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.     

Protein C deficiency manifesting as an acute myocardial infarction and ischaemic stroke

Protein C deficiency is a disorder in the coagulation cascade that results in predominantly venous thromboembolism. However, recent studies have implicated this disorder as a possible contributor to arterial thrombosis, especially myocardial infarction. There are six reported cases of myocardial infarction secondary to protein C deficiency in the literature. This is the first report of myocardial infarction and ischaemic stroke in the same patient as a manifestation of protein C deficiency. The investigation of hypercoagulable state is an essential component of the investigation of young patients with myocardial infarction.     

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.     

Implications of HER2 Amplification in Small,Node-Negative Breast Cancers: Do Asians Differ?

Background  

We investigated the implications of HER2 amplification in Asian women with small, node-negative breast cancer in low- and middle-income countries (LMCs).     

螺旋CT图像噪声的评价

目的 :评价螺旋CT中内插方式、螺距以及重建间隔对噪声的影响。方法 :采用SomatomPlus 4螺旋CT机。在相同条件下扫描直径为 2 0cm的水模 ,测得水模图像中心 40cm2 兴趣区的CT值标准差作为评价噪声水平的指标。结果 :3 60°线性内插的噪声减少 (t =3 4.87,P <0 .0 0 1) ,180°线性内插的噪声增加 (t =18.78,P <0 .0 0 1)。螺距大于 1.0或小于 1.0与螺距为 1.0时噪声水平的差异无显著性意义 (P >0 .0 5 )。随着重建间隔改变 ,相应噪声水平的差异无显著性意义 (P >0 .0 5 )。结论 :与常规扫描相比 ,螺旋CT内插方式对噪声有一定影响 ,而螺距与重建间隔对噪声水平影响不明显。