• 【剧烈颈部按摩后颈部肿胀。诊断: 宫颈淋巴性膨出】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Ceylan A,Akçam T,Karatas E,Celenk F
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【市中心地区子宫颈筛查的初步研究-国家计划的经验教训。】 复制标题 收藏 收藏
    DOI:10.1046/j.1365-2303.1997.4475044.x 复制DOI
    作者列表:Herity B,McDonald P,Johnson Z,Carroll B,Cody M,Duignan N,McGee D,O'Kelly F,Hurley M
    BACKGROUND & AIMS: :The objectives of this study were to examine aspects of organization of a proposed national screening programme based in general practice. The target population of women aged 25-59 years and their general practitioners (GPs), in a defined inner city area, was identified from a population register of persons eligible for free medical services; a computerized system was developed for invitations and record linkage of cytology results. Smears were examined in one laboratory and follow up of women with abnormal smears was undertaken by one gynaecologist. A random sample of non-responders was surveyed by questionnaire. Response following two invitations was only 20%. Practices with male doctors only had significantly lower response rates (P < 0.001) than those with a female doctor/nurse. A survey of non-responders showed that over 20% of addresses were incorrect and 16% of those interviewed were ineligible for smear tests. A preference for a female to undertake smears was expressed by 67%, and 77% believed that the purpose of the cervical smear was to detect cancer. An accurate population register, health promotion, support for GP practices, provision of alternative venues for smear tests, development of computer systems, accurate data entry and fail-safe follow up are aspects of a cervical screening service which must be addressed prior to setting up a national service.
    背景与目标: : 这项研究的目的是根据一般实践研究拟议的国家筛查计划的组织方面。从有资格获得免费医疗服务的人的人口登记册中确定了在确定的内城地区25-59岁妇女及其全科医生的目标人群; 开发了一个计算机化系统,用于邀请和细胞学结果的记录联系。在一个实验室中检查了涂片,并由一名妇科医生对涂片异常的妇女进行了随访。通过问卷调查对无反应者进行了随机抽样调查。仅20% 了两次邀请后的答复。男性医生的实践仅比女性医生/护士的实践具有显着较低的反应率 (P <0.001)。对无应答者的调查显示,超过20% 的地址不正确,并且16% 的受访者不符合涂片检查的资格。67% 表示偏爱女性进行涂片检查,77% 认为宫颈涂片检查的目的是检测癌症。准确的人口登记、健康促进、对全科医生做法的支持、提供涂片检查的替代场所、计算机系统的开发、准确的数据输入和故障安全随访是子宫颈筛查服务的各个方面,在建立国家服务之前必须解决这些问题。
  • 【以铂类为基础的化疗治疗的转移性或复发性宫颈癌患者的预后和预测因素。】 复制标题 收藏 收藏
    DOI:10.1186/s12885-017-3435-x 复制DOI
    作者列表:Karageorgopoulou S,Kostakis ID,Gazouli M,Markaki S,Papadimitriou M,Bournakis E,Dimopoulos MA,Papadimitriou CA
    BACKGROUND & AIMS: BACKGROUND:Recognizing resistance or susceptibility to the current standard cisplatin and paclitaxel treatment could improve therapeutic outcomes of metastatic or recurrent cervical cancer. METHODS:Forty-five tissue samples from patients participating in a phase II trial of cisplatin and ifosfamide, with or without paclitaxel were collected for retrograde analysis. Immunohistochemistry and genotyping was performed to test ERCC1, III β-tubulin, COX-2, CD4, CD8 and ERCC1 (C8092A and N118 N) and MDR1 (C3435T and G2677 T) gene polymorphisms, as possible predictive and prognostic markers. Results were statistically analyzed and correlated with patient characteristics and outcomes. RESULTS:Patients with higher levels of ERCC1 expression had shorter PFS and OS than patients with low ERCC1 expression (mPFS:5.1 vs 10.2 months, p = 0.027; mOS:10.5 vs. 21.4 months, p = 0.006). Patients with TT in the site of ERCC1 N118 N and GT in the site of MDR1 G2677 T polymorphisms had significantly longer PFS (p = 0.006 and p = 0.027 respectively). ERCC1 expression and the ERCC1 N118 N polymorphism remained independent predictors of PFS. Interestingly, high III beta tubulin expression was associated with chemotherapy resistance and fewer responses [5/20 (25%)] compared to lower III β-tubulin expression [15/23 (65.2%)] (p = 0.008). Finally, ΙΙΙ β-tubulin levels and chemotherapy regimen were independent predictors of response to treatment. CONCLUSIONS:ERCC1 expression proved to be a significant prognostic factor for survival in our metastatic or recurrent cervical cancer population treated with cisplatin based chemotherapy. ERCC1 N118 N and MDR1 G2677 T polymorphism also proved of prognostic significance for disease progression, while overexpression of III β-tubulin was positively correlated with chemotherapy resistance.
