Imaging of compressive vertebral haemangiomas

Compressive vertebral haemangiomas (VHs) are rare. Correct preoperative diagnosis is useful both for operative planning (since compressive VHs are extremely vascular lesions) and to allow preoperative embolisation. Numerous radiological signs for VHs have been described, but compressive VHs frequently have atypical features. In particular, magnetic resonance features are not well established. We present imaging features in three cases of compressive VH and review the imaging findings in an additional 106 previously published cases. Findings were typical in 52 of 80 plain film (65 %), 33 of 41 computed tomography (80 %) and 13 of 25 magnetic resonance examinations (52 %). The prevalence of previously described imaging features is reported. Awareness of the range of magnetic resonance features is important since this is frequently the initial investigation in patients presenting with symptoms of neural compression. Since computed tomography is typical in 80 % of cases, this is a useful confirmatory test if magnetic resonance features are suspicious but not diagnostic of compressive VH. Received: 6 August 1999; Revised: 4 November 1999; Accepted: 4 November 1999     

五步推拿法辅治小儿腹泻经验

运用五步推拿法加减辅助内服中药治疗小儿腹泻，据证之虚实运用相应的补泻手法，有促进药物吸收、增强疗效、缩短疗程的作用，而且无痛苦，无毒副作用，患儿容易接受，更宜于服药困难的小儿，并举验案五则以证之。     

Transient oculomotor nerve palsy due to non-aneurysmal neurovascular compression

Acute oculomotor nerve palsy requires urgent exclusion of aneurysmal compression. We report a 62 year old man with a transient right third nerve palsy with pupillary involvement, who was found to have neurovascular compression of the cisternal oculomotor nerve as it curved over a duplicated superior cerebellar artery on high resolution MR imaging. Direct vascular compression should be considered in patients with isolated cranial neuropathies in whom other pathologies have been excluded.     

重症肝炎患者静脉采血后按压方法效果的比较与分析

目的对单棉签平行血管按压法和双棉签并排垂直血管按压法的效果进行比较,选择更好的按压方式尽可能地减少重症肝炎患者在静脉采血后可能出现的皮肤出血、血肿、皮下瘀斑等不良情况,减轻病患的痛苦。方法将重症肝炎患者与普通患者分为观察组与对照组,在组内又分别采用单棉签平行血管按压法和双棉签并排垂直血管按压法进行止血,并记录各组的反应情况。结果观察组内采用双棉签并排垂直血管按压法,皮肤出血、血肿、皮下瘀斑的概率明显低于采用单棉签平行血管按压法(P<0.01),差异具有统计意义;而对照组内采用两种按压方式出现不良反应的概率差异无统计学意义。结论对普通患者而言,两种按压方式的差别不大;但对于重症肝炎患者来说,双棉签并排垂直血管按压法能够有效地降低皮肤出血、血肿和皮下淤斑的发生率,进而达到更好的治疗和护理效果。     

颈部推拿对兔颈动脉粥样硬化重度狭窄病变的#br# 血管拉伸力学特性的影响 颈部推拿对兔颈动脉粥样硬化重度狭窄病变的血管拉伸力学特性的影响

目的　探讨颈部推拿手法对兔颈动脉粥样硬化（CAS）重度狭窄的血管拉伸力学特性的影响。 方法　45只新西兰兔随机分为颈椎旋转组（n=12）、推桥弓组（n=12）、模型对照组（n=12）和空白对照组（n=9），在颈椎旋转组、推桥弓组和模型对照组建立左侧CAS模型，并分别接受颈椎旋转手法、推桥弓手法干预3周，模型对照组和空白对照组不作手法干预。取左侧颈动脉进行单轴拉伸试验和病理观察，比较四组兔颈动脉的拉伸力学特性。 结果　（1）26只兔造模成功，其中颈椎旋转组、推桥弓组、模型对照组兔颈动脉的最大载荷显著高于空白对照组，同时最大应变显著低于空白对照组(P<0.05)；（2）颈椎旋转组兔颈动脉的弹性模量显著高于模型对照组、推桥弓组和空白对照组（P<0.05），而推桥弓组兔颈动脉的弹性模量与模型对照组相比差异无统计学意义(P>0.05)。 结论　动脉粥样硬化病变可致兔颈动脉血管拉伸力学特性下降，而颈部旋转推拿治疗可导致严重粥样硬化病变并重度狭窄的兔颈动脉弹性下降，为临床安全应用颈部推拿手法提供了参考。     

Outcome of manipulation under anesthesia with or without intra-articular steroid injection for treating frozen shoulder: A retrospective cohort study

Manipulation under anesthesia (MUA) combined with intra-articular steroid injection (ISI) is preferred in management of the refractory frozen shoulder (FS). This study aimed to evaluate the effect of MUA with ISI or not on pain severity and function of the shoulder.Data on 141 patients receiving MUA with primary FS refractory to conservative treatments for at least 1 month were retrospectively obtained from medical records. We performed propensity score matching analysis between patients receiving MUA only and those receiving MUA plus ISI, and then conducted logistic regression analysis to identify the risk factors for the need to other treatments during 6-month follow-up.More improvement in terms of the SPADI pain scores and passive ROM at 2 weeks after first intervention remained in patients receiving MUA plus ISI after matching. The need to other treatments during 6-month follow-up occurred in 10.6% patients (n = 141). Logistic regression analysis revealed that a repeat MUA 1 week after first intervention was a protective factor (OR 0.042; 95% CI 0.011–0.162; P = .000) and duration of disease was the only one risk factor (OR 1.080; 95% CI 1.020–1.144; P = .008) for the need to other treatments during follow-up.ISI immediately following MUA provided additional benefits in rapid relief of pain and disability for patients with refractory FS. Pain and disability of the shoulder may be rapidly alleviated by an earlier MUA from the onset of the symptoms and a repeat MUA 1 week after first intervention.     

Elution kinetics,antimicrobial activity,and mechanical properties of 11 different antibiotic loaded acrylic bone cement

Antibiotic-loaded acrylic bone cements (ALABC) spacers are routinely used in the treatment of prosthetic joint infections. The objectives of our study were to evaluate different ALABC for elution kinetics, thermal stability, and mechanical properties. A 10 or 20% mixture (w/w) beads of medium viscosity bone cement (DePuy, Inc) and vancomycin (VAN), gentamycin (GM), daptomycin (DAP), moxifloxacin (MOX), rifampicin (RIF), cefotaxime (CTX), cefepime (FEP), amoxicillin clavulanate (AmC), ampicillin (AMP), meropenem (MER), and ertapenem (ERT) were formed and placed into wells filled with phosphate-buffered saline. Antibiotic concentrations were determined using high-performance liquid chromatography. Antimicrobial activity was tested against Micrococcus luteus ATCC 9341 or Escherichia coli ATCC 25922. AmC, AMP, and FEP concentration rapidly decreased after day 2, being almost undetectable at day 4. Sustained and high elution rates were observed with VAN, GM, MOX, and RIF for the 30-day duration of the experiment. DAP, MER, ERT, and CTX elution rates constantly decreased from day 4. All antibiotics tested retained antimicrobial activity proving thermal stability. Mechanical properties of ALABC were maintained except when RIF was used.