228 research outputs found

    Chronic ulcerative stomatitis: Case series of an under‐recognized entity

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146622/1/cup13347_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146622/2/cup13347.pd

    Malignant melanoma with osteosarcomatous differentiation in a lymph node metastasis

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145523/1/cup13283.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145523/2/cup13283_am.pd

    Superficial papular neuroma: Case series of a new entity

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138273/1/cup12981.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138273/2/cup12981_am.pd

    Musculoskeletal Pain:Current and Future Directions of Physical Therapy Practice

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    Musculoskeletal (MSK) pain is 1 of the most common problems managed by clinicians in MSK care. This article reviews current frameworks for the assessment and management of MSK pain within evidence-based physical therapy practice. Key considerations related to the biopsychosocial model of pain, evidence-based practice, assessment, treatment, physical activity/movement behavior, risk stratification, communication as well as patient education and self-management skills within physical therapy and physical and rehabilitation medicine are addressed. The future direction of MSK pain management is also discussed, including strategies to promote evidence-based practice, behavior change, social prescribing, and the use of technologies.status: Published onlin

    CD34‐positive superficial myxofibrosarcoma: a potential diagnostic pitfall

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    Background Myxofibrosarcoma (MFS) arises most commonly in the proximal extremities of the elderly, where it may involve subcutaneous and dermal tissues and masquerade as benign entities in limited biopsy samples. We encountered such a case, in which positivity for CD34 and morphologic features were initially wrongly interpreted as a ‘low‐fat/fat‐free’ spindle cell/pleomorphic lipoma. Case series have not assessed prevalence of CD34 reactivity among cutaneous examples of MFS. Methods We performed a systematic review of our institution's experience, selecting from among unequivocal MFS resection specimens those superficial cases in which a limited biopsy sample might prove difficult to interpret. These cases were immunostained for CD34 and tabulated for clinicopathologic characteristics. Results After review of all MFS diagnoses over 5 years (n = 56), we identified a study group of superficial MFS for comparison to the index case (total n = 8). Of these, the index and three additional cases (4 of 8, 50%; 2 low, 2 high grade) demonstrated positive staining for CD34 , with diffuse staining of spindled cells including cellular processes. Four additional cases showed no or equivocal/rare staining. Conclusions CD34 positivity should be recognized as prevalent among such cases and should not be inappropriately construed as inveighing against a diagnosis of MFS in favor of benign entities.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98187/1/cup12158.pd

    What is a sentinel node? Re-evaluating the 10% rule for sentinel lymph node biopsy in melanoma

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    Introduction Many surgeons use the “10% rule” to define whether a lymph node is a sentinel node (SLN) when staging malignant melanoma. However, this increases the number of SLN removed and the time and cost of the procedure. We examined the impact of raising this threshold on the accuracy of the procedure. Methods We reviewed the records of 561 patients with melanoma (624 basins) who underwent SLN with technetium Tc99 labeled sulfur colloid using a definition of a SLN as 10% of that of the node with the highest counts per minute (CPM). Results Of the 624 basins, 154 (25%) were positive for metastases. An average of 1.9 nodes per basin were removed (range 1–6). Metastases were found in the hottest node in 137 cases (89% of positive basins, 97% of basins overall). Increasing the threshold above 10% decreased the number of nodes excised and the costs involved, but incrementally raised the number of false negative cases above baseline (a 4% increase for a “20% rule,” 5% for a “30% rule,” 6% for a “40% rule,” and 7% for a “50% rule”). Taking only the hottest node would raise the false negative rate by 11%. Conclusions Although using thresholds higher than 10% for the definition of a SLN will minimize the extent of surgery and decrease the costs associated with the procedure, it will compromise the accuracy of the procedure and is not recommended. J. Surg. Oncol. 2007;95:623–628. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56055/1/20729_ftp.pd

    Neurofilament is superior to cytokeratin 20 in supporting cutaneous origin for neuroendocrine carcinoma

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147795/1/his13758.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147795/2/his13758_am.pd
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