UnitTwentyTwoCaseHistoryA19yearwhitemanwasexaminedbecauseofill"definedpaininallofhisteeth.CURRENTILLNESS-Thepatientsaidthathehadgeneralizedpainofaproxysmalnatureinallofhisteethbutprimarilyinhismandibularteeth.Thepainwassointensethatitpreventedhimfromsleepingatnight.Theinitialonsetofthefacialpainwasthreemonthsbeforetheexamination.Thepatientalsooccasionallyhadintermittentandrecurringpreauricularpaintherewasnohistoryoffacialswellingorasymmetry.Previously,therehadbeenepisodesofsevereabdominalpainandarchingofthearmsandlegs.Thepaininthepatient'slegswasmuchworsewhenhewalked.MEDICALHISTORY-thepatienthadhadtheusualchildhooddisease;hehadhadnoseriousinjures,noallergies,andwasnottakinganymedicationotherthananonnarcoticanalgesicoccasionally.Whilehewasinahospitalfortreatmentofpneumoniaattheageof10,anobstructionofthelowersegmentofthelefturethraandhydronephrosisontheleftsidewasdiagnosed.Whenhewasbetweentheageof10and15heunderwentaseriesofurologyproceduretocorrecttheobstruction;finally,anephrectomywasontheleftside.Chronicpyelonephritisandhydronephrosisontherightsidedevelopedsubsequently.Thepatientalsohadbenignhepatomegalyandbilateralconductivelossofhearing.FAMILYHISTORY-thepatientwasoneofninechildren,noneofwhomhadsimilarmanifestation.Bothparentswereingoodhealth.PHYSICALEXAMINATION-Thepatientwasaslenderpersonwhoappearedyoungerthan19yearsofage.Hisvitalsignswereasfollows:bloodpressure,104/68;pulserate,80withregularrhythmandintensity;respiration,16/min;andtemperature,99oF,orally.Hewas5feetlinchtallandweighted95lb.Thepatient'sheadwasslightlydolichocephalicandappeareddisproportionatelylarge.Therewerereddish–purplemacularlesionsinvolvingthelowlipandtheskinbetweenthechinandlowlip.Thefacewasextremelypale.Facialhairwasthinandsoftintexture,givingtheimpressionthatthepatientdidnotshave.Thevoicewashighpitched.Theeyeshadtortuous,engorgedveinsattheperipheryofthecornea.Therewerenoapparentcornealabnormalitiesonslit-lampexamination;therewasnoevidenceofabnormalitiesofthelenses.Thepupilswereround,equal,andreactiontolightandaccommodation.Theextraocularmovementswereintact.Thefundusdemonstratedtortuousretinalveinswithevidenceofarteriovenousnicking.Thediskwasflat,yellowishincolor(thesamecolorasthesurroundingretina),andwithoutdistinctboards,whichmadethemdifficulttodistinguish.Thedentalarcheswereextremelywidewithaveryshallowmaxillarypalatalvault.Theteethweresmallandwidespaced;someteethwereincompletelyeruptedandrotated.Thebucculmucosa,tongue,floorofthemouth,andpalatalmocosawerewithoutabnormalities.Theleftmaxillarylateralincisorwascongenitallymissing.Thepatienthadhadextensiverestorativedentistry.Hisoralhygienewassuboptimalwithageneralized,moderatemarginalgingivitis.Thepatienthadminimalcariouslesions.Hehadseveremalocclusionwithverylittletoothcontact.Otherresultsoftheexaminationoftheheadandneckwerewithinnormallimits.Thechestwasdecreasedinsizebutwasequallyexpandablebilaterally.Thelungswerecleartopercussionandauscultation.Auscultationoftheheartdisclosedaregularrhythmwithoutevidenceofrub,gallop,ormurmur;thepluseswereequalandstrongbilaterallyintheextremitiesandtrunk.Therewasadiffuse,bilaterallysymmetricaldistributionoflesionsoverthelowerportionoftheabdomen,thegroin,andthescrotalarea;thelesionsweresimilartothoseontheface.Thereseemedtobeaslight,contenderenlargementoftheliver.Allotheraspectsoftheabdominalexaminationwerewithinnormallimits.Thepalmsofthehandswereexceptionallypaleandtherewasevidenceofvascularlesionssimilartothoseonthebody.Neurologicalexaminationofthepatientdisclosednoabnormalities.Panoramicradiographicexaminationdisclosedbilateralmaxillaryfourthmolarsandsixmandibularpremolarsbilateralwithevidenceofperiapicalpathologiccondition.Thedevelopmentoftheuneruptedteethwasconsiderabledelayed.Thereweresixincompletelyeruptedandimpactedteethinthemaxillaadmandible.Cephalometricradiographicanalysisshowedthatthepatient’sfacialgrowthwasnormal.Thesellaturcicaappearedenlarged(itmeasured1.5×1.2cm)onalateralcephalometricradiograph.Thecalvariaappearedthickerthannormal.VOCABULARYl.paroxysmal陣發的，發作的2.mandibular下頜(骨)的3.intermittent間歇的4.preauricular耳前的5.asymmetry不對稱6.episodes發作7.aching疼痛的8.abdominal腹(部)的9.injury傷，損傷10.allergy變應性，變態反應ll.nonnarcotic①非麻醉的②非麻醉藥12.analgesic①止痛的②止痛劑13.pneumonia肺炎14.urethra輸尿管15.hydronephrosis腎盂積水16.urology泌尿科學17.nephrectomy腎切除術18.pyelonephritis腎盂腎炎19.hepatomegaly肝大20.rhythm節律21.dolichocephalic長頭的22.macular斑〔點〕的23.tortuous纖曲的24.engorged充盈的，充血的25.periphery外周[部〕，周圍〔部〕26.cornea角膜27.split-lamp裂隙燈28.lenses晶狀體(1ens)30.extraocular眼外的31.fundus底，基底32.retinal視網膜的33.nicking局部血管縮窄34.disks盤，板35.maxillary上頜的，上顱骨的36.palatal腭的37.vault彎窿38.buccal頰的39.mucosa粘膜40.incisor切牙41.restorative修復的42.gingivitis齦炎43.carious齲的44.malocclusion錯合45.rub摩擦46.gallop奔馬律47.murmur雜音48.extremities肢,端49.trunk軀干，干50.groin腹股溝51.scrotal陰囊的52.neurological神經病學的53.panoramic曲面體層的54.radiographic放射照相的55.molar磨牙56.premolar前磨牙57.periapical根尖周的58.impacted阻生的(牙)59.cephalometrlc頭測量法的60.sellaturcica蝶鞍61.calvaria顱蓋EpidemiologicsurveyofdentopathiescausedbytetracyclineinaprimaryschoolinTianjinMedicalworkershadpaidimpairmentofteethbytetracycline.465schoolchildreninTianjinwereexaminedforthispurpose.It’srecognizedthatthisdiseasewaswidespreadamongchildren.Theprevalencerate01thisdiseaseisabout78.06%.Theetiology,mechanism,influentialfactors,diagnosisandtheclassificationofthediseasewerediscussed.Thefollowingconclusionhastobeemphasized:Theknowledgeofthisdiseasemustbepopularized;Tetracyclineoughttobeavoidedduringandbeforetheageof7yearsold;Preventivemeasuresmustbetakenpromptly.AmodelforlymphedemainrabbitearsAsimpleinexpensivemethodtoproduceexperimentalmodelforlymphedemainrabbitearisdescribed.Inforty-sevenoffiftyrabbitears,measurementofearthickness,waterdisplacement,skinthickness,diameteroflymphaticsandhistopathologyoftheexperimentalearcandemonstratethelymphedema.Threerabbitearsfailedbecauseoftechnicalreasons.Instudyingthefindingsofexperimentallymphedema,someclinicalphenomenaareexplainedandmodificationsofoperativeprocedureofmicrolymphatico-venousanastomosisfortreatinglymphedemaaresuggested.ThedetectionofhumanrotavirusbyrapidimmuneelectronmicroscopyThepositiverateofhumanrotavirusinfeceswassignificantlyincreasedwhendetectedbyrapidimmuneelectronmicroscopy(RIEM)thanbydirectelectronmicroscopy(EM).In89cases,78%werepositivebyRIEMand60.7%byEM.Itshouldbenotedthat20/35EmnegativecasesshowedpositivebyRIEM.Atotalof83.6%positiveratecanbeachievedwhenRIEMandEMwereusedincombination.Onlyverysmallamountofantigenandantibodywereusedandneedednotultracentrifugationinthisprocedure.Thismethodissimple,rapid,sensitiveandspecific,andabletodifferentiatethevirusbyitsmorphologyinthediagnosisofvirusgastroenteritis.Secondaryhyperparatbyroidism:Reportof5casesFivecases(2weremalesand3females)ofsecondaryhyperparathyroidismwerereported.Theirmeanagewas22.6years(16-45)andanaveragecourseofthediseasewas12years(2-25).Ofthesepatients,3casesaresecondarytohypophosphatemicvitaminDresistantrickets.1casewithhypophosphatemicVitaminD-dependentosteomalaciaandlcasewithchronicrenalosteodystrophy.Fourcas