牙源性脓肿标本中的产黑色素类杆菌群菌株分离鉴定

本文对４４例牙源性脓肿（尖周脓肿２４例，牙周脓肿１２例，冠周脓肿８例）脓液标本中的产黑色素类杆菌群菌株进行分离、培养、鉴定。其中３８例存在产黑菌群，以中间型类杆菌阳性率最高。牙龈类杆菌在牙周脓肿中检出率最高。２４例尖周脓肿可分离出６株牙髓类杆菌而其它两种牙源性脓肿则无牙髓类杆菌，推测该菌与牙髓尖周感染的病理过程有关。     

脑脓肿的诊断及治疗

目的：进一步探讨脑脓肿发病情况，影像学表现，选择最佳治疗方法，提高治疗效果。方法：回顾分析１４７裂离脓肿的发病，病因，影像学表现，治疗方法及死亡率下降因素，结果：脑脓肿发病年龄较年青，血源性及隐源性脑脓肿发病率升高，ＣＴ结合ＭＲＩ可明确诊断，选择最佳手术方法。ＣＴ应用后死亡率由２３．８％下降到７．５％，结论：ＣＴ为脑脓肿最主要的诊断方法，ＣＴ定位下穿刺排脓可治愈大部分脑脓肿。     

Epidural abscess following epidural steroid and local anaesthetic injection

Epidural abscess is a well-recognised but rare complication of epidural catheter placement. We have found only five previous reports of epidural abscess from noncatheter-related administration of steroids and/or local anaesthetic. We describe a further case which led to critical illness and emphasise the association between diabetes mellitus and epidural infection.     

Pyoderma gangrenosum associated with ulcerative colitis and subcutaneous and splenic abscesses

Pyoderma gangrenosum is a rare, chronic, inflammatory ulcerative skin disease of unknown etiology and pathogenesis. It is often associated with systemic disease. We describe a patient with pyoderma gangrenosum associated with ulcerative colitis and aseptic abscesses of the subcutis and spleen, which have been rarely reported previously. These manifestations were cleared by combined therapy with minocycline hydrochloride and diaphenylsulfone.     

Remote abscess formation during interferon-α therapy for viral hepatitis

Abscess formation at the injection site is an unusual infectious complication of interferon- α (IFN- α ) treatment of chronic hepatitis C virus (HCV) infection, but remote abscess formation during IFN- α therapy is very rare. In the present communication, we report three cases of remote abscess formation detected among 68 patients with chronic viral hepatitis treated with IFN- α , and review the pertinent English literature. We believe that, as fever and constitutional symptoms are common side effects of IFN- α treatment, a high index of suspicion is indicated to exclude abscess formation in cases of unexplained fever during IFN- α therapy.     

Peritonsillar abscess — Do we need anaerobic cover?

Objective To find out the usability and advantage with regard to the advent of new and more costly antibiotics. In the treatment of Peritonsillar abscess the demonstration of, both aerobic and anaerobic organisms has raised the question of possible need to treat with antibiotics effective against anaerobes. It was in this very context that this study was planned to find out if we still have an economically and easily available antibiotic to treat Peritonsillar abscess. Conclusions Injectable penicillin is the drug of choice in PTA as GABHS and staphylococcus aureus coagulase positive are the most common organism associated with this condition. Even where penicillin resistant organism is present, effective management of the abscess is possible if it is drained well and weak hydrogen peroxide gargles are used along with injectable penicillin.     

坏疽穿孔性阑尾炎阑尾切除术后腹腔残余脓肿防治的体会

目的总结坏疽穿孔性阑尾炎阑锁阑尾切除术后发生腹腔残余脓肿(PAIAA)的原因及防治体会。方法对2003年-2006年7月共763例阑尾切除术,其中75例坏疽穿孔阑尾炎,术后5例发生腹腔残余脓肿的临床资料行回顾性分析。结果5例病例均治愈出院,3例经抗感染保守治疗脓肿逐渐吸收而愈,2例手术引流后治愈。结论坏疽穿孔阑尾炎术后易发生腹腔残余脓肿,术中术后的正确处理是可以减少阑尾术后腹腔残余脓肿的发生。     

Ultrastructure of primary squamous cell carcinoma of the submandibular gland

Primary squamous cell carcinoma of the submandibular gland is a rare tumor. In this report, the histological and ultrastructural features of a case of primary squamous cell carcinoma arising in the left submandibular gland is presented. Light microscopically, the tumor consisted of well differentiated keratinizing squamous cell nests. Ultrastructurally, the tumor cells were oval or spindle-shaped, and several tumor cells had intracytoplasmic desmosome-like structures, resembling intercellular desmosomes. The majority of the tumor cells contained a large number of intermediate filaments (tonofilaments). Intercellular desmosomes were well developed. No secretory granules were found. These ultrastructural features may enable us to distinguish primary squamous cell carcinoma from mucoepidermoid carcinoma which is often misdiagnosed as squamous cell carcinoma.     

Ischemic stroke in infancy,childhood, and adolescence

The authors studied 34 patients with juvenile ischemic cerebrovascular disease over a 15-year period. Of the 34 patients, 23 had intracranial occlusions attributed to cerebral thrombosis or embolism and 11 had occlusions resulting from moyamoya disease. Clinicopathological features were evaluated in the 23 cases with ischemic stroke, but not those with moyamoya disease. The cause of the arterial occlusion remained undetermined in 11 patients and was found to be an embolism based on congenital heart disease in 8, on trauma in 3, and on infection in 1. Cerebral angiography was performed in 21 patients. Of these, 17 had stenoses or occlusions corresponding to their symptoms. CT scans were performed in 10 patients; the lesion in question showed no stenosis or occlusion with cerebral angiography. With regard to prognosis, patients with unknown etiology had good outcomes compared with those with congenital heart disease. With respect to acute infantile hemiplegia, 10 patients had convulsive seizures and 4 had a history of an earlier infection. Angiography and CT scans in patients with congenital heart disease demonstrated arterial occlusive sites in the middle cerebral artery region. Three patients had abscesses after their ischemic lesions.