歼击机飞行员颈椎X线检查分析

目的探讨我国歼击机飞行员经受的过载作用对其颈椎组织可能产生的影响及其有效防护措施。方法对１１６名现役歼击机飞行员和同期６２名地勤人员作颈椎结构关系异常出现率和颈椎退变情况的对比分析。结果飞行员颈椎结构关系异常出现率为４７．４１％，地勤人员为２２．５８％，前者明显增高；飞行员中颈椎曲度异常、骨质增生、椎管和椎间隙狭窄者均较地勤人员显著增多；本组飞行员的年龄和飞行总时间对颈椎的退变和颈痛的发生也有明显影响，即高年资、飞行总时间长的飞行员，其颈部病患程度也较重。结论持续过载作用可致颈椎退变提前发生；颈椎退变程度与飞行员年龄和飞行总时间相关     

颈椎生理曲度改变的X线表现及其临床意义

目的 分析颈椎生理曲度改变的X线表现及其临床意义.方法 125例临床怀疑颈椎生理曲度异常的病例均摄颈椎正侧位、双斜位片,摄片时患者头颈部体位为立位听鼻线平行于水平面.在颈椎侧位片上测量椎体前缘序列弧线的弧弦距.结果 在125例中,颈椎生理曲度轻度变直见于76例（60.8%）,颈椎生理曲度明显变直或消失32例（25.6%）,颈椎生理曲度呈节段性向后凸出13例（10.4%）,以及颈椎椎体间发生局限性偏移或错位4例（3.2%）.结论 颈椎生理曲度改变的X线表现,在排除外伤等其他因素后,可提示颈椎病的诊断.     

歼击机飞行员颈椎X线表现调查

目的　探讨高 G加速度对飞行员颈椎可能产生的影响及其临床意义。　方法　对一组正常歼击机飞行员的颈椎 X线摄片分析 ,同样对一组正常地面人员的摄片 ,就常见的异常 X线征像结合临床情况进行讨论分析比较。　结果　飞行员组颈椎“切凹征”的出现率较对照组明显增高 ;颈曲变直、反向或侧弯程度都比对照组要显著 ;颈椎椎间隙狭窄情况两组无明显差异。对照组颈椎既往症状发生率显著增高于飞行员组。　结论　加速度负荷可能是加速颈椎退变主要因素之一 ,但 X线所示的颈椎退行性改变并不一定意味着临床症状的出现 ;飞行员常规保持体育运动对颈椎临床症状的预防具有重要的临床意义。     

MRI评价青少年脊柱侧凸患者T_1斜率与颈椎曲度及椎间盘退变的关系

目的 MRI评价青少年脊柱侧凸患者T_1斜率与颈椎曲度及椎间盘退变的关系。方法回顾性分析青少年特发性脊柱侧凸患者MRI图像385例,依据患者的颈椎曲度形态分为曲度正常、变直和反曲3组,测量患者的T_1斜率和颈椎间盘退变分级。结果 385例青少年脊柱侧凸患者,颈椎曲度正常90例(23.4%),T_1斜率均值为28.1°±3.8°;颈椎曲度变直205例(53.2%),T_1斜率均值为16.6°±5.5°;颈椎曲度反曲90例(23.4%),T_1斜率均值为9.8°±4.1°,颈椎曲度正常与异常者间T_1斜率差异有统计学意义(F=331.8,P0.01);颈椎曲度异常及T_1斜率与各个独立椎间盘退变有显著相关性。结论青少年特发性脊柱侧凸患者的T_1斜率和颈椎曲度及颈椎间盘退变有明显相关性,颈椎曲度异常患者T_1斜率较低,颈椎间盘退变率高,低T_1斜率是脊柱侧凸患者颈椎退变的潜在风险因素。     

不同机种飞行人员颈椎曲度改变的特征探讨

目的　探讨歼、强击机和运输、轰炸机飞行人员颈椎生理曲度改变特征。方法　在颈椎侧位片上 ,测量各椎体曲度值 ,并与参考常值作比较。结果　在 2 0～ 2 9岁范围内 ,歼、强击机飞行人员颈椎曲度异常发生率为 5 9.2 %,运输、轰炸机飞行人员颈椎曲度异常发生率为 14 .3%;在 30～ 39岁范围内 ,歼、强击机飞行人员颈椎异常发生率为 83.3%。运输、轰炸机飞行人员颈椎异常发生率为 75 %。结论　歼、强击机飞行员颈椎曲度异常率高于运输、轰炸机 ;各机种年龄大的飞行员颈椎曲度异常率高于年轻飞行员。     

