外伤性睾丸脱位2例

外伤性睾丸脱位临床少见，易漏诊，误诊。我院自1998年8月～2003年4月共收治2例，现报告如下。     

外伤性睾丸脱位的手术治疗

外伤性睾丸脱位较少见。作者在临床工作中遇到2例,现报道如下: 临床资料 例1 男,19岁。因外伤后右睾丸下降不全2月入院。2月前因车祸致会部开放性损伤,当时无血尿、休克症状。在院外行清创缝合术。术后1月余发现右侧腹股沟内侧有一包块。查体:双侧阴囊不对称,右侧阴囊空虚,于耻骨联合外侧可触及一光滑包块,约3cm×2cm×2cm大小,边缘清楚。左侧阴囊内睾丸大小、形态正常。B超示右侧睾丸移位。1991年1月在腰麻下行右侧睾丸复位固定术。术中见右侧睾丸位于耻骨联合外侧皮下,睾丸形态、大小正常,睾丸、精索与周围组织粘连。遂     

Bosworth骨折脱位1例并文献复习

踝关节骨折是四肢骨折中常见损伤,但Bosworth骨折脱位是踝关节罕见的骨折脱位,由Bosworth在1947年首先描述及报道^[1],其特点是腓骨骨折近端嵌入胫骨后侧而导致距骨脱位后难以闭合复位,需要切开复位。因其损伤机制及特点,容易出现漏诊,如未及时诊治,或按照一般踝关节骨折处理.     

双侧睾丸精母细胞性精原细胞瘤1例并文献复习

目的 探讨睾丸精母细胞性精原细胞瘤(spermatocytic seminoma,SS)的临床病理学特征、诊断及鉴别诊断、治疗及预后.方法 对1例双侧睾丸SS组织行EnVision两步法免疫组化染色,并复习相关文献.结果 双侧睾丸肿瘤呈无痛性缓慢生长,组织学上肿瘤边界清楚,包膜完整,肿瘤细胞弥漫分布,黏附性差,由3种类型细胞组成,缺少淋巴细胞浸润及间质肉芽肿反应.免疫表型:肿瘤细胞CD99、CD117、BCL-2阳性,CK、CD3、CD7、CD20、CD30、inhibin、PLAP、CK18均阴性,Ki-67增殖指数为50%.结论 SS是一种罕见的睾丸肿瘤,与经典性精原细胞瘤的临床及病理特点均不同,好发于老人,双侧发生者更为罕见.其与经典性精原细胞瘤、胚胎性癌和淋巴瘤鉴别非常重要,单纯睾丸切除后不需进一步治疗,预后良好.     

睾丸原发性类癌1例报道及文献复习

1材料与方法患者,34岁,偶感右侧阴囊部坠胀不适6天,自查发现右侧睾丸明显较左侧睾丸大,而且较左侧硬。B超示右侧睾丸实质性占位性肿块;CT示右侧睾丸增大,实质性占位,考虑为肿瘤。体检:右侧阴囊皮肤无红肿,右侧睾丸大小5cm×3.8cm,质地较硬,无压痛;肛门、前列腺未见异常,腹股沟淋巴结及全身体表淋巴结未触及肿大。临床诊断:右侧睾丸肿瘤,行右侧睾丸切除术。术中见右侧睾丸内肿块3.1cm×2.8cm,质地较硬。标本经常规石蜡切片,HE染色,并做PCK、NSE、CgA、Syn、PLAP、vimentin和AFP免疫组化(S P法)标记。2病理检查2.1眼观右侧肿大的睾…     

输尿管子宫内膜异位症1例并文献复习

目的:提高对输尿管子宫内膜异位症(ureteral endometriosis)的认识.方法:分析1例输尿管子宫内膜异位症,并结合文献复习讨论.结果:本案例中患者以"腰酸背痛2月余"入院,全身麻醉下行输尿管活检术及输尿管镜检查术,术中见输尿管内息肉样生长新生物,参考临床病史诊断为输尿管子宫内膜异位症,行输尿管部分切除术及输尿管吻合术.结论:输尿管子宫内膜异位症虽不常见,且临床表现缺乏特异性,诊断明确时常常已经造成肾功能损害,所以应提高对输尿管内膜异位症的认识,对于有不明原因痛经、血尿、腰腹部坠胀或有子宫内膜异位症病史的患者,应结合影像学检查考虑输尿管内膜异位症,确诊后予以积极的手术和药物治疗,长期预后良好.     

Kartagener综合征一例并文献复习

目的探讨Kartagener综合征的临床特点、诊断标准,以提高对Kartagener综合征认识。方法 Kartagener综合征1例。患儿,女,10岁余。因反复咳嗽1年,咯血4次入院。回顾性分析该患儿临床资料,检索国内外文献,进行总结分析。结果患儿隐匿起病,主要表现为反复咳嗽,咳脓痰,伴咯血。CT示双肺支扩伴感染,全内脏反位,鼻窦炎。经抗感染对症治疗1周后,临床症状消失出院。检索国内外文献发现,Kartagener综合征以全内脏反位,支气管扩张,副鼻窦炎三联征为诊断标准。治疗以对症治疗为主。结论 Kartagener综合征是一种罕见的常染色体隐性遗传病,加强对该病的认识,有利于提高对该病的诊断率,减少误诊率。对该病的致病基因、机制的进一步研究,可能提供更好的诊断和治疗方法。     

