PubMed Health⌕ Search

Biomedical subjects

Mirna Situm

Publications and source records attributed to Mirna Situm.

At least 19 recordsLinked to original sources
PubMed2006

The role of preoperative lymphoscintigraphy in surgery planning for sentinel lymph node biopsy in malignant melanoma.

AIM: To evaluate four years of preoperative lymphoscintigraphy experience and the accuracy of sentinel lymph node biopsy in our institution in melanoma patients with various tumor thicknesses. An additional aim was to evaluate the recurrence rate related to pathohistological findings. METHODS AND PATIENTS: During the period from February 2002 to November 2005, 201 patients underwent sentinel node biopsy. Lymphoscintigraphy for identification of sentinel nodes was performed four to six hours prior to operation of the patient. Sentinel lymph node biopsy using an intraoperative hand-held gamma probe was performed in all patients, together with wide local excision of biopsy wound or primary lesion (N=56). Immediate complete basin dissection was performed in patients with sentinel node metastases. In four patients delayed complete lymph node dissection was performed after definitive histopathologic examination of sentinel nodes. The accuracy of sentinel node biopsy was determined by comparing the intraoperative rates of sentinel node identification and the subsequent development of nodal metastases in regional nodal basins in patients with tumor-negative sentinel nodes and in those with tumorpositive sentinel nodes. RESULTS: Using preoperative lymphoscintigraphy, we identified sentinel nodes in all but one of the 201 patients (99.0%), and in 248 nodal basins (1.2/patient) we observed 372 sentinel nodes (1.52 sentinels/basin; 1.8 sentinels/patient). The highest number of sentinel nodes was noticed in the groin of patients with melanoma on the lower extremities (1.5/patient), followed by the axilla (1.3/patient). Anomalous lymphatic drainage patterns were observed in 15.0% of all patients. The identification rate of sentinel nodes was 99.0% overall: 100% for the groin basins, and 98.0% for the axilla and head and neck basin. Forty-two patients (20.8%) had tumor-positive sentinel nodes. Ten patients (5.0%) had local or distant recurrences during a median follow-up of 23.1 months (range 2-46). The rate of false-negative lymphatic mapping and sentinel node biopsy as measured by nodal recurrence in patients with tumor-negative sentinel nodes was 1.3%. During the follow-up period, three of 201 patients died from other diseases and three patients died as the result of melanoma metastases, with a median follow-up of 13.5 months (range 12-22). CONCLUSION: Preoperative lymphoscintigraphy is a sensitive, inexpensive and essential method for the identification of drainage basins, determination of the number and position of sentinel nodes and their location outside the usual nodal basins. Scintigraphic findings may lead to changes in surgical management due to the unpredictability of lymphatic drainage. The low incidence of regional disease recurrence in patients with tumor-negative sentinel nodes supports the use of preoperative lymphoscintigraphy and sentinel node biopsy as a safe and accurate procedure for staging the regional nodal basin in patients with malignant melanoma.

Aged↗
PubMed2006

Metastatic melanoma and vitiligo: a case report.

Different clinical studies report the connection between malignant melanoma (MM) and vitiligo, as the etiology of both diseases evolves around melanocytes. A case is presented of a 70-year-old female patient with metastatic MM in lymphatic node of the right groin, which developed simultaneously with the "vitiligo-like patches" over the face and extremities. Some authors suggest that the appearance of depigmentation during the course of MM might be considered a good prognostic sign. However, our patient subsequently developed multiple lung metastases as well as metastases in lymphatic nodes of the other groin region. This case shows that MM and vitiligo may develop simultaneously, indicating the possibility of similar mechanisms in the destruction of both benign and malignant melanocytes.

Aged↗
PubMed2005

Malignant melanoma--future prospects.

