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31.
A retrospective review is presented of 1353 consecutivepatients with histopathologically confirmed invasive breast carcinoma treatedradically with curative intent during the decade 1980–89.None had received adjuvant systemic therapy with hormonesor prolonged chemotherapy. The distribution of lymph-node negative(N–) and lymph-node positive (N+) patients was 75%and 25%, respectively.The treatment and outcome were analysed as regardsconventional prognostic parameters, in particular considering the axillarylymph-node status and the responsible hospital category (GeneralMunicipal Hospitals (MH)) versus Comprehensive Cancer Center (CC)).The most striking difference was detected as regardsthe number of examined lymph nodes. The mediannumber of nodes described at the MH was7, as compared to 14 at the CC(p < 0.001). In patients with pT1 tumoursthe highest rate of lymph-node positivity was observedwhen 10 or more axillary nodes were removed.Adjuvant radiotherapy reduced the loco-regional recurrence rate inthe N– patients, whereas only the regional recurrenceswere reduced among the N+ patients. The five-and 10-year tumor-related survival rates were 86% and76%, respectively, with no difference between the MHand the CC.As life-prolonging adjuvant hormone therapy and chemotherapy isnow available for patients with axillary lymph nodemetastases, it is important that patients with breastcancer are operated adequately with the aim toremove at least 10 axillary lymph nodes. Athorough examination of the axillary content should beperformed by the pathologist, and the number ofresected lymph nodes and metastases should be reported.The establishment of nation-wide standard criteria for themanagement of breast cancer is recommended.  相似文献   
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Summary ? Objectives. A number of different image-guided surgical techniques have been developed during the past decade. None of these methods can provide the surgeon with information about the dynamic changes that occur intra-operatively. The development of open configurated MRI-scanners leads to new perspectives in the intra-operative management and resection control of intracranial tumours.  Material and Method. Using a vertical open 0.5 T MRI-scanner for intra-operative MR image guided neurosurgery, forty-four patients (20 female/24 male) with different intracranial tumours have been operated on since August 1997. The patients ranged in age from 20 to 70 years (mean±standard deviation=47.2±15.9 ys).  Results. In 36 (82%) of 44 patients the tumours were completely removed with the aid of MR image-guidance. In 8 cases (18%) complete removal was not achieved. Postoperatively 6 (14%) of 44 patients developed neurological deficits which were transient in 5 cases (paresis, dysphasia). In these patients the tumours were located in or near eloquent brain areas (sensorimotor cortex/speech center).  Conclusion. Intra-operative MRI is helpful for navigation as well as determining of tumour margins to achieve a complete and safe resection of intracranial lesions. Complications related to the surgical procedure are reduced and the risk of neurological deterioration due to tumour removal and postoperative complications is minimized. It can be concluded that the intra-operative application of interventional MRI technology may represent a major step foreward in the field of neurosurgery.  相似文献   
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In the present study, we comparatively evaluated the anticoagulant efficacy of the new direct thrombin inhibitor melagatran in cord vs. adult plasma. In contrast to heparin, melagatran does not require antithrombin as a cofactor. Thus, anticoagulant treatment with melagatran is of special interest in neonatal patients, whose plasma is relatively deficient in antithrombin. We evaluated the anticoagulant action of increasing amounts of melagatran (0.1–2.0 μmol/l) in both cord and adult plasma by means of calibrated automated thrombography (CAT) with respect to the lag time until the onset of thrombin formation, time to thrombin peak maximum (TTP), endogenous thrombin potential (ETP), and thrombin peak height. Melagatran exhibited approximately the same ability to prolong lag times or TTPs in both cord and adult plasma. Similar concentrations (IC50) of melagatran were required to double the lag times (0.44±0.04 μmol/l vs. 0.52±0.05 μmol/l) or to double the TTPs (0.91±0.08 μmol/l vs. 1.06±0.09 μmol/l) in cord vs. adult plasma. Melagatran exhibited a higher ability to suppress ETPs or thrombin peak heights in cord vs. adult plasma. Markedly lower concentrations (IC50) of melagatran were required to suppress ETPs (0.27±0.03 μmol/l vs. 0.70±0.06 μmol/l) or thrombin peak heights by 50% (0.29±0.03 μmol/l vs. 0.53±0.04 μmol/l) in cord vs. adult plasma. We conclude that our results suggest a higher ability of melagatran to suppress thrombin formation in cord vs. adult plasma. Thus, lower amounts of melagatran might be required in neonates undergoing antithrombotic therapy.  相似文献   
35.
