280-330 mm of rainfall. From 1962 to 1979 the weather was highly variable, with particularly frequent droughts and over rainfall resulting in yield losses of 13 to 32 percentin in this period. Thus it is important to analyse the consequences of possible future climate change on crop in Hungary. REFERENCES A.E. Johnston. 2000. Some aspects of nitrogen use efficiency in arable agriculture. K. Scogs-o. Lantbr. Akad. Tidskr. 139: 8. Kádár, I-Márton, L.-Horváth, S. 2000. Mineral fertilisation of potato (Solanum tuberosum L.) on calcareous chernozem soil. Plant Production. 49: 291-306. László, M. 2000. Nutrition of potato (Solanum tuberosum L.) on Hungary on a chernozem soil. Acta Agronomica Óváriensis. 42: 81-93. László, M. 2001a. Climate change and N, P, K, Mg fertilization effects on potato (Solanum tuberosum L.) yield and quality. EAPR. Hamburg. In press László, M. 2001b. Year and N- fertilizer effect on winter rye (Secale cereale L.) yield in a long term field experiment. XLIII. Georgikon Days. University of Veszprém. Keszthely László, M.-Imre, K.-Jose, E.M. 2000a. Effects of Crotalaria juncea L. and Crotalaria spectabilis ROTH. on soil fertility and soil conservation in Hungary. Acta Agronomica Óváriensis. 42: 99

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  18. Partial ion yield and NEXAFS of 2-(perfluorooctyl)ethanethiol self-assembled monolayer: Comparison with PTFE results

    CERN Document Server

    Setoyama, H; Murase, T; Imamura, M; Mase, K; Okudaira, K K; Hara, M; Ueno, N

    2003-01-01

    Partial-ion-yield (PIY) spectra using ion time-of-flight (TOF) method and near-edge absorption fine structure (NEXAFS) spectra were measured for 2-(perfluorooctyl)ethanethiol [CF sub 3 (CF sub 2) sub 7 (CH sub 2) sub 2 SH] self-assembled monolayer (F8-SAM) on Au(1 1 1) near carbon K-edge. The PIY spectra of the F8-SAM at the magic angle, where -CF sub 3 groups exist at the surface were compared with those of the rubbed polytetrafluoroethylene (PTFE) thin film. The F sup + intensity from the F8-SAM at the photon energy of the sharp peak of the NEXAFS, which originates from the excitation of C1s electron to sigma sup * (C-F) states at -CF sub 2 - chain, was extremely smaller than that from the rubbed PTFE film. This result clearly indicates that the ions observed by PIY do not originate from the film inside but from the surface. This was confirmed by changes in ion-TOF mass spectra during soft X-ray induced etching of the F8-SAM. The NEXAFS peaks of the F8-SAM were also assigned by considering PIY results.

  19. Biochar improves fertility of a clay soil in the Brazilian Savannah: short term effects and impact on rice yield

    NARCIS (Netherlands)

    Melo Carvalho, de M.T.; Madari, B.E.; Bastiaans, L.; Oort, van P.A.J.; Heinemann, A.B.; Silva, da M.A.S.; Maia, A.H.N.; Meinke, H.B.

    2013-01-01

    The objective of this study was to report single season effects of wood biochar (char) application coupled with N fertilization on soil chemical properties, aerobic rice growth and grain yield in a clayey Rhodic Ferralsol in the Brazilian Savannah. Char application effected an increase in soil pH,

  20. Yield trends in the long-term crop rotation with organic and inorganic fertilisers on Alisols in Mata (Rwanda)

    NARCIS (Netherlands)

    Rutunga, V.; Neel, H.

    2006-01-01

    A crop rotation system with various species was established on Alisols at Mata grassland site, oriental side of Zaire-Nile Watershed Divide (CZN), Rwanda. Inorganic and organic fertilizers were applied in various plots under randomized complete blocs with three replicates. Crop yield data for each

  1. Sweet potato yields and nutrient dynamics after short-term fallows in the humid lowlands of Papua New Guinea

    NARCIS (Netherlands)

    Hartemink, A.E.

    2003-01-01

    Shifting cultivation is common in the humid lowlands of Papua New Guinea but little is known about the effect of different fallows on sweet potato (Ipomoea batatas) yield and nutrient flows and pools in these systems. An experiment was conducted in which two woody fallow species (Piper aduncum and

  2. Enhancement of preneoplastic lesion yield by Chios Mastic Gum in a rat liver medium-term carcinogenesis bioassay

    International Nuclear Information System (INIS)

    Doi, Kenichiro; Wei, Min; Kitano, Mitsuaki; Uematsu, Naomi; Inoue, Masayo; Wanibuchi, Hideki

    2009-01-01

    The mastic (Pistacia lentiscus var. chia) tree is native throughout the Mediterranean region and has long proved a source of food additives and medical treatments. To investigate the modifying effects of Chios Mastic Gum on rat liver carcinogenesis, 6-week-old male F344 rats were subjected to the established rat liver medium-term carcinogenesis bioassay (Ito-test). At the commencement, rats (groups 1-4) were intraperitoneally injected with 200 mg/kg body weight of diethylnitrosamine (DEN). After two weeks, mastic was added to CRF (Charles River Formula)-1 powdered basal diet at doses of 0, 0.01, 0.1 and 1% in groups 1-4, respectively. At week 3, all rats were underwent two-thirds partial hepatectomy. The experiment was terminated at week 8. As results show, liver weights were significantly increased in a mastic dose-dependent manner among groups 1-4. The numbers (/cm 2 ) and the areas (mm 2 /cm 2 ) of glutathione S-transferase placental form (GST-P)-positive cell foci (≥ 0.2 mm in diameter) were significantly increased in the DEN-1% group compared to the DEN-alone group, along with the average areas per foci and larger-sized foci (≥ 0.4 mm). 5-Bromo-2'-deoxyuridine (BrdU) + GST-P double-immunohistochemistry showed the highest BrdU-labeling indices within GST-P foci in the DEN-1% group. 8-hydroxydeoxyguanosine (8-OHdG) levels in liver DNA did not vary, while real-time quantitative polymerase chain reaction (PCR) analysis of livers revealed many up- or down-regulated genes in the DEN-1% group. In conclusion, this is the first report to display a promotion potential of Chios Mastic Gum on the formation of preneoplastic lesions in the established rat liver medium-term carcinogenesis bioassay

  3. 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.

  4. Ultrastructural examination of skin biopsies may assist in diagnosing mitochondrial cytopathy when muscle biopsies yield negative results.

    Science.gov (United States)

    McAfee, John L; Warren, Christine B; Prayson, Richard A

    2017-08-01

    Ultrastructural evaluation of skin biopsies has been utilized for diagnosis of mitochondrial disease. This study investigates how frequently skin biopsies reveal mitochondrial abnormalities, correlates skin and muscle biopsy findings, and describes clinical diagnoses rendered following the evaluation. A retrospective review of surgical pathology reports from 1990 to 2015 identified skin biopsies examined by electron microscopy for suspected metabolic disease. A total of 630 biopsies were included from 615 patients. Of these patients, 178 also underwent a muscle biopsy. Of the 630 skin biopsies, 75 (12%) showed ultrastructural abnormalities and 34 (5%) specifically showed mitochondrial abnormalities including increased size (n=27), reduced or abnormal cristae (n=23), dense matrices (n=20), and increased number (n=8). Additional findings included lysosomal abnormalities (n=13), lipid accumulation (n=2) or glycogen accumulation (n=1). Of the 34 patients with mitochondrial abnormalities on skin biopsy, 20 also had muscle biopsies performed and nine showed abnormalities suggestive of a mitochondrial disorder including absent cytochrome oxidase staining (n=2), increased subsarcolemmal NADH, SDH, or cytochrome oxidase staining (n=1), or ultrastructural findings including large mitochondrial size (n=5), abnormal mitochondrial structure (n=5), and increased mitochondrial number (n=4). The most common presenting symptoms were intellectual disability (n=13), seizures (n=12), encephalopathy (n=9), and gastrointestinal disturbances (n=9). At last known follow-up, 12 patients had a definitive diagnosis of a mitochondrial disorder. One patient each had Complex I deficiency, Complex III deficiency, Charcot-Marie-Tooth disease, pyruvate dehydrogenase deficiency, and Phelan-McDermid syndrome. Our results suggest that skin biopsy sometimes yields diagnostic clues suggestive of a mitochondrial cytopathy in cases with a negative muscle biopsy. Copyright © 2017 Elsevier Inc. All rights

  5. 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.)

  6. 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.)

  7. 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.)

  8. Evaluating strategies to improve glucosinolate concentration and root yield of field-grown horseradish in a Mediterranean environment: preliminary results

    Directory of Open Access Journals (Sweden)

    Anna Rita Rivelli

    2016-03-01

    Full Text Available Horseradish is grown for its enlarged taproot that is widely used as a dish condiment and as a source of horseradish peroxidase. Nowadays, the species is gaining great interest due to the richness in bioactive compounds that besides providing a high nutritional value are tested for innovative applications in different fields. Nevertheless, the effect of crop management on root yield and glucosinolates (GLS biosynthesis is poorly documented. Aim of this study was to evaluate the root yield and GLS concentration of two field-grown horseradish accessions (Cor and Mon grown with nitrogen (N alone and both N and sulphur (S (-N-S, +N-S and +N+S treatments and harvested at different times [late autumn (LA, 2011 and 2012, early spring (ES, 2012]. Yield increased throughout the harvests up to 48% on average of the fertilised treatments and 25% in the unfertilised control. Conversely, root GLS concentration significantly declined in the unfertilised control throughout the harvests [from 7.6 in LA_2011 to 1.43 μmol/g dry matter (DM in LA_2012] while it highly increased in plants grown with N alone and with both N and S by 46 and 98%, respectively, from LA_2011 to ES_2012 (up to 11.9 and 21.1 μmol/g DM, respectively; then it drastically decreased by 80% on average, in the next harvest. Among individual GLS, the concentration of sinigrin and nasturtin similarly varied as effect of the analysed factors, showing the highest values in Cor accession. The data show that although the level of GLS is highly dependent on genotype, fertilisation and harvesting date may play a primary role in determining the yield and GLS concentration in horseradish root.

  9. The Short-Term Effects of Rice Straw Biochar, Nitrogen and Phosphorus Fertilizer on Rice Yield and Soil Properties in a Cold Waterlogged Paddy Field

    Directory of Open Access Journals (Sweden)

    Linlin Si

    2018-02-01

    Full Text Available Crop productivity in cold waterlogged paddy fields can be constrained by chronic flooding stress and low temperature. Farmers typically use chemical fertilizer to improve crop production, but this conventional fertilization is not very effective in a cold waterlogged paddy field. Biochar amendment has been proposed as a promising management approach to eliminating these obstacles. However, little is known about the performance of biochar when combined with N fertilizer and P fertilizer in cold waterlogged soils. The aim of this study was, therefore, to assess the main effects and interactive effects of rice straw biochar, N and P fertilizer on rice growth and soil properties in a cold waterlogged paddy field. The field treatments consisted of a factorial combination of two biochar levels (0 and 2.25 t ha−1, two N fertilizer levels (120.0 and 180.0 kg ha−1 and two P fertilizer levels (37.5 and 67.5 kg ha−1 which were arranged in a randomized block design, with three replicates. Results confirmed that biochar application caused a significant increase in the soil pH due to its liming effect, while this application resulted in a significant decrease in soil exchangeable cations, such as exchangeable Ca, Mg, Al and base cations. The interactive effect of N fertilizer, P fertilizer and biochar was significant for soil total N. Moreover, a negative effect of biochar on the internal K use efficiency suggested that K uptake into rice may benefit from biochar application. According to the partial Eta squared values, the combined application of N fertilizer and biochar was as effective as pure P fertilization at increasing straw P uptake. The addition of biochar to farmers’ fertilization practice treatment (180.0 kg N ha−1, 67.5 kg P2O5 ha−1 and 67.5 kg K2O ha−1 significantly increased rice yield, mainly owing to improvements in grains per panicle. However, notable effects of biochar on rice yield and biomass production were not detected

  10. 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

  11. Long-Term Effects of Rotational Tillage On Visual Evaluation of Soil Structure, Soil Quality and Crop Yield

    DEFF Research Database (Denmark)

    Munkholm, Lars Juhl; Heck, Richard; Deen, Bill

    year old long-term rotation and tillage treatment experiment on a Canadian silt loam soil. Measurements were carried out in the topsoil for three different rotations: R1 (C-C-C-C) continuous corn (Zea mays L.), R6. (C-C-O(RC), B(RC)) corn, corn, oats (Avena fatua L.) and spring barley (Hordeum vulgare...... L.) and R8, (C-C-S-S) corn, corn, soybean (Glycine max L.), soybean. A red clover (Trifolium pretense L.) cover crop was under seeded in oats and spring barley in R6. In 2010, first year corn was grown in R6 and R8. The tillage treatments included no tillage, NT and mouldboard plowing, MP. Topsoil...

  12. Spatio-temporal patterns of the effects of precipitation variability and land use/cover changes on long-term changes in sediment yield in the Loess Plateau, China

    Science.gov (United States)

    Gao, Guangyao; Zhang, Jianjun; Liu, Yu; Ning, Zheng; Fu, Bojie; Sivapalan, Murugesu

    2017-09-01

    Within China's Loess Plateau there have been concerted revegetation efforts and engineering measures since the 1950s aimed at reducing soil erosion and land degradation. As a result, annual streamflow, sediment yield, and sediment concentration have all decreased considerably. Human-induced land use/cover change (LUCC) was the dominant factor, contributing over 70 % of the sediment load reduction, whereas the contribution of precipitation was less than 30 %. In this study, we use 50-year time series data (1961-2011), showing decreasing trends in the annual sediment loads of 15 catchments, to generate spatio-temporal patterns in the effects of LUCC and precipitation variability on sediment yield. The space-time variability of sediment yield was expressed notionally as a product of two factors representing (i) the effect of precipitation and (ii) the fraction of treated land surface area. Under minimal LUCC, the square root of annual sediment yield varied linearly with precipitation, with the precipitation-sediment load relationship showing coherent spatial patterns amongst the catchments. As the LUCC increased and took effect, the changes in sediment yield pattern depended more on engineering measures and vegetation restoration campaign, and the within-year rainfall patterns (especially storm events) also played an important role. The effect of LUCC is expressed in terms of a sediment coefficient, i.e., the ratio of annual sediment yield to annual precipitation. Sediment coefficients showed a steady decrease over the study period, following a linear decreasing function of the fraction of treated land surface area. In this way, the study has brought out the separate roles of precipitation variability and LUCC in controlling spatio-temporal patterns of sediment yield at catchment scale.

  13. Spatio-temporal patterns of the effects of precipitation variability and land use/cover changes on long-term changes in sediment yield in the Loess Plateau, China

    Directory of Open Access Journals (Sweden)

    G. Gao

    2017-09-01

    Full Text Available Within China's Loess Plateau there have been concerted revegetation efforts and engineering measures since the 1950s aimed at reducing soil erosion and land degradation. As a result, annual streamflow, sediment yield, and sediment concentration have all decreased considerably. Human-induced land use/cover change (LUCC was the dominant factor, contributing over 70 % of the sediment load reduction, whereas the contribution of precipitation was less than 30 %. In this study, we use 50-year time series data (1961–2011, showing decreasing trends in the annual sediment loads of 15 catchments, to generate spatio-temporal patterns in the effects of LUCC and precipitation variability on sediment yield. The space–time variability of sediment yield was expressed notionally as a product of two factors representing (i the effect of precipitation and (ii the fraction of treated land surface area. Under minimal LUCC, the square root of annual sediment yield varied linearly with precipitation, with the precipitation–sediment load relationship showing coherent spatial patterns amongst the catchments. As the LUCC increased and took effect, the changes in sediment yield pattern depended more on engineering measures and vegetation restoration campaign, and the within-year rainfall patterns (especially storm events also played an important role. The effect of LUCC is expressed in terms of a sediment coefficient, i.e., the ratio of annual sediment yield to annual precipitation. Sediment coefficients showed a steady decrease over the study period, following a linear decreasing function of the fraction of treated land surface area. In this way, the study has brought out the separate roles of precipitation variability and LUCC in controlling spatio-temporal patterns of sediment yield at catchment scale.

  14. 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.

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

    International Nuclear Information System (INIS)

    Fussl, C. M.

    2009-01-01

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

  16. Brain Information Sharing During Visual Short-Term Memory Binding Yields a Memory Biomarker for Familial Alzheimer's Disease.

    Science.gov (United States)

    Parra, Mario A; Mikulan, Ezequiel; Trujillo, Natalia; Sala, Sergio Della; Lopera, Francisco; Manes, Facundo; Starr, John; Ibanez, Agustin

    2017-01-01

    Alzheimer's disease (AD) as a disconnection syndrome which disrupts both brain information sharing and memory binding functions. The extent to which these two phenotypic expressions share pathophysiological mechanisms remains unknown. To unveil the electrophysiological correlates of integrative memory impairments in AD towards new memory biomarkers for its prodromal stages. Patients with 100% risk of familial AD (FAD) and healthy controls underwent assessment with the Visual Short-Term Memory binding test (VSTMBT) while we recorded their EEG. We applied a novel brain connectivity method (Weighted Symbolic Mutual Information) to EEG data. Patients showed significant deficits during the VSTMBT. A reduction of brain connectivity was observed during resting as well as during correct VSTM binding, particularly over frontal and posterior regions. An increase of connectivity was found during VSTM binding performance over central regions. While decreased connectivity was found in cases in more advanced stages of FAD, increased brain connectivity appeared in cases in earlier stages. Such altered patterns of task-related connectivity were found in 89% of the assessed patients. VSTM binding in the prodromal stages of FAD are associated to altered patterns of brain connectivity thus confirming the link between integrative memory deficits and impaired brain information sharing in prodromal FAD. While significant loss of brain connectivity seems to be a feature of the advanced stages of FAD increased brain connectivity characterizes its earlier stages. These findings are discussed in the light of recent proposals about the earliest pathophysiological mechanisms of AD and their clinical expression. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. Short-term effects of milking frequency on milk yield, milk composition, somatic cell count and milk protein profile in dairy goats

    DEFF Research Database (Denmark)

    Torres, Alexandr; Hernandez Castellano, Lorenzo E; Morales-delaNuez, Antonio

    2014-01-01

    Goats in Canary Islands are milked once a day by tradition, but in most countries with high technology on farms, goats are milked twice a day, which is known to improve milk yield. Therefore it is important to know whether the increase of milking frequency can improve the production without impai...... was returned to X2 and X1. Finally, quantitative analysis showed an increase in intensities of milk protein bands from X1 to X2, but the intensities of casein bands (αS1-CN, αS2-CN, β-CN, κ-CN) and major whey proteins (α-La, β-Lg) decreased from X2 to X3.......Goats in Canary Islands are milked once a day by tradition, but in most countries with high technology on farms, goats are milked twice a day, which is known to improve milk yield. Therefore it is important to know whether the increase of milking frequency can improve the production without...... impairing milk quality. The objective of this study was to investigate the short term effects of three milking frequencies on milk yield, milk composition, somatic cell count (SCC) and milk protein profile in dairy goats traditionally milked once a day. Twelve Majorera goats in early lactation (48±4 d...

  18. Long-term manure applications improve soil productivity and sustain high crop yield for acidic red soils

    Science.gov (United States)

    Intensive use of chemical nitrogen (N) fertilizers has resulted in severely reduced productivity of red soils (Ferralic Cambisol) due to accelerated acidification. Manure has been shown to be effective in improving soil productivity by preventing or reversing the acidification process, but little in...

  19. 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

  20. Brown midrib corn silage fed during the peripartal period increased intake and resulted in a persistent increase in milk solids yield of Holstein cows.

    Science.gov (United States)

    Stone, W C; Chase, L E; Overton, T R; Nestor, K E

    2012-11-01

    the BMRCS treatment were likely because of a reduction in fill, whereas the increased intakes in the postpartum period in cows fed the BMRCS were either because of the higher intakes during the prepartum period or because of a reduction in fill limitations in the postpartum period. The carryover response in wk 4 to 15 may have resulted from cows that received BMRCS during the transition period being in a more positive nutrient balance than cows fed CCS. The results of this study indicate the importance that digestible NDF can have in transition diets and the long-term production responses that can occur when intake is increased in the transition period. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  1. Final NOMAD results on {nu}{sub {mu}}{yields}{nu}{sub {tau}} and {nu}{sub e}{yields}{nu}{sub {tau}} oscillations including a new search for {nu}{sub {tau}} appearance using hadronic {tau} decays

    Energy Technology Data Exchange (ETDEWEB)

    Astier, P.; Autiero, D.; Baldisseri, A.; Baldo-Ceolin, M.; Banner, M.; Bassompierre, G.; Benslama, K.; Besson, N.; Bird, I.; Blumenfeld, B.; Bobisut, F.; Bouchez, J.; Boyd, S.; Bueno, A.; Bunyatov, S.; Camilleri, L.; Cardini, A.; Cattaneo, P.W.; Cavasinni, V.; Cervera-Villanueva, A.; Chukanov, A.; Collazuol, G.; Conforto, G.; Conta, C.; Contalbrigo, M.; Cousins, R.; Daniels, D.; Degaudenzi, H.; Del Prete, T.; De Santo, A.; Dignan, T.; Di Lella, L.; Couto e Silva, E. do; Dumarchez, J.; Ellis, M.; Feldman, G.J.; Ferrari, R.; Ferrere, D.; Flaminio, V.; Fraternali, M.; Gaillard, J.-M.; Gangler, E.; Geiser, A.; Geppert, D.; Gibin, D.; Gninenko, S.; Godley, A.; Gomez-Cadenas, J.-J.; Gosset, J.; Goessling, C.; Gouanere, M.; Grant, A.; Graziani, G.; Guglielmi, A.; Hagner, C.; Hernando, J.; Hubbard, D.; Hurst, P.; Hyett, N.; Iacopini, E.; Joseph, C.; Juget, F.; Kirsanov, M.; Klimov, O.; Kokkonen, J.; Kovzelev, A.; Krasnoperov, A.; Kustov, D.; Kuznetsov, V.E.; Lacaprara, S.; Lachaud, C.; Lakic, B.; Lanza, A.; La Rotonda, L.; Laveder, M.; Letessier-Selvon, A.; Levy, J.-M.; Linssen, L.; Ljubic, A.; Long, J.; Lupi, A.; Marchionni, A.; Martelli, F.; Mechain, X.; Mendiburu, J.-P.; Meyer, J.-P.; Mezzetto, M.; Mishra, S.R.; Moorhead, G.F.; Naumov, D.; Nedelec, P.; Nefedov, Yu.; Nguyen-Mau, C.; Orestano, D.; Pastore, F.; Peak, L.S.; Pennacchio, E.; Pessard, H.; Petti, R. E-mail: roberto.petti@cern.ch; Placci, A.; Polesello, G.; Pollmann, D.; Polyarush, A.; Popov, B.; Poulsen, C.; Rico, J.; Riemann, P.; Roda, C.; Rubbia, A.; Salvatore, F.; Schahmaneche, K.; Schmidt, B.; Schmidt, T.; Sconza, A.; Sevior, M.; Sillou, D.; Soler, F.J.P.; Sozzi, G.; Steele, D.; Stiegler, U.; Stipc, M.; Stolarczyk, Th.; Tareb-Reyes, M.; Taylor, G.N.; Tereshchenko, V.; Toropin, A.; Touchard, A.-M.; Tovey, S.N.; Tran, M.-T.; Tsesmelis, E.; Ulrichs, J.; Vacavant, L.; Valdata-Nappi, M.; Valuev, V.; Vannucci, F.; Varvell, K.E.; Veltri, M.; Vercesi, V.; Vidal-Sitjes, G.; Vieira, J.-M.; Vinogradova, T.[and others

    2001-09-17

    Results from the {nu}{sub {tau}} appearance search in a neutrino beam using the full NOMAD data sample are reported. A new analysis unifies all the hadronic {tau} decays, significantly improving the overall sensitivity of the experiment to oscillations. The 'blind analysis' of all topologies yields no evidence for an oscillation signal. In the two-family oscillation scenario, this sets a 90% CL allowed region in the sin{sup 2}2{theta}{sub {mu}}{sub {tau}}-{delta}m{sup 2} plane which includes sin{sup 2}2{theta}{sub {mu}}{sub {tau}}<3.3x10{sup -4} at large {delta}m{sup 2} and {delta}m{sup 2}< 0.7 eV{sup 2}/c{sup 4} at sin{sup 2}2{theta}{sub {mu}}{sub {tau}}=1. The corresponding contour in the {nu}{sub e}{yields}{nu}{sub {tau}} oscillation hypothesis results in sin{sup 2}2{theta}{sub e{tau}}<1.5x10{sup -2} at large {delta}m{sup 2} and {delta}m{sup 2}<5.9 eV{sup 2}/c{sup 4} at sin{sup 2}2{theta}{sub e{tau}}=1. We also derive limits on effective couplings of the {tau} lepton to {nu}{sub {mu}} or {nu}{sub e}.

  2. [Effects of long-term mixed application of organic and inorganic fertilizers on canopy apparent photosynthesis and yield of winter wheat].

    Science.gov (United States)

    Zhao, Jun; Dong, Shu-ting; Liu, Peng; Zhang, Ji-wang; Zhao, Bin

    2015-08-01

    A field experiment was conducted using the winter wheat (Triticum aestivum) variety Shimai 15. The source of organic nitrogen was cow manure, and four fertilization treatments were included, i.e., no N fertilizer application, single application of urea, single application of cow manure, and mixed application of urea and cow manure. The effects of different applications of inorganic and organic nitrogen on canopy apparent photosynthesis (CAP), photosynthetic rate of flag leaves (Pn), leaf area index (LAI), florescence parameters and grain yield of winter wheat were determined. The results showed that urea had the largest effect on the early growth period, as at this stage the CAP, Pn and LAI of the single application of urea were the highest, which was followed by the mixed application and the single application of cow manure. However, 10 days after anthesis, the single application of cow manure and the mixed application delayed the leaf senescence process when compared with the single application of urea. This could be due to the two treatments having higher anti-oxidant enzyme activity and promoting a longer green leaf duration, which could maintain a higher photosynthetic capability. What' s more, the mixed application had a better performance and got the highest grain yield. Consequently, the mixed application of organic and inorganic fertilizers could delay leaf senescence and maintain a better canopy structure and higher photosynthesis capability at the late grain filling stage, which resulted in a higher grain yield.

  3. Ordering blood tests for patients with unexplained fatigue in general practice: what does it yield? Results of the VAMPIRE trial.

    NARCIS (Netherlands)

    Koch, H.; Bokhoven, M.A. van; Riet, G. ter; Alphen-Jager, J.T. van; Weijden, T.T. van der; Dinant, G.J.; Bindels, P.J.

    2009-01-01

    BACKGROUND: Unexplained fatigue is frequently encountered in general practice. Because of the low prior probability of underlying somatic pathology, the positive predictive value of abnormal (blood) test results is limited in such patients. AIM: The study objectives were to investigate the

  4. Ordering blood tests for patients with unexplained fatigue in general practice: what does it yield? Results of the VAMPIRE trial

    NARCIS (Netherlands)

    Koch, Hèlen; van Bokhoven, Marloes A.; ter Riet, Gerben; van Alphen-Jager, Jm Tineke; van der Weijden, Trudy; Dinant, Geert-Jan; Bindels, Patrick Je

    2009-01-01

    Background Unexplained fatigue is frequently encountered in general practice. Because of the low prior probability of underlying somatic pathology, the positive predictive value of abnormal (blood) test results is limited in such patients. Aim The study objectives were to investigate the

  5. Evaluation of an organic package of practice towards integrated management of Solanum tuberosum and its comparison with conventional farming in terms of yield, quality, energy efficiency and economics

    Directory of Open Access Journals (Sweden)

    Antara Seal

    2017-09-01

    Full Text Available A study was taken up during 2014-16 for evaluating the potential of an organic package of practice towards integrated crop production (green farming in comparison to conventional farmers’ practice in West Bengal, India. Under green farming, compost was integrated with chemical fertilizer for soil management while organic plant/ pest management was undertaken utilizing Inhana Rational Farming (IRF Technology. The study indicated higher yield (9.7 %, higher nutrient use efficiency and economic sustainability under green farming irrespective of study area or potato variety. Higher qualitative expression in terms of starch content, pulp pH, vitamin C etc. under green farming might be due to the organic plant management aimed at energization of plant biochemical functions. Soil quality development as noted under green farming might have been influenced by the on-farm produced compost containing rich self- generated micro flora (in order of 1016 per colony forming unit.. The study indicated that green farming may serve as an efficient substitute of conventional farming towards yield sustenance, abatement of food toxicity and quality end product; through higher use of renewable energy and activation of plant physiological functions.

  6. Associations between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results

    OpenAIRE

    Lyden, Hannah; Gimbel, Sarah I.; Del Piero, Larissa; Tsai, A. Bryna; Sachs, Matthew E.; Kaplan, Jonas T.; Margolin, Gayla; Saxbe, Darby

    2016-01-01

    Associations between brain structure and early adversity have been inconsistent in the literature. These inconsistencies may be partially due to methodological differences. Different methods of brain segmentation may produce different results, obscuring the relationship between early adversity and brain volume. Moreover, adolescence is a time of significant brain growth and certain brain areas have distinct rates of development, which may compromise the accuracy of automated segmentation appr...

  7. Associations Between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results

    Directory of Open Access Journals (Sweden)

    Hannah Lyden

    2016-09-01

    Full Text Available Associations between brain structure and early adversity have been inconsistent in the literature. These inconsistencies may be partially due to methodological differences. Different methods of brain segmentation may produce different results, obscuring the relationship between early adversity and brain volume. Moreover, adolescence is a time of significant brain growth and certain brain areas have distinct rates of development, which may compromise the accuracy of automated segmentation approaches. In the current study, 23 adolescents participated in two waves of a longitudinal study. Family aggression was measured when the youths were 12 years old, and structural scans were acquired an average of 4 years later. Bilateral amygdalae and hippocampi were segmented using three different methods (manual tracing, FSL, and NeuroQuant. The segmentation estimates were compared, and linear regressions were run to assess the relationship between early family aggression exposure and all three volume segmentation estimates. Manual tracing results showed a positive relationship between family aggression and right amygdala volume, whereas FSL segmentation showed negative relationships between family aggression and both the left and right hippocampi. However, results indicate poor overlap between methods, and different associations between early family aggression exposure and brain volume depending on the segmentation method used.

  8. Associations between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results.

    Science.gov (United States)

    Lyden, Hannah; Gimbel, Sarah I; Del Piero, Larissa; Tsai, A Bryna; Sachs, Matthew E; Kaplan, Jonas T; Margolin, Gayla; Saxbe, Darby

    2016-01-01

    Associations between brain structure and early adversity have been inconsistent in the literature. These inconsistencies may be partially due to methodological differences. Different methods of brain segmentation may produce different results, obscuring the relationship between early adversity and brain volume. Moreover, adolescence is a time of significant brain growth and certain brain areas have distinct rates of development, which may compromise the accuracy of automated segmentation approaches. In the current study, 23 adolescents participated in two waves of a longitudinal study. Family aggression was measured when the youths were 12 years old, and structural scans were acquired an average of 4 years later. Bilateral amygdalae and hippocampi were segmented using three different methods (manual tracing, FSL, and NeuroQuant). The segmentation estimates were compared, and linear regressions were run to assess the relationship between early family aggression exposure and all three volume segmentation estimates. Manual tracing results showed a positive relationship between family aggression and right amygdala volume, whereas FSL segmentation showed negative relationships between family aggression and both the left and right hippocampi. However, results indicate poor overlap between methods, and different associations were found between early family aggression exposure and brain volume depending on the segmentation method used.

  9. Long-term hormonal contraceptive use is associated with a reversible suppression of antral follicle count and a break from hormonal contraception may improve oocyte yield.

    Science.gov (United States)

    Letourneau, Joseph M; Cakmak, Hakan; Quinn, Molly; Sinha, Nikita; I Cedars, Marcelle; Rosen, Mitchell P

    2017-09-01

    Unlike infertility, patients presenting for fertility preservation (FP) are often using combined hormonal contraceptives (CHC). We studied whether long-term (≥6 months) CHC use is associated with reversible suppression of antral follicle count (AFC). This is a longitudinal study of FP cycles from 2012 to 2016. We studied three groups: those without CHC exposure (NO CHC), those with CHC usage with a CHC break (BREAK), and without a break (NO BREAK) prior to ovarian stimulation. We assessed ovarian reserve by AFC at initial consultation and discussed the possibility of CHC suppression of AFC. Patients chose between ovarian stimulation with no CHC break versus ovarian stimulation after a CHC break. AFC was measured serially in the BREAK group. We assessed whether AFC suppression was reversed in the BREAK group. Total oocyte yield was compared among the NO CHC, BREAK, and NO BREAK groups. T tests, ANOVA, and linear/logistic regressions were used. Seven hundred forty-three women underwent FP. Twenty-one percent (n = 154) were taking long-term CHC (≥6 months). AFC suppression was more likely with CHC use (OR 1.6, 95% CI 1.1-2.4, P = 0.011). The BREAK group (n = 79) stopped CHC for an average of 4 months. AFC improvement started at 1 month and plateaued at approximately 6- to 7-month break. The BREAK group had approximately twice as many oocytes per initial AFC as NO BREAK (2.8 ± 3.8 vs. 1.4 ± 0.9, P women present for FP on CHC, AFC may be suppressed. A CHC break of several months is associated with an increase in AFC and a potential improvement in overall egg yield.