As the incidence and already high mortality rates of malignant melanoma have been steadily increasing in recent decades, the early detection and excision of malignant melanoma have imposed as the most important task. Staging of malignant melanoma is determined according to the level of invasion (Clark level) and vertical thickness (Breslow scale). Besides operative therapy, which is the only effective treatment for malignant melanoma, postoperative adjuvant chemotherapy, immunotherapy, radiotherapy, and biologic therapy also are of great importance. In recent years, immunologic strategies including tumor vaccine and adjuvant therapy with interferon-alfa have been attempted to improve survival of patients with more advanced malignant melanoma. A recent melanoma research has focused on target therapy such as immunotherapy (vaccines, monoclonal antibodies, dendritic cells) and gene therapy. Genetic immunization has become an attractive strategy for the development of melanoma vaccines, because a number of antigens recognized by cellular components of the immune system have been identified at the molecular level. Numerous chemotherapeutic agents have shown activity in the treatment of metastatic malignant melanoma, such as dacarbazine (dimethyl triazene imidazole carboxamide); other agents have been used, however, with less success. However, a very modest effect was recorded in advanced malignant melanoma. There are many experimental trials using combined therapy for malignant melanoma, including chemotherapy (dimethyl triazene imidazole carboxamide) and biologic therapy (interleukin (IL)-2, interferon (IFN)-gamma, IFN-alfa). The results obtained open particularly interesting prospects in the field of malignant melanoma with high relevance for its development and progression. Molecular therapeutics and vaccine development will probably be an important focus for the future melanoma treatment.

Antigens, Neoplasm↗
PubMed2005

Psychodermatology: a brief review for clinicians.

Psychodermatologic disorders are conditions involving an interaction between the mind and the skin. These disorders fall into three major categories: psychosomatic disorders, primary psychiatric disorders and secondary psychiatric disorders (Koo 1995). The treatment of psychodermatologic disorders is almost impossible without a holistic team approach involving psychiatrist, dermatologist and psychologist. Majority of psychodermatologic disorders can be treated with cognitive-bihevioral psychotherapy, psychoterapeutic stress-and-anxiety-management techniques and psychotropic drugs. Psychopharmacologic treatment with anxiolytics, antidepressants, antipsychotics and mood stabilizers can be prescribed by dermatologist, after consulting the psychiatrist.

Diagnosis, Differential↗
PubMed2004

Lethal injuries among the members of the 4th Guardian Brigade of Croatian Army during the 1991-1995 war.

OBJECTIVE: We analyzed the causes of deaths among the members of the 4th Guardian Brigade (GB) of the Croatian Army during the war in Croatia from 1991 to 1995: the site of the lethal injuries, the type of wounds, and estimated the severity of injuries with lethal outcome according to the Abbreviated Injury Scale. METHODS: This was a retrospective study using the files and data obtained from 4th GB, Croatian Ministry of Defense, and Croatian Ministry of War Veterans. RESULTS: During the War in Croatia from 1991 to 1995, 182 members of 4th GB were killed. One hundred fifteen (63.2%) suffered lethal injuries caused by shell fragments, 47 (25.8%) soldiers had gunshot wounds, and 20 ( 11.0%) died in traffic accidents. Mean Abbreviated Injury Scale for killed soldiers was 7.61 +/- 1.27. CONCLUSION: During the war in Croatia, the leading causes of death were mines and explosions, and, in a minor proportion, gunshot wounds.

Blast Injuries↗
PubMed2004

From circumscribed scleroderma (morphea) to subcutaneous panniculitis-like T-cell lymphoma: case report.

Subcutaneous panniculitis-like T-cell lymphoma is a rare form of non-Hodgkin lymphoma. It presents clinically as panniculitis, with erythematous, firm subcutaneous infiltrates and recurrent papulonodules. A 45-year-old male Croat presented with a 6-month history of tender erythematous subcutaneous skin lesions without systemic symptoms. Analysis of a lesion biopsy specimen showed circumscribed scleroderma (morphea). During hospitalization, skin biopsies from two subcutaneous lesions on the stomach were repeated, and pathohistologic analysis corresponded primarily to panniculitis in the context of morphea. Pathohistologic analysis and immunohistochemistry of a specimen obtained by tumor excision from the back indicated subcutaneous panniculitis-like T-cell lymphoma. Histologic analysis revealed a dense infiltrate of atypical T-lymphoid cells expressing CD8(+) phenotype located in the subcutaneous tissue with histiocyte-phagocytizing apoptotic cells. Specific hematologic analysis and medical treatment were continued. This case report illustrates the importance of continuous follow-up with repeat biopsy and use of immunohistologic techniques for early diagnosis.

Humans↗
PubMed2003

The secret.

Explore the source record for details and available documents.

