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PubMed1986

[Extended radical operation of cancer of the rectum].

Extended radical operation for rectal cancer included the high ligation of inferior mesenteric artery and the dissection of lateral lymph nodes. There was no significant difference between overall survival of extended operation and conventional operation, although in Dukes B cases, 5-year survival rate was significantly higher in extended operation than in conventional. Extended operation caused high incidence of postoperative urinary and sexual dysfunction compared with conventional operation. We conclude that extended radical operation must be performed only in those patients, when tumors locate in the lower part of the rectum and invade beyond the proper muscle layer.

Humans↗

PubMed1979

Effects of increasing concentrations of minocin on the motility of bovine spermatozoa processed in various extenders.

The effect of minocycline hydrochloride (Minocin) on bovine spermatozoa was studied in eggyolk-citrate, Tris buffer and whole milk extenders. Each of the extenders contained penicillin, streptomycin, lincomycin-spectinomycin and four levels of minocin (10, 260, 510 and 760 mug/ml). Split ejaculates from Holstein sires were diluted in each of the extenders. This was followed by microscopic evaluation for progressive motility after initial dilution at 32 degrees C, after cooling at 5 degrees C and complete dilution, immediately after freezing and after 14 days of storage in liquid nitrogen. Under the experimental conditions employed, a decrease in the percent progressive motility was observed in the eggyolk-citrate and Tris buffer extenders with increasing concentration of minocin. Little or no difference in the percent progressive motility in the whole milk extender, either before or after freezing was observed when the minocin concentration was elevated.

Animals↗

PubMed1983

[Chemotherapy of small cell carcinoma of the lung in relation to lymph node metastasis and extending pattern of tumor].

Chemotherapeutic effects on the lymph node metastasis were studied in relation to the predominancy of T or N factor, extending patterns of tumor, histologic subtype, and cytologic characteristics, using cyclophosphamide, vincristine and 5-FU. N2, N3, N4 indicate ipsi-lateral, contra-lateral mediastinal, and supra-clavicular node, respectively. Chemotherapy was equally effective to the lymph node metastasis regardless a degree of progression, but survivals depended on the progression. Predominancy of both primary tumor (T) and involved lymph node (N) was analysed on chest X-rays. The Deffer response was observed in Type N than in Type T. Extending patterns of primary tumor were classified on X-ray films according to Suzuki's criteria: a longitudinal submucosal spreading along the bronchus (I): infiltration beyond the bronchial wall, extending to the depth, and fusing into a mass (III): and intermediate (II). In type I, the tumor was seen like an assembly of clubs extending along the bronchial tree, and Type III tumor showed a mass-like shadow with relatively high density and clear margin. Overall response rates were remarkably higher in Type I and lower in Type III. Type I was more frequently accompanied by large lymph node involvement than Type III. The highest response rate was obtained in Type I with N-predominancy and the lowest in Type III with T-predominancy. Responses to chemotherapy of lymph node metastasis depended upon these extending patterns. A half of Type III cases were polygonal cell type, which showed the lowest response rate in our institute. Regarding to cytologic classification by Horai, 67% response of good was found in Type I and 65% of response poor in Type III. These biological characteristics are considered to be a useful indicator for the selection of treatment modalities.

Carcinoma, Small Cell↗

PubMed1982

Reversible developmental change in the ability of ciliary ganglion neurons to extend neurites in culture.

