Occurrence of melanoma in "dysplastic" nevus spilus: report of case and analysis by flow cytometry

We report a case of melanoma arising in a large nevus spilus. On histologic examination, the nevus spilus had diagnostic features of melanocytic dysplasia. Further characterization by flow cytometry showed DNA-aneuploidy within the melanoma as well as in one of the darker pigmented papules within the nevus spilus. The significance of this finding and a review of melanomas originating in nevi spili are presented.     

重度溃疡性结肠炎1例内科优化治疗

重度溃疡性结肠炎通常病情重、发展快,出现危及生命的并发症和结肠切除的风险特别高.对于溃疡性结肠炎,当内科治疗无效时可考虑手术治疗.1例重度溃疡性结肠炎经采用常规药物治疗无效,出现低血压性休克等并发症,达到行外科手术的指征,因患者为年轻未婚、未恋女性,术后存在影响生活质量、性功能障碍、不孕等风险,故经分析内科疗效不佳的原因后采取规范治疗方案,充分增强营养支持,调节肠道微生态等个体化治疗,患者由重度转为轻度.对该患者的内科优化治疗提示营养支持在溃疡性结肠炎中与药物治疗同样重要.     

Retrograde access via the popliteal artery to facilitate the re‐entry technique for recalcitrant superficial femoral artery Chronic total occlusions

Subintimal recanalization is beneficial in selected patients with peripheral chronic total occlusions (CTO). However, in complex cases, re‐entry into the true arterial lumen may prove to be unsuccessful with a conventional guidewire or a re‐entry catheter when using standard femoral artery access. Our case series describes these technical dilemmas along with strategies that can be utilized to overcome these challenges. © 2011 Wiley‐Liss, Inc.     

Contemporary Controversies in Digoxin Use in Systolic Heart Failure

Digoxin remains one of the oldest therapies for heart failure; however, its safety and efficacy have been controversial since its initial use. Questions that remain include the clinical efficacy of digoxin when added to contemporary medical therapy, when and if it should be added, and how to minimize adverse effects. In this review, we will summarize recent data on the use of digoxin in systolic heart failure and address some of the controversies regarding the role of digoxin in the modern era of heart failure treatment.