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PubMedDate not supplied

Stages of change in physical exercise: a test of stage discrimination and nonlinearity.

OBJECTIVES: To investigate the utility of the protection motivation theory (PMT), social-cognitive theory (SCT) and transtheoretical model's (TTM) processes of change (POC) by (1) discriminating between TTM's stages with planned comparisons and (2) examining higher-ordered trends across stages. METHODS: 1582 individuals were included in the analyses that tested severity, vulnerability, response-efficacy, self-efficacy, POC, pros and cons, social and environmental support. RESULTS: The findings provide evidence for the utility of the PMT and TTM's POC for stage discrimination; stage discontinuity patterns are supported. CONCLUSIONS: Promotion of health behavior should target stage-specific variables, such as threat appraisals for early stage movements.

Adult↗

PubMed1998

[Surgical therapy of complicated sigmoid diverticulitis: single stage or multi-stage operation?].

Surgical tactics for the teatment of complicated diverticulitis are in constant evolution and remain a subject of controversy. Amongst 53 patients operated on for complicated sigmoid diverticulits over a 10 year period in our hospital, 29 underwent a Hartmann's procedure (3 Hinchey's stage II, 19 stage III and 7 stage IV). Only 11 out of 20 having survived the operation underwent restoration of bowel continuity (55%). This experience is in line with the literature. Surgeons have become conscious that in reality the colostomy was permanent in a significant proportion of patients who were poor candidates for a second operation. Therefore there is a tendency to perform as far as possible a resection of the sigmoid and a colo-rectal anastomosis in a one-stage procedure. In the absence of prospective randomized studies and objective criteria, the decision to resect the sigmoid in a one-stage or in a multi-stage procedure is based on consensus and clinical judgement.

Aged↗

PubMedDate not supplied

Soft tissue exposure of endosseous implants between stage I and stage II surgery as a potential indicator of early crestal bone loss.

Implants are well accepted as a means of dental rehabilitation. While integration success rates are high, crestal bone loss can occur, and it may not become apparent until stage II surgery and implant uncovering. The purpose of this study was to quantify the relationship between exposure of implants through the oral mucosa between stage I and stage II implant surgery and early changes in crestal bone height. Bone levels were measured during placement of 275 implants in the maxillae of 50 subjects. Repeated bone height measurements were obtained at implant uncovering. Fourteen implants in 7 patients were exposed to the oral cavity through the mucosa at stage II surgery. Patients with 1 or more exposed sites demonstrated a likelihood of bone loss 3.9 times greater than patients with nonexposed sites (Fisher exact test, P = .0003). These results suggest that exposure of an implant between stage I and stage II implant surgery might serve as a potential indicator of the occurrence of early bone loss.

Alveolar Bone Loss↗

PubMed1979

In vivo recovery of factor VIII: a comparison of one-stage and two-stage assay methods.

The recovery and half-life of VIII:C in the plasma of severely haemophilic patients was measured by one-stage and two-stage assays after injection of two Factor VIII concentrates (Hemofil, Hyland and Fraction I-O, Kabi). Plasma volumes were measured with an Evans' Blue technique, and both concentrates and post-infusion samples were measured against the same plasma standard. There was a highly significant difference in recoveries estimated by the two assay methods. The one-stage assays gave the most consistent results, in that the average recovery was 100%, whereas the two-stage assays gave only about 80% of the value expected from in vitro assays. There was no differences in recoveries between the two concentrates. The two-stage assays gave a slightly shorter half-life than the one-stage assays, and the half-life of Hemofil was also shorter than that of Fraction I-O.

Biological Assay↗

PubMed2002

Maxillary sinus augmentation using deproteinized bovine bone (Bio-Oss) and Impladent Dental Implant System. Part I. Comparison between one-stage and two-stage procedure.

