We describe the study of a patient with metastatic melanoma to axillary nodes presenting during pregnancy. The factors considered in her management are discussed, including issues related to staging, the decision not to terminate the pregnancy and the relative efficacy and fetal toxicity of the available treatment options. An overview of the known effects of radiotherapy on the fetus is presented and the technical alterations that were used to decrease the toxicity of radiotherapy are discussed.
Current master plans for “Total Quality Management” and the “Deming Approach” devote rleatively minor attention to a key operation- the actual design of the product. This paper discusses techniques and procedures for management of the design function to assure optimum product quality and reliability, with the objective of complete customer satisfaction. Areas covered are: Design Personnel, Product Design Specification, Formal Design Review, Fault Tree Analysis, Failure Mode and Effect Analysis, and Field Performance Data Collection and Use.
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