RESUMO
Mohs micrographic surgery is presented as a rational surgical management approach for thin malignant melanoma. Advantages of the Mohs micrographic surgery fresh-tissue technique include tissue conservation, low local recurrence rates, and outpatient reconstruction. It is likely that in the future many physicians and patients will choose Mohs micrographic surgery for the surgical treatment of thin malignant melanoma.
Assuntos
Melanoma/cirurgia , Cirurgia de Mohs , Neoplasias Cutâneas/cirurgia , Humanos , Incidência , Melanoma/patologia , Estadiamento de Neoplasias , Neoplasias Cutâneas/patologiaRESUMO
An anonymous survey was conducted among 100 randomly selected fellows of the American Society for Dermatologic Surgery. Forty-one respondents provided information about their experience with percutaneous injury. Causes of injury during 6278 invasive procedures performed during a 1-month period included suture needlesticks (two injuries), injection needlestick (one), needle recapping (one), scalpel blade (one), skin hook (one), and an injury during the transport of an instrument (one). Dermatologic surgeons were more likely to injure their dominant fingers. Attitudes of dermatologic surgeons were surveyed regarding operating on patients while the physician or assistant was actively infected with human immunodeficiency virus, hepatitis B virus, herpetic whitlow, or paronychia caused by Staphylococcus aureus. Dermatologic surgeons believed that they should be allowed to operate while infected with human immunodeficiency virus (41.5%), hepatitis B virus (40%), herpetic whitlow (25%), and paronychia caused by S. aureus (20%). Few dermatologic surgeons would disclose preoperatively to patients infections present in themselves or in operating team members that were due to human immunodeficiency virus (29.4%), hepatitis B virus (27.8%), herpetic whitlow (28.6%), or paronychia caused by S. aureus (33.3%).
Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Dermatologia , Cirurgia Geral , Agulhas , Pele/lesões , Ferimentos Perfurantes/etiologia , Atitude do Pessoal de Saúde , Infecções por HIV/transmissão , Humanos , Estudos Retrospectivos , Sociedades Médicas , Inquéritos e Questionários , Estados UnidosRESUMO
Data were collected from three medical centers in the USA, Poland, and Japan regarding 11 patients with advanced squamous cell carcinoma (SCC) secondary to epidermodysplasia verruciformis (EV). Analysis was conducted regarding primary tumor location, age at onset of EV, age at diagnosis of SCC, treatment of SCC, history of local tumor recurrence, presence of metastases, and age at death. Three of 11 patients developed both lymph node and visceral metastases and the mean patient age at death was 44 years (N = 6) with no patient to date living past 54 years. Mean patient survival time following metastases was 1.7 years (N = 2). Human papilloma virus typing of nine patients was performed. Current controversies regarding the treatment of patients with advanced SCC in the setting of EV are reviewed.
Assuntos
Carcinoma de Células Escamosas/mortalidade , Epidermodisplasia Verruciforme/complicações , Neoplasias Cutâneas/mortalidade , Adolescente , Adulto , Fatores Etários , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Criança , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Japão , Pessoa de Meia-Idade , Polônia , Prognóstico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Estados UnidosRESUMO
Tumor necrosis factor (TNF) potentiates the antiviral activity of interferon-gamma (IFN-gamma) directly and through induction of IFN-beta in HEp-2 cells. Antibody to IFN-beta inhibits a large component of the TNF and IFN-gamma synergy and immunoreactive IFN-beta can be detected in the supernatant fluids of TNF-treated HEp-2 cells. Furthermore, the kinetics of development of this synergy and its susceptibility to inhibition by antibody to IFN-beta is demonstrated.