    背景与目标:
  • 【颈椎压迫性脊髓病: 融合是主要的预后指标吗?】 复制标题 收藏 收藏
    DOI:10.3171/spi.2007.6.6.3 复制DOI
    作者列表:Sorar M,Seçkin H,Hatipoglu C,Budakoglu II,Yigitkanli K,Bavbek M,Kars HZ
    BACKGROUND & AIMS: OBJECT:A variety of factors may affect the neurological improvement in patients with cervical compression myelopathy (CCM) after surgery. The aim of this study was to report and discuss the prognostic factors in a group of patients with insufficient decompression of the spinal canal. METHODS:A prospective follow up and analysis of 20 consecutive patients with CCM treated between 2000 and 2002 was performed. All patients were surgically treated via an anterior approach, either by anterior cervical discectomy and fusion with instrumentation or by cervical corpectomy and fusion with instrumentation. The surgical results were examined using the modified Japanese Orthopaedic Asssociation disability scale, with reference to the findings of magnetic resonance imaging, computed tomography, and radiography. Seventeen patients (85%) experienced a 50% or more recovery rate as calculated using the Hirabayashi formula during the follow-up period (mean 32.5 months), despite a persistently narrow spinal canal and permanent or increased intramedullary high-intensity signal after surgery. CONCLUSIONS:Results of the study showed that patients with CCM benefited from anterior cervical discectomy and fusion with instrumentation or cervical corpectomy and fusion with instrumentation procedures despite insufficient decompression of the spinal canal. Fusion of the affected level(s) might be the reason for the acquired high recovery rates. The authors also conclude that the neurological improvement is not correlated with the reversal of or decrease in the intramedullary high-intensity signal change after surgery.
    背景与目标:
  • 【肉毒杆菌毒素在宫颈和颌面部疾病中的治疗用途: 循证综述。】 复制标题 收藏 收藏
    DOI:10.1016/j.tripleo.2007.02.004 复制DOI
    作者列表:Ihde SK,Konstantinovic VS
    BACKGROUND & AIMS: INTRODUCTION:The role of botulinum toxin as a therapeutic agent for several conditions is expanding. We sought to determine if botulinum toxin is safe and effective in treating patients with cervical dystonia and maxillofacial conditions. Our purpose was to establish a safety and efficacy profile to determine whether or not this treatment may be used prophylactically in patients undergoing dental implant therapy. METHODS:We performed a systematic search of the literature to identify randomized clinical trials evaluating patients treated with botulinum toxin as an adjunct to dental implant therapy, maxillofacial conditions including temporomandibular disorders (TMD), and cervical dystonia. RESULTS:Four randomized controlled trials (RCTs) met our search criteria in the area of cervical dystonia and chronic facial pain. No RCTs were identified evaluating dental implant therapy. Patients with cervical dystonia exhibited significant improvements in baseline functional, pain, and global assessments compared to placebo. Adverse events were mild and transient with numbers needed to harm (NNH) ranging from 12 to 17. Patients with chronic facial pain improved significantly from baseline in terms of pain compared to placebo. Rates of adverse events were less than 1%. CONCLUSION:Botulinum toxin appears relatively safe and effective in treating cervical dystonia and chronic facial pain associated with masticatory hyperactivity. No literature exists evaluating its use in dental implantology. Randomized clinical trials are warranted to determine its safety and efficacy in dental implantology and other maxillofacial conditions such as bruxism.
