Another option to treat Kümmell’s disease with cord compression

The efficiency of short-segment fixation with transpedicle body augmenter (a titanium spacer with bone-ingrowth porous surface, TpBA) to treat Kümmell's disease with cord compression (stage III) was retrospectively evaluated. No laminectomy or instrumentation reduction was done. Inclusion criteria included Frankel CDE, single-level within T10-L2. FU rate was 88%, i.e. 21 cases were included. Frankel function classification was 6E9D6C. Mean age was 72+/-8 years. F:M was 16:5. FU period was 48 M (range, 30-76 M). The hospitalization was 4.5+/-2.2 days; operation time, 70.4+/-17.2 min; blood loss, 150+/-72 cc. Final Frankel class was 20E1D. Complications included two superficial infection and one pneumonia. Body height and kyphosis were all corrected significantly and well preserved at the final visit. No TpBA dislodgement or implant failure was noted; however, three cases developed new compression fractures. The clinical outcome showed 81% with P1 or P2 by Denis pain scale. This method can decompress spinal canal, maintain kyphosis correction and vertebral restoration, prevent implant failure, and attain good clinical results.     

股骨近端解剖型钢板治疗股骨粗隆下不稳定性骨折

目的:探讨股骨近端解剖型钢板治疗股骨粗隆下不稳定骨折的临床价值.方法:自2001年1月～2003年6月采用切开复位、股骨近端解剖型钢板内固定治疗股骨粗隆下不稳定骨折23例.根据术前术后X线片及术后髋关节功能、站立及行走等恢复情况评价内固定效果.结果:17例获得随访,随访时间6个月～3年,根据黄公怡评定标准,优9例,良6例,差2例.结论:股骨近端解剖型钢板治疗高位股骨粗隆下不稳定骨折具有安全可靠、能允许术后早期部分负重等特点,是治疗高位股骨粗隆下骨折的理想选择.     

Optimization of the protrusion shape for a couette-type flow

A study is made of the longitudinal 2D viscous steady flow and heat flux between two plates. Optimal shape design problems are solved in explicit form and shown to have unique global extrema. Conformal mappings are used to bring the problems into a fixed domain and solve them as Dirichlet boundary value problems in the form of Cauchy integrals and series expansions. For the simplest problem statement the optimum is shown to coincide with the well-known concrete dam outline of constant hydraulic gradient.     

Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries

We present a three-dimensional anatomical computer model of the terminal branches of the posterior cerebral artery and circle of Willis, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries. This can help to identify the arteries in conventional and magnetic resonance angiography. Our rendition of the cerebral arteries can be matched with CT, MR und PET images to indicate the areas of extension of the individual branches, allowing neuromorphological and functional correlations.     

解剖型钢板固定干骺部骨折评价(附98例报告)

目的：探索MAY解剖型钢板在干骺部骨折治疗中的应用。方法：通过对98例干骺部骨折采用MAY解剖型钢板固定的评析，评价该手术的优越性。结果：MAY解剖型钢板在干骺部骨折治疗中疗效满意。结论：MAY解剖型钢板是根据骨骼的特定部位的解剖形态制作的，与干骺部骨轮廊相匹配，因而手术操作极为方便，创伤小，固定骨折稳定性好，有利于骨折愈合和功能锻炼，是干骺部骨折理想的内固定材料。     

An unusual reduction technique prior to surgical treatment for traumatic spondylolisthesis in the lower cervical spine

Traumatic spondylolisthesis in the lower cervical spine is rare and only a few cases have been reported. We present a 56-year-old man who had severe C6-C7 spondylolisthesis without major neurological complications, caused by a traffic accident. Plain CT images showed a pedicular fracture on the right side and a laminar fracture on the left side at C6, but magnetic resonance images revealed no spinal cord compression. Application of a halo brace and maintaining the neck in slight flexion without traction resulted in reduction of the spondylolisthesis to nearly normal alignment. Anterior fusion using an autogeneous bone graft and a plate was easily performed without loss of correction. We suggest that preoperative reduction using a halo brace in slight flexion without longitudinal skull traction is useful and effective for severe traumatic spondylolisthesis in the lower cervical spine.     

