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视网膜母细胞瘤的近代诊断及处理

国际眼科纵览 1982年第1期 26-31页

作者： shields j a 孙葆忱

视网膜母细胞瘤是一种小儿眼内恶性肿瘤。大约15,000例小儿中有1例可发生此病。由于该病有局部蔓延及全身转移倾向,所以要求诊断准确,处理及时。该病的发生率、遗传学、病因学及鉴别诊断等以往已有广泛的讨论。本文将复习视网膜母细胞... 详细信息

视网膜母细胞瘤是一种小儿眼内恶性肿瘤。大约15,000例小儿中有1例可发生此病。由于该病有局部蔓延及全身转移倾向,所以要求诊断准确,处理及时。该病的发生率、遗传学、病因学及鉴别诊断等以往已有广泛的讨论。本文将复习视网膜母细胞瘤的近代诊断及处理方法。一、诊断方法有些眼部良性疾患在临床上与视网膜母细胞瘤相似而可被误诊。1974～1978年间作者共有136例小儿疑为视网膜母细胞瘤就诊,其中60例为视网膜母细胞瘤,76例为其他病变(表I)。良性病变者无一例因误诊为视网膜母细胞瘤而摘除眼球。 (一)病史: 在对患者进行眼部检查前,应从家长得到患者的详尽病史。许多病例的病史对诊断的预测可提供有价值的资料。病史应包括患儿母亲的孕期及分娩等情况。应特别注意母亲是否得过风疹、

关键词：视网膜母细胞瘤小儿房水恶性肿瘤瘤细胞白内障如银内障眼球摘除术间接眼底镜

1:100万土壤-土地图数据库及土壤退化信息解译

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土壤学报 1991年第4期28卷 355-371页

作者：周慧珍 j.A.shields K.W.G.Válentine D.R.Coote 中国科学院南京土壤研究所 210008 加拿大土地资源研究中心

改进世界土壤和土地资源的制图,发展一个能够传递精确的、有用的和实时的土壤-土地资源信息系统,有利于土地资源管理人员去制订规划和作出任何决策。标准化的信息也便于国际与国内的信息传递与交换。本研究工作以世界1:100万土壤-土地... 详细信息

改进世界土壤和土地资源的制图,发展一个能够传递精确的、有用的和实时的土壤-土地资源信息系统,有利于土地资源管理人员去制订规划和作出任何决策。标准化的信息也便于国际与国内的信息传递与交换。本研究工作以世界1:100万土壤-土地数字化数据库工作手册为准则。分四个阶段进行:1.土壤-土地图的编制;2.地图数字化和地图文件的建立;3.土壤-土地数字化数据库的建立;4.土壤-土地图及数据库信息的介评。

关键词：土壤-土地图数据库土壤退化信息解译制图

Storylines of family medicine Ⅶ: family medicine across the lifespan

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Family Medicine and Community Health 2024年第S3期12卷 61-69页

作者： William B Ventres Leslie A Stone Katharine C Barnard Sara G shields Mark j Nelson Maria Verónica Svetaz Clara M Keegan joel j Heidelbaugh Paige B Beck Lucille Marchand Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine and Community Health UMass Chan Medical SchoolWorcesterMassachusettsUSA john Peter Smith Hospital Family Medicine Residency Fort WorthTexasUSA Family and Community Medicine Hennepin HealthcareMinneapolisMinnesotaUSA Family Medicine University of Vermont Larner College of MedicineBurlingtonVermontUSA Family Medicine University of Michigan Medical SchoolAnn ArborMichiganUSA Family Medicine and Community Health University of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅶ:family medicine across the lifespan’,authors address the following themes:‘Family medicine maternity care’,‘Seeing children as patients brings joy to work’,‘Family medicine and the care of adolescents’,‘Reproductive healthcare across the lifespan’,‘Men’s health’,‘Care of older adults’,and‘Being with dying’.May readers appreciate the range of family medicine in these essays.