    背景与目标:
  • 6 Cervical spine and shoulder pain. 复制标题 收藏 收藏

    【颈椎和肩部疼痛。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Hawkins RJ,Bilco T,Bonutti P
    BACKGROUND & AIMS: :The complex problem of combined neck and shoulder pain was investigated in 26 operations in 13 patients who had a shoulder procedure (subacromial decompressions or rotator cuff repairs) and an anterior cervical spine fusion. This select group of complex patients illustrates the diagnostic studies required to determine whether the pain comes primarily from the cervical spine, shoulder, or both. Good pain relief was accomplished after 24 of the 26 surgical procedures (average follow-up, 4.3 years). In the 13 patients, eight presented with nearly equal neck and shoulder pain as the chief complaint, whereas in the remaining five patients, the initial complaint was predominantly neck pain with only minor shoulder involvement. The shoulder pain became more significant after the anterior cervical fusion in these five patients. This study emphasizes the need for a careful evaluation of patients with combined neck-shoulder pain syndrome in a systematic approach allowing appropriate treatment.
    背景与目标: : 在13例接受肩部手术 (肩峰下减压或肩袖修复) 和颈椎前路融合术的患者中,对26例颈肩疼痛的复杂问题进行了研究。这一组复杂的患者说明了诊断研究,以确定疼痛是否主要来自颈椎,肩膀或两者。在26次外科手术中的24次 (平均随访4.3年) 后,疼痛缓解良好。在13例患者中,有8例的颈部和肩部疼痛几乎是主要主诉,而在其余5例患者中,最初的主诉主要是颈部疼痛,仅轻微的肩部受累。在这五名患者中,颈椎前路融合后,肩部疼痛变得更加明显。这项研究强调需要以系统的方法对合并颈肩疼痛综合征的患者进行仔细评估,以进行适当的治疗。
  • 【上下颈脊髓损伤患者尿动力学结果的比较。】 复制标题 收藏 收藏
    DOI:10.1038/sc.2013.83 复制DOI
    作者列表:Sayılır S,Ersöz M,Yalçın S
    BACKGROUND & AIMS: STUDY DESIGN:Retrospective study. OBJECTIVES:To analyze the neurogenic bladder characteristics and treatment approaches in patients with upper and lower cervical spinal cord injury (SCI) in order to make proper and reasonable decisions to the relevant patients. SETTING:Rehabilitation center in Ankara, Turkey. METHOD:Ninety patients with cervical SCI were included. The urodynamic analyses of the patients were conducted retrospectively by using the urodynamic laboratory records. The patients were divided into two groups as the upper cervical SCI (UCSCI) group (C1-C5) and lower cervical SCI (LCSCI) group (C6-C8). RESULTS:In this study, 82 male (91.1%) and 8 (8.9%) female patients were included. There were 51 UCSCI patients with the mean age of 34.2 ± 16.1 years and 39 LCSCI patients with the mean age of 30.4 ± 12.5 years. Detrusor overactivity and preservation of the bladder-filling sensation were significantly more frequent in the UCSCI group than in the LCSCI group (P=0.048, P=0.000 respectively). Moreover, there were statistically significant differences between the groups regarding the bladder-emptying methods, residual volume and the frequency of anticholinergic and alpha blocker use (all P<0.05). No significant difference was found between the groups regarding the frequency of autonomic dysreflexia, detrusor hypocompliancy and the bladder-storage and -emptying disorders (all P>0.05). CONCLUSION:Our results demonstrate that there are differences in the upper and lower SCI cases in terms of neurogenic bladder characteristics and treatment approaches.
