Cutaneous presentation of a myxoid cyst occurring at the knee joint.
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Biomedical subjects
Publications and source records attributed to P Kersey.
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These guidelines for management of primary cutaneous squamous cell carcinoma present evidence based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation. To reflect the collaborative process for the UK, this article is subject to dual publication in the British Journal of Dermatology and the British Journal of Plastic Surgery.
These guidelines for management of primary cutaneous squamous cell carcinoma present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation.
MOTIVATION: The SWISS-PROT group at the EBI has developed the Proteome Analysis Database utilizing existing resources and providing comprehensive and integrated comparative analysis of the predicted protein coding sequences of the complete genomes of bacteria, archaea and eukaryotes. The Proteome Analysis Database is accompanied by a program that has been designed to carry out interactive InterPro proteome comparisons for any one proteome against any other one or more of the proteomes in the database.
The SWISS-PROT group at EBI has developed the Proteome Analysis Database utilising existing resources and providing comparative analysis of the predicted protein coding sequences of the complete genomes of bacteria, archaea and eukaryotes (http://www.ebi.ac. uk/proteome/). The two main projects used, InterPro and CluSTr, give a new perspective on families, domains and sites and cover 31-67% (InterPro statistics) of the proteins from each of the complete genomes. CluSTr covers the three complete eukaryotic genomes and the incomplete human genome data. The Proteome Analysis Database is accompanied by a program that has been designed to carry out InterPro proteome comparisons for any one proteome against any other one or more of the proteomes in the database.
UNLABELLED: The program varsplic.pl uses information present in the SWISS-PROT and TrEMBL databases to create new records for alternatively spliced isoforms. These new records can be used in similarity searches. AVAILABILITY: The program is available at ftp://ftp.ebi.ac.uk/pub/software/swissprot/, together with regularly updated output files. CONTACT: pkersey@ebi.ac.uk
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We have evaluated three methods of assessing patients with cyclical breast symptoms (cyclical mastopathy--CM). One method, a screening questionnaire, was used to identify women with CM, and two others, a symptom severity questionnaire and a daily diary, were used prospectively to record the severity of symptoms in relation to the menstrual cycle. The screening questionnaire was assessed for test-retest reliability and for agreement between the recalled severity of symptoms and those recorded during prospective measurement. The symptom severity questionnaire and diary were assessed by examining their ability to discriminate between pre- and postmenstrual phases of the menstrual cycle, differences in symptom severity at these times being the cardinal feature of CM. Test-retest reliability of premenstrual symptoms by the screening questionnaire gave correlation coefficients over 0.70 for 9 of the 11 items assessed. The symptom severity questionnaire showed significant differences between pre- and post-menstrual scores for 8 of the 11 items assessed and the diary for each of the 2 items assessed. Comparison of symptom severity as recalled and as prospectively recorded showed only modest agreement. These results show that the instruments used to assess symptom severity performed satisfactorily but that the screening questionnaire used to identify women with CM, although reliable, correlated only moderately well with prospective measurement.
We reviewed the charts of 393 consecutive patients referred to the Toronto-Bayview Regional Cancer Centre and the Ontario Cancer Institute between January 1, 1978, and December 31, 1982, with clinical stage I malignant melanoma to determine the predictive value of routine staging investigations. The investigations reviewed included physical examination, liver function tests, radionuclide liver-spleen and bone scans, chest x-ray, whole-lung tomograms, CT chest scans, CT brain scans, and bipedal lymphangiograms. The clinical stage of nine patients was changed, eight as a result of physical examination and one as a result of lymphangiogram. No other investigations detected metastatic melanoma at referral. We recommend that staging investigations for patients referred with clinical stage I malignant melanoma be restricted to a complete physical examination and a baseline chest x-ray for all patients.
The feasibility of clinical trials involving the surgical management of primary melanoma was assessed through a survey of Canadian surgeons who treat this disease. Surgeons were polled as to their current practice regarding node dissection and margins of resection of the primary lesion. Their interest in randomized trials addressing these practices was also assessed. Two hundred and forty questionnaires were distributed to 20 centres across Canada. The total number of patients with melanoma seen annually by the 131 surgeons who responded was 790 - of the approximately 1000 new cases of melanoma diagnosed in Canada each year. Of responding surgeons, 63% currently perform wide excision (taking 3 to 5 cm of normal tissue) for lesions less than 1.5 mm in depth and 37% perform limited excision (including 1 to 2 cm of normal tissue). Of all surgeons responding, 76% were interested in a randomized trial comparing wide and limited excision in these superficial lesions. Currently, 90% of surgeons perform wide excision of lesions 1.5 mm or more in depth and 10% perform limited excision. Fifty-nine percent were interested in a randomized trial comparing wide and limited excision in these deeper lesions. Twenty-four percent of surgeons routinely perform prophylactic node dissection on all patients with lesions 1.5 mm or more in depth; 66% wait until there is clinical suspicion of nodal metastases and 9% follow some other policy. The results of this survey indicate that (a) surgical management is varied, (b) radical surgery remains common practice and (c) surgeons are interested in randomized trials that will determine optimal treatment.
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Propionibacterium acnes is the bacterial species most consistently isolated from acne lesions. Intradermal injection of a heat-killed suspension of P. acnes induced a delayed erythematous and often popular inflammatory reaction which was maximal after 24-48 h. This response was dose related and was probably mediated at least partly by immune mechanisms. In eighty-one subjects with acne of varying severity of the acne. These findings indicate that the host response to P. acnes is an important variable in determining the severity of inflammatory acne.
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