胸交感神经钛夹阻断术预防手汗症患者术后代偿性多汗

胸腔镜下胸交感神经切除术(TES)已经成为目前治疗原发性手汗症的一种简单而有效的方法.但其术后无法预期的躯干、大腿内侧等处的代偿性多汗困扰了一部分病人,严重者影响工作和生活.因此,我们在胸腔镜双侧T2-4胸交感神经切除治疗手汗症方法[1]的基础上改良了术式:用钛夹钳夹T2交感神经节以阻断神经传导治疗手汗症并预防术后代偿性多汗,取得了一定效果,报道如下.     

发作性运动诱发性舞蹈手足徐动症24例临床分析

发作性运动诱发性舞蹈手足徐动症（PKC）是发作性运动障碍中最常见的一种类型Ⅲ。本文回顾性总结我院自1985年至2009年6月收治及随访的24例PKC患者的临床资料,旨在总结PKC的临床特点及治疗方法,探讨PKC的发病机制。     

鼓膜切开置管加腺样体切除治疗儿童分泌性中耳炎72例

目的 探讨儿童分泌性中耳炎的病因及治疗方法.方法 回顾性分析72例分泌性中耳炎儿童行鼓膜切开置管术加腺样体切除术治疗儿童分泌性中耳炎.结果 术后回访9个月～2年,72例(112耳)中107耳语频听力提高20～35 db,5耳听力无明显改善,可能与鼓膜穿孔及中耳粘连有关,手术治愈率达95.54%(107/112).结论 儿童分泌性中耳炎的发病因素颇多,腺样体肥大是儿童分泌性中耳炎较为主要的发病因素,鼓膜切开置管加腺样体切除术是行之有效的方法.     

囊性肾癌31例临床分析

目的 探讨囊性肾癌的诊疗方法,提高本病诊治水平.方法 回顾性分析31例囊性肾癌患者的临床资料,其中男性20例,女性11例,发病年龄29～76岁,中位年龄57.5岁,并对诊疗问题进行讨论.结果 31例患者中26例行肾癌根治术,5例行肾部分切除术.经病理确诊肾癌囊性变24例,多房囊性肾癌6例,单纯性囊肿癌变1例;透明细胞癌28例,嫌色细胞癌3例.术后随访5～104个月,平均28个月,25例无瘤存活.结论 囊性肾癌是肾癌的一种特殊类型,采用B超、CT等影像学检查,可以提高囊性肾癌的术前诊断率,手术治疗效果满意,预后佳. Abstract： Objective To improve the diagnosis and treatment of cystic renal cell carcinoma (CRCC). Methods The data of thirty - one cases of CRCC were analyzed retrospectively, and the problems related to the diagnosis and treatment were discussed. There were 20 male and 11 female patients with an age range from 29 to 76 (median: 57.5) include in our study. Results In the 31 cases of CRCC, 26 cases were received radical nephrectomy and 5 cases were received partial nephrectomy. Histopathologic examination demonstrated 24 cases of renal cell carcinoma cystic degeneration,6 multilicular cystic renal cell carcinoma and 1 preexisting simple cyst cancerization ;28 cases were clear cell carcinoma and 3 cases were chromophobe carcinoma. The patients were followed -up for 5 - 104 months (mean 28 months) and 25 patients survived with no evidence of cancer recurren. Conclusions CRCC reprecents a distinct subtype of renal cell carcinoma. With the help of CT and B ultrasound, CRCC can be diagnosised timely and accurately. Our results indicate that CRCC can be cured by surgery and the prognosis is favorable.     

经乳晕切口治疗多种乳腺良性疾病的探讨

目的 探讨经乳晕切口治疗多种乳房良性疾病的优势、适应证和手术技巧.方法 采用经乳晕切口治疗132例乳腺良性疾病（包括纤维腺瘤 91例,局限性腺体增厚12例,囊肿 8例,乳头溢液 13例, 良性乳腺叶状肿瘤2例,男性乳腺发育症6 例）.结果 本组术后都得到随访,其中107例对乳房外形和切口满意或非常满意,因觉切口较长不太满意19例,不满意正面切口的有6例.术后1个月复查乳头感觉正常117例,部分麻木15例.切口I/甲愈合130例,因局部血肿延迟愈合2例,无皮缘坏死、切口感染等并发症.结论 经乳晕切口可用于治疗多种乳腺良性疾病,并发症少,具有美容优势.在实施该手术的过程中应正确选择适应证、注意解剖层次,术后成型、适当引流、加压包扎都是手术成功需要考虑的因素.     

未婚青年女性乳晕直径的测定及相关因素分析

目的:探讨中国未婚青年女性乳房乳晕美学标准的正常值,为乳房整形术提供参考和依据.方法:测量564名健康未婚青年女性的身高、体质量、胸围和乳晕直径等项目,计算各测量值的均值和标准差,对身高、体质量、胸围等与乳晕直径有关的各项指标用SPSS 11.0统计软件进行相关性分析.结果:乳晕直径均值和标准差为(3.346±0.694)cm;乳晕直径与身高无关,但与体质量和胸围密切相关.结论:符合美学标准的中国青年女性乳晕直径的测定,可为乳晕整形和再造提供理论依据.     

Central areolar choroidal and retinal pigment epithelial dystrophy: a family report

Central areolar choroidal and retinal pigment epithelial dystrophy (CACD) is a rare hereditary macular disease characterized by a bilateral, symmetric, and well-circumscribed solitary area in the macula with choroidal and retinal pigment epithelial atrophy. We report a family of CACD confirmed by both clinical presentation and hereditary pattern. Three members of the family were examined. They had noticed gradual visual deterioration with poor color discrimination since the fourth to fifth decades. All of them showed a bilaterally symmetric bull's-eye pattern of macular dystrophy with a sharp border of underlying large or middle choroidal vessels, which was unassociated with any surrounding lesions. Fluorescein angiography revealed a transmission window defect due to retinal pigment epithelial atrophy with remaining choriocapillaris intermingled with a hypofluorescent area of choriocapillaris atrophy. Electroretinography revealed a mild reduction in the photopic amplitude, while the scotopic response was normal. A normal electro-oculography was also noted. The family history indicated autosomal dominant inheritance. The loss of visual acuity was caused by progressive atrophy of both the retinal pigment epithelium and the choriocapillaris. It is important to detect CACD in the early stages, because this diagnosis can exert a considerable influence on a patient's subsequent life.     

Metastatic apocrine sweat gland adenocarcinoma in a terrier dog

This report describes the clinical and pathological aspects of an apocrine sweat gland carcinoma with distant metastasis in an aged dog. A 7-year-old male terrier dog was referred to small animal hospital of Shahid Bahonar University of Kerman with a 5.5×3.5 centimeter pedunculated mass on its head near left auricular region which had been progressively growing since three months ago. The radiography showed no local and distant metastasis. Surgical excision and histological evaluation was done. Histologically, the mass was composed of epithelial cells arranged in glandular and solid patterns. The morphologic findings suggested either a primary or metastatic apocrine-gland carcinoma. Immunohistochemically, the tumor cells were intensely positive for cytokeratin 7 and 20 and negative for S100 protein. On the basis of histopathological and clinical findings, the tumor was diagnosed as a malignant apocrine gland tumor, arising from apocrine sweat glands of the skin. Local tumor recurrence with anorexia and weight loss was reported by the owner nine month later. Severe submandibular and prescapular lymphadenomegaly was noted in clinical examination. Several large pulmonary nodules were noted in chest radiographs resembling mediastinal lymph node metastasis. Second surgery and chemotherapy was rejected by the owner due to grave prognosis of the patient. The animal was died 45 days later due to respiratory complications. Tumors of apocrine sweat glands are relatively uncommon in dogs whereas apocrine gland adenocarcinoma with distant metastasis is extremely rare.     

