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: 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 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*

Extraskeletal mesenchymal chondrosarcomas (EMCs) are relatively uncommon, and a location in the upper extremity, especially in the shoulder or axillary region, is rare. Furthermore, the radiographic findings of EMCs do not show any features that distinguish them from other neoplasms, and therefore, definitive diagnoses are made based on histological features. EMC is an aggressive tumor with a poor prognosis, and requires wide surgical excision. However, its treatment may involve peculiarities such as a difficulty in obtaining a proper surgical margin in the axillary region or shoulder. In this report, the authors present two rare cases of EMCs in the axillary region.
Axilla ; Chondrosarcoma, Mesenchymal ; Prognosis ; Shoulder ; Upper Extremity

No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

OBJECTIVE: We wanted to evaluate whether tumors located in a segmental border zone are predisposed to local recurrence after performing segmental transarterial chemoembolization for hepatocellular carcinoma. MATERIALS AND METHODS: Seventy-three hepatocellular carcinoma nodules were retrospectively analyzed for local tumor recurrence after performing segmental transarterial chemoembolization by using follow-up CT studies (median follow-up period: 20 months, range: 4-77 months). The tumors were divided into two groups according to whether the lesions were located at the segmental border zone (Group I) or not (Group II). Comparison of the tumor characteristics and chemoembolization methods between the two groups was performed using the chi-square test. The local recurrence rates were compared by Kaplan-Meyer method and analyzed with the log rank test. RESULTS: Local tumor recurrence occurred for 25 hepatocellular carcinoma nodules (42.9%). The follow-up periods, tumor characteristics and chemoembolization methods between Groups l and ll were comparable. The local recurrence rate was 64.0% (16/25) in Group I and 18.8% (9/48) in Group II. The difference was statistically significant on the univariate and multivariate analyses (p = 0.000 for both). CONCLUSION: Tumor location in a segmental border zone was a significant risk factor for local tumor recurrence after performing segmental transarterial chemoembolization for hepatocellular carcinoma.
Risk Factors ; Retrospective Studies ; Proportional Hazards Models ; Neoplasm Recurrence, Local ; Middle Aged ; Male ; Liver Neoplasms/*pathology/*therapy ; Iodized Oil/administration & dosage ; Humans ; Female ; Doxorubicin/administration & dosage ; Chi-Square Distribution ; *Chemoembolization, Therapeutic ; Carcinoma, Hepatocellular/*pathology/*therapy ; Aged ; Adult

BACKGROUND: Rocuronium has a high incidence of inducing pain by intravenous injection, and different methods have been used to minimize the incidence and severity of this pain. In this study, we have compared the effects of lidocaine and metoclopramide pretreatments on rocuronium injection pain. METHODS: Ninety healthy patients scheduled for general anesthesia were randomly divided into three groups; a saline group (n = 30), a lidocaine group (n = 30), and a metoclopramide group (n = 30). Each patient received 2 ml of pretreatment solution (normal saline, 2% lidocaine, or 0.5% metoclopramide) via an 18 G angiocatheter inserted in the antecubital fossa after applying an arm tourniquet inflated to 50 mmHg. The tourniquet was released 1 minute later, and this was followed by an intravenous injection of 0.6 mg/kg of rocuronium. General anesthesia then induced with thiopental sodium (5 mg/kg). The assessment of pain was made at the induction of anesthesia and in the recovery room, and the severity of pain was classified as none, mild, moderate, or severe by an observer. RESULTS: The severity and incidence of pain diminished significantly in the lidocaine and metoclopramide groups compared with the saline group at the induction of anesthesia (P < 0.05), but no significant difference was observed between the lidocaine and metoclopramide groups. Similar results were obtained in the recovery room; one patient in each of the saline and metoclopramide groups had no recall regarding injection pain. CONCLUSIONS: Intravenous metoclopramide pretreatment is as effective as intravenous lidocaine pretreatment for alleviating rocuronium injection pain.
Anesthesia ; Anesthesia, General ; Arm ; Humans ; Incidence ; Injections, Intravenous ; Lidocaine* ; Metoclopramide* ; Recovery Room ; Thiopental ; Tourniquets