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41.
Thoracoscopy provides a minimally invasive technique for the diagnosis and management of many posterior mediastinal masses. Benign neurogenic tumors, esophageal tumors, and bronchogenic cysts all can be approached using video-assisted thoracic surgical (VATS) techniques. Malignant lesions are still best approached via open thoracotomy. VATS techniques allow for less pain and dysfunction and can result in shortened hospital stays.  相似文献   
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Su Vida, Su Salud/Your Life, Your Health is a community program to increase participation in breast and cervical cancer screening. This program illustrates the diffusion of an innovative outreach strategy from a research environment to two local health departments. The program uses A Su Salud, the communication model in which positive role models are featured in the media, and community volunteers who give positive social reinforcement. Local health departments in Galveston and Corpus Christi, TX, were selected to implement the model because of excessive mortality rates in the region and the departments' adequate level of resources and commitment. Over an 18-month period, 54 stories of role models appeared in the media in Corpus Christi, and 60 appeared in Galveston. There were 490 volunteers active in Corpus Christi and 279 in Galveston. Of 365 inquiries to the Corpus Christi program, 35 percent were from the Mexican American target group of women ages 40-70. Of 1,457 women who contacted the Galveston program, 9 percent were from the African American target group ages 40-70. Local health departments are well-suited to participation in cancer control research applications because they have direct access to high-risk populations and have the authority to institutionalize effective interventions.  相似文献   
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Combinations of EDTA-Tris and two aminoglycoside antibiotics (amikacin and neomycin) were tested for synergistic activities against the microorganisms associated with otitis externa in dogs and for the solutions' stability over time. Synergistic activity was observed when EDTA-Tris plus amikacin and EDTA-Tris plus neomycin were tested against Staphylococcus intermedius, Proteus mirabilis, Pseudomonas aeruginosa, and Escherichia coli, but not against Candida albicans. Stability studies over a 3-month period indicated that the test solutions were stable at room temperature and that their antimicrobial activity was maintained.  相似文献   
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BACKGROUND: From January 1993 to December 1994, we conducted a prospective study to investigate the evolutionary change of rebleeding risk in bleeding peptic ulcers. To obviate possible confounding factors that would influence decision making for discharge of patients, subjects with coexistent acute illnesses, systemic bleeding disorders, alcoholism, and use of nonsteroidal anti-inflammatory drugs were excluded. METHODS: Emergency endoscopies were performed in patients with hematemesis or a melena within 24 hours of admission. Ulcer lesions were divided into six categories according to endoscopic findings. The residual risks of rebleeding of each type of ulcers were calculated for 10 days, and the critical point of acceptable rebleeding risk after discharge was set at 3%. RESULTS: Three hundred ninety-two patients with bleeding peptic ulcers completed the study. The ulcers, characterized by clean bases, red or black spots, adherent clots, nonbleeding visible vessels without local therapy, nonbleeding visible vessels with local therapy, and bleeding visible vessels with local therapy took 0, 3, 3, 4, 4, and 3 days, respectively, to decrease rebleeding risk to below the critical point. All episodes of fatal rebleeding (n = 4) occurred within 24 hours after admission. CONCLUSIONS: Patients with clean-based ulcers can be discharged in the first day of admission. The optimal duration required for hospitalization of patients with ulcers characterized by nonbleeding visible vessels at initial endoscopy is 4 days. The remaining patients with ulcers marked by other bleeding stigmata may be discharged after a 3-day observation.  相似文献   
47.
The addition of vertebral disc degeneration to the job-related disease register raises the question of vertebral disc degeneration patterns according to loading strain. The readings of the lumbar vertebra of construction workers and nurses were compared with those of a group without workload. In the groups examined, aged 35 to 50, monosegmental damage was found in only 17% of the patients with high workload, as opposed to 29% of those with no workload, mostly with monosegmental damage at level L5/S1. Damage to the upper segments of the lumbar spine with intact discs in between was found exclusively in patients with high workload. Multiple segment damage in the age range examined was found in subjects with activities that add to the load of the spinal column. The value of MRI in assessing and evaluating illness originating from the vertebral discs is currently being discussed.  相似文献   
48.
Recognition by integrin proteins on the cell surface regulates the adhesive interactions between cells and their surroundings. The structure of the 'I' domain that is found in some but not all integrins, has been determined. However, the only integrin ligands for which structures are known, namely fibronectin and VCAM-1, are recognized by integrins that lack I domains. The intercellular adhesion molecules ICAM-1, 2 and 3 are, like VCAM-1, members of the immunoglobulin superfamily (IgSF), but they are recognized by an I domain-containing integrin, lymphocyte-function-associated antigen 1 (LFA-1, or CD11a/CD18). Here we present the crystal structure of the extracellular region of ICAM-2. The glutamic acid residue at position 37 is critical for LFA-1 binding and is proposed to coordinate the Mg2+ ion in the I domain; this Glu 37 is surrounded by a relatively flat recognition surface and lies in a beta-strand, whereas the critical aspartic acid residue in VCAM-1 and fibronectin lie in protruding loops. This finding suggests that there are differences in the architecture of recognition sites between integrins that contain or lack I domains. A bend between domains 1 and 2 of ICAM-2 and a tripod-like arrangement of N-linked glycans in the membrane-proximal region of domain 2 may be important for presenting the recognition surface to LFA-1. A model of ICAM-1 based on the ICAM-2 structure provides a framework for understanding its recognition by pathogens.  相似文献   
49.
Because of concerns among veterans over Agent Orange exposure, the Department of Veterans Affairs (VA) has conducted a series of studies of specific cancers among Vietnam veterans. Lung cancer is the topic of investigation in this report. The VA's Patient Treatment File (PTF) was used to identify 329 Vietnam era veterans with a diagnosis of lung cancer made between 1983 and 1990. The PTF is a computerized hospitalized database of inpatient records, including patients' demographic data, and diagnoses. A record is created for each patient discharged from any one of the VA's Medical Centers. Variables abstracted from the military record include education, race, branch of service, Military Occupational Specialty Code, rank, and units served within Vietnam. Two hundred sixty-nine controls were randomly selected from the PTF file of men hospitalized for a reason other than cancer. A second control group numbering 111 patients with colon cancer was also selected from the PTF file. Data were also gathered on exposure to Agent Orange through the location of each individual ground troop veteran's unit in relation to an area sprayed and the time elapsed since that area was sprayed. The crude odds ratio between service in Vietnam and lung cancer was of borderline significance (odds ratio = 1.39 with 95% confidence interval = 1.01-1.92). The relationship disappeared when the confounder year of birth was considered. We conclude from these data that there is no evidence of increased risk in lung cancer associated with service in Vietnam at this time.  相似文献   
50.
A technique for fabricating many different wavelength lasers on the same wafer has been developed. High energy ion implantation was used to selectively blue shift the emission wavelength of an InP-based quantum well laser structure. This structure was then processed into fully functional broad-area lasers whose current threshold was unaffected by the implantation process, indicating extremely high material quality after bandgap-shifting. This process has the potential for the integration of not only different wavelength lasers, but also other devices, such as waveguides, detectors, modulators, etc., on a single wafer.  相似文献   
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