This study was undertaken to compare implant survival after one- or two-stage sinus augmentation. Ninety-two maxillary sinuses in 77 patients were augmented with deproteinized bovine bone (Bio-Oss). These sinuses were sub-divided into two groups: Group 1 (n = 49) was operated on with a one-stage procedure, and Group 2 (n = 43) with a two-stage operation. A hundred and eighty-five implants were inserted in these augmented sinuses. Clinical and radiographical evaluations were performed and recorded according to certain criteria. The follow-up period was ranging from 16 to 44 months. Out of the implants inserted using the one-stage procedure, all survived. Two implants failed in the two-stage procedure group (98.91% implant survival). This study showed that no statistically significance was observed between the two surgical techniques (P < 0.05). Therefore, the authors concluded the type of surgical procedure (one- or two-stage) has no effect on implant survival.

Alveolar Ridge Augmentation↗

PubMed2004

Influences of different palatoplasties on palatal growth and speech development: comparison between Osada's two-stage palatoplasty and one-stage mucosal flap procedure.

Palatal growth and articulation in two different palatal closure techniques, Osada's two-stage procedure and the conventional one-stage procedure, were evaluated in 12 patients. Osada's procedure (hard palate closure using a vomer flap with complete closure of the raw surface by a full thickness skin graft) is a two-stage operation that consists of early soft palate closure at the time of lip closure (3 to 6 months of age). The palatal sizes and the depth of the palatal arch were significantly greater in the two-stage group than in the one-stage group at 1 year of age and, 3 to 5 years of age. There were no differences between the two groups at the velopharyngeal closure evaluation after hard palate closure and at final speech evaluation. Osada's two-stage palatoplasty has many advantages and we believe that this is one of the most recommendable procedures at present.

Articulation Disorders↗

PubMedDate not supplied

A comparison of one-stage radial keratotomy with two-stage radial keratotomy in myopia.

To determine the efficacy of one-stage compared with two-stage radial keratotomy, a study was designed to compare both eyes of the same patient with moderate myopia; one eye was operated in one stage and the fellow eye in two stages. The surgical technique was identical in all four procedures of the two patients. Although the case for greater effectiveness with one-stage radial keratotomy cannot be proven on the basis of only a few cases, one-stage surgery appears to be more effective and more predictable.

Adult↗

PubMedDate not supplied

[Correlation between age and developmental stages of permanent teeth and developmental stages of hand-wrist skeletal].

A total of 190 randomly selected panoramic radiographs of teeth and Hand-Wrist radiographs of the patients at the Faculty of Dentistry, Mahidol University was studied with the age varied from 3-22 years, both sexes. Regression analysis showed that there was a high correlation between age with developmental stages of teeth and Hand-Wrist developmental stages. Estimation of age can be done through the equation, based on given scores of developmental stages of teeth and Hand-Wrist developmental stages... Correlation between Age and Developmental Stages of Permanent Teeth and Development Stages of Hand-Wrist Skeletal.

Adolescent↗

PubMed1986

Factor VIII: C (FVIII: C) recovery and half-life after infusion of steam-treated high purity factor VIII concentrate in severe hemophilia A--comparison of one-stage assay, two-stage assay and a chromogenic substrate assay.

Factor VIII:C recovery and half-life was measured in 16 hemophilia A patients under comprehensively standardized conditions. Each patient received the same lot of a steam-treated high purity FVIII concentrate at a dose of 19-33 U/kg body weight. A comparison was made between the one-stage assay, the two-stage assay and a chromogenic substrate test for FVIII:C determination using a FXa-sensitive chromogenic substrate. Factor VIII:C potency of the administered FVIII concentrate was measured using calibration curves derived from a concentrate standard and FVIII:C plasma levels were read from calibration curves derived from a plasma standard. The chromogenic assay showed a good reproducibility at FVIII:C levels between 0.015 and 0.50 U/ml. The FVIII:C recoveries calculated from the results of the one-stage assay, the two-stage assay and the chromogenic substrate test were 109 +/- 20, 92 +/- 14 and 81 +/- 11% (mean +/- SD), respectively. The elimination half-lives of FVIII:C were calculated by non-linear least square analysis using a modified computerized Gauss-Newton algorithm. The half-lives calculated from the FVIII:C plasma levels measured by the one-stage assay, the two-stage assay and the chromogenic test were 23.8 +/- 6.4, 22.2 +/- 5.7 and 17.1 +/- 4.8 h (mean +/- SD), respectively. No previous study has reported such long half-life values. Our findings indicate that measurements of recoveries and half-lives by the chromogenic FVIII:C assay and by computerized non-linear least square analysis allow the possibility of individualized FVIII replacement therapy.

