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61.
Molecular identification of a small supernumerary marker chromosome by in situ hybridization: diagnosis of an isochromosome 18p with probe L1.84 总被引:1,自引:0,他引:1
A dysmorphic child was found by cytogenetic analysis to have an extra small marker chromosome. The marker chromosome was shown to possess a chromosome 18 centromere by in situ hybridization, and probably represents an isochromosome 18p. Centromere specific probes should be of value in identifying extra small marker chromosomes, and thereby provide better understanding of the clinical significance of these. 相似文献
62.
Mahrdad Farahmand M.D. Brett C. Sheppard M.D. Clifford W. Deveney M.D. Karen E. Deveney M.D. Richard A. Crass M.D. 《Journal of gastrointestinal surgery》1997,1(2):182-187
Between 1989 and 1995 we performed completion gastrectomy for non-malignant disease in 21 patients (11 men and 10 women, mean
age 48.4 years). These patients had undergone a total of 48 prior gastric operations. Indications for completion gastrectomy
in this group were anastomotic ulceration with stricture in eight patients, alkaline reflux gastritis and/or esophagitis in
eight, postsurgical gastroparesis in two, gastroesophageal necrosis in two, and gastrocutaneous fistula in one. Major preoperative
symptoms included nausea and vomiting in 16 cases, abdominal pain in 15, dysphagia in 14, heartburn in seven, and weight loss
in five. Following completion gastrectomy, five patients (24%) had serious complications and there was one postoperative death
(5%). Five patients were lost to follow-up. For the remaining 15 patients, mean follow-up has been 30 months with a range
of 1 to 70 months. These patients were all interviewed and eight (53%) report significant improvement, two (13%) report moderate
improvement, and four (27%) report no improvement; one patient (7%) has had worsening of symptoms since undergoing completion
gastrectomy. The average body weight index was essentially unchanged after completion gastrectomy. We conclude that completion
gastrectomy with Roux-en-Y esophagojejunostomy results in a favorable outcome in the majority of selected patients with diseases
of the foregut who are unresponsive to less radical treatment.
Presented at the Thirty-Seventh Annual Meeting of The Society for Surgery of the Alimentary Tract, San Francisco, Calif.,
May 19–22, 1996. 相似文献
63.
F. Picard E. Montbarbon Y. Tourne J. M. Leroy D. Saragaglia 《International orthopaedics》1997,21(5):352-354
Summary. A pseudo-tumour due to metallosis is described in association with an iso-elastic hip replacement. This is a relatively rare
lesion which may be difficult to diagnose. Scintigraphy and radiography may be helpful in distinguishing the lesion from a
primary or secondary neoplasm, but the presence of osteolysis adjacent to the prosthesis will suggest the true nature of the
lesion.
Accepted: 29 February 1996 相似文献
Résumé. Les auteurs rapportent un cas de manifestation pseudo-tumorale d’une métallose sur prothèse de hanche de type iso-élastique. Il s’agit d’une lésion relativement rare qui peut parfois avoir un aspect inquiétant. Elle nécessite un bilan radiologique et scintigraphique pour éliminer une tumeur primitive ou secondaire, mais le diagnostic est facilement évoqué devant une ostéolyse au contact de la prothèse. Nous décrirons notre démarche diagnostique et thérapeutique dans ce cas.
Accepted: 29 February 1996 相似文献
64.
John T. Pardeck John W. Murphy Karen A. Callaghan 《Early child development and care》1994,97(1):67-72
This article suggests that the United States educational system needs significant changes. The goal of the article is to present a basic educational philosophy that would facilitate this reform. Specifically, education should be viewed as not only a means to an end that teaches basic skills for employment, but also as a process that enhances social development and self-actualization. Recommendations are offered to achieve this important goal. 相似文献
65.
Karen Rosendahl Stein Magnus Aukland Kari Fosse 《European Radiology Supplements》2004,14(4):L138-L145
Appendicitis is the commonest acute surgical emergency of childhood, and occurs in approximately 2–4 per 1000 infants. It is usually seen in infants older than 5 years but can occur at any age. Atypical clinical findings are seen in 30–50% of children, especially the younger ones, and often leads to a delayed diagnosis. Preoperative clinical assessment alone has yielded an accuracy ranging between 70 and 90% but is associated with a normal appendectomy rate of 13–25%. Preoperative imaging using the graded compression US technique and/or different helical CT techniques has been able to reduce this rate to 3–7% without an increase in perforation rate. An extensive review of the literature revealed several papers examining the accuracy of different imaging modalities and strategies of acute appendicitis in children. The reported sensitivity of US varied between 87 and 95%, vs 95–97% for helical CT, while the specificity ranged between 85 and 98% for US and 94 and 97% for helical CT. Only one truly randomised study was found, showing that compared with US alone, a combination of US and helical CT increased the sensitivity from 86 to 99%, while the specificity decreased from 95 to 89%. We conclude that imaging should be performed in all children with suspected appendicitis and that US should be the initial procedure with CT as a complementary tool. 相似文献
66.
