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D Monnier† C Vidal‡ L Martin§ A Danzon¶ F Pelletier† E Puzenat† MP Algros†† D Blanc† R Laurent† PH Humbert† F Aubin† 《Journal of the European Academy of Dermatology and Venereology》2006,20(10):1237-1242
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare malignant tumour of the skin, with an estimated incidence of 0.8 to five cases per 1 million people per year. OBJECTIVE: To study epidemiological, immunohistochemical and clinical features, delay in diagnosis, type of treatment and outcome of DFSP from 1982 to 2002. METHODS: Using data from the population-based cancer registry, 66 patients with pathologically proved DFSP were included (fibrosarcomatous DFSP were excluded). Each patient lived in one of the four departments of Franche-Comté (overall population of 1 million people) at the time of diagnosis. The main data sources came from public and private pathology laboratories and medical records. The rules of the International Agency for Research on Cancer were applied. RESULTS: The estimated incidence of DFSP in Franche-Comté was about three new cases per 1 million people per year. Male patients were affected 1.2 times as often as female patients were. The trunk (45%) followed by the proximal extremities (38%) were the most frequent locations. DFSP occurred mainly in young adults between 20 and 39 years of age. Mean age at diagnosis was 43 years, and the mean delay in diagnosis was 10.08 years. Our 66 patients initially underwent a radical local excision. Among them, 27% experienced one or more local recurrences during 9.6 years of follow-up. There was one regional lymph node recurrence without visceral metastases. These recurrences were significantly related to the initial peripheral resection margins. We observed a local recurrence rate of 47% for margins less than 3 cm, vs. only 7% for margins ranging from 3 to 5 cm [P=0.004; OR=0.229 (95%, CI=0.103-0.510)]. The mean time to a first local recurrence was 2.65 years. Nevertheless, there was no death due to the DFSP course at the end of the follow-up, and the final outcome was favourable. CONCLUSION: Our study emphasizes the importance of wide local excision with margins of at least 3 cm in order to prevent local recurrence. However, the recent development of inhibitors of signal transduction by the PDGFB pathway should soon modify the surgical strategy, which is often too mutilating. 相似文献
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Steven R. Jensen M.D. Dawn R. Voegeli John C. McDermott Andrew B. Crummy 《Cardiovascular and interventional radiology》1986,9(4):202-204
Eight lymphatic fluid collections were drained percutaneously. There were no immediate or late complications. Seven patients
had follow-up; 1 required surgical drainage of a residual or recurrent lymphocele, and another had reaccumulated fluid in
a lymphocele which was detected on autopsy. The remaining lymphatic collections responded to percutaneous drainage. Percutaneous
drainage is safe and can be an effective tool in the management of lymphatic collections. 相似文献
5.
F T McDermott G Whelan D J St John G L Barnes R Elliott R Herrmann G T Schmidt R A Smallwood 《The Medical journal of Australia》1987,146(10):525, 528-525, 529
Information on the relative incidence of Crohn's disease and ulcerative colitis was obtained by a prospective investigation at six Melbourne teaching hospitals. One hundred and eleven patients who presented with chronic inflammatory bowel diseases between 1980-1981 were admitted to the study. Forty (36%) patients were diagnosed as having Crohn's disease and 63 (57%) patients as having ulcerative colitis. The type of chronic inflammatory bowel disease could not be determined in eight (7%) patients. These findings suggest that the relative frequency of Crohn's disease and ulcerative colitis in Melbourne hospitals is within the range that is reported for northern Europe and the United States. 相似文献
6.
M.B. McDermott A.C. Lind E.F. Marley L.P. Dehner 《Pediatric and developmental pathology》1998,1(4):300-308
Deep granuloma annulare (DGA) is one of several lesions of skin and superficial soft tissues whose histologic character is
a palisading granuloma with a small central focus of necrosis or necrobiosis. Unlike the other palisading necrobiotic lesions,
DGA has a predilection for children in the first 5 to 6 years of life. A painless subcutaneous nodule(s) in the lower anterior
tibial region or foot and the scalp, typically in the occiput, was the most common presenting feature in this study of 35
cases. Additional or recurrent lesions were reported in approximately 70% of cases with clinical follow-up. All lesions showed
the presence of necrobiosis; however, one of the characteristic features was the multinodular character of the predominantly
mononuclear cellular aggregates. The presence of vascular spaces at the periphery of the nodular profiles served as a clue
to the diagnosis of DGA. The palisading arrangement of the mononuclear cells was evident only in those foci with central necrobiosis.
