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Infantile Digital Fibroma Treated With Mohs Micrographic Surgery 总被引:2,自引:0,他引:2
John G. Albertini MD Maj USAF MC Michael Jude Welsch MD CPT USA MC Leo A. Conger MD LTC USA MC Lester F. Libow MD COL USA MC Dirk M. Elston MD COL USA MC 《Dermatologic surgery》2002,28(10):959-961
BACKGROUND: Infantile digital fibroma (IDF) is a rare benign fibrous tumor of childhood that frequently recurs despite local excision. Conservative, nonsurgical management may result in regression and/or joint deformity. OBJECTIVE: To describe the histologic features of IDF and discuss a case excised using Mohs micrographic surgery (MMS). METHODS: Case report and review of the clinical, histologic, and ultrastructural features. RESULTS: Characteristic inclusion bodies of actin were identified with hematoxylin and eosin, Masson's trichrome, and rapid actin immunostain. The tumor was debulked and the majority was removed after one stage of MMS, except where the deep margin approached the joint space. The defect healed by secondary intention. At 2 years the patient had no recurrence or functional joint deformity. CONCLUSION: MMS is a surgical treatment option for IDF. 相似文献
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A cost evaluation of implementing a quality-oriented, regional perinatal data system. 总被引:2,自引:0,他引:2
We evaluated the cost impact of implementing a perinatal data system (PDS) on birth certificate (BC) processing and perinatal quality improvement (QI) reporting. Relevant staff in all birthing hospitals in the 15-county Central New York region (N = 23) were interviewed at baseline prior to implementation of the PDS and one year after implementation of the PDS to ascertain the time and costs of BC processing and of QI report generation. The average time and cost to collect and complete BCs did not change significantly from baseline to year 1. The time and costs to complete QI reports decreased significantly by 70 percent during this same period. Hospitals fully using the PDS for QI reporting purposes took, on average, six percent of the time it took other hospitals to generate comparable QI reports. The PDS significantly reduced the time and cost of generating perinatal reports from a consolidated database over what hospitals had done previously. Given the richness of the reports and the efficiency with which they are produced, hospitals are encouraged to adopt electronic means of BC processing and accessing these data for QI reporting purposes. 相似文献
4.
Xian ZH Zhang SH Cong WM Wu WQ Wu MC 《第二军医大学学报》2005,26(11):1320-1320
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most prevalent fatal cancers in the world. Despite advances in early diagnosis and improvements in surgical techniques, the survival of patients with HCC even after resection is poor because of the high incidence of recurrences. Therefore, the identification of prognostic factors may be helpful in the development of new treatment protocols. AIMS: To investigate HER-2/neu status in HCC by immunohistochemistry (IHC) and fluorescence in situ hybridisation (FISH), and to explore the possibility of using trastuzumab in the treatment of HCC. METH ODS: Eight hundred and sixty eight surgical samples from patients with primary HCC were examined for their HER-2/neu status. IHC for HER-2/neu was performed with the HercepTest kit; FISH analysis was performed with the PathVysion HER-2 DNA probe kit. The correlations between HER-2/neu overexpression and clinicopathological characteristics were analysed statistically. RESULTS: HER-2/neu overexpression was detected in 21 (2.42%) of the 868 primary HCCs. Only one specimen showed HER-2/neu gene amplification by FISH. No significant associations were found between HER-2/neu overexpression and the clinicopathological parameters. CONCLUSIONS: There is a low frequency of HER-2/neu overexpression/amplification in HCC. There appears to be no role for HER-2/neu as a prognostic marker and no benefit of anti-HER-2/neu trastuzumab treatment in patients with HCC. 相似文献
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MC Brouard P Chavaz L Borradori 《Journal of the European Academy of Dermatology and Venereology》2004,18(1):89-92
BACKGROUND: Bowel-associated dermatosis-arthritis syndrome denotes the occurrence of diarrhoea with arthritis and skin lesions related to bowel disease with or without bowel bypass. In this condition, the histological finding of cutaneous aseptic neutrophilic cell infiltrate is non-specific and common to a wide spectrum of neutrophilic dermatoses, including pyoderma gangrenosum. OBSERVATION: We describe a 78-year-old woman with fever, abdominal discomfort and arthralgias, who developed grouped pustular lesions on her shins with histologically spongiform pustule formation. Aetiological assessment disclosed diverticular disease with sigmoid stenosis. CONCLUSION: Although clinical and histological features in our case fit the diagnosis of bowel-associated dermatosis-arthritis syndrome, they may also correspond to a pustular variant of pyoderma gangrenosum. Our observation raises the question of the nosological classification of bowel-associated dermatosis-arthritis syndrome within the spectrum of neutrophilic diseases. 相似文献
6.
