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21.
The precise role of brachytherapy in treating patients with adenocarcinoma of the prostate remains unclear. Recent literature suggests that the long-term disease-free survival of patients with well-differentiated and localized tumors who receive brachytherapy is comparable to that of patients with similar tumors who are treated with radical prostatectomy or external-beam radiation. Advances in imaging technology, treatment planning software, and delivery apparatus have resulted in a technique that is accurate and reproducible. We explore the development of contemporary brachytherapy and examine the current published data relating to its emergence as a medically successful, cost-effective, and low-morbidity therapeutic modality for patients with stage T(1c), T(2a) prostate cancer. 相似文献
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D. A. Saltzman B. Chavers W. Brennom R. Vernier R. L. Telander 《Pediatric surgery international》1998,13(4):268-270
Hemolytic uremic syndrome (HUS) consists of an acute onset of microanglopathic hemolytic anemia, thrombocytopenia, and renal
dysfunction. HUS-associated colitis can be seen in up to 100% of patients and is usually associated with severe abdominal
pain and distention. Colonic perforation is a complication of HUS that has a reported incidence of 1%–2%, and although there
are several case reports in the literature describing perforation of the colon, it is still very difficult to discern the
abdominal symptoms associated with HUS colitis from perforation. Four cases of colonic perforation are reported here from
a consecutive series of 57 patients, in which a trend in the length of time from the onset of symptoms of HUS to colonic perforation
was determined. A review of the literature for cases of HUS-associated colonic perforation was also performed. The time from
the onset of HUS symptoms to colonic perforation in our series was similar to that found in the literature review (11 ± 5
vs 14 ± 8 days). Awareness that this complication has a tendency to occur towards the end of the 2nd week during the course
of HUS is essential to avoid an unnecessary and untimely surgical intervention.
Accepted: 25 June 1997 相似文献
25.
Wang WS; Hsieh RK; Chiou TJ; Liu JH; Fan FS; Yen CC; Tung SL; Chen PM 《Japanese journal of clinical oncology》1998,28(9):551-554
A 54-year-old man was treated with weekly 24-h infusion of high-dose
5-fluorouracil (2600 mg/m2) and leucovorin (100 mg/m2) for metastatic colon
cancer. At first, he tolerated the treatment well and no significant
toxicity was identified. After a total of eight courses of treatment, a
stable disease was observed, but mild shortness of breath was found on
occasion. The patient had no previous history of cardiac disease and the
heart performance assessed by left ventricular ejection fraction before
treatment was normal. Unfortunately, acute pulmonary edema with lethal
cardiogenic shock occurred during the ninth course of treatment, in spite
of intensive medical treatment. The chest X-ray showed extreme
cardiomegaly. Repeated assessment of his heart function by echocardiogram
and ventricular ejection fraction revealed a very poor cardiac performance.
Toxic cardiogenic shock during weekly 24-h infusion of high-dose
5-fluorouracil and leucovorin is extremely rare. To the best of our
knowledge, no case has been reported in the English literature. We report a
case and the relevant literature about the incidence, clinical picture and
possible pathophysiology on 5-fluorouracil-related cardioxicity is
reviewed.
相似文献
26.
Everett F. Magann MD Suneet P. Chauhan MD Neil S. Whitworth PhD Jack H. Klausen MD rew K. Saltzman MD John C. Morrison MD 《The Australian & New Zealand journal of obstetrics & gynaecology》1998,38(2):172-175
Summary: This investigation was undertaken to determine if the accuracy of the ultrasound assessment of abnormal amniotic fluid volume (oligohydramnios or poly-hydramnios) is improved by employing multiple sonographic amniotic fluid measurements. Four ultrasound techniques consisting of the subjective assessment (ultrasonic visualization without measurement), largest vertical pocket, amniotic fluid index and 2-diameter pocket technique were performed followed by amniocentesis and dye-dilution confirmation of amniotic fluid volume in 66 singleton pregnancies. The ultrasound accuracy to detect abnormal amniotic fluid volume ranged from 61% with the largest vertical pocket to 70% with the 2-diameter pocket procedure used separately. Receiver operator characteristic curves demonstrated that combining the 4 ultrasonic measurements did not improve the accuracy of identifying amniotic fluid volumes. 相似文献
27.
Contribution of individual projections alone and in combination for radiographic detection of ankle fractures 总被引:4,自引:0,他引:4
Brandser EA Berbaum KS Dorfman DD Braksiek RJ El-Khoury GY Saltzman CL Marsh JL Clark WA 《AJR. American journal of roentgenology》2000,174(6):1691-1697
OBJECTIVE: We wanted to determine whether the standard three-view ankle radiographic series could be replaced by a two-view combination, and if so, which two-view combination (anteroposterior with lateral or mortise with lateral) would be superior. MATERIALS AND METHODS: During a 12-month period, we retrospectively reviewed 556 consecutive ankle radiographic studies consisting of anteroposterior, mortise, and lateral views. One hundred twenty patients with at least one ankle fracture were paired with 140 healthy control subjects. Each image in the three-view examination was separated and sorted by view and studied independently; all images were reviewed by two skeletal radiologists and two orthopedic surgeons. Each radiograph was evaluated for fracture of the medial, lateral, and posterior malleoli and the foot using a five-point confidence rating. Performance of each view and modeled two- and three-view combinations of views was evaluated with modified receiver operating characteristic analysis. RESULTS: The data provide little support for preferring either two-view combination (anteroposterior-lateral or mortise-lateral) for any type of fracture. The three-view combination does detect significantly more fractures than some two-view combinations in some locations, and there is a statistically significant cost in diagnostic accuracy for eliminating the anteroposterior or mortise view. CONCLUSION: Reducing the ankle radiographic series from three to two views would result in a small but significant decrease in the detection of fractures of the ankle and foot. Both two-view combinations are equivalent for fracture detection. 相似文献
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