Margaret J. Harrison Kaysi Eastlick Kushner Karen Benzies Gwen Rempel Cathy Kimak 《分娩》2003,30(2):109-115
ABSTRACT: Background: Increasingly, women seek involvement in decisions about their health care. The purpose of this study was to examine women's experience of, and satisfaction with, their involvement in health care decisions during a high‐risk pregnancy. Methods: Forty‐seven women with hypertension or threatened preterm delivery (including multiple births) were interviewed after the birth of their child. They received prenatal care at home from nurses in a community program or were hospitalized. The in‐depth interviews were audiotaped and transcribed; data were analyzed using constant comparative methods. Results: Women identified an increased feeling of responsibility for the health of their baby and themselves, but differed in choosing active or passive involvement in health care decisions. Women who wanted active involvement achieved it through one of three processes: struggling for, negotiating, or being encouraged. Women who wanted passive involvement and women facing health crises used the process of trusting in the expertise of nurses and physicians. Women were satisfied if the care from health care professionals was congruent with how they wanted to be involved in decision‐making. Conclusions: Although most women want to be actively involved in health decision‐making during a high‐risk pregnancy, some prefer a passive role. The setting of prenatal care, community‐based or in‐hospital, was less important than the ability of nurses and physicians to support the woman in her preferred role in decision‐making. (BIRTH 30:2 June 2003) 相似文献
67.
James F. Meschia Edward Junkins Karen J. Hofman 《American journal of medical genetics. Part A》1992,44(5):664-667
Epidermal nevi are typically congenital but rarely familial. We report on a family in which 3 relatives have systematized epidermal nevi. The propositus also has evidence of a hemangioma and a hemangioendothelioma. Peripheral blood and skin fibroblast karyotypes of the propositus did not show evidence of mosaicism. Epidermal nevi have been associated with nondermatologic pathology, involving the nervous, vascular, and skeletal systems in sporadic cases. This report demonstrates that nondermatologic pathology can be also be associated with systematized epidermal nevi in a familial setting. The apparent skipping of generations may be explained by autosomal dominant inheritance with decreased penetrance. © 1992 Wiley-Liss, Inc. 相似文献
68.
Francisco M. Averhoff Edward Brink Bette Pollard Karen Resha Gloria Bryan Margaret V. Vaillancourt 《The Journal of school health》1997,67(7):304-308
ABSTRACT: On March 11–12, 1996, a workshop on how to implement new adolescent immunization (AI) recommendations was held in Atlanta, Ga. Sponsored by the Centers for Disease Control and Prevention, it was a collaborative effort of the National Immunization Program, the Division of Adolescent and School Health/National Center for Chronic Disease Prevention and Health Promotion, and the Hepatitis Branch/National Center for Infectious Diseases. The workshop brought together organizations and individuals interested in adolescent health and immunizations so they could address how new Al recommendations can be implemented most effectively. This article offers an overview of their discussions and suggestions, including issues of cooperation, education, legislation, and Al program development among health provider organizations, health departments, schools, community groups and various other agencies relating to adolescent health services. 相似文献
69.
Dr. Harvey I. Pass MD Karen Kranda RN Barbara K. Temeck MD Irwin Feuerstein MD Seth M. Steinberg PhD 《Annals of surgical oncology》1997,4(3):215-222
Background: We analyzed morbidity and mortality, sites of recurrence, and possible prognostic factors in 95 (78 male, 17 female) patients
with MPM on phase I–III trials since 1990. A debulking resection to a requisite, residual tumor thickness of ≤ 5 mm was required
for inclusion.
Methods: Preoperative tumor volumes were determined by three-dimensional reconstruction of chest computerized tomograms. Pleurectomy
(n=39) or extrapleural pneumonectomy (EPP; n=39) was performed. Seventeen patients could not be debulked. Preoperative EPP
platelet counts (404,000) and mean tumor volume (491 cm3) were greater than that seen for pleurectomy (344,000, 114 cm3).
Results: Median survival for all patients was 11.2 months, with that for pleurectomy 14.5 months, that for EPP 9.4 months, and that
for unresectable patients 5.0 months. Arrhythmia (n=14; 15%) was the most common complication, and there were two deaths related
to surgery (2.0%). Tumor volume of >100 ml, biphasic histology, male sex, and elevated platelet count were associated with
decreased survival (p<0.05). Both EPP and pleurectomy had equivalent recurrence rates (27 of 39 [69%] and 31 of 39 [79%],
respectively); however, 17 of 27 EPP recurrences as opposed to 28 of 31 pleurectomy recurrences were locoregional (p2=0.013).
Conclusions: Debulking resections for MPM can be performed with low operative mortality. Size and platelet count are important preoperative
prognostic parameters for MPM. Patients with poor prognostic indicators should probably enter nonsurgical, innovative trials
where toxicity or response to therapy can be evaluated.
Presented at the 49th Annual Cancer Symposium of The Society of Surgical Oncology, Atlanta, Georgia, March 21–24, 1996. 相似文献
70.
Jill Macleod Clark PhD BSc RGN Jill Maben MSc BA RGN Karen Jones BA RHV RGN 《Journal of advanced nursing》1997,26(1):161-168
This is the first of two papers which address aspects of the findings of a large scale study commissioned by the English National Board which set out to examine the impact of Project 2000 on perceptions of the philosophy and practice of nursing. The findings presented here suggest that there have been fundamental shifts in perceptions of the nature and discipline of nursing. Students and diplomates of the course perceive themselves as knowledgeable doers, with their practice well grounded in theory and research. They value the interpersonal skills teaching and place the patient firmly at the centre of care delivery, viewing the patient holistically and being prepared to be fierce patient advocates where necessary. It is difficult to determine the extent to which these shifts can be attributed to the Project 2000 course, although the Project 2000 approach to education appears to be an important factor. 相似文献