Wallerian degeneration is well known as the anterograde degeneration of axon and their accompanying myelin sheath from injury to the proximal portion of the axon or its cell body. The most common cause of wallerian degeneration is cerebral infarction. Authors experienced three patients with old hemispheric infarct with typical wallerian degeneration in the brain stem, which was demonstrated by magnetic resonance imaging (MRI) in two cases and CT in one case. This report demonstrates the wallerian degeneration in the corticospinal tract on the MRI and CT with the brief review of the literatures.
Axons ; Brain Stem ; Brain* ; Cell Body ; Cerebral Infarction ; Humans ; Magnetic Resonance Imaging* ; Myelin Sheath ; Pyramidal Tracts ; Wallerian Degeneration*

The CT findings of the acute cerebral infarction are well known. However the CT findings of early stroke within 24 hours of the onset have not been sufficiently reported. The purpose of this study is to evaluate early acute cerebral infarction on CT within 24 hours after ictus. The early and accurate CT diagnosis could lead to the appropriate therapy and improved outcome of the patients. Authors retrospectively analyzed 16 patients with early acute cerebral infarction. Acute cerebral infarction was confirmed by follow-up CT in 11 patients, SPECT in 4 patients, and MRI in 1 patient. The CT findings of early acute cerebral infarction include effacement of cortical sulci or cistern (n=16, 100%), hyperattenuation of MCA (n=3), obscuration of lentiform nucleus (n=6), loss of insular ribbon (n=6) and subtle low density in hemisphere (n=5). The most frequent findings was effacement of cortical sulci in our study, and it was though to be the most important sign of early acute cerebral infarction.
Cerebral Infarction* ; Corpus Striatum ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Stroke ; Tomography, Emission-Computed, Single-Photon

Frequent anomalies causing a left-sided appendix are situs inversus and malrotation. The ectopic position of the appendix frequently causes a delay or error in diagnosis because of atypical symptoms. A physical examination is of limited value unless dextrocardia is present. A left-sided appendix is a rare anomaly, but when other diseases are ruled out, it must be considered especially at the emergency department.
Appendicitis* ; Appendix ; Dextrocardia ; Diagnosis ; Emergency Service, Hospital ; Physical Examination ; Situs Inversus

Some of the techniques for bone grafting for delayed union or nonunion of the long bone are used currently. In 1991, at arthroscopy workshop in Phoenix, Arizona, Lanny L. Johnson, M.D. reported a case of endoscopic bone grafting for the delayed union on the humerus. He suggested the possibilities of endoscopic bone grafting such as minimal incision, magnified visualization, accurate debridement, accurate graft placement, vascular preservation, outpatient surgery and reduced cost. The author performed endoscopic bone grafting and extra-articular adhesionlysis on the delayed union of femur with extra-articular ankylosis. The patient was a 28 year old housewife with blood type Rh(-). The duration after initial operation was more than 9 months. The result of the graft was satisfactory. In the future endoscopic bone grafting could be performed for nonunion, delayed union and congenital bone defect.
Ambulatory Surgical Procedures ; Ankylosis ; Arizona ; Arthroscopy ; Bone Transplantation ; Debridement ; Education ; Femur ; Humans ; Humerus ; Transplants

No abstract available.
Moyamoya Disease*

We evaluated MR imaging of spondylolytic spondylolisthesis degenerative spondylolisthesis and retrolisthesis in 14, 9 and 20 patients respectively. Sagittal and axial spin echo and gradient echo images were obtained with 25-30cm FOV and 5mm/0.5mm thickness/gap by using spine surface coil. Sagittal images showed defects of pars interarticularis just inside of the pedicles of spines in all the cases of spondylolytic spondylolisthesis with relatively variable signal intensity. Displaced vertebrae were commonly observed at L5 (8/14) in spondylolytic spondylolisthesis, at L4 (5/9) in degenerative spondylolisthesis and at variable locations in retrolisthesis. The mean length of displacement of vertebrae in spondylolytic spondylolisthesis was about 7mm and less displacement was onserved in degenerative spondylolisthesis and retrolisthesis. Seven, four and six cases of pseudobulging of disk at displaced level were observed in cases of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis respectively. Seven, five and 14 cases of true disk lesions were onserved in cases of spondylolytic spondylolisthesis, degenertive spondylolisthesis and retrolisthesis respectively. Grade II neural foraminal stenoses (obliteration of one half epidural fat of neural foramen) were commonly (8/14) seen in spondylolytic spondylolisthesis, however the other two types showed less severe neural foraminal stenosis. In conclusion, MR imaging is a highly accurate method for the diagnosis and evaluation of spondylolisthesis and associated lesions of spine and disks.
Constriction, Pathologic ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Methods ; Spine ; Spondylolisthesis*

Dentocutaneous fistula of the face neck is an infrequent manifestation of chronic dental infection. A periapical dental abscess may be initiated by disease, trauma, or thermal or chemical injury and develops into an extensive necrosis of surrounding tissue. Diagnostic errors can result in multiple excision, biopsies, and ineffective long-term antibiotic therapy. Awarness that periapical dental abscess is the most common etilolgic factor of cutaneous sinus tracts involves the face & neck will facilitate their early diagnosis and prevent needless treatment or anxiety for the patient. From 1994 to 1998, we have performed 6 cases of dentocutaneous fistula. Among of them, three were men and the others were women, age ranged from 18 to 66-year-old, and morbidity period was from 3 weeks to 3 years, the follow-up period ranged from 5 to 18 months (mean period 11 months). In conclusion, an understanding of the pathogenesis of cutaneous fistulae arising from dental infections will lead to proper early diagnosis and treatment without unnecessary surgery.
Abscess ; Aged ; Anxiety ; Biopsy ; Cutaneous Fistula ; Diagnostic Errors ; Early Diagnosis ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Male ; Neck ; Necrosis ; Unnecessary Procedures

We analyzed the MR findings of spinal epidural mass in 23 patients retrospectively. MR images were performed at 1.5T unit. The lesions were confirmed as metastasis(12 cases), lymphoma (2 cases), leukemia(1 cases), multiple myeloma(2 cases), meningioma(3 cases), neurofibroma(1 case), dysraphism with lipoma(1 case) and lipomatosis(4 cases), Most MRI examinations consisted of T1, proton density and T2 weighted sagittal imaging of the spine, with additional pulse sequences or image planes as needed for clarification. The level of the spinal epidural mass was cervical spine level in 2 cases, thoracic in 15 cases, lumbar in 7 cases, and sacral in 2 cases. The location of epidural mass within the spinal canal was eccentric in 20 cases, multiple in 2 cases, and encircled in 4 cases. Paraspinal mass was seen in 11 cases. Signal intensity of epidural mass was variable. The marrow of spine revealed low signal intensity(SI) on TIWI and high SI on T2WI in 14 cases. In conclusion, MRI is a useful diagnostic tool for the evaluation of spinal epidural mass.
Bone Marrow ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Protons ; Retrospective Studies ; Spinal Canal ; Spine

To evaluate the typical appearance and the influence in the image interpretation of the metallic artifact which is known as one of the patient-related field artifacts, we analysed the magnetic resonance (MR) images of 40 patients (the total number of metallic materials were 45) acquired at MR 1.5T unit. All patients were screened for the presence of metal. The metallic implants were surgical wires and clips, orthopedic devices, and the other miscellaneous materials. The artifacts produced by metallic objects can be seen on MRI as the focal loss of signal and/or the local distortion of the image. Regardless of their ferromagnetic properties, metallic implants created regional artifacts in their images. Ferromagnetic materials, such as a lead fragment, showed severe artifacts and nonferromagnetic metals showed mild to moderate artifacts. The conspicuity of artifact was related tot he composition, mass, shape, orientation, and the location of the metallic objects in the body. Under high magnetic field strength, there were no significant differences between the various pulse sequences. Artifacts are particularly prominent on gradient-echo images. Our findings indicate that MR imaging of patients with standard nonferromagnetic metallic materials can be successfully performed and usefully interpretated.
Artifacts* ; Humans ; Magnetic Fields ; Magnetic Resonance Imaging* ; Magnets ; Metals ; Orthopedics

Secondary osteoarthritis of hip joints is a common disease and is frequently followed by chronic sublexation and dislocation. Twenty four case of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the ossification and calcification of the acetabular labrum, 2) the thickeness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints.
Acetabulum ; Dislocations* ; Hip Joint* ; Hip* ; Ilium ; Joints ; Osteoarthritis ; Osteoarthritis, Hip ; Radiography ; Retrospective Studies