颈椎生理曲度测量改进法及参考常值

目的 改变目前临床放射科测量颈椎曲度的不精准、不合理方法,制订出逐个椎体的测量法并求出飞行员颈椎曲度的正常参考值。方法 坐位摄片,头稍后仰,X线管中心对准第4颈椎,投照距离1.8 m。在X线片上,从枢椎齿状突后上缘至第7颈椎后下缘作直线;沿各椎体后缘作弧线;测各椎体后缘中点至直线的距离,以毫米计量。结果 按此法对100例健康男性飞行人员、30例健康男性地面人员和30例患颈椎病的男性飞行人员进行测量,结果表明:健康飞行员组C_2为4.29±1.16 mm,C_3为8.68±2.42 mm,C_4为11.35±2.86 mm,C_5为12.07±3.02 mm,C_6为9.37±2.68 mm,C_7为4.58±1.65 mm。与健康地面人员组各相应椎体曲度无显著性差异(P>0.05),健康飞行员组和健康地面人员组与颈椎病组飞行员各相应椎体曲度存在显著性差异(P<0.01)。结论飞行人员颈椎生理曲度参考常值作为X线颈椎片测量的一个定量指标,对于飞行人员颈椎曲度的健康鉴定具有一定的意义。     

高G载荷与飞行员颈椎病的关系研究

目的：研究高G载荷与飞行员颈椎病的关系。方法：以颈椎病住院飞行员54例为研究对象，根据影像学检查结果，分析不同机种（G载荷不同）颈椎病例数及颈椎生理曲度情况。结果：强击机飞行员16例（29，6％），歼击机14例（25．9％），轰炸机12例（22．2％），运输机7例（13.0％），直升机5例（9，3％）。强击机和歼击机组颈椎生理曲度正常率明显低于直升机组（P〈0.01）；强击机组和歼击机组颈椎曲度反向发生率明显高于直升机组（P〈0.01）；强击机组与歼击机组颈椎生理曲度异常发生率无显著差异（P〉0．05）。结论：G载荷越高，对飞行员颈椎的影响越大，应采取相应预防措施。     

各机种飞行员颈椎X线对比分析（摘要）

目的探讨飞行环境对各机种飞行员颈椎及周围软组织产生的影响。方法对83名歼击机、强击机和80名运输机、轰炸机飞行员颈椎X线表现进行对比分析。结果歼击机、强击机飞行员与运输机、轰炸机飞行员颈椎分类X线表现中,椎体不稳有非常显著差异,项韧带钙化有明显差异,生理曲度异常35岁（含35岁）以下有明显差异。结论持续性过载作用对颈椎及周围软组织产生急性损伤。     

高性能战斗机飞行员脊柱损伤与退变及其临床意义

目的 概述关于高性能战斗机飞行员脊柱损伤与退变研究概况。资料来源与选择国内外近二三十年来相关文献报道。资料引用 相关文献19篇。资料综合 对脊柱生物力学及临床实验研究、脊柱X线平片研究、脊柱局部CT扫描的研究、临床症状学分析等诸方面问题都做了详细论述。结论 高性能战斗机飞行员工作环境具有加速脊柱(尤其是颈椎)退变的作用。但是，高性能战斗机飞行员脊柱提前退变的实际临床意义仍然不是十分清楚。     

某部新兵体检颈椎X线检查异常情况调查

目的：调查了解某部新兵体检中颈椎X线检查异常情况。方法：选择某部新兵40例,采用数字化X线摄影系统（DR）,对所有受检者摄立位颈椎正、侧位X线片。通过DR后处理系统进行颈椎测量判读,并结合临床症状进行分析。结果：本组40例中,颈椎X线检查异常27例,占67．5％,表现为曲度异常、序列异常及椎体后上缘骨质表面密度异常。曲度异常中,颈椎曲度变直5例,占总调查例数的12．5％;颈椎轻度反张18例,占45．0％;颈椎中重度反张4例,占10．0％．其中,第7颈椎棘突陈旧性骨折伴曲度反张1例,占总调查例数的2．5％。27例中均未发现椎间隙异常和颈椎融合情况。结论：某部新兵颈椎X线检查异常较常见,应加强颈椎健康教育,提高颈椎病一级预防水平。     

Ambiguous genitalia: Diagnosis,evaluation, and treatment

The pediatric radiologist plays a significant role in the evaluation and the treatment of infants with ambiguous genitalia. On the first day of life, an investigation should be initiated that includes studies, in particular a sonogram, to demonstrate the presence or absence of a uterus, and a genitogram to define the presence of a vagina. Once gender assignment has been made, information regarding the size of the vagina and its position in regard to the urogenital sinus becomes essential to the pediatric urologist when planning a course for reconstruction. Herein we break down intersex states into four major categories: female pseudohermaphroditism, male pseudohermaphroditism without müllerian structures, and male hermaphroditism with müllerian structures and true hermaphroditism. The role of the radiologist in each of these states is discussed.     