From stages 35 to 40 in the chicken embryo, ciliary ganglion neurons undergo a developmental change which is detected in our assay system as a marked decline in the ability to extend neurites when placed in culture. This developmental loss is observed when the neurons are placed in culture as single, dissociated cells or as undissociated ganglion explants. The loss of the ability to extend neurites in culture is not a transitory phenomenon, for no recovery of this ability is observed during the rest of embryonic development or posthatching. There is a close temporal correlation between the embryonic period during which the ability of ciliary ganglion neurons to extend neurites declines and the period (stages 35 to 40) when these neurons form functional peripheral synapses in the embryo. The ability to extend neurites rapidly is not recovered during normal development as long as the ganglion and its connections within the organism remain intact. However, if the ciliary ganglia are removed from a stage 40 embryo and cultured for 3 to 4 days before being dissociated, the neurons have largely recovered their ability to initiate neurite outgrowth rapidly. This recovery after removal from the embryo is also presumably responsible for the eventual dense outgrowth of neurites from stage 40 ganglion explants after a 3- to 4-day delay in culture. Our results, in conjunction with similar results from other systems, suggest a cause and effect relationship between the establishment or disruption of peripheral connections and the loss or recovery, respectively, of the ability to extend neurites rapidly.

Animals↗

PubMed1995

Withdrawal and extended leave during residency training: results of a national survey.

BACKGROUND: Although national figures for medical student withdrawal and extended leave have long been reported, similar data have not been available for residents in training. METHOD: Data for this study came from the American Medical Association survey of the 1991-92 residency year, in which program directors were asked for information about residents who had taken extended leave or had withdrawn or been dismissed from their programs prior to completion. Data are reported for 89,368 residents enrolled in 6,302 programs (89.2% of all surveyed programs). RESULTS: During the 1991-92 year, 2,449 residents (2.7%) withdrew or were dismissed from their programs and 887 (1.0%) took extended leave. Specialty and program changes accounted for 56% of the withdrawals, while performance difficulties were implicated in 12.9%. Maternity or paternity leave was involved in 32.2% of extended leaves, followed by research sabbaticals (11.4%) and physical problems (10.5%). Women had higher rates of both withdrawal and extended leave than men. Withdrawal for performance difficulties was lowest among graduates of U.S. and Canadian allopathic schools as compared with graduates of osteopathic or foreign medical schools, and lowest among Caucasians as compared with those of other racial-ethnic identities. CONCLUSION: Although overall figures and percentages are low, there are small but persistent losses of residents annually that vary by specialty, gender, race-ethnicity, and education.

Data Collection↗

PubMed1995

Increase in expression levels of interferon-inducible genes in senescent human diploid fibroblasts and in SV40-transformed human fibroblasts with extended lifespan.

The normal human fibroblast line, TIG-3 which senesces at around 80 population doubling levels (PDLs), expressed interferon (IFN)-inducible genes such as 6-16, 2', 5'-oligoadenylate synthetase (2,5-A) and HLA B7 near the end of the proliferative lifespan. Other normal fibroblast line such as MRC-5 also expressed IFN-inducible genes when senesced. Clones transformed with SV40 T-antigen, which extended their proliferative lifespan by about 20-30 PDLs, also expressed IFN-inducible genes during their extended life. Anti-IFN-beta antibodies added in culture medium repressed the expression of IFN-inducible gene in both normal senescent and life-extended SV40-transformed cells. IFN-beta repressed DNA synthesis in normal TIG-3 and induced IFN-inducible genes in both normal and SV40-transformed TIG-3. Conditioned medium recovered from life-extended SV40-transformed cells contained IFN-beta, but not IFN-alpha, IFN-gamma or TNF-alpha and possessed an activity that inhibited DNA synthesis of young TIG-3. Addition of anti-IFN-beta antibodies into the medium enhanced the serum-induced DNA synthesis of near senescent (91% lifespan completed) TIG-3, while it neither induced DNA synthesis in fully senescent TIG-3 nor extended the proliferative lifespan of TIG-3. These results suggest that normal and SV40-transformed human fibroblasts increase expression of IFN-beta with increasing proliferative age especially near the end of their lifespan resulting in induction of IFN-inducible genes and possibly in growth repression.

Cell Line↗

PubMed1994

Single-dose bioavailability of two extended-release lithium carbonate products.