Adolescent↗

PubMed1995

In vitro cultivation of third-stage larvae of Brugia malayi to the young adult stage.

The in vitro cultivation of the filarial nematode Brugia malayi from the infective stage to the fourth and the young adult stage is described. Different culture conditions including cell-free systems and co-culture with different human lymphatic cell lines were compared. Cell-free systems reported by others to promote the in vitro development of the parasites to the adult stage failed to work, i.e. the parasite development stopped at the L4 stage and the larvae died after approximately 3 weeks. Cocultivation with each of the cell lines used enhanced the survival of the parasites. The best results were obtained employing the human T cell leukemia line Jurkat and human dermal fibroblasts as feeder cells in RPMI 1640 supplemented with 10% heat-inactivated human serum. This culture system allowed the cultivation of B. malayi for more than 7 weeks with an average growth of the larvae by factor 6.4 (0.77 +/- 0.035 cm) and a maximum growth by factor 10 (1.2 cm). 69% of the initially cultivated larvae (which corresponded to 100% larvae alive at that time) reached the fourth larval stage after 14 days, and 2.6% of the initially cultivated larvae (which corresponded to 17% of the parasites alive at that day) had reached the young adult stage by day 37 of culture. Parasites remained alive up to 52 days. During the first four weeks of culture, both the length and the periods of moulting of the in vitro cultivated filariae closely resembled those observed with B. malayi in vivo in rodent hosts.

Aedes↗

PubMed1982

Prognostic indicators in stage III and localized stage IV breast cancer.

One hundred eighty-three patients with Stage III and nonmetastatic Stage IV breast cancer, seen between 1960-1975 at the Division of Radiation Oncology, Mallinckrodt Institute of Radiology, were retrospectively analyzed to determine the prognostic significance of the following clinical features: (1) "grave signs" (skin ulceration, skin fixation, chest wall fixation, and edema); (2) size of primary tumor; (3) nodal stage; and (4) inflammatory changes. Since therapy among 147 patients with noninflammatory cancer comprised of either irradiation alone (54 patients) or surgery plus irradiation (93 patients), all the above factors were analyzed also with respect to the method of treatment. In 147 patients with noninflammatory carcinoma, the local failure rate, regional failure rate, distant failure rate and five-year disease free survival were all unaffected by the presence or absence of "grave signs," whether treated by irradiation alone or surgery plus irradiation. The size of the primary tumor, in patients treated with irradiation alone, influenced the rate of local failure (44% for tumors 0-8 cm and 76% for tumors greater than or equal to 8 cm) and five-year disease-free survival (30 versus 4%, respectively). Such a statistically significant difference in local failure rate or disease-free survival was not noted when treated with combined modality. N stage also influenced the prognosis in patients treated with irradiation alone since the regional failure rate increased from 9% for N0, N1 to 58% for N2, N3 patients. This was reflected in a decreased disease-free survival (4 versus 30%) for patients with advanced nodal disease who were treated with irradiation alone. No such difference was noted when the nodal disease was treated with a combination of surgery and irradiation. The 36 patients with inflammatory carcinoma had essentially the same incidence of local, regional and distant failure as the 147 patients with noninflammatory carcinoma but the appearance of distant metastases occurred significantly earlier in patients with inflammatory carcinoma than in those with noninflammatory carcinoma. This earlier appearance of distant metastases was reflected in the significantly lower disease-free survival for the patients with inflammatory carcinoma (6 versus 28%). The data from this analysis suggests that consideration should be given to removing the presence of grave signs from the current AJC staging system and substituting in its place the size of the primary tumor (less than 8 cm versus greater than or equal to 8 cm). Further analysis on a large number of patients is needed to substantitate this recommendation.

Breast Neoplasms↗

PubMed1986

The correlation between the radiologic staging studies and histopathologic findings in aggressive stage 3 giant cell tumor of bone.

The histologic features of aggressive Stage 3 benign giant cell tumor of bone were correlated with their radiologic staging studies. Our series includes 24 patients treated at the University of Florida, Department of Orthopaedic Oncology, from January 1979 to July 1983. Particularly in 13 cases, results of routine specimen histologic as well as of the histologic study of macrosections containing the entire resected specimen (the tumor and surrounding bone and soft tissue) were evaluated. Surgical staging studies including plain radiographs, bone scintigrams, computerized axial tomography scans, tomography, and angiography were used to delineate the anatomic location of the lesion. Within this group of giant cell tumors, the general histologic features resemble those of the classic giant cell tumor. However, certain aggressive features best demonstrated on the macrosections, such as cortical and subchondral invasion, capsular and reactive bony zone infiltration, "digital extension" of the tumor, and neovascularity correlated well with the anatomic localization and aggressiveness found on the staging studies. Those findings emphasize the value of staging studies in the delineation of the histologic potential of these benign aggressive lesions.

Adolescent↗

PubMed2003

[Sentinel lymph node excision (SLNE) and positron emission tomography in the staging of stage I-II melanoma patients].

BACKGROUND AND OBJECTIVE: Sentinel lymph node excision (SLNE) and positron emission tomography (PET) were evaluated in the staging of 51 Stage I and II melanoma patients (staged according to the guidelines of the German Dermatological Society). PATIENTS/METHODS AND RESULTS: Tumor thickness ranged from 1.0 mm to 6.0 mm (median: 1.5 mm; mean: 2.07 mm). At least one sentinel lymph node (SLN) was excised in all patients; 80 SLN were excised from 69 lymphatic drainage areas. Positive SLN were detected in 6 patients (11.8%). Additional positive lymph nodes were not detected in any of these patients in the following complete lymph node dissection of the affected lymph node basin. Preoperative PET was performed in 40 patients and did not detect any of the micrometastases that were subsequently found by SLNE. During the follow up of 7-40 months (mean 21.9 months) 3 patients experienced tumor progression; 2 of 3 had a positive SLN. CONCLUSIONS: According to the current literature SLNE is recommended in primary tumors greater than 1 mm thickness. PET cannot be expected to give additional information in the staging of stage I-II patients.

Adult↗

PubMed1988

Induction of cytoplasmic polarity in heterokaryons of mouse 4-cell-stage blastomeres fused with 8-cell- and 16-cell-stage blastomeres.

Cell surface and cytoplasmic polarity is exhibited by the blastomeres of mouse preimplantation embryos following compaction at the 8-cell stage of cleavage. It has been hypothesized that cytoplasmic polarity is initiated by plasma membrane functions of polar blastomeres that are absent from apolar blastomeres. To test this hypothesis the plasma membranes of "test" polar and apolar 8-cell- and 16-cell-stage blastomeres were inserted into the plasma membrane of "carrier" 4-cell-stage blastomeres by polyethylene glycol-mediated fusion of carrier-test blastomere pairs. After a 4-hr culture period each heterokaryon was scored for the distribution of two marker organelles--lipid droplets and nuclei--with respect to their proximity to the plasma membrane insert from the test blastomere. Plasma membrane inserts from polar test blastomeres were identified by labeling their apical domains with fluorescently tagged (succinylated) concanavalin A. The incidence of polar heterokaryons (those exhibiting a discrete fluorescently labeled area of plasma membrane corresponding to the apical domain inherited from the test blastomere) was 55/85 (69%) and 48/79 (61%) for 8-cell-stage and 16-cell-stage test blastomeres, respectively. In all polar heterokaryons, both nuclei were subjacent to the fluorescent label (apical domain of a polar plasma membrane insert), while the majority of lipid droplets resided in the hemisphere opposite the fluorescent label. In all 61 apolar heterokaryons examined (those lacking a discrete fluorescently labeled plasma membrane area) both nuclei were centrally located and lipid droplets were randomly distributed. These observations are consistent with the hypothesis that cytoplasmic polarity can be initiated by properties that distinguish the plasma membranes of polar blastomeres from those of apolar blastomeres.

Animals↗

PubMed1982

Para-aortal lymph nodes dissection in 20 cases of primary epithelial ovary carcinoma stage I (Figo): influence on staging.

