摘要:

Forehead skin temperature measured by a strip of liquid-crystal material was compared to esophageal, rectal, and axillary temperatures measured by thermistor probes in patients having general anesthesia for coronary artery bypass grafting. Before extracorporeal circulation, forehead skin temperature was lower than axillary, rectal, and esophageal temperatures by approximately 2.2 C (4.0 F). During rapid warming, forehead skin temperature rose concurrently with the other temperatures measured but remained significantly different. The liquid-crystal strip may be useful as a safe, convenient method for routine monitoring of temperature trends during general anesthesia in patients whose exact core temperature need not be continuously monitored. We believe that infants, patients undergoing extracorporeal circulation, major abdominal, vascular, or neurosurgical procedures, or patients with a history of temperature regulatory problem are probably best monitored by a method which more exactly reflects core temperature.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

We reviewed 76 cases of small cell bronchogenic carcinoma seen at the University of South Florida Medical Center. One third of the 55 patients who have subsequently died did so within one month of diagnosis. Thirty-five patients were treated with cyclophosphamide, adriamycin, vincristine, and radiation therapy including prophylactic cranial irradiation. Of these 35 patients, 40% demonstrated a complete remission for a total objective response rate of 63%. The projected median survival of patients referred for study is 14 months. Improved survival was found in patients less than 60 years of age, with limited disease, who responded to treatment and in whom there were no violations of protocol. Patients treated with combination therapy appear to survive longer than untreated patients and those treated with radiation therapy alone. Toxicity was tolerable and there were no deaths related to treatment. Small cell bronchogenic carcinoma is a rapidly progressive systemic disease responsive to multimodality therapy with long-term survival in some patients.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

National survival statistics for breast cancer victims are basically the same today as they have been for the last 50 years. Less than 60% survive five years after diagnosis, and they frequently must accept mutilating results of treatment. To improve this bleak picture, our efforts should be directed toward prevention. One aspect of prevention would be to identify the breasts most likely to develop malignancies and remove the breast tissue with planned restoration of contour. Subcutaneous mastectomy and immediate insertion of Silastic gel prostheses has not met with the desired results either medically or esthetically. The complications with this procedure are numerous, and there is an unnatural “cystic” appearance on the chest wall with a thin skin covering through which the prostheses can be palpated. We advocate subcutaneous mastectomy with appropriate fixation of the nipples and areolae on the pectoral muscle and fascia, followed several months later by subpectoral augmentation. This two-staged procedure has proved to be a reliable one with few serious complications. It is hoped it will play a significant role not only in reducing the mortality associated with breast cancer but also in lessening the undesirable psychologic impact of the loss of breasts.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A surgically treated case of a mesenchymal hamartoma, a rare, benign liver tumor of infants and occasionally children, is reported. The clinical picture is characterized by marked, usually rapid abdominal enlargement. If untreated, the tumor may compromise other organ systems, resulting in death. The treatment is surgical removal. The tumor is characterized by proliferation of collagenous connective tissue, immature mesenchyme, and multiple cysts or pseudocysts of varying sizes. The origin of the tumor has not yet been definitely determined. Ultrasonography combined with radionuclide scanning was useful in establishing a working, preoperative diagnosis.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The combination of clindamycin phosphate and gentamicin sulfate in treating 53 patients with a variety of serious infections was studied. Initial cultures of specimens from 31 patients yielded both anaerobic and aerobic pathogens. Eleven cultures showed only anaerobic organisms and 11 showed only aerobes. Of patients treated with clindamycin and gentamicin and surgical intervention, 87.8% had bacteriologic cure. Clinical response was poor in only two cases. Two patients developed rash and one had diarrhea, but no reactions suggestive of pseudomembranous colitis were seen.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Extracardiac rhabdomyomas are rare benign lesions of striated muscle origin. A review of the world literature revealed about 27 acceptable cases of benign, adult-type rhabdomyoma with a distinct male predominance. In most of the reported cases, the tumor was located in the head and neck region, usually submucosal or deeper. The case reported here is unusual because the tumor was subcutaneously located in the neck. The tumor was fairly well circumscribed, multilobulated, and easily shelled out. Light microscopy showed large round to elongated cells with granular, highly eosinophilic cytoplasm, often with peripheral vacuolation. Cross striations were infrequent. The nuclei were often peripheral and had prominent nucleoli. Electron microscopic studies confirmed the tumor's myogenic origin. Myofibrils with Z band material, abundant mitochondria, and glycogen particles were observed.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

There is sharp disagreement as to what constitutes the proper surgical approach to localized carcinoma of the prostate. We have performed 31 radical perineal prostatectomies in a six-year period with no mortality and minimal morbidity. Thirteen of these patients were understaged preoperatively and had extraprostatic cancer; however, only one has died from his tumor. One patient is incontinent but none has troublesome local symptoms. These patients required an average of 15 postoperative days, none required more than two units of blood, and careful preoperative consultation has minimized the psychologic stress of impotence. These data contrast sharply with the published morbidity and mortality statistics associated with a preliminary staging lymphadenectomy and a definitive radical retropubic prostatectomy. Also, we are convinced that our patients with stage C cancer have been done a real service by removing the prostate gland even though cancer remains in the stumps of the seminal vesicles. Unless the advocates of the staged procedure can demonstrate an improvement in their patients' survival data, we believe the radical perineal prostatectomy remains the procedure of choice for the cure of localized prostatic cancer and we would advocate this operation as an acceptable palliative approach to selected patients with stage C lesions.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A variety of tumors of the parapharyngeal space were operated upon during one training year at the Pack Medical Foundation, New York. These tumors characteristically present as a mass of the upper neck, behind the angle of the mandible and/or as a lateral pharyngeal mass bulging medially. Surgeons who operate in the parapharyngeal space must be thoroughly familiar with the complex anatomy of blood vessels, nerves, and muscles in this area and possess a thorough knowledge of the variety of tumors in this region of the head and neck.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Twenty-two cases of primary urethral malignancy have been diagnosed at the Medical University Hospital from 1955 to 1976. These lesions are uncommon and prognosis is poor except when disease is diagnosed in the early stages and treated aggressively. Anterior lesions are more often diagnosed at an early stage but may be mistaken for benign processes, delaying appropriate therapy. Our experience with urethral malignancies is reviewed and includes an association of carcinoma with urethral caruncles and diverticula. The first reported association of a urethral diverticulum with carcinoma in the male is presented and two additional cases of adenocarcinoma in female urethral diverticula are reported. Excision of urethral caruncles and diverticula is encouraged.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Considering the current state of surgery for intracranial aneurysm, a philosophy for treating intracranial aneurysms associated with other entities is presented. The premise is based on a comprehensive review of the literature relative to the risk factors applied to intracranial aneurysms and personal experience in dealing with the combination of problems of aneurysms diagnosed in association with other intracranial aneurysms, vascular malformations, neoplasms, trauma, and inflammatory diseases. A patient's problem must be considered individually and comprehensively, using all known prognostic factors and the specific features of the case for an appropriate therapeutic regimen to be designed. Current mortality and morbidity rates warrant the surgical intervention for the incidentally diagnosed aneurysm, but the occurrence of an aneurysm in conjunction with another serious entity demands careful, comprehensive evaluation. The surgical challenge of these complex problems should take second priority to a careful therapeutic deliberation to promote the best final outcome.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID