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71.
van Rijk MC Tanis PJ Nieweg OE Loo CE Olmos RA Oldenburg HS Rutgers EJ Hoefnagel CA Kroon BB 《Annals of surgical oncology》2007,14(2):627-632
Background Preliminary data have shown encouraging results of a single intratumoral radiopharmaceutical injection that enables both sentinel
node biopsy and probe-guided excision of the primary tumor in patients with nonpalpable breast cancer. The aim of the study
was to evaluate this approach in a large group of patients.
Methods Lymphoscintigraphy was performed in 368 patients with nonpalpable breast cancer after intratumoral injection of 99mTc-nanocolloid (.2 mL, 123 MBq, 3.3 mCi) guided by ultrasound or stereotaxis. The sentinel node was pursued with the aid of
vital blue dye (1.0 mL, intratumoral) and a gamma ray detection probe. In case of breast-conserving surgery, the probe was
used to guide the excision.
Results At least one sentinel node could be identified intraoperatively in 357 patients (97%), of whom 69 had involved nodes (19%).
Age over 60 years was associated with less frequent nonaxillary lymphatic drainage and absence of internal mammary chain dissemination.
Tumor-free margins were obtained in 262 (89%) of the 293 patients who underwent segmental excision. Re-excision of the primary
tumor bed was performed in six patients (2%). During a median follow-up of 22 months, one breast recurrence and one axillary
recurrence were observed.
Conclusions Lymphatic mapping and probe-guided tumor excision of nonpalpable breast cancer by intralesional administration of a single
dose of 99mTc-nanocolloid and blue dye resulted in 97% identification of the sentinel node and in tumor-free margins in 89% of the patients
who underwent breast-conserving surgery. Longer follow-up is needed to substantiate the accuracy and safety of this technique. 相似文献
72.
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74.
目的探讨经关节入路微创钢板固定(MIPPO)技术治疗股骨远端C型骨折的临床疗效。方法2002年4月~2005年2月,应用MIPPO技术治疗股骨远端C型骨折14例,按AO/ASIF分类:C1型3例,C2型6例,C3型5例。先行关节内骨折切开复位、松质骨螺钉固定,再行髁上部分骨折间接复位、经关节内切口插入髁支撑钢板或LISS钢板桥接固定骨折。结果12例患者获得10~32个月(平均18.4个月)随访,骨折均获愈合,愈合时间10周~12个月,平均4.6个月。按Kolmert和Wulff的评价标准:优4例,良5例,可2例,差1例,优良率为75%。结论应用MIPPO技术治疗股骨远端C型骨折实现了微创操作,具有创伤小、软组织干扰少、骨折愈合快等优点,疗效满意。 相似文献
75.
蔡俊超 《中华移植杂志(电子版)》2010,(4)
随着器官移植体液免疫理论的发展与抗体检测技术的进步,抗体介导的排斥反应(AMR)已逐渐被认识和引起关注。其治疗难度大、逆转率较低,已成为导致移植物失功的重要原因。本文较为系统地介绍了AMR的免疫机制、诊断与防治进展,以及供者特异性抗体的检测技术和临床意义,从而提出供者特异性抗体是引起移植物排斥反应特别是慢性排斥反应的主要原因,移植受者需常规监测抗体以利及时干预和治疗。 相似文献
76.
C Badenas J To-Figueras JD Phillips CA Warby C Muñoz and C Herrero 《Clinical genetics》2009,75(4):346-353
Porphyria cutanea tarda (PCT) arises from decreased hepatic activity of uroporphyrinogen decarboxylase (UROD). Both genetic and environmental factors interplay in the precipitation of clinically overt PCT, but these factors may vary between different geographic areas. Decreased activity of UROD in erythrocytes was used to identify patients with UROD mutations among a group of 130 Spanish PCT patients. Nineteen patients (14.6%) were found to harbor a mutation in the UROD gene. Eight mutations were novel: M1I, 5del10, A22V, D79N, F84I, Q116X, T141I and Y182C. Five others were previously described: F46L, V134Q, R142Q, P150L and E218G. The new missense mutations and P150L were expressed in Escherichia coli. D79N and P150L resulted in proteins that were localized to inclusion bodies. The other mutations produced recombinant proteins that were purified and showed reduced activity (range: 2.3–73.2% of wild type). These single amino acid changes were predicted to produce complex structural alterations and/or reduced stability of the enzyme. Screening of relatives of the probands showed that 37.5% of mutation carriers demonstrated increased urinary porphyrins. This study emphasizes the role of UROD mutations as a strong risk factor for PCT even in areas where environmental factors (hepatitis C virus) have been shown to be highly associated with the disease. 相似文献
77.
