No abstract available.
Humans ; Inpatients*

The effects of hind-limb immobilization by skeletal fixation of bilateral ankle and knee joints. for sither one or five weeks on glycogen concentrations, glycogen resynthetic activities and insulin responses to glucose uptake of hind-limb muscles were studied on male Splague-Dawley rats. There were significant drops in muscle wet weight to body weight ratio of immobilized soleus and plataris. In the group immobilized for one week, the ratios of sleous and plantaris were decreased by 11% and 38% respectively; and in the group immobilized for five weeks, the ratios were decreased by 42% in both muscles equally. The glycogen concentration and glycogen resynthetic activities of soleus and plantaris muscles in immobilized rats were decreased significantly in the one week group. However, in the five week group, these values were increased significantly compared to the values of those muscles of the one week group. The increased values of the five week group did not exceed those of the control group. The glucose uptake rate of the soleus muscle of the hind-limbs immobilized for one week and for five weeks were studied in vitro. The basal glucose uptake rate of the muscle of the control group was 8.4 ± 0.77Mol/gm/20min. The values of basal rate and insulin responses to the glucose uptake rates in the doses of physiological and supramaximal on the soleus muscles immobilized for one week was significantly decreased, but after immobilization for five weeks, these values were not significantly different statistically those from of the control group statistically.
Animals ; Ankle ; Body Weight ; Extremities ; Fracture Fixation ; Glucose ; Glycogen ; Humans ; Immobilization ; In Vitro Techniques ; Insulin ; Knee Joint ; Male ; Metabolism ; Muscle, Skeletal ; Muscles ; Rats

PURPOSE: To evaluate changes in the spinal canal in cases of L5 spondylolysis, as seen on sagittal MR images. MATERIALS AND METHODS: We retrospectively analysed the MR findings of 27 patients suffering from L5 spondylolysis without spondylolisthesis and compared them with 100 control subjects. Spondylolysis had been confirmed by conventional radiography. On midsagittal MR images, sagittal canal ratio (SCR) was defined as midsagittal canal diameter at L5 devided by that at L1. We analysed the frequency of posterior epidural fat deposition (posterior epidural fat between the posterior margin of the dural sac and the anterior cortical margin of the spinous process on the midsagittal line), and compared this with the frequency in 100 control subjects. RESULTS: Mean SCR value in 27 patients with L5 spondylolysis (1.22) was significantly greater than 100 control subjects (0.96, p<0.001). Mean SCR value in 17 patients with L5 spondylolysis and posterior epidural fat deposition (1.27) was significantly higher than in nine control subjects with posterior epidural fat deposition (0.97). Posterior epidural fat deposition was more frequently indentified in patients with L5 spondylolysis (63%) than in control subjects (9%). CONCLUSION: The possibility of L5 spondylolysis is suggested when on midsaggital MR imaging, the anteroposterior diameter of the L5 spinal canal is seen to be widened and posterior epidural fat deposition is noted.
Humans ; Magnetic Resonance Imaging ; Radiography ; Retrospective Studies ; Spinal Canal* ; Spondylolisthesis ; Spondylolysis*

OBJECTIVE: To evaluate the clinical usefulness of sonoelastography in infants with congenital muscular torticollis (CMT). METHODS: The medical records of 215 infants clinically diagnosed with CMT were retrospectively reviewed. Fifty-three infants met the inclusion criteria as follows: 1) infants diagnosed as CMT with a palpable neck mass before 3 months of age, 2) infants who were evaluated initially by both B-mode ultrasonography and sonoelastography, and 3) infants who had received physical therapy after being diagnosed with CMT. We checked the thickness of the sternocleidomastoid (SCM) muscles in B-mode ultrasonography, strain ratio of the SCM muscles in sonoelastography, and treatment duration. We evaluated the correlation between the treatment duration and the following factors: SCM muscle thickness, ratio of SCM muscle thickness on the affected to unaffected side (A/U ratio), and strain ratio. RESULTS: Both the thickness of the affected SCM muscle and the A/U ratio did not show significant correlation with the treatment duration (p=0.66, p=0.90). The strain ratio of the affected SCM muscle was significantly greater than that of the unaffected SCM muscle (p<0.001), and the strain ratio showed significant correlation with the treatment duration (p=0.001). CONCLUSION: Sonoelastography may be a useful adjunctive tool to B-mode ultrasonography for evaluating infants with CMT, especially when predicting their rehabilitation outcomes.
Elasticity Imaging Techniques* ; Humans ; Infant* ; Medical Records ; Muscles ; Neck ; Prognosis ; Rehabilitation ; Retrospective Studies ; Torticollis* ; Ultrasonography