The single-dose bioavailabilities of two extended-release lithium carbonate products and an immediate-release product were compared. Nonsmoking healthy volunteers ages 20-31 (n = 12) were randomly assigned to one of three groups and given three treatments, each separated by a one-week period. The treatments, which were given to each group in a different sequence, consisted of three 300-mg immediate-release lithium carbonate tablets (Lithotab), two 450-mg extended-release lithium carbonate tablets (Eskalith CR), and three 300-mg extended-release lithium carbonate tablets (Lithobid). Blood samples were collected just before drug administration and at intervals up to 48 hours afterward. Urine was collected for 96 hours. Plasma and urine lithium concentrations were determined by flame-emission spectrophotometry, and lithium pharmacokinetic values and the cumulative urinary excretion of lithium were computed. Mean maximum plasma lithium concentration (Cmax) differed significantly among all three lithium carbonate products. Eskalith CR produced a 40% lower Cmax and Lithobid a 25% lower Cmax than Lithotab; Lithobid produced a 23% higher Cmax than Eskalith CR. Lithotab had a significantly shorter mean time to maximum plasma lithium concentration than either extended-release product. Mean cumulative urinary excretion of lithium did not differ significantly among the three products. Two extended-release lithium carbonate products were not bioequivalent when given in single doses to healthy volunteers.

Adult↗

PubMed1993

Effects of four different extenders and three different freezing rates on post-thaw viability of dog semen.

Ejaculates were collected from 17 dogs. After initial evaluation the ejaculates were split into four equal aliquots and diluted with either Triladyl, Pipes, IMV Universal or Tris-fructose-citric acid extender, all containing egg yolk and glycerol. The extended semen was frozen in 0.5 ml straws at a slow, intermediate or fast freezing rate. After thawing, the percentage of progressively motile spermatozoa and the velocity of forward motion was evaluated. There was no difference between the extenders with regard to progressive motility. The slow, intermediate and fast freezing rates resulted in the highest, intermediate and lowest motility values, respectively, regardless of extender. All four extenders were equally suitable for freezing canine semen at a slow freezing rate.

Animals↗

PubMed1997

[Intraoperative radiotherapy combined with extended resection for pancreatic cancer].

Since 1984, intraoperative radiotherapy combined with extended resection for pancreatic cancer has been performed in our clinic to prevent local recurrence. Following extended resection, a dose of 30 Gy of 9-12 MeV electrons was administered to the operative field including the paraaortic area from the diaphragm above to the inferior mesenteric artery below. Results of the combined therapy of 35 patients were compared to results of 11 patients who underwent extended resection alone. The combined therapy group compared to extended resection alone group showed improvement in the survival rate. It's 5 year survival rate was 16.8% in all the 35 cases, 22.3% in patients who had macroscopic tumor clearance and 18.9% in patients with Stage IVa tumour according to The Japanese classification. In autopsies of 10 cases who underwent the combined therapy, only 4 had local recurrence enclosed by thick, firm connective tissue. There was no any local recurrence in 2 cases who underwent non curative resection. Enhanced local control induced by the combined therapy, however, only has a limited impact on overall survival, because of system disease progression, especially hepatic metastases. These results suggest that combination of IORT and extended resection should be performed on selected patients to control local recurrence and anticancer treatment for metastases of the liver must be established for the cure of pancreatic cancer as soon as possible.

Combined Modality Therapy↗

PubMed1999

Guestworker migration, remittances and the extended family: evidence from Pakistan.

"The paper places migration in the context of the extended family. It models informal loans between migrant and extended family for financing the costs of international labor migration. To show repayments to extended family is important; we trace the effects of such loans on migrant savings and remittance to the immediate family. We employ a standard life-cycle approach, which predicts that the demand for extended family financing rises with migration costs and falls with pre-migration wealth. Remittance to the immediate family and savings retained abroad both fall with the pre-migration loan." These hypotheses are tested using data from a survey of return migrants to Pakistan carried out in 1986.

Asia↗

PubMed1989

The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses.