目的观察变应性鼻炎(AR)脱敏治疗的效果,探讨影响变应性鼻炎脱敏治疗效果的相关因素。方法对185例AR患者通过皮肤试验,选择敏感变应原浸液,按递增剂量进行常规皮下脱敏治疗。根据患者治疗前后的症状和体征得分情况,分为显效、有效和无效。选择性别、年龄、病程、病情、伴慢性鼻窦炎、伴哮喘、脱敏治疗时间、皮试反应等8个影响变应性鼻炎脱敏治疗效果的可能因素进行多元回归分析,筛查影响脱敏治疗效果的因素。结果总有效率74.6%,其中显效22.9%,有效51.7%。影响脱敏治疗效果的主要因素是治疗时间,即时间越长,效果越好(P〈0.01);其次是年龄因素,年龄越小,效果越好(P〈0.05);伴慢性鼻窦炎和伴哮喘也可能影响脱敏治疗效果(P值分别为0.072和0.069)。结论变应性鼻炎脱敏治疗是有效的,脱敏治疗时间越长、年龄越小,效果越好。 相似文献
78.
79.
High sensitivity of radiolabelled antimyosin scintigraphy in assessing anthracycline related early myocyte damage preceding cardiac dysfunction 总被引:2,自引:0,他引:2
Valdés Olmos RA Carrió I Hoefnagel CA Estorch M ten Bokkel Huinink WW López-Pousa J Dalesio O 《Nuclear medicine communications》2002,23(9):871-877
In antimyosin scintigraphy was evaluated at various cumulative anthracycline dose levels in order to early identify patients with severe cardiac injury and increased long-term risk of cardiac dysfunction. Twenty-four patients receiving standard doses of 60-75 mg.m(-2) doxorubicin or 90-112.5 mg.m(-2) epirubicin were followed at baseline, low (two cycles), middle (four cycles), and high (six cycles) cumulative dose using (111)In antimyosin 48 h heart-to-lung ratio (HLR), left ventricle ejection fraction (LVEF) and peak filling rate (PFR). At a low cumulative dose only HLR was significantly increased (P=0.0001); at middle dose HLR (P<0.0001) and LVEF (P=0.0054), but not PFR, were significantly changed, and at high dose HLR (P<0.0001), LVEF (P=0.0001) and PFR (P=0.033) all changed significantly. Concerning individual results, HLR became abnormal in 18 patients (75%) at low, 22 (92%) at middle, and 24 (100%) at high cumulative dose whereas LVEF and PFR remained within normal limits in all patients. It is concluded that myocyte damage appears to precede left ventricle systolic and diastolic dysfunction in anthracycline treatment. (111)In antimyosin scintigraphy is very sensitive in detecting myocardial damage after cumulative dose levels even as low as 120-150 mg.m(-2) doxorubicin or 180-225 mg.m(-2) epirubicin. 相似文献
80.
Phase 1 study to identify tumour hypoxia in patients with head and neck cancer using technetium-99m BRU 59-21 总被引:2,自引:2,他引:0
Hoebers FJ Janssen HL Olmos AV Sprong D Nunn AD Balm AJ Hoefnagel CA Begg AC Haustermans KM 《European journal of nuclear medicine and molecular imaging》2002,29(9):1206-1211
The aim of this study was to assess the safety and biodistribution of technetium-99m BRU 59-21, a novel radioactively labelled 2-nitro-imidazole hypoxic marker, in head and neck cancer patients and to correlate uptake with pimonidazole staining. (99m)Tc-BRU 59-21 was administered intravenously (mean dose 824 MBq, range 780-857 MBq) to ten head and neck cancer patients scheduled for primary surgery, and whole-body images and SPET scans were then obtained. Uptake of radioactivity in the regions of interest was determined and tumour to normal tissue ratios were calculated after correlative evaluation with MRI/CT. Twelve to 16 h before surgery (up to 2 weeks after the scan), patients received pimonidazole intravenously. Tumour sections were stained immunohistochemically for pimonidazole binding. No serious adverse events were reported. In five patients there were ten adverse events, which were mild in intensity and resolved completely without intervention. Uptake of (99m)Tc-BRU 59-21 was observed in eight of the ten primary tumours. Tumour to normal tissue ratios on the SPET scans for primary tumour and lymph nodes increased from 1.8 (range 0.9-2.7) to 2.1 (range 0.8-3.7) between 30 min and 3 h post injection. Tumour to normal tissue ratios in the primary tumour were significantly correlated with pimonidazole staining for SPET scans performed 30 min and 3 h post injection ( P=0.016 and P=0.037, respectively). When primary tumour and involved lymph nodes were considered in conjunction, correlation between the tumour to normal tissue ratio and pimonidazole staining was observed for early ( P<0.001) but not for late SPET scans ( P=0.076). However, late scans showed better tumour delineation than early scans. Administration of (99m)Tc-BRU 59-21 in head and neck cancer patients appears to be safe and feasible. Uptake and retention in tumour tissue was observed, suggestive of tumour hypoxia, and this was supported by correlations with staining for the hypoxic marker pimonidazole. 相似文献