📄 uropreopprosnote.ascx
字号:
<img src="../../Images/shim.gif" border="0" width="4" height="0">5-Impotent</span></td>
</tr>
</table>
</td>
</tr>
<tr>
<td class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Preoperative Predictions</span><img src="../../Images/shim.gif" border="0" width="200" height="1"><span class="blackBoldText">Date:</span>
<table width="700" border="0" cellspacing="0" cellpadding="0">
<tr>
<td>
<table width="700" border="0" cellspacing="0" cellpadding="0">
<tr>
<td align="center" width="87" height="30" class="FormInsideTableTopCell"><strong>Clinical T stage</strong></td>
<td width="87" class="FormInsideTableTopCell"> </td>
<td align="center" width="87" class="FormInsideTableTopCell"><strong>Gleason</strong></td>
<td width="87" class="FormInsideTableTopCell"> </td>
<td align="center" width="87" class="FormInsideTableTopCell"><strong>PSA</strong></td>
<td width="87" class="FormInsideTableTopCell"> </td>
<td align="center" width="87" class="FormInsideTableTopCell"><strong>Post RP 5 yr </strong></td>
<td width="87" class="FormInsideTableTopCell"> </td>
</tr>
<tr>
<td align="center" class="FormInsideTableRegCell" height="30"><strong>SVI</strong></td>
<td class="FormInsideTableRegCell"> </td>
<td align="center" class="FormInsideTableRegCell"><strong>LNI</strong></td>
<td class="FormInsideTableRegCell"> </td>
<td align="center" class="FormInsideTableRegCell"><strong>OC</strong></td>
<td class="FormInsideTableRegCell"> </td>
<td align="center" class="FormInsideTableRegCell"><strong>ECE</strong></td>
<td class="FormInsideTableRegCell">Left:<br>Right:</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td valign="top" class="FormOuterTableRow">
<table width="700" border="0" cellspacing="0" cellpadding="0">
<tr>
<td class="FormInsideTableRegCell"><span class="blackBoldText">Biopsy</span><br>Indicate the number of cores positive over the total number of cores taken, percent cancer, and millimeters of cancer in each region.</td>
<td class="FormInsideTableRegCell"><span class="blackBoldText">MRI</span><br>Mark areas suspicious for cancer and extracapsular extension (ECE). Darker shading means more suspicious.</td>
<td class="FormInsideTableRegCell"><span class="blackBoldText">DRE</span><br>Mark areas suspicious for cancer based on rectal exam. Darker shading means more suspicious.</td>
</tr>
<tr>
<td class="FormInnerRowRightBorder" align="center"><img src="../../Images/FormImages/Preop_ProstateGrid.gif" border="0" width="200" height="200"></td>
<td class="FormInnerRowRightBorder" align="center"><img src="../../Images/FormImages/Preop_ProstateGrid.gif" border="0" width="200" height="200"></td>
<td class="FormInnerRowRightBorder" align="center"><img src="../../Images/FormImages/Preop_DRE.gif" border="0" width="200" height="200"></td>
</tr>
<tr>
<td height="120" align="left" valign="top" class="InnerFormTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="1">Notes:</td>
<td align="left" valign="top" class="InnerFormTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="1">Notes:
<br><img src="../../Images/shim.gif" border="0" width="5" height="15">MRI
Ureth. Length:________________<br>
<img src="../../Images/shim.gif" border="0" width="5" height="15">MRI
Veins (0-4+):_________________<br>
<img src="../../Images/shim.gif" border="0" width="5" height="15">Prostate
Volume (cc):_____________<img src="../../Images/shim.gif" border="0" width="25" height="1"></td>
<td align="left" valign="top" class="InnerFormTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="1">Notes:</td>
</tr>
</table>
</td>
</tr>
<tr>
<td class="FormOuterTableRow"> <table align="center" border="0" width="100%" cellpadding="0" cellspacing="0">
<tr>
<td colspan="2" valign="middle" height="22"><span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="4" height="1">Biochemical Markers</span><img src="../../Images/shim.gif" border="0" width="150" height="1"><span class="blackBoldText">PSA DT:</span><img src="../../Images/shim.gif" border="0" width="100" height="8"><span class="blackBoldText">PSA Velocity (ng/ml/yr):</span></td>
</tr>
<tr>
