Resection Management in Radical Operations for Hypopharyngeal Carcinoma
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Abstract:
下咽頭癌の食道重複癌頻度は30～40%であるが, 食道癌が下咽頭癌の予後因子になるのかは明らかでない。そのため, 食道重複癌の取り扱いには, 根治性, 予後と侵襲, QOLのバランスを熟慮する必要がある。食道重複癌のうち表在癌の頻度は高く, 食道抜去の適応となる症例は下咽頭癌全体の10～20%程度と考えられる。下咽頭癌の進展は, 粘膜下リンパ流によって進展する不可視病変が特徴である。特に梨状陥凹癌や後壁癌では上方断端の取り扱いが問題となり, 20 mm程度のマージンを取るとともに, 術中迅速診断を活用する必要がある。下咽頭癌の予防的郭清術は, 転移率の高さから, かなり限定される。そのため, 予防的郭清術を施行するには, しっかりとした術前転移診断が必須である。超音波エコーによる転移診断が最も良好であるが, それでも転移リンパ節の検出は半数程度であり, 転移個数の診断となるとさらに困難である。術前のリンパ節転移診断の限界からみて, 転移リンパ節の個数別に頸部郭清術式をきめることは現状では困難と考えられた。Cite
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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The nationally-recognized Susquehanna
Chorale will delight audiences of all
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music making, successful in their
aim to make the audience feel,
to be moved, to be part of the
performance - and all this while
working at an extremely high
musical level.AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA¢AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA Experience choral
singing that will take you to new
heights!
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