Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Broström procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Broström procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion Early unrestricted weight-bearing in a stirrup brace following the Broström procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

PURPOSE: To evaluate the usefulness of magnetic resonance imaging (MRI) for assessing fracture types and soft tissue injuries associated with tibial plateau fractures. MATERIALS AND METHODS: MRI was performed in 38 patients with tibial plateau fractures, each of which was classified according to the Schatzker system. We evaluated MR images and assessed the prevalence of each fracture type and accompanying soft tissue injuries. We also assessed whether ligamentous injury correlated with the extent of articular depression, splitting, and comminution. In 24 patients, diagnosis was based on MRI and operative or arthroscopic findings, and in 14 patients, on MRI alone. RESULTS: The totals of fracture types I, II, III, IV, V and VI were 4 (11 %), 15 (39 %), 6 (16 %), 4 (11 %), 4 (11%), and 5 cases (13 %), respectively. In 30 cases (79 %), there were associated ligamentous or meniscal injuries. Medial collateral ligaments and lateral menisci were injured in 17 (45 %) and 14 cases (37 %), respectively. Type II and IV fracture patterns were associated with soft tissue injuries in 14 of 15 cases (93 %) and 4 of 4 cases(100 %), respectively. As the extent of articular depression increased and the extent of bony comminution decreased, there was an increased prevalence of accompanying ligamentous injuries. CONCLUSION: In tibial plateau fractures, MR imaging is a useful diagnostic modality for the evaluation of both fracture type and accompanying ligamentous or meniscal injuries.
Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Soft Tissue Injuries*

To establish systematic diagnosis and treatment planning of dentofacial deformity patient including facial asymmetry or hemifacial microsomia patient, comprehensive analysis of three dimensional structure of the craniofacial skeleton is needed. Even though three dimensional CT has been developed, landmark identification of the CT is still questionable. In recent, a method for correcting cephalic malpositioning that enables accurate superimposition of the landmarks in different stages without using any additional equipment was developed. It became possible to compare the three-dimensional positional change of the maxillomandible without invasive procedure. Based on the principle of the method, a new program was developed for the purpose of diagnosis and treatment planning of dentofacial deformity patient via three dimensional visualization and structural analysis. This program enables us to perform following menu. First, visualization of three dimensional structure of the craniofacial skeleton with wire frame model which was made from the landmarks observed on both lateral and frontal cephalogram. Second, establishment of midsagittal plane of the face three dimensionally, with the concept of "the plane of the best-fit". Third, examination of the degree of deviation and direction of deformity of structure to the reference plane for the purpose of establishing surgical planning. Fourth, simulation of expected postoperative result by various image operation such as mirroring, overlapping.
Congenital Abnormalities ; Dentofacial Deformities ; Diagnosis ; Facial Asymmetry ; Goldenhar Syndrome ; Humans ; Skeleton

The clinical application of the three-dimensional radiographic technique had been limited to standard Broadbent-Bolton cephalometer with biplanar stereoradiography. We developed a new method for compensating the error of head position in ordinary non-biplanar cephalostat. It became to possible to use the three dimensional cephalogram commonly in clinical bases. 1. The method of methemetical compensation of head positioning error in non-biplanar condition was evaluated with dry skull. The error of the method of first and the second trial was 0.46+/-1.21, 0.33+/-0.90mm, which means the error of the head positioning correction in conventional cephalogram was within clinical acceptance. 2. The reproducibility of this system for clinical application was 0.54 mm (-2.99~2.26mm) which defines the absolute mean difference of the first and second trial. Compare to the The landmark identification error 1.2+/-1.6mm, the error of the measurement was within the range of landmark identification error. The result indicates the adequate clinical accuracy of the computation of three-dimensional coordinates by compensation of the error of the head position in ordinary non-biplanar cephalostat.
Compensation and Redress* ; Head* ; Skull

Extrapelvic endometriosis is a fairly rare phenomenon. The majority of extrapelvic endometriosis involves scar tissue following obstetric or gynecologic procedures. Abdominal wall endometriosis secondary to cesarean section is a very rare condition, being reported in less than 0.5% of patients undergoing cesarean section. It has a distinct presentation and treatment. An abdominal mass with noncyclical symptoms is a common presentation. Imaging techniques are nonspecific and needle biopsy may confirm the diagnosis. Wide excision is the treatment of choice for abdominal wall endometriosis as well as for recurrent lesions. A patient with a history of cesarean section presented with a painful, enlarging mass. The pain was cyclic and aggravated just prior to menstruation. The patient was treated with surgical scar excision pathologically confirmed as endometriosis. We present this case with a brief review of literature.
Abdominal Wall ; Biopsy, Needle ; Cesarean Section ; Cicatrix* ; Diagnosis ; Endometriosis* ; Female ; Humans ; Menstruation ; Pregnancy

Trichotillomania (TTM) is a disorder characterized by repetitive hair pulling, frequently from the scalp and/or eyebrows, leading to noticeable hair loss and functional impairment. TTM remains a poorly understood and inadequately treated disorder despite increased recognition of its prevalence. We review available neuroimaging studies conducted in patients with TTM, covering structural and functional neuroimaging in turn. Data from patients' structural and functional neuroimaging results enabled us to identify the neural circuitry involved in the manifestation of hair pulling. Finally, we highlighted the future importance of neuroimaging studies in children and adolescents with TTM.
Adolescent ; Brain ; Child ; Eyebrows ; Functional Neuroimaging ; Hair ; Humans ; Neuroimaging ; Prevalence ; Scalp ; Trichotillomania

