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PubMed1979

Extended wear of hydrophilic contact lenses in aphakia - an alternative to intraocular lens implantation.

Since not every patient will be a candidate for an intraocular lens, there will always be a portion of aphakic patients who are candidates for extended wear hydrophilic lenses. Aphakic patients to be fitted successfully with extended wear contacts must be motivated, aware of the risks, and require frequent lens cleaning and replacement on an individual basis. While future improvement of hydrophilic lenses is to be expected and anticipated, the extent of these improvements is still uncertain. However, preliminary reports are encouraging. Extended wear contact lenses are not the only answer to aphakia. They are but one alternative available to the ophthalmologist for maximizing the visual rehabilitation of the aphakic patient. Even with the increasing use and acceptance of intraocular lenses, the use of extended soft lens wear has a place in this rehabilitation.

Aphakia, Postcataract↗

PubMed1976

Lymphosarcoma. A comparison of extended to conservative chemotherapy.

Sixty-three patients with Stage III and IV lymphocytic lymphoma were randomized for induction treatment between a single course of nitrogen mustard and a 14-day course of prednisone (conservative therapy) or sequential rotation of BCNU, nitrogen mustard and cytoxan with intermittent vincristine and prednisone for 6 months (extended therapy). Maintenance therapy by an oral alkylating agent (cytoxan or chlorambucil) with or without prednisone was given. Complete remission occurred in 75% of the conservative and 77% of the extended therapy group. The median duration of remission was similar, and greater than 27 months in both groups, and there was no difference in survival. At 1 year 80% of patients with no prior chemotherapy were in remission vs. 47% of patients with prior chemotherapy (p less than .01). No significant advantage for extended chemotherapy was found. The addition of vincristine was not helpful in induction and prednisone during maintenance did not improve the duration of remission or survival.

Adult↗

PubMed1979

Extended-wear contact lenses and intraocular lenses for aphakic correction.

We evaluated extended-wear soft contact lens use in 128 aphakic eyes of 113 patients, 44 of whom had been unable to wear conventional contact lenses; 116 eyes (91%) have been successfully fitted and have worn the extended-wear lenses without significant complication. Eleven patients were unable to wear the lens or had to be discontinued for transient lens-related problems. In 103 eyes successfully fitted the lens is removed for cleaning less often than monthly. Ninety six of the 116 eyes fitted have visual acuity as good as, or better than, with aphakic correcting spectacles. The results obtained with the extended-wear soft contact lens are similar to those obtained with intraocular lenses, except for the recent high incidence of inflammation seen after intraocular lens insertion when using ethylene-oxide-sterilized lenses.

Adolescent↗

PubMed1979

The results of treatment of microinvasive carcinoma (stage iA) of the uterine cervix by means of simple and extended hysterectomy.

At the Department of Obstetrics and Gynecology of Tohoku University, radical hysterectomy with pelvic lymphadenectomy had been performed on patients with microinvasive carcinoma of the uterine cervix before 1966. Investigation of lymph nodes of 90 patients treated in this manner has shown no lymph node metastasis of tumor cells in any of them. Since 1967, microinvasive carcinoma has been treated as a matter of principle by extended hysterectomy without lymphadenectomy. From that time until 1974, 119 cases of microinvasive carcinoma have been treated by extended hysterectomy and 69 such cases by simple hysterectomy. The 5-year relative survival rate was 0.989 for extended hysterectomy patients and 1.008 for simple hysterectomy patients. Together, a 5-year relative survival rate of 0.992 was obtained.

Adult↗

PubMed1979

Complications associated with extended wear of soft contact lenses.