Isolated Multiple Bilateral Thyroid Metastases from Prostatic Adenocarcinoma: Case Report and Literature Review

Solitary metastasis from prostate adenocarcinoma to thyroid gland is very rare and usually associated with other distal metastasis. This report describes for the first time isolated multiple bilateral thyroid metastasis from prostatic adenocarcinoma. A 67-year-old man who is known as a case of prostatic adenocarcinoma was admitted to a hospital as a case of a multinodular goiter on the basis of clinical and CT scan findings. Total thyroidectomy was performed and histopathology result showed adenomatous goiter containing bilateral metastatic prostatic adenocarcinoma. This is the first report of isolated multiple bilateral thyroid gland metastasis from prostatic adenocarcinoma without other distal metastasis. Such lesions are very rare and can be misdiagnosed, so high index of suspicion for thyroid metastasis should be always maintained in all oncology patients with isolated thyroid mass because early resection and thyroidectomy will change the prognosis for patient.     

Traumatic Cervical Cord Transection without Facet Dislocations-A Proposal of Combined Hyperflexion-Hyperextension Mechanism: A Case Report

A patient is presented with a cervical spinal cord transection which occurred after a motor vehicle accident in which the air bag deployed and the seat belt was not in use. The patient had complete quadriplegia below the C5 level and his imaging study showed cervical cord transection at the level of the C5/6 disc space with C5, C6 vertebral bodies and laminar fractures. He underwent a C5 laminectomy and a C4-7 posterior fusion with lateral mass screw fixation. Previous reports have described central cord syndromes occurring in hyperextension injuries, but in adults, acute spinal cord transections have only developed after fracture-dislocations of the spine. A case involving a post-traumatic spinal cord transection without any evidence of radiologic facet dislocations is reported. Also, we propose a combined hyperflexion-hyperextension mechanism to explain this type of injury.     

Bee Pollen-Induced Anaphylaxis: A Case Report and Literature Review

Bee pollen is pollen granules packed by honey bees and is widely consumed as natural healthy supplements. Bee pollen-induced anaphylaxis has rarely been reported, and its allergenic components have never been studied. A 40-year-old male came to the emergency room with generalized urticaria, facial edema, dyspnea, nausea, vomiting, abdominal pain, and diarrhea 1 hour after ingesting one tablespoon of bee pollen. Oxygen saturation was 91%. His symptoms resolved after injection of epinephrine, chlorpheniramine, and dexamethasone. He had seasonal allergic rhinitis in autumn. Microscopic examination of the bee pollen revealed Japanese hop, chrysanthemum, ragweed, and dandelion pollens. Skin-prick with bee pollen extracts showed positive reactions at 0.1 mg/mL (A/H ratio > 3+). Serum specific IgE to ragweed was 25.2, chrysanthemum 20.6, and dandelion 11.4 kU/L; however, Japanese hop, honey-bee venom and yellow-jacket venom were negative (UniCAP®, Thermo Fisher Scientific, Uppsala, Sweden). Enzyme-linked immunosorbent assay (ELISA) confirmed serum specific IgE to bee-pollen extracts, and an ELISA inhibition assay for evaluation of cross-allergenicity of bee pollen and other weed pollens showed more than 90% of inhibition with chrysanthemum and dandelion and ~40% inhibition with ragweed at a concentration of 1 µg/mL. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-immunoblot analysis revealed 9 protein bands (11, 14, 17, 28, 34, 45, 52, 72, and 90 kDa) and strong IgE binding at 28-34 kDa, 45 and 52 kDa. In conclusion, healthcare providers should be aware of the potential risk of severe allergic reactions upon ingestion of bee pollen, especially in patients with pollen allergy.     

胸骨异位胸腺瘤1例报告并文献复习

目的：探讨胸骨异位胸腺瘤的临床和病理特征,以提高临床诊断和治疗水平。方法和结果：复习异位胸腺瘤相关的临床和病理文献。手术治疗并经术后病理确诊胸骨异位胸腺瘤1例,术后随访30个月,无局部复发和转移。结论：异位胸腺瘤发生于胸骨非常罕见,目前国内外尚未见有文献报道;一旦确诊即应手术切除,预后取决于病理分型和分期。     

Gastric Volvulus: A Case Report and a Review of Literature

Volvulus of sigmoid colon and cecum is not uncommon in tropical Africa, but gastric volvulus is relatively rare, especially when compared with various causes of peptic ulcer syndrome seen at the University College Hospital in Ibadan, Nigeria.     

Systemic Mastocytosis: Case Report and Literature Review

A case of systemic mastocytosis is reported and the literature reviewed. Although the dermatological manifestation of this rare disease, in the form of urticaria pigmentosa, is well recognized and goes along with the osteosclerotic changes that can be seen with systemic mastocytosis, it is imperative to rule out malignancy as a cause for a new onset of ascites and newly discovered sclerotic osseous changes.     

Hypothyroidism: A Rare Cause of the Bilateral Carpal Tunnel Syndrome��A Case Report and a Review of the Literature

Reported herein is a patient who developed symptoms of bilateral carpal tunnel syndrome following radioactive iodine induced hypothyroidism. A review of the literature is presented.