  10. Modified Grice-Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy.

    Science.gov (United States)

    Güven, Melih; Tokyay, Abbas; Akman, Budak; Encan, Mehmet E; Altintaş, Faik

    2016-03-01

    The aim of this study was to report the experience with the use of a modified Grice-Green technique, which was performed using a partial subperiosteal fibular bone graft because of valgus unstable foot in children with cerebral palsy. Fifteen feet of 11 patients were evaluated on the basis of the appearance of the feet, clinical symptoms, and radiographic measurements. After an average follow-up duration of 24 (9-39) months, all feet showed satisfactory clinical and radiological results. Solid fusion and sustained correction took place in all feet. The gap at the donor site was bridged with new bone in all cases. No donor-site morbidity was detected. This modification of the Grice-Green technique can be used effectively in the correction of planovalgus foot in cerebral palsy.

  11. Long-term no-tillage application increases soil organic carbon, nitrous oxide emissions and faba bean (Vicia faba L.) yields under rain-fed Mediterranean conditions.

    Science.gov (United States)

    Badagliacca, Giuseppe; Benítez, Emilio; Amato, Gaetano; Badalucco, Luigi; Giambalvo, Dario; Laudicina, Vito Armando; Ruisi, Paolo

    2018-05-20

    The introduction of legumes into crop sequences and the reduction of tillage intensity are both proposed as agronomic practices to mitigate the soil degradation and negative impact of agriculture on the environment. However, the joint effects of these practices on nitrous oxide (N 2 O) and ammonia (NH 3 ) emissions from soil remain unclear, particularly concerning semiarid Mediterranean areas. In the frame of a long-term field experiment (23 years), a 2-year study was performed on the faba bean (Vicia faba L.) to evaluate the effects of the long-term use of no tillage (NT) compared to conventional tillage (CT) on yield and N 2 O and NH 3 emissions from a Vertisol in a semiarid Mediterranean environment. Changes induced by the tillage system in soil bulk density, water filled pore space (WFPS), organic carbon (TOC) and total nitrogen (TN), denitrifying enzyme activity (DEA), and bacterial gene (16S, amoA, and nosZ) abundance were measured as parameters potentially affecting N gas emissions. No tillage, compared with CT, significantly increased the faba bean grain yield by 23%. The tillage system had no significant effect on soil NH 3 emissions. Total N 2 O emissions, averaged over two cropping seasons, were higher in NT than those in CT plots (2.58 vs 1.71 kg N 2 O-N ha -1 , respectively; P emissions in NT plots were ascribed to the increase of soil bulk density and WFPS, bacteria (16S abundance was 96% higher in NT than that in CT) and N cycle genes (amoA and nosZ abundances were respectively 154% and 84% higher in NT than that in CT). The total N 2 O emissions in faba bean were similar to those measured in other N-fertilized crops. In conclusion, a full evaluation of NT technique, besides the benefits on soil characteristics (e.g. TOC increase) and crop yield, must take into account some criticisms related to the increase of N 2 O emissions compared to CT. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Results of the Abbott RealTime HIV-1 Assay for Specimens Yielding “Target Not Detected” Results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test▿

    OpenAIRE

    Babady, N. Esther; Germer, Jeffrey J.; Yao, Joseph D. C.

    2009-01-01

    No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding “target not detected” results by CTM.

  13. Results of the Abbott RealTime HIV-1 assay for specimens yielding "target not detected" results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test.

    Science.gov (United States)

    Babady, N Esther; Germer, Jeffrey J; Yao, Joseph D C

    2010-03-01

    No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding "target not detected" results by CTM.

  14. Streamflow response and sediment yield after farmland abandonment: results from a small experimental catchment in the Central Spanish Pyrenees

    Directory of Open Access Journals (Sweden)

    Serrano-Muela, M. P.

    2010-12-01

    Full Text Available A small catchment affected by agricultural practices in the past, then progressively abandoned and naturally re-vegetated was monitored in the central Spanish Pyrenees. The results obtained over a 9-year period revealed the complexity of its hydrological and geomorphological behaviour. Several runoff generation processes can occur at the same time and in different parts of the catchment, depending on the water reserves conditions and rainfall characteristics. Sediment response is mainly controlled by the spatial and temporal dynamics of water and sediment contributing areas within the catchment. The sediment output illustrates the complexity of the geomorphic response of mountain environments modified by past farmland activities.

    Se presenta una síntesis de la investigación realizada en una pequeña cuenca experimental afectada por una intensa actividad agraria en el pasado y sujeta a un proceso de revegetación natural en la actualidad en el Pirineo Central. Los principales resultados obtenidos demuestran su complejo comportamiento hidrogeomorfológico. El análisis de la información hidrológica sugiere que diferentes procesos dominantes de generación de escorrentía pueden ocurrir de manera simultánea en diferentes áreas de la cuenca, en función del estado de humedad de la misma y de las características de la precipitación. La respuesta sedimentológica está principalmente controlada por la dinámica espacio-temporal de las áreas fuente de escorrentía y de sedimento. La exportación de sedimento ilustra la complejidad de la respuesta geomorfológica en los ambientes de montaña afectados por actividades agrarias en el pasado.

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Rui Gao

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

  17. 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

  18. Laparoscopic and open subtotal colectomies have similar short-term results

    NARCIS (Netherlands)

    Hoogenboom, Froukje J.; Bosker, Robbert J. I.; Groen, Henk; Meijerink, Wilhelmus J. H. J.; Lamme, Bas; Pierie, Jean Pierre E. N.

    2013-01-01

    Background: Laparoscopic subtotal colectomy (STC) is a complex procedure. It is possible that short-term benefits for segmental resections cannot be attributed to this complex procedure. This study aims to assess differences in shortterm results for laparoscopic versus open STC during a 15year

  19. Simplicial quantum gravity with higher derivative terms: Formalism and numerical results in four dimensions

    International Nuclear Information System (INIS)

    Hamber, H.W.; Williams, R.M.; Cambridge Univ.

    1986-01-01

    Higher derivative terms for Regge's formulation of lattice gravity are discussed. The analytic weak-field expansion for the regular tessellation α 5 of the four-sphere is presented. Preliminary numerical results for some computations in four dimensions are also discussed. (orig.)

  20. 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

  1. 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

  2. Short-term results after arthroscopic resection of synovial plicae in the radiohumeral joint

    DEFF Research Database (Denmark)

    Brahe Pedersen, Jens; Kristensen, Pia Kjær; Mønsted, Peter

    2017-01-01

    INTRODUCTION: Painful Synovial Plicae (SP) in the posterolateral corner of the radiohumeral joint may be confused with lateral epicondylitis. The SP may impinge between the radial head and the humeral capitellum causing pain and snapping. The aim of this study was to evaluate the short-term results...

  3. Long-term results of synchronized radiotherapy in squamous cell carcinomas

    International Nuclear Information System (INIS)

    Esser, E.; Wannenmacher, M.

    1979-01-01

    Two clinical pilot investigations concerning the so-called synchronised radiotherapy of inoperable oral cavity-oropharynx carcinomas are compared. There are no considerable therapeutical differences. Synchronisation-caused partial effects cannot be manifested clinically. Generally, chemoradiotherapy seems to bring an improvement of the short-term results, with an increased rate of side effects. (orig.) 891 MG/orig. 892 RDG [de

  4. Peri-apatite coating decreases uncemented tibial component migration: long-term RSA results of a randomized controlled trial and limitations of short-term results.

    Science.gov (United States)

    Van Hamersveld, Koen T; Marang-Van De Mheen, Perla J; Nelissen, Rob G H H; Toksvig-Larsen, Sören

    2018-05-09

    Background and purpose - Biological fixation of uncemented knee prostheses can be improved by applying hydroxyapatite coating around the porous surface via a solution deposition technique called Peri-Apatite (PA). The 2-year results of a randomized controlled trial, evaluating the effect of PA, revealed several components with continuous migration in the second postoperative year, particularly in the uncoated group. To evaluate whether absence of early stabilization is diagnostic of loosening, we now present long-term follow-up results. Patients and methods - 60 patients were randomized to PA-coated or uncoated (porous only) total knee arthroplasty of which 58 were evaluated with radiostereometric analysis (RSA) performed at baseline, at 3 months postoperatively and at 1, 2, 5, 7, and 10 years. A linear mixed-effects model was used to analyze the repeated measurements. Results - PA-coated components had a statistically significantly lower mean migration at 10 years of 0.94 mm (95% CI 0.72-1.2) compared with the uncoated group showing a mean migration of 1.72 mm (95% CI 1.4-2.1). Continuous migration in the second postoperative year was seen in 7 uncoated components and in 1 PA-coated component. All of these implants stabilized after 2 years except for 2 uncoated components. Interpretation - Peri-apatite enhances stabilization of uncemented components. The number of components that stabilized after 2 years emphasizes the importance of longer follow-up to determine full stabilization and risk of loosening in uncemented components with biphasic migration profiles.

  5. Immediate and intermediate-term results of optical coherence tomography guided atherectomy in the treatment of peripheral arterial disease: Initial results from the VISION trial

    International Nuclear Information System (INIS)

    Cawich, Ian; Paixao, Andre R.M.; Marmagkiolis, Konstantinos; Lendel, Vasili; Rodriguez-Araujo, Gerardo; Rollefson, William A.; Mego, David M.; Cilingiroglu, Mehmet

    2016-01-01

    Background: Long-term patency rates for percutaneous peripheral arterial interventions are suboptimal. Optical coherence tomography (OCT) guided atherectomy may yield superior patency by optimizing plaque removal while preserving the tunica media and adventitia. Methods: The VISION study is a multicenter prospective study of patients with peripheral arterial disease undergoing OCT guided atherectomy with the Pantheris™ device. In 11 patients enrolled in a single center, we report procedural and clinical outcomes, at 30 days and 6 months. Results: The mean age was 63 ± 11 years and 73% (n = 8) were men. The target lesion was in the superficial femoral artery in 82% (n = 9) of the patients. Mean stenosis severity was 87% ± 10% and mean lesion length was 39 ± 31 mm. Procedural success was observed in all patients with no device related complications. Mean post-atherectomy stenosis was 18% ± 15%. Almost all excised tissue consisted of intimal plaque (94%). At 30 days, significant improvements in Rutherford class, VascuQoL scores and ABI were observed, 0.9 ± 0.8 vs. 3.1 ± 0.7 (p = 0.01), 4.9 ± 1.9 vs. 3.6 ± 1.5 (p = 0.03) and 1.04 ± 0.19 vs. 0.80 ± 0.19 (p < 0.01) respectively. At 6 months, there were significant improvements in Rutherford class (1.0 ± 1.0 vs. 3.1 ± 0.7, p = 0.01) and ABI (0.93 ± 0.19 versus 0.80 ± 0.19, p = 0.02) but not in VascuQoL scores (3.7 ± 1.4 versus 3.6 ± 1.5, p = 0.48). Target lesion revascularization occurred in 18% (n = 2) of the patients. Conclusion: OCT guided atherectomy resulted in high procedural success, no device related complications and encouraging results up to 6 months. Histological analysis suggested little injury to the media and adventitia. Larger studies are needed to confirm the efficacy of this approach. - Highlights: • OCT- guided atherectomy may yield superior patency by optimizing plaque removal and preserving the tunica media and adventitia. • OCT guided atherectomy resulted in high procedural

  6. Immediate and intermediate-term results of optical coherence tomography guided atherectomy in the treatment of peripheral arterial disease: Initial results from the VISION trial

    Energy Technology Data Exchange (ETDEWEB)

    Cawich, Ian; Paixao, Andre R.M. [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Marmagkiolis, Konstantinos [Citizens Memorial Heart and Vascular Institute, Bolivar, MO (United States); University of Missouri, Columbia, MO (United States); Lendel, Vasili; Rodriguez-Araujo, Gerardo; Rollefson, William A.; Mego, David M. [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Cilingiroglu, Mehmet, E-mail: Cilingiroglumehmet@gmail.com [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Koc University, School of Medicine, Istanbul (Turkey)

    2016-10-15

    Background: Long-term patency rates for percutaneous peripheral arterial interventions are suboptimal. Optical coherence tomography (OCT) guided atherectomy may yield superior patency by optimizing plaque removal while preserving the tunica media and adventitia. Methods: The VISION study is a multicenter prospective study of patients with peripheral arterial disease undergoing OCT guided atherectomy with the Pantheris™ device. In 11 patients enrolled in a single center, we report procedural and clinical outcomes, at 30 days and 6 months. Results: The mean age was 63 ± 11 years and 73% (n = 8) were men. The target lesion was in the superficial femoral artery in 82% (n = 9) of the patients. Mean stenosis severity was 87% ± 10% and mean lesion length was 39 ± 31 mm. Procedural success was observed in all patients with no device related complications. Mean post-atherectomy stenosis was 18% ± 15%. Almost all excised tissue consisted of intimal plaque (94%). At 30 days, significant improvements in Rutherford class, VascuQoL scores and ABI were observed, 0.9 ± 0.8 vs. 3.1 ± 0.7 (p = 0.01), 4.9 ± 1.9 vs. 3.6 ± 1.5 (p = 0.03) and 1.04 ± 0.19 vs. 0.80 ± 0.19 (p < 0.01) respectively. At 6 months, there were significant improvements in Rutherford class (1.0 ± 1.0 vs. 3.1 ± 0.7, p = 0.01) and ABI (0.93 ± 0.19 versus 0.80 ± 0.19, p = 0.02) but not in VascuQoL scores (3.7 ± 1.4 versus 3.6 ± 1.5, p = 0.48). Target lesion revascularization occurred in 18% (n = 2) of the patients. Conclusion: OCT guided atherectomy resulted in high procedural success, no device related complications and encouraging results up to 6 months. Histological analysis suggested little injury to the media and adventitia. Larger studies are needed to confirm the efficacy of this approach. - Highlights: • OCT- guided atherectomy may yield superior patency by optimizing plaque removal and preserving the tunica media and adventitia. • OCT guided atherectomy resulted in high procedural

  7. 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.

  8. Short- and long-term effects of forage supplementation of calves during the preweaning period on performance, reproduction, and milk yield at first lactation.

    Science.gov (United States)

    Castells, Ll; Bach, A; Terré, M

    2015-07-01

    Sixty female Holstein calves [body weight (BW)=39.5±3.76kg] were fed a ground starter concentrate [19% crude protein, 19% neutral detergent fiber (NDF)] during the preweaning period. Furthermore, oats hay (68% NDF) was supplemented only during the postweaning period (CON) or during both pre- and postweaning periods (OH) to evaluate performance until first breeding, diet digestibility after weaning, reproductive performance, and milk yield at first lactation. Calves were individually housed and bedded with wood shavings. All calves were offered 6 L/d of milk replacer (MR) at 12% dry matter (DM) in 2 feedings until 28d of age, 3 L/d of MR at 12% DM in 2 feedings from 29 to 44d of age calves, and 1.5 L of MR at 12% DM in 1 feeding from 45 to 51d of age. Animals were weaned at 52d of age. Starter concentrate and forage intake were recorded daily and BW weekly until 65d of age. Two weeks after weaning, total-tract apparent digestibility was determined in 6 calves per treatment. Heifer BW was recorded at 10 mo of age. Breeding and milk yield at first lactation were also recorded. Starter concentrate intake was greater in OH compared with CON animals during the preweaning period. As a result, calves in the OH treatment had greater average daily gain (ADG) than CON animals during the preweaning period. After weaning, OH calves consumed more forage than CON animals, but we found no differences between treatments in ADG and starter concentrate intake. Similarly, total-tract apparent digestibility did not differ between treatments, and BW and ADG from 2wk after weaning to 10mo of age did not differ between treatments. Moreover, no differences in reproductive performance [age at first artificial insemination (AI), age at fertile insemination, conception rate at first AI, and number of AI] or milk yield at first lactation were observed between treatments, although a positive relationship between growth rate early in life and future energy-corrected milk yield was found. We

  9. 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.

  10. 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.

  11. Ketogenic enteral nutrition as a treatment for obesity: short term and long term results from 19,000 patients

    Directory of Open Access Journals (Sweden)

    Cappello Gianfranco

    2012-10-01

    Full Text Available Abstract Background Only protein diet has been used successfully to prevent loss of lean body mass first in post-surgical and then in obese patients. We studied overweight and obese patients receiving short treatments of an exclusively protein-based nutritional solution as 24-hour enteral infusion. Methods 19,036 patients (age 44.3 ± 13, M:F = 2:5 with an initial body mass index of 36.5 ± 7.1 underwent 10-day cycles of enteral nutrition through a fine nasogastric tube. The nutritional solution consisted solely of 50–65 g of proteins, plus vitamins and electrolytes. The 24-hour infusion was controlled with a small portable pump. Before and after each 10-day cycle body composition was checked with a Handy 3000 impedance analyzer. At the onset of treatment, average fat mass was 40.9 ± 12.8 kg while body cell mass was 42.7 ± 7.2 kg in males and 27.4 ± 4.6 kg in females. Results After an average of 2.5 cycles the patients lost 10.2 ± 7.0 kg of body weight, 5.8 ± 5.5 kg of fat mass and 2.2 ± 3.3 kg of body cell mass. No significant adverse effects were recorded except asthenia and constipation which were easily controlled with therapy. Long-term results were obtained from 15,444 patients and after an average of 362 ± 296 days we found a mean weight regain of 15.4%. Conclusion Ketogenic Enteral Nutrition treatment of over 19,000 patients induced a rapid 10% weight loss, 57% of which was Fat Mass. No significant adverse effects were found. The treatment is safe, fast, inexpensive and has good one-year results for weight maintenance.

  12. 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

  13. Economic evaluation of short-term wind power forecast in ERCOT. Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Orwig, Kirsten D.; Hodge, Bri-Mathias; Brinkman, Greg; Ela, Erik; Milligan, Michael [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Banunarayanan, Venkat; Nasir, Saleh [ICF International, Fairfax, VA (United States); Freedman, Jeff [AWS Truepower, Albany, NY (United States)

    2012-07-01

    A number of wind energy integration studies have investigated the monetary value of using day-ahead wind power forecasts for grid operation decisions. Historically, these studies have shown that large cost savings could be gained by grid operators implementing the forecasts in their system operations. To date, none of these studies have investigated the value of shorter term (0- to 6-h ahead) wind power forecasts. In 2010, the Department of Energy and the National Oceanic and Atmospheric Administration partnered to form the Wind Forecasting Improvement Project (WFIP) to fund improvements in short-term wind forecasts and determine the economic value of these improvements to grid operators. In this work, we discuss the preliminary results of the economic benefit analysis portion of the WFIP for the Electric Reliability Council of Texas. The improvements seen in the wind forecasts are examined and the economic results of a production cost model simulation are analyzed. (orig.)

  14. Early and mid-term results of lung transplantation with donors 60 years and older.

    Science.gov (United States)

    López, Iker; Zapata, Ricardo; Solé, Juan; Jaúregui, Alberto; Deu, María; Romero, Laura; Pérez, Javier; Bello, Irene; Wong, Manuel; Ribas, Montse; Masnou, Nuria; Rello, Jordi; Roman, Antonio; Canela, Mercedes

    2015-01-01

    There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Mouse embryonic stem cells efficiently lipofected with nuclear localization peptide result in a high yield of chimeric mice and retain germline transmission potency.

    Science.gov (United States)

    Ma, Haiching; Liu, Qin; Diamond, Scott L; Pierce, Eric A

    2004-06-01

    Embryonic stem (ES) cells are an important tool in developmental biology, genomics, and transgenic methods, as well as in potential clinical applications such as gene therapy or tissue engineering. Electroporation is the standard transfection method for mouse ES (mES) cells because lipofection is quite inefficient. It is also unclear if mES cells treated with cationic lipids maintain pluripotency. We have developed a simple lipofection method for high efficiency transfection and stable transgene expression by employing the nonclassical nuclear localization signal M9 derived from the heterogeneous nuclear ribonucleoprotein A1. In contrast to using 20 microg DNA for 10 x 10(6) cells via electroporation which resulted in 10-20 positive cells/mm2, M9-assisted lipofection of 2 x 10(5) cells with 2 microg DNA resulted in > 150 positive cells/mm2. Electroporation produced only 0.16% EGFP positive cells with fluorescence intensity (FI) > 1000 by FACS assay, while M9-lipofection produced 36-fold more highly EGFP positive cells (5.75%) with FI > 1000. Using 2.5 x 10(6) ES cells and 6 microg linearized DNA followed by selection with G418, electroporation yielded 17 EGFP expressing colonies, while M9-assisted lipofection yielded 72 EGFP expressing colonies. The mES cells that stably expressed EGFP following M9-assisted lipofection yielded > 66% chimeric mice (8 of 12) and contributed efficiently to the germline. In an example of gene targeting, a knock-in mouse was produced from an ES clone screened from 200 G418-resistant colonies generated via M9-assisted lipofection. To our knowledge, this is the first report of generation of transgenic or knock-in mice obtained from lipofected mES cells and this method may facilitate large scale genomic studies of ES developmental biology or large scale generation of mouse models of human disease. Copyright 2003 Elsevier Inc.

  16. Short term respiratory health effects of ambient air pollution: results of the APHEA project in Paris.

    OpenAIRE

    Dab, W; Medina, S; Quénel, P; Le Moullec, Y; Le Tertre, A; Thelot, B; Monteil, C; Lameloise, P; Pirard, P; Momas, I; Ferry, R; Festy, B

    1996-01-01

    STUDY OBJECTIVE: To quantify the short term respiratory health effects of ambient air pollution in the Paris area. DESIGN: Time series analysis of daily pollution levels using Poisson regression. SETTING: Paris, 1987-92. MEASUREMENTS AND MAIN RESULTS: Air pollution was monitored by measurement of black smoke (BS) (15 monitoring stations), sulphur dioxide (SO2), nitrogen dioxide (NO2), particulate matter less than 13 microns in diameter (PM13), and ozone (O3) (4 stations). Daily mortality and ...

  17. Mid-term results of total knee arthroplasty with a porous tantalum monoblock tibial component.

    Science.gov (United States)

    Hayakawa, Kazue; Date, Hideki; Tsujimura, Shunzo; Nojiri, Sho; Yamada, Harumoto; Nakagawa, Kenji

    2014-01-01

    The objectives of the present study were to assess the mid-term results of cementless total knee arthroplasty (TKA) with the porous tantalum monoblock tibial component and to examine the time course of bone changes on plain radiographs. The subjects were 32 patients, 29 patients were available for follow-up. We investigated the mid-term results of TKA after a mean follow-up period of 7 years and 8 months. We also examined changes of the bone over time on plain radiographs. The Knee Society Clinical Rating scores showed significant improvement. Bone changes around the tibial component were as follows: new bone formation and longitudinal trabecular thickening in 41.4% (Type A), only longitudinal trabecular thickening in 41.4% (Type B), and no changes in 17.2% (Type C). Type A and B changes were more frequent in patients with osteoarthritis, whereas Type C was only seen in patients with rheumatoid arthritis. Three knees had an initial gap, but this disappeared in all cases, and no new radiolucent lines were detected. Stress shielding was observed in seven knees (21.9%), but there was no implant loosening related to it. When we examined the relationship between the mechanical axis and the locations of the tips of the tibial pegs in patients with or without stress shielding, no significant differences were found. The results of mid-term follow-up have demonstrated favorable bone ingrowth, suggesting that porous tantalum is a promising material for cementless TKA. © 2013.

  18. 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

  19. 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

  20. Laparoscopic and open subtotal colectomies have similar short-term results.

    Science.gov (United States)

    Hoogenboom, Froukje J; Bosker, Robbert J I; Groen, Henk; Meijerink, Wilhelmus J H J; Lamme, Bas; Pierie, Jean Pierre E N

    2013-01-01

    Laparoscopic subtotal colectomy (STC) is a complex procedure. It is possible that short-term benefits for segmental resections cannot be attributed to this complex procedure. This study aims to assess differences in short-term results for laparoscopic versus open STC during a 15-year single-institute experience. We reviewed consecutive patients undergoing laparoscopic or open elective or subacute STC from January 1997 to December 2012. Fifty-six laparoscopic and 50 open STCs were performed. The operation time was significantly longer in the laparoscopic group, median 266 min (range 121-420 min), compared to 153 min (range 90-408 min) in the open group (p < 0.001). Median hospital stay showed no statistical difference, 14 days (range 1-129 days) in the laparoscopic and 13 days (range 1-85 days) in the open group. Between-group postoperative complications were not statistically different. Laparoscopic STC has short-term results similar to the open procedure, except for a longer operation time. The laparoscopic approach for STC is therefore only advisable in selected patients combined with extensive preoperative counseling. Copyright © 2013 S. Karger AG, Basel.

  1. 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

  2. [Neoadjuvant Chemotherapy Using S-1 for Pancreatic Cancer - Mid-Term Results].

    Science.gov (United States)

    Homma, Yuki; Honda, Goro; Sakamoto, Katsunori; Kurata, Masanao; Honjo, Masahiko; Hirata, Yoshihiro; Shinya, Satoshi

    2016-10-01

    Although surgical resection is the only curative strategy for pancreatic cancer, the prognosis of patients with pancreatic cancer remains poor. Recently, neoadjuvant treatment has been frequently employed as a promising treatment. Here, the mid-term results of neoadjuvant chemoradiotherapy(NACRT)using S-1, which has been performed in our hospital since 2008, are reported. Seventy-nine patients with resectable or borderline resectable pancreatic ductal adenocarcinoma, who had been intended to undergo NACRT treatment using S-1, were enrolled. The NACRT comprised radiotherapy( 1.8 Gy×28 days)and full-dose twice-daily oral S-1 given on the same days as the radiotherapy. The results of the NACRT and pancreatectomy and the patients' prognoses were evaluated. Fifty-five patients(69.6%)underwent pancreatectomy, with no case of mortality. The curative resection rate was 94.5%. Postoperative adjuvant chemotherapy was administered in 46 patients(83.6%). The 3-year survival rates of all 79 patients and 55 pancreatectomy patients were 40.1% and 50.4%, respectively. NACRT using S-1 was found to be feasible, and good mid-term outcomes were obtained. However, analysis of the long-term outcomes and comparisons with other novel anti-cancer drugs are still required.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Results of a Study of the Vegetative Growth, Yield and Fruit Quality of Different Grafting Combinations of the Apple Cultivar ‘Krista’

    Directory of Open Access Journals (Sweden)

    Univer Toivo

    2017-06-01

    Full Text Available Long-term field trials with the apple cultivar ‘Krista’ on different vegetative rootstocks were held at the Polli Horticultural Research Centre (58°07`N, 25°32`E in Southern Estonia in 2005-2015. Trees were grafted on 13 rootstocks: M26, M27, P59, E75, B9, B396, B491, MTT1, Supporter 1, Supporter 2, Supporter 3, Supporter 4, and MM106. The apple cultivar ‘Krista’ is well suited for growing in the climatic and soil conditions of Estonia. The cultivar performs best on vegetative rootstocks that are well-adapted to the Estonian climate: MM106, E75, B396, M26, M27, and P59. The rootstocks Supporter 1, Supporter 2, Supporter 3, and Supporter 4 did not turn out to be suited for growing in Estonia. The trees grafted on rootstocks MM106, E75, MTT1, and M26 grew taller, had a bigger crown spread and crown volume. In dense orchards with the planting scheme 4 × 1.5 m, trees with a smaller crown diameter may be grown on rootstocks MM27, P59, and Supporter 4. During the trial, the largest yields were harvested from trees grafted onto rootstocks MM106, MTT1, B396, M26, E75, and B9. Some rootstock combinations appeared to be positively related to average fruit weight in some years, but the same cannot be concluded for the whole duration of the trial.

  8. Improving yield and nitrogen fixation of grain legumes in the tropics and sub-tropics of Asia. Results of a co-ordinated research programme

    International Nuclear Information System (INIS)

    1998-07-01

    The Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture initiated a Co-ordinated Research Project on The Use of Isotopes in Studies to Improve Yield and N 2 Fixation of Grain Legumes with the Aim of Increasing Food Production and Saving N-fertilizer in the Tropics and Sub-Tropics of Asia that was operational from 1990 to 1995. This Project was underpinned by extensive experience in the use of 15 N-labelled fertilizer in quantifying N 2 fixation by food and pasture legumes; the isotope-dilution technique, recognized as the most accurate mode of quantifying fixation, was developed at the IAEA and has been used profitably for over 20 years in co-ordinated research projects that were focused on aspects relevant to the sustainability of agriculture in developing countries in which food security is most under threat. This effort to improve N 2 fixation by food legumes in Asia, and in so doing to increase productivity of cereal-based farming systems as a whole, was timely in terms of regional needs. It was complemented by an overlapping Co-ordinated Research Project entitled ''The Use of Nuclear and Related Techniques in Management of Nitrogen Fixation by trees for Enhancing Soil Fertility and Soil Conservation in Fragile Tropical Soils''. The project involved scientists from Australia, Bangladesh, China, India, Malaysia, Pakistan the Philippines, Sri Lanka, Thailand and Viet Nam

  9. Predicting visual semantic descriptive terms from radiological image data: preliminary results with liver lesions in CT.

    Science.gov (United States)

    Depeursinge, Adrien; Kurtz, Camille; Beaulieu, Christopher; Napel, Sandy; Rubin, Daniel

    2014-08-01

    We describe a framework to model visual semantics of liver lesions in CT images in order to predict the visual semantic terms (VST) reported by radiologists in describing these lesions. Computational models of VST are learned from image data using linear combinations of high-order steerable Riesz wavelets and support vector machines (SVM). In a first step, these models are used to predict the presence of each semantic term that describes liver lesions. In a second step, the distances between all VST models are calculated to establish a nonhierarchical computationally-derived ontology of VST containing inter-term synonymy and complementarity. A preliminary evaluation of the proposed framework was carried out using 74 liver lesions annotated with a set of 18 VSTs from the RadLex ontology. A leave-one-patient-out cross-validation resulted in an average area under the ROC curve of 0.853 for predicting the presence of each VST. The proposed framework is expected to foster human-computer synergies for the interpretation of radiological images while using rotation-covariant computational models of VSTs to 1) quantify their local likelihood and 2) explicitly link them with pixel-based image content in the context of a given imaging domain.

  10. Immediate and intermediate-term results of optical coherence tomography guided atherectomy in the treatment of peripheral arterial disease: Initial results from the VISION trial.

    Science.gov (United States)

    Cawich, Ian; Paixao, Andre R M; Marmagkiolis, Konstantinos; Lendel, Vasili; Rodriguez-Araujo, Gerardo; Rollefson, William A; Mego, David M; Cilingiroglu, Mehmet

    Long-term patency rates for percutaneous peripheral arterial interventions are suboptimal. Optical coherence tomography (OCT) guided atherectomy may yield superior patency by optimizing plaque removal while preserving the tunica media and adventitia. The VISION study is a multicenter prospective study of patients with peripheral arterial disease undergoing OCT guided atherectomy with the Pantheris™ device. In 11 patients enrolled in a single center, we report procedural and clinical outcomes, at 30days and 6months. The mean age was 63±11years and 73% (n=8) were men. The target lesion was in the superficial femoral artery in 82% (n=9) of the patients. Mean stenosis severity was 87%±10% and mean lesion length was 39±31mm. Procedural success was observed in all patients with no device related complications. Mean post-atherectomy stenosis was 18%±15%. Almost all excised tissue consisted of intimal plaque (94%). At 30days, significant improvements in Rutherford class, VascuQoL scores and ABI were observed, 0.9±0.8 vs. 3.1±0.7 (p=0.01), 4.9±1.9 vs. 3.6±1.5 (p=0.03) and 1.04±0.19 vs. 0.80±0.19 (patherectomy resulted in high procedural success, no device related complications and encouraging results up to 6months. Histological analysis suggested little injury to the media and adventitia. Larger studies are needed to confirm the efficacy of this approach. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. 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.

  12. 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

  13. 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.

  14. Percutaneous angioplasty of portal vein stenosis that complicated liver transplantation: the mid-term therapeutic results

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kwang Bo; Choo, Sung Wook; Do, Young Soo; Shin, Sung Wook; Cho, Sung Gi; Choo, In Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-09-15

    We wanted to valuate the mid-term therapeutic results of percutaneous transhepatic balloon angioplasty for portal vein stenosis after liver transplantation. From May 1996 to Feb 2005, 420 patients underwent liver transplantation. Percutaneous transhepatic angioplasty of the portal vein was attempted in six patients. The patients presented with the clinical signs and symptoms of portal venous hypertension or they were identified by surveillance doppler ultrasonography. The preangioplasty and postangioplasty pressure gradients were recorded. The therapeutic results were monitored by the follow up of the clinical symptoms, the laboratory values, CT and ultrasonography. The overall technical success rate was 100%. The clinical success rate was 83% (5/6). A total of eight sessions of balloon angioplasty were performed in six patients. The mean pressure gradient decreased from 14.5 mmHg to 2.8 mmHg before and after treatment, respectively. The follow up periods ranged from three months to 64 months (mean period; 32 months). Portal venous patency was maintained in all six patients until the final follow up. Combined hepatic venous stenosis was seen in one patient who was treated with stent placement. One patient showed puncture tract bleeding, and this patient was treated with coil embolization of the right portal puncture tract via the left transhepatic portal venous approach. Percutaneous transhepatic balloon angioplasty is an effective treatment for the portal vein stenosis that occurs after liver transplantation, and our results showed good mid-term patency with using this technique.

