早期乳腺癌钼靶X线诊断

目的：提高对早期乳腺癌的x线诊断水平。材料与方法：将30例经钼靶X线诊断后，手术和病理证实为早期乳腺癌的病例作回顾性分析。结果：早期乳腺癌的X线征象有①仅表现为细微小钙化6例占20％。②表现为致密小结节(直径≤2．Oem)16例(53％)。③结节并钙化为4例(13％)。④局部结构浓密、紊乱2例(17％)。⑤血管异常增粗1例。⑥未见异常表现1例。结论：早期乳腺癌除了较典型的微小钙化征象以外，其它征象不典型，需结合临床及病理进一步提高诊断水平。     

乳腺癌X线表现分析

目的分析乳腺癌典型及不典型X线征象,提高对乳腺癌不典型X线表现的认识。方法对61例经手术病理证实的乳腺癌资料进行回顾性分析。结果61例乳腺癌主要X线征象:肿块39例;微小钙化30例;不伴肿块及微小钙化的乳腺局部结构紊乱4例、星芒征3例、非对称性密度增高3例。结论肿块及微小钙化是乳腺癌最主要、最直接的X线征象,但部分乳腺癌X线上缺乏上述2种表现,单纯以结构紊乱、非对称性密度增高或星芒征为主要表现。提高对此类乳腺癌不典型X线表现的认识,有利于防止误、漏诊。     

早期乳腺癌的X线表现（附18例报告）

目的：提高对早期乳腺癌X线征象的认识。方法：回顾性分析资料完整的18例早期乳腺癌X线表现。结果：早期乳腺癌X线征象主要有：砂砾样微小钙化12例，其中X线未见确切肿块或结节而以钙化灶为唯一征象者6例；局限性片状、结节样致密影3例；乳腺结构局部扭曲紊乱1例；血管影迂曲、增多、增粗1例；无异常X线征象1例。结论：砂砾样微小钙化是早期乳腺癌非常重要的诊断依据，甚至是唯一恶性征象；局限性密度增高，乳腺结构局部扭曲紊乱，血管影迂曲、增多、增粗等征象在排除乳腺炎和手术穿刺活检等病史后，可考虑有早期乳隙癌的可能。     

乳腺癌钼靶X线征象分析(附114例报告)

目的探讨乳腺癌钼靶X线表现、X线分型和病理关系,以提高乳腺癌诊断水平。方法收集经手术病理证实、有完整影像资料的乳腺癌114例,回顾分析其钼靶X线征象及与病理关系。结果乳腺癌分5型:肿块型34例,肿块伴钙化型27例,钙化型28例,结构异常型21例,隐匿型4例。浸润性导管癌最多,占61.4%,其次是单纯癌,占20.1%。结论肿块型、肿块伴钙化型和钙化型乳腺癌钼靶X线表现具有特征性,乳腺钼靶X线摄影能明确诊断。结构异常型乳腺癌X线表现不典型,认识其X线征象,可明显提高乳腺癌的影像诊断率。     

早期乳腺癌X线征象421例分析

目的提高对早期乳腺癌X线征象的认识。方法回顾性分析421例经病理证实的早期乳腺癌的X线特征。结果421例病例中,非浸润性癌87例(20.6%),早期浸润性癌97例(23.0%),早期浸润性特殊型癌52例(12.4%),浸润性非特殊型癌(肿块直径≤1 cm)185例(44.0%)。乳腺X线检查显示89%的非浸润性癌和70%的早期浸润性癌灶可见钙化,而肿块在2组的发现率仅分别为18.0%和43.0%。结论乳腺X线片中微小钙化灶对早期乳腺癌的诊断具有重要价值。如果患者有乳头溢液,建议进一步进行乳腺导管造影检查。     

早期乳腺癌的X线表现（附40例报告）

目的 提高对早期乳腺癌X线征象的认识。材料与方法 将40例早期乳腺癌X线征象作回顾性分析。结果 早期乳腺癌X线征象有：泥沙样微细钙化30例（75％）,X线未见肿块或结节而钙化灶为唯一恶性征象者18例（45％）,与对侧乳房比较呈不对称局限性密度增高15例（37．5％）,致密小结节影14例（35％）,乳腺结构局部扭曲紊乱4例（10％）,条索状导管增粗5例（12．5％）,血管影迂曲、增多、增粗1例,无异常X线征显示1例。结论 （1）泥沙样微细钙化仍是早期乳腺癌非常重要的诊断依据,甚至是唯一恶性征象。（2）非对称性局限性密度增高,乳腺结构局部扭曲紊乱,在排除乳腺炎和手术穿刺活检病史后,应考虑早期乳腺癌可能。（3）在串珠型结节样乳腺中混杂着的恶性致密小结节影,易被忽视,须与健侧乳腺仔细对照观察,以发现小癌或微小癌。（4）对临床疑为小纤维腺瘤,如果X线征有边缘模糊或小角状突起时,应予高度重视,进行活检。     

