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The Laryngoscope Jan 1998A prospective, double-blind, randomized, placebo-controlled study was performed to evaluate the effect of antibiotic prophylaxis in ear surgery. The present study... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
A prospective, double-blind, randomized, placebo-controlled study was performed to evaluate the effect of antibiotic prophylaxis in ear surgery. The present study reports on the results of 750 patients, half of whom received cefuroxime for 1 day, the other half, placebo. All postoperative infections occurring within 2 weeks after the intervention were recorded, together with several preoperative and perioperative parameters. It is concluded that exploratory tympanoplasties (including stapedotomy) and "dry perforation" tympanoplasties should be considered "clean" operations according to the American National Research Council and do not benefit from antibiotic prophylaxis. On the other hand, tympanoplasties performed on draining ears and on ears with cholesteatoma should be considered "dirty" operations for which antibiotic prophylaxis may decrease the postoperative infection rate by factor 3. All postoperative infections healed without sequels under proper treatment, except for three that resulted in graft necrosis--one in the placebo group and two in the cefuroxime group. In consequence, prophylaxis may not be mandatory in the dirty group, although the authors advocate its use for the sake of patient and surgeon comfort.
Topics: Antibiotic Prophylaxis; Cefuroxime; Double-Blind Method; Ear Diseases; Humans; Prospective Studies; Surgical Wound Infection; Tympanoplasty
PubMed: 9432077
DOI: 10.1097/00005537-199801000-00020 -
International Journal of Gynecological... Jul 1997Carcinomas metastatic to the ovary are often difficult to distinguish from primary ovarian carcinomas. Adenocarcinoma of the colon may simulate both primary endometrioid... (Comparative Study)
Comparative Study
Necrosis in 84 ovarian carcinomas: a morphologic study of primary versus metastatic colonic carcinoma with a selective immunohistochemical analysis of cytokeratin subtypes and carcinoembryonic antigen.
Carcinomas metastatic to the ovary are often difficult to distinguish from primary ovarian carcinomas. Adenocarcinoma of the colon may simulate both primary endometrioid and mucinous ovarian tumors. The histologic finding of "dirty" necrosis in association with a "garland" or cribriform pattern has been suggested as a useful feature in distinguishing metastatic colonic carcinomas from primary endometrioid ovarian carcinomas. This study was performed to determine the use of "dirty" necrosis in distinguishing primary ovarian carcinoma from metastatic colonic carcinoma by studying 71 of the former and 10 of the latter. At least focal dirty necrosis was found in 68% of primary ovarian epithelial cancers, including 92% of the endometrioid subtype, and in 100% of the metastatic colonic carcinomas. A subgroup of cases was evaluated immunohistochemically using cytokeratin (CK) 7, CK 20 and carcinoembryonic antigen (CEA). The phenotype of CK 7 +/CK 20-/CEA-was present in 92% of primary ovarian carcinomas studied, whereas, 90% of metastatic colonic carcinomas were CK 7-/CK 20 +/CEA+. The finding of dirty necrosis is not specific for metastatic colonic cancer, and differential cytokeratin immunostaining is a useful adjunct in this differential diagnosis.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoembryonic Antigen; Carcinoma; Colonic Neoplasms; Female; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratins; Middle Aged; Necrosis; Ovarian Neoplasms
PubMed: 9421090
DOI: No ID Found -
American Journal of Clinical Pathology Jun 1992The distinction of metastatic ovarian carcinoma from a primary malignant ovarian neoplasm is crucial to its subsequent management. The most common metastatic carcinoma...
The distinction of metastatic ovarian carcinoma from a primary malignant ovarian neoplasm is crucial to its subsequent management. The most common metastatic carcinoma that mimics primary ovarian carcinoma is that of large bowel origin. The clinical and pathologic features of 25 cases of intestinal adenocarcinoma metastatic to the ovaries were analyzed. The patients ranged in age from 47 to 80 years (average age, 60 years). Most patients had abdominal pain and a pelvic mass. In 56%, the ovarian tumors and the large bowel carcinomas were discovered synchronously; 44% were metachronous. Seventy-five percent of the tumors were unilateral. Gross examination revealed that all the ovarian tumors were solid and cystic with smooth outer surfaces. Most of the tumors showed hemorrhage and necrosis. Histologic examination showed that 13 cases had a predominantly endometrioid-like pattern, four cases were predominantly mucinous, and the rest demonstrated a mixed pattern. The presence of a garland pattern with cribriform areas and "dirty" necrosis were the most distinctive features that were helpful in correctly differentiating these tumors from primary endometrioid ovarian carcinoma, with which they are often confused. Immunohistochemical stains for carcinoembryonic antigen showed strong intracytoplasmic positive staining in all the cases of intestinal adenocarcinoma metastatic to the ovaries, in contrast to primary ovarian endometrioid carcinoma, which stain negatively for carcinoembryonic antigen or show only intraluminal or apical positivity. As expected, intestinal adenocarcinoma metastatic to the ovaries had a very poor prognosis. Seventy percent of the patients died within a period of 1 to 19 months (average, 8.2 months). Its distinction from primary ovarian carcinoma is crucial because the management and prognosis of metastatic ovarian carcinoma of large intestine origin is different.
