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PubMed1982

Radionuclide bone scanning of osteosarcoma: falsely extended uptake patterns.

The pathologic specimens of 18 osteosarcomas of long bones were examined to correlate histologic abnormalities with abnormalities seen on preoperative 99mTc pyrophosphate or methylene diphosphonate bone scans. Seven scans accurately represented the extent of the tumor. Eleven scans disclosed increased activity extending beyond the radiographic abnormalities. In eight of these, there was no occult tumor extension and in the other three, the scan activity did not accurately portray the skip metastases that were present. Therefore, these 11 scans demonstrated the falsely extended pattern of uptake beyond the true limits of the tumors. Pathologic slides were available for 10 of the 11 areas of bone that exhibited extended uptake. In two instances, there was no pathologic abnormality. In the other eight cases we found marrow hyperemia, medullary reactive bone, or periosteal new bone. This is the first description of these histologic abnormalities of medullary bone in areas of extended uptake on radionuclide bone scans.

Adolescent↗

PubMed2005

[Extended ankle and foot fasciotomy as an enhancement to the surgical treatment of patients with prolonged ischemia of the lower extremities].

AIM: To present the technique and efficacy of extended ankle and foot fasciotomy, as a surgical limb-salvage procedure associated with the successful revascularization after the gold interval. METHOD: A retrospective review of six patients at the age of 16- 79 years (mean 39) in the period from 1996 to 2003, treated with the extended ankle and foot fasciotomy. There were four males undergoing the delayed treatment of war injuries to the lower extremity, and two females with atherosclerotic occlusive disease (a. illiacae dex and a. poplitealis dex.). The average ishemic time in the wounded patients was 22 hours (range, 14-30 hours), and ischemic time in occlusive disease (range, 48-72 hours). Clinical signs, indications, surgical access and the technique of extended ankle and foot fasciotomy was reported. RESULTS: The obtained results were classified as early and late. There was no cases with lethal outcome. Incisional wounds closed 15 days after the intervention, using secondary suture or skin transplant sec. Thiersch. The satisfactory functional results were achieved in 4 of the patients, 1 had a small edema, while amputation was performed in 1 patient. CONCLUSION: In cases of prolonged foot ischemia with edema and paresthesia in the toes, extended ankle and foot fasciotomy should be performed as a surgical limb-salvage procedure.

Adolescent↗

PubMed2000

Effect of dietary selenium and vitamin E on the ultrastructure and ATP concentration of boar spermatozoa, and the efficacy of added sodium selenite in extended semen on sperm motility.

Three experiments evaluated the effects of dietary Se and vitamin E on the ultrastructure of spermatozoa, ATP concentration of spermatozoa, and the effects of adding sodium selenite to semen extenders on subsequent sperm motility. The experiment was a 2 x 2 arrangement of treatments in a randomized complete block design. A total of 10 mature boars were fed from weaning to 18 mo of age diets fortified with two levels of supplemental Se (0 or .5 ppm) or vitamin E (0 or 220 IU/kg diet). The nonfortified diets contained .06 ppm Se and 4.4 IU vitamin E/kg. In Exp. 1, the spermatozoa from all boars were examined by electron microscopy. Vitamin E had no effect on structural abnormalities in the spermatozoa. When the low-Se diet was fed the acrosome or nuclei of the spermatozoa was unaffected, but the mitochondria in the tail midpiece were more oval with wider gaps between organelles. The plasma membrane connection to the tail midpiece was not tightly bound as when boars were fed Se. Immature spermatozoa with cytoplasmic droplets were more numerous when boars were fed the low-Se diet, but the occurrence of midpiece abnormalities occurred in boars fed diets with or without Se or vitamin E. Our results suggest that Se may enhance spermatozoa maturation in the epididymis and may reduce the number of sperm with cytoplasmic droplets. In Exp. 2, the concentration of ATP in the spermatozoa was evaluated in the semen of all treatment boars. When the low-Se diet was fed, ATP concentration was lower (P < .01), whereas vitamin E had no effect on ATP concentration. Experiment 3 investigated the effect of diluting boar semen with a semen extender with sodium selenite added at 0, .3, .6, or .9 ppm Se. Three ejaculates from each boar were used to evaluate these effects on sperm motility to 48 h after dilution. Sperm motility declined (P < .01) when Se was added to the extender, and this decline was exacerbated as the concentration of added Se increased (P < .01). The added Se was demonstrated to be tightly adhered to the spermatozoa. Overall, these results suggest that low Se-diets fed to boars resulted in abnormal spermatozoal mitochondria, a lower ATP concentration in the spermatozoa, and a loose apposition of the plasma membrane to the helical coil of the tail midpiece, but no effect from inadequate vitamin E was demonstrated. Adding sodium selenite to the semen extender reduced sperm cell motility.

