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Laparoscopic pelvic lymph node dissection has been applied as a minimally invasive staging technique for men with prostate cancer. This procedure has been shown to shorten markedly postoperative hospitalization, decrease analgesic requirements and shorten convalescence period compared to open pelvic node dissection. However, the laparoscopic procedure takes longer to perform and many disposable instruments are used, thus increasing the cost. We determine the overall cost of laparoscopic versus open pelvic lymph node dissection. Between January 1989 and April 1992, 61 men underwent only staging pelvic lymph node dissection for cancer of the prostate at a single university teaching hospital. Of these patients 11 and 50 underwent open and laparoscopic pelvic lymph node dissection, respectively. Information from the hospital business office was reorganized into preoperative, intraoperative and postoperative expenses. All individual charges were transformed up or down to the dollar amounts of the 1990 to 1991 fiscal year so as to correct for inflationary changes. Preoperative costs were not significantly different between the 2 operative approaches. Intraoperative expenses were 52% greater if laparoscopic pelvic lymph node dissection was performed and can be explained by the longer operative times and use of disposable instrumentation. However, the postoperative period lasted an average of 1.61 days following laparoscopic pelvic lymph node dissection. Postoperative nursing and analgesic requirements were significantly more for patients undergoing open pelvic lymph node dissection. The overall postoperative costs following open pelvic lymph node dissection were 280% more expensive than for the laparoscopic procedure. The overall total costs were approximately $1,250 more for laparoscopic pelvic lymph node dissection. Wages lost or earned during this period and rapid return to normal activity following laparoscopic pelvic lymph node dissection would, in our opinion, justify this additional cost.  相似文献   
13.
Theory is presented to provide insight into the observation that attenuation through vegetation is proportional to vegetation water content. In this analysis, the canopy is modeled as a sparse layer of randomly oriented particles (leaves, stalks, etc.) over a flat, homogeneous ground plane (soil) and an expression is obtained for the “optical depth”. The formulas developed by Ulaby and El Rayes are used to relate this expression to the water content of the canopy. In the low frequency extreme (Rayleigh scatterers), the attenuation varies almost linearly with water content and inversely with wavelength. In contrast, in the high frequency limit, the attenuation is independent of both water content and frequency, in between, geometry dependent “resonances” occur even at the low frequency end of the microwave spectrum (e.g. L-band) making the dependence of attenuation on frequency and water content specific to canopy architecture  相似文献   
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OBJECTIVE: Our purpose was to evaluate the feasibility of intrapartum fetal pulse oximetry, the distribution of fetal oxygen saturation values, and the relationship with the neonatal outcome in a population with an abnormal fetal heart rate. STUDY DESIGN: A prospective multicenter observational study was performed from June 1994 to November 1995. Fetal oxygen saturation was continuously recorded with use of a Nellcor N-400 fetal pulse oximeter in case of an abnormal fetal heart rate during labor. Simultaneous readings of fetal oxygen saturation and fetal blood analysis were obtained at inclusion and before birth. Feasibility, adverse effects, distribution of fetal oxygen saturation values, and relationship with neonatal outcome were assessed. RESULTS: One hundred seventy-four patients were included. From 172 attempted sensor placements, the procedure was impossible in three cases and fetal oxygen saturation values were obtained in 164 cases (95.3%). Physicians considered sensor placement an easier task than an attempt at fetal blood analysis (easy in 87.5% vs 78.9% for fetal blood analysis, p = 0.03). The mean reliable signal time (+/- SD) was 64.7% +/- 32% during the first stage. There were no serious adverse effects in the study population. The mean fetal oxygen saturation during the first stage of labor was 42.2% +/- 8.0% (10th to 90th percentile range 30% to 53%). Fetal oxygen saturation was significantly correlated with scalp pH (r = 0.29, p = 0.01) but not with neonatal umbilical artery pH or gas values. There was a significant association between low fetal oxygen saturation (< 30%) and poor neonatal condition. CONCLUSION: The feasibility of fetal pulse oximetry is satisfactory in clinical practice. It is easy to use and provides a fair rate of recorded values, even in a population with suspicion of fetal distress. A low fetal oxygen saturation is significantly associated with an abnormal neonatal outcome.  相似文献   
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The Mn0.23Ga1.85S3 phase belongs to the solid solution ф0, stable at low temperature in the Ga2S3MnS system. It is hexagonal superstructure of the wurtzite, with the Ga2S3α′ type (a = 6.397 A?; c = 18.027 A?Z = 6; space groupe P61 or P65). Its crystal structure has been refined by the least squares method to a final R = 0.06 with 323 independant reflections. This structure is closely related to Ga2S3 α described by Hahn and Frank, and differs only by the partial occupation of the vacant metal site of Ga2S3 by Mn atoms in statistical disorder.  相似文献   
18.
Among the new semiconductor materials for telecom devices, the GaInNAs-GaAs structure presents interesting properties for low-cost applications, like high differential gain and high T/sub 0/. Another key aspect of the performance is the behavior of the GaInNAs-GaAs based lasers under high bit rate direct modulation. Here, we demonstrate the dynamic capabilities of GaInNAs-GaAs three-quantum-well ridge structure through 2.5-Gb/s directly modulated laser emission and transmission on standard fiber, in the temperature range 25/spl deg/C-85/spl deg/C. Besides transmission is demonstrated up to 10 Gb/s at 25/spl deg/C on the same fiber, without penalty and bit-error-rate floor.  相似文献   
19.
In this paper we consider two performance modelling techniques from the perspectives of model construction, generation of an underlying continuous time Markov process, and the potential for reduction in the Markov process. Such careful comparison of modelling techniques allows us to appreciate the strengths and weaknesses of different approaches, and facilitates cross-fertilization between them. In the present case we take a characteristic of one formalism, functional rates in Stochastic Automata Networks, and introduce it to the other formalism, Performance Evaluation Process Algebra. We investigate the benefits of this cross-fertilization, particularly from the perspectives of Markov process generation and reduction.  相似文献   
20.
In Part I of this paper, a theoretical basis is presented using a two-degrees-of-freedom model. In this second part of the study, the passive control and the two types of semiactive controls introduced in Part I are examined numerically for a taut cable experiencing wind-induced galloping motion. The passive and the semiactive control schemes for taut cables show a good similarity with the results obtained for the two-degrees-of-freedom model. The potential of using these control schemes in practical applications to flexible structures is demonstrated.  相似文献   
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