甲状腺微小癌36例临床分析

目的:探讨甲状腺微小癌的诊断和外科治疗经验。方法:36例甲状腺微小癌患者,10例行患侧腺叶切除术,20例行患侧腺叶加峡部切除术,3例行甲状腺次全切除术,加局部淋巴结清扫术1例,加功能性颈淋巴结清扫术2例,术后均服用甲状腺素片80~120mg/d,服药时间维持手术后1~3年,定期复查甲状腺激素水平,以"轻度甲亢"症状为用药标准调整服药用量。2例术后做同位素治疗。结果:术后2例曾出现短暂声音嘶哑,后逐渐恢复,1例出现短期的低钙抽搐。34例术后随访3~10年,平均随访5年,除1例混合型癌伴发肝转移者死亡外,其余无复发和死亡。结论:甲状腺微小癌女性发病较多,以单发癌结节为主,B超、细针穿刺细胞学检查(FNAC)、术中快速冰冻病理检查等方法综合运用能提高甲状腺微小癌的检出率,甲状腺微小癌手术治疗的预后较好。     

正常人肺静脉管径及其血流频谱的研究

肺静脉血流和肺静脉管径的变化与左房压力及左心室舒张功能密切相关 [1 ,4 ] 。超声心动图可以直接、动态观察肺静脉内径及血流频谱变化 ,但是目前超声尚无健康人肺静脉内径正常值。我们应用彩色超声多普勒技术对正常人及孕周 2 4周以上的妊娠妇女进行肺静脉内径及血流频谱研究 ,以探索正常人肺静脉的显示率、内径正常值、血流频谱特点。观察高动力状态及呼吸对肺静脉管径和血流频谱的影响。1　材料与方法1.1　研究对象　 16 9例排除心肺疾患的健康人分组进行研究。其中成年男性组 4 4例、成年女性组 4 6例、儿童组 14例、中期妊娠组 (中妊 …     

Enhancement of hepatic hemangiomas with levovist on coded harmonic angiographic ultrasonography.

OBJECTIVE: To evaluate the pattern of contrast enhancement with Levovist on coded harmonic angiographic ultrasonography of hepatic hemangiomas. METHODS: Twenty hemangiomas were evaluated with coded harmonic angiographic ultrasonography and a microbubble contrast agent. Verification of the diagnosis of a hemangioma was made by means of dynamic computed tomography (n = 8), dynamic magnetic resonance imaging (n = 1), radionuclide scanning (n = 6), or follow-up ultrasonography (n = 5). Ultrasonographic images were obtained before contrast agent administration and with a bolus injection of 2.5 g of a microbubble contrast agent (300 mg/mL Levovist; Schering AG, Berlin, Germany) every 10 to 15 seconds for 5 minutes. The contrast enhancement patterns of the 20 hemangiomas were assessed. RESULTS: The tumor diameters as measured on ultrasonography were 7 to 97 mm (mean, 26.7 mm). Of the 20 hemangiomas, peripheral globular enhancement with progressive centripetal fill-in was shown in 15 (75%), rimlike enhancement with progressive centripetal fill-in was shown in 2 (10%), and homogeneous enhancement was shown in 1 (5%). In the remaining 2 lesions (10%), the enhancement patterns could not be seen, because they were not found on coded harmonic angiographic ultrasonography. CONCLUSIONS: Coded harmonic angiographic ultrasonography with a microbubble contrast agent can depict the typical enhancement pattern in most hepatic hemangiomas.     

离子碘和分子碘过量对甲状腺功能与形态影响

目的　比较离子碘和分子碘过量对非碘缺乏Wistar大鼠甲状腺功能和形态的影响及差别。方法　固相免疫放射分析法测定实验大鼠血清TSH ,放射免疫分析法测定血清TT4 、TT3 。砷铈分光光度法测定尿碘。光、电镜下观察甲状腺内形态学变化 ,用图像分析仪测量滤泡上皮细胞高度和滤泡腔面积。结果　补充 840 μg碘 /L 90d时 ,可使血清TSH值增高 ,但是未见显著性差异。血清TT4 明显高于双蒸馏水 (DDW )组 ,P <0 0 5,但同剂量离子碘和分子碘比较 ,血清TT4 值无显著性差异。补碘组光、电镜下可见滤泡腔面积增大 ,滤泡上皮细胞变扁 ,细胞核染色深 ,滤泡融合破裂 ,巨滤泡形成 ,毛细血管减少。超微结构显示甲状腺滤泡上皮细胞内质网扩张 ,次级溶酶体增多 ,微绒毛减少 ,染色体浓集。与DDW组相比 ,滤泡上皮细胞高度明显降低 ,滤泡腔面积增大 ,P均 <0 0 5。相同剂量离子碘和分子碘比较无显著性差异。结论　碘摄入浓度 >840 μg/L时 ,会对大多部分甲状腺滤泡上皮细胞产生抑制和破坏 ,使血清TT4 值明显增高 ,离子碘和分子碘对甲状腺影响无明显区别     

儿童甲状腺癌13例临床分析

本文报告１９８５－１９９４年收治的儿童甲状腺癌１３例。年龄７－１６岁。男３岁，女１０例。所有病例无不适，而以颈部肿物就诊。除１例根治术前未做过任何治疗外，其余病例均曾进行过不恰当治疗，颈淋巴结转移１０例，肺转移３例，骨转移１例。病理诊断：乳头状癌１０例，滤泡癌３例。手术以患侧腺叶及峡部切除或加健侧大部分切除为佳。如有颈淋巴结转移应同时行颈部清扫术。本文对儿童甲状腺癌的特征、误诊原因及其治疗进行了计     

Ovarian and uterine findings in pelvic sonography: comparison between prepubertal girls, girls with isolated thelarche, and girls with central precocious puberty.

