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81.
MM Latham GP Smart B Hedland-Thomas CS Harper 《Journal of Medical Imaging and Radiation Oncology》1997,41(4):357-360
Early-stage squamous cell carcinoma of the larynx is usually treated with local field radiotherapy. Surgery is used for salvage following recurrence. Further recurrences present a more difficult therapeutic problem which requires individualized management. The aims of local control, survival, maintenance of function and minimizing side effects all need to be balanced according to the site and extent of disease. The present case study looks at the management of a 54-year-old man with multiple recurrences from a squamous cell carcinoma of the larynx. It describes a technique of endoluminal brachytherapy using an iridium-192 wire spiralled around the outer part of a tracheostomy tube that achieves good local control while enabling self-insertion and self-cleaning during the procedure. The dose given was 2500 cGy at 5 mm over 25.2 h and was achieved with minimal early or delayed side effects. The patient had no further symptoms relating to the stomal recurrence until his death from metastatic disease 6 months later. 相似文献
82.
A qualitative study of women's views about how health professionals communicate about infant feeding 总被引:2,自引:0,他引:2
Objective
To look at how communication by health professionals about infant feeding is perceived by first time mothers.Design
Qualitative semi‐structured interviews early in pregnancy and 6–10 weeks after birth.Subjects and setting
Twenty‐one white, low income women expecting their first baby were interviewed mostly at home, often with their partner or a relative.Results
The personal and practical aspects of infant feeding which were important to women were seldom discussed in detail in ante‐natal interviews. In post‐natal interviews women described how words alone encouraging them to breastfeed were insufficient. Apprenticeship style learning of practical skills was valued, particularly time patiently spent watching them feed their baby. Women preferred to be shown skills rather than be told how to do them. Some felt pressure to breastfeed and bottle feeding mothers on post‐natal wards felt neglected in comparison. Women preferred their own decision‐making to be facilitated rather than being advised what to do. Some women experienced distress exposing their breasts and being touched by health professionals. Continuity of care and forming a personal relationship with a health professional who could reassure them were key factors associated with satisfaction with infant feeding communication.Conclusions
The infant feeding goal for many women is a contented, thriving baby. In contrast, women perceive that the goal for health professionals is the continuation of breastfeeding. These differing goals can give rise to dissatisfaction with communication which is often seen as ‘breastfeeding centred’ rather than ‘woman centred.’ Words alone offering support for breastfeeding were often inadequate and women valued practical demonstrations and being shown how to feed their baby. Spending time with a caring midwife with whom the woman had developed a personal, continuing relationship was highly valued. Women were keen to maintain ownership, control and responsibility for their own decision‐making about infant feeding.83.
含巨菊形团的玻璃样变梭形细胞肿瘤 (HSCTGR)是近年来才被命名的间叶性肿瘤 ,光镜下类似低度恶性纤维粘液肉瘤。作者观察了 3例HSCTGR的光镜、电镜及免疫组化表现。3例中男性 2例 ,分别为 41和 5 4岁 ,女性 1例 ,6 2岁。肿瘤位于深部软组织 ,2例在下肢 ,1例在上臂。大体上 ,最大径 3~ 13 3cm不等 ,境界清楚 ,呈棕红色或黄白色 ,质实 ,可伴囊性变 ,其中发生于小腿的 1例合并有股骨骨肉瘤 ,小腿部肿块仅做了活检。光镜下 3例图像相似 ,均有纤维粘液样区 ,2例伴有玻璃样变 ,1例有灶性骨化。肿瘤细胞为温和的卵圆形至梭形细胞 ,… 相似文献
84.
M Dakkak MD MRCP BP Jones MB ChB GP MGB Scott MB ChB MRCGP PJH Tooley MB BS MRCGP JR Bennett MD FRCP 《International journal of clinical practice》1994,48(1):10-14
SUMMARY Patients with endoscopically confirmed oesophagitis (n=49) were treated for 8 weeks with either cisapride (10 mg four times a day) or ranitidine (150 mg twice a day) in a double-blind study in general practice. Mean overall symptom scores fell from 10.8 to 4.5 in the cisapride group and from 9.9 to 4.4 in the ranitidine group over the course of the study. The proportion of patients reporting improvements in individual symptoms in the two treatment groups (cisapride and ranitidine respectively) were: heartburn, 66% and 55%; acid regurgitation, 53% and 47%; epigastric pain, 60% and 52%; satiety, 57% and 47%; bloating, 69% and 71%; belching, 65% and 72%; nausea, 62% and 85%; vomiting, 77% and 66%; poor appetite, 50% and 75%. Improvement in the endoscopic grade of oesophagitis was observed in 66% of patients receiving cisapride and 63% of those receiving ranitidine. It was concluded that cisapride is as effective as ranitidine in relieving the symptoms of oesophagitis and in healing oesophageal erosions. 相似文献
85.
