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21.
D H Char J R Castro J M Quivey T L Phillips A R Irvine R D Stone S Kroll 《Ophthalmology》1989,96(12):1708-1715
The optimum radiation therapy for uveal melanoma is uncertain. Both helium ion irradiation and 125I brachytherapy have been used to treat this neoplasm. This investigation analyzed the control and complication rates of uveal melanomas treated with helium ions of 125I plaques. In both a retrospective and a prospective dynamically balanced study, the control rates appeared to be similar. There were more posterior segment complications after 125I plaques and more anterior segment complications, including neovascular glaucoma, after helium ion irradiation. The follow-up period is too short to draw definitive conclusions on the radiation complications. Overall, approximately 89% of eyes were retained and less than 4% of treated eyes were removed because of failure to control the tumor. 相似文献
22.
Controlled study of haloperidol, pimozide and placebo for the treatment of Gilles de la Tourette's syndrome 总被引:5,自引:0,他引:5
E Shapiro A K Shapiro G Fulop M Hubbard J Mandeli J Nordlie R A Phillips 《Archives of general psychiatry》1989,46(8):722-730
The results of this controlled study of the treatment of 57 patients with Gilles de la Tourette's syndrome suggested that both haloperidol and pimozide were more effective than placebo, but that haloperidol was slightly more effective than pimozide. Adverse effects occurred more frequently with haloperidol vs placebo than with pimozide vs placebo, but the frequency was not significantly different for haloperidol compared with pimozide. Clinically significant cardiac effects did not occur at a maximum dosage of 0.3 mg/kg or 20 mg/d for pimozide and 10 mg/d for haloperidol. However, the QTc interval was prolonged during pimozide treatment compared with that during haloperidol treatment, although the values for both medications were not in an abnormal range. 相似文献
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24.
Sobel Somani Leslie D Mackeen Yair Morad J Raymond Buncic Derek C Armstrong John H Phillips Alex V Levin 《Journal of AAPOS》2003,7(1):54-59
PURPOSE: To determine whether 3-dimensional ultrasonography (3D US) provides information about anatomy and position of extraocular muscles to better guide surgeons approaching strabismus in patients with craniosynostosis who often have anomalous or absent eye muscles. METHODS: The 4 rectus eye muscles were imaged using 3D US for 7 children with craniosynostosis before or after strabismus surgery. Reconstructed 3D images were interpreted as having normal or abnormal anatomy and position, based on comparison with images acquired from 6 normal eyes. Interpretation was validated against the intraoperative findings from strabismus surgery. RESULTS: A total of 34 scans from the study group were used for comparison and validation purposes. Accuracy of anatomical assessments was 85% +/- 12% (percentage +/- confidence interval) and of positional assessments was 62% +/- 16%. Sensitivity and specificity of anatomical assessments was 80% +/- 14% and 88% +/- 10%, respectively. Anatomic anomalies detected by 3D US included excessively thick, thin, scarred and fibrotic, and absent muscles. Sensitivity and specificity of positional assessments was 48% +/- 17% and 85% +/- 12%, respectively. Positional anomalies such as muscle displacement off the normal clock hour axis or posteriorly displaced insertion were also detected. CONCLUSIONS: The 3D US may have an adjunctive role in determining anatomy and position of rectus muscles in patients with craniosynostosis, although it was more accurate in assessing anatomic features rather than positional features of rectus muscles. 相似文献
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26.
Role of Multiple Scouting Biopsies before Mohs Micrographic Surgery for Extramammary Paget's Disease 总被引:3,自引:0,他引:3
Appert David L. MD Otley Clark C. MD Phillips P. Kim MD Roenigk Randall K. MD 《Dermatologic surgery》2005,31(11):1417-1422
Background. Extramammary Paget's disease (EMPD) frequently extends subclinically, resulting in high recurrence rates after surgical excision. Mohs micrographic surgery (MMS) improves cure rates but may require time-consuming reexcision of subclinical extension. A mechanism to estimate the location and extent of subclinical extension would be helpful.
Objective. To describe and evaluate a technique for multiple scouting biopsies before MMS for EMPD.
Method. A retrospective review of patients at Mayo Clinic who had multiple scouting biopsies before MMS for EMPD without dermal invasion.
