Total hip arthroplasty (THA) can be a good treatment option for avascular necrosis (AVN) of the femoral head. However, because dislocation can frequently occur after surgery, THA is a concern in patients with a neuromuscular disease, such as cerebral palsy or poliomyelitis. In patients with poliomyelitis, only one case of AVN of the femoral head in the affected limb has been reported in the English literature. Here, the authors report on a case of AVN of the femoral head in a patient with poliomyelitis, who was treated with a large diameter femoral head metal-on-metal THA using a modified minimally invasive-2-incision technique.
Arthroplasty ; Cerebral Palsy ; Dislocations ; Extremities ; Head ; Hip ; Humans ; Necrosis ; Neuromuscular Diseases ; Poliomyelitis ; Tacrine

Vitamin D deficient ricket is now a rare disease in the developed countries because of the generally improved nutrition and medical awareness but occasional cases are found in the special susceptible populations. The ricket is characterized pathophysiologically by a failure of the normal mineralization of bones and epiphyseal cartilages and is susceptible to the fractures because of the weakness and increased plasticity of bones. The fractures occurred in rickets are known to be delayed in union but it should be normal if the ricket is effectively treated. Authors reviewed 7 cases of fractures occurred in the vitamin D deficient rickets which were managed at Daegu Fatima Hospital during the years from 1980 to 1986 and the following results were obtained. 1. The cases were 4 boys and 3 girls having ages from 6 to 11 years who were all in the same group of restricted population of poor nutrition. 2. 10 fractures noted in 7 cases including two cases of multiple fractures and a case of refracture and most of the fractures occurred in femurs except for a humerus and a forearm bones. 3. The causes of fractures were uncertain because the definite histories were unable to obtain but any violent trauma was not suggested. 4. The fractures were treated by the usual methods of skin tractions or cast immobilizations and daily doses of 2,000 U. or 5,000 U. of vitamin Dwere given as soon as the rickets are recognized. 5. The normal healing of the fractures and rickets occurred in the cases who were given vitamin D initially when the diagnosis of rickets were made. 6. The healing of fractures were very delayed in 2 cases who were missed to recognize the rickets initially and vitamin D was not given.
Daegu ; Developed Countries ; Diagnosis ; Female ; Femur ; Forearm ; Fractures, Multiple ; Growth Plate ; Humans ; Humerus ; Miners ; Plastics ; Rare Diseases ; Rickets ; Skin ; Traction ; Vitamin D ; Vitamins

Many of the dizziness patients annually visit ENT (ear, nose, throat) clinics because the vestibular function is the major organ to keep body balance and belongs to the Otorhinolaryngology. Nevertheless, many otolaryngologists feel that it is not easy to access the dizziness patients. The reason is that dizziness is not a final diagnosis and it is necessary to start the diagnosis of dizziness and find out the cause. Also, the causes of dizziness belong to multiple medical departments. That is why we need to pay more attention. Among them, traumatic vertigo can be manifested in various ways depending on the injury site and mechanism, and it is often difficult to predict the medical prognosis. Therefore, this review article focuses on traumatic vertigo. In this paper, we discussed its epidemiology and mechanism to help clinicians to treat patients with traumatic vertigo.
Craniocerebral Trauma ; Diagnosis ; Dizziness ; Epidemiology ; Humans ; Nose ; Otolaryngology ; Prognosis ; Vertigo

The fMRI signals are composed of many various signals. It is very difficult to find the accurate parameter for the model of fMRI signal containing only neural activity, though we may estimating the signal patterns by the modeling of several signal components. Besides the nose by the physiologic motion, the motion of object and noise of MR instruments make it more difficult to analyze signals of fMRI. Therefore, it is not easy to select an accurate reference data that can accurately reflect neural activity, and the method of an analysis of various signal patterns containing the information of neural activity is an issue of the post-processing methods for fMRI. In the present study, fMRI data was analyzed with the Independent Component Analysis(ICA) method that doesn't need a priori-knowledge or reference data. ICA can be more effective over the analytic method using cross-correlation analysis and can separate the signal patterns of the signals with delayed response or motion related components. The Principal Component Analysis (PCA) threshold, wavelet spatial filtering and analysis of a part of whole images can be used for the reduction of the freedom of data before ICA analysis, and these preceding analyses may be useful for a more effective analysis. As a result, ICA method will be effective for the analysis of signal patterns in fMRI and the pre-filtering may be necessary for the reduction of the degree of freedom of the data.
Freedom ; Magnetic Resonance Imaging* ; Noise ; Nose ; Principal Component Analysis

PURPOSE: The purpose of this study was to determine the diagnostic value of a sign of early enhancing superior ophthalmic vein (SOV), as seen on helical CT images in patients with carotid-cavernous fistula (CCF). MATERIALS AND METHODS: This study involved 16 patients with CCF and 28 control patients. Axial CT images with scanning delays of 30 seconds following bolus injection of contrast material (90 mL, 3 mL/sec) were obtained, and this procedure was followed by coronal CT imaging. To determine the presence or absence of early enhancement or, dilatation of the SOV, bulging of the cavernous sinus, and enlargement of extraocular muscle, CT images were analysed by three observers in a blinded, random manner. Early enhancement of SOV was determined to be present where enhancement of the SOV was similar to or stronger than that of the ipsi-lateral posterior cerebral artery. RESULTS: A sign of early enhancing SOV was seen in 14 of the 16 patients with CCF but in no control patients (88% sensitivity and 100% specificity). The respective sensitivity and specificity of other CT features were 71% and 100% (dilatation of the SOV, as seen on axial images), 60% and 83% (dilatation of the SOV, as seen on coronal images), 71% and 89% (dilatation of the cavernous sinus), and 65% and 98% (enlargement of extraocular muscle). CONCLUSION: A sign of early enhancing SOV is a characteristic and specific CT finding of CCF, and is useful for the diagnosis of CCF.
Cavernous Sinus ; Diagnosis ; Dilatation ; Fistula* ; Humans ; Posterior Cerebral Artery ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Veins*

PURPOSE: This study was performed in order to compare unenhanced CT with diffusion-weighted, T2-weight-ed,and fast FLAIR MR imaging in the detection of hyperacute cerebral ischema induced in a dog and to deter-mine whichmodality first detected cerebral ischemia. MATERIALS AND METHODS: Experimental cerebral infarction was induced bythe occlusion of intracerebral arter-ies using embolic materials (polyvinyl-alcohol, 300 -6 00 micro) introducedthrough a microcatheter into the internal carotid artery of five dogs weighing 12 -20 kg. Serial CT and MR imageswere obtained at one hour intervals from one to five hours after occlusion, and were analyzed independently by tworadiologists. We assessed changes in attenuation, as seen on unenhanced CT and the signal intensity of the lesionon each MR image, and measured the contrast-to-noise ratio (CNR) of the lesions. RESULTS: Ischemic lesions weredetected on unenhanced CT 1 -3 hours after occlusion of cerebral arteries. In all dogs, the lesions were detectedearliest on diffusion-weighted images obtained at 1 hour. They were detect-ed on T2-weighted images at 3 -5 hoursand on fast FLAIR images of 2 -5 hours. The CNR of ischemic lesions increased gradually during the 5-hour period.It was highest on diffusion-weighted images, while on unen-hanced CT, T2-weighted, and fast FLAIR images it wassimilar. CONCLUSION: Hyperacute ischemic lesions were detected earliest on diffusion-weighted images, and earlieron unenhanced CT than on fast FLAIR or T2-weighted MR image.
Animals ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Arteries ; Cerebral Infarction* ; Dogs* ; Magnetic Resonance Imaging*

PURPOSE: The minimum stimulus onset asynchronoy(SOAmin) is one of important experimental parameters for an event-related fMRl experiment designed with the stochastic stimulus. In this study, the most efficient SOAmin is explored for the stronger activation in motor and language tasks with the stimulus designed stochastically. MATERIALS AND METHODS: The event-related fMRl during motor and language tasks were obtained in four normal right-handed subjects. EPI-BOLD sequence is used at 1.5 Tesla MR system for the acquisition of event-related fMRl. For each task the subjects are responded for the stimulus' with 2, 3, 4, and 6 seconds SOAmin. The obtained images are processed with SPM99, and the p value is set as 0.05 for the significant activation detection. The Z value and the number of activated pixels are compared for each task. RESULTS: For the motor task, the primary and supplementary motor areas are activated, and for the language task the consistent activated signals are detected in the Broca's. The activated signal is to be stronger for the shorter SOAmin for both motor and language tasks. At primary motor area, the activated signals is the strongest for 3 seconds SOAmin and for the supplementary motor area the result with 2 seconds SOAmin shows the strongest activation. And the result of language task shows the strongest activation at the 2 seconds SOAmin. CONCLUSION: In the event-related fMRl of motor and language tasks with the stochastically designed stimulus, the 2 or 3 seconds SOAmin is efficient for more activated and clustered activation.