Adenosine Triphosphate↗

PubMed1991

Results of acoustic neuroma surgery by the extended middle cranial fossa approach.

The results of surgery in 160 cases of AN are reported. Surgery was carried out by the extended middle cranial fossa (EMCF) approach in 138 cases and by the middle cranial fossa (MCF) approach in 22 cases. The tumor extended an average of 28.9 mm into the posterior cranial fossa; 42% of the tumors extended 31 mm or more. Mortality was 1.9%. Of the 3 cases of death, two had large tumors of 45 mm and 52 mm each, and one was a case of recurrence. Total tumor removal was achieved in an average of 78.8% of the cases. When the cases were classified by date of operation, the total tumor removal rate in the 60 most recent cases was 93.3%. The rate of facial nerve presentation was 82.4% on average and 93% in the recent cases. Hypoglossal-facial nerve anastomosis was performed in 33% of the cases in which facial nerve function failed to recover for an extended period of time. Among recent cases, however, anastomosis has been carried out in 22% of the cases. Hearing was preserved in 20 cases. Useful hearing was preserved in 8 (38%) of 22 cases. Recurrence was confirmed through surgery in 3 cases. Recurrence was suspected but was unconfirmed in 3 cases.

Adolescent↗

PubMed1996

External device for tissue expansion: clinical evaluation of the skin extender.

Tissue expansion is a well known way of repairing soft tissue defects. However, traditional tissue expanders have certain disadvantages such as the need for repeated outpatient visits for the filling of the expander and a long period of time required before the final result is achieved. A series of other devices have recently been developed. We have evaluated one of these, a skin extender developed by Blomqvist and Steenfos, in 10 lesions of the extremities in nine adult patients. The defects ranged from 3.5-10 cm wide and the extenders were inserted under local anaesthesia. The patients were taught how to tighten the extenders themselves, so there was no need for repeated visits to the outpatient department. Nine of the 10 defects were excised within 14 days; the remaining one developed a wound infection. The results show that this skin extender is a simple, fast, and economical device for repairing soft tissue defects, and in certain cases it is more suitable than a traditional tissue expander. Its major drawback is unsightly scars in the normal skin beside the previous defect.

Adult↗

PubMed1985

Motility and fertility of frozen bull spermatozoa in tris-yolk and milk extenders containing amikacin sulfate.

Amikacin sulfate, an aminoglycoside antibiotic, effective against some streptomycin-resistant organisms, was tested in bull semen extended with whole milk and egg yolk-Tris extenders in a 6 X 5 X 2 factorial arrangement. Semen from six bulls was frozen in extenders containing 500, 1000, and 2500 microgram/ml of amikacin, a control containing 500 IU/ml of penicillin plus 1000 micrograms/ml of streptomycin plus 500 IU/ml of polymyxin, and control plus amikacin (1000 micrograms/ml). Semen was frozen in .5 ml polyvinyl chloride straws in liquid nitrogen vapor and stored in liquid nitrogen for 2 wk. Straws were thawed in a water bath at 35 degrees C for 30 s. Postthaw motility of spermatozoa in each treatment was assessed using two straws by two observers independently. At amikacin concentrations of 500, 1000, or 2500 micrograms/ml, the percentage of motile spermatozoa averaged 47, 45, and 36% in whole milk and 52, 46, and 46% in egg yolk-Tris. Control and control plus amikacin (1000 micrograms/ml) were 49 and 47% in whole milk and 48 and 52% in egg yolk-Tris. Only amikacin in milk at 2500 micrograms/ml, depressed sperm motility. A fertility trial was conducted to compare the control mixture of antibiotics in whole milk with whole milk also containing 500 micrograms/ml of amikacin. The nonreturn rate to 1182 first service inseminations with semen treated with amikacin (500 micrograms/ml) plus control antibiotics was 70.4% compared with 70.5% for 1494 first service inseminations with control semen. Amikacin can safely be added to whole milk and egg yolk-tris extenders to control streptomycin-resistant organisms.

Amikacin↗

PubMed1987

Glycerolation and thawing effects on bull spermatozoa frozen in detergent-treated egg yolk and whole egg extenders.