  15. Trade-off results and preliminary designs of Near-Term Hybrid Vehicles

    Science.gov (United States)

    Sandberg, J. J.

    1980-01-01

    Phase I of the Near-Term Hybrid Vehicle Program involved the development of preliminary designs of electric/heat engine hybrid passenger vehicles. The preliminary designs were developed on the basis of mission analysis, performance specification, and design trade-off studies conducted independently by four contractors. THe resulting designs involve parallel hybrid (heat engine/electric) propulsion systems with significant variation in component selection, power train layout, and control strategy. Each of the four designs is projected by its developer as having the potential to substitute electrical energy for 40% to 70% of the petroleum fuel consumed annually by its conventional counterpart.

  16. 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.)

  17. [Contract focused short-term group therapy--results of an evaluation].

    Science.gov (United States)

    Hirschberg, Rainer; Meyer, Birgit

    2010-01-01

    A short description outlines the development of commission focused short-term therapy (AFoG) for children and adolescents. Subsequently the generic principles of psychotherapy are applied to AFoG in order to underline the basic assumptions of this variation of systemic group therapy. Behavioural changes arising in different contexts (school, family, group therapy) show the need for an appropriate flexibility of group therapy techniques. The evaluation was accomplished using the Child Behaviour Checklist (CBCL 4-18) at the beginning and 3 month after the end of the group therapy. The results show positive effects which finally are discussed critically.

  18. Long-term effect of biochar application on yield-scaled greenhouse gas emissions in a rice paddy cropping system: A four-year case study in south China.

    Science.gov (United States)

    Qin, Xiaobo; Li, Yu'e; Wang, Hong; Liu, Chong; Li, Jianling; Wan, Yunfan; Gao, Qingzhu; Fan, Fenliang; Liao, Yulin

    2016-11-01

    To evaluate long-term effect of biochar application on yield-scaled greenhouse gas emissions (YSGE) in a paddy rice cropping system, a 4-year field experiment by static chamber - gas chromatograph method was conducted in South China. Principal component analysis and terminal restriction fragment length polymorphism (T-RFLP) and real-time qPCR was used to unravel the microbial mechanisms of biochar addition. Six treatments were included: control (CK), application of 5tha(-1) biochar (BC1), application of 10tha(-1) biochar (BC2), application of 10tha(-1) biochar (BC3), rice straw return at 2400kgha(-1)(RS) and inoculated rice straw return at 2400kgha(-1)(RI). The results indicated that biochar amendment significantly decreased methane (CH4) and gross greenhouse gas (GHG) emissions. This may primarily be ascribed to the stimulated biodiversity and abundance of methanotrophic microbes, increased soil pH and improved aeration by reducing bulk density after biochar incorporation. Compared with CK, RS and RI, 26.18%, 70.02%, 66.47% of CH4 flux and 26.14%, 70.16%, 66.46% of gross GHG emissions were reduced by biochar (mean of three biochar treatments), respectively. Furthermore, biochar significantly increased harvest index of double rice production (p<0.05). In comparison with CK, RS and RI, 29.14%, 68.04%, 62.28% of YSGE was reduced by biochar, respectively, and the highest biochar addition rate (20tha(-1)) contributed most to the mitigation of GHG emissions (36.24% decrease compared to CK) and improvement of rice yield (7.65% increase compared to CK). Results of our study suggested that long-term application of biochar should be the potential way to mitigate GHGs emissions and simultaneously improve rice productivity in the paddy rice system. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. The yield of adequate and conclusive fine-needle aspiration results in thyroid nodules is uniform across functional and goiter types.

    Science.gov (United States)

    Liel, Y

    1999-01-01

    Relatively little is known about the cytological characteristics of hyperfunctioning (hot) thyroid nodules. Concern has been expressed that fine-needle aspiration (FNA) identifies hot nodules as follicular tumors or indeterminate, and as a consequence patients could be unnecessarily referred for surgery. Between 1979 and 1996, thyroid FNA was performed on 829 patients. Result of thyroid scan was available in 326; 69 (21%) patients had hot, and 257 (79%) had warm or cold thyroid nodules. Nodules in each of these major groups were divided into 2 subgroups: clinically solitary nodules and dominant nodules in multinodular goiters (MNG). The frequencies of adequate versus inadequate FNA samples, and of conclusive versus indeterminate FNA results were determined separately for each of the groups and subgroups. In addition, patients with hot nodules and overt hyperthyroidism were identified and evaluated separately. Bivariate analyses were performed for the frequency of adequate versus inadequate smears and conclusive versus indeterminate results between hot, toxic, and cold-warm nodules, and between solitary nodules and MNG. The frequency of adequate aspirations and conclusive results in the various groups and subgroups was found to be statistically indistinguishable. In conclusion, the yield of adequate samples and the rate of conclusive results of FNA in thyroid nodules is similar, irrespective of the functional state or of goiter presentation. Hot thyroid nodules do not seem to produce an increase in the rate of inadequate or indeterminate FNA results, and therefore, do not affect the overall performance of thyroid FNA.

  20. Hot topic: Bovine milk samples yielding negative or nonspecific results in bacterial culturing--the possible role of PCR-single strand conformation polymorphism in mastitis diagnosis.

    Science.gov (United States)

    Schwaiger, K; Wimmer, M; Huber-Schlenstedt, R; Fehlings, K; Hölzel, C S; Bauer, J

    2012-01-01

    A large proportion of mastitis milk samples yield negative or nonspecific results (i.e., no mastitis pathogen can be identified) in bacterial culturing. Therefore, the culture-independent PCR-single strand conformation polymorphism method was applied to the investigation of bovine mastitis milk samples. In addition to the known mastitis pathogens, the method was suitable for the detection of fastidious bacteria such as Mycoplasma spp., which are often missed by conventional culturing methods. The detection of Helcococcus ovis in 4 samples might indicate an involvement of this species in pathogenesis of bovine mastitis. In conclusion, PCR-single-strand conformation polymorphism is a promising tool for gaining new insights into the bacteriological etiology of mastitis. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  1. Overexpression of pyruvate decarboxylase in the yeast Hansenula polymorpha results in increased ethanol yield in high-temperature fermentation of xylose.

    Science.gov (United States)

    Ishchuk, Olena P; Voronovsky, Andriy Y; Stasyk, Oleh V; Gayda, Galina Z; Gonchar, Mykhailo V; Abbas, Charles A; Sibirny, Andriy A

    2008-11-01

    Improvement of xylose fermentation is of great importance to the fuel ethanol industry. The nonconventional thermotolerant yeast Hansenula polymorpha naturally ferments xylose to ethanol at high temperatures (48-50 degrees C). Introduction of a mutation that impairs ethanol reutilization in H. polymorpha led to an increase in ethanol yield from xylose. The native and heterologous (Kluyveromyces lactis) PDC1 genes coding for pyruvate decarboxylase were expressed at high levels in H. polymorpha under the control of the strong constitutive promoter of the glyceraldehyde-3-phosphate dehydrogenase gene (GAPDH). This resulted in increased pyruvate decarboxylase activity and improved ethanol production from xylose. The introduction of multiple copies of the H. polymorpha PDC1 gene driven by the strong constitutive promoter led to a 20-fold increase in pyruvate decarboxylase activity and up to a threefold elevation of ethanol production.

  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 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.

  4. 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.

  5. 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

  6. Psychological vulnerability to daily stressors in old age: Results of short-term longitudinal studies.

    Science.gov (United States)

    Schilling, Oliver Karl; Diehl, Manfred

    2015-08-01

    A growing numbers of intensive longitudinal studies examine the short-term variability of behavior in response to daily stressors. Collectively, these studies address the vulnerability for stress-related emotional burden as assessed in terms of the intraindividual association between daily stressors and negative affect (NA). This article provides a brief overview of the relevant research on so-called affective reactivity to daily stressors and focuses on findings on development of age-related stressor reactivity across the adult lifespan. Two theoretical propositions have been put forward. Firstly, it has been postulated that aging should be associated with increased affective reactivity, i.e. it has been assumed that the vulnerability in terms of physiological stress reactivity increases across the adult life span and, thus, a higher stress-induced emotional reactivity should result with increasing age. Secondly, it has been argued that due to the continued development of emotional self-regulation skills, there should be an age-related decrease in stress reactivity and, hence, an increased resilience. Findings on age differences in NA reactivity to daily stressors, however, have been inconsistent. A possible explanation for the inconsistent findings may lie in the fact that the postulated dynamics of increased vulnerability or resilience imply different time-related reactions to stressors. In particular, the activation and effectiveness of emotional self-regulation strategies increase with increasing time intervals from the stressors. This leads to the conclusion that with increasing age the resilience for longer periods of stress and accumulated stress should increase. Results from our own research support this hypothesis, where older adults reacted to multiple stressors in a more adaptive way than younger adults.

  7. Mid term results of Furlong LOL uncemented hip hemiarthroplasty for fractures of the femoral neck.

    Science.gov (United States)

    Chandran, Prakash; Azzabi, Mohammed; Burton, Dave J C; Andrews, Mark; Bradley, John G

    2006-08-01

    We report the mid-term results of hemiarthroplasty with the Furlong hydroxyapatite coated bipolar prosthesis for displaced (Garden type III and IV) intracapsular hip fracture in 480 patients operated between 1989 and 2000. Three hundred sixty eight (77%) patients were lost to follow-up due to death, dementia or movement away from the area. In the patients followed up there was an 8% reoperation rate for infection, aseptic loosening, periprosthetic fracture and acetabular erosion. One hundred and twelve patients with a mean follow-up of 4 years (3-14) were studied. Eighty eight percent had no or slight pain, 77% could mobilise outdoors and 89% needed either no aid or a single walking stick to mobilise. Radiographic assessment revealed a stable implant with visible osseointegration in 91%. We conclude that hemiarthroplasty with the hydroxyapatite coated bipolar Furlong LOL prosthesis for displaced intracapsular fracture of the neck of the femur gives good mid term results in elderly patients for return to mobility, use of mobility aids and freedom from pain. It avoids the need for cement and provides satisfactory incorporation into the host bone. The use of a modular head makes revision to total hip replacement easier.

  8. Short-term results of medial patellofemoral ligament reconstruction for patellar dislocation

    International Nuclear Information System (INIS)

    Sakuraba, Koji; Miura, Hiromasa; Matsuda, Shuichi; Okazaki, Ken; Iwamoto, Yukihide; Fukuoka, Shinji

    2009-01-01

    The short-term results of medial patellofemoral ligament (MPFL) reconstruction were reviewed. MPFL reconstruction surgery was performed on 13 patients (13 knees, three male, five female, mean age 24.1 years) with recurrent and habitual dislocation of the patella. After average 18.5 month follow-up, there has been no recurrence of dislocation and limitation of range of motion except for one case. The mean Kujula score was 60±20.2 preoperatively and 91±15 postoperatively. According to the Crosby and Insall grading system, six ceses were excellent, six cases were good, and one case was fair to poor. On axial radiographs, the mean congruence angle was 31.3±21.4deg preoperatively and -3.65±20.72deg postoperatively. The mean tilting angle was 32.1±7.9deg preoperatively and 21.9±8.39deg postoperatively. The mean lateral shift was 41.6±9.7% preoperatively and 24.5±9.9% postoperatively. These results demonstrate the short-term effectiveness of MPFL reconstruction. (author)

  9. 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.

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    Steen Harald

    2009-08-01

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

  12. 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

  13. 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.)

  14. Short-Term Audiological Results of Diode Laser in Comparison with Manual Perforation in Stapes Surgery.

    Science.gov (United States)

    Hamerschmidt, Rogerio; Saab, Stephanie Sbizera; Carvalho, Bettina; Carmo, Carolina do

    2018-04-01

    Introduction  Diode laser is a new alternative in stapes surgery for otosclerosis. The present study is the first to compare the short-term results of the surgery performed using diode laser to those obtained through the conventional fenestration technique. Objective  To use audiometry to establish a comparative analysis between the functional results obtained through surgery for otosclerosis using diode laser and the conventional technique. Method  Audiometric evaluation of 12 patients submitted to stapes surgery for otosclerosis, using diode laser or conventional fenestration by needle and drills, between 2014 and 2015. Each group was composed of 6 patients. Pre and post-operative measures were compared for three months in both groups. The speech recognition threshold, the air and bone conduction threshold, as well as the gap between them at 500 Hz, 1 KHz, 2 KHz and 4 KHz were measured. Results  Significant difference in bone conduction and SRT was observed when compared post- and preoperative results in the diode group. However diode and conventional technique groups presented significant differences in air conduction and air-bone gap, suggesting that both can provide functional improvement. Conclusion  Laser stapedotomy is a safe technique with good results. Both laser surgery and the conventional technique have improved the hearing of patients with a discreet advantage for the diode laser. Further prospective and randomized clinical trials are required to disclose all possible benefits of the stapes surgery using diode laser.

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

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    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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    P. Dalin

    2006-11-01

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

  2. 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.

  3. 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.

  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. 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.

  6. 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.

  7. 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

  8. Scoliosis short-term rehabilitation (SSTR according to 'Best Practice' standards - are the results repeatable?

    Directory of Open Access Journals (Sweden)

    Borysov Maksym

    2012-01-01

    Full Text Available Abstract Claims have been made in a pilot study that a new form of short-term rehabilitation according to 'Best Practice' standards would change signs and symptoms of patients with scoliosis in the short-term. Aim of this study is to repeat the study published 2010 with a larger sample of patients using the same protocol. Both authors have undergone training in this special approach to scoliosis rehabilitation in 2010. Materials and methods 34 patients with Adolescent Idiopathic Scoliosis (AIS, 32 girls and 2 boys, average age 13.7 years and an average Cobb angle of 28.7 degrees (21-43 degrees underwent Scoliosis Short-Term Rehabilitation (SSTR of seven days. Two days with an intensity of 3 × 90 min sessions/day, and five days with an intensity of 2 × 60 min sessions/day. Angle of trunk rotation (ATR was measured before and after the time of treatment as well as the active correctability of the ATR after the programme as it has been done in the pilot investigation. Additionally to that, we also recorded the changes in Vital Capacity (VC before and after the programme. Results ATR was reduced significantly from 11,5 degrees to 8,4 degrees, the active correctability as measured with the Scoliometer (TM was also reduced significantly from the ATR after treatment 8,9 degrees to 6,5 degrees in the patients with thoracic curves. VC improved significantly (P Discussion The results achieved in the pilot investigation published previously are repeatable. The deformity of the trunk can be reduced significantly after SSTR. During the pilot study VC was not investigated. In our study VC improved significantly. Therefore, also shorter rehabilitation times with an appropriate programme seem to be able to change signs and symptoms of a patient with scoliosis. Like the out-patient Schroth programme as described in a study from Turkey, the SSTR provides benefits leading to an improvement of the condition. Conclusion Out-patient rehabilitation following the

  9. 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.

  10. Measurements of fission yields

    International Nuclear Information System (INIS)

    Denschlag, H.O.

    2000-01-01

    After some historical introductory remarks on the discovery of nuclear fission and early fission yield determinations, the present status of knowledge on fission yields is briefly reviewed. Practical and fundamental reasons motivating the pursuit of fission yield measurements in the coming century are pointed out. Recent results and novel techniques are described that promise to provide new interesting insights into the fission process during the next century. (author)

  11. 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.)

  12. 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.

  13. 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

  14. 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...

  15. 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

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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)

  19. 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

  20. 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.

  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. [Long-term results of midtarsal arthrodesis for flatfoot in adults].

    Science.gov (United States)

    Staquet, V; Mehdi, N; Naudi, S; Maynou, C; Mestdagh, H

    2007-09-01

    Arthrodesis proposed for the surgical treatment of reducible pes planovalgus (flatfoot) in adults is designed to relieve pain and correct the deformity. The purpose of this work was to present the radiological and clinical results obtained with midtarsal arthrodesis performed in 22 cases of pes planovalgus. This study concerned 22 cases of reducible flatfoot (Johnson grade 2) in 19 patients (11 males, 8 females, mean age 43 years, age range 15-75 years). Clinical outcome was assessed in terms of pain, function and motion using the AOFAS and Mann classifications. Radiological assessment (loaded anteroposterior and lateral views with Méary cerclage) noted the Djian angle, talometatarsal alignment, talar slope, calcaneal slope, calcaneal valgus, and osteoarthritis stage in adjacent joints. Mean follow-up was 7 years 4 months (range 6 months-20 years 3 months). Two nonunions resolved favorable after cancellous grafting. The Kitaoka score was 73.5/100 points (range 53-94). Pain and function improved from 2.8 to 1.1 points (/4 points) and from 3.45 to 1.6 points (/4) on the Mann scale. Flexion-extension remained unchanged. The foot was aligned correctly in 68% of cases. The mean talar slope and the talocalcaneal divergence were normal at last follow-up but there was a persistent undercorrection of the Djian angle in 68% of the feet and a break in the Méary line in 41%. Calcaneal valgus was reduced 6.6 degrees (16.6 to 10 degrees ) but the podoscope footprint was still the flatfoot type in 86% of the feet. For 50%, the neighboring joints presented progressive osteoarthritic degeneration. Subjectively the patients were very satisfied or satisfied with minor reservations for 73%. None of the patients was disappointed with the results. The objective outcome was excellent or good in 68% of the feet. The results in terms of pain relief, function, motion, complications, and rate of satisfaction were comparable with results presented in the literature. Midtarsal arthrodesis

  3. Long-term effect of biochar application on yield-scaled greenhouse gas emissions in a rice paddy cropping system: A four-year case study in south China

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Xiaobo [Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, The Key Laboratory for Agro-Environment, Ministry of Agriculture, No.12 Zhongguancun South Street, Haidian district, Beijing 100081 (China); Semiarid Prairie Agricultural Research Centre, Agriculture and Agri-Food Canada, P.O. Box 1030, Swift Current, Saskatchewan S9H 3X2 (Canada); Li, Yu' e, E-mail: liyue@caas.cn [Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, The Key Laboratory for Agro-Environment, Ministry of Agriculture, No.12 Zhongguancun South Street, Haidian district, Beijing 100081 (China); Wang, Hong [Semiarid Prairie Agricultural Research Centre, Agriculture and Agri-Food Canada, P.O. Box 1030, Swift Current, Saskatchewan S9H 3X2 (Canada); Liu, Chong; Li, Jianling; Wan, Yunfan; Gao, Qingzhu [Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, The Key Laboratory for Agro-Environment, Ministry of Agriculture, No.12 Zhongguancun South Street, Haidian district, Beijing 100081 (China); Fan, Fenliang [Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing 100081 (China); Liao, Yulin [Soils and Fertilizer Institute of Hunan Province, Changsha 410125 (China)

    2016-11-01

    To evaluate long-term effect of biochar application on yield-scaled greenhouse gas emissions (YSGE) in a paddy rice cropping system, a 4-year field experiment by static chamber - gas chromatograph method was conducted in South China. Principal component analysis and terminal restriction fragment length polymorphism (T-RFLP) and real-time qPCR was used to unravel the microbial mechanisms of biochar addition. Six treatments were included: control (CK), application of 5 t ha{sup −} {sup 1} biochar (BC1), application of 10 t ha{sup −} {sup 1} biochar (BC2), application of 10 t ha{sup −} {sup 1} biochar (BC3), rice straw return at 2400 kg ha{sup −} {sup 1}(RS) and inoculated rice straw return at 2400 kg ha{sup −} {sup 1}(RI). The results indicated that biochar amendment significantly decreased methane (CH{sub 4}) and gross greenhouse gas (GHG) emissions. This may primarily be ascribed to the stimulated biodiversity and abundance of methanotrophic microbes, increased soil pH and improved aeration by reducing bulk density after biochar incorporation. Compared with CK, RS and RI, 26.18%, 70.02%, 66.47% of CH{sub 4} flux and 26.14%, 70.16%, 66.46% of gross GHG emissions were reduced by biochar (mean of three biochar treatments), respectively. Furthermore, biochar significantly increased harvest index of double rice production (p < 0.05). In comparison with CK, RS and RI, 29.14%, 68.04%, 62.28% of YSGE was reduced by biochar, respectively, and the highest biochar addition rate (20 t ha{sup −} {sup 1}) contributed most to the mitigation of GHG emissions (36.24% decrease compared to CK) and improvement of rice yield (7.65% increase compared to CK). Results of our study suggested that long-term application of biochar should be the potential way to mitigate GHGs emissions and simultaneously improve rice productivity in the paddy rice system. - Graphical abstract: Relative change ratio of different biochar amendments and rice straw residues to CK treatment during the

  4. Long-term effect of biochar application on yield-scaled greenhouse gas emissions in a rice paddy cropping system: A four-year case study in south China

    International Nuclear Information System (INIS)

    Qin, Xiaobo; Li, Yu'e; Wang, Hong; Liu, Chong; Li, Jianling; Wan, Yunfan; Gao, Qingzhu; Fan, Fenliang; Liao, Yulin

    2016-01-01

    To evaluate long-term effect of biochar application on yield-scaled greenhouse gas emissions (YSGE) in a paddy rice cropping system, a 4-year field experiment by static chamber - gas chromatograph method was conducted in South China. Principal component analysis and terminal restriction fragment length polymorphism (T-RFLP) and real-time qPCR was used to unravel the microbial mechanisms of biochar addition. Six treatments were included: control (CK), application of 5 t ha"− "1 biochar (BC1), application of 10 t ha"− "1 biochar (BC2), application of 10 t ha"− "1 biochar (BC3), rice straw return at 2400 kg ha"− "1(RS) and inoculated rice straw return at 2400 kg ha"− "1(RI). The results indicated that biochar amendment significantly decreased methane (CH_4) and gross greenhouse gas (GHG) emissions. This may primarily be ascribed to the stimulated biodiversity and abundance of methanotrophic microbes, increased soil pH and improved aeration by reducing bulk density after biochar incorporation. Compared with CK, RS and RI, 26.18%, 70.02%, 66.47% of CH_4 flux and 26.14%, 70.16%, 66.46% of gross GHG emissions were reduced by biochar (mean of three biochar treatments), respectively. Furthermore, biochar significantly increased harvest index of double rice production (p < 0.05). In comparison with CK, RS and RI, 29.14%, 68.04%, 62.28% of YSGE was reduced by biochar, respectively, and the highest biochar addition rate (20 t ha"− "1) contributed most to the mitigation of GHG emissions (36.24% decrease compared to CK) and improvement of rice yield (7.65% increase compared to CK). Results of our study suggested that long-term application of biochar should be the potential way to mitigate GHGs emissions and simultaneously improve rice productivity in the paddy rice system. - Graphical abstract: Relative change ratio of different biochar amendments and rice straw residues to CK treatment during the rice growing seasons from 2012 to 2015. * and *** stand for

  5. 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

  6. 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

  7. 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)

  8. 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)

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

    International Nuclear Information System (INIS)

    Bianco, Fernando J.; Scardino, Peter T.; Stephenson, Andrew J.; DiBlasio, Christopher J.; Fearn, Paul A.; Eastham, James A.

    2005-01-01

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

  10. 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. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. [Soil Olsen-P content changing trend and its relationship with phosphorus surplus and crop yield under long-term fertilization in loessial soil region on the Loess Plateau, China].

    Science.gov (United States)

    E, Sheng Zhe; Yang, Zhi Qi; Zeng, Xi Bai; Wang, Ya Nan; Luo, Zhao Xia; Yuan, Jin Hua; Che, Zong Xian

    2017-11-01

    The changing trend of soil available phosphorus (Olsen-P) content in soil and its relationship with soil phosphorus surplus and crop yield are fundamental when making appropriate phosphate fertilizer recommendations. In this paper, the influences of long-term fertilization on crops phosphorus uptake, soil phosphorus surplus, changing trend of soil available phosphorus content and relationships of soil available phosphorus content with soil phosphorus surplus and crop yield were investigated through 34 years (1981-2015) long-term trial in loessial soil region on the Loess Plateau. The experiment had a completely-randomized-block split-plot design in triplicate. Two main-plot treatments were no farmyard manure and farmyard manure (M), and four subplot treatments were CK (no fertilizer), N (application of chemical fertilizer N), NP (application of chemical fertilizer NP) and NPK (balanced application of chemical fertilizer NPK), respectively. The results showed that fertilization treatments and crop types significantly influenced uptake amount of phosphorus and soil phosphorus surplus. Averaged over time from 1981 to 2015, wheat mean phosphorus uptake amounts of CK, N, NP, NPK, M, MN, MNP and MNPK were 8.63, 10.64, 16.22, 16.21, 16.25, 17.83, 20.39 and 20.27 kg·hm -2 , while rape phosphorus uptakeamounts of eight treatments were 4.40, 8.38, 15.08, 15.71, 10.52, 11.23, 17.96 and 17.66 kg·hm -2 , respectively. The surplus amount of soil phosphorus significantly correlated with the amount of phosphorus applied to soil. When soil phosphorus surplus amount equal zero, wheat and rape phosphorus input amounts were 10.47 kg·hm -2 and 6.97 kg·hm -2 , respectively. Soil phosphorus surplus amount significantly influenced the changing trend of available phosphorus content in soil. CK and N treatments had no phosphorus input, and soil available phosphorus content exhibited a declining trend, annually decreased by 0.16 mg·kg -1 and 0.15 mg·kg -1 , respectively. In contrast

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

    International Nuclear Information System (INIS)

    Conzelmann, G.; Quintanilla, J.; Conde, L.A.; Fernandez, J.; Mar, E.; Martin del Campo, C.; Serrato, G.; Ortega, R.

    2006-01-01

    This article discussed the results of a bottom-up analysis of Mexico's energy markets which was conducted using an energy and power evaluation program. The program was used to develop energy market forecasts to the year 2025. In the first phase of the study, dynamic optimization software was used to determine the optimal, least-cost generation system expansion path to meet growing demand for electricity. A separate model was used to determine the optimal generating strategy of mixed hydro-thermal electric power systems. In phase 2, a nonlinear market-based approach was used to determine the energy supply and demand balance for the entire energy system, as well as the response of various segments of the energy system to changes in energy price and demand levels. Basic input parameters included information on the energy system structure; base-year energy statistics; and, technical and policy constraints. A total of 14 scenarios were modelled to examine variations in load growth, sensitivities to changes in projected fuel prices, variations in assumed natural gas availability, system reliability targets, and the potential for additional nuclear capacity. Forecasts for the entire energy system were then developed for 4 scenarios: (1) reference case; (2) limited gas scenario; (3) renewable energy; and (4) additional nuclear power generation capacity. Results of the study showed that Mexico's crude oil production is projected to increase annually by 1 per cent to 2025. Imports of petroleum products resulting from the country's rapidly growing transportation sector will increase. Demand for natural gas is expected to outpace projected domestic production. The long-term market outlook for Mexico's electricity industry shows a heavy reliance on natural gas-based generating technologies. It was concluded that alternative results for a constrained-gas scenario showed a substantial shift to coal-based generation and associated effects on the natural gas market. 4 refs., 26

  18. Long-term results following multidisciplinary treatment of localized Ewing's sarcoma in children and adolescents

    International Nuclear Information System (INIS)

    Ullmann, C.; Sauer, R.; Grabenbauer, G.G.; Dunst, J.

    2008-01-01

    Purpose: To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma. Patients and Methods: Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patients received local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins. Results: Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients ≤ 14 years at diagnosis had overall survival rates of 66% and 61% at 5 and 10 years compared to older patients with corresponding survival rates of 47% and 31%, respectively (p = 0.05). Patients with tumors of lower volume (≤ 100 ml) had significantly better survival rates at 5 and 10 years: 82% and 60% versus 42% und 39% (p = 0.03). Seven of 52 (14%) patients experienced local failure; no significant impact was noted for any of the following factors: treatment protocol, radiation dose, surgery. Conclusion: Radiotherapy with and without surgery of Ewing's sarcoma is a highly effective local treatment option. It seems preferable to mutilating surgery. (orig.)

  19. 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

  20. Clinical and Radiological Results over the Medium Term of Isolated Acetabular Revision

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    Nicola Piolanti

    2014-01-01

    Full Text Available Acetabular cup loosening is associated with pain, reduced function, and instability of the implant. If such event happens while the femoral implant is in a satisfactory position and is well fixed to the bone, isolated acetabular revision surgery is indicated. The aim of this single-center retrospective study was to evaluate the clinical and radiological results over the medium term (12-month follow-up mean 36, max 60 of isolated acetabular revisions surgery using a porous hemispheric revision shell matched with a cemented all-poly cup and large diameter femoral head (>32. 33 patients were enrolled. We collect any relevant data from the clinical board. Routine clinical and radiographic examinations were performed preoperatively; the postoperative follow-up was made at 1, 3, and 6 months and yearly thereafter. At the last available follow-up, we report satisfactory improvement of functional scores in all the patients; 2 patients (6.1% showed thigh pain and only 4 hips (12.11% presented mild groin pain; all the femoral components are well fixed and there were no potential or pending rerevisions. With bias due to the follow-up and to the retrospective design of the study, we report clinical, functional, and radiological satisfactory results.

  1. 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)

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

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    Luciano Merlini

    2011-01-01

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

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

    International Nuclear Information System (INIS)

    Sathaye, J.

    1991-01-01

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

  4. Yield and Quality of Sequentially Grown Cherry Tomato and Lettuce under Long-Term Conventional, Low-Input and Organic Soil Management Systems

    NARCIS (Netherlands)

    Moccia, S.; Chiesa, A.; Oberti, A.; Tittonell, P.A.

    2006-01-01

    Besides to conventional fertiliser use, organic and low-input technologies are being increasingly used for soil management in vegetable production. However, different factors operating during crop growth (i.e. the pre-harvest factors) and related to soil properties may affect yield and quality of

  5. Postpartum body condition score and results from the first test day milk as predictors of disease, fertility, yield, and culling in commercial dairy herds.

    Science.gov (United States)

    Heuer, C; Schukken, Y H; Dobbelaar, P

    1999-02-01

    The study used field data from a regular herd health service to investigate the relationships between body condition scores or first test day milk data and disease incidence, milk yield, fertility, and culling. Path model analysis with adjustment for time at risk was applied to delineate the time sequence of events. Milk fever occurred more often in fat cows, and endometritis occurred between calving and 20 d of lactation more often in thin cows. Fat cows were less likely to conceive at first service than were cows in normal condition. Fat body condition postpartum, higher first test day milk yield, and a fat to protein ratio of > 1.5 increased body condition loss. Fat or thin condition or condition loss was not related to other lactation diseases, fertility parameters, milk yield, or culling. First test day milk yield was 1.3 kg higher after milk fever and was 7.1 kg lower after displaced abomasum. Higher first test day milk yield directly increased the risk of ovarian cyst and lameness, increased 100-d milk yield, and reduced the risk of culling and indirectly decreased reproductive performance. Cows with a fat to protein ratio of > 1.5 had higher risks for ketosis, displaced abomasum, ovarian cyst, lameness, and mastitis. Those cows produced more milk but showed poor reproductive performance. Given this type of herd health data, we concluded that the first test day milk yield and the fat to protein ratio were more reliable indicators of disease, fertility, and milk yield than was body condition score or loss of body condition score.

  6. Colorectal cancer screening in patients with spinal cord injury yields similar results to the general population with an effective bowel preparation: a retrospective chart audit.

    Science.gov (United States)

    Teng, Brandon J; Song, Shawn H; Svircev, Jelena N; Dominitz, Jason A; Burns, Stephen P

    2018-03-01

    Retrospective chart audit. To compare adequacy of colonoscopy bowel preparation and diagnostic findings between persons with SCI receiving an extended inpatient bowel preparation and the general population. Veterans Affairs Puget Sound Healthcare System, Seattle, WA, USA. We reviewed an electronic database of all colonoscopies performed at a tertiary Veterans Affairs medical center between 7/12/13 and 15/10/15. Patients with SCI received a multi-day bowel preparation with magnesium citrate, and 8-10 liters of polyethylene glycol-3350 and electrolyte colonic lavage solution (PEG-ELS) over two and one half days. The control population received a standard bowel preparation consisting of magnesium citrate and 4 liters of PEG-ELS over 1 day. Two hundred and fifty-five patients were included in the study, including 85 patients with SCI. Average risk screening was a more common colonoscopy indication in patients with SCI vs. the control population (24 vs. 13% p = 0.03). There was no difference in adequacy of bowel preparation (87 vs. 85%, p = 0.73) or adenoma detection rate (55 vs. 51%, p = 0.59) when comparing patients with SCI with the control population. No difference in polyp histopathology was detected (p = 0.748). Our study demonstrated that an extended bowel preparation for patients with SCI produces similar bowel preparation results and diagnostic yield when compared to patients without SCI undergoing colonoscopy.

