No abstract available.
Stomach

No abstract available.
Accidents, Traffic* ; Depression* ; Headache* ; Memory*

The neuropsychiatric sequelae of traumatic brain injury are effects on complex aspect of cognition, emotion and behavior. They include problems with attention and arousal, concentration, executive function, intellectual changes, memory inpairments, personality changes, affective disorders, anxiety disorders, psychosis, apathy, aggression, and irritability. There are many useful therapeutic approaches available for people who have been brain injuries. Although a multifactioral, multidisciplinary, collaborative approach to treatment is proposed, for purposes of exposition the author have divided treatment into psychopharmacological, cognitive, behavioral, psychological, and social interventions.
Aggression ; Anxiety Disorders ; Apathy ; Arousal ; Brain Injuries* ; Cognition ; Executive Function ; Humans ; Memory ; Mood Disorders ; Psychotic Disorders

No abstract available.
Education, Distance*

BACKGROUND AND OBJECTIVES: Idiopathic restrictive cardiomyopathy is a very rare and poorly recognized disease in children. This study is performed to describe the clinical course and to define potential predictors of outcome. MATERIAL AND METHOD: We reviewed the medical records and diagnostic studies of 11 consecutive patients during the period from Jan.1991 to Aug. 2000. RESULTS: The age at diagnosis was 1.2-13 years (median 7 years) and the duration of follow up was 3-90 months (median 3.6 years). All except one were symptomatic (dyspnea in ten, chest pain in four). The chest pain was associated with significant ST depression on both resting and exercise ECG, suggesting myocardial ischemia. Two had complete heart block as either initial or terminal event. Cardiac catheterization was done in nine ( mean pulmonary arterial wedge pressure 23+/-6mmHg, systolic pulmonary arterial pressure 47+/-14mmHg, mean right atrial pressure 11+/-9mmHg). Echocardiographic dimensional ratio of left atrium and aorta (LA/Ao) was 2.41+/-0.58. Mitral E/A inflow ratio was 2.72+/-1.42, E wave deceleration time was 93.6+/-44.2ms. During follow up, six died. The 2 year and 5 year cumulative survival rates were 54.5% and 18.8% respectively. The predictor for nonsurvivor were pulmonary venous congestion and LA/Ao >2.5(p<0.05). Verapamil was tried in 6 cases without favorable effect in all. CONCLUSION: Considerable numbers of restrictive cardiomyopathy have myocardial ischemia associated with ST depression and chest pain. The patients with pulmonary venous congestion and severe left atrial enlargement (LA/Ao>2.5) were at risk for death, requiring prompt definitive treatment such as cardiac transplantation.
Aorta ; Arterial Pressure ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Restrictive* ; Chest Pain ; Child* ; Deceleration ; Depression ; Diagnosis ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Atria ; Heart Block ; Heart Transplantation ; Humans ; Hyperemia ; Medical Records ; Myocardial Ischemia ; Pulmonary Wedge Pressure ; Survival Rate ; Verapamil

Continued improvements in treatments of the thoracolumber spine have occured in the last several years. The operative treatment of choice currently is short segment fusion(instrumentation one level above to one level below the injury). The development of pedicle screw systems has brought short segment fusion into clinical reality from the posterior approach. We analysed the clinical results of 20 patients with unstable fracture and fracture-dislocation of thoracolumbar spine who were treated with the posterior transpedicular screw system. The mean fol- low-up was 18 month. Ll was the most common injury level and the bursting fracture was the most common fracure type by Denis classification. The mean preoperative sagital index was 21.5。 and improved 8.1。 postoperatively. The mean preoperative anterior and posterior height of the vertebral height were 56.9% and 88.8% and improved postoperatively 94.7 and 88.8 respectively. The mean preoperative neural canal impingement in neural defici: patient was 47.2% and was improved 30.65% postoperatively. The mean prooperative ASIA motor was 34.1 and improved 41.7 postoperatively. There was no metal failure. These data suggested that the posterior transpedicular screw fixation, transpedicle bone graft, decompression and posterolateral bone graft was able to porvide sufficient stability and to achieve the neurologic improvement.
Asia ; Classification ; Decompression ; Humans ; Neural Tube ; Pedicle Screws ; Spine ; Transplants

No abstract available.
Posterior Cruciate Ligament*

We have experienced two cases of Wernicke's encephalopathy associated with hypere-mesis gravidarum. Delay in it's diagnosis caused a protracted illness and persisting neurol-ogic deficits. Because of its association with chronic alcoholism, possibility of Wernicke's encephalopathy may not be considered in early stage of disease. The clinical feature, the principle of management and the prevention of Wernicke's encephalopathy are discussed.
Alcoholism ; Diagnosis ; Female ; Hyperemesis Gravidarum* ; Pregnancy ; Wernicke Encephalopathy*

Purpose: We evaluated, retrospectively, twenty hips that had undergone revision surgeries because of massive pelvic osteolysis in order to determine the retention rate of acetabular metal shells and polyethylene liner exchanges.. Materials and Methods: We performed liner exchanges for massive osteolysis around stable HG acetabular cups with severe polyethylene wear in twenty-three hips, between June 1996 and May 2003. Clinical and radiological follow-up was available for 20 hips for more than 2 years. In 18 hips, we performed curettage of the granulomatous tissue and tightly packed morselized cancellous allografts into the screw holes or the peripheral rims for the acetabular osteolytic lesions. The mean follow-up period was 3.8 years (range, 2.4 to 9.3 years) and the mean of time from the primary total hip arthroplasties to the component exchanges, was 8.2 years (range, 5.6 to 12.4 years). Results: During the follow-up period, all of the hips were functioning well, and none required any subsequent repeat surgeries. Dislocations occurred three times after the repeat operations in one hip, which was treated successfully with an abduction brace. None of the hips demonstrated a progression of the pre-existing osteolytic lesions or the development of any new osteolytic lesions. At the final follow-up, none of the acetabular components demonstrated any evidence of loosening. Conclusion: Our results demonstrated that isolated liner exchanges and debridement of the granulomatous tissue, with or without bone grafting, can be an effective alternative solution to revision of the cup for massive osteolysis around well-fixed, cementless, acetabular cups in selected patients. Retention of the pre-existing cementless acetabular cup provides less intra-operative and post-operative morbidity. However, in order to determine the longevity of the retained cementless acetabular cups, further long-term studies are necessary.
Acetabulum* ; Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Braces ; Curettage ; Debridement ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Longevity ; Osteolysis* ; Osteolysis, Essential ; Polyethylene ; Retrospective Studies ; Transplants*

No abstract available.
Arthritis, Rheumatoid* ; Elbow Prosthesis* ; Elbow*