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Long-term Period (long-term + period)
Selected AbstractsAntiepileptic Drug Withdrawal after Successful Surgery for Intractable Temporal Lobe EpilepsyEPILEPSIA, Issue 2 2005Young Dae Kim Summary:,Purpose: To investigate the prognosis related to antiepileptic drug (AED) discontinuation after successful surgery for intractable temporal lobe epilepsy. Methods: The clinical courses after temporal lobectomies (TLs) were retrospectively analyzed in 88 consecutive patients. All the patients had TLs as the only surgical procedure, and they had been followed up for longer than 3 years. AED discontinuation was attempted if the patient had been seizure free without aura for ,1 year during the follow-up period. Results: Sixty-six (75%) patients achieved complete seizure freedom for ,1 year; 28 patients were seizure free immediately after surgery (immediate success); and 38 patients became seizure free after some period of recurrent seizures (delayed success). AED discontinuation was attempted in 60 (91%) of 66 patients with a successful outcome. In 13 (22%) patients, seizure relapse developed during AED reduction (n = 60), and in seven (12%) patients after discontinuation of AEDs (n = 38). The seizure recurrence rate was not different between the immediate- and delayed-success groups. Among 20 patients with seizure relapse related to AED tapering, nine (45%) of them regained seizure freedom after reinstitution of AED treatment, and AEDs were eventually discontinued in six of them. Seizures that recurred after complete AED discontinuation had a better prognosis than did the seizures that recurred during AED reduction (seizure freedom in 86% vs. 23%). At the final assessment, 54 (61%) patients had been seizure free ,1 year; 37 without AEDs and 17 with AEDs. The successful discontinuation of AEDs was more frequent for patients with a younger age at the time of surgery and for those patients with shorter disease duration. Conclusions: Our results suggest that seizure freedom without aura at ,1 year is a reasonable indication for the attempt at AED discontinuation. The subsequent control of recurrent seizures was excellent, especially if seizures relapsed after the complete discontinuation of AEDs. Younger age at the time of surgery and a shorter disease duration seem to affect successful AED discontinuation for a long-term period. [source] Use of image analysis techniques for objective quantification of the efficacy of different hair removal methodsINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 2 2007S. Bielfeldt In the field of consumer-used cosmetics for hair removal and hair growth reduction, there is a need for improved quantitative methods to enable the evaluation of efficacy and claim support. Optimized study designs and investigated endpoints are lacking to compare the efficacy of standard methods, like shaving or plucking, with new methods and products, such as depilating instruments or hair-growth-reducing cosmetics. Non-invasive image analysis, using a high-performance microscope combined with an optimized image analysis tool, was investigated to assess hair growth. In one step, high-resolution macrophotographs of the legs of female volunteers after shaving and plucking with cold wax were compared to observe short-term hair regrowth. In a second step, images obtained after plucking with cold wax were taken over a long-term period to assess the time, after which depilated hairs reappeared on the skin surface. Using image analysis, parameters like hair length, hair width, and hair projection area were investigated. The projection area was found to be the parameter most independent of possible image artifacts such as irregularities in skin or low contrast due to hair color. Therefore, the hair projection area was the most appropriate parameter to determine the time of hair regrowth. This point of time is suitable to assess the efficacy of different hair removal methods or hair growth reduction treatments by comparing the endpoint after use of the hair removal method to be investigated to the endpoint after simple shaving. The closeness of hair removal and visible signs of skin irritation can be assessed as additional quantitative parameters from the same images. Discomfort and pain rating by the volunteers complete the set of parameters, which are required to benchmark a new hair removal method or hair-growth-reduction treatment. Image analysis combined with high-resolution imaging techniques is a powerful tool to objectively assess parameters like hair length, hair width, and projection area. To achieve reliable data and to reduce well known image-analysis artifacts, it was important to optimize the technical equipment for use on human skin and to improve image analysis by adaptation of the image-processing procedure to the different skin characteristics of individuals, like skin color, hair color, and skin structure. [source] A New Technique for the Old Arterial Graft: Internal Thoracic ArteryJOURNAL OF CARDIAC SURGERY, Issue 2 2008Ufuk Tutun M.D. It stays patent well in the long-term period, and this evidence is directly related to the superior later outcome in terms of longevity. Coronary artery bypass grafting with multiarterial grafts can be performed safely, and better long-term result can be expected with the use of arterial conduits, especially ITA. We describe a simple and practical technique for the left ITA grafting by dividing the ITA graft and using its proximal and distal parts in situ for the distal left anterior descending (LAD) artery and the obtuse marginal artery grafting. [source] Long-term pancreatic endocrine function following pancreatoduodenectomy with pancreaticogastrostomyJOURNAL OF SURGICAL ONCOLOGY, Issue 6 2008Yoshiaki Murakami MD Abstract Background and Objectives The aim of this study was to evaluate long-term pancreatic endocrine function following pancreatoduodenectomy with pancreaticogastrostomy. Methods Records of 52 patients who had survived for three or more years following pancreatoduodenectomy with pancreaticogastrostomy were studied retrospectively. Serum HbA1c levels had been measured prior to and at 3- to 6-month intervals after surgery. Results Three of 42 patients with normal preoperative serum HbA1c levels (,5.8%), and five of 10 patients with elevated preoperative serum HbA1c levels (>5.8%) showed deterioration of glucose tolerance. Five of these eight patients developed a pancreatic fistula postoperatively. However, the average serum HbA1c levels of patients with normal preoperative serum HbA1c levels have remained within the normal range for 3,10 years after surgery. Conclusions Pancreatic endocrine function was maintained for a long-term period after pancreatoduodenectomy with pancreaticogastrostomy. Impaired glucose tolerance appeared to be associated with postoperative pancreatic fistula formation. J. Surg. Oncol. 2008;97:519,522. © 2008 Wiley-Liss, Inc. [source] Lentivirus-mediated knockdown of aggrecanase-1 and -2 promotes chondrocyte-engineered cartilage formation in vitroBIOTECHNOLOGY & BIOENGINEERING, Issue 4 2010Zheng-Hui Wang Abstract Chondrocyte-based tissue engineering has emerged as a promising approach for repair of injured cartilage tissues that have a poor self-healing capacity. However, this technique faces a major limitation: dedifferentiation of chondrocytes occurs following several passages in culture. Aggrecan, a major component of cartilage extracellular matrix, plays an essential role in chondrocyte differentiation. The aim of this study is to determine whether inhibition of chondrocyte aggrecanases, key degradative enzymes for aggrecan in cartilage, could benefit chondrocyte differentiation and the preservation of chondrocyte phenotype within a long-term period. Lentivirus-mediated RNA interference (RNAi) was employed to target both aggrecanase-1 and -2 in primary rat chondrocytes, and the transduced cells were seeded into chitosan,gelatin three-dimensional scaffolds. Histological, morphological, and biochemical analyses were performed at 1,8 weeks post-implantation to study chondrocyte survival, differentiation, and function. We found that lentivirus-mediated RNAi notably decreased the abundance of aggrecanase transcripts in chondrocytes but did not affect cell viability. Most importantly, compared to the control constructs seeded with untransduced chondrocytes, the aggrecanase inhibition increased chondrocyte proliferation and reinforced the production of glycosaminoglycans and total collagen, indicative of chondrocyte differentiation. The mRNA expression of chondrocyte marker genes (collagen II and aggrecan) was enhanced by aggrecanase silencing relative to the control. Together our data demonstrate that inhibition of endogenous aggrecanases facilitates chondrocyte differentiation and chondrocyte-engineered cartilage formation in vitro. The combination of lentiviral delivery system and genetic manipulation techniques provides a useful tool for modulation of chondrocyte phenotype in cartilage engineering. Biotechnol. Bioeng. 2010;107:730,736. © 2010 Wiley Periodicals, Inc. [source] The effect of large-scale circulation on precipitation and streamflow in the Gulf of California continental watershedINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 7 2003Luis Brito-Castillo Abstract The interannual variability of summer and winter rainfall and streamflow in the Gulf of California continental watershed is compared. Varimax-rotated empirical orthogonal function (EOF) analysis is applied to 15 streamflow series, in the period from 1960 to 1990, and two regions are defined: a central region and a southern region. Results show that in both regions, between 1944 and 1999, the long-term rainfall variability is well explained by the long-term streamflow