Skin cancer; from cause to cure.
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Biomedical subjects
Publications and source records attributed to P Robins.
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A retrospective study of 338 patients with malignant lesions of the auricle is presented. The results of treatment using Mohs microscopically controlled surgery and conventional surgical excision are compared and the high incidence of recurrence is stressed. The incidence, etiology, pathology, and subclinical extension of auricular tumors are discussed. The treatment of choice is Mohs microscopically controlled surgery and a plea is made for a more radical therapeutic approach to these often casually treated neoplasms.
Elucidation of the molecular mechanism of mammalian nucleotide excision repair requires the availability of purified proteins, DNA substrates with defined lesions and suitable repair assays. Repair assays introduced in recent years vary from testing individual steps and successions of steps in vitro to systems that closely reflect the entire process in vivo. In the first part of this review, an in vivo microinjection system is discussed. The second part of the article reviews an in vitro system for study of repair synthesis promoted by cell extracts. Both systems can be utilized as assays during the purification of protein factors that complement repair-defective xeroderma pigmentosum cells. The effect of purified repair proteins from other organisms on mammalian repair is also considered.
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The repair of large defects resulting from ablation of a primary malignancy of the skin requires judicious decision. Failing reasonable surety of extirpation, permitting spontaneous healing, if feasible, is the best cours. Grafting or primary closure that does not require extensive undermining are usually second choices. Flap repair is least desirable, except in instances where immediate function is necessary.
Both consumers and health service providers need access to up-to-date information, including patient and practice guidelines, that allows them to make decisions in partnership about individual and public health in line with the primary health care model of health service delivery. Only then is it possible for patient preferences to be considered while the health of the general population is improved. The Commonwealth Government of Australia has allocated $250 million over five years, starting July 1, 1997, to support activities and projects designed to meet a range of telecommunication needs in regional, rural, and remote Australia. This paper defines rural and remote communities, then reviews rural and remote health services, information, and telecommunication technology infrastructures and their use in Australia to establish the current state of access to information tools by rural and remote communities and rural health workers in Australia today. It is argued that a suitable telecommunication infrastructure is needed to reach disadvantaged persons in extremely remote areas and that intersectoral support is essential to build this infrastructure. In addition, education will make its utilization possible.
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