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顽固性肌张力障碍综合征:103例报道

世界核心医学期刊文摘（神经病学分册） 2005年第3期1卷 36-37页

作者： Schrag A. Trimble M. Quinn n. Bhatia K. 江山 Univ. Dept. of Clin. neurosciences Roy. Free and Univ. Coll. M ed. Sch. London NW3 2PF United Kingdom Dr.

We describe the clinical features of 103 patients presenting with fixed dyston ia and report the prospective assessment and investigation of 41 of them. Most p atients were female (84%) and had a young age of onset [mean 29.7 (SD 13.1) ye a rs]. A peripheral injury preceded onset in 63%and spread of dystonia to other b ody regions occurred in 56%. After an average fol low up of 3.3 years (overal l disease duration 8.6 years), partial (19%) or complete (8%) remission had oc curred in a minority of patients. The fixed postures affected predominantly the limbs (90%), and rarely the neck/shoulder region (6%) or jaw (4%). In the pro spectively studied group, pain was present in most patients and was a major comp laint in 41%. Twenty percent of patients fulfilled criteria for Complex Regiona l Pain Syndrome (CRPS). no consistent investigational abnormalities were found a nd no patient tested (n = 25) had a mutatioin the DYT1 gene. Thirty seven perce nt of patients fulfilled classification criteria for documented or clinically es tablished psychogenic dystonia; 29%fulfilled DSM iv (Diagnostic and statistica l manual of mental disorders, 4th edition) criteria for somatization disorder, w hich was diagnosed only after examination of the primary care records in many ca ses; and 24%fulfilled both sets of criteria. Ten percent of the prospectively s tudied and 45%of the retrospectively studied patients did not have any evidence of psychogenic dystonia, and detailed investigation failed to reveal an alterna tive explanation for their clinical presentation. Detailed, semi structured neu ropsychiatric assessments in a subgroup of 26 patients with fixed dystonia and i n a control group of 20 patients with classical dystonia revealed dissociative ( 42 versus 0%, P = 0.001) and affective disorders (85 versus 50%, P = 0.01) sig nificantly more commonly in the fixed dystonia group. Medical and surgical treat ment was largely unsuccessful. However, seven patients who underwent multidisc

关键词：肌张力障碍躯体化障碍总病程心理性疼痛感诊断标准物理治疗疼痛综合征多学科治疗精神障碍诊断

配对病例对照研究:危重婴儿中念珠菌血症的发病风险因素

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世界核心医学期刊文摘（儿科学分册） 2006年第1期2卷 24-25页

作者： Feja K.n. Roberts K. L. Saiman 朱新菊 Columbia University Division of Pediatric Infectious Diseases PH4W 622West 168th Street New York NY 100 32 United States Dr.

Objective: To determine risk factors for late-onset candidemia among infants in the neonatal intensive care unit (nICU). Study design: We performed a matched case-control study from March 2001 to January 2003 in 2 level III-iv.nICUs. Case s ubjects had candidemia diagnosed more than 48 hours after hospitalization. Contr ol subjects (3 per case) were matched by study site, birth weight, study year, a nd date of enrollment. Potential risk factors included medical devices, medicati ons, gastrointestinal (GI) pathology (congenital anomalies or necrotizing entero colitis) and previous bacterial bloodstream infections (BSIs). Results: Forty-f ive cases of candidemia occurred during the study period and accounted for 15%o f BSIs. C. albicans caused 62%of infections (28/45); C. parapsilosis, 31%(14/4 5). Multivariate analysis revealed that catheter use (odds ratio [OR] = 1.06 per day of use; 95%confidence interval [CI] = 1.02 to 1.10), previous bacterial BS Is (OR = 8.02; 95%CI = 2.76 to 23.30) and GI pathology (OR = 4.57; 95%CI = 1.6 2 to 12.92)were significantly associated with candidemia. In all, 26/45 cases (5 8%) of candidemia occurred in infants who would not have qualified for fluconaz ole prophylaxis according to the Kaufman criteria. Conclusions: We confirmed pre vious risk factors (catheter-days) and identified novel risk factors (previous BSI and GI pathology) for candidemia in critically ill infants that could guide future targeted antifungal prophylaxis strategies.

