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181.
Concomitant administration of granulocyte transfusions and amphotericin B in neutropenic patients: absence of significant pulmonary toxicity 总被引:1,自引:0,他引:1
One hundred and ninety-five series of granulocyte transfusions in 144 patients were evaluated with respect to possible severe pulmonary toxicity from concomitant administration of granulocytes and amphotericin B. Dyspnea as a side effect of granulocyte transfusion was equally common among patients receiving amphotericin B and those in a matched control group not receiving amphotericin B. Granulocyte transfusions and amphotericin B were given simultaneously in 35 transfusion series, involving 32 patients. Respiratory deterioration, defined as the appearance of new pulmonary infiltrates on chest x-ray, occurred in 11 of these 35 episodes. Patients developing respiratory deterioration were similar to those not developing respiratory deterioration in age, diagnosis, disease status, duration of concomitant therapy, and outcome, but more often had positive fungal cultures as an indication for treatment (91% versus 58%; p = 0.1). In 8 patients, the episodes of respiratory deterioration were readily explained by congestive heart failure, by simultaneous bacteremia or fungemia, or by fungal pneumonia discovered at autopsy. One patient had a leukoagglutinin reaction (responsive to steroids) and the other 2 had unexplained, but reversible respiratory deterioration. We concluded that concomitant administration of granulocyte transfusions and amphotericin B is not associated with unexpected or rapidly fatal pulmonary toxicity and when appropriate, can be safely accomplished. 相似文献
182.
Absence of functional messenger RNA activity for beta globin chain synthesis in beta 0-thalassemia 总被引:3,自引:0,他引:3
Functional human globin messenger RNA was isolated from reticulocytes of two patients with homozygous beta 0-thalassemia, three patients with sickle cell beta 0-thalassemia, and one patient doubly heterozygous for beta 0-thalassemia and hemoglobin Lepore. When incubated in the Krebs type II mouse ascites tumor-cell-free system, messenger RNA from these patients actively directed the synthesis of human beta s and/or alpha- and gamma-globin chains but failed to stimulate the synthesis of any beta A-chains, even though nonthalassemic human globin mRNA preparations consistently stimulated two to four times as much beta A- or beta S-globin chain synthesis as alpha-chain synthesis when incubated in the same system under the same conditions. These results strongly suggest that functional beta A-chain-specific globin mRNA is absent in beta 0-thalassemia. 相似文献
183.
184.
Cindy B. Matsen MD Allison Hirsch BA Anne Eaton MS Michelle Stempel MPH Alexandra Heerdt MD Kimberly J. Van Zee MD Hiram S. Cody III MD Monica Morrow MD George Plitas MD 《Annals of surgical oncology》2014,21(10):3330-3335
Background
Ductal carcinoma in situ with microinvasion (DCISM) is a rare diagnosis with a good prognosis. Although nodal metastases are uncommon, sentinel lymph node biopsy (SLNB) remains standard care. Volume of disease in invasive breast cancer is associated with SLNB positivity, and, thus we hypothesized that in a large cohort of patients with DCISM, multiple foci of microinvasion might be associated with a higher risk of positive SLNB.Methods
Records from a prospective institutional database were reviewed to identify patients with DCISM who underwent SLNB between June 1997 and December 2010. Pathology reports were reviewed for number of microinvasive foci and categorized as 1 focus or ≥2 foci. Demographic, pathologic, treatment, and outcome data were obtained and analyzed.Results
Of 414 patients, 235 (57 %) had 1 focus of microinvasion and 179 (43 %) had ≥2 foci. SLNB macrometastases were found in 1.4 %, and micrometastases were found in 6.3 %; neither were significantly different between patients with 1 focus versus ≥2 foci (p = 1.0). Patients with positive SLNB or ≥2 foci of microinvasion were more likely to receive chemotherapy. At median 4.9 years (range 0–16.2 years) follow-up, 18 patients, all in the SLNB negative group, had recurred for an overall 5-year recurrence-free proportion of 95.9 %.Conclusions
Even with large numbers, there was no higher risk of nodal involvement with ≥2 foci of microinvasion compared with 1 focus. Number of microinvasive foci and results of SLNB appear to be used in decision making for systemic therapy. Prognosis is excellent. 相似文献185.
The surgical oncologist is frequently responsible for the screening and diagnosis of women with breast cancer. In this pivotal role, they are often the first to discuss treatment options, including nonsurgical interventions, with breast cancer patients. Recent long-term clinical trial data provide support for the use of tamoxifen to prevent breast cancer in women at high risk of the disease. A breast cancer risk assessment can help identify women at higher than average risk for the disease, who may be appropriate candidates for chemoprevention. It is important for the surgical oncologist to understand the current indications and evidence regarding the use of tamoxifen for breast cancer prevention and treatment as they counsel their patients on available options. 相似文献
186.
M. Engelbach S. Heerdt R. Görges T. Kunt A. Pfützner T. Forst K. Diefenbach S. Walgenbach J. Beyer 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1998,383(6):456-459
Introduction: Persistent detectable calcitonin (CT) values can be frequently observed after treatment of medullary thyroid carcinomas (MTCs).
Apart from residual C cells or incomplete tumor extirpation, ectopic CT production should be taken into account. CT determination
in patients without MTC and after total thyroidectomy should reveal to what extent, apart from the C cells, other neuroendocrine
cells show a relevant CT production. Objectives: The objective of this study was to find out whether ectopic CT production can be detected using an assay specifically recognizing
the monomeric form of CT. Methods: The CT serum values were obtained from 94 healthy individuals and 64 patients who had undergone total thyroidectomy and radioiodine
therapy because of follicular or papillary carcinoma. Results: In the group of thyroidectomized patients, the CT values were below the detection limit of the assay. In the tested patients,
there was neither a physiological (C cell) nor a pathological (MTC cell) secretion of monomeric CT. Conclusion: A relevant ectopic monomeric CT production could be excluded because the patients were without detectable CT concentration.
For this reason, postoperative CT concentrations of the monomeric form in MTC patients can be traced either to remaining C
cells or to tumor cells. For a differentiation of these two possibilities further diagnostics is necessary.
Received: 29 January 1998; in revised form: 16 July 1998 / Accepted: 12 August 1998 相似文献
187.
188.
Choroidal hematoma and effusion: evaluation with MR imaging 总被引:2,自引:0,他引:2
To evaluate the usefulness of magnetic resonance (MR) imagining in the evaluation of choroidal pathologic conditions, the authors studied 15 patients with either choroidal hematoma or choroidal effusion with a 1.5-T MR imager. These two lesions were reliably distinguished from each other on the basis of MR findings. Choroidal hematomas appeared as lenticular-shaped masses in the wall of the eyeball, and signal intensity depended on the age of the hematoma. Choroidal effusions appeared as crescentic or ring-shaped areas of increased signal on both T1- and T2-weighted images in an anatomic distribution corresponding to the choroidal and suprachoroidal spaces. 相似文献
189.
PG Ortiz† BG Skov‡ E Benfeldt† 《Journal of the European Academy of Dermatology and Venereology》2005,19(4):487-490
Alpha(1)-antitrypsin deficiency, a relatively frequent mutation in the population, is associated with the development of panlobular emphysema and liver cirrhosis. The deficiency is in rare cases associated with the development of panniculitis, and very differentiated clinical courses have been reported in the literature. We report a case of panniculitis in a patient with alpha(1)-antitrypsin deficiency and describe briefly the pathophysiology of the disease and current treatment possibilities. 相似文献
190.