结节病易误诊,据王洪武等~([1])收集国内18篇关于此病误诊的文献,误诊率高达63.2%,当然有误诊就会有误治,如孙永昌等~([2])报道26例结节病在影像学检查诊断的第一印象中拟诊结核5例,其中就有2例完成规范的抗结核治疗,为此应引起临床对本病诊治的重视。

Sarcoidosis

Acoustic imaging balloon catheters formed by a disposable liquid-confining sheath supporting a high fidelity, flexible drive shaft which carries on its end an ultrasound transducer and includes an inflatable dilatation balloon. The shaft and transducer rotate with sufficient speed and fidelity to produce real time images on a T.V. screen. In preferred embodiments, special features that contribute to the high fidelity of the drive shaft include the particular multi-filar construction of concentric, oppositely wound, interfering coils, a pre-loaded torque condition on the coils enhancing their interfering contact, and dynamic loading of the distal end of the probe, preferably with viscous drag. The coil rotating in the presence of liquid in the sheath is used to produce a desirable pressure in the region of the transducer. Numerous selectable catheter sheaths are shown including a sheath with an integral acoustically-transparent window, sheaths with end extensions that aid in positioning, a liquid injection-producing sheath, a sheath having its window section under tension employing an axially loaded bearing, a sheath carrying a dilatation or positioning balloon over the transducer, a sheath carrying a distal rotating surgical tool and a sheath used in conjunction with a side-viewing trocar.

Acoustic imaging catheter and the like

An apparatus for use as a catheter, a guidewire, a catheter sheath for use with catheter introducers or a drug infusion catheter/guidewire. The apparatus (20) including a flexible metallic tubular member (22) with an encasing (26) covering the tubular member that creates a fluid-tight seal around the periphery of the tubular member. In one embodiment, the tubular member can be a coiled metallic hypotube design. This coiled design can include either a single filament or multi-filament wire wrap. In a second embodiment, the flexible tubular member can be formed by cutting a predetermined configuration of slots into a single hollow thin-walled metal tube at predetermined spacings, depth and patterns.

Flexible tubular device for use in medical applications

An elongate medical device including an inner elongate member, a reinforcing member, and an outer tubular member is described. The reinforcing member may be a helically wound continuous wire including a first portion having a first cross-sectional profile, a second portion having a second cross-sectional profile, and a transition region located between the first portion and the second portion. The first cross-sectional profile may be different from the second cross-sectional profile. In some embodiments, the first cross-sectional profile may be circular or non-circular and the second cross-sectional profile may be circular or non-circular.

Elongate medical device with continuous reinforcement member

A system (10) for externally locating a sensor in tissue, comprising an external probe including at least first and second electromagnetic output coils (12) with non-parallel longitudinal axes; and output coil (2) driver for alternately energizing the first and second output coils, for generating a time-varying magnetic field which penetrates the patient's skin (7); a sensor coil (30), having a longitudinal axis, for developing an induced electrical voltage in response to the time-varying magnetic field; a distance determinator, responsive to the induced voltage from the sensor coil (30), for determining from the induced voltage, the distance between the output coils (12) and the sensor coil (30), independently of the relative angle, in a horizontal plane, between the sensor coil (30) longitudinal axis, and the longitudinal axes of the output coils (12); and a direction determinator for determining and displaying the direction, in the horizontal plane, in which the sensor coil (30) longitudinal axis is pointing.

Catheter depth, position and orientation location system

An instrument for use in catheterization of small distal branch arteries includes a guide wire having a short flexible distal section connected with a relatively long, multi-wire, axial and rotary torque transmitting section to guide a soft, thin-walled, flexible catheter through the compound curves involved in the junctions between various arterial branches. A method for catheterization of blood vessels includes the steps of sequentially advancing the catheter and guide wire to negotiate these compound turns in the arterial system.

Spring guide wire with torque control for catheterization of blood vessels and method of using same

The bone changes of childhood leukemia, present in about two-thirds of cases, are often of value for differentiation when the clinical diagnosis is obscure. Although the bone lesions are not specific for this disease, except perhaps in the late stages, they are of significance in that similar lesions are not usually associated with the diseases which leukemia most often resembles clinically. The transverse line of radiolucency beneath the metaphyses of the long bones, the earliest and most common manifestation of bone involvement in leukemia, is rare in other diseases of children over the age of two years. The extensive destructive lesions in the long bones occurring late in the disease present a characteristic pattern not seen in other conditions, except perhaps metastatic neuroblastoma. Earlier stages of destruction, periosteal reaction, and osteosclerosis are other changes which may be present in a recognizable pattern, or may give a clue as to the diagnosis when interpreted in the light of the clinica...

The bone lesions of childhood leukemia; a survey of 140 cases.

Over fifty years have passed since Boeck first described a condition of the skin which he designated as sarcoid. Since that time many observers and investigators have contributed freely to the literature concerning the various manifestations of this disease The findings of greatest interest to us in sarcoid are hypercalcemia and soft-tissue calcifications, particularly nephrocalcinosis and nephrolithiasis. Very little is to be found in the literature referable to these changes, although hypercalcemia is given more attention than soft-tissue calcifications. During the past several years, at the Johns Hopkins Hospital, the Hospital of the University of Pennsylvania, and the University of Maryland Hospital, we have had the opportunity of studying and reviewing 7 cases of sarcoidosis with hypercalcemia and renal calcifications. Although roentgenograms for only 5 of these cases are now available, the histories of all 7, including postmortem studies in 3, will be presented. Case Reports Case I: N. S., a 44-year...

Nephrocalcinosis associated with sarcoidosis: a presentation and discussion of seven cases.

A flexible probe including a series of bristles at its extremity for exploring and collecting specimens from the labrynthine passages of internal organs is formed by attaching a series of bristles to the extremity of a tightly wound coil of fine wire, a section of wire coil near the bristles having adjacent turns whose cross sections are reduced at one side of the coil so that when the coil is put under tension by a core wire extending from one end to the other of the coil the extremity including the bristles will be turned in the direction of the reduced cross section, one element of a two-piece handle being attached to the other end of the coil, the other element of the handle being attached to the core wire and the two elements being in frictional engagement so that any degree of inclination of the bristles can be accomplished and maintained with one hand.

Controllable tip brush for medical use

The authors describe a new guide wire and two new biopsy instruments, all controllable, used for bronchial biopsy. The instruments have complete mobility, no internal moving parts, and are capable both of cutting a fragment below the surface of the lesion and of collecting exfoliated cellular material when cutting is impossible or undesirable. The brush was used in 142 cases with a carcinoma diagnosis of about 80°; the helicon and auger were used in 47 cases with a carcinoma diagnosis approaching 90° and to obtain diagnostic biopsies from 4 benign lesions including a 14-mm benign healed granuloma.

James K. V. Willson

Papers

Spring guide wire with torque control for catheterization of blood vessels and method of using same

The bone lesions of childhood leukemia; a survey of 140 cases.

Nephrocalcinosis associated with sarcoidosis: a presentation and discussion of seven cases.

Controllable tip brush for medical use

Transbronchial biopsy of benign and malignant peripheral lung lesions. Description of three new instruments.