A histiocytic disorder or fibrohistiocytic process was a common consideration in the differential diagnosis, especially in
those cases with less apparent foci of necrosis. Palisading histiocytes with prominent eosinophilic cytoplasm and some nuclear
atypism were problematic with regard to possible epithelioid sarcoma. Our study failed to identify any underlying or predisposing
factors in the development of DGA. Despite the fact that DGA is a well-documented lesion in children, it occurs sufficiently
infrequently that it is often not considered clinically when it presents as a subcutaneous mass or masses in a child. Its
recognition by the pathologist is especially important as the occurrence of additional lesions in a high proportion of children
can be anticipated without undue concern.
Received June 16, 1997; accepted October 28, 1997. 相似文献
7.
J. O’Byrne S. Eustace M. M. Stephens M. N. M. R. Farahat G. Yanni R. Posten G. S. Panayi S. Sant R. Costello M. Barry J. Hassan C. Feighery B. Bresnihan A. Whelan F. Coakley A. M. de Paor R. B. Reilly E. B. Casey V. J. Tormey G. Kearns K. Gaffney P. J. Freyne M. Callaghan O. FitzGerald D. Veale E. O’Nuallain D. Reen D. Veale M. Farrell O. FitzGerald S. Rogers L. Barnes R. J. Coughlan C. McCarthy M. McDermott D. Hourihane C. O'Morain S. O'Reilly P. Hartley E. Casey L. Clancy F. Mulcahy N. Hall A. Murphy C. Breen D. Kelleher M. Abuzakouk C. O'Farrelly 《Irish journal of medical science》1992,161(6):438-442
8.
Over the past decade, the unfortunate reality is that the income gap has widened between Canadian families. Educational outcomes are one of the key areas influenced by family incomes. Children from low-income families often start school already behind their peers who come from more affluent families, as shown in measures of school readiness. The incidence, depth, duration and timing of poverty all influence a child’s educational attainment, along with community characteristics and social networks. However, both Canadian and international interventions have shown that the effects of poverty can be reduced using sustainable interventions. Paediatricians and family doctors have many opportunities to influence readiness for school and educational success in primary care settings. 相似文献
9.
Denis O'Mullane PhD ; Helen P. Whelton PhD ; Pat Costelloe BDS David Clarke BDS ; Stephen McDermott MSc ; Jacinta McLoughlin MDS 《Journal of public health dentistry》1996,56(5):259-264
The visit of Dr. Trendley Dean to Dublin in the mid-1950s helped accelerate the decision to introduce water fluoridation as a public health measure in the prevention of caries in the Republic of Ireland. A challenge to the constitutional validity of the Health (Fluoridation of Water Supplies) Act 1960 failed and in 1964 the water supplies of Dublin city were fluoridated. Over the next seven to eight years all the major urban communities in the Republic of Ireland were fluoridated. Currently, 67 percent of the 3.5 million people in the country reside in fluoridated communities. Studies conducted over the last 20 years show that residents of fluoridated communities have better dental health than those in nonfluoridated communities—the mean dmft is lower in children and the number of natural teeth present in adults is higher. 相似文献
10.
MP Costi D Tondi M Rinaldi D Barlocco G Cignarella DV Santi C Musiu I Pudu G Vacca P La Colla 《European journal of medicinal chemistry》1996,31(12):1011-1016
A new series of N-(substituted)benzyl-1,8-naphthalimides 4, structurally related to the previously reported thymidylate synthase (TS) inhibitor naphthaleins 3, were synthesized and compounds tested for their inhibition of several species of TS. Moreover, their in vitro cytotoxicity together with antimycotic and antibacterial properties were assayed. While no activity was detected in the antibacterial tests, the m-nitro (4ae) and the p-nitro (4af) derivatives were found able to partially inhibit TS at low micromolar concentrations. Introduction of nitro or (substituted)-amino groups in position 4 of the naphthalic ring always led to less active compounds. 相似文献