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排序方式: 共有1099条查询结果,搜索用时 15 毫秒
1.
AM Manganoni† C Farisoglio† G Tucci† F Facchetti‡ PG Calzavara Pinton† 《Journal of the European Academy of Dermatology and Venereology》2007,21(10):1333-1336
BACKGROUND: Development of more than one primary melanoma in a patient is a relatively uncommon but well-recognized phenomenon. Its frequency has ranged from 1.2% to 8.2% in several series. This subgroup of patients with multiple primary lesions has not been characterized sufficiently. We report the experience of the Melanoma Unit of University Hospital Spedali Civili of Brescia, Italy. METHOD: Study subjects were drawn from 1240 patients with histologically confirmed melanoma, including melanoma in situ. From this group, multiple melanomas developed in 47 patients (3.79%). Every one of our patients has been taught to perform self-examination of the skin to detect suspicious pigmented lesions. RESULTS: Of the 47 patients described in this study, 38 had two primary melanomas, 7 had three melanomas and 2 had 5 and 10 melanomas, respectively. Mean age at first diagnosis was 46.2 years. The majority of subsequent melanomas (74.5%) were removed within 5 years of the initial operation. Synchronous lesions were found in 10 patients. In male patients, the lesion appeared most frequently on the trunk; in female patients, melanoma appeared mostly on the lower extremities. The second primary melanomas developed in the same anatomic region from the first in 53.2% of our patients. The proportion of in situ to invasive melanomas was greater for the second melanomas compared with the first melanomas. Regarding invasive melanomas, the mean thickness of the first melanomas was 1.31 mm compared with 0.66 mm for the second ones. Dividing patients into two groups, of more and less than 50, it is highlighted that in older patients synchronous lesions appear more frequently (36.4% vs. 8.0%); the median time interval between sequential melanomas is longer (84 vs. 63.7 months); and the ratio between the primary and secondary melanoma mean thickness is lower (1.21 : 1.08 vs. 1.43 : 0.63 mm). CONCLUSIONS: The study confirms that second primary melanoma is usually thinner than the first lesion, and it is more common in the same region of the body as the initial melanoma. The highest risk for a second melanoma is during the first 5 years, but a much longer time interval of 28 years is possible. Continued medical follow-up with complete skin examinations seems prudent, but it is very important to promote self-skin evaluation in patients to detect not only metastases but also subsequent primary melanomas in their earliest phases. 相似文献
2.
Marwan H. Saab Douglas C. Smith Paul K. Aka Robert W. Brownlee J. David Killeen 《Cardiovascular and interventional radiology》1992,15(4):211-216
Percutaneous transluminal balloon angioplasty (PTA) was performed in 17 tibial arteries with an average cross-sectional area
stenosis of 92% (range 75–99%) in 13 patients (14 limbs) for limb salvage. In 4 of 14 lower extremities, PTA of femoropopliteal
arteries was also performed. Technical success with 50% or less residual stenosis was achieved in all 17 tibial vessels. At
approximately 2 months after PTA, clinical improvement had occurred in 10 of 14 limbs; no patient was made worse. Most recent
follow-up (mean 19 months, range 8–34 months) revealed continued satisfactory clinical success with no further vascular intervention
in 9 of these 10 limbs (one patient died). Short segmental stenoses, residual stenoses less than 40% following PTA, and absence
of diabetes or gangrene appear to be predictors of favorable clinical outcomes. Our results suggest that PTA of focal tibial
stenosis is an effective and safe treatment modality in properly selected patients and that wider use of PTA may be justified. 相似文献
3.
Left ventricular aneurysm: a new surgical approach 总被引:16,自引:0,他引:16
V Dor M Saab P Coste M Kornaszewska F Montiglio 《The Thoracic and cardiovascular surgeon》1989,37(1):11-19
Since 1984, we have used a circular patch to reconstruct the left ventricle ("endoventricular circular plasty") in order to maintain a more physiologic cavity. This technique has three theoretical advantages over standard linear closure of the left ventricle (LV). First, it allows exclusion of the septal akinetic segment of the LV. Secondly, circular reorganization of the remaining LV muscle avoids the restraint caused by the linear suture closure and achieves a more physiologic LV cavity. Thirdly, circular plasty using the patch allows a complete resection of aneurysmal segments including resection of extensive subendocardial scar tissue, when appropriate, without critically compromising the cavity size. The technique involves the following steps: --Resection of dyskinetic or akinetic LV free wall and thrombectomy when indicated. --A dacron patch lined with pericardium is secured at the junction of the endocardial muscle and scarred tissue, thereby excluding non contractile portions of the LV and septum. --Myocardial revascularization is performed as indicated with particular attention paid to revascularizing the proximal left anterior descending segment. The group of patients forming this study includes 130 cases of LV reconstruction since 1984. The three main indications for surgery were angina (40%), cardiac failure (35%), arrhythmias (10%). There have been 8 hospital deaths, 4 late mortalities related to recurrence of cardiac failure in this group.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
4.
