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91.
92.
Kemal Uygur Ismet Bayramoglu Aysegul Naziko?lu Metin Yilmaz Yildirim Bayazit Sevda Muftuoglu 《Otology & neurotology》2005,26(6):1118-1121
OBJECTIVE: To compare ultrastructure of the chorda tympani nerve by light and electron microscopy in patients with otosclerosis and chronic suppurative otitis media. STUDY DESIGN: Comparative prospective study. SETTING: Tertiary care, referral medical center. PATIENTS: The tympanic segments of chorda tympani nerves were collected for ultrastructural investigation in 20 cases with chronic suppurative otitis media and 10 cases with otosclerosis that underwent middle ear surgery. RESULTS: Histopathologic examinations of the suppurative group showed that unmyelinated fibers were almost totally lost and replaced by collagen fibers. The thickness of the myelin sheaths was very slender, whereas some of them were atrophic. A substantial increase was encountered in the endoneural collagen substance and connective tissue, whereas inflammatory elements and edema were present occasionally. Degenerative alterations of the myelinated fibers mainly occurred in the form of adaxonal vacuoles. There was disorganization and separation of parallel lamellae of Schmidt-Lanterman clefts. CONCLUSION: The chorda tympani nerve should be preserved in otologic surgery. However, inadvertent dissection of the chorda tympani nerve in chronic suppurative otitis media surgery will not possibly cause a postoperative disturbance in light of ultrastructural changes that occur in the nerve. 相似文献
93.
Nilgün Güvener 《中华医学杂志(英文版)》2005,118(11):963-965
Thyroid storm is a state of severe hyperthyroidism perhaps accompanied by systemic organ decompensation. This is a life threatening condition. In this report, we present a case of thyroid storm caused by trauma, with several atypical features including multiple organ failure, elevated transaminases and acute renal failure. Prompt recognition and treatment is important in limiting the morbidity and mortality associated with this condition. 相似文献
94.
Objective: To investigate the effects of topical travoprost 0.004% and topical bimatoprost 0.03% on retrobulbar blood flow (RBF). Methods: Nineteen young healthy men without any known ocular or systemic disorder were enrolled in this prospective, double-masked, randomized, cross-over study. Baseline RBF mea- 相似文献
95.
Adrian P. Crawley Mark S. Cohen Ph.D. E. Kent Yucel Brigitte Poncelet Thomas J. Brady 《Cardiovascular and interventional radiology》1992,15(1):32-42
Recently developed technologies that allow the collection of magnetic resonance imaging (MRI) in as little as 26 msec have been explored in their application to angiography. Advantages are demonstrated in scan time reduction, insensitivity to patient motion (especially in abdominal applications), flow quantification, and temporal resolution. We demonstrate that because such single-shot techniques are inherently resistant to flow dephasing during acquisition that allow for sustained high signal intensities to be achieved when images must be combined through the cardiac cycle. Such high temporal resolution scans may be utilized for the collection of time-resolved angiograms. With these techniques we demonstrate the collection of complete MR angiograms in the course of reasonable 10–25 sec breath holds. The relative simplicity of the technique, coupled with its overall short acquisition time, allows us to incorporate angiography into other imaging protocols without adding significant time burdens. Results to date are promising for further improvements in spatial resolution, without extension of scan time. 相似文献
96.
Chagpar A Middleton LP Sahin AA Meric-Bernstam F Kuerer HM Feig BW Ross MI Ames FC Singletary SE Buchholz TA Valero V Hunt KK 《Cancer》2005,103(8):1581-1586
BACKGROUND: The ideal pathologic assessment of sentinel lymph nodes (SLNs) in patients with breast carcinoma remains controversial. The authors evaluated how detailed assessment of SLNs using immunohistochemistry (IHC) and serial sectioning would affect treatment decisions and outcomes in patients with breast carcinoma who had negative SLNs on standard hematoxylin and eosin staining. METHODS: The SLNs from patients who were treated between June 1998 and June, 1999 and who had negative lymph node status determined by hematoxylin and eosin staining (n = 84 patients) were evaluated further with serial sectioning and cytokeratin IHC. Patients were offered adjuvant therapy based on primary tumor factors. RESULTS: The median patient age was 57 years, and the median tumor size was 1.2 cm. At a median follow-up of 40.2 months, 81 patients (96%) were alive with no evidence of disease, 1 patient was alive with disease, 1 patient had died of disease, and 1 patient had died of other causes. Fifteen patients (18%) had micrometastases identified on IHC. Of the total 84 patients, information regarding adjuvant therapy was not available for 5 patients. Of the remaining 79 patients, 10 patients (13%) were not offered adjuvant chemotherapy but had positive SLN status determined by IHC. SLN status based on IHC evaluation did not correlate with age (P = 0.077), tumor size (P = 0.717), grade (P = 0.148), estrogen receptor status (P = 1.000), or lymphovascular invasion (P = 0.274). Furthermore, IHC-detected positive SLN status did not correlate with distant metastasis (P = 0.372) or overall or distant metastasis-free survival (P = 0.543 and P = 0.540, respectively). CONCLUSIONS: Although the finding of SLN micrometastases by IHC may change management in > 12% of patients, preliminary results suggested that such micrometastases do not affect outcomes significantly. 相似文献
97.
Cabioglu N Hunt KK Buchholz TA Mirza N Singletary SE Kuerer HM Babiera GV Ames FC Sahin AA Meric-Bernstam F 《Cancer》2005,104(1):20-29
BACKGROUND: The risk of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) is associated with treatment and tumor-related variables, such as surgical margin status and the use of systemic therapy, and these variables have changed over time. Correspondingly, the authors of the current study hypothesized that the contemporary multidisciplinary management of breast carcinoma would lead to an improvement in IBTR rates after BCT. METHODS: Between 1970 and 1996, 1355 patients with pathologic Stage I-II invasive breast carcinoma underwent BCT (breast-conserving surgery and adjuvant radiation therapy) at The University of Texas M. D. Anderson Cancer Center. Contemporary methods of analyzing surgical margins were in routine use by 1994. To analyze the effect of this variable and others, patient and tumor characteristics and IBTR rates in patients treated during 1994-1996 were compared with those in patients treated from 1970 to 1993. RESULTS: Characteristics were similar in patients treated during 1994-1996 (n = 381) and those treated before 1994 (n = 974) except for patients aged >50 years (63.3% vs. 51.7%, P < 0.001), and patients who had a family history of breast carcinoma (37.9% vs. 30.8%, P = 0.017). Patients treated after 1994 were less likely to have positive or unknown margins (2.9 % vs. 24.1 %, P = 0.0001), more likely to receive chemotherapy (40.5% vs. 26%, P < 0.001), and more likely to receive hormonal therapy (33.3% vs. 19.4%, P < 0.001), but less likely to receive radiation boosts to the primary tumor bed (59.8% vs. 89%, P < 0.001). The 5-year cumulative IBTR rate was significantly lower among patients treated in 1994-1996 than among patients treated before 1994 (1.3% vs. 5.7%, P = 0.001) largely because of the drop in IBTR rates among patients aged < or = 50 years (1.4 % vs. 9.1 %, P = 0.0001). On multivariate analysis, age > 50 (hazards ratio [HR] = 0.401; P = 0.0001), presence of negative surgical margins (HR = 0.574; P = 0.017), and use of adjuvant hormonal therapy (HR = 0.402; P = 0.05) were independent predictors of improved 5-year IBTR-free survival. On subgroup analysis, use of chemotherapy was associated with increased IBTR-free survival among women aged < or = 50 years (HR = 0.383; P = 0.001). Although 5-year cumulative IBTR rates were lower among women aged > 50 years than among younger women before 1994 (2.6 % vs. 9.1%, P < 0.0001), no such difference was found in the group treated in 1994-1996 (1.2 % for age > 50 yrs vs. 1.4 % for < or = 50 yrs, P = 0.999). CONCLUSIONS: The IBTR rate after BCT appears to be declining, especially among patients < 50 years of age. However, long-term follow-up is necessary to confirm this finding. This finding may reflect changes in surgical approaches and pathologic evaluation as well as an increased use of systemic therapy. The current low incidence of IBTR with multidisciplinary management of breast carcinoma may result in more patients choosing BCT over mastectomy. 相似文献
98.
