No abstract available.

Objective To discuss clinical efficacy of patients treated with surgical treatment for posttraumatic elbow stiffness combined with pain.Methods From January 2011 to December 2014,release treatment was performed on 32 cases of posttraumatic contracture of the elbow combined with pain by operation.There were 22 males and 10 females,at average age of 39 years(range from 18 to 65 years).25 cases of these patients with mild-to-moderate pain got a simple elbow release operation.There were 4 cases of severe pain patients complicated with elbow dislocation,after fully release the elbows,reduction was performed under the direct;Both elbow arthrolysis and dermal transplantation interval type elbow arthroplasty were performed in 3 cases of severe pain patients which had severe osteoarthritis.A total of 26 patients were installed hinged external fixator after operation for early functional exercise.Results All patients were followed up for an average time of 14 months(from 12 to 18 months).All patients were significantly improved in the range of elbow and pain symptoms.Postoperative joint function improvement:2 patients with severe stiffness improved to moderate stiffness,19 patients with moderate or severe stiffness improved to mild stiffness,and the remaining of 11 cases without stiffness,The improvement rate was 100％.Postoperative pain:6 cases of moderate or severe pain relieved for mild pain,26 patients pain disappeared,the pain relief rate was 100％.Mayo elbow performance score were evaluated before and after surgery.Preoperative score:the results were good in 6 cases,fair in 14 cases and poorin 12 cases;postoperative score:excellent in 20 cases,good in 8 cases and fair in 4 cases,the good rate is 87.5 ％.The difference between preoperation and postoperation was statistically significant (P＜0.05).Conclusion Elbow arthrolysis combined external fixation is beneficial to early functional rehabilitation and restoring the flexion and extension function of stiff elbow,at the same time,the pain caused by stale dislocation or arthritis of elbow can also get good effect.

Objective To examine the effect of ultrasonic debridement combined with continuous skin stretching to repair refractory infective wound bed.Methods From January 2016 to July 2016,we treated 15 cases of chronic,refractory infective wound beds using ultrasonic debridement combined with skin stretching technique.Results All the 15 (100％) cases were cured without necrosis of the stretched skin edges.Conclusions Ultrasonic debridement combined with continuous skin stretching is an appropriate technique for repairing the refractory wound bed in the patients who are older,in poor general condition,or poor condition of local skin and soft tissue,or have poor postoperative effect,or surgical contraindication or at higher risk of surgery.

PURPOSE: To analyze the MR findings of cyclosporine-induced neurotoxicity in patients receiving high dose ofcyclosporine and to suggest the possible pathogenetic mechanism. MATERIALS AND METHODS: The cases of seven patients (2 males, 5 females ; 18-36 years old) who suffered seizures after receiving high-dose cyclosporine for bone marrow transplantation due to diseases such as a plastic anemia or leukemia were retrospectively reviewed. We evaluated the location and pattern of abnormal signal intensity seen on T2 weighted images, the presence of contrast enhancement, and the changes seen on follow-up MR performed at intervals of 12-30 days after initial MR in five of seven patients. We analyzed levels of blood cyclosporine and magnesium, and investigated the presence of hypertension at the site of the seizure. RESULTS: Locations of the lesions were bilateral(n=5),unilateral(n=2), parietal(n=6), occipital(n=6), temporal(n=4), and in the frontal lobe(n=3). Frontal lesions showed high signal intensities in the borderline ischemic zone of the frontal lobe between the territory of the anterior and middle cerebral arteries. In six of the seven patients, cortical and subcortical areas including subcortical U-fibers were seen on T2-weighted images to be involved in the parietooccipital lobes. Only one of the seven showed high signal intensity in the left basal ganglia. All lesions showed high signal intensity onT2-weighted images, and iso to low signal intensity on T1-weighted. In five of seven patients there was nodefinite enhancement, but in the other two, enhancement was slight. In four of seven patients seizures occurred within high therapeutic ranges (250 - 450 ng/ml), while others suffered such attacks at levels below the therapeutic range. After cyclospirine was administered at a reduced dosage or stopped, follow-up MR images showed the complete or near-total disappearance of the abnormal findings previously described. Only two patients had hypertension, and the others normotension. Five of the seven had hypomagnesemia(1.3 -1.74 mg/dl; N : 1.9 -3.1mg/dl). CONCLUSION: Most patients with cyclosporine neurotoxicity showed high signal intensity in the corticaland subcortical areas of the parietooccipital lobes, including subcortical U-fiber, as seen on T2 weighted images,and no abnormal enhancement after Gd-DTPA injection. These MR findings should be helpful for the diagnosis of cyclosporine neurotoxicity.
Anemia ; Basal Ganglia ; Bone Marrow Transplantation ; Cyclosporine* ; Diagnosis ; Female ; Follow-Up Studies ; Frontal Lobe ; Gadolinium DTPA ; Humans ; Hypertension ; Leukemia ; Magnesium ; Male ; Middle Cerebral Artery ; Plastics ; Retrospective Studies ; Seizures