A 71-year-old woman was assigned to our department for Tc-99m myocardial perfusion SPECT(MPS) and coronary CT angiography. She admitted for substernal pain, via the ER, 2 days ago. The heart was scanned after intravenous injection of 925 MBq of (99m)Tc-sestamibi adenosine-induced stress SPECT using dual head gamma camera (Hawkeye, GE healthcare. USA). The MPS shows decreased tracer uptake in the apical & mid area of anterior & lateral wall and mid & basal inferior wall. Coronary CT angiograph was obtained using Discovery VCT (GE healthcare). 3D angiography portrayed significant stenosis of ramus intermedius(RI) and posterolateral branch of right coronary artery(PLB) with fibrocalcified plaque. Two images were fused using Cardiac IQ fusion softwear package (Advantage workstation 4.4, GE healthcare) The fusion images explain the perfusion defect of anterior, lateral and inferior wall is due to stenosis of the RI and PLB. And 3 days later, coronary angiography was done and revealed the marked stenosis of RI and PLB. Then balloon angioplasty and stent was instituted in RI. Cardiac SPECT/CT fusion imaging provides additional information about hemodynamic relevance and facilitates lesion interpretation by allowing exact allocation of perfusion defects to its subtending coronary artery.1,2)
Aged ; Angiography ; Angioplasty, Balloon ; Constriction, Pathologic ; Coronary Angiography ; Delivery of Health Care ; Female ; Gamma Cameras ; Head ; Heart ; Hemodynamics ; Humans ; Injections, Intravenous ; Myocardium ; Perfusion ; Radius ; Stents ; Tomography, Emission-Computed, Single-Photon

PURPOSE: To assess the result of staged minimally invasive plate osteosynthesis (MIPO) for distal tibial fracture with an open wound or injured soft tissue. MATERIALS AND METHODS: In 20 patients (mean age, 47.8 year-old) with distal tibial fractures, there were 4 type A fractures and 16 type C fractures based on the AO classification system. Eight of the 20 patients had open fractures. MIPO was performed on average 23.9 days after bridging external fixation. At the final follow-up, we assessed the radiological results of bone union and alignment. Functional results were also evaluated by measuring the degrees of ankle motion and the American Orthopedic Foot & Ankle Society (AOFAS) scores. RESULTS: Seventeen of 20 cases (85%) achieved primary union at an average of 21.3 weeks. There were 3 cases of nonunion requiring a bone graft. The mean AOFAS score was 88.5 (range, 67~92) and the average range of ankle motion was 49.2degrees (plantarflexion: 37.4degrees, dorsiflexion: 11.8degrees). Complication included 2 cases of minor mal-alignment, 1 case of claw toe and 1 case of peroneal neuropathy. Patients over the age of 60 had lower functional results. Additional factors did not affect the final results. CONCLUSION: Staged MIPO may achieve satisfactory results in distal tibial fractures with soft tissue compromise, decreasing deep infections and soft tissue complications.
Animals ; Ankle ; Follow-Up Studies ; Foot ; Fractures, Open ; Hammer Toe Syndrome ; Humans ; Orthopedics ; Peroneal Neuropathies ; Tibial Fractures ; Transplants

PURPOSE: To evaluate contrast enhancement patterns of nodular hepatocellular carcinomas (HCCs) on three-phasespiral CT. MATERIALS AND METHOD: A retrospective analysis of contrast enhancement patterns was performed in 48 patients with HCC. Three-phase dynamic CT images of hepatic arterial dominant phase, portal dominant phase, and delayed phase were obtained at 30, 65, and 360 seconds after the initiation of injection of contrast material, respectively. Iodized-oil CT was performed two weeks after angiography and infusion of iodized-oil. Masses were divided into three groups, according to size ; 1-20 mm (n=34), 21-40 mm (n=26), and over 40 mm (n=19). Contrast enhancement patterns of tumors compared with attenuation of surrounding liver parenchyma, were cheracterized asone of four types, as follows : high, iso, low, and mixed attenuation. RESULTS: Seventy-three of 79 HCC nodules detected on iodized-oil CT (92%) were detected on three-phase spiral CT. In the 1-20 mm group, masses showed high-attenuation in the arterial dominant phase(19/34, 55.9%), and iso-attenuation in the portal dominant phase(16/34, 47.1%) and delayed phase(18/34, 52.9%). In the 21-40mm group, masses showed high-attenuation in the arterial dominant phase(21/26, 80.8%), low-attenuation in the portal dominant phase(13/26, 50%) and delayed phase(21/26, 80.8%). In the over 40 mm group, the masses showed mixed-attenuation in the arterial dominantphase(9/19, 47.4 %), low-attenuation in the portal dominant phase(12/19, 63.2%), and delayed phase(16/19, 84.2%).The most common enhancement pattern was high(arterial dominant)-iso(portal dominant)-iso(delayed) in the 1-20 mmgroup (8/34, 23.5 %), high-low-low in the group 21-40mm (8/26, 30.8%), and mixed-low-low in the over 40mm group(5/19, 26.3%). CONCLUSION: Hepatocellular carcinomas showed variable enhancing patterns according to the size ofthe tumor on three-phase spiral CT. Understanding these enhancing characteristics of HCCs on three-phase spiral CT may be helpful in their diagnosis.
Angiography ; Carcinoma, Hepatocellular* ; Diagnosis ; Liver ; Retrospective Studies ; Tomography, Spiral Computed*