Croatia↗
PubMed2003

Dermatology in war.

Explore the source record for details and available documents.

Anecdotes as Topic↗
PubMed2003

Alterations in CDKN2A locus as potential indicator of melanoma predisposition in relatives of non-familial melanoma cases.

AIM: To examine constitutional alterations of CDKN2A/p16INK4A locus as a potential indicator of melanoma predisposition among the first-degree relatives of patients with malignant melanoma. METHOD: The study included eight families with a single member affected with melanoma. Members of the families were screened for allelic cosegregation with 9p21 region polymorphic markers IFNA, D9S126, and D9S104. The patient's tumors were screened for loss of heterozygosity (LOH) with the same markers, as well as for single strand conformational polymorphism (SSCP) variability of CDKN2A. In suspect cases, constitutional DNA was examined by SSCP and direct sequencing. RESULTS: LOH was detected in four cases, and SSCP indicated variability in at least one CDKN2A exon in these tumor samples. In three of four LOH cases, the remaining allele cosegregated within the family, which was interpreted as a preliminary indicator of potential genetic predisposition. In one of these three families, we found constitutional CDKN2A mutations in the patient and one of the relatives. In the second family, only the patient had the constitutionally altered gene, whereas no constitutional CDKN2A alterations were detected in the third family. All significant mutations were different and had not been reported before. CONCLUSION: We detected one case of melanoma predisposition among unaffected family members, which corresponded to statistical expectations for such a small number of screened families. Since constitutional mutations of CDKN2A exons have limited incidence, our stepwise approach seemed to be more informative and more affordable than straightforward CDKN2A sequencing of all subjects.

Alleles↗
PubMed2003

Triage.

Explore the source record for details and available documents.

Croatia↗
PubMed2003

Treatment of vitiligo: current methods and new approaches.

Vitiligo is an acquired idiopathic hypomelanotic disorder characterized by circumscribed depigmented maculae. It can be treated in many ways. The choice of therapy is individually adjusted depending on various factors, such as the patient age, type and stage of disease, and affected body site. Current treatment modalities include psoralen with exposure to ultraviolet A (PUVA) radiation therapy, narrow-band UVB therapy, topical corticosteroids, depigmentation therapy with monobenzylether of hydroquinone, and surgical treatments (minigrafting, thin split-thickness grafting, suction blister grafting, micropigmentation). There are also some new treatment modalities, such as 308-nm excimer laser, vitamin D analogues, tacrolimus, depigmentation with Q-switched ruby laser, and grafting of cultured melanocytes.

Humans↗
PubMed2003

George.

Explore the source record for details and available documents.

Anecdotes as Topic↗
PubMed2002

Images.

Explore the source record for details and available documents.

Croatia↗
PubMed2002

Church bells.

Explore the source record for details and available documents.

Croatia↗
PubMed2002

The right to forgive.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed2002

Olive tree.

Explore the source record for details and available documents.

Anecdotes as Topic↗
PubMed2002

Search systems and medical data quoting from the internet.

The Internet as a new medium also has its use in medicine. Plenty of information which can be found on the world computer network, needs an efficient searching as well as an evaluation system and quoting of the information obtained. Twelve most popular search engines were chosen--9 general: Netscape, Altavista, HotBot, Goggle, Northern Light, Magellan, Infoseek, MSN; 2 specialized medical search engines: Medscape and Medline; and one Croatian search engine: Cross. The efficiency of searching was observed by analyzing the number of obtained pages, their contents and examples of the quoted references from the Internet. The searching was done using the mentioned search engines, and results varied from 2,189,793 network pages found on the Infoseek for the term 'skin cancer' to 0 pages with the search engine Cross for the term 'melanoma+therapy'. When comparing the results for a single term using various search engines, it is concluded that the number of pages varied because of different databases and specialized scooters that search and make indexes. It is possible to use logical operators and more advanced search systems with the majority of search engines. The quoting system is based on mentioning the names of the author and his work, the access date and url (uniform resource locator) addresses of the network pages. Permanent and reliable access to quotations could not be established with previous quotation systems. Dermatologic terms have been well dealt with concerning general population, whereas professionals are recommended to use Medline and reviewed web pages. There have been very few professional and professionally relevant and comprehensive pages on the Internet relative to the total of web pages.

Humans↗