Radiographic gradation of lumbosacral dysgenesis.

The caudal dysgenesis syndrome comprises partial or complete agenesis of the lumbosacral vertebrae, as well as associated musculoskeletal, neurologic and visceral abnormalities. Maternal diabetes mellitus appears to be the most important etiologic factor, but for most patients the etiology is unknown. In the majority of cases, radiologic diagnosis is established readily, but minor degrees often coinciding with a serious urologic disease or a lower limb abnormality may be overlooked.     

A screwdriver in the skull

The examination of the body of a murdered adult female found in her apartment revealed the presence of a 6-inch screwdriver in the skull cavity that had been inserted through the medial border of the left eye. The presence of a small bruise around the medial aspect of the eye together with the absence of fresh hemorrhage along the tract of the screwdriver was consistent with a postmortem origin. Death, however, was caused by a large incised wound of the neck and multiple skull fractures consistent with hammer blows.     

国内外45,X/46,XY混合型性腺发育不全患者临床特征的比较分析

目的 总结和比较中国、南美洲及欧洲人群45,X/46,XY混合型性腺发育不全(45,X/46,XY MGD)患者的临床特点.方法 分析解放军总医院收治的7例45,X/46,XY MGD患者的临床特征,与北京协和医院总结的中国病例、巴西的南美洲及挪威和丹麦的欧洲人群病例的临床特征进行对比分析.结果 国内外45,X/46,XY MGD患者普遍身材矮小、面部多痣、存在较低的发际线等与特纳综合征相似的临床表现,易合并心脏、肾脏等内脏畸形,患者多表现为外生殖器表型不明确,性腺表现形式多样;实验室检查多表现为促性腺激素水平升高,性激素水平降低.45,X/46,XYMGD的治疗主要为手术切除有肿瘤发生风险的性腺组织,用生长激素促进患者的身高增长以及使用性激素替代治疗.但国内外患者在就诊原因和诊断年龄上有较大差异,国人多以生长发育迟缓就诊,国外患者就诊原因多样,除生长发育迟缓外,还包括外生殖器畸形、不孕、胎儿染色体异常等.国外患者多在产前或是出生时就诊断45,X/46,XY MGD,而中国患者平均诊断年龄较国外患者大4.7岁.结论 国内外45,X/46,XY MGD患者临床表现差别不大,但中国患者就诊年龄较大,主要以生长发育迟缓就诊.     

高原地区颅骨与核团大小的影像学相关性研究

目的　研究高原藏汉族人群颅骨与脑内核团大小的相关性 ,从而为理想的手术效果提供客观依据。　方法　在西藏高原应用头部 CT对 10 4 8例颅骨和 5 2 7例脑内核团结构进行测量 ,并通过 SPSS10 .0统计软件进行分析。　结果　颅骨长度与丘脑长 (r=0 .174 ,P<0 .0 1)、豆状核长 (r=0 .2 0 0 ,P<0 .0 1)和尾状核头长 (r=0 .133,P<0 .0 1)呈显著正相关。颅骨宽度与丘脑宽 (r=0 .15 1,P<0 .0 1)、豆状核宽 (r=0 .2 0 7,P<0 .0 1)和尾状核头宽 (r=0 .10 1,P<0 .0 5 )呈显著性正相关。随着颅骨长宽值的增大 ,丘脑、豆状核和尾状核头长宽值也随之增大。颅骨长径每增加 10 mm,丘脑、豆状核和尾状核头长分别增加2 .2 18± 0 .170 m m、2 .2 2 2± 0 .172 m m和 1.136± 0 .111m m;颅骨宽径每增加 10 mm,丘脑、豆状核和尾状核头宽相应的增加1.2 2 2± 0 .12 9m m,1.2 0 3± 0 .171m m和 0 .6 94± 0 .112 m m。　结论　我们进行的颅骨与核团大小的对比研究 ,可以为术前靶点精确定位提供有益的帮助 ,使手术达到更加理想的效果     

The skull in renal osteodystrophy

The skull radiographs of 68 patients undergoing dialysis for chronic renal failure were reviewed for evidence of renal osteodystrophy. Four patients (6%) were positive and the unusually severe changes seen in one patient are described in detail. The changes seen in the skull in renal failure, both before and after treatment, are discussed.