Haemangiomas are the most common tumours of infancy. They typically proliferate then involute with considerable variation
as regards to their rates of proliferation and involution. Haemangioma of the nasal tip is a lesion of special characteristics.
During proliferation, it expands, contracts and deviates the nasal cartilages. Particularly, it regresses slowly and frequently
involutes incompletely. That is why excision of the lesion is frequently suggested. The present study was conducted to evaluate
open rhinoplasty after initial non-excision treatment modalities namely, intra-lesional corticosteroid injections and laser
treatment, as a protocol of treatment for nasal tip haemangiomas. Twelve patients with nasal tip haemangiomas were included
in the present study. Patients of both sexes, of different ages, with deep and mixed haemangiomas were studied. Disfigurement
was the constant presenting symptom. Initial non-excision treatment reported different responses as denoted by the regression
of the lesions’ size. Haemangiomas constantly extended between the medial crura of the alar cartilages as noted by the constant
widening of the columella pre-operatively and the obvious separation of the nasal cartilages intra-operatively. This separation
was constantly found to require approximation by sutures. The results of the present study concluded that whenever an early
presentation with nasal tip haemangioma could be established, initial non-excision treatment followed by open rhinoplasty
could be a useful protocol of treatment. Within the limitations of the present study, this protocol could achieve an early,
safe and effective treatment for nasal tip haemangiomas with provisionally acceptable cosmetic outcomes so far. 相似文献
This study investigates whether tissue recoil or patient intrinsic factors influence the final position of the nipple areola
complex (NAC) after reduction mammoplasty.
The age, pre-operative ptosis, BMI and weight of the tissue resected were recorded as patient intrinsic factors in 37 patients
undergoing reduction mammoplasty. The “spring-back” value was defined as the distance from the sternal notch to a nipple landmark
on the breast meridian with the patient sitting up, minus the same measurement repeated with the patient recumbent to eliminate
the pull of gravity on the breast. Spring back was measured pre-operatively for the nipple and nipple mark then post-operative
for the nipple. The difference in centimeters between the final post-operative distance from the sternal notch to the nipple
and the level intended by the pre-operative nipple mark was termed the “judgment error.” The final position of the post-operative
nipple and the judgment error was compared to the spring-back values and patient intrinsic factors.
Pre-operative ptosis was statistically related to increasing patient BMI and mass of tissue resected per breast. Pre-operative
spring-back values for the nipple increased with increasing ptosis, BMI and decreasing age. Spring-back values were greater
in the lower pole of the breast than in the upper pole. The final position of the nipple was higher than the pre-operative
mark in 65% of cases, lower in 8% and as marked in 27% of cases. The post-operative NAC was, on average, 0.6 cm higher than
planned pre-operatively. The post-operative distance from the sternal notch to the nipple increased with increasing pre-operative
ptosis, mass of breast tissue resected per breast and all three spring-back values. The difference between the level of the
pre-operative mark and the final nipple position showed a weak correlation with post-operative spring-back values.
The parameters of ptosis, BMI, weight of tissue resected per breast and pre-operative nipple spring back reflect body habitus
and breast size. Spring-back values vary between the upper and lower pole of the breast. The final NAC position was higher
than that intended at pre-operative marking in the majority of cases. The surgeon instinctively marks the nipple lower in
patients with greater pre-operative ptosis and in whom a larger resection is anticipated. Judgment error did not relate to
intrinsic factors nor to pre-operative spring-back values; hence, these parameters cannot be applied as predictive tools for
more accurate pre-operative marking of the nipple position. This study suggests that the pre-operative nipple mark should
be placed, with the patient sitting up, at least 23 cm from the sternal notch and 0.6 cm lower than the final position estimated
using the inframammary crease as a landmark.
An invited commentary on this paper is available at . 相似文献
Conclusions Noninvasive imaging of neurohumoral upregulation in remodeled myocardium suggests that an imaging strategy can be developed
for predicting the rate of remodeling and likelihood of HF development. This should allow a more judicious use of neurohumoral
antagonists especially in subjects who do not have manifest HF.74 In others specific targeted imaging may allow timely selection of individualized treatment strategies and ensure optimization
of therapeutic intervention. Similar to ACE and AII receptors, multiple other targets in the hormonal cascades can identify
the likelihood of adverse and favorable remodeling.74相似文献
Colorectal cancer, if detected early, has greater than 90% 5-year survival. However, survival has been shown to vary across
racial/ethnic groups in the United States, despite the availability of early detection methods. 相似文献
Pituitary metastases of solid tumours are infrequent, specially as a first manifestation. When they happen, they are usually
due to breast or lung cancer and are asymptomatic or produce diabetes insipidus. It is very strange that they produce hormonal
deficiency.We present a case report of a bronchogenic adenocarcinoma in a 65-year-old man which began with panhypopituitarism, diabetes
insipidus and visual alterations. Magnetic resonance imaging revealed a large sellar mass, with clivus infiltration and invading
the right cavernous sinus. The biopsy result was adenocarcinoma metastases from lung cancer.相似文献
Objective: To summarize changes in folic acid awareness, knowledge, and behavior among women of childbearing age in the United States since the U.S. Public Health Service (USPHS) 1992 folic acid recommendation and later fortification. Methods: Random-digit dialed telephone surveys were conducted of approximately 2000 women (per survey year) aged 18–45 years from 1995–2005 in the United States. Results: The percentage of women reporting having heard or read about folic acid steadily increased from 52% in 1995 to 84% in 2005. Of all women surveyed in 2005, 19% knew folic acid prevented birth defects, an increase from 4% in 1995. The proportion of women who reported learning about folic acid from health care providers increased from 13% in 1995 to 26% in 2005. The proportion of all women who reported taking a vitamin supplement containing folic acid increased slightly from 28% in 1995 to 33% in 2005. Among women who were not pregnant at the time of the survey in 2005, 31% reported taking a vitamin containing folic acid daily compared with 25% in 1995. Conclusions: The percentage of women taking folic acid daily has increased modestly since 1995. Despite this increase, the data show that the majority of women of childbearing age still do not take a vitamin containing folic acid daily. Health care providers and maternal child health professionals must continue to promote preconceptional health among all women of childbearing age, and encourage them to take a vitamin containing folic acid daily.
Background. Accepted practices of informed consent often result in suboptimal patient understanding of research studies.Methods. This pilot study aimed to assess trial-specific tailored materials, compared to a widely used generic booklet about clinical
trials, randomly assigned to 118 candidates for cancer clinical trials. Study outcomes were: satisfaction with decision-making;
satisfaction with materials; and subjective understanding of the clinical trial.Results. There were no major differences between groups. Participants rated tailored materials higher as a useful reference.Conclusions. Trial-specific materials hold utility for reference during clinical trials. Studies of informed consent are feasible, although
important factors limit research. 相似文献