The purpose of this study was to describe the CT findings of focal organizing pneumonia and to compare the findings with pathology. CT findings of histologically proven focal organizing pneumonias in 26 consecutive patients were analyzed. In 17 patients who had undergone surgical resections, the findings were correlated with pathology. Focal organizing pneumonias appeared as a nodule (n= 13) or a mass (n=13), ranging from 9 mm to 66 mm in diameter. Ground-glass opacity was seen in 6/13 (46%) nodules and 6.5/13 (50%) masses (k=.48) with an extent ranging from 5% to 75% (mean, 16%). In 4/26 (15%) patients, the extent was more than 50% of the lesion. They showed smooth (n=4), lobulated (n=8), spiculated (n=1), or lobulated and spiculated margin (n=13). On correlative analysis, nodule or mass on CT consisted histologically of intraalveolar exudate or microabscess, chronic inflammatory cell infiltration, fibrotic nodules, and polypoid granulation tissue in the alveolar or bronchiolar spaces. Ground-glass opacity consisted of interstitial fibrosis and chronic inflammatory cell infiltration and intraalveolar polypoid granulation tissue. Focal organizing pneumonia may simulate a lung cancer with variable appearances on CT and the findings reflect underlying histopathology of the disease.
Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Male ; Middle Age ; Pneumonia/pathology/*radiography ; *Tomography, X-Ray Computed

Objective: To summarize the effect of propeller flap pedicled with cutaneous branch of digital artery for skin defect at children’s thumb tip. Methods: From December 2012 to October 2015, 12 children with skin defects at thumb tip were treated. The nail matrix was kept in 4 cases, partly injuried in 8 cases. The skin defects size ranged from 1.0 cm×1.0 cm to 1.5 cm×2.0 cm, all more than the size of nail roots. A triangular flap on lateral side of thumb was designed with cutaneous branch of digital artery on thumb ulnar side at wound edge. The defects at donor sites were covered with skin grafts. Results: The flap size ranged from 1.0 cm×1.0 cm to 1.5 cm×2.0 cm. All the flaps and skin grafts survived with primary healing. The children were followed up for 6-12 months(average, 8 months). The flaps had soft texture and good color match and thickness. The cosmeticresult was satisfactory with normal nail growth. According to the standard of the hands of the Chinese Medical Association functional evaluation trial, the hand function was assessed as excellent in 9 cases, good in 3 cases 6 months after operation. Conclusions Propeller flap with cutaneous branch of digital artery is suitable for the skin defect at children’s thumb tip with both satisfactory cosmetic and functionalresult . Themethod is easily performed with reliable venous drainage and less morbidity.

BACKGROUND AND PURPOSE: Alzheimer's disease (AD) is associated with structural alterations in the medial temporal lobe (MTL) and functional alterations in the posterior cortical region, especially in the early stages. However, it is unclear what mechanisms underlie these regional discrepancies or whether the posterior cortical hypometabolism reflects disconnection from the MTL lesion or is the result of local pathology. The precuneus, an area of the posteromedial cortex that is involved in the early stages of AD, has recently received a great deal of attention in functional neuroimaging studies. To assess the relationship between the precuneus and hippocampus in AD, we investigated the volumes of these two areas using a magnetic resonance volumetric method. METHODS: Twenty-three subjects with AD and 14 healthy age-matched controls underwent T1-weighted three-dimensional volumetric brain magnetic resonance imaging. Volumetric measurements were performed in the precuneus and hippocampus. RESULTS: Compared to controls, AD patients exhibited a significant reduction in total precuneal volume, which was more prominent on the right side, and significant bilateral reductions in hippocampal volume. No correlation was found between the total volumes of the precuneus and hippocampus in the AD group. CONCLUSIONS: These results suggest that volumetric measurements of both the precuneus and hippocampus are useful radiological indices for the diagnosis of AD. Furthermore, the lack of correlation is attributable to local pathology rather than being a secondary consequence of MTL pathology.
Alzheimer Disease ; Brain ; Functional Neuroimaging ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Temporal Lobe

