B超下经皮穿刺注射无水乙醇治疗单纯性肝囊肿32例

1991～ 2 0 0 1年 ,我们采用Ｂ超引导下经皮穿刺注射无水乙醇治疗单纯性肝囊肿 32例 ,效果良好。1　临床资料1 1　一般情况　男 9例 ,女 2 3例 ;除 1例为 8岁儿童外 ,其余为 4 5～ 6 6岁。表现为右上腹胀痛不适 7例 ,右季肋区隐痛 5例 ,包块 6例 ,余无任何症状 ,体检时Ｂ超发现肝脏均增大及压痛 14例 ,肝功能均正常。右肝 1个囊性占位病变 11例 ,左肝 3例 ;右肝多发弥散性囊性占位 9例 ,左肝 2例 ;左右肝多发7例。直径 2 8～ 7 6ｃｍ ,最大的囊肿 12ｃｍ× 11ｃｍ× 9ｃｍ。1 2　治疗方法　均在Ｂ超下经皮肝囊肿穿刺 ,抽净囊液后将无水乙醇…     

肾包虫囊肿的CT诊断

目的 :探讨肾包虫囊肿及其破裂感染的CT表现及诊断意义。材料和方法 :本组 7例患者均行CT平扫与增强扫描 ,经手术病理或临床资料证实。结果 :3例单纯型囊肿 ,2例表现为肾实质内水样密度的囊性肿物 ,其边缘光滑 :4例多子囊型囊肿 ,内部含有多个更低密度子囊。 2例破裂 /感染型 ,其内外囊分离 ,1例囊腔内有塌陷折叠并且钙化的内囊膜 ;另 1例囊周水肿并增强。结论 :CT对肾包虫囊肿的定位和定性诊断、分型以及破裂感染的判断颇为准确 ,是目前诊断肾包虫囊肿安全可靠的检查方法     

多间隔多房多子囊肝包虫病３６０例手术治疗体会

1974 1999年 ,我院共收治肝包虫病 2 850例 ,其中多间隔多房多子囊性肝包虫病 360例 ( 12 6% ) ,首次手术后遗漏囊肿 6例。术后随访 12 5年 ,复发174例 ( 4 8 3% )。1　临床资料1 1　一般情况　 360例 ,男 2 78例 ,女 82例 ;年龄568岁 ,4 0岁以下占 86 8%。囊肿位肝右叶 2 84例 ,肝左叶 76例。房多者 4或 5个 ,少者 2个房 1个间隔 ,其中 2或 3个间隔或 3或 4个房者 2 2 8例 ,占63 3%。切除间隔囊腔最大平面面积约 32ｃｍ× 2 4ｃｍ ,子囊多达两器械盆。1 2　手术方法　均常规行包虫囊肿穿刺、内囊摘除术。术中仔细探查、辨认间隔与包虫外囊…     

超声及声触诊组织量化技术在肝囊肿与囊性肝包虫诊断中的初步应用

目的探讨超声及声触诊组织量化技术(VTQ)在肝囊肿与囊性肝包虫诊断中的应用价值。方法选择48例均进行了常规超声检查的患者,被纳入研究范围:肝脏囊性局灶病变直径3cm和深度在4~8cm之间。48例经手术切除或穿刺活检病理证实的肝囊肿及囊型肝包虫,应用超声成像技术检查获得囊肿的声像图特征并采用VTQ检测囊内容物的剪切波速度(Vs)。对每一患者,在触摸组织量化区进行5次测量得到的结果,区分单纯囊肿和肝包虫囊肿。判读方法:5次测量至少有2次获得数值者诊断为肝包虫囊肿;5次测量均为无值者诊断为肝囊肿。结果敏感性、特异性、阳性预测值、阴性预测值和准确性分别为86.7%、83.3%、89.7%、78.9%和85.4%。结论超声及VTQ在肝囊性病变的鉴别诊断中有重要的价值。     

肝囊肿CT导向经皮穿刺注射无水酒精硬化治疗

目的 评价CT导向经皮穿刺注射无水酒精硬化治疗对肝囊肿的疗效。方法 36例肝囊肿患（30例单发，6例多发）均经CT导向经皮穿刺针吸与注射无水酒精硬化治疗。疗效判定标准是依据囊肿经治疗后较术前缩小程度分类4级，即0级：囊肿大小无变化；Ⅰ级：囊腔缩小＜1／3;Ⅱ级：囊腔缩小≥1／3但≤2／3；Ⅲ级：囊腔消失。结果 术后除3例单发小囊肿患失访外，其余33例（36个囊肿）均经随访1个月－2年。随访发现36个囊肿中0级3个，Ⅰ级5个，Ⅱ级10个，Ⅲ级18个。本组总有效率为91.7%(33/36)。结论 肝囊肿CT导向经皮穿刺针吸与注射无水酒精硬化治疗其操作简便、安全，疗效显，是肝囊肿保守性治疗的一种颇具应用前景的介入性技术，值得向基层医院推广。     