In this study 20 cases of primary epithelial ovary carcinoma stage I (Figo) were presented. In 5 cases (25%) para-aortic lymph nodes were positive, because of which their stage changed into Stage III. This shows that for correct staging of ovary carcinoma stage I, extirpation of the para-aortal glands is obligatory. It was observed that tumors on the external surface of the ovary and tumor cells in the peritoneum fluid were not related to positive para-aortal glands. The para-aortic metastases were found in the tumors with a histologic grading according to Broders' classification III and IV.

Aorta↗

PubMed1993

Ability of preoperative serum prostate-specific antigen value to predict pathologic stage and DNA ploidy. Influence of clinical stage and tumor grade.

Although the preoperative serum prostate-specific antigen (PSA) concentration has been demonstrated to be directly proportional to pathologic stage, it has been found to be unreliable for predicting final pathologic stage on an individual basis. Statistical analysis was thus performed to determine whether combining various preoperative parameters could enhance the predictive power of PSA. Multivariate logistic regression analysis revealed that, indeed, local clinical stage (determined by digital rectal examination) and tumor grade (determined from the biopsy specimen) significantly enhanced the predictive power of PSA (P < 0.0001 and < 0.0001, respectively). These preoperative parameters were thus all combined into a model from which probability plots were generated. These probability plots allow the practicing urologist to estimate preoperatively for an individual patient the probability of a given pathologic stage and DNA ploidy status. For example, the predicted probability of organ-confined disease for a patient with a PSA value of 10 ng/mL, when used alone, is 53 percent. However, the predicted probability of organ-confined disease for a patient with a PSA value of 10 ng/mL, clinical Stage B2, and high-tumor grade is only 30 percent. Thus, the findings of this investigation allow the physician maximal use of the preoperative variables to discuss more accurately with the patient what might be expected at the time of operation and to plan more precisely the surgical procedure that will possibly ensure complete removal of the prostate cancer with the least compromise to normal physiologic function (continence and potency).

Aged↗

PubMed1990

Stage III and stage IV endometrial carcinoma: a review of 41 cases.

Forty-one patients with clinical stage III and IV carcinoma of the endometrium presented to Jackson Memorial Hospital between the years 1977 and 1988. These patients were studied as to their presenting symptoms, prognostic factors, therapeutic regimens, and survival. Sixty-one percent of our patients presented with postmenopausal bleeding. Prognostic factors included extent of disease and tumor bulk rather than histologic type, grade, or depth of myometrial invasion. Overall 5-year survival was 7/32 (22%), with 6/22 (27%) for stage III and 1/10 (10%) for stage IV. Those patients who received surgery plus radiation fared better than those who received either alone. Hormonal therapy offered little, if any, benefit. CAP-M chemotherapy was used as adjunctive treatment in 10 patients and its use is discussed. It is our hope that we may later use this study to compare the newer surgical staging in advanced cases of endometrial carcinoma with the previously used clinical staging system.

Adenocarcinoma↗

PubMed1984

Phase II randomized trial of radiotherapy alone vs the sequential use of chemotherapy and radiotherapy in stage III non-small cell lung cancer. Phase II trial of chemotherapy alone in stage IV non-small cell lung cancer.

In order to clarify if the sequential combination of chemotherapy and radiotherapy offered any advantage over radiotherapy alone in stage III non-small cell lung cancer, 33 patients were randomized between radiotherapy alone or chemotherapy followed by radiotherapy, then chemotherapy again. Chemotherapy consisted of a combination of cisplatinum, VP-16 and adriamycin. Twenty-four patients with stage IV disease received the same chemotherapy regimen alone for six cycles. Median survival for stage III patients receiving radiotherapy alone was 5 months. For patients receiving the sequential combination of chemotherapy and radiotherapy median survival was 11 months (log-rank test, P = 0.025). Median survival for stage IV patient receiving chemotherapy alone was 15 months. It is concluded that the sequential combination of chemotherapy and radiotherapy is significantly superior to radiotherapy alone in patients with stage III non-small cell lung cancer.

Adult↗