<td valign="top" class="FormInnerRowRightBorder"> <table width="100%" border="0" cellpadding="1" cellspacing="0" class="FormInnerRowRightBorder">
<tr >
<td width="100" align="center" valign="middle" class="FormInsideTableTopCell">Date
<br>
(mm/dd/yyyy)</td>
<td align="center" valign="middle" class="FormInsideTableTopCell">Marker</td>
<td align="center" valign="middle" class="FormInsideTableTopCell">Value</td>
<td align="center" valign="middle" class="FormInsideTableTopCell">Data<br>
Source</td>
</tr>
<asp:Repeater ID="labTests" runat=server>
<ItemTemplate>
<tr>
<td height="17" align="center" class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "LabDateText") %>
</td>
<td class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "LabTest") %>
</td>
<td class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "LabResult") %>
</td>
<td class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "LabQuality") %>
</td>
</tr>
</ItemTemplate>
</asp:Repeater>
</table></td>
<td valign="top" class="blackBoldText"><table border="0" width="100%" cellpadding="1" cellspacing="0">
<tr>
<td width="100" align="center" valign="middle" class="FormInsideTableTopCell">Date
<br>
(mm/dd/yyyy)</td>
<td align="center" valign="middle" class="FormInsideTableTopCell">Marker</td>
<td align="center" valign="middle" class="FormInsideTableTopCell">Value</td>
<td align="center" valign="middle" class="FormInsideTableTopCell">Data<br>
Source</td>
</tr>
<tr>
<td height="17" align="center" class="FormInsideTableRegCell">/<span><img src="../../Images/shim.gif" border="0" width="22" height="1"></span>/</td>
<td class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
</tr>
<tr>
<td height="17" align="center" class="FormInsideTableRegCell">/<span><img src="../../Images/shim.gif" border="0" width="22" height="1"></span>/</td>
<td class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
</tr>
<tr>
<td height="17" align="center" class="FormInsideTableRegCell">/<span><img src="../../Images/shim.gif" border="0" width="22" height="1"></span>/</td>
<td class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td class="FormOuterTableRow"><table width="700" border="0" cellspacing="0" cellpadding="4">
<tr>
<td><span class="blackBoldText">Signatures</span><br></td>
<td colspan="2"> </td>
</tr>
<tr>
<td width="100"><span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="6" height="1">PA:</span></td>
<td width="400"><span class="blackBoldText">___________________________________________</span></td>
<td width="200"><span class="blackBoldText">Date:____/____/____</span>
</td>
</tr>
<tr>
<td><span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="6" height="1">Fellow:
</span></td>
<td><span class="blackBoldText">___________________________________________</span></td>
<td><span class="blackBoldText">Date:____/____/____</span> </td>
</tr>
<tr align="center">
<td colspan="3">
<table width="692" cellpadding="4" cellspacing="0" class="FormInnerTableBlackTopRow">
<tr>
<td>Patient understands all risks and benefits and agrees to
proceed.<br> <span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="1" height="20">MD
/ Attending:<img src="../../Images/shim.gif" border="0" width="18" height="8">__________________________________________<img src="../../Images/shim.gif" border="0" width="108" height="8">Date:____/____/____</span></td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td height="14" align="center" valign="bottom" class="blackBoldText">GU33<img src="../../images/shim.gif" border="0" width="45" height="1">U37<img src="../../images/shim.gif" border="0" width="45" height="1">CMIC
Approval Date: 6/05<img src="../../images/shim.gif" border="0" width="45" height="8"><!--rev:9/17/04--><img src="../../images/shim.gif" border="0" width="45" height="1">Page
<span id="PageNumber">2</span> of <span id="TotalPages">2</span><img src="../../images/shim.gif" border="0" width="45" height="1">B/02.070.<span class="blackBoldTextSmall">33</span></td>
</tr>
</table>
</div>
</div>
⌨️ 快捷键说明
复制代码
Ctrl + C
搜索代码
Ctrl + F
全屏模式
F11
切换主题
Ctrl + Shift + D
显示快捷键
?
增大字号
Ctrl + =
减小字号
Ctrl + -