OBJECTIVE: To describe pelvic sonographic findings in girls as old as 7 years, to compare prepubertal girls with girls who had isolated thelarche or central precocious puberty, and to verify the accuracy of sonographic variables for distinguishing prepubertal girls from girls with central precocious puberty. METHODS: Ninety-six prepubertal girls and 2 reference groups (8 girls with isolated thelarche and 8 with idiopathic central precocious puberty) were included. Ovaries were classified morphologically as homogeneous, paucicystic, macrocystic, multicystic, and having isolated cysts. Receiver operating characteristic curves were used to choose the best cutoff points. RESULTS: Chronologic and bone age were correlated with uterine length, area, and volume and ovarian volume in prepubertal girls (P < .0001). Ovarian morphologic characteristics in prepubertal girls differed significantly from those of the reference groups (P < .0001). The best cutoff points were uterine length of 4.0 cm, uterine area of 4.5 cm2, uterine volume of 3.0 cm3, and ovarian volume of 1.0 cm3. CONCLUSIONS: Uterine and ovarian growth are proportional to age in prepubertal girls. Mean ovarian volume greater than 1 cm3 showed 100% sensitivity and specificity for discriminating between prepubertal girls and girls with central precocious puberty. Microcysts are common in prepubertal girls, but the presence of 6 or more follicles up to 10 mm in diameter may suggest central precocious puberty in girls younger than 8 years.     

Ten-year-old boy with post-traumatic priapism

Summary The case of a 10-year-old boy with post-traumatic priapism after perineal trauma is presented. Interdisciplinary treatment using angiography and selective catheter embolization for juvenile high-flow priapism is demonstrated. The literature and the diagnostic possibilities resulting from color duplex sonography are discussed.      

精神分裂症患者血清 T3、T4 含量测定分析

目的　探讨精神分裂症患者血清三碘甲状腺原氨酸 (T3 )、甲状腺素 (T4 )的含量变化。方法　采用放射免疫法测定 2 0 3例精神分裂症患者和 15 6例正常健康人血清T3 、T4 含量 ,并进行比较。结果　精神分裂症组血清T3 、T4 均低于健康对照组 (P <0 .0 1或P <0 .0 5 ) ,男、女无显著差异 (P >0 .0 5 )。结论　精神分裂症可影响垂体 甲状腺轴系统 ,使内分泌调节功能紊乱     

2687例血清甲状腺球蛋白抗体和微粒体抗体测定及其临床意义

报告2687例血清甲状腺球蛋白抗体和甲状腺微粒体抗体的放射免疫测定结果,九类病人的抗体阳性率如下:甲状腺正常病人12.6(30/239)、孤立甲状腺结节16.9%(62/383)、弥漫性甲状腺肿35.4%(226/638)、多结节甲状腺肿54.7%(104/190)、甲亢未治疗77.7%(404/520)、甲亢治疗中67.2%(218/345)甲亢临床已治愈60.3(102/169),原发性甲减80.8%(118/146)、亚急性甲状腺炎35.1%(20/57)。各种甲状腺疾病的总阳性率为51.2%(1254/2448)。对甲状腺自抗体阳性在甲状腺疾病的诊断、治疗、和预后判断上的意义进行了讨论。     

Absence of a relationship between umbilical cord thickness and coiling patterns.

OBJECTIVE: The purpose of this study was to evaluate a relationship between the umbilical cord thickness and cord coiling patterns during the fetal sonographic anatomic survey in the second trimester of pregnancy. METHODS: This was a prospective study of 470 patients with singleton pregnancies who had a fetal anatomic survey with recorded umbilical coiling patterns between 18 and 23 weeks' gestation. The umbilical cord thickness was assessed as an umbilical diameter at the level of the fetal abdominal cord insertion and compared with the antenatal umbilical coiling index (aUCI), calculated as a reciprocal value of the distance between a pair of umbilical cord coils. RESULTS: Three hundred twenty-one patients had adequate sonographic umbilical cord images and maternal demographic, antenatal, and labor data to meet inclusion criteria. The mean aUCI was 0.41 with 10th and 90th percentiles of 0.21 and 0.60, respectively. A total of 10.6% (34/321) and 9.3% (30/321) of patients were categorized as having hypocoiled and hypercoiled umbilical cords, respectively. The mean cord diameter +/- SD was 9.48 +/- 0.97 mm (range 7.0-12.5 mm). There was no statistically significant correlation between aUCI and umbilical cord thickness (P = .1164). CONCLUSIONS: An aUCI, or umbilical coiling pattern, does not correlate with umbilical cord thickness. It appears that a lesser amount of the umbilical supportive tissue, mainly Wharton jelly, is not related to an increased umbilical cord coiling pattern.