Although tubal pregnancy is increasing, primary ovarian ectopic pregnancy has remained a rare event. However, recent reports suggest an increasing incidence to both tubal and term pregnancies. Ovarian pregnancy occurs within the ovary and on the corpus luteum. Earlier diagnosis is now possible, owing to the availability of highly specific radioimmunoassay for human chorionic gonadotrophin and the development of transvaginal ultrasonography. Clinical and even intraoperative diagnosis is difficult and confirmation may be made only by microscopic examination of the tissue specimen. Current understanding of the etiological factors, classification, possible pathogenesis, clinical presentation, diagnostic steps, reevaluation of diagnostic criteria, preferred management and future fertility are detailed. The therapy is surgical and currently more conservative than in the past, because of improvement in operative laparoscopy. We report a case of primary ovarian pregnancy treated conservatively under laparoscopic surgery with a brief review of literature.
Chorion ; Classification ; Corpus Luteum ; Diagnosis ; Female ; Fertility ; Humans ; Incidence ; Laparoscopy ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Ultrasonography

Magnetic resonance imaging (MRI)-related techniques can provide information related to the electrical properties of the body. Understanding the electrical properties of human tissues is crucial for developing diagnostic tools and therapeutic approaches for various medical conditions. This study reviewed the principles, development, and application of electrical conductivity mapping using MRI. To review the magnetic resonance electrical properties tomography (MREPT)-based conductivity mapping technique and its application to brain imaging, first, we explain the definition and fundamental principles of electrical conductivity, some factors that influence changes in ionic conductivity, and the background of mapping cellular conductivities. Second, we explain the concepts and applications of magnetic resonance electrical impedance tomography (MREIT) and MREPT. Third, we describe our recent technical developments and their clinical applications. Finally, we explain the benefits, impacts, and challenges of MRI-based conductivity in clinical practice. MRI techniques, such as MREIT and MREPT, enabled the measurement of conductivity-related properties within the body. MREIT assessed low-frequency conductivity by applying a lowfrequency external current, whereas MREPT captured high-frequency conductivity (at the Larmorfrequency) without applying an external current. In MREIT, the subject’s safety should be ensuredbecause electrical current is applied, particularly around sensitive areas, such as the brain, or in subjects with implanted electronic devices. Our previous studies have highlighted the potential ofconductivity indices as biomarkers for Alzheimer’s disease. MREPT is usually applied to humansrather than MREIT. MREPT holds promise as a noninvasive tool for characterizing tissue properties and understanding pathological conditions.

Magnetic resonance imaging (MRI)-related techniques can provide information related to the electrical properties of the body. Understanding the electrical properties of human tissues is crucial for developing diagnostic tools and therapeutic approaches for various medical conditions. This study reviewed the principles, development, and application of electrical conductivity mapping using MRI. To review the magnetic resonance electrical properties tomography (MREPT)-based conductivity mapping technique and its application to brain imaging, first, we explain the definition and fundamental principles of electrical conductivity, some factors that influence changes in ionic conductivity, and the background of mapping cellular conductivities. Second, we explain the concepts and applications of magnetic resonance electrical impedance tomography (MREIT) and MREPT. Third, we describe our recent technical developments and their clinical applications. Finally, we explain the benefits, impacts, and challenges of MRI-based conductivity in clinical practice. MRI techniques, such as MREIT and MREPT, enabled the measurement of conductivity-related properties within the body. MREIT assessed low-frequency conductivity by applying a lowfrequency external current, whereas MREPT captured high-frequency conductivity (at the Larmorfrequency) without applying an external current. In MREIT, the subject’s safety should be ensuredbecause electrical current is applied, particularly around sensitive areas, such as the brain, or in subjects with implanted electronic devices. Our previous studies have highlighted the potential ofconductivity indices as biomarkers for Alzheimer’s disease. MREPT is usually applied to humansrather than MREIT. MREPT holds promise as a noninvasive tool for characterizing tissue properties and understanding pathological conditions.

Magnetic resonance imaging (MRI)-related techniques can provide information related to the electrical properties of the body. Understanding the electrical properties of human tissues is crucial for developing diagnostic tools and therapeutic approaches for various medical conditions. This study reviewed the principles, development, and application of electrical conductivity mapping using MRI. To review the magnetic resonance electrical properties tomography (MREPT)-based conductivity mapping technique and its application to brain imaging, first, we explain the definition and fundamental principles of electrical conductivity, some factors that influence changes in ionic conductivity, and the background of mapping cellular conductivities. Second, we explain the concepts and applications of magnetic resonance electrical impedance tomography (MREIT) and MREPT. Third, we describe our recent technical developments and their clinical applications. Finally, we explain the benefits, impacts, and challenges of MRI-based conductivity in clinical practice. MRI techniques, such as MREIT and MREPT, enabled the measurement of conductivity-related properties within the body. MREIT assessed low-frequency conductivity by applying a lowfrequency external current, whereas MREPT captured high-frequency conductivity (at the Larmorfrequency) without applying an external current. In MREIT, the subject’s safety should be ensuredbecause electrical current is applied, particularly around sensitive areas, such as the brain, or in subjects with implanted electronic devices. Our previous studies have highlighted the potential ofconductivity indices as biomarkers for Alzheimer’s disease. MREPT is usually applied to humansrather than MREIT. MREPT holds promise as a noninvasive tool for characterizing tissue properties and understanding pathological conditions.