Boxing injuries: neurologic, radiologic, and neuropsychologic evaluation

Boxing is an endeavor that may have to be re-evaluated in the coming years as to whether it should be designated as a sport. It is the only "sport" in which victory is determined by the amount of physical damage done to the opponent. We have presented the largest number of professional and amateur boxers (58) evaluated by various modern diagnostic modalities and have unequivocally demonstrated the deleterious effects of boxing upon the brain. There have been few, if any, meaningful actions taken by the promoters of boxing to correct the conditions under which boxers are subjected to physical abuse. Recommendations regarding the creation of a National Board of Boxing to supervise this "sport" have not been heeded. Suggested safeguards for the boxer, including mandatory medical and boxing history records (passports), use of headgear and approved safe boxing gloves, avoiding blows to the head, improved boxing ring floors, mandatory neurologic examinations, and more competent physicians at ringsides making medical decisions, have essentially not been implemented. The suggestions that mandatory computed tomograms at various stages in a boxer's career be used to determine possible changes of atrophy have not been followed, even when the CT scans have been made available at no cost to the boxers. The effective use of neuropsychologic evaluation, even when offered at no cost, has also been denied. The established medical injuries due to boxing and the lack of any sustained and significant efforts on the part of organized boxing create an atmosphere that is conducive to following the call for the consideration of a ban of boxing.     

Simple elbow dislocations: evaluation, management, and outcomes

Elbow dislocations are common athletic injuries and occur during a fall onto an outstretched hand as a combination of axial-compressive and rotational-shear forces are conducted across the elbow joint. Simple dislocations are those that involve purely ligamentous injury, while complex dislocations include periarticular fractures. The initial assessment, radiographic evaluation, and on-field treatment of these injuries is discussed. Multiple reduction techniques are described with the patient positioned both supine and prone. Definitive management involves primarily nonoperative treatment with limited immobilization and early active range of motion to minimize joint contracture and hasten return to pre-injury activities. For unstable elbows, surgical treatment is usually appropriate. Operative management may involve exploration, lateral ligament repair or reconstruction, and assessment of the need for medial ligament repair or reconstruction. The role of arthroscopic and arthroscopically assisted surgery for elbow dislocation is evolving. Clinical series have shown that extended periods of immobilization (> 3 weeks) are associated with poor outcomes. Early active range of motion should be initiated as early as possible because late or recurrent instability is uncommon. Contracture is the most common adverse sequela of elbow dislocation. The literature indicates an average of 3° to 8° of extension loss with standard management of simple elbow dislocations.     

Postmortem evaluation of cholesterol,triglyceride, and apolipoprotein levels

International Journal of Legal Medicine - Cholesterol and triglyceride levels have been analyzed in the forensic setting and their values correlated with atherosclerotic lesions found at autopsy...     

Ambiguous genitalia: diagnosis, evaluation, and treatment.

The pediatric radiologist plays a significant role in the evaluation and the treatment of infants with ambiguous genitalia. On the first day of life, an investigation should be initiated that includes studies, in particular a sonogram, to demonstrate the presence or absence of a uterus, and a genitogram to define the presence of a vagina. Once gender assignment has been made, information regarding the size of the vagina and its position in regard to the urogenital sinus becomes essential to the pediatric urologist when planning a course for reconstruction. Herein we break down intersex states into four major categories: female pseudohermaphroditism, male pseudohermaphroditism without müllerian structures, and male hermaphroditism with müllerian structures and true hermaphroditism. The role of the radiologist in each of these states is discussed.     

Acquired gastrointestinal fistulas: classification,etiologies, and imaging evaluation

Fistulas are abnormal communications between two epithelial-lined surfaces. Gastrointestinal fistulas encompass all such connections that involve the alimentary tract, and they can be congenital or acquired in nature. This review focuses on acquired gastrointestinal fistulas. Development of an acquired gastrointestinal fistula can greatly affect patient outcome, yet the clinical manifestations are often protean in nature and the etiology, elusive. Imaging plays an important role in the detection and management of acquired gastrointestinal fistulas. The more routine use of cross-sectional imaging (especially computed tomography and magnetic resonance imaging) has altered the standard sequence of radiologic evaluation for possible fistulas, but fluoroscopic studies remain a valuable complement, especially for confirming and defining the anomalous communications. In this review, a classification scheme for gastrointestinal fistulas is provided, major causes are discussed, and individual fistula types are elaborated with an emphasis on contemporary imaging approaches.     

The pathogenesis, radiologic evaluation, and therapy of pleural effusions

Radiology has played a pivotal role in the management of patients with pleural effusions. By confirming the presence of an effusion and providing information regarding the size and distribution of fluid, chest radiography greatly facilitates initial diagnostic thoracentesis. Identification of even small effusions is important because these commonly occur and may have clinical significance. The development of improved antibiotics and a wider range of interventional techniques has increased the reliance on the radiologic imaging of pleural disease in order to plan appropriate therapy. The newer imaging modalities of CT and sonography have proved to be particularly valuable in detecting small effusions and demonstrating single or multiple loculations. Additional features, such as the degree to which a pleural process has become organized and whether there is adjacent lung parenchymal disease, are well assessed on CT. Experience with MR has been limited, but preliminary data suggest that it may be a valuable addition and/or alternative to CT.