下鼻道后部巨大结石1例

1　临床资料　患者 ,女 ,5 2岁。因间断性鼻塞 2 0ａ加重 3ｄ ,于 1997年 10月 13日就诊。患者于 30ａ前曾做过上颌窦根治术 ,感冒后鼻塞加重 ,常规处理后缓解 ,但未做过特殊检查。外鼻无畸形 ,鼻中膈无明显偏曲 ,双下鼻甲充血 ,轻度肿胀 ,右下鼻道偏后隐见一圆形隆起 ,鼻道内无脓痂及分泌物。鼻窦Ｘ线片示 :(1)双上颌窦陈旧性炎症 ;(2 )鼻腔后部稍偏右有一约 1 6ｃｍ× 1 8ｃｍ透亮区。ＣＴ示右下鼻道后部结石。诊断为右下鼻道后部结石。于当日下午在局麻下行右下鼻道取石术。结石为椭圆形 ,大小约 1 8ｃｍ× 1 6ｃｍ× 1 0ｃｍ ,上附鲜红…     

首诊鼻息肉的鼻腔、鼻窦横纹肌肉瘤1例报告

病人 ,男 ,5 0岁 ,工人。右侧鼻阻 1月余 ,门诊以鼻息肉收治入院。发病无明显诱因。入院查体 :一般情况好。右鼻腔内可见灰白色半透明新生物 ,位于鼻腔顶部及后鼻孔处。遂在局麻下行鼻息肉摘除术 ,术中顺利摘除肿物 4ｃｍ× 2ｃｍ× 1ｃｍ。术后病理报告为鼻息肉伴部分炎性坏死。 7ｄ痊愈出院。术后右鼻腔仍通气不畅 ,半年后逐渐加重。经ＣＴ检查发现右鼻腔、右上颌窦、筛窦内均可见软组织影 ,右上颌窦骨壁呈膨胀性变薄 ,内侧壁部分骨质缺如。报告为鼻及鼻窦息肉形成但不排除恶性肿瘤。查体吸净右鼻腔脓血性分泌物后 ,见右鼻腔内充满灰白色…     

下鼻甲骨骨化纤维瘤一例报告

患者　男 ,12岁。因左鼻腔渐进性鼻塞半年入院。患儿无明显诱因出现左侧鼻腔渐进性鼻塞 ,无流涕、出血等症状。曾服用抗菌素 ,鼻腔局部应用减充血剂 ,症状未见好转。入院查体 :少儿男性 ,全身情况好 ,鼻腔检查左侧下鼻甲头端形态正常 ,中段膨大阻塞鼻道 ,表面粘膜光滑 ,减充血剂收敛无改变 ,触及较硬。ＣＴ冠状、轴位扫描示 :左下鼻甲骨膨大成环形骨性壁 ,内有积液 ,约 1.0ｃｍ× 1.5ｃｍ× 1.5ｃｍ大小 ,上颌窦、前组筛窦积液 (图 1,2 ) ,入院后在全麻下行鼻内窥镜下肿物切除术 ,术中发现左下鼻甲中段呈球形膨大 ,中鼻甲挤压变形 ,肿物外层…     

外伤后迟发性张力性脑内巨大气囊一例

患者　男 ,35岁 ,2个月前交通伤后头面部着地 ,当时有双鼻道流血性液体 ,短暂昏迷。ＣＴ检查 :左额颞硬膜外小血肿 ,脑挫裂伤 ,颅底骨折。经保守治疗 ,1周后脑脊液鼻漏停止 ,住院 2 0ｄ痊愈出院。出院 2 0余天后出现额部隐痛伴左侧鼻道流清亮液体 ,晨起时多 ,初为数滴 ,半个月后达每日 15ｍｌ左右。自感流液时有微小声响由鼻根部向上移动 ,摇头时自觉颅内有响动。头痛逐渐加重 ,伴有情绪易激动、记忆力差表现。无发热、咳嗽、打喷嚏。检查左侧嗅觉减退 ,鼻漏液糖定性 ( ) ,ＭＲＩ示左额叶 6 .5ｃｍ× 5ｃｍ× 4.5ｃｍ葫芦样、底部呈漏斗状…     

螺旋CT诊断肾上腺肿瘤(附16例报告)

将我院 1998 -0 5～ 2 0 0 0 -10应用螺旋ＣＴ检查 ,并经手术和病理证实的 16例肾上腺肿瘤总结如下。1　临床资料男 6例 ,女 10例 ,年龄 9～ 5 5岁。左侧 6例 ,右侧 10例。多饮多尿伴全身乏力 2例 ,阵发性高血压 1例 ,左腰痛 2例 ,进行性消瘦伴腹部肿块 1例 ,上腹痛反复发作 1年 2例 ,临床无症状 8例。2　检查方法应用西门子ＡＲ -ｓｔａｒ螺旋扫描机 ,13 0ｋＶ、80ｍＡ ,扫描时间1.5ｓ ,层厚 10ｍｍ ,螺距为 1.5 ,扫描范围剑突下 2ｃｍ至肾图 1　Ａ .右侧巨大神经母细胞瘤 ,增强扫描肿块边界清楚 ,有完整包膜 ,瘤体内密度不均匀 ,可见点条…     