    背景与目标:
  • 【腰椎肌肉组织降低L 4L 5椎间盘上的前剪切力。】 复制标题 收藏 收藏
    DOI:10.1016/0268-0033(91)90005-B 复制DOI
    作者列表:Potvin JR,Norman RW,McGill SM
    BACKGROUND & AIMS: :The purpose of this study was to assess the possible role of muscles in offsetting the anterior shear forces caused by the load and upper body mass and their accelerations that act on the L 4L 5, intervertebral joint during dynamic squat lifts. Fifteen males lifted five loads from 5.8 to 32.4 kg. Anterior shear forces estimated to be acting on the lumber spine, based on model output, ranged from 492 N at 5.8 kg to 736 N at 32.4 kg. However, the peak shear force that had to be supported by the facets and possibly the disc remained relatively constant at approximately 200 N, regardless of the load mass. The posteriorly directed fascicles of the lumbar portions of the iliocostalis lumborum and longissimus thoracis muscles increased their force output, as estimated from an EMG driven model, in proportion to the anterior load shear force demands, thereby sharing the load on the intervertebral joint. It appears that the combination of anatomical design and neural control of the musculature leads to a situation where the resultant shear force on the joint can be maintained at a relatively constant and safe level in the types of lifts studied. This 'safety' mechanism is useful only with the preservation of lordosis during lifting, when the muscles must provide the majority of the support moment.
    背景与目标: : 这项研究的目的是评估肌肉在抵消动态下蹲提升过程中作用于L 4L 5椎间关节的负荷和上半身质量及其加速度引起的前剪切力中的可能作用。十五只雄性从5.8举起五只重物到32.4千克。根据模型输出,估计作用在木材脊柱上的前剪切力范围为5.8千克时的492 N至32.4千克时的736 N。然而,无论负载质量如何,必须由小平面和可能的圆盘支撑的峰值剪切力保持在大约200 N处相对恒定。根据EMG驱动模型估算,The肋腰和胸肌的腰部部分的后向束与前载荷剪切力需求成比例地增加了其力输出,从而分担了椎间关节的载荷。看来,解剖设计和肌肉组织的神经控制的结合导致了这样一种情况,即在所研究的提升类型中,关节上的合力剪切力可以保持在相对恒定且安全的水平。这种 “安全” 机制仅在举起期间保留脊柱前凸时有用,此时肌肉必须提供大部分支撑时刻。
  • 【粪肠球菌性心内膜炎引起的齿状突突和颈椎炎的败血症坏死: 第一份报告。】 复制标题 收藏 收藏
    DOI:10.1532/HSF98.20071151 复制DOI
    作者列表:Mosquera V,Campos V,Valle JV,Juffé A
    BACKGROUND & AIMS: :We describe a 75-year-old male patient who developed a general syndrome, with a fever of 39 degrees C, weight loss, and cervical pain, during the month following a urological procedure. The presence of positive blood cultures for Enterococcus faecalis, aortic vegetations, and severe aortic regurgitation observed with echocardiogram confirmed the diagnosis of infective endocarditis (IE). Magnetic resonance imaging of the spinal cord showed significant erosion and irregularities of the odontoid apophysis, with hyperintensity of bone marrow in T2-weighted images because of edema and inflammation. These findings suggested an infective necrosis of the odontoid apophysis. Despite the common occurrence of rheumatologic manifestations in IE, with prevalence rates of 25% to 44%, spondylodiscitis is rarely observed (5%-13%). The lumbar region is the most commonly involved. We found only one other reported case of cervical spondylodiscitis. The case we describe is the first report of septic necrosis of the odontoid apophysis associated with IE.
