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21.
R A Clary M J Cunningham R D Eavey 《The Annals of otology, rhinology, and laryngology》1992,101(7):598-600
The accuracy of computed tomography (CT) in distinguishing an abscess from cellulitis in children who present with orbital manifestations of paranasal sinus infection remains in question. In this 10-year retrospective study, CT results are compared with surgical findings in 19 patients with orbital complications who underwent surgical exploration within 24 hours of their CT scans. Fifteen of the 19 CT scan interpretations indicated abscesses that were verified intraoperatively. Two patients had negative surgical explorations despite CT interpretations predicting abscesses. An abscess was also surgically documented in 1 of 2 patients whose preoperative scans indicated cellulitis alone. We conclude that the correlation between radiologic and operative findings in 16 of these 19 cases, although not absolute, does substantiate the use of CT scanning as a therapeutic guide in children presenting with orbital disease secondary to paranasal sinusitis. 相似文献
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Recent evidence suggests that the putative dopamine (DA) autoreceptor antagonists, (+)-AJ 76 and (+)-UH 232, share some neurochemical and behavioral effects with both psychostimulants and neuroleptics. The ability of (+)-AJ 76 and (+)-UH 232 to mimic or antagonize the stimulus effects of cocaine was investigated in rats trained to discriminate 5 mg/kg (N=8) or 10 mg/kg (N=8) of cocaine from saline in a two-lever, water-reinforced, drug discrimination task. In the cocaine (10 mg/kg) group, administration of (+)-AJ 76 (2.5–20 mg/kg) engendered only a partial substitution for cocaine (maximum 60% cocaine-lever responses). Given in combination with cocaine (10 mg/kg), (+)-AJ 76 (2.5–40 mg/kg) did not significantly attenuate the cocaine cue. A fixed dose of (+)-AJ 76 (2.5 or 10 mg/kg) plus various doses of cocaine (1.25–5 mg/kg) did not alter the cocaine dose-response curve. (+)-UH 232 (2–16 mg/kg) produced primarily saline-appropriate responding in rats trained to discriminate 5 mg/kg of cocaine and was unable to block the interoceptive cocaine state when given in combination with cocaine (5 mg/kg). (+)-UH 232 (2 or 8 mg/kg) also did not alter the cocaine dose-response curve. These results suggest that (+)-AJ 76 and (+)-UH 232 elicit only weak or no cocaine-like stimulus effects and, unlike neuroleptics, do not attenuate the cocaine cue. 相似文献
24.
V R Bohman R W Stettler B B Little G D Wendel L J Sutor F G Cunningham 《Obstetrics and gynecology》1992,80(4):609-613
OBJECTIVE: To better understand hepatitis C viropathies and seroprevalence by performing an epidemiologic analysis of pregnant women seropositive for antibody against hepatitis C. METHODS: We studied 1013 consecutive obstetric patients at Parkland Memorial Hospital who gave informed consent for detailed interviews and serotesting. Sera were analyzed for antibody to the hepatitis C virus using both C100-3 and RIBA-4 assays. Neonatal assessment was carried out in the immediate postpartum period. RESULTS: Hepatitis C antibody was detected in 2.28% (N = 23) of the 1005 women in whom analysis was completed. Factors associated with seropositivity included intravenous (IV) drug use, sexually transmitted diseases, hepatitis B infection, maternal age greater than 22.5 years, increased parity (eg, greater than 2.1), history of transfusion, and three or more different lifetime sexual partners or a sexual partner who used IV drugs. Maternal and neonatal outcome was not different between hepatitis C antibody-positive and -negative groups. CONCLUSIONS: Epidemiologic data are consistent with sexual and parenteral modes of transmission. Women with hepatitis C antibody did not have excessive perinatal complications compared with antibody-negative women. A model protocol and cost analysis for screening pregnant women for hepatitis C infection are presented. However, routine screening for hepatitis C is not advocated. 相似文献
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26.
Steven C. Cunningham M.D. Farin Kamangar M.D. M.P.H. Min P. Kim M.D. Sommer Hammoud Raqeeb Haque Anirban Maitra M.B.B.S. Elizabeth Montgomery M.D. Richard E. Heitmiller M.D. F.A.C.S. Michael A. Choti M.D. F.A.C.S. Keith D. Lillemoe M.D. F.A.C.S. John L. Cameron M.D. F.A.C.S. F.R.C.S. F.R.C.S.I. Charles J. Yeo M.D. F.A.C.S. Richard D. Schulick M.D. F.A.C.S. 《Journal of gastrointestinal surgery》2005,9(5):718-725
Gastric adenocarcinoma is the second leading cause of cancer death worldwide. In Western series, survival rates vary widely
and are generally lower than those reported from Eastern series. We performed a retrospective analysis of cases operated on
at the Johns Hopkins Hospital over the past 18 years and collected data on demographics, tumor characteristics, pathologic
stage, treatment methods, complications, survival time, and other relevant factors. Survival according to stage of disease,
Lauren tumor type, tumorlocation,time period, andadministration of adjuvant therapy wasanalyzed, andresultswerecompared with
those of other Western series. During this period, 436 patients with gastric adenocarcinoma underwent resection. We have shown
a statistically significant association between survival and margin status, stage of disease, and Lauren tumor type. Overall
5-year survival was 26%, and 5-year survival after R0 resection was 33%. No significant difference was detected between survival
and tumor location, time period of treatment, or administration of adjuvant therapy. Analysis of various Western series reveals
major differences between the cohorts under study, such as stage of disease, extent of resection, tumor type, and tumor location.