We evaluated the results of sequential SPECT dual-isotope imaging with Tl-201 and Tc-99m MIBI in 24 patients, all of whom also had coronary angiography within the past one month. Coronary angiography showed that 12 patients had no CAD, 4 patients had one-vessel CAD, 7 patients had two-vessel CAD and 1 patient had three-vessel CAD. Serial studies of resting Tl-201 and dipyridamole stress Tc-99m MIBI were completed within 2 hours. When more then 50% of coronary artery narrowing was considered significant. The overall sensitivity and specification of CAD detection were 91.7%. The sensitivity of CAD detection in patients with one-vessel and multi-vessel diseases was 75% and 100%, respectively. Therefore, sequential dual-isotope SPECT demonstrated high sensitivity and specificity of CAD detection. In conclusion, sequential dual-isotope imaging is feasible and can be completed in a short time and may therefore enhance laboratory throughput and patient convenience.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Dipyridamole ; Humans ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To evaluate the technical feasibility and oncologic safety, we assessed the short-term and long-term outcomes of laparoscopic resection of the small bowel gastrointestinal stromal tumors smaller than 5 cm by comparing those of open surgery by subgroup analysis based on tumor size. MATERIALS AND METHODS: From November 1993 to January 2011, 41 laparoscopic resections were performed among the 95 patients who underwent resection of small intestine < or =10 cm in diameter. The clinicopathologic features, perioperative outcomes, recurrences and survival of these patients were reviewed. RESULTS: The postoperative morbidity rates were comparable between the 2 groups. Laparoscopic surgery group showed significantly shorter operative time (P=0.004) and duration of postoperative hospital stay (P<0.001) than open surgery group and it was more apparent in the smaller tumor size group. There were no difference in 5-year survival for the laparoscopic surgery versus open surgery groups (P=0.163), and in 5-year recurrence-free survival (P=0.262). The subgroup analysis by 5 cm in tumor size also shows no remarkable differences in 5-year survival and recurrence-free survival. CONCLUSIONS: Laparoscopic resection for small bowel gastrointestinal stromal tumors of size less than 10 cm has favorable short-term postoperative outcomes, while achieving comparable oncologic results compared with open surgery. Thus, laparoscopic approach can be recommended as a treatment modality for patients with small bowel gastrointestinal stromal tumors less than 10 cm in diameter.
Gastrointestinal Stromal Tumors ; Humans ; Intestine, Small ; Laparoscopy ; Length of Stay ; Operative Time ; Recurrence

PURPOSE: To evaluate the technical feasibility and oncologic safety, we assessed the short-term and long-term outcomes of laparoscopic resection of the small bowel gastrointestinal stromal tumors smaller than 5 cm by comparing those of open surgery by subgroup analysis based on tumor size. MATERIALS AND METHODS: From November 1993 to January 2011, 41 laparoscopic resections were performed among the 95 patients who underwent resection of small intestine < or =10 cm in diameter. The clinicopathologic features, perioperative outcomes, recurrences and survival of these patients were reviewed. RESULTS: The postoperative morbidity rates were comparable between the 2 groups. Laparoscopic surgery group showed significantly shorter operative time (P=0.004) and duration of postoperative hospital stay (P<0.001) than open surgery group and it was more apparent in the smaller tumor size group. There were no difference in 5-year survival for the laparoscopic surgery versus open surgery groups (P=0.163), and in 5-year recurrence-free survival (P=0.262). The subgroup analysis by 5 cm in tumor size also shows no remarkable differences in 5-year survival and recurrence-free survival. CONCLUSIONS: Laparoscopic resection for small bowel gastrointestinal stromal tumors of size less than 10 cm has favorable short-term postoperative outcomes, while achieving comparable oncologic results compared with open surgery. Thus, laparoscopic approach can be recommended as a treatment modality for patients with small bowel gastrointestinal stromal tumors less than 10 cm in diameter.
Gastrointestinal Stromal Tumors ; Humans ; Intestine, Small ; Laparoscopy ; Length of Stay ; Operative Time ; Recurrence