关键词：念珠菌血症发病风险入院日期导尿管白色念珠菌先天性畸形使用天数医疗设备细菌感染近平滑

Profile of Radiological Examinations in the Radiology and Medical Imaging Department of the Medical Clinic “KALALE” in Mali

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Open Journal of Medical Imaging 2024年第3期14卷 128-136页

作者： Traore Ousmane Diakite Siaka Sidibe Drissa Massan Diallo Ousmane Wélé Keita Modibo Diarra Ouncoumba Dembele Mamadou n’Diaye Mamadou Sangare Modibo Coulibaly Ibrahim Traore Chieck B Keita Adama Diaman Department of Radiology University Hospital Center of Point G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies Bamako Mali Community Medicine Service of the FMOS of Point G Bamako Mali Department of Radiology KALALE Medical Clinic Bamako Mali Department of Radiology Reference Health Center of Commune III Bamako Mali Laboratory of Analysis and Pathological Cytology University Hospital Center of Point G Bamako Mali

Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magnetic resonance, reflection of ultrasound waves or radioactivity, with which we sometimes associate optical imaging techniques such as endoscopy. The objective of our study was to study the profile of radiological examinations in the radiology and medical imaging department of the “KALALE” medical clinic. Methodology: This was a descriptive, prospective study that took place over a period of six (6) months in the radiology and medical imaging department of the “KALALE” medical clinic and the centers of health of communes III and iv of Bamako in Mali. Data collection was carried out on a survey form. The parameters studied were sociodemographic data, clinical data, radiological data. Results: We recorded 6030 radiology examinations of which 19% of the examination frequency cases came from the “KALALE” medical clinic and 81% of the cases were referrals from the reference health centers of communes III and iv. There were 1500 X-rays or 24.9% of cases including 54% cases of bone X-rays;5% of cases of skull and face X-rays;5% of cases of Intravenous Urography (ivU);4% of cases of Hysterosalpingography (HSG);3% of cases of Retrograde Ureterocystography (UCR) and 1% of cases of X-ray of the Abdomen without preparation (ASP). We found 4530 ultrasounds or 75.1% of cases. Conclusion: Medical imaging has become essential in the study of the human body and now constitutes an essential tool for the detection and treatment of most pathologies, from simple fractures to the most serious tumors.

关键词： Profile Radiological Examinations KALALE Clinic Mali

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类似晚期卵巢癌的子宫内膜异位症

世界核心医学期刊文摘（妇产科学分册） 2006年第11期2卷 40-41页

作者： Goumenou A. Matalliotakis I. Mahutte n. Koumantakis E. 张旸 Department of Obstetrics and Gynecology University of Crete Heraklion Greece Dr.

Objective: To report a case of endometriosis associated with massive ascites, pleural effusion, and extremely elevated Ca- 125. Design: Case report. Setting: University hospital. Patient(s): A 46-year-old, white nulligravida with bilateral adnexal masses, Ca- 125 of 3,504 U/mL, abdominal pain, ascites, and a pleural effusion. Intervention(s): Chemotherapy followed by exploratory laparotomy for suspected ovarian cancer. Main Outcome Measure(s): Surgical findings and histopathology. Result(s): Intraoperative examination and histology ruled out malignancy but found stage iv endometriosis. Conclusion(s): In rare instances advanced endometriosis may be associated with ascites, pleural effusions, and large pelvic masses. For this reason endometriosis should be included in the differential diagnosis of reproductive-age women presenting with apparent ovarian malignancy.

关键词：子宫内膜异位症晚期卵巢癌合并腹水胸膜渗出组织学检查罕见病例未产妇剖腹探查术附件肿物

新发晚期卵巢癌患者使用拓扑替康/卡铂后使用紫杉醇/卡铂治疗的Ⅱ期研究

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 60-61页

作者： Gordon A.n. Asmar L. Messing M.J. 张剑萍 Texas Oncology P.A. Ch arlesA. Sammons Cancer C. DallasTX United States

