侵袭性胸腺瘤伴胸膜局限性受侵一例

患者女,40岁。3个月前无明显诱因出现左侧胸痛,呈针扎样疼痛,深呼吸时加重,同时伴胸闷及干咳,未曾就诊,胸痛症状逐渐减轻,但仍有胸闷。并于1周前行胸片检查发现纵隔肿瘤,左侧胸膜包块入院治疗。自患病以来,无发热及乏力,偶有咳嗽,呈干咳,无声音嘶哑、无呕血及黑     

后纵隔胸腺瘤一例报告

患者男性,34岁,因胸闷、胸骨后疼痛1月就诊,查体及实验检查无异常。胸部正侧位X 线片示:右中纵隔块影,密度均匀,边界清楚,诊断:纵隔淋巴结肿大。CT 增强检查示:右后纵隔可见一 8cm×6cm×6cm块影,向右肺凸起,中心密度稍低,周边强化,边缘规则,光滑,双侧支气管向前向外推移,食道向左推移,邻近骨质无破坏,诊断:右后纵隔块影考虑神经源性肿瘤。     

纵隔纤维组织细胞瘤1例

1　病历简介患者 ,女 ,2 3岁。两月前无明显诱因出现胸闷、胸痛、伴轻咳 ,近 10天发热并症状加重来院就诊。体检 :右侧锁骨上淋巴结 1个如蚕豆大小 ,胸廓无畸形 ,两肺呼吸音清。Ｘ线检查 :胸部正位示右上前纵隔见较大肿块影 ,肿块边缘呈分叶状 ,气管左移 (图 1)。胸透 :转动体位可见肿块内有密度减低影。抗炎治疗后复查胸片 ,见原右上纵隔增宽影范围缩小。结合胸部侧位片考虑为前上纵隔肿瘤。ＣＴ扫描 :前纵隔见囊性密度的肿块影 ,形态不规则并侵及右后纵隔 ;其内密度不均 ,可见气体样低密度影 ,与前胸壁粘连 ,最大横径约 9.4ｃｍ (图 2 )。…     

纵隔脂肪肉瘤1例报告

1 病例介绍患者男性,65岁,主诉胸痛,胸闷1个月入院.患者1个月前无明显诱因出现胸痛胸闷,活动和平卧时胸闷加重,偶尔咳嗽,咳少量白痰.查体无异常发现.1.1影像学检查:CT示左后纵隔可见一圆形软组织密度影,CT值16Hμ,大小约14cm×10cm×13cm,边界清,于右后纵隔可见一近卵圆形脂肪密度及软组织密度相混杂影CT值—56～16Hμ,大小约12cm×8cm×4cm,二者分界欠清(图1).MR示在T1加权像上,于左、右后纵隔区分别见一近圆形等T1、长T1(左侧病灶)与近卵圆形短T1、长T1(右侧病灶)混杂信号区,两者分界欠清,大小分别为     

纵隔巨大淋巴结增生症1例

患者男,23岁,于入院前1周健康体检,胸透时发现右前上纵隔肿瘤,无胸闷、胸痛、气促等症状.     

源于膈神经的巨大胸内神经纤维瘤1例

1　临床资料　患者 ,女 ,3 0岁 ,因左胸痛、胸闷 0 .5ａ入院 ,以左侧平卧时胸闷最明显。无咳嗽、咳痰及发烧。查体 :左上胸廓饱满 ,呼吸动度弱 ,触觉语颤减低 ,叩实音 ,呼吸音消失。胸片及ＣＴ检查均示左胸腔内占位性病变。诊断 :纵隔肿瘤。在静脉复合麻醉下行纵隔肿瘤切除术 ,胸骨正中切口。切开左侧纵隔胸膜 ,见肿瘤与前胸壁严重粘连 ,采用胸膜外剥离及切除第 2、3、4前肋始能游离肿瘤。最后见肿瘤内侧有一蒂与膈神经相连 ,其内有动脉通过 ,完整切除肿瘤。术后痊愈出院。病理 :神经纤维瘤 ,包膜完整 ,重 1 72 0ｇ,大小为 2 2ｃｍ× 1 7ｃ…     

前纵隔孤立性纤维瘤1例

<正>女,58岁,心慌8个月入院,一般状况可,无发热、胸痛呼吸困难,偶有胸闷、憋气、咳嗽。CT平扫示前纵隔结节,密度均匀,边界清晰(见图1),增强扫描呈轻度强化(见图2)术中见:肺与胸膜呈广泛膜状粘连,完整切除肿瘤及周围脂肪组织,取出肿瘤后观察:表面被膜完整。病理及免疫组化     

读片窗

患者　女 ,4 0岁。自诉 1个月前无明显诱因出现胸痛 ,呈阵发性隐痛 ,位于胸骨后 ,每次持续时间半天至 1天不等。无大汗淋漓、恶心、呕吐 ,无放射性 ,未予治疗。近 10天来伴干咳 ,无气喘、发热 ,偶有胸闷 ,食欲、睡眠欠佳。血常规及大、小便正常。胸片示 :右纵隔旁见一约 6 .5ｃｍ× 10 .0ｃｍ团块状阴影向右肺野突出 ,与纵隔呈反“Ｄ”字形 ,侧位于后纵隔与胸壁相连 (↑ ) ,下缘略宽 (图 1、2 )。ＣＴ扫描示 :右侧胸腔中部后内侧可见一约7.0ｃｍ× 4 .0ｃｍ大小梭形影 ,ＣＴ值为 11ＨＵ ,边界光滑 ,密度均匀。增强扫描未见强化 ,纵隔与肺门…     

食管囊肿一例报告

男,21岁.体检时发现纵隔肿块,但无明显症状,未经治疗.半年来自觉胸痛、胸闷、气喘,吞咽困难而来我院诊治.查体:心肺无异常,腹软,肝脾未触及。血沉68mm/h.X 线检查,后前位胸片示肿块位于右侧纵隔,大小为9cm×17cm,密度均匀,轮廓规则光整(图1),肿瘤上达胸骨柄下缘,下突出右心隔角,食管中下段受压向左移位,直径约13cm。胸部右侧位     

纵隔内异位胰腺一例报告

患者,女,50岁.不明原因胸骨后疼痛,胸闷1月余来院就诊.查体:心肺正常.食管吞钡检查未见异常.实验室检查无特殊.X 线与CT 检查:胸部X 线平片示两肺门有圆弧状隆起阴影,与纵隔交界呈钝角,外缘光整,侧位示病变位于前纵隔(图1、2).CT 平扫示前纵隔内有一     

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.