高原地区CT导引经皮腰椎间盘髓核切吸术的临床研究

目的：探讨高原地区CT导引经皮腰椎间盘髓核切吸术（CT-PLD）的临床应用价值。方法：对68例腰椎间盘突出症患者实施了CT-PLD。（1）术前扫描病变椎间盘，筛选病例，并研究手术方案；（2）于即时CT图像上选择最佳的穿刺层面，设计穿刺路径，记录穿刺参数，并于体表标记穿刺点；（3）按既定参数进行穿刺；（4）经CT扫描确认穿刺进入椎间盘，扩张进针路径，进行切吸；（5）术毕CT扫描，观察进针路径有无出血及椎间盘还纳情况。结果：68例共79个椎间盘均穿刺成功。经3-18个月的随访，28例症状完全消失，36例症状明显减轻且能正常工作及生活，椎间盘还纳为1-4mm，显效率为94.12%。结论：CT-PLD安全有效，并发症少，是高原地区腰椎间盘突出症的理想的治疗方法。     

纵隔类癌的CT表现(附6例报道)

目的：分析纵隔类癌的CT表现，探讨CT诊断价值。方法：对1994年一2001年经4所医院病理证实的纵隔类癌6例进行临床、病理、CT对照分析。结果：①临床无特异性表现，极少出现类癌综合征；②CT表现为中上纵隔肿块，位于胸腺区或向其内生长，与心底部大血管及心包关系密切，并有沿血管间隙生长的特点，造影后有轻、中度强化，可发生胸内外转移；③CT表现与病理、预后密切相关。结论：纵隔类癌较罕见，可能来源于胸腺。CT发现以上特点可提示诊断，还可观察肿块大小、位置、范围、内部及与血管心包的关系，帮助确定手术方案及推测预后，但确诊需依靠病理。     

Subzonal insemination (SUZI) or in vitro fertilization (IVF) in microdroplets for the treatment of male-factor infertility

Purpose The results of subzonal insemination (SUZI) and in vitro fertilization with microdroplet insemination used in couples with male-factor infertility are presented. Results The total fertilization rate was 17.4% for SUZI (n=89) and 49.3% for microdroplet IVF (n=100). The fertilization rate for standard IVF (n=510), not including any male-factor infertility and performed during the same period, was 73.2%. The “take-home baby rate≓ per started cycle and per embryo transfer (ET), respectively, was 10 and 17.6% for SUZI and 20 and 24.7% for microdrop IVF. For standard IVF these figures were 27 and 31.7%. Conclusion It was concluded that microdroplet IVF can be used with good results in cases of moderate malefactor infertility. The normal (2PN) fertilization rate with the SUZI technique was only 15.1%. However, despite the low fertilization rate, SUZI should be considered when dealing with severe male-factor infertility.     

子宫肌瘤的CT诊断

目的：总结子宫肌瘤的ＣＴ特证，讨论其应用价值。材料与方法：分析３８例经手术病理证实为子宫肌瘤的ＣＴ征象，对横断面上显示病变大小、位置与宫腔关系及病变的强化进行评价。结果：３８例中除１例误诊为子宫内膜癌外，ＣＴ都确诊为子宫肌瘤，其ＣＴ诊断准确率为９７３％。其中浆膜下型１０例，壁间型１８例，粘膜下型２例，混合型８例。全部病例子宫均有不同程度增大；肌瘤表现为低密度或等密度的实质性肿块，边界清楚。较大的肌瘤可有低密度坏死灶。钙化灶３例，占７９％。增强扫描肌瘤与正常肌层相差５～１０ＨＵ。结论：ＣＴ在显示子宫肌瘤的大小、位置与宫腔关系上有较高的诊断价值，可作为Ｂ超检查的重要补充手段     

Acquired immunodeficiency syndrome-associated non-Hodgkin's lymphomas and other malignancies in patients with hemophilia

Non-Hodgkin's lymphoma (NHL) is the most common human immunodeficiency virus (HIV)-associated malignancy in hemophiliacs. We studied the incidence and clinicopathologic features of NHL in 3,041 hemophiliacs followed at 18 US Hemophilia Centers between 1978 and 1989. Of the 1,295 (56.6%) who were HIV(+), 253 (19.5%) developed acquired immunodeficiency syndrome (AIDS), of whom 14 (5.5%) developed NHL. Three NHL occurred in HIV(-) hemophiliacs, for a 36.5-fold greater risk in HIV(+) than HIV(-) hemophiliacs (P < .001). The NHL incidence rate was 29-fold greater than in the US population by Surveillance, Epidemiology, and End Results (SEER) estimates (P < .001). Between 0 and 4 lymphomas have been observed per year between 1978 and 1989. At presentation 13 (92.9%) of the HIV(+) NHL were extranodal. Ten were stage IV, 1 stage II, and 3 stage IE. Ten (71.4%) were high-grade, 3 (21.4%) intermediate-grade, and 1 (7.1%) was a low-grade B-cell lymphoma. Epstein-Barr virus (EBV) DNA was detected in 36% by in situ hybridization, including one central nervous system (CNS) lymphoma. The mean CD4 cell count at NHL diagnosis was 64/mm3, the mean latency from initial HIV infection was estimated to be 59 months, and the median survival was 7 months. The incidence of basal cell carcinoma in HIV(+) hemophiliacs was 18.3-fold greater than in HIV(-) hemophiliacs (P < .001) and 11.4-fold greater than in the US population (P < .001). In conclusion, incidence rates of NHL and basal cell carcinoma in HIV(+) hemophiliacs are significantly increased over rates in HIV(-) hemophiliacs and over rates in the US population. Clinicopathologic presentation of NHL in HIV(+) hemophiliacs is similar to that in HIV(+) homosexual men.     

The New Brunswick Health Council at a glance

This article presents an overview of the work of the New Brunswick Health Council (NBHC) since its creation by exploring its mandate and by presenting its different initiatives and publications as they relate to the NBHC's areas of work: population health, care experience, sustainability, and citizen engagement.     

Diffuse large cell lymphoma in a patient with hairy cell leukemia: immunoglobulin gene analysis reveals separate clonal origins

A 75-year-old man with hairy cell leukemia (HCL) was found to have an immunoblastic lymphoma of the small bowel. Immunologic and genotypic characterization of these neoplasms revealed both the HCL and the immunoblastic lymphoma to be of the B cell lineage. The HCL expressed the HCL-associated antigens detected by the monoclonal antibodies HC-1 and HC-2, whereas the immunoblastic lymphoma failed to react with these antibodies. In addition, surface immunoglobulin light chains could not be accurately determined for the hairy cells, whereas the immunoblastic lymphoma was shown to express only kappa immunoglobulin light chains. These immunophenotype differences were compatible with either the clonal evolution of the HCL into the immunoblastic lymphoma or a separate clonal origin for these two neoplasms. An analysis of tumor DNA by Southern blot hybridization revealed different heavy-chain and kappa light-chain gene rearrangements in these two malignancies. Thus the occurrence of the large cell lymphoma most likely represents the emergence of a second clonally unrelated B cell malignancy.