原发性阴茎平滑肌肉瘤1例

病人,男,36岁.两年前发现阴茎左侧根部皮下肿物,约有绿豆大小,突出皮肤表面,为无痛性结节,不伴尿频、尿急、尿痛及排尿困难.两月前,发现肿物增大变快,偶伴有隐痛.入院查体见阴茎成人型,阴茎体左侧根部可触及约2 cm×0.7 cm×0.5 cm 大小皮下肿物,质地较硬、光滑,与皮肤无粘连,阴茎体无溃破,尿道口无红肿,无异常渗出,双侧睾丸附睾无肿大,双侧附睾及精索处未触及结节,双侧腹股沟未触及肿大淋巴结.     

读片窗

患者 女,11岁.左侧腰背部皮下肿物1年余.1年前无诱因出现左侧腰背部小面积皮肤色素沉着,其下可触及一肿物,大小约6 cm×4 cm,无疼痛、皮肤瘙痒等症状.1年来,皮肤色素沉着面积不断增大,相应皮下肿物体积也随之增大,达20 cm×30 cm.否认家族中有类似患者.专科检查:颈部、胸部、背部、腰部皮肤可见斑片状咖啡色色素沉着,大小不等,约0.5 cm×0.8 cm.左侧腰背部可见一大小约20 cm×30 cm皮下隆起,肿物质地中等,活动尚可,轻微触痛.实验室检查及胸片报告均未见异常.     

颌下腺脂肪瘤一例

1资料和方法 患者,男,65岁。2009年3月入院。患者于2年前无意中发现左侧颌下肿物,无疼痛,肿物逐渐增大,进食时左侧颌下肿物区域无明显胀痛。检查：左侧颌下区隆起,触诊可扪及实性肿物,约4cm×3cm大小,质地柔软,表面光滑,可活动,无压痛。B超检查示左侧颌下腺包膜下可见一大小1．2cm×3．6cm×2．6cm低回声区,边界清楚,形态规则,内回声不均匀;彩色多普勒示异常区血流不丰富。     

彩超误诊浆细胞性乳腺炎1例

患者,女,31岁.发现左乳渐增性包块2月余.2个月前无意中发现左乳有一约乒乓球大小之包块,渐增大至鸡蛋大小,稍感胀痛,遂来我院诊治.查体:左侧乳房皮肤无红肿及桔皮样改变,乳头无内陷及分泌物,乳头上方皮肤呈酒窝征,内上象限可见一6.0cm×4.0cm×4.0cm大小椭圆形包块,表面光滑,质较硬,活动度较差,轻度压痛,左侧腋窝未及肿大淋巴结,右侧乳房未触及肿块.超声所见:左侧乳头上方探及一稍低回声实性肿物(图1),偏外上、内上、外下象限,约图1 左侧乳腺内稍低回声肿物图2 肿块内血流频谱呈低速高阻型6.1cm×2.3cm,形态不规则,边界尚清楚,无明显侧壁及后方声影.CDFI:肿块内可见丰富的血流信号,其动脉血流呈低速高阻型频谱(图2),RI:0.82～1.0.彩超诊断:左侧乳腺内实性肿物,乳腺癌可能性大.     

左腘窝钙化性腱膜纤维瘤1例

正患者男,7岁。5年前发现左侧腘窝肿物,伴左下肢屈膝障碍。外院膝关节MR检查考虑左侧腘窝腱鞘巨细胞瘤。为进一步诊治来我院就医。查体:左侧腘窝可触及2cm×3cm肿物,轻压痛,质软、边界不清,无活动,皮肤温度、颜色无异常。X线示:左侧腘窝区见稍高密度肿块影,邻近骨质未见异常(图1)。MR表现:左侧腘窝区腓肠肌前方见长椭圆形异常信号影,边界尚清,体积约大小约3. 1cm×2. 2cm×     

肾母细胞瘤1例

患儿　男 ,6岁。腹部肿物 3年 ,3年前出现血尿 ,无疼痛 ,当地就诊发现左腹部肿物 ,未给特殊治疗。不久血尿消失 ,腹部肿物逐渐增大 ,无腹痛。外科检查 :全腹膨隆 ,腹肌软 ,肝未扪及巨大肿块 ,约 2 5cm× 2 0cm× 18cm ,质硬 ,无触痛。B超发现腹腔内巨大占位 ,囊实性 ,临床考虑到患儿生存时间较长 ,瘤体巨大 ,多为畸胎瘤。CT平扫见左侧腹腔内巨大肿块 ,大小约为 2 0cm× 19cm× 13cm ,边界尚清 ,左侧肾盂 ,肾盏受压变形 ,与肾脏分界不图 1　左侧腹腔内巨大囊实性肿块 ,大小约 2 0cm× 19cm× 13cm ,边界尚清 ,包膜完整 ,其内密度不均　图 2…     

左侧外阴外毛根鞘癌一例

病例资料 患者,女, 61岁,8年前发现左侧大阴唇肿物,直径约2 cm ,逐年缓慢增大,半个月前于外院行外阴肿物切除术,为求进一步治疗,门诊以"外阴肿物"入院,盆腔增强 MR (3T ):左侧大阴唇区见斑片状等T1 稍长T2 信号,大小约2 .5cm×1 .1cm ,增强扫描明显较均匀强化(图1～3).     

脑胶质肉瘤1例

患者女性,60岁。无诱因突发言语不利,CT检查发现颅内肿物,为进一步治疗而转入我院。查体：意识清楚,病理反射未引出。MRI检查：左侧颞叶及左侧基底节区可见大小约3.4cm×3.3cm×3.2cm长T1长T2信号肿物,内可见     

左腰骶部恶性血管外皮细胞瘤一例

患者男,25岁。发现左侧腰骶部无痛性肿物3个月,左下肢麻木1月余入院。体检:腰椎右侧轻度弯曲,左侧腰骶部明显隆起,可见一大小约7cm×6cm×5cm的三角形肿物,质硬、固定、无压痛,皮肤无明显红肿。左下肢感觉麻木。X线片示:L4、5椎体左侧软组织块影,左侧腰大肌肿胀,L5左侧横突下缘、左骶骨、髂骨上缘见斑片状骨密度减低。CT示:左侧腰骶部背侧肌群内见一不规则形软组织肿块,大小约9.5cm×8.0cm×14.5cm,其内密度稍不均匀,大部分CT值约36HU,内部见少许斑点、索条样稍高密度,CT值约0HU,肿块边界尚清楚,左侧骶骨及L4、5左侧横突至腰骶椎椎管…     

下颌骨软骨肉瘤一例

患者　女,32岁。左腮腺区肿物2个月,加速生长1周。2个月前无意中发现,无疼痛及不适感,随后该肿物渐进性增大。近1周生长迅速,且出现疼痛和不适感,张口受限。体检:左右颌面部不对称,左侧膨隆。左耳前可扪及一大小约4 .0cm×2 .0cm椭圆形肿物,前界为咬肌前缘,下界为下颌骨下缘,上界为颧弓下缘,后界为耳屏前。质地较硬,表面光滑,境界清楚,活动度差。张口度两横指,腮腺导管口无红肿,轻挤压腺体见清亮分泌物流出。B超:左侧耳前探及4 .1cm×2 .0cm实性肿物,有包膜,内部回声不均,可见多个钙化点,彩色多普勒示较丰富血流信号CT所见:下颌骨左侧升支…     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.