BACKGROUND AND PURPOSE: Alzheimer's disease (AD) is associated with structural alterations in the medial temporal lobe (MTL) and functional alterations in the posterior cortical region, especially in the early stages. However, it is unclear what mechanisms underlie these regional discrepancies or whether the posterior cortical hypometabolism reflects disconnection from the MTL lesion or is the result of local pathology. The precuneus, an area of the posteromedial cortex that is involved in the early stages of AD, has recently received a great deal of attention in functional neuroimaging studies. To assess the relationship between the precuneus and hippocampus in AD, we investigated the volumes of these two areas using a magnetic resonance volumetric method. METHODS: Twenty-three subjects with AD and 14 healthy age-matched controls underwent T1-weighted three-dimensional volumetric brain magnetic resonance imaging. Volumetric measurements were performed in the precuneus and hippocampus. RESULTS: Compared to controls, AD patients exhibited a significant reduction in total precuneal volume, which was more prominent on the right side, and significant bilateral reductions in hippocampal volume. No correlation was found between the total volumes of the precuneus and hippocampus in the AD group. CONCLUSIONS: These results suggest that volumetric measurements of both the precuneus and hippocampus are useful radiological indices for the diagnosis of AD. Furthermore, the lack of correlation is attributable to local pathology rather than being a secondary consequence of MTL pathology.
Alzheimer Disease ; Brain ; Functional Neuroimaging ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Temporal Lobe

OBJECTIVES: Characteristic symptoms, including hyperactivity and easy distractibility, in children with attention-deficit hyperactivity disorder (ADHD) suggest that their brain status, even at rest, might differ from that of healthy children. This study was conducted in order to determine whether resting state brain activity is compromised in medication-naive children with ADHD. METHODS: Twenty medication-naive children with ADHD (mean age 10.3+/-2.5) and 28 age- and gender-matched healthy volunteers (mean age 10.3+/-2.0) underwent measurements for resting state brain activity using functional magnetic resonance imaging (fMRI). Among resting state related-independent components (RSICs) extracted from fMRI data using independent component analysis, a significant difference in RSICs was observed between groups, using a mixed Gaussian/gamma model. RESULTS: Except for IQ, which was higher in the healthy control group, no demographic difference was observed between the two groups (p<.001). Significantly less activation of one RSIC, which includes the bilateral precuneus/posterior cingulate cortex, occipito-temporal junction, and anterior cingulate cortex, was observed in the ADHD group, compared with the control group (p<.05). CONCLUSION: An abnormal RSIC, posterior default mode network (DMN), was observed in the medication-naive ADHD group. Results of our study suggest that abnormality of posterior DMN is one of the main pathophysiologies of ADHD.
Brain ; Child ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging

PURPOSE: To evaluate the efficacy and safety of fluoroscopy-guided, radiologic placement of a tunneled central venous catheter into the superior vena cava (SVC). MATERIALS AND METHODS: Thirty five patients underwent tunneled central venous catheter placement to facilitate long-term chemotherapy. They included 33 leukemicpatients, one colon cancer patient, and one multiple myeloma patient. After confirming central venous patency witha injection of contrast media via the peripheral cephalic or basilic vein in the wrist joint, the subclavian veinwas punctured under fluoroscopic guidance. A 7F double lumen TPN catheter was placed into the SVC through asubcutaneous tunnel in the anterior chest wall. RESULTS: Catheter placements were successful in all patients. The mean procedure time was 17.2 minutes, mean fluoroscopy time was 1.3 minutes, mean number of punctures was 1.4, and mean volume of injected contrast media was 43.5 cc. Only two of all leukemic patients developed mild hematomas atthe puncture site, but these soon resolved themselves. None of the patients developed pneumothorax or hemothorax.but late complications included local infection in two patients (6%) and thrombotic occlusion of the catheter inone (3%). The occluded catheter was successfully recanalized with Urokinase infusion. CONCLUSION: Fluoroscopy-guided, radiologic placement of a tunneled central venous catheter is an easy and safe method, anduseful for patients requiring long-term venous access.
Catheters ; Central Venous Catheters* ; Colonic Neoplasms ; Contrast Media ; Drug Therapy ; Fluoroscopy ; Hematoma ; Humans ; Multiple Myeloma ; Ocimum basilicum ; Pneumothorax ; Punctures ; Subclavian Vein ; Thoracic Wall ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior ; Wrist Joint