  7. Low Yield of Chest Radiography in General Inpatients and Outpatients with "Positive PPD" Results in a Country with Low Prevalence of TB.

    Science.gov (United States)

    Eisenberg, Ronald L; Heidinger, Benedikt H

    2017-07-01

    The purpose of this study was to assess the frequency and spectrum of abnormalities on routine screening chest radiographs among inpatients and outpatients with "positive purified protein derivative (PPD)" in a large tertiary care academic medical center in a country with low prevalence of tuberculosis (TB). The reports of all chest radiographs of general inpatients and outpatients referred for positive PPD (2010-2014) were evaluated for the frequency of evidence of active or latent TB and the spectrum of imaging findings. The results of additional chest radiographs and computed tomography scans were recorded, as were additional relevant clinical histories and symptoms. Of the 2518 patients who underwent chest radiography for positive PPD, the radiographs were normal in 91.3%. The vast majority of the abnormal radiographs demonstrated findings consistent with old tuberculous disease. There were three cases (0.1%) of active TB, all of which were either recent immigrants from an endemic area or had other relevant histories or clinical symptoms suggestive of the disease. Universal chest radiography in general inpatient and outpatient populations referred for positive PPD is of low yield for detecting active disease in a country with low prevalence of TB. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. 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

  9. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-08-15

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

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

    Directory of Open Access Journals (Sweden)

    Lidia Vladimirovna Luchikhina

    2013-01-01

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

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

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    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

  13. Linear accelerator radiosurgery for vestibular schwannomas: Results of medium-term follow-up.

    Science.gov (United States)

    Ellenbogen, Jonathan R; Waqar, Mueez; Kinshuck, Andrew J; Jenkinson, Michael D; Lesser, Tristram H J; Husband, David; Javadpour, Mohsen

    2015-01-01

    To examine tumour control, via volume changes, and the complications of linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) treatment of vestibular schwannomas (VSs) on medium-term follow-up. Between September 2003 and November 2009 fifty consecutive patients with VSs treated with SRS using a marginal dose of 12.5 Gy utilizing a LINAC equipped with a micro-multileaf collimator were identified. Evaluation included serial magnetic resonance imaging (MRI), and neurological and hearing examinations. The median tumour volume at treatment was 2.4 (range: 0.24-10.59) cm3. The intracranial diameter of the tumours ranged between 7.7 and 28.7 (median: 15.8) mm. Follow-up MRI was available for analysis on 49 patients. The median radiological follow-up period was 5.8 (range: 1.4-9.2) years. The median tumour volume at last follow-up was 1.1 (range: 0.03-5.3) cm3. VS decreased in size in 45 (90%) patients, with a median reduction in tumour volume of 1.46 (range: 0.06-9.29) cm3 or a median tumour size reduction of 59% of the baseline (range: 6-90%) in these patients. VS remained stable in 2 patients and increased in size in 2 patients. Only 1 patient (2%) required additional intervention (surgery). 15 patients had useful hearing pre-treatment; 10 post-treatment pure-tone audiograms of these patients were available. 5 (50%) patients still had useful hearing post treatment. Non-auditory adverse radiation effects included new (House-Brackmann grade II) or worsened facial nerve palsy (House-Brackmann grade II to grade V) in 2 (4%) patients and trigeminal sensory disturbance in 2 (4%) patients. At medium term, the vast majority of VSs treated with LINAC-based SRS exhibit tumour shrinkage. The slightly higher rate of facial nerve palsy compared with Gamma Knife surgery (GKS) results may be related to the learning curve. Other complications were similar to reported GKS results for VSs of comparable sizes.

  14. 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.

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

    International Nuclear Information System (INIS)

    Sumila, M.; Notter, M.; Bodis, S.; Gruber, G.; Itin, P.

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-04-15

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

  17. Mid- term results of stryker® scorpio plus mobile bearing total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Kobayashi Hideo

    2012-10-01

    Full Text Available Abstract Background The mobile bearing knee system was introduced to lessen contact stress on the articular bearing surface and reduce polyethylene wear. The purpose of the current study was to investigate the mid-term results of patients undergoing total knee arthroplasties (TKAs using Scorpio Plus Mobile Bearing Knee System (Stryker, Mahwah, NJ, and compare the outcomes between patients with osteoarthritis and osteonecrosis (OA·ON group and patients with rheumatoid arthritis (RA group. Methods Eight males and 58 females were followed up for a period of 4.4- 7.6 years from June 1, 2003 to December 31, 2005. There were 53 knees with osteoarthritis, 17 knees with rheumatoid arthritis, and 6 knees with osteonecrosis. Clinical and radiographic follow- up was done using The Japanese Orthopedic Association knee rating score (JOA score and Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Results With regard to the JOA score, there was significant improvement in both groups. The postoperative range of motion was between 0.8°and 116.8° in OA·ON group, and between 0.0° and 113.7° in RA group. There were no significant differences with the radiographic evaluation between two groups. Spontaneous dislocation of a polyethylene insert occurred in one patient, and deep infection was occurred in one patient. Conclusion There was significant improvement with regard to the clinical and radiographic results of patients undergoing TKAs using the model. The risk of polyethylene insert dislocation related to the mobile bearing TKA is a cause for concern.

  18. 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

  19. Reconstruction After Hemipelvectomy With the Ice-Cream Cone Prosthesis: What Are the Short-term Clinical Results?

    Science.gov (United States)

    Barrientos-Ruiz, Irene; Ortiz-Cruz, Eduardo José; Peleteiro-Pensado, Manuel

    2017-03-01

    patients. Of those, two developed superficial infections with necrosis, two developed deep infections, and one patient developed wound necrosis without apparent infection. No prostheses were removed as a result of these complications [corrected]. Median MSTS score was 19 out of 30 when 0 is the worst possible result and 30 a perfect function and emotional status. Five of seven primary tumors had wide margin surgery and three of seven developed local recurrences by the end of the followup. Pelvic reconstruction with the Ice-Cream Cone prosthesis yielded fair functional results at short-term followup. Longer term surveillance is called for to see whether this implant will represent an improvement over available reconstructive alternatives such as allograft, custom-made implants, and saddle prostheses. We are cautiously optimistic and continue to use this implant when we need to reconstruct the periacetabular area in patients without Enneking Zone 1 involvement. Level IV, therapeutic study.

  20. Electrocoagulation improving bone cement use in middle-ear surgery: short-term and middle-term results.

    Science.gov (United States)

    Galy-Bernadoy, C; Akkari, M; Mondain, M; Uziel, A; Venail, F

    2016-12-01

    Bone cement is used for ossicular chain repair and revision stapes surgery. Its efficient use requires cautious removal of mucosa from the ossicles. This paper reports a technique for easy, fast and safe removal of this mucosa prior to cement application. It consists of the application of monopolar electrocoagulation on the ossicles prior to bone cement application. The outcomes of six cases of revision stapes surgery and seven cases of partial ossiculoplasty, conducted between 2007 and 2012 using this new technique, were evaluated. Intra-operative reports and audiometric data were collected. During the last assessment, reconstruction using bone cement resulted in mean post-operative air-bone gaps of 4.1 ± 6.5 dB in revision stapes surgery cases and 5.7 ± 5.5 dB in partial ossiculoplasty cases, reflecting a significant hearing improvement (p = 0.03). No complications were observed. Electrocoagulation allows the removal of mucosa from the ossicles in an easy, fast and safe manner, enabling the use of bone cement for ossicular chain reconstruction.

  1. Short-term adaptations as a response to travel time: results of a stated adaptation experimentincreases

    NARCIS (Netherlands)

    Psarra, I.; Arentze, T.A.; Timmermans, H.J.P.

    2016-01-01

    This study focused on short-term dynamics of activity-travel behavior as a response to travel time increases. It is assumed that short-term changes are triggered by stress, which is defined as the deviation between an individual’s aspirations and his or her daily experiences. When stress exceeds a

  2. 2015 Long-Term Hydrologic Monitoring Program Sampling and Analysis Results Report for Project Rulison, Co

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-01

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

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  4. [Long-term result of total versus partial fundoplication following esophagomyotomy for primary esophageal motor disorders].

    Science.gov (United States)

    Zhu, Zi-jiang; Chen, Long-qi; Duranceau, Andre

    2008-02-15

    To compare the long-term results of total and partial fundoplication on esophagus myotomy. From January 1978 to October 1998, 64 patients with achalasia or diffuse esophageal spasm underwent esophagomyotomy and antireflux operation via left thoracotomy. Twenty-one patients underwent Nissen total fundoplication (Nissen group) and 43 patients underwent Belsey Marker IV partial fundoplication (Belsey group). Clinical, radiologic, radionuclide transit, manometric, 24-hour pH monitoring and endoscopic assessments were performed before and after the operation. There was no operative death and major complications for either group. At over 6 years follow-up and compared to Belsey group, patients in Nissen group revealed a higher frequency of dysphagia (P = 0.025) and more radionuclide material retention (P = 0.044). Both operative procedures reduced the lower esophageal sphincter pressure gradient. However, in Nissen group, the esophageal diameter observed on radiology was significantly increased from 3.9 cm preoperatively to 5.5 cm postoperatively (P = 0.012), while it kept the same for Belsey group (from 5.4 to 5.3 cm, P = 0.695). Reoperation in order to relieve the recurrent dysphagia and esophageal obstruction was performed on 8 patients in Nissen group and 1 in Belsey group (P < 0.01). When treating achalasia or diffuse esophageal spasm by esophageal myotomy and an antireflux operation, a total fundoplication is not appropriate, whereas a partial fundoplication provides proper antireflux effect without significant esophageal emptying difficulty.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  6. 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.

  7. Long term results of no-alcohol laser epithelial keratomileusis and photorefractive keratectomy for myopia

    Directory of Open Access Journals (Sweden)

    Leopoldo Spadea

    2015-06-01

    Full Text Available RESULTS: Twenty-one eyes and 22 eyes completed follow-up of 60mo in LASEK and PRK group respectively. Manifest refraction at 60mo follow-up was -0.01 and 0.26 in LASEK and PRK group respectively. In the LASEK group mean UDVA and mean CDVA after 60mo were 20/22 and 20/20 respectively (P>0.01. In the PRK group mean UDVA and mean CDVA at 60mo follow-up were 20/20 and 20/20 after 60mo (P>0.01. The efficacy indexes were 0.87 and 0.95, and the safety indexes were 1.25 and 1.4 respectively for LASEK group and PRK group.CONCLUSION:Both standard PRK and no-alcohol LASEK offer safe and effective correction of low-moderate myopia in the long term without any statistically significant difference between the two groups.

  8. Valve-sparing aortic root replacement in children: intermediate-term results.

    Science.gov (United States)

    Patel, Nishant D; Arnaoutakis, George J; George, Timothy J; Allen, Jeremiah G; Alejo, Diane E; Dietz, Harry C; Cameron, Duke E; Vricella, Luca A

    2011-03-01

    Valve-sparing root replacement (VSRR) is an attractive option for aortic aneurysm in children with low-operative risk, but mid- and late-term results are not yet known. Between 1997 and 2009, 56 children (mean age 11.5 years) underwent VSRR at our institution. Twenty-six (46.4%) had Marfan syndrome and 24 (42.8%) had Loeys-Dietz syndrome. Mean preoperative max sinus diameter was 4.2±0.8 cm (Z-score 7.7±2.9). Five (8.9%) had >2+ aortic insufficiency (AI). Two (3.6%) underwent David I reimplantation with a straight-tube, 12 (21.4%) had a Yacoub remodeling procedure, and 42 (75.0%) had reimplantation using a Valsalva-graft. There were one (1.8%) operative and three (5.4%) late deaths. One patient required reoperation for bleeding and one required late repair of a distal pseudoaneurysm. Mean follow-up was 5.2 years (range 0-12 years). No patients suffered thromboembolic events or had endocarditis. Of the 12 remodeling patients, four (33.3%) developed >2+ AI and required aortic valve repair or replacement. No patient developed >2+ AI after reimplantation. VSRR in children is a safe alternative to aortic root replacement with mechanical or biological prostheses. In this particular group of patients with connective tissue disorders and proclivity toward annular dilation and late AI, reimplantation is superior to remodeling.

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

    LENUS (Irish Health Repository)

    Kavanagh, E G

    2012-02-03

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

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

    Science.gov (United States)

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

    1979-09-01

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

  11. Dispersant trial at ANO-2: Results from a short-term trial prior to SG replacement

    International Nuclear Information System (INIS)

    Fruzzetti, K.; Frattini, P.; Robbins, P.; Miller, A.; Varrin, R.; Kreider, M.

    2002-01-01

    Corrosion products in the secondary side of pressurized water reactor (PWR) steam generators (SGs) primarily deposit on the SG tubes. These deposits can inhibit heat transfer, lead to thermal-hydraulic instabilities through blockage of tube supports, and create occluded regions where corrosive species can concentrate along tubes and in tube-to-tube support plate crevices. The performance of the SGs is compromised not only by formation of an insulating scale, but by the removal of tubes from service due to corrosion. A potential strategy for minimizing deposition of corrosion products on SG internal surfaces is to use an online dispersant to help prevent the corrosion products from adhering to the steam generator surfaces. By inhibiting the deposition of the corrosion products, the dispersant can facilitate more effective removal from the SGs via blowdown. This type of strategy has been employed at fossil boilers for many decades. However, due to the use of inorganic (sulfur and other impurities) polymerization initiators, polymeric dispersants had not been utilized in the nuclear industry. Only recently has a poly-acrylic acid dispersant, developed by BetzDearborn (PAA), been available that meets the criteria for nuclear application. This paper summarizes the results of the short-term PAA dispersant trial in Winter/Spring 2000, lasting approximately 3 months, performed at Arkansas nuclear one unit 2 (ANO-2)-including the chronology of the trial, the increase in blowdown iron removal efficiency with use of the dispersant, and observed effects on SG performance. (authors)

  12. Dispersant trial at ANO-2: Results from a short-term trial prior to SG replacement

    Energy Technology Data Exchange (ETDEWEB)

    Fruzzetti, K.; Frattini, P. [Electric Power Research Inst., Palo Alto, CA (United States); Robbins, P. [Entergy Operations, Arkansas Nuclear One, Russellville, AR (United States); Miller, A. [Pedro Point Technology, Inc., Pacifica, CA (United States); Varrin, R.; Kreider, M. [Dominion Engineering Inc., McLean, VA (United States)

    2002-07-01

    Corrosion products in the secondary side of pressurized water reactor (PWR) steam generators (SGs) primarily deposit on the SG tubes. These deposits can inhibit heat transfer, lead to thermal-hydraulic instabilities through blockage of tube supports, and create occluded regions where corrosive species can concentrate along tubes and in tube-to-tube support plate crevices. The performance of the SGs is compromised not only by formation of an insulating scale, but by the removal of tubes from service due to corrosion. A potential strategy for minimizing deposition of corrosion products on SG internal surfaces is to use an online dispersant to help prevent the corrosion products from adhering to the steam generator surfaces. By inhibiting the deposition of the corrosion products, the dispersant can facilitate more effective removal from the SGs via blowdown. This type of strategy has been employed at fossil boilers for many decades. However, due to the use of inorganic (sulfur and other impurities) polymerization initiators, polymeric dispersants had not been utilized in the nuclear industry. Only recently has a poly-acrylic acid dispersant, developed by BetzDearborn (PAA), been available that meets the criteria for nuclear application. This paper summarizes the results of the short-term PAA dispersant trial in Winter/Spring 2000, lasting approximately 3 months, performed at Arkansas nuclear one unit 2 (ANO-2)-including the chronology of the trial, the increase in blowdown iron removal efficiency with use of the dispersant, and observed effects on SG performance. (authors)

  13. 2015 Long-Term Hydrologic Monitoring Program Sampling and Analysis Results at Rio Blanco, Colorado

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-01

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

  14. Homeopathy in paediatric atopic diseases: long-term results in children with atopic dermatitis.

    Science.gov (United States)

    Rossi, Elio; Bartoli, Paola; Bianchi, Alba; Da Frè, Monica

    2012-01-01

    To study the socio-demographic features, the prescribed remedies and the outcome of atopic diseases in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy), and the long-term outcome of children suffering from atopic dermatitis (AD) after an approximate 8-year period (range 5-10 years). Our data derive from an observational longitudinal study carried out on 213 children (38.6%) with atopic diseases out of 551 children consecutively examined from September 1998 to December 2008. We used the Glasgow Homeopathic Hospital Outcome Score to evaluate the results that were classified on the basis of a Likert scale. Eighty-three (39%) children were affected by asthma, 51 (24%) by allergic rhinoconjunctivitis, 76 (36%) by AD and 3 (1%) by food intolerance. Follow-up patients were 104 (48.8%), and 65 (62.5%) of them reported a major improvement or resolution. The parents of paediatric patients suffering from AD, who had started homeopathic treatment at homeopathy in atopic children. Furthermore, according to the data from the literature paediatric patients treated with homeopathy seem to show a reduced tendency to maintain AD and develop asthma (and allergic rhinitis) in adult age. Copyright © 2011 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  15. Mid-term results of ankle fractures with and without syndesmotic rupture.

    Science.gov (United States)

    Veen, Egbert J D; Zuurmond, Rutger G

    2015-03-01

    This study investigated the effect of short term removal of syndesmotic screws on the ankle function after 6 years, as there still exists controversy on the duration of screw stabilization. Patients with an ankle fracture who received surgery between 1998 and 2004 were reviewed. One group was composed of patients with an ankle fracture needing a syndesmotic repair with screws. The second was composed of operated patients that did not need syndesmotic repair. The primary scoring used was the Olerud-Molander Ankle Score (OMAS). A total of 59 patients were studied with comparable characteristics, with no significant difference on the OMAS after 6 years between the repair group (81.9) and the non-repair group (90.4). On additional clinical scoring groups remained the same. Joint degeneration was seen in both groups (86.7% vs. 55.5%). Patients with ankle fractures using syndesmotic repair and screw removal after 8 weeks and operated patients without syndesmotic injury have comparable results after 6 years. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  16. Chemoradiation therapy and resection for carcinoma of the esophagus: short-term results

    International Nuclear Information System (INIS)

    Parker, E.F.; Marks, R.D. Jr.; Kratz, J.M.; Chaikhouni, A.; Warren, E.T.; Bartles, D.M.

    1985-01-01

    The purpose of this report is to record the results of a treatment protocol for patients with carcinoma of the esophagus. In May, 1980, the authors initiated a program of chemoradiation therapy preliminary to resection in patients in whom the protocol was applicable. The chemotherapy consisted of mitomycin-C, 10 mg as a bolus intravenous injection on day 1, and 5-fluorouracil, 1,000 mg per square meter of body surface area given intravenously on each of days 1 through 4. The radiation therapy consisted of 3,000 rads in three weeks using cobalt 60 or 6 MeV or greater, with ports to cover the tumor and mediastinum. Among the patients treated according to the protocol, the operability rate was increased. The resectability rate remained about the same as in our previous experience. The operative mortality was lessened appreciably. The percentage of resected specimens of the esophagus showing residual tumor decreased. However, the absence of any residual tumor in the surgical specimen has not conferred any improved chance of long-term survival to date

  17. Complications and long-term follow-up results in titanium mesh cage reconstruction after cervical corpectomy.

    Science.gov (United States)

    Nakase, Hiroyuki; Park, Young-Su; Kimura, Hajime; Sakaki, Toshisuke; Morimoto, Tetsuya

    2006-07-01

    The incidence of the complications and long-term outcome with a minimum 2-year follow-up of anterior cervical reconstruction using titanium mesh cage is evaluated. Relevant literature was also reviewed to discuss the potential risk factors of the complications of this procedure. From 1999 to 2003, 26 patients with cervical spine disorders, (12 patients with OPLL, 7 with cervical spondylosis, 3 with vertebral tumors, 2 with osteomyelitis, and 2 with traumatic lesions) were operated on by this procedure. The series included 14 males and 12 females with a mean age of 60.9 years. Corpectomy was performed on 1 (14 cases), 2 (12 cases). Autologous bone fragments were taken from the excised vertebra. The average improvement rate as scored on the neurosurgical cervical spine scale was 67.4%. The average follow-up period was 54.3 months (range, 24 to 72 months) in 21 who were followed up, and bone union was observed in all cases (22/22 cases) that could be followed up for more than 6 months postoperatively. The average time required for fusion was 6.7 months. Postoperative complications included dyspnea (1 case) and cerebrospinal fluid leakage (2 cases), which was treated by lumbar drainage, without any additional repair operation. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. This reconstruction technique yielded good clinical results and helped to avoid complications associated with harvesting bone from the iliac crest donor site. However, risk factors related to the method should be carefully considered.

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

    International Nuclear Information System (INIS)

    Briganti, Francesco; Napoli, Manuela; Leone, Giuseppe; Marseglia, Mariano; Mariniello, Giuseppe; Caranci, Ferdinando; Tortora, Fabio; Maiuri, Francesco

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  20. 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.)

  1. Long-term results of radiation combined with cisplatin in localized muscle invasive bladder cancer

    International Nuclear Information System (INIS)

    Hara, Takahiro; Nishijima, Jun; Miyachika, Yoshihiro; Yamamoto, Yoshiaki; Nagao, Kazuhiro; Sakano, Shigeru; Matsuyama, Hideyasu; Naito, Katsusuke

    2011-01-01

    Although radical cystectomy is the standard treatment for localized muscle invasive-bladder cancer, bladder preservation therapies have been tried for selective patients in several institutes. However, the indication of bladder preservation therapy remains controversial. To select patients who are good candidates for bladder preservation therapy, we evaluated our long-term experience with radiation therapy (conformal radiotherapy (CRT)) combined with cisplatin. Between 1994 and 2009, 90 patients with bladder cancer (clinical stage T2-4N0M0) with no evidence of upper urinary tract cancer were treated with CRT. The response was evaluated by transurethral resection (TUR) of the tumor, urine cytology and CT scan. Thirty-seven cases (41.1%) achieved pathological complete response (CR) which was defined as no microscopic residual tumor in the bladder. After TUR, 74 cases (82.2%) achieved local control of the cancer that was considered as clinical CR. Among 16 patients for whom clinical CR was not achieved, 8 cases were treated with immediate radical cystectomy. We evaluated the long-term results of CRT in 82 cases with bladder preservation. The median follow-up was 36.6 months (range, 4.1-155.1). The five-year overall survival rate and the 5-year progression-free survival rate were 73.0% and 59.2%, respectively. Clinical T stage and type of tumor (primary or recurrent) were prognostic factors for overall survival (p=0.003 and p=0.017). Likewise, clinical T stage and type of tumor were prognostic factors for progression-free survival (p=0.022 and p=0.033). In addition, primary cT2 cases had a significantly better prognosis than those with other T stage and recurrence in overall survival and progression-free survival (p=0.007 and p=0.018). Based on these data, we concluded that primary cT2 tumors were good candidates for radiation combined with cisplatin for bladder preservation therapy. (author)

  2. Valve-sparing root replacement in children with aortic root aneurysm: mid-term results.

    Science.gov (United States)

    Lange, Rüdiger; Badiu, Catalin C; Vogt, Manfred; Voss, Bernhard; Hörer, Jürgen; Prodan, Zsolt; Schreiber, Christian; Mazzitelli, Domenico

    2013-05-01

    We aimed at evaluating the results of aortic valve-sparing root replacement (AVSRR) in children with aortic root aneurysm (ARA) due to genetic disorders in terms of mortality, reoperation and recurrent aortic valve regurgitation (AVR). Thirteen patients (mean age 9.7 ± 6.5 years, 10 months-18 years) underwent AVSRR for ARA between 2002 and 2011. Six of the 13 patients had Marfan syndrome, 3 Loeys-Dietz syndrome (LDS), 2 bicuspid aortic valve syndrome and 2 an unspecified connective tissue disorder. AVR was graded as none/trace, mild and severe in 5, 7 and 1 patient, respectively. The mean pre-operative root diameter was 45 ± 10 mm (mean Z-score 10.3 ± 2.0). Remodelling of the aortic root was performed in 4 patients, reimplantation of the aortic valve in 9 and a concomitant cusp repair in 4. The diameter of the prostheses used for root replacement varied from 22 to 30 mm (mean Z-score = 2.3 ± 3). The follow-up was 100% complete with a mean follow-up time of 3.7 years. There was no operative mortality. One patient with LDS died 2.5 years after the operation due to spontaneous rupture of the descending aorta. Root re-replacement with mechanical conduit was necessary in 1 patient for severe recurrent AVR 8 days after remodelling of the aortic root. At final follow-up, AVR was graded as none/trace and mild in all patients. Eleven patients presented in New York Heart Association functional Class I and 1 in Class II. In paediatric patients with ARA, valve-sparing root replacement can be performed with low operative risk and excellent mid-term valve durability. Hence, prosthetic valve-related morbidity may be avoided. Due to the large diameters of the aortic root and the ascending aorta, the size of the implanted root prostheses will not limit later growth of the native aorta.

  3. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-01

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

  5. Long-term results of the Ross procedure in a population-based follow-up.

    Science.gov (United States)

    Kallio, Merja; Pihkala, Jaana; Sairanen, Heikki; Mattila, Ilkka

    2015-05-01

    centre, the Ross procedure has provided good long-term results in this challenging group of paediatric patients. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. Mitral valve reconstruction in Barlow disease: long-term echographic results and implications for surgical management.

    Science.gov (United States)

    Jouan, Jérôme; Berrebi, Alain; Chauvaud, Sylvain; Menasché, Philippe; Carpentier, Alain; Fabiani, Jean-Noël

    2012-04-01

    Owing to the complexity of the underlying lesions, Barlow disease remains a challenge for surgeons performing mitral valve repair. We aimed to assess whether our most recent results involving several surgeons were comparable with those of a previous experience in which mitral valve repair was performed by a more limited group of surgeons. From September 2000 to January 2007, 200 patients with Barlow disease (135 men and 65 women; mean age, 56 ± 13 years) were referred to our institution for surgical treatment of their mitral regurgitation. We retrospectively analysed the mitral lesions characteristics, the surgical techniques used, and clinical outcomes. Follow-up echocardiograms were biannually reviewed. Lesions comprised annular dilatation, excess tissue, and leaflet prolapse in all cases. The most frequent prolapsed segments were P2 (88.5%; n = 177) and A2 (55.5%; n = 111). Annular calcifications and restrictive valvular motion were associated in 20% (n = 40). Repair was feasible in 94.7% (n = 179/189) of non-redo interventions. Immediate postoperative echocardiography showed residual mitral regurgitation greater than 1+ in 6 cases; these patients were all reoperated on within the next months. Operative mortality was 1.5% (n = 3). Mean follow-up was 77.5 ± 25.6 months. At 8 years postoperatively, overall survival was 88.6% ± 3.1%, freedom from reintervention was 95.3% ± 1.7%, and freedom from late recurrent moderate mitral regurgitation (>2+) was 90.2% ± 3.1% Provided that the fundamental principles of mitral valve reconstruction are respected, the surgical techniques are highly reproducible with good long-term results, similar to those published during the pioneering phase of this surgery. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  7. Comparison of Oncologic Short Term Results of Laparoscopic Versus Open Surgery of Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Solati

    2015-06-01

    Full Text Available Background Today, with improvements in laparoscopy technique, surgery of rectal cancer is performed by laparoscopy. Objectives This study was performed to evaluate oncologic results of open versus laparoscopic surgery of rectal cancer in terms of resection margins, removal of lymph nodes and recurrence rate. Patients and Methods This descriptive-analytic study was performed on 88 patients with middle and lower rectal cancer in the two equivalent groups of laparoscopic and open surgery in Mashhad Ghaem and Omid hospitals during 2011 - 2013. Information including age, sex, number of removed and involved lymph nodes, proximal, distal, and radial margins, tumor stage and location, recurrence and disease-free survival collected in the questionnaire and analyzed using descriptive statistics and frequency distribution tables and t-test. Results Both groups of open and laparoscopic surgery had similar characteristics of age, sex, recurrence and disease-free survival, tumor margins and one-year mortality. The number of removed and involved lymph nodes was higher in the laparoscopic group (5.16 vs. 3.55, respectively, with P < 0.050, and 1.74 vs. 0.59 with P = 0.023, but the ratio of involved lymph nodes to the total number of removed lymph nodes was not different between the two groups (LNR (P = 0.071. Tumor stage was higher in the laparoscopic group and most were in stages II and III (P < 0.001. Conclusions Laparoscopic surgery is an effective technique for safe margin and removing lymph nodes in rectal cancer.

  8. 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.

  9. Human papillomavirus-based cervical cancer prevention: long-term results of a randomized screening trial.

    Science.gov (United States)

    Denny, Lynette; Kuhn, Louise; Hu, Chih-Chi; Tsai, Wei-Yann; Wright, Thomas C

    2010-10-20

    Screen-and-treat approaches to cervical cancer prevention are an attractive option for low-resource settings, but data on their long-term efficacy are lacking. We evaluated the efficacy of two screen-and-treat approaches through 36 months of follow-up in a randomized trial. A total of 6637 unscreened South African women aged 35-65 years who were tested for the presence of high-risk human papillomavirus (HPV) DNA in cervical samples underwent visual inspection of the cervix using acetic acid staining and HIV serotesting. Of these, 6555 were randomly assigned to three study arms: 1) HPV-and-treat, in which all women with a positive HPV DNA test result underwent cryotherapy; 2) visual inspection-and-treat, in which all women with a positive visual inspection test result underwent cryotherapy; or 3) control, in which further evaluation or treatment was delayed for 6 months. All women underwent colposcopy with biopsy at 6 months. All women who were HPV DNA- or visual inspection-positive at enrollment, and a subset of all other women had extended follow-up to 36 months (n = 3639) with yearly colposcopy. The endpoint-cervical intraepithelial neoplasia grade 2 or worse (CIN2+)-was analyzed using actuarial life-table methods. All statistical tests were two-sided. After 36 months, there was a sustained statistically significant decrease in the cumulative detection of CIN2+ in the HPV-and-treat arm compared with the control arm (1.5% vs 5.6%, difference = 4.1%, 95% confidence interval [CI] = 2.8% to 5.3%, P cryotherapy.

  10. Prospective, randomized, open-label, blinded-endpoint (PROBE) designed trials yield the same results as double-blind, placebo-controlled trials with respect to ABPM measurements.

    Science.gov (United States)

    Smith, David H; Neutel, Joel M; Lacourcière, Yves; Kempthorne-Rawson, Joan

    2003-07-01

    This meta-analysis aimed to determine whether ambulatory blood pressure monitoring (ABPM) results from double-blind, placebo-controlled (DBPC) and prospective, randomized, open-label, blinded-endpoint (PROBE) hypertension trials are statistically comparable. Two DBPC and three PROBE parallel-group studies were selected from an angiotensin II receptor blocker clinical programme. These were fixed-dose studies involving similar mild to moderate hypertensive patient populations. All used SpaceLabs 90207 ABPM devices, and each comprised a 4-week placebo period and a 4-8-week treatment period. Data from patients receiving telmisartan 80 mg were used to compare the results of DBPC (126 patients) and PROBE (734 patients) trials. The analysis had approximately 87% power to show equivalence between the two design types in terms of ruling out differences of >or= 3 mmHg in SBP and >or= 2 mmHg in DBP. Office blood pressure was also compared. The change from baseline in mean 24-h ambulatory SBP was -12.2 mmHg in DBPC trials and -12.3 mmHg in PROBE trials, a rounded difference of 0.2 mmHg [95% confidence interval (CI): -1.8, 2.1]. The change from baseline in mean 24-h ambulatory DBP was -7.7 mmHg in DBPC trials versus -7.9 mmHg in PROBE trials, a difference of 0.2 mmHg (95% CI: -1.1, 1.5). Ambulatory pulse pressure results were identical. Thus, changes in mean 24-h ambulatory blood pressure from the DBPC and PROBE trials in this meta-analysis are statistically equivalent in terms of ruling out a difference of >or= 3 mmHg in SBP and >or= 2 mmHg in DBP. This supports the validity of the PROBE design in assessing antihypertensive efficacy based on blinded ABPM measurements.

  11. Preservation of RK and M for Long Term Storage Facilities: The Results of a French Study

    International Nuclear Information System (INIS)

    Schneider, Thierry

    2012-01-01

    Due to the specific long lasting radioactivity of high level waste types, new issues may arise for radiation protection. In this perspective, technical, societal and organizational aspects have to be considered. For the two latter aspects, it is interesting to analyse the efficiency of protection systems available in other fields than nuclear waste management, in order either to protect society from specific risk or to preserve world heritage. Few years ago, CEPN together with MUTADIS have performed a specific study, commissioned by CEA (Commissariat a l'Energie Atomique). The presentation briefly presented the case studies performed on long term protection, as well as the key lessons related to the continuity and sustainability of the surveillance and control of radioactive waste facilities, and the effectiveness of financing schemes for the long term management of radioactive waste. This study has identified a set of performance criteria to deal with long term protection. These results were notably discussed within the framework of the European project COWAM 2 in a working group involving experts, authorities, waste managers, locally elected representatives and NGOs. One part of the study was to analyse the characteristics of protection systems used to manage risks associated with the presence of past underground cavities and mines. A case study presented was the following: After the closing of last mines, maintenance also ended, which, years later, caused ground collapses which led to discussions on responsibility. The connection between the safety problems and the loss of economic activities was underlined. In this context, the IGC (Inspection Generale des Carrieres) was set up. An important part of its functioning is the interaction with the building owners of Paris. The arrangement is that the current owners pay for assuring safety, even though the cause of the safety issue goes back long before owners bought the premises. It was pointed out that market value

  12. 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.