关键词： life illustration family

Branchio-oculo-facial综合征新的眼部表现

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世界核心医学期刊文摘（眼科学分册） 2005年第7期1卷 17-18页

作者： Demirci H. shields C.L. shields j.A. 王永强 Oncology Service Wills Eye Hospital 840 Walnut StreetPhiladelphia PA 19107 United States

Purpose: To report new ocular manifestations of branchio- oculo- facial (BOF) syndrome. Design: Case report. Methods: A 10- year- old girl with known BOF syndrome was referred because of a fundus lesion in her left eye. Results: She had undergone excision of a left orbital dermoid cyst at age 18 months and a branchial cleft fistula from the right side of neck at age 4 years. Examination disclosed openings of sinus tracts on each side of the nose connecting the lacrimal sac to skin. In the right eye, an iris pigment epithelial cyst was confirmed with ultrasound biomicroscopy. In the left eye, there was a combined hamartoma of the retina and retina pigment epithelium. Conclusion: BOF syndrome can display mild to severe craniofacial, auricular, oral, and ophthalmic anomalies. In this case, the ophthalmic manifestations included lacrimal sac fistula, orbital dermoid cyst, iris pigment epithelial cyst, and combined hamartoma of the retina and retinal pigment epithelium.

关键词： facial 视网膜色素上皮泪囊瘘超声生物显微镜眼底损害眼眶皮样囊肿错构瘤鳃裂瘘眼部异常上皮囊肿

115例视盘黑色素细胞瘤的病例报道:2004年Samuel johnson纪念讲座第一部分

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世界核心医学期刊文摘（眼科学分册） 2005年第2期1卷 55-56页

作者： shields j.A. Demirci H. Mashayekhi A. shields C.L. 黎黎 Oncology Service Wills Eye Hospital Thomas Jefferson University Philadelphia PA Uni ted States Dr.

Purpose To report clinical variations and the natural course of melanocytoma o f the optic disc. Patients and methods A retrospective study was conducted on a consecutive series of patients with melanocytoma of the optic disc who were evaluated at the Ocular Oncology Service at Wills Eye Hospital. Demographic information and variations i n appearance and size of the tumor and local ocular complications were noted. Fr equency of tumor growth and malignant transformation was recorded. Clinical fact ors, including patient data and tumor features, were analyzed for their impact o n visual acuity loss of 2 or more Snellen lines and the tumor growth, using Cox proportional hazards regression models. Kaplan-Meier survival estimates of prob ability of visual acuity loss of 2 or more Snellen lines and probability of tumo r growth were performed as a function of time from the initial examination. Main outcome measures Visual acuity loss of 2 or more Snellen lines, tumor growth, a nd malignant transformation of the tumor. Results There were 115 patients (116 e yes) with melanocytoma of the optic disc. The mean age at diagnosis was 50 years ; 38%of patients were male and 62%of patients were female; 65%of patients wer e white, 29%of patients were African American, and 6%of patients were Asian, H ispanic, Indian, or Arabic. The lesion was unilateral in 99%of patients. Visual symptoms that seemed to be related to the melanocytoma were present in 24%of p atients, and an afferent pupillary defect was noted in 9%of patients. Associate d ocular abnormalities included ocular melanocytosis (8%), racial melanosis (7 %), optic nerve hypoplasia (2%), and retinitis pigmentosa (1%). The melanocyt oma was dark brown to black in 100%of patients. The mean tumor diameter was 2 m m and the mean thickness was 1 mm. Associated findings included a choroidal comp onent (54%), retinal component (30%), optic disc edema (25%), retinal edema ( 16%), localized subretinal fluid (14%), retinal exudation (12

关键词： Samuel johnson 色素细胞瘤视网膜出血视网膜色素变性视网膜静脉阻塞视盘水肿眼底血管造影视网膜水肿视力损害荧光素

1643例黑色素细胞结膜肿瘤和非黑色素细胞结膜肿瘤的临床调查

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世界核心医学期刊文摘（眼科学分册） 2005年第2期1卷 56-57页

作者： shields C.L. Demirci H. Karatza E. shields j.A. 黎黎 Ocular Onco logy Service Wills Eye Hospital Thomas Jefferson University Philadelphia PA United States Dr.

