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In a total of 18 patients with bile duct cancer, the effectiveness of microwave treatment in eradicating the cancer was examined. Lesions in the common bile duct and the bile ducts downstream of the common bile duct were treated in 10 patients. In the remaining eight, primary cancer of the distal common bile duct was treated. All patients underwent stent insertion, and removal of the stent was scheduled for 14 days after treatment. Cancer masses showed hyperenhancement on T1- and T2-weighted magnetic resonance (MR) images, and gadolinium-enhanced T1-weighted MR images on day 21 after treatment. Ten patients could undergo the planned scheduled stent removal. Four showed recurrence of residual disease, and three died of the disease. The remaining six patients had no evidence of recurrence or metastasis at the time of diagnosis.A steep learning curve.
This article describes the adaptation of a cardiopulmonary resuscitation (CPR) course that is appropriate for junior health professionals without prior CPR experience. We piloted this course in four UK hospitals. The course includes patient-based learning, including: learning postures, hands-on practice and feedback on performance. The course is paced in a manner that enables each participant to develop confidence and competency. We measured the outcomes of this course, using both direct observation of CPR performance and feedback. Follow-up to these participants a year later indicated that all had the confidence and competency to treat an out-of-hospital cardiac arrest (OOHCA). This scheme is a viable strategy to improve knowledge and skills of junior health