The wearing of contact lenses has increased dramatically in the past decade; over 4 million people in the United States now use extended-wear soft contact lenses, and 9 million use daily-wear soft contact lenses. Numerous reports have caused concern that the use of soft contact lenses, especially extended-wear lenses, may result in a substantial risk of ulcerative keratitis. To examine this issue, we conducted a prospective study in five New England states to estimate the incidence of ulcerative keratitis among those who use cosmetic extended-wear and daily-wear soft contact lenses. To obtain the numerator for each estimate of incidence, we surveyed all practicing ophthalmologists in the study area to identify all new cases diagnosed over a four-month period. To provide the denominator, we conducted a survey of 4178 households to estimate the number of persons who wore each type of soft contact lens. The annualized incidence of ulcerative keratitis was estimated to be 20.9 per 10,000 persons using extended-wear soft contact lenses for cosmetic purposes and 4.1 per 10,000 persons using daily-wear soft contact lenses for cosmetic purposes (P less than 0.00001).

Adolescent↗

PubMed2000

ATPase-positive dendritic cells in the limbal and corneal epithelium of guinea pigs after extended wear of hydrogel lenses.

PURPOSE: It has been said that Langerhans cells can be induced to migrate into the central cornea by various stimuli. We investigated whether extended wear of hydrogel lenses induced the migration of Langerhans cells into the central cornea. METHODS: Guinea-pig eyes were fitted with hydrogel contact lenses, and the number of adenosine triphosphatase (ATPase)-positive dendritic cells at the limbus, peripheral, and central corneal epithelium was quantified after 1, 2, 4, and 8 nights of extended wear. The cells were identified with histochemical procedures using ATPase stain. RESULTS: At baseline, ATPase-positive dendritic cells were seen at the limbus and peripheral cornea, with the density decreasing from limbus to peripheral cornea. There were no cells in the central cornea. With extended wear, cells increased in number at the peripheral cornea from 2 nights onward, and cells were seen in the central cornea from 4 nights onward. CONCLUSION: Extended wear of hydrogel lenses induced migration of ATPase-positive dendritic cells (Langerhans cells) into the central cornea. It is possible that they may play a role in the pathophysiology of some of the adverse events seen with contact lens wear.

Adenosine Triphosphatases↗

PubMed1985

Rigid gas-permeable lenses for extended wear--a 1-year clinical evaluation.

A 1-year evaluation of the feasibility of the use of gas-permeable rigid lenses for extended wear was carried out, using two different materials. Forty subjects were entered into the study. Fifteen were fitted with the Polycon II lens and another 15 with the Boston IV lens. These two groups wore the lenses on a weekly basis for the duration of the study. Two other groups, the controls, were fitted with the same types of lenses as the experimental groups, but wore the lenses on a daily basis. All lenses were made to the Syntex specifications for the Polycon lens and the groups were comparable with regard to age, sex, refractive error, corneal astigmatism, and any pre-existing ocular pathology. All subjects carried out the same care regimen for their lenses and were examined after 24 h, 1 week, 1 month, 3 months, 6 months, and 1 year. Examinations performed at the follow-up visits were to determine any clinically observable effects of lens wear in each patient in all groups. The results of the study suggest that the extended wear of gas-permeable rigid materials is a viable option. However, the results also indicate that extended wear is not without problems, and these need to be studied more fully before the use of gas-permeable rigid lenses for extended wear can be recommended.

Adult↗

PubMed2000

Daily disposable vs. disposable extended wear: a contact lens clinical trial.

