We evaluated the results following the use of hinged Ilizarov and free tissue transfer to correct the eqinus deformity of the foot associated with extensive scarring of the leg and ankle in nine patients. The deformity was secondary to ischemic and neuropathic changes after trauma to the leg, ankle and foot. The average age of the patients was seventeen years (range, thirteen to thirty-four years). The average duration of follow-up was twenty-one months (range, twelve to thirty-eight months). Free tissue transfer was done in all cases, parascapular flap was done in seyen cases, groin flap was done in two cases. Among the nine cases, free tissue transfer and hinged Ilizaov were done at the same time in four cases, The average interval of the other five patients between free tissue transfer and hinged Ilizaov was three months (range, two to four months). The duration of distraction was four to six weeks, and the apparatus was kept in place for an additional two months after the desired position of correction had been achieved. The results were evaluated using two criteria, dorsiflexion and range of motion of ankle joint. Criteria on dorsiflexion of ankle, the results were good in seven cases, fair in two cases. Criteria on range of motion of ankle, one case being performed ankle fusion was not evaluated. Total eight cases were evaluated for range of motion of ankle. The results were good in six cases, fair in two cases. On the basis of our results, we believe that severe eqinus deformities of the foot associated with extensive scarring of the leg and ankle can be corrected with heel cord lengthening, free tissue transfer and hinged Ilizarov.
Ankle Joint ; Ankle* ; Cicatrix* ; Congenital Abnormalities ; Equinus Deformity* ; Follow-Up Studies ; Foot ; Groin ; Heel ; Humans ; Leg* ; Range of Motion, Articular

Budd-Chiari Syndrome is a rare disorder due to obstruction of hepatic venous outflow and generally follows a rapid fatal course. Hepatic vein thrombosis is a common complication with a high mortality rate and surgery for this condition is associated with a high perioperative mortality. Those who survive the acute phase almost invariably go on to develop cirrhosis of the liver and die within a few years from hepaic failure, bleeding esophageal varices or other complications of chronic liver disease. We have experienced the anesthetic management of three parients with Budd-Chiari syndrome who were treated with finger fracture and mesoatrial shunt. It is important that the anesthesiologist realizes that certain pathophysiological changes occur during the several surgical approaches to relieve the effect of hepatic vein obstruction, and perioper-ative hepatic dysfunction.
Budd-Chiari Syndrome* ; Esophageal and Gastric Varices ; Fibrosis ; Fingers ; Hemorrhage ; Hepatic Veins ; Humans ; Liver ; Liver Diseases ; Mortality

No abstract available.
Bone Regeneration* ; Bone Substitutes*

PURPOSE: Abdominal CT scans in patients with intraperitoneal fluid were retrospectively studied to identify characteristic features useful for differential diagnosis of various causes. MATERIALS AND METHODS: One hundred and seventy patients with intraperitoneal fluid collection were classified as categories of hepatic disease, carcinomatosis, and infectious disease. We analyzed sites of fluid collection, the presence of peritoneal thickening, omental and mesenteric fat infiltration, and lymph node enlargment. RESULTS: Intraperitoneal fluid was present in subhepatic space, subphrenic space, paracolic gutter, mesentery, and fossa of the gallbladder in decreasing order of frequency. Fluid in the gallbladder fossa was the most frequent in hepatic diseases. The fluid collection in subhepatic and subphrenic space was less frequent in infectious diseases. Peritoneal thickening was noted in infectious diseases, and carcinomatosis. Omental fat infiltration and enlarged lymph nodes were the most frequent in carcinomatosis (58% and 44%, respectively), whereas, mesenteric fat infiltration and enlarged lymph nodes were the most common in infectious diseases (61%, and 26%, respectively). CONCLUSION: The location of peritoneal fluid collection showed some lesion specific characteristics, and CT features of fat infiltration and enlarged lymph nodes of peritoneum, omentum, and mesentery were helpful for differential diagnosis between carcinomatosis and infectious diseases.
Ascitic Fluid ; Carcinoma ; Communicable Diseases ; Diagnosis, Differential ; Gallbladder ; Humans ; Lymph Nodes ; Mesentery ; Omentum ; Peritoneum ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: We performed the study prospectively to evaluate the advantage of fat suppression MR in the diagnosis of rotator cuff injury. MATERIALS AND METHODS: Ten symptomatic patients were studied with both conventional T2WI and FST2WI using chemical shift technique. Each image was analyzed for the assessnent of injuries, conspicuity of the lesion, the presence of effusion in subacromial bursae and joint space, and presence of humeral head injury. Arthroscopy was done in 4 patients following MRI. RESULTS: We could made presumptive diagnoses on FSMR as identical as on conventional MR in six cases(1 normal, 2 tendinitis, 2 partial thickness tear, 1 full thickness tear), two of them were confirmed by arthroscopic procedures. Two cases of partial thickness tear proved by arthroscopy were detected on FST2WI, whereas they were considered tendinitis on conventional T2Wl. There were another 2 cases who showed tendinitis on FSMR, but normal on conventional T2Wl. They, however, were not confirmed by either arthroscopy or surgical procedure. CONCLUSION: We found the FSMR were superior to conventional T2Wl in the conspicuity of lesions and detection of joint effusion and abnormalities on the humeral head. We think FSMR of the shoulder could have significant diagnostic advantages over the conventional spin-echo MR imaging.
Arthroscopy ; Diagnosis ; Humans ; Humeral Head ; Joints ; Magnetic Resonance Imaging ; Prospective Studies ; Rotator Cuff* ; Shoulder ; Tendinopathy

No abstract available.

Primary peptic ulcer disease in not known to be the result of underlying illness or trauma. These are most frequently duodenal or prepyloric. Since clinical features of peptic ulcer in children can easily be confused with many other disorders, the diagnosis is usually made when one of the more dramatic presentations, such as perforation, bleeding and obstruction. Recently, we experienced 2 cases of duodenal obstruction due to peptic ulcer in children. So, we report it with review of references.
Child* ; Diagnosis ; Duodenal Obstruction* ; Hemorrhage ; Humans ; Peptic Ulcer*

No abstract available.
Craniocerebral Trauma* ; Disseminated Intravascular Coagulation* ; Head* ; Humans ; Latex*

PACS (Picture Archiving and Communications System) is a computer-based image storage and retrieval system that can store, recall and display medical images rapidly on high resolution workstations. The image acquisition system consists of direct digital interface to computed radiography (CR) system. We reviewed X-rays of 84 patients who had both studies of Dual energy X-ray Absorptiometry (DXA) and AP, lateral views of lumbar vertebrae between January and December of 1995. We tried to verify the clinical implication of pixel values on PACS for DXA by comparing pixel values and bone mineral density (BMD) of the 2nd, 3rd and 4th lumbar vertebrae. They were all female between 44 and 72 years old, average age of 59. Bone mineral density (BMD), represented in DXA of a total of 252 vertebrae were mostly in the range of between 0.228 (22%) and 1.318 (121%). Pixel values of the AP and lateral views of the 2nd, 3rd and 4th vertebrae in the PACS workstation were closely correlated to bone mineral density (p=0.0001). The values of the DXA (bone mineral density and T score) get comparatively lower as the pixel values get smaller. In conclusion, the pixel value on PACS interfaced to CR could be utilized as an easy, speedy and economical tool for screening of osteoporosis.
Absorptiometry, Photon* ; Aged ; Bone Density ; Female ; Humans ; Lumbar Vertebrae ; Mass Screening ; Osteoporosis ; Radiography ; Spine

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis