Dysplastic nevi. Markers for increased risk for melanoma

A total of 452 white patients, classified into four dysplastic nevi groups, were followed prospectively by repetitive, complete cutaneous examinations using total-body photographs taken on entry into the study. Sixteen patients (3.5%) developed 18 newly diagnosed malignant melanomas (MM) during an average follow-up period of 27 months. Twelve of the 18 MM were in situ, and all of the six primary invasive MM diagnosed prospectively in this follow-up were less than 0.89 mm in Breslow thickness, implying an excellent prognosis. Compared with reference populations, the number of MM detected significantly exceeded the number estimated to occur in the comparable age-matched control groups. These data support the concept of repetitive follow-ups of all groups of patients with dysplastic nevi.     

Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy

Gadolinium-labeled diethylenetriaminepentaacetic acid was used as a contrast agent for stereotactic magnetic resonance (MR) imaging in six selected patients with brain tumors who underwent stereotactic biopsy. Regions of contrast enhancement demonstrated by computed tomography (CT) and MR imaging in four of the six patients correlated with areas of malignant neovascularity and endothelial proliferation within solid tumor. Radiation necrosis produced contrast enhancement indistinguishable from that of recurrent neoplasm. Isolated tumor cells within intact white matter were identified in biopsy specimens obtained outside of regions that were depicted as abnormal by contrast material-enhanced CT, as well as by precontrast and postcontrast T1- and T2-weighted MR images.     

Measurement of central somatosensory conduction time in patients undergoing cardiopulmonary bypass: an index of neurologic function

It is feasible to monitor somatosensory evoked potentials and central somatosensory conduction times during open heart surgery and cardiopulmonary bypass with moderate or profound hypothermia. Central conduction times are reproducible, have acceptably low interpatient and intrapatient variability, and are not significantly affected by fentanyl-induced anesthesia. There is a predictable logarithmic relationship between central conduction times and temperature with the central conduction time increasing by 6.6 percent for a 1 degree C decrease in temperature. These data indicate that somatosensory conduction times may be a useful index of central nervous system integrity during open heart surgery that utilizes cardiopulmonary bypass and hypothermia.     

Malignant melanoma in the 1990s: the continued importance of early detection and the role of physician examination and self-examination of the skin

Despite the exciting new techniques being developed to help diagnose early malignant melanoma, the current standard of care remains periodic examination of the skin. The combination of routine physician examination coupled with self-examination of the skin provides an opportunity for the identification of early malignant melanoma. Removal of such thin lesions can significantly reduce the ever-increasing mortality rate from this potentially serious form of cutaneous cancer.