Patient characteristics related to intensity of weight reduction care in a university medical clinic

Objective:To identify patient characteristics related to intensity of weight reduction care provided in a primary care practice. Design:Cross-sectional study linking data from a patient survey and data from medical records. Setting:Internal medicine housestaff clinic in an urban university hospital. Participants:321 outpatients who represented a systematic sample of all outpatients who had visited the clinic over one year. Measurements and main results:The patient population was largely black (86%) and female (65%). Most patients (54%) were overweight [body-mass index (BMI)>85th percentile for the United States by gender]. Intensity of care was defined by a composite scale: points were awarded for actions documented in the medical chart or recalled by the patient. Factors independently associated with a higher intensity of care among the 161 overweight patients were: BMI [odds ratio (OR)=1.13 per kg/m ²;95% confidence interval (95% CI)=1.04, 122; p=0.002], the patient’s self-perception of being overweight (OR=5.37; 95% CI=1.99, 14.46; p=0.001), and age of 64 years or younger (OR=2.48; 95% CI=1.12, 5.48; p=0.02). Race, gender, and presence of hypertension or hypercholesterolemia were not associated with greater intensity of care. Conclusions:Patients with hypertension and hypercholes-terolemia may be receiving suboptimal weight reduction care. Heightened awareness of being overweight may enbance the provision of weight reduction care. Prospective studies are required to confirm these findings. Received from the Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins Health Institutions, Baltimore, Maryland. Supported by the Pew Charitable Trusts and the Rockefeller Foundation Health of the Public Program. Computer analysis was supported by a grant from the National Center for Research Resources, National Institutes of Health, General Clinical Research Centers 5M01RR00035.     

Radial turbo spin echo imaging

Fast MR imaging methods should provide a familiar contrast behavior at a reduced scan time. The multi-spin echo approach (TSE) is one of the most promising techniques satisfying this condition. Although the data acquisition time is significantly reduced, image quality may still suffer from artifacts due to patient motion and flow. The radial turbo spin echo (rTSE) approach combines TSE methods and projection reconstruction (PR) techniques. In PR images, artifacts induced by patient motion or flow are known to have a different appearance with lower level of intensity. The contrast and artifact behavior of the rTSE approach has been investigated. The new technique has been applied to abdominal imaging with acquisition times shorter than 30 s and to heart imaging in combination with cardiac triggering.     

几种^99mTc标记人免疫球蛋白（HIG）方法的比较

用４种还原剂即抗坏血酸、氯化亚锡、２－巯基乙醇（２－ＭＥ）、２－巯基乙胺（２－ＭＥＡ）还原人免疫球蛋白（ＨＩＧ），并进行＾９９ｍＴｃ直接标记，比较了４种还原剂所制备标记产物的稳定性、标记条件与过程。同时研究了间接标记产物＾９９ｍＴｃ－ＤＴＰＡ－ＨＩＧ与直接标记产物的一些性质差异，以期寻找一种标记率高、产物稳定、操作简便的＾９９ｍＴｃ标记ＨＩＧ方法，为临床炎症显像提供方便。     

改良真皮帽双环法行乳房缩小整形术

目的：灵活应用真皮帽双环法行乳房缩小成形。方法：采用传统的双环法设计切口，外下象限辅助S形切口线，保留乳晕周围较大面积完整的真皮帽，切除乳房外下象限腺体组织，设计外上及内下两个腺体组织瓣交错连接固定成形，乳晕周围内外环真皮荷包缝合，修整乳晕周围及外象限多余皮肤，切口呈环形，辅助切口瘢痕较小。结果：术后三月随访，新乳房的大小和形态．乳头乳晕的位置和形态均满意，除具有良好的感觉及勃起功能外，还保留了泌乳功能。结论：用组织瓣旋转固定的改良真皮帽双环法行乳房缩小成形，手术操作简单，组织瓣及乳头乳晕供血丰富，组织损伤小，值得推广。