The major complications with extended wear lenses are due to hypoxia and lens deposits. Certain patients tend to deposit proteins and lipids on the lens surface with daily wear and at a greater frequency during prolonged wear. A build-up of these deposits can be associated with decreased vision, conjunctival irritation, and giant papillary conjunctivitis. Frequent lens cleaning and the frequent use of concomitant topical artificial tears will hopefully reduce the incidence of lens deposits and their complications. Superficial circumlimbal vascularization occurs in a large percentage of patients who have worn lenses for weeks at a time. Corneal edema, ocular irritation, and decreased vision are also the hallmarks of a decreased oxygen supply to the cornea. A thin-loose-fitting lens will increase the percentage of patients who are able to successfully use extended wear lenses by increasing the amount of oxygen available to the cornea. Cessation or reduction in duration of lens wear will decrease the frequency and severity of this complication. Conjunctival and corneal infections are real risks; lens loss, breakage, deformation, or discoloration also occur during extended wear.

Calcium↗

PubMed1977

Effect of extended photoperiod on the spermatogenic activity of chicken-pheasant hybrids.

1. Males of chicken-pheasant hybrids and non-breeding pheasants were exposed to photoperiods of 10 or 20 h/d to test the effect of light on spermatogenic activity. 2. Testicular weights of hybrids and pheasants exposed to 10 h/d were similar and extending the photoperiod did not increase this in hybrids, although it caused a 48-fold increase, and complete recovery of spermatogenic activity, in pheasant. 3. Extending the photoperiod caused an increase in the number of primary spermatocytes and a corresponding decrease in the number of spermatogonia in hybrids, however, stages beyond primary spermatocytes were not present. This suggests that the stimulus of extending the photoperiod, while sufficient to induce meiosis in existing germ cells, is not enough to effect proliferative bursts or to overcome the meiotic arrest in the hybrids.

Animals↗

PubMed1975

Subunit arrangement in the extended sheath of pyocin R.

An optical diffraction study has been made of electron micrographs of extended sheaths of pyocin R. It has been demonstrated that the extended sheath consists of annuli of six subunits, which are arranged in a helix of 3.57 annuli per one turn. The annulus repeat in the helix direction is 35A. The dimensions and probably the helical parameters of pyocin R sheath are different from those of T4 phage tail, but a structural correlation appears to exist between the extended sheath of pyocin R and that of the phage tail.

Bacteriocins↗

PubMed1977

Time-extended family interviewing.

This paper presents a family-therapy technique--time-extended family interviewing--in which the therapist extends the traditional one-hour interview to three to seven hours, by plan, at a particular point in the life of a case and for a particular purpose. Extended sessions promote movement in a case for a variety of reasons. Furthermore, the use of such sessions highlights the dimension of time as an important element of good casework practice.

Adult↗

PubMed2026

Extending the Treatment Window for Intravenous Thrombolysis in Acute Ischemic Stroke: An Updated Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Intravenous thrombolysis (IVT) is the standard treatment for acute ischemic stroke within 4.5 hours of onset. However, imaging-based selection may extend the treatment window. This systematic review and meta-analysis evaluated the efficacy and safety of IVT administered beyond 4.5 hours after stroke onset or last known well (LKW) in patients selected based on imaging findings. METHODS: A comprehensive search of PubMed, Scopus, and Cochrane Library was performed to identify randomized controlled trials comparing IVT with alteplase or tenecteplase (TNK) administered >4.5 hours after stroke onset/LKW vs standard care. Primary outcomes were 3-month excellent (modified Rankin Scale [mRS] 0-1) functional outcome and symptomatic intracranial hemorrhage (sICH). Secondary outcomes included good (mRS 0-2) functional outcome, recanalization, and 3-month mortality. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analysis assessed differences between alteplase and TNK. RESULTS: Fourteen studies involving 4,944 patients were included. The mean age was 69.8 years, 58.2% were male, the median National Institutes of Health Stroke Scale score was 9, and 12.3% received preplanned endovascular thrombectomy (EVT). A total of 2,492 patients received IVT in an extended time window (4.5-24 hours). Compared with standard care, extended IVT was associated with higher odds of achieving an excellent functional outcome (OR: 1.43 [95% CI 1.25-1.63]), a good functional outcome (OR: 1.25 [95% CI 1.11-1.40]), and recanalization (OR: 3.28 [95% CI 2.09-5.16]). There was no difference in 3-month mortality (OR: 1.21 [95% CI 0.95-1.53]). However, IVT increased the risk of sICH (OR: 2.51 [95% CI 1.47-4.28]). Sensitivity analysis excluding patients who received EVT showed no impact on the outcomes. TNK exhibited similar efficacy to alteplase but showed potentially lower odds of sICH (OR: 1.96, 95% CI 1.06-3.64) compared with alteplase (OR: 5.29, 95% CI 1.80-15.57); however, the subgroup difference was not significant (p = 0.11). DISCUSSION: Among patients selected based on imaging, 4.5-24 hours after stroke onset/LKW, IVT improves outcomes despite an increased risk of sICH. TNK showed similar efficacy to alteplase, with a possible lower risk of sICH; however, direct comparisons in future trials are needed.

Humans↗

PubMed1977

Treatment tolerance and early complications with extended field irradiation in gynaecological cancer.

Treatment tolerance and early complications have been analysed in patients treated with extended field irradiation and pelvic irradiation alone. At the Centre Georges-François Leclerc, 126 patients were treated for carcinoma of the uterine cervix and endometrium from May, 1972 to November, 1974. All patients received external irradiation using a 25 MV X-ray beam. Follow-up has been nearly complete in all patients with the minimum follow-up being 15 months and the average 24 months. Treatment tolerance was approximately the same for all field sizes except when the field was extended to the top of D12. In this situation the patients occasionally required a short rest during their irradiation. The age of the patient was found to contribute significantly to the tolerance, with 70% of the patients who experienced poor tolerance being older than 60 years. Complications were evenly distributed in all all catagories of field size and appeared to be affected only by age and previous surgery. Of the patients who experienced complications 68% were older than 60 years, and of the 37 patients who had previous surgery, 32% had a complication. With certain treatment modifications the treatment tolerance and early complications appear acceptable when using extended field irradiation for gynaecological cancer.

Adenocarcinoma↗

PubMed1977

Effects of package, extender, and light on stored frozen bull spermatozoa.

Spermatozoa were analyzed when fresh, freshly frozen, and stored at --196 C for 6 and 18 mo after processing in egg yolk-citrate and Promine-D extender with varying exposure to light and packaging in straws or glass ampules. Over all treatments there were decreases with time in spermatozoal motility, oxygen uptake, and cellular glutamic oxaloacetic transaminase due to freezing-thawing. Percent progressive motility decreased from spermatozoa freshly frozen (36.5%) to those stored for 6 mo (33.6%). Oxygen uptake in freshly frozen samples was 8.4 microliter per 10(8) cells per h. In frozen semen stored for 6 and 18 mo corresponding values were 12.2 and 8.3 microliter. Packaging methods did not have a significant effect on oxygen uptake, but package interacted with storage. Egg yolk-citrate extender supported greater progressive spermatoal motility than did promine-D. Extender interacted with storage for all criteria. Visible light radiation reduced progressive spermatozoal motility from 40.2 to 38.0% and oxygen uptake from 11.8 to 10.8 microliter per 10(8) cells per h. Light interacted with storage time. Correlations between all criteria and storage times were not important practically.

Animals↗

PubMed1977

A physician extender training program based on clinical algorithms.

The ability of physician extenders to provide patient care in a variety of settings has been reported widely. Less attention has been paid to training programs, especially those of short duration, for physician extenders. A three-month training program for physician extenders at a large teaching hospital was based on teaching the skills needed to run 39 clinical algorithms. The course content and the methods used to test the students during the three months may prove of value to those preparing similar programs.

California↗

PubMed1979

Survival of Haemophilus equigenitalis in different antibiotic-containing semen extenders.

The ability of Haemophilus equigenitalis, the causal agent of contagious equine metritis 1977, to survive in various antibiotic-containing semen extenders was studied at different environmental temperatures. Gentamicin sulphate was found to be markedly superior to ampicillin or a combination of sodium benzyl penicillin and polymyxin B sulphate, Semen treated with the former antibiotic was either sterile at cultural examination or else yielded appreciably fewer colonies of H. equigenitalis than the untreated semen control. Ampicillin had no observable effect on the survival of this organism. Gentamicin was most effective when semen-extender mixtures were held at room temperature rather than at 37 or 4 degrees C. No detrimental effects on sperm motility were observed following the use of the different antibiotic-containing semen extenders in the presence or absence of H. equigenitalis.

Animals↗

PubMed1979

An extended wear hard contact lens in aphakia.

In reviewing the literature, there are several reports of limited success with both hard and soft contact lenses for continuous or extended wear. Aphakia is the most common indication for continuous wear, especially in monocular aphakes who are unable to insert and remove their lenses for various reasons. Because of its unusual oxygen permeability, silicone is the logical choice of material for an extended wear lens. However, because of the problems in manufacture, as well as its hydrophobic characteristics, poor centering, and problems with proper edging, no silicone lens has had wide clinical application to date. This paper reports on a preliminary study in a group of 21 aphakic patients fitted with the Polycon lens made of a new material consisting of polymethylmethacrylate in combination with silicone. Although gas permeable, the oxygen permeability is probably not adequate to maintain corneal metabolism without some interchange of oxygen containing tears. However, a significant proportion of the patients were able to wear this lens for an extended period of time without removal.

Aged↗

PubMed1977

An analysis of extended and exponentially-fed-batch cultures.

Under certain conditions it is shown that an extended culture is equivalent to an exponentially-fed-batch culture, that an exponentially-fed-batch culture (and an extended culture) can be maintained at a steady state and that an exponentially-fed-batch culture may be mimicked by a continuous-flow culture with a constant dilution rate. Operational conditions required to maintain steady states are specified.

Bacteria↗

PubMed1978

Uptake of glusose-C14 and fructose-C14 by buffalo spermatozoa in extenders during cold storage.

Buffalo spermatozoa exhibit insignificant uptake of glucose-C14 and fructose-C14 when semen samples were preserved in cold for 96 h in 2 extenders. Incorporation of C14 in spermatozoa, TCA precipitable proteins and soluble sugar phosphates was either equal or less in semen samples preserved in cold. CAW appeared to be a better extender than SKMEY as revealed by sugar uptake in cold.

Animals↗

PubMed1979

Extended-wear contact lenses in 525 aphakic eyes.

Extended-wear contact lenses were fitted to 225 patients with monocular aphakia and 150 with bilateral aphakia. They were observed from three months to three years. Eighty-eight of the 195 eyes fitted with a Softcon lens became red and painful within 14 days during extended wear. The Hydrocurve lens was better tolerated in 55, but many patients had acute congestion, pain, and tearing. Deposits accumulated rapidly on the Sauflon-PW lens. Some 90% of all patients can be fitted successfully with the cellulose acetate butyrate lens or the silicone lens. The silicone coating of the silicone lens is lost or damaged in about 20% of the patients because of excess mucous accumulation.

Aphakia, Postcataract↗

PubMed1978

The use of extended profundaplasty in limb salvage.

Obstructive lesions of the profunda femoris artery extending beyond the lateral circumflex branch were repaired in sixty-two limbs with superficial femoral occlusion and profound ischemia. The operation relieved rest pain in all thirty-four limbs with this symptom. Of twenty-eight limbs with tissue loss, twenty-two were salvaged without further reconstructive surgery. This experience illustrates that in diffuse profunda disease, extended profundaplasty is a useful alternative to femoropopliteal by pass, particularly for the relief of rest pain, and does not preclude more distal arterial reconstruction.

Aorta, Abdominal↗