骨斑点症X 线诊断(附家族三代3 例报道及文献复习)

目的:探讨家族性骨斑点症的临床及X线表现特征,提高X线诊断准确水平。方法:回顾性分析经临床证实的3例骨斑点症患者的临床及X线表现,并复习相关文献。结果:家族性骨斑点症X线特征为关节骨端多发斑点状致密影,边缘清楚,密度均匀。本组患者中2例有症状,1例患者无任何症状。常规生化检测无异常。结论:根据典型的X线特征及遗传特点,对骨斑点症可见做出正确诊断。     

The XXXXY Chromosome Anomaly: Report of Three New Cases and Review of 30 Cases from the Literature

The majority of abnormal sex chromosome complexes in the male have been considered to be variants of Klinefelter''s syndrome but an exception should probably be made in the case of the XXXXY individual who has distinctive phenotypic features. Clinical, radiological and cytological data on three new cases of XXXXY syndrome are presented and 30 cases from the literature are reviewed. In many cases the published clinical and radiological data were supplemented and re-evaluated. Mental retardation, usually severe, was present in all cases. Typical facies was observed in many; clinodactyly of the fifth finger was seen in nearly all.Radiological examination revealed abnormalities in the elbows and wrists in all the 19 personally evaluated cases, and other skeletal anomalies were very frequent. Cryptorchism is very common and absence of Leydig''s cells may differentiate the XXXXY chromosome anomaly from polysomic variants of Klinefelter''s syndrome. The relationship of this syndrome to Klinefelter''s syndrome and to Down''s syndrome is discussed.     

Dermatophytosis in Military in the Central-West Region of Brazil: Literature Review

Background

Dermatophytes represent a group of keratinophilic fungi capable of invading the superficial layer of the skin, hair, and nails of humans and animals. There is a high prevalence of dermatomycosis in tropical regions, and military personnel are susceptible to this kind of infection due to the type of occupational activities.

Objective

This study was to investigate dermatophytosis in military, in addition to predisposing factors to such infections.

Methods

The direct examination of the 221 samples obtained was conducted by preparing fresh slides, clarified with KOH. The clinical materials were seeded in duplicate in SDA and in Mycosel agar medium. The identification of the etiologic agents was performed according to the Riddell technique.

Results

99/221 (44.8 %) of the dermatophyte infection agents distributed in the three taxonomic genera that cause Tinea were recovered. The Trichophyton genus was the most representative and T. rubrum species 33 (33.3 %), the most prevalent. The other species found were as follows: T. tonsurans 13 (13.1 %), T. verrucosum 11 (11.1 %), T. interdigitale 9 (9.1 %), and T. mentagrophytes 6 (6.1 %). Among the most affected anatomical sites were skin 83 (83.8 %) and nails 17 (17.2 %).

Conclusions

Dermatophyte infections are common disorders in tropical countries. These infections lead to a variety of clinical manifestations. This study reports the incidence of dermatophytosis in the military personnel in the Central-West Region of Brazil. The occupational activities of the military individuals, in addition to the hot and humid climate of the region, can predispose them to infection by these fungal entities.     

Anaerobic Balanoposthitis: Two Cases and Review of the Literature

Anaerobic balanoposthitis is an infection of the glans penis and prepuce caused by anaerobic Gram-negative rods. It is characterized by intense inflammation and edema of the prepuce, superficial ulcers on the glans penis, foul-smelling subpreputial discharge, and bilateral inguinal lymphadenopathy. Infection tends to be locally destructive with severe tenderness of the penis and can result in considerable necrosis and tissue damage. The presence of a tight foreskin and sub-optimal hygienic practices seem to be a prerequisite for this condition to develop. Anaerobic Gram-negative rods belonging to the genus Bacteroides are the most commonly incriminated in the pathogenesis. Possible modes of transmission include contact with infected mucosal surfaces, such as during sexual intercourse, contamination by colonized saliva, or extension from the perirectal area. We report the first two cases of anaerobic balanoposthitis in HIV-positive patients and review the literature. Both patients had a previous history of sexually transmitted diseases and practiced sub-optimal hygiene. In both cases response to therapy was complete within 48–72 h.     

