Objective To make a clinical analysis on the patients with triceps paralysis caused by cervical radiculopathy.Methods From May 1998 to November 2003, 15 patients (11 males, 4 females, aged 34-76 years) with cervical radiculopathy were analyzed retrospectively, who had no symptoms of the compressed pyramidal tract of the medulla. The affection occurred at C3,4 in 1 patient, at C4,5 in 9 patients and at C5,6in 5 patients. According to the Yamazaki classification, there were 4 patients with the paramedian disc protrusion, 5 with the lateral disc protrusion，4 with the uncovertebralosteophyte, and 2 with the superior articular process hypertrophy. All the patients complained of the unilateral shoulder weakness, especially on abduction. Muscle atrophy occurred when radiculopathy was serious. There was a radicular painin the shoulder, the scapular region, and the forearm. Some of the patients haddysesthesia but with no pathological reflex, symptoms of the pyramidal tract ofthe medulla or hyperreflexia of the tendon reflex on the neurological examination. Before operation, the triceps strength was 2.40±0.51, the scale of the nerve root symptoms was 7.60±1.45, and the width of the intervertebral foramina on MRI was 2.90±0.15 mm. Of the patients, 13 had undergone the anterior cervical discectomy, the uncovertebral joint recection, and uncoforaminotomy; 2 had undergone the posterior medial facetectomy and foraminotomy to decompress the nerve root. Results According the follow-up for 16-24 months averaged 19.4 months revealed that the pain was obviously relieved, the scale of the nerve root symptoms was 3.34 ± 0.62, the triceps strength was enhanced to 4.40 ± 0.74, and the width of the intervertebral foramina was 4.07±0.16 mm. There was a significant difference postoperatively when compared with preoperatively (Plt;0.01）. Conclusion The cervical radiculopathy is usuallyaccompanied by the cervical spondylosis myelopathy. It is rarely encountered that the disease happened alone with no symptoms of the compressed pyramidal tractof the medulla. The disease is related to the foraminal disc herniation, the foraminal osteophyte formation, and the processus articularis proliferation. The treatment of choice is resection of the osteophyte or the herniated disc, and decompression of the nerve root.
目的 探讨肺郎格罕细胞组织细胞增多症（pulmonary Langerhans cell histiocytosis, PLCH）的临床特征、诊断和治疗。 方法 回顾性分析1999年-2008年4例病理确诊的PLCH。 结果 4例患者均为男性；13～56岁；2例吸烟。临床特征是活动后气短、气胸。胸部CT表现为网格状、囊状或结节状影像。肺活检病理结果：光学显微镜下可见病理性郎格罕细胞，免疫组织化学法检测发现4例S-100均为阳性，2例CD1a阳性，1例CD68阳性。 结论 PLCH胸部CT表现为网结节或囊性变，病理检查见病理性郎格罕细胞浸润细支气管壁和上皮细胞的间质，免疫组织化学CD1a抗原、S-100蛋白阳性可明确诊断。