bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular analyses of sentinel lymph nodes: an open question
Authors: Bonin S , Niccolini B , Calacione R , Gambardella B , Geatti O , Stanta G , Trevisan G 
Published: March 2003

AbstractAims To detect micrometastases in the sentinel lymph nodes (SLN) of melanoma patients the authors analysed 52 lymph nodes (47 SLNs and five non‐sentinel) and 17 corresponding primary skin melanomas using reverse transcriptase–polymerase chain reaction assays in paraffin‐embedded tissues to detect the mRNAs of tyrosinase, MAGE1, MAGE3, MIA, MART‐1 and mRNA coding for telomerase catalytic component.Results Our data show that the use of molecular markers for melanoma micrometastases detection in SLN is still in a very preliminary stage. In comparing the molecular analysis results with the pathological staging we did not find any evident correlation with the expression of the analysed genes in SLN. There are no data for judging the prognostic significance of the detection of circulating tumour cells in patients without clinically recognizable metastases. Despite progress in the field with simultaneous detection of several markers it was assumed that tyrosinase mRNA remains the best target for the detection of metastatic melanoma cells.
Treatment of recalcitrant psoriatic arthritis with anti‐tumor necrosis factor‐α antibody
Authors: Wollina U , Konrad H 
Published: March 2003

AbstractCurrently available treatments for psoriatic arthritis are either not completely effective or toxic in some patients. As tumour necrosis factor (TNF)‐α is involved in both the joint and skin involvement in psoriatic arthritis, blockade of TNF‐α seems a reliable way to treat patients with this disease. We report two patients with progressive recalcitrant psoriatic arthritis treated with low‐dose methotrexate (7.5 mg, once per week) in combination with intravenous chimeric monoclonal anti‐TNF‐α antibody (infliximab, 3 mg/kg body weight). Both showed a dramatic and rapid response in the reduction of pain, followed by improvement of laboratory and clinical signs of joint inflammation. Skin disease also responds after a short delay. The observation shows that infliximab is effective and well tolerated in patients with recalcitrant progressive psoriatic arthritis. Different kinetics of symptom release during treatment suggest a variable role for TNF‐α in disease pathways of pain, joint inflammation and skin involvement.
Tinea pedis in European marathon runners
Authors: Lacroix C , Baspeyras M , De La Salmonière P , Benderdouche M , Couprie B , Accoceberry I , Weill F‐X , Derouin F , Feuilhade de Chauvin M 
Published: March 2003

AbstractBackground Epidemiological studies suggest that 15% of the population in industrial countries suffer from tinea pedis (athlete’s foot) and that persons who do sports are a high‐risk population.Objective To investigate the responsibility of dermatophytes in interdigital lesions of the feet in European marathon runners and to identify associated risk factors.Subjects and methods Runners of the 14th Médoc Marathon (n = 147) were interviewed on risk factors for tinea pedis and underwent physical and mycological examinations.Results Interdigital lesions of the feet were found in 66 runners (45%). A dermatophyte was isolated in 45 runners (31%), 12 of whom were asymptomatic. Trichophyton interdigitale and T. rubrum accounted for 49% and 35.5%, respectively, of the cases of tinea pedis. Thirty‐three (22%) of the 102 runners free of dermatophyte infection had lesions resembling those of tinea pedis. Increasing age and use of communal bathing facilities were predictive of T. rubrum culture.Conclusions Marathon runners are at high risk for tinea pedis, but dermatophytes are responsible for only half of the foot lesions found in runners. The existence of asymptomatic carriers calls for prophylactic measures.
Transdermal application of prostaglandin E1 ethyl ester for the treatment of trophic acral skin lesions in a patient with systemic scleroderma
Authors: Schlez A , Kittel M , Scheurle B , Diehm C , Jünger M 
Published: March 2003

