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 探討肺郎格罕細胞組織細胞增多癥（pulmonary Langerhans cell histiocytosis, PLCH）的臨床特征、診斷和治療。 方法 回顧性分析1999年-2008年4例病理確診的PLCH。 結果 4例患者均為男性；13～56歲；2例吸煙。臨床特征是活動后氣短、氣胸。胸部CT表現為網格狀、囊狀或結節狀影像。肺活檢病理結果：光學顯微鏡下可見病理性郎格罕細胞，免疫組織化學法檢測發現4例S-100均為陽性，2例CD1a陽性，1例CD68陽性。 結論 PLCH胸部CT表現為網結節或囊性變，病理檢查見病理性郎格罕細胞浸潤細支氣管壁和上皮細胞的間質，免疫組織化學CD1a抗原、S-100蛋白陽性可明確診斷。