乳腺肿瘤的钼靶X线诊断

目的　明确乳腺肿瘤的钼靶摄影 (mammography)征象 ,评价钼靶在早期乳腺癌诊断中的价值。 方法　总结分析我院从1 760例乳腺疾病钼靶X线摄影中检出并经手术和病理证实为乳腺肿瘤 1 67例 ,其中乳腺良性肿瘤 1 2 4例 ,乳腺癌 43例。结果　①43例乳腺癌的钼靶X线征象 ,圆形 ,不规则形肿块 2 6例 ,占 60 .46 % ,X线测量肿块比值小于临床 ;微小钙化 1 5例 ,占 34 .88% ;局部浸润 2例 ,占 4 .65 %。②良性乳腺肿瘤钼靶X线征象 ,多为圆形、椭圆形肿块 ,周边透明晕征。X线测量肿块比值大于临床。结论　乳腺钼靶X线在乳腺肿瘤检查中 ,特别对早期乳腺癌的诊断很有价值。乳腺癌的主要直接征象和间接征象在乳腺癌的早期诊断中具有重要意义     

乳腺叶状囊肉瘤的X线表现(附13例报告)

目的 :通过对乳腺叶状囊肉瘤X线征象分析以提高对其X线诊断水平。方法 :回顾性分析 13例经手术病理证实的乳腺叶状囊肉瘤X线征象。结果 :13例X线征象 :①肿物较小、边缘光滑锐利 4例 ,大小约 3 .75cm× 2 .9cm ;②肿物较大、边缘呈分叶状 4例 ,大小约 8.2 5cm× 7.12cm ;③肿物较小、边缘粗糙 2例 ,大小约 2 .2 5cm× 2 .2 5cm ;④腺体密度均匀未见肿物 1例 ;⑤腺体结构不良 2例。结论 :肿物大且呈分叶状 ,密度均匀 ,边缘清晰、锐利是诊断叶状囊肉瘤的重要依据 ,但有时需与乳腺纤维瘤、乳腺癌仔细鉴别     

乳腺肿瘤X线摄影临床价值分析

目的探讨乳腺X线摄影在乳腺肿瘤鉴定与诊断中的应用价值。方法分析70例X线摄影的乳腺肿块患者的影像学资料,X线诊断结果与病理结果进行对比分析。结果乳腺X线摄影结果与金标准病理诊断的符合率为80.00%。70例腺肿块患者的肿块及结构扭曲、钙化等征象23例,仅表现微钙化征象11例,毛刺样肿块21例,伴乳头凹陷8例,乳腺皮肤增厚10例,肿块周围粗大血管征5例。6例良性病变误诊为恶性病变:3例为右乳外上象限肿块影,边缘清晰,呈浅分叶状,未见明显钙化,术后病理结果为乳腺结核;2例为左乳外上象限大片状致密影,其内大片成簇状微小钙化,病理结果为乳腺囊肿;1例为左乳头深部肿块影,边缘模糊欠规整,病理结果为乳腺囊肿。8例良性病变因钼靶表现为边缘模糊,未见明显毛刺征象,术前误诊为乳腺癌。乳腺肿瘤钼靶X线诊断乳腺肿瘤的敏感性、特异性及准确性分别为79.49%、80.65%、80.00%。结论肿块及微小钙化是乳腺癌最直接、最主要的X线征象,乳腺X线摄影对乳腺组织结构显示清晰,特别是对微小钙化有很高的诊断价值。     

乳腺X线摄影对早期乳腺癌的诊断价值分析

目的探讨乳腺X线摄影对早期乳腺癌的诊断价值。方法对70例乳腺X线摄影IB-RADS评分4级及以上,经病理证实的病例,进行X线诊断结果与病理结果对照比较。结果良性3例,恶性67例,正确诊断率95.7%。其中肿块及其它征象47例,仅表现微钙化征象23例。结论肿块及微小钙化是乳腺癌最直接、最主要的X线征象,乳腺X线摄影对乳腺组织结构显示清晰,特别是对微小钙化。     

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.     

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.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

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).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

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）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.