Anterior commissure: anatomic-MR correlation and use as a landmark in three orthogonal planes

Correlation of cryomicrotomic and myelin-stained sections of human cadaver heads with spin-echo magnetic resonance (MR) images documents that MR imaging routinely displays the anterior commissure in three orthogonal planes as a distinct white-matter tract that resembles bicycle handlebars. The anterior commissure crosses the midline at the upper end of the lamina terminalis, just anterior to the anterior columns of the fornices. To each side of midline, it curves antero-inferolaterally and then postero-inferolaterally through the lateral nucleus of the globus pallidus to course with the white matter of the external and extreme capsules toward the middle and inferior temporal gyri. Because the anterior commissure is easily recognizable in all three planes at differing pulse sequences, the commissure has proved to be a major landmark for identification of the complex anatomy of this region, especially in sagittal sections.     

Spermatic vein embolization with hot contrast material: fertility results

Spermatic venography with hot contrast material embolization was undertaken in 81 patients with varicoceles and infertility. Long-term follow-up information was available in 91% of the patients, and there was an overall conception rate of 40.5%. Embolization with hot contrast material was easily performed without special embolization devices and proved to be a safe and effective technique.     

Lung cancer staging

Lung cancer remains a significant cause of death worldwide. A simple, accurate staging system is necessary to plan treatment regimens and to assess their effect on survival rates. In addition, the staging system provides a basis for planning research on newer adjuvant therapies for lung cancer. It should be applicable internationally, facilitating a global effort toward improved survival. The new AJCC staging system was designed to meet these needs, with initial international reports confirming its utility. Since diagnostic radiologists often are instrumental in pretreatment evaluation of these patients, familiarity with this new system is a must.     

Computed tomography of the pulmonary hila: 2. abnormal anatomy

Computed tomography can be used to evaluate abnormal pulmonary hila. A series of cases is presented that illustrate the appearance of dilated pulmonary arteries, absent pulmonary artery, hilar adenopathy, and hilar masses.     

Tantalum inhalation and airway responses.

We studied the effects of tantalum inhalation bronchography on pulmonary function in 14 normal volunteers. Based on the radiographic type of deposition, the subjects were divided into three groups: (1) subjects who deposited tantalum mainly in the trachea, (2) subjects who deposited tantalum in segmental bronchi without radiographic evidence of bronchospasm, and (3) subjects who deposited tantalum in segmental bronchi with radiographic evidence of bronchospasm. Unlike the first two groups, the third group developed a significant but small decrease in the FEV. Airway reactivity as assessed by methacholine challenge did not explain the difference in response to tantalum in the third group. There were no consistent changes in total lung capacity, residual volume, or closing volume in any of the groups. Even though there were falls in FEV and specific conductance in individuals in groups 2 and 3, these changes did not pose any significant clinical risk.     

Efficacy and safety of hyaluronan treatment in combination therapy with home exercise for knee osteoarthritis pain

OBJECTIVE: To assess the efficacy and safety of intra-articular injections of sodium hyaluronate combined with a home exercise program (HEP) in the management of pain associated with osteoarthritis (OA) of the knee. DESIGN: Single-blinded, parallel-design, 1-year clinical study with sequential enrollment. SETTING: University-based outpatient physiatric practice. PARTICIPANTS: Sixty patients (18 men, 42 women; age, > or =50 y) with moderate-to-severe pain associated with OA of the knee. INTERVENTIONS: (1) Five weekly intra-articular hyaluronate injections (5-HYL); (2) 3 weekly intra-articular hyaluronate injections (3-HYL); or (3) a combination of an HEP with 3 weekly intra-articular hyaluronate injections (3-HYL+HEP). MAIN OUTCOME MEASURES: The primary outcome measure was a 100-mm visual analog scale for pain after a 50-foot walk (15.24 m). Secondary measures included the Western Ontario and McMaster Universities Osteoarthritis Index subscales. RESULTS: The 3-HYL+HEP group had significantly faster onset of pain relief compared with the 3-HYL (P<.01) and 5-HYL groups (P=.01). All groups showed a mean symptomatic improvement from baseline (reduction in baseline pain at 3 mo was 59%, 49%, and 48% for the 3-HYL+HEP, 3-HYL, and 5-HYL groups, respectively) that was clinically and statistically significant. There were no between-group differences in the incidence or nature of adverse events. CONCLUSIONS: The combined use of hyaluronate injections with HEP should be considered for management of moderate-to-severe pain in patients with knee OA.     

ISOLA器械治疗小儿脊柱侧凸

目的定期随访评价ISOLA器械治疗小儿脊柱侧凸.方法41例小儿脊柱侧凸患儿,特发性脊柱侧凸32例,神经肌肉性脊柱侧凸5例,其他类型的脊柱侧凸4例,术前、术中、术后均摄X线片,记录Cobb角,顶椎的移位及旋转,躯干偏离中线程度.结果Cobb角术前平均为66°,术后1年为36°,术后2年为36°.1年后,所有患儿的脊柱均完全融合.顶椎的偏离改善了14mm.躯干偏离改善了5mm.特发性脊柱侧凸患儿1年后有基本的正常活动.术后4例出现并发症,1例深部感染,1例骶尾部褥疮,1例横钩脱落,1例L3椎弓根螺丝钉脱落.结论目前有多种后路器械治疗小儿脊柱侧凸.严格掌握手术指征及ISOLA的原理,该术式能获得较为满意的疗效.