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91.
Sanjeev Patil FRCS M. V. Chandu de Silva MD Jim Crossan FRCS Robin Reid FRCPath 《The Journal of foot and ankle surgery》2003,42(5):290-295
Twelve chondrosarcomas of the bones of the feet from 11 patients in the Scottish Bone Tumor Registry were reviewed. One patient with diaphyseal aclasis (osteochondromatosis) developed 2 chondrosarcomas. The mean age of patients was 52.3 years (range, 17 to 83 years). Men were predominantly affected. Four tumors affected the tarsal bones; the rest involved the short tubular bones. The usual clinical presentation was a painful, progressively enlarging swelling. Radiologically, most showed some bone expansion, cortical destruction with indistinct margins, and soft-tissue extension. Histologically, the majority were middle-grade tumors. Treatment included curettage or local excision for 4 tumors and amputation or ray resection for 8 tumors. Follow-up varied from 6 months to 18 years (average, 5.8 years). Local recurrence after surgery was seen in 3 patients. All 3 died because of metastases to the lungs or brain. 相似文献
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CANDY MB ChB MORRISON MB ChB MRCP PATON BSc PhD DipCB LOGAN MB ChB BSc FRCP FRCPath & LAWSON MB ChB FRCA 《Paediatric anaesthesia》1998,8(5):421-423
We report a case of hyperpyrexia presumed due to topical salicylate toxicity occurring immediately following general anaesthesia for appendicectomy in an eleven year old boy. Some of the features strongly suggested the diagnosis of malignant hyperpyrexia. 相似文献
94.
Bovine papillomaviruses have a major contribution to make in unravelling the mechanisms of oncogenesis by this group. Most papillomaviruses can exert their biologic effect only in vivo, but several of the bovine types transform fibroblasts in culture; the altered cells have measurable attributes such as anchorage independence, density inhibition, and tumorigenicity in nude mice. Another important feature is that subgenomic fractions of DNA can be transfected into cells and elicit transformation. It is, therefore, possible to undertake quantitative molecular biologic and genetic studies in a way which is impossible with most papillomaviruses. Large amounts of virus can be obtained from bovine tumors. The six currently characterized viruses have all been cloned by recombinant techniques, and are the subject of intensive comparative research in many laboratories. 相似文献
95.
Background The definition of a clear margin in breast-conserving therapy is uncertain. The purpose of this study was to correlate the
tumor-margin distance of the excision specimen with the presence of residual tumor at reoperation. We also analyzed predictors
of compromised margins and of residual disease.
Methods All patients who underwent breast-conserving therapy for invasive disease from 1999 to 2003 were reviewed. Pathologic characteristics
and the precise tumor distance from the radial margin were recorded. A radial margin was compromised if invasive or (ductal)
in situ carcinoma was <5 mm from the margin.
Results Of the 612 patients who underwent breast conservation, 211 (34%) had compromised margins, and 39 had undetermined margins.
Of the 161 patients who had a reoperation for compromised margins, 87 (54%) had residual disease. Residual disease after reoperation
was present in 58% (56 of 96), 56% (9 of 16), and 45% (22 of 49) of those with tumor-margin distances <1 mm, ≥1 and <2 mm,
and ≥2 and <5 mm, respectively. There was a progressive decline in residual disease for each millimeter until a rate of 22%
for tumor-margin distances of ≥4 mm and <5 mm was reached. Pathologic size (P = .004), an extensive intraductal component (P = .002), referral from a symptomatic rather than a population-based screening program (P = .02), and the absence of a preoperative diagnosis by core biopsy (P < .0001) were predictive of compromised margins. Only young age (<45 years) was predictive of finding residual disease on
reoperation (P = .02).
Conclusions A total of 45% of patients who had tumor 2 to 5 mm from the radial margin had residual disease on reoperation. Our results
support a policy of requiring a 5-mm margin in patients undergoing breast-conserving therapy for invasive disease. 相似文献
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99.
Carl E. Silver MD Randall P. Owen MD MS Juan P. Rodrigo MD PhD Kenneth O. Devaney MD JD FCAP Alfio Ferlito MD DLO DPath FRCSEd ad hominem FRCS ad eundem FDSRCS ad eundem FHKCORL FRCPath FASCP IFCAP 《Head & neck》2011,33(7):1052-1059
A number of histologic variants of well‐differentiated papillary carcinoma have been found to be associated with more aggressive tumor behavior. Tall cell, columnar cell, diffuse sclerosing, solid/trabecular, and insular variants of well‐differentiated papillary thyroid cancer are all potentially more aggressive than conventional papillary thyroid cancer. When subjected to multivariate analysis, however, evidence that the histologic subtype of tumor is an independent predictor of outcome is weak. Rather, the aggressive variants tend to present with features recognized by other staging systems as associated with a worse prognosis, including higher histologic grade, extracapsular spread, large tumor size, and the presence of distant metastases. Prognosis is directly related to the presence of these features. The state of our knowledge is limited by the relatively small number of cases that have been studied. The presence of an aggressive variant of papillary carcinoma should alert the surgeon that he is dealing with a potentially aggressive tumor. Clinical treatment decisions should be based on the stage of the disease, influenced by the knowledge that the aggressive variants tend to be associated with higher risk factors. The surgeon must be prepared to perform at the first, or second stage, a total thyroidectomy, central compartment neck dissection, additional lymphadenectomy, and/or resection of invaded surrounding structures, and search for distant metastasis. Postoperative radioactive iodine should generally be administered for these variants as they will generally be intermediate to advanced tumors. The tall cell variant is often refractory to such treatment but may be susceptible to treatment targeted against BRAF mutation. External beam irradiation may be used in cases of incomplete resection. © 2010 Wiley Periodicals, Inc. Head Neck, 2011 相似文献
100.
Jesus E. Medina MD Alfio Ferlito MD DLO DPath FRCSEd ad hominem FRCS ad eundem FDSRCS ad eundem FHKCORL FRCPath FASCP IFCAP K. Thomas Robbins MD FRCSC Carl E. Silver MD Juan P. Rodrigo MD PhD Remco de Bree MD Mohamed N. Elsheikh MD Randal S. Weber MD Jochen A. Werner MD 《Head & neck》2011,33(5):746-752
We report here a review of the literature intended to clarify the nomenclature and boundaries of the nodes in the “central compartment” of the neck, the frequency with which tumors from the different laryngeal sites metastasize to these nodes, and the indications for central compartment node dissection in the treatment of cancers of the larynx. From this review, we conclude that, until consensus is reached about grouping of the lymph nodes in this area, it is best to refer to these nodes by their anatomic location, ie, prelaryngeal, pretracheal, or paratracheal lymph nodes. It is also advisable to describe dissection of these nodes as selective neck dissection (SND) with an annotation about the specific lymph node groups removed. Metastases in prelaryngeal and paratracheal lymph nodes in patients with squamous cell carcinoma of the larynx are associated with increased tumor recurrence, more frequent metastases in lymph nodes of the lateral compartment of the neck, and decreased survival. If untreated, they may lead to the development of peristomal recurrence. Therefore, elective treatment of level VI nodes is recommended in patients with squamous cell carcinomas of the subglottic region, advanced glottis carcinomas with subglottic extension, and in certain advanced carcinomas of the supraglottic region. © 2010 Wiley Periodicals, Inc. Head Neck, 2011 相似文献