CT导引下肝肾囊肿抽吸硬化治疗

目的：总结CT导引下肝肾囊肿穿刺抽吸硬化治疗的疗效和操作经验。材料和方法：肝囊肿11，肾囊肿15例，多囊肾1例，囊肿大小为3．5－12cm，均用15cm长20GGreene针穿刺治疗，抽出囊液量为21－550ml，囊液抽净后注入99．7％的无水酒精。结果：治疗后症状均有明显好转或消失，本组随访肝囊肿7例、肾囊肿11例，疗效指数I级1例（多囊肾），Ⅱ级肝肾囊肿各2例，Ⅲ级肝囊肿5例肾囊肿8例。穿刺操作顺利，无严重并发症发生。结论：CT导引下肝肾囊肿抽吸硬化治疗操作简便、创伤小、疗效高可作为替代外科手术的有效的治疗方法，多囊肾的单纯抽吸治疗可明显减轻症状，改善肾功能，是一种较好的治疗手段。     

脾脏包虫囊肿的CT诊断

目的: 探讨脾脏包虫囊肿的CT表现特征和鉴别诊断.材料和方法: 回顾性分析经手术病理证实9例脾脏包虫囊肿的CT表现.结果: 9例10个囊肿中,单发8例,多发1例,单纯型6例,多子囊包虫囊肿型3例.CT主要表现: 圆形或椭圆形边缘光整,清晰,密度均匀的水样密度,囊性病变;可见到囊壁弧形线状、间断的钙化1例;母囊内有分隔或大小不等的子囊,囊壁很薄,子囊的密度总是低于母囊密度1例;囊肿破裂继发感染,囊内可见纤细条状及碎片影,密度不均匀,CT值升高1例;增强扫描外囊壁呈轻度增强3例.结论: 脾脏包虫囊肿CT表现较具特征性,CT是诊断该病安全可靠的的检查方法之一,对临床选择治疗方案有重要的意义.     

MSCT对肝包虫囊肿及并发症的诊断价值

目的:探讨MSCT在肝包虫囊肿及其并发症诊断中的应用价值。方法:回顾性分析我院经手术确诊的46例肝包虫囊肿的CT表现。结果:46例共61个包虫囊肿。单房性包虫囊肿14例,多房性包虫囊肿32例;有钙化16例,无钙化30例。其中有并发症19例。单房性包虫囊肿并发症中内在性破裂4例;多房性包虫囊肿并发症中13例为交通性破裂,直接破裂2例,合并感染2例。误诊1例,46例术前CT诊断正确率为97.8%。结论:螺旋CT可为肝包虫囊肿及并发症诊断、治疗提供可靠的影像依据,具有较大的临床应用价值。     

CT导引下穿刺注射无水乙醇治疗肾囊肿

目的　评估CT导引经皮穿刺肾囊肿注射无水乙醇治疗的临床经验。方法　 4 4 5例 5 10个肾囊肿于CT导引下经皮穿刺肾囊肿抽液后注射无水乙醇治疗 ,4 4 5例中 385例为单发肾囊肿 ,5 3例多发肾囊肿 ,7例多囊肾。囊肿直径为 1.9～ 13.5cm。用 18～ 2 1G抽吸针穿刺抽吸 ,抽出囊液量为 3～780ml。注入 99.7%乙醇 ,乙醇量以抽出囊液的 2 5 %为合适。结果　本组 396例 (42 7个囊肿 )用CT扫描或超声检查随访 ,随访时间为 3个月到 1年以上 ,单发肾囊肿疗效为 97% ,其中囊腔消失为 82 % ,多发肾囊肿疗效为 95 % ,其中囊腔消失为 79% ,多囊肾疗效为 6 7%。并发症为局部疼痛 (2 8例 ) ,血尿 (4例 ) ,无严重并发症出现。结论　CT导引经皮穿刺肾囊肿乙醇治疗对单发肾囊肿和多发囊肿是一种有价值的治疗方法     

肌肉软组织包虫囊肿的CT诊断

目的 探讨原发性肌肉软组织包虫囊肿的CT表现.资料与方法 分析11例经手术病理证实的肌肉软组织包虫囊肿的CT表现.结果 11例中,发生在颈部3例,胸壁2例,腰大肌3例,背部1例,腹壁1例,臀部1例;其中单发6例,多发5例,共17枚病灶.CT平扫均表现为单囊型包虫囊肿,呈圆形或卵圆形囊性低密度肿物, 密度均匀,接近水的密度, 边缘光滑清楚,周围组织有受压、推移改变.增强扫描囊肿无强化.结论 CT可显示肌肉软组织包虫囊肿的部位、大小、形态和内部特征.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme