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判断多胎妊娠羊膜性和绒毛膜性的临床实践

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中国产前诊断杂志（电子版） 2011年第1期3卷 21-25页

作者：赵胜 Jennifer J.Wan David Schrimmer V'eronique Tach'e Kristen quinn D.Yvette Lacoursiere Gina james 湖北省妇幼保健院超声科湖北武汉430070 美国加州大学圣迭戈分校医学中心生殖医学科

目的以组织病理诊断为参照,评价一所三级医院及转诊医生产前判断多胎妊娠羊膜性和绒毛膜性的准确性。方法回顾性分析289例多胎妊娠转诊医生、三级医院及组织病理学判断羊膜性和绒毛膜性的情况。结果从基层医院转诊来的289例多胎妊娠中,... 详细信息

目的以组织病理诊断为参照,评价一所三级医院及转诊医生产前判断多胎妊娠羊膜性和绒毛膜性的准确性。方法回顾性分析289例多胎妊娠转诊医生、三级医院及组织病理学判断羊膜性和绒毛膜性的情况。结果从基层医院转诊来的289例多胎妊娠中,仅43.6%(126/289)在转诊前获得准确判断。三级医院诊断羊膜性和绒毛膜性的总体准确率为94.8%(274/289),并且双胎及三胎妊娠100%在早孕期得到诊断。因为不确定羊膜性和绒毛膜性而转诊的病例中,包括46.1%(113/245)的双胎和64.1%(25/39)的三胎。结论早期发现关键性的超声特征可用以准确判断羊膜性和绒毛膜性。转诊医生准确判断羊膜性和绒毛膜性与三级医院相比明显不够准确,建议这些基层医院提高诊断技能并在诊断不确定时及时转诊。

关键词：多胎妊娠双胎羊膜性胎盘形成超声

A phaseⅡprospective trial of photobiomodulation therapy in limiting oral mucositis in the treatment of locally advanced head and neck cancer patients

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 345-354页

作者： Janielle K.-A.Taylor Leila J.Mady Khalil Baddour Uzoma K.Iheagwara Shuyan Zhai james P.Ohr Daniel P.Zandber Vikram C.Gorantla Robert L.Ferris Seungwon Kim Umamaheswar Duvvuri Mark W.Kubik Shaum Sridharan Jonas T.Johnson Karen D.Holeva Annette E.quinn David A.Clump School of Medicine University of PittsburghPittsburghPennsylvaniaUSA Department of Otorhinolaryngology—Head and Neck Surgery University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Otolaryngology—Head and Neck Surgery UPMCPittsburghPennsylvaniaUSA UPMC Department of Radiation Oncology UPMCPittsburghPennsylvaniaUSA Biostatistics UPMC Hillman Cancer CenterPittsburghPennsylvaniaUSA Department of Medicine Division of Hematology/OncologyUPMC Hillman Cancer CenterPittsburghPennsylvaniaUSA Department of Immunology UPMCPittsburghPennsylvaniaUSA Department of Plastic and Reconstructive Surgery University of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA

Objective:This study aimed to compare the historical incidence rate of severe oral mucositis(OM)in head and neck cancer patients undergoing definitive concurrent chemoradiation therapy(CRT)versus a prospective cohort of patients with locally advanced head and neck squamous cell carcinoma(HNSCC)treated with prophylactic photobiomodulation therapy(PBMT).Methods:This US-based,institutional,single-arm,phaseⅡprospective clinical trial was initiated in 50 patients(age≥18 years,Karnofsky Performance Scale Index>60,with locally advanced HNSCC(excluding oral cavity)receiving definitive or adjuvant radiation therapy(RT)with concurrent platinum-based chemotherapy(CT).PBMT was delivered three times per week throughout RT utilizing both an intraoral as well extraoral delivery *** outcome measure was incidence of severe OM utilizing both the National Cancer Institute Common Toxicity Criteria,version 4.0(NCI-CTCAE)Grade≥3 and the World Health Organization Mucositis Grading Scale(WHO)Grade≥3 versus historical controls;secondary outcome measures included time to onset of severe OM following therapy ***:At baseline,all patients included in final analysis(N=47)had OM Grade *** RT and CT dose was(66.3±5.1)Gy and(486.1±106.8)mg/m ^(2),*** OM was observed in 11 of 47 patients(23%,confidence interval:12,38).OM toxicity grade trended upward during treatment,reaching a maximum at 7 weeks(WHO:1.8 ***-CTCAE:1.7).Subsequently,OM grade returned to baseline 3 months following completion of *** mean time to onset of severe OM was(35±12)*** mean time to resolution of severe OM was(37±37)***:Compared to historical outcomes,PBMT aides in decreasing severe OM in patients with locally advanced *** represents a minimally invasive,prophylactic intervention to decrease OM as a major treatment-related side effect.

关键词： chemoradiotherapy oral mucositis photobiomodulation therapy squamous cell carcinoma of head and neck

滤泡性甲状腺癌皮肤转移:4例病例报道及文献回顾

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世界核心医学期刊文摘（皮肤病学分册） 2005年第12期1卷 26-27页

作者： quinn T.R. Duncan L.M. Zembowicz A. Faquin W.C. 李政霄 Dr. Pathology Services Inc. 640 Memorial Drive Cambridge MA 02139 United States

Cutaneous metastasis of follicular carcinoma of the thyroid is very rare, and when it occurs, can exhibit a variety of histologic appearances. The 4 cases presented here were identified from the surgical pathology files of the james Homer Wright Laboratories of Pathology at the Massachusetts General Hospital (MGH). The cases consisted of 4 patients, 3 men and 1 woman, aged 52 to 75 years, with cutaneousmetastasis of follicular thyroid carcinoma. The tumors include a conventional follicular carcinoma, a follicular carcinoma with anaplastic transformation following initial metastasis, the first reported cutaneous metastases of a follicular carcinoma with oncocytic features (Hü rthle cell carcinoma), and a follicular carcinoma with a prominent insular carcinoma component. All 4 tumors were widely invasive within the thyroid gland. Sites of dermal metastases included a post- thyroidectomy scar, scalp, and sacral skin. Three metastases retained the morphologic and immunocytochemical features of the primary thyroid tumors. However, in one case there was high- grade transformation to anaplastic carcinoma following treatment of a sacral metastasis with accompanying loss of the characteristic immunophenotype of follicular thyroid carcinoma. Awareness of the varied morphologies of metastatic follicular thyroid carcinoma to the skin may prompt immunohistochemical analysis and the request for a complete clinical history, ultimately preventing misdiagnosis.

关键词：滤泡性甲状腺癌滤泡性癌文献回顾甲状腺肿瘤首例报道甲状腺切除术后瘢痕瘤细胞免疫细胞化学麻萨诸塞