AbstractAn early clinical symptom in scleroderma patients is Raynaud's phenomenon. Later cutaneous manifestations of the disease include oedematous swelling in the extremities and in more extreme cases often very painful, refractory acral necroses. We report on a 56‐year‐old female patient who participated in a prospective, double‐blind, multicentre comparative pilot study because of her severe Raynaud symptoms, with dystrophic skin lesions on both hands. The goal of the study was to evaluate the efficacy and safety of prostaglandin E1 ethyl ester in a transdermal drug delivery system compared with placebo in patients with secondary Raynaud's phenomenon associated with systemic scleroderma or mixed connective tissue disease. After 2 weeks of verum treatment the patient experienced a marked improvement of Raynaud's attacks, with increased capillary flow velocity, reduced blood stasis and clinical healing of the acral trophic lesions. For this patient the transdermal application of prostaglandin E1 ethyl ester in the form of a medicated patch proved to be a simple and effective therapy for the acral trophic skin lesions associated with systemic scleroderma.
Fatal scleroderma renal crisis caused by gastrointestinal bleeding in a patient with scleroderma, Sjögren's syndrome and primary biliary cirrhosis overlap
Authors: Szigeti N , Fábián G , Czirják L 
Published: March 2003

AbstractA 57‐year‐old female patient presented with a long history of overlapping autoimmune disease, including limited cutaneous systemic sclerosis, Sjögren's syndrome and primary biliary cirrhosis. Another unusual finding was that the mild skin involvement (limited cutaneous systemic sclerosis, subcutaneous calcinosis) was combined with serious internal organ involvement, including honeycombing and finally scleroderma renal crisis. The most important finding was, that two decades later she developed severe telangiectasia of the gastrointestinal and urinary tract. Furthermore, a specific type of vascular malformation, i.e. gastric watermelon stomach was also found. The chronic gastrointestinal bleeding primarily derived from a watermelon stomach caused protein overload, which provoked the onset of the scleroderma renal crisis that finally led to the patient's death.
Gemcitabine‐induced erysipeloid skin lesions in a patient with malignant mesothelioma
Authors: Kuku I , Kaya E , Sevinc A , Aydogdu I 
Published: March 2003

AbstractGemcitabine is a nucleoside analogue that has shown to have antineoplastic activity in different solid tumours (lung, pancreas, bladder, colon, ovarian, and breast cancer) and malignant mesothelioma. The toxic effects of gemcitabine include myelosuppression, flu–like syndrome, altered liver function tests, bronchospasm, rash, itching, and fever. However, gemcitabine‐induced erysipeloid skin reaction was reported in a small number of patients with previous history of radiotherapy or lymphedema. We reported a male patient who developed erysipeloid skin reaction following gemcitabine treatment in the absence of radiotherapy and lymphedema.
Giant exophytic basal cell carcinoma treated with radiotherapy
Authors: Rossi R , Campolmi P , Giomi B , Massi D , Cappugi P 
Published: March 2003

AbstractBasal cell carcinomas may attain giant proportions due primarily to recurrence or because the tumour is neglected. We report the case of a 66‐year‐old man who presented with a bleeding, polypoid, cutaneous tumour located on the left shoulder region of 13 years duration. The man had not received any previous treatment. The lesion was biopsied and histopathologically diagnosed as a solid type basal cell carcinoma with focal areas of squamous differentiation and keratinization. The man refused complete surgical removal and therefore was treated with roentgentherapy, with satisfactory results and no complications in the irradiated area. No recurrences had manifested after 1 year follow‐up.
The Impact of Service User Cognitive Level on Carer Attributions for Aggressive Behaviour
Authors: Tynan Hannah , Allen David 
Published: March 2003