Technique. The clinical extent of EMPD is identified. The scouting biopsy sites are determined and documented with photographs. The scouting biopsy specimens are sent for permanent sections. The results of the scouting biopsies help guide the extent of the initial Mohs layer. The tumor is cleared with MMS. An additional 1 mm peripheral margin of tissue is usually submitted for permanent sections.
Results. Multiple scouting biopsies were done in five patients. Four of the five patients had at least one true-positive result. At least one true-negative result was obtained in all five patients. Two patients had at least one false-negative result.
Conclusion. Multiple scouting biopsies before MMS for EMPD without dermal invasion can be a beneficial adjuvant technique.
DAVID L. APPERT, MD, CLARK C. OTLEY, MD, P. KIM PHILLIPS, MD, AND RANDALL K. ROENIGK, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. 相似文献
Objective. To describe and evaluate a technique for multiple scouting biopsies before MMS for EMPD.
Method. A retrospective review of patients at Mayo Clinic who had multiple scouting biopsies before MMS for EMPD without dermal invasion.
Technique. The clinical extent of EMPD is identified. The scouting biopsy sites are determined and documented with photographs. The scouting biopsy specimens are sent for permanent sections. The results of the scouting biopsies help guide the extent of the initial Mohs layer. The tumor is cleared with MMS. An additional 1 mm peripheral margin of tissue is usually submitted for permanent sections.
Results. Multiple scouting biopsies were done in five patients. Four of the five patients had at least one true-positive result. At least one true-negative result was obtained in all five patients. Two patients had at least one false-negative result.
Conclusion. Multiple scouting biopsies before MMS for EMPD without dermal invasion can be a beneficial adjuvant technique.
DAVID L. APPERT, MD, CLARK C. OTLEY, MD, P. KIM PHILLIPS, MD, AND RANDALL K. ROENIGK, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. 相似文献
27.
The response of the unattached 218Po activity size distribution to variations in H2O and SO2 concentration was investigated in a high-purity N2 atmosphere. Lognormal size distributions were reconstructed from screen diffusion battery data using a random search and optimization procedure. For relative humidities of 1% to 90%, SO2 concentrations of 0-6 ppm, and residence times of 38 s, median diameters of the unattached mode ranged from 0.50 (+/- 0.04) to 0.80 (+/- 0.06) nm, corresponding to diffusion coefficients of 0.1-0.05 cm2 s-1. Increases in water vapor concentration resulted in an enhanced rate of ion neutralization and suppression of ion cluster formation. Decreases in cluster diameter with increasing humidity were therefore observed. Addition of SO2 at constant relative humidity resulted in an initial increase in diameter, with a subsequent decrease. Geometric standard deviations averaged 1.05 (+/- 0.01) to 1.06 (+/- 0.01) in all cases, with the unattached fraction comprising 83% to 88% of the total distribution. Results suggest that increases in water vapor concentration enhance neutralization in the immediate vicinity of the recoil path through water radiolysis. Conversion of OH to H2OSO4 on addition of SO2 provides a binary condensable phase capable of clustering around the ion at low relative humidities, increasing particle size. High H2O and SO2 concentrations enhance neutralization through electron scavenging and subsequent ion collision near the end of the recoil path, decreasing the number of available cluster sites and suppressing cluster formation. This reduction is more significant than the increasing size of the stable ion cluster, with increasing H2O and H2SO4 concentrations as predicted by Raes, resulting in decreases in both median diameter and distribution spread. 相似文献
28.
29.
30.
The importance of intraoperative cholangiography during laparoscopic cholecystectomy 总被引:4,自引:0,他引:4
E H Phillips G Berci B Carroll L Daykhovsky J Sackier M Paz-Partlow 《The American surgeon》1990,56(12):792-795
Laparoscopic cholecystectomy (LC) using electrocoagulation was successfully performed in 56 out of 58 selected patients. Cholangiography was performed in 53 patients. Six patients had common duct stones; five were unsuspected preoperatively. After the gallbladder was removed, three patients underwent open common duct exploration. In another five cases, anatomical anomalies were discovered. Cholangiography performed via the cystic duct before any structures are divided can prevent the most serious complication--common duct injury. Cholangiography should be attempted on all patients undergoing LC. 相似文献