    背景与目标: : 我们描述了一名75岁的男性患者,该患者在泌尿外科手术后的一个月内出现了一般综合征,发热39摄氏度,体重减轻和宫颈疼痛。超声心动图观察到粪肠球菌,主动脉植被和严重的主动脉反流的阳性血培养物证实了感染性心内膜炎 (IE) 的诊断。脊髓的磁共振成像显示出齿状突突的明显侵蚀和不规则,由于水肿和炎症,T2-weighted图像中的骨髓强度高。这些发现表明齿状突突的感染性坏死。尽管IE中常见的风湿病表现,患病率为25% 至44%,但很少观察到椎间盘炎 (5%-13%)。腰部是最常见的累及部位。我们只发现了另外一例颈椎炎病例。我们描述的病例是与IE相关的齿状突突的败血性坏死的首次报道。
  • 【土耳其农村地区护士对乳腺癌和宫颈癌危险因素和筛查行为的认识。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-2354.2007.00856.x 复制DOI
    作者列表:Yaren A,Ozkilinc G,Guler A,Oztop I
    BACKGROUND & AIMS: :Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. There is limited data on breast and cervical cancer knowledge, screening practices and attitudes of nurses in Turkey. A self-administered questionnaire was used to investigate the knowledge and attitude of nurses on risk factors of the breast and cervical cancer as well as screening programmes such as breast self-examination (BSE), clinical breast examination, mammography (MMG) and papanicolaou (pap) smear test. In total, 125 out of 160 nurses participated in the study (overall response rate was 80.6%). The risk factors and symptoms of breast cancer was generally well known, except for early menarche (23.2%) and late menopause (28.8%). For cervical cancer, the correct risk factors mostly indicated by the nurses were early age at first sexual intercourse (56%), smoking (76%), multiple sexual partners (71.2%). As for screening methods, it was believed that BSE was a beneficial method to identify the early breast changes (84.8%) and MMG was able to detect the cancer without a palpable mass (57.6%). Little was known about the fact that women should begin cervical cancer screening approximately 3 years after the onset of sexual intercourse (23.2%) and if repeated pap smear test were normal, it could be done every 2-3 years. Most of the nurses considered that MMG decreases the mortality in breast cancer (65.6%) and also believed that pap smear test decreases the mortality in cervical cancer (75.2%). Despite high level of knowledge of breast cancer risk factors, symptoms and screening methods, inadequate knowledge of cervical cancer screening method were found among nurses.
    背景与目标: : 乳腺癌和宫颈癌是全世界女性癌症死亡的最常见原因,但实际上它们在很大程度上是可以预防的疾病。土耳其有关乳腺癌和宫颈癌知识,筛查实践和护士态度的数据有限。采用自编问卷调查护士对乳腺癌和宫颈癌危险因素的知识和态度,并进行乳房自我检查 (BSE),临床乳房检查,乳房x线检查 (MMG) 和巴氏涂片检查等筛查计划。总共160名护士中有125名参加了研究 (总有效率为80.6%)。除初潮早期 (23.2%) 和绝经晚期 (28.8%) 外,乳腺癌的危险因素和症状通常是众所周知的。对于宫颈癌,护士指出的正确危险因素主要是初次性交年龄早 (56%),吸烟 (76%),多性伴侣 (71.2%)。至于筛选方法,认为BSE是识别早期乳房变化的有益方法 (84.8%),并且MMG能够在没有可触及肿块的情况下检测癌症 (57.6%)。对于女性应在性交开始后大约3年开始进行宫颈癌筛查 (23.2%),并且如果重复的巴氏涂片检查正常,则每2-3年进行一次,这一事实知之甚少。大多数护士认为MMG可以降低乳腺癌的死亡率 (65.6%),并且还认为子宫颈抹片检查可以降低宫颈癌的死亡率 (75.2%)。尽管对乳腺癌危险因素,症状和筛查方法的了解程度很高,但护士对宫颈癌筛查方法的了解不足。
  • 【[腰椎间盘突出症患者的慢性疼痛因子。]。】 复制标题 收藏 收藏
    DOI:10.1007/BF02527877 复制DOI
    作者列表:Hasenbring M,Marienfeld G,Ahrens S,Soyka D