Background  This study was designed to test the hypothesis that carer attributions for aggressive behaviour vary according to a service user's severity of intellectual disability.Methods  Forty‐two residential care staff participated in an investigation examining the effects of the level of a service user's intellectual disability on causal attributions for their aggressive behaviour. Equal numbers of participants were assigned to either a ‘mild disability’ or a ‘severe disability’ condition and required to read a vignette depicting a service user with aggressive challenging behaviour. The service user's cognitive abilities were experimentally manipulated across conditions, whilst the behaviour described remained unchanged. Participants were required to make attributions along Weiner's (1980) dimensions of locus, stability and controllability, and in accordance with five prominent models of challenging behaviour (Hastings 1997b).Results  The service user depicted in the mild disabilities condition was perceived to have significantly greater control over factors causing the aggressive behaviour than the service user in the severe disabilities condition. Participants in the severe disabilities condition considered the aggression to be significantly more challenging. Learned behaviour and emotional causal models of aggressive behaviour were favoured, whilst the physical environment account was seen as least appropriate. Additionally, the biomedical model was rated as significantly more applicable in the severe disability condition than in the mild disability condition.Conclusions  Implications for staff and service users are discussed. In particular, the relationship between staff causal attributions for challenging behaviour, their emotional responses and willingness to engage in helping behaviour is explored.
Effects of maternal hyperoxygenation on ductus venosus flow velocity waveforms in normal third‐trimester fetuses
Authors: Soregaroli M. , Rizzo G. , Danti L. , Arduini D. , Romanini C. 
Published: March 2003

AbstractOn the basis of the data obtained in sheep fetuses showing a high interdependence between umbilical vein oxygenation and ductus venosus flow, we investigated the effect of maternal hyperoxygenation on ductus venosus velocity waveforms in normal third‐trimester human fetuses. Ductus venosus velocity waveforms were recorded by using color and pulsed Doppler ultrasonography before and after 15 min of maternal administration of humidified 60% oxygen. During maternal hyperoxygenation, there was a significant increase of both estimated peak velocities during systole, diastole and atrial contraction and the mean temporal velocity during the total cardiac cycle and systolic and diastolic portions. On the other hand, during maternal hyperoxygenation, no significant changes were found in fetal heart rate or in the ratios between peak velocities and mean temporal velocities during systole and diastole. These findings suggest a close relationship between fetal oxygenation and ductus venosus velocity waveforms that may be useful in monitoring fetal hypoxemia. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Fetal hydrometrocolpos
Authors: Saxena R. , Divan G. , Long A. M. , Arulambalam K. J. , Nicolaides K. H. 
Published: March 2003

AbstractThis report describes a case of hydrometrocolpos presenting antenatally as a cystic mass arising from the pelvis of a female fetus. The baby was born at 33 weeks and died within an hour due to pulmonary hypoplasia. Postmortem examination demonstrated hydrometrocolpos, dense adhesions in the abdomen and pulmonary hypoplasia. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Relapse of maternal thyrotoxicosis presenting as a second‐trimester fetal goiter
Authors: Vali A. , Wiles P. , Thomas N. B. , Ludlam A. 
Published: March 2003

AbstractA large fetal goiter was detected at 22 weeks of gestation during an antenatal ultrasound scan of a woman with a previous history of Graves' disease treated by partial thyroidectomy. This unsuspected finding initiated maternal investigations and treatment. In untreated cases poor fetal outcome is common and unfortunately fetal thyrotoxicosis/thyroid enlargement frequently remains unrecognized in the first pregnancy. We report the case and its management and discuss the literature emphasizing the importance of screening for antibodies in the ‘at‐risk’ women and the increasing importance of ultrasound in the evaluation and follow‐up of these patients.Reports of thyrotoxic fetal goiters are extremely rare and, to our knowledge, there have been no previous reports of this in the second trimester. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Incorporating the four‐chamber view of the fetal heart into the second‐trimester routine fetal examination
Authors: Tegnander E. , Eik‐Nes S. H. , Linker D. T. 
Published: March 2003

AbstractThe four‐chamber view of the fetal heart is reported to he the most useful view for detecting congenital heart defects. In 7322 non‐selected, consecutive pregnancies of women attending a second‐trimester (18 weeks) routine ultrasound scanning program, we examined our ability to obtain a four‐chamber view in the fetus within the 30 min generally allocated to do the scan and record data. Five trained nurse‐midwives performed the examinations between June 1988 and September 1990. In the first part of the study, a four‐chamber view could not be obtained in 7%, while in the second part, the failure rate was 4%, which showed a learning effect over time. The demonstration of a four‐chamber view was significantly better with a 5 MHz than with a 3.5 MHz transducer. The ability to obtain the four‐chamber view improved as the gestational age increased. The main reason for not being able to obtain the four‐chamber view with the 3.5 MHz transducer was poor imaging; for the 5 MHz transducer, it was an unfavorable position of the fetus. Education and experience, as well as good equipment, are important factors in obtaining good results. The time spent learning to obtain a four‐chamber view reliably was relatively long. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Transabdominal versus transvaginal ultrasound in the diagnosis of polycystic ovaries in a population of randomly selected women
Authors: Farquhar C. M. , Birdsall M. , Manning P. , Mitchell J. M. 
Published: March 2003

