Purpose: This study aims to explore and describe the phenomenon of women with infertility and to enhance understanding on how infertility affects their lives and the specific social consequence they encountered. Method: A qualitative phenomenological design was adopted in this study. A total of 13 women who are infertile participated in the study. A snowball sampling method was adopted. Data were analysed through thematic analysis. Results: Four themes emerged in the study, including (i) non-escapable cultural burden in Chinese family; (ii) psychological distress: isolation caused by envy; (iii) disappointment towards reproductive health services; and (iv) self-compassion and religion as coping strategies. Conclusions: The causes of infertility are highly complex. Apart from medical conditions, many social conditions would also probably trigger the difficulty of conceiving. Health care professional should also focus on the social and psychological aspects of women of infertility.
The case histories of four patients who developed hemiatrophy of the tongue from 3 to 9 years after a course of curative radiation therapy for carcinomas of the head and neck are presented. These patients were subsequently followed for from 1½ to 6 years without local recurrence of the tumor, distant metastasis, or involvement of other cranial nerves, indicative of only a unilateral hypoglossal nerve atrophy. A review of the literature showed that peripheral and cranial nerve damages after radiation therapy have been reported for the optic nerve, hypoglossal nerve, oculomotor nerve, abducens nerve, recurrent laryngeal nerve, brachial plexus nerves, and peripheral nerves of the extremities. Review of clinical and experimental data indicated that in most cases, the damages were probably caused by extensive connective tissue fibrosis around and infiltrating the nerve trunks. Three possible types of peripheral and cranial nerve damages after radiation therapy are identified.
The therapy records of 66 patients with carcinomas of the paranasal sinuses were reviewed; primary carcinomas occurred in the maxillary sinus in 50 patients, the ethmoid sinus in 11 patients, the sphenoid sinus in 4 patients and the frontal sinus in 1 patient. The tumors of the maxillary sinus were staged retrospectively according to the American Joint Committee staging system recommended in 1976; 1 of 2 patients with T1,5 of 1 1 patients with T2,lO of 34 patients with T3 and 1 of 3 patients with T4 lesions showed no evidence of disease (NED) at 3 years. Combined high dose irradiation (6,000 rads in 6 weeks) followed by radical surgery in 4 to 6 weeks was well tolerated; this approach is recommended for the treatment of T1, T2, and selected T3-4 maxillary sinus lesions. Only 2 of 11 patients with ethmoid sinus lesions survived at 3 years.cancer 40:303a-3041, 1977.
ARCINOMAS ORIGINATING FROM THE MUCOSALC walls of the paranasal sinuses are uncommon, constituting only 2% of human cancew7 Chronic sinusitis and polyposis have long been suspected to be etiologic factors although lacking in firm supportive data; *' a small increase in the incidence of adenocarcinoma in woodworkers had been reported by Acheson.' Because the involved sinuses served no direct vital functions and that symptoms produced by the growing tumor are nonspecific, early diagnosis of a malignant disease is often difficult and later, the impact of finding a widespread, locally advanced tumor with deep infiltration and extensive bone destruction is often felt acutely. Careful radiographic studies and a thorough knowledge of the intricate anatomy of the paranasal sinuses are helpful in identifying these lesions; opacifications astriding distinct anatomic
This study reviews 21 cases of thyroid lymphoma diagnosed between 1969 and 1980. The thyroid gland was the primary site in all but two cases. The 20 patients with non-Hodgkin lymphoma had a mean age of 66 years, 75% were women, and all were Caucasian. A rapidly growing thyroid mass with hoarseness, dysphagia, and difficulty in breathing was the initial finding. Most patients had diffuse histiocytic lymphomas. Associated Hashimoto thyroiditis was found histologically in 57% of the cases. Using the immunoperoxidase stain method on tissue sections, intracytoplasmic monoclonal immunoglobulin was demonstrated in 5 of 15 cases. All but two patients received radiation therapy, and 13 received chemotherapy. The median survival was 8 months; 20% died of unrelated causes and 32% are alive (average duration: 27 months). Dissemination, after local control by radiation therapy, was the leading cause of death. The prognosis was better in men, in patients under the age of 65 years, and in those patients who, on biopsy, did not have involvement of the extrathyroid soft tissue or regional lymph nodes.
Corynebacterium parvum, a non-specific immunopotentiator, was administered intravenously to 12 patients with advanced cancer at 2, 3, and 4 mg/m2 dose levels in combination with radiation therapy. One dose of C. parvum was given every 7 days for a total of 4 doses in 21 days. Symptoms and signs developed by these patients for a period of 3 to 6 hours during and shortly after the i.v. infusion of the first dose of C. parvum were moderately severe in nine patients and mild in three patients. For the second, third, and fourth doses of C. parvum, patients had fewer and less intense reactions and were given their treatments on an outpatient basis. There was no added morbidity to the patients' tolerance to either palliative or radical dose levels of radiation therapy. Changes in renal, hepatic, hematologic, and immunologic functions were minimal. At the above dose levels, the use of C. parvum to stimulate the reticuloendothelial system in humans by the intravenous route can be safe and well tolerated provided the side effects are appreciated and symptomatic treatments administered.
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