neonate with hand, foot, and mouth disease complicated with brainstem encephalitis and pulmonary edema: a complete recovery

Hand, foot, and mouth disease [HFMD] with serious complications and fatal cases have been reported over the last decade worldwide. The authors report a rare case of HFMD in a neonate complicated with brainstem encephalitis and pulmonary edema. She had fever, lethargy, dyspnea. Physical examination revealed shock signs, fine rales on both lungs, absent Moro reflex. The patient had a rapidly progressive course with seizures, coma, no spontaneous breathing, chemosis. There were some vesicles on left sole and red maculopapular rashes on perianal skin. She had a history of exposure to HFMD. Fecal sample was positive for EV71 RNA by real-time PCR. Chest X-rays showed bilateral pulmonary infiltrates. MRI of the brain showed significant hypointensity in the brainstem on T1WI and hyperintensity on T2WI. She recovered well. This case highlights severe HFMD in neonates is rare. Medical history and physical examination are important in making diagnosis

Correlation of CT presentation with histo-differentiation and p53 and Ki67 expressions in gastric cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the relationship between spiral CT findings and histological differentiation and expressions of p53 and Ki67 in gastric carcinoma.</p><p><b>METHODS</b>Triphasic spiral CT was performed in 158 patients. CT findings included maximal diameter and thickness of tumor in three dimensional CT images, degree of enhancement, mucous situation, lymph nodes, and visceral metastasis were recorded. The expressions of p53 and Ki67 were detected with immunohistochemistry and reverse transcription polymerase chain reaction.</p><p><b>RESULTS</b>The thickness of tumor (chi2 = 5.554, P = 0.018), degree of enhancement (chi2 = 4.978, P = 0.026), and lymph nodes metastasis (chi2 = 6.061, P = 0.014) in the three dimensional CT images were significantly correlated with tumor histological differentiation. Lymph nodes metastasis was significantly correlated with the expression of p53 (chi2 = 5.028, P = 0.025). The expression of Ki67 was significantly correlated with the thickness of tumor (chi2 = 5.674, P = 0.017) and lymph nodes metastasis (chi2 = 5.028, P = 0.025).</p><p><b>CONCLUSION</b>Multi-slice CT is a simple and noninvasive technique, and can be used for assessing the histological differentiation of gastric cancer as well as the expressions of p53 and Ki67 before the operation.</p>

Multiple myeloma with pleural involvement

This study presents the differential diagnosis of metastatic tumors of the pleura vs. primary pleural malignancies in a male patient whose diagnosis was multiple myeloma with pleural involvement and confirmed by bone marrow aspiration and pleural biopsy. Computed tomography [CT] manifestations of this case were retrospectively analyzed, and compared with those of primary pleural malignancies. The CT manifestations of this case mainly involved bilateral multiple pleural nodules with irregular thickening. These nodules were also associated with rib damage and lung metastases, manifestations characteristic of metastatic tumors. The presence of a primary pleural malignancy correlated with patients' clinical history and imaging data, and involved unilateral pleural involvement, and to a lesser extent, mediastinal pleural involvement and pleural effusions. A pleural biopsy can establish a definitive diagnosis. Therefore, multiple myeloma with pleural involvement can be differentiated from primary pleural malignancies by using a combination of imaging data and clinical laboratory tests

Value of multi slice spiral computed tomography in diagnosing lymph node metastasis of gastric cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the value of multi-slice spiral computed tomography (CT) in the preoperative evaluation of lymph node metastasis.</p><p><b>METHODS</b>Totally 45 patients with gastric cancer detected by 64-slice spiral CT were enrolled in this study. The potential lymph node metastasis was evaluated by measuring or calculating the long diameter, extent of enhancement, and short-to-long diameter ratio of the lymph nodes. The results were compared with postoperative pathological findings.</p><p><b>RESULT</b>A long diameter ≥ 8mm,enhanced density ≥ 80Hu, and short-to-long diameter ratio ≥ 0.7 had the best consistency with postoperative pathological findings.</p><p><b>CONCLUSION</b>As a simple and noninvasive technique, multi-slice spiral CT is helpful to identify potential lymph node metastasis of gastric cancer based on long diameter, extent of enhancement, and short-to-long diameter ratio of the lymph nodes, and thus provide important information for surgery selection, prognosis, and development of new procedures.</p>