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American family physician · Nov 2003
Practice Guideline GuidelineACOG releases guidelines on cervical cytology screening.
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Nihon Kyobu Shikkan Gakkai Zasshi · Mar 1997
Case Reports[Alveolar hemorrhage and glomerulonephritis in two patients with anti-neutrophil cytoplasmic antibodies].
A 55-year-old woman and a 56-year-old woman were admitted to the hospital because of dyspnea on exertion and bloody sputum. Chest roentgenography and computed tomography showed bilateral infiltrative shadows. Examination of bronchoalveolar lavage fluid and of specimens obtained by transbronchial lung biopsy revealed alveolar hemorrhage and hemosiderin-laden macrophages. ⋯ Test for anti-neutrophil cytoplasmic antibody (ANCA) were positive; alveolar hemorrhage and glomerulonephritis accompanied by ANCA-related vasculitis was diagnosed. The patients' condition improved with administration of prednisolone and cyclophosphamide. Measurement of ANCA was useful for monitoring the activity of the disease.
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Four consecutive patients underwent resection and graft replacement of ascending aorta or aortic arch for acute dissection. Retrograde cerebral perfusion (RCP) was used during circulatory arrest. RCP at 15 degrees C was administered through the superior vena cava. ⋯ Minor neurological disturbance was found in 1 patient, he was discharged from hospital at day 11 without any detectable neurological deficit. This technique was attractive because it provided a dry operative field unencumbered by perfusion cannulas or clamps, facilitated construction of a more secure distal anastomosis, and avoided the risk of further injury resulting from the aortic cross clamp. It seems that RCP allows longer circulatory arrest time.
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Epidermoid carcinoma of the penis is a rare type of cancer. Treatment of the primary lesion consists of amputation, although curietherapy can be effective in some cases as a conservative treatment. The prognosis is determined by the presence of absence of lymph node invasion, but the therapeutic strategy to be used when invaded lymph nodes are present remains controversial. Lymph node dissection is the only effective treatment of metastatic adenopathy, but its high morbidity rate limits its indications.