Gardner综合征之软组织肿瘤的追踪观察与研究

目的：分析研究Gardner综合征一家系12例患者的软组织肿瘤的自然演变过程与结肠息肉癌变之间的关系。方法：自1989年3月至1998年10月对一家系12例Gardner综合征患者进行了长期追踪观察，采用人体体表摄影，X线平片照像，消化道气钡双对比造影，纤维结肠镜及手术切除，10年中每年观察1-2次，重点患者2次以上。结果：12例均患有软组织肿瘤。活检证实；硬纤维瘤4例。皮脂腺囊肿2例。脂肪瘤2例。神经纤维瘤2例。混合性肿瘤2例。在结肠息肉癌变的5例患者中软组织肿瘤均有不同程度的变化。表现为突然增大，增多，表面发生溃破等。结论：软组织肿瘤的突然增大增多与结肠息肉癌变有密切关系。     

Syndrome‐associated soft tissue tumours

Soft tissue neoplasms may be associated with a variety of genetic disorders and malformation syndromes, especially when they arise in children, adolescents and early adulthood. This review summarizes the principal histopathological types of soft tissue tumours which occur in various syndromes, with an emphasis on pathological features, genetic aspects and considerations for the diagnostic pathologist.     

Tumeurs hamartomateuses et pluritissulaires

Hamartoma are defined by the benign proliferation of cells normally occurring in the affected tissue or organ. The structure of the hyperplasic region can greatly differ from the normal histology of the affected tissue, due to the quantity, the layout, or the maturation state of tumoral cells. Hamartoma of the maxilla and mandible are a heterogeneous group of diseases. They nevertheless share two major therapeutic characteristics: surgical treatment of the mass effect and the deformations induced by tumoral growth and mandatory screening for associated extra-facial tumors.     

Basal cell carcinoma in a patient with intestinal polyposis

A 22-year-old female, with multiple polyposis of the colon and two central nervous system tumors, also suffered from recurrent basal cell carcinoma. The purpose of this report is to alert physicians to the possibility that basal cell carcinoma occurring at an unusually young age may be another manifestation of the familial polyposis syndromes.     

Failure of penicillin to eradicate group B streptococcal colonization in the pregnant woman. A couple study.

Prophylactic treatment of couples with oral penicillin has been recommended as a means of eradicating GBS from the parturient female. In 1977 and 1978 this hypothesis was tested in an investigation of couples from a middle and upper socioeconomic group in Houston, Texas. A group of 40 women, known to be colonized with GBS during the third trimester of pregnancy, and their husbands were treated simultaneously with oral penicillin. Patients were recultured 3 weeks following completion of therapy and at the time of delivery. At the time of delivery 67% of the women remained colonized with GBS. This percentage does not differ substantially from that obtained in a series of untreated colonized women. This study demonstrates that oral penicillin treatment of couples is not an effective means of reducing maternal colonization at the time of delivery.     

Occult radiologic changes in the skull and jaw in familial adenomatous polyposis coli

It has been suggested that radiology of the skull and jaw in familial polyposis coli may be a useful marker in up to 90 percent of cases. These x-rays were reviewed independently by a dental surgeon and a neuroradiologist in 51 patients. Only seven patients (14 percent) had significant lesion seen in the context of screening. Each of these patients also had other extracolonic manifestations of familial polyposis coli. The Cleveland Clinic Foundation experience with radiology of the jaw and skull is that it is not a useful screening tool.     

For the good of a common discipline. 1931

This historical commentary reprints excerpts from Mary Sewall Gardner's January 1, 1931, editorial in the original Public Health Nursing journal. Gardner (1871-1961) directed the Providence District Nursing Association until her retirement in 1931. She had also served as president of the National Organization for Public Health Nursing. In her editorial, Gardner sought to relieve the sense of hopelessness caused by the deepening Depression and ameliorate the fear that public health nursing advances had been reversed. An introduction to the impact of the Great Depression on working classes and its impact on organizations responsible for visiting nurses provides the background to help evaluate Gardner's intent. Her words find parallels in the inaugural address of Franklin Delano Roosevelt in 1933. This suggests that the pervasive crisis produced a distinctive tone and perspective of interdependence and mutual resolve that leaders used to help their followers through troubling times.     

Team-based simulations for new surgeons: Does early and often make a difference?

Background

Current work hour restrictions and the expansion of requirements for surgery residents has led to decreased time on high-acuity rotations such as trauma and acute care surgery. In an effort to improve resident competency, we examined the efficacy of a new team-based trauma curriculum for postgraduate year 1 (PGY1) residents.