子宫输卵管造影漏诊完全型纵隔子宫并颈管纵隔一例

病例资料患者,女,27岁,因男方无精症来我中心要求供精人工授精治疗。患者月经规律,12岁初潮,月经周期为28~30d,经期5~6d,经量中等,无痛经,性生活正常。否认结核病史。查体:一般状况好,心肺未见异常,第二性征发育正常。妇科检查:外阴发育正常,阴道通畅,宫颈光滑,宫口呈圆形,子宫左后位,正常大小,表面光滑,未扪及突起,质地中等,活动尚可;双附件区未扪及包块,无压痛。2年前外院子宫输卵管造影(hystero-salpingography,HSG)显示右侧输卵管阻塞不通(图1a);经中西医结合抗感染治疗2年后复查,HSG显示左侧输卵管未显影(图1b),提示:单角子宫。月经…     

CT诊断2例男性假两性畸形

1　病例简介本组 2例 ,社会性别均为女性 ,系亲姐妹 ,年龄分别为 18岁和 11岁。父母非近亲结婚 ,母孕期无服药史 ,无家族遗传病史。智力正常 ,蹲位排尿 ,无喉结 ,无胡须 ,双侧乳房未发育。两者外生殖器形态相似 ,均似女性。阴蒂肥大 ,阴囊呈大阴唇样 ,无小阴唇 ,尿道开口在阴蒂下部 ,无阴道 ,双侧腹股沟内可扪及蚕豆大小肿物 ,活动。染色体核型均为 46,ＸＹ。盆腔ＣＴ示 :膀胱充盈 ,盆腔内未见子宫及卵巢影像 ,亦未见精囊及前列腺。双侧腹股沟区 ,股动、静脉内侧 ,可见类三角形软组织结节影 ,边缘清晰 (图 1)。ＣＴ增强扫描示结节呈中度强化…     

盆腔横过异位孤立肾1例报告

盆腔异位孤立肾并越过中线者罕见 ,我院发现 1例 ,现报告如下。女性 ,43岁。因反复中下腹痛、腹胀 1年余 ,近半月有所加重 ,于 1998-0 8-2 7来院就诊。患者从未来过月经 ,无生育。无明显泌尿系统症状及体征。既往史和家族史无特殊。查体 :形体矮小 ,头颈及四肢正常。乳房发育中等 ,乳头较小。心肺正常。腹软 ,肝脾未触及。外阴发育正常。化验 :肝、肾功能正常。尿常规脓细胞 ,红细胞 。ＣＴ检查 :作腹部平扫及增强扫描 ,自膈顶起至耻骨联合平面。层厚 10ｍｍ、间距 10ｍｍ。双肾区被肠管占据 ,中上腹区未发现肾脏影。盆腔内于膀胱右后…     

卵巢成熟性囊性崎胎瘤恶变1例

患者,女,43岁,因“发现盆腔包块伴下腹坠胀半年”于1999—9—13入院。既往无特殊。末次月经:1999—8—26。入院时查:体温:38℃,脉搏:92次/分,呼吸:18次/分,血压:15.0/11.0kPa,贫血貌。心、肺无异常。腹软,肝脾未扪及,移动性浊音(一)。妇科检查;子宫们诊欠满意,整个盆腔被包块占据,     

卵巢性索间质瘤一例

患者　女,26岁。未婚,一直无月经来潮,7年前开始出现周期性腰部酸痛,伴轻微下腹痛,每次持续数天缓解。2 d前上述症状加重,伴双下肢疼痛、恶心及呕吐,行抗炎解痉治疗症状无明显好转。体检:女性貌,双侧乳房未发育,外阴发育不良,呈幼稚形,无腋毛、阴毛。肛查:盆腔右侧附件区可     

输卵管纤维性间皮瘤1例报告

患者　女 ,64岁。主诉无明显诱因出现下腹部疼痛、触及包块而入院。妇科检查 :外阴未产式、萎缩 ,宫颈光滑 ,宫体及附件摸不清 ,下腹部可扪及一约 5个月小儿头大肿块 ,质地中等 ,活动度好。Ｂ超 :拟诊子宫肿瘤。ＣＴ :ＣＴ征象为盆腔不均匀密度巨大肿瘤 ,肿瘤内不均匀强化 ,并见囊性变 (附图 )。手术所见 :盆腔内见约 11ｃｍ× 18ｃｍ大小肿块 ,呈暗灰色。表面高低不平 ,活动度好 ,无粘连 ,其蒂部为右侧输卵管 ,长约 10ｃｍ ,逆时针扭转 72 0°。子宫略小 ,未扪及肿块。作肿瘤全切除。病理诊断 :右侧输卵管伞端纤维性间皮瘤。讨论 :输卵管肿…     

腹膜后巨大纤维脂肪瘤1例报告

纤维脂肪瘤并不少见 ,但源于腹膜后 ,肿瘤巨大 ,几乎充满整个腹腔的并不多见。我院遇 1例报道如下。　　患者　女 ,48岁。因腹胀、腹痛 1年多来我院就诊。既往无特殊疾病史 ,近半年来有呃气 ,进食量逐渐减少 ,进行性消瘦 ,大小便正常。查体 :生命体征正常 ,消瘦 ,全身未扪及肿大淋巴结 ,心肺 (— )。腹部膨隆 ,未见肠形及蠕动波 ,腹壁静脉无曲张。腹部扪及一巨大质地较硬肿块 ,上界于剑突下 ,下界达盆腔 ,内外界不清 ,表面光滑 ,欠活动 ,无压痛。肝脾未扪及 ,移动性浊音 (— ) ,肠鸣音存在。实验室检查 :血细胞分析正常。AFP及CEA正常。B…     

卵巢卵泡膜细胞瘤合并畸胎瘤一例

患者女，４８岁。因下腹部肿块１年入院。１年前自己摸到下腹肿块，渐增大，无明显不适，月经规则。体检：宫颈Ⅰ°糜烂，子宫及附件扪不清。于盆腔正中触及一约８ｃｍ×８ｃｍ肿块，质硬，压痛明显。Ｂ超示：盆腔内实质性肿块，子宫稍增大，宫内光点增粗。腹平片示左输尿...     

女童先天性骶尾部藏毛窦1例

正患者女, 12岁。发现骶尾部肿物12年入院,肿物约鸽蛋大小,稍红肿,无疼痛,无发热,近12年来肿物缓慢增大。既往骶尾部无外伤、手术史,无家族史。专科检查:骶尾部可见并扪及一肿物,大小约2.0cm×1.0cm,表面稍红肿,边界尚清,质地偏硬,活动度差,无压痛,肛检:直肠内未扪及明显肿物。MRI检查:骶尾椎发育正常,骶尾部软组织未见异常信号影,未见肿物,皮肤完整。     

磁共振诊断男性假两性畸形1例

患者,社会性别女,17岁.因无月经来潮在当地医院未能明确诊断而来本院就诊.查体:一般情况好,心肺无异常,无月经史.妇科检查外生殖器呈女性,阴蒂较大,双侧腹股沟内可扪及活动度良好的包块.第二性征为女性,染色体核型(46,XY).MRI扫描横断位见左右腹股沟内侧各见一实性结节影,两者大小相似,约1.9 cm×1.9 cm×2.5 cm大小(图1).盆腔内未见子宫及附件影(图2).增强扫描后冠状位见双侧腹股沟实性结节有强化,可见阴道口(图3).MRI诊断:双侧隐睾,腹股型,结合临床考虑男性假两性畸形,阴茎发育不全.     

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.