Is endoscopic ultrasonography indispensable in assessing the appropriateness of endoscopic resection for gastric cancer?

BACKGROUND AND STUDY AIMS: Endoscopic resection is increasingly being used in the treatment of early gastric cancer. The aim of the present study was to investigate the accuracy of pretherapeutic staging techniques for assessing the appropriateness of endoscopic resection. PATIENTS AND METHODS: Both endoscopy and endosonography were carried out at our institution in the treatment of 234 early gastric cancers, with histological confirmation of malignancy following surgical resection (137 lesions) or endoscopic resection (97 lesions). The accuracy in detecting intramucosal cancer with each of the diagnostic procedures was assessed. RESULTS: The accuracy rates for detecting intramucosal cancer using endoscopy and endosonography were calculated as 84 % (197 of 234) and 78 % (182 of 234), respectively. The accuracy tended to be lower in lesions located in the upper third of the stomach, in those measuring 2 cm or more in diameter, and in those with an undifferentiated histology with ulcer fibrosis. However, there were no significant differences in the accuracy rates between endoscopy and endosonography. Precise staging was achieved by endoscopy alone in 103 of 109 differentiated adenocarcinomas without ulcer fibrosis, where the lesions measured less than 2 cm in diameter. CONCLUSIONS: Endoscopic resection is indicated in intramucosal gastric cancer lesions showing differentiated histology, no ulcer fibrosis and a diameter of less than 2 cm. EUS may additionally be used for further evaluation in these patients.     

Study of the psychological factors of diabetes patients

Objective To explore the relationship between diabetes and psychology factors.Methods We investigated 64 patients of diabetes type 2 with EPQ score of character,SCL-90 score of the symptom and the score of socidal support,and compared the scores with that of control group.Results The SXL-90 score of diabetics was higher than that of control group remarkably(P&;lt;0.010,score of social support of diabetics was lower than that of control group(P&;lt;0.001).Conclusion The psychological factor play a proper role in the generation and development of diabetes.It is worth further study and should be paid more attention.     

Abdominal actinomycosis: complication of endoscopic stenting in chronic pancreatitis?

Pancreatic endotherapy is frequently performed in patients with chronic pancreatitis and stenoses of the main pancreatic duct. In a patient with long-standing chronic pancreatitis and treatment with pancreatic stents, metastatic pancreatic head carcinoma was suspected because of infiltration of the neighboring organs and hepatic lesions. Ultrasound-guided aspiration of one liver lesion revealed grains typical for actinomycosis. In the light of this case, an extracted pancreatic stent was microbiologically investigated for actinomycetes in another patient who had a suspicious lesion of the pancreatic head. Microbiological examination of the extracted pancreatic stent revealed colonization by Actinomyces meyeri, Klebsiella oxytoca, and mixed cultures of anaerobic and saprophytic Gram-positive bacteria. In the following weeks, she developed a septic clinical picture with multiple abscesses of the liver. Actinomyces meyeri, Corynebacterium species, Candida and Enterococcae were cultivated in the aspirates. It seems possible, that treatment with pancreatic stents could have caused invasion of actinomycetes into the parenchyma of the pancreas, which was already harmed by the chronic inflammation, followed by the typical infiltrative growth and hematologic or biliary seeding into the liver.     

Foot nursing of patients with diabetes

Incidence of atherosclerosis was higher in patients with diabetes.Atherosclerosis of peripheral limbs mainly affect artery of lower limbs and abnormal feeling of foot and intermittent limping was the manifestation.To explore nursing methods of foot in patients with diabetes.     

Manifestations and causes of psychological and behavioral problems in infant patients and patients of early age

Largeamountsclinicalfactsdemonstratethatmanydiseasescaninduceemotionaldisturbancesandpsychologicalproblemssuchasfear,anxiety,restlessness,agitationandirritabilityininfantilepatientsandpatientsofearlyage.Theauthorwouldliketodiscussbrieflyseveralcommonpsychologicalandbehavioralproblemsandthecorrespondingcausesofthem.1CommonpsychologicalandbehavioralproblemsininfantpatientsandpatientsofearlyageCryingandmakingnoise:Cryingandmakingnoiseisasignalinfantsandchildrenusetoconveylargeamountsofinformation…     

Manifestations and Causes of psychological and behavioral problems in infant patients and patients of early age

Lage amounts clinical facts demonstrate that many diseases can induce emotional disturbances and psychological problems such as fear,anxiety,restlessness,agitation and irritability in infantile patients and patients of early age.The author would like to discuss briefly several common psychological and behavioral problesms and the corresponding causes of them.     