Bull sperm in Experiment 1 were added to a standard egg yolk-Tris extender containing 0, .25, .5, 1.0, 1.5, and 2.0% (vol/vol) of the detergent mixture, sodium and triethanolamine lauryl sulfate. Glycerol was added in one step to the initial extender or in three steps after cooling semen to 4 degrees C. The extended semen was packaged in .5-ml French straws and frozen over static nitrogen vapor. Thawing was at 4, 30, and 60 degrees C. There was little difference due to the method of adding glycerol provided detergent was present. Percentages of motile sperm after freezing in the six concentrations of detergent, in ascending order, were 31, 45, 52, 51, 48, and 36. Percentages of motile sperm following thawing at 4, 30, and 60 degrees C were 36.5, 46.0, and 48.6. Acrosome retention also was better preserved with the higher thaw temperatures. A second experiment, similar in design to the first one, was conducted with whole egg-Tris extender. The best results were in whole egg-Tris containing .125% detergent where post-thaw motile sperm of 70.4% greatly exceeded 30.7% without sodium and triethanolamine lauryl sulfate. Fertility of sperm frozen in yolk-Tris-detergent was equivalent to whole milk used as a control.

Animals↗

PubMed1993

Survival of bull spermatozoa seeded and frozen at different rates in egg yolk-tris and whole milk extenders.

Six factorially arranged experiments were designed to study effects of seeding, freezing, and thawing rates in whole milk and egg yolk-Tris extenders commonly used for commercial cryopreservation of bull sperm. In these extenders, semen normally is supercooled to -13 or -14 degrees C unless the sperm are seeded. When sperm were supercooled or seeded, either mechanically or with immobilized silver iodide, and frozen to -196 degrees C, the postthaw percentages of motile sperm were 59, 57, and 64%, respectively. Freezing rates of -15, -25, and -35 degrees C/min gave similar sperm survival rates and were superior to -5 degrees C/min. For milk, the critical freezing temperature extended to -75 degrees C before transfer to liquid nitrogen gave good results. For egg yolk-Tris extender, transfer to liquid nitrogen was less critical once -50 degrees C had been attained. Thawing of sperm in water baths at 25 and 45 degrees C gave similar results, and both temperatures were superior to 5 degrees C. The postthaw percentage of motile sperm in egg yolk-Tris was equal or superior to that of sperm frozen in milk. A freezing rate of -15 degrees C/min to -100 degrees C and thawing at 25 degrees C consistently gave good results.

Animals↗

PubMed1996

Experience with use of extended length peritoneal shunt catheters.

The placement of a ventriculoperitoneal (VP) shunt is the current treatment of choice for diversion of cerebrospinal fluid associated with hydrocephalus. Although there are a host of reported potential abdominal complications related to the procedure, they are notably uncommon. The authors report their experience with the primary insertion of an extended length open-ended peritoneal tubing (120 cm) undertaken expressly to avoid the need for a lengthening procedure because of growth of the patient. In a review of new insertions of VP shunts using the extended length tubing over a 14-year period at Childrens Hospital of Los Angeles, a total 998 shunts were placed in 952 patients, with a mean follow-up period of 6.7 years. The patients experienced a total of 52 distal shunt revisions for a variety of malfunction etiologies. In patients ranging in age from premature neonate to 20 years, there was no increase in the distal complication rate, and specifically no complications were experienced that were directly related to the use of the extended length tubing. The authors conclude that the use of an extended length peritoneal shunt catheter is not associated with an increase in complications and eliminates the need to lengthen the peritoneal catheter for growth of the patient.

Adolescent↗

PubMed1982

Development of extender and techniques for frozen turkey semen. 2. Fertility trials.

The effects of cryoprotectant concentrations, redilution, centrifugation, and dialysis techniques on fertility of fresh and frozen-thawed turkey semen were tested. Fresh extended semen with final concentrations of 4.8, 5.6, 9.6, and 11.2% cryoprotectant (dimethylsulfoxide and ethylene glycol, 1:1 ratio) showed a significant (P less than .05) decrease in fertility when compared to semen without cryoprotectant. Fertility of fresh semen extended with 4.8% cryoprotectant when centrifuged or rediluted and centrifuged, was unaffected when compared to cryoprotectant treated semen. Fertility of frozen-thawed semen after redilution and centrifugation was low, but samples rediluted one part semen for two parts extender yielded significantly (P less than .05) higher fertility than semen rediluted 1:1. Fresh semen extended with 11.2% cryoprotectant showed a highly significant (P less than .01) decrease in fertility despite dialysis, while semen with 9.6% cryoprotectant showed no difference when compared to dialyzed semen without cryoprotectant. Fertility of frozen-thawed semen dialyzed against blood plasma (approximately pH 7.9) and blood plasma adjusted with TES2 to pH 7.4 or pH 7.2 was not significantly different. Fertility of frozen-thawed semen dialyzed for 30 min was significantly higher (P less than .01) than semen dialyzed for 15 min or 0 min. Frozen-thawed semen dialyzed with a semen to dialysate ratio of 1:15 and 1:24 supported significantly higher (P less than .01) fertility than at 1:50 ratio. The AGPT3 dialysate yielded significantly higher (P less than .01) fertility than blood plasma adjusted to pH 7.2 with TES.