    BACKGROUND & AIMS: :Using a biopsychosocial model of chronic radicular pain, we conducted a prospective study on the predictability of the therapy outcome in 41 lumbar disc patients from the Department of Neurology, University of Kiel. Before therapy, all patients had an extensive neurological and psychological examination. The criteria for the therapy outcome werepersistent pain and theduration of hospital stay in days. As for the psychological predictors, we examined the amount of depression as a state variable (Beck Depression Inventory BDI), depression as a trait variable (Giessen test), several paincoping modes (Hoppe scale) and the general health locus of control. As somatic predictors, we assessed the duration of pain before treatment, the number of previous operations, motoric paresis and the patient's age. The results indicated that the BDI was the best predictor of persistent pain and of the duration of hospital stay as well. The sensitivity and specificity were more than 90%. Patients with a BDI score >9 remained 8 days longer in the hospital than patients with lower BDI scores. In contrast to this, depression as a personality dimension allowed no correct prediction of patients with persistent pain. Thus, only the situational aspect of a depressive state is a relevant risk factor for chronicity. Overt pain behavior, avoidance behavior and fatalistic control expectations are the best predictors of persistent pain besides the BDI. Patients with persistent pain when discharged from the hospital had significantly more overt pain behavior preoperatively than patients without pain. They admitted that they changed their posture more often; they groaned, grimaced, or rubbed the painful area more often. Thus, these data confirm the operant conditioning theory of Fordyce within a prospective design. Furthermore, patients with strong avoidance behavior in pain situations and with fatalistic health expectations remained 8 to 10 days longer in the hospital. Regarding the somatic factors, only paresis is a significant predictor of these criteria. Patients with clear paresis showed more pain and a longer duration of hospital stay. In general, there was no significant correlation between the organic and psychological predictors, so independent psychological screening and the prospect of psychological interventions are necessary measures to prevent persistent pain in lumbar disc patients.
    背景与目标: : 使用慢性神经根痛的生物心理社会模型,我们对基尔大学神经病学系的41名腰椎间盘患者的治疗结果的可预测性进行了前瞻性研究。治疗前,所有患者都进行了广泛的神经和心理检查。治疗结果的标准是持续疼痛和住院天数。至于心理预测因子,我们检查了作为状态变量的抑郁量 (贝克抑郁量表BDI),作为特征变量的抑郁量 (吉森测验),几种疼痛应对模式 (霍普量表) 和总体健康控制源。作为躯体预测指标,我们评估了治疗前疼痛的持续时间,先前的手术次数,运动感觉和患者的年龄。结果表明,BDI是持续性疼痛和住院时间的最佳预测指标。敏感性和特异性均超过90%。BDI评分> 9的患者比BDI评分较低的患者在医院停留的时间延长了8天。与此相反,抑郁症作为人格维度,无法正确预测持续疼痛的患者。因此,只有抑郁状态的情境方面才是慢性病的相关风险因素。除BDI外,明显的疼痛行为,回避行为和宿命控制期望是持续性疼痛的最佳预测指标。出院后持续疼痛的患者术前明显比没有疼痛的患者明显更明显。他们承认他们更经常改变姿势; 他们更经常地呻吟、做鬼脸或摩擦痛苦的地方。因此,这些数据证实了预期设计中Fordyce的操作条件反射理论。此外,在疼痛情况下具有强烈回避行为且具有宿命论健康期望的患者在医院停留的时间延长了8至10天。关于躯体因素,只有瘫是这些标准的重要预测指标。患有明显的瘫的患者表现出更多的疼痛和更长的住院时间。总的来说,器质性和心理预测因子之间没有明显的相关性,因此独立的心理筛查和心理干预的前景是预防腰椎间盘突出症患者持续性疼痛的必要措施。
  • 【4号染色体的缺失与宫颈癌的发展有差异: slit2作为候选肿瘤抑制基因的证据。】 复制标题 收藏 收藏
    DOI:10.1007/s00439-007-0375-6 复制DOI
    作者列表:Singh RK,Indra D,Mitra S,Mondal RK,Basu PS,Roy A,Roychowdhury S,Panda CK
    BACKGROUND & AIMS: :The aim of this study was to locate the candidate tumor suppressor genes (TSGs) loci in the chromosomal 4p15-16, 4q22-23 and 4q34-35 regions associated with the development of uterine cervical carcinoma (CA-CX). Deletion mapping of the regions by microsatellite markers identified six discrete areas with high frequency of deletions, viz. 4p16.2 (D1: 40%), 4p15.31 (D2: 35-38%), 4p15.2 (D3: 37-40%), 4q22.2 (D4: 34%), 4q34.2-34.3 (D5: 37-59%) and 4q35.1 (D6: 40-50%). Significant