Topics: Adenocarcinoma; Aged; Aged, 80 and over; Carcinoma; Diagnosis, Differential; Female; Humans; Intestinal Neoplasms; Intestine, Large; Middle Aged; Ovarian Neoplasms
PubMed: 1595595
DOI: 10.1093/ajcp/97.6.751 -
Acta Cytologica 1992Based upon a review of cytologic specimens obtained from 46 patients, the morphologic characteristics of metastatic colon carcinoma and primary pulmonary adenocarcinoma... (Comparative Study)
Comparative Study
Based upon a review of cytologic specimens obtained from 46 patients, the morphologic characteristics of metastatic colon carcinoma and primary pulmonary adenocarcinoma were compared and contrasted. A monoclonal antibody (D-14) reported to be helpful in identifying colorectal carcinoma was also evaluated. Colon brushings and washings from 10 patients with colonic carcinoma and a variety of respiratory tract cytology samples from 16 and 20 patients with metastatic colonic and primary pulmonary adenocarcinomas, respectively, formed the basis of this review. The presence of well-formed glands and dirty necrosis was significantly more characteristic of colon carcinoma. Other cytologic features and D-14 staining were not sufficiently distinctive to allow a separation from primary pulmonary adenocarcinoma.
Topics: Adenocarcinoma; Colonic Neoplasms; Cytodiagnosis; Diagnosis, Differential; Humans; Lung Neoplasms
PubMed: 1543007
DOI: No ID Found -
Archives of Pathology & Laboratory... Jan 1992Pulmonary metastases may develop in patients with colonic carcinoma. Histopathologic separation of a solitary colonic metastasis from a primary pulmonary adenocarcinoma...
Pulmonary metastases may develop in patients with colonic carcinoma. Histopathologic separation of a solitary colonic metastasis from a primary pulmonary adenocarcinoma may be problematic. With the use of a polyclonal antibody to carcinoembryonic antigen, a monoclonal antibody to cytokeratin (CAM 5.2), and a monoclonal carcinoembryonic antigen antibody (D-14), we compared 23 colonic carcinomas metastatic to the lung with 24 primary pulmonary adenocarcinomas. Both carcinomas manifested similar histologic features. However, foci of "dirty necrosis" were common in all but one of the colonic neoplasms, and foci were observed in only four of the primary lung carcinomas. The polyclonal carcinoembryonic antigen antibody did not distinguish metastatic colonic carcinoma from primary pulmonary adenocarcinoma. All colonic tumors stained with D-14, while three primary pulmonary adenocarcinomas stained diffusely, and eight stained focally. Staining with D-14 will not absolutely distinguish colonic from pulmonary adenocarcinoma. However, positive D-14 staining and the presence of dirty necrosis should identify most colonic carcinomas. True-negative D-14 staining practically excludes a colonic origin.
Topics: Adenocarcinoma; Antibodies, Monoclonal; Carcinoembryonic Antigen; Carcinoma; Colonic Neoplasms; Diagnosis, Differential; Humans; Lung Neoplasms
PubMed: 1734831
DOI: No ID Found -
Neuroradiology 1992The CT appearances of 13 cases of pathologically proven aspergillosis involving paranasal sinuses were reviewed. Symptoms included rhinorrhea, nasal obstruction,...
The CT appearances of 13 cases of pathologically proven aspergillosis involving paranasal sinuses were reviewed. Symptoms included rhinorrhea, nasal obstruction, headache, facial pain and foul smell from the nose. At operation, these lesions appeared yellowish, brownish, grey or black in colour, and contained dirty or muddy material. Microscopic examination of the tissue removed showed an Aspergillus ball with chronic inflammation but without invasion of the nasal or sinus mucosa in 6 cases, and tissue invasion with necrosis and inflammation in 7. The structures involved, in order of frequency, were: maxillary sinus, nasal cavity, ethmoid sinus, orbit and cavernous sinus. The orbit was involved in 2 cases, therefore categorized as invasive; the other 11 cases were non-invasive as judged by CT. Calcification was seen in the lesions of 9 cases. In most cases the adjacent bony structures showed areas of erosion and sclerosis. Aspergillosis should be suspected in the presence of a mass in the paranasal sinuses or nasal cavity with calcification within it, which may not appear solid or dense and is separate from the walls of the sinus.
