It is well known that spinal instability should be evaluated in the standing lateral position. Standing dynamic flexion and extension radiographs are usually used to assess spinal instability. Here, we report a patient who experienced distraction instability while in the supine position rather than the standard standing position. To our knowledge, this is the first report of lying-down instability undetected on standing dynamic flexion and extension radiographs. We discuss the pathophysiological mechanism of this uncommon but possible entity and provide a review of the literature.
Deception* ; Humans ; Supine Position

Two patients with basilar bifurcation aneurysm were treated by different approach, low lying posteriorly projecting aneurysm was clipped with subtemporal approach and high bifurcated basilar bifurcation aneurysm with multiplicity approached through pterional method. The author reviewed literature concerning the approaches of basilar bifurcation aneurysm.
Aneurysm* ; Deception ; Humans

Pyelocaliceal diverticula are eventuations of the upper collecting system, lying within the renal parenchyma and communicating with the main collecting system via a narrow channel. They are smooth-walled and are lined by transitional cell epithelium. Their lining is nonsecretory but they contain urine derived by passive filling from the adjacent collecting system. The vast majority of these lesions are small, measuring below 1cm in diameter. A pyelocaliceal diverticulum containing multiple sandy stones is presented with review of literature.
Deception ; Diverticulum* ; Epithelium

PURPOSE: The objective of this study was to evaluate the findings of ultrasonography (US) in patients withis-chial bursitis. MATERIALS AND METHODS: Our study included 27 patients (mean age 62 years) who underwent US fora painful mass or tenderness in the buttock area. In six of these 27, serous fluid was obtained by needleaspiration, and in five cases, bursal excision permitted histologic confirmation. The other sixteen patients werefollowed up for one or two months with only NSAID medication; all showed some improvement or remission of symptoms. Using a 5-10 MHz linear array probe, US examination was performed while the patient was lying facedown. US images were analyzed with regard to location and size of the lesions, thickness of cyst wall, thepres-ence of internal septa or mural nodules, echogenicity of the cyst wall, fluid content, internal septa,compressibility by a probe, and Doppler signals within the cyst wall. RESULTS: In all 27 patients, ischialbursitis was located superficially to ischial tuberosity. Lesion size(maximum diameter) was 1.5-7(mean 3.8)cm, andthe cyst wall was 0.2-0.8cm thick. Internal septa and mural nodules were seen in 12 cases (44%) and 13 cases(48%), respectively. The cyst wall was identifiable in 21 cases (78%), appearing as a single layer with lowechogenicity (n=10) or with high echogenicity (n=1); it also appeared as two (n=6) or three (n=4) layers ofdifferent echogenicities. When internal septa were present, fluid within the cyst was low echoic in 59% of cases,high echoic in 30%, and of mixed echogenicity (so-called compartmentalization) in 15%. In all cases, the cystbecame deformed, when compressed by a probe. In all patients who underwent doppler examination, some vascularitywas found within the cyst wall. CONCLUSION: US helped to detect ischial bursitis; US findings were thin-walled cystic lesion located superficially to ischial tuberosity, with or without internal septa and mural nodules, andeasy compressibility.
Bursitis* ; Buttocks ; Deception ; Humans ; Ultrasonography

BACKGROUND AND PURPOSE: In contrast to the posterior- and horizontal-canal variants, data on the frequency and therapeutic management of anterior-canal benign paroxysmal positional vertigo (AC-BPPV) are sparse. To synthesize the existing body of evidence into a systematic review regarding the incidence and treatment of AC-BPPV. METHODS: Systematic search of medical databases employing predefined criteria, using the term "anterior canal benign paroxysmal positional vertigo." RESULTS: The electronic search retrieved 178 unique citations, 31 of which were considered eligible for further analysis. Analysis of the collected data revealed an estimated occurrence of AC-BPPV among benign paroxysmal positional vertigo patients of 3% (range 1-17.1%). No controlled therapeutic trials could be identified, and so the analysis was focused on uncontrolled case series. Treatment was categorized into three groups: Epley maneuver, Yacovino maneuver, and specific, nonstandard maneuvers described in individual articles. All three categories demonstrated success rates of over 75%, and the overall sample-size-weighted mean was 85.6%. CONCLUSIONS: The present analysis demonstrated that AC-BPPV comprises about 3% of all BPPV cases. It can be treated safely using the Epley, Yacovino, and other maneuvers with rates of symptom resolution lying in the range of that reported for the other, more frequent canal variants. Multicenter controlled trials are needed in order to develop evidence-based guidelines for the treatment of AC-BPPV.
Deception ; Diagnosis* ; Humans ; Incidence ; Vertigo*

Prolonged soft tissue compression results in discomfort and pain secondary to local ischemia in normal individuals. During surgery, patients are immobile and unable to perceive the discomfort of prolonged pressure, and the anesthetized patient lacks a protective mechanism to prevent pressure sores. Many intrinsic and extrinsic factors are associated with pressure sore development; however, the intensity and duration of pressure are critical components in the etiology of pressure sores. We conclude that interface pressure on a patient lying on an operating table during a long operation is a primary factor of postoperative occipital pressure sores.
Deception ; Humans ; Ischemia ; Operating Tables ; Pressure Ulcer*

This paper describes the results of the investigation of the intraocular pressure response upon postural change in 56 healthy adults and in 20 hypertensive patients, with a short study of 9 diabetic patients. Both hypertensive and diabetic groups showed abnormal response. In the hypertensive and diabetic groups the mean rise at immediately after lying was significantly higher than that occuring during 15 min in lying, that is, 1.9 mmHg compared to 0.8 mmHg in hypertensive group and 2.4 mmHg compared to 0.5 mmHg in diabetic group(p<0.05).
Adult ; Deception ; Humans ; Hypertension* ; Intraocular Pressure*

Calyceal diverticula are eventrations of the upper collecting system, lying within the renal parenchyma, communicating with the main collecting system via a narrow channel and lining by transitional tell epithelium. Most are asyptomatic and rarely require any form of treatment but complicated one needs surgical correction. We experienced one case of calyceal diverticulum associated with stone in 47 year old man. This calyceal diverticulum was removed by partial nephrectomy.
Deception ; Diverticulum* ; Epithelium ; Humans ; Middle Aged ; Nephrectomy*

We report a case of sebaceous hyperplasia showing linear arrangement in a 13-year-old girl. The lesion was found at birth and became prominent gradually. Multiple small discrete yellowish papules were arranged in a linear pattern on the temporal srea of the face. Unusual, incidental histopathologic finding was a sebaceous lobule lying in a dilated infundibular portion, which appeared to represent transfollicular extrusion of sebaceous lobule as a natural phenomenon.
Adolescent ; Deception ; Female ; Humans ; Hyperplasia* ; Parturition

Pararenal pseudocyst is an unknown condition caused by renal trauma, in which there is an encysted collection of urine or serous fluid lying outside the renal pelvis and parenchyma We have experienced 3 cases of pararenal pseudocyst The results were as follow; 1. Three cases of pararenal pseudocyst were caused by trauma 2. Among the three cases, 2 cases of pararenal pseudocyst were communicated with the renal pelvis and upper and the other was the renal parenchyma. 3. 2 cases of the nephrectomy were performed due to severe hydronephrosis and permanent nephrocutaneous fistula. In third case of pararenal pseudocyst, we could preserve the kidney because. of early detection and management.
Deception ; Fistula ; Hydronephrosis ; Kidney ; Kidney Pelvis ; Nephrectomy