correlation was noted among the deleted regions D1, D2 and D3. The deletions in D1, D2, D5 and D6 regions are suggested to be associated with the cervical intraepithelial neoplasia (CIN), and deletions in the D2, D3, D5 and D6 regions seems to be associated with progression of CA-CX. The deletions in the D2 and D6 regions showed significant prognostic implications (P = 0.001; 0.02). The expression of the candidate TSG SLIT2 mapped to D2 region gradually reduced from normal cervix uteri -->CIN --> CA-CX. SLIT2 promoter hypermethylation was seen in 28% CIN samples and significantly increased with tumor progression (P = 0.04). Significant correlation was seen between SLIT2 deletion and its promoter methylation (P = 0.001), indicating that both these phenomena could occur simultaneously to inactivate this gene. Immunohistochemical analysis showed reduced expression of SLIT2 in cervical lesions and CA-CX cell lines. Although no mutation was detected in the SLIT2 promoter region (-432 to + 55 bp), CC and AA haplotypes were seen in -227 and -195 positions, respectively. Thus, it indicates that inactivation of SLIT2-ROBO1 signaling pathway may have an important role in CA-CX development.
    背景与目标: : 这项研究的目的是在与子宫颈癌 (ca-cx) 发展相关的4p15-16、4q22-23和4q34-35染色体区域中定位候选肿瘤抑制基因 (tsg) 位点。通过微卫星标记对区域进行的缺失映射确定了六个具有高缺失频率的离散区域,即。4p16.2 (D1: 40%),4p15.31 (D2: 35-38%),4p15.2 (D3: 37-40%),4q22.2 (D4: 34%),4q34.2-34.3 (D5: 37-59%) 和4q35.1 (D6: 40-50%)。在删除的区域D1,D2和d3之间注意到显着的相关性。建议D1,D2,D5和D6区域的缺失与宫颈上皮内瘤变 (CIN) 有关,而D2,D3,D5和D6区域的缺失似乎与ca-cx的进展有关。D2和D6区的缺失显示出显著的预后意义 (P = 0.001; 0.02)。定位于D2区域的候选TSG SLIT2的表达从正常宫颈->CIN-> CA-CX逐渐减少。在28% CIN样品中观察到SLIT2启动子高甲基化,并且随着肿瘤进展而显着增加 (P = 0.04)。SLIT2缺失与其启动子甲基化之间存在显著相关性 (P = 0.001),表明这两种现象可以同时发生以使该基因失活。免疫组织化学分析显示,宫颈病变和ca-cx细胞系中SLIT2的表达降低。尽管在SLIT2启动子区域 (-432至 + 55 bp) 中未检测到突变,但在-227和-195位置分别观察到CC和AA单倍型。因此,这表明SLIT2-ROBO1信号通路的失活可能在ca-cx的发育中起重要作用。
  • 【颈椎前路微椎间盘切除术伴或不伴融合。】 复制标题 收藏 收藏
    DOI:10.1097/BSD.0b013e31802f80c8 复制DOI
    作者列表:Oktenoglu T,Cosar M,Ozer AF,Iplikcioglu C,Sasani M,Canbulat N,Bavbek C,Sarioglu AC
    BACKGROUND & AIMS: BACKGROUND:Anterior cervical microdiscectomy (ACD) is commonly applied in the surgical treatment of cervical disc herniation. However, following discectomy procedure to perform a fusion process is still controversial. Therefore, a controlled, multicentric, prospective, randomized study was designed. MATERIAL AND METHOD:Totally 20 patients were operated. Eleven patients were operated with applying simple anterior microdiscectomy technique. Nine patients were operated via ACD and fusion with a semirigid plate technique. Preoperative and postoperative [immediate; postoperative first day and postoperative 1 y (mean 13.95 mo)] computed tomography studies and plain x-rays were obtained. The cervical disc and bilateral neural foramen heights of the operated level and adjacent segments were calculated. Pain assessment was performed using visual analog pain scale. Mann-Whitney statistical analysis method was applied to compare the outcomes for both groups. RESULTS:Satisfactory result was achieved in both groups. The pain scores for major complaint (arm pain) were decreased significantly in all patients after surgery regardless of the type of technique applied. The improvement in neck pain scores was significant