Krista Kupres DO Capt Usa MC Steven E. Rasmussen MD MAJ Usaf Fs MC John G. Albertini MD MAJ Usaf MC 《Dermatologic surgery》2002,28(5):388-389
BACKGROUND: Low cost, nonsterile examination gloves are used routinely to perform various dermatologic procedures. OBJECTIVE: To evaluate the perforation rate of nonsterile examination gloves in routine dermatologic procedures. METHODS: Three hundred fifty nonsterile latex examination gloves used to perform shave biopsies were evaluated for perforations using an air inflation/water submersion method. Ninety gloves, which were intentionally perforated with a 30-gauge needle, were used as controls to assess our evaluation method. RESULTS: Eight of the 350 gloves were found to have a perforation, which corresponds to a 2.3% perforation rate. Seven of the eight perforations were found in the web space between the second and third finger sleeves, with one being an obvious manufacturing error. All 90 perforations of the control group were correctly identified. CONCLUSION: There appears to be a very low risk of glove perforation when nonsterile examination gloves are used in routine dermatologic procedures. 相似文献
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P Aubry P Assayag A Haddad A Akesbi E Brochet C Guerot P E Valere 《Archives des maladies du coeur et des vaisseaux》1988,81(10):1175-1180
Correlations between left ventricular segmental kinetics and collateral circulation patterns were studied in 292 patients with coronary disease (182 women, 274 men: mean age 54 years). Left ventricular segmental kinetics were analyzed qualitatively by angiography (10 segments were individualized on RAO and LAO projections) and rated as normal, hypokinetic, akinetic or aneurysmal. The type of collateral circulation observed (contralateral, homocoronary and homolateral) and the number of collateral vessels were recorded. Collateral circulation was present in 49 p. 100 of the patients and in 29 p. 100 of the 587 pathological arteries (i.e. more than 50 p. 100 stenosis) identified. 89 p. 100 of the occluded arteries were revascularized by collateral circulation, the latter being effected by 213 collateral vessels (mean: 1.41 +/- 0.36 vessel per occluded artery). Collateral circulation through 1, 2 or 3 collateral vessels was noted in 62 p. 100, 35 p. 100 and 3 p. 100 respectively of the cases. Collateral circulation was contralateral in 51 p. 100, homocoronary in 33 p. 100 and homolateral in 16 p. 100 of the cases. Normal or hypokinetic segments in the territory of an occluded artery were more frequent in the presence (43 p. 100) than in the absence (31 p. 100) of collateral circulation, but the difference was not significant. They were also more frequent in three-vessel patients (59 p. 100) than in one-vessel (21 p. 100; p less than 0.01) or two-vessel (37 p. 100; p less than 0.05) patients in the presence of collateral circulation.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
10.
Five female patients and one male patient with solid and papillary epithelial neoplasms of the pancreas were examined with computed tomography (CT). The mean age of the patients was 27 years (range, 13-46 years). All cases showed well-encapsulated, round or lobulated masses consisting of both cystic and solid areas. Cystic portions showed CT numbers that suggested hemorrhagic necrosis. There were no internal septations within the masses. In three tumors located in the head of the pancreas, dilatation of the biliary tree was absent or minimal, although the masses were large. Two tumors contained calcifications. One tumor demonstrated metastatic deposits in liver and lymph nodes. Metastatic masses appeared similar to the primary pancreatic mass. Solid and papillary neoplasm of the pancreas should be the primary diagnostic consideration when characteristic CT findings are detected in a young female patient. 相似文献