Animals↗

PubMed1990

Effects of alcohol and extended practice on divided-attention performance.

The effects of alcohol and extended practice on divided attention were investigated using a visual tracking task and an auditory detection task. Subjects performed the tasks with and without alcohol, under single-task (S) and dual-task (D) conditions, both before and after they had received extended practice under single-task conditions without alcohol. Tracking accuracy improved with practice and was impaired under divided-attention conditions but was not affected by alcohol. Speed of detection was impaired by alcohol, improved by practice, and impaired by divided attention. Extended practice did not reduce the influence of alcohol. The effects of both alcohol and practice on speed of detection were significantly greater under dual-task conditions than under single-task conditions. Analysis of detection-task reaction times in terms of relative divided-attention costs, (D-S)/S, showed no effect of alcohol, but a highly significant reduction in costs with extended practice. It is concluded that (1) alcohol and practice can have quantitatively, but not qualitatively, similar effects on speeded performance, and (2) the effect of alcohol is not influenced by the attentional requirements of the task.

Alcohol Drinking↗

PubMed1992

Use of patient care extenders in critical care nursing.

This article explores the implementation and use of patient care extenders in two critical care units. Experimentation and diversity in changing the care-delivery system were the forces motivating the management team to redesign the existing nursing care-delivery system. The impetuses for the change process were the use of the role of the registered nurse and cost containment. Two case studies will illustrate from a practical perspective how the change occurred. Although the same nurse manager was responsible administratively for the two units, the patient care extender models were implemented differently. This was based on the conviction that each unit is unique with regard to patients and staff needs. The first case study occurred in an 18-bed cardiac telemetry unit in which the patient extender care model was integrated with direct patient care activities of the unit. In the second case study, which occurred in a ten-bed cardiac care unit, the patient care extender was integrated with indirect patient care activities. The approach to this article is practical, and it is intended for units that may be dealing with these issues in these changing times in health care.

Humans↗

PubMed1977

Endemic amebiasis in an extended family.

Two cousins from a large Spanish-American family were simultaneously diagnosed as having amebic liver abscesses. Survey of 183 extended-family members revealed that 45.7% of 162 had a positive amebiasis indirect hemagglutination test and 12.6% of 111 had cysts or trophozoites of Entamoeba histolytica demonstrated in a single stool examination. A total of five family members had had liver abscesses; two deaths had occurred. In a random sample survey of the remainder of the community, only one person (0.3%) had a positive serologic test. Within the extended family, person-to-person appeared to be the predominant mode of transmission. Water supplies were not contaminated. Both community and extended family homes had the same source of water. Type and source of food supply were not correlated with infection and there was no evidence to implicate an infected food handler. Clustering of seropositivity occurred in homes without indoor toilets. Homes of the extended family were more crowded and significantly fewer of them had indoor toilets. Endemic foci of amebiasis continue to exist in the United States. Follow-up family and other close contacts of persons with amebiasis will frequently identify other cases.

Feces↗

PubMed2006

[Study of the extended process for mammographic film with two-dimensional shape analysis of micro-calcifications].

This paper describes the extended development process (extended process) that compensates for the image quality of mammographic film exposed at a lower radiation dose. First, we developed films exposed to a phantom with several small particles that simulated micro-calcifications at high and lower radiation doses, respectively. Next, we evaluated the image quality of those films developed for the standard development time of 90 seconds, and for the extended development times of 150 seconds and 210 seconds. Then we extracted micro-calcification regions and calculated the areas, perimeters, and normalized areas of micro-calcifications by using image analysis. There was no significant difference in areas or shape measurements between the development times of 90 seconds and 150 seconds in obtaining the same high-quality images as the standard process. Therefore, we determined that the development time of 150 seconds was the most appropriate time. As a result, we achieved a 20% reduction in radiation dose by using the extended process for mammographic film.

Calcinosis↗

PubMed2004

[Evaluation of image quality in mammographic film with the extended process].

