Ectopic orbital meningioma is a rare tumor usually affecting the medial orbit. We present two cases that occurred in a 56-year-old woman and a 28-year-old man. The tumors in both patients were subtotally excised via orbitotomy surgery and were located in the superior quadrant in one of our patients and in the temporal quadrant in the other. Following histopathologic diagnosis, external beam radiotherapy (EBRT) was administered to one patient and intensity modulated radiotherapy to the other. We identified 12 other well-documented cases of ectopic orbital meningioma previously reported. Ectopic meningioma should be considered in the differential diagnosis of medial as well as lateral and superior orbital tumors. The tumor is usually well circumscribed but can be ill defined in imaging studies. There are intralesional calcifications and sclerosis of adjacent bone in some cases. Ectopic orbital meningioma can recur after incomplete excision. Based on the efficacy of EBRT in optic nerve sheath meningioma, we used this treatment to decrease the risk of recurrence in our two patients and found no tumor recurrence at follow-ups of 24 and 74 months, but one patient had severe vision loss from radiation retinopathy. 相似文献
Up to 136 laboratories participated in a joint effort to assess the trueness of routine measurements for 14 serum components. An unmodified, fresh‐frozen human serum (“IMEP‐17 Material 1”), produced for an international inter‐laboratory comparison, served as the “master material”. The serum had assigned values of the highest available metrological quality, and is assumed to involve no or negligible commutability problems. The material was used in the assignment of traceable values to two other reference sera, “CAL” and “X”, through parallel measurements on the three materials according to a common protocol. In this transfer process, uncertainty estimates were provided for all values. The material CAL had been supplied with reference measurement procedure values in 1997, and the two sets of assigned values agreed well. A lyophilized control serum “HK02” was also included in the routine analysis series. It, too, had assigned values based on reference measurement procedures. Significant matrix effects were found. The project has provided:
Assigned traceable values for 14 components in a fresh‐frozen serum, available to Nordic laboratories for the coming years as “NFKK reference serum X”.
Confirmation of earlier assigned reference measurement procedure values for a number of components in CAL, the main calibrator in the Nordic Reference Interval Project (NORIP). The transferred values will now serve as the primary reference.
Evidence of long‐term stability (≥5 years) of the fresh‐frozen serum CAL when stored at ?80°C.
Evidence of substantial matrix effects in the processed serum HK02. The findings should be used to discuss to what extent reference measurement procedure values are useful and cost‐efficient for this type of material.
External fixation of the pelvic girdle was used in a consecutive series of ten female patients suffering from suspected chronic instability of the sacro-iliac joint. The condition was attributed to pelvic relaxation after pregnancy in seven patients and to trauma in three.External fixation of the pelvis with a trapezoid frame reduced the average radiographic displacement of the symphysis from 5.0 to 2.4 mm in eight patients, relieved the dorsal pain in seven, and markedly improved walking ability in five. Seven of the ten patients were subsequently subjected to an anterior sacro-iliac joint arthrodesis in which square compression plates and autogenous bone grafts were used. At follow-up examination five of these patients were improved, and two unchanged. The results suggest that external fixation of the pelvis is useful in assessing painful sacro-iliac joint instability and should precede surgical intervention. 相似文献
Background. Many prehospital cardiac arrests occur in public places. Even the best EMS systems have a finite response time. Therefore, it has been recommended that automated external defibrillators (AEDs) be placed in public areas for immediate access by trained members of the general public. Objective. To determine the locations of multiple cardiac arrests in order to plan for placement of public-access AEDs. Methods. Retrospective review of all primary cardiac arrests in calendar year 1997. Cardiac arrests in which resuscitation was not attempted (DOA), traumatic cases, pediatric cases, and those due to “other” causes were excluded. Location of the cardiac arrest was obtained from the ambulance run ticket. The EMS system is an urban, Midwestern, all-ALS, public-utility model system with fire department first re-sponders that transports approximately 58,000 patients annually. Results. There was scene response to 922 cardiac arrests. 377 DOAs and 219 nonprimary cardiac arrests were excluded. There were 326 primary cardiac arrests. Sixteen locations had more than one cardiac arrest: ll locations had two cardiac arrests, four locations had three cardiac arrests, and one location had four cardiac arrests. The airport, an airline overhaul facility, a casino, and two hotels each had two cardiac arrests; the other Iocations of multiple cardiac arrests were in nursing homes. The Professional sports stadiums had no cardiac arrests. Conclusions. Since very few locations had more than one cardiac arrest, it may be difficult to identify high-yield public places in which to place an AED. Nursing homes may want to consider AED availability. 相似文献
The authors have successfully implemented automated external defibrillation (AED) training in police departments that function as first responders. The initial elements are to think the project through, and to develop clear policies and procedures for the police as they relate to dispatching so there is timeliness of notification, because response time is such a critical element. Roles for all of the participants must be clearly defined and understood by all parties for such aspects as scene management, scene responsibility of care, and transfer of care to the receiving facilities. Communication to the entire health care community that the police have an expanded role in defibrillation is desirable. A system to evaluate training, compliance with protocol, and efficacy must be developed and closely monitored. While this is a tremendous amount of work and a large time investment, the result can be a dramatic increase in patient survival. 相似文献
Objective. Rates of resuscitation from cardiac arrest are directly tied to time to defibrillation. To maximize results, the first arriving care provider should be equipped and trained to defibrillate. This would include police in those systems where they serve this function; to date, no training program has been examined for effectiveness in this group. The purpose of this study was to evaluate a training program designed to train police first respondes in the use of an automated external defibrillator (AED). Methods. One hundred seventy police officers previously trained to the level of first responders underwent a four-hour course to teach incorporation of the AED in their practice. The evaluation of police performance was assessed by written tests prior to, immediately after, and six months post initial training. Actual field use was evaluated by using separate data collection forms filled out at the time of the resuscitation by both police and EMS providers. Each trip sheet was also reviewed. Cassette tapes from the AED were reviewed for continuous ECG tracings and audio recordings to validate and confirm the previous data. Results. One hundred twenty-eight police cases were reviewed. The officers performed with few errors in AED operation, with the only problem areas being incorrect airway management and delay in performance of CPR to use the AED to reanalyze a nonshockable rhythm. These results were compared with those of the only two other studies examining the performance of first responders, which were EMTs and firefighters. The police results compared favorably with, and in some instances exceeded, those results. Conclusion. Police first responders trained in the use of AEDs performed at a level equivalent or superior to that in other reported studies. Future training strategies should stress proper integration of airway and CPR skills. 相似文献
This paper presents data from studies that have compared the efficacies of biphasic truncated exponential (BTE) and monophasic damped sine (MDS) waveform defibrillation in patients with out-of-hospital cardiac arrest and in in-hospital defibrillation. When a shock is delivered, rhythms evolve rap-idly in a variety of directions and take different courses, even over a short time. When defibrillation is defined as termination of ventricular fibrillation at 5 seconds postshock, whether to an organized rhythm or asystole, low-energy BTE shocks appear to be more effective than high-energy MDS shocks in out-of-hospital arrest. For future research, the terms associated with defibrillation should be standardized and used uniformly by all investi-gators. In particular, there should be an agreed-upon definition of shock efficacy. 相似文献