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71.
72.
Dr. David H. Berger MD Barry W. Feig MD Donald Podoloff MD James Norman MD C. Wayne Cruse MD Douglas S. Reintgen MD Merrick I. Ross MD 《Annals of surgical oncology》1997,4(3):247-251
Background: If cutaneous lymphoscintigraphy (CL) is accurate in predicting the draining lymph node basins at risk from primary axial
melanomas, then regional metastases should only occur in those lymph node basins identified by CL.
Methods: This study is a retrospective review of patients undergoing CL for primary axial melanomas from June 1, 1985, until June
31, 1992. Data retrieved included age, gender, number of basins identified, location of basins identified, management of basins,
recurrence in lymphatics, development of distant disease, and long-term follow-up.
Results: A total of 181 patients underwent elective LND, and 48 patients (27%) had melanoma in the nodes within the dissected basin.
Of these 181 patients, seven developed nodal metastases as their site of first recurrence. All seven recurrences were seen
at sites dissected or at sites indicated by CL, which the primary surgeon elected not to treat initially. Of the 116 patients
observed, 16 (14%) developed lymph node metastases as their first site of recurrence. Fifteen of these 16 patients had their
site of lymph node metastases predicted by CL. In this study, CL predicted 98.6% of all lymph node metastases.
Conclusions: The high overall reliability of CL as demonstrated by long-term follow-up indicates that the information obtained by CL can
be reliably used to guide intervention. Initial evaluation of patients with high-risk cutaneous melanomas at sites with ambiguous
lymphatic drainage must include CL in order to determine the draining lymph node basins and to plan therapy.
Presented at the 47th Annual Cancer Symposium of The Society of Surgical Oncology, Houston, Texas, March 17–20, 1994. 相似文献
73.
In December, 1989, the Department of Transportation (DOT) in conjunction with the Federal Aviation Administration (FAA) mandated an extensive urine drug testing program for selected positions within the airline industry. At the end of 1 year we have tested 7,872 applicants under these rules, with a positive finding rate of 0.17%. We have also tested 32,157 applicants, including those applying for DOT-covered positions, with a positive rate of 2.82%. Considering only the two major drugs of abuse--marijuana and cocaine--we found the positive rate to be an order of magnitude greater than the rate discovered under the DOT program. We present these data together with a discussion of some of the possible reasons for this major disparity. We also present findings for barbiturates and benzodiazepines which are not tested under the DOT program, but which have safety implications related to the aviation industry. 相似文献
74.
Joseph Berger 《Canadian Medical Association journal》1988,138(4):303-304
75.
We have developed a reliable technique for labeling and examining neural structures in soft tissues associated with articular joints and have tested it in human wrist joints under various specimen-related conditions. The labeling protocol employs an immunohistochemical process with a panneuronal marker (PGP 9.5) as the primary antibody and Alexa Fluor 488 as the fluorescing secondary antibody. Imaging was done using a confocal laser scanning microscope, which produced exceptionally detailed three-dimensional images of nerve endings and transiting nerve fibers from thick sections of wrist joint ligaments obtained from human cadavers. The protocol provided a practical postmortem window for specimen acquisition and processing without significant apparent worsening of image quality. The images produced are resistant to fading with repeated exposure to a fluorescent light source, which gives many opportunities for observation. Background staining is minimal, producing high contrast labeling of target tissues, which, in turn, enhances image analysis. 相似文献
76.
Assessment of immunization as a technique to extend the chilled storage life of vacuum‐packaged lamb
The growth at — 1.5°C of Lactobacillus delbrueckii, a meat spoilage organism, was evaluated on vacuum‐packaged lamb legs obtained from animals immunized against that organism. Growth was significantly lower than that on similarly treated legs obtained from non‐immunized lambs. These findings suggest that immunization against spoilage organisms may contribute toward increasing the chilled storage life of fresh meat. 相似文献
77.
