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101.
Gastroduodenoscopy and retrograde cholangiopancreatography has been performed on 25 occasions in 20 children aged between 7 and 16. Radiographs of the clinically relevant duct or ducts were achieved in 96% of attempts, with no complications. The diagnostic information proved useful clinically; in particular it provided a precise map if biliary or pancreatic surgery was being contemplated. Several unexpected congenital duct anomalies were found. This and other recent reports, particularly from Germany, indicate that endoscopic retrograde cholangiopancreatography deserves greater application in children, and can also be used in babies. 相似文献
102.
103.
Badgwell B Cormier JN Xing Y Yao J Bose D Krishnan S Pisters P Feig B Mansfield P 《Annals of surgical oncology》2009,16(1):42-50
The purpose of this study was to determine the outcome of surgery for patients with recurrent gastric or gastroesophageal
cancer. We queried records from 7,459 patients who presented with gastric or gastroesophageal cancer to our institution from
1973 through 2005 to identify those for whom resection of recurrent disease had been attempted. We assessed the associations
between various clinicopathologic factors and resectability with logistic regression analysis and between clinicopathologic
factors and overall survival (OS) with the Cox proportional hazards model. Sixty patients underwent attempted resection for
recurrent cancer. In 31 cases (52%), recurrent disease proved unresectable at laparotomy. Factors associated with the ability
to undergo re-resection included neoadjuvant treatment prior to initial resection [odds ratio (OR) 12.2, 95% confidence interval
(CI) 1.9–75.6] and having an isolated local recurrence (OR 5.1, 95% CI 1.3–20.5). Of the 29 patients who underwent re-resection,
14 required adjacent organ resection, and 6 required interposition grafting. Three- and 5-year OS rates for all 60 patients
were 21% and 12%, respectively; median follow-up time was 23 months. Median OS for patients undergoing resection was 25.8 months
(95% CI 17.1–49.8) versus 6.0 months (95% CI 4.0–10.5) for unresectable patients (P < 0.001). Initial tumor location at the gastroesophageal junction was associated with diminished OS [hazard ratio (HR) 2.8,
95% CI 1.2–6.5] and ability to undergo resection of recurrence was associated with improved OS (HR 0.2, 95% CI 0.1–0.6). We
conclude that surgical resection of select patients with recurrent gastric or gastroesophageal cancer can result in improved
OS but often requires adjacent organ resection or interposition graft placement. 相似文献
104.
105.
C M Mansfield 《Cancer》1990,66(1):1-5
Patients with early breast cancer (T1-2 N0-1) can be treated by lumpectomy and irradiation with a local control and survival equal to more radical surgery. Between 1982 and 1988, 323 patients with early breast cancer were treated, when possible, with Ir-192 implants at the time of lumpectomy to a local dose of 2000 cGy in 40-50 hours. Ten to 14 days later, the whole breast was treated to 4500 cGy at 180 per fraction in 5 weeks. The 6-year actuarial survival for stages I and II disease was 98% and 91%, respectively, and the recurrence-free survival was 96% and 98%, respectively. When these 323 patients were evaluated by T status, a local control of 97% was the same for T1 and T2 lesions. The cosmetic results were good to excellent in 95% of the patients. This approach has improved our ability to accurately place the boost dose in the breast. 相似文献
106.
107.
108.
Hypodermoclysis is a method of subcutaneous fluid administration particularly useful in elderly patients and in palliative care settings where intravenous access may be difficult. Subcutaneous fluid delivery is an effective method of rehydration and of opioid administration, and can prevent the need for intravenous catheterization and consequently hospitalization. It is a simple procedure to initiate, safe, less distressing to the patient, and does not predispose to intravascular related infections. The reported incidence of infection at the delivery site is extremely low. However, local guidelines should be agreed so that a standardized protocol is operated and risks of localized infection are minimized. 相似文献
109.
110.
P Mansfield D N Guilfoyle R J Ordidge R E Coupland 《Physics in medicine and biology》1986,31(2):113-124
The high-speed echo-planar imaging (EPI) technique is used to obtain rapid T1 and spin density measurements by a two-point method. It is shown that neglect of edge effects in the slice selection procedure leads to significant systematic errors in T1. T1 maps for two young patients, obtained at 4.0 MHz, are presented. The T1 and spin density values obtained are used to produce computer-generated images in inversion recovery simulations. These results demonstrate marked improvement in image contrast without paying the time penalty incurred in real experiments, thereby greatly increasing patient throughput potential. 相似文献