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31.
Ayman Agha Gabriel Glockzin Matthias Woenckhaus Wolfgang Dietmaier Igors Iesalnieks Hans J. Schlitt 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):671-677
Background Insular thyroid carcinoma was described as a tumor with aggressive behavior, and patients usually present themselves with
an advanced tumor stage. Whether the insular component is an independent factor for poor prognosis remains unclear. Therefore,
in the present study, we compared the survival of patients with advanced insular, follicular, and papillary thyroid cancer.
Materials and methods The clinical behavior of tumors in three groups of patients with T4 thyroid carcinoma—8 patients with insular, 11 patients
with follicular, and 21 patients with papillary thyroid carcinomas—was compared. Disease-free survival and disease-specific
death were analyzed statistically. Cox regression analysis was used to evaluate the influence of histotype and other prognostic
factors.
Results At 3 years, survival was 37.5% (mean 26 months) among patients with insular thyroid carcinoma, 80% (mean 59 months) among
those with follicular, and 89% (mean 126 months) among those with papillary thyroid carcinomas (p = 0.007). Disease-free survival in patients without initial distant metastasis was worst in patients with insular thyroid
carcinoma (20%) compared to those with follicular (75%) and those with papillary thyroid carcinomas (71%).
Conclusion Patients with advanced insular thyroid carcinoma have a poorer outcome in comparison to patients with similar advanced stage
who have follicular or papillary thyroid carcinoma. 相似文献
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Jürgen Hoyer Sylvia Helbig Hans‐Ulrich Wittchen 《Clinical psychology & psychotherapy》2006,13(6):414-421
The present survey assessed consumer satisfaction of patients having undergone psychotherapy for depression as well as service characteristics including treatment access, communication of diagnosis and treatment rationale, quality assurance and adverse events. The study was conducted in the form of a 15‐item questionnaire that was published in one of Germany's leading health magazines. 473 persons responded (81.5% women, age range 17–83). 49.8% of the respondents reported substantial or reasonable improvement; two out of three patients stated they had been satisfied with their therapy. Improvement and satisfaction were greater in those patients who had been informed about diagnosis and treatment; they were lower when unpleasant experiences were reported. Methodological restrictions of the study are outlined and hypotheses about potential strengths and deficits in the delivery of psychotherapy for depression in Germany are proposed. Copyright © 2006 John Wiley & Sons, Ltd. 相似文献
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38.
The Usefulness of Magnetic Resonance Imaging in the Diagnosis of Anterolateral Impingement of the Ankle 总被引:3,自引:0,他引:3
LCDR Doug Duncan MD CAPT Tim Mologne MD CDR Hans Hildebrand MD Mark Stanley MD LT Richard Schreckengaust MD CAPT Dave Sitler MD 《The Journal of foot and ankle surgery》2006,45(5):304-307
The purpose of this study is to assess the sensitivity and specificity of magnetic resonance imaging (MRI) in the diagnosis of anterolateral impingement of the ankle and to assess the most helpful sequence in making the diagnosis. Twenty-four patients who had undergone ankle arthroscopy were chosen. Twelve patients had arthroscopically documented anterolateral impingement, and 12 patients with no impingement on arthroscopy served as controls. Two musculoskeletal radiologists and an orthopedic surgeon, blinded to the operative diagnosis, retrospectively reviewed selective MRI images in the sagittal, axial, and coronal planes. The sensitivities and specificities were calculated for all 3 reviewers. The Kendall coefficient of concordance was calculated for overall agreement among reviewers. Sensitivities varied from 0.75 to 0.83, whereas specificities varied from 0.75 to 1.00. Using the Fisher exact test of contingency, the sensitivities and specificities showed that all reviewers' interpretations were statistically significant with P = .039, .001, and .012, respectively. The axial images were felt to be most helpful in making the diagnosis. The physicians felt that the sagittal images were helpful in 67%, 83%, and 100%, respectively. MRI is a useful tool that can aid the clinician in the diagnosis of anterolateral impingement of the ankle. T1 sagittal images demonstrating displacement of the normal fat signal anterior to the fibula by scar can be useful and help to confirm the diagnosis. 相似文献
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Costimulatory molecules of the B7 family regulate the activation of T lymphocytes. T cell activation is promoted by binding of B7 molecules to CD28 and inhibited by binding to CTLA-4 (CD152). The balance between positive signals through CD28 and negative signals through CTLA-4 is critical for the fate of the T cell and is subject to tight regulation. Recent in vitro and in vivo studies have significantly advanced our understanding of the function of the CTLA-4 receptor. The results of these experiments suggest that CTLA-4 is critical for the induction of self-tolerance, and that it may have distinct signaling functions in resting and activated T cells. In resting T cells, CTLA-4 crosslinking leads to cell-cycle arrest, whereas in activated T cells, CTLA-4 crosslinking induces apoptosis. In this article, we will review the physiologic functions of the CTLA-4 receptor. 相似文献