Wegener's Granulomatosis: A Review of Three Cases

Clinical and autopsy features in three cases of Wegener''s granulomatosis are presented. The disease is characterized by the triad of necrotizing granulomatous lesions of the respiratory tract, segmental necrotizing angiitis of arteries and veins, and necrotizing glomerulitis commonly terminating in uremia. Correct antemortem diagnosis was made in two of the three cases-in one by recognition of the characteristic triad and in the other by a biopsy from the antrum. Pathological lesions were chiefly in respiratory tract, spleen, kidneys and blood vessels. Necrotizing granulomatous lesions were present in the lungs. Glomerular lesions were particularly severe and wide-spread in two of the three patients, leading to uremia. Trabeculitis of the spleen, an unusual lesion, was a noticeable feature in all three. Fibrinoid necrosis, with little or no inflammatory infiltration, was the prevailing type of vascular necrosis. The characteristics of the disease process suggest a hypersensitivity mechanism. Similarities to, but significant differences from, polyarteritis nodosa are recognized.     

脑发育性静脉畸形9例临床影像特征分析及文献复习

目的:研究脑发育性静脉畸形(Cerebral Developmental Venous Anomalies,CDVA)临床及影像学特征及复习CDVA文献。方法:回顾性收集了自2011年11月至2014年3月我科确诊的9例CDVA的病人,对其临床特征、影像学检查方法包括电子计算机断层扫描(Computed Tomography,CT)、核磁共振成像(Magnetic Resonance Imaging,MRI)、数字减影血管造影(Digital Subtraction Angiography,DSA)及特征进行分析并对相关文献进行复习。结果:(1)临床症状:9例病人的临床症状包括头晕4例(4/9)、头痛4例(4/9)、恶心不适2例(2/9)、站立不稳1例((1/9)、小脑出血史1例(1/9)、眼部症状行眼科检查偶然发现小脑CDVA1例(1/9);(2)病变部位:病变位于幕上4例(4/9);幕下5例(5/9);(3)影像学检查:9例病人中,6例行CT平扫或增强扫描(3例平扫,3例平扫+增强);4例行MRI(1例平扫,3例平扫+增强);3例行DSA检查;(4)影像学特点:CT增强及重建、MRI的T1WI增强、SWI、MRA及DSA静脉期像均可显示出髓静脉及其形成的特征性"海蛇头"征象和其引流静脉。结论:CT、MRI、DSA影像学方法均可用于CDVA的诊断,在临床实践中需根据需要优化选择联合应用。     

睾丸间质细胞瘤3例报告及文献复习

目的：探讨睾丸间质细胞瘤的临床病理特点及诊疗方法。方法：分析并总结3例睾丸间质细胞瘤患者的,J盏床病理资料并文献复习。结果：1例术中冰冻切片诊断为睾丸间质细胞瘤,2例术前细针穿刺病理诊断为睾丸间质细胞瘤,病理组织学表现为瘤细胞呈团、条索或弥漫分布,体积较大,呈多角形胞质丰富嗜酸性,边界清楚。2例患者行单侧睾丸切除,1例行睾丸肿瘤剜除术,术后分别随访24、15、10个月未见复发。结论：睾丸间质细胞瘤发病率低,临床表现缺乏特异性,易误诊,确诊需依赖病理组织学检查,细针穿刺病理可明确诊断并有助于手术的选择及手术范围的确定。     

睾丸间质细胞瘤3例报告及文献复习

目的:探讨睾丸间质细胞瘤的临床病理特点及诊疗方法。方法:分析并总结3例睾丸间质细胞瘤患者的临床病理资料并文献复习。结果:1例术中冰冻切片诊断为睾丸间质细胞瘤,2例术前细针穿刺病理诊断为睾丸间质细胞瘤,病理组织学表现为瘤细胞呈团、条索或弥漫分布,体积较大,呈多角形胞质丰富嗜酸性,边界清楚。2例患者行单侧睾丸切除,1例行睾丸肿瘤剜除术,术后分别随访24、15、10个月未见复发。结论:睾丸间质细胞瘤发病率低,临床表现缺乏特异性,易误诊,确诊需依赖病理组织学检查,细针穿刺病理可明确诊断并有助于手术的选择及手术范围的确定。     

布氏杆菌脑膜炎病例报道2例及文献复习

目的:目前布氏杆菌性脑膜炎在国内只是偶见报道,本文报道2例布氏杆菌性脑膜炎,对其诊断及治疗进行探讨,并对布氏杆菌脑膜炎进行文献回顾.方法:我们近期连续通过检查脑脊液内布氏杆菌抗体的办法诊断了2例布氏杆菌性脑膜炎,并通过给予四环素、利福霉素及链霉素治疗1个月并通过随访.结果:半年后脑脊液内布氏杆菌抗体恢复阴性,临床症状完全消失.结论:通过我们的观察应用上述3联药物综合治疗1月对布氏杆菌性脑膜炎是有效的.     