    1996-01-01

    Purpose: To evaluate the short and long term effects of total lymphoid irradiation (TLI) in the treatment of allograft rejection in cardiac transplant patients. Materials and Methods: From 1986 to 1995, 48 courses of TLI were delivered to 47 patients who had received cardiac transplants at Stanford University. In 38 cases, TLI was administered for chronic, intractable allograft rejection despite conventional anti-rejection therapy, including corticosteroids, azathioprine, cyclosporine, OKT3, DHPG, RATG, and methotrexate. Ten patients received TLI prophylactically, beginning radiation between 5 and 16 days after heart transplantation. The prescribed radiation dose was 800 cGy given in 80 cGy fractions twice weekly to all major lymph node regions using mantle and inverted Y fields. Patients continued to receive all medications except azathioprine which was held during TLI to prevent severe marrow suppression. All patients were closely monitored for episodes of rejection, infection, prednisone requirements, blood counts, and complications of treatment. Post-irradiation follow up ranged from 6 months to 9.1 years with a mean of 3.1 years. Results: The actual mean dose of radiation was 730 cGy delivered over a mean of 39 calendar 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, the frequency of rejection dropped from 0.46 episodes/patient/month before radiation to 0.14 episodes/patient/month during TLI (p 3 during TLI (p = 0.01) and remained low at 167.6 cells/mm 3 2-4 months after treatment (p = 0.05). CD8+ lymphocytes also decreased during treatment from 233.2 to 65.8 cells/mm 3 (p = 0.003) but rose significantly above normal to 381.3 cells/mm 3 2-4 months after TLI (p 0.05). Thus, the ratio of helper/suppresser T-cells was chronically decreased. Infection rates were not significantly different before, during or after

  13. Forecasting olive crop yields based on long-term aero biological data series and bio climatic conditions for the southern Iberian Peninsula

    Energy Technology Data Exchange (ETDEWEB)

    Aguilera, F.; Ruiz-Valenzuela, L.

    2014-06-01

    In the present study, bio-meteorological models for predicting olive-crop production in the southern Iberian Peninsula were developed. These covered a 16-year period: 1994-2009. The forecasting models were constructed using the partial least-squares regression method, taking the annual olive yield as the dependent variable, and both aero biological and meteorological parameters as the independent variables. Two regression models were built for the prediction of crop production prior to the final harvest at two different times of the year: July and November. The percentage variance explained by the models was between 83% and 93%. Through these forecasting models, the main factors that influence olive-crop yield were identified. Pollen index and accumulated precipitation, especially as rain recorded during the pre-flowering months, were the most important parameters for providing an explanation of fluctuations in fruit production. The temperature recorded during the two months preceding budburst was another important variable, which showed positive effects on the final yield. The July model that provides accurate predictions of fruit production eight months prior to the final harvest is proposed as an optimal model to forecast fruit produced by olive trees in western Mediterranean areas. (Author)

  14. [Total gastrectomy for gastric cancer: can the type of lymphadenectomy condition the long-term results?].

    Science.gov (United States)

    Di Martino, N; Izzo, G; Cosenza, A; Vicenzo, L; Monaco, L; Torelli, F; Basciotti, A; Brillantino, A; Marra, A

    2005-01-01

    Gastric cancer is the second tumor for frequency in the world. Surgery is still the only curative treatment. Good results in terms of long distance survival, postoperative morbidity and mortality have been achieved in the last years. The extension of lymphadenectomy is an important and discussed matter and it is not clear if lymphadenectomy may contribute to improve the surgical results. The Japanese surgeons were the first ones, in the 60's, to introduce a D2-D3 extended lymphadenectomy, but the real benefits of this technique are still being discussed. Indeed lymphonodal metastasis seem to be one of the most important prognostic factors in the gastric cancer and the level and the number of metastatic nodes are useful to predict the patients' survival. The aim of this study is to value the D2 lymphadenectomy in the patients who were treated with total gastrectomy for gastric adenocarcinoma, comparing the results both with the D1 lymphadenectomy and the D3-D4, paying attention to the survival rates related with the lymphonodal dissection. From 1998 to 2004, we studied 87 patients with gastric cancer. Out of 78 patients treated surgically, 9 were judged unresectable. Out of 69 patients treated surgically, one died before surgery and so he was put away by this study. All the patients were treated with total gastrectomy and a GI tract reconstruction by Roux's Y termino-lateral esophageal-jejunal anastomosis. In 20 patients we also made a splenectomy. We followed the Japanese Research Society for Gastric Cancer guidelines, according to which nodes are gathered into 16 levels and divided in 4 groups (N1-N4) depending on the cancer localization. The extension of the lymphadenectomy has been classified according to the level of the removed nods. The patients were divided into 3 groups. First group: patients undergone a total gastrectomy with D1 lymphadenectomy. Second group: patients undergone D2 lymphadenectomy. Third group: patients undergone D3 and D4 lymphadenectomy

  15. Long-Term Results from an Epiretinal Prosthesis to Restore Sight to the Blind.

    Science.gov (United States)

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

    2015-08-01

    Retinitis pigmentosa (RP) is a group of inherited retinal degenerations leading to blindness due to photoreceptor loss. Retinitis pigmentosa is a rare disease, affecting only approximately 100 000 people in the United States. There is no cure and no approved medical therapy to slow or reverse RP. The purpose of this clinical trial was to evaluate the safety, reliability, and benefit of the Argus II Retinal Prosthesis System (Second Sight Medical Products, Inc, Sylmar, CA) in restoring some visual function to subjects completely blind from RP. We report clinical trial results at 1 and 3 years after implantation. The study is a multicenter, single-arm, prospective clinical trial. There were 30 subjects in 10 centers in the United States and Europe. Subjects served as their own controls, that is, implanted eye versus fellow eye, and system on versus system off (native residual vision). The Argus II System was implanted on and in a single eye (typically the worse-seeing eye) of blind subjects. Subjects wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina. The primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by 3 computer-based, objective tests. A total of 29 of 30 subjects had functioning Argus II Systems implants 3 years after implantation. Eleven subjects experienced a total of 23 serious device- or surgery-related adverse events. All were treated with standard ophthalmic care. As a group, subjects performed significantly better with the system on than off on all visual function tests and functional vision assessments. The 3-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind from RP. Earlier results from this trial were used to gain approval of the Argus II by the Food and Drug Administration and a CE mark in

  16. 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

  17. Long-term results of radioiodine (131I) therapy in 331 patients with Graves' disease

    International Nuclear Information System (INIS)

    Saito, Shintaro; Sakurada, Toshiro; Yamamoto, Makiko; Yoshida, Katsumi; Kaise, Kazuo

    1980-01-01

    To evaluate the long-term results of 131 I treatment for Graves' disease, the thyroid function was studied in 331 patients 5 - 17 years after this therapy. Twenty-five patients were hypothyroid and had already been on thyroid medication. Among the remaining 306 patients without any treatment for thyroid disorder, 188 patients (61.4%) had a normal thyroid-stimulating hormone (TSH) level (less than 10 μU/ml) of whom 151 were euthyroid with normal thyroxine (T 4 ) and triiodothyronine (T 3 ) level. 118 patients (38.6%) had a high TSH level, of whom 22 were hypothyroid with low T 4 and T 3 levels and 38 were with normal T 3 and low T 4 levels, and 14 patients out of this 38 were clinically hypothyroid. Although all of the patients with high TSH levels do not require the replacement therapy for hypothyroidism, the overt hypothyroidism seems to occur sooner or later in patients with a lower T 4 level. Among 331 patients studied, 61 (18.4%) were clinically hypothyroid. The incidence of hypothyroidism was 20.7% after 10 years of 131 I treatment and 33% after 15 - 17 years. The incidence of patients with high TSH levels was 50% after 10 years of 131 I treatment and 60% after 15 - 17 years. Both of cumulative incidence of hypothyroidism and patients with high TSH levels increased linearly with years after the treatment, which coincided with the linear decrease of mean T 4 and T 3 levels and linear increase of mean TSH level with years after the treatment. The difference of positive incidence of antithyroid antibodies between cases of normal TSH level and high TSH level was not significant. (author)

  18. Short- and long-term results following standing fracture repair in 34 horses.

    Science.gov (United States)

    Payne, R J; Compston, P C

    2012-11-01

    Standing fracture repair in the horse is a recently described surgical procedure and currently there are few follow-up data. This case series contains 2 novel aspects in the standing horse: repair of incomplete sagittal fractures of the proximal phalanx and medial condylar repair from a lateral aspect. To describe outcome in a case series of horses that had lower limb fractures repaired under standing sedation at Rossdales Equine Hospital. Case records for all horses that had a fracture surgically repaired, by one surgeon at Rossdales Equine Hospital, under standing sedation and local anaesthesia up until June 2011, were retrieved. Hospital records, owner/trainer telephone questionnaire and the Racing Post website were used to evaluate follow-up. Thirty-four horses satisfied the inclusion criteria. Fracture sites included the proximal phalanx (incomplete sagittal fracture, n = 14); the third metacarpal bone (lateral condyle, n = 12, and medial condyle, n = 7); and the third metatarsal bone (lateral condyle, n = 1). One horse required euthanasia due to caecal rupture 10 days post operatively. Twenty horses (66.7% of those with available follow-up) have returned to racing. Where available, mean time from operation to return to racing was 226 days (range 143-433 days). Standing fracture repair produced similar results to fracture repair under general anaesthesia in terms of both the number of horses that returned to racing and the time between surgery and race. Repair of lower limb fracture in the horse under standing sedation is a procedure that has the potential for tangible benefits, including avoidance of the inherent risks of general anaesthesia. The preliminary findings in this series of horses are encouraging and informative when discussing options available prior to fracture repair. © 2012 EVJ Ltd.

  19. Long-term results of aortic valve-sparing operations in patients with Marfan syndrome.

    Science.gov (United States)

    David, Tirone E; Armstrong, Sue; Maganti, Manjula; Colman, Jack; Bradley, Timothy J

    2009-10-01

    The appropriateness of aortic valve-sparing operations in patients with Marfan syndrome has been questioned. This study examines the long-term results of these operations in patients with Marfan syndrome. From 1988 to 2006, 103 consecutive patients with Marfan syndrome (mean age, 37 +/- 12 years) and aortic root aneurysm had aortic valve-sparing operations. Emergency surgery was performed in 11 patients: 8 for acute type A aortic dissection and 3 for unexplained persistent chest pain. Fourteen patients also had mitral valve surgery. The technique of aortic valve reimplantation was used in 77 patients, and aortic root remodeling was used in 26 patients. Patients were followed prospectively and underwent annual echocardiographic studies. The mean follow-up was 7.3 +/- 4.2 years and 100% complete. There was 1 operative death and 5 late deaths. Four of the 6 deaths were due to complications of aortic dissections. The patients' survival at 15 years was 87.2% compared with 95.6% for the general population of Ontario matched for age and sex. Seven patients had important aortic insufficiency: 4 mild to moderate, 2 moderate, and 1 moderate to severe. Freedom from greater than mild aortic insufficiency at 15 years was 79.2%. Three patients, all after aortic root remodeling, had aortic valve replacement, 2 for aortic insufficiency and 1 for endocarditis. At the most recent follow-up, 97 patients were alive: 86 were in functional class I, and 11 were in functional class II. Aortic valve-sparing operations provided excellent clinical outcomes in this series of patients with Marfan syndrome. Postoperatively, complications of aortic dissections were the leading cause of death.

  20. Intermediate-term results of partial plantar fascia release with microtenotomy using bipolar radiofrequency microtenotomy.

    Science.gov (United States)

    Lucas, Douglas E; Ekroth, Scott R; Hyer, Christopher F

    2015-01-01

    Plantar fasciitis is a common condition, with most patients treated successfully with nonoperative management. Recalcitrant disease has been managed with surgical procedures that vary in design and associated morbidity. The present study sought to determine the intermediate-term results of percutaneous bipolar radiofrequency microtenotomy in recalcitrant plantar fasciitis. The patient medical records were reviewed, and data were gathered for all the patients who met the inclusion criteria. The foot function index and visual analog scale (VAS) pain scale questionnaires were mailed to the 111 patients. Of the 111 patients, 61 (55.0%) returned their questionnaires and were ultimately included in the present analysis. Of the 61 patients, 44 (72.1%) were female and 17 were (27.9%) male, with an average reported follow-up of 33.3 ± 8.6 (range 16.1 to 46.6) months. The median postoperative VAS score was 0.0 (range 0.0 to 10.0), and the median foot function index score was 3.1 (range 0.0 to 97.1). The patients were subdivided into success and failure groups according to their satisfaction. Of the 61 patients, 51 (83.6%) were satisfied and would recommend the procedure to a friend. The median VAS score in the success group was 0.0 (range 0.0 to 5.0), and the median VAS score in the failure group was 6.0 (range 0.0 to 10.0), a significant difference (p plantar fasciitis. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Adjustable Perineal Male Sling for the Treatment of Urinary Incontinence: Long-term Results.

    Science.gov (United States)

    Altan, Mesut; Asi, Tariq; Bilen, Cenk Yucel; Ergen, Ali

    2017-08-01

    To present the long-term results in patients with urinary incontinence who were treated with adjustable perineal male sling. An adjustable male sling procedure was performed in 45 patients with a mean age of 67.6 ± 7.8 years who had urinary incontinence. The mean period between primary prostatic surgery and the sling procedure was 36.7 months. The difference between the classical sling and the adjustable one is a 10 cm tissue expander between the 2 layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via this port, in case of recurrence or persistence of incontinence. Mean follow-up was 48 ± 29 months. Average operative time was 101.1 ± 25.5 minutes (45-150). Median daily pad use in these patients decreased from 8(2-12) to 1(0-10) (P dry rate was higher in patients with nonsevere incontinence compared to the others with severe incontinence (57.9% vs 23.1%, P = .029). Nevertheless, there was no significant difference in the case of total success rate (78.9% vs 57.7%, respectively; P = .135). Age was significantly greater in both complete dry group (71.1 ± 4.8 vs 65.4 ± 8.7) and total success group (70.1 ± 5.2 vs 62.4 ± 5.2) (P = .017 and P < .001, respectively). Adjustable male sling is an acceptable procedure with low complication rates especially in patients with mild and moderate incontinence. At the same time, this procedure may be offered to patients with previous incontinence surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Evaluation on In-vessel Source Term in PGSFR (2015 Results)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Won; Chang, Won-Pyo; Ha, Kwi-Seok; Ahn, Sang June; Kang, Seok Hun; Choi, Chi-Woong; Lee, Kwi Lim; Jeong, Jae-Ho; Kim, Jin Su; Jeong, Taekyeong [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    This strategy requires nuclear plants to have features that prevent radionuclide release and multiple barriers to the escape from the plants of any radionuclides that are released despite preventive measures. Considerations of the ability to prevent and mitigate release of radionuclides arise at numerous places in the safety regulations of nuclear plants. The effectiveness of mitigative capabilities in nuclear plants is subject to quantitative analysis. The radionuclide input to these quantitative analyses of effectiveness is the Source Term (ST). All features of the composition, magnitude, timing, chemical form and physical form of accidental radionuclide release constitute the ST. Also, ST is defined as the release of radionuclides from the fuel and coolant into the containment, and subsequently to the environment. Since the TMI accident in 1979, extensive experimental and analytical information has been accumulated on the accident ST for LWRs. Such mechanistic models and computer codes as the MELCOR and MAAP have been developed. The results of extensive calculations and experiments have been used to formulate an alternative to the simple TID-14844 ST for regulatory purpose. The in-vessel STs are calculated through several phases: The inventory of each radionuclide is calculated by ORIGEN-2 code using the peak burnup conditions. The nominal value of the radiological inventory is multiplied by a factor of 1.1 as an uncertainty margin to give the radiological inventory. ST in the release from the core to primary sodium is calculated by using the assumption of 4S methodology. Lastly, ST in the release from the primary sodium to cover gas space is calculated by using the assumption of 4S methodology.

  3. Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results.

    Science.gov (United States)

    Erdem, Suna; Imboden, Sara; Papadia, Andrea; Lanz, Susanne; Mueller, Michael D; Gloor, Beat; Worni, Mathias

    2018-06-01

    Curative management of deep infiltrating endometriosis requires complete removal of all endometriotic implants. Surgical approach to rectal involvement has become a topic of debate given potential postoperative bowel dysfunction and complications. This study aims to assess long-term postoperative evacuation and incontinence outcomes after laparoscopic segmental rectal resection for deep infiltrating endometriosis involving the rectal wall. This is a retrospective study of prospectively collected data. This single-center study was conducted at the University Hospital of Bern, Switzerland. Patients with deep infiltrating endometriosis involving the rectum undergoing rectal resection from June 2002 to May 2011 with at least 24 months follow-up were included. Aside from endometriosis-related symptoms, detailed symptoms on evacuation (points: 0 (best) to 21 (worst)) and incontinence (0-24) were evaluated by using a standardized questionnaire before and at least 24 months after surgery. Of 66 women who underwent rectal resection, 51 were available for analyses with a median follow-up period of 86 months (range: 26-168). Forty-eight patients (94%) underwent laparoscopic resection (4% converted, 2% primary open), with end-to-end anastomosis in 41 patients (82%). Two patients (4%) had an anastomotic insufficiency; 1 case was complicated by rectovaginal fistula. Dysmenorrhea, nonmenstrual pain, and dyspareunia substantially improved (p endometriosis including the rectal wall is associated with good results in endometriotic-related symptoms, although patients should be informed about possible postoperative impairments in evacuation and incontinence. However, its clinical impact does not outweigh the benefit that can be achieved through this approach. See Video Abstract at http://links.lww.com/DCR/A547.

  4. Long-term results after external radiotherapy in age-related macular degeneration. A prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Prettenhofer, U.; Mayer, R.; Stranzl, H.; Oechs, A.; Hackl, A. [Dept. of Radiotherapy, Univ. Medical School, Graz (Austria); Haas, A. [Dept. of Opthalmology, Univ. Medical School, Graz (Austria)

    2004-02-01

    Purpose: to prospectively evaluate the short- and long-term efficacy of external radiotherapy (RT) in patients with age-related macular degeneration (AMD) by comparing two different dose schedules. Patients and methods: in this prospective, nonrandomized, comparative study including 80 patients, the efficacy of external RT with a total dose of 14.4 Gy (group A, n = 40) and 25.2 Gy (group B, n = 40) was compared. Patients of group a were irradiated between September 1995 and July 1996, patients of group b between August 1996 and November 1997. 67 patients presented with occult choroidal neovascularization (CNV), 13 with classic subfoveal lesions. Complete ophthalmologic investigation was performed before RT, at intervals of 3 months during the 1st year after RT, and of 6 months thereafter. Results: 12 months after RT, vision deteriorated in 85% (14.4 Gy) and 65% (25.2 Gy) of patients. Central visual field decreased with both dose schedules. There was no morphological benefit in neovascular changes. After 48 months, complete follow-up was possible in 46 patients who showed a significant loss of vision similar to the natural course of AMD. Conclusion: external RT of AMD with 14.4 Gy as well as with the escalated dose of 25.2 Gy showed a poor beneficial outcome after 6 and 12 months, respectively. After a follow-up of 4 years, visual outcome in irradiated patients was similar to the natural course of the disease. A conspicuous efficacy of RT in prevention of blindness could not be demonstrated. (orig.)

  5. Influence of raw milk quality on processed dairy products: How do raw milk quality test results relate to product quality and yield?

    Science.gov (United States)

    Murphy, Steven C; Martin, Nicole H; Barbano, David M; Wiedmann, Martin

    2016-12-01

    This article provides an overview of the influence of raw milk quality on the quality of processed dairy products and offers a perspective on the merits of investing in quality. Dairy farmers are frequently offered monetary premium incentives to provide high-quality milk to processors. These incentives are most often based on raw milk somatic cell and bacteria count levels well below the regulatory public health-based limits. Justification for these incentive payments can be based on improved processed product quality and manufacturing efficiencies that provide the processor with a return on their investment for high-quality raw milk. In some cases, this return on investment is difficult to measure. Raw milks with high levels of somatic cells and bacteria are associated with increased enzyme activity that can result in product defects. Use of raw milk with somatic cell counts >100,000cells/mL has been shown to reduce cheese yields, and higher levels, generally >400,000 cells/mL, have been associated with textural and flavor defects in cheese and other products. Although most research indicates that fairly high total bacteria counts (>1,000,000 cfu/mL) in raw milk are needed to cause defects in most processed dairy products, receiving high-quality milk from the farm allows some flexibility for handling raw milk, which can increase efficiencies and reduce the risk of raw milk reaching bacterial levels of concern. Monitoring total bacterial numbers in regard to raw milk quality is imperative, but determining levels of specific types of bacteria present has gained increasing importance. For example, spores of certain spore-forming bacteria present in raw milk at very low levels (e.g., products to levels that result in defects. With the exception of meeting product specifications often required for milk powders, testing for specific spore-forming groups is currently not used in quality incentive programs in the United States but is used in other countries (e.g., the

  6. Short-term visual result after simultaneous photorefractive keratectomy and small-aperture cornea inlay implantation

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2016-11-01

    Full Text Available Majid Moshirfar,1,2 Ryan T Wallace,3 David F Skanchy,4 Jordan D Desautels,5 Steven H Linn,1 Phillip C Hoopes Jr,1 Daniel S Durrie1,6 1Hoopes, Durrie, Rivera, Research Center, Hoopes Vision, Draper, UT, 2Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 3Brigham Young University, Provo, UT, 4McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 5Tufts University School of Medicine, Boston, MA, 6Durrie Vision, Overland Park, KS, USA Purpose: To report the short-term results of simultaneous photorefractive keratectomy (PRK and small-aperture cornea inlay implantation (KAMRA surgery in treating presbyopia. Methods: Simultaneous PRK and KAMRA inlay surgery was performed on 21 patients from July 2015 to March 2016. Follow-up exams were conducted at 1, 3, and 6 months postoperatively. Our patients were also divided preoperatively into three categories: myopic, hyperopic, and emmetropic. Over the 6-month period, the main outcome measures were uncorrected near visual acuity (UNVA, changes in best-corrected distance visual acuity, and mean spherical equivalent refraction. Results: At 6-month follow-up, 83% (10/12 of patients had a monocular UNVA of 20/40 or better, and 75% had a binocular UNVA of 20/40 (J5 or better. At 6 months, the overall mean refractive spherical equivalent (MRSE was -0.60 D (±0.42 standard deviation [SD], range: -1.38 to -0.13 with a mean change of -0.43 D (±1.19 SD, range: -1.5 to 2.63 compared to preoperative data. Overall, 91% (10/11 of patients were within a ±0.5 D range of our target -0.75 D for KAMRA use. One-hundred percent (5/5 of the hyperopes, 50% (1/2 of emmetropes, and 100% (4/4 of myopes met the targeted range. At 6 months, the MRSE for the hyperopic subgroup (n=5 was 0.33 D (±0.20 SD, the MRSE for the emmetropic subgroup (n=2 was -1.19 D (±0.19 SD, and the MRSE for the myopic

  7. Estimation of Source Term Behaviors in SBO Sequence in a Typical 1000MWth PWR and Comparison with Other Source Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Woon; Han, Seok Jung; Ahn, Kwang Il; Fynan, Douglas; Jung, Yong Hoon [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    Since the Three Mile Island (TMI) (1979), Chernobyl (1986), Fukushima Daiichi (2011) accidents, the assessment of radiological source term effects on the environment has been a key concern of nuclear safety. In the Fukushima Daiichi accident, the long-term SBO (station blackout) accident occurs. Using the worst case assumptions like in Fukushima accident on the accident sequences and on the availability of safety systems, the thermal hydraulic behaviors, core relocation and environmental source terms behaviors are estimated for long-term SBO accident for OPR-1000 reactor. MELCOR code version 1.8.6 is used in this analysis. Source term results estimated in this study is compared with other previous studies and estimated results in Fukushima accidents in UNSCEAR-2013 report. This study estimated that 11 % of iodine can be released to environment and 2% of cesium can be released to environment. UNSCEAR-2013 report estimated that 2 - 8 % of iodine have been released to environment and 1 - 3 % of cesium have been released to the environment. They have similar results in the aspect of release fractions of iodine and cesium to environment.

  8. Long term results of primary radiation therapy for squamous cancer of the base of tongue

    International Nuclear Information System (INIS)

    Harrison, LB; Lee, H; Kraus, DH; Zelefsky, M; Strong, EW; Pfister, DG; Raben, A; Shah, J; White, C; Carper, E; Portenoy, R

    1996-01-01

    excellent long term oncologic and functional results although most patients do have some symptomatology related to their cancer or its treatment

  9. Mid-term results of different aortic valve-sparing procedures in Marfan syndrome.

    Science.gov (United States)

    Schmidtke, Claudia; Karluss, Antje; Sier, Holger; Hüppe, Michael; Brauer, Kirk; Sievers, Hans-H

    2012-03-01

    Marfan patients with aortic root aneurysm are typically treated with the Bentall procedure, though aortic valve-sparing procedures (AVSPs) are also possible. The study aim was to compare the authors' experience with two such techniques performed at their institution, namely a reimplantation according to David (David I) and remodeling according to Yacoub. Between 1996 and 2009, a total of 37 Marfan patients underwent an AVSP at the authors' institution. Of these patients, 25 (mean age 32 +/- 14.9 years) underwent surgery according to David (group D), and 12 (mean age 35 +/- 10.9 years) according to Yacoub (group Y). The patients underwent both clinical and echocardiographic follow up examinations at a mean of 42.0 +/- 36.4 months after surgery. One patient from each group had moved abroad and was lost to follow up. The remaining 35 patients were alive at follow up, and none presented with any major neurological or bleeding complications. In addition, no significant differences were noted between the groups in terms of NYHA classification, left ventricular function, or left ventricular diameter. At follow up, aortic valve function was also comparable between groups, with a peak/mean gradient of 9.4 +/- 6.4/5.3 +/- 3.5 mmHg and 5.1 +/- 3.3/2.8 +/- 1.5 mmHg for groups D and Y, respectively (p = 0.081/0.058). The measured mean grades of aortic valve regurgitation were comparable in groups D and Y (0.6 +/- 0.7 and 1.1 +/- 0.6, respectively; p = 0.055). However, aortic root dimensions obtained via M-mode were smaller in group D patients (29.6 +/- 2.3 mm) than in group Y patients (36.1 +/- 6.6 mm) (p = 0.027). Only three patients from group Y required reoperation on the aortic valve due to valvular regurgitation (p = 0.028); two of these had presented with aortic dissection at the first operation. Both types of AVSP can be performed with comparably good interim clinical results, and also low mortality and morbidity, in patients with Marfan syndrome.

  10. Treatment of Low Back Pain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results.

    Science.gov (United States)

    Huber, Stephan; Priebe, Janosch A; Baumann, Kaja-Maria; Plidschun, Anne; Schiessl, Christine; Tölle, Thomas R

    2017-12-04

    Even though modern concepts of disease management of unspecific low back pain (LBP) postulate active participation of patients, this strategy is difficult to adapt unless multidisciplinary pain therapy is applied. Recently, mobile health solutions have proven to be effective aides to foster self-management of many diseases. The objective of this paper was to report on the retrospective short-term results of a digital multidisciplinary pain app for the treatment of LBP. Kaia is a mobile app that digitalizes multidisciplinary pain treatment and is in the market as a medical product class I. For the current study, the data of anonymized Kaia users was retrospectively analyzed. User data were evaluated for 12 weeks regarding duration of use and effect on in-app user reported pain levels, using the numerical rating scale (NRS), depending on whether LBP was classified as acute, subacute, or chronic back pain according to current guidelines. Data of 180 users were available. The mean age of the users was 33.9 years (SD 10.9). Pain levels decreased from baseline NRS 4.8 to 3.75 for all users at the end of the observation period. Users who completed 4, 8, or 12 weeks showed an even more pronounced decrease in pain level NRS (baseline 4.9 [SD 1.7] versus 3.6 [SD 1.5] at 4 weeks; baseline 4.7 [SD 1.8] versus 3.2 [SD [2.0] at 8 weeks; baseline 4.6 [SD 2.2] versus 2.6 [SD 2.0] at 12 weeks). In addition, subgroup analysis of acute, subacute, or chronic classification revealed no significant main effect of group (P>.30) on the reduction of pain. Conclusions: This retrospective study showed that in a pre-selected population of app users, an app digitalizing multidisciplinary rehabilitation for the self-management of LBP reduced user-reported pain levels significantly. The observed effect size was clinically relevant. Ongoing prospective randomized controlled trials (RCTs) will adjust for potential bias and selection effects. This retrospective study showed that in a pre

  11. Mid-term results of the BIOLOX delta ceramic-on-ceramic total hip arthroplasty.

    Science.gov (United States)

    Lee, Y K; Ha, Y C; Yoo, J-I; Jo, W L; Kim, K-C; Koo, K H

    2017-06-01

    We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival. Four patients (four hips) died and 18 patients (20 hips) were lost to follow-up within five years. The remaining 252 patients (286 hips) were followed for a mean of 66.5 months (60 to 84). There were 144 men (166 hips) and 108 women (120 hips) with a mean age of 49.7 years (16 to 83) at surgery. The mean pre-operative Harris Hip Score of 47.1 points improved to 93.8 points at final follow-up. Six patients reported squeaking in seven hips; however, none were audible. Radiolucent lines involving Gruen zones one and/or seven were seen in 52 hips (18.2%). No hip had detectable wear, focal osteolysis or signs of loosening. One hip was revised because of fracture of the ceramic liner, which occurred due to an undetected malseating of the ceramic liner at the time of surgery. One hip was revised for a periprosthetic fracture of the femur, and one hip was treated for periprosthetic joint infection. The six-year survivorship with re-operation for any reason as the endpoint was 99.0% (95% confidence interval 97.8% to 100%). The rate of delta ceramic fracture was 0.3% (one of 286). While ceramic head fracture was dominant in previous ceramic-on-ceramic THA, fracture of the delta ceramic liner due to malseating is a concern. Cite this article: Bone Joint J 2017;99-B:741-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

  12. 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

  13. 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...

  14. Laparoscopic sacrocolpopexy with bone anchor fixation: short-term anatomic and functional results.

    NARCIS (Netherlands)

    Withagen, M.I.J.; Vierhout, M.E.; Mannaerts, G.H.; Weiden, R.M.F. van der

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate short-term anatomic and functional outcomes and safety of laparoscopic sacrocolpopexy with bone anchor fixation. METHODS: A prospective cohort study of women undergoing laparoscopic sacrocolpopexy between 2004 and 2009. Anatomic

  15. 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

  16. 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.

  17. Endovascular therapy of abdominal aortic aneurysm: results of a mid-term follow-up

    International Nuclear Information System (INIS)

    Pitton, M.B.; Schweitzer, H.; Herber, S.; Thelen, M.; Schmiedt, W.; Neufang, A.; Dueber, C.

    2003-01-01

    Prospective study to evaluate clinical results and complications of endovascular abdominal aortic aneurysm treatment in a mid-term follow-up. Materials and methods: A total of 122 patients (9 females, 113 males, average age 70.0±7,9 years) with abdominal aortic aneurysms were treated with stent grafts (53 Vanguard or Stentor endografts, 69 Talent endografts). Group I consisted of 40 patients who had all aortic tributaries of the aneurysm sac occluded prior to endovalscular grafting, either spontaneously by parietal thrombosis or by selective coil embolization of the respective ostia preserving collateral circulation distal to the vessel occlusion. Group II consisted of 82 patients and included all cases without or with incomplete coil embolization with at least one patent vessel. Stent grafting was performed in general anesthesia in the first 21 patients, followed by peridural anesthesia in 15 cases, and local anesthesia with conscious sedation in 86 cases. The results were evaluated with Spiral-CT, MRI and radiographs of the endovascular graft, with follow-up examinations obtained at 3, 6, 12 months, and every year - Implantation was successfully completed in all cases without primary conversion surgery, laparotomy or any significant complication. Mean follow-up was 29±21 months (maximum 82 months). The 30-day mortality was 0,8% due to a myocardial infarction 3 days after discharge from the hospital. A total of 47 re-interventions were performed in 29 patients (23.8%), with 35 re-interventions in 18 cases with Vanguard or Stentor endografts and 12 re-interventions in 11 patients with Talent endografts. 23 percutaneous re-interventions included distal graft extension (n=11), Wallstent for kinking and limb stenosis (n=3), and secondary coil embolization of collateral vessels (n=9). 24 surgical re-interventions included proximal graft extension (n=6), new endovascular grafts (n=3), surgical clipping of lumbar and mesenteric artery branches for type-II endoleaks

  18. 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.)