86.
Ferreri AJM; Dolcetti R; Musto P; Dognini GP; Doglioni C; Ponzoni M 《Annals of oncology》2007,18(2):401-403
According to the interesting letter from Arnaud et al. [1],the prevalence of hepatitis C virus (HCV) infection in ocularadnexal lymphoma (OAL) patients diagnosed at the Institut Curieis 2%, which is significantly lower compared with the 13% observedin our series [2]. Intriguingly, the single French patient withOAL and HCV infection displayed a disseminated lymphoma andwas the sole patient who died of lymphoma progression, whichis in line with the negative prognostic 相似文献
87.
88.
89.
Hydroxyurea increases hemoglobin F levels and improves the effectiveness of erythropoiesis in beta-thalassemia/hemoglobin E disease 总被引:5,自引:0,他引:5
Fucharoen S; Siritanaratkul N; Winichagoon P; Chowthaworn J; Siriboon W; Muangsup W; Chaicharoen S; Poolsup N; Chindavijak B; Pootrakul P; Piankijagum A; Schechter AN; Rodgers GP 《Blood》1996,87(3):887-892
Hydroxyurea (HU) is one of several agents that have been shown to enhance hemoglobin (Hb) F levels in patients with sickle cell disease and may be useful as a therapy for beta-globinopathies. However, limited information exists on the effects of HU in patients with thalassemia. Accordingly, we examined the hematologic effects of orally administered HU in 13 patients with beta-thalassemia/Hb E, including four patients who had been splenectomized. These patients were treated with escalating doses (final range, 10 to 20 mg/kg/d) for 5 months and were observed in the outpatient hematology clinic every 2 to 4 weeks. Complete blood counts including reticulocyte counts, amounts of Hb E and Hb F, G gamma:A gamma and alpha:non-alpha globin biosynthetic ratios were evaluated before and during treatment. Almost all patients responded with an average increase of 33% in Hb F levels, from a mean (+/- SD) of 42% +/- 11% to 56% +/- 8% (P < .0001), and a reciprocal decline in the percentage of Hb E from 59% +/- 9% to 49% +/- 8% (P < .001). Reticulocytosis was decreased from a mean (+/- SD) of 18.0% +/- 15.6% to 11.7% +/- 9.1% (P < .05); there was also a slight (10%) but statistically significant increase in hemoglobin levels and an improved balance in alpha:non-alpha globin chains ratios. The side effects were minimal in most patients, although these patients tended to tolerate a lower dose of HU before significant myelosuppression than has been our previous experience in sickle cell disease. One splenectomized patient died of sepsis during the trial. We conclude that increased Hb F production in beta-thalassemia/Hb E patients, with an improvement in the alpha:non-alpha globin ratios and, probably, the effectiveness of erythropoiesis, can be achieved using HU. Longer trials of HU in this population, including at other doses and in combination with other agents, appear warranted. 相似文献
90.
Mononuclear leukocytes isloated from the blood of previously treated patients with advanced active Hodgkin disease contained high concentrations of monocytes and showed poor lymphocyte blastogenesis to mitogens. In five of eight patients with disseminated disease, blastogenesis became normal or improved markedly when the leukocyte suspensions were depleted of monocytes before culture. Addition of autologous macrophages to the monocyte-depleted lymphocytes resulted in a reappearance of the inhibition of blastogenesis. Monocyte inhibition was associated with the presence of active disease, lymphocytopenia, and low lymphocyte/monocyte ratios in the peripheral blood. The role of previous treatment is uncertain, since inhibition tended to disappear when the patients were retreated. Inhibitory monocyte-lymphocyte interactions may be one of the causes of impaired cell-mediated immunity in Hodgkin disease. 相似文献