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select node content but ignore certain children


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I'm trying to gather a variable. I need a select statement that will reliably achieve the outputs below:
XML is
<study.name>Cold Agglutinin <intl type="spelling"><us>Titer</us><ca>Titre</ca></intl> </study.name>

Need output to be Cold Agglutinin Titer

Gets only what's in <us> descendant

OR

<study.name><intl type="spelling"><us>Color</us><ca>Colour</ca></intl> Perception Test</study.name>

Need output to be Color Perception Test

Gets only what's in <us> descendant

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