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OBJECTIVES: To evaluate approaches to thyroid carcinoma invading the aerodigestive tract, with particular attention to well-differentiated carcinomas. STUDY DESIGN: Retrospective review of experience with thyroid carcinoma invading the aerodigestive tract over a 20-year period at a tertiary referral hospital. METHODS: The medical records of all patients with a diagnosis of thyroid cancer treated at Emory University Hospital, Atlanta, Georgia, from 1977 through 1997 were reviewed. Multiple clinical variables were analyzed including treatment, development of recurrence, and survival. Survival and time to local recurrence were determined by Kaplan-Meier analysis, and statistical comparisons were made using log-rank analysis. RESULTS: Five hundred thirty-six cases were identified; 28 patients (5.2%) were identified with invasive disease involving the aerodigestive tract. Histologic findings at the time of invasion included 15 well-differentiated (WD) carcinomas and 13 poorly differentiated (PD) carcinomas. Eight of the 28 patients (5 WD, 3 PD) underwent surgical resection of some portion of the aerodigestive tract with curative intent. Ten patients (8 WD, 2 PD) underwent incomplete resection with tumor left adjacent to aerodigestive tract structures. All patients undergoing incomplete resection developed local recurrence. Six required salvage resection, as opposed to no recurrences in WD carcinomas following complete resection (P = .01). Survival at 5 years for WD carcinomas undergoing complete resection versus initial incomplete resection was 100% versus 50%, respectively (P = .27). CONCLUSION: Review of our experience shows that complete resection of thyroid carcinoma invading the aerodigestive tract can offer prolonged palliation, improved local control, and the opportunity for cure in selected patients. 相似文献
53.
A new mean-value type of algorithm is developed for analyzing multi-facility blocking models with state-dependent arrival rates. It can be applied to a broad class of blocking systems with simultaneous resource possession including, for example, circuit-switched networks. The underlying recursion is cast in terms of blocking probabilities and marginal state probabilities. The developments made here generalize previous results that were restricted to the case of constant arrival rates. 相似文献
54.
Summary A sequence of tasks that must be performed on a sequential database can be scheduled in various ways. Schedules will differ with respect to the number of accesses made to peripheral storage devices and the amount of memory space consumed by buffers. Buffer requirements are discussed for task schedules that avoid accesses to peripherals storing the sequential database. The relationship between certain thrifty scheduling policies and loop jamming, a standard code optimization technique, is also identified. Application to UNIX pipelines and to file processing is discussed.This work is supported in part by NSF Grant MCS-8003340 and MCS-8103605. Schneider is also supported by a Faculty Development Grant from IBM Corporation 相似文献
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TT Tong M B?aszczyk M Przytocka-Jusiak R Mycielski 《Canadian Metallurgical Quarterly》1998,47(2):203-211
The simultaneous determination of amino and organic acids in plant tissue extracts using capillary gas chromatography is described. Plant leaves were extracted in 5% (w/v) perchloric acid and neutralized extracts were purified using C18 cartridges. The amino and organic acids in purified extracts were then converted to tert-butyldimethylsilyl (TBDMS) derivatives prior to separation and detection by capillary gas chromatography (GC) with flame ionization detection. Conditions required for optimal derivatization were investigated. Amino and organic acids were readily converted to their TBDMS derivatives using N-methyl-N-tert-butyldimethylsilyltrifluoroacetamide in dimethylformamide solvent 1:6 (v/v) with an average recovery of 90% and a reproducibility of about 5%. The characteristic [M-57] and [M-159] fragment ion of the TBDMS derivatives was confirmed using GC-MS. The proposed method was demonstrated by the determination of amino and organic acids in extracts of Acacia and Eucalyptus leaves, where detection limits were 1-20 ng. 相似文献
56.
Low-cycle fatigue data for annealed AISI Type 304, 316, and 348 stainless steel to 816°C have been analyzed and a new relationship has been identified associating fatigue data with shortterm tensile behavior. A logarithmic plot of plastic strain range vs time to fracture was shown to be linear with a slope of minus unity. This line was also found to originate at the point corresponding to the tensile ductility. A similar analysis for elastic strain range data revealed a relationship with the strain-hardening exponent measured in a short-term tensile test at the same temperature and strain rate. These correlations have been combined to provide an equation for predicting the relationship between total strain range and cycles to fracture. This approach has been termed the Method of Characteristic Slopes. 相似文献
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Chardonnet CO Sams CE Conway WS Mount JR Draughon FA 《Journal of food protection》2001,64(9):1425-1429
The efficacy of sucrose combined with CaCl2 during osmotic dehydration (OD) was tested for the control of Botrytis cinerea, Colletotrichum acutatum, and Penicillium expansum growth on lightly processed apple slices. The objective of this work was to determine whether the addition of CaCl2 in the osmotic solutions would limit the proliferation of fungal decay organisms. Slices were submitted to OD for 1 h at 25 degrees C in solutions containing 5 to 65% sucrose. Calcium chloride was added to a similar set of sucrose solutions at 0 to 8%. Control slices were made of untreated slices, and slices were processed in water. The mass ratio of the slices did not vary when fruit pieces were processed in solutions containing 5 to 65% sucrose. These slices showed a high susceptibility to spoilage compared to the control slices not submitted to OD: a significant twofold and 60% increase in decay area caused by B. cinerea and P. expansum, respectively, was observed when slices were processed in 50% sucrose/0% CaCl2; C. acutatum showed a significant 50% increase in decay area when slices were processed in 20% sucrose/0% CaCl2. Calcium uptake was significantly increased when slices were processed in CaCl2 solutions, and the highest Ca content was observed when processed in 8% CaCl2, reaching 40 times that of the control slices processed in water. Calcium-treated slices were less susceptible to spoilage by all three pathogens, and the most effective combination in reducing apple slice spoilage was 20 to 30% sucrose combined with 2% CaCl2. 相似文献
60.
To increase performance while operating within a fixed power budget, the AMD opteron processor integrates multiple times86-64 cores with a router and memory controller. AMD's experience with building a wide variety of system topologies using Opteron's hypertransport-based processor interface has provided useful lessons that expose the challenges to be addressed when designing future system interconnect, memory hierarchy, and I/O to scale with both the number of cores and sockets in future times86-64 CMP architectures. 相似文献