Complete disappearance of lung abnormalities on high-resolution computed tomography: A case of histiocytosis X

A case of pulmonary Langerhans cell histiocytosis, proved by both lung high-resolution computed tomography and lung biopsy, is described. Following smoking cessation, lung nodules and cysts gradually disappeared on serial computed tomography scans, with complete clearance of the lesions after 12 months. The role of tobacco smoking is discussed, in detail, against the background of the literature.     

上颌窦黏膜囊肿对牙槽嵴顶入路上颌窦底提升术的影响

目的研究牙槽嵴顶入路上颌窦底提升术后,上颌窦内黏膜囊肿的变化和囊肿区种植体周围的成骨情况,探讨上颌窦黏膜囊肿对牙槽嵴顶入路上颌窦底提升术的影响。 方法选取12例上颌后牙缺失骨量不足并患有上颌窦黏膜囊肿的患者,在不摘除窦腔内黏膜囊肿的情况下,经牙槽嵴顶入路提升上颌窦底同期植入种植体14枚。术前测量上颌窦底高度,术后当日测量种植体穿入窦底长度,术后1年测量穿入窦腔内的种植体周围成骨高度,观察黏膜囊肿对种植体周围成骨的影响。采用配对样本t检验对比术前-术后当日及术前-术后6个月黏膜囊肿投影面积变化,评估手术创伤与黏膜囊肿的相互的影响。 结果通过牙槽嵴顶入路上颌窦底提升术植入的种植体在含有上颌窦黏膜囊肿的上颌后牙区种植体周围成骨良好,术后6个月时全部14枚种植体形成良好骨结合。术前上颌窦底高度为（5.5 ± 1.4）mm,术中种植体穿入上颌窦长度为（2.9 ± 1.3）mm,上颌窦底厚度平均增加了（1.8 ± 1.0）mm。根据测量结果计算黏膜囊肿投影面积,术前（201.2 ± 184.0）mm²,术后当日（133.6 ± 187.6）mm²,术后6个月（134.5 ± 107.1）mm²。术前-术后6个月的成对差分均值及标准差[（66.6 ± 142.8）mm²]明显增大,说明术后6个月时黏膜囊肿的体积呈现出多样化的表现。术前-术后当日的黏膜囊肿投影面积相比显著减小,差异有统计学意义（t= 2.685,P= 0.021）,术前-术后6个月的黏膜囊肿投影面积差异无统计学意义（t= 1.617,P= 0.134）。手术短期内会对上颌窦内黏膜囊肿造成一定的创伤,但未对上颌窦黏膜囊肿产生激惹、恶化等不良影响。 结论上颌窦内黏膜囊肿的存在不影响牙槽嵴顶入路上颌窦底提升术的实施与种植体周围成骨。     

先天性胆管囊肿的超声图象诊断

本文报告经手术证实的29例先天性胆管囊肿的超声检查结果,符合率(28/29)96.55%.文中叙述了胆总管囊肿(26例)、肝内胆管囊肿(1例)和混合型胆管囊肿(2例)的声象图表现.     

Cowper’s syringocele in an adult

Cowper’s syringocele is cystic dilatation of the excretory bulbourethral gland duct. It is an uncommon condition and is usually reported in children. There are only ten previous case reports of late presentation in adulthood to the best of our knowledge. We present the imaging findings of such a case manifesting at 30 years of age.     

创伤性肺内血肿与血气囊肿的处理规范

目的 探讨创伤性肺内血肿或血气囊肿的处理规范.方法 对我院1999年8月-2010年8月救治的21例创伤性肺内血肿或血气囊肿患者(AIS≥4)资料进行回顾性分析.结果 (1)全组病死率为14％(3/21),死因为呼吸道大出血窒息;(2)67％(14/21)伴有咯血症状,咯血时间为1～240d,平均15.8d,肺内血肿或血气囊肿咯血时间约为单纯肺气囊肿咯血时间的3.4倍;(3)肺内血肿或囊肿消失时间平均为61.6d,其中肺内血肿和血气囊肿消失时间为单纯肺气囊肿消失时间的3.4倍.(4)肺内血肿或血气囊肿大小及部位影响救治方式、救治结局及预后.结论 规范创伤性肺内血肿或血气囊肿的治疗是提高救治成功率的关键,对直径＞6.0cm的肺内血肿或血气囊肿以及肺气囊肿伴重度漏气呼吸不能维持者需及早行确定性手术.     