This report deals with the image quality of film used in mammography in terms of changing the processing time of the film and reducing the radiation dose. We initially performed phantom experiments to investigate the extended process that could provide high image quality of the film. We then measured silver grain sizes using an optical microscope to investigate processing time, so that silver grains would not be coarse during the extended process. It was found that micro-calcifications could be clearly detected by the extended process by using a lower radiation dose and that the extended process did not affect coarsening of the silver grains.

Image Processing, Computer-Assisted↗

PubMed2003

Extended oral anticoagulant therapy after a first episode of pulmonary embolism.

BACKGROUND: The optimal duration of oral anticoagulant treatment after a first episode of pulmonary embolism remains uncertain. OBJECTIVE: To evaluate the long-term clinical benefit of extending a 3-month course of oral anticoagulant therapy to 6 months (pulmonary embolism associated with temporary risk factors) or to 1 year (idiopathic pulmonary embolism) in patients with a first episode of pulmonary embolism. DESIGN: Multicenter randomized study with independent, blinded assessment of the outcome events. SETTING: 19 Italian hospitals. PATIENTS: 326 patients who had had 3 months of oral anticoagulant therapy without experiencing recurrence or bleeding. MEASUREMENTS: The primary study outcome was recurrence of symptomatic, objectively confirmed venous thromboembolism. RESULTS: Among 165 patients assigned to extended anticoagulant therapy, 15 patients (9.1%) had a recurrence of venous thromboembolism (3.1% per patient-year; average follow-up, 34.9 months), as compared with 18 of 161 patients (11.2%) assigned to discontinue treatment (4.1% per patient-year; average follow-up, 32.7 months); the rate ratio was 0.81 (95% CI, 0.42 to 1.56). All but one of the recurrences occurred after anticoagulant treatment was discontinued. Nineteen recurrences (57.6%) were episodes of pulmonary embolism, two of which were fatal. Three major bleeding episodes were observed during extended anticoagulation (1.8%). Among patients with idiopathic venous thromboembolism, 11 of 90 patients assigned to extended anticoagulation and 11 of 91 patients assigned to discontinue treatment experienced a recurrence (relative risk, 0.99 [CI, 0.45 to 2.16]). CONCLUSION: Patients with pulmonary embolism have a substantial risk for recurrence after discontinuation of oral anticoagulation, regardless of treatment duration. Physicians should try to identify patients who are at high risk for recurrent venous thromboembolism and are therefore potential candidates for indefinite oral anticoagulant therapy.

Acenocoumarol↗

PubMed1999

Extended field of view sonography in musculoskeletal imaging.

The usage patterns and benefits of extended field of view sonography were analyzed prospectively in 100 consecutive musculoskeletal ultrasonographic examinations. Extended field of view sonography was used in 23 of 58 abnormal cases (10 of 41 shoulders, five of eight other joints, seven of seven extra-articular extremities, one of two interventional procedures) and two of 42 normal cases. Of 23 abnormal cases using extended field of view sonography (12 of 46 tendon tears and 11 of 12 fluid collections or masses), this modality helped in measuring abnormalities in 13, displaying abnormalities in 19, showing spatial relationships in 17, communicating findings in 13, and making diagnoses in 0. Extended field of view is a useful technique for musculoskeletal ultrasonography. The primary benefits are measuring and displaying abnormalities (most often fluid collections or masses and extra-articular extremity abnormalities).

Adolescent↗

PubMed1999

Extended radical esophagectomy for superficially invasive carcinoma of the esophagus.

BACKGROUND: The purpose of the study was to determine whether extended radical esophagectomy is both clinically and oncologically indicated for patients with superficially invasive esophageal carcinomas. METHODS: We reviewed 51 patients with this disease in whom extended radical esophagectomy was performed. RESULTS: Major morbidity developed in 80% of the patients associated with no mortality after the operation. At surgery lymph node metastases were found in 29 patients (57%). Although the number of positive nodes was 3 or less in 93% of those patients, the tumors metastasized not only to the mediastinal nodes but also to the cervical and abdominal nodes, frequently jumping the first echelon of nodes. The overall 5-year survival rate was 68%. The survival curve of the patients with positive nodes was significantly worse (P < .01) than that of patients with negative nodes: the respective 5-year survival rates were 47% and 93%. However, no significant difference was detected between the survival curves of the patients with cervical metastases and those with noncervical metastases. CONCLUSIONS: Extended radical esophagectomy is needed for complete tumor clearance and may be effective in improving the rate of cure in patients with superficially invasive esophageal carcinoma. However, patients should be selected carefully for the performance of extended radical esophagectomy because this procedure is potentially associated with high morbidity rates.

Adult↗