Many of the reported differences among Western series may be due to cohort differences, such as stage of disease, extent of
resection, tumor type, and tumor location. 相似文献
27.
Rehospitalization for respiratory illness in infants of less than 32 weeks' gestation 总被引:6,自引:0,他引:6
All 133 surviving infants of gestational age less than or equal to 32 weeks born July 1, 1985, to June 30, 1986, as well as a socioeconomically matched full-term control group were observed prospectively for 2 years to determine the incidence of rehospitalization for respiratory illness. Perinatal and seasonal factors associated with increased risk for such hospitalizations were also examined. Forty-seven (36%) preterm infants were rehospitalized compared with 3 (2.5%) of 121 term infants (P less than .001). Preterm infants with and without rehospitalization were similar for mean birth weight (1104 +/- 329 g and 1188 +/- 360 g, respectively) and gestational age (28 +/- 2 weeks for both groups); however, infants who were subsequently rehospitalized had required more days of mechanical ventilation, supplemental oxygen therapy, and neonatal intensive care. While a history of bronchopulmonary dysplasia was a risk factor for rehospitalization (45% compared with 25% of those without bronchopulmonary dysplasia, P less than .05), preterm infants with no history of bronchopulmonary dysplasia still showed a 10-fold increase compared with control infants. Among the 43 infants who required no mechanical ventilation beyond the day of birth, 10 (23%) required rehospitalization.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
28.
Guy J Petruzzelli Kelly Cunningham Darl Vandevender 《Otolaryngology--head and neck surgery》2007,137(5):717-721
OBJECTIVE: To determine the role of native condyle preservation in local recurrence after segmental mandibulectomy in patients with head and neck squamous cell carcinoma. METHODS: Retrospective chart review with main outcome measuring local control of cancer. RESULTS: Between 1994 and 2003, 72 patients (48 men, 24 women) with an average age of 73.5 years without previous treatment underwent segmental mandibulectomy. Fifty-four cases (n = 54) involved the mandible posterior to the mental foramen and are the subject of this review. In 36 patients, the condyle was preserved and mandibular continuity was restored. In 18 patients, condyle and ramus were resected without mandibular reconstruction. Reconstructive modalities included primary closure (3), split-thickness skin graft (3), pedicle flap (19), and free tissue reconstructions (29). Overall local-regional recurrence rate was 22 percent (12 of 54); no recurrences were identified in patients who underwent condylar resection. Recurrences were observed in patients with mandibular reconstruction by both plate and pedicle flap (5 of 9) or (osteo) myocutaneous free flap (7 of 27). CONCLUSION: Condylar preservation may predispose patients to local recurrence after segmental mandibulectomy. This does not translate into overall reduction in survival. 相似文献
29.
J C Laschinger J N Cunningham F G Baumann M M Cooper K H Krieger F C Spencer 《The Journal of thoracic and cardiovascular surgery》1987,94(2):271-274
Somatosensory evoked potentials were used to locate intercostal arteries critical to spinal cord blood flow in nine dogs. To mimic a clinical situation, the proximal descending thoracic aorta (left subclavian artery to T7) was excluded with cross-clamps, and partial pulsatile left atrial-femoral artery bypass was instituted to maintain distal aortic pressure at 100 mm Hg. Progressively lower aortic segments were excluded (T7-10, T10-L1, L1-3, L3-6, L6-7) until loss of somatosensory evolved potentials occurred. Spinal cord blood flow measurements at the time of evoked potential loss revealed significant ischemia (p less than 0.02 versus baseline) in the excluded segment in seven animals but normal spinal cord blood flow in the remainder of the cord. Upon reperfusion, significant reactive hyperemia (p less than 0.02) was noted only in previously ischemic cord segments. Two animals exhibited no change in somatosensory evoked potentials or spinal cord blood flow despite exclusion of the entire thoracoabdominal aorta, presumably as a result of spinal collaterals. Loss of somatosensory evoked potentials despite adequate distal perfusion indicates that critical intercostal vessels have been excluded from systemic and bypass circulations. Use of evoked potential measurements in both experimental and clinical situations provides a means for assessing adequacy of spinal cord blood flow during cross-clamping and can alert the surgeon to the need for reimplantation of critical intercostal arteries during surgical resection of the thoracoabdominal aorta. 相似文献
30.
D Cunningham M Soukop N L Gilchrist G J Forrest D C Carter C S McArdle S B Kaye J W Dobbie M Smith 《Medical oncology and tumor pharmacotherapy》1986,3(1):25-28
Twenty-five patients, 16 with gastric cancer and nine with colonic cancer, received TNO-6 30 mg m-2 every four weeks. No objective tumour response was recorded. Nausea and vomiting occurred in 21 patients and was severe in 17. Severe marrow suppression developed in five patients. Renal function was unaffected in all but one patient who developed renal failure, probably as a result of septicaemia. However, the renal tubular enzyme N-acetyl-beta-D-glucosaminidase was measured in six patients and showed a rise in all. In this study TNO-6 had no anti-tumour activity in gastrointestinal malignancy, but produced significant renal tubular damage. 相似文献