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991.
992.
Dr. Paul Russo MD Young Kim MD Sanuj Ravindran BA William Huang BA Murray F. Brennan MD 《Annals of surgical oncology》1997,4(5):421-424
Background: Complete resection of a retroperitoneal sarcoma often requires removal of adjacent organs. In this study we evaluated the
role of nephrectomy during operation for retroperitoneal sarcoma.
Methods: Between July 1982 and July 1995, 75 of the 371 (20%) patients who underwent resection of retroperitoneal sarcoma at MSKCC
underwent concommitant nephrectomy. Data concerning the reasons for nephrectomy, degree of sarcomatous renal involvement,
and survival were retrospectively analyzed.
Results: Fifty-four patients (72%) underwent nephrectomy during the initial resection, and 21 (28%) during a resection of a recurrent
or persistent tumor. The most common reason for nephrectomy was total encasement by sarcoma (n=40; 53%), followed by dense
adherence of the tumor to the kidney (n=21; 28%), and the direct invasion of the kidney by tumor (n=2; 3%). Pathology demonstrated
an absence of kidney invasion in the majority of cases (55 of 75; 73%). Renal capsular invasion was present in 11 of 75 (15%),
renal parenchymal invasion in 7 of 75 (9%), and renal vein invasion in 2 of 75 (3%) of cases. There were no significant differences
in survival based on degree of sarcoma involvement of the kidney, tumor grade, or whether the resection was for primary or
recurrent disease. The 53 patients who underwent a complete gross resection of all tumor had a significantly improved long-term
survival compared to the 20 patients who did not (50% versus 20% DFS at 5 years, respectively; p<0.001).
Conclusions: Decisions for concomitant nephrectomy during resection of retroperitoneal sarcoma should be based on whether this maneuver
will provide a complete resection of all gross tumor, in which case the long-term disease-free survival of 50% is comparable
to the reported 5-year survival of all patients with retroperitoneal sarcoma who are completely resected.
Presented at the 49th Annual Cancer Symposium of the Society of Surgical Oncology, Atlanta, Georgia, March 21–24, 1996. 相似文献
993.
994.
We present our approach to the preoperative preparation and anaesthetic management for awake craniotomy in a 12-year-old boy. Management included conscious sedation with a propofol infusion plus local anaesthetic infiltration of the scalp, periosteum, and dura. The complications which may be encountered during such procedures and their treatments are reviewed. 相似文献
995.
本文报告了小牛胸腺肽(CTP)治疗乙肝患者50例(慢迁肝23例,慢活肝16例,重症肝炎11例)和HBsAg携带者10例的结果,CTP对消除或减轻临床症状和体征,改善肝功能具有明显的疗效,对慢迁肝,慢活肝和重症肝炎的治疗效果基本相同,各组间无显著性差异。对HBV血清学指标无重要改变,对HBsAg携带者疗效不侍。并对剂景、疗程与疗效的关系进行了讨论。 相似文献
996.
Rajendra Nigam MD Richard Schottenfeld MD Thomas R. Kosten MD 《Journal of substance abuse treatment》1992,9(4):305-309
The authors describe the successful use of an adjunctive group psychotherapy for substance-abusing patients with major psychiatric disorders (bipolar, schizophrenia, schizoaffective, psychotic depression, and atypical psychosis). The group utilizes a psychoeducational approach that focuses on substance abuse causes and consequences, principles of recovery, and relapse prevention strategies. Eight patients with prolonged histories of abuse of cocaine, alcohol, marijuana, or other drugs were enrolled in this weekly group treatment at a community mental health center drug treatment program, while continuing in treatment with their current case manager or primary therapist. Six of the eight patients achieved periods of stable abstinence, documented by self-report, urine toxicology screens, continued group attendance, and improved social functioning. Case examples are utilized to illustrate the group process. 相似文献
997.
998.
999.
We have developed a computerized neuromuscular monitoring system (NMMS) using commercially available subsystems, i.e., computer
equipment, clinical nerve stimulator, force transducer, and strip-chart recorder. This NMMS was developed for acquisition
and analysis of data for research and teaching purposes. Computer analysis of the muscle response to stimulation allows graphic
and numeric presentation of the twitch response and calculated ratios. Since the system can store and recall data, research
data can be accessed for analysis and graphic presentation. An IBM PC/AT computer is used as the central controller and data
processor. The computer controls timing of the nerve stimulator output, initiates data acquisition, and adjusts the paper
speed of the strip chart recorder. The data processing functions include establishing control response values (when no neuromuscular
blockade is present), displaying force versus time and calculated data graphically and numerically, and storing these data
for further analysis. The general purpose nature of the computer and strip chart recording equipment allow modification of
the system primarily by changes in software. For example, new patterns of nerve stimulation, such as the posttetanic count,
can be programmed into the computer system along with appropriate data display and analysis routines. The NMMS has functioned
well in the operating room environment. We have had no episodes of electrocautery interference with the computer functions.
The automated features have enhanced the utility of the NMMS. The prime advantages of this system are (1) the ability to customize
its features by altering its controlling programs, (2) the ready availability of the hardware and software, (3) the general
purpose nature of the system, so that it is not limited to this one application, and (4) the adaptable nature of the system. 相似文献
1000.
Treatment for inflammation of the tonsils has taken a variety of therapeutic forms over the years, ranging from the application of iodine and massage in the preantibiotic era to the tonsillectomy, which prevails today. The architecture of the cryptic tonsil, its clinical implications, and the rationale for a conservative, yet effective treatment modality focusing on the tonsillar crypts are addressed in this article. Also described are the procedures and results of a retrospective clinical study in which conventional tonsillectomy was compared with CO2 SwiftLase cryptolysis. Although our observations are not based on a prospective, controlled study, the information disseminated here may be useful to otolaryngologists who routinely perform tonsillectomy in their practice, using conventional surgical dissection methods or the CO2 laser. According to our experience with a population of 120 patients, cryptolysis offers some clear advantages, particularly when performed with the SwiftLase apparatus. The procedure can be performed safely in an ambulatory surgery or office setting under local anesthesia. The cooperative patient avoids the cost and risks of general anesthesia. Limited tissue destruction significantly reduces operative and postoperative complications, discomfort, and recovery time. To conclude, CO2 SwiftLase cryptolysis is a safe and cost-effective method of treating tonsil pathology without unnecessary sacrifice of the organ, and undue risks and expenses to the patient.11,12 相似文献