胃囊性病变的影像学鉴别

本文搜集手术病理证实的发生于胃部的多种囊性病变（胃憩室,胃重复畸形,异位胰腺囊肿,胃肠间质瘤囊变）,胃周易误诊为胃来源的囊性病变（肝左叶囊肿、胰腺假性囊肿）,以及文献报道的胃壁脓肿。回顾上述病例的临床资料,针对其影像学表现,对胃的囊性病变的影像学特征进行归纳和小结,同时结合临床表现、病理改变对胃囊性疾病进行阐述,以期提高对胃囊性病变的认识。     

耳鼻喉综合动力系统切除会厌囊肿23例

目的探讨利用耳鼻喉科综合动力系统（MedtrnicXPS 3000）切除巨大会厌囊肿的可行性及治疗效果。方法使用耳鼻喉科综合动力系统,对23例巨大会厌囊肿患者（14例伴有吸气性呼吸困难）于咽喉黏膜表面麻醉下行会厌囊肿切除术。结果23例均一次性完成手术,无手术并发症,术后随访6个月无复发。结论采用耳鼻喉科综合动力系统切除巨大会厌囊肿是在直视、负压吸引的指示下操作,切除病变囊壁具有准确精细、彻底、对周围组织损伤小、术后无复发的优点。但需充分掌握手术技巧,在做好气管切开的准备情况下进行手术。     

70°鼻内镜在新生儿先天性会厌囊肿的诊断

新生儿先天性会厌囊肿是一种较为少见的先天性疾病,1881年由Abercrombic命名,1970年De Sant比较详细的描述本病的病理、病因及治疗,此后国内渐有报道[1～4]。本病多见于新生儿期,容易误诊,若不及时诊治可发生严重并发症,甚至导致患儿窒息死亡。     

The problems and advantages of one lung ventilation during surgical intervention in pulmonary hydatid cyst disease

Background Hydatid disease is the most severe helminthic zoonosis, with an important public health problem especially in rural areas in Turkey. The aim of this study was to review the problems and advantages encountered in surgical treatment of 43 patients who were ventilated with one-lung ventilation during last four years. Methods Patients, operated with one-lung ventilation, constitute the study group. Data related to symptoms, radiographic findings, performed surgical procedures, perioperative and postoperative morbidity, hospitalization time, and cyst recurrence were collected from each individual's records. Results Cystotomy and capitonnage were performed in all cases. Perioperative complications were seen in 5 patients. Four of these 5 patients had double-lumen endotracheal tube malpositioning. In one patient hypoxemia developed. The most common postoperative complication was atelectasis. One patient had recurrent cysts. There was no perioperative or postoperative death. Conclusions We prefer cystotomy and capitonnage because it is a fast and effective technique with limited postoperative complications. One-lung ventilation prevents the exposure of lower lung areas from massive aspiration, which may cause acute obstruction of airways, and contamination by cyst contents from the operative part of the lung that causes recurrent disease. One-lung ventilation in pulmonary hydatid cyst surgery may be preferred owing to lower mortality and morbidity rates.     

Percutaneous puncture of spinal cysts in the diagnosis and therapy of syringomyelia and cystic tumors

Summary The experience with percutaneous puncture of intraspinal cystic lesions is reported in four cases: an extradural cyst demonstrated with air, a spinal cord tumor with lipiodol and two cases of syringomyelia with metrizamide. Percutaneous puncture of cystic lesions makes possible an accurate delineation of the lesion and a histological approach through biochemical and cytological analysis of the aspirated cystic fluid, while aspiration of the fluid of cystic tumors decompresses the spinal cord and thus plays a therapeutic role.