Topics: Aged; Aspergillosis; Aspergillus; Female; Humans; Male; Middle Aged; Paranasal Sinus Diseases; Paranasal Sinuses; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 1436464
DOI: 10.1007/BF00598965 -
The American Journal of Surgical... Feb 1987The most common secondary ovarian neoplasm to mimic an ovarian primary tumor is metastatic large intestinal adenocarcinoma. Even after histologic examination, metastases...
The most common secondary ovarian neoplasm to mimic an ovarian primary tumor is metastatic large intestinal adenocarcinoma. Even after histologic examination, metastases often are mistaken for primary adenocarcinomas, especially endometrioid carcinoma. We analyzed the clinical and pathologic features of 22 cases of documented large intestinal carcinoma metastatic to the ovary. Patients' ages ranged from 42 to 76 years. None of the intestinal primary tumors were Dukes stage A, 32% were Dukes B, and 68% were Dukes C. In nine patients (41%), the intestinal carcinomas had been resected previously from 4 to 60 months before removal of the ovarian metastases. Both ovaries were involved in 43% of the cases. Histologically, 19 cases were classified as pseudoendometrioid type, two as mucinous type, and one as mixed pseudoendometrioid-mucinous type. The most characteristic microscopic features of the ovarian metastases were garland and cribriform growth patterns, intraluminal "dirty" necrosis, segmental destruction of glands, and absence of squamous metaplasia. Special stains for mucosubstances were variable and not helpful in differential diagnosis. Immunohistochemical staining for carcinoembryonic antigen (CEA) was strongly positive. Recognition of these distinctive histologic features is crucial to proper identification of the intestinal origin of these ovarian tumors. Inappropriate treatment as primary ovarian carcinomas thereby is avoided, and more accurate assessment of prognosis is achieved.
Topics: Adenocarcinoma; Adult; Aged; Diagnosis, Differential; Female; Humans; Intestinal Neoplasms; Intestine, Large; Middle Aged; Ovarian Neoplasms; Prognosis
PubMed: 3812871
DOI: 10.1097/00000478-198702000-00005 -
Veterinarno-meditsinski Nauki 1987Serologic investigations were carried out with 441 samples of blood sera from ewes, coupled with histopathologic studies of 18 aborted fetuses. Positive serologic Q... (Comparative Study)
Comparative Study
Serologic investigations were carried out with 441 samples of blood sera from ewes, coupled with histopathologic studies of 18 aborted fetuses. Positive serologic Q fever results were obtained by the CF-test with 14.4 per cent of the sheep. Abortions were ascertained with 4 to 8 per cent of the animals per flock in the final month of pregnancy. Nonviable lambs were also obtained that died in the course of the first hours after lambing. The gross lesions observed consisted in the swelling and hyperemia of the cotyledons, with gray-whitish deposits; the chorion was diffusely thickened, was folded, with a dirty-reddish colour, and in some cases also presented gray-whitish deposits. Histopathologically, featuring in the fetuses were the lympho-leukocytic accumulations and the lytic micronecrotic foci in the liver, kidneys, adrenals, and lymph nodes, while the central nervous system showed lympho-leukocytic meningoencephalitis.
Topics: Abortion, Veterinary; Animals; Female; Fetus; Necrosis; Pregnancy; Q Fever; Sheep; Sheep Diseases
PubMed: 3617464
DOI: No ID Found -
Schweizerische Rundschau Fur Medizin... Jul 1981
Topics: Arteriosclerosis; Fingers; Humans; Myocardial Infarction; Risk
PubMed: 7267613
DOI: No ID Found -
Annales Chirurgiae Et Gynaecologiae... 1975The series consists of 60 boys and 43 girls, aged from 1 to 14 years, mean 4.95 years, whose right (42) or left (61) foot was caught between the bicycle (97) or moped...
The series consists of 60 boys and 43 girls, aged from 1 to 14 years, mean 4.95 years, whose right (42) or left (61) foot was caught between the bicycle (97) or moped (6) spokes. The skin was involved with ankle sprain, with fracture or without other injuries in 97 children; lateral aspect of the ankle and foot in 65 and heel in 21 patients. The X-rays revealed 10 tibial fractures, 4 fractures of the tibia and fibula, one fracture of the medial malleolus, one of the lateral malleolus and one bimalleolar fracture. Hence an X-ray of the leg should always be taken. Twenty-six patients were treated on the ward, 77 as outpatients. The mean total time of healing in the group as a whole was 25 days and 44 days in patients having a fracture. Heel avulsion injuries caused by the spokes need special attention. The vitality of the crushed and dirty, caudally or medially based skin flap is minimal and very often yields a marginal or total necrosis if primary suture is done.
Topics: Accidents, Traffic; Adolescent; Ankle Injuries; Child; Child, Preschool; Female; Fibula; Foot Injuries; Fractures, Bone; Heel; Humans; Infant; Leg Injuries; Male; Play and Playthings; Skin Transplantation; Sports; Tibial Fractures; Transplantation, Autologous
PubMed: 237459
DOI: No ID Found