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泪液排泄系统病变:丹麦1910～1999年643例泪液排泄系统活体标本的临床病理学研究

世界核心医学期刊文摘（眼科学分册） 2005年第8期1卷 16-17页

作者： Marthin J.K. Lindegaard J. Prause J.U. Heegaard S. 司冰心 Eye Pathology Institute University of Copenhagen Frederik V's Vej 11 DK-2100 Copenhagen Denmark

Purpose: To determine the frequency of histologically verified lesions of the lacrimal drainage system in Denmark between the years 1910 and 1999. Furthermore , to correlate the clinical diagnosis with the pathology diagnosis. Methods: Ret rospective review of all pathology reports from 1910 to 1999 in the files of the Eye Pathology Institute, University of Copenhagen, describing a lesion of the l acrimal drainage system. In addition, a retrospective review of all reports desc ribing a lesion of the lacrimal drainage system from the Danish Pathology Databa se. All specimens were re-evaluated, except in cases with a primary diagnosis o f dacryocystitis. In these cases a sample of 25%was re-evaluated. Results: A t otal of 643 lesions were collected. Dacryocystitis was the most frequent lesion, constituting 508 cases (79%). The remaining cases were diagnosed as dacryolith iasis (62 cases; 7.9%), tumour (29 cases; 4.5%), trauma (19 cases; 3.0%), con genital malformation (nine cases; 1.4%), canaliculitis (eight cases; 1.2%) and granulomatous inflammation (eight cases; 1.2%). Seventeen tumours were maligna nt, of which B-cell lymphoma was the most common (six cases). In 0.6%of cases with a clinical diagnosis of dacryocystitis/lithiasis a non-suspected malignant tumour was diagnosed. Micro-organisms were uncommon in dacryocystitis (9%) bu t frequent in cases of dacryolithiasis (87%). Conclusion: Dacryocystitis was by far the most frequent lesion of the lacrimal drainage system referred for histo pathological evaluation. Dacryolithiasis was often associated with micro-organi sms, especially Gram positive rods. Histopathology is necessary to confirm suspe cted tumours, more than half of which were inflammatory lesions, and to detect t umours that sometimes masquerade as inflammation.

关键词：泪液排泄系统活体标本临床病理学泪囊炎泪小管炎肉芽肿性炎症革兰阳性杆菌先天畸形泪石哥本哈根大学

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结膜松弛症的临床病例对照及组织病理学研究

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世界核心医学期刊文摘（眼科学分册） 2005年第8期1卷 41-41页

作者： Francis I.C. Kim P. 宋虎平 Chatswood Grove 12-1 4 Malvern Avenue Chatswood NSW 2007 Australia Dr.

Background/aims: Conjunctivochalasis, a secondary cause of the watery eye, is frequently seen in the older age group as an elevation of the bulbar conjunctiva lying along the lateral or central lower lid margin. A prospective, interventio nal, casecontrolled clinical and histopathological study was conducted. The rele vant features of 18 patients (29 eyes) who had their conjunctivochalasis resecte d as part of the surgical management of their watery eye syndrome were examined. In the control group, tissue was obtained from an age matched series of 24 norm al subjects undergoing routine cataract surgery. Methods: 24 controls (24 specim ens) and 18 patients (29 specimens) had conjunctival strip biopsies, taken from the usual lid margin level bulbar conjunctiva in line with the inferior limbus ( controls), and the clinically apparent conjunctivochalasis (patients). These wer e submitted for histological study. Resolfs: 23 of 24 control sections demonstra ted normal conjunctival variation. Four of 29 patient specimens demonstrated a c hronic non-granulomatous conjunctivitis, while three eyes of the patient group (two patients) demonstrated features of elastosis. Of the four patients who had the inflammatory infiltrates, three had functional nasolacrimal duct obstruction s (FNLDOs) and one had a primary acquired nasolacrimal duct obstruction (PANDO). Of the two patients who had elastosis, one had an FNLDO and the other had norma l lacrimal drainage and was Jones 1 positive. Conclusion: Six of 18 patients-th at is, seven of 29 specimens of conjunctivochalasis demonstrated signs of elasto sis or of chronic non-granulomatous inflammation. Clinically, patients had a sp ectrum of aetiologies of their watery eye syndrome.

关键词：结膜松弛症病理学研究下睑缘泪溢泪液排泄系统白内障手术干预性鼻泪管阻塞肉芽肿性炎症炎性浸润

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泪液排泄障碍的术前及术后超声评价

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世界核心医学期刊文摘（眼科学分册） 2005年第3期1卷 31-31页

作者： Stupp T. Pavlidis M. Busse H. Thanos S. 王媛

In addition to the obligatory clinical tests, imaging of the lacrimal drainage system (LDS) is useful in its clinical evaluation. The purpose of this study wa s to examine the usability and reliability of ultrasonography in the evaluation of the lacrimal drainage system. Observational cohort study. A prospective study was conducted at a single institution. We performed ultrasound examinations on 17 patients with epiphora before and after surgery, and on 17 asymptomatic volun teers, to visualize and evaluate the anatomic and functional condition or pathol ogic abnormalities of the *** evaluation of the LDS was possible in all individuals. Pathologic abnormalities (canaliculitis, diverticulitis, concre tion, or dilation of the lacrimal sac, and reduced functionality of the orbicula r muscle and/or lacrimal sac pump) could be well demonstrated. In the postsurgic al course, functional patency of the dacryocystorhinostomy opening could be veri fied in all cases. Sonography of the LDS appears to represent a reliable diagnos tic technique supplementary to clinical tests in the presurgical and postsurgica l examination of patients with epiphora. Pathologic abnormalities that may not b e apparent in routine X ray dacryocystography can be demonstrated with ultrasou nd techniques. Patients also benefit from the avoidance of exposure to ionizing radiation. However, ultrasound is not suitable for imaging the lower part of the lacrimal sac and the lacrimal duct because of the presence of overlying bony st ructures.

关键词：术后超声排泄障碍泪液排泄系统眼轮匝肌溢泪泪囊鼻腔造口术泪囊造影泪小管炎超声成像泪囊扩张

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