小儿嗜酸性膀胱炎临床分析

目的 探讨嗜酸性膀胱炎的临床表现和诊治方法。方法 对上海第二医科大学附属新华医院于1998～2003年收治的嗜酸性膀胱炎患儿6例进行临床分析并结合文献复习。6例患儿平均8．3岁,表现为尿频、尿急,排尿困难,遗尿及间歇性血尿,腹痛。影像学检查示膀胱壁增厚和占位性病变。均在膀胱镜下或开放手术,组织活检后诊断为嗜酸性膀胱炎。患儿分别接受自体膀胱扩大术,膀胱肿块切除术和单纯口服泼尼松、抗生素治疗。结果 5例患儿随访5—28个月,排尿异常症状消失,影像学检查无膀胱占位性病变。结论 嗜酸性膀胱炎诊断主要依靠膀胱镜下病变组织活检。从病例分析及文献回顾来看,治疗应以药物保守为主。手术只在病变难以控制时考虑。     

甲状腺功能亢进症心动过缓9例分析

目的 了解甲状腺功能亢进症也存在心动过缓的临床表现。方法 9例甲亢患进行甲状腺功能测定,心电图描记,动态心电图监测,窦房结功能检测,应用抗甲状腺药物治疗。结果 经抗甲状腺药物治疗后,心律正常。结论 甲亢可影响窦房结功能使其心动过缓。     

Pneumonia presenting as acute abdomen in children: a report of three cases

From 10th September 1998 till 5th June 1999, the Paediatric and Cardiothoracic Surgery Units of Sultanah Aminah Hospital Johor Bahru managed three children with lung collapse secondary to pneumonia. The dominant initial clinical presentation in all three cases was acute abdominal pain. Basal pneumonia was diagnosed in two cases post-operatively after surgical contributory causes were excluded intra-operatively. Thoracotomy, evacuation of infected debris and decortication of the collapsed lung was done in all three cases. In children presenting with acute abdominal pain, basal pneumonia should be considered as a possible contributory cause.     

牙源性鼻旁瘘管(附6例报告)

目的探讨上颌尖牙根尖炎并发鼻旁瘘管的诊断和治疗方法。方法对6例上颌尖牙根尖炎并发鼻旁瘘管进行回顾分析。6例患者行鼻部CT或X线拍片检查未见明显异常,4例误诊为上颌骨骨髓炎、皮脂腺囊肿感染和基底细胞癌等;2例行牙X线摄片检查确诊为牙源性鼻旁瘘管;手术治疗采用局部切除缝合、拔除病源牙、搔刮根尖创面,清除病灶。结果6例患者面部切口全部I期愈合,经过2~10年追踪观察,瘘管未再复发。结论鼻旁瘘管应首先考虑牙源性疾病所致,进行口腔科检查有助于减少误诊。     

Acute disseminated encephalomyelitis: a report of six cases

Six children with Acute Disseminated Encephalomyelitis (ADEM) were seen at the Penang Hospital over a two year period (July 1999-June 2001). Diagnosis was based upon typical clinical features and characteristic findings on neuroimaging. Cerebrospinal fluid examination and other investigations were done, where appropriate, to rule out other causes of central nervous system disease. Three children had a prodromal illness. The most common presenting symptoms were fever, seizures, ataxia, focal neurological deficits and labile mood. Two children presented with status epilepticus. All children had an abnormal neurological examination. Brain magnetic resonance imaging revealed hyperintense signals on T2-weighted and FLAIR sequences in the subcortical and deep white matter regions of the frontal, parietal, and temporal lobes, as well as in the thalami, cerebellum and brainstem. One child had multiphasic disseminated encephalomyelitis (three episodes). The child with multiphasic disease had only one treated episode, and has suffered mild disability. Three children were treated with either methylprednisolone or immunoglobulins, and remain well. One child received both treatments but expired as a result of severe gastrointestinal bleeding from the use of methylprednisolone. The child who was not treated has severe disability.     

小儿心脏肿瘤的诊断与外科治疗——附6例报告

目的 探讨小儿心脏肿瘤的诊断及外科治疗。方法 回顾分析我院1993－1999年收治的6例经手术病理确诊心脏肿瘤患儿的临床资料。结果 2例术后放弃治疗，其余病例随访2年恢复良好。结论 小儿心脏肿瘤的诊断主要依靠超声心动图，近年来又发现食道超声及MRI检查对心脏肿瘤的诊断有很大帮助。一般良性肿瘤的手术效果较为满意，预后好。恶性肿瘤因病变快、病情重，治疗效果不佳，即使手术能完全切除仍需辅以放疗或化疗，预后差。     

颈椎嗜酸性肉芽肿（附5例报告）

目的：探讨颈椎嗜酸性肉芽肿的诊断和治疗，方法；分析５例经病理证实颈椎嗜酸性肉芽肿的临床经过，３例有脊髓和神经根受压症状，其中２例行颈前路病灶清除植骨融合术１例行颈后路附件病灶清除和桥式植骨术，２例只有颈痛和颈部活动受限，行石膏围领固定。结果：３例经手术治疗者随访１０个月至２年，效果满意，２例非手术治疗者中１例失随访，另１例病变停止发展而自愈。结论：本病有自愈倾向，也有转变为恶性网织细胞增生症的可能     

Cat-scratch disease presenting as the oculoglandular syndrome of Parinaud: a report of two cases

We report the case histories of a 50 year old man and 14 year old daughter who presented with the oculoglandular syndrome of Parinaud caused by cat-scratch disease.     

A report of six cases

Six cases of gonococcal arthritis are described. Three presented during the initial “bacteremic stage” with polyarthralgia, fever, skin lesions and sterile synovial fluid. Two presented during the “septic joint stage” with positive synovial culture, and one presented during the “stage of residual deformity”. Transient electrocardiographic changes were noted in two of the six cases. All responded to antibiotic therapy. One required additional surgical intervention.

The condition is common, coinciding with the rising incidence of symptomatic and asymptomatic gonorrhea. Gonococcal infection must be considered in the differential diagnosis of migratory polyarthralgia, tenosynovitis, oligoarthritis, fever or unusual skin lesions. Criteria for diagnosis, lines of treatment and relevant literature are reviewed.

     

Splenic cysts: a report of six cases and a brief review

Six cases of splenic cysts, removed surgically in the Royal Free Hospital during the last 10 years, are presented. These include a hydatid cyst, two primary, epithelium lined, and three secondary, non-epithelium lined cysts. The histology, aetiology, symptomatology, diagnosis, treatment and complications of splenic cysts are discussed.     

Campylobacter enteritis presenting as an acute abdomen.

A case is reported of a young patient with Campylobacter enteritis who underwent first appendicectomy and then a laparotomy because of the severity of the pain and the marked abdominal signs.