Multiple myeloma was diagnosed in 3 patients following episodes of pneumococcaemia associated with neutropenia and decreased serum concentration of normal immunoglobulins. Severe pneumococcal infection is commonly encountered during the course of multiple myeloma, but has not been stressed as a presenting feature of the disease. 相似文献
78.
Cervical root stimulation (CRS) was compared with conventional EMG, nerve conduction, and late response studies in 34 patients with possible cervical radiculopathy. Cervical roots were stimulated by monopolar needles inserted into paraspinal muscles, recording compound muscle action potentials in biceps, triceps, and abductor digiti minimi muscles. In 18 patients with clinical evidence of radiculopathy, EMG was abnormal in 11 (61%), but CRS was abnormal in all 18. Of 16 patients with symptoms but no signs of radiculopathy, EMG was abnormal in 5 (31%) and CRS was abnormal in 9 (56%). 相似文献
79.
In spite of extensive investigations of the rat's meso-cortico-limbic system, the dopaminergic (DA) innervation of the hippocampal formation (HF) has not heretofore been visualized by histochemical techniques. However pharmacological and biochemical studies strongly suggested its existence. We used tyrosine-hydroxylase (TH) as an immunocytochemical marker of DA neurons in rats in which the noradrenaline cortical innervation was previously destroyed by neurotoxins. The absence of noradrenergic axons was routinely controlled with dopamine-beta-hydroxylase immunocytochemistry. TH-positive axons, thus DA axons, reach the HF primarily through the fimbria in which they occupy a specific lateral sector. They innervate the ventral and caudal parts of the HF, the subiculum and the adjacent CA1 hippocampal field being the main targets. This DA terminal field in the HF, matches with the area projecting toward the nucleus accumbens. Thus the hippocampo-striatal projections which represent a link of functional importance between the limbic and central motor systems might be modulated by the dopaminergic meso-cortico-limbic pathway. The present immunocytochemical study confirms the very dense innervation of the entorhinal cortex (EC): DA axons are organized in dense fiber islands and occupy primarily the superficial layers (I-II-III). Da innervation predominates in the lateral part of EC, which is the site of multimodal cortical afferences and therefore relays information between the whole neocortex and the hippocampus. Thus the DA system could play an important role of modulation on hippocampal and parahippocampal functions. 相似文献
80.
Management of abdominal sepsis 总被引:2,自引:0,他引:2
D. Berger K. Buttenschoen 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1998,383(1):35-43
Introduction: Today the management of the different forms of peritonitis is generally standardised. The classification of primary and secondary
peritonitis is well accepted. From a pathophysiological point of view, postoperative and post-traumatic peritonitis should
be considered as independent entities. The bacteriological isolates from the inflamed peritoneal cavity do not correlate with
the clinical course, and the occurrence of enterococci and bacteroides may be slightly related to ongoing infectious complications.
Classification: Valuable scoring systems mainly rely on systemic signs of the septic disease and seem to better differentiate the prognosis
of the disease than more surgically oriented scores do. Although the scoring systems did not allow any clinical decision,
they should be used to help better compare patients treated in different institutions. The observation of the minor relevance
of bacteriology and the superiority of general sepsis scores agrees with the fact that pre-existing septic organ dysfunction
and pre-existing comorbidity are the main determinants of mortality. Treatment: Surgical therapy focuses on the control of the source of infection because it has been clearly shown that, without resolving
the source of infection, the prognosis remains poor. Adjuvant surgical measures aim at the further reduction of the bacterial
load in the peritoneal cavity. Planned relaparotomy, relaparotomy on demand, and continuous closed peritoneal lavage are used.
Results: Clinical results proved these methods to be equally effective although pathophysiological considerations favour closed peritoneal
lavage. Conclusion: Summarising the available data, we need a more sophisticated understanding of the pathophysiology of the peritonitis, and
well-designed clinical studies are necessary to define the optimal surgical treatment modalities.
Received: 27 November 1997 相似文献