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Edwin O. Onkendi Travis J. McKenzie Melanie L. Richards David R. Farley Geoffrey B. Thompson Jan L. Kasperbauer Ian D. Hay Clive S. Grant 《World journal of surgery》2014,38(3):645-652
Background
Intense postoperative monitoring has resulted in increasing detection of patients with recurrent papillary thyroid cancer (PTC). Our goals included quantifying successful reoperation, and analyzing surgical complications and reasons for relapse.Methods
From 1999 to 2008, a total of 410 patients underwent reoperation for PTC relapse. We analyzed post-reoperative disease outcomes, reasons for relapse, and complications.Results
Bilateral reoperative thyroidectomy was performed in 13 (3 %) patients; lobectomy, 34 (8 %); central neck (VI) soft tissue local recurrence excision, 47 (11.5 %); bilateral VI node dissection, 107 (26 %); unilateral VI dissection, 112 (27 %); levels II–V dissection, 93 (23 %); levels III–V, 86 (21 %); lateral single- or two-compartment dissection, 51 (12 %); and node picking, 20 (5 %) of level VI and 53 (13 %) lateral neck. Complications occurred in 6 %; including hypoparathyroidism, 3 %; unintentional recurrent laryngeal nerve (RLN) paralysis, 3 %; phrenic nerve injury, 0.5 %; spinal accessory nerve injury, 0.5 %; and chyle leak in 1.6 %. Of 380 (93 %) patients with follow-up (mean 5.2 years); 274 (72 %) patients are alive with no structural evidence of disease, 38 % developed disease relapse (mean 2.1 years), 42 (11 %) died from PTC, and 55 (14 %) are alive with disease. The reason for relapse was a false negative pre-reoperative ultrasound (US) in 18 (5 %), nodal recurrence in the operative field in 37 (10 %), a combination of these two reasons in 10 (3 %), and disease virulence (local or systemic recurrence) in 81 (21 %).Conclusions
Although 72 % of patients were rendered structurally disease free after reoperation, nearly 40 % suffered additional relapse. Improved surgical technique or preoperative localization might positively affect 15–20 %; at least 20 % reflect the biologic aggressiveness of the disease. 相似文献4.
GM Durbin NJ Hunter N McIntosh EO Reynolds PD Wimberley 《Archives of disease in childhood》1976,51(3):163-169
A controlled trial of elective intervention with continuous inflating pressure (CIP) was performed in infants with severe hyaline membrane disease who weighed more than 1000 g at birth. Infants entered the trial if their arterial oxygen tension (PaO2) fell below 60 mmHg while breathing a fractional inspired oxygen concentration (F1O2) greater than 0-95. 11 out of 12 infants in the CIP-treated group and 10 out of 12 in the control group survived. 7 treated and 6 control infants required mechanical ventilation. When CIP was started the Pao2 of the treated infants increased, and they breathed high concentrations of oxygen for a significantly shorter period than the control infants. During the 31-month duration of the trial 107 other infants with severe hyaline membrane disease were admitted who did not meet the criteria for entry to the trial. 37 survived after breathing high concentrations of oxygen (F1O2 greater than 0-60) spontaneously without any ventilatory assistance, and the remaining 70 infants were already being ventilated on their arrival in the unit, usually because they had required mechanical ventilation during transfer from other hospitals. The neonatal survival rate for those infants born in this hospital during the study period was 88% (50 out of 57 infants) and for those referred from other hospitals it was 69% (51 out of 74 infants). The maximum further increase in overall survival rate that might have been achieved in our population of infants if CIP had been initiated very early in the course of the illness was 5%--i.e. from 77% (101/131) to 82% (107/131). 相似文献
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Mewissen MW; Erickson SJ; Foley WD; Lipchik EO; Olson DL; McCann KM; Schreiber ER 《Radiology》1989,173(1):155-157
Color Doppler flow imaging or compression ultrasound (US) was used to prospectively determine frequency of thrombosis at 54 venous insertion sites (47 in common femoral veins, seven in right internal jugular veins) after percutaneous placement of Greenfield filters for interruption of the inferior vena cava. Fifty-one filters were successfully placed in 51 patients with a dilator set or a balloon angioplasty catheter. Nine focal thrombi were detected in the common femoral vein (19%) and one in the right internal jugular vein (14%). Use of dilators induced eight thrombi (24%), compared with two (10%) from balloon catheters. The left common femoral vein had a high frequency of thrombosis, regardless of dilation technique (five of nine). Of nine patients with acute common femoral vein thrombosis, four became symptomatic within 10 days after the procedure. Patients may remain asymptomatic or have delayed symptoms; thus, US is valuable for determining patients at risk of thrombosis of the common femoral vein. 相似文献
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Lineage-restricted regulation of the murine SCL/TAL-1 promoter 总被引:10,自引:2,他引:10
Bockamp EO; McLaughlin F; Murrell AM; Gottgens B; Robb L; Begley CG; Green AR 《Blood》1995,86(4):1502-1514
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Onkendi EO Boostrom SY Sarr MG Farnell MB Nagorney DM Donohue JH Kendrick ML Lombardo KM Haddock MG Que FG 《Journal of gastrointestinal surgery》2012,16(2):320-324
Aim
To evaluate the role of neoadjuvant chemoradiation therapy and rescue surgery in the management of unresectable or recurrent duodenal adenocarcinoma. 相似文献10.
1. In order to determine whether 5HT2 receptor antagonists can modify Ca2+ uptake via voltage-operated Ca2+ channel (VOC) in arterial smooth muscle, a comparative study of the effects of selected Ca2+ uptake blockers and 5HT2 receptor antagonists on K+-induced contractions of rat aortic strip was undertaken. 2. The antagonist drugs studied included the Ca2+ uptake blockers verapamil, nifedipine, felodipine, diltiazem and cin-narizine, the 5HT2 receptor antagonists cyproheptadine, ritanserin, mianserin, and ketanserin and the α1-adrenoceptor antagonist prazosin. 3. With the notable exception of prazosin, each of these compounds diminished K+-induced aortic responses. 4. The following order of potencies (mean IC50 values in mol/L) was established: felodipine (7.0 × 10-11) >nifedipine (4.8 × 10-9) >verapamil (5.5 × 10-8) >cyproheptadine (6.2 × 10-8) > diltiazem (4.1 × 10-7) >cinnarizine (1.3 × 10-6) >ritanserin (1.8 × 10-6) >ketanserin (9.0 × 10-6) > mianserin (2.0 × 10-5). 5. The results suggest that antagonists of 5HT2 receptors can modulate Ca2+ uptake via VOC in rat aorta. 相似文献