Obstructive jaundice due to isolated tuberculosis of the pancreas: endoscopic treatment instead of surgery?

The optimal treatment for relieving biliary obstruction due to isolated pancreatic tuberculosis has not so far been defined, and most previously reported patients were treated surgically. We describe a 17-year-old, immunocompetent girl who was admitted with obstructive jaundice caused by a tuberculous mass in the head of the pancreas. Antituberculous therapy alone failed to alleviate the jaundice, and she was therefore treated by stent insertion and, subsequently, balloon dilation of the common bile duct stricture. At follow-up 5 years later, magnetic resonance cholangiopancreatography showed no evidence of stricture in the common bile duct.     

Nursing understandings of 112 patients after orthomorphia of lateral curvature

Background:Theoperationoforthomorphiaoflateralcurvatureiscomplicatedandtraumatic.Itspreoperativepreparationislongandthegeneralreactionofpatientsislarge.Thepostoperativeeffectofoperationwillbeinfluencedifpatientsarenotnursedproperly.Objective:Tosummarizepreoperativeandpostoperativenursingkeypointsandunderstandingsoforthomorphiaoflateralcurvatureandpreventkindsofcomplications.Unit:Departmentofspinalsurg,GeneralHospitalofLanzhouMilitaryRegion.Subjects:112patients,68malesand44females,aged6-22y…     

Rehabilitative nursing of pulmonary infection of in-patient old psychosis patients

comBackground：Pulmonaryinfectionisakindofproliferativeinflammatoryreactiontouncontrolledmicroorganismthatinvadelowerrespiratorytract．Inoldpeople，becauseciliummovementdecrease，pulmonaryfunctiondecrease，coughispoorandreactionisdull，sputumiseasytoobstructairway，theninfluenceventilatefunction，leadtopersistentpulmonaryinfection，influencepatients＇livingandevenleadtodeath．Objective：Tostudyonsetinformationofpulmonaryinfectionofin－patientoldpsychosispatientsandtodecreaseincidenceofpul－mon…     

Use of real‐time magnetic resonance image guidance in endoscopic sinus surgery

We evaluated the effectiveness of magnetic resonance image (MRI) guidance using an optical tracking system (MRI‐guided therapy: MRT) in performing endoscopic sinus surgery (ESS). The profiles of the fourteen patients in the present study were as follows: eleven with mucocele in the paranasal sinus, one with recurrent chronic sinusitis, one with maxillary cancer, and one with Graves' ophthalmopathy. Preparation of the MRT system required an additional 54?min in cases involving general anesthesia, and an additional 17?min in cases involving local anesthesia, in comparison with corresponding control groups undergoing ESS in a traditional operating room. We developed nonmetal probes that were visualized in a real‐time mode and assistive devices for the optical tracking system that were equipped to avoid obstruction caused by surgical instruments as well as by the hands of surgeons. Using these unique devices, anatomic landmarks were visualized using the present MRT system. The prognosis of patients was favorable, and in particular, no patients with sinus mucocele showed a recurrence of their lesions. We concluded that the MRT system used here for performing ESS was beneficial, especially in terms of the intranasal marsupialization of sinus mucoceles and for the verification of orbital contents.     

Homœopathic treatment of patients with adenomas of the prostate

37 patients with prostatic adenomas were treated with homœopathy for 6–9 months in an open study. Most showed subjective improvement in urinary and sexual function and improved objective measures of urinary function. Testosterone levels rose, but there was no reduction in size of the prostate on ultrasound. Possible modes of action are discussed.     

Exploratory survey of patients’ needs and perceptions of psychosocial oncology

Cancer is a major disease that affects a significant proportion of the population worldwide. With a decrease in mortality due to advancements in oncology treatment, there is an expanding role for psychosocial oncology. A satellite clinic for medical treatment (only chemotherapy) of cancer is available at the Guelph General Hospital (GGH). Patients accessing the chemotherapy clinic at GGH have minimal access to psychosocial or supportive care and it is not known if the existing services are addressing the psychosocial symptoms of cancer patients. Participants were asked to complete an anonymous survey which included self-report measures of depression, symptom severity, quality of life, and social support while receiving treatment at this facility. There was a great deal of variability in the patients’ emotional symptoms at this satellite clinic, though many patients reported emotional difficulties. Greater social work presence may lead to better identification of patients who would benefit from psychosocial oncology services.