Objective. Incorporating topotecan into standard platinum/taxane chem otherapy for advanced ovarian cancer has been complicated by myelosuppression. This study evaluated sequential doublets of topotecan and carboplatin, followed by paclita xel and carboplatin, in newly diagnosed advanced ovarian cancer patients. Method s. Forty-five patients (median age, 56 years; range, 38-77 years) with stage I II/iv disease and GOG performance status nrolled and received four cyc les of topotecan (1.0 mg/m2/day on days 1 to 3) and carboplatin (AUC 4 on day 1) , followed by four cycles of paclitaxel (175 mg/m2 via 3-h iv infusion on day 1 ) and carboplatin (AUC 5 on day 1). All cycles were 21 days. Antitumor response was assessed after four and eight cycles; patients with clinical complete respon se (CR) underwent second-look laparotomy for determination of pathologic CR (PC R). Dose reductions were instituted for grade 4 neutropenia and thrombocytopenia , and for grade 3/4 nonhematologic toxicity. Results. Among 41 CA-125 evaluable patients, complete and partial responses were observed in 29 (70.7%) and 11 (26.8%) patients, r espectively. Of the 12 clinical CRs (43%) in 28 evaluable patients, 10 patients underwent second-look laparotomy, with 3 PCRs (30%). Median time to progressi on was 14 months and actuarial survival was 23 months. neutropenia was the prima ry toxicity and cause of dose adjustments and delays, including two deaths. Conc lusion. The antitumor activity observed is comparable with other series, althoug h neutropenic complications were increased. Progression-free and actuarial surv ivals were slightly inferior. A Phase Ⅲtrial (GOG182) of sequential doublets in the reverse sequence is ongoing.

关键词：晚期卵巢癌拓扑替康标准化疗方案抗肿瘤效应非血液系统毒性行为状况紫杉烷类肿瘤进展剖腹探查术完全缓解率

附件及腹膜癌症患者术中输血:对症状性静脉血栓及其生存率的影响

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世界核心医学期刊文摘（妇产科学分册） 2006年第2期2卷 44-45页

作者： Abu-Rustum n.R. Richard S. Wilton A. 朱晓明 Department of Surgery Gynecology Service Memorial Sloan-Kettering Cancer Center 1275 York Avenue New York NY 10021 United States

Objective. To determine whether perioperative packed red blood cell (PRBC) and fresh frozen plasma (FFP) transfusions during ovarian, tubal, or peritoneal cancer surgery increase the risk of symptomatic postoperative venous thromboembolism (VTE) and adversely affect overall survival. Methods. We conducted a retrospective review of all cases of surgical exploration for resection of stage IIIC-iv adnexal/peritoneal cancer between november 1998 and May 2002 at Memorial Sloan-Kettering Cancer Center. Patients with a history of prior or active preoperative VTE were excluded. Routine intraoperative and postoperative VTE prophylaxis including lower extremity external pneumatic compression with or without postoperative subcutaneous heparin was utilized in all cases. Symptomatic postoperative VTE was diagnosed by lower extremity Doppler or computerized tomography (excluding cases with only ovarian vein thrombosis). Clinical parameters were examined by a logistic regression analysis to identify independent prognostic predictors of postoperative symptomatic VTE, which occurred within 30 days of surgery. Survival was calculated using the Kaplan-Meier method. Results. In all, 174 patients underwent exploratory surgery, and 6 (3.4%) were excluded due to active or prior history of VTE. Of the remaining 168 patients, 71 (42%) received at least one perioperative transfusion of PRBC or FFP. Postoperative VTE was documented in 5 of 46 (11%) patients who received a postoperative transfusion compared to 3 of 122 (2.5%) patients who did not (P = 0.04; odds ratio, 4.8); moreover, VTE was noted in 3:16 (19%)patients who received postoperative FFP compared to 5:152 (3.3%) patients who did not (P = 0.01, odds ratio of 6.78). Age, stage, body mass index, length of the operation, blood loss, presence of ascites, volume of ascites, residual disease status, preoperative hemoglobin level and coagulation profile were not associated with increased risk for VTE. When survival results were stratified

关键词：术中输血静脉血栓肿瘤细胞减灭术围手术期开腹探查术新鲜冰冻血浆手术期间病灶情况临床参数

初选化疗后继之外科肿瘤细胞减灭术治疗Ⅲ/Ⅳ期上皮性卵巢癌

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世界核心医学期刊文摘（妇产科学分册） 2006年第12期2卷 11-12页

作者： Everett E.n. French A.E. StoneR.L. 王淑珍 Department of Obstetrics and Gynecology Division of Gynecologic OncologyUniversity of Virginia Health SystemCharlottesvilleVAUnited States Dr.

Objective:The purpose of this study was to evaluate differences in morbidity,progression-free interval,and survival in women with advanced epithelial ovarian cancer treated with initial chemotherapy versus initial surgery. Study design:All women with epithelial ovarian cancer who were treated surgically at our hospital between January 1,1995,and January 1,2003,were eligible; the cases of 200 patients met the criteria and underwent retrospective chart review. Results:ninety-eight patients (49%) had initial chemotherapy,and 102 patients (51%) had initial surgery. Patients who received initial chemotherapy were more likely to have stage iv disease (initial chemotherapy,27%,vs initial surgery,8%; P = .042) and grade 3 disease (initial chemotherapy,73%,vs initial surgery,61%; P = .025). Optimal cytoreduction was achieved more often in patients who received initial chemotherapy (initial chemotherapy,86%,vs initial surgery,54%; P nly optimal cytoreduction (P = .022),and not treatment choice (P = .089),had an impact on median survival. Conclusion:Initial chemotherapy is a reasonable alternative to initial surgery for the treatment of selected patients with advanced epithelial ovarian cancer.

关键词：上皮性卵巢癌肿瘤细胞减灭术存活情况研究设计日至

胎盘附着处滋养细胞肿瘤:55例病例分析及针对影响预后因素的文献回顾

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世界核心医学期刊文摘（妇产科学分册） 2006年第6期2卷 53-54页

作者： Baergen R.n. Rutgers J.L. Young R.H. 吕涛 new York Presbyterian Hospital Weill Cornell Medical Center 520 East 70th Street Starr 1002 New York NY 10021 United States

Objective. The placental site trophoblastic tumor is a rare form of gestational trophoblastic disease. Fifteen percent of reported cases have been fatal, but predicting behavior in individual patients has been challenging. Methods. The clinical, gross and histopathological features of 55 cases and 180 cases in the literature were analyzed for their effect on survival and in relation to tumor stage. Results. The 55 patients in our series were 20 to 62 (average 32) years of age. The tumors occurred on an average of 34 months after the last known gestation. 84% were stage I, 2% stage II, 5% stage III, and 9% stage iv. Serum levels of human chorionic gonadotropin (hCG)were elevated (average 691 mIU/ml) in 77% of the cases. The tumors were on average 5 cm in greatest dimension and were composed microscopically of infiltrative sheets of intermediate (extravillous) trophoblastic cells. The mitotic rate ranged from 0 to 20 (average 5.0) per 10 high power fields. The follow- up interval averaged 4.6 years. Eight patients (15% ) died from metastatic tumor, and nine additional patients had metastases or a recurrence but were alive at last contact. The most common metastatic sites were the lungs, liver, and vagina. Conclusions. Significant factors associated with adverse survival in the present series were age over 35 years (P = 0.025), interval since the last pregnancy of over 2 years (P = 0.014), deep myometrial invasion (P = 0.006), stage III or iv (P 1000 mIU/ml (P = 0.034), extensive coagulative necrosis (P = 0.024), high mitotic rate (P = 0.005), and the presence of cells with clear cytoplasm (P nly stage and clear cytoplasm were independent predictors of overall survival, while stage and age were the only independent predictors of time to recurrence or disease- free survival. In the literature, factors associated with survival were stage (P nterval from preceding pregnancy of over 2 years (P = 0.029), previous term pr

关键词：滋养细胞肿瘤病例分析预后因素胎盘附着文献回顾人绒毛促性腺激素滋养细胞疾病平均年龄组织病理学临床表现

THE EFFECT OF TRAnSITIOn METAL IOnS-MAnGAnESE On HYDROGEn PEROXIDE BLEACHInG

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天津科技大学学报 2004年第A1期19卷 168-172页

作者： ShuhuiYang YumengZhao BaokuWen Yonghaoni TianjinUniversityofScience＆Technology TianjinChina UniversityofnewBrunswick N.B.Canada

In this investigation, the catalytic activities of Mn(II),Mn(III) and Mn(iv) towards decomposing hydrogenperoxide were compared. Among Mn (II), Mn (III)and Mn (iv), Mn (II) is not catalytically active indecomposing hydrogen peroxide. However, both Mn(113) and Mn (iv) are, and Mn (III) has a strongereffect than Mn(iv).In addition, we also studied the practical methods todecrease the Mn-induced decomposition of hydrogenperoxide. The results showed that sodium silicate andmagnesium sulfite in combination can effectivelydecrease the decomposition of hydrogen *** optimum dosage of sodium silicate was about0.5% (on solution). Adding chelants such as DTPAor EDTA simultaneously with stabilizers candecrease hydrogen peroxide decomposition. For Mn(iv), the EDTA is more effective than *** sodium thiosulfate simultaneously withmagnesium sulfate, sodium silicate and DTPA toalkaline peroxide solution can result in more residualhydrogen peroxide, and a higher pulp brightness.

关键词：过氧化氢漂白过渡金属离子锰稳定剂还原剂螯合剂