Respiratory distress syndrome (RDS) is a major cause of death in premature neonates, and it is caused by the failure of morphological and biochemical lung maturation (synthesis and secretion of lung surfactant). It is known that cortisol, thyroxine, prolactin, epidermal growth factor (EGF), and estrogen accelerate the lung maturation. Cortisol and thyroxine are currently used in the antenatal treatment for the prevention of RDS in premature neonates. In order to evaluate the effect of EGF on the levels of cortsol, thyroxine, and prolactin, this study was undertaken. Phosphate buffered saline (PBS) with and without EGF was directly injected into the 25 days gestational fetus in uterus. Blood was collected for the measurement of cortisol, thyroxine, and prolactin one day or two days after the injection. Body weights and lung weights were also measured. The results were as follows: 1. There was no significant difference in body weights and lung weights between PBS-treated group(control group) and EGF-treated poup(experimental group), 24 hours and 48 hours after the injection. 2. 24 hours after the injection, the levels of cortisol were significantly inaeased in the EGF-treated group compared with those in the PBS-treated group. However 48 hours after the injection, there was no significant difference in the levels of cortisol between the two groups. The levels of thyroxine and prolactin in the EGF-treated group did not significantly differ from those in the PBS-treated group 24 hours and 48 hours after the injection. In conclusion, in vivo, the synthesis of cortisol may be affected by EGF treatment, which suggests that the action of EGF for lung maturation may be partially mediated by the increased endogenous levels of cortisol.
Body Weight ; Cause of Death ; Epidermal Growth Factor* ; Estrogens ; Fetus ; Humans ; Hydrocortisone ; Infant, Newborn ; Lung ; Prolactin* ; Rabbits* ; Thyroxine* ; Uterus ; Weights and Measures

PURPOSE: To assess the enhancement patterns of sellar and parasellar tumors at two-phase helical CT. MATERIALS AND METHODS: Thirty-two patients with pathologically proven sellar and parasellar tumors [meningioma (n=17), pituitary mocroadenoma (n=6), neurogenic tumor (n=5), cavernous angioma (n=1), chondrosarcoma (n=1), osteosarcoma (n=1), sphenoid carcinoma (n=1)] were included in this study. Two-phase helical CT was performed after the injection of 90 mL of contrast material at a rate of 3 mL/sec. Transverse helical CT scans were obtained during the early and late phases, with scanning delays of 30 and 120 seconds, respectively. Delayed coronal images were obtained after delayed axial images. Attenuation change and the enhancement patterns of the tumors were visually assessed; the former was also assessed quantitatively as the ratio of the CT number at late-phase axial and coronal scanning to that at early-phase scanning. RESULTS: Visual assessment of two-phase helical CT images revealed decreased attenuation in all 17 meningiomas, no change in all six pituitary macroadenomas and increased attenuation in 5 all five neurogenic tumors on late-phase axial scans as compared with early phase scans. Coronal images showed decreased attenuation in all 17 meningiomas, increased attenuation in all five neurogenic tumors and no change in four pituitary macroadenomas (66.7%). The ratio of CT numbers was significantly different between meningiomas, neurogenic tumors and pituitary macroadenomas(p<0.05). CONCLUSION: According to their histopathology, sellar and parasellar tumors showed characteristic enhancement patterns at two-phase helical CT. An analysis of the observed enhancement patterns can be useful in the differential diagnosis of juxtasellar tumors.
Chondrosarcoma ; Diagnosis, Differential ; Hemangioma, Cavernous ; Humans ; Meningioma ; Osteosarcoma ; Tomography, Spiral Computed*

No abstract available.
Prognosis* ; Subarachnoid Hemorrhage, Traumatic*