AbstractA study was conducted which compared transvaginal and transabdominal ultrasound in determining the prevalence of polycystic ovaries in a population of women. Women, chosen randomly from electoral rolls, were sent a letter inviting them to take part in a study determining the presence of polycystic ovaries. A transvaginal and transabdominal ultrasound scan was performed on day 5–9 of their menstrual cycles. A total of 187 women (mean age 33 years) took part in the study. The prevalence of polycystic ovaries was 21% (40/187) by transabdominal ultrasound and 27% (36/134) by transvaginal ultrasound. No differences existed between women with polycystic and normal ovaries with respect to uterine size and endometrial thickness. Mean ovarian volume was larger in women with polycystic ovaries irrespective of the use of hormonal contraception or breast feeding. There was no difference in the prevalence of polycystic ovaries diagnosed by transabdominal or transvaginal ultrasound in the group of randomly selected women. However, almost 20% of the women declined a transvaginal ultrasound examination. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
The characterization of flow signals from tubal and ovarian arteries using intraoperative continuous wave Doppler
Authors: Aleem F. , Zeitoun K. , Calame R. , Trinca D. , Zalud I. , Schulman H. 
Published: March 2003

Ovarian vascular Doppler is a promising screening test for early ovarian cancer detection. However, disagreements on flow indices used, flow signal shapes and ovarian vessel localization cause continuing controversy. We aimed at clarifying some of this confusion by directly measuring the adnexal arterial blood flow during laparotomy. A 10‐MHz continuous Doppler probe was used to examine adnexal vessels in 24 patients undergoing laparotomy for benign gynecological pathology. Resistance (RI) and pulsatility (PI) indices were calculated for each vessel and the shape of the flow signals was noted. The tubal arteries showed a low‐velocity flow pattern with relatively high end‐diastolic flow when compared to the ovarian artery signals obtained from the infundibulopelvic ligament.The mean RIs for the tubal artery and ovarian artery in the infundibulopelvic ligament were 0.59 ± 0.02 and 0.73 ± 0.02, respectively. The mean PIs for the tubal and ovarian artery in the infundibulopelvic ligament were 1.11 ± 0.09 and 1.53 ± 0.1, respectively. The tubal artery showed a significantly lower RI and PI when compared to the ipsilateral ovarian artery at the infundibulopelvic ligament (p < 0.001 and p = 0.002, respectively) and its hilar branches (p = 0.03 for RI and p = 0.03 for PI). We conclude that tubal artery flow signals, which are measured directly for the first time in this study, are characteristic and are distinct from the ovarian artery signals. Tubal artery signals might be erroneously picked up during transvaginal color Doppler sonography of the ovaries, especially in the presence of conditions causing a decreased impedance to blood flow in the pelvis, such as ovarian tumors. Recognizing the flow signal from the tubal artery may help in differentiating ovarian and tubal vessels detected during color Doppler sonography.
Quantitative flow measurements for classification of ovarian tumors by transvaginal color Doppler sonography in postmenopausal patients
Authors: Prömpeler H. J. , Madjar H. , Sauerbrei W. , Lattermann U. , Pfleiderer A. 
Published: March 2003