only in patients who were treated with fusion procedure. There were no significant changes in disc height and neural foramen height measurements for both groups in adjacent levels in immediate and 1-year postoperative periods. The patients who were operated with simple ACD technique showed no significant decrease at postoperative first day in disc height and neural foramen height. However, the 1-year postoperative radiologic studies showed a significant decrease in disc height and neural foramen dimensions compared with preoperative values. The patients who were treated with fusion process showed a significant increase in disc height and nonsignificant increase in neural foramen heights at immediate postoperative study. However, with time, all dimensions showed significant decrease compared with preoperative values. CONCLUSIONS:ACD technique offers satisfactory outcome regardless of whether fusion process is applied or not. Fusion with semirigid plate offers an advantage at operated level in immediate postoperative period in regard of disc height and neural foramen height. However, semirigid anterior plates by definition do not stop subsidence and the advantage that is offered by this technique is not persistent. On the other hand, to apply fusion process with semirigid plate system offers significantly less narrowing in disc height compared with simple ACD technique.
    背景与目标:
  • 【通过环形电外科手术成功处理了由于囊性宫颈子宫内膜异位症破裂而导致的大量出血。】 复制标题 收藏 收藏
    DOI:10.1016/j.fertnstert.2007.04.011 复制DOI
    作者列表:Iwase A,Goto M,Kurotsuchi S,Harata T,Kaseki S,Kikkawa F
    BACKGROUND & AIMS: OBJECTIVE:To report a case of cystic cervical endometriosis that caused a massive hemorrhage due to rupture of a cyst and successful management with a loop electrosurgical excision procedure (LEEP). DESIGN:Case report. SETTING:University Hospital. PATIENT:A 37-year-old nulliparous woman. INTERVENTION(S):Medical management including surgical treatment. MAIN OUTCOME MEASURE(S):Clinical follow-up and pathologic diagnosis. RESULT(S):A hemorrhagic cystic cervical mass was excised with emergent LEEP. The mass was found to be cervical endometriosis. There was no evidence of recurrence until 1 year after excision. CONCLUSION(S):Cystic formation of cervical endometriosis--like ovarian endometrioma, which causes a massive hemorrhage due to rupture--is extremely rare, although cervical endometriosis is generally asymptomatic. Hysterectomy is considered in such cases but can be avoided via LEEP that incorporates partial excision of the uterine cervix.
    背景与目标:
  • 15 Risk of cervical cancer after HPV vaccination. 复制标题 收藏 收藏

    【HPV疫苗接种后发生宫颈癌的风险。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Markman M
    BACKGROUND & AIMS: :It will likely be more than 20 years before there is unequivocal evidence available that HPV vaccination decreases the incidence of invasive cervical cancer. However, existing data strongly suggests that as many as 440,000 cervical cancer cases and 220,000 deaths due to this malignancy will be prevented with the establishment of an effective worldwide HPV immunization program.
    背景与目标: : 可能需要20多年的时间才能有明确的证据表明HPV疫苗可以降低浸润性宫颈癌的发生率。然而,现有数据强烈表明,通过建立有效的全球HPV预防接种计划,将预防多达440,000例宫颈癌病例和由于这种恶性肿瘤导致的220,000死亡。

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