  19. Two decades of genetic profiling yields first evidence of natal philopatry and long-term fidelity to parturition sites in sharks

    KAUST Repository

    Feldheim, Kevin Andrew; Gruber, Samuel H.; DiBattista, Joseph; Babcock, Elizabeth A.; Kessel, Steven T.; Hendry, Andrew P.; Pikitch, Ellen K.; Ashley, Mary V.; Chapman, Demian D F

    2013-01-01

    in the 1993-1997 cohorts returned to give birth 14-17 years later, providing the first direct evidence of natal philopatry in the chondrichthyans. Long-term fidelity to specific nursery sites coupled with natal philopatry highlights the merits of emerging

  20. Extra soil fertilization of mother plants increases botanical seed yield but not long-term germination in wild Solanum (potato) species

    Science.gov (United States)

    Potato has about 100 wild species relatives that are multiplied in the form of botanical seed populations by genebanks, and distributed for use in research and breeding, so factors that affect long term seed germination are of interest. In 1987 the US Potato Genebank conducted routine seed multiplic...

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

    Directory of Open Access Journals (Sweden)

    Lili Zhang

    Full Text Available In order to discover the advantages and disadvantages of different fertilization regimes and identify the best management practice of fertilization in greenhouse fields, soil enzyme activities involved in carbon (C transformations, soil chemical characteristics, and crop yields were monitored after long-term (20-year fertilization regimes, including no fertilizer (CK, 300 kg N ha-1 and 600 kg N ha-1 as urea (N1 and N2, 75 Mg ha-1 horse manure compost (M, and M with either 300 or 600 kg N ha-1 urea (MN1 and MN2. Compared with CK, fertilization increased crop yields by 31% (N2 to 69% (MN1. However, compared with CK, inorganic fertilization (especially N2 also caused soil acidification and salinization. In the N2 treatment, soil total organic carbon (TOC decreased from 14.1±0.27 g kg-1 at the beginning of the long-term experiment in 1988 to 12.6±0.11 g kg-1 (P<0.05. Compared to CK, N1 and N2 exhibited higher soil α-galactosidase and β-galactosidase activities, but lower soil α-glucosidase and β-glucosidase activities (P<0.05, indicating that inorganic fertilization had different impacts on these C transformation enzymes. Compared with CK, the M, MN1 and MN2 treatments exhibited higher enzyme activities, soil TOC, total nitrogen, dissolved organic C, and microbial biomass C and N. The fertilization regime of the MN1 treatment was identified as optimal because it produced the highest yields and increased soil quality, ensuring sustainability. The results suggest that inorganic fertilizer alone, especially in high amounts, in greenhouse fields is detrimental to soil quality.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    haemorrhage patients. For tractional retinal detachment patients, use of silicone oil was associated with low vision (visual acuity4 and p-values ≤ 0.03, logistic regression). Of the 134 patients who were phakic after surgery, 43% and 29% were phakic......-term predictor of low vision after surgery is use of silicone oil for endotamponade. About 2/3 of phakic patients will subsequently have cataract surgery the first 10 years after diabetic vitrectomy....

  3. Mid-term results of correction of Tetralogy of Fallot with absent pulmonary valve

    Directory of Open Access Journals (Sweden)

    Sachin Talwar

    2017-11-01

    Conclusions: In contrast to children and adults with TOF/APV, infants carry significant early mortality. But the mid-term outcome for patients who survive the initial repair of TOF/APV is acceptable. However, these patients require constant surveillance and irrespective of the methods of RVOT management, the reoperation rates are expected to be high as more of these patients survive into adulthood.

  4. 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.

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

    International Nuclear Information System (INIS)

    2009-01-01

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

  6. 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.

  7. 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.

  8. Tape functionality: position, change in shape, and outcome after TVT procedure--mid-term results.

    Science.gov (United States)

    Kociszewski, Jacek; Rautenberg, Oliver; Kolben, Sebastian; Eberhard, Jakob; Hilgers, Reinhard; Viereck, Volker

    2010-07-01

    This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape-urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape-urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.

  9. Concrete/Febex Bentonite Interaction: Results On Short-Term Column Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Escribano, A.; Turrero, M.J.; Torres, E.; Martin, P.L. [CIEMAT, Environmental Department, Avda. Complutense, 22, 28040 Madrid (Spain)

    2008-07-01

    Interaction between the alkaline pore fluids from the concrete engineered barriers and the bentonite at the repository conditions may generate products that can diffuse through the porous structure of the bentonite affecting their properties. A comprehensive study based on series of short term experiments is being performed to provide experimental evidences on the physical, chemical and mineralogical changes during the concrete-compacted bentonite interaction. Samples were analyzed by XRD, SEM-EDS and FTIR. Measurements of swelling capacity, specific surface area and chemical analysis for cation exchange capacity and soluble salts analyses were also performed. (authors)

  10. Concrete/Febex Bentonite Interaction: Results On Short-Term Column Experiments

    International Nuclear Information System (INIS)

    Escribano, A.; Turrero, M.J.; Torres, E.; Martin, P.L.

    2008-01-01

    Interaction between the alkaline pore fluids from the concrete engineered barriers and the bentonite at the repository conditions may generate products that can diffuse through the porous structure of the bentonite affecting their properties. A comprehensive study based on series of short term experiments is being performed to provide experimental evidences on the physical, chemical and mineralogical changes during the concrete-compacted bentonite interaction. Samples were analyzed by XRD, SEM-EDS and FTIR. Measurements of swelling capacity, specific surface area and chemical analysis for cation exchange capacity and soluble salts analyses were also performed. (authors)

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

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Just, Sven; Foegh, Pia

    2015-01-01

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

  12. Effect of the long-term elevation of CO2 concentration in the field on the quantum yield of photosynthesis of the C3 sedge, Scirpus olneyi

    International Nuclear Information System (INIS)

    Long, S.P.; Drake, B.G.

    1991-01-01

    CO 2 concentration was elevated throughout 3 years around stands of the C 3 sedge Scirpus olneyi on a tidal marsh of the Chesapeake Bay. The hypothesis that tissues developed in an elevated CO 2 atmosphere will show an acclimatory decrease in photosynthetic capacity under light-limiting conditions was examined. The absorbed light quantum yield of CO 2 uptake (φ abs ) and the efficiency of photosystem II photochemistry were determined for plants which had developed in open top chambers with CO 2 concentrations in air of 680 micromoles per mole, and of 351 micromoles per mole as controls. When measured in an atmosphere with 10 millimoles per mole O 2 to suppress photorespiration, shoots showed a φ abs of 0.093 ± 0.003, with no statistically significant difference between shoots grown in elevated or control CO 2 concentration. Efficiency of photosystem II photochemistry was also unchanged by development in an elevated CO 2 atmosphere. Shoots grown and measured in 680 micromoles per mole of CO 2 in air showed a φ abs of 0.078 ± 0.004 compared with 0.065 ± for leaves grown and measured in 351 micromoles per mole CO 2 in air; a highly significant increase. In accordance with the change in φ abs , the light compensation point of photosynthesis decreased from 51 ± 3 to 31 ± 3 micromoles per square meter per second for stems grown and measured in 351 and 680 micromoles per mole of CO 2 in air, respectively

  13. Long term operation of nuclear power plants – IAEA SALTO peer review service and its results

    Energy Technology Data Exchange (ETDEWEB)

    Krivanek, Robert, E-mail: r.krivanek@iaea.org

    2014-12-15

    Highlights: • SALTO peer review service is designed for reviewing of ageing management and NPPs’ preparedness LTO. • It has been established as an effective tool to review the compliance with IAEA safety standards. • The important issues for safe LTO are being identified by SALTO missions. • Analysis of those issues is provided in the paper. • This peer review service is strongly recommended for NPPs prior to entering LTO period. - Abstract: This paper presents main IAEA activities for safe long term operation (LTO) which includes establishment of IAEA Safety Standards and other LTO related documents, fostering information exchange and establishing databases and provision of SALTO (Safety Aspects of Long Term Operation) peer review service. This paper provides insights into IAEA SALTO peer review service objectives, scope and methodology. The SALTO peer review service was designed to assist nuclear power plant (NPP) operators in adopting a proper approach to LTO of their plants and in implementing complete and appropriate activities to ensure that plant safety will be maintained during the LTO period. The SALTO peer review service can also support regulators in establishing or improving regulatory and licensing strategies for LTO of NPPs. Issues derived from 19 SALTO missions and 2 LTO modules of OSART (Operational Safety Review Team) missions conducted during the period of 2005 to March 2014 are also analyzed in this paper.

  14. 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.

  15. LONG TERM RESULTS AFTER STAPLED HEMORRHOIDOPEXY ALONE AND COMPLEMENTED BY EXCISIONAL HEMORRHOIDECTOMY: A RETROSPECTIVE COHORT STUDY.

    Science.gov (United States)

    Araujo, Sergio Eduardo Alonso; Horcel, Lucas de Araujo; Seid, Victor Edmond; Bertoncini, Alexandre Bruno; Klajner, Sidney

    2016-01-01

    Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision. The same surgeons operated on all cases. Patients underwent stapled hemorrhoidectomy associated with excisional surgery if symptoms attributable to external hemorrhoid piles were observed preoperatively, or if residual prolapse or bulky external disease was observed after the firing of the stapler. A closed excisional diathermy hemorrhoidectomy without vascular ligation was utilized in all complemented cases. All clinical variables were obtained from a questionnaire evaluation obtained through e-mail, telephone interview, or office follow-up. The median duration of postoperative follow-up was 48.5 (6-40) months. Patients with grades 3 and 4 hemorrhoid disease were operated on more frequently using stapled hemorrhoidopexy complemented with excisional technique (95.2% vs. 55.4%, p=0.001). Regarding respectively stapled hemorrhoidopexy and stapled hemorrhoidopexy complemented with excision, there was no difference between the techniques in relation to symptom recurrence (43% and 33%, p=0.45) and median interval between surgery and symptom recurrence (30 (8-84) and 38.8 (8-65) months, p=0.80). Eight (12.3%) patients were re-operated after stapled hemorrhoidopexy and 2 (9.6%), after hemorrhoidopexy with excision (p=0.78). Patient distribution in both groups according to the degree of postoperative satisfaction was similar (p=0.97). Stapled hemorrhoidopexy combined

  16. 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

  17. Steps to Health employee weight management randomized control trial: short-term follow-up results.

    Science.gov (United States)

    Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

    2015-02-01

    To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System. A total of 550 obese (body mass index, ≥30 kg/m2) employees were randomized 1:1 between January 2011 and June 2012 to the education-based Weight Management (WM) or the WM+ arm, which focused on behavior modification. Employees were contacted to complete a follow-up visit approximately 14 months after baseline. There were no clinically, or statistically, meaningful differences between arms, but there were modest reductions in body mass index, and positive, meaningful changes in diet and physical activity for both arms. The modest positive effects observed in this study may suggest that to achieve weight loss through the workplace more intensive interventions may be required.

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

    International Nuclear Information System (INIS)

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

    1992-11-01

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

  19. Radiation therapy for wet type age-related macular degeneration. Long term follow-up results

    Energy Technology Data Exchange (ETDEWEB)

    Sasai, Keisuke; Hiraoka, Masahiro; Mandai, Michiyo; Takahashi, Masayo; Honda, Yoshihito [Kyoto Univ. (Japan). Faculty of Medicine

    1998-12-01

    Between April, 1994 and July, 1995, 33 patients with occult type choroidal neovascularization (CNV) with or without the classical type CNV of the wet type age-related macular degeneration ARMD were treated with radiation therapy (10 Gy/5 fx/1 week or 20 Gy/10 fx/2 weeks). This phase I/II study showed that radiation therapy seems to be useful for CNV during the first 12 months. Some eyes which initially showed good response to irradiation began to lose their visual acuity. However, the dose of 20 Gy in 10 fractions seemed useful to maintain the visual acuity better than 0.1 in this long term follow-up study (24 months). (author)

  20. Interpretation of scenario results in terms of described and mapped land change trajectories and archetypes

    DEFF Research Database (Denmark)

    Kuemmerle, Tobias; Stürck, Julia; Levers, Christian

    Module VISIONS seeks to identify critical pathways to reach desired futures for land systems (i.e., visions). In order to do so, work package (WP) 11 links the model-based scenarios (module ASSESSMENT) to the visions formulated derived in a transdisciplinary process together with stakeholders...... of future developments of current land change archetypes; and (3) an interpretation of future land change in light of long-term land system trajectories. Synthesizing across these analyses, six key insights emerged. First, future land change was relatively similar across marker scenarios and different...... policy alternatives, for many regions in Europe, suggesting strong path dependency. Second, the impact of policy options can differ (a) between regions in Europe and (b) among marker scenarios, highlighting the need for contextualized, regionalized policy making. Third, the expansion and intensification...

  1. Videoscopic Heller myotomy for achalasia--results beyond short-term follow-up.

    Science.gov (United States)

    Bloomston, M; Boyce, W; Mamel, J; Albrink, M; Murr, M; Durkin, A; Rosemurgy, A

    2000-08-01

    Heller myotomy has long been utilized for patients failing nonoperative management of achalasia. Videoscopy has been advocated to decrease the morbidity of Heller myotomy; however, few reports document outcome beyond 1 year after videoscopic Heller myotomy. To determine perioperative morbidity, relief of dysphagia, and the incidence of postoperative reflux symptoms following videoscopic Heller myotomy with follow-up to over 4 years. Patients with achalasia documented by barium esophogram and esophageal manometry underwent videoscopic Heller myotomy beginning in 1992. Intraoperative peroral endoscopy was utilized to guide the cephalad and caudad extent of myotomy. A barium esophogram was undertaken in the immediate postoperative period to evaluate for subclinical leak and assess esophageal emptying. Seventy-eight patients underwent videoscopic Heller myotomy. The mean age was 51 years +/- 19 (range 14 to 91). Most (62%) patients had undergone pneumatic dilation prior to surgical consultation and 54% had previous botox injections. All patients complained of dysphagia and 40% had symptoms of heartburn prior to myotomy. After myotomy, 91% of patients stated that their swallowing was improved with myotomy. Thirteen patients (18%) experience heartburn more than once per week after myotomy. The average length of stay was 2 +/- 2 days, with 72% of patients spending 2 days or fewer in the hospital. Six (7.7%) major complications occurred: five esophageal perforations and one enterotomy without long-term sequellae. Three procedures (3.8%) were converted to "open" procedures. No deaths occurred. We conclude that videoscopic Heller myotomy is safe and efficacious, with low morbidity and mortality. Videoscopic myotomy provides relief beyond the short term for dysphagia due to achalasia with minimal reflux symptoms. We advocate videoscopic Heller myotomy in the treatment of severe dysphagia due to achalasia not adequately palliated by or amenable to nonoperative management

  2. High-precision radiotherapy for meningiomas. Long-term results and patient-reported outcome (PRO)

    Energy Technology Data Exchange (ETDEWEB)

    Kessel, Kerstin A.; Fischer, Hanna; Combs, Stephanie E. [Technical University of Munich (TUM), Department of Radiation Oncology, Munich (Germany); Helmholtz Zentrum Muenchen (HMGU), Institute for Innovative Radiotherapy (iRT), Department of Radiation Sciences DRS, Neuherberg (Germany); Oechnser, Markus [Technical University of Munich (TUM), Department of Radiation Oncology, Munich (Germany); Zimmer, Claus [Technical University of Munich (TUM), Department of Neuroradiology, Munich (Germany); Meyer, Bernhard [Technical University of Munich (TUM), Department of Neurosurgery, Munich (Germany)

    2017-11-15

    To evaluate long-term outcome after high-precision radiotherapy (RT) of meningioma patients in terms of survival and side effects. We analyzed 275 meningioma cases: 147 low-grade and 43 high-grade meningiomas (WHO II: n = 40, III: n = 3). In all, 85 patients had no pathologically confirmed histology but were determined as low-grade based on multimodal imaging. Surgery was performed in 183 cases. RT was delivered as either radiosurgery (RS, n = 16), fractionated stereotactic radiotherapy (FSRT, n = 241), or intensity-modulated radiation therapy (IMRT, n = 18). Of 218 patients contacted for patient-reported-outcome (PRO), 207 responded (95%). Median follow-up was 7.2 years. For low-grade meningioma the survival rate (OS) was 97% at 3 years, 85% at 10 years, and 64% at 15 years, for atypical meningioma 91% at 3 years, 62% at 10 years, and 50% at 15 years. Local control rate (PFS) for low-grade meningioma was 91% at 3 years, 87% at 5 years, and 86% at 10 years, for atypical cases 67% at 3 years and 55% at 5 years. Of all, 3.0% of patients reported worsened or new symptoms grade ≥3 during RT and the first 6 months thereafter; 17.5% reported a deterioration after more than 2 years. We found the prognostic factors tumor volume and age significantly influencing OS and PFS. Complemented by PRO, we found long-term low toxicity rates in addition to excellent local control. Thus, due to the beneficial risk-benefit profile of benign and high-risk meningiomas, RT should be performed as adjuvant treatment and should not be postponed until tumor progression. (orig.) [German] Langzeitergebnisse nach Hochpraezisionsstrahlentherapie (RT) von Patienten mit Meningeomen hinsichtlich Ueberleben und Nebenwirkungen. Es wurden 275 Meningeomfaelle untersucht: 145 benigne (WHO I), 40 atypische (WHO II) und 3 anaplastische (WHO III) Meningeome; bei 85 Patienten bestand keine histologische Sicherung. Voroperiert waren 183 Faelle (67 %). Bei 16 Patienten wurde eine Radiochirurgie (RS

  3. 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.

  4. 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.

  5. Long-term results of incisional hernia repair with retromuscular mesh

    Directory of Open Access Journals (Sweden)

    Miran Rems

    2011-04-01

    Conclusions: The retromuscular mesh placement for postoperative hernia repair results in a low rate of recurrences and postoperative complications. Complications are more common in patients admitted due to incarceration and in patients having suffered from stoma. Pain inflicted by postoperative hernia repair is an underrated with treatment results.

  6. Two decades of genetic profiling yields first evidence of natal philopatry and long-term fidelity to parturition sites in sharks

    KAUST Repository

    Feldheim, Kevin Andrew

    2013-12-09

    Sharks are a globally threatened group of marine fishes that often breed in their natal region of origin. There has even been speculation that female sharks return to their exact birthplace to breed (\\'natal philopatry\\'), which would have important conservation implications. Genetic profiling of lemon sharks (Negaprion brevirostris) from 20 consecutive cohorts (1993-2012) at Bimini, Bahamas, showed that certain females faithfully gave birth at this site for nearly two decades. At least six females born in the 1993-1997 cohorts returned to give birth 14-17 years later, providing the first direct evidence of natal philopatry in the chondrichthyans. Long-term fidelity to specific nursery sites coupled with natal philopatry highlights the merits of emerging spatial and local conservation efforts for these threatened predators. © 2013 John Wiley & Sons Ltd.

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

    International Nuclear Information System (INIS)

    Marnitz, Simone; Zich, Alexander; Budach, Volker; Jahn, Ulrich; Neumann, Oliver; Martus, Peter; Arnold, Renate

    2014-01-01

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

  8. Long-term results from the Contura multilumen balloon breast brachytherapy catheter phase 4 registry trial.

    Science.gov (United States)

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

    2014-12-01

    To describe the long-term outcomes from a completed, multi-institutional phase 4 registry trial using the Contura multilumen balloon (CMLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer. Three hundred forty-two evaluable patients were enrolled by 23 institutions between January 2008 and February 2011. All patients received 34 Gy in 10 fractions, delivered twice daily. Rigorous target coverage and normal tissue dose constraints were observed. The median follow-up time was 36 months (range, 1-54 months). For the entire patient cohort of 342 patients, 10 patients experienced an ipsilateral breast tumor recurrence (IBTR). Eight of these IBTR were classified as true recurrences/marginal miss (TRMM), and 2 were elsewhere failures (EF). Local recurrence-free survival was 97.8% at 3 years. For the entire cohort, 88% of patients had good to excellent overall cosmesis. The overall incidence of infection was 8.5%. Symptomatic seroma was reported in only 4.4% of patients. A separate analysis was performed to determine whether improved outcomes would be observed for patients treated at high-volume centers with extensive brachytherapy experience. Three IBTR were observed in this cohort, only 1 of which was classified as a TRMM. Local recurrence-free survival at high-volume centers was 98.1% at 3 years. Overall cosmetic outcome and toxicity were superior in patients treated at high-volume centers. In these patients, 95% had good to excellent overall cosmesis. Infection was observed in only 2.9% of patients, and symptomatic seroma was reported in only 1.9%. Use of the CMLB for APBI delivery is associated with acceptable long-term local control and toxicity. Local recurrence-free survival was 97.8% at 3 years. Significant (grade 3) toxicity was uncommon, and no grade 4 toxicity was observed. Treatment at high-volume centers was associated with decreased late toxicity. Copyright © 2014 Elsevier Inc

  9. 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...

  10. Results of repeated transsphenoidal surgery in Cushing's disease. Long-term follow-up.

    Science.gov (United States)

    Valderrábano, Pablo; Aller, Javier; García-Valdecasas, Leopoldo; García-Uría, José; Martín, Laura; Palacios, Nuria; Estrada, Javier

    2014-04-01

    Transsphenoidal surgery (TSS) is the treatment of choice for Cushing's disease (CD). However, the best treatment option when hypercortisolism persists or recurs remains unknown. The aim of this study was to analyze the short and long-term outcome of repeat TSS in this situation and to search for response predictors. Data from 26 patients with persistent (n=11) or recurrent (n=15) hypercortisolism who underwent repeat surgery by a single neurosurgeon between 1982 and 2009 were retrospectively analyzed. Remission was defined as normalization of urinary free cortisol (UFC) levels, and recurrence as presence of elevated UFC levels after having achieved remission. The following potential outcome predictors were analyzed: adrenal status (persistence or recurrence) after initial TSS, tumor identification in imaging tests, degree of hypercortisolism before repeat TSS, same/different surgeon in both TSS, and time to repeat surgery. Immediate postoperative remission was achieved in 12 patients (46.2%). Five of the 10 patients with available follow-up data relapsed after surgery (median time to recurrence, 13 months). New hormone deficiencies were seen in seven patients (37%), and two patients had cerebrospinal fluid leakage. No other major complications occurred. None of the preoperative factors analyzed was predictive of surgical outcome. When compared to initial surgery, repeat TSS for CD is associated to a lower remission rate and a higher risk of recurrence and complications. Further studies are needed to define outcome predictors. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  11. Long-term results of treatment with diquafosol ophthalmic solution for aqueous-deficient dry eye.

    Science.gov (United States)

    Koh, Shizuka; Ikeda, Chikako; Takai, Yoshihiro; Watanabe, Hitoshi; Maeda, Naoyuki; Nishida, Kohji

    2013-09-01

    To evaluate the preliminary long-term efficacy of diquafosol ophthalmic solution for aqueous-deficient dry eye. Fifteen patients with mild-to-moderate aqueous-deficient dry eye were enrolled. After a washout period, the patients were treated with 3 % diquafosol ophthalmic solution for 6 months. We assessed 12 subjective dry eye symptoms, corneal and conjunctival staining with fluorescein, tear film break-up time (BUT), lower tear meniscus height measured with anterior-segment optical coherence tomography, Schirmer's testing, and adverse reactions at baseline and 1, 3, and 6 months after the start of treatment. Treatment with diquafosol ophthalmic solution significantly improved dry eye symptoms, corneal staining, BUT, and tear meniscus height at 1 month and maintained the effectiveness for 6 months. Conjunctival staining significantly improved 3 and 6 months after treatment. No significant adverse reactions developed. Prolonged use of diquafosol ophthalmic solution for 6 months produced significant improvement both subjectively (dry eye symptom score) and objectively (ocular staining score and tear function tests) for aqueous-deficient dry eye.

  12. Long-term Results of Ventral Penile Curvature Repair in Childhood.

    Science.gov (United States)

    Golomb, Dor; Sivan, Bezalel; Livne, Pinhas M; Nevo, Amihay; Ben-Meir, David

    2018-02-01

    To assess the postpubertal outcome of ventral penile curvature repaired in infancy in terms of recurrence and aesthetics. Postpubertal patients treated for hypospadias and ventral penile curvature in infancy at a tertiary medical center were invited to undergo assessment of the quality of the repair. Findings were compared between patients with a straight penis after skin release and patients who required dorsal plication. The cohort included 27 patients of mean age 16.5 years who were reported with straight penis after surgery. Postpubertal curvature was found in 6 of 14 patients (43%) successfully treated by skin release and 10 of 13 patients (77%) who underwent dorsal plication (P = .087). Significant curvature (≥30 degrees) was found in 1 of 14 patients in the skin-release group and 4 of 13 in the dorsal plication group (P = .16). Rates of redo urethroplasty were 2 of 14 (14%) and 5 of 10 (50%), respectively. Patient satisfaction with the appearance of the penis did not differ significantly. Ventral penile curvature repaired in infancy often recurs after puberty. The need for dorsal plication has a trend-level association with recurrence of penile curvature in puberty. It might also be related to the degree of postpubertal penile curvature and the need for redo urethroplasty. Procedure type does not affect patient satisfaction with the postpubertal appearance of the penis. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-12-01

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

  14. Long-term results of splenectomy in adult chronic immune thrombocytopenia.

    Science.gov (United States)

    Guan, Yue; Wang, Shixuan; Xue, Feng; Liu, Xiaofan; Zhang, Lei; Li, Huiyuan; Yang, Renchi

    2017-03-01

    We performed this study in adult patients with chronic primary immune thrombocytopenia to explore the long-term efficacy and safety of splenectomy. Data of 174 patients who underwent splenectomy in our hospital from 1994 to 2014 were analyzed. After splenectomy, 126 (72.4%) patients achieved a complete response (CR) and 28 (16.1%) achieved a response (R). Thirty-two (20.8%) responders relapsed with a median time of 24 months. Compared with non-responders and recurrent patients, the stable responders were younger and had higher preoperation and postoperation peak platelet count, later peak platelet count emergence time, and more megakaryocytes. Corticosteroid-dependent patients were more likely to response to splenectomy than those refractory to corticosteroid. We performed a relapse-free survival analysis among the 154 responders. In univariate analyses, corticosteroid dependent and time from diagnosis to splenectomy ≤24 months showed predictive value to persistent response. But only corticosteroid dependent was a significant predictor in multivariate analysis. The 30-d complication rate after the surgery was 25.9%. There were five (2.9%) patients experienced thrombosis and three (1.7%) refractory patients died during follow-up. Splenectomy was a safe treatment with a cure rate of 58.0%. Corticosteroid dependent showed predictive value to persistent response. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    International Nuclear Information System (INIS)

    Kobashi, Yuko; Hoshikawa, Yoshikazu

    2004-01-01

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

  16. Two healing lengths in a two-band GL-model with quadratic terms: Numerical results

    Science.gov (United States)

    Macias-Medri, A. E.; Rodríguez-Núñez, J. J.

    2018-05-01

    A two-band and quartic interaction order Ginzburg-Landau model in the presence of a single vortex is studied in this work. Interactions of second (quadratic, with coupling parameter γ) and fourth (quartic, with coupling parameter γ˜) order between the two superconducting order parameters (fi with i = 1,2) are incorporated in a functional. Terms beyond quadratic gradient contributions are neglected in the corresponding minimized free energy. The solution of the system of coupled equations is solved by numerical methods to obtain the fi-profiles, where our starting point was the calculation of the superconducting critical temperature Tc. With this at hand, we evaluate fi and the magnetic field along the z-axis, B0, as function of γ, γ˜, the radial distance r/λ1(0) and the temperature T, for T ≈ Tc. The self-consistent equations allow us to compute λ (penetration depth) and the healing lengths of fi (Lhi with i = 1,2) as functions of T, γ and γ˜. At the end, relevant discussions about type-1.5 superconductivity in the compounds we have studied are presented.

  17. Transcatheter device closure of ruptured sinus of Valsalva: Immediate results and short term follow up

    Directory of Open Access Journals (Sweden)

    Sen Supratim

    2009-01-01

    Full Text Available This is a retrospective, observational study comprising of eight patients with isolated rupture of the sinus of Valsalva (RSOV who underwent transcatheter device closure. The mean age of presentation was 32.8 ± 10.0 years. New York Heart Association (NYHA class at the time of presentation was II (six patients and III (two patients. The RSOVs were all closed using a patent ductus arteriosus device. The mean procedural time was 42.3 ± 5.4 minutes, while the fluoroscopic time was 24.5 ± 6.9 minutes. All had complete closure of the shunt. The average hospital stay was 2.9 ± 1.1 days. There were no major complications. The patients were followed up for a mean of 11.3 ± 4.1 months. At the time of the last follow up all the patients were in NYHA class I. We conclude that in the short term, transcatheter closure of isolated RSOV is a viable alternative to surgical repair.

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

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  19. Influences of Biodynamic and Conventional Farming Systems on Quality of Potato (Solanum Tuberosum L.) Crops: Results from Multivariate Analyses of Two Long-Term Field Trials in Sweden.

    Science.gov (United States)

    Kjellenberg, Lars; Granstedt, Artur

    2015-09-15

    The aim of this paper was to present results from two long term field experiments comparing potato samples from conventional farming systems with samples from biodynamic farming systems. The principal component analyses (PCA), consistently exhibited differences between potato samples from the two farming systems. According to the PCA, potato samples treated with inorganic fertilizers exhibited a variation positively related to amounts of crude protein, yield, cooking or tissue discoloration and extract decomposition. Potato samples treated according to biodynamic principles, with composted cow manure, were more positively related to traits such as Quality- and EAA-indices, dry matter content, taste quality, relative proportion of pure protein and biocrystallization value. Distinctions between years, crop rotation and cultivars used were sometimes more significant than differences between manuring systems. Grown after barley the potato crop exhibited better quality traits compared to when grown after ley in both the conventional and the biodynamic farming system.

  20. Influences of Biodynamic and Conventional Farming Systems on Quality of Potato (Solanum Tuberosum L. Crops: Results from Multivariate Analyses of Two Long-Term Field Trials in Sweden

    Directory of Open Access Journals (Sweden)

    Lars Kjellenberg

    2015-09-01

    Full Text Available The aim of this paper was to present results from two long term field experiments comparing potato samples from conventional farming systems with samples from biodynamic farming systems. The principal component analyses (PCA, consistently exhibited differences between potato samples from the two farming systems. According to the PCA, potato samples treated with inorganic fertilizers exhibited a variation positively related to amounts of crude protein, yield, cooking or tissue discoloration and extract decomposition. Potato samples treated according to biodynamic principles, with composted cow manure, were more positively related to traits such as Quality- and EAA-indices, dry matter content, taste quality, relative proportion of pure protein and biocrystallization value. Distinctions between years, crop rotation and cultivars used were sometimes more significant than differences between manuring systems. Grown after barley the potato crop exhibited better quality traits compared to when grown after ley in both the conventional and the biodynamic farming system.

  1. Percutaneous Transluminal Angioplasty of Renal Artery Fibromuscular Dysplasia: Mid-term Results

    International Nuclear Information System (INIS)

    Kim, Hyo Jin; Do, Young Soo; Shin, Sung Wook; Park, Kwang Bo; Cho, Sung Ki; Choe, Yeon Hyeon; Choo, Sung Wook; Choo, In Wook; Kim, Duk Kyung

    2008-01-01

    To evaluate mid-term imaging, clinical follow-up, and restenosis rates from patients that had undergone percutaneous transluminal renal artery angioplasty (PTRA) for symptomatic renal artery fibromuscular dysplasia (FMD). Between March 1999 and July 2006, 16 consecutive renal artery FMD patients underwent PTRA for poorly controlled hypertension. The patients were enrolled into this retrospective study after receiving 19 primary and four secondary PTRAs in 19 renal artery segments. Follow-up monitoring of blood pressure, use of antihypertensive medication, and the serum creatinine level after PTRA were assessed at 1, 3, 6, 9, 12 months, and each following year. The degree of restenosis was evaluated with computed tomographic angiography (CTA) after PTRA at 6, 12 months, and every year if possible. Technical and clinical success rates for the treatment of FMD, and restenosis rates for the renal artery were evaluated. The technical success rate for primary PTRA was 79% (15/19) and the complication rate was 16% (3/19). Hypertension improved in 80% (12/15) of the patients after four weeks follow-up, and was finally cured or improved in 93% (14/15) during the mean follow-up period of 23.6 months. There was a cumulative 22% (4/18) restenosis rate during the follow-up period. All of the patients were treated with a second PTRA without complications and all of the patients were cured of hypertension after the second PTRA. Percutaneous transluminal renal artery angioplasty for clinically symptomatic renal FMD is technically and clinically successful and safe to perform. For all patients with restenosis, there was a good response after undergoing a second PTRA

  2. Yield trends and yield gap analysis of major crops in the world

    OpenAIRE

    Hengsdijk, H.; Langeveld, J.W.A.

    2009-01-01

    This study aims to quantify the gap between current and potential yields of major crops in the world, and the production constraints that contribute to this yield gap. Using an expert-based evaluation of yield gaps and the literature, global and regional yields and yield trends of major crops are quantified, yield gaps evaluated by crop experts, current yield progress by breeding estimated, and different yield projections compared. Results show decreasing yield growth for wheat and rice, but ...

  3. Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview

    Directory of Open Access Journals (Sweden)

    Tiren Davut

    2012-01-01

    Full Text Available Abstract Background The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%. Nine patients (32% developed impingement symptoms and in 7 patients (25% subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14% developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11% had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.

  4. Long Term Results of Visual Field Progression Analysis in Open Angle Glaucoma Patients Under Treatment.

    Science.gov (United States)

    Kocatürk, Tolga; Bekmez, Sinan; Katrancı, Merve; Çakmak, Harun; Dayanır, Volkan

    2015-01-01

    To evaluate visual field progression with trend and event analysis in open angle glaucoma patients under treatment. Fifteen year follow-up results of 408 eyes of 217 glaucoma patients who were followed at Adnan Menderes University, Department of Ophthalmology between 1998 and 2013 were analyzed retrospectively. Visual field data were collected for Mean Deviation (MD), Visual Field Index (VFI), and event occurrence. There were 146 primary open-angle glaucoma (POAG), 123 pseudoexfoliative glaucoma (XFG) and 139 normal tension glaucoma (NTG) eyes. MD showed significant change in all diagnostic groups (pfield indices. We herein report our fifteen year follow-up results in open angle glaucoma.

  5. Long-Term Results After Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions Nordic Bifurcation Study 5-Year Follow-Up Results

    DEFF Research Database (Denmark)

    Maeng, M.; Holm, N. R.; Erglis, A.

    2013-01-01

    Objectives This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study. Background Randomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy. Methods...... complex strategy of planned stenting of both the main vessel and the side branch. (C) 2013 by the American College of Cardiology Foundation...

  6. Short-term Results of Vagus Nerve Stimulation in Pediatric Patients with Refractory Epilepsy

    Directory of Open Access Journals (Sweden)

    Chih-Yi Chen

    2012-06-01

    Conclusion: The effective management of medically intractable seizure remains challenging to most clinical physicians. In addition to ketogenic diet and epilepsy surgery, VNS provides an alternative way to manage this issue. Our results suggest that VNS is well tolerated in pediatric patients, and is a favorable and safe method of treating intractable seizure in common clinical practice.

  7. Long-term results of various therapy concepts in severe pilon fractures.

    Science.gov (United States)

    Koulouvaris, Panagiotis; Stafylas, Kosmas; Mitsionis, Gregory; Vekris, Marios; Mavrodontidis, Alexandros; Xenakis, Theodore

    2007-07-01

    Intra-articular fractures of the tibia plafond are among the most challenging of orthopaedic problems. This is a retrospective case-control study of surgically treated pilon fractures which was undertaken to compare the internal fixation with the two external fixation methods. This is a case-control study of 55 patients with 55 pilon fractures. There were 36 type C and 19 type B. Of these fractures, 24 were open and 31 closed. Three surgical protocols were used. In 20 patients, Group A, a half pin external fixator with ankle spanning was performed. The mean age of patients was 42.0 years (22.0-74.0), SD 14.1 and the mean follow-up was 77.7 months (38.0-132.0), SD 25.4. In 22 patients, Group B, a single ankle sparring ring hybrid external fixator under a small arthrotomy was performed. The mean age of patients was 48.4 years (28.0-76.0), SD 12.4 and mean follow-up was 67.9 months (36.0-132.0), SD 27.8. In 13 patients, Group C, a two-staged internal fixation was performed. The mean age was 45.6 years (30.0-66.0), SD 9.7 and the mean follow-up was 78.6 months (55.0-132.0), SD 25.4. We addressed the dissimilarity of the type of fracture in each group performing supplementary stratified analyses within each fracture type group. Group A had union in 6.9 months, group B in 5.6 months and group C in 5.1 months; P = 0.009. Six patients (Group A), two (Group B), and one (Group C) had limitation of ankle motion; P = 0.47. One patient from group C developed infection and the plate was removed. Four patients (Group A), one (Group B), and one (Group C) have developed posttraumatic arthritis (loss of joint space and pain); P = 0.25. Seven patients from Group A have reduced their activities; P = 0.004. In stratified statistical analysis by type of fracture, the associations noted for both fracture groups combined were also noted separately within each fracture group. In this long term follow-up study, the two-staged internal fixation and the hybrid fixation with small arthrotomy

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

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    Suzan Güven Yılmaz

    2012-03-01

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

  9. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-05-15

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

  11. Long-term results with a nonionic contrast medium - a clinical experience report

    International Nuclear Information System (INIS)

    Hruby, W.; Stellamor, K.

    1987-01-01

    Between January 1982 and May 1986 more than 50 000 patients were examined radioligically with water-soluble (ionic and nonionic) contrast media at the Department of Radiology Rudolfstiftung, Vienna. 1983 only 2,2% of the contrast agents used were nonionic, in 1985 the share had increased to 53,3%. During this period the rate of drug-related side effects (DRSE) decreased from 6,9% (1983) to 3,3% (1985). From 1983 to 1985 DRSE were observed with 1952 patients after administration of ionic agents, whereas after application of nonionic media adverse reactions occurred in only 6 cases, so that DRSE rates of 6,98% respectively 0,07% resulted for ionic respectively nonionic contrast media. These results are discussed with regard to the physicochemical properties and physiological actions of ionic and nonionic contrast agents. (orig.) [de

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    , and discomfort resulting in abutment and/or implant removal. RESULTS: One hundred eighty-five implantations in 176 patients were reviewed. Overall, 3.8% of the implants were lost spontaneously after a mean of 2.5 years. Implant loss in children was 18% versus 2.5% in adults and 3.8% in elderly. Adverse skin...... reactions occurred in 14% of observations overall; in 10% in children compared with 16% in adults and 9% in elderly. Partial or total skin overgrowth was seen in 4% and 6% of the observations in children and adults, respectively, whereas none of the elderly experienced this problem. The abutment was removed...... common complication. Children lose the implant more frequently than adults. Elderly patients have less adverse skin reactions/skin overgrowth. Discomfort leading to abutment removal is a concern especially among adults....

  13. Low-term results from non-conventional partial arthroplasty for treating rotator cuff arthroplasthy

    Directory of Open Access Journals (Sweden)

    Antônio Carlos Tenor Júnior

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the evolution of the functional results from CTA(rhemiarthroplasty for surgically treating degenerative arthroplathy of the rotator cuff, with a mean follow-up of 5.4 years.METHODS: Eighteen patients who underwent CTA(r partial arthroplasty to treat degenerative arthroplathy of the rotator cuff between April 2007 and June 2009 were reevaluated, with minimum and mean follow-ups of 4.6 years and 5.4 years, respectively. Pre and postoperative parameters for functionality and patient satisfaction were used (functional scale of the University of California in Los Angeles, UCLA. All the patients underwent prior conservative treatment for 6 months and underwent surgical treatment because of the absence of satisfactory results. Patients were excluded if they presented any of the following: previous shoulder surgery; pseudoparalysis; insufficiency of the coracoacromial arch (type 2 B in Seebauer's classification; neurological lesions; or insufficiency of the deltoid muscle and the subscapularis muscle.RESULTS: With a mean follow-up of 5.4 years, 14 patients considered that they were satisfied with the surgery (78%; the mean range of joint motion for active elevation improved from 55.8° before the operation to 82.0° after the operation; the mean external rotation improved from 18.9° before the operation to 27.3° after the operation; and the mean medial rotation remained at the level of the third lumbar vertebra. The mean UCLA score after the mean follow-up of 5.4 years was 23.94 and this was an improvement in comparison with the preoperative mean and the mean 1 year after the operation.CONCLUSION: The functional results from CTA(r hemiarthroplasty for treating rotator cuff arthroplasty in selected patients remained satisfactory after a mean follow-up of 5.4 years.

  14. MID-LONG TERM RESULTS OF MANIPULATION AND ARTHROSCOPIC RELEASE IN FROZEN SHOULDER

    Science.gov (United States)

    CELIK, HALUK; SECKIN, MUSTAFA FAIK; AKCAL, MEHMET AKIF; KARA, ADNAN; KILINC, BEKIR ERAY; AKMAN, SENOL

    2017-01-01

    ABSTRACT Objective: Surgical treatment options should be discussed in cases of frozen shoulder, which is usually treated in a conservative manner. In this study, we evaluated the efficacy of manipulation and arthroscopic release in cases of frozen shoulder which resisted conservative treatment. Methods: A total of 32 patients who underwent manipulation and arthroscopic capsular release in 34 shoulders were included in the study. The average follow-up period was 49.5 months (range: 24-90 months). No reason for onset could be found in 8 (25%) patients, who were classified as primary frozen shoulder; twenty-four (75%) patients were classified as secondary frozen shoulder due to underlying pathologies. The average pre-operative complaint period was 11 months (range: 3-24 months). After arthroscopic examination, manipulation was performed first, followed by arthroscopic capsular release. The range of motion in both shoulders was compared before the procedure and in the last follow-up visit. Constant and Oxford classifications were used to assess functional results, and the results were assessed statistically. Results: Patient values for passive elevation, abduction, adduction-external rotation, abduction-external rotation, and abduction-internal rotation increased in a statistically significant manner between the preoperative assessment and follow-up evaluation (p<0.01). The average change of 47.97±21.03 units observed in the patients’ values obtained in the control measurements against the pre-op Constant scores was determined to be statistically significant (p<0.01). According to the Oxford classification, 29 shoulders were sufficient. Conclusion: Successful results can be obtained with arthroscopic release performed after manipulation in patients with frozen shoulder resistant to conservative treatment. Level of Evidence IV, Case Series. PMID:29375258

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

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    Yusuf Yıldırım

    2016-10-01

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

  16. Chemoradiotherapy with or without consolidation chemotherapy using cisplatin and 5-fluorouracil in anal squamous cell carcinoma: long-term results in 31 patients

    Directory of Open Access Journals (Sweden)

    Roh Jae

    2008-01-01

    Full Text Available Abstract Background The objectives of this study were to evaluate long-term results of concurrent chemoradiotherapy (CRT with 5-fluorouracil and cisplatin and the potential benefit of consolidation chemotherapy in patients with anal squamous cell carcinoma (ASCC. Methods Between January 1995 and February 2006, 31 patients with ASCC were treated with CRT. Radiotherapy was administered at 45 Gy over 5 weeks, followed by a boost of 9 Gy to complete or partial responders. Chemotherapy consisted of 5-fluorouracil (750 or 1,000 mg/m2 daily on days 1 to 5 and days 29 to 33; and, cisplatin (75 or 100 mg/m2 on day 2 and day 30. Twelve patients had T3–4 disease, whereas 18 patients presented with lymphadenopathy. Twenty-one (67.7% received consolidation chemotherapy with the same doses of 5-fluorouracil and cisplatin, repeated every 4 weeks for maximum 4 cycles. Results Nineteen patients (90.5% completed all four courses of consolidation chemotherapy. After CRT, 28 patients showed complete responses, while 3 showed partial responses. After a median follow-up period of 72 months, the 5-year overall, disease-free, and colostomy-free survival rates were 84.7%, 82.9% and 96.6%, demonstrating that CRT with 5-fluorouracil and cisplatin yields a good outcome in terms of survival and sphincter preservation. No differences in 5-year OS and DFS rates between patients treated with CRT alone and CRT with consolidation chemotherapy was observed. Conclusion our study shows that CRT with 5-FU and cisplatin, with or without consolidation chemotherapy, was well tolerated and proved highly encouraging in terms of long-term survival and the preservation of anal function in ASCC. Further trials with a larger patient population are warranted in order to evaluate the potential role of consolidation chemotherapy.

  17. Phosphorus-32 intracavitary irradiation of cystic craniopharyngiomas: current technique and long-term results

    International Nuclear Information System (INIS)

    Pollock, Bruce E.; Lunsford, L. Dade; Kondziolka, Douglas; Levine, Geoffrey; Flickinger, John C.

    1995-01-01

    Purpose: The management of patients with craniopharyngiomas is often multifaceted and multidisciplinary. The purpose of this study was to examine the results of phosphorus-32 intracavitary irradiation in the treatment of patients with predominately cystic craniopharyngiomas. Methods and Materials: Thirty patients with cystic craniopharyngiomas underwent phosphorus-32 intracavitary irradiation at our center between 1981 and 1993. The median patient age was 26 years (range, 3-70 years). Thirteen patients had intracavitary irradiation as the primary surgery for their cystic tumors, whereas 17 patients had adjuvant intracavitary irradiation after microsurgical resection, fractionated radiotherapy, or both. Patients in the adjuvant treatment group were more likely to have preoperative anterior pituitary insufficiency (p = 0.008 Fischer exact test) and diabetes insipidus (p = 0.003 Fischer exact test). The median follow-up was 37 months (mean, 46 months, range, 7-116 months). Results: Phosphorus-32 intracavitary irradiation resulted in cyst regression in 28 of 32 treated cysts (88%). Ten patients (33%) have had tumor progression requiring further surgical intervention. Three patients (10%) died: two of tumor progression, and one of unrelated causes. Visual acuity and fields improved or remained stable in 63% of the patients. Fifteen patients had residual anterior pituitary function before intracavitary irradiation and 10 (67%) retained their preoperative endocrine status. New-onset diabetes insipidus occurred in 3 of 17 patients (18%) who had normal posterior pituitary function preoperatively. Fourteen of 20 adult patients (70%) continued to perform at their preoperative functional level; 3 of 5 pediatric patients who were age appropriate at the time of treatment continued to develop normally. No difference was noted between primary and adjuvant treatment patients with respect to cyst control, visual deterioration, or endocrine preservation after phosphorus-32

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse. Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated by a validated questionnaire and anatomy...... in 3% of cases and 12% controls. None of the recurrence rates was significantly different for cases versus controls. No vaginal erosions were seen. Previous surgery was a significant risk factor with odds ratio 7.3 for another recurrence. Recurrence rates defined by POPQ plus symptoms were low compared...

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse. METHODS: Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated...... as POPQ > -1 plus symptoms revealed recurrence in 3% of cases and 12% controls. None of the recurrence rates was significantly different for cases versus controls. No vaginal erosions were seen. Previous surgery was a significant risk factor with odds ratio 7.3 for another recurrence. CONCLUSIONS...

  20. Fractional Differential Equations in Terms of Comparison Results and Lyapunov Stability with Initial Time Difference

    Directory of Open Access Journals (Sweden)

    Coşkun Yakar

    2010-01-01

    Full Text Available The qualitative behavior of a perturbed fractional-order differential equation with Caputo's derivative that differs in initial position and initial time with respect to the unperturbed fractional-order differential equation with Caputo's derivative has been investigated. We compare the classical notion of stability to the notion of initial time difference stability for fractional-order differential equations in Caputo's sense. We present a comparison result which again gives the null solution a central role in the comparison fractional-order differential equation when establishing initial time difference stability of the perturbed fractional-order differential equation with respect to the unperturbed fractional-order differential equation.

  1. A Simplified Method for Three-Dimensional (3-D Ovarian Tissue Culture Yielding Oocytes Competent to Produce Full-Term Offspring in Mice.

    Directory of Open Access Journals (Sweden)

    Carolyn M Higuchi

    Full Text Available In vitro growth of follicles is a promising technology to generate large quantities of competent oocytes from immature follicles and could expand the potential of assisted reproductive technologies (ART. Isolated follicle culture is currently the primary method used to develop and mature follicles in vitro. However, this procedure typically requires complicated, time-consuming procedures, as well as destruction of the normal ovarian microenvironment. Here we describe a simplified 3-D ovarian culture system that can be used to mature multilayered secondary follicles into antral follicles, generating developmentally competent oocytes in vitro. Ovaries recovered from mice at 14 days of age were cut into 8 pieces and placed onto a thick Matrigel drop (3-D culture for 10 days of culture. As a control, ovarian pieces were cultured on a membrane filter without any Matrigel drop (Membrane culture. We also evaluated the effect of activin A treatment on follicle growth within the ovarian pieces with or without Matrigel support. Thus we tested four different culture conditions: C (Membrane/activin-, A (Membrane/activin+, M (Matrigel/activin-, and M+A (Matrigel/activin+. We found that the cultured follicles and oocytes steadily increased in size regardless of the culture condition used. However, antral cavity formation occurred only in the follicles grown in the 3-D culture system (M, M+A. Following ovarian tissue culture, full-grown GV oocytes were isolated from the larger follicles to evaluate their developmental competence by subjecting them to in vitro maturation (IVM and in vitro fertilization (IVF. Maturation and fertilization rates were higher using oocytes grown in 3-D culture (M, M+A than with those grown in membrane culture (C, A. In particular, activin A treatment further improved 3-D culture (M+A success. Following IVF, two-cell embryos were transferred to recipients to generate full-term offspring. In summary, this simple and easy 3-D ovarian

  2. Derivation of the source term, dose results and associated radiological consequences for the Greek Research Reactor – 1

    Energy Technology Data Exchange (ETDEWEB)

    Pappas, Charalampos, E-mail: chpappas@ipta.demokritos.gr; Ikonomopoulos, Andreas; Sfetsos, Athanasios; Andronopoulos, Spyros; Varvayanni, Melpomeni; Catsaros, Nicolas

    2014-07-01

    Highlights: • Source term derivation of postulated accident sequences in a research reactor. • Various containment ventilation scenarios considered for source term calculations. • Source term parametric analysis performed in case of lack of ventilation. • JRODOS employed for dose calculations under eighteen modeled scenarios. • Estimation of radiological consequences during typical and adverse weather scenarios. - Abstract: The estimated source term, dose results and radiological consequences of selected accident sequences in the Greek Research Reactor – 1 are presented and discussed. A systematic approach has been adopted to perform the necessary calculations in accordance with the latest computational developments and IAEA recommendations. Loss-of-coolant, reactivity insertion and fuel channel blockage accident sequences have been selected to derive the associated source terms under three distinct containment ventilation scenarios. Core damage has been conservatively assessed for each accident sequence while the ventilation has been assumed to function within the efficiency limits defined at the Safety Analysis Report. In case of lack of ventilation a parametric analysis is also performed to examine the dependency of the source term on the containment leakage rate. A typical as well as an adverse meteorological scenario have been defined in the JRODOS computational platform in order to predict the effective, lung and thyroid doses within a region defined by a 15 km radius downwind from the reactor building. The radiological consequences of the eighteen scenarios associated with the accident sequences are presented and discussed.

  3. Radiological source terms resulting from sabotage to transportation casks: Final report

    International Nuclear Information System (INIS)

    Miller, N.E.; Fentiman, A.W.; Kuhlman, M.R.; Ebersole, H.N.; Trott, B.D.; Orban, J.E.

    1986-11-01

    The Nuclear Regulatory Commission (NRC) promulgated a rule, 10 CFR 73.37, which established requirements for safeguarding shipments of spent fuel to reduce the risk from acts of sabotage of highly radioactive materials. After the rule became effective, experimental programs conducted by Battelle for the NRC and by Sandia for the DOE showed the consequences of an attack using explosives on a shipment of PWR spent fuel were significantly less than had been indicated by earlier analytical studies. As a result, NRC is considering modifying the safeguards requirements. In support of NRC's efforts to modify the rule, Battelle has conducted additional experimental studies to evaluate the consequences of attacks on shipments of high-temperature gas-cooled reactor (HTGR) spent fuel, nonpower reactor (NPR) spent fuel, and vitrified high-level waste (HLW). Model casks containing surrogates of the spent fuels or high-level waste were penetrated by the jet from a precision shaped charge. Air samples collected after each test were used to estimate the quantities of respirable material released after the cask was penetrated. Results of the tests were scaled by specially developed scaling factors to estimate the releases that may occur from attacks on full-sized shipments of the materials. It was concluded that the sabotage of shipments of HTGR spent fuel, NPR spent fuel, or vitrified HLW should have no greater consequences than those predicted for shipments of PWR spent fuel

  4. Results of interagency effort to determine carbon-14 source term in low-level radioactive waste

    International Nuclear Information System (INIS)

    Gruhlke, J.M.; Meyer, G.L.; Neiheisel, J.

    1987-01-01

    A preliminary estimate of the risks from the shallow land disposal of low-level radioactive wastes by EPA in 1984-1985 indicated that Carbon-14 caused virtually all of the risk and that these risks were relatively high. Therefore, an informal interagency group, which included the US Department of Energy, US Geological Survey, US Nuclear Regulatory Commission, and US Environmental Protection Agency, formed in 1985 to obtain up-to-date information on the activity and chemical form of Carbon-14 in the different types of LLW and how Carbon-14 behaves after disposal. The EPA acted as a focal point for collating the information collected by all of the Agencies and will publish a report in Fall 1986 on the results of the Carbon-14 data collection effort. Of particular importance, the study showed that Carbon-14 activity in LLW was overestimated approximately 2000%. This paper summarizes results of the Carbon-14 data collection effort. 40 references, 1 figure, 3 tables

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

    Directory of Open Access Journals (Sweden)

    Sarac A

    2014-04-01

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

  6. Faecal incontinence after chemoradiotherapy in anal cancer survivors: Long-term results of a national cohort

    International Nuclear Information System (INIS)

    Bentzen, Anne Gry; Guren, Marianne G.; Vonen, Barthold; Wanderås, Eva H.; Frykholm, Gunilla; Wilsgaard, Tom; Dahl, Olav; Balteskard, Lise

    2013-01-01

    Purpose: To examine the prevalence and severity of faecal incontinence amongst anal cancer survivors after chemoradiotherapy. Material and methods: Anal cancer survivors from a complete, unselected, national cohort, minimum 2-years follow-up, were invited to a cross-sectional study. The St. Mark’s incontinence score was used to evaluate occurrence and degree of faecal incontinence the last four weeks. The results were compared to age- and sex-matched volunteers from the general population. Results: Of 199 invited survivors and 1211volunteers, 66% and 21%, respectively, signed informed consent. The survivors had significantly higher St. Mark’s score than the volunteers (mean 9.7 vs. 1.1, p < 0.001). Incontinence of stool of any degree was reported by 43% vs. 5% (OR 4.0, CI 2.73–6.01), and urgency was reported by 64% vs. 6% (OR 6.6, CI 4.38–9.90) of the survivors and volunteers, respectively. Only 29% of those with leakage of liquid stool used constipating drugs. Survivors of locally advanced tumours had a higher incontinence score (p < 0.01). Conclusions: Moderate to severe faecal incontinence is common amongst anal cancer survivors. Post-treatment follow-up should include the evaluation of continence, and incontinent survivors should be offered better symptom management and multidisciplinary approach if simple measures are insufficient

  7. Femoral pseudoarthrosis and knee stiffness: long-term results of a one-stage surgical approach.

    Science.gov (United States)

    Gomes, João L Ellera; Ruthner, Roberto P; Moreira, Luiz

    2010-02-01

    The objective of this study was to analyze the surgical results of the simultaneous treatment of femoral pseudoarthrosis and knee stiffness using a combined one-stage approach (quadricepsplasty + osteoperiosteal decortications + bone autografting + fracture stabilization). Twelve patients (six men) followed up for a minimum of 10 years and who had undergone surgery for these combined procedures were contacted for evaluation. Their mean age at the time of the surgery was 30 years (standard deviation, SD 15; range 22-65 years), and mean time from initial trauma was 16 months (SD 6, range 10-32 months). Mean range of motion improved from 10 degrees (SD 9) to 112 degrees (SD 13) postoperatively. Fractures healed in all patients, and improvement in their range of motion was statistically significant (Student's t-test = 31; P time interval since disease onset (Pearson correlation = -0.672; P = 0.017). Postoperative recovery was uneventful, and no deaths or severe complications occurred in this series. Despite increased tissue handling, blood loss and postoperative morbidity, the simultaneous treatment of femoral pseudoarthrosis and knee stiffness was successful, and results suggested that the earlier a combined approach is used, the better the outcome may be.

  8. [Results of long-term follow-up of transsexual patients].

    Science.gov (United States)

    Rauchfleisch, U; Barth, D; Battegay, R

    1998-09-01

    From 69 transsexual patients (48 men, 21 women) having consulted the Basel University Psychiatric Outpatient-Department between 1970 and 1990, 13 men-to-woman- and 4 woman-to-man-transsexuals could be examined in a follow-up (5-20 years after the operation). The social conditions and the quality of life of the 13 men-to-woman-transsexuals had significantly deteriorated: 9 of the 13 depend on life annuity or on social welfare assistance. The patients live socially very isolated. Eight of them report almost not being able to experience sexual pleasure, 10 suffer from anxieties, depression or addictions. Three regret having demanded the operation and two have passed a second operation for restoration of the original state. The 4 woman-to-man-transsexuals showed slightly better results: 2 of them are fully professionally active and live in constant personal relationships of several years of duration. The 2 others, however, suffer from depression and problems of addiction and give the impression of affective lability. The results lead to the following conclusions: 1. the criteria of indication for the operation of the transsexuals should be observed thoroughly, especially the psychotherapeutic accompaniment before the operation during at least 1 year; 2. the question of emotional stability, of frustration tolerance and of the danger of an outbreak of psychosis are to be examined carefully; 3. the professional and social integration before and after the operation is of central importance.

  9. Carcinoma cervicis uteri. Long-term follow-up therapeutic results.

    Science.gov (United States)

    Ptácková, B; Kucera, F; Caha, A; Tacev, T; Spurný, V; Kabela, M; Konecný, M; Krystof, V

    1982-01-01

    The principle of the therapy of carcinoma cervicis uteri in the Research Institute of Clinical and Experimental Oncology in Brno is the combination of betatron megavoltage irradiation and cobalt 60 irradiation with intracavital radium irradiation. On the basis of many years' study concerning the therapy and therapeutic results of this tumor accurate directions of total therapy were elaborated. Carcinoma is diagnosed and classified precisely according to valid international directions. In addition to basic examination, limb lymphography was introduced giving the strategy of irradiation when lymphatic system is involved and in early stages of the disease. By preliminary evaluation of the obtained data a certain improvement of therapeutic results is proven. About 15% more patients are alive till 5 years without any signs of the disease than in precedent years. In spite of a high dose summation given by the extent of megavoltage irradiation the number of postirradiation reaction, nor early late, is increased to much. Complex therapy of this tumor is performed by a team of physicians composed of gynecologist, radiologist, rentgendiagnosticist, pathologist, and radiation physicist. By increasing the number of cured patients and their return and enclosure into further working process the savings in state budget are achieved. The effectiveness of the carcinoma cervicis uteri therapy is therefore dependent not only on earlier diagnosis and modern irradiation technique, but also on the cooperation of a team of physicians who plan, perform and follow the therapy.

  10. Electroconvulsive stimulation results in long-term survival of newly generated hippocampal neurons in rats

    DEFF Research Database (Denmark)

    Olesen, Mikkel Vestergaard; Wörtwein, Gitta; Folke, Jonas

    2017-01-01

    Electroconvulsive stimulation (ECS) is one of the strongest stimulators of hippocampal neurogenesis in rodents that represents a plausible mechanism for the efficacy of electroconvulsive therapy (ECT) in major depressive disorder. Using design-based stereological cell counting, we recently...... in neurogenesis facilitates the behavioral outcome of the forced swim test (FST), an animal model of depression. The results showed that ECS in conjunction with CRS stimulates hippocampal neurogenesis, and that a significant quantity of the newly formed hippocampal neurons survives up to 12 months. The new Brd......U-positive neurons showed time-dependent attrition of ∼40% from day 1 to 3 months, with no further decline between 3 and 12 months. ECS did not affect the number of pre-existing dentate granule neurons or the volume of the dentate granule cell layer, suggesting no damaging effect of the treatment. Finally, we found...

  11. Defining Learning Space in a Serious Game in Terms of Operative and Resultant Actions

    Science.gov (United States)

    Martin, Michael W.; Shen, Yuzhong

    2012-01-01

    This paper explores the distinction between operative and resultant actions in games, and proposes that the learning space created by a serious game is a function of these actions. Further, it suggests a possible relationship between these actions and the forms of cognitive load imposed upon the game player. Association of specific types of cognitive load with respective forms of actions in game mechanics also presents some heuristics for integrating learning content into serious games. Research indicates that different balances of these types of actions are more suitable for novice or experienced learners. By examining these relationships, we can develop a few basic principles of game design which have an increased potential to promote positive learning outcomes.

  12. Long-term result of arthroplasty in the treatment of a case of ochronotic arthropathy

    Directory of Open Access Journals (Sweden)

    Sinan Karaoğlu

    2016-10-01

    Full Text Available Alkaptonuria is a rare metabolic disease caused by a partial or total deficiency of homogentisic acid oxidase, which results in excess homogentisic acid (HGA levels. Homogentisic acid and its oxidation products can accumulate in hyaline cartilage, tendons, and ligaments. A 55-year-old male was admitted complaining of worsening chronic pain in his left knee. A radiographic evaluation showed tricompartmental end- stage osteoarthritis. A cemented total knee replacement was performed. At the 10-year follow-up, he had returned to full activity, had no knee pain, and was very satisfied with the outcome. No abnormality was observed in the femoral, tibial, or patellar components on radiography. We believe that total knee replacement is a good option in a patient with marked degenerative arthritis secondary to ochronotic arthritis.

  13. 8 years of CPV: ISFOC CPV plants, long-term performance analysis and results

    Science.gov (United States)

    Martínez, María; Sánchez, Daniel; Calvo-Parra, Gustavo; Gil, Eduardo; Hipólito, Ángel; de Gregorio, Fernando; de la Rubia, Oscar

    2017-09-01

    ISFOC is an R&D center focused on CPV in Puertollano (Spain). It was founded in 2006 and has 2.3MW of CPV plants in operation and connected to the grid since 2008. Therefore, for the time of the conference ISFOC has more than 8 years of real operation data. The performance analysis has been focused on ISFOC - La Nava CPV plant: 800kW of Concentrix (Soitec), SolFocus and Isofotón and one flat PV plant mounted on two-axis tracker. The main result obtained is that the rate of performance decrease obtained for a mature CPV technology and IEC 62108 certified is in the range of flat PV values, this means that the CPV technology does not present higher degradation rates than flat PV.

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

    Directory of Open Access Journals (Sweden)

    Eugène Dürr

    2008-08-01

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

  15. [Endoprosthesis of the ankle joint. Indications and long-term results].

    Science.gov (United States)

    Endrich, B; Terbrüggen, D

    1991-10-01

    The treatment of a post-traumatic, progressively more painful ankle joint causes increasing disablement. It might require alternatives to conventional surgery if a patient does not consent to ankle arthrodesis to alleviate the pain. Therefore, we report on a retrospective study of 10 patients (age 25-73 years at the time of surgery). All of them refused arthrodesis; thus 10 total ankle arthroplasties were performed between 1982 and 1989. 5 women and 5 men were treated who have been suffering from severe post-traumatic arthrosis for 3-46 years. Since performance of a single-axis arthroplasty (ICLH prosthesis) in each patient, the mean follow-up has been 4.6 years. One year after surgery, the results could be considered good or excellent in 9 of the 10 patients; only 1 person experienced local wound infection, which led to removal of the implant 4 months later and ultimately to arthrodesis. Two years later, 7 patients are eligible for follow-up because 1 underwent surgery in February 1989. Another patient experienced aseptic loosening after 18 months; he was admitted to our hospital for arthrodesis. Three years after endoprosthetic surgery, all except 1 woman with occasional pain and stiffness were found to have satisfactory results on follow-up. The relief of pain was gratifying in all patients, with ankle function well maintained (at least 0-0-30 degrees). At present, the prosthesis is still functional in 6 patients (surgery 1.5-8 years ago). They can go about their usual daily business without apparent pain and with appropriate function; 2 of them, however, show radiolucent lines on standard X-rays of the ankle, suggesting some loosening.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-01

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

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

    Science.gov (United States)

    Mudgett, Paul; Pilgrim, Jeffrey S.

    2015-01-01

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

  18. Long-term results of curative intraluminal high dose rate brachytherapy for endobronchial carcinoma

    Directory of Open Access Journals (Sweden)

    Kawamura Hidemasa

    2012-07-01

    Full Text Available Abstract Background The treatment strategy of central lung tumors is not established. Intraluminal brachytherapy (ILBT is widely used for palliative treatment of endobronchial tumors, however, it is also a promising option for curative treatment with limited data. This study evaluates the results after ILBT for endobronchial carcinoma. Method Sixteen-endobronchial carcinoma of 13 patients treated with ILBT in curative intent for 2000 to 2008 were retrospectively reviewed. ILBT using high dose rate 192 iridium thin wire system was performed with 5 Gy/fraction at mucosal surface. The patient age ranged from 57 to 82 years old with median 75 years old. The 16 lesions consisted of 13 central endobronchial cancers including 7 roentgenographically occult lung cancers and 3 of tracheal cancers. Of them, 10 lesions were treated with ILBT of median 20 Gy combined with external beam radiation therapy of median 45 Gy and 6 lesions were treated with ILBT alone of median 25 Gy. Results Median follow-up time was 32.5 months. Two-year survival rate and local control rate were 92.3% and 86.2%, respectively. Local recurrences were observed in 2 lesions. Three patients died due to lung cancer (1 patient and intercurrent disease (2 patients. Complications greater than grade 2 were not observed except for one grade 3 dyspnea. Conclusions ILBT combined with or without EBRT might be a curative treatment option in inoperable endobronchial carcinoma patients with tolerable complication.

  19. The weed composition in an orchard as a result of long-term foliar herbicide application

    Directory of Open Access Journals (Sweden)

    Maria Licznar-Małańczuk

    2016-09-01

    Full Text Available The weed composition and the dominance of individual species occurring in an orchard were assessed at the Research Station of the Wrocław University of Environmental and Life Sciences, Poland, during the first 10 years after orchard establishment. ‘Ligol’ apple trees were planted in the spring of 2004 (3.5 × 1.2 m. Foliar herbicides were applied in 1 m wide tree rows twice or three times per each vegetation period. In the inter-row spaces, perennial grass was maintained. Ten years of maintenance of herbicide fallow contributed to a change in the weed composition in the orchard. It changed as a result of different responses of the most important weed species to the foliar herbicides. Total suppression of Elymus repens was observed in the first year after planting the trees. Convolvulus arvensis, Cirsium arvense, and other perennial weeds, completely disappeared in the succeeding periods. The maintenance of herbicide fallow did not affect the abundance of Taraxacum officinale. The percentage of the soil surface covered by Trifolium repens and Epilobium adenocaulon, perennial weeds with considerable tolerance to post-emergence herbicides, increased during the fruit-bearing period of the trees. The abundance of these weeds was significantly reduced only in the rows with the stronger growing trees on the semi-dwarf P 2 rootstock. Stellaria media was the dominant annual weed. Senecio vulgaris, Poa annua, Capsella bursa-pastoris, and Lamium spp. were also frequently observed. A significant increase in the abundance of annual and perennial weeds was found in the tree rows as a result of improved water availability after a period of high precipitation.

  20. Ocean acidification effects on mesozooplankton community development: Results from a long-term mesocosm experiment

    Science.gov (United States)

    Algueró-Muñiz, María; Alvarez-Fernandez, Santiago; Thor, Peter; Bach, Lennart T.; Esposito, Mario; Horn, Henriette G.; Ecker, Ursula; Langer, Julia A. F.; Taucher, Jan; Malzahn, Arne M.; Riebesell, Ulf; Boersma, Maarten

    2017-01-01

    Ocean acidification may affect zooplankton directly by decreasing in pH, as well as indirectly via trophic pathways, where changes in carbon availability or pH effects on primary producers may cascade up the food web thereby altering ecosystem functioning and community composition. Here, we present results from a mesocosm experiment carried out during 113 days in the Gullmar Fjord, Skagerrak coast of Sweden, studying plankton responses to predicted end-of-century pCO2 levels. We did not observe any pCO2 effect on the diversity of the mesozooplankton community, but a positive pCO2 effect on the total mesozooplankton abundance. Furthermore, we observed species-specific sensitivities to pCO2 in the two major groups in this experiment, copepods and hydromedusae. Also stage-specific pCO2 sensitivities were detected in copepods, with copepodites being the most responsive stage. Focusing on the most abundant species, Pseudocalanus acuspes, we observed that copepodites were significantly more abundant in the high-pCO2 treatment during most of the experiment, probably fuelled by phytoplankton community responses to high-pCO2 conditions. Physiological and reproductive output was analysed on P. acuspes females through two additional laboratory experiments, showing no pCO2 effect on females’ condition nor on egg hatching. Overall, our results suggest that the Gullmar Fjord mesozooplankton community structure is not expected to change much under realistic end-of-century OA scenarios as used here. However, the positive pCO2 effect detected on mesozooplankton abundance could potentially affect biomass transfer to higher trophic levels in the future. PMID:28410436

  1. Calf Augmentation and Restoration: Long-Term Results and the Review of the Reported Complications.

    Science.gov (United States)

    Niechajev, Igor; Krag, Christen

    2017-10-01

    Augmentation or reconstruction of the calves is indicated in patients with thin legs, for bodybuilders, or when there is a defect after an injury or illness. The principle of placing implants under the investing crural fascia was worked out in the 1980s. The senior author (I.N.) introduced many technical modifications and improvements for this operation, among them the new instrument, an inserter for the calf implants. Presented patient material is unique in that the more challenging reconstructive cases almost equal the numbers of the aesthetic cases. During the years 1991 through 2016, 50 patients underwent 60 calf contour corrections. Indications were aesthetic in 23 patients, six were bodybuilders, and 21 underwent lower leg reconstruction because of deformity caused by illness. According to evaluation by the surgeon, excellent-to-good results were obtained in 30 out of 37 followed patients. Patients rated their results as very good (18), good (10), acceptable (7) and bad (2). One 28-year-old professional bodybuilder sustained acute anterior compartment syndrome in one leg. Implants were removed 16 h after surgery, but he developed ischaemia in the anterior compartment leading to the necrosis of muscles. After several surgical operations, including microsurgical transfer of the innervated central caput of the quadriceps femoris muscle, he could resume his bodybuilding activities. Other complications were minor and manageable. Calf augmentation, performed properly, has evolved to be a safe, efficient and aesthetically pleasing operation. The possibility of acute compartment syndrome should be kept in mind. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  2. 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.

  3. [True/Flex intramedullary nailing for forearm shaft fractures. Long-term results].

    Science.gov (United States)

    Trlica, J; Počepcov, I; Kočí, J; Frank, M; Holeček, T; Dědek, T

    2012-01-01

    Presentation of technical experience and the clinical and functional results of intramedullary fixation of forearm shaft fractures. Between January 1994 and December 2009, a total of 96 patients with 144 radial and/or ulnar fractures (ulna, 33; radius,15; both, 48) were treated by nailing (True/Flex®). According to the AO classification there were 22-A, 22-B and 22-C type fractures in 39 (41%), 44 (46%) and 13 (13%).cases, respectively. Of these, 82 (85%) were closed (types: 0, 48; I, 33; II, 1) and 14 (15%) were open (types: I, 13; II, 1; III, 0) fractures. Seventy-eight patients (81%) were followed up and their functional outcomes were evaluated according to the criteria of Anderson et al. The average interval between the operation and final follow-up was 28 months (15 to 96 months) The average time to surgery was 2.2 days (0 to 25 days). Early complications were recorded in 4% of the patients (1x bursitis olecrani; 1x end cup replacement; 1x bending of nails) and late complications in 15% (5x non-union; 2x delay union; 4x bursitis olecrani; 1x ruptured tendon). Bone healing was achieved in 95% of the cases and took on average 16 weeks (7 to 34 weeks). No infection, refracture or synostosis occurred. Primary loss of reduction was recorded in four cases due to distraction in one, bent nails in two and a wrong size of the implant in one; secondary loss of reduction was found in three cases, with two cases of radius shortening and one 10°malrotation. No primary malrotation was recorded, but secondary loss of alignment was seen in the distal part of the radius and the proximal part of the ulna. Functional results according to the Anderson criteria were excellent and good in 87% of the cases. Intramedullary mailing provides good stability to mid- and distal-third shaft fractures of the ulna and mid- and proximalthird shaft fractures of the radius, particularly in AO type A and type B fractures. The technical aspects of the method are analysed in detail in this paper

  4. Photorefractive keratectomy after cataract surgery in uncommon cases: long-term results

    Directory of Open Access Journals (Sweden)

    Anna Maria Roszkowska

    2018-04-01

    Full Text Available AIM: To evaluate the efficacy and safety of the excimer laser correction of the residual refractive errors after cataract extraction with intraocular lens (IOL implantation in uncommon cases. METHODS: Totally 24 patients with high residual refractive error after cataract surgery with IOL implantation were examined. Twenty-two patients had a history of phacoemulsification and IOL implantation, and two had extra-capsular cataract extraction with IOL implantation. Detailed examination of preoperative medical records was done to explain the origin of the post-cataract refractive errors. All patients underwent photorefractire keratectomy (PRK enhancement. The mean outcome measures were refraction, uncorretted visual acuity (UCVA, best corrected visual acuity (BCVA and corneal transparency and follow up ranged from 1 to 8y. RESULTS: The principal causes of residual ametropia was inexact IOL calculation in abnormal eyes with high myopia and congenital lens abnormalities, followed by corneal astigmatism both suture induced and preexisting. After cataract surgery and before the laser enhancement the mean spherical equivalent (SE was -0.56±3 D ranging from -4.62 to +2.25 D in high myopic patients, instead it was -1±1.73 D ranging from -3.25 to +3.75 D in the astigmatic eyes, with a mean cylinder of -3.75±0 ranging from -3 to +5.50 D. After laser refractive surgery the mean SE was 0.1±0.73, ranging from -0.50 to +1.50 in the myopic group, and it was -0.50±0.57 ranging from -1.25 to +0.50 in astigmatic patients, with a mean cylinder of -0.25±0.75. In myopic patients the mean UCVA and BCVA were 0.038±0.072 logMAR and 0.018±0.04 respectively, both ranging from 0.10 to 0.0. In astigmatic patients, the mean UCVA and BCVA were 0.213±0.132 and 0.00±0.0 respectively, UCVA ranging from 0.50 to 0.22 and BCVA was 0.00. All patients presented normal corneal transparency. No ocular hypertension was detected and no corneal haze was observed. All registered

  5. LONG-TERM TREATMENT RESULTS OF BONE SARCOMA PATIENTS WITH CONSIDERATION OF SERUM METALLOPROTEINASE LEVELS

    Directory of Open Access Journals (Sweden)

    I. V. Babkina

    2015-01-01

    Full Text Available Background: Bone sarcomas are extremely malignant prone to rapid hematogenic metastasing. Evaluation of biological marker expression by the tumor is important not only for the search of new potential chemotherapy targets, but for the assessment of the disease prognosis.Aim: A comparative evaluation of matrix metalloproteinases (MMP-2, -7, -9 and tissue inhibitor of metalloproteinase-1 (TIMP-1 in the serum of patients with primary bone tumors and in healthy people to identify their potential association with the histological characteristics of the tumor and the disease prognosis.Materials and methods: A comparative study of serum MMP-2, -7, -9, and TIMP-1 levels was performed in 54 patients with primary bone tumors (malignant, 45 patients, including central osteosarcoma in 21, periosteal osteosarcoma in 4, Ewing's sarcoma in 11, primary chondrosarcoma in 6, undifferentiated pleomorphic sarcoma in 3, and borderline giant cell tumors in 9 and in 26 healthy individuals with the use of the immunoenzyme technique (Biosource, USA, for TIMP-1 and R&D, USA, for MMP-2, -7, and -9. Results: The TIMP-1 levels in the serum of patients with central and periosteal osteosarcomas were significantly higher than in the serum of healthy controls (р = 0.038 and p = 0.007, respectively. The MMP-9 levels in patients with bone malignancies were significantly lower than that in the normal controls (p < 0.05. There was a positive correlation between serum TIMP-1 and MMP-9 levels in patients with central, periosteal and Ewing's sarcomas (r = 0.37, p = 0.024. No significant differences in the 5-year survival rates related to serum TIMP-1, MMP-2, -7, -9 levels were found in patients with bone sarcomas. However, in those with osteosarcoma and serum MMP-2 > 160 ng/ml, the overall 5-year survival rate was 1.6-fold higher than in those with lower MMP-2 levels, and in those with ММP-9 levels < 377 ng/ml, the 5-year survival rate was 1.4-fold higher than in patients with

  6. 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

  7. 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.

  8. 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,

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

    International Nuclear Information System (INIS)

    Chopra, O.K.; Chung, H.M.

    1988-01-01

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

  10. Metabolomics for organic food authentication: Results from a long-term field study in carrots.

    Science.gov (United States)

    Cubero-Leon, Elena; De Rudder, Olivier; Maquet, Alain

    2018-01-15

    Increasing demand for organic products and their premium prices make them an attractive target for fraudulent malpractices. In this study, a large-scale comparative metabolomics approach was applied to investigate the effect of the agronomic production system on the metabolite composition of carrots and to build statistical models for prediction purposes. Orthogonal projections to latent structures-discriminant analysis (OPLS-DA) was applied successfully to predict the origin of the agricultural system of the harvested carrots on the basis of features determined by liquid chromatography-mass spectrometry. When the training set used to build the OPLS-DA models contained samples representative of each harvest year, the models were able to classify unknown samples correctly (100% correct classification). If a harvest year was left out of the training sets and used for predictions, the correct classification rates achieved ranged from 76% to 100%. The results therefore highlight the potential of metabolomic fingerprinting for organic food authentication purposes. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  11. DISEASE MODIFYING THERAPY AND OUTCOME OF RHEUMATOID ARTHRITIS: RETROSPECTIVE ASSESSMENT OF LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    D. E. Karateyev

    2000-01-01

    Full Text Available Aim of study: To investigate the relation between patterns of basic treatment and the outcome of disease in patients with rheumatoid arthritis (RA. Material and methods: We studied retrospectively two groups of patients with RA (1987 ACR criteria: 1 main group - died (72 patients, mean duration of disease from the onset to death 12.8±0.9 years; 2 control group - alive to 1999 with duration of disease at least 15 years (90 patients, mean follow-up period 19.4±0.47 years. Results: Some patterns of basic treatment were observed: 1 "passive ” strategy - only hydroxychloroquine or sulphasalazine during many years; 2 "inteirupted " treatment - early treatment gold or cytotoxics, but when improvement occurred, therapy with DMARD was interrupted for 1-2 years or more, after that re-started etc.; 3 “emergency” strategy’ - 7-10years of "passive" treatment, after that se\\>ere destruction and/or amyloidosis appeared, and cytotoxics started; 4 typical "pyramid " strategy; 5 "active " strategy - early start of treatment with active DMARD (melotrexate, gold with consecutive change of DMARDs without interruption of basic treatment (very close to "sawtooth ” strategy. The most of died patients were treated with "passive ” and "interrupted" strategies, but the most of patients in control group were treated with "pyramid” and "active" strategies. Conclusion: active strategy of basic treatment has a positive influence on the survival ofpatients with R.A.

  12. Octreotide Is Ineffective in Treating Tumor-Induced Osteomalacia: Results of a Short-Term Therapy.

    Science.gov (United States)

    Ovejero, Diana; El-Maouche, Diala; Brillante, Beth A; Khosravi, Azar; Gafni, Rachel I; Collins, Michael T

    2017-08-01

    Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome in which unregulated hypersecretion of fibroblast growth factor 23 (FGF23) by phosphaturic mesenchymal tumors (PMT) causes renal phosphate wasting, hypophosphatemia, and osteomalacia. The resulting mineral homeostasis abnormalities and skeletal manifestations can be reversed with surgical resection of the tumor. Unfortunately, PMTs are often difficult to locate, and medical treatment with oral phosphate and vitamin D analogues is either insufficient to manage the disease or not tolerated. Octreotide has been proposed as a potential treatment for TIO due to the presence of somatostatin receptors (SSTR) on PMTs; however, the role of somatostatin signaling in PMTs and the efficacy of treatment of TIOs with somatostatin analogues is not clear. In an effort to evaluate the efficacy of octreotide therapy in TIO, five subjects with TIO were treated with octreotide for 3 days. Blood intact FGF23, phosphate, and 1,25(OH) 2 D 3 , and tubular reabsorption of phosphate (TRP) were measured at frequent time points during treatment. Octreotide's effects were assessed by comparing group means of the biochemical parameters at each time-point to mean baseline values. There were no significant changes in blood phosphate, FGF23, 1,25(OH) 2 D 3 , or TRP during octreotide treatment, consistent with a lack of efficacy of octreotide in treating TIO. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

  13. Percutaneous pulmonary valvuloplasty with balloon. Results and short and medium term follow up

    International Nuclear Information System (INIS)

    Cadavid, Ana M; Diaz, Luis H; Lince, Rafael; Donado, Juan R; Ruz, Miguel

    2006-01-01

    The objective is to assess the results and 10 years follow-up of percutaneous pulmonary valvuloplasty in an institution. Methods: retrospective, descriptive study of 187 patients with pulmonary stenosis to whom a valvuloplasty with balloon was performed between 1995 and 2005. The procedure was classified as successful when the transvalvular pulmonary gradient diminished to 30 mm Hg, by echocardiography, after an effective procedure. Results: 192 valvuloplasties were performed in 187 patients, 51.9% male, mean age between 3.1 ± 3.8 years (between 1 day and 21 years) and mean weight 13.18 ± 11.14 kg (2.5 to 55 Kg). 11.7% of the patients were newborns, 22.5% were critical stenosis and 27.8% were associated to congenital cardiopathy. 95.2% of valvuloplasties were successful with significant reduction of the transvalvular gradient from 63.32 ± 28.05 mm Hg to 9.57 ±10.41 mm Hg (p=0.000) and from the right ventricular systolic pressure from 84.09 ± 28.91 mm Hg to 39.89 ±16.98 mm Hg (p=0.000). It was found a relation between the presence of an associated cardiopathy and the need of a second valvuloplasty (p=0.000), as well as between the performance of surgery (p=0.000) and the presence of restenosis (p=0.000). There were complications in 17 patients, being the embolic phenomena the most frequent ones. Only a newborn with critical stenosis and cardiogenic shock previous to the procedure, died. Follow-up of 129 patients (68.7%) between 1 month and 9.5 years (mean age 1.73 ± 2.41 years) was realized. Significant restenosis was presented in 24 (18.6%) patients, moderate in 13 and severe in 11. Restenosis was related to a lesser diameter in the pulmonary ring (p=0.006) and with valvular dysplasia (p=0.011). No significant relationship between restenosis and patient's age in the first valvuloplasty (p=0.607), the use of a balloon (p=0.053), the relationship balloons / ring (p=0.108) or the gradient post valvuloplasty (p=0.559) was found. There was a clear relationship

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

    Energy Technology Data Exchange (ETDEWEB)

    Castro, A. P. G., E-mail: apgcastro@dem.uminho.pt [Center for Mechanical and Materials Technologies, Department of Mechanical Engineering, University of Minho, Guimarães (Portugal); INSIGNEO Institute for in silico Medicine, Department of Mechanical Engineering, University of Sheffield, Sheffield (United Kingdom); Paul, C. P. L. [Department of Orthopaedic Surgery, VU Medical Center, Amsterdam (Netherlands); Research Institute MOVE, Faculty of Human Movement Sciences, VU Medical Center, Amsterdam (Netherlands); Detiger, S. E. L.; Smit, T. H.; Royen, B. J. van [Department of Orthopaedic Surgery, VU Medical Center, Amsterdam (Netherlands); Research Institute MOVE, Faculty of Human Movement Sciences, VU Medical Center, Amsterdam (Netherlands); Skeletal Tissue Engineering Group Amsterdam, VU Medical Center, Amsterdam (Netherlands); Pimenta Claro, J. C. [Center for Mechanical and Materials Technologies, Department of Mechanical Engineering, University of Minho, Guimarães (Portugal); Mullender, M. G. [Department of Orthopaedic Surgery, VU Medical Center, Amsterdam (Netherlands); Research Institute MOVE, Faculty of Human Movement Sciences, VU Medical Center, Amsterdam (Netherlands); Department of Plastic, Reconstructive and Hand Surgery, VU Medical Center, Amsterdam (Netherlands); Alves, J. L. [Center for Mechanical and Materials Technologies, Department of Mechanical Engineering, University of Minho, Guimarães (Portugal)

    2014-11-20

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

  15. Comparison of long-term results between osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis.

    Science.gov (United States)

    Charoenrook, Victor; Michael, Ralph; de la Paz, Maria Fideliz; Temprano, José; Barraquer, Rafael I

    2018-04-01

    To compare the anatomical and the functional results between osteo-odonto-keratoprosthesis (OOKP) and keratoprosthesis using tibial bone autograft (Tibial bone KPro). We reviewed the charts of 258 patients; 145 had OOKP whereas 113 had Tibial bone KPro implanted. Functional success was defined as best corrected visual acuity ≥0.05 on decimal scale and anatomical success as retention of the keratoprosthesis lamina. Kaplan-Meier survival curves were calculated for anatomical and functional survival as well as to estimate the probability of post-op complications. The anatomical survival for both KPro groups was not significantly different and was estimated as 67% for OOKP and 54% for Tibial bone KPro at 10 years after surgery. There was also no difference found after subdividing for primary diagnosis groups such as chemical injury, thermal burn, trachoma and all autoimmune cases combined. Estimated functional survival at 10 years post-surgery was 49% for OOKP and 25% for Tibial bone KPro, which was significantly different. The probability of patients with Tibial bone KPro developing one or more post-operative complications at 10 years after surgery (65%) was significantly higher than those with OOKP (40%). Mucous membrane necrosis and retroprosthetic membrane formation were more common in Tibial bone KPro than OOKP. Both types of autologous biological KPro, OOKP and Tibial bone KPro, had statistically similar rate of keratoprosthesis extrusion. Although functional success rate was significantly higher in OOKP, it may have been influenced by a better visual potential in the patients in this group. Copyright © 2018 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    APG eCastro

    2014-11-01

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

  17. The Use of Cryotherapy for Papilloma and Early Laryngeal Cancers: Long-term Results.

    Science.gov (United States)

    Benninger, Michael S; Derakhshan, Adeeb; Milstein, Claudio F

    2015-07-01

    Retrospective chart review. To determine the efficacy of adjuvant cryotherapy in the treatment of early glottic cancer and laryngeal papillomatosis. The use of cryotherapy in conjunction with traditional modalities has recently been proposed to improve voice outcomes in patients with early laryngeal cancer as compared to pretreatment conditions. This study investigates its utility in improving oncological outcomes and decreasing recurrences of laryngeal papillomatosis. Patients with either early glottic cancer or laryngeal papillomatosis that received cryotherapy as part of their surgical regimen were investigated. All patients were seen at a large tertiary care center within a 10-year window. Demographic data were collected and all postoperative notes were reviewed. Recurrences of the laryngeal cancer were noted, as was the duration of time between successive papillomatosis operations. The charts of 54 glottic cancer and 29 papillomatosis patients that received cryotherapy were reviewed. One patient from the papillomatosis cohort was excluded from statistical analysis due to lack of follow-up. Overall, 16 (30%) of the laryngeal cancer patient experienced a malignant recurrence. The overall 5-year survival of these patients was 98% and the 5-year disease-free survival was 74%. The use of adjuvant cryotherapy in the treatment of laryngeal papillomatosis extended the duration of time between surgeries by an average of 79 days (P=.23). The use of adjuvant cryotherapy in the treatment of early glottic cancer does not improve the rate of carcinoma recurrences. Additionally, cryotherapy does not result in a statistically significant increase in the duration of disease-free period for laryngeal papillomatosis patients, although the observed increase may be clinically important. © The Author(s) 2015.

  18. Direct Stenting in Patients with Acute Lower Limb Arterial Occlusions: Immediate and Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Galanakis, Nikolaos [University of Crete Medical School, Interventional Radiology Unit, Department of Medical Imaging, University Hospital Heraklion (Greece); Kontopodis, Nikolaos [University of Crete Medical School, Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital Heraklion (Greece); Peteinarakis, Ioannis; Kehagias, Elias [University of Crete Medical School, Interventional Radiology Unit, Department of Medical Imaging, University Hospital Heraklion (Greece); Ioannou, Christos V. [University of Crete Medical School, Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital Heraklion (Greece); Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr [University of Crete Medical School, Interventional Radiology Unit, Department of Medical Imaging, University Hospital Heraklion (Greece)

    2017-02-15

    PurposeThe purpose of this study is to accentuate the efficacy of direct stenting (stent placement without predilatation of the lesion) in patients with acute lower limb arterial ischemia (ALLI).Materials and MethodsBetween January 2010 and September 2015, 16 patients (11 men and 5 women) underwent direct stenting of acute arterial occlusions. All patients had contraindication for surgical revascularization or catheter-directed thrombolysis. According to SVS/ISCVS Classification, six patients had IIa and ten patients IIb ALLI. The occlusions were located in CIA, EIA, SFA, or popliteal artery. Mean follow-up time with clinical examination and color Duplex ultrasonography was 37.6 months (range 1–72). We analyzed the technical and clinical outcomes of the procedures, as well the complications and patency rates.ResultsTechnical success was achieved in all patients (16/16) and there was significant clinical improvement in 15 patients. There was neither distal embolization nor procedure-related complications. During the 6 years of follow-up, four patients died due to non-procedure-related causes and there were two minor and one major amputations. The primary patency rates and the amputation-free survival rates were 93.7 and 87% at 1 year, 75.2 and 71.2% at 3 years, and 75.2 and 62.3%, respectively, at 6 years.ConclusionsDirect stenting may be a valuable alternative procedure for acute arterial occlusions in selected cases with high technical success and significant clinical improvement.Level of EvidenceLevel 4, Case Series.

  19. Direct Stenting in Patients with Acute Lower Limb Arterial Occlusions: Immediate and Long-Term Results

    International Nuclear Information System (INIS)

    Galanakis, Nikolaos; Kontopodis, Nikolaos; Peteinarakis, Ioannis; Kehagias, Elias; Ioannou, Christos V.; Tsetis, Dimitrios

    2017-01-01

    PurposeThe purpose of this study is to accentuate the efficacy of direct stenting (stent placement without predilatation of the lesion) in patients with acute lower limb arterial ischemia (ALLI).Materials and MethodsBetween January 2010 and September 2015, 16 patients (11 men and 5 women) underwent direct stenting of acute arterial occlusions. All patients had contraindication for surgical revascularization or catheter-directed thrombolysis. According to SVS/ISCVS Classification, six patients had IIa and ten patients IIb ALLI. The occlusions were located in CIA, EIA, SFA, or popliteal artery. Mean follow-up time with clinical examination and color Duplex ultrasonography was 37.6 months (range 1–72). We analyzed the technical and clinical outcomes of the procedures, as well the complications and patency rates.ResultsTechnical success was achieved in all patients (16/16) and there was significant clinical improvement in 15 patients. There was neither distal embolization nor procedure-related complications. During the 6 years of follow-up, four patients died due to non-procedure-related causes and there were two minor and one major amputations. The primary patency rates and the amputation-free survival rates were 93.7 and 87% at 1 year, 75.2 and 71.2% at 3 years, and 75.2 and 62.3%, respectively, at 6 years.ConclusionsDirect stenting may be a valuable alternative procedure for acute arterial occlusions in selected cases with high technical success and significant clinical improvement.Level of EvidenceLevel 4, Case Series.

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

    Science.gov (United States)

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

    2002-06-30

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

  1. Minimally invasive (MIS) Tönnis osteotomy- A technical annotation and review of short term results.

    Science.gov (United States)

    Balakumar, Balasubramanian; Racy, Malek; Madan, Sanjeev

    2018-03-01

    We detail a modified single incision approach to perform the Tonnis triple pelvic osteotomy by a minimally invasive approach. 12 children underwent minimally invasive Tonnis Osteotomy. There were five boys and seven girls in this study group. Average age was 11 years (9-15 years) at the time of surgery. Mean follow-up was 20.5 months (13-39 months). The average preoperative Antero-Posterior (AP) Centre Edge (CE) angle was -8.8° (-38.6°-18°), the average post-operative AP CE angle was 29.7° (25.1°-43.7°). The average preoperative lateral CE angle was -4.7° (-16°-0°), the average postoperative Lateral CE angle was 28.5° (21.3°-37.4°). The Sharp's angle before and after surgery were 55.7° (51.3°-66°) and 32.4° (16.1°-40.1°) respectively. The mean Tönnis angle before and after the osteotomy were 28.86° (19.7°-43.4°) and 6.3° (0.5°-9.4°) respectively. There was one major complication with sciatic nerve palsy which is in the recovery phase on followup and six minor complications including two cases of transient lateral femoral cutaneous nerve injury, two cases of ischial non-union, over granulation of the wound in one case, and metalwork irritation in one case. We have described a minimally invasive Tonnis osteotomy as a viable option based on our results. This technique is recommended for those who are conversant with the traditional pelvicosteotomies.

  2. Does length of common limb influence remission of diabetes? Short-term results

    Directory of Open Access Journals (Sweden)

    Ramraj V Nagendra Gupta

    2016-01-01

    Full Text Available Background: Despite strict patient selection criteria, diabetes remission is not seen in all patients after gastric bypass. Can length of the common limb influence diabetes remission? Aim: To find if any correlation exists between the length of the common limb and remission of diabetes. Study Design: Prospective study. Materials and Methods: Twenty-five consecutive patients with Type II diabetes mellitus and a fasting C-peptide >1 ng/ml who underwent laparoscopic Roux-en-y gastric bypass were included. All patients had standard limb lengths and length of the common limb was measured in all patients. Patients were followed up and glycated haemoglobin (HbA1c was repeated at 6 months postoperatively. Pre- and postoperative HbA1c were then correlated with the lengths of common limb to look for any relation. Statistical Analysis: Descriptive and inferential statistical analysis, analysis of variance (ANOVA. Results: Of the 25 patients, 15 were females and 10 were males. The mean age was 44.16 years and the mean body mass index (BMI was 43.96 kg/m 2 . Preoperative HbA1c varied from 5.8 to 12.3%. Length of the common limb varied from 210 to 790 cm (mean 470.4 cm. HbA1c at 6 months ranged from 4.8 to 7.7% (mean 5.81%. On comparison of preoperative and 6 months postoperative HbA1c and correlating with the length of common limb, we found that patients with a common limb of length 600 cm length (P = 0.004. Conclusion: A shorter common limb does appear to have better chances of resolution of Type II diabetes mellitus in our study, thus paving the way for further studies.

  3. Mid-term clinical results of tissue-engineered vascular autografts

    International Nuclear Information System (INIS)

    Matsumura, Goki; Shin'oka, Toshiharu; Hibino, Narutoshi; Saito, Satoshi; Sakamoto, Takahiko; Ichihara, Yuki; Hobo, Kyoko; Miyamoto, Shin'ka; Kurosawa, Hiromi

    2007-01-01

    Prosthetic and bioprosthetic materials currently in use lack growth potential and therefore must be repeatedly replaced in pediatric patients as they grow. Tissue engineering is a new discipline that offers the potential for creating replacement structures from autologous cells and biodegradable polymer scaffolds. In May 2000, we initiated clinical application of tissue-engineered vascular grafts seeded with cultured cells. However, cell culturing is time-consuming, and xenoserum must be used. To overcome these disadvantages, we began to use bone marrow cells, readily available on the day of surgery, as a cell source. Since September 2001, tissue-engineered grafts seeded with autologous bone marrow cells have been implanted in 44 patients. The patients or their parents were fully informed and had given consent to the procedure. A 3 to 10 ml/kg specimen of bone marrow was aspirated with the patient under general anesthesia before the skin incision. The polymer tube serving as a scaffold for the cells was composed of a copolymer of lactide and ε-caprolactone (50:50) which degrades by hydrolysis. Polyglycolic or poly-l-lactic acid woven fabric was used for reinforcement. Twenty-six tissue-engineered conduits and 19 tissue-engineered patches were used for the repair of congenital heart defects. The patients' ages ranged from 1 to 24 years (median 7.4 years). All patients underwent a catheterization study, CT scan, or both, for evaluation after the operation. There were 4 late deaths due to heart failure with or without multiple organ failure or brain bleeding in this series; these were unrelated to the tissue-engineered graft function. One patient required percutaneous balloon angioplasty for tubular graft-stenosis and 4 patients for the stenosis of the patch-shaped tissue engineered material. Two patients required re-do operation; one for recurrent pulmonary stenosis and another for a resulting R-L shunt after the lateral tunnel method. Kaplan-Meier analysis in

  4. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence.

    Science.gov (United States)

    McGaghie, William C; Issenberg, S Barry; Cohen, Elaine R; Barsuk, Jeffrey H; Wayne, Diane B

    2011-06-01

    This article presents a comparison of the effectiveness of traditional clinical education toward skill acquisition goals versus simulation-based medical education (SBME) with deliberate practice (DP). This is a quantitative meta-analysis that spans 20 years, 1990 to 2010. A search strategy involving three literature databases, 12 search terms, and four inclusion criteria was used. Four authors independently retrieved and reviewed articles. Main outcome measures were extracted to calculate effect sizes. Of 3,742 articles identified, 14 met inclusion criteria. The overall effect size for the 14 studies evaluating the comparative effectiveness of SBME compared with traditional clinical medical education was 0.71 (95% confidence interval, 0.65-0.76; P medical education in achieving specific clinical skill acquisition goals. SBME is a complex educational intervention that should be introduced thoughtfully and evaluated rigorously at training sites. Further research on incorporating SBME with DP into medical education is needed to amplify its power, utility, and cost-effectiveness.

  5. 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)

  6. 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)

  7. 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.

  8. 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

  9. 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.

  10. Percutaneous ethanol injection therapy (PEIT) for small hepatocellular carcinomas (HCCs) : prognostic factors affecting short-term follow-up results

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ah Young; Han, Joon Koo; Kim, Tae Kyoung; Yun, Eun Joo; Lee, Ki Yeol; Choi, Byung Ihn [Seoul National Univ. (Korea, Republic of). Coll. of Medicine

    1998-06-01

    The purpose of this study is to analyze the effect of various parameters used in PEIT on the short-term results of this procedure for the treatment of small HCC. Among 76 lesions in 63 patients wi