Tortoriello DV; McGovern PG; Colon JM; Loughlin J; Santoro N 《Human reproduction (Oxford, England)》1998,13(11):3005-3008
We report an instance of critical ovarian hyperstimulation syndrome in a
highly responsive in-vitro fertilization patient despite the preventive
measure of a 4 day 'coast' interval during which no gonadotrophins were
administered while gonadotrophin-releasing hormone agonist therapy
continued until serum oestradiol concentrations fell below 3000 pg/ml.
相似文献
5.
The rapid increase in body mass that often occurs following creatine (Cr) supplementation is believed to be due to intracellular water retention. The purpose of this study was to determine whether Cr consumption alters the magnetic resonance (MR) transverse relaxation (T(2)) distribution of skeletal muscle. Transverse relaxation can be used to model water compartments within a cell or tissue. In this double-blind study, subjects were asked to supplement their normal diet with creatine monohydrate (20 g day(-1) for 5 days) mixed with a grape drink (Creatine group, n = 7), or the grape drink alone (Placebo group, n = 8). Phosphorous MR spectroscopy was used to determine the effectiveness of the supplementation protocol. Subjects that responded to the Cr supplementation (i.e. showed a > 5 % increase in the ratio of the levels of phosphocreatine (PCr) and ATP) were placed in the Creatine group. Both proton MR imaging and spectroscopy were used to acquire T(2) data, at 1.89 T, from the flexor digitorum profundus muscle of each subject before and after supplementation. Following the supplementation period, the Creatine group showed a gain in body mass (1.2 +/- 0.8 kg, P < 0.05, mean +/- S.D.), and an increase in PCr/ATP ratio (23.8 +/- 16.4 %, P < 0.001). Neither group showed any changes in intracellular pH or T(2) calculated from MR images. However, the spectroscopy data revealed at least three components (> 5 ms) at approximately 20, 40 and 125 ms in both groups. Only in the Creatine group was there an increase in the apparent proton concentration of the two shorter components combined (+5.0 +/- 4.7 %, P < 0.05). According to the cellular water compartment model, the changes observed in the shorter T(2) components are consistent with an increase in intracellular water. 相似文献
6.
7.
Marc Gellman Susan Spitzer Gail Ironson Maria Llabre Patrice Saab Rosemary De Carlo Pasin Donald J. Weidler Neil Schneiderman 《Psychophysiology》1990,27(5):544-551
Ambulatory blood pressure was studied as a function of posture, place, and mood in 131 subjects classified according to race, gender, and hypertensive status. The effect of posture was significant and explained a substantial proportion of within-subject variability. After controlling for posture, significant place and mood effects were observed when subjects were sitting but not when they were standing. Home vs. work differences in both systolic and diastolic blood pressure were significantly greater in Whites than in Blacks. Similar differences in systolic blood pressure were greater in mild hypertensive than in normotensive subjects. The results of this study underscore the need to control for effects of posture when interpreting ambulatory blood pressure readings. 相似文献
8.
9.
Battaglia C; Artini PG; Giulini S; Salvatori M; Maxia N; Petraglia F; Volpe A 《Human reproduction (Oxford, England)》1997,12(11):2477-2482
The objective of this study was to evaluate the Doppler flow variations
which occur following the use of different protocols of ovarian stimulation
in an IVF programme, and to investigate the thromboxane production by
cultured endometrial cells and its influence on embryo implantation. A
total of 60 patients underwent three different ovarian stimulation
protocols: long gonadotrophin-releasing hormone agonist (GnRH-a), short
GnRH-a and no GnRH-a. Transvaginal ultrasonography and colour Doppler
analysis were performed before and during the treatment. On the day that
the Doppler examination took place, luteinizing hormone, follicle
stimulating hormone, plasma oestradiol and thromboxane concentrations were
assayed. On the day of oocyte retrieval, endometrial cells were collected
and cultured, and their thromboxane production evaluated. No significant
differences in hormonal, ultrasonographic or Doppler parameters were
observed between the three groups. Ten out of 56 patients who had a
successful embryo transfer became pregnant. In the group of pregnant women
the pulsatility index values of both uterine and spiral arteries was lower
than in non-pregnant patients, and was associated with significantly lower
thromboxane concentrations from cultured endometrial cells. It is concluded
that thromboxane plays a role in embryo implantation, and that Doppler flow
analysis of uterine and spiral arteries in infertile patients may be
important in the management of ovarian stimulation.
相似文献