Presentations of agenesis of the hemidiaphragm in an adult

A 67-year-old man presented with chest tightness and vomiting of one-week duration. On physical examination bowel sounds were heard on the left chest. Plain chest x-ray, barium swallow, and CT scan suggested gastric volvulus with diaphragmatic hernia. At laparotomy there was complete agenesis of the left hemidiaphragm with no diaphragmatic remnants seen and no associated lung hypoplasia. This is an extremely rare condition and careful assessment is needed to differentiate between diaphragmatic hernia and agenesis of the diaphragm as more cases could be diagnosed in the future as a result of good perinatal care of agenesis of hemidiaphragm AHD and long term survival to adulthood.     

成人先天性肺不发育和发育不全的CT诊断

目的探讨成人患者先天性肺不发育和发育不全在CT表现上的特征。方法CT平扫19例明确诊断的先天性肺不发育和发育不全的患者,观察和分析CT资料。结果病变分布于左肺13例,右肺5例,双肺1例。肺不发育CT表现主要为肺叶团状、条状的完全实变,叶支气管呈盲端或为巨大空腔,支气管完全不显示。肺发育不全CT表现为肺呈体积缩小的多囊状改变或为肺叶血管纹理稀疏伴肺段支气管管壁增厚聚拢。结论CT扫描可以准确判断肺和支气管的发育畸形程度,明确先天性肺不发育和发育不全的诊断。     

An adult case of isolated unilateral pulmonary agenesis under general anesthesia

Pulmonary agenesis is a rare congenital malformation of unknown etiology that is defined as the complete absence of the bronchus,lung parenchyma,and pulmonary vasculature.The exact incidence of this rare abnormality is not known but is believed to range from 0.003 4% to 0.009 7%.1 Pulmonary agenesis affects men and women almost equally.Left sided agenesis is more common.More than half of the reported cases are associated with anomalies involving cardiovascular,gastrointestinal,skeletal,and urogenital systems and patients die within the first five years of life.Although some cases are compatible with long-term survival and normal growth,completely symptom free and well tolerated surgery is extremely rare.Here we present a case of congenital left lung agenesis in an adult woman tolerating general anesthesia well for modified radical mastectomy.     

Penile parkinsonism

Priapism following the administration of the tranquillizer pericyazine (Neulactil) is reported. No other aetiology was found after full investigation. The condition resolved during treatment with intravenous benztropine (Cogentin). An attempt has been made to explain the aetiology and rationalize the treatment given.     

先天缺牙的研究进展

牙齿的发育不全是一种人类常见的发育异常,包括牙齿的萌出异常、数目异常、形态异常及结构异常。先天性的牙齿缺失属牙齿发育异常中的数目异常,是指临床检查牙齿口内部分或全部缺失,既往没有牙齿脱落或拔牙史,X线检查亦未见颌骨内该缺失牙的牙胚。个别牙缺失多见于恒牙列,最常见的是第三磨牙,其次是第二双尖牙及上颌侧切牙;全部的无牙症比较罕见,其常常累及乳牙和恒牙,通常与某些复杂疾病有关,如外胚层发育不全综合征等。多数牙先天缺失影响患者咀嚼功能,并且影响患者的容貌、身体发育和心理健康。     

阴茎癌治疗的研究进展

阴茎癌是男性恶性肿瘤中较罕见的一种疾病,其具有潜在的破坏性影响,通常一经确诊即为晚期,错过其治疗的最佳时机,给患者及泌尿科医师带来严峻挑战。目前,阴茎癌的治疗方法多样,主要以手术切除病灶为主,同时辅以放化疗联合治疗。其中,阴茎癌手术治疗常分为原发病灶切除和腹股沟盆腔淋巴结转移灶清扫两种。随着腹腔镜的广泛使用,越来越多的医师开始运用腹腔镜进行淋巴结清扫。对于淋巴结转移明确的患者,腹腔镜的应用能提高其疗效和减少并发症。因此,未来应选择合理且规范的诊疗以为阴茎癌患者带来良好结局。     

Penile metastasis from rectal carcinoma

We are presenting a 65-year old patient with metastatic carcinoma of the penis which was discovered 19 months after abdomino-perineal resection for rectal cancer (Duke A). There was also metastasis in the perineum and one rib. Penile biopsy and cavernosography were carried out and established the metastatic nature. The patient declined further therapy and died 5 months after diagnosis.