肾肉瘤样癌及肾癌肉瘤各一例

例 1　女 ,6 3岁。右侧腰背部疼痛加重 2个月余 ,呈持续性隐痛。体检 :右肾区可触及肿物 ,活动轻压痛。ＣＴ检查 :右肾正常部分体积明显增大 ,其中下份逐渐呈巨大囊样改变 ,大小约 16ｃｍ×12ｃｍ× 8ｃｍ。其内以液体密度为主 ,强化后肾被膜清晰、完整 ,囊内液体无增强 ,肾下极内侧实质强化明显 ,并与腰大肌界限模糊。右肾门上方示 2 0ｃｍ×2 5ｃｍ× 2 0ｃｍ大小的肿大淋巴结 ,下腔静脉明显变细。ＣＴ诊断 :考虑为右肾囊腺癌 (图 1,2 )。手术 :术中试图沿脂肪裂内游离时囊肿破裂 ,内流出 12 0ｍｌ暗红色液体。囊内包裹大量坏死组织 ,…     

鼻腔骨纤维异常增殖症2例报告

骨纤维异常增殖症 (简称骨纤 )是较为常见的骨病 ,但单发于鼻腔及鼻咽腔等处的骨纤鲜见报道。本文报告 2例分别发生于鼻腔、鼻咽腔的骨纤 ,其中 1例因发病部位少见且病灶表现不典型而致误诊。1　病例报告例 1　患者　男 ,15岁 ,维吾尔族 ,因“左鼻腔渐进性肿大伴鼻塞 3年”入院。专科检查 :左鼻膨隆 ,左中下鼻道充满灰白色肿物 ,表面粗糙 ,触之硬 ,右鼻正常。ＣＴ检查 :左鼻腔内可见5ｃｍ× 4ｃｍ× 4ｃｍ大小椭圆形骨样高密度灶 ,内密度不均 ,ＣＴ值 2 895 36ＨＵ ,病灶边缘光整 ,有较致密骨壳环绕灶周 ,上颌骨轻度受侵蚀 ,病灶延伸至筛窦…     

巨型鼻窦脓囊肿2例

1　临床资料　例 1,女 ,5 7岁。右额部肿块 10ａ ,近 1ａ生长迅速 ,伴头痛 ,右眼球突出 ,视物成双。于 1997年 3月2 0日入院。检查 :一般情况好 ,右额部触及 4ｃｍ× 5ｃｍ包块 ,质地硬 ,表面欠光整 ,压痛不明显 ,软组织无肿胀。右眼球向外下方突出 ,眼球运动略受限、复视 ,视力正常。头颅ＣＴ见右额窦呈膨胀性扩大 ,内外板簿 ,有断裂 ,右侧大脑额叶受压内移 ,腔内充满密度均匀软组织 ,ＣＴ值37Ｈｕ,增强无强化。诊断右额窦粘液囊肿。于 1997年 3月 31日全麻下行右额窦囊肿摘除术 ,术中见窦腔前后径4ｃｍ ,横径 6ｃｍ ,上下径 5ｃｍ ,内充满…     

鼻腔成软骨细胞瘤一例

患者　男 ,2 5岁。左鼻腔阻塞感伴脓涕 2个月 ,左耳听力下降 1周。检查 :左嗅裂有少许脓液 ,左下鼻甲后端有一红色新生物并与下鼻甲融合 ,肿物大小约 1.5ｃｍ× 2 .5ｃｍ ,触之不易出血 ,质韧。右鼻腔无异常。ＣＴ表现 :左鼻腔后部有一软组织肿块影 ,ＣＴ值 5 1ＨＵ ,大小 1.5ｃｍ× 3 .0ｃｍ× 4.0ｃｍ ,其内有不规则斑片状钙化 ,ＣＴ值5 3 6ＨＵ。肿块经鼻后孔突向左侧鼻咽腔并阻塞左咽鼓管咽口(附图 ) ;肿块向上达鼻腔顶部 ,向下至鼻腔底 ;左上颌窦内侧壁附图　左侧鼻腔后部有一软组织肿块影 ,其内伴有不规则钙化 ,肿块向后突入左鼻咽腔…     

巨大鼻结石一例

患者　男,５６岁。主诉右侧鼻腔通气不畅伴额枕部头痛１年余,加重１个月,无恶心呕吐及视物模糊等。２０年前鼻部曾被石屑击伤,行手术取除。ＣＴ检查：见右侧鼻腔有４．２ｃｍ×２．２ｃｍ×３．０ｃｍ不规则高密度影,边界清楚,ＣＴ值２８６９ＨＵ,鼻中隔及左侧上颌窦内侧壁骨质吸收,周围有淡薄略高密度影包绕,向后达鼻后孔,向左达上颌窦,ＣＴ值为５７ＨＵ。ＣＴ诊断：右侧鼻腔异物,考虑鼻石,并周围感染（附图）。在局麻下行鼻腔异物取除术,取出一约４ｃｍ×２ｃｍ×２ｃｍ大小石块。巨大鼻结石一例@王西惠!721008$宝鸡市中心…     

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.