variability in both seasons, the result being statistically significant at the 95% level. We conclude that regional streamflows in that period are climate driven. This conclusion is reinforced when we show that the large-scale circulation (700 hPa heights) explains: (i) wet and dry conditions in both regions; (ii) conditions of wet and dry years with the same signal of El Niño and La Niña events; and (iii) long-term periods in association with the Pacific decadal oscillation (PDO). When the PDO is in its warm phase, summers are likely to be dry with an El Niño event and wet with a La Niña event. In the cool phase of the PDO, summers are influenced by more localized events (i.e. the position of the subtropical continental ridge). In winter, warm and cool phases of the PDO are likely to be associated with wet and dry winters respectively. Copyright © 2003 Royal Meteorological Society [source] Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in BrazilJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2006Luiz A. Chambrone Abstract Aim: The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. Material and Methods: A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. Results: Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (>60 years) and smoking were statistically significant (p<0.05). Conclusion: The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss. [source] Effects of date extract on adhesion of Candida species to human buccal epithelial cells in vitroJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 5 2000Khaled H. Abu-Elteen Abstract: The adherence of three Candida species to human buccal epithelial cells (BEC) following treatment with different concentrations of date extract was investigated in vitro, as well as the effect of a mouth rinse with date extract on the adhesion of yeast to BEC. Adhesion of C.albicans, C.tropicalis and C.kefyr to BEC was significantly reduced after both short- and long-term periods of yeast exposure to various concentrations of date extract (reduction between 25% and 52% of the control value). A similar inhibition of adherence was observed upon pre-incubation of BEC with date extract. There was a significant reduction (P<0.001) in the adherence of yeast to BEC collected immediately or 5,20 min after an oral rinse with 10% date extract. No statistically significant difference was observed in the adhesion of BEC collected 30 min after an oral rinse with date extract and control BEC. In addition, pre-treatment of either Candida or BEC, or both, with date extract resulted in reduced adherence, the magnitude of which was largest when both types of cells were pre-treated. Date extract also inhibited germ-tube formation of C. albicans (56,85% inhibition), which might contribute to the effects on adherence. [source] Methotrexate in psoriasis: 26 years' experience with low-dose long-term treatmentJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2000U-F. Haustein Abstract Objective,To evaluate the efficacy, safety and side-effects of methotrexate (MTX) in psoriasis. Design,A 26-year retrospective study. Setting,Department of Dermatology, Leipzig University, Leipzig, Germany. Patients,One hundred and fifty-seven patients with extensive plaque psoriasis, erythrodermic, pustular and arthropathic forms, were treated with low-dose methotrexate (15,20 mg maximum weekly dosage [Weinstein schedule]), the majority for long-term periods. The mean cumulative dose was 3394 mg, the mean duration 237 weeks. Results,The effect of MTX treatment was good in 76%, moderate in 18% and poor in 6% of subjects; 61% experienced side-effects, most frequently due to liver function abnormalities, bone marrow suppression, nausea, gastric complaints and hair loss. In 20% of cases the subjects were forced to discontinue therapy; 9% refused therapy due to physical and psychological discomfort, 2% wanted to become pregnant, 16% were lost to follow-up, 6% died from multimorbidity and old age. Three subjects (2%) developed cancer of the lung, breast or cervix uteri, possibly in relation to long-term MTX treatment. Altogether there were no deaths or life-threatening side-effects attributable to MTX treatment, and no cases of progressive liver cirrhosis apart from two extensive skin necroses due to overdosage (misunderstanding, suicidal attempt) that were treated successfully with citrovorum factor. Conclusion,Low-dose MTX (<15,20 mg/week) is an effective therapy for extensive and severe forms of psoriasis if patients are selected carefully and monitored regularly, particularly with respect to liver and bone marrow toxicity. This helps to reduce severe side-effects even during long-term treatment. Drug interactions must be avoided. MTX therapy according to the guidelines is relatively safe and still has a place in the systemic treatment of psoriasis with 40 years of experience and an acceptable safety record. [source] | ||||||||||