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1.
T. Pinzer M. Reiß H. Bourquain K. G. Krishnan G. Schackert 《Acta neurochirurgica》2006,148(10):1085-1090
Summary Aspergillosis belongs to the group of mycotic diseases of paranasal sinuses. The invasive forms, and particularly the fulminant
forms, are potentially fatal. Isolated aspergillosis of the sphenoid sinus or the clivus is a difficult diagnosis, since the
often misleading clinical manifestations of this rare disease develop late. These patients become apparent by neurological
signs such as cavernous sinus syndrome, pseudotumor of the pituitary or the orbit. Diagnosis is often made intra-operatively
or on histological examination.
We report a case of invasive aspergillosis uniquely involving the sellar area revealed by clinical features suggesting a pseudotumor
of the pituitary. Although such lesions are almost always seen in immune suppressed subjects, in our case, the patient was
immune competent and had no past history of sinusitis.
The question of whether, and when to perform limited or extensive surgery remains an issue for discussion, owing to the rarity
of this disease honed by lack of experience. It depends on several factors: the kind of disease, the immunity, the subtype
of invasive fungal sinusitis and the degree of tissue invasion. 相似文献
2.
Tass H Malik Iain A Bruce Gerard Kelly Richard T Ramsden Shakeel R Saeed 《Skull base》2007,17(4):235-238
In cases of cerebrospinal fluid (CSF) rhinorrhea following lateral skull base surgery, fibrosis and fibrin formation resulting from meningitis has been postulated as a mechanism of spontaneously resolving the CSF leak. This study was undertaken to explore any possible relationship between the cessation of CSF leak and meningitis. A retrospective study at a tertiary referral center of 232 consecutive patients was performed. Out of a total of 232 procedures, 29 patients developed CSF rhinorrhea, of whom 7 subsequently developed meningitis. Bacteria were isolated in CSF obtained at lumbar puncture in 5 cases, with the CSF analysis in the remaining 2 cases suggesting aseptic meningitis. Conservative treatment failed to stop the CSF rhinorrhea in 6 of 7 cases. In this study, the development of meningitis did not appear to aid in the resolution of the CSF rhinorrhea. We conclude that surgical intervention should not be delayed in the expectation that meningitis and conservative interventions may promote CSF leak resolution. 相似文献
3.
应用标准微电极技术,研究了关附甲素对豚鼠右心室乳头肌动作电位最大除极速率(Vmax)的频率依赖性抑制作用(RDB),并与美西律,奎尼丁,劳卡尼进行了比较. 在相同刺激间隔(300 ms),产生50%左右RDB的药物浓度下,美西律的RDB开始最快,其第2个Vmax所产生的抑制已占RDB的64%,奎尼丁,劳卡尼和关附甲素的RDB开始速率常数分别为每个动作电位0.165, 0.076和0.136. 美西律,奎尼丁,劳卡尼和关附甲素产生RDB的恢复时间常数分别为1.4, 9.0, 18.2和44.0 s,而且它们的恢复时间常数是不依赖于药物浓度而变化的,结果提示,关附甲素是一个慢动力学钠通道阻滞剂. 相似文献
4.
目的:为了更完全地切除中颅凹底内外沟通性肿瘤。方法:采用经过改良的Mickey额颞颞下窝入路。其改良主要是将额骨瓣连同其表面附着的颞肌以及游离后的眶颧骨块一并向下翻开,并将手术程序作了相应改变。结果:成功切除了13例肿瘤。术后3例恢复了轻工作,6例能自主生活,3例生活仍需别人照顾,1例复发未再次手术。结论:采用改良的额颞颞下窝入路对中颅凹底内外沟通性肿瘤暴露充分,切除广泛。Mickey入路改良的优点:颞肌血运的保留,有利于骨瓣与正常颅骨的早期融合。同时颞肌附着点的保留,有利于咀嚼功能。 相似文献
5.
6.
义齿PMMA基托表面粗糙度影响的实验研究 总被引:2,自引:0,他引:2
目的:研究技工操作因素对义齿树脂基托表面粗糙度的影响。方法:在不同粉液比、充填时期、聚合温度、混合方式以及出盒温度成型的上颌半口义齿基托上选取1.5cm^2范围,按照统一的打磨顺序,由粗到细打磨抛光完成,浸入冷水中,7天后进行粗糙度测试,所得数据经t检验统计处理。结果:在单体含量降低组、丝状期充填组.热处理时直接放入70℃水中维持9h组与对照组相比,均存在显著差异(P〈0.05)。结论:影响PMMA树脂表面粗糙度的制作工艺因素有单体含量降低、丝状期充填和未经100℃高温热处理。 相似文献
7.
Summary A retrospective study of 61 patients with glomus jugulare tumours treated at the National Hospital for Neurology and Neurosurgery, and at the Royal National Throat, Nose and Ear Hospital, London. The average age at presentation was 41.7 years. The patients were mainly treated by a posterolateral combined otoneurosurgical approach. 42/61 of the patients had total or subtotal excision of their tumours, 7/61 had partial removal and the remaining 11/61 had no operation. Only one case required a 2-staged procedure. There were two deaths in the postoperative period, one from intracerebral haemorrhage and the other from the left hemisphere infarction.Postoperative radiotherapy was given to 5/7 of the patients who had partial removal. 3/40 of the patients with total removal had postoperative radiotherapy, and a further 3/40 had received radiotherapy pre-operatively.Of the 11 patients who did not undergo surgery, 7/11 were treated with radiotherapy and 4/11 had embolisation only. 相似文献
8.
9.
P. J. Donald 《European archives of oto-rhino-laryngology》2007,264(7):713-717
The purpose of this paper is to detail the contraindications for surgery, with curative intent for those patients who suffer
from a head and neck malignancy that invades the intracranial space. This is based on a 30-year experience of over 250 patients.
The most important contraindications are anatomical. Surgery is not done if the following structures are invaded: brain stem,
eloquent portions of the cerebrum, superior sagittal sinus, both internal carotid arteries, both cavernous sinuses and certain
vital bridging veins. Certain tumor factors are absolute but are occasionally relative contraindications: such as distant
metastatic disease especially if multiple and at multiple anatomic sites. Some tumors that behave in a particularly virulent
fashion that defy complete resection but are often difficult to predict preoperatively. Lack of patient medical fitness or
absence of patient commitment to the operative procedure is make-up two serious contraindications to surgery.
Presented at the 77th Annual Meeting of the German Society for Oto-Rhino-Laryngology, Head and Neck Surgery, 24–28 May 2006,
Mannheim, Germany. 相似文献
10.
对我省医学临床教学基地评审结果进行分析,就大部分基地教学意识不强、教学设施不完善、教学条件有待改善、师资队伍素质水平不高等问题进行了阐述,并针对存在的问题提出建议和思考,从建章立制规范管理、加强建设、提供保障、重视培训、提高素质、强化管理、创新机制等方面进行探索,希望能使我省医学临床教学基地质量得以提高、完善,为我省培养一流的医学专业人才奠定基础. 相似文献