Three new isocoumarin derivatives ( 2- 4) were isolated together with monocerin ( 1) from Microdochium bolleyi, an endophytic fungus from Fagonia cretica, a herbaceous plant of the semiarid coastal regions of Gomera. Compounds 2 and 3 are both 12-oxo epimers of 1, and 4 is a ring-opened derivative of 1. The structures were elucidated by detailed spectroscopic analysis and comparison with reported data. The absolute configurations were determined by a modified Mosher's method. Compounds 1, 3, and 4 showed good antifungal, antibacterial, and antialgal activities against Microbotryum violaceum, Escherichia coli, Bacillus megaterium, and Chlorella fusca. Compound 2 was moderately antifungal and antialgal.  相似文献   
36.
Zusammenfassung Das Wachstumsverhalten zweier in das Gehirn von Goldhamstern implantierter menschlicher Tumoren (H. Ad. Nr. 1 und H. S. Nr. 1) wurde untersucht. Bei allen Tieren konnte ein Tumorwachstum histologisch nachgewiesen werden. Cortisonvorbehandlung der Wirtstiere begünstigte bei H. Ad. Nr. 1 die Tumorausbreitung und führte frühzeitiger zum Tode. Das intracerebrale Tumorwachstum führte jedoch auch unabhängig von der Wirtsvorbehandlung bei allen Tieren zum Tode innerhalb von 4 Wochen nach der Transplantation. Beide Geschwulst-typen wuchsen am besten in den liquorhaltigen Räumen, weniger in der Hirnsubstanz. Die Bevorzugung der Meningen durch beide Tumortypen entspricht der allgemeinen Erfahrung über die cerebrale Metastasierung entdifferenzierte Sarkome und Adenocarcinome.
Summary The growth behavior of two human tumors (H. Ad. No. 1 and H. S. No. 1) transplanted to the hamster brain has been studied. Tumor growth could be histologically verified in all animals inoculated. Cortisone-conditioning of the host increased tumor expansion and resulted in an earlier and more rapid death rate in the H. Ad. No. 1 group. Regardless of tumor or host-conditioning employed, all animals succumbed to intracerebral tumor growth by the end of the fourth week post transplantation. Both tumor types grew better in the ventricles and subarachnoid space than in the brain tissue itself. The predilection of these two tumor types for the meninges confirms our clinical knowledge on the pattern of cerebral metastasis of dedifferentiated sarcomas and adenocarcinomas.


Mit Unterstützung der Deutschen Forschungsgemeinschaft.  相似文献   
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Ohne Zusammenfassung Im Auszug vorgetragen von Dr. R. Kraus am IX. internat. Congresse für Hygiene und Demographie (Madrid April 1898).  相似文献   
39.
European Archives of Psychiatry and Clinical Neuroscience - Significant evidence links white matter (WM) microstructural abnormalities to cognitive impairment in schizophrenia (SZ), but the...  相似文献   
40.
The purpose was to evaluate the relative glycosaminoglycan (GAG) content of repair tissue in patients after microfracturing (MFX) and matrix-associated autologous chondrocyte transplantation (MACT) of the knee joint with a dGEMRIC technique based on a newly developed short 3D-GRE sequence with two flip angle excitation pulses. Twenty patients treated with MFX or MACT (ten in each group) were enrolled. For comparability, patients from each group were matched by age (MFX: 37.1 ± 16.3 years; MACT: 37.4 ± 8.2 years) and postoperative interval (MFX: 33.0 ± 17.3 months; MACT: 32.0 ± 17.2 months). The Δ relaxation rate (ΔR1) for repair tissue and normal hyaline cartilage and the relative ΔR1 were calculated, and mean values were compared between both groups using an analysis of variance. The mean ΔR1 for MFX was 1.07 ± 0.34 versus 0.32 ± 0.20 at the intact control site, and for MACT, 1.90 ± 0.49 compared to 0.87 ± 0.44, which resulted in a relative ΔR1 of 3.39 for MFX and 2.18 for MACT. The difference between the cartilage repair groups was statistically significant. The new dGEMRIC technique based on dual flip angle excitation pulses showed higher GAG content in patients after MACT compared to MFX at the same postoperative interval and allowed reducing the data acquisition time to 4 min.  相似文献   
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