Borderline Nuclear Abnormality In Cervical Smears: A Cytological Review of 200 Cases With Histological Correlation

The cervical cytology and histology specimens from 200 patients referred to colposcopy with borderline nuclear abnormality were reviewed. Human papillomavirus (HPV)-associated changes were identified in 103 of 200 (53%) referral smears and in 139 of 150 (91%) biopsy specimens. Cervical intraepithelial neoplasia (CIN) was less frequently diagnosed on review compared with the original histopathology reports (30.7%vs 45.4%); the discrepancy was largely attributable to a lower incidence of CINI. There was agreement in the grading of borderline nuclear abnormality in 161 of 200 referral smears following review. Twenty-three smears were upgraded to mild dyskaryosis, whereas 16 were reclassified as negative.     

影像诊断在颅内动脉瘤中的研究进展

颅内动脉瘤(intracranial aneurysms,ICA)是由于脑血管局部异常改变而产生的血管瘤样突起,世界2%的人口患有颅内动脉瘤。颅内动脉瘤是引起脑卒中的第三大病因,仅次于脑血栓形成和高血压脑出血,脑卒中病死率、致残率极高,总病死率约为40~50%,早期诊断ICA对预防脑卒中意义重大。颅内动脉瘤的早期诊断主要依赖于影像学检查,近年多层螺旋CT、MRI及DSA技术的迅猛发展对颅内动脉瘤的早期诊断有很大帮助,本文就CT以及MRI功能成像在颅内动脉瘤的应用研究进展进行综述。     

Acromegaly: A Review of 100 Cases

Clinical and pathological findings in 100 cases of acromegaly were reviewed. Great individual variation in manifestations of the disease was apparent. The chronic course was evidenced by 30 patients presenting symptoms unrelated to acromegaly. Headache, visual disturbances, arthritis and elevated blood pressure were common. The incidence of diabetes mellitus, thyroid and adrenal dysfunction was similar to that reported in other series. Gonadal disturbances were frequent. Two patients had galactorrhea and two had hyperparathyroidism. Radiologically, pituitary fossae were normal in 24. Pituitary histology in 29 cases revealed four eosinophilic adenomas, but most were mixed eosinophilic-chromophobic. Fifty-two patients received radiation therapy. Rhinorrhea and optic nerve fibrosis were seen in this group. Twenty-four patients were operated upon, with no operative deaths since 1945 and no morbidity since 1952. Visual failure was the clearest indication for surgery. Treatment will be difficult to evaluate until an index of growth hormone secretion is generally available.     

Kidney Transplantation: Analysis of 200 Cases

The first 200 renal allograft operations performed at Addenbrooke''s Hospital, Cambridge, have been analysed. At the time of writing the fractional graft survivals at one, two, and three years were 53%, 49%, and 39% respectively, and these showed no observable change through the seven years of the programme. On the other hand, the survival of patients undergoing renal transplantation steadily improved, the most recent survival rates at one, two, and three years being 83%, 78%, and 67%, whereas the overall rates were 74%, 66%, and 54% respectively. The survival of second allografts was similar to that of first allografts. Ninety per cent. of the patients whose allografts functioned for a year or more returned to active and gainful employment. The return of children to school and of housewives to running a household was similarly gratifying. We conclude on both social and economic grounds that renal transplantation is fully justified as a therapeutic procedure.     

Wegener's Granulomatosis: A Review of Three Cases

Clinical and autopsy features in three cases of Wegener''s granulomatosis are presented. The disease is characterized by the triad of necrotizing granulomatous lesions of the respiratory tract, segmental necrotizing angiitis of arteries and veins, and necrotizing glomerulitis commonly terminating in uremia. Correct antemortem diagnosis was made in two of the three cases-in one by recognition of the characteristic triad and in the other by a biopsy from the antrum. Pathological lesions were chiefly in respiratory tract, spleen, kidneys and blood vessels. Necrotizing granulomatous lesions were present in the lungs. Glomerular lesions were particularly severe and wide-spread in two of the three patients, leading to uremia. Trabeculitis of the spleen, an unusual lesion, was a noticeable feature in all three. Fibrinoid necrosis, with little or no inflammatory infiltration, was the prevailing type of vascular necrosis. The characteristics of the disease process suggest a hypersensitivity mechanism. Similarities to, but significant differences from, polyarteritis nodosa are recognized.     

Syringomyelia: A Clinical Review of 75 Cases

Records of 75 patients with syringomyelia are reviewed. Their clinical course fell into one of three main groups: (1) those with a long history of a steadily progressive disability; (2) those with a long history but little or no progression of their disability; and (3) those with a short, fairly rapid downhill course.On the basis of this study, x-ray therapy seems to be of little value in the treatment of this disease. Surgical treatment on the other hand appears to offer more hope for a selected group of patients who are progressing at the time of examination. In this group surgery is recommended (1) in the presence of a foramen magnum anomaly with signs and symptoms related to this deformity; (2) in the presence of a distended cord with pain and evidence of a spinal fluid block; and (3) when the possibility of an ependymoma exists.