胎盘植入的影像学表现(病例报道及文献复习)

目的:探讨胎盘植入(placental implantation abnormality,PIA)的影像学表现特征。方法:分析经手术病理证实的1例胎盘植入的MRI及超声表现,并复习文献资料。结果:MRI:以同序列子宫外围肌层信号为参照,T_1WI植入胎盘呈等信号或略高信号,与宫壁结构分界不清;T_2WI植入胎盘呈高信号,信号强度高于宫壁,胎盘组织侵入肌层,结合带局部变薄或中断;T_1WI增强,胎盘显著强化,明显强于宫壁。超声:局部胎盘厚度增加,其内见多个大小不一、形态不规则的无回声区;胎盘后方子宫肌层厚薄不均,其内见大片状稍强回声区;胎盘与子宫肌层接触的地方有异常的彩色的血流。结论:胎盘植入的影像学表现具有特征性,MRI结合超声检查有助于做出正确的定位和定性诊断。     

骨斑点症的X线分析(附6例报道及文献复习)

目的:对骨斑点症的临床特征、发病机理及鉴别诊断进行讨论,并探讨骨斑点症的X线特征,以提高对该病的影像学认识。方法:回顾性分析6例骨斑点症患者的临床及X线表现,其中3例患者属于同一家族,并对1例28岁患者随访1年,并复习相关文献。结果:病变好发部位为骨盆、跗骨、腕骨、指(趾)骨和长管状骨的骨骺及干骺端,影像表现为0.2~1.6 cm散在多发的大小不等的圆形或卵圆形致密阴影为特征,靠近关节面病灶较密集,大部分病灶位于松质骨内,病灶长轴与骨小梁走行相平行,密度均匀,边界清晰,相邻关节软骨骨质未见异常改变,其中4例病灶呈双侧对称性分布。1例随访病灶未见有明显变化。6例患者无任何症状,男女比为2:1,实验室相关检查均未见异常。结论:骨斑点症属于骨发育异常,是一种遗传性疾病,具有遗传学特点,X线检查是发现和诊断本病的主要依据,其X线表现具有特征性,熟悉其临床及X线特征有助于提高对该病的诊断。     

Misspecifications of Stimulus Presentation Durations in Experimental Psychology: A Systematic Review of the Psychophysics Literature

Background

In visual psychophysics, precise display timing, particularly for brief stimulus presentations, is often required. The aim of this study was to systematically review the commonly applied methods for the computation of stimulus durations in psychophysical experiments and to contrast them with the true luminance signals of stimuli on computer displays.

Methodology/Principal Findings

In a first step, we systematically scanned the citation index Web of Science for studies with experiments with stimulus presentations for brief durations. Articles which appeared between 2003 and 2009 in three different journals were taken into account if they contained experiments with stimuli presented for less than 50 milliseconds. The 79 articles that matched these criteria were reviewed for their method of calculating stimulus durations. For those 75 studies where the method was either given or could be inferred, stimulus durations were calculated by the sum of frames (SOF) method. In a second step, we describe the luminance signal properties of the two monitor technologies which were used in the reviewed studies, namely cathode ray tube (CRT) and liquid crystal display (LCD) monitors. We show that SOF is inappropriate for brief stimulus presentations on both of these technologies. In extreme cases, SOF specifications and true stimulus durations are even unrelated. Furthermore, the luminance signals of the two monitor technologies are so fundamentally different that the duration of briefly presented stimuli cannot be calculated by a single method for both technologies. Statistics over stimulus durations given in the reviewed studies are discussed with respect to different duration calculation methods.

Conclusions/Significance

The SOF method for duration specification which was clearly dominating in the reviewed studies leads to serious misspecifications particularly for brief stimulus presentations. We strongly discourage its use for brief stimulus presentations on CRT and LCD monitors.     

肾移植术后移植肾动脉破裂4 例及文献复习

目的:提高肾移植术后移植肾动脉破裂的诊治水平。方法:回顾性分析临床所见4例肾移植术后移植肾动脉破裂诊治并复习国内外病例文献资料。结果:移植肾动脉破裂口均不在吻合口,离吻合口距离为0.5~0.8cm;破裂原因:3例为霉菌感染,1例为细菌感染;经行移植肾切除和抗真菌、抗菌治疗后,2例受者恢复血透,1例因术中肺梗塞死亡,1例因失血性休克而死亡。结论:移植肾动脉破裂临床上较少见,后果严重,不仅会影响到移植肾功能,更可能危及病人生命,早期诊断、紧急手术探查和特异性治疗可改善预后,挽救患者生命。