AbstractColor Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumors in postmenopausal patients. An ATL UM9/HDI was used. The following flow criteria were analyzed: lowest resistance index (RI) and pulsatility index (PI), total number of arteries and number of central arteries and the maximum, mean and sum of systolic, end‐diastolic and time‐averaged maximum velocities of all intratumoral vessels. In 98% of malignant and in 85% of benign lesions, vessels were detected. All flow criteria showed highly significant differences between benign and malignant tumors (p < 0.0001). However, there was a considerable overlap between benign and malignant tumors (e.g. the median of the lowest RI was 0.62 (range 0.26–1.0) for benign and 0.40 (0.22–0.66) for malignant tumors; the median of the maximum systolic velocity was 17.5 cm/s (range 5.2–61.5 cm/s) for benign and 47.05 cm/s (14.6–105.0 cm/s) for malignant tumors).Differentiation of malignant tumors by the lowest RI and PI, number of arteries and maximum of systolic flow velocities gave a sensitivity of 77–85%, specificity of 77–83% and accuracy of 80–84%. Differentiation was superior by calculation of the maximum end‐diastolic velocities and by the summation of the systolic, end‐diastolic and time‐averaged maximum flow velocities: sensitivity 90–9.5% specificity 83–86% and accuracy 87–91%. This study confirms that a single measurement is not sufficient for an accurate differentiation of ovarian lesions and, besides the measurement of minimum RI and PI, the measurements of flow velocities as Doppler criteria play an important role. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasonic demonstration of local myometrial thickening in early intrauterine pregnancy
Authors: Tadmor O. P. , Rabinowitz R. , Diamant Y. Z. 
Published: March 2003

AbstractIn a group of women in the first and early second trimesters of pregnancy, local thickening of a limited region of the myometrium was observed ultrasonically. This prospective study aimed to evaluate the incidence and nature of this phenomenon. Local myometrial thickening was observed in 72 women out of 5521 examined (1.3%). Twenty‐two were given ritodrine hydrochloride 10 mg by mouth, and 46 were monitored for up to 60 min without treatment. The local myometrial thickening in the ritodrine hydrochloride‐treated group disappeared in 21 out of 22 women (95.5%) compared with the observed group, where the phenomenon disappeared in only 37 women (80.4%). Local myometrial thickenings probably represent transient uterine contractions; they tend to appear early in pregnancy, are prolonged, and may respond to ritodrine hydrochloride. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
The role of color Doppler in diagnosis of endometriomas
Authors: Aleem F. , Pennisi J. , Zeitoun K. , Predanic M. 
Published: March 2003

AbstractThe aim of this study was to characterize the appearance of the .vascular pattern of endometriomas in terms of color Doppler and to verify the role of Doppler flow indices in differentiating endometriomas from other pelvic masses. Twenty patients with suspected endometriosis were referred for evaluation and surgical management of adnexal masses and/or infertility problems. Before surgery, transvaginal sonography was performed using an Ultramark 9 (ATL) Ultrasound system. The color Doppler was used for evaluation of the vascular color distribution. Flow parameters (resistance index (RI) and pulsatility index (PI)) were obtained using pulsed Doppler. A total of 24 masses were identified in the 20 patients studied. Sixteen masses proved to be endometriomas, with a mean size of 3.5 ± 0.4 cm. Of confirmed endometriomas, 81% had a regular internal surface and 63% showed the characteristic homogeneous low‐level echoes filling the cyst. Eleven of 16 (69%) endometriomas showed flow by color Doppler. The flow was characteristically limited, with few spots of vascular color seen in each mass. Cases that showed dense vascularity with color Doppler proved not to be endometriomas. The mean ± SE of the RI and PI for the endometriomas were 0.59 ± 0.02 and 0.95 ± 0.1, respectively. All endometriomas showed an RI of > 0.5 with a range of 0.5–0.74, while the PI was 0.59–1.95. No significant differences between flow indices for endometriomas and other benign cystic lesions were noted. Scattered vascularity, one feature of adnexal endometriomas, may help to differentiate them from other lesions of dense vascular distribution, such as corpora lutea or ovarian neoplasms. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal diagnosis and management of meconium peritonitis: a case report and review of the literature
Authors: Konje J. C. , de Chazal R. , MacFadyen U. , Taylor D. J. 
Published: March 2003

AbstractWe present a case of meconium peritonitis which was associated with a short bowel and complicated by progressive bowel distension and difficulty in making a definitive diagnosis of cystic fibrosis. Treatment was by bowel resection and an ileostomy (and later bowel anastomosis), followed by parenteral nutrition which was complicated by hepatitis. The literature is reviewed and management dilemmas and options are discussed. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology