A multifactorial analysis of melanoma: prognostic histopathological features comparing Clark's and Breslow's staging methods

A multifactorial analysis was used to identify the dominant prognostic variables affecting survival from a computerized data base of 339 melanoma patients treated at this institution during the past 17 years. Five of the 13 parameters examined simultaneously were found to independently influence five year survival rates: 1) pathological stage (I vs II, p = 0.0014), 2) lesion ulceration (present vs absent, p = 0.006), 3) surgical treatment (wide excision vs wide excision plus lymphadenectomy, p = 0.024), 4) melanoma thickness (p = 0.032), and 5) location (upper extremity vs lower extremity vs trunk vs head and neck, p = 0.038). Additional factors considered that had either indirect or no influence on survival rates were clinical stage of disease, age, sex, level of invasion, pigmentation, lymphocyte infiltration, growth pattern, and regression. Most of these latter variables derived their prognostic value from correlation with melanoma thickness, except sex which correlated with location (extremity lesions were more frequent on females, trunk lesions on males). This statistical analysis enabled us to derive a mathematical equation for predicting an individual patient's probability of five year survival. Three categories of risk were delineated by measuring tumor thickness (Breslow microstaging) in Stage I patients: 1) thin melanomas (<0.76 mm) were associated with localized disease and a 100% cure rate: 2) intermediate thickness melanomas (0.76-4.00 mm) had an increasing risk (up to 80%) of harboring regional and/or distant metastases and 3) thick melanomas (>/=4.00 mm) had a 80% risk of occult distant metastases at the time of initial presentation. The level of invasion (Clark's microstaging) correlated with survival, but was less predictive than measuring tumor thickness. Within each of Clark's Level II, III and IV groups, there were gradations of thickness with statistically different survival rates. Both microstaging methods (Breslow and Clark) were less predictive factors in patients with lymph node or distant metastases. Clinical trials evaluating alternative surgical treatments or adjunctive therapy modalities for melanoma patients should incorporate these parameters into their assessment, especially in Stage I (localized) disease where tumor thickness and the anatomical site of the primary melanoma are dominant prognostic factors.     

Serum HIV-1 RNA levels and time to development of AIDS in the Multicenter Hemophilia Cohort Study

Normal women produce small amounts of active androgens. When androgen levels are elevated, such as for example in the polycystic ovary syndrome, this is followed by the development of male physical characteristics and muscle mass, structure and function as well as android adipose tissue distribution and function. Psychological features and stress reactions also seem similar to those of men. Such women have an increased risk of developing hypertension, non-insulin-dependent diabetes mellitus and cardiovascular disease. Recent data have shown that these physical, and psychological characteristics, as well as risk of ill health, are also found in the population of women selected at random. Women in the lowest quintiles of levels of sex-hormone-binding globulin--an indicator inversely related to active androgens--are at risk of developing hypertension, non-insulin-dependent diabetes mellitus and cardiovascular mortality. The mechanism probably includes muscular insulin resistance, following a relative androgen excess. It is thus apparent that androgens, even within the highest levels of the nonselected population of women, are powerful predictors of serious disease development. The population at risk might be as large as about 20% of middle-aged women. This is an area of female disease risk which requires more attention in screening and intervention procedures.     

巨磁电阻读出磁头

用巨磁电阻（GMR）材料构成的磁电子学新器件,已开始在计算机存储领域成功地获得了应用,本文介绍了用于计算机硬件磁盘驱动器的巨磁电阻磁头,描术字它的工作原理、性能特点及研究现状和发展趋势。     

防老剂种类及用量对丁腈橡胶疲劳裂纹扩展的影响

考察了防老剂种类及用量对丁腈橡胶疲劳过程中预制裂纹扩展的影响,并对其断面形貌进行了SEM观察。结果表明,在MB/RD、DTPD、4010和2246 4组防老剂中,防老剂2246耐疲劳性能最好,其用量为4份时效果最佳。     

采用光滤波器的边缘检测布里渊光纤传感系统

提出了采用边缘光滤波器来测量光纤传感中布里渊频域的方案.分析了影响布里渊频移测量精度的因素,给出了布里渊频移测量精度和信噪比的关系.结果表明,在热噪声近似下,布里渊频移测量精度与热噪声、边缘光滤波器透射函数的导数及布里渊散射光信号功率有关.     

多点热式气体质量流量测试方法实验研究

在已研制单点热式气体质量流量计的基础上,针对目前大口径或不规则管道气体质量流量测量中存在的问题,提出了基于多点测量的热式气体质量流量测试方法.文章对敏感元件(热膜探头)温度特性和以热膜探头为测点的多点测试方法进行了大量的试验研究.实验结果表明:多点测试方法中,以对数线性法最好;多点热式气体质量流量测试方法可以明显改善某些单点测量中出现的较大偏差,测量精度可以达到1.5%,扩展不确定度小于3.4%.     

超大范围坐标测量系统的现场测试基准及其误差分析

CCD立体视觉坐标测量系统已有广泛应用,但其有效测量范围通常在十数米之内.超大范围坐标测量系统是一种适于野外环境的坐标测量系统,其测量范围可覆盖直径达数百米的圆形区域.文章从分析测量系统数学模型入手,指出了建立现场测试基准的必要性,随后给出一种既能保障测量结果正确可靠又可简化测量模型的基准建立方法,并分析了基准建立过程中各引入误差对系统误差的影响.实验数据证明了文中测量原理及测试基准建立方法的可行性.     

单光纤光栅实现位移、温度同时区分测量

结合光纤光栅悬臂梁调谐的特点,采用悬臂梁矩形梁结构,将光纤光栅粘贴在悬臂梁侧面,利用反射波的带宽对应变敏感而对温度不敏感的特性解调悬臂梁自由端的垂直位移,和反射波的中心波长对温度敏感而对应变不敏感的特性解调温度,成功地实现了对位移和温度的同时测量.基于光谱分析仪0.1 nm的光谱分辨率,实验可得到位移、温度同时区分测量系统的带宽随位移变化的灵敏度为0.153 nm/mm,位移分辨率为0.193 mm,位移测量范围可达6.15 mm;中心波长随温度变化的灵敏度为0.029 nm/℃,温度分辨率为3.4℃,温度测量范围为45℃.实验结果与理论分析基本一致.     

电子鼻模式识别算法的比较研究

文中比较了k-近邻法、线性判别分析、反向传播人工神经网络、概率神经网、学习向量量化以及自组织映射6种电子鼻模式识别算法的分类能力.采用了1个定量指标(识别精度)和4个定性指标(运算速度、训练速度、内存容量、抗干扰能力)对不同算法进行了系统比较.研究表明基于神经网络的模式识别算法比基于统计理论的模式识别算法具有更高的识别精度.如果同时考虑定性指标,当训练速度要求不高时,宜采用学习向量量化算法;能满足内存需求前提下,优先推荐采用概率神经网算法.对于选择性高的信号,采用线性判别分析可以达到最佳效果.