BACKGROUND: The purpose of this work was to compare traditional standards of contact lens success and patient-reported preferences in the daily-disposable and disposable extended-wear contact lens modalities. METHODS: This study was a randomized, cross-over contact lens clinical trial involving 50 patients. After the baseline examination, two outcome examinations were performed including the self-administration of the Refractive Status and Vision Profile (RSVP) survey, an additional survey, and masked visual acuity and slit-lamp assessments. RESULTS: No differences were noted on the RSVP when comparing treatment modalities. Patients were considered equally successful in terms of wearing time, overall comfort, visual acuity, and ocular health criteria. In terms of patient preferences, a significant number of patients preferred the disposable extended-wear modality over the daily-disposable modality (chi2(1) = 4.08, p = 0.04). Patients preferred disposable extended-wear over daily-disposables due to convenience (odds ratio = 30.33). CONCLUSIONS: Disposable extended-wear represents a convenient contact lens option for contact lens patients.

Adolescent↗

PubMed2003

Corneal thickness results in the Menicon Z 30-day continuous wear and ACUVUE 7-day extended-wear contact lens clinical trial.

PURPOSE: This study was conducted to measure the corneal thickness changes associated with wearing 30-day tisilfocon A (Dk = 163) and 6-day etafilcon A (Dk = 28) contact lenses. The probable cause of the outcomes is discussed. METHODS: Thirty subjects were fitted with Menicon Z rigid gas-permeable (RGP) contact lenses and a control group (n = 30) was fitted with ACUVUE hydrogel lenses, at two study sites. After a 2-week period of daily wear, subjects began prolonged wear. Measurements were performed at the dispensing visit, and then at the 2-week daily wear, the 1-week, 6-month, and 12-month extended- and continuous-wear visits. RESULTS: Repeated measures analysis of covariance was performed on mean corneal thickness. There was a significant increase in corneal thickness in the hydrogel lens extended-wear group compared to the RGP group (P = 0.03). The mean corneal thickness in the ACUVUE group was 2.58% higher at the 2-week daily wear visit, 2.38% higher at the 1-week extended-wear visit, 2.96% higher at the 6-month, and 2.97% higher at the 1-year visit compared to the RGP continuous-wear patients. DISCUSSION: Patients wearing high-Dk RGP contact lenses for continuous wear may have thinner corneas (within the normal thickness range) probably because of minimal hypoxia-induced corneal stromal swelling; RGP-induced reversible corneal epithelial compression; deceased epithelial sloughing; or long-term contact lens-induced keratocyte apoptosis. Patients wearing hydrogel contact lenses for extended wear may have thicker corneas because of hypoxia-induced corneal stromal swelling. Additional evidence of corneal hypoxic stress is seen in the higher prevalence of striae and epithelial microcysts in the hydrogel group and greater variability of corneal thickness measurements in the soft contact lens group in our results.

Adult↗

PubMed2002

Spherical indentations of human and rabbit corneal epithelium following extended contact lens wear.

PURPOSE: Mucin balls appear to cause spherical indentations in the corneal epithelium during silicone hydrogel extended contact lens wear. The purpose of this report is to describe and quantify these spherical indentations, as examined in the human cornea by in vivo confocal microscopy and by in vitro immunocytochemistry in the rabbit cornea. METHODS: Confocal images of full-thickness corneal epithelium were taken from three human patients participating in a 1-year extended contact lens-wear trial. Diameter and depth of the indentations were determined and measured. Two rabbit corneas showing identical indentations were stained with propidium iodide (nuclear stain) and Ki-67 (proliferation marker) and were examined using a laser scanning confocal microscope. RESULTS: The diameter of the spherical indentations is largest on the epithelial surface, ranging from 33.9 to 78.8 microm. Indentations form spherical sections whose depth variably extends into the corneal epithelium, reaching as far as the basal lamina. The rabbit model showed no epithelial nuclei within the indentation. Furthermore, stromal cells localized immediately beneath the indentations were positive for Ki-67 (proliferation). DISCUSSION: Spherical indentations of the corneal epithelium induced by mucin balls appear to be gaps or holes that can extend deep into the corneal epithelium. Indentations may potentially open a pathway for infectious microorganisms to penetrate the cornea. Surprisingly, stromal cells immediately beneath the holes were stimulated to proliferate, and there seemed to be an increase in localized cell density.

Adult↗

PubMed1997

Extended wear disposable soft contact lenses as an alternative to photorefractive keratectomy: report of 4 years experience.

PURPOSE: To establish whether, in a well-informed population, the use of extended wear disposable soft contact lenses (EWDSCL) poses an unacceptable risk to vision and corneal health due to complications associated with their use. METHODS: A 4 year retrospective review of EWDSCL, involving 371 patients in Melbourne from a single general ophthalmology practice. The important aspects of this group were that all patients were given written instructions about the methods of ensuring initial and ongoing cleanliness of lenses, no lenses were cleaned and reinserted, and no solutions other than the saline in the original packaging, and comfort crops, were used. Two types of EWDSCL were used in powers from -9.0 to +6.0 D, and with an initial aim of 4 weeks uninterrupted extended wear. Follow-up was from 2 to 52 months, with an average of 24 months. RESULTS: Of the 354 patients followed up, 236 (66%) regularly wore them on an extended overnight basis, and of these 180 (76%) wore them for the suggested 4 week period before renewal of lenses. In the 471 eyes of 236 patients, adverse reactions occurred at the following rates, marginal infiltrates (12 cases, 2.5%); corneal oedema (10 cases, 2%) peripheral corneal vascularization (2 cases, 0.4%); and presumed infective keratitis (1 case, 0.2%). No eyes lost one or more lines of Snellen acuity. CONCLUSIONS: When disposable soft contact lenses do not come into contact with cleaning solutions, saline from bottles or aerosol cans, or storage cases, their use on an extended wear basis (up to 4 weeks continuous) appears to be associated with a low risk of minor or major complications. The results of this review indicate that controlled usage of EWDSCL is safer than previous reports have indicated.

Adolescent↗

PubMedDate not supplied

Effects of extended-wear soft contact lenses on the ocular surface and central corneal thickness.

PURPOSE: New contact lens materials with high oxygen permeability are said to be convenient for the extended-wear (EW) schedule. We evaluated the short-term effect of EW soft contact lens usage on ocular surface and central corneal thickness. PATIENTS AND METHODS: Fifty-two eyes of 26 patients were included in the study. Sixteen of the patients used the high oxygen-permeable lenses for a 30-day extended-wear schedule (group I). Ten patients used the lenses on a daily wear basis (DW, group II). All patients were evaluated for visual acuity and central corneal thickness by corneal and conjunctival biomicroscopy, Schirmer and tear break-up time (BUT) tests. Impression cytology was performed in the superior/temporal, inferior/nasal quadrants of the conjunctiva, 1 mm from the limbus, with cellulose acetate filter paper. The specimens were graded under light microscopy according to Nelson's classification. RESULTS: Three patients in the EW group were excluded from the study as they discontinued lens usage due to slight discomfort and hyperemia. Biomicroscopic findings and tear function tests indicated no increased pathological results. Central corneal thickness decreased from 554 +/- 9.55 to 546 +/- 9.30 microm (mean +/- SEM) in the EW group (p = 0.002), whereas no significant change occurred in the DW group. Cytological evaluation of the EW group showed an 88% increase in metaplasia (p = 0.007), especially close to the limbal areas and in the superior quadrants; this ratio was 30% in the DW group. Snake-like chromatin changes were found to be increased, from 4 to 6 patients, in the EW group while it remained the same in the DW group (p > 0.05). Individual comparisons of the initial and final pathological conditions of the ocular surfaces in the two groups showed that there was an increase in pathology in the EW group while there was no significant difference in the DW group. CONCLUSIONS: On a 30-day extended-wear basis with high oxygen-permeable lenses, the possible development and increase of conjunctival cytologic changes secondary to mechanical trauma is one of the main remaining problems. Conjunctival and related immunologic pathologies should not be overlooked when prescribing an extended-wear lens schedule.

Adolescent↗