颈椎骨折类型与脊髓损伤关系之临床观察

通过对９２例颈椎骨折病例的分析，发现屈曲型损伤最多见（５３％），其次为过伸型（２６％），压缩型（２１％）。屈曲型和压缩型多见于年轻人，而屈曲损伤导致的脱位及过伸型则多见于年龄较大者。爆裂骨折引起的神经损害最重，其次为屈曲型、过伸型及压缩（非爆裂）骨折。神经功能改善率以爆裂型骨折最差，死亡率亦最高，以压缩（非爆裂型）骨折最好，其次为过伸型及屈曲型。文内对各型的特点进行了详细讨论。     

Long-term follow-up by video of cervical dystonia treated with botulinum toxin

We have analysed video recordings of 21 patients with cervical dystonia treated with botulinum toxin. Fourteen patients have a record both of their response shortly after injections were commenced and between four years five months and six years seven months later. Our analysis shows that the long term outcome is often better than the initial response. We suggest that chronic treatment with botulinum toxin allows different muscles to those initially injected to be identified as contributors to the dystonia. Subsequent injection of these muscles leads to further improvement. It implies that cervical dystonia is a more widespread disorder of motor control, rather than simply limited to a few muscles.     

对神经根型颈椎病CT扫描的价值探讨

对50例神经根型颈椎病的CT征象进行了分析,并与X线平片加以比较。认为CT不仅在神经根型颈椎病的诊断中具有独特作用,而且在确定手术方法和手术途径的选择上也很有意义。作者认为在CT机还没有普及的情况下,摄一张良好的钩椎关节放大斜位片或椎间孔断层片对诊断神经根型颈椎病应是首选的。CT和X线平片相结合,综合分析,更有价值。     

Case-control study of risk factors for cervical neoplasia in Denmark. II. Role of sexual activity,reproductive factors,and venereal infections

Sexual, reproductive and venereal risk factors for cervical neoplasia were investigated in a population-based case-control study of 586 women with histologically verified, cervical squamous-cell carcinoma in situ, and 59 women with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in Copenhagen. Cases were identified from the computerized Danish Cancer Registry. An age-stratified control group (n=614) was drawn at random from the female population in the study area by means of the Danish Central Population Register. A structured questionnaire was mailed to cases as well as controls. Increasing number of sexual partners exerted a significant effect on the risk both for carcinoma in situ, and invasive cancer, independently of age at first intercourse and other potential confounders. Conversely, the association with early age at first intercourse became statistically insignificant after allowance for other risk factors, although an increasing risk was still observed with decreasing age at sexual debut. Early age at first episode with genital warts was a significant risk factor for carcinoma in situ, perhaps indicating a possible increased susceptibility of the cervix epithelium during adolescence. A history of genital warts was a good predictor of risk for carcinoma in situ, whereas a history of previous gonorrhea was associated with an increased risk for invasive carcinoma. Women with multiple births had a significantly increased adjusted risk, especially for carcinoma in situ, although some association was also observed with invasive cervical cancer. The study supports the hypothesis of cervical neoplasia being a sexually transmitted disease, and that carcinoma in situ and invasive cervical carcinoma, to a high degree, have similar patterns of risk factors.Drs Kjaer, Engholm, and Lynge are with the Danish Cancer Registry. Dr Dahl is with the Department of Surgery, Slagelse Hospital, Denmark. Dr Bock is with the Department of Gynecology, Rigshospitalet, Copenhagen, Denmark. Dr Jensen, formerly with the Danish Cancer Registry, is deceased. Address correspondence to Dr Kjaer, Danish Cancer Registry, Institute of Cancer Epidemiology, Danish Cancer Society, Rosenvengets Hovedvej 35, Box 839, Copenhagen. Denmark. The Danish Cancer Society supported this study through grants.     

Cell surface phenotype of in vitro proliferating lymphocytes in HTLV-I-associated myelopathy (HAM/TSP)

The in vitro proliferation of peripheral blood lymphocytes (PBLs) without any mitogenic stimulation is one of the hallmarks of human T lymphotropic virus type I (HTLV-I) infection. Recent evidence suggests a difference in the degree of the phenomenon between HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and asymptomatic HTLV-I carriers (AC). In this article, we demonstrated several alterations in the features of the in vitro transformed lymphocytes between patients with HAM/TSP (n = 16) and AC (n = 8). The percentages of total CD8+ and CD8+CD28+ cells were significantly increased in the in vitro proliferating T lymphocytes derived from the patients with HAM/TSP when compared to those from AC. HAM/TSP was segregated from AC by the high degree of the proliferation of CD8+CD28+ cells. The expression of HTLV-I-specific antigens on the cultured PBLs was detected only in the subjects which showed low CD8+CD28+/CD4+ ratio of the in vitro proliferating lymphocytes. These findings suggest that this phenomenon distinguishes HAM/TSP from AC, not only in quantity but also in quality.     

颈椎髓外硬膜下结核瘤1例

患者,男,38岁,以颈项部疼痛1个月,突发左上肢麻木无力3d入院。1个月前,无明显诱因,出现颈部疼痛,无双上肢感觉障碍,无活动受限,无头晕头痛,就诊于当地医院(具体治疗不详),症状无改善。3d前突然出现左上肢麻木无力,右上肢麻木感,排尿无力。既往:3年前无明显诱因出现颈部皮肤溃烂     

颈椎前路钢板椎间融合器系统治疗颈椎间盘突出症

颈椎前路手术在颈椎间盘疾病中已广泛应用，手术方法主要为颈前路减压加椎间植骨融合术。但不管是早期的自体骨融合的颈前路手术，还是后来进一步发展的颈前路钢板以及椎间融合器技术，都存在着诸如融合失败率高、植骨块移位、塌陷、螺钉断裂、钢板松动等并发症，造成手术疗效不佳以致于二次手术。自2002年2月-2004年1月采用颈椎间盘摘除、颈椎前路钢板椎间融合器（PCB）系统内固定、植骨融合术治疗颈椎间盘突出症后均无前述并发症的发生，疗效满意，现报道如下。     

LCT联合阴道镜检查对宫颈病变筛查的临床分析

目的:评价液基细胞学检查(liquid-based cytologic test,LCT)配合阴道镜检查对子宫颈病变的诊断价值。方法:收集2006年1月~2007年8月在我院妇科门诊就诊患者,采用LCT检测,对细胞学检查异常的1116例进行阴道镜检查及活检。结果:LCT异常者占10.15%,LCT和阴道镜对低度鳞状上皮内瘤变(LSIL)的检出率分别为65.45%和71.01%,高度鳞状上皮内瘤变(HSIL)为70.54%和84.50%,宫颈浸润癌(CC)为89.55%和92.53%。结论:细胞学筛查是诊断宫颈病变的重要方法,配合阴道镜下活检,能提高子宫颈癌前病变和宫颈早期浸润癌检出率,具有重要的临床意义。     

Ectopic cervical salivary glands

Summary Ectopic salivary glands in the neck are very unusual lesions. Generally they are localized to the oropharyngeal region, near the mandible and para-parotid lymph nodes. They occur occasionally on the anterior border of the sternocleidomastoid muscle in the soft tissues of the neck. We wish to report on a singular association of ectopic salivary glands with partial hearing loss, preauricular fistula, palatoschisis, anal fistula, and an arteria lusoria. Morphological, histological and embryological aspects are discussed.