伴大汗腺分化的乳腺癌临床病理特征及病理分析

目的:探讨非特殊型乳腺癌中罕见亚型之伴大汗腺分化的癌(ACB)的临床病理特征、免疫表型特点,并与浸润性导管癌(IDC)进行鉴别及病理分析。方法:回顾性分析沈阳二四五医院、辽阳辽化医院病理科2010年1-12月的手术病例中的24例ACB和24例浸润性导管癌的临床病理特征、免疫组化标记结果,进行病理分析并复习相关文献。结果:ACB平均发病年龄(57.07±10.45)岁,比浸润性导管癌的(50.46±9.18)岁高(P<0.05);ACB的免疫标记雌激素受体(ER)、孕激素受体(PR)阴性为主,表皮生长因子(HER-2)阴性多见,仅极少数阳性,而浸润性导管癌的ER、PR、HER-2的阳性率明显高于ACB(P<0.05);ACB特征性恒定表达雄激素受体(AR)和GCDFP-15)。结论:乳腺伴大汗腺分化的癌是乳腺癌中罕见特殊亚型,有特征性的临床病理特征,乳腺病变中伴有大汗腺改变的多为良性,极易漏诊恶性病变,应从细胞形态和组织结构仔细辨别出伴大汗腺分化的癌,有非常重要的意义。     

乳晕区美容切口治疗569例乳腺良性肿瘤临床分析

目的:探讨乳晕区美容切口在治疗乳腺良性肿瘤中的临床应用价值。方法:通过对569例乳腺良性肿瘤患者实施乳晕区美容切口手术治疗,同时与传统手术切开方法相比较。结果:569例患者都通过乳晕区美容切口方法完成,临床效果满意,病理检查恶变者及时实施根治性手术。结论:乳晕区美容切口治疗乳腺良性肿瘤具有较好的临床应用价值。     

单纯大汗腺切除法治疗腋臭临床疗效

"腋臭"俗称"狐臭",是一种常染色体显性遗传疾病,人群发病率高.我科采用1～2个小切口在直视下切除含大汗腺的皮下组织将形成的全厚皮片原位回植,于1999年6月至2003年12月,共治疗78例患者,取得满意的疗效.     

Clinical features and linkage analysis for a Chinese family with autosomal dominant central areolar choroidal dystrophy

Background A Chinese family with autosomal dominant central areolar choroidal dystrophy （CACD） was identified. The purpose of this study was to collect the clinical findings from the family and to identify the genetic entity by linkage analysis.
Methods Forty-three individuals from 3 generations of the family underwent ophthalmologic examinations, including best-corrected visual acuity, examination of the anterior segments, and inspection of the ocular fundus after pharmacologic mydriasis. Affected family members further underwent color vision test, color fundus photography, fluorescein angiography, automated perimetry, and electroretinography. The family was followed up for 30 months. Peripheral venous blood or buccal swabs were collected from each family member and genomic DNA was extracted. Linkage analysis was performed for candidate genes or loci using microsatellite markers.
Results Seven family members in 3 continuous generations were diagnosed as having autosomal dominant CACD. The family showed progressive development of the disease, affecting both male and female. Age of onset of visual disturbances varied between 11 and 50 years. Phenotypic variability among affected individuals was apparent and ranged from relatively normal-appearing fundus with mild parafoveal pigment mottling to geographic atrophy of the macula. Fluorescein angiography showed hyperfluorescent parafoveal changes in early stage or well-demarcated area of chorioretinal atrophy with enhanced visibility of the residual underlying choroidal vessels in the late stage. Peripheral retina and visual fields were normal in affected individuals. Electroretinogram showed normal or mild reduction in the photopic amplitude. Eight candidate genes （STGD4, RCD1, peripherin/RDS, GUCA 1A, RIMS1, UNC119, GUCY2D, and AIPL1） and two genetic loci （4p15.2-16.3, and 17p13） were excluded to be responsible for the disease by linkage analysis.
Conclusions The clinical findings Of this Chinese family with CACD shared similarities with previously reported families of other ethnicities. Linkage analysis excluded the known genes and genetic loci, indicating genetic heterogeneity of the disease.     

Isolated renal mucormycosis

Isolated renal mucormycosis is very rare and we describe such a case masquerading as a hypernephroma in a poorly-controlled diabetic.