Akinci F Yildirim A Ogutman B Ates M Gozu H Deyneli O Aydar S Isci E Balcioglu L Sayhan OZ 《Evaluation & the health professions》2005,28(1):53-66
This article describes the adaptation of the Finnish 15D standardized measure of health-related quality of life (HRQoL) instrument for use in Turkey and assesses its psychometric properties. The HRQoL is measured in a sample of 75 patients with Type 2 diabetes using both 15D and Nottingham Health Profile (NHP) instruments. The internal consistency within the domains of 15D was high, with Cronbach's alpha values 0.89 for 15D scale and 0.89 for NHP. Significant correlations were observed between the scores of similar domains of 15D and the NHP in general health perception supporting the construct validity of the new 15D Turkish version. Overall, the results indicated that the adaptation of the 15D for use in Turkey was successful. The Turkish version was found to be a reliable and valid instrument. It is suitable and applicable to both clinical and population-based studies for the measurement of HRQoL in Turkey. 相似文献
99.
Zumrutdal A Sezer S Demircan S Seydaoglu G Ozdemir FN Haberal M 《Nephrology (Carlton, Vic.)》2005,10(5):453-458
AIM: To investigate the associations of different risk factors with carotid artery intima-media thickness (C-IMT) in non-diabetic haemodialysis (HD) patients who had no clinical evidence of atherosclerosis. METHODS: Seventy-two HD patients (43 men, 29 women; mean age: 34.5 +/- 10.6 years; mean time on HD: 47.9 +/- 40.0 months) and 40 age- and sex-matched healthy controls (26 men, 14 women; mean age: 35.5 +/- 7.1 years) participated in the study. The relationship between C-IMT and haematocrit-corrected erythrocyte sedimentation rate (Hct-corrected ESR), beta 2 microglobulin (beta2M) and serum cardiac troponin I (cTnI) levels beyond C-reactive protein (CRP), lipid profile and lipoprotein(a), fibrinogen, homocysteine and left ventricular hypertrophy (LVH) were examined. RESULTS: Mean C-IMT of the HD patients was significantly greater than that of the control subjects (0.59 +/- 0.06 vs 0.53 +/- 0.07 mm, P = 0.002). C-IMT of patients was positively correlated with age (r = 0.33), body mass index (r = 0.40), Hct-corrected ESR (r = 0.37), CRP (r = 0.34), beta2M (r = 0.34), cTnI (r = 0.26), triglyceride (r = 0.26) and fibrinogen (r = 0.28) levels (P < 0.05 for all). The mean C-IMT was significantly greater in patients with LVH than it was in those without LVH (P = 0.004). In multivariate regression analysis, age (P = 0.02), beta2M (P = 0.001), log-transformed CRP (P = 0.03) and LVH (P = 0.01) were independently related with C-IMT. CONCLUSION: Besides well-known cardiovascular (CV) risk factors, cTnI and beta2M were related with C-IMT in that they may have important roles in early-onset atherosclerosis in this high-risk population. 相似文献
100.
Altundag O Gullu I Altundag K Yalcin S Ozyar E Cengiz M Akyol F Yucel T Hosal S Sozeri B 《Head & neck》2005,27(1):15-21
BACKGROUND: Induction chemotherapy with cisplatin and fluorouracil and radiotherapy is an effective alternative to surgery in patients with carcinoma of the larynx and hypopharynx who are treated for organ preservation. METHODS: We designed a protocol to evaluate the possibility of organ preservation in patients with advanced, resectable carcinoma of the larynx and hypopharynx. Forty-five eligible patients who were followed up between April 1999 and May 2001 were enrolled. Initially, these patients were treated with two cycles of induction chemotherapy consisting of cisplatin, 20 mg/m2/day on days 1 to 5, and 5-fluorouracil, 600 mg/m2/day by continuous infusion on days 1 to 5. Patients who had a complete response to chemotherapy were treated with definitive radiotherapy; patients who had a partial response to chemotherapy were treated with chemoradiotherapy. Cisplatin, 35 mg/m2/week, was introduced throughout the duration of radiotherapy. Patients who had no response or progressive disease underwent surgery with postoperative radiotherapy. Patients with N2 or N3 positive lymph nodes underwent neck dissection after the treatment. RESULTS: The mean age was 56.6 years (range, 34-75 years). The overall response rate to induction chemotherapy was 71.1%, with a 17.8% complete response rate and 53.3% partial response rate. With a median follow-up of 13.7 months, 23 (51.1%) of all patients and 63.3% of surviving patients have had a preservation of the larynx or hypopharynx and remain disease free. The most common toxicities were nausea and vomiting and mucositis. CONCLUSION: Organ preservation, with multimodality treatment, may be achievable in some of the patients with resectable, advanced larynx or hypopharynx cancers without apparent compromise of survival. 相似文献