Objective To report the spectrum and frequency of melanocytic and nonmelanocyt ic conjunctival tumors in an ocular oncology practice. Design Retrospective noninterventional case series. Participants One thousand six hundred forty-three consecutive patients with a c onjunctival mass evaluated at an ocular oncology department. Methods A chart rev iew was conducted to obtain the clinical features of the patient and tumor and t o tabulate and categorize the diagnoses. Main outcome measures Tumor diagnosis o verall and relative to patient age, race, and gender and relative to tumor locat ion and laterality. Results In 1643 consecutive patients, the tumor was classifi ed as melanocytic in 872 cases (53%) and nonmelanocytic in 771 cases (47%). Th e nonmelanocytic categories included congenital choristomatous (n=40 2%), epi thelial (n=219 13%), vascular (n=63 4%), fibrous (n=7 60. Of the 219 patients with e pithelial tumors, 80%occurred inmales, whereas the incidence of melanocytic les ions was equal in males and females. African-American patients represented only 7%of epithelial tumors,junctival tumors were of melanocytic origin in 53%of cases and nonmelanocy tic origin in 47%. Overall, melanocytic tumors, epithelial tumors, and lymphoid tumors acco

关键词：黑色素细胞临床调查黑色素沉着病牙瘤黏液瘤瘤样病变上皮型黄色瘤血管瘤黑素瘤

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化学减容法治疗视网膜母细胞瘤的远期视力

世界核心医学期刊文摘(眼科学分册) 2006年第3期 21-22页

作者： Demirci H shields C.L Meadows A.T shields j.A. 陈立军 Ocular Oncology Service Wills Eye Hospital Thomas Jefferson University 840 Walnut St Philadelphia PA 19107 United StatesDr.

Objective: To evaluate long-term visual outcome following chemoreduction. Design: Interventional case series evaluating 54 eyes of 40 children with retinoblastoma successfully treated with chemoreduction, consisting of a combination of intravenous carboplatin, etoposide phosphate, and vincristine sulfate plus focal therapy without external beam radiotherapy or enucleation. All patients were followed up for at least 5 years. Patient and tumor data were analyzed for their effect on the main outcome measures (final visual acuities of 20/40 or better and of 20/200 or better) using univariate and multivariate regression models. Patien ts who failed chemoreduction were excluded. Results: There were 4 eyes in Reese -Ellsworth group I, 7 in group II, 3 in group III, 15 in group IV, and 25 in gr oup V. The mean distance from the posterior tumor margin to the optic disc was 2 mm, and from the tumor margin to the foveola it was 3 mm. After a mean follow- up of 68 months, 27 eyes (50%) had a final visual acuity of 20/40 or better, an d 36 eyes (67%) had final visual acuity of 20/200 or better. Of 33 eyes with ma cular tumor, only 8 (24%) had a final visual acuity of 20/40 or better, and 15 (45%) had a final visual acuity of 20/200 or better. Of 21 eyes with extramacul ar tumor, 19 (90%) had a final visual acuity of 20/40 or better, and all (100% ) had a final visual acuity of 20/200 or better. Conclusion: The clinical factor s that predicted visual acuity of 20/40 or better were a tumor margin at least 3 mm from the foveola and optic disc and an absence of sub-retinal fluid.

关键词：视网膜母细胞瘤视力减容

ELISA夹心法中抗体质量的重要性——评价选用的商品试剂

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微生物学免疫学进展 1988年第1期 50-52页

作者： shields j G Turner M W ,范亚民

ELISA的许多特性中以其能有效地检测各种生物液或细胞培养上清液中低浓度的免疫球蛋白类或亚类为最。虽然对抗血清的选择很严格,但对试验取得成功所需之纯度还缺少深入研究。最近,几家公司介绍的高

关键词：抗体 IgG 绵羊试剂夹心法 ELISA 商品

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可持续发展对采矿部门的挑战

产业与环境 2001年第S1期23卷 16-19页

作者： Deborah j.shields Slavko V.Solar 温官 USDA Forest Service-Researeh asd Development Rocky Mountain Research station Geological survey of Slovenia

支撑实际上所有可持续能力定义的基本原理现在已经应用于采矿部门，然而，它们的应用仍然具有明显和潜在的障碍障碍包括原理本身以及它们在一些情况下与当前运作的社会和经济系统不一致这一事实．我们作出如下结论：由于有许多途径来... 详细信息

支撑实际上所有可持续能力定义的基本原理现在已经应用于采矿部门，然而，它们的应用仍然具有明显和潜在的障碍障碍包括原理本身以及它们在一些情况下与当前运作的社会和经济系统不一致这一事实．我们作出如下结论：由于有许多途径来定义和实施可持续发展，引用它的原理可能带来不同的可能结果．这井不降低解决公开问题的可能性，而且它更可能为适合每一种特定矿物操作或活动的特殊条件的平衡的解决方法，以及每一个国家的独特处境带来机遇．

关键词：可持续能力利益攸关者自然资本国际条约矿物资源社会资本矿物开采预防原理政策和法律公众参与