Interrupted aortic arch (IAA) is a rare congenital anomaly characterized by a complete luminal and anatomical interruption between the ascending and descending thoracic aorta. It is usually detected in the perinatal period or during infancy, but a very few cases have been reported in adults. Here, we present the case of a 42-year-old man who visited our hospital for arterial hypertension and in whom IAA was diagnosed with echocardiography and confirmed by computed tomography angiography.
Objectives: To evaluate the sensitivity and accuracy of the HPV DNA test in conjunction with thin prep cytology test as a screening method of human papillomavirus (HPV) infection. To study either the cervical erosion is related to high risk HPV infection or to determine the mean age distribution that is more prone to HPV infection. Material and Methods: The study is a retrospective cohort implemented to determine the real performance of liquid based medium and HPV DNA testing combined in second clinical hospital of Jilin University Changchun, China. The study group included total 150 patients from January 1, 2011 to December 30, 2012. A computerized search identified patients with thin prep test results and high risk HPV DNA testing during a 2-year period was recruited. The patients were chosen after proper speculum examination followed by thin prep cytology (TCT) and HPV DNA test. Cytologic specimens were obtained with endocervical brush, which was rinsed into the vial of Cytyc. The residual samples after the cytology report were taken for reflex HPV DNA test. The manufacture protocol was followed for HPV DNA testing using Hybrid Capture II. Colposcopic biopsy was performed for the diagnosis purpose, in patients who had atypical squamous cells of undeter-mined significance (AUS-US), low grade intraepithelial lesion (LSIL) or high-grade intraepithelial lesion (HSIL) in cytology and with positive results of highrisk HPV DNA. The diagnostic criteria were based on the Bethesda System (TBS). Findings: The high risk HPV positive women with abnormal cytology had a CIN I risk of 73 (86%), whereas 35 (23.3%) high-risk HPV positive women out of 109 (72.7%) normal cytology who underwent histological biopsy had CIN I 16 (10.7%). The risk for cervical intraepithelial neoplasia (CIN) in women with high-risk HPV positive with normal cytology was higher among women invited for the first time 31 - 40 years of age 12 (8%) than among older women 1 (0.7%). Out of 44 (29.3%) women who had I degree erosion with 6 (14%) positive HPV DNA test 38 (86%) had a normal histology biopsy showing no statically significant between them. Conclusion: The data confirm that HR-HPV DNA testing is much more sensitive than cytology alone and that HPV DNA testing helps in identifying women with high risk of serious cervical disease in an efficient and medically acceptable manner. The other most significant advantage of this cervical cancer screening method is that women who are HPV DNA positive can easily and quickly referred for colposcopic examination (within one year), which could identify the precancerous and cancer stage. And those who are HPV DNA negative can safely have much longer screening intervals saving considerable costs. With mean age being 38 ± 10 years, age older than 30 years should undergo HPV DNA testing with cytology triage ...
IntroductionECG diagnosis of a posterior wall myocardial infarction is difficult to diagnose through the standard 12 lead ECG, especially in the acute stage. The posterior wall MI may occur as an isolated event or often associated with an inferior wall myocardial infarction Posterior leads V7, V8 and V9 are usually ignored but it is suggested that these leads can provide ECG information that is useful for characterization of inferior AMI and diagnosis of posterior wall MI [1,2]. 15 or 18 leads ECG should be performed to correctly diagnose culprit artery in inferior wall MI. ST elevation in inferior and posterior leads (V7, V8 and V9) is usually associated with occlusion of the left circumflex artery with the involvement of large infarct zone and complications [3,4]. ECG detection of posterior infarction is associated with concomitant ST depression in leads V1 to V3. However these changes are neither sensitive nor specific [5][6][7].The aim of our study was to assess the ST segment elevation in posterior leads V7, V8, V9 for the identification of IRA and the diagnosis of posterior wall MI. We also dealt with relation of ratio of ST elevation in lead II and lead III to assess the culprit IRA for the patient with inferior wall MI. MethodsFor the retrospective study, we had collected 355 patients having an acute inferior wall MI admitted in the cardiovascular department of the First Hospital of Jilin University. The patient's data were collected from Januar, 2011 to December, 2011. Only 121 patients (male 102 and female 19) met our inclusion criteria which include chest pain lasting for more than 30 minutes before hospital admission, elevation of creatinine kinase (CK-MB) greater than twice the upper limit (normal: 0-3.5 ng/ml) and the ECG shows ST segment >0.1 mV (1mm) in at least 2 of 3 the inferior leads (II, III and aVF). The patients excluded from the study who had previous history of acute myocardial infarction, coronary artery bypass surgery or percutaneous coronary intervention prior to current hospitalization, evidence of recent left bundle branch block or left ventricular hypertrophy in ECG, and significant stenosis in both LCX and RCA or triple vessel disease so that a single infarct related artery could not be defined. ElectrocardiographyECG was recorded in all patients at a paper speed of 25 mm/s and voltage 10 mm/mv. For inferior STEMI, the inclusion criteria are ST elevation > 0.1 mV in at least two of three inferior leads (II, III and aVF).In addition to standard 12 leads, three posterior chest leads V7 to V9 should be recorded for the study. Posterior leads are recorded on the same horizontal plane as lead V6 more specifically, lead V7 on the posterior axillary line, lead V8 on the posterior scapular line AbstractObjectives: The aim of the study was to assess the role of ST segment elevation in the Posterior leads V7, V8, and V9 for the diagnosis of acute posterior wall infarction and the identification of infarct related artery (IRA) in patients with acute inferior wall MI. Background:The posterio...
Objectives: To evaluate the sensitivity and accuracy of the HPV DNA test in conjunction with Thinprep cytology test as a screening method of human papillomavirus (HPV) infection. Method: In our retrospective study, 158 women with age group 21-70 years having positive thin cytology test were recruited. A computerized search identified patients with ASCUS, LSIL, HSIL in Thinprep test results and high risk HPV DNA testing and cervical biopsy results of these patients. Results: Out of 158 patients, HPV DNA tests were positive in 52 (32.9%) and negative in 106 (67.1%). High grade CIN and Carcinoma Cervix were commonly associated with ASCUS and HSIL as CIN I, II-III, III, Carcinoma Cervix, were 53.6%, 24.3%, 22.2% and 15% respectively for ASCUS (n=67); and 0%, 63.2%, 77.8%, 75% for HSIL (n=49). HPV DNA positive extremely favors CIN II-III, III and cervical cancer as Human Papilloma Virus DNA test were positive in 22 (78.6%) out of 28 cases of CIN I, 36 (97.5%) out of 37 cases of CIN II-III, 9 (100%) out of 9 cases of CINIII and 4 (100%) out of 4 cases of cervical cancer. There was significant correlation of TCT with HPV, age and CIN (P<0.0001). HPV DNA was common in increasing age group as compared to young age (21-30 years, n=39 [46.2%] vs. 61-70 years, n=4 [100%]). Conclusion:Combined thin cytology test along with HR HPV DNA test has great value in determining high grade of cervical intraepithelial neoplasia and cervical neoplasia. Keywords: Human papilloma virus, cervical intraepithelial neoplasia, squamous intraepithelial neoplasia, atypical squamous cells thin cytology test © 2013 Shrestha et al; licensee Herbert Publications Ltd. This is an Open Access article distributed under the terms of Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0). This permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. IntroductionThe concept of preinvasive disease of the cervix was introduced in 1947, when it was recognized that epithelial changes could be identified that had the appearance of invasive cancer but were confined to the epithelium [1]. Subsequent studies showed that these lesions, if left untreated could progress to cervical cancer [2]. Improvements in cytologic assessment led to the identification of early precursor lesions called dysplasia, a name that acknowledges the malignant potential of these lesions. The concept of cervical intraepithelial neoplasia (CIN) was introduced in 1968, when Richart suggested that dysplasias have the potential for progression [3]. The criteria for the diagnosis of intraepithelial neoplasia may vary according to the pathologist but the significant features are cellular immaturity, cellular disorganization, nuclear abnormality, and increased mitotic activity. The extent of the mitotic activity, immature cellular proliferation, and nuclear atypia identifies the degree of neoplasia. If the presence of mitoses and immature cells is limited to the lower third of the epithelium, the lesi...
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