Noninvasive diagnosis of Pneumocystis carinii pneumonia by PCR on oral washes
Noninvasive diagnosis of Pneumocystis carinii pneumonia by PCR on oral washes
复制标题
DOI：
10.1016/s0140-6736(97)24045-6
复制
发表时间：
1997-11-08
期刊：
影响因子：
168.9
通讯作者：
Lundgren, B
中科院分区：
文献类型：
--
作者：
HelwegLarsen, J;Jensen, JS;Lundgren, B
多柔比星（Doxil）是一种有效的全身治疗艾滋病相关卡波西肉瘤的药物。1，2我们报告了阿霉素脂质体在经典卡波西肉瘤治疗中的成功应用。一名76岁的意大利血统的白色HIV-1阴性男性在62岁时注意到小腿上的黄斑病变。活检标本证实了卡波西肉瘤的诊断。在接下来的十年里，这种疾病是无痛的，只需要偶尔的局部治疗。在72岁时，病变迅速进展为疼痛结节和溃疡性肿瘤，累及双臂和双腿。患者接受局部放疗，随后全身给予多柔比星、长春新碱、博莱霉素和依托泊苷。在这些方案中的每一个的初始改善之后，疾病进展。他手臂上的一个大的疼痛肿瘤需要手术切除，随后形成疤痕，包括手部挛缩和肿瘤的多灶性复发。此时，他的胳膊和腿上有50多处皮肤结节性病变，伴有一些溃疡和复发性水肿。开始静脉注射脂质体阿霉素治疗（20 mg/m2），3周为一个周期。该药物由Sequus Pharmaceuticals Inc（门洛帕克，加州）根据纽约大学医学中心研究协会机构委员会批准的研究方案提供。在第一个治疗周期后，观察到肿瘤大小减小超过50%，水肿和疼痛消退。经过4个周期的治疗后，所有病灶均已清除（图）。他继续接受阿霉素治疗14个周期（累积剂量为280 mg/m2），
Stealth liposomal encapsulated doxorubicin (Doxil) is an approved effective systemic therapy for AIDS-associated Kaposi’s sarcoma. 1, 2 We report successful use of liposomal doxorubicin in the treatment of classic Kaposi’s sarcoma. An HIV-1-negative 76-year-old white man of Italian ancestry noticed macular lesions on his lower legs at the age of 62. A biopsy specimen confirmed the diagnosis of Kaposi’s sarcoma. Over the next decade, the disease was indolent and required only occasional local treatment. At the age of 72, the lesions progressed rapidly to painful nodules and ulcerating tumours involving both arms and legs. He was given local irradiation and, subsequently, systemic doxorubicin, vincristine, bleomycin, and etoposide. After initial improvement with each of these regimens, the disease progressed. A large painful tumour on his arm required surgical debulking with subsequent scar formation, including contracture of the hand, and multifocal recurrence of the tumour. By this time, he had more than 50 cutaneous nodular lesions with some ulcerations and recurrent oedema on his arms and legs. Intravenous liposomal doxorubicin treatment (20 mg/m2) in 3-week cycles was started. The drug was supplied by Sequus Pharmaceuticals Inc (Menlo Park, California) according to a research protocol which had been approved by the New York University Medical Center Institutional Board of Research Associates. After the first cycle of treatment, a more than 50% reduction in tumour size was seen with resolution of oedema and pain. After four cycles of treatment, clearing of all lesions was seen (figure). He continued to receive doxorubicin treatment for 14 cycles (cumulative dose of 280 mg/m2) and